1 00:00:00,450 --> 00:00:02,170 - Welcome back to the Becker's Healthcare Podcast, 2 00:00:02,315 --> 00:00:04,375 devote to the people who power US healthcare. 3 00:00:04,715 --> 00:00:06,055 I'm Molly Gamble at Becker's 4 00:00:06,055 --> 00:00:08,495 and delight to have you join us for another episode filled 5 00:00:08,495 --> 00:00:09,975 with insights from healthcare leaders. 6 00:00:10,585 --> 00:00:13,695 Today I'm spending some time with Dr. Jason Co. Dr. 7 00:00:13,835 --> 00:00:15,895 Co serves as the director of the Orthopedic 8 00:00:15,955 --> 00:00:17,455 and Spine Institute and Endeavor, 9 00:00:17,575 --> 00:00:21,015 formerly North Shore University Health System, chairman 10 00:00:21,035 --> 00:00:22,815 of its Department of Orthopedic Surgery, 11 00:00:23,075 --> 00:00:24,575 and also Chief Medical Officer 12 00:00:24,725 --> 00:00:27,055 with Chicago Fire Major League Soccer team. 13 00:00:27,635 --> 00:00:29,015 Dr. Co, welcome to the podcast. 14 00:00:29,195 --> 00:00:31,735 Thanks for being my guest today. How are you? 15 00:00:31,735 --> 00:00:33,215 And where does the podcast find you? 16 00:00:34,225 --> 00:00:35,755 - Well, Molly, uh, thanks a lot. 17 00:00:35,975 --> 00:00:38,475 Uh, I'm excited to be here today. I'm doing great. 18 00:00:38,895 --> 00:00:41,435 Um, I'm particularly looking forward to this season 19 00:00:41,435 --> 00:00:45,275 because the Chicago fire have their home opener coming up, 20 00:00:45,415 --> 00:00:46,995 and the team is looking great. 21 00:00:47,615 --> 00:00:49,715 Oh. So we've had a good team last year 22 00:00:49,775 --> 00:00:51,115 and made some key additions, 23 00:00:51,115 --> 00:00:52,515 so we're looking forward to a great season. 24 00:00:53,555 --> 00:00:54,595 - Terrific. That's wonderful to hear. 25 00:00:54,875 --> 00:00:57,555 I, I think Chicago sports fans, we, we, 26 00:00:57,555 --> 00:00:59,595 that's welcome news, Dr. 27 00:00:59,735 --> 00:01:03,475 Co. So thanks for, for listeners in the area, um, some, 28 00:01:03,475 --> 00:01:04,515 something to look forward to. 29 00:01:04,815 --> 00:01:06,995 But speaking of the Chicago Fire, I think 30 00:01:06,995 --> 00:01:09,675 as my introduction just highlighted, you wear many hats 31 00:01:09,675 --> 00:01:12,595 as an orthopedic surgeon team, physician leader. 32 00:01:13,175 --> 00:01:14,715 Can you walk us through your role 33 00:01:14,935 --> 00:01:17,395 so our listeners can just better appreciate your 34 00:01:17,395 --> 00:01:18,475 perspective today? 35 00:01:21,005 --> 00:01:23,495 - Sure. Um, well, I mean, you started 36 00:01:23,495 --> 00:01:26,175 with orthopedic surgeon and I think that's part of, uh, 37 00:01:26,955 --> 00:01:28,095 my definition. 38 00:01:28,435 --> 00:01:31,655 Um, for me, uh, I went into orthopedic surgery 39 00:01:31,755 --> 00:01:32,815 to help people get better. 40 00:01:33,115 --> 00:01:35,495 Uh, I keep people active and pain free, 41 00:01:36,195 --> 00:01:38,615 and that really informs a lot of my goals. 42 00:01:39,355 --> 00:01:42,175 The, uh, I'm a practice reading orthopedic surgeon. 43 00:01:42,495 --> 00:01:46,975 I typically do, uh, over 300 to 400 surgeries a year, 44 00:01:47,595 --> 00:01:49,535 uh, see lots of patients, 45 00:01:49,995 --> 00:01:52,775 and it's a true source of, uh, enduring joy 46 00:01:52,775 --> 00:01:54,855 and satisfaction in my life to be able 47 00:01:54,855 --> 00:01:55,895 to help people get better. 48 00:01:56,835 --> 00:02:00,215 Uh, with regards to that, um, it's allowed me 49 00:02:00,215 --> 00:02:02,495 to become very effective as a team physician. 50 00:02:03,035 --> 00:02:07,295 Uh, being an orthopedic surgeon, assessing patients, uh, 51 00:02:07,305 --> 00:02:09,255 helps me assess injured athletes, 52 00:02:09,255 --> 00:02:11,055 whether they're professional or recreational. 53 00:02:11,875 --> 00:02:15,735 Um, it does make me think about things in a, 54 00:02:15,935 --> 00:02:19,935 a different way in terms of where the individual is in terms 55 00:02:20,235 --> 00:02:22,575 of their team, the timing of sport. 56 00:02:23,275 --> 00:02:26,735 Uh, we're always focused on the athletes first. Mm-Hmm. 57 00:02:26,775 --> 00:02:29,215 . And then finally, as a leader, uh, 58 00:02:29,245 --> 00:02:32,415 I've been running the Department of Orthopedic Surgery at, 59 00:02:32,515 --> 00:02:34,775 uh, endeavor, which was formerly North Shore 60 00:02:35,115 --> 00:02:36,255 and now for a dozen years. 61 00:02:36,275 --> 00:02:39,575 And we've become the busiest orthopedic department in 62 00:02:39,805 --> 00:02:43,775 Chicago, uh, the market leader in terms of the number 63 00:02:43,795 --> 00:02:46,215 of cases that we do at our dedicated 64 00:02:46,215 --> 00:02:47,735 orthopedic and spine hospital. 