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If you thought this podcast was supposed to be about information security, you might be confused about why we’re featuring heart disease.

Bottom line: Dead CISOs don’t get bonuses.

On this episode, I interview Dr. Joel Kahn, triple-board certified cardiologist, author of 6 books, and restaurant owner — also my physician — about techniques for managing stress and preventing heart disease.

What we talked about:

  • The truth about stress
  • 3 techniques and tools to invest in your health
  • How to uncover silent health risks
  • What Dr. Kahn is excited about for the future of preventative medicine

 

Check out these resources we mentioned during the podcast:

 

To hear this episode, and many more like it, you can subscribe to The Virtual CISO Podcast here.

If you don’t use Apple Podcasts, you can find all our episodes here.

Time-Stamped Transcript

This transcript was generated primarily by an automated voice recognition tool. Although the accuracy of the tool is 99% effective you may find some small discrepancies between the written content and the native audio file.

Narrator (00:06):

You’re listening to the Virtual CISO Podcast, a frank discussion providing the best information security advice and insights for security, IT, and business leaders. If you’re looking for no BS answers to your biggest security questions or simply want to stay informed and proactive, welcome to the show.

 

John Verry (00:25):

Hi there, and welcome to another episode of the Virtual CISO Podcast. I’m your host John Verry, and with me as always, the Wally Pipp to my Lou Gehrig, Jeremy Sporn.

Jeremy Sporn (00:34):

That is not what I told you to say.

John Verry (00:38):

Now you know why I was laughing. That’s the little smirk I had. So now you don’t have a pithy comeback.

Jeremy Sporn (00:48):

[crosstalk 00:00:48]. All right, you got me. Touche. John one, Jeremy zero.

John Verry (00:54):

Yep. It’s probably a lot more than that, but we won’t get into the scoreboard for now. By this point, you’ve had a chance to listen to my interview with Dr. Joel Kahn. What’d you think?

Jeremy Sporn (01:05):

Yeah. I got to be honest, of all the episodes you’ve recorded, this has got to be one of the most interesting ones. It really, really wowed. It starts off great, from the resume of this guy, Dr. Joel Kahn, one of the world’s leading cardiologists, published five books, six is on the way, featured on the Joe Rogan Experience; owns two restaurants, runs the Kahn clinic. He has more certifications and extra names than Rocky Balboa in Rocky IV. But very interesting drink of choice. For anyone who listens to our podcast knows we ask everyone that question, and I was not expecting what he was going to pull out there. Really, really incredible guy.

John Verry (01:47):

He’s super interesting, and you can tell that he’s done this kind of stuff a lot. He’s been on documentaries. He’s been on TV shows. He’s been on Rogan. So he’s not uncomfortable in front of a microphone. And you can tell he’s a polished individual. And he’s a very, very smart man. I got to tell you, for a guy who’s as smart and as well-known as he is and as successful as he is, he’s equally that nice. He’s actually my doctor. I fly once a year out to Detroit because I think he’s the best cardiologist in the United States or the world, as far as I’m concerned. And I got to tell you. So I know him reasonably well. The person you saw on the screen is actually who he is in real life. He’s a really good guy.

Jeremy Sporn (02:28):

Yeah. It does come through. I would echo that he clearly cares about his patients and keeping people healthy. You could almost say he cares about every heart in the world. There you go. Do I get a check for that one?

John Verry (02:44):

No. There’s a minus associated with that one. So here’s the question. Did it work? The idea behind this podcast, and the idea that there’s an inordinate amount of stress right now in the information security space. As we know, stress and inflammation caused by stress is the leading cause of disease, including heart disease. The idea for him being on the show was the people that we’re talking to and working with every day are under these stresses. Do you think that worked? This is kind of an off-topic subject, but I thought it was valuable, and I thought we did enough to tie it into risk management and tie it into the holistic view of information security.

Jeremy Sporn (03:25):

Yeah, I did. Everyone else who’s going to listen to it, if you make it past this far, [crosstalk 00:03:32].

John Verry (03:31):

I just hear people clicking on [crosstalk 00:03:38].

Jeremy Sporn (03:38):

The reason I say yes is he broke things down very simply, and things that you can do, not theories or vague notions. It’s, hey, these are things that you can do to effect change in your life. If you’re experiencing stress, if you are a CISO of a mid-sized organization and you know that the pressure’s pouring on, these are tests that you can go get done to see your risk exposure, risk exposure yet again. These are practical things you can do to make sure that you’re not only living a healthy life but that you continue to stay healthy moving forward. So yes is the answer to your question.

John Verry (04:15):

Yeah. And what’s a really interesting thing, so you know how we always talk about information security as understanding scope, understanding risk, and then understanding gap or where you have vulnerability. If you really think about his approach, scope is you come in, he gathers all this information. Risk is subject to understanding those vulnerabilities that you have, understanding whether or not you’ve got problems with your cholesterol, problems with lipoprotein(a), whether you’ve got APOE4 alleles which are in the wrong direction. So yeah, there is a parallel, and hopefully it’s going to work for the show. Any last thoughts?

Jeremy Sporn (04:48):

Yeah. For anyone who didn’t understand any of the acronyms that John just rattled off, they will explain what those are in the show, and we’ll have lots of reference-able notes in the show notes, so don’t feel like you need to be Googling things every single second of their conversation.

John Verry (05:04):

Okay. Because I think most people are thinking about not continuing on. He did make a recommendation for a very unusual one, and I happen to know that somebody bought a couple bottles.

Jeremy Sporn (05:17):

Oh, I did, and I partook, and it was awesome.

