For Kidney Health: Prevention is KEY!
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Kara Wada, MD: Welcome back everyone to this week's episode of the Becoming Immune Confident Podcast. I'm your host, Dr. Kara Wada, board-certified pediatric and adult allergy immunology, lifestyle medicine physician and systemic Sjogren's patient. And I am so excited and honored to welcome one of my colleagues and friends, Dr. Didi, to the podcast today. She is the founder of YoungerSelf MD medical clinic, health and wellness, and she is Board Certified in internal medicine, nephrology, which we'll talk all about. And hypertension, also known as high blood pressure. She is an Adjunct Professor with Morehouse School of Medicine and as a physician and health coach, she helps adults at risk prevention and treating chronical medical conditions like diabetes, high blood pressure, obesity, and kidney disease in as little as 30 minute consultation so that they can go on to live healthier, happier, and longer lives. Thank you so much for taking time outta your busy schedule to join us today, Dr. Didi. I'm so excited to welcome you as, you have the honor, you're the first nephrologist that we have had on the podcast.
Ndidiamaka Obadan, MD: Wow. That's amazing. Thank you so much for having me, Dr. Kara. I'm so glad to be here. And just for my whole name is Ndidiamaka Obadan and I'm fondly known as Dr. Didi. It's a whole sentence, right?
Kara Wada, MD: Can you share a little bit about what you do and how you ended up doing what you do?
Ndidiamaka Obadan, MD: That's a long story. We'll cut it short. What I do? I'm a physician. I am an educator. I identify as an educator because I wanna stay affiliated and in touch with my university and pass on my knowledge.
I'm also a TEDx speaker. I love to speak and share my experience with the world. So I went to medical school. I'm the founder of YoungerSelf MD Medical Clinic Health and Wellness, which is a practice located in Kennesaw, Georgia.
And I'm an entrepreneur at this stage of my life. I love to practice in the clinical setting. I have transitioned from the inpatient hospital setting to the nephrology outpatient setting as well, and now I'm doing both in my own capacity as an entrepreneur.
Kara Wada, MD: Can you share a little bit about what the daily life of a kidney specialist may look like? Who are you seeing in clinic? What things are you talking about?
Ndidiamaka Obadan, MD: Wow, that's a good question. So one of the things that made me go into this field of nephrology is how versatile it is. There's so many different aspects and I have decided to try to carve out the aspects that I like to focus on.
So a typical day for me at this point is to go to my clinic, because I'm trying to just stay within the outpatient side, but generally, for most nephrologists, you can be an academician and that there are different tracks, is what I'm trying to say. There's the traditional track would be for them to go to the clinic setting or it depends.
They might wanna go to the hospital first to round on their patients and do consults and then go to the clinic in the afternoon and go for dialysis rounds. Different other times of the day, and they'll be on call at night. The call is typically weekend calls in some settings and Friday to Monday and yeah so there's so many different settings.
So for me, currently I'm practicing mostly in the clinic setting and I have an interest to continue seeing some dialysis patients although my focus now in the clinic is mostly on prevention, as we're talking about earlier and as was the topic of my TEDx talk, I haven't been through different clinical settings. Oh, I forgot to add the part about the research track. There's also a research track for nephrologist, which is where I originally started from in research doing evidence-based guidelines, clinical practice guidelines in Boston many years ago. I feel like that's a totally different life, lifetime ago.
But yeah so there are so many different tracks that the nephrologist can take and after seeing all those, I figured now at this stage, I really wanna focus on the prevention of kidney disease 'cause I think it really dawned on me that there's a lot more that we can do as specialists to try to prevent kidney disease when I saw all the pain and suffering that was going on within the hospital setting. At some point in my life, I wanted to be an intensivist strictly, you too, right?
Kara Wada, MD: Yeah. For A hot minute. There's something sexy about it. Saving lives.