65 00:02:48,395 --> 00:02:51,935 Uh, this requires obviously a coordination of a number 66 00:02:51,935 --> 00:02:53,055 of different moving parts, 67 00:02:53,915 --> 00:02:56,975 but again, having worked with teams, having been on teams, 68 00:02:57,615 --> 00:03:01,005 I think that, uh, that's informed me in terms 69 00:03:01,145 --> 00:03:02,565 of my management style 70 00:03:02,745 --> 00:03:05,725 and bringing people together to work towards a common goal. 71 00:03:05,905 --> 00:03:08,405 And in this case, a common goal is, uh, 72 00:03:08,405 --> 00:03:11,365 outstanding orthopedic and spine care. Mm-Hmm. 73 00:03:11,405 --> 00:03:12,965 - . Mm-Hmm, . Well, 74 00:03:12,965 --> 00:03:14,285 let's dive into some field notes. 75 00:03:14,305 --> 00:03:16,405 If you'll share this with us in our listeners about 76 00:03:16,885 --> 00:03:19,645 interesting trends you're detecting right now in the fields 77 00:03:19,645 --> 00:03:21,845 of orthopedic surgery and sports medicine. 78 00:03:22,425 --> 00:03:23,645 Is there anything up and coming 79 00:03:23,675 --> 00:03:25,405 that listeners should be keeping an eye on 80 00:03:25,425 --> 00:03:28,245 or things that maybe you're seeing intensify compared 81 00:03:28,245 --> 00:03:29,325 to the past couple of years? 82 00:03:32,035 --> 00:03:35,275 - Absolutely. So one of the things that's happening is that 83 00:03:35,785 --> 00:03:38,075 orthopedics and spine surgery has gone 84 00:03:38,075 --> 00:03:40,635 through amazing advancements in technology. 85 00:03:40,735 --> 00:03:42,075 And the technology is, 86 00:03:42,515 --> 00:03:45,235 includes both improvement in surgical techniques, 87 00:03:45,295 --> 00:03:47,515 but also other aspects such 88 00:03:47,515 --> 00:03:49,635 as rehabilitation, pain management. 89 00:03:50,255 --> 00:03:52,315 And this is some of what we focused our 90 00:03:52,315 --> 00:03:53,355 work and research on. 91 00:03:54,255 --> 00:03:57,155 So at this point in time, we're seeing the majority 92 00:03:57,175 --> 00:03:58,835 of our patients have, for example, 93 00:03:58,885 --> 00:04:01,715 joint replacements on an outpatient basis. 94 00:04:02,335 --> 00:04:06,875 Uh, patients are able to, uh, have procedures that are 95 00:04:06,975 --> 00:04:09,195 so minimally invasive and recover so quickly 96 00:04:09,855 --> 00:04:13,315 and have, uh, great pain control so that they're able 97 00:04:13,315 --> 00:04:15,835 to go home the same day, um, 98 00:04:16,335 --> 00:04:19,795 and, uh, they're able to return back to their normal life, 99 00:04:19,855 --> 00:04:21,515 uh, a lot quicker than they were before. 100 00:04:21,695 --> 00:04:24,715 So, uh, that's a trend that we continue to see develop. 101 00:04:25,095 --> 00:04:27,795 Um, this is supported in many ways by the use 102 00:04:27,795 --> 00:04:31,715 of increasing technology, uh, around, uh, computer assisted 103 00:04:31,715 --> 00:04:32,835 or robotic surgery. 104 00:04:33,575 --> 00:04:38,355 Um, and, uh, for example, the, uh, probably 90 plus percent 105 00:04:38,355 --> 00:04:40,675 of the joint replacements done at our Orthopedic 106 00:04:40,675 --> 00:04:43,395 and Spine Institute are, uh, done with the assistance 107 00:04:43,395 --> 00:04:46,915 of either robotic or computer assisted, uh, tools 108 00:04:47,185 --> 00:04:49,315 that allow us to sort of, uh, 109 00:04:49,315 --> 00:04:52,115 really truly measure much more precisely than we are 110 00:04:52,115 --> 00:04:53,155 with manual tools. 111 00:04:54,365 --> 00:04:56,135 Some of the other things that are happening in sports 112 00:04:56,455 --> 00:04:57,695 medicine is, uh, 113 00:04:57,745 --> 00:05:00,255 continuing interest in regenerative techniques 114 00:05:00,255 --> 00:05:01,415 and regenerative medicine. 115 00:05:01,875 --> 00:05:03,375 Uh, we're doing research 116 00:05:03,435 --> 00:05:05,935 and using, uh, harnessing the body's, uh, 117 00:05:06,035 --> 00:05:09,375 own regenerative capabilities in implicit in the blood 118 00:05:09,475 --> 00:05:12,735 or, uh, bone marrow to help patients, uh, heal 119 00:05:12,755 --> 00:05:14,375 and restore back to normal function. 120 00:05:15,075 --> 00:05:18,095 And then also in, uh, sports medicine in general, 121 00:05:18,355 --> 00:05:21,175 we really try to approach our athletes from a 122 00:05:21,195 --> 00:05:22,575 multidisciplinary approach. 123 00:05:22,875 --> 00:05:25,295 And so that means, you know, keeping track 124 00:05:25,295 --> 00:05:27,935 of things like sleep timing and nutrition, 125 00:05:28,195 --> 00:05:31,975 and how we taste the intensity of training 126 00:05:32,555 --> 00:05:35,495 and workload, uh, on our athletes. 