0:04

Eight oh six thirteen ten WIBA in full scope with doctor Nicole Hemkiss, Wisconsin's

0:10

direct care doctor. Of course. Doctor Hamkins comes to us from Advocate MD,

0:14

a direct primary care practice with two offices here in Madison, soon to

0:19

be a third writ in Fitchburg. Also another location in Rock County and Janesville

0:23

at ten twenty one Mineral Point Avenue West Side, location in Middleton Eastside and

0:28

Madison on Farroks Drive mentioned Farrooalks Avenue. Excuse me mention the Janesville location that's

0:33

on Mineral Point Avenue in the newest location soon to be in Fitchburg at thirty

0:38

two twenty Sein Road that's going to be opening up scheduled to open up later

0:43

this month. The website I mentioned ADVOCATESDPC dot com. Great website and resource

0:48

to learn more about Advocate MD and the telephone number to make an appointment and

0:51

become a member at Advocate MD six oh eight two six eight sixty two eleven.

0:55

At six oh eight two six eight sixty two eleven, Doctor hamkis how

0:59

you doing this morning? I'm doing well, Sean, how are you?

1:02

I'm doing really really, I'm looking out the window and I'm thinking goodness,

1:06

it's going to be about a perfect day ahead, and let's really quick talk,

1:10

you know, and getting out and enjoying enjoying life and spending time doing

1:14

fun things. I know. One of the cool things you've been sharing on

1:18

your Advocate MD facebook page is some kind of lifestyle stuff and a little bit

1:23

about some of the doctors at Advocate MD what you guys do for recreation and

1:26

exercise, and it kind of brings us to lifestyle medicine. And this is

1:32

something that I don't know that a lot of doctors are talking with patients about,

1:36

but it's a very important part of medicine, isn't it. Doctor, Yes, you know. So I think we think of primary care, and

1:44

so our practice is a direct primary care clinic. So we're all family medicine

1:48

doctors. And I like to describe primary care as encompassing four categories. So

1:53

you have preventive care, which is our well examed, our screenings, and

1:57

this lifestyle medicine that we'll talk about is part of that. Then you have

2:01

chronic disease management. So if you take medication for your blood pressure or you

2:07

know, you have high cholesterol, you have issues with your thyroid, you

2:10

have joint pain or these things that we follow over time and see patients for

2:15

and help them manage. And then you have urgent care, so you have

2:19

a cough, a sprained ankle, your baby is running a fever, you

2:23

know, all of these kind of more acute things. And then lastly last

2:27

category is in office procedures, So we've talked about in our practice we try

2:31

to offer a range of things that we can do in the office rather than

2:36

having to refer you to a specialist. So with things like dermatologic procedures,

2:40

removing moles, freezing things, gynecologic procedures, orthopedic procedures like joint injections,

2:46

trigger point injections, and prolotherapy that doctor Balen does. So those are the

2:52

four categories, and the first category that prevents medicine is where we would include

2:57

this lifestyle medicine dog this morning with doctor Nicole Hempkiss of Advocate, MD,

3:00

the website ADVOCATESDPC dot com. That's Advocates DPC dot com, delfa, I'm

3:06

going to make an appointment to become a member at Advocate MD. Six'h eight

3:09

two six eight sixty two eleven. That's six'sh eight two six eight sixty

3:14

two eleven. So kind of breaking down those four categories, let's start off

3:16

talking about nutrition. Nutrition is obviously vital, and I used to always hear

3:23

you are what you eat, and that is actually there is truth to that, isn't there? Doctor? You know, I always tell patients that,

3:30

I especially patients that come to me that are losing maybe you know, wanting

3:32

to lose weight, is that it's about ninety to ninety five percent of losing

3:38

weight is what you put into your mouth, and then the other five to ten percent is activity. They're both Activity is important for many reasons. Part

3:46

of it is, you know, maintaining a healthy weight and losing weight, but we'll talk more about that. But the nutrition component is so critical.

