Heart Attacks Don't Happen Suddenly—They Happen Like This

Welcome to the Living to 100 Club Podcast.

Here's our host, Dr. Joseph Casciani. Welcome to the Living to 100 Club, where we explore what it really means to live longer and better. I'm Dr. Joe Casciani, a geropsychologist focused on the mindset, habits, and science of aging well. Each episode brings you practical ideas and conversations to help you stay engaged, resilient, and purposeful at any age. In today's program, I'm speaking with cardiologist and preventive healthcare expert, Dr. Pratiksha Gandhi, about heart health, aging, and the growing importance of prevention and lifestyle-based care. Dr. Gandhi is the founder and CEO of Co-Cardio Inc. and has spent nearly 3 decades helping individuals improve cardiovascular health through holistic and preventive approaches used alongside traditional medical care. A little background on Dr. Gandhi. Kokardio is the continuation of Pratiksha Gandhi's lifelong mission to prevent heart attacks and reverse heart disease naturally with holistic solutions as an adjunct to standard care. Now, Dr. Gandhi brings her expertise and knowledge to San Diego She's on a mission to share her knowledge and experience to revolutionizing how we approach heart care and save lives. Pratiksha Gandhi, MD, has published 5 books and has been published in US News, California Herald, Times of India, LA Wire, and New York Weekly. Pratiksha Gandhi stands as a beacon in the field. In 2016, the International Association of Cardiologists in New York hailed her as a leading physician of the world. Quite a distinction. And in March 2017, she was proudly awarded the top 50 global women healthcare leader. Congratulations, Dr. Gandhi, and welcome to our program.

Thank you. Thank you, Dr. Juhl.

Yeah. You're welcome. So I'm really excited about our conversation. I know you have a lot of experience, not just in cardiac care, but in helping people learn about staying healthy. So let me, let me just begin by— you've spent decades focused on preventive cardiology and holistic heart care. What originally drew you to this area of medicine, and how do you define preventive heart care today.

Yeah, thank you. And this is the great start because I always like to share my story of the Indian origin where I was born and brought up. And I got— I was a young medical graduate and you're always like kind of into the system doing the conventional thing. But this was like in the late '90s when we were having a small nursing home where I was working. And typically after heart attack, a patient is told to go for open heart surgery or angioplasty. And this particular person, Sopan, was not having the money to do the surgery. And I was like observing him that how can I help him because he didn't have the money. And that's where, along with my MD in preventive medicine, I've also done, like yoga, meditation, naturopathy, homeopathy, Ayurveda, and all that. So I said, okay, now the conventional system he's not able to afford. Why don't I bring in like, you know, like holistic? So it just started with this one thing where I started literally in my small consulting room teaching him about diet, exercise, yoga. And lo and behold, like in 6 months, his treadmill— like we, I do all the conventional cardiology tests, like the treadmill, the echoes and everything. It all came with flying colors, and he was able to walk for 4 miles, you know, no chest pain. And it was like a life-changing experience, not only for him but for me, because I felt that— yeah, because I felt that, oh my gosh, like, uh, uh, uh, you know, why to like just give like a death sentence that if you don't do a surgery you're going to die? Why can't I, you know, flip the script, you know? And that's how I founded the Institute of Preventive Cardiology, and it became like my lifelong mission to help people. Like, hey, we can prevent heart attack. And, you know, even if you don't want to do surgeries, there is definitely a lot of potential in helping people with lifestyle changes and alternate methods. Uh, it's not like everyone can do it, but definitely quite a lot of people. But the sad part is, you know, Dr. Joe, that people are not given this option, you know.

Yeah.

And that is where I stand, that, you know, like, I think people should be given wider options and varieties, you know, in how they can heal themselves.

Sure. Yeah. Well, that's, that's a good story to kind of have such an impact on you that set the stage for your future in holistic care, cardiology plus holistic care. So many people think of heart disease as something that just happens with age. From, from your perspective, what are, what are some of the most overlooked contributions to heart disease and which lifestyle habits have the greatest impact on heart health?