127 00:05:36,115 --> 00:05:37,495 So these are some of the exciting things 128 00:05:37,495 --> 00:05:38,855 that I see happening right now. 129 00:05:40,145 --> 00:05:41,945 - I mean, these are big shifts that you just touched on, 130 00:05:41,965 --> 00:05:44,025 and I'm curious for either more 131 00:05:44,025 --> 00:05:46,425 and more joint replacements moving to the outpatient setting 132 00:05:47,165 --> 00:05:51,745 or the regenerative medicine up uptick in the growth of 133 00:05:51,745 --> 00:05:54,145 that option for athletes especially. 134 00:05:54,725 --> 00:05:57,225 Is there anything around patient expectations 135 00:05:57,465 --> 00:05:59,325 and the management of those expectations 136 00:05:59,755 --> 00:06:02,205 that you found yourself needing to rely on more 137 00:06:02,385 --> 00:06:03,965 as these things take off 138 00:06:03,985 --> 00:06:06,085 and grow in their frequency or popularity? 139 00:06:10,325 --> 00:06:15,245 - Absolutely. I think one of the things is, uh, it is, uh, 140 00:06:15,255 --> 00:06:16,525 since the field is changing 141 00:06:16,625 --> 00:06:21,605 and continuing to develop, uh, is about, uh, providing, 142 00:06:22,065 --> 00:06:26,365 uh, patients with the knowledge that there are lots of ways 143 00:06:26,365 --> 00:06:30,405 that we can help them, uh, in a less invasive way that, uh, 144 00:06:30,425 --> 00:06:31,845 allows them to be pain-free 145 00:06:31,845 --> 00:06:34,245 and restored to full function much quicker than they 146 00:06:34,245 --> 00:06:35,365 might've thought before. 147 00:06:36,625 --> 00:06:40,645 As you know, I mean, our population, uh, there's a, 148 00:06:41,005 --> 00:06:44,965 a large number of, uh, older, uh, athletes 149 00:06:45,145 --> 00:06:48,365 and older people who are part of that baby boomer, 150 00:06:48,465 --> 00:06:49,485 uh, generation. 151 00:06:50,065 --> 00:06:54,045 And the expectations that they have, uh, for themselves is 152 00:06:54,045 --> 00:06:55,605 to stay active longer. 153 00:06:56,185 --> 00:06:58,165 Uh, they've had active lifestyles. 154 00:06:58,165 --> 00:06:59,325 They want to continue 155 00:06:59,325 --> 00:07:01,205 to maintain their health and independence. 156 00:07:02,065 --> 00:07:05,885 And so I, it's part of our role to help make sure 157 00:07:05,885 --> 00:07:07,885 that they're able to maintain that. 158 00:07:10,345 --> 00:07:11,715 - Well, let's dive into that more 159 00:07:11,715 --> 00:07:14,875 because my, my next question was about patient populations 160 00:07:15,255 --> 00:07:18,995 and orthopedic surgical needs among varying demographics. 161 00:07:19,175 --> 00:07:20,995 Are there any shifts worth, worth mentioning? 162 00:07:20,995 --> 00:07:24,835 You already talked about in the large number of older adults 163 00:07:25,175 --> 00:07:27,955 and older athletes who wanna stay active for much longer. 164 00:07:28,235 --> 00:07:29,835 I think you can even see that in some sports 165 00:07:29,865 --> 00:07:31,035 like golf, for instance. 166 00:07:31,655 --> 00:07:36,555 Um, you see some of the, the ages of these players are, 167 00:07:36,785 --> 00:07:38,035 what about younger patients? 168 00:07:38,175 --> 00:07:40,315 Are you seeing more need for orthopedic surgery 169 00:07:40,485 --> 00:07:42,155 among any younger patients? 170 00:07:42,155 --> 00:07:43,195 That's worth pointing out. 171 00:07:46,175 --> 00:07:47,615 - Absolutely. I, one of the things 172 00:07:47,615 --> 00:07:49,855 that we're seeing nowadays, uh, 173 00:07:49,955 --> 00:07:54,895 and has been an area of some concern for orthopedic surgeons 174 00:07:54,895 --> 00:07:58,335 who do sports medicine, is the increasing sub-specialization 175 00:07:59,035 --> 00:08:01,095 of kids at a younger and younger age. 176 00:08:01,755 --> 00:08:05,535 Uh, this idea that, you know, you could be a kid 177 00:08:05,555 --> 00:08:08,495 and you could play, you know, baseball during one season 178 00:08:08,715 --> 00:08:09,815 or football during another, 179 00:08:09,995 --> 00:08:13,135 or, you know, soccer and basketball. 180 00:08:13,675 --> 00:08:18,655 Uh, now there's some increased number 181 00:08:18,715 --> 00:08:23,695 of folks who are just doing one sport, uh, 365 days a year. 182 00:08:24,755 --> 00:08:27,775 And what that can lead to is over training, 183 00:08:27,965 --> 00:08:29,015 overuse injuries. 184 00:08:29,755 --> 00:08:33,055 Uh, and sometimes, you know, frankly, burnout on, uh, 185 00:08:33,075 --> 00:08:37,855 on the psychological side, um, we encourage, uh, kids to, 186 00:08:38,315 --> 00:08:41,015 uh, pursue a variety of different sports 187 00:08:41,155 --> 00:08:43,335 and to have a variety of different interests. 