Why Heart Disease Still Leads

Dr. Soyombo 0:00

Cardiovascular diseases is a group of diseases, and it is the number one cause of death and disability on this planet. And an estimated 650 million people currently live with cardiovascular disease worldwide. So that's approximately one in 12 persons that has cardiovascular disease. So if you look at US data, um, black men are about 1.6 times more likely to die from heart disease and at young ages compared to white men. Okay. Um they experience earlier onset of high blood pressure, they have higher rates of heart failure and stroke, they have greater mortality when they do have a heart condition, and they have more severe complications of these risk factors.

Grantley Martelly 0:49

This is the Real Health Black Men podcast, where we empower men to take control of their health. We provide vital information and build community support. Join us as we discuss everything from major health challenges to mental wellness to physical fitness. So if you're ready to level up your health and your life, you're in the right place. Let's get started.

Meet A Cardiologist In Barbados

Grantley Martelly 1:17

Welcome back to Real Health Black Men. Thank you for joining us. Thank you for your supporting us. I want to thank all who have just become our supporters and sending me notes and emails. I really appreciate that. Let me know how to adjust the podcast to make sure that we're meeting your needs. Today I'm in Barbados again, and uh I have the pleasure of meeting with Dr. Soyombo. Dr. Soyombo is a non-invasive cardiology specialist and a consultant for the Department of Cardiology Services at the Queen Elizabeth Hospital here in Barbados. She's also the founder of Heart Healthy Incorporated, a practice focused on prevention, diagnosis, and management of heart disease. And as you can tell, our topic today is going to be heart disease and heart health in men. So Dr. Soyombo, welcome to our podcast.

Dr. Soyombo 2:06

Thank you for having me. It's a pleasure to be here to talk about a topic that is near and dear to my heart. As we talk about heart disease in men, but also this is also for women as caretakers, also with heart disease. I have my heart disease pin on. So this topic is for everyone, really.

Grantley Martelly 2:22

Yes, because with a focus on the time the caretakers are also a part of the story.

Dr. Soyombo 2:28

Definitely, the whole family.

Grantley Martelly 2:30

So as we as we ground in, just give us a little bit about you, as much as you want to tell us about you and your upbringing where you're from or your practice, so that we can our audiences can know that you're not just a cardiologist, but you're a person just like them. Yeah.

Dr. Soyombo 2:46

Well, so I like to consider myself I am an American Niger Bajan, a non-invasive cardiologist. So yes, people always ask me, where is your last name from? It is from Nigeria, which is where I spent most of my formative years, primary and secondary school. I was born in the U.S., um, which is where I went to college, medical school, did most of my medical training and worked before moving to Barbados about nine years ago, almost nine years ago. So I went to medical school at the University of Michigan, which is where I was born. And I had a friend there, his name was Kemi, um, who's from Barbados, and he would kind of rant and rave about his, well, not rant, rave about his little island of paradise. And so in the summer of my first year of medical school, I was interested in doing research and I wanted to go somewhere exotic. So I found something, um, a research program that was here in Barbados. It was a program sponsored by the National Science Foundation many years ago. And we, and they sent us to the Chronic Disease Research Center here in Barbados, which was at the time under the leadership of Dr. Sir Henry Fraser. At the time, I had no idea what part of medicine I was going into. And cardiology was not on my radar. But interesting enough, our research was on acculturation and how Western values were beginning to impact the way of life in Barbados and leading to chronic diseases in Barbados. This was even before the, you know, before the fast food and chifetes and things came around. And fast forward 25 years later, we know the impact it has and continues to have uh on the rise of heart disease around the world, acculturation and Western way of living. So, as I mentioned, cardiology was not on my radar, but I did my cardiology rotations and and I was hooked. I uh I love the heart. I was fascinated by the heart. And I do like working with my hands, but I know I didn't want to be a surgeon. So cardiology sort of gave me a perfect balance of doing procedures, patient management, continuity of care. And, you know, uh that's when I decided to go into it. So I had to go into internal medicine first, which I did at Cornell University, New York Presbyterian Hospital in New York. And I did my fellowship training in cardiology in Georgetown, um University, Washington Hospital Center in DC. During my training, I did get a chance to come back to Barbados to do an elective. I also went to Nigeria, so that gave me a bit of an exposure into the healthcare system in both places. And after training, I went on to practice in New Jersey before I relocated to Barbados in 2017, generally for a change of pace. And because I kind of knew the environment, it kind of was a balance between the US and Nigeria.

Grantley Martelly 5:25

Uh Barbados grew on you.

Dr. Soyombo 5:27

It grew on me. It definitely grew on me. It reminded me, it really reminded me of growing up in Nigeria.

Grantley Martelly 5:32

So you said you were a non-invasive cardiologist, you're not a surgeon, and to many of our listeners, that may be a surprise.

What A Non-Invasive Cardiologist Does

Grantley Martelly 5:41

So could you explain the difference between what you do and what other cardiologists do?

Dr. Soyombo 5:46

So there's cardiovascular surgeon. So those are actually, so people always ask me, oh, do you operate surgeries? So that's a whole different field. So as I said, I went into internal medicine. Okay. So you learn medicine and cardiology is one of the sub-specialties of internal medicine. Okay. And then there's a field of surgery, and cardiovascular surge is a field of surgery. Okay. Under cardiology, there are many subspecialties. So you have invasive and non-invasive. So invasive will be the cardiologists that deal with procedures. So if you have a blockage in your artery, they would do the angiogram. Or if you need a pacemaker or have a problem with the electricity in your heart, they would go in and when we say invasive, meaning they're cutting the skin, it's not open heart surgery, but they're breaking the skin to do procedures on your heart. Um, and then there are also structural cardiologists that do things also outside of putting stents, you know, putting in valves percutaneously and repairing things percutaneously without having to cut open your heart. So that's the invasive side of cardiology. The non-invasive side is where I where I'm at, which is more imaging and patient management. So all cardiologists, for the most part, all manage patients regardless. Um, we all do a bit of imaging, but we focus more on the imaging side of things and the patient management. So the testing, so the stress testing, the echocardiograms, the ECGs, the holters, using all of those things to make a diagnosis without having to go in and cut open the skin. We do do some minor procedures as non-invasive cardiologists, such as uh, you know, transtophageal echocardiograms, or we go in with a camera to look into your heart. And there are some non-invasive cardiologists who do some invasive but not interventions. So they go in and do the calves, but they don't necessarily go in and put in stents.

Grantley Martelly 7:28

Okay.

Dr. Soyombo 7:29

So, and then you have the electrophysiologist who deal with more of the electricity, so many different parts. But so I work in non-invasive, which means I don't break open the skin for anything ideal related to the heart.

Grantley Martelly 7:40

So yeah, so most people think of the cardiologist as a cardiovascular surgeon. Yes. But it's a broader field.

