Full Transcript Introduction to wearables and embodied awareness 0:00 For somebody that is a high performer in any field, I don't care what field you're in, this can be very helpful for helping you tune into your body. 0:11 The question is, how do you feel? 0:14 And when I ask that question to a lot of my patients, or my coaching clients, they don't know. 0:20 They're not embodied. 0:22 they're, not really connected.They don t slow down enough to know, like, do I have some chest tightness? 0:28 Does my stomach hurt? 0:30 Am I tired? 0:31 I really haven't gotten some great sleep since, you know before I went to medical school. 0:35 I've no idea if I'm tired or not. 0:36 When people have lost that connection to their body, I like to add the wearable in to start to provide objective data. 0:45 You're listening to the Lifestyle Medicine podcast with Dr. 0:48 Ivan Rusilko, brought to you by Access Labs, where we explore new perspectives at the forefront of personalized healthcare. 0:58 Welcome back to The Lifestyle Medicine Podcast. 1:00 I'm Dr Ivan Russell, your host, and we're powered by access labs. 1:04 If your doctor's not checking your labs, they're not a doctor. 1:06 And today we have Dr Andrea Austin, who's, not only an ER physician, she's a coach to other physicians worldwide, which I can't be more excited to have 1:13 her to talk about. 1:14 Wearables, we're going over wearables today. 1:16 So Dr. 1:16 Austin, thank you so much for stopping by. 1:18 Well, it's awesome to be here and I love talking about this topic. 1:22 I'm very curious. 1:23 A lot of physicians, especially once you get up there in a year such as myself, you start looking at wearable and a lot them just scratch their heads, 1:30 right? 1:30 They don't know how to incorporate them. 1:32 It's very user-dependent especially with the actual patients. 1:35 What's your biggest hurdle when it comes to kind of getting physicians onboarded to the whole wearability craze that's going on right now? 1:41 Right. 1:42 Well, there's actually been, you know, a few articles in the lay press, kind of bagging on wearables and saying, should we be using this? 1:51 Are they accurate? 1:53 Is it too much data? 1:55 And so I understand the critiques and I think they're still a really powerful tool, but like every tool you have to know how and when and why you're using 2:07 that tool. 2:08 No, very, true. 2:08 And again, it's kind of hard to imagine people would be critiquing too much information these days, especially with the advance of things like AI. 2:16 Now, did you incorporate AI into any of your actual protocols when it comes to that? 2:20 Interesting question. 2:21 You know, I would say I am not fully versed in how some of the wearable, a lot of math involved in, how do we provide the data that they provide us.
Why physicians should use wearables 2:32 I'm sure there's AI in the background. 2:38 coming up with some protocols or some recommendations for people, but it's all always a human in the loop. 2:43 I'm always very involved before I would ever give any information to a client. 2:49 But really what I think the value of the wearable is, is specifically the heart rate variability. 2:58 for many of our physicians that might be listening is where our nurses were traumatized by the fifth vital sign. 3:04 So that used to be pain, right? 3:06 And you used get in trouble with the Joint Commission if you didn't have a pain score documented because it was the 5th vital signs. 3:13 Well, what I like to say is the Fifth Vital Sign should really be heart rate variability because that number tells me so much about someone's overall well-being. 3:25 Now, can you explain how heart rate variability is actually calculated? 3:28 Because I'm sure a lot of people know what it is and know number they should have, but nobody really knows where it comes from. 3:33 Right. 3:33 Well, again, a lotta math. 3:35 There's a square root involved. 3:36 I will not subject anyone to that. 3:38 The basic premise and even mostly people at this point, if you have an Apple watch or some other device, you've probably seen your heartbeat, 3:46 or you been at the doctor and you had an EKG done, Or you can just Google real quick, what does a rhythm strip or heartbeats look like? 3:56 And so you see these squiggly lines. 3:58 And for the clinicians listening, we have the P wave and the R wave, and S wave. 4:03 So if calculate the distance between the two R waves, that's called your our to our wave distance. 4:12 And we actually want a lot of variability. 4:16 That sounds weird. 4:17 It sounds like we want our heartbeats to be regular. 4:21 We don't want an arrhythmia. 4:24 Absolutely true. 4:26 The beat to beat variability is good because what that ends up representing is the balance between your parasympathetic and sympathetic system.