188 00:08:43,795 --> 00:08:45,455 And one of the things that actually, 189 00:08:45,455 --> 00:08:49,215 if you take a look at the professional level, is that 190 00:08:50,195 --> 00:08:53,735 in such areas like, uh, major League Baseball 191 00:08:53,875 --> 00:08:57,325 or the NFL mm-Hmm, , um, many of these people, 192 00:08:57,945 --> 00:08:59,325 uh, have had, uh, 193 00:08:59,705 --> 00:09:02,445 played multiple sports throughout their high school careers. 194 00:09:03,265 --> 00:09:05,485 The, uh, super Bowl winning, uh, quarterback, 195 00:09:05,485 --> 00:09:08,125 Patrick Mahomes was a outstanding baseball player 196 00:09:08,225 --> 00:09:12,605 before, uh, he decided to pursue his career in football. 197 00:09:12,785 --> 00:09:16,805 So I think the idea that there's, uh, 198 00:09:17,145 --> 00:09:21,405 people should explore different sports and, uh, practice 199 00:09:21,405 --> 00:09:23,685 and try doing cross training in different areas, 200 00:09:24,345 --> 00:09:25,645 it will help avoid some 201 00:09:25,645 --> 00:09:27,925 of these overuse injuries that we're seeing. Mm-Hmm, 202 00:09:27,965 --> 00:09:29,945 - , that's really interesting. 203 00:09:30,045 --> 00:09:33,185 And is that typically like high school age, you start 204 00:09:33,185 --> 00:09:36,105 to really notice that increasing sub-specialization 205 00:09:36,105 --> 00:09:39,025 where they're really leaning into one specific sport? 206 00:09:39,125 --> 00:09:40,665 Or is it even younger than that? 207 00:09:42,165 --> 00:09:44,215 - Well, we used to see it in high school age students, 208 00:09:44,275 --> 00:09:46,855 but now we're starting to see, uh, kids 209 00:09:46,955 --> 00:09:49,175 who are even younger than that, um, 210 00:09:49,525 --> 00:09:51,975 getting specialized in one sport right away. 211 00:09:53,375 --> 00:09:57,155 And so, uh, one of the things that our, uh, 212 00:09:57,155 --> 00:09:59,475 professional organizations like the American Academy 213 00:09:59,535 --> 00:10:00,675 of Orthopedic Surgeons 214 00:10:00,695 --> 00:10:03,075 and the American Orthopedic Society 215 00:10:03,075 --> 00:10:06,675 for Sports Medicine are focused on is, uh, injury prevention 216 00:10:06,675 --> 00:10:09,435 and trying to allow kids to have time to, 217 00:10:09,855 --> 00:10:11,475 for their bodies to grow and recover. 218 00:10:12,095 --> 00:10:14,635 Um, these are growing developing bodies. 219 00:10:15,175 --> 00:10:17,355 Uh, they respond to different stresses differently. 220 00:10:18,015 --> 00:10:22,195 And if people are overtrained, then uh, injuries can occur. 221 00:10:22,655 --> 00:10:26,315 So for example, uh, you know, I've taken care of, uh, 222 00:10:26,605 --> 00:10:27,795 major league baseball teams, 223 00:10:27,855 --> 00:10:31,715 and, uh, what we're seeing is actually that, uh, 224 00:10:32,125 --> 00:10:35,115 elbow injuries to the ulnar collateral ligament are 225 00:10:35,115 --> 00:10:38,315 happening in younger and younger kids at this point in time. 226 00:10:38,865 --> 00:10:41,835 What used to be the Tommy John operation 227 00:10:41,895 --> 00:10:44,915 for Major League baseball players is now happening, uh, uh, 228 00:10:45,175 --> 00:10:46,595 in college 229 00:10:47,015 --> 00:10:49,595 and high school athletes as a result 230 00:10:49,595 --> 00:10:50,635 of some of this overuse. 231 00:10:51,215 --> 00:10:54,395 - Wow. Wow. I've heard, I mean, I've heard of Tommy, Jenn 232 00:10:54,395 --> 00:10:56,275 and I always equated that with pretty 233 00:10:57,825 --> 00:10:59,635 like long standing athletes, those 234 00:10:59,655 --> 00:11:01,155 who had been playing for quite a while. 235 00:11:01,255 --> 00:11:04,195 So for now, an athlete in high school in their teens 236 00:11:04,375 --> 00:11:06,475 to be undergoing that, that's a pretty big shift. 237 00:11:08,935 --> 00:11:10,715 - It is, and I think it's 238 00:11:10,715 --> 00:11:13,635 because of the fact that we're seeing, uh, more 239 00:11:13,635 --> 00:11:14,835 and more, uh, 240 00:11:15,635 --> 00:11:18,955 athletes really focusing on just one sport all the time. 241 00:11:19,335 --> 00:11:23,355 And, uh, so what we're trying to do as, uh, 242 00:11:23,365 --> 00:11:25,675 orthopedic exploits medicine community is sort 243 00:11:25,915 --> 00:11:30,195 of provide the idea that, um, people can fatigue. 244 00:11:30,655 --> 00:11:31,715 You might be very strong, 245 00:11:32,375 --> 00:11:34,435 but if your body fatigues, 246 00:11:34,465 --> 00:11:36,995 then it puts more stress on the other 247 00:11:36,995 --> 00:11:38,155 tissues around the joint. 248 00:11:38,655 --> 00:11:39,835 - Mm-Hmm. . Mm-Hmm. . 