John Verry (05:20):

So for no other reason, listen to get to the wine selection. With no other further ados, let’s get to the show. Thanks, Jeremy.

Jeremy Sporn (05:30):

You got it.

John Verry (05:33):

Joel, welcome. Good to catch up with you.

Dr. Joel Kahn (05:36):

Thank you so much. Let’s do some good today here in 2020.

John Verry (05:39):

Sounds good. Let’s start easy. Let’s tell people who you are and what it is that you do.

Dr. Joel Kahn (05:45):

Sure. I am standing in my medical office in suburban Detroit, Michigan. I’m a triple board certified cardiologist, many decades of cath lab, stint, angioplasty experience. But I’m a reform now aggressive preventive cardiologist believing with one of my trademark phrases, “Prevent, not stint.” Very popular with the hospitals, as you might imagine. Deep dives into trying to understand why people develop the number one killer of men and women in the United States and the Western World which is clogged arteries to the heart.

Dr. Joel Kahn (06:22):

I’m a professor at Wayne State University. I’ve written six books. I have a podcast, and YouTube, and do the whole social media thing with the message of upstream, find out early, don’t wait ’til you’re in an emergency room. That’s kind of the theme of my practice. It’s take you apart, figure out what’s good and bad, put you back together, and hopefully see you at 100 because I plan to be there plus, plus, plus.

John Verry (06:47):

You left off, one of the things I think most people might actually recognize you for is some of the stuff you’ve done on TV as well as the Joe Rogan Podcast, which I think has been viewed some insane number of times. Right?

Dr. Joel Kahn (06:57):

Yeah. I think it’s the longest Joe Rogan, 1175. If anybody’s a Rogan fan, 1175 last fall, a nutrition discussion debate. But a lot of appearances on Dr. Phil, The Doctors Show, Dr. Oz, Larry King, lot of local Detroit TV including Today. I like getting the message out. That’s where the people are. The people are on those big volume shows, so I happily join in even if it’s ugly and a bit of a debate.

John Verry (07:26):

Right. I think I learned about you through, weren’t you in What the Health? the documentary?

Dr. Joel Kahn (07:30):

Yeah. The 2017 sort of hit food documentary What the Health. And now 2019 there’s a new one called the Game Changers. But I didn’t quite have the brawn and the biceps to make it into that movie.

John Verry (07:45):

Yeah. And it’s funny because the genesis of this idea to have you on is this idea of the stress that people are going through, and we’ll talk about that in a second. But you also wrote a book which immediately made me think of this. It was the first book that I ever read that you wrote, which was the Dead Execs Don’t Get Bonuses. There you go.

Dr. Joel Kahn (08:05):

Okay. Sorry.

John Verry (08:06):

We’re going to get to Dead CISOs Don’t Get Bonuses either, or Dead CISOs Can’t Protect Their Companies. Quick question. I always like to start and personalize things a little bit. You always find out something about a person. I think I might know your answer based on one time we were together in your restaurant you run, The Greenspace Café there in Detroit. What’s your drink of choice? When you’re a cardiologist, you’re a holistic vegan person, when you go to have something to drink what’s it going to be?

Dr. Joel Kahn (08:33):

Well, if it’s not at the bar, it’s going to be filtered water. It is a wonderful world we live in. I am not Debbie Downer, but the ritziest suburb of Detroit has lead in their water even though they have one of the best water filter systems getting into those big old homes. You can’t hide anywhere, but you can hide under filtered water. And I’m not talking plastic bottles that are ruining the oceans and the environment; I’m talking a home water filter. My office has a water filter. My restaurants have reverse osmosis. Or I’m drinking organic tea, and I do stress the word ‘organic’. I’m not a Debbie Downer, but pesticides and other chemicals are now accepted in standard medicine as an important cause of fertility problems, weight problems, thyroid problems. And if it’s not organic tea, cold or hot, and filtered water, I am drinking European red wine. Again, I hide from California. I don’t trust the way that grapes are grown. And there may be people out there that own a vineyard and are offended by that.

John Verry (09:34):

So Italian? Do you go Chianti Classico? [crosstalk 00:09:39]-

Dr. Joel Kahn (09:38):

That’s going to be where I’m going to go.

John Verry (09:40):

[crosstalk 00:09:40]. Which way do you go?

Dr. Joel Kahn (09:42):

Well, I’m going to teach you something right now. My current interest is Pulia, a region of Italy on the Adriatic Sea near the boot. And there is a movement there and throughout Europe called raw wines or natural wines. They’re very unfiltered. They’re very rustic. There’s no pesticides, herbicides. They’re often biodynamic and organic. And I am in love with Valentina Passalacqua. She doesn’t know it. But I have found a wine shop in New York that ships me her raw, unfiltered wines, about $25 a bottle. It’s not cheap. It’s not outrageous. And I’m telling you, you’re a better person at the end of a liter than you were when you started.

John Verry (10:18):

It’s so funny you mention that because I was in Italy for the first time last year, and I found the same thing, that you could enjoy red wine at a level that if you overindulge here in the US you wake up the next day not feeling so good, and I didn’t have the same experience there. So I do believe that there is something there. I think, to be honest with you, all of their food. Their fruits and vegetables are outstanding.

Dr. Joel Kahn (10:37):

There’s a difference in the laws about the use of Roundup and GMO alterations. It’s not perfect, but it is ahead of the United States’ protection of its citizens in the food arena.

