Dr. Martinez-Cruz Talks Innovative Medical Practices and Weight Loss

Dr. Martinez-Cruz Talks Innovative Medical Practices and Weight Loss

In this episode of Open Forum in The Villages, host Mike Roth interviews Dr. Bayoan Martinez-Cruz about his unique medical practice in The Villages, Florida. They discuss Dr. Martinez-Cruz's background, his transition from a traditional practice to a membership-based model, and the benefits it provides to his patients. The conversation covers a range of health topics vital to seniors, including the use of GLP-1 drugs for weight loss, their side effects, and additional therapeutic benefits for conditions like dementia and liver disease. Listener questions and practical tips for health management are also addressed, making this episode a comprehensive guide for anyone interested in senior health and wellness.

00:00 Welcome to Season Seven
00:53 Meet Dr. Bayoan Martinez-Cruz
01:01 The Concierge Medical Practice
01:31 Dr. Martinez-Cruz's Background
06:48 Weight Loss Drugs Discussion
20:23 Side Effects of GLP-1 Drugs
28:06 Additional Weight Loss Medications
32:04 Conclusion and Contact Information
33:13 Support and Next Episode

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Transcript

Dr. Martinez-Cruz Talks Innovative Medical Practices and Weight Loss

[00:00:00] NANCY: Welcome to Season seven of Open Forum in The Villages of Florida. In this show, we talk to leaders of clubs and interesting folks who live in and around The Villages. We also talk to people who have information vital to seniors. You will get perspectives of what is happening in The Villages, Florida area.

We are a listener supported podcast. There will be shoutouts for supporters. 

[00:00:33] Mike Roth: This is Mike Roth. Listeners, I'm thrilled to share with you this podcast, my passion project for you. This podcast brings you knowledge, inspiration, and things you need to know about the people and The Villages here in Florida.

[00:00:51] Mike R: On Open Forum in The Villages, Florida. I'm here today with Dr. Bayoan Martinez-Cruz . Thanks for joining me, doctor.

[00:01:00] Dr. Bayoan Martinez-Cruz (2): It's my pleasure. 

[00:01:01] Mike Roth: You run a concierge medical practice here in The Villages. 

[00:01:07] Dr. Bayoan martinez-Cruz: Actually, it is not a concierge, it's a creation of myself where I charge a fee as a club.

patients get the guarantee of seeing me when they need to see me and not when I want to see them. If I do a concierge, then the fees will be much higher than what I normally charge. 

Okay. And why don't you tell our listeners a little bit more about your background, where you went to medical school, where you interned, and how long have you been here in, in The Villages?

I was born and raised in the Dominican Republic. Went to medical school back there. In the first university in the Americas, founded in 1538 and I came to the United States in 1988 already as a physician. I started practicing at Montefiore Medical Center in the Bronx where I did training in internal medicine.

From there I moved to. The Massachusetts General Hospital in Boston the main teaching hospital for Harvard Medical School. I became an instructor in clinical medicine as well as a practicing physician and moved to The Villages in 2006. since then, I have been in The Villages area. 

Practicing in The Villages area. 

[00:02:35] Mike R: What drew you to The Villages?

[00:02:37] Dr. Bayoan martinez-Cruz: Correct. The most important thing is that I do not like big cities. I like countryside peace, quiet. And I thought that was the ideal location for me. Because it has all the amenities of a big city, but all the life of a countryside. 

[00:02:58] Mike R: You set up your practice here, this concierge club in 2006? 

[00:03:05] Dr. Bayoan martinez-Cruz: I was working as a clinician and medical director for a private group. In 2013, I became independent. Too many patients to take care of. I was working about 18 hours per day and I told my wife that I was certain I would die young, working the heart.

So I decided to build a, membership. Where patients pay a fee to be part of the membership and I take care of those patients. But I was not mandated to have thousands of patients. 