Heart rate variability as a key biomarker 4:37 So when you see variability between heartbeats, and we're talking at the milli millisecond level, we can't see it always from the human eye. 4:48 It's such little variability. 4:50 But that variability shows that your parasympathetic response is strong. 4:55 So we want to see it. 4:57 And actually, one of my friends that's an obstetrician pointed out to me, well, it kind of makes sense because when we're watching babies' heart rates 5:06 on the monitors, we are looking for variability. 5:08 I was like, I've never thought about it that way. 5:10 But yes, so we were looking at that beat-to-beat variability Okay, great. 5:16 And now, so this obviously differs by age, correct? 5:19 I mean, you're having adolescents, teenagers, middle-aged, elderly. 5:23 What's a good heart rate variability for the general population? 5:28 Yeah. 5:28 So there's, there is a curve that you can, again, take a look at. 5:32 Take this with a massive grain of salt. 5:36 But roughly kind of your age is what you can. 5:40 So if I'm in my, let's kind the reverse of that. 5:43 When you're in your 20s, having like a heart rate variability in the 60s. 5:48 That's very common. 5:50 And as we get older and older, maybe into our 60's, 80's we're seeing more like in the 20s. 5:55 That is a huge grain of salt because the thing that's different about heart rate variability compared to pulse and blood pressure is there's more individual variation. 6:07 And so this is where I think the case for wearables becomes very important. 6:12 If my heart rate variability is different than your heart-rate variability and I go to the doctor and let's say they did measure it. 6:20 Most doctors don't measure right now. 6:22 They did. 6:22 You're not going to really be able to tell me if it's good or bad because it is one moment in time. 6:27 But if I'm using a wearable device, And I begin to know my true baseline. 6:33 Then I can start to see how it's being affected by other things that I'm doing. 6:38 And so it is a very individualistic vital sign. 6:42 So what's the best time? 6:43 Is it during sleep? 6:44 It is during activity? 6:46 is it just regular resting? 6:47 I know a lot of people just like to like leave it on and figure out like they don't wake up and be like, I got my this much delta sleep and my HRV was this. 6:54 Or what do you think the time to actually test this, this parameter? 6:57 Yeah. 6:58 I honestly think the more data, the better. 7:01 So, you know, that's why I'm a fan of the continuous monitoring. 7:06 People ask me all the time, they're like, well, I have an Apple device, an apple watch or a Garmin watch. 7:12 Why would I buy an Aura or whoop device? 7:16 And I don't have relationships with any of these companies. 7:20 And the real, the reason you may consider doing it is the battery life. 7:25 Because with my Apple Watch, as much as I love Apple products, my watch, you know, The battery is only good for about 20 hours. 7:34 And so, and then to charge it takes like 20 minutes. 7:38 So if I wanted to wear it to bed to monitor my sleep and heart rate variability, I'd have to figure out a time during the day to charge it. 7:45 And I also don't like wearing my watch to bad because it feels like work. 7:49 Watch and work are linked in my brain. 7:52 Where the ring, i'm a fan of the Ring, the Aura. 7:55 There's different rings out on the market now as well. 7:59 and then I have friends that are big into the bands from an aesthetic standpoint. 8:05 I don' really like the band as much, but that's.