John Verry (10:51):

Cool. Like I said, there was a Forbes article that I forwarded to you right after we had chatted about this that talked about the insane levels of stress in our particular field. You’re a cardiologist, but in our field, information security, a tremendous amount of stress that these executives are under. Stress isn’t good for you, right? Tell me what happens when people are under a lot of stress from both a health perspective as well as from a heart perspective.

Dr. Joel Kahn (11:16):

Yeah. It’s that fine line between stress and enjoying the pressure of performance. Some people like deadlines, like piling their plate high, actually enjoy the process, breathe their way through it. And others are slamming their coffee cup and pounding the table and grabbing for donuts. It’s pretty hard. My job involves pressure, deadlines, important decisions. Yours certainly does, and your colleagues’. So it is partly mindset.

Dr. Joel Kahn (11:50):

Gratitude, this is early 2020, gratitude is probably one of the more powerful emotions to have because we do have jobs and we have homes, and yes, there’s always problems. I have them too. I own restaurants. There’s always problems. But gratitude for at least being in the game does help to de-stress. But the adverse effects of stress can raise your cortisol levels, raise your blood sugar, can affect your cholesterol and raise it, can certainly affect your blood pressure, ultimately, day after day, can impact the health of your arteries and therefore the health of your heart, the health of your brain. We’re talking to a lot of men, your healthy sexual response. Always want to throw that in. That’s part of the stress damage that occurs.

Dr. Joel Kahn (12:32):

We can’t retire and close shop. We have to learn some strategies to recognize when we’re stressed to deal with it in a healthy manner. The worst part of stress is slamming down the frappuccino, grabbing the donut, the bagel loaded with cream cheese [inaudible 00:12:52] that really doesn’t qualify as much of a healthy calorie intake. But on the other hand, if you surround yourself with some healthy habits, the fun of the pursuit is great. I think we’re in the most exciting times in the world in your industry and my industry. I believe in abundance and not scarcity, so I think it’s a great time to believe. Just need some tools.

John Verry (13:16):

Just for a quick question, a question I’ve never asked your prior. The stress and the cortisol levels, I know they do a lot of bad things to you; will they specifically cause arteries to become more clogged. I’ve heard some people talk about potential of sheer forces caused by high blood pressure. That’s one of the theories. Do you think that stress would lead to greater likelihood of coronary artery calcification?

Dr. Joel Kahn (13:41):

Yeah, there’s no doubt about it. Some people will no type A behavior, type B behavior. That’s kind of 1950s, 1960s research by a gentleman named Meyer Friedman. There’s other ways to slice it. It was the psychological profile of a stressed person with some adverse habits and the increased risk of developing clogged arteries. And you’re right. Heart disease develops slowly over years and decades; although it can show up like a viper biting you in a matter of seconds even though it preceded for years silently.

Dr. Joel Kahn (14:15):

But absolutely, that 10-millimeter mercury rise in blood pressure day after day, week after week, that 20-point rise in cholesterol day after day, week after week, that stress may bring out, just that slight increase in blood sugar from cortisol and stress, let alone eating poorly, it’s that chronic injury to the lining of your arteries, what we call your endothelium. And yes, ultimately, you may be at risk for thickening and plaque and calcification. And one day you raise your voice at your spouse, and the big one, [crosstalk 00:14:48]-

John Verry (14:48):

Yeah. I recognize that. [crosstalk 00:14:51]-

Dr. Joel Kahn (14:51):

My wife told me to say that. My wife said, “Be sure to tell them not to yell at their-“

John Verry (14:58):

Yeah. I’m going to tell you that I must’ve seen that in re-reruns, because I couldn’t possibly be old enough to have watched it when it was on TV. What are some of the key strategies for people to be thinking about in terms of ways for reducing this impact of stress? Because to some extent, like you said, in order to have a fun, exciting job you’re going to have some level of stress. So what can we do to mitigate some of the impact?

Dr. Joel Kahn (15:18):

What I would certainly want to make sure we get in this conversation is before we have strategies, you’ve been in the industry now whether you’ve been in five years, 15 years, 25 years. If you don’t know something called your heart artery calcium score, you’re not in the game of being responsible to your health, your family, and your business. Unless you’ve had a bypass, a heart attack, and a stint and you’re listening to this, in which case of course you know you have heart disease. Hopefully you have wrapped around you a good cardiologist, maybe a good cardiac rehab or gym program. And hopefully some exposure to the work of Dr. Dean Ornish, MD, on the mind, body, diet, fitness approach. A great book of 2019 he wrote called Undo It, that I would recommend to those heart patients out there.

Dr. Joel Kahn (16:10):

But if you believe it’s 2020 and you have no heart disease, you need to get to your local hospital and you need to have a CT scan called a calcium CT scan. 10 seconds, boom, quick picture of your heart. It comes out zero, you have no calcium in your arteries, you’re 99% protected from badness for the next five, ten years. And if that number comes back 50 or 500 or 1500, you’ve got silent and potentially serious heart disease. And you need to know that and get with somebody who knows what to do next, even if you feel good. Because heart disease does not give clues to executives very often until the day they start feeling awful and call 911, or even the day they drop dead at their desk, in their bed, on the tennis court, or on a vacation. So get that test. It’s about $100.

John Verry (16:58):

Real quick, that’s a CACaS, the [crosstalk 00:17:01]-

Dr. Joel Kahn (17:01):

Coronary artery calcium score. Most cities require a prescription at the local hospital. State of Texas, every citizen gets one for free at age 50. Very progressive. There’s a great documentary on Netflix called The Widowmaker, movie that indicates why Texans get an opportunity to get a free scan. Again, I’m not truly being promotional. This is a very inexpensive book. That’s what this lays out, why you have to have one to be fiscally responsible to yourself, your family, and your business.