[00:03:42] Mike R: I was in Cincinnati and my doctor there would see 60 patients a day, correct? About 15 minutes each. And one day he said he was going to have a patient's meeting and he rented to the big auditorium and he said, I'm going to enter the MD VIP concierge practice and you could join me there for a fee or we'll send your medical records wherever you want them to go, and all of a sudden he was cut down to 600 patients.

[00:04:15] Dr. Bayoan martinez-Cruz: Absolutely. my goal is a thousand patients and currently in the eight hundreds. But that is a guarantee that if you need to see me tomorrow, I'm open for you. 

[00:04:25] Mike R: And that's one of the biggest complaints people have about physicians here in, in primary care in The Villages. If you have the Village's health service, I don't know what they're calling themselves now. You could wait a week or more to see a doctor for a condition that might wind you up in the emergency room where it could be taken care the same day. Much better.

[00:04:47] Dr. Bayoan martinez-Cruz: Emergency rooms are not trained to deal with day-to-day issues.

They are trained to manage. Emergency situations. So they are not as great at managingasthma or high blood pressure diabetes unless they are really out of control they can do the best they can to bring it down. And then the consequence will be admission to the hospital. So we can start the process of adjusting you to the home medications.

the medicine that we practice is completely different, 

[00:05:23] Mike R: But in the emergency room, they don't know who you are. They don't really know what your true history was. Although I was impressed when I was in Manchester in New Hampshire. I fell on the escalator, my suitcase fell on my wrist, and I had to go to the emergency room

okay. And by some hook or crook, they were able to see my medical records because they were on the same system as my other doctors. I don't know , but I had three or four physicians here in The Villages and they were able to pull up my medical records in Manchester, New Hampshire. I thought that was really cool.

[00:05:59] Dr. Bayoan martinez-Cruz: The goal, originally when we went into electronic medical records, Was that eventually all the medical records will be interconnected so we can pull records from anywhere in the United States. But that met resistance because of the risk of privacy being given away. So we haven't been able to fully accomplish that goal.

Yeah. But it would be extraordinarily good for patients when we can interconnect all the electronic medical records. So it doesn't matter where you go, they will have your record there. 

[00:06:36] Mike R: It was a good thing when they had every drug that I was taking right there on the screen. The doctor could know what I was allergic to, and that made it a much better visit. So I asked you to come here to talk today about weight loss drugs. There are a number of 'em out there on the market today in the GLP1 family.

That have seemed to have had some success. Are you using those drugs extensively in your practice now? 

[00:07:06] Dr. Bayoan martinez-Cruz: Yes. There is a restriction and we're concerned about the price.

They are expensive medications. I tell my patients to see it as an investment the same way they would with plastic surgery, The benefit of weight loss is not only psychological but also health-wise it changes the course of many diseases.

today we have potential cures for some conditions, including with this particular group of medication. What is very prevalent today? That is dementia. 

[00:07:41] Mike R: Dementia. 

[00:07:42] Dr. Bayoan martinez-Cruz: Dementia is the unhelp

[00:07:45] Mike R: How does that work with the GLP one drugs like Ozempic and Zepbound 

[00:07:52] Dr. Bayoan martinez-Cruz: Correct. The studies show that memory. Doesn't come back, but it stopped getting worse with the use of ozempic or Zepbound.

We don't have any data on that yet, But it's coming because Monro tends to be a combination medication. It's an appetite suppressant, but it also has some hormonal benefits, Monro is already approved for sleep apnea Because it improves patients with sleep apnea. Yes, it has a lot to do with weight loss. But it's being used officially, insurances like Medicare are paying for patients with sleep apnea to use Monro.

[00:08:34] Mike Roth: Yeah. We had Peter Bernard on and he told our audience that he was taking Z bound. To reduce his weight. And it also has reduced his need for his CPAP machine. 

[00:08:48] Dr. Bayoan martinez-Cruz: There is evidence that he has the potential to cure liver disease, in particular fatty liver disease and liver fibrosis.

With the ozempic, data shows a 63% reduction in liver. fibrosis. With the mounjaro preliminary data shows up to a 90% decrease in fibrosis. for the audience liver cirrhosis is basically fibrosis of the liver.