Ndidiamaka Obadan, MD: And of course as a physician, you're saving lives for the most part at all times, hopefully but in the ICU and the emergency room, it's really fast paced and you have to make decisions quickly. There's no time to ponder and I was very good at that, and I was very good with my hand. I still am, I'm still good at, doing things and helping and procedures. We were trained to really do a lot. But what happened was I got a different experience, especially during COVID. I started to see a lot of patients who would come into, even before COVID, I think they started way before COVID when I started making my mind to really help us make us focus more on prevention.
When a patient comes into the hospital and they've never been told that they have problems with their kidneys, and they walk up to me and now all of a sudden I'm telling them that you have to be on, this is what's going on and your kidneys have failed and now they're no longer working anymore. That's why you feel so crappy. That's why your body is swelling. That's why you'll feel so tired and have all this weird taste in your mouth. Or maybe that's why you have some bleeding tendencies. And now we have to go ahead and put you on dialysis and or we need to start working you up to get a transplant, or we need to start working to get an access.
It depends on when they come. Usually, if they come really emergently, then we have to go ahead and start putting in some catheters. It's usually very traumatic for the patients. It's traumatic for the family members, their loved ones. Everyone is running crazy all over the place.
And then, after all the chaos, I would go back home and reflect and just think, did all that really need to happen? Like seriously, having my research experience of, going through charts and trying to ask all the questions, why did this happen? Why did this happen? I would go back and find out that all this started from someone who had some risk factors that they may have been able to prevent or control.
The most common cause of kidney disease is diabetes. Most people have diabetes, high blood pressure, obesity, metabolic syndrome, hyperlipidemia, all combined together, and by the time, each of them makes the other one worse and they're all damaging the organs particularly the kidneys, the heart, or if the person's coming down, we have so many different causes. Don't let me spiral down. Interrupt me please, because this is something I'm so passionate about and I can just keep going and going about it.
Kara Wada, MD: You added potential of like autoimmune disease too, right? We're using prednisone pretty often as a rescue, that prednisone has consequences. It increases our blood sugar. Increases our blood pressure, right?
Ndidiamaka Obadan, MD: Back in the day it was like the golden drug. Our predecessors, I feel like they must have done the best they could. So yeah, prednisone was the drug for everybody at some point in time but it does come with its side effects and like you were saying, so yeah, science has evolved such that we now have many different options and those medications also come with their side effects as well and at the end of the day it's like a balancing act of trying to make sure that we're not doing any harm, as we all said we were gonna do when we started working as physicians.
Kara Wada, MD: So when you were talking about prevention, are there some strategies that you tend to talk to your patients about time and time again that are things we could share here.
Ndidiamaka Obadan, MD: Yes and I know as related to autoimmune, since your audience is mostly autoimmune. A lot of autoimmune conditions that affect the kidneys and some of them we can interrupt because the environmental factors and all the other socioeconomic factors, social determinants of health may worsen those things. There are a lot of disparities that have been found in people with lupus and many other ethnic groups, like the Hispanics, Asian population and mostly the African-American population have a high incidence of lupus.
So yeah, the environmental factors, in addition to the genetics and as we're talking about earlier, the medications, the things that we consume over the counter those are factors, because they have a lot of chemicals, that are added in. So I was sharing a couple of minutes ago to my patients, now, not all supplements are good. A lot of these things have so many different concoctions that might interfere with your system and cause you to react in a certain way. There are a lot of other ways that we can prevent triggering these. Even if you have inherited the conditions, because there's some genetic factors, right? There are some genes that are associated with some of these autoimmune conditions, but there are some things that we can do to modulate those genes and our diet, for example, consuming a highly anti-inflammatory diet is definitely going to bring out the worst of the worst genes that you can think about and stimulate all the autoimmune disease and cause the kidney problems
Kara Wada, MD: High sodium, high saturated. Are there other things that you tend to tell people to stay away from or to add things that are beneficial?
