Healthy Wealthy & Wise Dr. William T. Choctaw, MD, JD
The Healthy Wealthy and Wise Podcast, with Dr. William T. Choctaw, MD, JD is a monthly podcast that focuses on personal growth and development by exploring a range of topics related to mental and physical health, personal wealth, leadership, and interpersonal relationships. Dr. Choctaw draws on his 75yrs experience and 50 plus years of surgical practice since graduating from Yale University School of Medicine.
Each month, we strive to provide our listeners with mental, physical, and spiritual strength by giving actionable advice, tips, guidance, and information to help them achieve their own personal, professional, and spiritual goals. We consider the health of the mind, body, and spirit paramount as a single unit that provides a cumulative strength greater than the individual parts, to strengthen the whole person.
We appreciate the natural differences in need between men, women, adults, and children. We recognize that the power to be happy is within each of us and under our control. We embrace technology and identify how it is applicable to our daily success. We address the entire human experiences from generation z to the baby boomers.
We’re passionate about the total person, and helping our listeners build and lead a full, well-rounded and happy life. So, tune in every month for an inspiring, encouraging, and informative podcast!
Healthy Wealthy & Wise Dr. William T. Choctaw, MD, JD
Young, Athletic, and at Risk: The Reality of Sudden Cardiac Arrest in Sports
How much do you know about sudden cardiac arrest in young athletes? Arm yourself with knowledge as we unpack this pressing issue on our Healthy, Wealthy, and Wise podcast. We're tackling a subject that's not only alarming but also heart-wrenching, as we unravel the unexpected and shocking occurrence of sudden cardiac arrest among young, seemingly healthy athletes. We'll be highlighting the critical research of Dr. Charles Webb from LSU Health in Shreveport, Louisiana, while also sharing the news story of Bronny James, son of NBA superstar Lebron James.
Why are young athletes, in the prime of their health, experiencing sudden cardiac arrest? Join us as we delve into the mysteries and complexities surrounding this issue. We'll be investigating the intriguing links between hormonal surges, heart maturity, and extreme heat exposure. More importantly, we'll be discussing the vital role of physical exams in identifying risk factors, signs, and symptoms. Learn about the powerful, lifesaving measures you can take, including CPR and the use of AEDs. Also, learn the importance of the important role the electrocardiogram "EKG" as a prevention tool!
Equip yourself with the power of knowledge—that's the key to safeguarding the health of our young athletes.
Healthcare Quality Leadership Education Group
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The Host, Dr. William Choctaw; MD, JD, is a healthcare leadership expert, possessing a Medical Doctorate from the Yale University School of Medicine, and a Jurist Doctorate from Western University. Over a span of 50 years practicing medicine, he has served as Chief of Staff, Chief of Surgery, and as a member of the medical executive committee at Citrus Valley Medical Center over a 10 year period. Also, while practicing at Citrus Valley Medical Center, he served as Chief Transformation Officer, (developed a Robust Process Improvement/Lean Six Sigma program). Dr. Choctaw lectures nationally and internationally on medical leadership issues for hospital staffs, executives, and managers. He served as a Physician Surveyor on the Joint Commission. He's the author of 2 books, "Medical Malpractice: A Physician's Guide to the Law" and "Transforming the Patient Experience: A New Paradigm for Hospital and Physician Leadership, published by the Springer Publishing Co. He’s the President of Choctaw Medical Group, Inc., a clinical practice and medical legal consulting firm for medical staff executives, physician leaders, and hospitals.
Welcome to the Healthy, wealthy and Wise podcast with Dr William Chokta, mdjd. Our mission is to empower you with the knowledge and the tools you need to thrive in all aspects of your life. Join us now as we discuss everything from nutrition and exercise to money management and personal growth. Dr Chokta will provide insightful advice on how to improve your physical and financial health, as well as your emotional and mental well-being. Whether you're looking to boost your energy levels, unlike financial freedom or cultivate a more positive mindset, we've got you covered. Get ready to become the best version of yourself, so let's get started. Here's Dr William Chokta, mdjd.
Speaker 2:Good morning, welcome to our Healthy, wealthy and Wise podcast. I'm Dr William T Chokta and we're delighted to have you with us. Today we're going to talk about Bonnie James. Bonnie James why young, healthy athletes have sudden cardiac arrest. Why young, healthy athletes have sudden cardiac arrest Each month.