The liver a soft organ becomes hard like a stone. when medication decreases fibrosis we are talking about a potential cure for liver cirrhosis. the importance of curing liver cirrhosis? is significant; it carries a 50% chance of becoming liver cancer. so when we cure cirrhosis, we are decreasing the potential for liver cancer.

[00:09:45] Mike Roth: And that's not the same as fatty liver disease. 

[00:09:47] Dr. Bayoan martinez-Cruz: Fatty liver disease is the deposit of fat in the liver tissue, and it is abnormal. the way I tell my patients to see liver disease is taking them mentally to a supermarket. And seeing a cow liver that is homogeneous coffee ground. then I tell them, put some yellow spot and that is fatty liver.

The fatty liver has a risk of becoming liver cirrhosis. liver cirrhosis can, become hepatoma or liver cancer. 

[00:10:24] Mike R: How is that fatty liver disease diagnosed?

[00:10:27] Dr. Bayoan martinez-Cruz: usually an ultrasound is the best method to diagnose fatty liver disease. anyone that has fat deposited in the abdomen has fatty liver.

it's very common. Millions of Americans have, it, even if many don't know italcoholism is one, reason, drinking too much alcohol. diseases like diabetes are also highly associated with fatty liver disease. today we call it MASH because it is secondary to metabolic conditions.

[00:10:59] Mike Roth: I do have a friend who was diagnosed with fatty liver disease and she was overweight after six months on ozempic. She slimmed down a lot. She looked a lot better. She told me that she was cured of fatty liver disease and was off ozempic. Is that a regular occurrence?

[00:11:18] Dr. Bayoan martinez-Cruz: That is what we were just talking about with the ozempic over 60% decreasing fibrosis and highly chance of curing the liver disease with positive fat.

With the manjaro, the numbers are higher. The same thing happens with weight loss Ozempic and it's brand for weight loss help to decrease about 16% of the body weight. The manjaro about 22%, so it's a 6% difference in the reduction of weight between one and the other. 

[00:11:57] Mike R: Majaro is the newer one.

They, today, the manufacturing companies, because of the frequency of obesity or overweight in the populationover 60% of the American population are there. The company decided to sell directly to people. For a cash price of $500. That's Eli Lilly.

[00:12:24] Dr. Bayoan martinez-Cruz: . 

Eli Lilly, but also CPIC did the same thing, and I don't recall exactly what company makes of Ozempic.

[00:12:31] Mike Roth: For what number of doses do you get for $500? 

[00:12:35] Dr. Bayoan martinez-Cruz: Very good. All the dosages are $500. the maximum dose is 15 milligrams weekly. The one that preceded the 15 milligrams is 12.5. Those ones are just brand new as of a week ago. Before that they only made it to 10 milligrams.

Okay. And now you can buy even the 15 

[00:12:56] Mike Roth: And they're in these self-injectable single use correct dispensers? Yes. How many of those do you get for $500 

[00:13:03] Dr. Bayoan martinez-Cruz: Four weeks. 

[00:13:04] Mike R: So that's about $125 per week for four weeks. 

[00:13:10] Dr. Bayoan martinez-Cruz: But I can tell you that in a local pharmacy would be about $1,300.

[00:13:15] Mike R: That's a big difference.

[00:13:17] Dr. Bayoan martinez-Cruz: So again because of the benefits, the two manufacturers of Ozempic and Manjaro, both have done those special contributions. That is why most of your patients 

[00:13:29] Mike Roth: are buying the meds. 

[00:13:30] Dr. Bayoan martinez-Cruz: Many of my patients find that the medications are too expensive for them.

you have to understand that The Villages is a medium to high class community. But there are many of my patients that retired 30 years ago. they're in the high eighties now. The retirement check is low because it's based on 30 years ago.

[00:13:53] Mike R: Mitigating factor.

[00:13:54] Dr. Bayoan martinez-Cruz: . 

Correct. 

[00:13:55] Mike Roth: Do you recommend any compounding pharmacies for the drugs? 