What affects HRV and how to improve it 8:08 my personal preference. 8:10 There's many people that think the bands are better. 8:13 Yeah, there's so many options out there these days. 8:15 I mean, I can only imagine what's going to be there in the next five years, you know, but when it comes to like, if I come in and I, 8:21 my HRV is just in, in The Crapper. 8:24 How do I fix that? 8:25 Is it lifestyle parameters? 8:27 Are we talking hormones? 8:28 We talking nutrition, sleep? 8:30 Yeah. 8:31 So the biggest contributors to your heart rate variability, one is going to be sleep. 8:37 Fundamental. 8:38 And honestly, we can't have a health conversation without a sleep conversation. 8:42 It's the same with all my coaching clients. 8:45 I can give you all the mindset tools in the world, and if you're sleep deprived, they're not going work. 8:51 Sleep is fundamental. 8:52 Get that in order. 8:53 The other one that's a big one, especially for us in a middle age is alcohol. 9:00 Alcohol crushes your HRV. 9:06 So that's definitely one to watch. 9:09 And then the other thing too is really closer to bed. 9:12 You know, I know from my HRB, if I have a glass of wine at 9 PM and I go to bet at 10, my, HRD is going to be pretty bad. 9:21 the following day. 9:23 But if I had a glass of wine with dinner and I'm done by seven, I go to bed at 10, it's usually fine. 9:29 So both alcohol and then also proximity to sleep, and that's the same with food. 9:35 And this all makes sense, right? 9:37 It's all connected because we know if you're having a lot of food right before you go bed, your body's not having time to digest that. 9:44 It has to work harder when you are trying to that's going to fight you. 9:48 So those are like the bad things, right? 9:51 You know, your sleep, alcohol, eating too close to bed. 9:55 But the other things that can protect or improve HRV, so there's some literature that perhaps the cold immersion, the plunges can help with our HRB. 10:08 There's, you know some other thing to think about with that and definitely speak to a doctor before trying out those cold plunged. 10:15 And then the other thing that's fascinating about HRV is it really is kind of a canary in the coal mine. 10:22 And what I mean by that is if you optimize your sleep, you're avoiding eating close to bed. 10:28 You're giving your body time to recover after strenuous activity. 10:32 If you run 10 miles because you are training for a half marathon. 10:35 You know, the next day you probably need to take it easy, right? 10:38 That's not the day to do seven miles again, that's going to also affect your HRV because you're not allowing for recovery. 10:43 So if you are doing all those things and you not seeing an improvement in your hrv, That is really the time to start talking to a physician and find a 10:53 Physician that will listen to you because some might say, oh, you don't need To worry about your HrV. 10:58 If they're familiar with the literature on it, you should be worried about it because there's other conditions associated with low HRV. 11:06 And it's kind of a little bit of chicken and egg. 11:08 Is it, is your risk of depression, mental health things, cardiovascular things because your HRB is low or is you're HR V low because you have these things. 11:18 That's a hard to completely, um, dissect and to your point, like, is this something, does this suggest that maybe you need hormones supplementation? 11:28 It could. 11:29 And there's a lot of different things that could be affecting the HRV. 11:33 So I always say start with like kind of the, not that they're easy, but take out the common things, you know, are you optimizing your sleep? 11:40 Are you watching when you eat before you go to bed? 11:44 Are giving yourself time to recover? 11:46 When you do strenuous activities and if all that's yes and it's still low, then I think that is the time bring that to a trusted medical professional and 11:56 talk through what it could mean for you. 11:57 for sure. 11:58 I love how you brought up the aspect of sleep. 12:00 Sleep is probably my favorite thing to treat in patients. 12:03 And I always tend to see the correlation between cortisol DHE and IGF-1, three of the biggest things that are affected during sleep and again, 12:10 I'm also a big wearable guy too. 12:12 A whole AI company that takes AI plus labs plus wearables and it kind of gives you a whole picture of it. 12:18 So the more information for me, the better. 12:19 And I always tend to see not only my patients, but also in myself, like you said, you know, a couple of weeks of bad sleep, 12:25 whether it's you're going through a divorce, or death, whatever it could be, is definitely going to affect the HRV tremendously. 12:29 But you also see a drop off in things like IGF-1 and DHA, and also your rise in cortisol. 12:34 So it is kind of crazy how you sit there and you see these lab results, then you say your wearables, that then correlate with your lifestyle. 12:39 And lo and behold, there's this amazing pattern that is so basically straightforward and kind common sense. 12:46 It's a shame that not more physicians kind to get on board with. 12:48 Yeah, and I think the other thing too, what I like about the wearables is for somebody that is a high performer in any field, 12:58 I don't care what field you're in, this can be very helpful for helping you tune into your body. 13:05 The question is, how do you feel? 13:06 And when I ask that question to a lot of my patients, Or my coaching clients, they don't know because they're not embodied. 13:15 They're Not really connected. 13:17 they Don't slow down enough to know like, do I have some chest tightness?