3:53

So you can lose weight or maintain a healthy weight with not doing a lot

3:58

of exercise if you maintain a very healthy diet. And I, you know,

4:02

discuss nutrition with patients in the way that I think there's three components of

4:08

it. What you eat right, Like if if what you're eating is good

4:12

or bad, how much of that thing you eat right? So you can

4:15

eat a little bit of the bad stuff and a lot of the good stuff. And then what time of day you eat those things. You know,

4:24

people have probably heard a lot about, you know, intermittent fasting. That's

4:27

something that I discussed with patients, but I do really talk in detail with

4:32

them about what they eat on a daily basis. You know, how much

4:34

red meat they're eating, how much dairy they're eating, fruits, you know,

4:39

fruits and vegetables and whole grains, which I for most people, they

4:43

should be eating more of those things, you know, a very like high

4:46

fiber, more plant forward diet versus more heavy on meat and cheese, which

4:51

is what traditionally, you know, a lot of Wisconsinites grow up eating.

4:57

So Yes, nutrition is a very important part. And you know, as

5:00

we've talked about before, Sean, you know, unfortunately, in the traditional

5:04

system, when you have a family medicine doctor that's employed by one of the

5:08

large hospital systems, you typically might have a fifteen or twenty minute visit.

5:13

It's probably actually going to be you know, ten minutes or less that you're

5:15

in the room with a doctor, and it's difficult to discuss and detail these

5:19

things, right, I mean, you know, we're going to talk longer

5:23

on the radio than most people will have in the room with their doctor.

5:26

So how do you actually get to the point where you know, the doctor

5:30

is asking you these questions and giving you, you know, recommendations as far

5:33

as your diet. If you have a seven minute visit, well, the

5:36

problem is that doesn't exist astraight. You can't you know, get into those

5:41

kind of details. So that's why the direct primary care system is so great,

5:44

because we do have those hour long visits, you know, forty five

5:47

minutes to an hour to talk about all these things with our patients. That's

5:50

an interesting aspect too of direct primary care. And obviously I think of oftentimes

5:57

how great it is to have those those nice visits with your doc, and

6:00

of course I oftentimes think of discussing medical conditions. But as we're talking this

6:04

week about lifestyle medicine and all the great benefits having that conversation with your doctor

6:11

of saying, listen, I don't like where I am, I don't like

6:15

my diet. I want to make some modifications. Unfortunately, for a lot

6:18

of folks that aren't in direct primary care, that are in that traditional system,

6:23

they don't really get that comprehensive conversation about diet. And as we talk

6:27

about nutrition, you also mentioned exercise and exercise is important obviously to keep yourself

6:33

trim and those type of things. But there's great benefits heart and lungs and

6:38

other things, aren't there, doctor, Yes, And you know I'm always

6:42

at least I try to be careful and the words that I use. You

6:45

know, exercise is a good word, but for some people, I just

6:47

even use the word activity, right, because we can integrate more activity into

6:51

our daily lives, you know, taking the set of stairs instead of using

6:56

the elevator. You know, maybe if you have the ability to walk to

6:59

work, or to ride the like, or just walk to the restaurant rather

7:01

than take your car. You know, I know when I lived in Chicago

7:05

and lived in the city, I walked ninety percent of places. Right.

7:10

It's difficult to do that when you you know, live in a place like

7:13

Madison or you know, the suburbs, because you know, things aren't as

7:16

close to each other. But if you can integrate activity into your daily life,

7:20

so that could be walking your dog, you know, walking your kids

7:26

to the bus stop, you know, things that you're doing on a routine

7:29

basis. But yes, the exercise component is so important. Not just again

7:34

it's it's hard to exercise your way out of a bad diet. I always

7:40

refer to the commercial that I saw like a year ago or a couple of

7:43

years ago, where it was it was kind of a satire commercial, and

7:46

this lady comes up and she's drinking like a Starbucks proppacino, and she said

7:50

to oh, I just ran a five k or something, and I'm drinking

7:54

this drink and the drink has like fifteen hundred calories in it. So it's

7:57

like, well, you would have actually had to run, you know,

8:00

a half marathon to burn that drink or something. So it's like it's very

8:03

difficult because most of us are not running like a half marathon to burn off

8:07

the cheeseburger and fries or whatever. So most of us do not, you

8:11

know, are not able to out exercise our bad eating, you know, unless of course, you are an endurance athletes, a professional athlete. Those