Dr. Soyombo 7:45

Yes, it's it's different. And they their training is much different because they learn general surgery and then they branch into cardiologists, whereas we learn internal medicine and branch into cardiology. But it is different depending on what country you go to. So in the US and I think Barbados and the Caribbean, that's generally how it's done. Yeah.

Grantley Martelly 8:05

So what does your heart healthy institute do here?

Dr. Soyombo 8:09

Healthy heart imaging. Healthy heart Inc and imaging. So I love the balance of hospital work and private practice, continued earth care, prevention, managing people with heart condition, and helping them live healthy lives despite having a heart condition, or preventing the heart conditions by being proactive in terms of what they're doing. So most patients are referred to me from primary care doctors or if they've been hospitalized, either because they're at risk of a heart condition or because they have symptoms that might be suggestive of a heart condition, or they are at risk, you know, meaning family history or something else is going on. So we see patients here, we do cardiac testing, ECGs, halters, stress tests, echocardiograms, and we refer patients out for any further testing that they may need that's not done within our office here.

Grantley Martelly 9:00

So just from a layman's terms, it seems to me like you're a person has may have a cardiology issue or not, but you're testing to see if they do. And it doesn't mean that eventually they may not have to see a cardiovascular surgeon, but your work is seems to me to be before that and looking at are you healthy or not, if you're having a murmur or not, the stress test, that kind of stuff. The I I'm thinking of it i a along a line. The end of the line may be the surgeon. The in the invasion. Right. But there's a whole bunch of things that can be done between I'm not feeling good to I need a cardiovascular surgeon.

Dr. Soyombo 9:40

A lot of the time our patients don't end up with a cardiovascular surgeon. We don't want you to end up with a cardiovascular surgeon. Unfortunately, and as I said, cardiology, the field of cardiology is changing. We're able to do a lot more, especially in bigger countries. We're able to do a lot more that does not involve you going to a surgeon. So less invasive procedures that don't require cracking open the chest. Um, but obviously that is, and you know, seeing a surgeon is not the end of it because the surgeon does their surgery and you still come back to us to cardiologists. So we manage patients that have already seen the surgeon as well. They come back to us for continued care and to make sure that whatever condition we fixed, we can continue to manage it.

Grantley Martelly 10:18

Okay, yeah.

Dr. Soyombo 10:19

Because of course, things can progress and get worse. Um, and you need maintenance to make sure that that doesn't happen. So we like to avoid the surgeons, but we do work hand in hand with the surgeons at the hospital. We have conferences where we discuss every patient we send to surgery. We have a cardiac team where we meet and discuss what the imaging, what the testing, what the symptoms, we talk about the patient, and then we send them to the surgeons. So we all work very closely together, but we want to avoid them seeing a surgeon if possible.

Grantley Martelly 10:49

Can you define what cardiovascular health is and then some of the specific areas that it may encompass?

Dr. Soyombo 10:56

Cardiovascular health refers to the health of the heart, which is cardio, cardiovascular, which are the vessels of the body, right? And I do like to differentiate it from cardiovascular diseases, which are diseases of the heart and the blood vessels. Okay. Right. Cardiovascular diseases is a group of diseases, and it is the

What Cardiovascular Health Means

Dr. Soyombo 11:17

number one cause of death and disability on this planet. Planet meaning including Barbados. And an estimated 650 million people currently live with cardiovascular disease worldwide. Wow. So that's approximately one in 12 persons that has cardiovascular disease. Wow. When we think of cardiovascular diseases, uh, we're talking about all the diseases that affect the heart and the blood vessels. So just to kind of go through them with you, and I think an easy way, well, I'll come back to the analogy, but um, so we talk about the diseases that affect the arteries. Okay, so arteries that supply blood flow to the heart. If there are blockages there, that can cause heart attacks, angina, ischemic heart disease, corneal artery disease. We also have diseases that affect the arteries going to the brain, which can lead to a number one cause of strokes. You have diseases that can affect the arteries of the leg, causing claudication of what we call peripheral vascular disease. And then you have all the diseases of the arteries, such as aortic aneurysms, and you can have blood clots to the arteries that go to the lung, pulmonary embolus. Um, and then we talk about the valves in the heart, which can also malfunction. It can have valvular heart disease. Um, and then there's some rheumatic, which is diseases from infections in the past, strep, um, and other congenital diseases. We also have arrhythmias, which are diseases that affect the electricity of the heart. So these are all the spectrum of cardiovascular disease. And one important one I didn't say was diseases of the pump of the heart. That's heart failure. So all of these things come together and form the spectrum of cardiovascular diseases. So I like to kind of think about it as your home. You know, you have plumbing, you got to make sure it's working, you have electricity, you got to make sure it's working, the pump itself, the valves, which would be the doors. So you want everything to be in good working order in order to have good cardiovascular health. And one thing to keep in mind is that, you know, cardiovascular health goes beyond the absence of disease. Really is just about focusing on how efficiently your heart and your blood vessels can help pump oxygen and nutrients throughout your body to make you live a long, healthy life.

Grantley Martelly 13:23

So, what are some of the various aspects of uh cardiovascular health that we as people need to be aware of? This is this shows about black men. Everybody has a heart. So I'm sure there's not anything unique to black men, but we can get later into the how it differentiates into black men. So, what are some of the factors and some of the things that you need to be aware of?

Dr. Soyombo 13:44

So I think um the best way to think about this is using the framework that the ACC, the American Culture of Cardiology, has sort of put out. Um, it went from life's simple seven to now life's crucial nine, or sort of the nine things that we can uh regulate or control in order to have a healthy heart. On that note, all of these things obviously contribute to cardiovascular disease. So if we can deal with them, then we can reduce our risk of cardiovascular disease. So I like to break them into two

Life’s Crucial Nine Risk Factors

Dr. Soyombo 14:13

groups. So one is healthy factors, and the other is lifestyle behaviors. So health factors, lifestyle behaviors. So some of those health factors, again, which most of us know. So blood pressure, blood sugar, blood cholesterol, body weight, and psychological health. All right. So these are factors that affect your cardiovascular health. And obviously the diseases that can come out of those, if those factors are not controlled, include hypertension, high blood pressure, high cholesterol or dyslipidemia, diabetes from blood sugar, and obesity and metabolic syndrome from your weight. Lifestyle behaviors that can affect these things and also affect our overall health, not just with heart disease, but all disease processes, are the lifestyle behaviors that can contribute to these things, but that we can also change, which will include, of course, diet, physical activity, let's not forget sleep, avoiding tobacco or smoking, and then stress, which contributes to the psychological health. So I have stress or psychological health under both groups.

Grantley Martelly 15:11

Yeah.

