Sean O'Mara
SUMMARY KEYWORDS
visceral fat, people, physician, patient, kpi, podcast, disease, doctor, healthy, health, phil, long, muscles, body, smooth muscle, scan, measured, biomarker, skeletal muscle, visceral
SPEAKERS
Female Age 61, Dr. Philip Ovadia, Sean O'Mara, Jack Heald
Female Age 61 00:10
He was a morbidly obese surgeon destined for an operating table and an early death. Now he's a rebel MD who is fabulously fit and fighting to make America healthy again. This is Stay Off My Operating Table with Dr. Philip Ovadia.
Jack Heald 00:35
Well, we're back. We're live. This is the Stay Off My Operating Table podcast with Dr. Philip Ovadia. And we've got a special guest this week. They're all special. They're all really interesting to me. But Phil, when you told me that Sean O’Mara was coming on, you led me to believe this was going to be a rip-roaring conversation. So, if you don't mind, give us the 411 here.
Dr. Philip Ovadia 01:05
Yeah, definitely great to be back again, Jack. And most weeks he asked me, why do you why did you bring this guest on? This week, you should be asking me what the hell took you so long to get this guest on. Because Dr. Sean O’Mara and I have had a number of great conversations. And Sean is truly one of those outside-the-box physician thinkers. And the information that we've gone back and forth on the things that I've learned from him really brings a unique angle to the metabolic health picture that we've been unraveling over the past 50 plus episodes here on the podcast. So really excited to welcome Sean on. And Sean, why don't you just introduce yourself briefly to our audience?
Sean O'Mara 01:57
Sure. So, my name is Sean O'Mara. And by training, I'm an emergency medicine physician. But I retooled myself, having had a number of medical conditions and interaction with a patient that challenged me to change my diet, to now being a health and performance optimizing physician, based on that experience, just changing my diet, it had so much impact for me personally that it spilled over into my professional life. And I decided I had to become a researcher, looking into how a dietary, simple dietary change could have had such a profound effect on my own life. So, brings me to today being here. And I'm super excited. I've followed your work now for a few years. And you were one of the first physicians that I met through social media that really got, was speaking the same truths that I had come to realize about diet and the need to have lifestyle changes as really an effective part of people's approach to their to their lives and their own health conditions. And it hasn't been a particularly popular viewpoint, I think you'd agree that we're still out there, although we see a number of our colleagues coming on board. But the whole fact that it took me basically 15 or so years to realize this really leaves me with trepidation about the average person, if a physician could be so misinformed about the significance of diet and lifestyle on the human condition. I'm really terrified at how the rest of our population is going to be able to make decisions about and have the knowledge necessary to really be... That lead to healthy lives that were intended to live in our species. So super excited to join forces with you today. And continue on in this particular space to help people understand through social media, the internet, podcasting, the modern-day telecommunications, so we're able to reach as many people as possible and as quickly as possible with this message that really can dramatically change the lives of people.
Jack Heald 04:31
Okay, I love good stories. And there's a story in there that is just begging to be heard. You said you had your own health condition and you were challenged by a patient. Tell us that story.
Sean O'Mara 04:49
Sure, sure. So, it was actually working in in the hospital, we had a little Wellness Center, and you'd see all the doctors in there working away and I'd be in there slaving away about an hour and a half, an hour of working out. I always laughed at the general surgeon who would do bypass surgeries, he was getting overweight, being there working out like crazy trying to get control of himself. But there'd be this one guy would come in and blast and he'd be only there for like 5-10 minutes and he'd be leaving. I said, God, this guy gets paged out wondering why he shows up to work out. Well, this guy ended up being somebody that just bought a membership in this hospital Wellness Center. And so, I met him one day and I was chatting inside the Wellness Center. And he just was so incredibly healthy and fit. And I had all these medical conditions. I had Barrett's esophagus. So, I had these pre-cancerous lesions in my esophagus, I was being... I'd have an EGD, as scoping a garden hose down my mouth every three months, so often filth it, I wouldn't even do sedation. I’d be wide awake. They'd shove that EGD down my throat and was done. They just pull it out. I'd get off the table, walk out because I hadn't any sedation, I could go back and see patients round, do whatever I had to. And so, I just got, I'm so efficient with my time. But yeah, so I had high blood pressure, pre diabetic. I had... I was overweight. I have eczema all over my body. Restless leg syndrome. So, I kicked my legs all night long. Obstructive sleep apnea. So, I'd snore night all night long. Keep my wife awake, either kicking or snoring. And I had large prostate and just... I was a mess. And so, I heard about at that time, this guy said that I asked him why are you so healthy? What do you do that keeps you so active? “Guess what, I’m on paleo.” And I never heard that term before. So, I said, well, what's paleo, so he told me about it. And that was it, I went off and read a little bit about it online. But nobody told me that if you do these things, clear up your diet, that it's going to have any impact on your medical condition. So, I do it. And I just remember one day standing in my bathroom, urinating and it no longer was dribbling out of me, like if it just kind of dribble and fall out of me, there was no stream, there was no sense of masculinity, it would just kind of leak out. And here I am standing up this one day, and it's shooting out of me it sounds like Niagara Falls like it used to when I was a teenager, and I recollect it, I was no longer waking up at night. And so, you might think I’d be really happy about all these, but no, the epiphany that arrived at me was brought out fury. Fury that I had gone through medical school, and never learned what really changed all of these medical conditions, they all got better or went completely away was a dietary lifestyle change. And that was never once discussed, all the conditions I had were
Sean O'Mara 08:27