249 00:11:40,535 --> 00:11:42,195 You know, one other thing I wanted to ask you about Dr. 250 00:11:42,215 --> 00:11:46,395 Co is any thoughts on the growth 251 00:11:46,395 --> 00:11:48,355 of GLP ones and weight loss? 252 00:11:48,495 --> 00:11:51,515 And I know there's a lot of caveating around that in terms 253 00:11:51,515 --> 00:11:54,005 of making sure we're speaking realistically about the 254 00:11:54,005 --> 00:11:55,085 potential for those drugs. 255 00:11:55,085 --> 00:11:58,765 Obesity is gonna be a big problem public health wise 256 00:11:58,865 --> 00:12:00,405 and a priority for years to come. 257 00:12:00,825 --> 00:12:03,085 But are you seeing or hearing anything from patients about 258 00:12:03,115 --> 00:12:05,725 just having that tool being available 259 00:12:05,785 --> 00:12:07,525 to them in terms of weight loss goals? 260 00:12:07,585 --> 00:12:09,205 Is it affecting anyone's needs 261 00:12:09,305 --> 00:12:11,605 for orthopedic surgery or the recovery? 262 00:12:14,785 --> 00:12:17,155 - Well, I think like many things, there's, uh, 263 00:12:17,175 --> 00:12:18,195 pluses and minuses. 264 00:12:18,385 --> 00:12:22,035 Obviously, these new medications are able 265 00:12:22,055 --> 00:12:24,995 to really help people improve their overall 266 00:12:24,995 --> 00:12:26,235 cardiovascular health. 267 00:12:26,895 --> 00:12:30,515 Um, uh, I've seen patients who, uh, have 268 00:12:31,745 --> 00:12:34,635 gone off, uh, needing, uh, insulin 269 00:12:34,935 --> 00:12:37,315 or different kinds of cardiac meds. 270 00:12:37,575 --> 00:12:40,275 And so their overall health improves. 271 00:12:41,105 --> 00:12:44,515 This allows them in many ways to sort of be more comfortable 272 00:12:44,735 --> 00:12:46,675 and physically, uh, active 273 00:12:46,675 --> 00:12:49,635 because they're not carrying around an extra, uh, 274 00:12:49,875 --> 00:12:51,995 20, 30, 40, 275 00:12:52,055 --> 00:12:55,275 or a hundred pounds of weight, um, which can be, 276 00:12:55,615 --> 00:12:56,675 uh, very painful. 277 00:12:56,945 --> 00:13:01,155 What ends up happening for, uh, many obese patients is that 278 00:13:01,305 --> 00:13:04,235 that extra load causes extra forces on the joints 279 00:13:04,735 --> 00:13:08,275 and clearly contributes to joint pain and discomfort. 280 00:13:09,335 --> 00:13:10,795 On the other hand, one of the things 281 00:13:10,795 --> 00:13:13,355 that we are concerned about is the fact 282 00:13:13,385 --> 00:13:17,915 that when this rapid weight loss occurs, significant portion 283 00:13:17,935 --> 00:13:19,795 of that actually comes from muscle mass. 284 00:13:20,475 --> 00:13:23,355 Hmm. And so the, uh, 285 00:13:23,465 --> 00:13:26,195 body stores the glycogen primarily in the muscles. 286 00:13:26,415 --> 00:13:30,115 That's the first place the body goes to get energy. 287 00:13:30,655 --> 00:13:34,395 And so with these medications, um, it starts, uh, 288 00:13:34,545 --> 00:13:38,035 burning some of the muscle before it gets to the fat. 289 00:13:38,735 --> 00:13:41,515 Uh, so I think one of the critical things is, 290 00:13:41,715 --> 00:13:42,955 although people may be losing weight, 291 00:13:42,955 --> 00:13:45,315 that doesn't necessarily mean that they're going to be 292 00:13:46,025 --> 00:13:47,395 more fit Mm-Hmm. 293 00:13:47,435 --> 00:13:50,475 , uh, in terms of strength and endurance. 294 00:13:50,895 --> 00:13:53,275 And so, uh, I think it's very important 295 00:13:53,345 --> 00:13:56,445 that the message is not only, you know, 296 00:13:56,445 --> 00:13:58,885 there is some advantage in losing weight in terms 297 00:13:58,885 --> 00:14:03,765 of overall fitness and, you know, perhaps endurance, uh, 298 00:14:03,765 --> 00:14:05,485 since you're not carrying around as much, 299 00:14:06,065 --> 00:14:10,365 but without a thoughtful program where you're going to 300 00:14:11,605 --> 00:14:13,805 actually have to do some work to maintain muscle mass, 301 00:14:14,435 --> 00:14:16,325 will mean that you need to continue to 302 00:14:17,245 --> 00:14:18,445 maintain your activity level. 303 00:14:18,965 --> 00:14:21,765 Hmm. Um, I do think that's one thing that's, uh, 304 00:14:21,955 --> 00:14:23,365 very interesting nowadays. 305 00:14:23,625 --> 00:14:25,325 And, uh, you know, Peter Atia 306 00:14:25,345 --> 00:14:27,605 and others are, uh, discussing this, 307 00:14:27,825 --> 00:14:31,205 but the idea that you wanna maintain a certain amount 308 00:14:31,305 --> 00:14:33,605 of strength and muscle activity 309 00:14:34,225 --> 00:14:36,045 and endurance, uh, 310 00:14:36,195 --> 00:14:39,085 over your lifespan is critically important for people 311 00:14:39,105 --> 00:14:43,485 who are getting older to maintain an active and functional 312 00:14:43,505 --> 00:14:44,805 and independent lifestyle. 