8:18

people consume you know, high amounts of calories. But for the average person,

8:22

including myself, you know, we do have to be conscientious of the

8:26

calories and the types of foods we're eating. But the exercise component is even

8:31

more so important because of heart health, right, so activity and I and

8:35

I describe this in four categories. So it's aerobic activity, the thing that's

8:41

kind of getting your heart pumping. It's weight bearing or resistance activity, so

8:46

those things where your muscles are having to resist against something, which strengthen of

8:52

course muscle mass, which strength strengthens our bones. And then there's core,

8:56

so anything that's you know, you know, sit ups, pull ups,

9:00

you know push ups, those things that are core building that again help with

9:05

like lower back issues. And then lastly is flexibility and balance. So you

9:11

know, I talk about things with patients like yoga and pilates and just stretching,

9:15

exercise exercises, balance exercises. There's a lot of longevity doctors that look

9:22

at stability as one of the core components of longevity because if our body is

9:28

more stable, and you know again that that there's multiple components of that.

9:33

Flexibility, balance, all of those things were less injury prone as we get

9:37

older, and we know that, you know, as as people get older,

9:39

their their balance is worse, their mobility gets worse, and then you're

9:45

more prone to you know, things like hip fractures and things which are very

9:48

serious injuries when you get those, and those do affect your your lifespan.

9:52

So so the four components again are aerobic core, weight bearing or resistance,

10:00

and then stability, which would be like flexibility and balance. And so I

10:05

talk to I go through with all of my patients when I'm going through these

10:09

lifestyle medicine questions and ask them if they are doing these, what they are

10:13

doing with these and you know it could be. The other thing is I

10:18

try to counsel patients that, you know, start small, right, because

10:22

you when you talk about all this stuff, it sounds overwhelming, right,

10:24

It's like I can't do all four of these things every day or whatever.

10:28

I mean, start with fifteen minutes of aerobic exercise twice a week. I

10:33

mean, do a fast walk do I mean, if you're somebody that's healthy

10:37

enough to jog, or a combination of walking and jogging, if you're somebody

10:41

that's healthy enough to bike, So start with fifteen minutes. If you're someone

10:46

that doesn't exercise at all, it can be just a small, you know,

10:50

fast walk fifteen minutes twice a week, and then go from there after

10:54

a couple of weeks, increase it to three times a week. I think

10:58

I include myself in this. A lot of times we use the excuse of

11:01

I just don't have time. I don't have time in my schedule, you

11:03

know, with the kids and with working, and you get home from work

11:07

and you don't feel like, you know, taking a walk. And I

11:11

try to for myself reframe my thinking to think, this isn't like an add

11:16

on, this is something I have to do, right. It's like you

11:18

make the time to brush your teeth, you make the time to take a shower. I mean, like, these are all things in our life that

11:24

we have to make the time for because they're part of our daily routine or

11:28

you know whatever, a few times a week routine. So look at exercise

11:33

in the same way. It's not that you are making the time for it.

11:37

It's just something you have to do. And if it's fifteen or twenty

11:39

minutes, you know, the vast majority of us have fifteen or twenty minutes

11:43

where we can can do that. So I think that that's kind of just

11:46

a good way to reframe your thinking about that. One of the interesting things

11:50

too, with this stuff, doctors, it seems to build on itself,

11:54

is I think once you kind of make those steps to say, you know what I'm going to do, take that walk, that fIF teen twenty minute

12:00

walk a few times a week, then you're going, you know what, maybe I should do it three or four times because you start to see that

12:05

joy and then in no time, you're you're rocking. And for people who

12:09

don't know what is rocking, by the way, Yeah, so I recently

12:13

started listening to this Peter Attilla. He is a physician I think he's from

12:18

Canada originally that does a lot of research, both personal and you know,

12:22

clinical research on longevity, and so he has a lot of thoughts about,

12:28

you know, the types of exercises we should be doing. But rocking is

12:31

where you are walking at a brisk pace carrying a backpack that is weighted,

12:35

and he says to carry a third of your body weight, which is a

12:39

lot, and he said to start with like maybe a half of that amount.