brought about paradigms of treatment that would be mitigated, some symptomatically with medications, I bagged some medicine and I was just getting worse, like all our patients. And so, I decided this would be a little quite a bit different in the in the Surgical Arts where you can you can actually do something definitively. But for those of us who are more like fleas, internal medicine, doctors, emergency medicine doctors, we just give medicines. And so, I realized that in that moment, that, if a diet life story change could have that much of an impact on me, then I needed to really truly research how in the world that was possible because I just did not have... My medical training profession did not prepare me to understand the changes that took place to me. So that was a kind of a long story. But it's a story that could be anybody's who's listening today. Anybody who's out there listening, that has chronic disease, a lot of these conditions. It could be happening to you and so I became a researcher and I purpose to research the reversal of chronic disease. All of the conditions that I had been suffering from were chronic diseases, and I researched, what do you have to do to get rid of chronic disease? What are the best things to follow and track? And that's what led me to the to the research that I got involved in, a research practice in Minneapolis. I moved from Washington, DC where I've been practicing in a large Emergency Medicine Department out east and I joined a research practice with another physician MD PhD. Dr. Singh, who introduced me for the first time to the interesting biomarker of visceral fat. So that's kind of led me into becoming a researcher, and studying what you got to do to get rid of chronic disease, and what are the best things to follow. So, to this day, I still believe Dr. Singh is right, it's visceral fat, I have not found anything else more effective at eradicating chronic disease from the human body and human frame, than this one biomarker, visceral fat, so I do whatever I can to try to promote awareness about it, and introduce it to other physicians so that they can begin to utilize this really effective, powerful biomarker to help their patients.
Jack Heald 11:00
All right, I want to get into the visceral fat and the biomarkers. Before we do that, though, very briefly describe the type and amount of education you had to go through to become an emergency medicine doctor. And obviously, the reason I'm asking that is because your anger at finding out you were not educated.
Sean O'Mara 11:32
High levels. So, yeah, four years of college, and then four years of medical school. And then I did four years of an emergency medicine residency program. So that's four years passed the MD degree, so wasn't as long of a residency program is what Dr. Ovadia went through. But it was, it was pretty long, four years additional training. So quite a bit of training, looking at taking care of humans with all matters of disease and trauma as an addition to disease. And so, it was quite a bit of a formal education, medical education, that I had been provided, none of which prepared me for really effective lifestyle management and understanding what you got to do to really get somebody healthy, like I've learned now as a health and performance optimizing physician, medical researcher.
Dr. Philip Ovadia 12:36
Yeah, and isn't it amazing that, we've now had all sorts of we've had physicians from all sorts of specialties on this show now. We've had the family medicine doctors, we've had the cardiologists, we've had... You're an emergency room doctor. We've had a psychiatrist on, we've talked to all sorts of medical professionals. And it's amazing how consistently, we hear that in all of this training, 5, 10, 15 years of training that we all go through, and we don't learn about keeping people healthy. And we get out into our practices, and we spend all our time taking care of sick people, trying to fix sick people, and we don't think about keeping them healthy. And, you, I, so many others, we have this same story that it started with fixing ourselves with fixing our own health, and then coming to that realization that exactly what you said earlier, if we can't figure this out as physicians, what hope the non-physicians have in being able to figure this out, and certainly applaud, not only what you did in kind of changing practice styles, changing some of your management, but then taking that extra step to go into the research and figure out why this is, is really fascinating. So, before we get to the visceral fat part of it, just talk a little bit about that mindset switch that you had to undergo, that I had to undergo, that so many of us have undergone as to, “oh my god, most of what we learned is either wrong and or useless. And we got to find a different way.”
Sean O'Mara 14:32
Yeah, there's another layer to it and part of that mindset switch that I don't really talk too much about and I don't think I've ever meant it in another podcast. So, I'll bring it up in your show. And that was while I was active duty in the military, I took... I was selected to be a physician to the president in the United States, and the Vice President and the Secretary of State so very key government officials and so I would have to travel with the vice president or former presidents and occasions just be their doctor or medical team. Leave a medical team with them. And it was, it really was always fascinating. We had this capability, we could take care of, their shot in a trauma, heart attack or stroke. But when it came to, preventive care, just terrible. I mean, it just, they get the same crap that the rest of the country does. So, if you're listening today and think that no, it's at the top, no, it ain't. It's not at the top. The Senior Executive Service have no idea any more about how to be healthy than everybody else. And then, after taking care of Dick Cheney, Bill Clinton, George Bush, Colin Powell, Condoleezza Rice, I set up a company with some other White House doctors to provide medical care, essentially what we did for the White House, we did for 52 billionaires and royal families all over the world. And once again, it’s the wealthiest people in the world – absolute crap, they eat crap, they live crappy. They have nice cars and boats, but they don't have any more clue about being unhealthy than the average people. So anyway, unless you make your audience feel good, this isn't being closed held, this isn't the wealthy, the haves over the have nots. No. There are really very few people have got this figured out and probably once at the bottom of have it figured out better than the ones at the top. So, my mind shift that I had to go through, went through all those formal layers and exposure to the affluent kind of conventional system that I really had a good view on. And then it was just off of what happened to me that drove me into research to understand this better because I wanted to make sure that it wasn't an n of 1, that this wasn't just some fluky experience in Sean O’Mara that isn't going to happen everybody else. And unfortunately, the case is no, it's not. If you make the right changes, you start living healthy, you start eating healthy, you will you can expect to have reversal, chronic disease. And now the really exciting thing that I found, Phil, that is really interesting is that I...