Ndidiamaka Obadan, MD: When they already have established kidney disease or before, depending on their risk factors, if you already have established kidney disease and are having issues, yes, we wanna stay away from processed as much as possible. It's easier said than done. Processed foods. Because they come with all those preservatives. Now this is speaking from an allergy standpoint, the preservatives may cause you to react to one thing or the other. And so processed sugars.
Yeah the bad gut bugs, right? We have the good bugs and the bad bugs. And what you want to do is to anchor what we call it the gut microbiome. Microbiome, yes. We wanna keep those healthy and encourage the good gut micro biota.
So try to go fresh. Fresh is better. Fresh foods. So try to stay away from the canned everything, canned soups, because they are high in sodium as well as those preservatives that we're talking about.
Stay away from those, go fresh and cook your own meals if possible and the whatever over-the-counter medications that you're taking, especially in the allergy world, we tend to, people who have like acute respiratory may go and load up with some of those over-the-counter meds that have pseudophed rine and that will cause a lot of vasoconstriction and damage, multiple different things within us. So we wanna try to use them in moderation if you have to.
Kara Wada, MD: Yeah and then any rules of thumb with the nonsteroidals, cause those are so often used for the sinus headaches we get to the aches and pains and things we may get from like arthritis or other connective tissue stuff.
Ndidiamaka Obadan, MD: Yes, definitely. Non-steroid antiinflammatory, they come with different trade names. You just have to look at the bottle and see, I don't wanna go ahead and call trade names and then have all these companies. Naproxin, ibuprofen, meloxicam. So many different, and they changed the name. Even aspirin sometimes has NSAIDs included. They changed the name in different countries, it's different names. I'm originally from Nigeria, even though I've been in America for many years and I travel a lot, Canada, UK but in all these different countries and I'm sure you know that they have different names in different countries, so it's about identifying the generic names that 's common across board. One way to do that is to just identify NSAIDs. They can cause high blood pressure, they can worsen you r blood pressure, they can cause you to have GI bleeding. They can definitely affect your kidneys in multiple ways. There's so many different ways in which they affect the kidney. So there are many different ways that the NSAIDs affect the kidney directly and indirectly and they affect every other part of your body as well.
So they're good. I don't wanna make it seem as if they're the worst medicines in the world because there are some indications. So that's the thing, you can't just go all out and just bastardize or condemn this drug because it'll make it sound as if the original people who created the drug were out to kill and hurt everybody in the world. No, that's not what they were intending to do. But it's how it is used in the marketplace and when people are not aware of the side effects of these medications or self-medicating. That is why physicians go to medical school and go to residency and fellowship and do research and get all these years of training to gain the expertise so that they can make informed decision for their patients, with their patients. I always like to make these decisions in partnership with my patients.
So back to what I was saying about the NSAIDs, there are some good indication, like they can help with gouts, for example, pain and some acute inflammatory conditions, autoimmune conditions.
Sometimes you just have to use NSAIDs for a short period of time, and as prescribed, you might need to, don't overdo it, and that's when you start having issues.
Kara Wada, MD: Doing it under in consultation with your team too. For instance, I know I have some patients I share with some rheumatology colleagues and if someone is on long-term NSAIDs, they'll make sure to be monitoring their kidney function more frequently and and watching dosage, making sure you're not taking something in addition to your prescription, so maybe you have Meloxicam prescribed, it's important to know that ibuprofen is also an NSAID and you shouldn't be taking both.
Ndidiamaka Obadan, MD: That is a hundred percent correct. So being able to identify all the different trade names and knowing when you're taking multiple doses of the same thing, which can definitely cause things to happen. And then adjusting your medications, with your doctors and that's why it's good to keep those appointments.
Kara Wada, MD: One question that I get asked all the time, both on the internet and in the office and everything is what should I do to help like my body detox or is there something I should do?
And we know the liver and the kidneys are part of our natural system of getting rid of waste, but maybe you could talk a little bit about the nephrologist take on it.
