Advertise on podcast: Your Checkup: Patient Education Health Podcast

We break down the 5:2 diet in plain language and explain why it can work without any metabolic magic. We share what the research actually shows, how to do the low days safely, and who should pause and talk with their doctor first.  • what “five normal days, two low days” really means and why the low days should not be back to back  • why 5:2 works the same way other weight loss plans work through a weekly calorie deficit  • what studies show when 5:2 goes head to head with daily calorie cutting  • realistic expectations for weight loss and possible changes in blood pressure and blood sugar  • how to set up low days with protein, high-volume foods, fluids, and smart activity  • what hunger and other common low-day symptoms feel like and why they usually improve  • the real problem with long-term results being stick-with-it time  • when to talk to your doctor first including diabetes meds, eating disorder history, pregnancy, and frailty  You can find us on Threads, Instagram, or send us an email, or send us a voicemail, fan mail.  Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

We trace how a deep vein blood clot forms, breaks free, and lodges in the lungs as a pulmonary embolism, and we explain why symptoms can range from sharp chest pain to sudden collapse. We also lay out what makes us worry, how clinicians test and treat PE, and when you should stop guessing at home and get urgent help.  • how DVT risk factors stack over time  • why clots from the leg travel to the lungs  • ventilation perfusion mismatch and abrupt shortness of breath  • how right heart strain can drop blood pressure and cause fainting  • common symptom patterns including chest pain with breathing and coughing blood  • why a normal pulse ox does not rule out PE  • how emergency teams size up risk before imaging  • CT pulmonary angiogram, VQ scan, ultrasound, echocardiogram basics  • what anticoagulants do and what “blood thinner” gets wrong  • when to call 911 and why you should not drive yourself  • recovery, follow-up, and prevention after surgery or long travel  You can find us on Instagram, find us on Threads, you can send us an email  Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

We lay out a practical fall vaccine plan for 2026 by comparing what’s the same and what’s different across flu, COVID, and RSV guidance. We focus on the real-life questions people ask in clinic: when to get vaccinated, who needs extra doses, and how pregnancy and infancy change the RSV plan.  • annual flu vaccination for nearly everyone 6 months and older  • why flu shots change yearly and why timing still matters  • enhanced flu vaccine options for adults 65 and older and when not to delay  • when children need one flu dose vs two based on vaccine history  • flu shot myths, including why it cannot give you influenza  • updated COVID vaccine recommendations for adults, with extra planning for ages 65 and older  • pediatric COVID guidance based on age, risk, household exposure, and prior doses  • RSV vaccination for older adults and higher-risk adults 50 to 74  • pregnancy vaccination for flu and COVID in any trimester  • maternal RSV vaccination timing and infant antibody protection options  • expanded RSV protection for some children entering a second season  You can find us on Instagram, find us on Threads, you can send us an email, but most importantly, stay healthy, my friends.  Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

We walk through why potassium is the quiet partner in blood pressure control, and why focusing only on sodium misses half the story. We break down the safest ways to get more potassium, the research behind potassium-enriched salt substitutes, and the red-flag situations where extra potassium can be dangerous. • how potassium lowers blood pressure through kidney sodium excretion and vessel relaxation  • why most adults fall short on potassium while eating too much sodium  • the DASH-style “food first” approach and everyday potassium-rich foods  • what potassium-enriched salt substitutes are and what stroke outcome trials show  • hyperkalemia risks and the highest-risk groups, especially kidney disease  • medication interactions that can raise potassium, including ACE inhibitors, ARBs and spironolactone  • why over-the-counter potassium supplements are not a go-to blood pressure strategy  • two questions to ask your clinician before making changes  You can find us on Instagram, you can find us on Threads, send us an email, but most importantly, stay healthy, my friends. Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