313 00:14:45,415 --> 00:14:48,005 - Right, right. No, I mean, that's so true. 314 00:14:48,235 --> 00:14:50,805 Even, even just my question, you know, when we talk about 315 00:14:50,825 --> 00:14:51,845 or see headlines 316 00:14:52,105 --> 00:14:54,845 and the high level discussion about weight loss, I think 317 00:14:54,985 --> 00:14:57,325 so often we fail to make those distinctions between, 318 00:14:57,355 --> 00:14:59,085 like you said, fat and then muscle mass. 319 00:14:59,225 --> 00:15:02,285 So a really important thing for us to keep in mind, um, 320 00:15:02,345 --> 00:15:04,375 you know, in your opening remarks, 321 00:15:04,375 --> 00:15:05,735 and you were kind of talking us about, 322 00:15:05,735 --> 00:15:06,935 talking to us about your role as Dr. 323 00:15:06,935 --> 00:15:10,615 Co, you had made mention of your role as a team physician. 324 00:15:10,615 --> 00:15:13,535 You're the top physician for Chicago Fire in that role, 325 00:15:13,555 --> 00:15:16,655 you are the coordinator of an entire multidisciplinary team. 326 00:15:17,195 --> 00:15:19,695 Um, I, I wanted to ask you, you know, 327 00:15:19,735 --> 00:15:22,575 I think your contributions to the team are very clear, 328 00:15:22,875 --> 00:15:24,055 but I'm also curious how serving 329 00:15:24,115 --> 00:15:26,055 as a team physician has changed 330 00:15:26,155 --> 00:15:28,655 or shaped you, you know, what, what lessons 331 00:15:28,835 --> 00:15:30,375 or major lessons have you walked away 332 00:15:30,375 --> 00:15:32,415 with from these experiences being close 333 00:15:32,475 --> 00:15:33,655 to athletes and teams? 334 00:15:35,715 --> 00:15:39,435 - Absolutely. Um, first of all, uh, I would say, uh, 335 00:15:40,025 --> 00:15:42,355 it's a real privilege to take care of 336 00:15:43,195 --> 00:15:44,355 athletes performing at this level. 337 00:15:44,895 --> 00:15:48,995 Uh, professional athletes have, they're special people. 338 00:15:49,065 --> 00:15:53,835 They have a unique combination of talent, um, ability, 339 00:15:54,485 --> 00:15:58,915 dedication, art, and actually a lot of resilience. 340 00:15:59,255 --> 00:16:03,755 Um, if you take a look at, uh, what they're like, 341 00:16:04,155 --> 00:16:06,315 I mean, these are people who are in 342 00:16:06,975 --> 00:16:08,325 performing at the highest levels, 343 00:16:08,865 --> 00:16:11,765 but many of them over the years, particularly the veterans, 344 00:16:12,185 --> 00:16:15,325 uh, have accumulated some, uh, injuries 345 00:16:15,425 --> 00:16:18,085 and other, uh, areas of damage, uh, 346 00:16:18,145 --> 00:16:19,965 but continue to stay active. 347 00:16:19,985 --> 00:16:23,005 And to me, that's actually very inspiring that, uh, 348 00:16:23,065 --> 00:16:24,365 we all can stay active. 349 00:16:24,675 --> 00:16:28,405 That, um, even older patients who may have some arthritis 350 00:16:28,665 --> 00:16:30,165 or some other injuries 351 00:16:30,265 --> 00:16:34,765 or, uh, damage, uh, still will be able to remain active, 352 00:16:34,985 --> 00:16:36,765 remain pain-free and very functional. 353 00:16:38,065 --> 00:16:41,125 So some of the other things are, uh, again, being 354 00:16:41,765 --> 00:16:44,605 a team physician, you actually are part of the team. 355 00:16:44,945 --> 00:16:49,885 And you realize as a team member, you can serve, 356 00:16:50,265 --> 00:16:51,925 you may be really outstanding in one role. 357 00:16:51,925 --> 00:16:54,245 You can help in others, in others, uh, areas. 358 00:16:54,705 --> 00:16:57,405 Uh, you need the help of your other teammates. 359 00:16:58,025 --> 00:17:02,085 And the way I approach this in the team physician role 360 00:17:02,105 --> 00:17:05,405 and the chief medical officer role is I have outstanding 361 00:17:05,405 --> 00:17:08,365 colleagues who, um, like Julian Bales, 362 00:17:08,375 --> 00:17:11,365 who's a world class expert in concussion. 363 00:17:11,785 --> 00:17:14,885 Uh, we have world class experts in sports cardiology 364 00:17:15,145 --> 00:17:17,525 and expert exercise induce asthma. 365 00:17:17,945 --> 00:17:20,485 Uh, I'm able to identify some of these things 366 00:17:20,665 --> 00:17:24,045 and then help direct, uh, our athletes to those areas. 367 00:17:24,265 --> 00:17:28,925 And so, uh, to me, it's always, uh, a great 368 00:17:29,535 --> 00:17:32,085 experience to be working as part of a, a team 369 00:17:32,185 --> 00:17:33,885 of really outstanding providers. 