[00:14:00] Dr. Bayoan martinez-Cruz: That is an excellent question. the FDA. as we speak today. has stopped The compounding of those medications, particularly TirzepatideThey are allowed to sell whatever they were left with, but as of July they're not allowed to make any more for the people that want. to lose weight. There are also pills that we can use. I prescribe a lot of phentermine, because it is quite inexpensive.

[00:14:28] Mike R: Insurances don't pay for the cost of weight loss medication. the $500 have to come out of the pocket for the injectable. The phentermine costs about. $12 to $15 a month which is a big difference. Isn't that part of what was called FenFen? 

[00:14:46] Dr. Bayoan martinez-Cruz: Correct. The fen was a combination of two medications, very powerful, but one that was the most powerful.

The two were causing valve problems in the heart and were pulled out of the market. They left the weakest version which was phentermine. But nonetheless, in patients that stick to exercise and eat less and healthier they will lose 6% of their body weight. So if you need to lose 15, 20 pounds, that is a good choice.

as a practice if you fail losing weight on this type of medication, I could add other oral agents or. Pass you to the injectables. But now you are going to be convinced that you tried your best on something different and inexpensive and didn't do it for you. 

[00:15:41] Mike R: If someone goes on one of the GLP one drugs for weight loss, does that mean that they have to be on it for the rest of their lives, or does that mean that as soon as they stop it, they're going to gain back the weight that they lost?

[00:15:59] Dr. Bayoan martinez-Cruz: The question is very important because you have to realize that obesity is a chronic disease, when you become obese, you will be obese for the rest of your life.

The same way when you have cancer, you will have it for the rest of your life and you will have to go to an oncologist for management We never think that you are cured per se. the same thing happens with obesity. So likely you are going to need to be for the rest of your life on the medication.

[00:16:30] Mike R: Okay. Let's go back to the word obesity. Can you give our listeners a good definition of obesity?

[00:16:37] Dr. Bayoan martinez-Cruz: We use something called BMI. And the mass index has to be above 30 to be considered obese. And then we have different severities according to the numbers that you accumulate. 30 to 34 is mildly obese.

35 to 39 is moderate obese. And higher than 40 is severely obese. And when you get to 50, then you are called morbid, obese. We cannot forget that there are two types of surgeries that can be done. They work quite well in patients with obesity and actuallytaught us that we can cure diabetes.

When we were doing this type of procedure, patients lose a hundred pounds they are not diabetic any longer, and that changed many people's lives. There is also. A balloon inserted into the stomach that will occupy part of the stomach. So you don't have a lot of room to put food.

So you will get full, very easy, 

the problem with that balloon is that quite often it moves and loses air, so it's not very successful. There is a lot of failure in this particular procedure. It is not A big surgery, something very simple because they put it through the mouth with an endoscope.

[00:18:00] Mike R: So they can pull it out and put a new balloon in.

[00:18:03] Dr. Bayoan martinez-Cruz: Correct. And so usually require the balloon to be removed. But the gastric bypass or the more benign procedurehelp you to lose weight significantly. Important to say that in those patients that get gastric procedure, surgical procedure, they will need vitamins forever because the stomach absorbs, for example, vitamin B12.

And those patients usuallyget very little absorption. So they would need for life iron folic acid, vitamin B12. In order for them to keep themselves within normal. 

[00:18:44] Mike R: Okay. We're going to take a quick break now and listen to an Alzheimer's tip from Dr. Craig Curtis, and then we're gonna come back and we're going to talk about side effects.

[00:18:56] Dr. Craig Curtis: There's a lot that they can do. Published actually in the Journal of the American Medical Association. In February of 2024. So this month, this was a study done primarily at Rush University in Chicago, looking at those with brain amyloid. So those people that already have amyloid can a healthy lifestyle protect them from developing dementia?

And the answer was yes. By following these five, five healthy habits that were tracked. Those where they did not smoke, they did moderate exercise for at least 150 minutes a week. They kept their alcohol consumption to a minimum, approximately one to two drinks a day. And they regularly stimulated their brain by reading, going to museums, et cetera.

