TELEARUBA — broadcast
20260825 043000 UTC
439 transcript segments
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[00:00:00] that presence that makes a person stand out, in short,
[00:00:03] you're farming now is when you do poses that give you style
[00:00:07] points, presence or charisma, but beware, you can also
[00:00:11] lose it, for this reason
[00:00:14] why the power to make a various battles are already being fought among the young people of this new
[00:00:17] generation and look at this shocking bull
[00:00:21] that got stuck in a vehicle, all this was recorded by
[00:00:24] one of the cell phones of a person who was inside this
[00:00:28] car.
[00:00:30] An unusual episode occurred during a bull run through the countryside in
[00:00:34] Guadalajara in Spain. It is a bull that charged a vehicle in full
[00:00:38] motion. It also broke one of the rear windows. The
[00:00:41] impact caused one of the animal's horns to remain inside the
[00:00:45] cabin. The bull remained attached to the vehicle for several
[00:00:49] seconds while the vehicle continued to move forward. The scene was
[00:00:52] recorded on video by the occupants of the car who
[00:00:56] filmed the moment from the interior. In the images, you can see
[00:00:59] it next to the vehicle after going through the
[00:01:02] glass with one of its horns. The episode occurred
[00:01:06] within the framework of the patron saint festivities of Iriepal celebrated
[00:01:10] in honor of San Roque. During the journey, the Bull focused
[00:01:14] its attention on this car and the charge occurred. After
[00:01:17] remaining attached for a few seconds, the animal ended up
[00:01:21] stumbling and fell to the ground while the car continued its
[00:01:24] journey.
[00:01:30] our recommendation of the day arrives at this hour and it comes from
[00:01:34] Lotto, the Aruba lottery and the accumulated Mini
[00:01:37] Mega and its Mega Plus, the
[00:01:39] accumulated continues to rise, Lotto, the Aruba lottery comes with
[00:01:43] its tremendous accumulated for tomorrow, Tuesday, August
[00:01:46] 25th, where you can win 700,000 florins with the
[00:01:50] Mini Mega and with the Mega Plus you will have the possibility of
[00:01:53] winning the super accumulated millionaire of one million
[00:01:57] florins, this for tomorrow, Tuesday. Buy your
[00:02:00] Mini Mega and Mega Plus ticket before it's too late. Don't forget that Lotto
[00:02:04] 5 for this Wednesday has an accumulated of
[00:02:08] 180,000 florins, Lotto changing
[00:02:10] lives. And look at these images, a young man
[00:02:14] bought a washing machine online through social
[00:02:17] media and realized something digital that prevented him from
[00:02:21] seeing, well, it was just a
[00:02:23] sticker.
[00:02:25] This was the case of a user on Tiktok who shared his experience when
[00:02:29] buying a...
[00:05:51] Welcome to another episode of Caribbean Medical
[00:05:54] TV. Today we're getting to the very core of your
[00:05:57] physical health, the very essence that guides you through
[00:06:00] life, the heart. While the
[00:06:03] Caribbean is unique in many ways, we unite with the
[00:06:07] rest of the world in the rise of one of the most common chronic health
[00:06:10] conditions, heart disease.
[00:06:13] many of our Caribbean people, some unknowingly, are living with
[00:06:17] heart disease or know someone with this ailment.
[00:06:20] Unsurprisingly, this condition can influence our
[00:06:23] peace, our professions, our families, in short, our
[00:06:27] entire lives. Heart have three arteries and
[00:06:31] two arteries in the left side, that is what you call left main
[00:06:35] coronary artery, it divides into two, one is left anterior
[00:06:39] descending artery, which supplies the blood supplies to the
[00:06:42] heart muscle 60% of the heart muscle and then the
[00:06:46] left circumflex artery which supplies to the
[00:06:49] 20% of the left side of the artery and then right side
[00:06:53] right coronary artery we call it as it supplies to the
[00:06:56] 20% of the heart muscle so in total three arteries
[00:06:59] supplies 100% of the heart muscle so main one is
[00:07:03] led that is left anterior descending artery left are complex right
[00:07:07] coronary artery supplies to 20% each the heart is the main
[00:07:11] one from the blood and to different parts of the body, so the artery supposed to
[00:07:15] be healthy and nice. the causes of heart
[00:07:18] disease are no mystery. unfortunately, the risk
[00:07:22] factors are very common in our communities.