Dr. Soyombo 15:11

Right? Health factors and lifestyle behaviors. Because stress is something that can be a medical diagnosis, anxiety, depression, other things that can cause, affect your psychological health. But there are also things that in our behavior that contributes to our psychological health, which can include stress and other things if not managed correctly.

Grantley Martelly 15:30

Yeah, well, that's very interesting because I've done been doing a few episodes lately on mental and emotional health. And uh Many doctors that I've talked to are even practitioners, you know, a lot of times we don't get into the emotional and psychological health, but you went right into it. So there must be something there that your cardiologists see that our mental and emotional health has a direct impact on how our heart functions.

Dr. Soyombo 15:58

100%. And while it is a big field, it's not necessarily my area, right?

Grantley Martelly 16:03

Yeah.

Dr. Soyombo 16:04

But we see it in everything and people manage their conditions, you know, in terms of taking care of themselves and being able to do things they need to do for their heart health, anxiety playing a role, depression playing a role. And we do know that, you know, when people do have an event, a heart attack, it's not always the 90% clogged artery that causes that. It's the vulnerable plaque in a 50% clogged artery. And we don't know what it is that causes that artery to suddenly rupture and cause a heart attack. And I think, you know, stress and other things probably play a role with that. And there are some conditions that are directly linked to stress. There's some heart failure or heart pump condition, heart attack conditions that are directly related to overwhelming stress. So we see that obviously stress affects all of the factors we talked about: overeating and developing obesity and metabolic syndrome, eating the wrong things, high cholesterol, salts, and developing high blood pressure. So it affects everything. And again, all of these then contribute. So we see it a lot in cardiology and even treatment and management, you know, in terms of how people approach doctors and how people approach taking care of themselves. You know, if you're not mentally or psychologically well positioned, then it's going to be very difficult to manage a condition that you're diagnosed with. We're able to treat you and get you to leave to lead a good, healthy life. But if you can't manage those psychological factors, then of course it makes it very difficult and you get sicker and sicker and develop more complications.

Grantley Martelly 17:34

So you may be doing all the physical things that you as specialists can help with and other other medical professionals, but then you go home to a situation that Everything you might have just done for the last two hours begins to unravel. Because the home situation or the geography where a person lives automatically then just starts. And sometimes do you find that people are not even aware that these things are causing stress in their lives?

Dr. Soyombo 18:02

Yeah, no. Yeah, absolutely. People don't realize how much of a role it plays. And they ignore their health, one, because they're under a lot of stress, uh, or they don't ignore their health. They are doing a lot. And I think there's there was a concept I was gonna bring when we got to speaking about the um the genetic role that it plays, but there's something that I I came across the John Henrism effect. I don't know if you know what that is, but that's where we talk about the physiologic toll of

Stress, Trauma, And The Body

Dr. Soyombo 18:30

chronic repeated expo exposure to systemic trust stret systemic stressors can interact with genetic factors to sort of accelerate cardiovascular aging and high blood pressure. So that's where people are doing a lot. I think John Henry was a man that he came out of slavery, he owned all all this wealth, and at the age of 50, he died of um heart disease because of achieving so much and just pushing, pushing, pushing, pushing and not realizing that he was under a lot of stress, trying to overcome. But then at the end of the day, he died at a young age because he was not prioritizing his health and just not even realizing probably that he was under a lot of stress.

Grantley Martelly 19:37

Wow, that's interesting because as you're saying that, my mind just started to turn. This is not even on our our plan, but I'm on a committee, uh, a patient advisory committee back home, and one of the researchers that we're the patient committee that I'm on is called the GEMS Advisory Group, and it's looking at the germline, the environmental, the social, political, and cultural aspects of lethal prostate cancer. Right? You can probably apply it to heart disease. Right. And what it came out of is that they found that there are other things that they don't measure in the doctor's office that has an effect on a person's lifestyle and their health and where you live could be where it is. Your ju you germline geogenetics, but the environmental, social, and political things that people are into. I was one of my therapists that I interviewed said he talks to people who not even have realized that we have undergone a trauma and we're so moving forward, we just automatically adjust to that and keep moving forward. Exactly. Not realizing that that's putting the stress on our body. Right. And and I I I'm as you're talking, I'm seeing how that also relates to heart disease. Yeah, yeah.

Dr. Soyombo 20:51

Absolutely. You could walk.

Grantley Martelly 20:52

Absolutely. Another another person I was talking to was saying that they've the some of the people they've been trying to help, they found that if they don't look at where they live, most of the things that they're trying to do don't work because a lot of their clients are going back into environments that are contradictory to what they're trying to accomplish when they're it's a big field, and it's a lot, it's a lot uh you know, that needs to be addressed from a global and uh and a public health standpoint.

Dr. Soyombo 21:18

As much as we try to address it in the office, you know, we don't have all the answers and we don't have all the metrics to use at this point. Yeah.

Grantley Martelly 21:25

So what is a just to finish up this section here, what does a a a patient need to be aware of in terms of what are their numbers or their things that they should be tracking? You mentioned some of it, but where we say like uh blood pressure or cholesterol or that kind of stuff, can you put some numbers to it that people can say it? Because some people I talk to say, I get this results back from my doctor, and there's a whole bunch of numbers and I don't have a clue what they mean. And some people call their doctor and say that, but a lot of guys say, Oh, I just fouled that away because I don't understand what it meant.

Dr. Soyombo 22:00

Yeah. And and that's why we're talking about, you know, a lot of guys, especially the men, right? So I think even before we get into the numbers, I I wanted to just sort of put in perspective exactly. We talked about how many people have heart disease, but let's even just relate that to Barbados and black men and women in general. So if you look at US data, black men are about 1.6 times more likely to die from heart disease and at young ages compared to white men. Okay. They experience earlier onset of high blood. Pressure, which you brought up. They have higher rates of heart failure and stroke. They have greater mortality when they do have a heart condition. And they have more severe complications of these risk factors, dialysis and other conditions. And we have to keep in mind that race itself is not the disease. As we said, the drivers are a mixture of biology, the environment, access to care, chronic stress, um, our nutrition, our sleep habits, and most important, economic inequality, right? The system and a mistrust in the system, especially for black men. So these disparities are really driven by these factors and not necessarily by genetics, even those genetics do play a role. And when you look at black women, they tend to experience a higher burden of specific risks like stroke and uh hypertension compared to men or compared to, I shouldn't say men compared to other ethnic groups. However, black men are more likely to have a higher mortality rate. And for women, it's at a at a much older rate. So when you look in Barbados, the Barbados National Registry for Chronic Diseases actually tracks and records data on cancer, stroke, and acute heart attacks here in Barbados in order to help improve health programs and to monitor disease. And in 2022, that's the most data, that's the most recent data we have of everything. 556 Barbadians had a heart attack. 765 had a stroke. That's about 10 heart attacks a week, about 14 strokes a week on average. So this may not seem like a lot, but given our small population. It is a lot. And if you look at uh so easy way to look

Disparities And Barbados Heart Stats

Dr. Soyombo 24:02

at it is that for every 100,000 men in the population, about 146 had a heart attack and 98 died of a heart attack.

