Swimming With Sharks & Protecting Your Heart w/ Dr. Jacqueline Eubany

Episode Information

July 16, 2020

Electrophysiologist Dr. Jacqueline Eubany talks about her passion for women’s heart health, her work with the US navy, and her favorite places to go SCUBA diving.

Topics Include:

• How she started off medical school thinking she wanted to be an OB/GYN doctor and then transitioned after not liking it
• How she noticed that women had poorer outcomes than men after heart attacks and did research to find that cardiovascular disease kills more women than any other illness – one in three women
• Risk factors for heart attacks and how lifestyle changes including diet and exercise can decrease your risk up to 80%
• New developments in cardiology including smaller pacemakers
• Her work with the US Navy taking care of active duty military in San Diego, Guam, at the Bethesda Naval Hospital, and with the Marines in Camp Lejeune, North Carolina
• The importance of checking in with your doctor to see cholesterol levels and risk factors for heart attacks at any age
• What atrial fibrillation (AFib) is, new treatments and medications, and how to prevent a stroke
• How her TV and radio appearances have raised her profile and increased her credibility, even though that isn’t what she thinks should be valued in medicine
• What she learned while writing her book “Women and Heart Disease: The Real Story” and why it was so important for her to help improve outcomes for women
• How heart apps can be good in terms of giving reports that doctors can use but can also make people more anxious
• How Doctorpedia can help people by providing videos to help them learn about medical conditions that they wouldn’t retain in a doctor’s office visit
• How she loves SCUBA diving and has seen various marine life including sharks and sea lions

Highlights

• “I actually went to med school thinking I wanted to be an OB/GYN doctor because you know, you meet women who are doctors and a lot of the women I’ve met were OB/GYN doctors. So I just thought to myself, ‘oh, I want to do OB/GYN when I go to medical school,’ but I just did not like it at all and ended up not doing it.”
• “Why is it that we don’t recognize heart attacks in women? So I started doing research about this and I came to find out that cardiovascular disease kills more women than any other illness. It kills about one in three women, so about like every 80 seconds, a woman in the U.S. dies of cardiovascular disease.”
• “It’s not just a man’s disease. Women may have symptoms that are slightly different than men. A lot of times, women don’t recognize that they’re having it. A lot of times doctors don’t recognize that they’re having it. And most people just think of heart attacks as a man’s disease.”
• “You feel like you’re doing something for the country. I’m supporting the fleet, you know, supporting these guys that give up so much. They sacrifice so much for our freedom and to be able to take care of them when they came back was definitely a good thing for me overall.”
• “The most important thing in treatment of atrial fibrillation is preventing a stroke. So we have medications, blood thinners, that we give to patients to prevent them from strokes.”
• “I think with your doctors, you really need to make sure they have the board certification, they have the proper training and not because they’ve been on TV, but in our society we just put people on TV or who have a lot of a social following on a pedestal, which may not necessarily be good. But in my case it’s good because I do have the credentials and the backing.”
• “What was shocking to me was the fact that a lot of women are unaware of the statistics with women and heart disease. You know, the fact that it’s the number one killer, 1 in 3 women die from cardiovascular disease, and all of the symptoms – I was just shocked that women did not know that.”
• “If I have a patient who has some kind of heart ailment and I need to do a procedure on them. They come and they sit, and you talk to them for 30 minutes or what have you. Your patients probably only pick up about 10% of what you say because it’s all a lot of information for one visit. So I would see where they can go home and they can watch [videos on] the website, learn more, and then they can come back for another visit.”

Relevant Links

• Doctorpedia Spotlight Interview
• Dr. Eubany’s Book – Women and Heart Disease: The Real Story
• HeartAttackpedia
• AtrialFibrillationpedia

Episode Transcript

Daniel Lobell: (00:06)
Alright. I have Dr. Jacqueline Eubany on the line for the Doctorpedia show. How are you?

Dr. Jacqueline Eubany: (00:12)
I’m doing well! Thanks for having me on the show.

Daniel Lobell: (00:15)
Oh, we’re excited to have you. And I love to get the background of the doctors and kind of explore your past before we get into what you do and all the cool things in your specialty. So if you don’t mind, can you please tell the audience a little bit about yourself and maybe even starting in your childhood.

Dr. Jacqueline Eubany: (00:38)
Okay. So I actually was born in Nigeria but moved here when I was very young. I am one of four children by my mom and dad. I pretty much grew up in LA and I have a couple of other siblings that are physicians as well. But other than that, most of my life has really revolved around medicine.

Daniel Lobell: (01:08)
How old were you when you guys came over here from Nigeria?

Dr. Jacqueline Eubany: (01:12)
So I would say I was probably about maybe five years old.

Daniel Lobell: (01:16)
Do you remember anything from back then or is that before the memories?

Dr. Jacqueline Eubany: (01:21)
Yeah, no, I don’t remember anything per se, but I have been back on medical missions, so I’ve been in the country, but no, I don’t remember my childhood living there now.

Daniel Lobell: (01:32)
Do you still have family there?

Dr. Jacqueline Eubany: (01:36)
I do because my father is Nigerian, but my mother is actually from New York. So his side of the family, a lot of them are still there, but unfortunately I don’t know them.