[00:07:25] there has been a decline in mortality, but that
[00:07:28] decline plateaued around
[00:07:30] 2019-2020 and in fact has started to increase
[00:07:34] again. some of that was due to the excess mortality due
[00:07:37] to the COVID pandemic, but top of that there's been
[00:07:41] the epidemic. of obesity and
[00:07:43] diabetes that is added risk factor and thus
[00:07:47] cardiovascular disease has trended up over the last few years
[00:07:51] and cardiovascular disease mortality, so we still have lot of
[00:07:54] work to do here in the Caribbean and around the
[00:07:57] world. heart failure and cardiovascular disease are
[00:08:01] related. this is like a journey in the
[00:08:04] illness of the patient. the patient is
[00:08:07] starting point to have something that we call
[00:08:11] risk factors. for example, elevated high
[00:08:14] blood pressure that we call hypertension or
[00:08:18] high cholesterol or diabetes, that
[00:08:21] leads to changes in the heart and the
[00:08:24] arteries, a concept for example that our arteries
[00:08:28] getting older, stiffy and
[00:08:32] good ateroesclerosis,
[00:08:35] finally complications are rise, for example
[00:08:39] cerebrovascular disease, stroke,
[00:08:42] failure or kidney
[00:08:45] problems, if they are not address in the
[00:08:49] right manner, the patient can lead to very
[00:08:53] limited quality of life or unfortunately son
[00:08:56] ordain law the life. every person is an
[00:09:00] individual, but definitely
[00:09:03] having risk factors, high blood pressure, high
[00:09:07] cholesterol, smoking and
[00:09:09] diabetes are the person that can lead to... heart
[00:09:12] failure in the heart failure is not addressed or
[00:09:16] treated, the person, 50% of the
[00:09:19] persons die in the in the five years
[00:09:23] after the diagnosis, because there
[00:09:26] are sometimes no warning symptoms, many people are
[00:09:29] unaware they are at risk for heart problems, the key to
[00:09:33] prevention is being prepared, we had a 25
[00:09:36] year old young man recently who
[00:09:39] had no clue that he had anything and when i listened, heard the
[00:09:43] murmur of mitral stenosis, meaning that his mitral valve, the one on the left side
[00:09:47] between the top and bottom, wasn't opening, and when we did the echo, it
[00:09:50] showed that he had severe stenosis and he's 25 and never had a clue that
[00:09:54] he had this disease, so we can go on forever with these stories, but what we saying
[00:09:58] is if you identify, if you keep doing well person checks, something
[00:10:02] will tip somebody off that something is
[00:10:04] wrong,
[00:10:07] children have to be seen by pediatrician or a
[00:10:11] gp or somebody who's listening for
[00:10:13] abnormalities, not just you getting vaccines and done, but
[00:10:17] listening for a murmur,
[00:10:19] alert to the fact that rash could mean be more than rash,
[00:10:23] right? just thinking of the diagnosis. because we say what you don't think of you will miss
[00:10:26] in terms of diagnosing, so if
[00:10:29] you do that then there's a possibility.
[00:10:32] unfortunately, I am seeing the the
[00:10:35] incidence going up and I'm seeing it in younger patients.
[00:10:39] for example, I trained in the university of Calgary in
[00:10:42] Canada, and in my training when I did these
[00:10:46] procedures, did it in patients who were in 60 days 7
[00:10:49] days, but in gayana I am doing
[00:10:52] procedures or restance on patients. as young as
[00:10:56] 30s and in the 40s and we did a study in
[00:10:59] between 2022 to 2023 where we look at
[00:11:03] about 230 patients who present with this type of heart
[00:11:07] attack, we found that the average age was in the
[00:11:10] 50s, we found that they were predominantly male
[00:11:13] patients and a significant portion, almost
[00:11:16] 70% were South Asians or
[00:11:19] East Indians, lot of patients had diabetes,
[00:11:22] hypertension and 80% of the...
[00:11:25] presented late and did not receive the therapy within the 12
[00:11:29] hour period. the good news is that detection and
[00:11:32] treatment have been increasing in the caribbean. the heart
[00:11:36] patient of today has more options than the heart patient of
[00:11:39] decades ago. I think as a whole that the Caribbean is actually quite
[00:11:43] good at healthcare, so certain territories may be better certain
[00:11:47] things, but we haven't had to send patients away for a long time,
[00:11:51] actually. in terms of cardiovascular care specifically, we probably...