Speaker 2:We strive to provide you, our listeners, with mental, physical and spiritual strength by giving actual advice, tips, guidance and information to help you achieve your own personal, professional and spiritual goals. We consider the health of the mind, body and spirit paramount as a single unit that provides accumulative strength greater than the individual parts to strengthen the whole person. So today we're going to look at sudden cardiac arrest. This is a problem that's been in the news lately and we've done some interesting reviews, and we're going to give you our suggestions about how this particular issue should be addressed. I believe knowledge is power. I believe life is about being of service to others. I believe leaders can change the world. As always, we like to give you an outline of what we're going to talk about. We're going to talk about sudden cardiac arrest, not just cardiac arrest sudden cardiac arrest in young people, young athletes, to be specific. We're going to talk about some of the causes of this sudden cardiac arrest. We're going to define the differences between cardiac arrest and heart attacks and we're going to discuss ways that you can prevent it and suggest certain treatment modalities or methods that we think will help to mitigate this problem in the future. As part of our masterclass series, we always frequently look into healthcare-related issues. As we said before, we're going to look into healthcare issues as it relates to our youth and as it relates to our youth involved in competitive sports.
Speaker 2:When I talk about athletic competition or athletics, we can either look at it as recreational or competitive. For our purposes today, we're going to combine the two, that there is no distinction between competitive sports or competitive athletic competition or recreational athletic competition. The reason is that the main issue that we're looking at today primarily involves the effect of the activity on the body itself. Our belief is that whether you are playing in the final of the USC basketball tournament, at the Pac-10 or Pac-8, or whether you're playing 101 basketball with your brother in the backyard, you're still going to be just as competitive physically and the effects on your body will be similar. If you look at athletes and if you look at athletics among our children, particularly in junior high and high school and in college. You would note that about 8 million high school athletes are active in the United States presently. Of that number, and maybe a little higher now, about 500,000 college athletes are active presently.
Speaker 2:A lot of the very good work about student athletes and health has really been done by Dr Charles Welb at LSU Health in Shreveport, louisiana. I would encourage you to look up some of his very interesting work and very thorough and very informative. It will give you an idea about the scope of what we're talking about and some of the issues that we learn to evaluate. Specifically, what we're going to focus on is sudden cardiac arrest. Sudden cardiac arrest. Sudden means it's immediate cardiac means. It involves the heart. Arrest means the heart stops. Sudden means that it's immediate cardiac means. It involves the heart and arrest means the heart stops. We're going to look at the most common causes studying cardiac arrest. What's important for you to know is that sudden cardiac arrest is the most common cause of death in athletes. Let me say that again Sudden cardiac arrest is the most common cause of death in our athletes.
Speaker 2:I'm sure many of you may have heard in the news about Bronnie James. Bronnie is a freshman at USC. He's on the basketball team and, as you may already know, he's the son of the legendary superstar Lebron James, a professional basketball player. Bronnie, his son was in basketball practice at USC and he suddenly had a cardiac arrest. He immediately dropped to the floor and individuals rushed to him with a cardiac arrest. Even though you may not have heard of this a lot you don't hear about it a lot it does happen, and I will submit that it's happening more and more. Why? One? Because our population is growing. We're up to 8 billion people in the world now. Obviously, our population in this country is growing. I'm going to argue that there are more student athletes now, just because of that, and also because of the popularity of various types of sports like football, basketball, soccer, etc.
Speaker 2:If you were to research the literature, you will find that among children and when I say children, I'm talking about less than 20 years of age the most common cause of cardiac death in children is myocarditis. What does that mean? Myocardium means muscle, heart muscle. This means inflammation of Myocarditis, means inflammation of the heart muscle or inflammation of the heart. Myocarditis is recognized as the leading cardiac cause of death in young people and children. Having said that, though, it is not the leading cause of death of sudden cardiac arrest or the leading cause of sudden cardiac arrest. Sudden cardiac arrest is the main cause of death in our youth or in individuals less than 25 years of age. Again, sudden cardiac arrest is when the heart immediately stops. Patient drops to the floor, to the ground, wherever he or she may be.
Speaker 2:What we know, and we already know this, is that the most common cause of sudden cardiac arrest and athletic children or youth is cardiomyopathy. What is cardiomyopathy? Cardiomyopathy, as the name might implies, means that the heart muscle, the cardiomyome, is diseased somehow or does not function normally. Cardiomyopathy is an inherited weakness of the heart muscle, most apparent with extreme exercise. The thing about cardiomyopathy that you need to know first thing is it is inherited. You get it in your genes. It is in the genes. Some people have it, some people don't. There is nothing that the student has done to create it. It is in the genes.