Jack Heald 17:39
I’m sorry. I gotta stop you right there. I got to stop you, Sean. And you just said, I mean, we could literally drop the mic and walk away. Other than we haven't told the what. You just said if you will eat right. I don't remember your exact words. You will experience reversal of chronic disease. It wasn't just Sean O’Mara it happened to. You've got the science now.
Sean O'Mara 18:06
Oh, yeah. Okay. Yeah, we study...
Jack Heald 18:08
Didn't mean to interrupt, but that we can...
Sean O'Mara 18:14
Yeah, your audience sees pick up on that. It's real. We studied 5000 people, we scanned them, and we measured their chronic disease. And we watched the impact of lifestyle changes on that biomarker, visceral fat. And you can kind of expect like that is noteworthy, that chronic disease either gets better, or went completely weighed in on all these people. But what really got me surprised, it got me thinking and gives me hope that this is the future and it's gonna catch on, was not only was the absent, that disease left the body and fled, but to a person and every measurement, they perform better. So basically, let me put it this way, they lived better. Everything they did then got better. So, it's not just the fact that disease is abated and reversed, but you actually improve the quality of life in these people. They become strong, faster, smarter, better performing, better at every task that they did that we measured improved. So, I have great hope that the body of knowledge that is available, that once it's packaged up in a form that can be consumed and distributed through probably companies will be embraced by corporate America because they'll be able to reduce their highest, their second highest operating costs behind salaries and wages. Our employee expenses for healthcare, they'll be able to reduce that. And then secondly, there'll be it increase employee productivity. So now you're talking about now...
Jack Heald 20:11
There you go. There's another mic drop moment. Phil, there's your hook right there, buddy. Oh, my Lord. They're not just going to be healthier and cut your health care costs, they're actually going to be more productive. And that's not just marketing BS. That's, we've got the science to back it up.
Dr. Philip Ovadia 20:37
Yeah, I mean, the three of us on this call, on this podcast can all attest to that in our personal lives. And, certainly we've seen it with all of the patients that we work with, so it really isn't something to be debated, it isn't something that we need more proof of, we know that if you just change what you're eating, and you change a few habits about your lifestyle, you're going to get these great improvements. And as Sean said, it's not just fixing diseases, it's really improving your day-to-day life. And that's what's so exciting. But the work that you're doing now to have a way to measure that, because that is one of the challenges people want to know, how do I know if this is getting better? And we talk about bloodwork, and we talk about this and that, but you're really the first one that I heard talking about visceral fat, and you're still largely the only one talking about visceral fat. So, let's get into it a little bit. First, let's just start with, what is visceral fat? And why is it so important to all of these aspects of our health and performance?
Sean O'Mara 21:59
Yeah, so first of all, for the audience, I just want to tie some of it to you to go to Google and just don't limit your knowledge of visceral fat to what you hear from me or on this show or other shows, you really should develop a fascination for it because of its capacity for once eliminated, having such a powerful positive influence and effect on your health, your performance, and the quality of your life. So visceral fat, in short, is a is a collection of highly inflammatory tissue that's stored deep within your abdominal cavity. We call it visceral fat because it surrounds the viscera, the inner organs within the human body. And so, the inflammatory nature of these substances, that they release these inflammatory molecules, and they get distributed throughout the body and wreak havoc and cause inflammation throughout the body, and basically disease, but there are other aspects to it. We only know what we bother to look at and study. But recently, there was a very interesting study that came out in June of this year that showed the mechanism of cancer, where visceral fat releases a particularly a problematic protein called Freckleton that gets distributed throughout the body. And what it does is it attracts the first line and most important line of cancer fighting these NK killer T cells, it attracts them back into the visceral fat and traps them so basically sequester zoom in the manner that maybe a spleen might sequester erythrocytes. The visceral fat attracts these NK killer T cells within visceral fat and then renders them ineffective at fighting cancer. So now they're no longer out in the periphery, finding off cancer and of course, cancer is always occurring in the body and it's but for the action of these NK killer T cells in our bodies immunity that we would otherwise have active cancer and succumb from it. So, to the extent your immune system works effectively, you can fight off this cancer, but here's these visceral fats mechanism. And we've seen the strong association for decades now, between obesity and cancer and now we have a greater awareness of the exact mechanism by which visceral fat is causing cancer. So that is one influence of cancer but visceral fats, inflammatory cytokines, and other inflammatory molecules release and go and cause havoc throughout all tissues. And so, as you reduce the quantity of visceral fat, but there's another important factor - the exposure. So, lots of people know that visceral fat is bad, but the amount of time you're exposed to it is critically important. So, if we just dropped a bunch of visceral fat inside a patient, or let's be a little bit more practical, they quickly acquire a lot of visceral fat from a diet that's completely filled with processed foods, sedentary lifestyle, poor sleep, alcohol abuse, and stress. So, you bring all the big factors in cause that visceral fat, they'll accumulate it in a very short period of time. And guess what, not much disease. But over a period of time, as their body is exposed to that quantity of visceral fat, the disease