Daniel Lobell: (01:48)
Did your father or mother do anything in the medical field as well?

Dr. Jacqueline Eubany: (01:54)
No. My father was actually a lawyer, so neither of them were in the medical profession but my dad really wanted us to become doctors. So there are a couple of us in the family that are doctors. So we had that push from our father.

Daniel Lobell: (02:09)
How old were you when you decided that it was interesting to you to go into medicine?

Dr. Jacqueline Eubany: (02:14)
It actually started out just in school, being very good at science and math and just really enjoying that and people are sort of pushing you in that direction. Being in that field and enjoying it, the path just kind of fell into place for me. I don’t think it was anything like that I consciously made a decision at a certain age and said, “this is what I’m going to do.” I think it just came naturally as I explored the field of sciences. Then the next step came naturally and the next step came actually because I think that I was going to get a PhD, but I ended up in medical school. So it was just whatever I found interesting. Exploring that and exploring that and that’s how I ended up where I am today.

Daniel Lobell: (03:04)
So when you were in medical school, at that point did you already know what you wanted to specialize in or did that sort of develop as you understood the field more?

Dr. Jacqueline Eubany: (03:12)
Yeah, that same thing also developed as I understood the field more. I actually went to med school thinking I wanted to be an OB/GYN doctor because you know, you meet women who are doctors and a lot of the women I’ve met were OB/GYN doctors. So I just thought to myself, “oh, I want to do OB/GYN when I go to medical school,” but I just did not like it at all and ended up not doing it.

Daniel Lobell: (03:36)
What didn’t you like about it?

Dr. Jacqueline Eubany: (03:39)
Well I liked [laughs] I don’t know if I can say this on air, because you need parental consent to listen to it–

Daniel Lobell: (03:50)
[Laughs] Right.

Dr. Jacqueline Eubany: (03:50)
I liked the delivery part, you know? But the gynecologic part, I did not like.

Daniel Lobell: (03:59)
Understood.

Dr. Jacqueline Eubany: (03:59)
We can leave that up to your imagination.

Daniel Lobell: (04:01)
But you did continue to pursue a medical field with a specific interest in women. From what I understand, you work in cardiovascular health, is that correct?

Dr. Jacqueline Eubany: (04:13)
Absolutely. Yes. Yes. Right. I enjoy taking care of women.

Daniel Lobell: (04:17)
What I heard is that you have a particular interest in women’s heart health. Can you explain to the listeners how that differs maybe from men’s heart health and are there any specific issues that patients should be aware of?

Dr. Jacqueline Eubany: (04:29)
Well, yeah. As I progressed in my studies of cardiology, I started to notice that my female patients who came into the hospital and ended up having a heart attack had poorer outcomes – they didn’t do as well – as men who came in with heart attack. And I just was wondering: why was that? Why is it that we don’t recognize heart attacks in women? So I started doing research about this and I came to find out that cardiovascular disease kills more women than any other illness. It kills about one in three women, so about like every 80 seconds, a woman in the U.S. dies of cardiovascular disease.

Daniel Lobell: (05:18)
Wow.

Dr. Jacqueline Eubany: (05:18)
It’s not just a man’s disease. Women may have symptoms that are slightly different than men. A lot of times, women don’t recognize that they’re having it. A lot of times doctors don’t recognize that they’re having it. And most people just think of heart attacks as a man’s disease.

Daniel Lobell: (05:33)
Down with the heart attack patriarchy! Down with the heart attack patriarchy! [Laughs].

Dr. Jacqueline Eubany: (05:36)
[Laughs] That’s right! That’s right, it’s not just a man’s disease. So I just developed this passion for educating women about their heart health and the fact that it is the number one killer. You really should be aware of it. It doesn’t matter what age you are and there are things that you can do to decrease your risk of having it. So that’s where my passion is and that’s what I’ve been doing.

Daniel Lobell: (06:02)
I always felt it was unfair that they called it a heart attack because it’s really a heart surrender, isn’t it?

Dr. Jacqueline Eubany: (06:10)
[Laughs] Well, I guess you could say that, you know, when the heart stops, it just surrenders.

Daniel Lobell: (06:14)
The heart’s being attacked by the body. It’s not the other way around. [Laughs] Right?

Dr. Jacqueline Eubany: (06:20)
Yeah! I guess you’re right about that. [Laughs]

Daniel Lobell: (06:24)
What are some of the things let’s break it down into men and women, what are some of the signs that people should be aware of when it comes to potentially having a heart attack? And after that, I’m going to foreshadow, or I’ll just ask you the next question right now: what should people be doing to prevent that from happening?

Dr. Jacqueline Eubany: (06:48)
So we know that the classic symptoms of a heart attack that you read about in textbooks and that we all know about is the pressure pain in the left side of the chest that people describe like an elephant sitting on your chest that can radiate down your arm. And you’ve even probably seen pictures on the internet of men clutching the left side of their chests to indicate that they’re having a heart attack. But research shows that only about 43% of women who are having a heart attack have chest pains as your symptoms. Some women can have symptoms that are non-specific, like nausea, vomiting, fatigue, tired, not sleeping very well – so very nonspecific signs, which makes it sometimes difficult to make the diagnosis of a heart attack. So what I educate my female patients about is knowing your risk factors for a heart attack. So if you know your risk factors for a heart attack and if you have any of these nonspecific types of complaints, you really should seek medical attention to make sure that you are not having a heart attack.