Yeah, if you see, like most people in the layman as well as in cardiology, the focus is always about cholesterol. Like, you know, there has been an entire bandwagon on anti, like like lower cholesterol. And still, like, if we see, uh, like there was a study done in UCLA where they, they— it was more than 100,000 patients who got heart attack, and they found that almost 70% of them had like kind of, you know, cholesterol which is so-called in the normal levels. Yeah. So I always tell people that, uh, uh, it is not about cholesterol and statins. It is just one piece of the puzzle. What we are missing is about chronic inflammation. And, you know, there are certain biomarkers like ApoB, lipoprotein A, homocysteine, and these are all things which have been conventionally overlooked. But I'm glad that the recent guidelines, you know, are talking about this, especially Lp and ApoB and all these markers. And nowadays, we are living in a good era, I would say, where there is a lot of wellness movement going on. And A lot of these advanced biomarkers are becoming affordable and accessible by different lab tests and all. So we do a lot of advanced biomarkers and epigenetics and all those things, you know, to detect heart disease early.

So it's not inevitable. It's not just a normal course of cardiac disease as we age.

Absolutely. And the second aspect which you spoke about, that like the aging thing, right? So I would like to bring hear the patient's mindset, which is across that. I think as we age, when we get tired, oh, I'm aging, so I'm tired, you know, like, oh, I'm aging, so I can't climb those stairs, or like, I'm aging, so I cannot play golf the way I used to do. And many times I've seen that they just like kind of don't take action unless it becomes like a cardiac event. So here I would like to educate the listeners that chest pain is something which is known to people that, oh, I get a chest pain, I have to go to a doctor. But even like breathlessness on your regular activities which you are doing, or fatigue, you know, like people like, especially because when I always have met people like after heart attack or when they get like, you know, an event and they feel that, oh, I suddenly got a heart attack. I said, no, your body must be showing some signals, you know. So that is where this misconception and all these things came in, that they were thinking that that fatigue or getting breathless was like kind of aging process. You know, they never correlated it with that, that there are blockages being developed in their heart arteries, you know.

So there are lifestyle factors that can help. And we'll get into this a little bit more, but lifestyle factors that can minimize or mitigate.

Yes, yes.

Yes. Yeah. Yeah.

The lifestyle habits which we are talking about is, I think, the sleep. People, like, people talk a lot about their diet and exercise and all, but I believe that sleep is actually the foundation because most of the people in that attempt to be successful or be, you know, their jobs, their family compromise on their sleep. And that also drives the physiology a lot. So your sleep, your diet, your movement, and most important is your autonomic nervous system regulation. Like, you know, how are we managing our emotions and our thoughts? All these things, lifestyle habits, play a big role into the heart health.

Yeah. Well, I know, yeah, people kind of pride themselves on getting along with fewer hours of sleep, and that's not so smart. We know that now. So how about stress and emotional well-being, how are they connected to physical health and how do they contribute to cardiac cardiovascular disease?

I would like to share a story over here. Yes, I had a, I had a woman who used to get chest pain every day evening and she used to go to different cardiologists and she even like kind of did an angiogram, no blockages. So cardiologists were like— because conventional cardiology is all about do a treadmill, do an angiogram, and if there is a blockage, put a stent or a surgery. Okay, so that's, that's the traditional route. So, uh, there was no answer. So I just asked her a simple question that what is happening at 6 o'clock that you're getting a chest pain. Tell me what's happening in your life, you know. And then, uh, she told me that, you know, like in the evening when her son is coming back and he's doing certain things which are not acceptable to her and she's not able to voice herself, uh, and then she just gets into this chest pain, you know. So now you can understand that their stress and emotional well-being is so important because whenever we are like kind of suppressing ourselves or holding that anger inside, there is like what we call in, in science a coronary spasm. That literally your coronary spasm, yeah, arteries contract and then they give you a pain. And even the most of the— when I see people who have got acute coronary syndrome, like a heart attack or like a unstable and join up. They have either had like a bad day at work, financial stress, you know, like, or something is going on in their family. Most people, like, you know, like after divorce or of some bad stock market crash or business thing, you know. So, uh, stress and emotional well-being is extremely, and I would say, direct connected, uh, to heart health. And very important we address that.

Yeah, of course. I mean, you know, as a psychologist, I can see how our, you know, our worry, our tension, our anticipatory anxiety, like your patient who was worried about the events at 6 o'clock, I mean, very powerful. And you're saying we cannot separate that, we cannot detach that from a contributing factor to our—

Exactly.

Our health.

And I just worked up with her how to manage that situation, and the chest pain was gone, you know, like, it was So it was like many times like the healing happens when your body feels safe, you know. So I think empowering people to regulate the nervous system is the key.