A stroke can flip someone’s speech, strength, vision, or balance in seconds and sometimes there’s no pain at all. That’s exactly why people hesitate, wait it out, or try to “figure out what kind it is” at home. We don’t want you doing that. We want you recognizing sudden brain-function changes and calling 911. We walk through the fundamentals of stroke physiology in plain language, including the two major types: ischemic stroke (a blocked blood vessel) and hemorrhagic stroke (bleeding in or around the brain). You’ll learn why symptoms can look similar even though the treatments are very different, what clinicians mean by the ischemic penumbra, and why a non-contrast CT scan is often the first critical test in the emergency department. From there, we get practical: the BFAST warning signs (balance, eyes, face, arm, speech, time), why a transient ischemic attack (TIA) still counts as an emergency, and what “last known normal” means for treatment decisions. We also cover what happens next in the ER, including glucose checks, imaging, clot-busting meds like alteplase or tenecteplase for eligible patients, and when thrombectomy may be an option. Finally, we talk about recovery, rehab, the emotional toll on families, and prevention basics like controlling hypertension through primary care. If this helps you think of one person you love, share it with them. Subscribe, leave a review, and tell us: which stroke warning sign do you think most people ignore? Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

Coffee feels simple until you watch two people drink the same amount and have totally different outcomes. One of us can sip an afternoon coffee and sleep fine. The other can take a similar dose at noon and stare at the ceiling all night. So we slow it down and make it practical: coffee and caffeine are not the same thing, and the best way to understand your own response is to think in three variables we can actually test, the dose, the clock, and the person. We explain what caffeine is doing in the brain, starting with adenosine and sleep pressure, then why caffeine can make you feel more alert without paying back any sleep debt. If you have ever said “coffee makes me feel normal,” we talk through what that might mean, including the possibility of overnight caffeine withdrawal versus a true stimulant effect. We also get specific about dosing: a “cup” is not a dose, decaf is not zero, and caffeine can come from coffee, tea, soda, energy drinks, supplements, and even some medications. We discuss the FDA’s 400 mg per day benchmark as a population-level reference, not a personal target. Then we dig into timing and sleep quality. A key idea is that caffeine may still be in your system after the buzz is gone, and sleep impact is not just about falling asleep, it is also about how the whole night goes and how you function the next day. We talk about metabolism and sensitivity, how tolerance can build, and why symptoms like jitters, anxiety, palpitations, reflux, or disrupted sleep are worth listening to. We also share ACOG’s commonly cited pregnancy guidance to stay under about 200 mg per day and why your personal medical context can change the right plan. We close with what coffee research can and cannot tell us, why observational studies are reassuring but not prescriptions, and a simple self-experiment you can run this week: find the approximate caffeine in your usual drink, place it on your sleep clock, and see what you notice. If this helped, subscribe, share it with a friend who “can drink espresso at night,” and leave a review so more people can find the show. Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

A big weekend can make the scale jump, but that number rarely means you gained pounds of fat overnight. We break down why short term weight fluctuation happens and how to respond without panic or risky “fixes.”  • Scale weight reflecting water, fat, muscle, and digestive contents  • Why fast changes cannot be reverse engineered from one weigh in  • Sodium and fluid retention driving “water weight”  • Carbohydrates, glycogen storage, and the water that comes with it  • Hard workouts causing temporary water retention during muscle recovery  • Food timing, larger meals, and constipation affecting the number  • Menstrual cycle related fluid shifts and recurring patterns  • Weigh in consistency: same time, same scale, similar conditions  • Focusing on trends over time instead of one reading  • Returning to normal meals and routine instead of “compensating”  • Avoiding laxatives, deliberate dehydration, excessive water intake, or changing meds to force a lower number  • When to seek medical attention for swelling, shortness of breath, or chest pain  • Heart failure weigh in rules being different and following your care team’s thresholds  You could find us on Instagram. You can send us an email, your checkup pod at gmail.com.  Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