Daniel Lobell: (07:58)
Yeah. And let’s talk about the second part of the question. What can people do to prevent it?

Dr. Jacqueline Eubany: (08:07)
Right. So despite all of these statistics about it being the number one killer, we know that you actually can decrease your risk for heart attack by up to 80% by just implementing some simple lifestyle changes. I know people say, “oh, not the diet again,” but these are really effective in decreasing your risk for heart attacks. And some of these lifestyle changes include increasing your physical activities. You know, the American Heart Association recommends just 150 minutes a week of moderate physical activity or 75 minutes a week of vigorous activity. You know, don’t smoke if you smoke. We say moderate alcohol intake. For women, that’s just a glass of wine – a 5 ounce glass of wine.

Daniel Lobell: (08:54)
That’s too much or that’s the allowed amount?

Dr. Jacqueline Eubany: (08:56)
That’s the allowed amount, that’s the limit. Five ounces a day. One bottle of beer or a 12 ounce bottle of beer. Or if you drink hard liquor then we say one ounce of that. You want to lose weight if you’re overweight. You want to eat a healthy diet, diets that are rich in fruits and vegetables, lower in saturated fats and cholesterol and trans fats, those kinds of things.

Daniel Lobell: (09:23)
I read Dr. Michael Greger’s book, “How Not To Die.” Did you ever read that one?

Dr. Jacqueline Eubany: (09:29)
No, I did not. What was he talking about?

Daniel Lobell: (09:31)
Well, just what you’re saying. He was saying to keep a mostly plant-based diet.

Dr. Jacqueline Eubany: (09:37)
Absolutely.

Daniel Lobell: (09:37)
He said by doing that, it’s the only diet that’s been proven to reverse the effects of heart disease.

Dr. Jacqueline Eubany: (09:45)
What he’s saying is definitely true and it’s been echoed in the literature. So those things, the healthy eating, exercising, quitting the bad habits of smoking, cutting back on alcohol if you drink a lot, those kinds of things can really decrease your risk of having a heart attack by up to 80%.

Daniel Lobell: (10:06)
Do you keep a plant based diet?

Dr. Jacqueline Eubany: (10:09)
I do. Well, I mean I try to. I do eat a little bit of a fish. I like salmon. Salmon is good for you because it has the natural omega fatty acids. I eat mostly plant, but I do have some salmon so it’s not 100% plant-based. But I definitely don’t eat red meat and mostly vegetables, yes.

Daniel Lobell: (10:28)
So the diet really is a big key to this, huh?

Dr. Jacqueline Eubany: (10:32)
Absolutely. Diet and exercise is definitely the key to it.

Daniel Lobell: (10:36)
Are there specific kinds of exercise that are best for the heart and some that maybe are not?

Dr. Jacqueline Eubany: (10:41)
No. We want you to do any kind of physical activity that increases your heart rate for any specific amount of time. So some kind aerobic activity, whether it be walking, jogging – anything that just increases your heart rate for 30 minutes a day or something like that. So it doesn’t matter what you do, it doesn’t matter how aggressively or how physically rigorous you do it. We always say start at whatever level you are and slowly increase it. As long as you’re doing something every day for 30 minutes a day.

Daniel Lobell: (11:13)
Yeah. Are there any new developments in technology that are on the horizon for cardiology that excites you?

Dr. Jacqueline Eubany: (11:19)
Well, in my field – so not only am I a cardiologist, I have a specialty in what we call electrophysiology, which is the heart rhythm. I deal with abnormal heart rhythms. I don’t know if you’ve heard of pacemakers.

Daniel Lobell: (11:33)
Yeah.

Dr. Jacqueline Eubany: (11:33)
Pacemakers are these devices that we put into the heart to regulate your heart rate, especially in people who don’t have a heart rate, so they need this device to help their heart beat. So we have these pacemakers now that are about the size of your pinky – very small and they go directly into the heart. So the old pacemakers have leads and they have a can that can be intrusive sometimes. So the newer development is a small tiny little pacemaker that can go inside your heart and people don’t even know that you have a pacemaker. I think that’s very exciting.

Daniel Lobell (12:13)
Yeah. Do you think we’ll get to a point where everybody gets a pacemaker, whether they have a healthy heart or not? Just as a backup?

Dr. Jacqueline Eubany: (12:23)
Not everyone, but I think the longer you live, though, you probably will end up with a pacemaker. I’m talking if you’re like in your nineties and older because over time, sometimes the conduction system of the heart can fail as you get older. So we see that more in elderly people.

Daniel Lobell: (12:44)
I think when I’m old, I want to start a band like Danny and the Pacemakers, you know? That sounds like a good name for an geriatric band. Right?

Dr. Jacqueline Eubany: (12:58)
[Laughs] Yes it does.

Daniel Lobell: (12:58)
We play all the heart rhythms and blues. You know?