12:43

So I mean I started with twenty pounds, which that even felt like

12:46

a lot. But it's very interesting because I'd never done that before, and

12:50

I've never even really hiked with like a heavy backpack, you know, per

12:54

se. But when you first start walking, you you feel it almost immediately,

13:00

and you know, the first five minutes or so, I'm thinking, I don't know if I can do this for very long, but then you

13:03

actually kind of adjust to it, but you feel like you feel it in

13:07

your legs and different muscles that you don't normally feel walking. So that's combining

13:11

then your aerobic part and your you know, weight bearing resistance type of part

13:16

because you're using your muscles more than you normally would. It's pretty amazing as

13:20

we talk about some of these steps and some of these important things to be

13:24

doing when it comes to lifestyle medicine. We talked about nutrition, talked about

13:28

exercise. We're going to get into sleep, stress, and substances, the

13:31

three s's. We will do that next. In the meantime, I have

13:35

haven't checked out the website yet. What you doing? You got to get

13:37

on over there ADVOCATESDPC dot com. That's Advocates DPC dot com. You can

13:41

learn more about Advocate MD and Direct Primary Care all on the website ADVOCATESDPC dot

13:48

com. The telephone number six so eight to six eight sixty two eleven,

13:50

that's two six eight sixty two eleven to make an appointment to become a member

13:54

at Advocate MD, and again the website ADVOCATESDPC dot com. We're continue our

13:58

conversation with doctor Nicole hemp Us talk a little bit more about lifestyle medicine.

14:01

Will do that next as Full Scope continues right here on thirteen ten WUIBA eight

14:09

twenty two thirteen ten WIBA and full Scope with doctor Nicole Hemkiss, Wisconsin's directcare

14:15

doctor of course. Doctor Hemkiss comes Swiss from Advocate Empty, a direct primary

14:18

care practice with three soon to be four clinics right here in the area west

14:22

side of Madison, right in Middleton on Glacier Ridge Road, east side on

14:26

fair Oaks, down in Janesville at ten twenty one Mineral Point A and soon

14:31

to be the newest location South Madison, Fitchburg A thirty two to twenty Syin

14:35

Road that coming later this month. Learn more about Advocate MD the website ADVOCATEDPC

14:41

dot com. That's ADVOCATEDPC dot com. Talking with the doctor this week about

14:46

lifestyle medicine and this next one doctor. It seems like this one is best

14:50

when the other four are all being managed properly. And that brings us to

14:54

sleep. And let's talk about the importance of good rest and good sleep.

14:58

Ye you know, it's funny. It brings up this question. You know,

15:01

the doctors in our group and I discuss a lot, you know,

15:05

do we have to do you need to come in for yearly visits? You

15:09

know, a lot of times there's debate about this if you're a pretty healthy,

15:13

middle aged person. You know, of course, we have children come

15:15

in yearly for well child checks, and when they're very young, they come

15:18

in a lot more frequently. You know, when people get older, they

15:20

tend to have more chronic medical issues, so they tend to utilize the doctor

15:24

more often. But what about those people that are in like the twenty five

15:28

to fifty five year range. Do those people need to come in to the

15:31

doctor when they're healthy and they're not having symptoms? And my argument is always

15:35

yes, because I think there are things that we pick up not only when

15:39

we take your vital signs, when we do a few labs. You know.

15:41

Of course, again this is not to make money off of patients,

15:46

because we don't charge anything for a visit, and we charge you know,

15:48

very small amount for labs. So this is more just to have really good

15:54

preventive care and to see if we can pick up on things. And I find many times sleep is a question where people won't always you know, come

16:03

out initially with this as a concern, But when you ask them questions about

16:07

their sleep, like, oh, yeah, I'm not really sleeping very well.