The FDA just expanded Mounjaro’s label to include reducing the risk of major adverse cardiovascular events, and the headline is easy to love and easy to misunderstand. We slow it down and translate what the approval actually means for people living with type 2 diabetes, especially those worried about heart attack, stroke, and cardiovascular death. We unpack the exact endpoint behind the claim: MACE, which combines cardiovascular death, non-fatal heart attack, and non-fatal stroke, and we clarify what it is not saying (no, it is not “erasing plaque” or curing atherosclerotic cardiovascular disease). We also explain the real-world nuance around branding and indications: Mounjaro and Zepbound are both tirzepatide, but FDA labels are population-specific, and that can affect clinical decisions and insurance coverage. Then we walk through the Surpass-CVOT cardiovascular outcomes trial in plain English. The key twist is the comparator: tirzepatide was tested against Trulicity (dulaglutide), an active GLP-1 medication with known heart benefit, not placebo. That’s why understanding noninferiority vs superiority matters so much. We talk hazard ratios, absolute vs relative risk, and the surprising finding that bigger weight loss and a larger A1C drop did not translate into statistically superior cardiovascular outcomes during the study window. We close with practical guidance and a list of questions you can bring to your own checkup, including whether you have established cardiovascular disease, what makes you “high risk,” whether other cardioprotective meds are already doing the job, how dose changes could affect insulin or blood pressure meds, and what it will actually cost. If you found this helpful, subscribe, share the show with someone managing diabetes risk, and leave us a review so more people can find clear medical context. Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

Your lab portal lights up red and suddenly you are doing mental math on a creatinine value you have never thought about before. We get it and we see it all the time in clinic, so we built a clear guide to the three kidney tests that confuse people most: creatinine, eGFR (estimated glomerular filtration rate), and urine albumin or protein in the urine. We start with what the kidneys actually do, down at the level of nephrons and glomeruli, then explain why creatinine is a helpful clue but not a perfect answer. Creatinine is measured, eGFR is estimated from that measurement plus factors like age and sex, and the two numbers typically move in opposite directions. From there, we tackle the big misconception: one low eGFR does not automatically mean chronic kidney disease. “Chronic” implies time, so we talk about why trends and prior labs matter, and how dehydration, acute illness, and certain medications can cause temporary changes that look scary on paper. Then we add the missing piece many people never hear about: urine albumin testing. Protein leakage can signal kidney damage even when filtration looks relatively preserved, which is especially important for people with diabetes and hypertension. We wrap by sharing the questions we run through as clinicians so you can bring the right context to your next checkup. Subscribe, share this with someone who reads labs at midnight, and please leave a quick review if it helps you feel more confident about your kidney numbers. Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

A single executive order can spark a thousand headlines, but it can’t conjure new evidence into existence. We dig into the recent move to change childhood vaccine recommendations in the United States and why the American Academy of Pediatrics is pushing back with the same blunt message: the science hasn’t changed. If you’re a parent hearing “maybe the schedule isn’t safe,” we unpack what that claim would require scientifically and why politics is not a substitute for data. We also slow down on the parts that feel personal. Yes, it can look like “a lot of shots” when you’re staring at a baby’s thigh. But the number of syringes is not a measurement of immune overload. We talk through how the childhood immunization schedule is designed, what safety monitoring actually looks like, and why spacing vaccines out is not automatically safer. Delays create longer windows of vulnerability to measles, pertussis, and meningitis, and they add real burdens: more appointments, more missed work, more transportation stress, and more chances to fall behind. Then we address the question that never seems to die: vaccines and autism. We explain what happened, why researchers investigated it so intensely, and what the large studies across millions of children consistently show. From there, we land on the bigger takeaway: skepticism has two responsibilities, questioning what we think we know and accepting the answer when the evidence becomes overwhelming. If you want clear, evidence-based context from a family doctor and a nurse, hit play. Subscribe, share this with a parent who’s getting mixed messages, and leave a review so more people can find the show. Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

Hi all, no new episode this week because we are on vacation! Feel free to enjoy any of our other episodes until next week :) Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

The words you use to describe your health can either pin you down or set you free. We talk about patient-first language and why a small change from “I am” to “I have” can ease shame, reduce stigma, and make room for real problem-solving in both chronic illness and mental health. We share how this shows up in everyday clinic conversations: diabetes versus “a diabetic,” obesity versus “an obese person,” and especially the tricky stuff like anxiety, depression, and bipolar disorder. When symptoms feel baked into your personality, it’s easy to say “I’m crazy” or “this is just me.” We walk through a reframing that helps you separate your identity from what you’re experiencing, so it becomes you versus the condition, not you as the condition. That distance can make next steps like therapy, coping skills, and medication feel less like a judgment and more like care. We also talk about how mental health can be misunderstood socially, how migraines and processing can collide with fast-paced conversation, and we keep things light with a weekend recap, comfort food, and a reality TV check-in. If you’ve ever struggled to explain what you’re feeling or felt defined by a diagnosis, this one is for you. Subscribe for more patient education conversations, share this with someone who needs a kinder way to talk about their mental health, and leave us a review with the words that have helped you most. Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