[00:11:55] only selled pediatric cases for surgery, lot of the
[00:11:58] pediatric cases are done by something you call interventional procedures as well and those
[00:12:02] patients do not have to go away, adult cardiology patients do not go away
[00:12:06] for anything, so angioplasty,
[00:12:08] stens, surgical procedures including val replacement about procedures
[00:12:12] and this is within the caribian as a whole, and trinidad specifically
[00:12:16] quite in a good way has a highest percapita
[00:12:19] of cardiologists in caribbean, so we have essentially all the
[00:12:22] cardiology specialities locally,
[00:12:25] "a lot of people in the 30's and the 40's and the 50's don't think of health care as being part
[00:12:29] of a proactive thing, so waiting for something to happen, then go to the
[00:12:32] doctor, so we see both in men and women that you know the
[00:12:36] suddenness of cardiovascular disease, and it's one of those weird things that you
[00:12:39] have to look for, you can't just say i'm waiting for a symptom then to do a test,
[00:12:43] so it does mean going to your doctor having a frank discussion,
[00:12:46] again it makes the difference what we looking for, so if somebody has heart is in
[00:12:50] the family we might look a certain way, if it's a general checkup it might be just a different
[00:12:54] way of test." but we have the technology, this is not that is
[00:12:58] unique to some parts of the world, we have different ways of evaluation, we have
[00:13:02] CT scans, MRI machines, echo machines, so technology is
[00:13:05] available in the Caribion it is not unique to some other part of the world, we can do
[00:13:09] it, people just need to access it and again have that discussion with the health
[00:13:13] provided wherever you are and see what is the best tool for you to come up with that
[00:13:16] information. in the caribbean we do
[00:13:19] have different levels of of equipment, availability and access
[00:13:23] into different territories. Right, so part of what the Caribbean cardiac society
[00:13:27] does is brings together the
[00:13:29] um, you know, that network, kind of strengthen that
[00:13:33] network, establish that network. There are some areas
[00:13:36] that they may not require setting
[00:13:40] up of a special area each country, so by
[00:13:44] meeting together, the PMI say, listen, we are setting
[00:13:47] up this center for maybe pet scanning, and we would
[00:13:51] encourage from all the other islands that you could come here.
[00:13:54] Another... center might decide, well look, we are going to do lot of
[00:13:57] coronary intervention, and you difficult cases, you could bring
[00:14:01] them here, so you could have centers of excellence in different
[00:14:05] fields around the Caribbean. relatively recently in
[00:14:08] St. Lucia, St. Lucia established his cardiac catheterization laboratory, and what
[00:14:12] we did is that we had, persons coming from Martini, persons coming
[00:14:16] from Jamaica, and it would have been cardiologists, cardiovascular
[00:14:20] nurses, cardiovascular technicians travelling to help
[00:14:22] establish that cardiac. ization center in St.
[00:14:26] Lucia and that's what we like to do, we like to build capacity in the different regions
[00:14:30] and yes there is human resource capacity, but that the equipment and the
[00:14:34] availability of disposals and so on also very important. In the
[00:14:37] last years we have faced the appearance of
[00:14:41] diverse drugs for treating common diseases,
[00:14:44] diabetes, hypertension, obesity. When we take a look at
[00:14:47] those patients, patients with obesity, hypertension, diabetes
[00:14:51] usually suffers not only for that condition but also affects heart.
[00:14:55] kidneys, liver and other organs, and that's
[00:14:59] the point when we, the different specialists get together to
[00:15:03] treat the same patients and in the last year all of these
[00:15:07] medications usually
[00:15:09] works not in only one organ. let
[00:15:13] me give you an example, we have some molecules that can
[00:15:17] protect the heart at the same time that they protect the
[00:15:20] kidney and at the same time that they protect the liver, so it is
[00:15:23] important to have the different specialist
[00:15:27] perspective of using these medication and the management of these
[00:15:30] problem. beyond those traditional
[00:15:33] drugs that have been the cornerstone, the are
[00:15:37] new... technologies that have to do with
[00:15:40] genetically manufactured or genetic
[00:15:43] alterations or new medicines that are
[00:15:47] based on gene technology and the fact
[00:15:50] that the human genome has been identified and we
[00:15:54] can now have the technology to know the genes responsible.