Using wearables to understand stress and burnout 13:21 Does my stomach hurt? 13:23 Am I tired? 13:24 I mean, I really haven't gotten some great sleep since you know, before I went to medical school. 13:28 I've no idea if I'm tired or not. 13:29 So these are responses you hear. 13:32 And so when people have lost that connection to their body, I like to add the wearable in to start to provide objective data. 13:40 Like your sleep is bad, you're not getting enough REM, your recovery score has been incredibly low, more than half of the week. 13:49 So now we have data, the next step is starting to have a better sense of connecting how you feel. 13:55 to that data. 13:56 It's not always possible. 13:58 But in some cases, we can start to help people become more tuned to what they're actually feeling. 14:03 Oh, yeah, that makes total sense. 14:05 Did you see a correlation? 14:06 Because again, if you're wearing the ORA ring, you know, wearing it during sleep, and you are getting those parameters on delta sleep and REM and that 14:12 as well. 14:13 Are you making correlations across the board or are you focusing solely when it comes to not only yourself, but also the people that you teach, 14:18 solely on HRV or you incorporating those with other various biometrics? 14:23 Various things that the other one I really like, I'm most familiar with Aura since that's what I use, but a lot of the wearables provided now is a stress score. 14:33 And it's actually by the hour and it is fascinating because I think we all tell ourselves stories about our stress. 14:42 Like I worked a clinical shift that was stressful. 14:45 It was terrible. 14:46 If I work less clinical and I did more admin, my life would be better. 14:50 That was a story I used to tell myself. 14:52 And so then I started looking at my stress scores and my stressed spikes were higher on my admin days than they were on clinical days. 15:01 And that was a really interesting thing for me to start to sit with. 15:06 Like, okay, I'm fairly stressed out on admin day. 15:10 I need to take more micro breaks and do some deep breathing, maybe go outside. 15:17 Look at the sky. 15:18 I get to look at ocean a lot of times here in Florida, you know, do things like that, that like I'm actually quite stressed. 15:25 You know I think in my head and what really kind of cinched this for me is when I went through my worst burnout episode, 15:33 I was in the late thirties and I walked out to my car. 15:37 after an emergency department shift, and I had a little bit of chest pain. 15:41 And it wasn't the type of pain that I thought anything was actually wrong. 15:45 I figured it was emotional, stress-related, And I though to myself, you know, all disease starts somewhere. 15:55 So we all, I'm old enough at this point that, physician colleagues that have just, you know, had a huge MI. 16:04 And we all wonder like, how did that happen? 16:06 Well, it's a culmination of things, but this unmitigated stress and being so disconnected from our bodies is definitely part of the story. 16:16 Sure, for sure. 16:17 And I'm also curious too, because in our practice, like I said, diagnostics, whether it's wearables or labs or imaging, is extremely important. 16:24 What I've seen with my training patients is that women tend to have a little bit better HRV among my patients. 16:30 So is there a big difference? 16:31 I don't know if it is tied to maybe estrogen. 16:33 We're always checking estrogen levels and usually the older the woman, the lower the estrogen, so you kind of see worse HRB. 16:39 Do you see correlations like that with yourself, men versus women versus woman who are on hormone therapy versus not? 16:44 That's a great point. 16:46 My coaching practice has been mainly women, not because I'm not open to coaching men. 16:51 It's just who I've attracted so far. 16:54 So I haven't noticed that and I hadn't read that in the literature, but I think it probably makes sense. 17:01 And if it's something that you're seeing, again, it is a very individualistic vital sign. 17:07 I am more interested in what's the trend for that person. 17:13 And really, it's one of those vital signs that as you measure over time, so I'll give a couple of quick examples. 17:19 Last summer I broke my right proximal humerus, so long bone fracture, incredibly painful, lots of inflammation throughout my entire arm. 17:31 My HRV was in the toilet for a solid six weeks. 17:35 And I actually, I wore the ring. 17:38 I watched it because I was so curious if it would start to turn when I started to feel better. 17:46 And it did, it was pretty good, but I do want to touch on with that story. 17:52 This is where you have to know yourself or if you're guiding people using this technology, you to have know your people. 17:59 For me, that was not traumatizing to see the low HRV. 18:03 You know, I knew I was really injured and I curious about it. 18:09 And I could look at that number and didn't feel like it a judgment. 18:13 It was a reflection of my health and I wanted that information. 18:17 When that number starts to become a stressor and you start to feel added stress because of it, that's not helping you.