Speaker 2:If you were to look at cardiomyopathy and if you know that it is in the genes and if you know that it alone is the most single cause of sudden cardiac arrest in an athletic young person, your next question would be how do I detect it? How can I prevent it. What can I do? Believe it or not? The electrocardiogram, which has been around for generations as a test and as a standard for the heart. It is a very, very important thing. It has been around for generations as a test and as a standard test, is one of the best tests to use to identify individuals who may have cardiomyopathy. Some studies have even suggested over 90% can be identified with electrocardiogram. But would it not surprise you to know that not all and I would argue, probably most programs I'm talking about school athletic programs, athletic clubs that our kids play on probably don't use the EKG, the electrocardiogram, as a normal screening too? Let me say that again.
Speaker 2:Cardiomyopathy is the most common cause of sudden death, causing death and atollated young people in this country. One of the best ways to screen for cardiomyopathy is a method that we already have called electrocardiogram or the EKG, but the majority of the programs probably don't use it. There may be a number of reasons why they don't use it. Some may be costs, some may be just the idea of this. Doesn't happen very often, which is true, and we'll get to the numbers.
Speaker 2:It is not often that a sudden cardiac arrest occurs, but I'm going to suggest to you, would you really care, whatever the percentage is, if there was any chance that a minimum of your family or a child or your family, your son, your daughter, your grandkids, family members or just the kids down the street would die or be injured with a particular medical condition? Let's look at, take a broader view. If you look at adults, the most common cause of cardiac injury or cardiac death is carny artery disease and we'll talk about this in detail a bit later. But if you look at the youth and again I'm going to define youth as less than 25 years of age it's going to be cardiomyopathy or some type of arrhythmia. Those who are at highest risk for sudden death with cardiac disease are going to be athletes who are less than 25 years of age. They're going to be athletes who play soccer, basketball and football, which is obviously going to be the majority.
Speaker 2:Many believe that one of the reasons why this occurs, the sudden cardiac arrest occurs in these young people, is that they're at the end stage of puberty, the last growth spurts, if you will 19, 20, 21, all the way up to 25. The heart is at its peak maturity and the hormone levels are surging at this point. Just a theory, some believe that's one of the reasons why these individuals may be more susceptible at this age or at this stage in their life and their development, but what we do know is the cardiac disease alone a heart disease alone is the most common cause of death in this country, be you adult or a youth. What we're trying to do is to focus on our youth and a certain segment of our youth. These are the athletic youth and what things we can do to mitigate the problem of sudden cardiac death and this subset of athletes in our environment. Studies have shown that if you look at data from the NCAA and the first part of the 2000s, you get an idea that football and basketball and other types of competitive sports that are higher on the list, they suggest that boys are more susceptible than girls. That may very well be that actually, early on, there were more opportunities for boys to compete than there were for girls, so those numbers may be a bit skewed. But the point I want to make is that more and more of our children are participating athletically, which in general is a good thing, but also just be aware of one very serious risk with this enjoyable competition and things that we can do to mitigate the causes.
Speaker 2:Let me also, parenthetically, add that there is a difference between cardiac arrest, heart stopping and heart attack. There's a difference between cardiac arrest and heart attack. A cardiac arrest, which is what we're talking about today, is basically an electrical problem Because, remember, the heart is a muscle, but it is a muscle that functions with electrical current. The electrical the essay fires an electrical current to the muscle, squeezes down, pushes blood out of the heart. Electrical current fires and occur to the muscle in the heart. The muscle squeezes down, pushes blood out of the heart. On the other hand, a heart attack is not an electrical problem. A heart attack is a situation that occurs in mostly in people 25 years of age and older. It is basically a situation where the blood supply to the heart is impeded or decreased or blocked completely. So you have arteries that feed the heart, the blood to the heart muscle, that allow it to be healthy and to function normally when it receives the current, the electrical current to push blood out of the heart.
Speaker 2:But if that muscle is not fed with appropriate nutrition or nutrients via its own blood supply, ie the coronary artery, if those arteries are blocked, then that muscle will not get that sufficient amount of blood and then that muscle will not function properly, and that's what we call heart attack. Cardiac arrest, which is what we primarily talk about today, is an electrical problem. Heart attack is a plumbing problem. Cardiac arrest is an electrical problem that we're talking about with young people, particularly young athletes who are less than 25 years of age or younger who are less than 25 years of age. Heart attack is a plumbing problem that occurs in individuals who are greater than 25 years of age.