370 00:17:34,425 --> 00:17:37,245 Uh, it's also, um, I'm humbled 371 00:17:37,265 --> 00:17:38,965 by the people I get to work with. 372 00:17:39,425 --> 00:17:40,425 Mm-Hmm. 373 00:17:41,705 --> 00:17:44,125 - In that role, in that overseeing this multidisciplinary 374 00:17:44,275 --> 00:17:45,285 fantastic team. 375 00:17:45,345 --> 00:17:47,765 As you just touched on, you know, I think about one 376 00:17:47,765 --> 00:17:50,485 of your earlier remarks about high school students when they 377 00:17:50,635 --> 00:17:53,125 have this subspecialization like you were describing, 378 00:17:53,185 --> 00:17:54,765 it can be increased risk of burnout. 379 00:17:55,785 --> 00:17:58,285 Is there anything that, and I know you're an orthopedic 380 00:17:58,285 --> 00:18:01,645 surgeon, I don't wanna go into another specialty in any way 381 00:18:01,645 --> 00:18:03,445 that would make you feel like you're speaking out of, out 382 00:18:03,445 --> 00:18:08,205 of turn here, but the link between an injury and depression 383 00:18:08,785 --> 00:18:12,965 or the, the emotional side effects of being out of a game 384 00:18:13,105 --> 00:18:15,365 or out of the sport for a, a period of time. 385 00:18:15,945 --> 00:18:17,045 Is there anything you can share 386 00:18:17,045 --> 00:18:18,805 with our listeners about that link? 387 00:18:19,105 --> 00:18:21,405 And as the leader of the multidisciplinary team like you 388 00:18:21,405 --> 00:18:24,525 are, how you make sure that when we're talking about health, 389 00:18:24,835 --> 00:18:27,045 it's not just the muscle or the tendon, 390 00:18:27,045 --> 00:18:29,325 but also, you know, the, the whole athlete 391 00:18:29,385 --> 00:18:30,485 and any sort of emotional 392 00:18:30,485 --> 00:18:32,525 or mental effects that might come with that injury? 393 00:18:34,495 --> 00:18:37,735 - Absolutely. So, obviously, um, 394 00:18:38,235 --> 00:18:41,135 and, uh, I think many of us have had some sort 395 00:18:41,135 --> 00:18:44,055 of musculoskeletal injury, uh, during their life 396 00:18:44,235 --> 00:18:47,935 or some, uh, limitation, whether it was like a, a 397 00:18:48,875 --> 00:18:51,255 bad sprained ankle or severe back pain 398 00:18:51,255 --> 00:18:53,335 that impacted our ability for daily living. 399 00:18:53,955 --> 00:18:58,215 Uh, it for an athlete, uh, these can be very, uh, 400 00:18:58,355 --> 00:19:00,935 not only physically, but also emotionally devastating, 401 00:19:01,395 --> 00:19:04,375 and it can take a long time for people to recover from that. 402 00:19:04,875 --> 00:19:07,575 Mm-Hmm. , and one of my, uh, good friends, uh, 403 00:19:08,015 --> 00:19:11,735 actually, uh, from Sydney, Australia, uh, did a look. 404 00:19:12,295 --> 00:19:15,135 I did a study looking at essentially the psychological 405 00:19:15,285 --> 00:19:17,495 profile of people with ACL tears 406 00:19:18,115 --> 00:19:20,935 and, uh, a significant number of them. 407 00:19:21,675 --> 00:19:26,335 Um, even at a year, about close to 30%, even at a year, 408 00:19:26,975 --> 00:19:31,255 I still had some essentially, uh, inhibition 409 00:19:31,795 --> 00:19:33,935 and concern related to their knee 410 00:19:34,035 --> 00:19:36,015 and their return to ability, their ability 411 00:19:36,015 --> 00:19:37,375 to return to sports activity. 412 00:19:38,075 --> 00:19:41,695 Uh, these kind of injuries are significant. 413 00:19:41,915 --> 00:19:44,415 Um, and it does take time for people to go through that. 414 00:19:45,035 --> 00:19:48,495 Um, uh, one of the advantages, again, of being part 415 00:19:48,495 --> 00:19:53,395 of a a team is that, you know, if we have athletes 416 00:19:53,495 --> 00:19:56,595 who have, um, are having anxiety 417 00:19:56,735 --> 00:20:00,315 or, uh, concern dealing with these kind of issues, um, 418 00:20:00,545 --> 00:20:03,755 that goes beyond the kind of, uh, empathetic care 419 00:20:03,755 --> 00:20:07,275 that we can provide, um, is to also have them meet 420 00:20:07,275 --> 00:20:11,675 with frankly, uh, health professionals that are, uh, 421 00:20:12,225 --> 00:20:13,955 certified and specialized in these 422 00:20:13,955 --> 00:20:15,795 kind of mental health issues. Mm-Hmm. . 423 00:20:16,335 --> 00:20:19,245 - Mm-Hmm. . - Well, thanks for speaking. 424 00:20:19,365 --> 00:20:20,485 I, I was curious about that. 425 00:20:20,625 --> 00:20:21,765 Uh, and that's great to, I mean, 426 00:20:21,985 --> 00:20:23,725 I'm sure there's great resources available 427 00:20:23,825 --> 00:20:26,605 to the Chicago fire athletes and then some, um, 428 00:20:26,625 --> 00:20:29,765 but when we talk about injuries, I know even just 429 00:20:29,825 --> 00:20:32,285 as non-serious athletes like you were saying, Dr. 430 00:20:32,345 --> 00:20:33,645 Co, that can be really 431 00:20:33,885 --> 00:20:35,085 devastating to people and set them back. 432 00:20:35,305 --> 00:20:36,885 Um, so it's, it's great to hear 433 00:20:36,885 --> 00:20:38,365 that there's resources available, 434 00:20:38,985 --> 00:20:40,245 and I appreciate you mentioning 435 00:20:40,245 --> 00:20:42,565 to your colleagues research. That's fascinating. 