Key Points:
- Exploring the Link Between Inflammation and Brain Health in Veterans: Dave Vigerust shares his research at the VA on how closed head injuries and chronic inflammation in the brain may lead to increased risk of brain cancer, particularly in veterans who have experienced concussive forces. He emphasizes the need for continued exploration into these connections to improve long-term health outcomes for military personnel.
- The Overlooked Importance of Dental Health in Overall Wellbeing and Force Readiness: Vigerust highlights how undiagnosed dental infections can significantly impact cardiovascular health, diabetes, and even brain function. He stresses that dental health is often neglected but crucial, especially in the military where active infections could complicate injuries sustained in the field.
- Holistic Health, Self-Advocacy, and the Role of Environmental Exposure: Discussing how environmental exposure supports immune health and the importance of intuitive self-care, Vigerust encourages veterans to advocate for thorough screenings. He explains the essential links between oral health, sleep, and cognitive function, and suggests that unresolved infections and inadequate sleep could impact mental health, urging individuals to push for comprehensive care.
Transcript:
Emily Bose: Welcome back to another episode of Landing Zone Nashville. I’m Emily Bose, Managing Director here at Transition Overwatch, and really, really excited to be speaking with Dave Vigerust today. He is the Chief Scientific Officer at Spectrum Solutions, a Clinical Professor at the Woody L. Hunt School of Dental Medicine at Texas Tech, and an Adjunct Assistant Professor at the Department of Neurological Surgery at Vanderbilt University Medical Center. Dave, thanks so much for taking the time to be on the show with me today.
Dave Vigerust: Thank you so much for the invitation. Looking forward to it.
Emily: Absolutely. Well, we were chatting a little bit before we got started. I noticed in some of your history on LinkedIn that you spent quite a few years actually working at the VA, and it was interesting what you were telling me about even having a research arm at the VA being available there being a little unusual. So I’d love to hear just a little bit more about the work you’ve done with the VA and anything, any, you know, big takeaways or anything from that that you would love to share with the audience?
Dave: Sure. As I mentioned, the Nashville VA is one of the few in the country that have a research arm attached to them. You know, as most people are probably familiar with, you go to the VA, it’s a medical center, it’s a set of clinics and stuff. There are a few across the country that have research divisions as well. And I was part of that research division here in Nashville. I had a good part of my early training—my doctoral training was in that facility as well as some of my postdoc. And then I stayed on as a faculty member of sorts with a dual appointment between Vanderbilt and the VA.
Much of what I was doing there was in the area of infectious disease and really trying to understand, well, two things. Number one was trying to understand the host response—how we respond to different types of infections and how that might impact people in the VA. But then I also had, the reason why I have the adjunct position in neurosurgery, is I had a thought process at some point when I was at the VA about looking at closed head trauma and whether or not that closed head trauma could contribute to certain types of brain cancers. And so we did a little bit of work in that area before I left the VA for a more private entrepreneurial environment.
The idea was that there is inflammation that happens in the brain. And that inflammation oftentimes doesn’t resolve. And when it remains, when you have long-term, long-lasting inflammation, that can change normal, healthy cells into cells that are more cancerous. And I had a really strong—I still have a very strong interest in whether or not inflammation in the brain can contribute to that. Some of the early data that we had seemed to suggest that there was a higher frequency of certain types of brain cancers in the military and in veterans, especially those that had had some kind of closed head trauma. So I still have a very strong interest in doing things that help the military and the VA, although I’m not actively connected to the VA anymore. We’ve still tried to carry on conversations and engagement with both veterans groups and active military.
Emily: That’s awesome. And that sounds really interesting. I could imagine that the military would have a specifically large population that may have things like that. Would a traumatic brain injury or TBI fall into that category?
Dave: It does. Whether you’ve had a series of concussions, whether you’ve been in close proximity to an IED or some kind of explosive device. It also would pertain to people who are on ships, who are manning the guns and are around a lot of concussive force, especially repeated concussive force. So, you know, anybody who has, you know, that sort of exposure is at risk potentially of having these changes in the brain from inflammation.