Speaker 2:Another important point to remember, particularly when we talk about heart attacks, is that the symptoms of heart attacks differ significantly sometimes between men and women. This is an important factor because one of the things that we've learned I graduated from medical school in the 70s and back in the 70s we were taught that the heart attack was a classic substernial chest pain with pain that crushed the substernial chest pain, with pain radiating to the left arm. And indeed that was true. But what we didn't know at that time, that was primarily true in men that indeed women don't have that classic male approach or male symptomatology of heart attack. Women may have nausea and vomiting, they may have neck pain, they may have lower abdominal pain, they may have indigestion, they may have extreme fatigue and, indeed, in the last 30 plus years, a whole area of specialty has developed in terms of female heart disease, a heart disease that affects women.
Speaker 2:Recognizing the fact that men and women are different in multiple ways and indeed how they have heart attacks, is one of those ways. Another way that we can end up creating a heart attack or heart disease or sudden heart attack is by stressing our heart inappropriately. In addition to exercise, believe it or not, the environment can be a stressor for our heart, particularly if it's very hot. What we know is that this year, particularly in 2023, in the summer 2023, has been the hottest summer on record in the history of the earth or recorded history of the earth.
Speaker 2:What that means is that the climate is getting hotter and hotter. The hotter it gets, the more stress it puts on the heart, because it makes the heart have to work more, and obviously that affects those of us who are extremes of age the very young and the very, very old. So let's get back to our subject sudden cardiac arrest. Again, we're talking about sudden cardiac arrest that occurs in young athletes. Another athlete that we heard about a few months ago also was DeMar Hamlin, a football player, buffalo Bills, who end up having a sudden cardiac arrest, both DeMar Hamlin and Brody James. Both were in an environment where individuals could get to them quickly, do CPR and also do defibrillation if needed. So what would be some symptoms if you were coaching a team or you were just observing a team of a group of soccer players, let's say, and let's say one of those students, one of those young people, had this developmental abnormality that they would not know about. What would be some symptoms? Are there any symptoms to them developing a sudden cardiac arrest?
Speaker 2:Studies show that there are some mild symptoms that would be important to be aware of. One is that during the exercise, immediately afterwards, they may start to feel an unexpected type of shortness of breath. Let's say, for example, the coach has the team to run around the field after practice say football practice, soccer practice, whatever but this time when the student runs around the field, he's starting to feel more short of breath than usual and indeed cannot really make it all the way around the field. Now, this is always one of those situations where, obviously, it is the coach's purpose to push the athlete and you want to get the best out of them and you want to make sure that they are putting 110% into their activity. But at the same time, it's important to be aware that some problems can develop and sometimes they may not be able to do what they really want to do and run around the field as fast or as many times as they have done in the past. Other symptoms could be the student may feel, or began to feel, faint or a little dizzy, or just out of it. Another symptom may very well be chest pain.
Speaker 2:So what should individuals who work with youth and bond with various types of sports be aware of? First, you need to have a heightened awareness. Now I realize that this is challenging One, because the incidence of individuals having sudden cardiac arrest is going to be very small. It's going to be like $1,000 and $40,000. That's really very small. But think about it. Would it really matter whether it's one in 40,000 or one in four if it were your child or your family member, or a child that you do, etc. My point very simply is admittedly it occurs rarely, but the occurrence should be zero, the risk should be zero, and that's the point I'm trying to make here. Why should we accept one in 40,000 or one in 80,000? The risk should be zero. We certainly.
Speaker 2:Many times, when I was working with the drug commission on the latter part of my practice, we were suggesting to hospitals that we would survey, that we want them to have zero patient harm Zero. And certainly anytime you say zero harm with anything, people say oh, come on, you're dealing with humans and we're not all, we're not perfect, blah, blah, blah. And zero is not possible. And our reply would be you can get zero harm if you think you can get zero harm. We expect zero planes to fall out of the sky when we get on an airplane. We do not expect one in 40,000 or one in 80,000. We want zero, we want no risk, we want no problems at all and I submit that we can do the same thing for our children who are involved at Sledikly.