begins to manifest in their body. So, what that means to people is you can have a small amount of visceral fat for a very long period of time, and you will have disease as a consequence of visceral fat. Or you can have a very large amount for a very short period of time and not have much disease. So, it's important to know how much disease you have and how you are over a period of time, the dynamic nature of visceral fat is important to follow. So thus, my interest in this particular substance as a biomarker, to be aware of, and to introduce it to other providers so that they can understand that this is something we have to pay attention. And I'll go on to say that I recognize that there's a limitation, on the part of patients, you need to be able to afford an effective analysis of visceral fat, which really, in my opinion, requires either an MRI or CT. I don't think a DEXA scan is a good scan because it doesn't allow you to visualize that visceral fat. It just gives you a number. And so, an MRI CT allows you to take a look at that. And why that's important, Phil, is in my opinion, for a patient to be able to act on information necessary to change their lifestyle, they have to be able to process that information. And so, if you give them lab reports, there's not a lot of processing they can do. They have to look at numbers, and it basically comes through us as physicians to interpret it. So, nobody really changed their life over lab reports. But visceral fat is different, because you can actually take a look at it and stare at the enemy inside of you. And it seems to evoke a more primal response and a more fundamental response on the part of patients who see it to change their lifestyles. So, I've seen this over and over again, I'm not... I've never seen anything else as effective at changing lifestyle. In fact, I've shared repetitively on other podcasts that I had one patient even go so far as to pass out in front of me, sync up eyes, on a standing position fell and hit the ground after he saw how much visceral fat was inside of him previously think of him as a healthy man, and he realized he wasn't and the guy turned green, then he turned gray. And then he turned white, ischemic white. And I knew impending syncope was standing in front of me. But I could not get to the three feet, I needed to fast enough to catch him before he fell and hit the ground. So visceral fat really is a powerful marker to take a look at. And there was another recent study out in this past year that showed doctors who take the time to go through and you probably do these CT scans and radiology images with their patient explaining things have better, more meaningful results with that patient than those of us who simply read the report. So, leveraging that to visceral fat, you want to walk a patient through looking at that collection of highly inflammatory substances within their body and then track it over a period of time and show them, guarantee, you can guarantee that if they eliminate this visceral fat that they'll improve their existing conditions and along with it their body. So, when the other changes that happen are faces so I got so accustomed to looking at visceral fat in people and their faces before that I got pretty good at reading how much visceral fat was present in somebody, just by looking at their face, I can see the inflammation in their face. And so now I walked down the Mall of America, which is where I live in Minneapolis, and I do visceral fat assessments, everybody walking behind me, I can do a visceral fat assessment. And I think this is interesting because the future probably will be that we will be able to identify external changes in the body that will give us an indication of visceral fat, obviate the need to do expensive scans. And that's what our answer would have done for years, right? We would have had the medicine man and the medicine woman that would have caught us at the watering hole and said, “Jack, Phil, you got to talk to me, I'm seeing some bad change” or “Good job, Jack, liking what I'm seeing, your changes this way. So that body of knowledge that previously was part of our living for 4 million years or so however long homo sapiens has been around has been lost, because we've had this convergence and transference I should say, of modern technology, and since we started tracking labs or just numbers. Look what's happened to humans, we basically develop obesity and diabetes, we got more disease, more chronic disease, any point the existence of humanity. And it occurred to me just this week that I think we're looking at our laboratory studies from a quantifiable standpoint. We look at them numerically. And what we're missing is the quality of that number. So, for instance, TSHs, LDLs, one number is not going to apply to everybody else. The quality, either of that LDL, or the quality of the cell receptor is not being addressed in these lab studies. So, I think they're almost a fool's errand. They work to identify disease. And to that extent, they have some utility, but to the extent that we might otherwise use lab reports to try to optimize humans, it's not going, it’s only half the story. So, you got to look at the quality of what's being measured, as well as the quality of the environment in which that substance is. And they're very different.
Jack Heald 32:03
Expand on that. What do you mean the quality of the environment? Yeah,
Sean O'Mara 32:08
So, let's, let's talk about insulin. So, people are kind of talking about, what is your fasting insulin level? Well, your fasting insulin level, your number, what it is, at a particular time in the human body, let's say somebody has a fasting insulin level of three. If I try to apply that to Phil, my insulin receptors on my cell are different than Phil’s. Where's that in the discussion? It's not, you got these ranges where it's normal, and we're applying to everybody. So, I never hear this discussed, I just hear it's just this application of a number, all our lab values. And nobody's really saying every number that I've ever looked at, has another half of the story. What does it mean within the tissue? And that's a big part of the story. Because all everybody's tissue is very different, how they're going to respond to, or be influenced by or otherwise have some sort of biological interaction with whatever it is we're going to measure. So, what I want I want to do is...