We know that a lot of people, when they exit the military, they have trouble sleeping. They have difficulties like that. And loss of sleep and not having good restorative sleep kind of compounds that inflammation. It doesn’t allow our body to clear it. Ordinarily, when we sleep, that gives our brain the chance to remove all those toxins and inflammation. We need to get into deep restorative sleep for that to happen. And when you sleep poorly, that inflammation persists. So I was really interested in exploring that further. We were in the middle of writing some grants and trying to get some funding through the VA for that. We weren’t successful, but it’s still a very strong interest of mine to maybe circle back at some point and try to revisit that.
Emily: Absolutely. Well, if anybody at the VA tunes in, maybe reach out to Dave about that. If you’ve got good connections there. It’s football season, so it makes me think of all these guys that I watch hit their heads, you know, ten times a day on Sundays. Probably would be good candidates for that as well.
Something that you and I were chatting about beforehand was some interesting data that you had seen on dental health related to force readiness and some concerns about that. Can you tell me a little bit more about, I guess, number one, what that even would mean? And number two, is there anything that your average military member could do to look out for that for themselves?
Dave: Sure. I think what’s an underappreciated healthcare issue is our dental health. You know, most of us go to the dentist a couple of times a year. We probably see the dentist more than we see our normal, primary care doctor more often than not, right?
Emily: Probably.
Dave: But what’s been underappreciated is there’s a large segment of the population that carries infections that don’t really cause us a lot of distress. You know, so it doesn’t necessarily hurt. You might experience some bleeding when you brush your teeth, you might experience some bad breath. You’ve experienced things that are kind of annoyances, but not necessarily something that triggers, “Hey, that’s something I need to be aware of.”
And given the frequency of how often these infections occur in us, and the fact that our mouth is essentially the gateway to the rest of our body and our health, is that we’re not paying enough attention to our periodontal health, to our gum disease health, and we don’t get tested for it, right? So in medicine, for just about everything that you go see your doctor for, there’s a test, right? We check your cholesterol, we check your blood pressure, we check your hemoglobin A1C. You never get tested when you go to the dentist.
Emily: And that’s true.
Dave: The problem with that is that most of us—and it doesn’t matter how good your dental hygiene is—most of us are carrying some infections and some bacteria and organisms that are leading us to have more chronic disease later. And that could be heart issues. That could be diabetes. That could be fatty liver disease, or could be brain disorders. So, again, you know, this connection between the mouth and the brain is underappreciated in most people. It’s just not getting enough conversation.
And the reason why I think it’s a force readiness issue—I’ve had some discussions or have tried to make some inroads in discussions with the commanders of each of the dental branches for the Army, the Navy, the Air Force, and such. People get a dental screening before they deploy, but they don’t get tested to find out whether or not they’re carrying an active infection. And that can lead to issues, right? If you get wounded or you get injured, the bacteria can move from the mouth and move into that wound. They can cause infections that are downstream issues, right?
So to my mind, I think it’s something we should consider before people deploy. And it’s something we should consider as part of our general health and wellness exams. Right? You get your blood tested for cholesterol and, you know, if it’s high, you get put on a statin or you get put on a medication. We never pay attention to the mouth, and the mouth truly is the gateway to the rest of our health. So I think it’s something we need to advocate more for. I know none of us like to go to the dentist. I’m not a particular fan. But at the same time, I recognize that it’s a major contributor to how well I’m going to be health-wise. Cardiovascular wellness is impacted. Brain wellness is impacted. There’s a two-way relationship between diabetes and gum disease. They make each other worse.
So when you have gum disease, you have a higher risk for diabetes. And when you have diabetes, you exacerbate your gum disease. And, of course, like I say, most people don’t have pain. They have these other issues that are indicators, but it’s not something that throws up a red flag and says, “Oh, you know what? I’ve got some bleeding when I brush my teeth. That’s not normal. I need to go see something about that.” And the only true way of finding out whether you have an issue is to get tested. Just like you do to see if you have an issue with your heart to get tested, right?