And the final category was how well they followed the mind diet or a Mediterranean type diet. And they used autopsies. They actually used approximately 530 autopsies to prove that those that followed those healthy lifestyle habits or had those healthy lifestyle habits. Actually had less amyloid. It correlated those had less amyloid in their brain. 

[00:20:05] Warren: With over 20 years of experience studying brain health, Dr. Curtis's goal is to educate the village's community on how to live a longer, healthier life.

To learn more, visit his website, craig curtis md.com, or call 3 5 2 5 0 0 5 2 5 2 to attend a free seminar.

[00:20:21] Mike R: Dr. Martinez Cruz. Can you talk a little bit about the side effects that you've observed in your patients? Who are being treated with GLP one drugs?

[00:20:31] Dr. Bayoan martinez-Cruz: Both of them could cause constipation. some patients develop diarrhea, so it could be constipation or diarrhea.

Normally it wasn't either one that you develop. You overcome that if you keep using the medication. The most common. Side effect that I see in my practice is actually nausea. one of the things that I train my patients to do is have supper the last meal of the day, at least four hours before they go to bed.

Because one of the mechanisms that this GLP has, there are two mechanisms. One is in the brain, in the satiety center of the brain where it makes you get full quickly, right? The second mechanism is slowing your intestinal movement, which can lead to constipation, but also means that the food you ingest will sit in your stomach for a long period of time.

If you go to bed too quickly after supper, you are going to have severe acid reflux, and occasionally it can lead to you jumping out of bed to throw up. So it's important to make sure that the patient has supper the last meal of the day at least four hours before going to bed.

[00:21:48] Mike R: Okay, you're gonna make me resign. When I was in kindergarten in Miami, they had lunch and the teacher told me I always should eat all of my food. And so every day I ate all of my food on my plate. After a while, they gave me a little white pin. That looked like a plate with a knife and fork on it, and they said, now you're a member of the Clean Plate Club.

So I've been a member of the Clean Plate Club for more than 60 years. I guess I'm gonna have to resign from the Clean Plate Club.

[00:22:22] Dr. Bayoan martinez-Cruz: There is an important side effect that has been seen with ozempic and it is very important to mention. It doesn't happen too often, but some patients can lose their vision. 

That's a serious side effect.

[00:22:37] Dr. Bayoan martinez-Cruz: With the use of the ozempic.

I have one that lost in one eye only, but the ophthalmology swear that it is secondary to the use of ozempic. We don't have so far any information on Monro being related to losing your sight. But it's something that I mention to my patients that they need to check because as soon as they get a little bit of blurred vision, we need to stop those medications.

[00:23:04] Mike R: I heard from Dr. G last week that those vision studies were done by top ophthalmologists in the Boston area, which kind of puts in a certain bias, but anyway, you cut it. Losing your sight or any portion of your vision is a very serious condition, and he suggested that. That could be eliminated if they had proper hydration.

And he suggested that if you're on Ozempic or one of the other GLP1 drugs, you need to drink half of your body weight in ounces every day so that if you weigh 200 pounds, you'd have to drink a hundred ounces of liquid.

And I thought, wow, I could never get a hundred ounces of liquid into me. That's way, just way too much. .

[00:23:56] Dr. Bayoan martinez-Cruz: Correct. And I should mention that even though water is very healthy for all of uswhat hydrates you? You need some electrolytes to get hydrated, and that is why when you are dehydrated and you are taken to an emergency room, we give you water with salt. We doctors put a fancy name called Saline Solution, but that is what we give you to hydrate you.

We don't give you glasses of water. We give you saline solution. 

[00:24:25] Mike R: I've had problems with statin drugs and getting cramps in my legs. One of my friends told me that when that happens to them, they drink pickle juice. I said, pickle juice. And they said, sure enough it works for 'em. Well, I bought some pickle juice and little bottles, and if I ever get a leg cramp, I dilute it with some water.

And sure enough, if it doesn't work.