Speaker 2:Another thing is that all of these kids and all of the youth, whether it's college, whether it's high school, whether it's club soccer or club football or club basketball, all have physical exams. I suggest that those specific exams should be purposeful. It should not just be a single sheet where you check a box, but there should be a medical person who actually does a medical exam, ask the right questions, etc, etc. I personally think, because we now know that the EKG, the electrocardiogram, can pick up or identify those students who are most likely to have a problem with cardiomyopathy, that every student who is involved with athletic competition should have a screen in the electrocardiogram. I just think that should be the good one. Yes, I'm sure there's a cost associated with EKG. Yes, I'm sure that it might be a little disconcerting for a lot of individuals to think that, oh my goodness, you mean there could be a medical condition here. But ask yourself the question what if it were your child? Wouldn't you want to know? I certainly want to know. My grandkids are very, very active in soccer and I want them to be safe, as I'm sure you do with your children. We should be educated all of us who are involved, supporting our case with risk factors. We should be able to identify them and we should be able to provide treatment as necessary.
Speaker 2:One of the main treatments, obviously, if someone develops a cardiac arrest, is cardiopulmonary resuscitation of what we call CPR. Cpr has been around for a very, very long time. Many of you have not most of you are familiar with it. First thing you do is call 911. Second thing you do is lay the patient flat, or the person flat, so they can breathe. If indeed they are breathing, you want to listen to see if you can tell if they're breathing. If they're not breathing, then you want to start chest compressions. It's chest compressions, third of compressions, to two breaths, and you want to do that until you can get a help.
Speaker 2:Additionally, if indeed it is a cardiac arrest, studies have shown that you can significantly improve survival with what's called an automated external defibrillator. Basically, this is just a unit that shocks the heart. Think about when your computer goes down. Think about in a situation that's electrical. Many times what you do is you just turn it off and try to back on again, or you unplug it and you plug it back in. It's similar to that If that heart is stopped. Remember it's an electrical unit and you want to shock it with a defibrillator. It's one of the reasons why you will see defibrillators in airports and in a lot of public places. Now Studies have shown that a portable defibrillator can make a huge difference in survival in a lot of these patients, because time is really valuable. Many times, just by doing this on the spot, you can save their lives before you can get them to the hospital.
Speaker 2:So what have we learned? What we know is that sudden cardiac arrests in youth is uncommon. Again, as I said, it's like one in 40,000 or one in 80,000 per year. But again, my point is who cares if your child is that one, or a child that you know is that one, or a child in your neighborhood is that one? And that's something that we all can do, individually or collectively, to decrease that risk.
Speaker 2:We know that the majority of children who get sudden cardiac arrest, or individuals less than 25 years of age who gets a cardiac arrest while exercising competitively, that it is from a congenitive defects called hypertrophic cardiomyopathy. That cardiomyopathy is the most common cause. We know that a cardiomyopathy is basically a weakness of the muscle when pushed to extremes Athletically, a weakness of the muscle when that muscle is pushed to extremes Athletically. We know that it is inherited and that it is not something that you can prevent yourself from having. We also know that over 90% of individuals with this condition can be diagnosed with a basic electrocardiogram A basic electrocardiogram.
Speaker 2:So what's my point? My point is that there should be a zero risk of our children having cardiac arrest doing athletic competition or any other time. Zero risk. And so what I recommend is the following One, have a good history and physical done when the kids all get, because all of them have to have history and physicals, but many times the quality of those history and physicals may not be the same.
Speaker 2:Make sure, if you are a parent or guardian or just a concerned citizen, make sure good history and physicals are done, good questions are asked to make sure that the screening is done in an appropriate manner. Next, if you are a parent or concerned adult with children who engage in athletic competition, be proactive, notice things and, at the same time, ask questions. Now I'm going to caution. You Be diplomatic with your questions, because if you walk up to a soccer coach and say, by the way, do you guys have an EKG? And did you EKG my son before you put him on your soccer team and go ahead and start mentioning statistics, that sort of thing? The coach is going to start running from you, okay. So you want to be diplomatic, but you want to say bring it up in general, or maybe even bring it up in a group discussion among parents, maybe before even talking to the coach, if there's a support column, etc. Etc.
Speaker 2:Or if there's a teen mom or a teen dad, bring it up with that person in a very diplomatic way. But the goal is to make things safer for your children. That's the goal. We want zero risk, not 1%, not 5%, not 10%, zero. And when they used to tell us in the hospital, zero is important. As I said before, you get zero if you think you get zero.