Ndidiamaka Obadan, MD: For me, I didn't know if my opinions might be the popular opinion and that's okay. It's mine and I'm entitled to it. With the detoxing, it depends on where you're at. This is where I'll start from. What are you detoxing from? So if you're someone who's already having the habit of being addicted to, we talked about earlier, processed sugar and if you are, trying to get into detox from that, then yes, that would be a good, definitely suggestive and how to go about it is to start with your mindset.
Reach out to, if you don't have, so for some people they need to have a therapist. Some need a coach and some need both. You get with whoever it is that you need to start working on the mindset to create this first step, which for you to win in this new thing that you are about to embark on.
I really like to do things as naturally as possible, so you wanna build your own confidence in this new habit that you are about to start, right? Because you're trying to create a new person from the person who was addicted to sugars or whatever it is that you were addicted to.
And you get your accountability partners. Those guys we just talked about, other people who are gonna keep you in check. You decide that you're gonna do it, and you do it. If you're addicted to some of those drinks, energy drinks have a lot of those chemicals and preservatives that can worsen your autoimmune conditions, your inflammation and your kidneys.
You might be able to quit cold Turkey after you've made the decision to but some people need more help. And if you are one of those people, you know you need help, then you start, you break it down, you write the big goals and with the end of mind, You break down into smaller steps and start to move the needle slowly.
So instead of quitting from four drinks, trying to just go all the way from four drinks a day to zero, you might wanna break it down to two, from four to two, or even from four to three. And, see how you do on that.
Keep encouraging yourself, having all your coaches and mental health professionals or therapists or whoever it is you need, in fact you might even just have close family members or friends who understand you're about to embark on this journey.
The more people you can recruit, to your side to build this habit and stay consistent, the better, because you really don't wanna be hanging around the people who were causing you to get involved in that habit in the first place after you're trying to embark on this journey. The more you can recruit to to your side of forming the good habit, the better. You know what I mean?
Kara Wada, MD: Yes. What I'm also hearing is what you're not saying. We don't need to go out and buy some special product that is necessarily that's marketed to help us, like detox in some way or do a cleanse or what have you.
Boils down a lot into the mindset and making those habit changes instead.
Ndidiamaka Obadan, MD: As a kidney specialist when it comes to cleansing things, I'm not really a fan of those a lot of the cleansers we were just talking about.
Before you know it, the person's gonna come down with diarrhea and hypotension or some kind of weird consequence. There are some new medications that have kidney protecting effects. That is not what we're talking about. We're talking about natural healing, right?
My first thing would be to get your mindset intact, fixed, and start the new habit. Take action. Do it.
And the second thing would be to combat inflammation as best as you can. We talked a little bit about the diet, right? And to me it's another natural cleansing way, switching from an inflammatory to an anti-inflammatory diet and getting good sleep because that is when most of the healing processes take place in the body. Those would be, for me, the three biggest things to cleanse and to cleanse everything, all the organs in your body.
Naturally, we wanna stick to the natural cleansing.
Kara Wada, MD: I'm laughing cause the other thing that comes to mind, I'm thinking going non-toxic is the idea of our relationships too. And you hit upon that with finding that support network that is going to lift you up rather than try to keep you in the place that no longer serves you.
And so sometimes that is that is part of the cleanse as well, is, having to take a long, hard look at some of the relationships that we have.
Ndidiamaka Obadan, MD: The thing is relationships are very tricky. We can go to different angles. What I was gonna say is the philosophy of just cutting it off completely. The relationship or trying to mend it and build it. My original take was, I feel like you should try as much as possible to recruit, because sometimes it's not that easy to just transition to a different, it's possible, it's also an option, but at what cost? What are consequences of that transition and how many layers of, even possible generations are you gonna affect by making that transition?