Sure. And, you know, we talk about lifestyle factors to help minimize that kind of progression of cardiovascular disease. But what about, what about the whole notion of reversing it once it does once it had its onset? How can we, how can we think about reversing aspects of heart disease?

Well, that's a great question, Dr. Joe. And I think here I would definitely would like to mention the work of Dr. Dean Ornish, because he was the first one to write in his book about reversing heart disease, where he had done the angiograms, you know, of the patients and demonstrated that the blockages can be reversed. And I also had the opportunity in India that time where we had, uh, where I was trained yoga teacher, uh, we did this research for 1 year where we actually did the angiograms of the patient. We did a control study also where they were not following the lifestyle and the conventional medicine route. And here they followed 1 year of yogic lifestyle, and then we literally saw that not in all, but in some cases, especially who were not diabetics, we saw that if their blockage was like 80% or 90%, regress to 40%, you know, and it was also reported in the Indian Heart Journal. And then when I was also like, I had, I was India's first woman preventative cardiologist and I had the opportunity to scale and grow to 15 clinics. And like we, we had like, it's like 100,000 people through my team, which we had helped. And many times we will do like angiograms., you know, just to see where they are at, like, you know, if a patient asks for it. And we will definitely see that the people who have followed, uh, the, you know, the lifestyle changes, uh, many of them significant reversal in the blockages, which I put in my book too. So I would not say like it is for everyone, to be honest. That's a false claim if anybody says that. But I would definitely say that, uh, I won't like to disempower the patients, right? What's happening is that the system, like, okay, you're a heart patient, you have to take these medicines. If you don't do a procedure, you're not good. And you have to stick to this lifelong. And then they're just giving their power away to a system and not taking charge of their health. And that is where, you know, like, I feel that much more can be done. Because if people are in the power to and the knowledge, uh, how can— how this disease is caused, because I, I always tell in my workshops and all that in every minute you are either building a blockage or reversing a block, you know. So it's, it's all about your micro habits, the way you think, the way you eat, the way you live, the way you move, and above all, the way you love.

Yeah, the way you love.

Yeah, you know, so, so definitely, uh, that is in the patients with blockages. And now I am helping people through CoCardio, people who are in 40s and 50s who have strong family history and risk factors like blood pressure or insulin resistance, diabetes, stress. We are studying their biomarkers and epigenetic markers. We are helping them through lifestyle changes to reverse those things, which is easier than one becomes a full-blown patient, you know, because it is easy to work on a cardiometabolic health, uh, which is there. Uh, so we do the calcium scoring, and now there is a huge group of people who are at the beginning of the disease, but they have not reached a critical point where they have got a major blockage for a cardiologist to put a stent. And this is a window which people actually— for prevention. And what we are doing is proactive prevention through our programs.

Is that where you can have the greatest impact, you think, with the early signs, the earliest symptoms?

Yes. Why? Because, uh, there is a study which has been recently published. They studied 4.8 million American adults who got a heart attack. Okay, yeah, a lot of people. It's a big study and huge findings, uh, where they found that almost 63% who were high risk were not on any preventive therapy, and more than 50% didn't have any documented symptoms of any heart problem. So that's the reason we are talking of this 3-step framework, which is detect early, protect fully, and connect deeply. Because what is happening, that imagine now, like 50% are not having any symptoms. So that's the reason I always say that whenever you talk, oh, I'm fine, I'm fine, my cholesterol is fine, and I have any symptoms, you know, but there is a blockage developing inside which you may not know. So, you know, like going for your biomarkers, which I listed earlier, and calcium scoring. These are like— nowadays there are a lot of advances. I'm very happy we have got advanced scans and everything where even like before a heart attack can happen, we can actually scan and find out whether those blockages are developing or not. Not only that, whether this blockage will burst and give you an attack or not can also be actually, you know, diagnosed. So I feel this is very important and I'm passionate about because, uh, we can prevent all this premature, you know, deaths which is happening. Uh, we can prevent this heart attack because right now the system is reactive. The insurance triggers when you get a chest pain or a symptom. That time the insurance starts all the investigation which leads either to a stent or a surgery. But, uh, insurance doesn't cover anything which is like when there is no symptom. That's how unfortunately our system is designed. I call it the sick care rather than the preventative care. So, so when we are doing this early detection, we are giving people time to change themselves.