Dr. Joel Kahn (17:31):

So beyond that, you need some strategies. You need to have some mindfulness about when you’re getting red-faced, when you’re getting ticked off, when you’re feeling that rage and type A behavior. Breath work is the best of choices. The smart phone is one of the problems in our lives. It’s always going off, and messaging. I got a new smart watch. Every time I’m getting a LinkedIn. I’m very big on social media. [crosstalk 00:17:59]-

John Verry (17:59):

And as active as you are on Twitter.

Dr. Joel Kahn (18:00):

My watch is going off every five seconds. But I think it’s kind of cute right now. It’s a little Chinese watch. It has some interesting AI capability. But you need to have something to monitor internally. There’s apps. That’s what I was saying. But the answer to it is sometimes apps. There’s apps called Calm. There’s apps called Headspace. There’s a new one a guy called Breath Pacer. These are not my apps. You could take a few minutes when you feel the pressure cooker rising. You could just sit at your risk and literally breathe.

Dr. Joel Kahn (18:33):

Another simple one, people can look this up, Dr. Andrew Wyle, the big white-bearded physician out of the University of Arizona, teaches something that I teach my patients, four, seven, eight breathing. You’ve got a board meeting you’re going to walk into. You breath in through your nose for four seconds slowly, you hold it for seven. You breath out your mouth for eight. Do it four times. Takes about 75 seconds. It actually helps rebalance that stress system called the sympathetic, the calm system called the parasympathetic.

Dr. Joel Kahn (19:02):

It could be Thanksgiving dinner. It could be a business interaction. It does help you gain a little sense of calm. And it’s one of the simplest things before maybe you pick up the phone and have a challenging phone call with a customer or a business member of yours. So breath work is probably the easiest.

Dr. Joel Kahn (19:23):

Fitness helps. A workout every day clearly helps manage stress. I’m at a standing desk as we’re speaking. I stand-

John Verry (19:29):

As am I. I don’t know if you can tell.

Dr. Joel Kahn (19:31):

Yeah. About half the day. It helps to get up and down, walk up and down the hall, up and down stairs. We call them fitness snacks. Little 90-second little movements help. And good nutrition helps. You’re not helping yourself I the stress is being managed with candies and soda and calorie-empty bagels and worse, fried food. So when you put good nutrition in it just prepares your body and does help protect your arteries.

Dr. Joel Kahn (20:00):

[inaudible 00:20:00]. It would be a big omission not to talk about, give Arianna Huffington a shout out. Trying to get seven square hours of sleep at night. We talk about three square meals. Seven square hours. Which takes discipline. You can’t go to bed at one in the morning and wake up at 6:00 and get seven hours. Nobody has an app that does that. You got to be in bed by 11:00 to wake up at 6:00 to get seven hours. I have rituals of herbs and melatonin and CBD hemp and eye masks and white noise and lavender essential oil. If there’s a need, I can activate. A cold shower helps before bed. It’s something I’ve learned to do.

John Verry (20:41):

The whole new thing with brown fat, right?

Dr. Joel Kahn (20:43):

Oh, you’re on top of it. Yeah, it’s 10 seconds [crosstalk 00:20:47]-

John Verry (20:47):

[crosstalk 00:20:47] hormetic response. Yeah, it’s awesome stuff. It really is [crosstalk 00:20:49]-

Dr. Joel Kahn (20:49):

John, you’re there. Yeah. I do 10 seconds hot shower, 20 seconds cold, 10 seconds. I do that 10 times ending on cold. There is some belief it actually does provoke a response that’s rather healing and healthful to your body.

John Verry (21:03):

Yeah. Wim Hof has done some crazy stuff.

Dr. Joel Kahn (21:05):

Oh, wow, you’re up. You’re up. You’re up. Good man.

John Verry (21:08):

Cool. So those are some great strategies. The next thing I want to talk about is being proactive. You already talked about CaCs. Let’s talk about other forms of testing. For the record, I’ve been to see Dr. Kahn, and I live in New Jersey. I’ve bene out to see Dr. Kahn twice in his Detroit office. That’s how strongly I feel about him being what I think is the world’s leading holistic cardiologist. We’ve done some interesting work together. CaCs is one of those things.

John Verry (21:35):

Let’s talk a little bit about some of the other things. L-p-little-a is a big thing right now. APOE, 9P21. What are some other things? If somebody’s listening to this and they’re saying, “I should be concerned,” what are some of the things you would recommend in terms of some of the testing that you would do with people?

Dr. Joel Kahn (21:52):

What you just rattled off in a very sophisticated way that frankly 98% of physicians couldn’t rattle off unfortunately is that most people are getting the same blood work that patients got in the 1960s. And they’re not bad blood work. You need to know your liver, your kidney, your routine cholesterol, your fasting blood sugar. But that’s about the end of the list for most people seeing their family doc, even if they’re going to an executive health center; I’ll say Cleveland Clinic, Mayo Clinic, and other places you might get referred to or choose to go to. Yet lab testing has moved ahead by light years, just like the ability to use that CaCs CT scan, which frankly has been around for more than 20 years. But it cuts through the case. Where do you stand? Are you old inside or are you young inside? Hopefully young.