Jack Heald 33:23
I want to make sure I understand what you're saying. I had a friend years ago, who was diagnosed with Hashimoto’s. And she spent a lot of time trying to get straightened out, finally found a physician who seemed to understand what was really going on. And she reported back to me that the way that thyroid hormone is true, is typically measured. It wasn't just thyroid itself. It was free T3 and free T4 and TSA. I don't know what all it was. Those had to be measured, first of all, in order to get an accurate reading of the function of the thyroid. But beyond that, you had to find out what the baseline for that particular person was so that these numbers that they're looking at in the lab report can be put into the context of what is normal or healthy. Whatever normal is for that particular person. I think that's the illustration of what you just said about. Did I get that right?
Sean O'Mara 34:40
Well, yeah, design baseline is a baseline number, but it's just looking at a quantity of a substance. There's not a discussion about the health of the of the tissues that thyroid hormone will act on or thyroid stimulating hormone, there's so many different molecules that are involved in in the thyroid function. It's a fairly complex endocrine system. But we just look at numbers. Baseline changes down the road. Nobody's measuring the changes on the receptors, in a word, where those hormones are acting. How do you quantify that?
Jack Heald 35:25
Okay. I gotcha.
Sean O'Mara 35:27
How do you address the quality of the warmth of...?
Jack Heald 35:31
The actual physical and chemical environment that the hormone being measured exists within?
Sean O'Mara 35:38
Yeah, I mean, I take Phil's TSH, and you put it into me, hit the amount of TSH, how it works on his tissues is going to be very different than my own. But we just look at these numbers in this kind of very flat, one-dimensional aspect. And so, the necessity to look at the human body, and looking at what I call the knock, I call, but I am fond of using the metrics that are applied by researchers looking at markers of research called, using the factors of signal to noise. So, it's important to understand that in signal is what really matters, noise is what's distraction. So, we have the capacity to stop and pause and say how much signal is present within this, whatever we're looking at, and how much is noise. So, cholesterol is fraught with a lot of noise. I mean, it's just not something that is black and white, and really clear and pure signal. Visceral fat of everything that you could look at in the body has, in my opinion, the highest degree of signal relative to noise. So, it's why anecdotally in my experience, and in studies I look at that nothing is as effective for eradicating disease and changing people and approving them as much as visceral fat. And so, the other day I was reviewing a study that actually showed that it was the highest amount of causality for mortality between visceral fat, subcutaneous fat and liver fat was visceral fat. And I can't think I want to... There's a radiologist kind of trying to get me to explain them shown studies, why visceral fat is even worth tracking. I want to ask them, well, what else do you track? You’re radiologists, you read things all day long. What else is more important for the patient's health that you think needs to be read more than visceral fat? So, part of the problem is nobody trains radiologists or medical doctors on visceral fats.
Dr. Philip Ovadia 38:09
That’s exactly, yeah, and the sort of blind spots that we have because, we all see it, every scan, you get, it's there. It's just that no one's looking at it. And, I admit all of the... I'm a big proponent of coronary artery calcium scans for detecting early heart disease. But really before talking with you, I never, you never really bothered to look at. You get those cuts into the upper abdomen, and you can see the visceral fat, you can see the pericardial fat, and I, like you, I think you had commented on social media at some point, has anyone like ever seen a radiologist comment on the amount of visceral fat on all of these scans? They sit there reading all day. And I think there was a discussion at one point about, one of the radiologists chimed in and just said, well, everyone has it, so why bother commenting on it? But it's amazing how we develop these blind spots in medicine.
Dr. Philip Ovadia 39:22
And I think back to my days the first part of my training to become a cardiac surgeon, I went through general surgery training, and for five years, I was in lots of people's bellies. And you'd be moving this fat out of out of the way and you'd be digging through it, but you never really thought about, why is it here and what does it mean?
Sean O'Mara 39:46
Yeah, so I'll tell you a really interesting experience I just had on visceral fat was CT scan. So, think about how many CT dongles scans have done in our country are done on daily basis. So, I'm next to a guy is presenting a foot to a physician, 79 years old, Phil, this guy still practicing. He reads his own CTs. And there's a guy, acute belly pain showing up. And he appropriately gets a CT scan. And I watch my colleague, my learned 79-year-old colleague diagnosed he had a cancer, and he shows it to me. And I'm like, I would have missed that. I would not have picked it, pick that up. But I said, I said to him, I know why he's got that pancreatic cancer, because look at all the visceral fatty acids in there. And so, this colleague, who has been reading CTs for 38 years, he told me, he's looking like this at the scan. Where's the visceral fat as well that black stuff? And so, he looks again, and he goes, what black stuff you're gonna have to show me. And I said, it's all there. So let me just let me show. Look at all that black stuff. Okay. So that physician who's reading it for 38 years, have been looking past all that black stuff. Okay. So, but this guy was so smart. He looked
Jack Heald 41:24
Sean, we lost your audio there very briefly. You said it was so smart. And then we lost your audio? Yeah.