Would it be better to see if you can walk around and trying to recruit them? Because if you are getting healthy too, chances are they're gonna get healthy, right? We're trying to form good habits, right? We're trying to form good habits. Just the same way.
Kara Wada, MD: Influence can be contagious.
Ndidiamaka Obadan, MD: Yeah. Correct, just the same way the negative influence is contagious. The positive influence can be contagious and we can definitely create a win-win situation for everybody.
Kara Wada, MD: I love that a lot. So where can people find you to connect, to learn more, to listen to your TED talk?
Ndidiamaka Obadan, MD: I have a website my business name, youngerselfmd.com. My TED talk is on there and I'm currently accepting patients. As a health coach, as a physician health coach, I help adults at risk, prevent and treat medical conditions like diabetes, high blood pressure, chronic kidney disease, obesity in as little as a 30 minute consultation so they can go on to live healthier, happier, and longer live. So schedule an appointment with me on my website.
You can call me (404) - 566 - 4623 and I'll be happy to see you as well. Or you can go on my website, just click book now and we can talk.
Kara Wada, MD: Super easy. And that's for folks all over.
Ndidiamaka Obadan, MD: All over, correct? Yes.
Kara Wada, MD: So I always like to end each show, the name of the podcast becoming Immune Confident, do you anything to say how that kind of lands or what that means to you?
Ndidiamaka Obadan, MD: Yeah, that's a very interesting name. Becoming Immune Confident. I love it. So for me, what first comes to mind is, You are becoming immune to the negative that we were just talking about. You are creating a new you and forming into something better than what was and how to create this community of people that you're pulling along with you. It's a great, it's a powerful name. I love it. I love it.
Kara Wada, MD: I really like that idea that you touched upon too, of really aiming for that win- win when you are bringing and recruiting those others in your lives to have that support, that accountability for one another. Yes. It's really hard to make those changes day in and day out.
Ndidiamaka Obadan, MD: And as an entrepreneur, this can look like you being the boss and everybody you employ, recruiting them into the wellness, into the healthier options for doing things. It can be as a mom recruiting your kids and teaching them the good habits right from the get-go, right from when they're really young. As a wife, it can be recruiting your spouse into the good habits that you are trying to develop, if you're trying to get into a routine, get into a healthier diet so it can look different for different people.
Kara Wada, MD: Absolutely. My why and the reason I do all of this, and in large part are my kids. I know that there is that genetic susceptibility , even though we had no real family history of autoimmune disease before my generation or food allergy before my kid's generation ,with my second, obviously there are the genes there that can be turned on. So what can we do and what habits can I teach my kids and help other families learn so that they can decrease their risks as well. It sounds like a lot of the work you're doing with your community and clients as well, which is fantastic.
Ndidiamaka Obadan, MD: And we have a lot more work to do. We just started and we're gonna win for sure.
Kara Wada, MD: Yes. Thank you. Thank you. Thank you for your time, your expertise, your energy, for everything this morning. Dr. Didi, I appreciate you.
Ndidiamaka Obadan, MD: Oh, thank you for having me, Dr. Kara. This was really nice.
Kara Wada, MD: Hey, everyone. I am going to ask you once again to go into Apple podcasts and submit a review of the podcast for me.
But first I'm going to share a review from Dr Lex RX.
"Dr Wada's unique perspective is amazing considering she's both an auto-immune patient and physician. Her experience, expertise and insight make this podcast so valuable. Keep them coming."
One other from Amanda Katherine.
"Wow. So informative. Thank you for bringing more attention to autoimmune diseases. Each podcast is so informative and well thought out. Very impressed with all that you do."
Thank you so much, Dr Lex Rx and Amanda Katherine. I really appreciate the feedback and the review.
If you aren't subscribed yet head over to drkarawada.com and in the upper right corner, you can hit the subscribe button.
Thank you so much because apple podcast reviews are one of the ways to increase how many people are able to access and see all of this education and information we're putting out into the world.
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