Dr. Joel Kahn (22:39):

I’m just going to show an example. This is not a company I own. This is Quest Labs, the largest lab provider in the United States, who purchased a specialty lab called Cleveland Heart, full of all kinds of wonderful labs that in my experience are covered by people’s insurance largely, if not nearly completely. But we all know the health insurance is a rather sordid black box; you’re never quite sure. So you want to not only know the basics. You want to know some measurements of inflammation, something called high sensitivity c-reactive protein. Although there’s actually seven tests of inflammation here, and I get them all.

Dr. Joel Kahn (23:16):

You want to know perhaps some of these silent risks, and you mentioned the big one. One out of every four people, and there’s a lot of people listening to this, one of every four inherited a cholesterol called lipoprotein-little-a, really awkward, lipoprotein small case a. One out of every four, it can destroy a heart valve, and it can destroy the arteries to your heart and your neck. Even though your doctor says, “Hey, good news, your cholesterol is 162. Things look good,” your lipoprotein(a) still could be three times the level of normal. It’s about a $30 blood test. In Europe, just recently, they’ve added it to the routine protocol as a recommendation. Still not well known.

Dr. Joel Kahn (23:53):

My sixth book is coming out in a couple months called The Lipoprotein(a) Solution: America’s Silent Heart Killer, because it needs to be brought up, although we don’t know for sure the proper treatment. There are some genetic tests you mentioned. If you have a strong family history of heart disease. Why did dad have a heart attack at 48? I’m telling you, I can figure it out for you now. It’s blood work. It will show if dad wasn’t a three-pack a day smoker and a poor lifestyle, we can find out the genetics that you may have inherited, and you may want to know for your children. So yes, get better than average blood work. Get the CT scan.

Dr. Joel Kahn (24:28):

And the last thing I’d say, other than the basics, it’s not reasonable nowadays not to have a home blood pressure unit. You have a scale. You have a thermometer. The number one medical disease that kills people in the United States and the world is actually hypertension, which leads to coronary artery disease and heart attack. You need to know your blood pressure.

Dr. Joel Kahn (24:50):

You can do a scan of your carotids. If you want to do really basic, find Life Scan at a church or community center. My local hospitals for $50 will do a vascular screening, make sure you don’t have an aneurism in your belly. Some of that is overdone and hyped, but it never hurts to get a little idea. And as you know, John, in my office, we do a very special digital carotid scan called a CIMT that will tell you your vascular age. That’s a sophisticated question that you won’t find an answer from most docs providing.

Dr. Joel Kahn (25:22):

“Hey doc, 61 years old,” which I am, “What’s my vascular age?” A physician in the 1600s said if you know your vascular age you know your actual age. That’s kind of vision from a Dr. Thomas [Hynek 00:25:37]. So the carotid will tell you your true vascular age. Your CT scan CaCs will tell you your true vascular age. You couple it with a little better blood work, you’re really on top of where you stand. And it’s not always bad news.

Dr. Joel Kahn (25:48):

My most obese patient in my practice, no names and no fat shaming, has a calcium score of zero and some of the best blood work I’ve seen. And you shake your head. And that’s what’s called personalized medicine or precision medicine. Everybody’s different. And the equation is so difficult we need the numbers. Edward Demming that said you can’t adjust what you can’t measure, I think that was the quote [crosstalk 00:26:16]-

John Verry (26:16):

He’s the Six Sigma guy, right?

Dr. Joel Kahn (26:17):

Six Sigma guy, exactly. [crosstalk 00:26:19]. Yeah, you can’t fix what you can’t measure. And it’s true in medicine; we just don’t teach that very often.

John Verry (26:25):

You know what? The CIMT, and one thing which is really important for anyone listening is that I have, unfortunately, high lp(a), and I have a fair amount of coronary challenges, some clogging of the arteries. And I’m working with Dr. Kahn, and we’re using the CIMT as a proxy for what’s going on elsewhere in the body. Through our work together over the last year, you’ve been able to reduce my CIMT from about 40% clogged to about 37% clogged or something of that nature through a combination of diet and herbs and things of that nature. So I’m thankful that I found Dr. Kahn, because I was heading for a slab or another cath lab.

Dr. Joel Kahn (27:01):

Yeah. We’re going to work very hard to keep you away. That’s my goal with my patients. My 2020 goal with my patients is only walk in a hospital to visit a relative. There are bad things happening in hospitals, from super infections to complications. And I am a hospital staff member, but nobody speaks up about it because it’s a multibillion dollar industry nobody wants to swing their Don Quixote blade at. But it’s true; stay out of hospitals.

John Verry (27:31):

You and me both. Quick crystal ball, anything exciting in terms of genetic testing, immunotherapies, nanobots? Anything exciting on the horizon to look for that might be a little bit more of that magic button we all hope to find?

Dr. Joel Kahn (27:47):

I think we’ve already talked about a mouthful that’s way beyond standard medicine here, about getting a heart CT scan, about getting a carotid ultrasound, preferably a carotid intimal-medial thickness, CIMT, and getting advanced labs. And again, Quest is just something I use; it’s not something I own, God knows, but getting better than average labs.

Dr. Joel Kahn (28:07):

And if anybody, either the book I showed, that Execs Don’t Get Bonuses, just Google my name; I’ve written article after article after article. I have a blog in the Detroit Business Magazine a few months ago about the widow maker heart attack, how to avoid it. It gives everything we talked about. John, I’ll make sure that I email to you after [crosstalk 00:28:26]-

John Verry (28:26):

Yeah, that’d be great. We’ll [crosstalk 00:28:27] the notes.