Dr. Jacqueline Eubany: (13:02)
There you go. Keep the beat! Because that’s what the pacemaker does – it keeps the heart beating, so you’ve got to keep the beat going.

Daniel Lobell: (13:08)
Keep the beat. Yeah, we’re always on beat. [Laughs] But I wanted to ask you, I know that you worked as a physician in the U S Navy, which is really cool. Your clinic was responsible for the healthcare of active duty military. Do you have any interesting stories? Was that a challenging role both physically and emotionally for you?

Dr. Jacqueline Eubany: (13:35)
Yeah, I mean it was good. You feel like you’re doing something for the country. I’m supporting the fleet, you know, supporting these guys that give up so much. They sacrifice so much for our freedom and to be able to take care of them when they came back was definitely a good thing for me overall. But again, it can be emotionally draining because when they come back, you hear all of the stories about what life was like over there, which I’ll tell you is not very good. And you witness them going through the post-traumatic stress disorder. You witnessed their families and everything that they have to go through when this person comes back and tries to fit back into society. That can be emotionally draining sometimes. But overall I thought it was good. I felt like I was doing something good for the country. I really felt honored to take care of these guys who just sacrificed everything for this country.

Daniel Lobell: (14:43)
Where did you go?

Dr. Jacqueline Eubany: (14:44)
I didn’t go to Afghanistan or Iraq because I was in the military at the height of those wars. But I was stationed in San Diego, well I started out in San Diego, then I ended up in Guam, this small little Island in the Pacific. I’m sure you’ve heard of it. I was there for a few years. And then I was at the Bethesda Naval hospital, which was the president’s hospital. At that time it was George W. Bush. And then I ended up with the Marines in Camp Lejeune, which was in North Carolina. So I was in for a total of 12 years. It was a good time. It was the best years of my life.

Daniel Lobell: (15:30)
Yeah. It’s fascinating to me. I wonder, if you’re in active duty and you know, somebody’s shooting at you or something, and you go “Oh my G-d, I’m going to have a heart attack. This is so stressful!” Then they go, “well, we’ve got a heart attack doctor right here. You know, I wonder if that is consoling to people, you know?”

Dr. Jacqueline Eubany: (15:49)
[Laughs] Well, you know, stress can cause a heart attack. And a lot of times that’s why they end up seeing me because it’s very stressful and you get chest pains. That was definitely the catalyst for seeing a lot of these patients in my clinic. It is a very stressful situation being in war, I’ll tell you,

Daniel Lobell: (16:10)
I should’ve had you around in my childhood. Every time we did anything wrong, my dad always said, “you’re going to give me a heart attack!” And I would say, okay, well here’s Dr. Eubany. She can take care of it.

Dr. Jacqueline Eubany: (16:22)
[Laughs] That’s right. I will take care of the heart attack. That’s correct.

Daniel Lobell: (16:25)
Do strokes usually precede heart attacks?

Dr. Jacqueline Eubany: (16:31)
They don’t precede heart attacks, per se. But I guess the etiology, the cause, is very similar. Whereas the heart attack happens because you have blockages in the arteries that supply the heart with the oxygen and the nutrients it needs to function normally, a stroke is also a blockage in the artery that supplies the brain with the oxygen and nutrients that it needs. So if it doesn’t get that, that part of the brain dies and that’s the definition of a stroke. So they are caused by the same kind of thing, whether it be blood clots or it could be from high cholesterol or high blood pressure and those kinds of things.

Daniel Lobell: (17:14)
Is there any way that somebody who seems or feels like they might be in good health but wants to be certain, can check their arteries to see if they’re clogged?

Dr. Jacqueline Eubany: (17:25)
Well, if you’re asymptomatic, I always recommend that you just go see your primary care doctor. What we do is we try to determine what your risk for heart disease is and we do this by a series of blood tests – checking to see what your cholesterol is, checking to see if you’re diabetic, sitting there and talking to you in detail about your family for heart disease, checking your blood pressure and all those things. And when we get your full picture, then we can determine what your risk for stroke or heart attack is and then we can proceed, depending on what we find. We can either be aggressive or we could just tell you to continue with your lifestyle changes, but we don’t check the arteries per se until you’re having symptoms. Because you can have blockages of up to 30-40% and actually be fine. You don’t really start getting symptoms until the blockage reaches about 70%, because that’s when the heart cannot compensate any longer. The amount of oxygen that you need is definitely not enough. So at that point is when you have symptoms and you show up. So anytime before that you really don’t have any symptoms, so we say to implement these lifestyle changes because it prevents that plaque, that 30% plaque, from progressing to 70% or something like that.

Daniel Lobell: (18:54)
How quickly can it progress from 30 to 70%? Can you have 30% one month and 70% the next?

Dr. Jacqueline Eubany: (19:03)
I don’t think we know for sure how quickly it progresses. I guess it really depends from one person to another. But that 30% plaque can sometimes rupture as a result of whatever it could be “unstable plaque”, it can rupture and then you can have a blood clot that occludes that artery right away. And I guess you can call that quick progression. That’s when you have people that drop dead because you have this thing that just happens right away. But I would say that it progresses over many years, because it starts off probably now when you’re young. And that’s why we see heart attacks in older people because it’s taken sometimes that long to progress.