Grantley Martelly 24:10

Wow.

Dr. Soyombo 24:11

When you look at women, 89 out of 100,000 had a heart attack and 64 died of a heart attack. So, and this is just in 2022. So as you can see, men make up slightly more than half of those cases, totally. And most of the men, and in the men, the cases occurred mainly in the 55 to 74 age group, whereas in women, it was above the age of 85. So younger men are developing these conditions. So these figures from 2022 are one of the highest figures they had seen in the 14 years they've been following these numbers. I don't want to assume, but I I'm the sense I get is that those numbers are going up, despite what we're trying to do. If you look in Nigeria and the rest of Africa, cardiovascular disease is now accounting for one in three NCDs, you know, almost getting to the point of infectious diseases, which are the number one causes of death in in Africa. And of course, these rising cases are being driven by lots of things rapid urbanization, sedentary lifestyles, not everyone has a car now. So all of this is triggering an increase in high blood pressure, diabetes, obesity, and causing more cardiovascular disease. And hypertension is one of the biggest drivers in Africa. And it's not so much that these are just statistics, right? Uh, if you don't die from your cardiovascular disease, you're left with a disability. So, which impacts your ability to work, it affects your independence, it affects your family, workplace, income, everything. And then that even adds more stress to everything. So one of the things is we have to ask is why are these numbers going up? Right. Um, and some of that just has to do with some of this the rise, the stubborn rise in in these risk factors, the risk factors we discussed, and delays. Delays in not getting treated, not recognizing these risk factors, not having warning signs, presenting too late. And when you do get to the hospital, sometimes you don't get the care that you need, either because of lack of resources, which is an issue here in Barbados. And also even in the US, depending on places you live. You don't get easy access to, as we talk, it depends on where you live as well. There's also inequalities in terms of treatment, and they've seen that as well. So all of these things are why heart disease is such a big deal. And that brings me to your question about high blood pressure. So I think hypertension is one of our biggest issues, especially uh in black men. I think it's one of the most the single most important thing if we're going to discuss cardiovascular disease and how people can change things.

Grantley Martelly 26:35

You know, it's interesting, right? Because as you're thinking there, I'm thinking a lot of people have this idea that you live on an island and everything is chill. Nobody is earning, right? TV, no stress, everybody. There's lots of fruits, everybody's on the beach. But here we're talking about high rates of stress and cardiovascular disease and getting into hypertension.

Dr. Soyombo 26:59

Friend, because even when I moved to Barbados, people always thought, like, oh, you're you're just living in paradise. I'm like, no, I'm working, I'm hustling, like, you know, just like you. It's just that yes, I get to see the beach more regularly and you know, maybe reduces my stress level. And if I want to go, I don't have to drive a hundred miles. I can just, you know, walk to the beach. So yes, but yes, I I know the feeling. Uh let's get to that.

Grantley Martelly 27:21

Let's get back to the risk factors there. We get back into hypertension is one of the central issues when it comes to cardiovascular health.

Dr. Soyombo 27:29

Right. And you know, something you brought about is even in Barbados, like you said, you're looking at the island and everything, and why is it that we still have such high rates of hypertension? And, you know, there have been some that we do know that there's a genetic factor, and we also know that there are environmental factors, right? So genetically, studies have shown that people of African-American descent do have specific genes that help regulate salt and water that are abnormal. And so as a result, we're more sensitive to dietary sodium and increase risk of high blood pressure. You know, and as we know, as we mentioned, the genetics itself interplay with environmental factors that then lead to us developing

Hypertension And Salt Sensitivity

Dr. Soyombo 28:10

high blood pressure. So one of the things again, diet. So depending on where you are, depending on your socioeconomic status, we tend to eat a diet that is low in potassium, high in sodium. So when you already have a genetic predisposition to it and you have a diet that is not well, is not a balanced diet, either because you're not able to afford a healthy diet, or because you don't have the knowledge to know what is healthy, or because you're young and you think, oh, I can eat anything I want, you add that to the genetics, and then we start to see the that's why we see so much high blood pressure in Africa, in the Caribbean, in the United States. And again, high blood pressure is one thing that we know puts you at risk of developing. 90% of people that have strokes and heart attacks have high blood pressure. Especially in black people.

Grantley Martelly 28:55

Okay.

Dr. Soyombo 28:56

So it's very important that, you know, if we're looking at something, again, cardiovascularity is a huge topic, and we can talk about so many things. But I think when it comes to men, we really need to look at high blood pressure as something that we can manage, it's treatable, and we need to pay attention to if we're starting somewhere.

Grantley Martelly 29:12

And it's preventable.

Dr. Soyombo 29:13

And it is preventable. It is presentable.

Grantley Martelly 29:15

Yeah.

Dr. Soyombo 29:16

Right.

Grantley Martelly 29:16

So that that's interesting. Uh and we can get into to the misleading stuff about I'm feeling okay. But just this morning, I was with uh uh some people and one of the guys was there and he was saying, a lot of times guys don't want to go to the doctor because they don't want to hear the bad news of I may have this and I may have that. And I said to him, Knowledge is the key. Not knowing what you have, you can't do anything about it. Right. So the doctor is not giving you bad news, the doctor is giving you information that you need to be able to assimilate to make a decision. Yeah. If you don't go or you don't know. Yeah, yeah. I mean, literally two hours before I came here, I had this discussion with a friend here on the island.

Dr. Soyombo 29:58

But I think people think ignorance is bliss and you know, and they're not thinking through, you know, and then they end up in the hospital in a in a in a very bad state. As you said, there are lots of myths that surround, you know, people going to the doctor. And there is this fear, especially among black men, about going to the doctor. You know, people think that uh, you know, if I go to the doctor, you know, they're gonna put me on medications, they don't want to take the medications. Um it's funny. I uh just this past week, uh, you know, in on our line of work, you know, we round, we see patients in the hospital. And I was rounding, I mean, first I can't tell you how many times when I am rounding with the junior doctors, and you know, we see a lot of heart failure patients, and they come in and they present the patient and say, you know, patient has no past medical history. Meanwhile, their blood pressures are through the roof. And when you actually push a little further and ask them a question, you know, when was the last time you saw a doctor? They haven't seen a doctor in years. So they don't have any past medical history because they haven't seen a doctor in years.

Grantley Martelly 30:58

Yeah, but forget the file.