Dr. Joel Kahn (28:28):

Because these are a simple shopping list you can go to your doctor. That will take your health so far down the road in terms of being quantitative. But then, I am very engaged in looking at the future. Is it going to be things that spill out of the mouth, gene therapy, stem cells, something called CRISPR-9. We can cut your lipoprotein(a) gene and put in a non-lipoprotein(a) gene? Is it the supplements of the day, resveratrol, something called nicotinomide mononucleotide, NMN.

John Verry (29:01):

NMN, yeah. That’s David Sinclair. Did you read the book of his [crosstalk 00:29:03]-

Dr. Joel Kahn (29:04):

It’s a great book.

John Verry (29:06):

It’s a great book, yeah.

Dr. Joel Kahn (29:06):

But his page 304, this is what I do, which is the first page-

John Verry (29:12):

[crosstalk 00:29:12]-

Dr. Joel Kahn (29:13):

… the first page everybody goes to read, what does David say? 1,000 of metformin every morning. The doses he takes of those supplements are very expensive. But he has a researcher. He has easy access to them. I can’t even get near those doses without breaking the bank. And I don’t know that they’re going to work. It’s way premature to say we want to get crazy rapamycin.

Dr. Joel Kahn (29:36):

So I’m very optimistic. I think the next decade is going to be transformative in terms of artificial intelligence, ability to measure. The first prospective trial of metformin to prevent cancer and other diseases will embark in the next month or two from Albert Einstein Medical Center, something called a TAME study, T-A-M-E.

Dr. Joel Kahn (29:58):

But we don’t know the answers. And we’ve been messed up before by jumping on a bandwagon that proved to have … Even taking Prilosec every day-

John Verry (30:08):

Moving from butter to margarine, right? How many people in your practice because of that?

Dr. Joel Kahn (30:13):

But bring it right now, Omeprazole, Prilosec, which some people are taking for years because they once had heartburn in the ’70s, we now know is associated with some kidney injury, injury to the lining of your artery called the endothelium, possibly an increased risk of heart attack. I work really hard with my patients, get them off Protonix and Omeprazole, maybe onto Zantac or Pepsid. But you got to work with the GI doc if you got serious disease. Even simple things like that are important until we figure out the fancy stuff.

Dr. Joel Kahn (30:44):

Lifestyle right now, do you go the gym? Do you sleep? Do you smoke? What’s your weight? What are your numbers? That’s still the king of health and longevity, and will never be placed, but we’ll add things on to good lifestyle.

John Verry (30:58):

You run the Kahn Center for, I forget what you call it, Kahn Center for Cardiology or Lifespan. I can’t remember what you call it. Cardiac Longevity. I knew it was something. I had the heart and the lifespan; I didn’t have them together. Anything that you haven’t brought up? Obviously all the testing that we’re talking about doing, all the blood work, that stuff that’s standard practice. I know you started moving some other interesting stuff, the gains wave stuff [crosstalk 00:31:21]-

Dr. Joel Kahn (31:20):

Funny. I was going to bring that up, not so much-

John Verry (31:23):

[crosstalk 00:31:23]-

Dr. Joel Kahn (31:23):

Right.

John Verry (31:24):

And erectile dysfunction.

Dr. Joel Kahn (31:26):

How do you know that you might have clogged hear arteries but you’ve never been in an emergency room, you’ve never flunked a stress test, you’ve never had that awful feeling we call angina, chest pressure? And you mentioned it. It’s well known for 20 years in the scientific literature that 40% of men at age 40 start to develop erectile dysfunction, 50% of men at age 50, and so on. And I can tell you, from asking every male patient I’ve seen for years, that is about the truth. It can predict three to four years before a heart attack that there’s a vascular problem, a circulatory problem. There are other causes, testosterone, situational, diabetes. But clogged blood vessels to the pelvis can be showing up as a problem three, four years before clogged vessels to the heart or the brain.

Dr. Joel Kahn (32:10):

In the county of Olmsted, which is where Mayo Clinic is, they reported that the risk of heart attack in a man with erectile dysfunction is 50 times higher than men that don’t have erectile dysfunction. That’s higher than most other studies, but it’s pretty solid data from the Mayo center. So don’t ignore that. If you’re having erectile dysfunction, go get that CT scan. Go get those advanced labs. Maybe get a carotid. There is a therapy that’s transformative using shock waves like I use for kidney stones, but a much lower intensity for erectile dysfunction. I am I think the only cardiologist in the country using it. But I chose to do it because there’s more than 50 peer-reviewed scientific studies, and my patients were frustrated at the point pills weren’t working anymore.

Dr. Joel Kahn (32:56):

Before you take Viagra, Cialis, and Levitra type pills that are all generic now, you should know where your hear status is. Not that they’re unsafe drugs, but get that CT scan. Get the labs. Just be sure you’re not missing the boat on all that. That’s exciting to me.

John Verry (33:13):

Yeah, that’s a huge improvement for quality of life. Quick question for you. If it can clear, whether it’s generating new blood vessels or whether or not it’s clearing old blood vessels, theoretically, can we see this maybe as an advance for peripheral artery disease or even coronary artery disease at some point in the future?

Dr. Joel Kahn (33:32):

Very, very interesting question. I have actually treated patients already with peripheral arterial disease with the shock wave device. And I’m doing that because there is literature from Europe that it could be effective. Small number, but very safe procedure. It’s basically almost an ultrasound type procedure, and there’s no x-rays involved. There’s no needles.