Daniel Lobell: (19:44)
How young do people come into you with heart attacks these days?

Dr. Jacqueline Eubany: (19:51)
I’ve seen young people, I’ve seen people in their 30s, 20s. Those tend to be people who have a family history of it. So that’s why it’s very important to see your doctor and get a risk assessment. Because sometimes you can have a family predisposition to it and if your doctor knows and they’re more aggressive with prevention in you because you’d be considered high risk for a heart attack compared to somebody else. So we see them at all ages. The younger people, sometimes it’s genetic, sometimes it’s because they’re behaving badly, like they’re using drugs or something that they’re not supposed to be doing and things like that. But we do see it in younger people,

Daniel Lobell: (20:40)
We need an app. We need an app for people of my generation. It’s like a check your arteries app, you know, just click on it and it tells you what percent they’re clogged.

Dr. Jacqueline Eubany: (20:51)
[Laughs].

Daniel Lobell: (20:51)
I wonder if we’ll ever get there. I wonder if we’ll get to the point where you can actually tell–

Dr. Jacqueline Eubany: (20:57)
We might! With all of this progression we have in technology these days, you never know. I’m telling you, you just never know.

Daniel Lobell: (21:04)
You get an alert on your Apple Watch. It’s like blinking red. It’s like “go for a walk right now.” [Laughs]

Dr. Jacqueline Eubany: (21:13)
[Laughs] That would be funny, but possible! Possible.

Daniel Lobell: (21:16)
I have a friend who has AFib, I think is what it’s called. An irregular heartbeat. Is that, am I saying it right? Is it an AFib?

Dr. Jacqueline Eubany: (21:26)
Yeah. Atrial fibrillation. That’s correct.

Daniel Lobell: (21:28)
What is that? I never understood. Maybe it would be interesting to the listeners to know as well.

Dr. Jacqueline Eubany: (21:33)
Yeah. So atrial fibrillation happens when the top chamber – so you have four chambers of your heart. The top is the atria. So you have the right and the left atrium. And the bottom is a ventricle. You have a left and a right ventricle. So what happens is that the top chamber contracts and pushes blood to the ventricle and then the ventricle contracts and pushes blood to the rest of the body. So atrial fibrillation happens in the top team of the heart, in the atrium. So instead of contracting in a synchronized manner, it’s just really fibrillating. So it’s fibrillating and blood moves but doesn’t really move that much. Sometimes you have static blood or blood just sitting in the atrium because it’s not squeezing, it’s just just kind of shaking. I liken it to like a bag of worms. They’re jiggling and shaking and erratic and irregular. So that’s what it is. And with that kind of irregularity, it can make your heart rate fast. And with a fast heart rate, you have a lot of symptoms that people sometimes associate with AFib, like shortness of breath, chest pain. And the one important thing about atrial fibrillation or one of the biggest risks of atrial fibrillation is the risk of stroke. You’re at higher risk for stroke when you have atrial fibrillation because, like I mentioned earlier, when the heart’s not squeezing all the blood uniformly out, it’s just like a bag of worms. So you kind of have blood hanging out in the atrium sometimes and you know what happens in blood, it’s just sitting there? It forms a blood clot.

Daniel Lobell: (23:11)
It’s lazy blood.

Dr. Jacqueline Eubany: (23:11)
Yeah, lazy blood! And when it eventually moves, it goes straight to the brain and it blocks the arteries in the brain. And that’s how you develop a stroke from atrial fibrillation.

Daniel Lobell: (23:23)
So what kinds of things are on the horizon to help people like that?

Dr. Jacqueline Eubany: (23:27)
There are a few things that we do. One, the most important thing in treatment of atrial fibrillation is preventing a stroke. So we have medications, blood thinners, that we give to patients to prevent them from strokes. There’s actually a procedure now – not everyone qualifies for this procedure, you have to not be able to tolerate a blood thinner – but there’s a procedure where there’s a certain part of your atrium called your left atrial appendage. We deploy an occluder to just block off that little appendage because that appendage is where most of the blood clots form. So when you close that appendage off, then your risk for stroke now becomes back to normal without having to take medications. But not everybody qualifies for this procedure. It’s one of the newer procedures that’s that we’re doing these days for atrial fibrillation.

Daniel Lobell: (24:32)
I always thought it was fascinating how you have these four quadrants of the heart. Everybody always says, “I love you with all my heart,” but you never hear anybody say “I love you with three quarters, not the left ventricle.”

Dr. Jacqueline Eubany: (24:42)
[Laughs] That’s right. “With just the one chamber, not the other three chambers, but just that one chamber.”

Daniel Lobell: (24:49)
But especially if you qualify for that surgery and one of them is closed off, you can no longer love anybody with all your heart.

Dr. Jacqueline Eubany: (24:59)
Except that part, right.

Daniel Lobell: (24:59)
“I love you with all of my heart except this one part that I had closed off because I qualified for an AFib procedure, no longer able to do that one for you.”

Dr. Jacqueline Eubany: (25:11)
[Laughs] You are funny.