Dr. Soyombo 31:00

You know, they some of them since they were since they last saw their pediatrician. Or they saw a doctor and they were told they had high blood pressure and were told, okay, you need medications,

Why Men Avoid Doctors

Dr. Soyombo 31:09

and they never went back. And they never went back, yeah. Yeah, or they go back and they just don't want to take the medications for for many reasons. There was uh another issue, it was just even just a fear of doctors. There was another patient, that funny guy I saw in the hospital last week, and you know, he presented because he was filled with fluid. His legs were swollen like three times the amount. He only presented to his GP because he had scrotal swelling. It had progressed up to the point that it was affecting his scrotum. And uh I asked him, when's the last time he saw a doctor? And he couldn't tell me. And so I asked him, I said, you know, as anyone's prepared for this podcast, why is it that men don't like to see the doctor? And he said, Well, I'm paraphrasing, of course, because you know, his language was a bit different, but I guess he was talking to a friend and a friend was describing how you went to go see the doctor, and he said, Don't nobody want, you know, no doctor putting a finger up in my, you know, behind and making me pregnant. You know, so there's this misconception. Obviously, he doesn't mean making pregnant. Right. But he's talking about rectal exams.

Grantley Martelly 32:06

Yeah, he's talking about the discomfort that yeah.

Dr. Soyombo 32:08

Right.

Grantley Martelly 32:09

Uh and up down on. And yeah.

Dr. Soyombo 32:11

So there's this fear that you're gonna go to a doctor, they're gonna do something without understanding that these things may serve your life. You want you to live a healthy life. I mean, want you to live a productive life. And, you know, it's about having a conversation because there are many ways to scan a cat. And you have to see the doctor first, have the knowledge of what is going on, or even things to prevent you from developing a disease process so that you can, you know, get the best out of it.

Grantley Martelly 32:38

And it's not your doctor's fault that he's getting the doctor just presenting you the information. The doctors didn't cause you to have hypertension or caused you to have prediabetes. He the doctor is just telling you what he's seeing. And I don't know why there is that mental block for so many of my brothers about getting that information and make and using it to make wise decisions. You don't know. I interviewed another Barbadian a a while back and uh and unfortunately he passed away this spring from another another disease. But he said, the felons, right? That's how we say environmental. He said the felons always saying, you know, you ask him, How you doing? I alright. He said, he said, everybody alright until they're bent over in pain, and then they said, I think you need to call the doctor for me. Right. And what he was saying was that fellas, don't wait until you somebody gotta call the doctor for you. You need to go to the doctor while you're still alright. Right. Because all right is okay, but that doesn't mean you don't need to see the doctor. But we were just laughing the way he was putting it, you know, as he said, everybody alright. Yeah, no, no symptoms.

Dr. Soyombo 33:47

They think no symptoms, so lots of mess. No symptoms means no problem.

Grantley Martelly 33:51

Right.

Dr. Soyombo 33:51

You know, I'm okay, I'm young, I'm safe. Right, right. Some people think, well, I work out. So of course I can't have heart disease. I mean, you had someone on your podcast who, you know, gratefully, and I thank him for sharing his story. Um, he was an avid fitness enthusiast, and he had heart disease, which was surprising to him. So, you know, uh, other myths is that blood pressure medications cause erectile dysfunction. You also had someone on your podcast that it's not the blood pressure medicines. I mean, there are a few, okay, but most of it is a disease process. So that's another myth that that people think. Uh and some people are just are like, well, it's inevitable. I'm gonna get high blood pressure, I'm gonna get heart disease. So you know what? I'm just gonna avoid the doctor and do nothing about it. I had a close friend who that was his situation. He had a family history of heart disease, and I think he just felt it was inevitable that that was going to be him, and he just did not want to get help. And unfortunately he passed away. And by the time he realized he had symptoms, it was too late, despite being counseled on getting checked, on, you know, trying to get the cholesterol down and get things down. Uh so there's this fear, and I think there's also this sort of it's inevitable and there's nothing that can be done about it. There's a lot that can be done about it. And you can live a long, healthy life, even if you're diagnosed, or to even to prevent being diagnosed. If you know you have a family history and you're proactive about getting your numbers checked, I have a family history of diabetes, so I have to be careful, right? I know there are things I should be doing so that I don't develop that, so that I don't develop, you know, complications of that down the road.

Grantley Martelly 35:26

Yeah, there's so many things you can do with early detection and prevention that prevents you from getting there. Let's talk a little bit about the cultural factors. We have dietary factors. So, you know, cult food is really important in cultures, all cultures, and and uh you you know this and I know it from from our cultures. You know, a lot of us come back to Barbados and we want to eat Bijan food and we want to do all this stuff and we have our preferences. And I also want to I also remember you talking about when you were in medical school coming and studying how the diet was changing due to influences from America and Europe in the diet. So let's talk about dietary factors a little bit from a cultural perspective, because it doesn't mean that isn't bad, but what what do we need to be aware of about how our cultural preferences or cultural lifestyles may affect us health-wise?

Dr. Soyombo 36:18

I think, you know, as you said, food is it's a good question. Food is very important, and not just food, but good food. You know, people want to eat good food. Uh good food can be expensive. Our stressful lives make it hard for us to make good foods at home. So when you add that into the equation, what happens is people are eating out a lot. All right. Uh and back then, so one of the things we looked at, we went into the polyclinics and sort of had focus groups and discussed with, you know, people about their dietary modifications, what they were doing. And you could tell that people were moving away from home-cooked meals where you use ground provisions and healthy your your proteins and your uh your plant-based diet and healthy things to cook, you know, chicken to moving into now convenience foods, right? You know, have enough time to cook. So you're eating fast food that's loaded with salt, loaded with grease, loaded with calories. And, you know, so it it really plays a role in terms of why we're seeing this this uh rise in NCDs around the

Culture, Food, And Processed Eating

Dr. Soyombo 37:20

world. Uh and we're more sedentary too. And then you add the sedentary aspect of it. You know, you go to a drive-thru, you'd go you do you you sit in your car and great cat not even walking to get your food. I mean, I mean, don't get me wrong, that goes in the drive-thru.

Grantley Martelly 37:34

We all do, but you think about it, yeah. The difference is like 20 feet. But we don't get out of the car, yeah. Right.

Dr. Soyombo 37:41

And even when you look at our culture and saying that, oh, you know, we want to eat, you know, people want to eat well, you know, uh eating out a lot versus, as I said, the old way of cooking. You know, you have some of the occurrenarians that, you know, worked the fields and they also ate what they worked and have lived long healthy lives without comorbidities. But now we're seeing 30-year-olds developing diabetes and high blood pressure. And a lot of that again has to do with I think that we are the stress and not going back to how we used to eat back then. And then of course, you know, things that process food, you know, a lot of even if you're not eating out, it's easier to buy stuff off the shelf and throw things together. I mean, even I do it, right? Because you've had a long day at work and you come home and you don't have time to, you know, start soaking or craving something in the morning, finishing up it at night. So people are so even within your house, even if you don't eat out a lot, you're still buying a lot of processed foods. And we know that these processed foods, sugar sweetened beverages, other things that we're using, alcohol being one as well, uh, easy access to alcohol again to combat stress. And just because people feel like it doesn't make a difference, it's okay to drink. All these things affect our health. These are all parts of dietary things that we could change that could improve our health.