Dr. Joel Kahn (33:53):

In Europe, that device, shaking the chest, shockwaves to the chest, is approved for people who’ve had a previous heart attack and damage as a regenerative, restorative, stem-cell-releasing stimulus to the heart muscle. It’s unheard of in the United States, but perhaps 25 research studies from Europe that preceded the use for sexual medicine are very provocative to me. And if I can get the right resources I’d love to have it available for patients. It should be in major medical centers. It’s not reimbursable. There’s no FDA approval. But if you’ve had a heart attack and your doctor says you’re damaged, a lot of people would be interested.

John Verry (34:33):

Yeah, happy to spend the money.

Dr. Joel Kahn (34:36):

A non-invasive, reasonably proven way. So that’s exciting.

John Verry (34:41):

Just out of curiosity, is that a hormetic response? Is it a stress response, a healing response that’s causing it to provide this improvement?

Dr. Joel Kahn (34:49):

The biology of shaking a tissue causes microtrauma, and that induces you could call it hormesis, what doesn’t kill you makes you stronger, that the healing phase generates new blood vessels, nerve growth, stem cells, nitric oxide, kind of the big four win we’d hope for. But we can do it mechanically. That’s just insanely interesting.

John Verry (35:13):

Very cool stuff.

Dr. Joel Kahn (35:15):

I’m excited about artificial intelligence. You tell me your history. I’d rather have a computer help me. What does it mean to have a rash, and a runny nose, and an allergy to aspirin, and a sore stomach. Let me have Watson help me with that. Because nobody can ever keep up with the pace about the diagnostic and the therapeutic. So we are going to see in the next decade many more tools of artificial intelligence. I’ll just show you one just to stimulate you.

Dr. Joel Kahn (35:44):

I’m working with an Israeli company, I’m not an investor, that they’ll be at CES in Vegas. But you can use your smart phone, if anybody can see my smart phone, looking at my face, it can be the camera on your laptop or your pad or your phone, it can now measure blood pressure, heart rate, blood sugar, stress levels, heart rate variability, and soon to be alcohol blood level via skin changes that it can detect. It’s called photoplethysmography. It’s [crosstalk 00:36:15]-

John Verry (36:16):

Using near infrared kind of light?

Dr. Joel Kahn (36:19):

It’s just your camera and detecting little signals, almost like a photo lie detector test, in essence. The website has a great video of Mark Zuckerberg testifying in front of Congress. You can actually even analyze a recorded video. They claim that they can detect that he was blowing smoke up the Senate’s rear based on these vital signs. So stuff like that that your laptop may warn you, “We’ve been monitoring your vital signs. Your stress level’s rising. Here’s your five-minute breathing program.” Stuff like that I think is right on the verge of being available to all of us. Very cool.

John Verry (36:57):

Yeah, really cool stuff. Cool. Look, we covered a lot of ground. Anything else that you wanted to mention?

Dr. Joel Kahn (37:02):

No, I think that’s really … Test, not guess. That’s my little [crosstalk 00:37:08]-

John Verry (37:08):

There’s one thing you didn’t say, which I’m really surprised by, especially knowing you the way I do.

Dr. Joel Kahn (37:12):

Go plant-based.

John Verry (37:13):

There you go. Thank you. That was your last book was the Whole Food Heart Solution or something. That was a great one.

Dr. Joel Kahn (37:21):

You’re forcing me to [crosstalk 00:37:23]-

John Verry (37:23):

No, no. [crosstalk 00:37:23]-

Dr. Joel Kahn (37:22):

The Plant-Based Solution is now out in paperback; it’s a few bucks. It puts together the overwhelming science. You want a plant forward diet. I’m not going to beat on you, but some breakfast, some lunch, and some dinners should be without animal products, dairy, eggs, and meats. You should learn how to order in a restaurant and create at home some variety. And you should at least up the amount of whole produce that you’re eating, unquestionably, for your cancer risk, your diabetes risk, your brain health, and certainly your heart health, and your sexual health, to be honest.

Dr. Joel Kahn (37:56):

Don’t fear whole fruit. Grab an apple. Grab a pear. Grab even bananas, certainly berries of every kind. The overwhelming consensus is a plate, and this could be the USDA, the Canadian government, the Australian government, the Italian government, Harvard School of Public Health, a plate that’s largely filled with fruits, vegetables, whole greens, peas, beans, lentils, and even soy products, organic, is the healthful formula that you should apply. And you don’t need a doctor to tell you that. You can just go read. Go look up the Harvard School of Public Health Food Plate. You’ll see it laid out, without any financial conflict, as beautifully as it could be anywhere. It’s not the word ‘vegan’. It’s just plant forward diets.

John Verry (38:38):

Yeah. I like that idea, move away from … Because I think vegan has more of an activist component to it, more of that PETA, more trying to save the world. I think if we use the word whole food, plant-based, or non-processed food, things of that nature, because I think most of the people that are out there following that type of a diet, and I do as well, are not these zealots that are trying to convert people. We’re just trying to stay healthy. Cool stuff.

John Verry (39:02):

I always like to ask. I consider you to be a great cardiologist. So what fictional character or what real world person do you know, what are those attributes, who would be somebody else who you think would make a great cardiologist or even a great chief information security officer, if you think of it that way?

Dr. Joel Kahn (39:21):

That’s the most interesting question I’ve been asked in a long time. Elon Musk?

John Verry (39:27):

I think he’d be pretty good at anything.

Dr. Joel Kahn (39:29):

I think he’d be pretty good at anything. Out of the box, and creative, and innovative. I don’t know that he should be smoking blunts on national TV shows like he did with Joe Rogan, but it’s legal in California, so he didn’t break any laws; he just broke some corporate laws.

John Verry (39:46):

SEC might disagree with that.