Speaker 2:Also, one of the things that you want to suggest is that all the kids should get EKGs, a screening EKG. Again, you can pick up the most common reason for sudden cardiac arrest Most of the time with a screening EKG, electrocardiogram. Find the world when we get them. Again. I understand that it could be diplomatically difficult or challenging. Folks may say it's just too much money. But we see a lot of kids who have signs and have car washes to get uniforms. We have car washes or raise money to go on trips with the team. Certainly, something like getting an EKG can be done in that manner. If necessary, I would argue that parents and or adults would just donate money to get to buy an EKG and have a certified person to do it, which brings me to my next point. I think there should be individuals associated with each team, soccer team, basketball team, football team, college, high school, junior high or club or just recreational. That should be an adult, a minimum one adult, if not more, of individuals who are associated with all of these teams, who know CPR, cardiopulmonary resuscitation. Just take a course and become a certified CPR person. Most hospitals will offer a free course. You can find them in schools, just go online or just look it up. I guarantee you you can find someone close to you that gives certified, that gives CPR classes, and you become the person who is able to do cardiopulmonary resuscitation should you be in the area when something like that occurs and it's just something that's good to have who may be at a family gathering and someone elderly may end up having a cardiac arrest, and you can be of assistance there.
Speaker 2:It's the one is my point, but I'm thinking about it specifically with our youth and specifically with our children who have these cardiac arrests and things that we can do to help them and doing those critical moments to save their lives. Certainly, one of the suggestions that's available is things like fundraisers for EKGs and also I think each unit, each school, should have an AED, an automatic electronic defibrillator. I'm sure many schools have them, but I've got all schools, though, and I've got all teams though. These are very small units that can be hand carried and I think someone should be designated. It doesn't have to be a coach, it could be a team mom, team dad or just a good parent who's at every game to be responsible for that and know how to use it. Granted, these are things that may be outside of the norm, but I suggest to you that, certainly, as leaders and as individuals who want to make the world a better place, these are some little things, small things that are within our control, that we can do to save somebody's life. I wouldn't want to do that.
Speaker 2:So, in conclusion, the most common reasons for sudden cardiac arrest and child athletes is hypertrophy cardiomyopathy. This is a genetic condition that can be identified most of the times with use of an electrocardiogram as a screening tool. If you are in the area where a cardiac arrest has occurred remember it is an electrical problem you want to start CPR. First thing is called 911. Then began cardiopulmonary resuscitation pushing on the chest and breathing for the person if possible. You want to make sure that if there's an AED in the area, that you use that if necessary. And, above all, remember, we want zero risk of cardiac arrest in our children or, you know, child athletes. My basic principles number one God is in charge. I am a physician of faith and I would believe very strongly that I would not be who I am or do what I'm able to do, but for God being in my life. Second principle is.
Speaker 2:I have no bad days I used to have bad days and I decided about 30 years ago that I'd had enough, so I figured out that a day was good or bad If I said it was good or bad, so I eliminated them.
Speaker 2:I now have good days and I have great days. Don't sweat the small stuff, and most stuff is small. I have learned that whenever something happens to me that I perceive as negative or bad, that most of the times it's not as big a deal as I think it is, and so I figured out to go slow and just not sweat a lot of the things and most of the things that, when I put them in perspective, they're not that big a deal. Forgiveness is therapy. I have also learned that when I perceive that someone has done or said something negative toward me, I forgive them immediately, that it does not matter who's right or wrong.
Speaker 2:It does not matter what the facts are, that automatic forgiveness is therapy and I have learned to practice that. And finally, everything is a relationship. Relationships are based on three things Mutual respect, mutual trust and good communication. If you have those three things, you have a good relationship. If you do not, you have work to do. These podcasts are available every week and you can subscribe to them. You go to wwwbusproutcom for slash 21003. That's wwwbusproutcom for slash 21003. And finally, be the change you want to see in the world. Thank you, have a wonderful day.
Speaker 1:Thanks for listening to the Healthy, wealthy and Wise podcast with Dr William Choctaw, mdjd. We hope you enjoyed this episode. In fact, if you found this episode helpful, you can support and subscribe to the podcast on your favorite podcast platform with the keywords Dr William Choctaw, and you'll find it very quickly. Also, subscribing helps ensure that you don't miss any future episodes. And then takes the next step of action and share it with your family, friends and or your coworkers. They'll be glad you did so. Until the next time, live your best possible life the best possible way. You've been listening to the Healthy, wealthy and Wise podcast with Dr William Choctaw, mdjd.