Daniel Lobell: (25:15)

[Laughs] You have a huge online presence, having appeared on a variety of news media. I know that you were an expert cardiologist featured on the TV show that “The Doctors” and the radio show “Big Blend Radio.” So how does your public profile impact your relationship with your patients and does it instill in them more confidence in your work?

Dr. Jacqueline Eubany: (25:37)
Yeah, I mean, I hate to say this, but I actually think it does. In this era that we live in where social media just basically rules everything and it’s all about your likes and your following and all that stuff. It also translates into medicine, which is really shouldn’t. But yeah, once you’re on social media or on television, your credibility goes up higher, which I don’t necessarily agree with. I think with your doctors, you really need to make sure they have the board certification, they have the proper training and not because they’ve been on TV, but in our society we just put people on TV or who have a lot of a social following on a pedestal, which may not necessarily be good. But in my case it’s good because I do have the credentials and the backing. So being on social media and gaining that credibility as a result of being on TV is a good thing.

Daniel Lobell: (26:41)
Yeah. What do you think, uh, the medium of video is doing with regards to helping patients? Do you think it helps more? Does it hurt more? Do you think it’s important for doctors to be savvy with their online presence?

Dr. Jacqueline Eubany: (26:58)
I do. I do. Because a lot of people are on social media these days and you can reach a lot of people and you can definitely meet your patients if you’re on social media. But if you don’t, somebody else is going to get to them and you just want to make sure your patients are getting the best information, proper information. So I think it’s a good idea to be on social media.

Daniel Lobell: (27:24)
Yeah. You can go to the wrong website and read something based on a symptom you have and get so anxious that you actually do have a heart attack when you didn’t need to in the first place.

Dr. Jacqueline Eubany: (27:34)
Absolutely! Absolutely. So it’s very important to know what the source of the website is that you’re looking at, but if it’s a good, reputable site with good, reputable physicians like a Doctorpedia site, then it’s a trustworthy site and patients can trust the information that they gain from these websites.

Daniel Lobell: (28:00)
Yeah. That’s what’s so important about Doctorpedia is that they’re using great doctors like yourself who have credibility and have experience in the field, for people like me who might be freaking out and want to go online and get an answer.

Dr. Jacqueline Eubany: (28:16)
Yeah, that’s correct. Yeah. You have well trusted doctors, doctors who have been vetted and have good credentials are on this website and they’re disseminating the right information. It is definitely a good idea.

Daniel Lobell: (28:31)
I myself am an overweight person and I’ve been trying and successfully losing weight steadily over the last year.

Dr. Jacqueline Eubany: (28:39)
Good for you!

Daniel Lobell: (28:39)
Thank you. I always wonder, I’ve heard things, you hear all kinds of misinformation but sometimes it’s real information. Is there a concern about weight loss? Like could you be losing weight too quickly? Do you need to monitor it? Does it affect the heart in some way?

Dr. Jacqueline Eubany: (28:56)
If you lose too much weight, then it could be a problem. But I don’t think the rate is a problem. If you can get down to what we consider a normal BMI, if you’re in the normal range, then that’s okay. So heart health, you actually look at your waist circumference. We always say that if your waist circumference is greater than 30 or something like that, then your risk is high. So you want to exercise and get that down. There’s just something about abdominal fat that increases your risk. If you can get that lower, your risk goes down. But I don’t think the rate is an issue. You don’t want to lose too much weight, because that could be detrimental. You don’t want to be bulimic or anorexic or what have you. But losing weight is always good because it makes all of your numbers better. It makes your blood pressure better. If you have a gene for diabetes, if you lose weight, you may not express that gene. It definitely lowers your cholesterol and overall it’s a good thing.

Daniel Lobell: (30:05)
Is there a certain way that you recommend to your patients that they go about losing weight? Is there one way that works better than another that you’ve found?

Dr. Jacqueline Eubany: (30:14)
No, I mean I’d much rather they do it naturally. When I say naturally, I mean eating healthy, exercising. You understand probably that weight loss is not something that you do overnight, it requires a lifestyle change that you have to adopt for a long period of time. It’s not going to happen tomorrow, because when you do those drastic things, you inevitably gain it all back. But it should be a lifestyle change, which would take a while. But I prefer the lifestyle changes than doing the more drastic things that are “not the natural way” of losing weight.

Daniel Lobell: (30:57)
Right. Well, I’m doing it the natural way. Hopefully other people are too. [Laughs]

Dr. Jacqueline Eubany: (31:04)
Good! It’s a long journey, it’s not going to happen overnight. It’s a long journey. Take it one day at a time. And once you adapt to these new lifestyle changes, then it becomes easier and easier to maintain that.

Daniel Lobell: (31:18)
Yeah. Yeah. It’s the new habit forming. That’s the hardest part.

Dr. Jacqueline Eubany: (31:28)
Exactly.

Daniel Lobell: (31:28)
You wrote a book called “Women and Heart Disease: The Real Story.” And I know in this book you explain some of the things you talked about already in this interview about heart disease and how it kills, I think you said three times the amount of women–

Dr. Jacqueline Eubany: (31:42)
–six times more women than breast cancer.