436 00:20:43,485 --> 00:20:44,525 - I, I mean, and, 437 00:20:44,525 --> 00:20:46,365 and certainly what I want to say is like, 438 00:20:46,465 --> 00:20:49,565 we have a great team assembled to care for the Chicago fire, 439 00:20:50,185 --> 00:20:53,445 but, um, I grew up in this community. 440 00:20:53,525 --> 00:20:56,165 I live in this community. I have kids who played sports. 441 00:20:56,785 --> 00:20:59,375 Uh, I understand that all 442 00:20:59,375 --> 00:21:01,175 of our active patients have these kind of needs. 443 00:21:01,315 --> 00:21:03,815 And so what we've been really trying to do 444 00:21:04,005 --> 00:21:07,575 with our comprehensive sports medicine program is bring 445 00:21:08,005 --> 00:21:10,895 that kind of professional level care 446 00:21:11,555 --> 00:21:15,135 and comprehensive ability to address all the needs 447 00:21:15,135 --> 00:21:18,735 of our athletes, uh, to recreational athletes, 448 00:21:18,735 --> 00:21:21,695 whether they're in, um, high school or college 449 00:21:22,075 --> 00:21:23,135 or senior level, 450 00:21:23,555 --> 00:21:26,015 or even just older people who are playing pickleball. 451 00:21:26,835 --> 00:21:30,335 And, uh, so our, our thought is 452 00:21:31,455 --> 00:21:35,395 we approach our, uh, athletes, whether they're 453 00:21:35,495 --> 00:21:37,835 of any level as we would approach. 454 00:21:37,935 --> 00:21:41,115 And so, uh, bringing that kind of comprehensive approach 455 00:21:41,255 --> 00:21:44,475 that's not just around purely orthopedic surgery 456 00:21:45,175 --> 00:21:48,475 or, um, uh, other types of rehabilitation, 457 00:21:49,315 --> 00:21:52,355 I think really helps best address the needs of, uh, 458 00:21:52,495 --> 00:21:53,635 our people who wanna stay active. 459 00:21:54,215 --> 00:21:55,515 - Mm-Hmm. . Mm-Hmm. . 460 00:21:56,395 --> 00:21:58,485 - Well, this has been just such a dynamic conversation. 461 00:21:58,485 --> 00:21:59,925 I've learned a lot from you in a 462 00:21:59,925 --> 00:22:01,165 relatively short amount of time. 463 00:22:01,345 --> 00:22:03,285 Dr. Co, is there anything you'd like 464 00:22:03,285 --> 00:22:04,405 to leave our listeners with? 465 00:22:04,585 --> 00:22:05,645 Any closing thoughts? 466 00:22:07,475 --> 00:22:11,605 - Sure. I think, first of all, on, uh, we're thrilled 467 00:22:11,625 --> 00:22:13,285 to help people stay active. 468 00:22:13,665 --> 00:22:17,725 Our goal is to keep people moving active and pain-free. 469 00:22:18,345 --> 00:22:22,805 Uh, the more we learn about, uh, aging 470 00:22:23,145 --> 00:22:27,205 and life is that staying active is important 471 00:22:27,225 --> 00:22:28,365 to staying active 472 00:22:28,385 --> 00:22:31,045 and independent, independent for many years. 473 00:22:31,425 --> 00:22:34,245 Um, uh, one of the key things is 474 00:22:34,245 --> 00:22:36,125 that we see this aging demographic. 475 00:22:36,785 --> 00:22:41,125 Um, but I think the expectations of people now in their, 476 00:22:41,585 --> 00:22:42,605 uh, you know, sixties 477 00:22:42,745 --> 00:22:44,405 and seventies is in many cases, 478 00:22:44,435 --> 00:22:45,685 they're gonna keep playing tennis. 479 00:22:45,685 --> 00:22:46,805 They're gonna keep playing golf. 480 00:22:46,805 --> 00:22:51,605 They're still gonna, uh, uh, you know, wanna run or jog 481 00:22:51,605 --> 00:22:53,885 or play pickleball and be physically active. 482 00:22:53,945 --> 00:22:57,045 And I think, uh, part of our goal is to try to, uh, 483 00:22:57,075 --> 00:23:01,925 help people maintain their level of activity, their quality 484 00:23:01,945 --> 00:23:05,485 of life, their independence, um, at every step of the way. 485 00:23:05,905 --> 00:23:07,965 So keep moving, uh, 486 00:23:08,305 --> 00:23:10,605 and, uh, we're here to help you stay that way. 487 00:23:12,095 --> 00:23:13,485 - Great. Well, listeners, this has been Dr. 488 00:23:13,485 --> 00:23:16,005 Jason Coe, director of the Orthopedic and Spine Institute 489 00:23:16,005 --> 00:23:17,925 and Endeavor, chairman of its Department 490 00:23:17,925 --> 00:23:20,325 of Orthopedic Surgery, and Chief Medical Officer 491 00:23:20,325 --> 00:23:21,325 with Chicago Fire. 492 00:23:21,505 --> 00:23:23,365 Dr. Co, thank you so much for being my guest, 493 00:23:24,895 --> 00:23:25,895 - Molly. 494 00:23:25,895 --> 00:23:26,085 Thank you very much.