Grantley Martelly 38:53

Yeah, and sometimes, you know, I I try not to I try to be particular about saying when we talk about diet, it doesn't always saying that we we we can talk about the things that negatively affect our health. But there's also things in our diet that positively affect increase, you know, more more uh turmeric and more natural foods into our diet. So it doesn't diet doesn't always have to be negative. It can be asking the question, what can I do within my lifestyle and my environment to make my health even better? So yes, I don't have time to cook like I did, but when I eat, what can I be more than?

Dr. Soyombo 39:29

What can I put in there that's gonna be more yeah, that's gonna be more beneficial to me versus not. And there are lots of tricks and things there that people can get information about. If you're having difficulties, you know, you can speak to your doctor, they're lots of nutritionists. Um, and I don't want to say dietitian, um, they don't like to be called that, but nutritionist who can guide you to the right things to eat. Because a lot of time people think, oh, I'm doing nothing wrong, my blood sugar is spiking, my blood pressure is high, I'm doing nothing wrong, right? Right. But they don't understand that that nothing wrong might be exactly what they're doing that's affecting because it's so natural. Right. So even for people sometimes with diabetes, they say, Well, I you know, you I can't get my sugar under control. I'm eating lots of fruits and vegetables. But some of the fruits, you know, have a lot of sugar. So you have to eat them, you have to know which ones, and you have to eat them in moderation to make sure they're not spiking your blood sugar.

Grantley Martelly 40:20

Yeah. And I I I think this is really important topic too, for for especially for men, because a lot of times when you start talking about dietary, guys are like, Well, I don't want to go on a diet, you know. I want to eat what I want to eat and I want to do it. But dietary doesn't always mean you go on a diet. No, it's not. Sometimes it means you just do a few little changes here and there that can be a lot of things. Small, small stuff. Right. Because that's one of the cultural things. Women go on diet, men don't.

Dr. Soyombo 40:47

Yeah. You know. But even women, you know, for diets. Again, one thing I, you know, people, as you said, it's not about I always look at it a lifestyle change. Right. It's not a diet, it's a lifestyle change. It's a lifestyle change. You're eating better, you're eating healthier, right? So more fruits and vegetables, smaller portion sizes as much as you can. And not making drastic changes. Yeah, you want to go to that wedding and fit in that dress, you might go on a diet and make a drastic change for that reason. But really, it's not sustainable if it's not a lifestyle change that you're making. And little small steps can make a big difference.

Grantley Martelly 41:16

It can be very incremental. You don't have to do some of the stuff you see on TV, cuddle everything and do that. And sometimes that's in people's head, right? Like you said earlier about going to the doctor, right? It's in your head. Right. The same thing with food, it's in your head. Well, if if if you start talking to me about nutrition, that means that you want me to cuddle everything. My food's not gonna have any tears, my drink's not gonna have any tears, everything's gonna be bland. I don't want to talk about that. And I think that's not what we mean most of the time.

Dr. Soyombo 41:43

It's not, but I do think that there are some physicians and doctors out there. And I remember I was talking to a friend of mine who got a scare. And, you know, we have to understand we don't want to have the patient not come back and see us because we've now told them, don't eat anything, don't drink anything, right? You have to create that patient trust. So patients have gone the other extreme and then got sick because, you know, and that was the case. The doctor, I think he was found to be pre-diabetic and he cut everything out. And he was so miserable, you know. He was miserable, he was weak, he was tired because the doctor said, no, this, no, that, no, this, no that. And that's not, you know, it's not easy to do. So we have to be mindful, very abruptly. We have to be mindful of how we educate patients. And yes, we don't have all the answers, and that's why I tell a lot of people, well, you're better off senior nutritionist, because it does take a lot of time to sit and discuss all the different things and going through your food journal and all of that. So we have to be mindful of that, and patients also have to be mindful of that. That's small steps and not drastic big changes.

Grantley Martelly 42:43

Yeah. So, doctor, what are you what advice do you have for men who avoid regular medical checkups?

Dr. Soyombo 42:49

Well, first and foremost, uh, you're not gonna know until you are checked out. All right. Um you know, we we always one of the things that one of the the campaigns around the world and even here in Barbados Heart and Stroke Foundation is to know your numbers. You had asked about blood pressure. So if you don't see your doctor, how are you gonna know where you lie, right? Knowing what your blood pressure is and what it should be. Normal blood pressure is less than 120 over 80. That's normal blood pressure. People think only the diastolic being high isn't is is the issue. Or that 130, 140 is fine. Sometimes I ask people, you know, uh, what's your blood pressure? Oh, my blood pressure is fine. And I say, Well, what's the number? 140s, 150s. So you need education in terms of seeing the doctor, let them pointing out that your pressure is high and ways you can try to bring that down. Diet, exercise, they can look lifestyle modifications and they follow you over time so that as that blood pressure starts to go up past a range where maybe diet and exercise is not good enough, they can start to have a conversation about medications or what medications are gonna be best. If you're calm and your pressure is through the roof, you may have to be starting on medications right away because you are at risk of having a stroke or heart attack short term as opposed to, you know, long-term risk of those complications or dialysis or things like that. So you're not gonna know your numbers. You're not gonna know your cholesterol unless your doctor checks the blood test. Yeah. You're not gonna know your PSA unless the doctor checks the blood test. You're not gonna know if you have diabetes, you know, a lot of these things. And that's one of the reasons hypertension is called the silent killer because people don't feel Feel it. By the time you feel it, it's already too late. It's already causing damage slowly in different parts of your body.

Checkups, Targets, And Home Tracking

Dr. Soyombo 44:34

Same thing with blood sugar. By the time you feel it, sometimes you already have some damage already in your body. So in order to know your numbers and to lead a healthy, productive life, you have to see your doctor. And there are guidelines and recommendations for how often you see the doctor after, you know, you leave the pediatrician. It might be every, you know, three to two to three years, uh, three to five years, depending on where you are in your age. But once you get to a certain age, uh, you really need an annual physical. Now, you know, for teenage, for young adults, it's two to three years. And then once you get past a certain age, you should see a doctor annually. If you're on medications, you should be seeing the doctor every three to six months so that they can continue to feel the medications and observe your treatment to whatever medications you're on, whether it's for the blood pressure, whether it's for the cholesterol. So it's not a one fix, it's monitoring and managing these conditions by adjusting things.