HRV trends, recovery, and when to seek help 18:26 And that is when it may be time to take a device holiday. 18:30 I did a devices holiday when my dad went into hospice. 18:34 just put the ring away for two weeks. 18:36 I knew my numbers were going to be bad. 18:37 And I just thought, you know what? 18:40 There's nothing actionable here. 18:42 Like I can't change that my dad's on hospice and this is just going be a miserable two-weeks. 18:47 So I'm going just take it off because it's making me feel worse about a situation that's already really crummy. 18:53 That's the piece of advice and I wish the stories that have been recently in the lay press That's what it's really about. 18:59 Like you've got to know yourself or have a trusted clinician or coach that's helping you synthesize that information and use it for something actionable 19:09 and not just adding to our already very full, busy, stressful lives. 19:15 Oh, for sure. 19:15 And so when somebody comes in, whether you're coaching a physician or healthcare practitioner to utilize this, or it's one of your own patients, 19:22 and you find something that just doesn't make sense, the HRV is terrible, they might be going through something, what's your first line treatment? 19:27 Is it supplemental, is it lifestyle, was it a combination of both, hormonal? 19:31 Yeah, so my coaching practice, I don't prescribe anything. 19:36 So in my coach practice I just go through kind of the assessment, The big things that could potentially be contributing to it. 19:44 And so sleep is the number one culprit, especially among my coaching population being physicians. 19:52 And once we get to a point that we've identified, we have optimized everything we can, and this might be an actual medical situation, 20:00 then I'm telling them you need to reach out to. 20:03 A clinician and I say, if your clinician isn't comfortable reviewing this data with you, then you need to see somebody who is. 20:12 And thankfully, we're seeing more people. 20:14 You know, for me, I go to a functional medicine physician, she's boarded in emergency medicine, and then she did the functional medicines. 20:22 So we can have these conversations. 20:24 Increasingly more, people are finding people that they can. 20:28 That's what I would encourage. 20:31 If you've done kind of the basic things that we've talked about in this podcast and you're still seeing some numbers that are concerning, 20:39 there might be something else going on. 20:41 And then I've also had somebody reach out to me and say, you know, I'm a cancer survivor and since I have had cancer, my number is really low. 20:50 She reached out for advice and my advice was essentially just, You know I would encourage going to somebody. 20:58 that's comfortable with trying to optimize your health. 21:02 You know, there's the Western perspective of medicine. 21:05 I can say this because I still practice in Western medicine, you know. 21:08 We're trying prevent disease or, we're treating disease. 21:12 Increasingly, our patients are asking us to prevent diseases. 21:16 No, for sure. 21:16 And again, that's kind of the big swing right now. 21:18 You know what I mean? 21:19 And finding somebody who's willing to kind incorporate both of them, I think, is the most important thing. 21:23 There's a lot of people on the wellness side who are like, traditional medicine is horrible. 21:27 It's the worst thing in the world. 21:28 A lot traditional doctors are being the exact same way. 21:30 Wellness is crazy. 21:32 But there is proof in putting on both ends. 21:34 And I think that that's kind of one of the biggest things that people need to kind realize is that, you know, the integrative aspect of using traditional 21:41 Western medicine along with the actual wellness and prevention is kind the key to actually treating a patient and a disease at the same time, 21:48 I And when it comes to your selection of wearables, I know you're an aura girl. 21:54 We're out there for people listening. 21:57 What's a good way to kind of select it? 21:59 I mean, is it personal preference? 22:01 Is it what you feel? 22:02 is a brand? 