Daniel Lobell: (31:44)
Yeah. Were there any shocking discoveries that you made along the journey of writing this book and anything interesting that you found that maybe you would share with the listeners here?

Dr. Jacqueline Eubany: (31:57)
What was shocking to me was the fact that a lot of women are unaware of the statistics with women and heart disease. You know, the fact that it’s the number one killer, 1 in 3 women die from cardiovascular disease, and all of the symptoms – I was just shocked that women did not know that. So that’s one of the reasons why I did the book because, like I said, this first started out with me working as I was training as a cardiologist. I noticed that the women who ended up having a heart attack during their hospitalization didn’t do as well. They didn’t heal 100% like the men. The men came in, they were diagnosed the next day, they got their stents, they were out the door. The women, they came in, nobody knew they were having a heart attack. On day three, “oh my gosh, she’s having a heart attack!” As a result, she doesn’t heal very well. And she ends up just sickly with a bad heart, congestive heart failure and all that kind of stuff. So I started noticing this and then that’s when I started my research and then I started getting involved in the community, like going to churches and talking about heart disease. So when I would go out and talk to people about it, I realized that women had no idea. They just had no idea. That was very shocking to me because I think men know more about heart attacks than women. And then when I started talking to them about it, I realized that I really have to start from the basics. Like, they don’t even understand, you just need to go down to the basics.

Daniel Lobell: (33:35)
What are the basics?

Dr. Jacqueline Eubany: (33:36)
Just the association of blood pressure and diabetes, exercise and how that improves your cardiovascular health. Or when your family member is having heart attacks, you don’t understand that there could be a family connection and that it could happen to you as well. So just some of those things, that just the connection isn’t there. Like “Oh, my mother had a stroke but that has nothing to do with me.” “Oh, a heart attack? I won’t have a heart attack, I’m a woman.” You know, those kinds of just not understanding the connection between a healthy lifestyle – I’m going to just say healthy lifestyle, clean living – and your health. Just not even understanding that there’s a connection there and just having to explain just those basic things. So that’s what started me on the journey of writing this book because I was like, “we need to get these women up to speed, at least understand the basics and then we can move forward. When we’re all on at least one step, when we’re all on the same page, then we can learn more.

Daniel Lobell: (34:46)
Right. I mean, ever since I started eating healthy, it’s shocking to me, just the commercials and just seeing what people are eating and drinking and the lack of movement. And I was part of it! And now that I’m moving away from it, it’s just like, “whoa.” I was caught up in this whole thing, this whole unhealthy American lifestyle. I don’t know how or when it got so bad, but it’s really shockingly bad – just driving around my neighborhood, the billboards – one after another – promote bad health.

Dr. Jacqueline Eubany: (35:25)
Yeah, absolutely. Absolutely. So kudos to you for making these lifestyle changes. You will be all the better for it.

Daniel Lobell: (35:35)
I hope people will read your book and out your stuff on Doctorpedia and follow suit. I came up with my idea for the app that checks [laughs] how blocked your arteries are, but there are actually some apps out there that people can download and check their heart rhythms, blood pressure and so on. Do you find that these apps actually make patients more paranoid about their heart health or are they helpful?

Dr. Jacqueline Eubany: (36:01)
It can be helpful sometimes. It can be helpful in patients who for instance have – maybe they have high blood pressure and you want them to monitor their blood pressures at home on a regular basis so that as a physician, I know how to adjust their medications. So they bring me these charts of what their blood pressure has been doing over the past few weeks or months and that’s an app of them recording it and downloading it, so it could be helpful in that case. And then on the other hand though, for those Apple Watches that can monitor your heart rhythm and can sometimes tell you if you have an irregular heart rhythm that could possibly be atrial fibrillation. You have a lot of people who are anxious and come to see you, it just generates more doctors visits.

Daniel Lobell: (37:04)
[Laughs] That’s a good thing, at least on your end. Right? You’ve got people coming in.

Dr. Jacqueline Eubany: (37:09)
[Laughs] Yeah.

Daniel Lobell: (37:09)
How can Doctorpedia assist the online health space?

Dr. Jacqueline Eubany: (37:14)
I think just having good information about health conditions by reputable doctors is a good idea. Like for instance, if I have a patient who has some kind of heart ailment and I need to do a procedure on them. They come and they sit, and you talk to them for 30 minutes or what have you. Your patients probably only pick up about 10% of what you say because it’s all a lot of information for one visit. So I would see where they can go home and they can watch [videos on] the website, learn more, and then they can come back for another visit. This way, the second time around they’ve heard you, they’ve heard Doctorpedia and they have more questions, more informed questions because they understand a little bit more. So it can help educate patients when they leave the doctor’s office, because a lot of times, like I said, in a doctor’s office, you don’t have very long to be with the patient, you just blurt out all of this information to them, “risk factors, blah, blah, blah, see you later.” And it’s just a lot for them to digest. So going to a website where things are explained in a lot of detail in layman’s terms by doctors–

Daniel Lobell: (38:41)
–hey, those are my kind of terms! [Laughs]

Dr. Jacqueline Eubany: (38:41)
Right, exactly! So I think that’s a good idea.