Yes.

They are getting this beautiful 5, 10, 15 years where they are knowing, because these blockages take time to develop. It's not like an overnight process, you know.

Yeah, I have several questions here. What, um, what, what are the signs that should, um, kind of trigger a call to someone like yourself for these lifestyle changes? What, do we have to wait till, um, you know, the cardiac spasm or whatever's going on? What, can we get it from our routine labs and physicals or When should people be alerted to taking something, some different steps?

That's a great thing because I always like, I always say that waiting for chest pain to diagnose heart disease is like waiting for delivery to diagnose pregnancy. So that's a good sign. Yeah, yeah. So it's like, it's like, you know, when we are getting this chest chest pain and all those things, most of the times when people have it, those blockages are pretty much advanced, you know. So I would say that if you are an average age of the first heart attack in U.S. or 65 years, so I would say that the proactive prevention should start, uh, ideally from 40s, but if, if not, from 50s, you know, where, uh, you can actually— so the standard care will just give you a regular lipid profile, but we can always ask for advanced biomarkers and, you know, getting your risk. So your family, and, and especially as you ask that who should be working proactively, I feel that people who have got strong family history, either of their parents have like kind of collapsed with a heart attack or have undergone open heart surgery or anything like that, uh, strong candidates for proactive prevention. Or they have got a lot of risk factors where they have got high Lp, ApoB, all these biomarkers, on blood pressure, a lot of medications, or diabetes, you know, excessive stress, uh, or chronic inflammation. So these are all the people who are really brewing the disease inside without any visible symptoms. So I would say that it is worthwhile to get tested. And, uh, the framework, you know, my simple answer is that the sooner you detect early the easier the prevention becomes. Yes, right. And the more you kind of wait, you may have to like more effort. So all my life I saw that I was always meeting with these people with my India experience that after they get chest pain or breathlessness, they suddenly become alert. Or after bypass or angioplasty, I have met people who have been advised like second bypass. I have met people where there are 30 stents, no place to put stents, you know. So it's like I feel that the mindset is like, you know, okay, I'll do one procedure, another procedure, another procedure. And I feel that this podcast should become like an awakening call for everyone, that what you're doing is amazing. I really thank you for like inviting me here, that it is not about like living 200 is great, we are talking of longevity, but I think what we're discussing here is the health span, right?

Of course.

Yeah, the big four, the heart disease, Alzheimer's, cancer, and cardiometabolic. These are the big four. And what work we are doing is addressing this big four when we do the lifestyle optimization, where we go and work on your oxidative stress, chronic inflammation, making your cells stronger, mitochondrial dysfunction. You know, all these things are never spoken in conventional cardiology, you know. Yeah.

So that's so important that we, we should be more aware of what's going on because we don't feel the symptoms. We're not aware of it necessarily. So I'm not one to talk about commercial products on my program, but there is that device called, I don't want to say Cardia or something. You put your fingers on it and it gives you some reading of your cardiac performance. Are you familiar with that?

So yeah, so there are a lot of, uh, devices which are available where you can just put your finger and you can get your EKG and all those things.

Yeah.

And there are a lot of variables like the ring, like, you know, which I'm also wearing now and all that. So I feel that nowadays Apple Watch, Whoop, Oura, there are a lot of things which a common person can do as a variable, but this will not detect the kind of the risk which I'm talking of, where you're inside your arteries, the inner lining is endothelium, and there is an endothelial dysfunction happening. Uh, it's actually the beginning of the blockage in the heart arteries. It's like, imagine, like, cancer is detected after the tumor is big, right? But imagine cancer being detected when it is just at a cellular level, when just about the tumor is up to form. So then there is a lot of scope. So same way, right now conventional cardiology is diagnosing the blockage when it is becoming 70%, 80%, 90%. What I'm talking here, Dr. Joe, is right now the entire blood chemistry at a cellular level, whether it is going to form that blockage or it has formed that blockage, and whether that blockage is going to grow or give you a heart attack. This is a very advanced precision level preventive cardiology what I'm talking, you know.

But that's detectable now.

Yeah, yeah, that's detectable, and I believe that that's the future.

Yeah, that's the beauty of this. It's detectable.