So that’s part of the reason why I now have this appointment with the dental school there in El Paso. There’s a major base there; Fort Bliss is there. It’s a substantial base, right? For the infantry and such. And they have a very well kitted out and designed dental practice. They’re not doing this, so to me, I’d like to get into a dialogue with some of the commanders about whether this is something that could be done to further improve and enhance readiness.
Emily: Yeah, that makes a lot of sense. And you’re right, I could see how it would be something that would be quickly overlooked or maybe easier to sort of minimize if it doesn’t appear to be directly impacting your abilities in the moment to not necessarily realize that it can have such heavy downstream effects.
For someone who may be going through the process of transitioning out of the military, and, you know, we chatted about this a little bit earlier. I know you have some familiarity with sort of the post-VA care. What would you recommend they do if you feel comfortable sharing? What would you recommend they do to kind of self-advocate to get some of those things checked out? Because a lot of people, as they’re leaving the military, they have all kinds of medical appointments and different things that they go through to sort of sign off as they’re leaving. And sometimes I feel like it’s important to know what things to ask for, what tests you might want to ask for, things you might want to request. So is there something specific that if somebody had some concerns, let’s say they had some of that bleeding when they’re brushing their teeth or something like that, that they wanted to have that test done, what would they even ask for?
Dave: That’s a bit of a challenge. And again, it just comes from the knowledge that’s out there, right? Most of the VA facilities have a dental clinic. Just like the military, the dental clinics are not actively using diagnostics. I mean, they use X-ray, those sorts of things, right? So dentistry has just never been in a position where they use much in the way of diagnostics, right? And I think that was one of the things that COVID brought to us—it did highlight the fact that there are a number of powerful techniques out there that would give us insight into our health and wellness.
You know, for a long time on the medicine side, if you were testing for an infection of any kind of sort, you used an old-school culture and sensitivity sort of thing. So you take a sample, and you put it on a plate, and you grow it in the lab, and then you come back and you look at it three or four days later. Well, that’s three or four days later of delayed intervention. So what COVID—because we weren’t able to go and get sampled—COVID brought to us molecular technologies now that have been around for a while. But the VA is still a little bit behind the curve on some of those technologies. They just haven’t been up to the same speed as some of the other civilian side of medicine. So these dental clinics—it’s another reason why I’m really trying hard to get an audience with some of the leaders in this space to introduce this to them.
And when you’re transitioning out, I mean, it’d be great to have a full dental exam, make sure there are no abscesses, make sure there are no fractures, nothing else that’s going to cause them to have systemic issues once they’re out. But then once you’re in the VA system, remembering to go to the dental clinic. Right? Like I say, I’m not a big fan of it, but I know that you have to do it. And I’m sure most of us are like that. We don’t welcome the visit to the dentist, because when we go to the dentist, they usually find something that’s wrong, right?
Emily: Right.
Dave: Very few times have I gone to the dentist and he’s like, “Oh, you’ve got—everything’s great. You don’t have to do this.” But, you know, this is something that’s easy and simple. And all it takes is a little bit of a saliva sample. So it’s not hard to do. I think it has a dramatic impact on all of the other chronic issues that veterans have, right? Some, you know, service-related and some are just a reflection of getting older, you know, where we start to have diabetes and we start to have cardiovascular issues, and we start to have cognitive problems and that sort of thing. It’s just another way of reducing that and not allowing your dental health to be a contributing factor to your overall wellness, right? So asking for, “Hey, can I, you know, how often can I come in and get my teeth checked?” And when you think about it, you know, a lot of the veterans, the older veterans that I know, they all have teeth problems. You know, they all have problems with their teeth. So it’s something that if it was addressed a little more proactively, I think we would minimize more of the chronic disease issues that we see in the VA.
Emily: Yeah, that makes a lot of sense. And even just thinking for, you know, people that may not be in the VA system or, you know, may have transitioned out, veterans that may have transitioned back, weren’t retirees, you know, they don’t have that continuing care. Could they just go to their normal dentist and say, “Hey, can you run a diagnostic test for me on my, to see if I have any infections in my mouth?” and they would know what they were talking about or would they need to do a little bit of research? You know what I’m saying?