Sean O'Mara 41:34
So, he was so smart that he looked at that and had this epiphany, where he realized, that he had been looking past all this visceral fat. And so, he turned to me. And he goes without hesitation. It was an incredible moment. Does this mean that we should probably be following visceral fat instead of cholesterol? And I'm like, wow, that is amazing. This guy put it together in this one scan so quickly. So yeah, it's a thing that's just ignored by people. It's interesting to surgeons, I thought that they're just cutting through it, but they're... Nobody's picking up on this. And the other and just the marker they did, you'll probably feel good about this too. If you've blown past visceral fat is corresponding visceral fat now, Phil, are these fatty infiltrates of these fatty streaks within the skeletal muscle. They're associated now with sarcopenia. So, muscles atrophy and muscles and dynapenia where the muscles are becoming weaker. These fatty streaks now are being deposited within the musculature in the skeletal muscle. So, I asked my best friend is an orthopedic surgeon. So, I'm like, hey, I'm picking up with whenever there's visceral fat, or these fat streaks, get rid of visceral fat, and these fat streaks go away and the muscles start looking better, they start performing better, gets smart. And I said, you guys tracking this? And he goes, well, there is a study where the shoulder, he's Cuban, fatty infiltrates within those muscles around the shoulder suggests to the degree that they're present, bad outcome for surgery to reduce a rotator cuff repair, some specialized things. So, I'm like, well, that's all over the body. I mean, you guys do like hesitate and working on a knee or something else because these fatty infiltrates and if nobody else use that, they only just picked up on that one. And I'm like, Oh my God. It's all over the body and you only cut straight into the shoulder? So, it but we're not exposed to a medical school. I'll confess we weren’t tracking it. And it really in art for the National Science Foundation we were looking at visceral fat. But as we were doing scans for professional football players, we'd scan their legs. They didn't have these fatty infiltrates. But then we'd follow these older people had a lot of visceral fat, and they had these fatty infiltrates. And so, towards the end of our study, we realized that this is another port marker. And I think what's happening, to bring this back to Dr. Ovadia’s work, and trying to avoid cabbage is I think those fatty infiltrates are related, associated with visceral fat. The same process that causes this visceral fat probably causes these fatty infiltrates in the skeletal muscle, but also the smooth muscle of the vascular.
Jack Heald 44:47
Smooth muscle is. Yeah, please define because not a medical professional here.
Sean O'Mara 44:53
But the smooth muscle is the second body muscle and I tell my clients before you work on skeletal muscle...
Jack Heald 45:02
Real quick for those who aren’t watching. Our doctor here just did a gun show for us. All right, carry on.
Sean O'Mara 45:12
Yeah, so your skeletal muscle or your muscles that you think of when you hear muscle, but probably your more important muscles for your health, with the exception of your heart, right, your myocardial is probably the most important muscle group. Without that one, you're dead. There would be no arguments with Dr. Ovadia about that. But the muscles, there are muscles that line your cardiovascular, your arteries, your veins, your capillaries, and they, in fact, take up the largest amounts of space of tissue in those vasculature. And they're vulnerable to disease too. And so, these fatty infiltrates, I can't tell you for certain that I have to do histopathology. But I'm guessing that were Phil and I to go back to our days with Gross and Harvey histology and do some fresh frozen specimens off, some cuts through some vasculature, we would be able to histologically through a microscope detect some of these depositions of fat and I think that is, in fact, the process that we refer to as hardening of the arteries. So
Jack Heald 46:19
Is fat in this smooth muscle?
Sean O'Mara 46:23
Yes. So, these smooth muscles line your arteries, and they have a different function. They're not volitional. So there, you can contract voluntarily your skeletal muscle, but your smooth muscle are more automatic, they kind of happen on their own. They're also in your gastrointestinal tract of your small intestines, large intestines, your glands, so all of the autonomic kind of things that happen naturally automatically, do so through smooth muscle. And so, you have skeletal muscle and smooth muscle vulnerable to this inflammatory process, which over a period of time is degraded. And so, as a consequence of getting rid of and I don't know if it's directly caused by visceral fat, or correcting the lifestyle that causes visceral fat also corrects the negative effects on smooth muscle. And so, you see an improvement in the vascular performance. So, I have these visible pulses now that popped up all over my body, my belly now pops up. When I lay down, you can see blood coursing through my aorta, through the biomechanical forces involved in this bolus of blood bolting down my aorta, that to probably a conventionally trained physician, dudes got a triple A right there, look at that, that's got to be abdominal aortic aneurysm present in Sean's abdomen. So, I frequently will show, I'll drop on a pati2ent table, pull up my shirt and show this to my patients try to visualize, get them realize now look at your abdomen, it's flat, look at your arteries in your body, you don't have them. But if you get rid of these poor lifestyle changes, you'll start having visible manifestation. You'll see your blood flowing better. And it's very exciting to see and to live through that experience. Because with improved perfusion, your body gets healthier, and the quality of your life improves dramatically. Now you get blood flow better to the joints, to the back, every unit to the brain to the cerebral cortex. So, my memory has never been better. I literally walk around and think people are being freaking ripped off. Because I've been given, I feel like 30 years back in my life in terms of quality of enjoyment that I get to have, by the additional improvement and health and I see these other people that are walking around, they just you get to have a conversation. And they look like this. They just don't believe it. Everything tells them otherwise. So, what for podcasts like yours and social media where this this is more regularly and persuasively brought up authentically and sincerely. I don't know how else if another get otherwise get out to people to be aware of.