And I, I am very optimistic that that as we are spending trillions of dollars on heart care and everything, the research is going to go more towards how are we not going to have the cardiac events, because it is taking billions of dollars, like $700-800 billion annually, just this angioplasty, bypass, heart failure, heart transplant, and all those different procedures, you know. And the prevention will be much more actually cost-effective, of course, you know, helping people afterwards.

Yeah. So, I mean, this is such an important message, and I know our, my listeners will welcome this, that the earlier we can detect some of these conditions, the easier or the less difficult the treatment is, but also that it's not inevitable, that we do have some control over the onset and the progression of cardiovascular disease. That's such an important message because I, I mean, I've worked with seniors and I know a lot of people just kind of throw their hands up when they get these conditions and they say, well, it's out of my control. And even dementia, I mean, not to say we can prevent Alzheimer's, but there are dementias that are preventable or due to preventable causes. So a lot of things are under our control. And the more we understand and kind of appreciate that whole notion, I think the healthier we can become because, yes, we can do some things. And lifestyle changes, I mean, that's a big part of it. But I think the attitude and the belief that I can do something about this— I don't want to create false hopes, but I think it's— I think you're kind of affirming my impression that a lot of this can really— I wouldn't say be fixed, but it's under our control. Absolutely. Yeah. Yeah. So what's, what's your sense of the people who are successful? What, what are some of the common characteristics that they share when they are able to minimize or reduce their, their risk? What, what, what jumps out at you as some of the common features or characteristics of these people?

Yes. And I think you already said And making a segue that most people, when they are given a label, that, oh, I have no control of it. So I, what I have seen is that I'm very grateful to all the amazing patients which I have met. Now I call them like kind of my health partners or participants, because I feel that these people have such a resilient mindset that they just want to take ownership of their health. And they just want to do everything what it takes to be healthy. You know, they just are not ready to give their power away to a diagnosis or a sentence. And they are having this mindset of like, okay, let me find out a way, let me beat the system, let me find something alternative or holistic, you know, and all that stuff, you know. And especially the people who have worked with me, I can definitely share their characters. One thing what I have seen was that they are coachable. I think that's a very important thing because whenever, like, you know, if you think that I know it all, oh, and this and that, and you are not open to new possibilities, I would say that open mindset is extremely important. And especially when people age, I have seen the common thing that, oh, I am old, I'm supposed to think this way, I can't change. This is what I am, you know, like, so I, I always say that I think you should not be doing that. Aging of the body is not equal to the aging of the mind. I repeat, aging of the body is not equal to the aging of the mind because neuroplasticity and neuroscience has definitely shown that nerves which fire together wire together. Absorb— we know that at any age, whether it's your 70, 80, 90, 95, you can change your mind, your habits, your thoughts, you know. So I think that's now really emerging in neuroscience. So these people have like kind of never give up mindset, uh, they really have this, uh, like desire in them that, hey, I want to live long, but I want to live healthy. I just don't want to keep on doing these procedures. I don't want to keep on just medicating myself and have this side effects of this drugs, you know. So, uh, and second thing is that they also believe in investing in their own health. Because what happens is that unfortunately most people, what they only want to do, what is there in insurance. Now insurance is always going to do what is sick care. Insurance is never in this country, uh, and that's the reason I didn't even choose to take license in this Oh, so the, so the whole thing is like the word doctor came from dossier, means to teach.

To teach. Yes.

So I, when I became a doctor way back in India, my goal was that I want to help people, help them in emergency, give them medications, but help them to go to the root cause so that they don't need the medications, you know. But the— when this whole thing became commercialized with the pharma and this and that and all that stuff, what is happening now? Okay, labeling people, making them— giving them that disempowered identity, and then putting them on lifelong medications, and you can never come out. And I feel honestly that's a trap which we are putting people in. And not awakening their own body's healing mechanisms.

Yeah.

And the work which I am doing is that— that's why it is not for everyone. It's only for the people who believe that— I call it soul-based care, that we are a spirit, you know, having a human experience, and I have all the power inside me to heal, and I want to awaken that. So these are the kind of people, when we give them our expert help, they really come out with flying colors.

Yeah, well, that's great. I, I, I, I love the phrase you use, we want to take ownership of our own health. And, um, Western medicine tends to want to fix things and do this and do that and take these medications. And, um, we need to let people step back a little bit and see what they can do themselves along the way, or maybe first. Yeah.