16:10

Oh yeah, you know, I'm sleeping four or five hours a night and then I wake up and then I can't fall back asleep. So a

16:15

lot of people have trouble sleeping. A lot of people require, you know,

16:19

taking medication over the counter meds to help them sleep, and that can

16:25

be a symptom of an underlying issue, right, It could be a symptom of an underlying medical issue and underlying potentially mental health issue if they're anxious about

16:34

something. So that is something that we like to flesh out and figure out

16:38

what's going on rather than just prescribe you a sleep aid that's going to make

16:41

you fall asleep and kind of put a band aid on it. So so

16:45

again, yes, that is something where I ask patients a lot of questions

16:48

about how many hours a night are you sleeping, how do you fall asleep

16:51

at night? Do you have to do you wake up frequently during the night. And again, many people don't initially, you know, think of this

16:59

as something as it can, because maybe they've just gotten used to it or think it's just a normal part of life. But yes, if you are

17:04

having disrupted sleep on most nights, that's not necessarily a normal part of a

17:11

sleep pattern. So that's something you should talk to the doctor about. Talking

17:14

with doctor Nicole Hemkiz this morning of Advocate MD mentioned the website advocatedpc dot com.

17:19

That's ADVOCATECPC dot com. Learn more about Advocate MD. Also learn more

17:23

about the doctors at Advocate MD. Great options for yourself, your family.

17:27

If you're an employer looking for options when it comes to primary care for your

17:32

employees, definitely check out Advocate MD. Their telephone number six eight two six

17:36

eight sixty two eleven. That's six'oh eight two six eight sixty two eleven.

17:41

It seems like number four on this list doctor is the one that's that's

17:45

probably and maybe it's just personally seems to be the hardest to control, Like

17:49

the other things seem like if you do you know, nutrition and exercise and

17:53

sleep, those kind of things, you can allot things for stress is a

17:56

different kind of a different animal. Let's talk about the importance when it comes

18:00

to lifestyle medicine and the importance of understanding stress and the effect that has on

18:03

you. Yes, so I like to say that everyone has stress in our

18:08

life, right we you know, it tends to ebb and flow. There

18:11

are more stressful periods, There can be more stressful periods of time, but

18:15

even during the day, right you might have a stressful morning that the afternoon

18:18

is better. So it's something that it seems to be constantly changing. There

18:22

are people where they have kind of a heightened level of stress or anxiety all

18:25

the time. And the way I kind of discuss this with patients is that

18:30

you know, if you've found ways within your life your mental capacity to cope

18:38

with stress, if there are mechanism strategies that you use when you're having stressful

18:42

times and you are able to kind of settle that down. Of course,

18:48

there are medications you can take, but there are non medication options also.

18:52

But if you find that stress is to the point where it is affecting your

18:57

day to day life, it's affecting your relationship, it's affecting your ability to

19:00

work. If you're finding that you are having you know, what we call

19:04

panic attacks, where it comes to the point where it's overwhelming and you're having

19:07

physical symptoms of that stress or anxiety, then that's usually the point again where

19:14

it would be important to talk with your doctor about, you know, what

19:18

are your options for that. But again, you know, I like to

19:21

say stress is a normal part of life. We all have it. It's more just how we are able to deal with it, you know, and

19:26

again just figuring out if it's at the point where you need medications or talking

19:32

to a therapist or those sort of things. Do things like mindfulness, you know, kind of being present in the moment, kind of you know,

19:37

kind of removing judgment. Does that type of meditation, those kind of things.

19:41

Does that help? Can that Can those kind of things help as well? Or is there any science on that I think it can really help.