Jack Heald 49:41
I want to ask you to speak to the non-medical professionals specifically to business professionals right now who understand a key performance indicator. These guys who run a business, they've got a dashboard that has 12 or 18 or 24 gauges and dials and pie charts and bar charts on it, that they can just at a glance, can instantly assess the health of their business. Talk to those people, because I think they're gonna understand this approach.
Sean O'Mara 50:24
Yeah, so it's a great as a great question. So, what happens to business people that C levels, CEO, CFO, COOs running these companies that they are armed with KPI. And KPI or key performance indicators that get tweaked and to the extent that you measure the correct KPI, and then you embark on the correct interventions and strategies to optimize that KPI. You can literally drive that company towards a more favorable outcome or worse outcome, depending on your decision making. So, companies live and die on the basis of KPI. And so, a really good C level and a CEO really has finesse with KPI. Now, what I think is needed, but I try to espouse what I do with my own patients now, clients that I work with, is that I try to give them the very best KPI for their body. Okay. Their experience to date with conventional physicians is that their KPI is more like cholesterol laboratory reports, and are things that drive revenue attached to the healthcare system and that particular practice, rather than really truly optimize the biological collection of tissue that's in front of them. So, I changed it a little bit from calling a KPI to KBI - Key Biological Indicators. And then I get into fatty infiltrates and smooth muscle, visceral fat within the abdomen. And I look at facial inflammation and people and telangiectasias, changes in the skin. And I give those people a task to track all those things by photograph. And that gives them the strategies to change them. So essentially turning them into CEOs of their own corporation, their own body, giving them the Key Biological Indicators to follow. And if there's any business guys out there that run companies or men or women that run companies, and you do KPI, let me ask you something. You know how you run your company. And it turns on the validity, that KPI. Why do you let doctors get away with crappy KPI for your health? Why do you let them get away with this? And so that's the question. I think we, Dr. Ovadia and I should be asking our colleagues, why do you guys do that? I get that it's designed to generate revenue for the healthcare system. But have we got ourselves so removed from the improvement and treatment and the best centrist health interests of patients that we are now exclusively just looking at CPT coding, and what's attached to healthcare authorizations and, the healthcare’s big pharma, big medicine, big healthcare, big insurance, that we no longer are even paying attention to the fact that the longer this patient remains in our practice, the worse off they are? We wouldn't tolerate that in corporate America. Why do we tolerate it in the largest part of our economy, which is healthcare applied to individuals where they're just falling apart? So, I think what this means is that we see the potential for transformational change in the future, disruption from somebody probably similar to what Sami Inkinen is now doing with management diabetes for large self-insured companies. Sami Inkinen started the Trulia website app; you know that Zillow now owns and he's now running that company with... Dr. Sarah Hallberg recently just passed away. What was her company? Phil? Yeah. Verta Health is taking care diabetics for large self-insured companies. I don't know exactly their model, but basically, it's something along the lines I think where they take care of the diabetics for a portion of the cost of savings to those companies. I don't know the sandy necessarily wants to get out.
Jack Heald 54:49
That's interesting, but when I'm not hosting a podcast. I'm a marketing consultant in my particular, the group of guys we work with, we operate on a performance model. Most marketing organizations charge a flat fee to do the marketing. We don't. We charge however much money we make you. We get a percentage of that.
Sean O'Mara 55:18
Where were you when, 10 years ago...
Jack Heald 55:20
We’ll talk afterwards,
Sean O'Mara 55:22
I was always looking for you. There almost nobody does that, Jack, that’s...
Jack Heald 55:28
It's not about me, I want to go back to that that medical model there. We want to treat your... We will take care of your employees who are diabetics for a percentage of the amount of money we save you in health care. That's a brilliant model. Yeah, it aligns incentives.
Dr. Philip Ovadia 55:46
Yeah, that's exactly it. I mean, as Sean was saying, one of the central problems in the health care system is that the incentives are misaligned. And there is no incentive to keep people healthy. And, we have to get around that. And, whether the system does it, or whether individuals start doing it for themselves, to incentivize their own health, and I love that term, Sean, for people to start tracking their KBIs, and really, taking charge of their health, which is one of the themes that we talked about so much on this show that we can all wait around for the system to change, but that's probably not going to end well for most of us. So, we as individuals, we, as the individual physicians, and we as the individual, patients need to just take back control of our health and start looking at these actually useful metrics of our health. I'm kind of fascinated, by the external signs of all this, and, being able to correlate, what's going on in the inside to what's going on in the outside? And how you mentioned that the medicine men of way back, that's what they had, they would look at you, and they would know you're healthy or not healthy. And again, we've probably lost that ability, because when you look all around you, the reality is everyone's unhealthy. So, we cannot differentiate that anymore. But it's something I've consistently said, just the number of times that I've been with a patient, and they're like, oh, well, I'm not really losing as much weight as I want to, and this and that. But everyone's telling me how great I look. And I'm like, that's the sign. We just need a better way to quantify that, I guess.