Little note here. I don't want to be like kind of misunderstood. Like, yes, it is good whenever people have conditions to take medication and to adhere to it. I'm very much for it. I have done that all my life. I just don't like kind of pushing continuously and not having a conversation that you can, you know, do things in your power to not have more medications or reduce medications. Yeah, that is the difference.

That's an important qualifier. I mean, it's not like either or, right? Yeah, you need to complement. Yeah, that's important consideration. So let me ask you about, um, how we first met each other— EECP therapy. Fascinating, fascinating development. Tell us about EECP, and can you explain what it is, how it works, and how it's used? Sure.

Yeah, I remember our first meeting when we were presenting at the Alzheimer's Association, uh, because— so EECP stands for Enhanced External Counterpulsation Therapy, and this is very, uh, non-invasive, drug-free, US FDA-approved treatment which was actually, uh, first invented in Harvard University, and then later on Dr. John Huey, uh, from Vaso Medical, did a lot of extensive research with whom he was my mentor and I got trained with, uh, it got FDA approval for patients with chronic resistant angina. In the layman language, people who have chest pain which does not respond to medications and they've already done bypass or angioplasty. So there was a double randomized case control, like must ECP trial, where they've showed and documented that ECP actually increases the blood supply to the heart. And then also in 2009, there was a complete research in the European Society of Cardiology that it brings about angiogenesis, which is like, you know, growing new arteries in your heart, which is there. And recently it also got actually approved for mild Alzheimer's and improving cognitive decline in Europe. And it is under serious consideration in US also by the FDA, uh, for the brain health, you know. And, uh, in 2015, uh, ECP— so in '90s and 2000, ECP was all about heart patients, you know, like helping them. But in 2015, uh, it got approval for wellness, which is improving your HRV and VO2 max, and, you know, and so now it is a lot with athletes. So I think I should tell a little bit how it works, you know. So, so, so it's like a very simple therapy where the session is for 1 hour. The participant comes and lies down on a bed and then, you know, you have blood pressure like cuffs tied on the calves and thighs and the butts. And then it is timed with your EKG. So every beat we are actually increasing the blood supply to the kidneys, to the heart and to the brain by 30 or 40%. You know, so it is increasing your nitric oxide by almost 40%. So it is, it is actually like some patients call it like a bloodbath, you know, because it's like 40,000, 40,000 miles of arteries in our body and they are getting this complete circulation thing. And we are seeing a lot of improvements in the energy levels. People who are wearing the variables, they see improvement in their deep sleep, which is very important for restoration and longevity. People are seeing improvement in geration HRV, VO2 max, uh, you know, so lowering their blood pressure, lowering the sugar. So because it is literally improving your physiology and your circulation, so we are actually the first one in North County to actually bring it to the people, uh, coming out of the closet. Because this is like in more than 1,000 hospitals in U.S., you know, including all the big hospitals. If you see the Cleveland side, Mayo, like they all have these devices, but it is like kept in the closet after bypass angioplasty phase. So we like, uh, we brought it out because for the wellness, uh, use, you know, which is here. I believe that, yeah, I believe that as you're aging, like Sir William Osler had said that, you know, like longevity, you're as old as your arteries, you know. So I have something like, you may be like say 60 years, but your your arteries may be 80 years old. You know, your heart age is like different from your biological age. So what ECP is doing is like really making your arteries more elastic, more flexible, and more blood supply so that it can give you a better healthy heart, you know, and brain.

So it really has a range of benefits, even though it started to increase. I mean, it was initially used to stimulate circulation. Yeah, it's been shown to have other, other benefits, right?

I would, I would, I like this as a longevity tool and like a health improvement tool. I would not say that because I always like, coming from the Western medicine and MD background, I don't like anything to be spoken of as a panacea, as doing everything, you know. That's, that's, I don't like it. I always, I always like to discuss the science that, you know, ECP has got more than 400 published peer-reviewed studies and all, you know. And there is a lot of data and science out there. And above all, ECP is not for everyone also, because we have to do a stringent, uh, like kind of a pre-check because we are playing with the cardiovascular physiology. So even when we are giving for maybe, uh, wellness or sports or like people who are not heart patients, when we are giving them We do a very thorough check whether they are candidates for it or not and whether they will be benefited or not, you know. So I think that is a very ethical responsibility, you know. We should not be just giving anyone who comes in and knocks the door, okay, fine, you know, like do that.