[00:15:58] scientists are now making gene therapies,
[00:16:00] antibodies
[00:16:03] that can target certain molecules in a body
[00:16:06] to bring the... on the cholesterol, it's quite
[00:16:09] amazing and it resembles in many ways some of the advanced drug
[00:16:13] technologies that are used in cancer therapy where you can
[00:16:16] target the focus. this is now being applied in
[00:16:20] cardiology. what i presented
[00:16:22] was the work that we are doing in managing heart
[00:16:26] attacks and there is one particular heart attack called a
[00:16:29] stemi st elevation my carl infarction.
[00:16:32] what what happens in in that case is that the artery
[00:16:36] becomes blocked 100% percent so
[00:16:39] when that happens, patients will obviously get significant
[00:16:42] chest pains is that you have to open that
[00:16:45] artery as soon as possible and the early you
[00:16:49] open that artery the better the outcomes, so if you open that artery
[00:16:53] within the hours you have better
[00:16:56] chance, but there are certain therapies that you can give that would
[00:17:00] have to be given within 12 hours, in addition to
[00:17:04] that they goal standards actually taking the patient to the... cat
[00:17:07] lap and trying to open that artery with balloon, that is called
[00:17:11] PCI. so my presentation
[00:17:15] was based on the work we're doing in trying to
[00:17:19] have this therapy available in all the 10 regions of
[00:17:22] Giana. my area of focus is minimal invasive
[00:17:26] heart procedures, really percutaneous heart procedures, meaning doing heart
[00:17:30] valves or closing holes in the heart by just going through either an artery or the
[00:17:33] vein in the leg. these procedures are much safer than open. heart
[00:17:37] surgery, they require lower hospital time, lower
[00:17:41] hospital stay, they don't require ICU admission, so they of course
[00:17:45] save money and they save lives. my area of
[00:17:48] expertise is cornaries and blocked coronary order, so the real this is
[00:17:52] without question, the most cutting edge thing you can do for cornerers right now, the
[00:17:56] other thing that's is been around and is emerging and evolving is
[00:17:59] stenting, we still stent, more than half the
[00:18:03] patients are eligible for stent, those that are not
[00:18:06] eligible for stents are.
[00:18:37] apply that technology to almost 100% of my
[00:18:40] patients, we now on the cusp of
[00:18:43] learning how AI is
[00:18:46] interacting with the tools that we have been
[00:18:48] using, so now increasingly we're using
[00:18:52] AI to find
[00:18:55] tune both the treatments that we're giving
[00:18:58] and also to help us with the complex decision making,
[00:19:02] we can now also ask AI, AI, what do you
[00:19:05] think and and AI?
[00:19:08] will promote a well, that's what will suggest and will
[00:19:11] suggest a strategy. now it's not that he's committed to doing
[00:19:15] that, but it's like having an experienced partner that
[00:19:18] can give you some advice and you can think about it, and so that that's
[00:19:22] fantastic, especially for areas
[00:19:25] like in most Caribbean islands where you
[00:19:28] have few specialists or few super
[00:19:31] specialists who don't have even yoke
[00:19:35] colleague always to bounce idea. off of now you can talk to
[00:19:39] AI and collaborate and
[00:19:41] disagree and and at the end of the day the doctor
[00:19:45] remains the one who makes the decision, but he always
[00:19:48] feels as if he's surrounded by colleagues who can give him
[00:19:52] another opinion. as with many chronic non-communicable
[00:19:55] diseases, healthy changes in lifestyle can go a
[00:19:59] long way toward keeping your heart healthy. it is all about
[00:20:02] prevention and the risk factors. we've gotten very good at treating heart
[00:20:06] attacks, at treating... heart failure at treating the
[00:20:09] end stages of the disease, but we're
[00:20:12] still behind in terms of preventing disease. the number
[00:20:16] one risk factor in the Caribbean and around the world remains
[00:20:19] and will remain up to the year 2050 is
[00:20:22] hypertension. the problem with hypertension is that people
[00:20:26] either don't get it measured, don't know they have it, even if they have it,
[00:20:29] they feel okay, they don't feel it, and so they don't get it
[00:20:33] treated, so that's the number one modificable risk factor