19:48

I mean, of course it's patient dependent and the patient has to kind of

19:51

you know, quote buy into it. But I do think I mean that

19:55

is one of the things I suggest to patients is fifteen minutes a day if

19:57

you can, you know, turn off your phone and off the TV,

20:00

you know, lay down in a room. Some people do breathing exercises,

20:03

and people have apps. Again, it's hard because the phone is like one

20:06

of the reasons that we do have stress, right, because it's constantly pinging and we're seeing the news and everything is in the world is bad, but

20:11

if we can, uh, there are apps like one of them is called

20:15

Calm, where it will kind of guide you through how to meditate. And

20:19

I think for a lot of people that helps. You know, obviously years

20:23

ago, I think you know many people, many people are now today too

20:27

also religious. So I you know people that are religious, I say,

20:30

you know, prayer can be a good way to deal with stress. But

20:33

for some people that aren't religious, you know, meditation and deep breathing exercises,

20:40

all of those things. Talking this morning with doctor Nicole Hemkiss of Advocate

20:42

MD, the website Advocates DPC dot com. That's Advocates DPC dot com.

20:48

The telephonerm make an appointment, become a member at Advocate MD. Six SOH

20:52

eight two six eight sixty two eleven. That's six'SH eight two six eight

20:56

sixty two eleven. Here in Wisconsin, the state, and there's no no,

21:00

no secret, state's got a significant drinking problem. I have also noticed

21:06

in my in just a number of years, the attitude and kind of the

21:11

overall acceptances we talk about substance things like marijuana, like you'll you'll actually smell

21:17

it driving down the road. I was walking downtown Jamesville the other weekend and

21:21

there was somebody's sitting on a bench with it. I thought, oh, my goodness, what's happening. I feel like I feel like an old funny

21:26

duddy. But it is it is like that, and that brings us to

21:29

number five on our list of lifestyle medicine, which is which is substances doctor,

21:34

Yes, exactly, you know, I think that you know, Wisconsin

21:38

obviously has a different culture surrounding alcohol, you know, but it is something

21:45

that again, your doctor should be talking to you about and asking you questions

21:48

about. You know, how much alcohol are you drinking on a daily basis?

21:52

Do you smoke? You know, how to quit smoking? And then

21:56

you know, marijuana other substances. You know, not to get into a

22:00

debate about, you know, the health or dangers of marijuana youth, but

22:06

obviously there there are side effects and there are you know, issues that can

22:10

arise for people that have heavy or chronic marijuana youth. So I mean that's

22:14

something like you said, John, it's becoming I think more acceptable in general

22:18

in society that people are doing it, and it's legal in many places,

22:22

but you know, there are still health concerns surrounding it. So I think

22:26

that again is something that is important to talk to your physician about, you

22:30

know, when you get a chance. And one of the great things is,

22:33

as mentioned a little earlier, about getting that chance to sit down and

22:37

talk with your doctor and your doctor asking things about this. It's it's super

22:41

important obviously to have that relationship with your doctor, and I think we kind

22:45

of take that for granted, but the ability to be open, you know,

22:48

talk about things like substances or stress or or sleep and all of these

22:53

all of these things and one of the great things and one of the great

22:56

features of Advocate MD and direct primary care is you actually have time to get

23:00

to know your doctor. I get to sit down and talk with them and

23:03

build that level of trust and have that conversation, which as we talk about

23:07

these fantastic benefits of lifestyle medicine, they are there, they just need to

23:14

be applied, and having somebody to kind of guide you through that is absolutely

23:18

amazing. That's some of the great stuff with Advocate MD. Of course,

23:21

the website Advocates DPC dot com. That's Advocates DPC dot com. Tell form

23:26

number six oh eight two six eight sixty two eleven, that's six h eight

23:30

two six eight sixty two eleven talked about the beautiful day ahead, great day

23:33

to get out and relieve some stress by taking a nice walk and kind of

23:37

enjoying these days. Doc, I know you'll be doing it. You guys

23:40

are mentioned earlier about rucking and some other stuff you're sharing on your social media,

23:45

your thirty days of movement that does going on at the practice. Folks

23:48

can follow along there and Doc should be a perfect day to get out.

23:52

You enjoyed it and we'll talk real soon. Thanks you too, Son,

23:55

and the website Advocates DPC dot com. That's Advocates d P dot com News

24:00

comes you way next year on thirteen ten w I b e.