Grantley Martelly 45:26

And it may need to be adjusted, yeah.

Dr. Soyombo 45:28

Yeah, and they and there has to be your body's changing. You're getting older and different things change in your body. You go through a stressful period and your pressure goes through the roof. So things are constantly changing, and you need to be guided by that doctor. So, you know, find a doctor that you, you know, a GP, you always start with a general doctor. I have some people that come directly to me, but I always tell people always have a general practitioner that you can grow with because then they have records when your kidney function changes, when the PSA changes, when the blood pressure changes, they keep track of your records and you start to develop an honest conversation and you can have shared interactions with them in terms of how best to take care of yourself. So that's what I would advise that at least see a doctor incorporate. Now we have a public health system. All right. There's no reason. There's yes, there's complaints about long wait times in the polyclinics, but every single person in Barbados is able to see a doctor for free. You know, the hospital is supposed to be for acute care. And when we have a lot of people coming in because they haven't been managing themselves adequately, the hospital becomes overwhelmed. So it is there for acute care, but people need to take advantage of the private doctors, the private GPs, and the polyclinics in order to get themselves checked at least once a year, even if they're healthy.

Grantley Martelly 46:49

Yeah. And and that's the Caribbean context. Those are available all across the island, all across the country. And and but even for but even for people in the United States and other places, you know, be a lot of people have health insurance. Yeah. And certain annual physical and certain tests are free in within the health insurance policy. And we still don't take advantage of it. So yeah, we have the system here, we need to take advantage of it. But those of us who are in other countries, there may be other things you can do for your annual physical that don't cost you anything and don't send you price up. All it costs you is a visit to the doctor to get it done.

Dr. Soyombo 47:27

And it's much cheaper than on the back end when you do get a medical condition that could have been avoided or managed correctly if you're waiting because you think you can't get that health care or that preventative care that you need.

Grantley Martelly 47:41

Yeah, and and sometimes you can just uh let the doctor know, you know, that something is going on. In in the US or where we live, we have something called my charts.

Dr. Soyombo 47:49

Yeah.

Grantley Martelly 47:50

And it's this sophisticated thing where you're testing and everything in there. But one of the beautiful things in it is that you can send a message to your doctor. A lot of times people call the doctor and they say ready for the doctor called back. And doctors are really busy. But I love that because you can send them a message and you can get an answer back. Sometimes it's not the doctor, maybe the nurse practitioner or whatever, but they're run it by the doctor for you during one of their breaks, and then they get you an answer back to your question. I mean, that is like beautiful.

Dr. Soyombo 48:19

And everyone, you know, everyone is working together. You know, again, electronic medical records have really been a game changer. So people have are able to have more interaction, they're able to have access to their numbers, their lab values, their blood pressure, all of those things that you need to know. I mean, it's something that we don't quite have yet here in the in the public setting. And the power clinics, there's a bit of that, but they're working on it, and that's something that is coming in terms of uh an electronic medical record and giving people access to their information um so that they know how best to do with it. I mean, of course, you don't want to just have the information blindly, right? Guided by the information. Yeah because otherwise it can cause even more stress, not knowing what what those lepers may mean.

Grantley Martelly 49:04

We can talk about that, I won't get into that. So we let's talk a little bit about your preventative care and screenings. Right. And then we can wrap wrap it up. So you we talked about know your blood pressure, know your cholesterol, diabetes screening, uh, weight circumference, awareness, family history. Uh, let's talk a little bit about uh the genetic, but I think we talked we touched on it a little bit that sometimes genetics can play a part in our cardiovascular health. But that doesn't necessarily mean that it's hopeless.

Dr. Soyombo 50:49

No, no, not at all. The whole goal is whether you have heart disease or you're preventing heart disease, it is treatable and you can live a full life with that. But it's important to know what your risks are. Family history is very important from that standpoint. So one thing I do know, I mean, a lot of the older people, the older folks, they didn't like to bother their children. They didn't like to tell them what was going on. They they for fear of putting that weight on them or scaring them. But it's important to know. Like one of the questions I always ask when I see patients is family history of sudden cardiac death and what was the cause? Do they know what happened? Um, or they might say, Yeah, my mom has heart disease, but they're not really sure exactly what it is. Well, you have to know these things. Just because you know it does not mean you are going to have that disease process, but it helps us know what to screen for. It's kind of like with breast cancer. If you know you have a family history of breast cancer, you you should get screening early at an earlier age than someone who may not have a family history. So it's not just cancers, but even for heart disease, you know what did the parents or the grandparents die of and what age do they die from. Um, so that, as I said, it doesn't not every genetic condition is passed down. Very small amount is passed down. But it's important that you know so that you can adjust your lifestyle and know when to seek a doctor, especially if you're having symptoms that you're not quite sure about, uh, so you can address those things and prevent a complication. So what does some of those in heart disease is or cardiovascular disease has a wide spectrum depending on what you're looking at. Uh but one of the things that

Warning Signs And Time Is Muscle

Dr. Soyombo 52:21

we especially worry about, especially at where time is essence, is heart attacks and chest pain. Right. So chest pain, chest discomfort, chest pressure, shortness of breath, especially acute onset of shortness of breath, passing out. So losing consciousness. Again, losing consciousness could be dehydration, but it could be an arrhythmic, it could be a heart condition, swelling in the legs, that could be a sign of heart failure. It could be a sign that you just have venous disease, but it could also be a sign of heart failure. So anything that is out of the ordinary, studying symptoms, you have to get urgent or emergency care. Chronic symptoms, again, you may follow up with your GP who may have a history and be able to do some initial investigations before they then go ahead and either refer you or manage whatever symptoms it is. But in terms of heart attacks, strokes, those are acute conditions that require emergency treatment. So any loss of function, loss of speech, loss of strength, sudden loss of strength, those are all signs of strokes. And then the signs of heart attack, as I mentioned, sudden onset of crushing chest pain. Women may present differently than men when it comes to heart attack symptoms. So if you're feeling something that is out of the ordinary, then you need to present. For some, it may be as simple as fatigue. You know. So again, you should, you know, know your body, but also know when something feels different. Because time is muscle. So we didn't get into the specific cardiovascular diseases, but the concern is, and a lot of people again think they're just having heartburn. If that artery gets clogged because of atherosclerosis, which is plaque, we talked about heart disease being um a disease process where the vessels can get clogged up um due to high blood pressure, diabetes, all those things, but that plaque that forms in your arteries can then rupture and cause a clot to form, and then you don't get blood flow. So blood flow seizes. If blood does not reach an organ, that organ is gonna die. And that's what a heart attack is. So if they do not get you in within 90 minutes, and we say 90 minutes is six hours, 90 minutes is the golden time to open up that artery, that muscle is gonna die and it's not gonna recover. And that's how people develop heart failure because of one of the causes of heart failure, among other things, is when that muscle dies, the heart goes from pumping at normal six to six to five percent to pumping at 30 or even 20 or even 10, 15%, because that muscle is now is now gone. So certain conditions, same thing with a stroke. If the if you cannot open up that artery, then that muscle in the brain dies. If you get acute care and they can open up that artery within a period of time, you can get complete recovery and heal completely. So that's why we take chest pain very seriously.