Dave: Yeah. I think the general dentist, they weren’t trained in this, so they don’t have as much familiarity with it. There are quite a number of dentists that have become more interested in this. And there’s a number of societies, dental societies, that are promoting this oral systemic wellness, right? So it’s like, it’s not just what’s going on in your body, but I mean, we neglect that one part. And it’s unfortunate that, you know, a hundred years ago, dentistry and medicine separated. And it’s the only aspect of medicine that separates itself, right?
It’s interesting. Charles Mayo, the founder of the Mayo Clinic, he said a hundred and some odd years ago that the future of prevention, the future of preventative medicine, was in the hands of the dentist. Because he recognized even a hundred years ago that the mouth was a major component and a major contribution to how the rest of the body functions. And if the mouth is dysfunctional, the rest of the body is dysfunctional. So, and that was only, you know, maybe twenty or thirty years after they had this separation, right? For whatever reason, dentistry and medicine went their separate ways and never should they come back.
Now there is some interest from a number of different groups to bring them back together and to make medicine more holistic. Everybody and everything needs to be considered in context with each other, right? The mouth is not separate from the rest of the body. And because every, virtually every interaction with our environment is through the mouth—right? Drinking and eating and breathing—all of that is a direct sampling of our environment. And if we’re not paying attention to what’s happening here, we’re missing on the impact of what it’s doing elsewhere.
Emily: Right. And we’re seeing so many conversations now around food quality and, you know, dangers of processed foods or some of those things, you know, there’s so much that we’re putting into our mouths and through our whole system then that we don’t even always realize maybe the impacts of all of those things. So that’s interesting to hear. And my husband was just mentioning to me something he had seen around, you know, even considering how, let’s say like certain types of mouthwash could impact the microbiome in your mouth. That’s the start of your whole digestive system, you know? Does that check out, you know, with what you know about that?
Dave: Yeah, that’s part of the ongoing dialogue as well. We have seven hundred organisms or so that live in our mouth, and they serve to populate the rest of our GI tract. Right? We have many more than that in our GI tract. Out of those seven hundred, maybe two dozen of them are dangerous—dangerous in the sense where they don’t need to be there. They’re not organisms that are participating in a positive way.
And so what you do when you have a mouthwash, an antiseptic like a Listerine or Scope or any of those kinds of things is they’re broad-spectrum killers. They kill everything. So they kill the six hundred and eighty-four good ones that are helping to populate the rest of our GI tract and make our gut well and everything else—all of our microbiomes. So there’s been a lot of discussion about trying to curtail the use of some of those mouthwashes that are just kind of indiscriminate killers of everything. Yeah, they get rid of the bad ones, but they also get rid of all those good ones that we depend on.
And that’s the reason why I think we have gut problems. There’s a lot of people who have celiac disease and leaky gut. And a lot of that comes from a dysbiosis, an imbalance in our gut that starts in our mouth. And again, it’s kind of the headwaters for everything that follows. But yeah, I think there was even a lawsuit that was initiated recently on that subject of these mouthwashes that are probably doing more harm than good when it comes to our microbial balance.
Emily: That’s interesting. I heard similar concerns around COVID with all the hand sanitizer because, you know, you have microbiome everywhere, like on your skin and your hands, like there’s important bacteria that you have all over your body. And killing all of it all the time—you know, obviously there could be certain contexts where you might want to do that—but, um, yeah, it was something interesting that I saw start to pop up as we went along. And I mean, I still see people like constantly hand sanitizing just all over the place. They see a hand sanitizer, they just take it. It’s like you don’t think about the fact that it—like, just because something is antibacterial, like you said, not all bacteria is bad bacteria.
Dave: Right. And I don’t think we have really much, if any, conversation going on about that in sort of our public sphere. And, you know, that’s people—you know, that’s an ongoing problem for kids as well. Right? Not just what happened during COVID, but I mean, we’ve gotten over the last twenty years or so. I mean, parents have gotten more and more sensitive to dirt in the environment, right? So kids don’t go to daycare as much, right? Because you don’t want your kids to get sick from the kids at the daycare. You don’t let them play outside.