22:02 What is the best way about selecting your wearable? 22:05 Yeah, so some things I would keep in mind, one, you have to like wearing it. 22:10 And you know, I'll admit it, but I'm a bit vain. 22:14 I need the aesthetic to match, what I do. 22:18 So for me, the ring is the best option. 22:21 One, will you wear it? 22:22 Two, does it fit your budget? 22:24 And there's really two things for people to watch when they go to the budget. 22:28 There's the upfront cost of the device. 22:31 Honestly, there is a subscription. 22:33 They always get you with the subscription, subscription. 22:36 And at least the last time I had done some research, some devices put more of that upfront cost early on the device purchase in a very low cost subscription, 22:46 and some it's the flip. 22:47 The device is very inexpensive, but the subscription is more expensive. 22:51 But the other thing for you to think about is the devices may be covered by your health savings account. 22:59 and the subscription. 23:00 So that's, again, it doesn't mean it's free, but it is a perk you may want to look into. 23:06 I love that. 23:06 No, that is true. 23:07 And again health is wealth, you know what I mean? 23:09 Like I said, this is your most important asset. 23:11 You have to invest in it sometimes. 23:14 It might be worth some... 23:15 I found out that when you give somebody something for free they never take it seriously. 23:19 Maybe that subscription cost kind of makes them pay just a little bit more attention to it, or that, Well, so I always like to ask two questions to everybody 23:28 who comes on here, and the first one is going to be kind of altered because it's so unique on the wearable aspect of it. 23:33 When you're talking to your fellow healthcare practitioners, whether it was nurses, NPs, physicians, whoever it could be, 23:37 what would be your pitch into basically saying you need to start checking wearables, especially HRV?
Choosing the right wearable and practical use cases 23:43 Because a lot of people are like, that's not for me. 23:46 What's your biggest pitch for that, would you say? 23:48 Yeah, I mean, practically, as an emergency physician, you know, people come to me all the time saying I have palpitations, 23:56 or I think my heart rate was fast. 23:58 And increasingly, they actually are wearing a wearable already. 24:02 So I will say, when were you feeling that? 24:05 Let's pull up your Apple Watch, let's look on your phone when you were experiencing that, what was going on with your body? 24:12 It's not perfect, but there's been papers in the New England Journal of Medicine that the Apple Watch is very good at detecting atrial fibrillation. 24:20 Not perfect, not saying it's completely diagnostic. 24:23 Yes, they'll need confirmatory testing, but it really can add to that knowledge. 24:28 And for HRV, it is the real fifth vital sign. 24:31 We are living through the most stressful time. 24:34 I think, to be a human on the planet with all the stuff that's happening right now. 24:41 And this is the only vital sign that reflects truly what your parasympathetic response is. 24:49 There was a very fascinating study among pediatric and emergency medicine residents on their PICU rotation. 24:56 What they showed was that the EM residents' heart rates went higher. 25:00 So you say, oh, those ER residents, they were stressed out. 25:03 their HRV was better. 25:05 So what that meant is, yes, they had a spike in their heart rate, but they recovered faster. 25:11 And so that's what we want, right? 25:13 That you may have that sympathetic kicks in, especially if you've been in an emergency or in a high stress situation before, 25:19 your body's like, I know what but then that ability to pump the parasympathetics to turn on that breathing and say I'm going to be okay and I am not going 25:28 let this stress my heart over the long term. 25:32 Super true, very true. 25:34 And then for people who are patients who now either just strictly traditional or wellness or whatever it could be, how would you explain them in a very 25:43 concise but direct way that checking things like your wearables is almost as equally as important as diagnostic imaging, 25:49 diagnostic testing, wearing a heart monitor, all this other stuff that, you know, that they see super medical, how would you explain to them that wearables 25:57 are also in a way medical? 