[00:24:51] Dr. Bayoan martinez-Cruz: it's the salt in the water of the pickle juice. 

[00:24:54] Mike Roth: I find that. Much more pleasant than some of these athletic drinks 

[00:25:00] Dr. Bayoan martinez-Cruz: But I'm gonna tell you another one that is very healthy is the coconut water. Very high in electrolyte. 

[00:25:06] Mike R: What kind of water?

[00:25:07] Dr. Bayoan martinez-Cruz: Coconut. 

[00:25:08] Mike Roth: Oh, I didn't know about that. 

[00:25:10] Dr. Bayoan martinez-Cruz: Coconut water is very. It's probably one of the best thing to drink when you have kidney stones 

[00:25:16] Mike Roth: Comes from coconuts, not coconut milk. Coconut water. 

Water. So that's like the thin out milk. 

[00:25:22] Dr. Bayoan martinez-Cruz: It's, being sold everywhere.

And it is very healthy. During the Vietnam War. Soldiers that were wounded when a surgeon ran out of blood he decided to give coconut water through the IV, and those patients made it to Germany alive.

And so it was found out since then that coconut water is very similar to the plasma in the blood in case of a big emergency, we can do that too, and that will keep people alive. 

[00:25:56] Mike R: I will have to get some coconuts to put in my hurricane supply room.

[00:26:00] Dr. Bayoan martinez-Cruz: the kidney? No, I'm talking about for the kidneys. Yeah. Coconut water is one of the best thing, but also for hydration. Beer is for hydration and the beer is for the kidney stones. Ah, because it make you to pee. 

[00:26:13] Mike Roth: Yes.

[00:26:14] Dr. Bayoan martinez-Cruz: And the more urine, the smaller the kidney stone gets and you pass easier. 

[00:26:20] Mike R: Oh wow, that's interesting. A while ago, I gave up regular alcoholic beer and replaced it with Heineken's Double Zero. Is that in the same category?

[00:26:29] Dr. Bayoan martinez-Cruz: I don't know the answer to that, but I can tell you that. The problem with beers is that it is so high in calories.

One bottle has 450 calories. So imagine when you had two beers per supper. 

[00:26:45] Mike Roth: So that's why I went to the Heineken's Double Zero 'cause that's got no alcohol in it, it has less calories. 

[00:26:52] Dr. Bayoan martinez-Cruz: Correct. 

[00:26:53] Mike Roth: And it tastes like real beer. 

[00:26:55] Dr. Bayoan martinez-Cruz: But that probably will help you to develop.

Fat in the belly. Oh, 'cause of the calorie. Yeah. The best thing to drink after any meal or with the meal is water. But yes alcohol in moderation is good for people. 

[00:27:11] Mike Roth: And how much water should a person drink every day? 

[00:27:14] Dr. Bayoan martinez-Cruz: That is great. You have read many times that it's eight glasses of eight ounces of water.

But many studies have shown that your body will ask you when it is thirsty There have been cases in which you get water intoxication and you can die from it. you can develop, brain edema and die from it. the fact that we give a measure of how much we need to drink is very hard unless you are sick.

there is some disconnection between the thirst center in the brain and your body. You should be able to know when you are thirsty and drink to calm the thirst. the truth is that we don't have a real quantity of water to drink. 

[00:28:02] Mike Roth: Is there anything else you want to add Dr. ? 

[00:28:06] Dr. Bayoan martinez-Cruz: Yes there are two other medications that we use for weight loss. One is an anti-seizure medication. it was noticed that if patients had migraines, the migraines would get under control with this medication.

So today the most common usage of this medication is for migraines. it was also noted that patients would complain that. Food tastes bad and alcohol tastes really bad. So now it is used for patients who are alcoholic because it changes the taste of what they drink.

For patients who want to lose weight, it helps. there is also a combination pill with. phentermine to help with weight loss because you not only eat less, but you don't like what you're eating. 

And that is Topiramate. That is the generic name for the medication.