Yeah, yeah, get in line. It's, it's not a panacea.

Sure, exactly.

Yeah, yeah. So just, um, for my listeners, if anyone is interested in learning more about EECP. I did have a previous podcast with Jack Clifford, uh, someone who really benefited from this form of therapy, and he's trying to help educate the medical community about its benefits. So, uh, look for Jack Clifford on my podcast library. Um, Dr. Gandhi, this is a fascinating conversation. Let's just talk quickly about your one-day heart health workshops with CoCardio. Tell us about these and what do you do and how, how do people get involved?

Yeah, no, and I'm glad you brought up Jack Ripper because he's an amazing example that how he actually avoided bypass and, you know, has made it a life's mission to help everyone. That is really incredible because, and I, I feel very proud of him because in India I wrote a book, Living Without Heart Surgery, like, you know, because in US, like, it is like a kind of a different thing, but in India like most of my practice was like, uh, using ECP as an alternate to open heart surgery. So every day we used to have people like that. So that is, that is one great resource. And we also have like our YouTube channel, Cocario Inc., where we have a lot of, uh, uh, videos published by our, our cardiologist, Dr. Brian Asbill, who is our chief cardiologist. Dr. Vino, so who is a former professor at Stanford. So we have like a very equal team of all MDs Dr. Mark Kalina is our medical director from UCSD. He has worked in UCSD scripts and all. So if anybody wants like, uh, uh, from the medical doctors, you know, like education, then that is also one resource. And as you making a segue to that one-day workshop, and that is what we do, that we believe that, uh, we have detect early, which I spoke about, protect fully, which is like your ECP and lifestyle changes. But the third piece is connect deeply, because what happens is that we all know that loneliness is an epidemic. And there was actually interestingly a research done where people had heart attack and then even though they were with stents and medications, they started getting chest pain again. And it was like looking into the psychosocial factors and they found out that the people who are getting that, they felt that they were not loved by their spouse. Or they were alone. And that is where I feel the connection piece becomes very important, that half the people in this country are without any partners and trying to find, and many of them are with the partners, but they are having walls of isolation because it's like both partners are like kind of loving each other. And you are a psychologist, you must have seen this. And in couples, you know, that they are there with each other. And I always talk of that Five Languages of Love by Gary, you know, that book. And when we are doing these workshops, we are really building the frameworks of bringing and connecting the people together. So we are educating them on our, like, what should be their diet or how to exercise and, you know, like sleep and all those science-backed things. But when people come together in a group, there is a different kind of transformation and healing which happens. And I'm sure you experienced that.

Yes, I remember that. You kindly invited me to one of your workshops. Yeah. Yeah, I could tell there was a connection and people were really engaged with one another. Yes, that was very clear. Yeah. How often do you have these?

So we do every 3 months.

Every 3 months. Yeah.

And we, we, we are very intentional about it. There is— we like literally have a net promoter score of 100%. Like when we take our feedback, everybody tells us that you should be doing this, like, because I think they like that workshop as the best piece of what we are actually practicing. You know, like, okay, the device is there, the consult is there, or whatever it is. They really like hold it in their heart, the experiences and the friendships which they make when we bring people together. In fact, I had some people who told that, oh my gosh, and many times friends come, we were friends for 30 years, but we never spoke the way we spoke today with each other, like, you know, what would you do? Like, so that is the breakthrough, like, kind of people.

Not a lot of that happening when they visit their cardiologist, right? Yeah.

Oh, in 5 minutes, 10 minutes, that's not possible. Yeah.

Yeah. Well, this is great information. I, I, you know, I share your beliefs. I'm not a physician, but I, I really understand that people's attitudes and ownership of their own bodies and own health goes a long, long way. And I really commend you for, you know, supporting that, endorsing that, and carrying that flag. I think that's great. That's great. Thank you. So people can learn more about Cocardio. What's the website?

Yeah, it is just Cocardio Inc. C-O-C-A-R-D-I-O-I-N-C.com.

Great, great, great. Well, thanks, Thanks very much, Dr. Gandhi, uh, and thanks to all of our listeners for tuning in. If today's conversation gave you something to think about, you'll find more ideas, tools, and discussions at my website livingto100.club and also inside my Living to 100 community. Until next time, keep moving forward with purpose, curiosity, and a commitment to living well. At every age.