We break down why Cyclospora spikes every summer in the United States and why contaminated fresh produce can cause days to weeks of watery diarrhea. We share what to watch for, what testing to request, and how to lower risk without swearing off fruits and vegetables. • what Cyclospora is and why humans are the only known host • why May through August is peak season due to oocyst maturation • which foods show up most in outbreaks like cilantro and bagged salad mixes • why routine washing and chlorine are not reliable against Cyclospora • how fecal oral spread works and why it is not typically person to person • signature symptoms including explosive watery diarrhea and waxing and waning illness • who is at higher risk for severe disease including immunocompromised patients • why routine stool tests can miss it and the need for specific Cyclospora testing • first-line treatment with TMP-SMX and practical hydration tips • prevention strategies including recalls, cooking produce, and travel precautions Leave us a quick review. You could just give us a quick endorsement. Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

That moment when you stare into your medicine cabinet and think, “How did I end up taking all of these?” is more common than people admit and it’s loaded with meaning. We talk through the hidden emotions behind prescriptions: fear, identity, shame, and the quiet belief that needing medication means you failed. From our seats in primary care and nursing, we offer a calmer, more practical way to look at it: medicines are tools, not trophies, and avoiding them isn’t a badge of honor either.  We break medications into two clear buckets. Some help you feel better right now (pain relief, reflux meds, inhalers, allergy treatments). Others prevent future problems (statins, blood pressure medication, diabetes medication, osteoporosis meds) and the benefit can be almost invisible, which is exactly the point. We use the seatbelt analogy to explain why “not feeling different” can still mean a medication is working, and how to think in probabilities instead of scary absolutes. We also talk about side effects: what’s common, what’s rare, why many are reversible, and why it’s reasonable to ask for time to read and reflect before committing to a daily pill.  Then we get into the messy realities: supplements with slick marketing, direct-to-consumer drug ads, influencers, and even credentialed voices making claims without evidence. We explain why polypharmacy (often five or more meds) can create dizziness, falls, confusion, and mystery symptoms, and why deprescribing can be one of the best things a primary care clinician does. We also draw a bright line around higher-risk tools like opioids and benzodiazepines, when short-term use makes sense, and why opioids and benzos should never be taken together.  If you want a smarter, less anxious framework for your next medication conversation, hit play, then subscribe, share this with a friend who’s overwhelmed by their med list, and leave a review so more patients can find it. Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski

Sunlight feels harmless until you zoom in far enough to see what it’s doing inside a single skin cell. Today we follow that path, from UVA and UVB radiation to DNA damage, then through the built-in systems your body uses to prevent skin cancer in the first place. We keep it plainspoken but accurate, because understanding the biology makes the prevention advice feel a lot less like nagging and a lot more like control. We talk about melanin and why tanning is a defense response, not a health goal, plus the difference between DNA damage and a permanent mutation. Then we meet one of the most important safety players in the story: P53, the protein that can pause cell division for repairs or trigger apoptosis when a cell is too damaged to keep. We also explain why sunburn pain and peeling are signs of real cellular injury, not just a temporary cosmetic annoyance. From there, we compare basal cell carcinoma, squamous cell carcinoma, and melanoma, including why melanoma depth is such a big deal for spread and survival. We cover why most moles never become cancer, what changes are worth acting on, and how to use the ABCDE method and the ugly duckling sign. We also address a persistent myth directly: skin cancer can occur in every skin color, and it may show up in different places like palms, soles, and under nails. We’re Ed Delesky, a family medicine doctor, and Nicola Aruffo, a nurse, and we want you to leave with a practical plan: reduce future UV exposure, know what’s normal for your skin, and get help when something evolves. If this helped you, subscribe, share it with a friend who lives for “just one more hour in the sun,” and leave a review so more people can find the show. Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply. Support the show Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN Artwork Rebrand and Avatars: Vantage Design Works (Vanessa Jones)  Website: https://www.vantagedesignworks.com/ Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr Original Artwork Concept: Olivia Pawlowski