Topiramate. is used. Broadly for anxiety disorders and depression, but it is the only antidepressant that can help you lose weight It is called bupropion. People will know it as Wellbutrin there is also a medication that comes in combination with phentermine to lose weight.

[00:29:18] Mike Roth: A healthy BMI for people to strive to get to? If 30 is obese, what number below 30 should people strive to get to? 

[00:29:26] Dr. Bayoan martinez-Cruz: That concern is difficult to put a number on because everyone values their body. differently. Different women will not tolerate a 26. BMI That's too high for them.

They don't want to look whatsoever overweight. And they will come to me, saying prescribe me something because I need to lose 20 pounds from here to Christmas. I'm going to a wedding. I need to lose it. The ideal is that when you pass the 28th you start getting concerns about your weight.

I want to mention one thing two large studies, about 15 years apart, with no relationship between them. They took people followed them for years, and published papers saying that the ideal body weight is A BMI of 25 to 29.

The reason they chose those numbers in two different studies, 15 years apart, is because they said if you go to a cruise and come back with vomiting and diarrhea, that is common. Your body can tolerate 10 pounds weight loss in two days. but if you are in A BMI that is low, you can get gravely ill and even end up in an 

[00:30:44] Mike R: Intensive care unit. I've heard that GLP ones can cause pancreatitis where people can't hold weight on. Is that a common side effect?

[00:30:54] Dr. Bayoan martinez-Cruz: I haven't seen any case of pancreatitis in my patients, and I haven't read quite often evidence of pancreatitis. The same thing With thyroid cancer, but it was only done in animals in real humans. We haven't seen any cases. Now about the pancreatitis because of the concern of the pancreatitis, because the earlier generation of the GLP one that were used daily and twice a day, they could cause pancreatitis.

Every patient that participated in the trial for the medication to get approved. got a pancreas, MRI to start the study six months later and a year later, that was when they realized that the liver was getting better. So they said, oh, we need to do studies on the liver because we noticed that the liver is looking much better now.

Okay. But we haven't had pancreatitis attacks in patients. I remind you there are millions of people on this medication today. If the truth were that they cause pancreatitis or thyroid cancer, they should be much more common and we are not seeing it. 

[00:32:03] Mike R: Okay. If someone wants to get ahold of you to find out about joining your practice, how do they do that? What is your website, that they can go to, or is there a phone number that they can call?

[00:32:17] Dr. Bayoan martinez-Cruz: The easiest way is calling the office at 3 5 2 7 5 0 6 6 5 0. There is a 

[00:32:26] Dr. Bayoan Martinez-Cruz (2): website: m a r t i n e z c r u z m d . c o m .

[00:32:33] Dr. Bayoan martinez-Cruz: Okay. 

[00:32:34] Mike Roth: Thanks for being with us today. I know our listeners, will really appreciate the information that you provided. 

[00:32:39] Dr. Bayoan martinez-Cruz: I hope that it will help people to lose weight and get healthier this is what I do in my patients. Also, when the patients achieve the goal of the weight I keep the maintenance, but it's only once a month.

It is just one shot a month rather than weekly. That way, the cost decreases. But that is a reminder that they're gonna be obese forever and that they need to keep taking medications like we take medication for blood pressure or cholesterol. That is forever.

[00:33:11] Mike R: Thanks for being with us.

[00:33:13] Mike Roth: Listeners, I'm thrilled to share with you this podcast, which is my passion project, to bring knowledge, inspiration, and things you need to know about The Villages and the people living here. Be sure to hit the follow button to get the newest episode each week, or you can hit the purple supporter box.

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[00:33:50] NANCY: Remember, our next episode will be released next Friday at 9:00 AM Should you wanna become a major supporter of the show or have questions, please contact us at mike@rothvoice.com.

This is a shout out for supporters. Tweet Coleman, Ed Williams, Duane Roemmich, Paul Sorgen, and Dr. Craig Curtis at K 2 in The Villages. We will be hearing more from Dr. Curtis with short Alzheimer's tips each week. If you know someone who should be on the show, contact us at mike@rothvoice.com. The way our show grows is with your help.

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