[00:20:36] right now. "We're doing pretty well with cholesterol, people know their
[00:20:40] cholesterol, the statin drugs are ubiquitous to
[00:20:43] use, and almost free of side effects, and so lot more
[00:20:47] people getting their cholesterol lowered, but..." I mentioned, there's this
[00:20:51] rise in obesity and diabetes as the third risk
[00:20:54] factor by 2050, so we have to get our
[00:20:58] handle on that, and uh, so hypertension,
[00:21:01] obesity, diabetes are the areas that really need a lot of work over
[00:21:05] the next 20 years. The only way you know or you
[00:21:08] have information as to what your blood pressure is is if you are
[00:21:12] if you are checking it, so you must know your numbers, you must check your
[00:21:16] blood pressure, okay, and for those who have
[00:21:19] got high blood pressure, then whatever is between yourself and your
[00:21:22] physician, your doctor, whatever decision has been
[00:21:26] made, then you want to adhere to those principles, because they
[00:21:29] are very good treatment methods that would
[00:21:33] control the blood pressure and therefore remove that risk or
[00:21:36] decrease that risk of complications such as aotic
[00:21:40] disease, aotic anerism, aotic dissection, sometime you see it in
[00:21:44] young pregnant women as well during pregnancy, the person because you
[00:21:47] know the blood pressure changes during pregnancy, Sometimes you have
[00:21:51] women experiencing complications during their pregnancy where they've got to
[00:21:55] high blood pressure, high blood pressure sometimes can occur in pregnancy,
[00:21:58] and if it's not well managed, you can also develop aotic dissections and
[00:22:02] complications of aotic rupture. Exercise
[00:22:06] is really the best medicine, it's better than any medication that I can
[00:22:09] prescribe, or any cardiologist can prescribe,
[00:22:13] getting just simple walking, 7 or 8,00
[00:22:16] steps a day should be the goal. There are very good studies.
[00:22:20] now showing that's the level of exercise that reduces your cardiovascular
[00:22:23] risk, so if you can get a smart watch or smart phone or
[00:22:27] some fit bit, some way to count the number of steps you're doing a day
[00:22:31] and get really aim for that 7 or 8,00 steps a day,
[00:22:34] that can control your weight, control your blood pressure, improve your
[00:22:38] overall cardiovascular risk profile. it's shown to reduce
[00:22:42] cancer rates as well, so exercise is really the
[00:22:45] best medicine we have. one other aspect that's
[00:22:48] rising is need to get good
[00:22:51] sleep, the condition of obstructive sleep apnea
[00:22:54] is there on the horizon and rising and we realize a great
[00:22:58] contributor, so that's the other
[00:23:01] aspect that I think we need to clearly understand, that's creeping in
[00:23:05] as one of the things we need to pay attention to, not only diet and
[00:23:08] exercise, but good restorative
[00:23:11] sleep,
[00:23:18] we are two systems in the body,
[00:23:20] the sympathetic nervous system that is related to stress
[00:23:23] and the parasympathetic nervous
[00:23:26] system that is related to relaxation, and
[00:23:29] every time we take a deep breath in and out, we're
[00:23:33] actually activating the vagus nerve
[00:23:37] which in turn would cause
[00:23:40] relaxation after a small number of
[00:23:44] breaths,
[00:23:46] so that this is why things like meditation and yoga help.
[00:23:50] full because they actually help the physiology of the
[00:23:54] body. We are now realizing
[00:23:57] that what is really good are the good
[00:23:59] fats? Not all fats are good, the saturated
[00:24:03] fats for instance, but if you want eat diets
[00:24:07] that are high in like avocado, which was one
[00:24:11] time thought to be something bad, olive oil,
[00:24:14] which is one of the the best oils and the good fats
[00:24:18] that come from nuts. in places like
[00:24:21] Cuba and lot of the other places, Puerto Rico,
[00:24:25] because they eat so much rice and peas, they have found
[00:24:28] that there is less in the way of arterosclerosis,
[00:24:32] that too, with some meat and fish will be a
[00:24:36] good diet. Of course,
[00:24:39] green, leafy vegetables and foods, you know,
[00:24:43] which are around and in abundance just so they take a
[00:24:46] little bit more effort to get them on the table. but if
[00:24:50] you use this, this will be one of the the most
[00:24:54] helpful things in achieving a long life.