25:58 Yeah. 25:58 I mean, what I think about is, so if you go in, let's say you come into the emergency department for chest pain and we order a stress test for you, 26:08 or we even, even get a HeartCath, Okay, well, that showed what your condition of your arteries were today or, you know, the nuclear stress test showed 26:18 your cardiac function is today. 26:20 But what about tomorrow and the day after and day? 26:23 And so, we can't thank goodness. 26:25 We don't all want to be connected to CT scans and MRIs. 26:29 getting cardiac caths every other day, and we don't need that. 26:32 The wearables are that in-between, that there's that, in between. 26:37 And we're all running experiments, right? 26:39 So we all read an article like, ooh, maybe intermittent fasting is good for me. 26:43 Okay, well, how are you going to know if it's good you? 26:46 Like you feel better, you lose weight, like we are going come up with different metrics. 26:50 But I would say one of them should also be your HRV. 26:53 Because if you start an intermittent-fasting protocol and your HPV goes in the toilet, And it stays in the toilet. 27:00 Um, yeah, I do think that would be something that you should talk with a clinician about, you know, read the benefits of intermittent fasting. 27:08 I went to the extreme of the 16 hours, but now my HRVs and the teens. 27:15 So maybe we need to adjust that protocol. 27:17 Like, so I think medical testing is fantastic as it is. 27:21 So the, the wearable device is the early warning system. 27:24 Yeah. 27:25 It almost sounds like a bridge. 27:26 You know what I mean? 27:27 You have a diagnostic test for checking your hormones like testosterone, estrogen. 27:30 cardiovascular, HSCRP, anemia, all those different things that, you know, that you can look at to figure out what's affecting it, 27:36 but you don't really know that should be checking them until you actually see that there's a problem. 27:39 And I think HRV is something that people don' really understand, even physicians, clinicians, whoever you want to talk to. 27:45 Is that like, well, yeah, I saw that on Whoop or something. 27:48 But I do see definitely getting a bigger and better rap in the very near future. 27:53 So, Dr. 27:54 Austin, please, tell us where we can find you. 27:57 You know, are you social media, websites? 27:59 Yeah, absolutely. 28:00 So my website is AndreaAustinMD. 28:03 I'm most active on Instagram and LinkedIn, and you can me at Andrea Austin. 28:09 MD. 28:09 Rock and roll. 28:09 That sounds great. 28:10 And again, I'm Dr. 28:11 Ivan Rosilko. 28:11 This is a lifestyle medicine podcast powered by Access Labs. 28:15 You can find us on, oh geez, where are we at? 28:17 We are on Spotify, we're on Apple, or on YouTube. 28:20 We're pretty much anywhere podcasts are found and we have fantastic guests like Dr Austin. 28:24 So thank you so much for stopping by today. 28:25 Really. 28:26 Thank you. 28:27 It's been an honor. 28:28 All right, guys. 28:29 Have a good one. 28:29 Thanks for joining us today on the Lifestyle Medicine Podcast. 28:33 At Access Labs, every innovation we pursue is driven by one bold purpose, making personalized medicine more practical and accessible for patients and providers. 28:43 If this episode sparked new ideas or challenged how you think about patient care, awesome. 28:48 Follow the show and share it with a colleague who's ready to level up their practice. 28:52 Head over to our website at accesslabs.com and register your practitioner account today. 28:57 You'll get access to over a thousand routine and advanced biomarkers. 29:03 with 24-hour results. 29:05 When signing up, select Lifestyle Medicine Podcast as how you heard about us and score 10% off your first invoice. 29:13 Oh, and don't forget, drop us a review. 29:16 It helps more practitioners like you find us. 29:20 We'll see you next time.
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