Daniel Lobell: (38:43)
Yeah, definitely. So I know that you like to scuba dive and horseback ride and you bike, would you recommend these activities to patients and what is the best place that you’ve visited while you’ve been scuba diving?

Dr. Jacqueline Eubany: (38:57)
Yeah, I think exercising or doing certain activities is great. But I would caution you that if you haven’t exercised in a long time, I don’t want you to just get up and run a marathon. You always want to start slow and build up. Build up because you don’t want anything drastic happening. But in terms of scuba diving, one of my favorite places that I went scuba diving was in the Seychelles – a small little Island in the Indian Ocean, just off the coast of Africa. I thought that was just wonderful.

Dr. Jacqueline Eubany: (39:29)
What’s the coolest thing you’ve seen while you’re down there? In terms of marine life or coral – I don’t know. What can you report back to us? [Laughs]

Dr. Jacqueline Eubany: (39:44)
I really like all of marine life. I did see a shark once. Not one of those great whites–

Daniel Lobell: (39:52)
–the “not as great white.” The mediocre white shark. [Laughs]

Dr. Jacqueline Eubany: (39:57)
[Laughs] Exactly. The mediocre white sharks, the ones that don’t attack humans. So I’ve seen sharks, i’ve seen sea anemones, and I’ve seen sea lions and all different kinds of little critters, there. It’s just beautiful underwater, very relaxing. It’s just a good time.

Daniel Lobell: (40:17)
Yeah. I remember when I was younger, I got to do a little bit of scuba diving. I worked in an aquarium and they let me go in to clean the shark tank. I guess, “let me” – nobody else wanted to do it. [Laughs] I got to go and it was kind of thrilling. You get excited when they go by.

Dr. Jacqueline Eubany: (40:37)
Oh my goodness. Wow. That sounds very exciting.

Daniel Lobell: (40:42)
Yeah. But that sounds cool – off the coast of Africa. That sounds like the place to go.

Dr. Jacqueline Eubany: (40:49)
Yeah, it was exciting. Yeah.

Dr. Jacqueline Eubany: (40:52)
So I ask every doctor to round off the interview, to please share with me, share with the audience what you do to stay healthy.

Dr. Jacqueline Eubany: (41:01)
What do I do to stay healthy? Well, I exercise, I try to go to the gym. I try three days a week. I have a busy schedule, but I really try to go in three days a week, to do some kind of aerobic activity for at least 30 minutes a day. I try to eat healthy and pick healthy choices. You have to pack a meal at least three to four times a day because sometimes when you have a busy schedule, it’s very easy to grab the wrong thing and eat it. So what I generally do is I pack my lunch. I cut up apples in the morning and carrots and tomatoes. I have those as snacks so that if I get hungry randomly, I’m not reaching for the candy bar that’s everywhere in the nursing station and things like that. So I try to pack a healthy lunch, which definitely helps. I don’t drink that much alcohol. I love my wine, I will tell you that. So I try to minimize that to at least one glass.

Daniel Lobell: (42:11)
I’ve heard the rumor that red wine helps your heart. Is it true or is it an old wives tale?

Dr. Jacqueline Eubany: (42:16)
Well, it is true. Red wine can increase what we call good cholesterol, which is good for your heart. But if you drink too much of it, it can be detrimental as well. So that’s why the limit is five ounces. So you can see some hard benefits without the detriment of too much alcohol, because a lot of alcohol can be toxic to not just your heart but to every organ system in your body as well.

Daniel Lobell: (42:47)
How about whiskey? Is that good? [Laughs]

Dr. Jacqueline Eubany: (42:54)
[Laughs] Yeah, why don’t you drink the whole bottle? No! Again – everything in moderation. We say when you are going to use hard liquor, we say one shot, one ounce. One ounce a day would be okay.

Daniel Lobell: (43:09)
Alright. So just to run down it: 30 minutes of exercise that raises your heart rate a day, pack healthy snacks, drink a glass of wine but not too much, and that’s basically the formula, huh?

Dr. Jacqueline Eubany: (43:25)
That’s correct!

Daniel Lobell: (43:28)
Sounds good. And then jump in the water every now and then when you get the chance. It sounds like a pretty good life.

Dr. Jacqueline Eubany: (43:38)
That’s glamorizing my life, but sure! [Laughs]

Daniel Lobell: (43:42)
[Laughs] Sounds good. I mean, you’re saving people’s lives. You’re jumping in with sharks. I don’t know about the vegetable cutting up, if that’s so glamorous, but it seems like it’s a good choice. [Laughs]

Dr. Jacqueline Eubany: (43:54)
That’s right.

Daniel Lobell: (43:56)
Thank you so much for doing the show. Is there anything you want to add before we wrap up?

Dr. Jacqueline Eubany: (44:01)
I would say, again: heart disease is the number one killer of women. If you’re a woman out there, you should make sure you see your primary care doctor so that you can get stratified or you can have a risk stratification to determine what your risk for heart disease is and you can be treated accordingly based on what’s found.

Daniel Lobell: (44:24)
Thank you. Thanks for doing this.

Dr. Jacqueline Eubany: (44:25)
Thank you. You have a wonderful day.

Daniel Lobell: (44:28)
You too. Thanks so much.