Grantley Martelly 55:08

One of three key takeaways that you would like our audience to know about our discussion today, from our from our discussion today.

Dr. Soyombo 55:15

Yeah, I think uh, you know, I think it all you probably can figure that out from most of, you know, the conversation. Um, they go hand in hand, know your numbers, have a primary care doctor and get your annual, your physicals, you know, see your doctor regularly. And I think one of the messages that we have to put out there is that heart disease is preventable, it is treatable, and we need to spread that good word and not spread myths about heart disease. It's treatable, it's preventable, know your numbers and see your doctor regularly. So if anyone takes anything out of this, see your doctor, know what your numbers are doing, and if you have concerns about it, you need to have a discussion.

Grantley Martelly 55:54

Yeah.

Dr. Soyombo 55:54

And then check in on your friends and neighbors and let them know that you know you need to get checked out.

Grantley Martelly 56:00

Yeah, and keep your numbers in your phone. That's what I do now. I have a note there and I keep my numbers in there, I keep my medication, everything in there. Right. So if I go to the doctor or a new doctor and they ask me whatever, I just put up the note and I say, here, here's the thing. Yeah, I'm a I'm a stickler.

Dr. Soyombo 56:15

I'm a stickler for that. I tell patients all the time, I know that life is hectic. Everyone has a phone. All right. They keep everything on their phone. Um, and sometimes part of our job is managing the medications you're on, knowing what what is going on at home and the office. A lot of people have what we call white coat hypertension when they're in a doctor's office and their blood pressure's just through the roof.

Grantley Martelly 56:37

Yeah, that's right.

Dr. Soyombo 56:37

So one of the things we have I advise patients is keep track of your blood pressure at home. It's not just about knowing it in your doctor's office. We didn't touch on that, but it's important that you keep a diary at home. If you do have high blood pressure, make sure it's well controlled, not just in the doctor's office. And uh know your medications because God forbid you end up in the emergency department or you end up somewhere. You want to be able to tell them what you're on so that we don't cause a medical error by giving you something that interacts with something.

Grantley Martelly 57:04

Yeah. And I learned I learned

Key Takeaways And Community Support

Grantley Martelly 57:05

also not just the near but the medication, but the concentration of the medication. And the dose. The doses, yeah.

Dr. Soyombo 57:11

It can't be that little white pill or that little pink pill because there's thousands of white pills, but people always tell you that that that pill. I'm like, please take pictures of your medications. You don't have to bring the bottles. If you bring the bottles, great. But take pictures. But there's also a lot of polypharmacy. So you're seeing this doctor, you're seeing that doctor, and you may I may prescribe something, another doctor may prescribe something. So sometimes people are taking to all the same medication, and then they don't feel well, and they're claiming another medication, but it's also because they're not taking it correctly or they're mixing up incorrectly. So all your doctors should know exactly what you're taking, even if it's not related to whatever condition you're treating them with. Uh, just make sure they're aware that this is what I'm taking. It's important to some doctors based on how they're treating you, and for some doctors, they don't need that information, but you should always have that information readily handy.

Grantley Martelly 57:59

So use your phone, put it to use.

Dr. Soyombo 58:01

There's so many apps that you can use to keep track of these things, you know, to keep to look at the trend in your blood pressure. It can alert you when it's running high or when it's low, you can list all your medications.

Grantley Martelly 58:12

I mean, you don't have to you don't have to try to remember all of this stuff. There's so many tools out there, and lots of them are free. The note that I use on my phone is free. It just just put it in there. Like you said, sometimes I take a picture of it, and that that has helped me so many times where I just hand it to them, and I remember one doctor said, So thank you so much.

Dr. Soyombo 58:30

Yes, I love it when I love it when they cover that. I mean, we tend to tell our patients, especially our new patients, they're coming in.

Grantley Martelly 58:36

So let's end on hope. Let's end on hope. What are some community-based solutions and things that we can do? We, you know, this is a reality for us, but it is not the end of the world.

Dr. Soyombo 58:47

No, no, we all have to, yeah. I mean, I think at the end of the day, we have to be each other's what's the word? I don't want to say neighbor, but look out for each other. Keeper, right? There's the word. There are lots of ways to get the care you need. Churches, lots of health fairs people have, reaching out to people if you have a question or a problem. So outside of the doctor's offices I'm talking about. You know, and of course, there's there's uh organizations like the Heart Instruct Foundation of Barbados that does advocacy, they do training, they do teaching, they do rehabilitation, and they try to spread the word. They do campaigns where they spread the word about heart disease and diabetes and obesity. So, you know, there are lots of tools, not just Dr. Google. Dr. Google, you can get some information, but Dr. Google can also cause confusion and anxiety.

Grantley Martelly 59:33

And stress.

Dr. Soyombo 59:34

And a lot of stress. So you tend to get overloaded. Yeah, use your community, use the people at hand that can help. Uh and then we already spoke about, you know, just having a relationship with your doctor. The whole goal is to live a healthy heart life. And that is definitely doable, even if you're already diagnosed with heart disease.

Grantley Martelly 59:54

Yeah, it is. It is possible. So, how do people get a hold of you, Doctor? So, Yambo, if they would like to have ask any questions or if i in Barbados or outside of Barbados?

Dr. Soyombo 1:00:05

We have an email address. Our office is healthyheartbarbados at gmail.com. So you can send us an email in Barbados. You can call our office if you have questions, 417-3436, and they can definitely reach me that way. Yeah. And I'm also at the hospital, of course, the hospital operator.

Grantley Martelly 1:00:20

As well, yeah.

Dr. Soyombo 1:00:20

Yeah, yeah.

Grantley Martelly 1:00:21

Okay, well, thank you very much. And we will put in the show notes uh some more information about Dr. Soyombo and the information about how to get in touch with her if you have any questions. So check that out as well. And thank you for your support again. And Dr. Soyombo, thank you for taking the time today. I really appreciate you.

Dr. Soyombo 1:00:39

Yeah, and thank you for doing this and shedding light on heart disease, especially in our men. Thank you. And encourage them to take better or good, I shouldn't say better care of themselves. Thank you.

Grantley Martelly 1:00:51

Write to us at realhealthblackmen at gmail.com. Realhealth blackmen at gmail.com. To support this podcast, go to buymeacoffee.com forward slash Real Health Black Men. BuymeACOffee.com Real Health Black Men. To become a corporate sponsor, send us an email.