Dr. Joel Kahn (39:48):

Yes, SEC apparently wasn’t so happy with him. I go by the phrase, be open-minded but not so open-minded your brains fall out. We have a great medical tradition that has moved us forward, and we need coronary care units, and we need emergency procedures. But we had a breakthrough medical trial in November called the ischemia trial that even advanced heart patients who are outpatients, bad blockage, bad stress test, if they’re put on optimal medical treatment, that’s prescription drugs, they’re told to eat healthy and exercise, they don’t need bypass and stints in the vast majority of cases. That’s now a proven, randomized international study; cost us $100 million.

John Verry (40:31):

[crosstalk 00:40:31]-

Dr. Joel Kahn (40:31):

Well, I think this validated the breakthrough work that Ornish, [Pridic 00:40:35], and [Enestelson 00:40:36] did. But now we’re bringing it up to the largest, most expensive cardiac trial ever done on the topic. So it’s that out of the box. We need to change the paradigm. Take care of yourself. Get better than average testing. So any maverick out there, Richard Branson. Oh my god, would he make a great cardiologist, for example. Any of that kind of … I don’t want to leave women out of it. Arianna Huffington would make an amazing cardiologist.

John Verry (41:04):

Good stuff. Last question, and you can answer this from a different perspective. We’ve been talking with you as a cardiologist, but you’re also a business owner. You own the Kahn Center for Cardiac Longevity. I got it right that time. You own at least one, but I think two restaurants. Right?

Dr. Joel Kahn (41:21):

[crosstalk 00:41:21].

John Verry (41:21):

So from a perspective of a business leader, what do you think might be an interesting topic for other restaurants or other medical professionals that are running businesses of note from an information security perspective? What are some of the challenges you’re thinking about or some of the things you’re hearing from other people who do what you do?

Dr. Joel Kahn (41:38):

We’re all worried about security breaches. Pretty much all the medicine now is on electronic medical records and username and passwords. They all can be broken into. I’m concerned about that for my patients and their confidentiality, a little less so in the restaurant world, but certainly true in the medical world. So the kind of firewalls and other security methods we’re using, I’m glad we got people like you around in the medical world.

Dr. Joel Kahn (42:07):

Again, just the same message for all these executives. I just really plead to have responsibility in a fiduciary sense to your family and your business. Everything we talk about you need to say, look, in January 2020 I’m going to email John Verry and figure out, how do I get that CaCs, or how do I get this blood work. You will get some pushback from your primary care doc, maybe even your specialist. They don’t all support this idea of test not guess. Just live ’til you drop is the alternative. And I’m not a big fan of live until you drop.

John Verry (42:41):

No, because you just never know when that drop is going to occur, right? And that’s why they call it the widow maker. The other thing which I just want to point out that I like is you have a good podcast, and I also pay attention to your Kahn Chronicles. Remember when we talked about what’s [crosstalk 00:42:54]-

Dr. Joel Kahn (42:54):

Thank you, sir. Wow, that’s the first time that’s been mentioned on digital media.

John Verry (43:00):

Well, no, and I think you do a good job because what you’re doing is you’re kind of a filter for everything that’s out there that might be relevant to me. And having cardiac issues, I kind of pay attention to it. So I actually keep current with your Kahn Chronicles. And I find that a lot of the new stuff that I’m learning about and reading about, I’m kind of flying through that, so thank you for that.

Dr. Joel Kahn (43:14):

Wow. I’ll just give a shout out. If anybody goes to my website DrJoelKahn.com, there’s a little button that says ‘Kahn Chronicle’. And I want to say with a little humility, it’s kind of like the Drudge Report of constantly updating the media’s reports on medical and wellness items.

John Verry (43:32):

Yeah. And I like the fact that you steer it. You give some interpretation as well. [crosstalk 00:43:39]-

Dr. Joel Kahn (43:39):

I’m selecting.

John Verry (43:39):

Yeah, but you’re also giving some interpretation like, “Hey, this one was funded by this entity; you have to be aware of that.” Because the problem with all of these scientific studies is kind of figuring out what the angle is behind it, because everyone has an angle. Right? That’s just the nature of the world. So making sure at least that you’re reading it the proper way is important.

John Verry (43:54):

So if somebody wanted to get in touch with you in terms of wanting to work with the Kahn Center for Cardiac Longevity, Twitter handle, email, what’s the best way for them to get in touch with you?

Dr. Joel Kahn (44:05):

Yeah, Twitter’s D-R-J-K-A-H-N, Dr. J. Kahn. It’s the same on Instagram. And website, DrJoelKahn, J-O-E-L K-A-H-N. There’s a link to the restaurants, link to the clinic, link to the Kahn Chronicle. It’s a functional website, and you can reach me very easily. My patients text me, email me. I’m available always.

John Verry (44:28):

Cool. Dr. Kahn, awesome to catch up with you.

Dr. Joel Kahn (44:32):

Thank you. Lot of fun.

John Verry (44:33):

Thank you very much for being so open-minded. You credited the open-mindedness of those other people. Being open-minded to come on a podcast about information security. But I think this is going to be valuable to our folks, so thank you.

Dr. Joel Kahn (44:43):

Thank you. Have a great day.

John Verry (44:44):

Talk to you soon.

John Verry (44:46):

You’ve been listening to the Virtual CISO Podcast. As you’ve probably figured out, we really enjoy information security, so if there’s a question we haven’t yet answered or you need some help, you can reach us at Info.PivotPointSecurity.com. And to ensure you never miss an episode, subscribe to the show in your favorite podcast player. Until next time, let’s be careful out there.

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