Sean O'Mara 57:53
Yeah, well, this was interesting. Just yesterday, I was, I did a couple of days ago actually did a post on my Instagram about how Native Americans would hunt. And it's fascinating to me that we're the only species for 4 million years that would hunt the best animal in the tribe, the lions and the tigers looking for their tap, they go for the heifer, the one sick or dragging his leg, but we have cerebral cortex, the allowed us to think and identify signs on which animal in the herd was the best one to hunt, because they'd have the highest nutrient value, and the best microbes on their hide, that we would value for the microbiome. No, we didn't understand germs and the microbiome, but we knew that the best animal and the best fur, that nature gave you a secret... We laughed at these people, they had secret powers in the hide, they did. Okay, because the microbes, the lifestyle convict conferred, cats all along in that skin and the hair that would be conferred upon the recipient Hunter. And so, we would select the best when all the other animal species only hunt the easiest. And so, we knew how to select...
Jack Heald 59:11
We just opened an entirely new chapter here.
Dr. Philip Ovadia 59:13
Yeah. Part two. Yeah, we've had a running discussion how the next season of this podcast is going to be bringing everyone on for part twos because we always get to these fascinating nuggets towards the end of the podcast.
Sean O'Mara 59:33
Plus, for the last as part two, yeah, have me come back. And I will be glad to go into that because it really truly is. fantastically interesting and it's almost like people aren't quite ready for it. You kind of have to bait them along and so I haven't gotten to it yet in my own Instagram and Twitter accounts, but you'll see me launch on it shortly. Phil.
Jack Heald 59:55
Oh, this is good. Phil, if you got any other questions you want to ask for this podcast?
Dr. Philip Ovadia 1:00:04
I think this is a great place to wrap it up. And just Sean let everyone know how they can connect with, you were the best places to find you are. And for people who might be interested in working with you.
Sean O'Mara 1:00:18
Yeah. So, on Instagram, you can find me put out lots of data, information postings on how to optimize your health at just @ D-R-S-E-A-N-O-M-A-R-A at @drseanomara, and the same thing for Twitter, and Dr. Sean O’Mara with an apostrophe for YouTube. And then I have a website, just www D-R-S-E-A-N-O-M-A-R-A. I look for clients that are highly motivated. Alphas, I have lots of people coming to me that they want to work on me, I only work when people are super motivated, really want to optimize their health, because I study them. And I'm writing a book about it. And I don't have time to waste on people. They're like, I don't think I want to give up that arise. And I just don't really want to work that hard. I don't want to sprint and I don't have time for that. We're about this business of reversing chronic disease. So, if you're that kind of motivated person you want to be as help the healthiest person you possibly be. Might be worthwhile for you to give me a call and we'll talk.
Jack Heald 1:01:31
That's fantastic. You've got about I counted at least three phrases that you use in this podcast that would that would be fantastic titles for your book. The seriously just growl...
Sean O'Mara 1:01:48
Share them with me, Jack. I'm terribly impressed. I've never heard of a marketing guy one time and a probably walk around. I'm your ideal client walk around everyday thinking we need to get more professionals out there that say I want to be compensated based on performance. Because that I just almost never see that in marketing. I never have, not almost.
Jack Heald 1:02:10
Well, that’s because there's so much bad marketing.
Sean O'Mara 1:02:16
Well, that right away when you said that. You get it because who else would offer that except for somebody that confidence in their expertise? Yeah. And then we got... I can't tell you how many hundreds of 1000s of dollars I threw at marketing firms and got nowhere. But and nobody would guarantee me and I would ask them, but nobody would do it. And so, I had I found out about you, I’d give me my hundreds of 1000s of dollars, Jack. But anyway,
Jack Heald 1:02:44
To turn them into 10s of millions.
Sean O'Mara 1:02:47
Down below researcher I got no money. But yeah, maybe down the road. If I can figure out a for profit motive for businesses. I'm going to use you Jack to figure out how we how we get other providers truly compensated through performance. And yeah, and teach them how to reverse disease and get compensated for that. So that's the future of healthcare. I think
Jack Heald 1:03:14
I know there are a lot of health care professionals out there who are sick of the way the system they're stuck inside works. And I would be willing to bet that they would gladly trade their golden handcuffs for a model that allowed them to be paid for performance. It's such an honor to get to talk to you. All right, well, we're definitely going to have you back on I wanted to I've got a couple of things written down that we didn't get to that I want to ask you about. So that'll be for part two. Anything else? Phil?
Dr. Philip Ovadia 1:03:55
I think that we'll wrap it up for this week. We've wowed the people; we can't overwhelm them too much. All right.
Jack Heald 1:04:03
Well, let's call it a wrap then. For Dr. Phil Ovadia, I'm Jack Heald, and this has been Dr. Sean O’Mara. It's the Stay Off My Operating Table podcast. Follow Doctor Ovadia on Twitter @ifixhearts. His website is Ovadiahearthealth.com and you can take a metabolic health quiz at ifixhearts.co And we'll talk to you next time.
Jack Heald 1:04:30
America's fat and sick and tired. 88% of Americans are metabolically unhealthy and at risk of a sudden heart attack. Are you one of them? Go to at ifixhearts.co and take Dr Ovadia’s metabolic health quiz. Learn specific steps you can take to reclaim your health, reduce your risk of heart attack, and stay off Doctor obeyed his operating table. This has been a production 38 atoms.