[00:26:53] Caribbean Medical TV. Every year
[00:26:56] in March, we observe World Down Syndrome
[00:26:59] Day. Many in Trinidad and Tobago, like the rest of...
[00:27:02] world don multicolored socks to help raise awareness, but
[00:27:06] yet many people in classrooms, in the workplace, in
[00:27:09] public spaces, even in our own homes, do not
[00:27:12] understand people with down syndrome and how to support
[00:27:16] them. Over the years, Trinidad and Tibegos Down Syndrome
[00:27:19] family network has made strides to raise awareness and
[00:27:22] offer encouragement and community to families across the
[00:27:26] country. For members of the Down Syndrome Family
[00:27:29] Network, their mission to advocate for families of people with
[00:27:32] down syndrome is a highly personal one. It was difficult
[00:27:36] in the beginning. I didn't know anything about Down Syndrome, so I thought I
[00:27:40] was cursed you know for my son to be born with down syndrome. And
[00:27:43] then even realizing after three days that he also
[00:27:47] had congenital heart disease, he had three holes in his heart
[00:27:50] and needed the emergency surgery. So is almost
[00:27:54] like if okay, what next, what next? I mean he already has down
[00:27:57] syndrome, now you get three holes in his heart. Why, what did he do? What did
[00:28:01] I do, you to cause? this and not knowing that
[00:28:04] he didn't do anything, didn't do anything, it just happens and
[00:28:08] then a friend of mine, you know we actually sitting on having some
[00:28:12] drinks and i was ranting and he's just looking at
[00:28:15] me and over his drink he was sipping it and he looked at
[00:28:19] me straight in my eyes and he said what are you
[00:28:23] doing and he took a sip of his drink i wanted to slap that drink out
[00:28:26] of his hand you know and opened my
[00:28:30] mouth three times and i could not answer him
[00:28:33] because I realized then I wasn't doing
[00:28:37] anything, so I was a part of the problem, in fact I was the
[00:28:40] problem in my son's case, buse I wasn't doing anything
[00:28:44] to help him, and so that changed everything. The result was a
[00:28:48] collaboration among parents of children with down syndrome to
[00:28:51] establish a support network, means to reach out to those
[00:28:55] struggling and help them see that their children could have lives full
[00:28:59] of potential. I started educating myself, I started
[00:29:02] attending conferences abroad and that is
[00:29:05] where I got the concept of the network cuz I'm seeing how those
[00:29:09] other organizations grew from family support
[00:29:12] groups to huge international
[00:29:15] organizations, some of them are the largest advocacy
[00:29:19] organization for Down Syndrome in the world and it
[00:29:23] started off as family support group, so
[00:29:26] I came back and with some other parents we formed the Down
[00:29:30] Syndrome Family Network and in 15 years, you know, I
[00:29:34] always used to think that we haven't done anything, but people have to keep
[00:29:37] reminding me, look what you have done,
[00:29:41] the we the government has ratified the UN convention on the rights of persons
[00:29:45] with disabilities, they updated the national policy
[00:29:48] on persons with disabilities, and they have begun drafting
[00:29:52] national legislation for persons with disabilities, you know, so we
[00:29:56] anxiously away that, because that is the game changer right
[00:29:59] there for all persons with disabilities. "the support of
[00:30:03] organizations have helped to raise awareness of the best means to
[00:30:06] support families and people with down syndrome. truly power
[00:30:10] to make a difference program. they support us
[00:30:13] with our workshops and we have these workshops quarterly along with
[00:30:17] our conference annually in march where we bring
[00:30:21] parents together with professionals, you
[00:30:24] occupational therapists, speech therapists, physiotherapists
[00:30:28] and even as we had today in our
[00:30:31] workshop, find..." financial specialist from
[00:30:34] republic bank to tell us all about planning for the
[00:30:37] future investments and even starting from
[00:30:40] basic from a bank account and how that
[00:30:44] could help us plan for our children's future so
[00:30:48] power to make a difference is really making
[00:30:51] a difference partnership with the down syndrome family network
[00:30:55] and we hope that as we continue they will help
[00:30:58] add our cry.