And really, that’s how we educate our immune system. Our immune system has to be continually educated. And the only way it does that is by being exposed, right? By the things we eat, by the things we’re in contact with, right? So if every time you touch a door handle or an elevator button or a stair rail and you immediately go and you clean off your hands, you’ve taken away some of that education that your immune system needs. And it needs to be continually reinforced, right? Just like we have to over the course of our lifetimes, right? Sometimes we have to continue reading and we have to continue and trying to reinforce what we learned before—your immune system has that same need. It has to sample the environment and learn and grow and maintain itself. And when you put yourself into one of these sterile kinds of environments where everything is, you know, Lysol and Purell and overly clean, then you miss out on that immune education.
There were studies that kids… You know, back when I was a kid, we played outside and we came in filthy. And, like, comparison between kids like that versus kids today. Kids like that years ago, when they got dirty, they very rarely are sickly as adults. That’s not the same when you have kids that are protected from exposure. They have a tendency to be more allergic. They have a tendency to be, as adults, more sickly. And that kind of goes back to that lack of education when we’re young on our immune system that needs to be continually supported and focused throughout the rest of our life. We need to be exposed.
Emily: You know, so that’s fascinating.
Dave: I used to tell people, let your kids play with other kids. Let them play outside. Let them get dirty. It’s OK. We all survived it when we were kids. Now, certainly that’s not to say that you shouldn’t have some standard hygiene. But don’t go to the level where you’re depriving your immune system of that education.
Emily: That’s really interesting to think about. I have an almost one-and-a-half-year-old, so I’m in the throes of like, should I allow you to eat that off of this environment? You know, is this too dirty for you to eat off of?
Dave: But for kids, it’s almost intuitive, though. Everything goes in their mouth, right? Toys, everything’s in their mouth all the time. I think that’s kind of hardwired into us. That’s how we get exposed. That’s how we learn our environment, right? You have to sample. You have to touch. You have to feel. And for our immune system, you have to ingest. You have to expose. You have to get sick, right? I know nobody likes to be sick, but there’s a purpose for it. And that purpose is to educate our immune system. And you just don’t want it to go too far away. You know, you don’t want to get a fever that gets you higher. You don’t want to get, you know, a GI disturbance that dehydrates you and puts you in jeopardy, but there’s a fine line there to where it’s good for you.
Emily: That’s super interesting to think about. We can probably have a long conversation just down this trail because I feel like it’s not, uh, not talked about enough, you know? And, um, certainly I think after everything with COVID, I feel like, you know, people are much more sensitive, and it’s good to be reminded that it’s okay to get a cold. Obviously, if you’re someone who’s totally immunocompromised or, you know, any of those exceptions, you know, you have to do what’s right for your own health. But in general, you know, getting kids outside and dirty and things and even something like, you know, if they’re not super dirty they might not need a bath every single day. Like, you don’t necessarily have to wash all of the stuff off of them every five minutes either. So just kind of interesting.
One thing that I saw on your LinkedIn—you posted something about, you know, our breathing is supposed to be through the nose and not through the mouth. And I’ve seen a lot of people doing those, like, mouth tapes at night and stuff like that, which honestly freaks me out a little bit. But I’m curious to know, you know, what are your thoughts about that type of thing? Like, is that something that’s important to pay attention to, or is it a little overhyped?
Dave: No, no, I think it’s something we have to pay attention to. I mean, so many of us have breathing disorders. We have disordered breathing, right? Whether it’s because of weight, whether it’s because of anatomy. So people are on CPAPs, people are on all kinds of breathing devices and supportive devices, right? And when you breathe through your mouth, you change the whole environment of the mouth. You actually create an environment that’s more conducive to those bad actors that we talked about before.
And, you know, our nasal breathing is what we’re supposed to do because it cleans the air, right? We have a system of cleaning the air as it comes into our nasal pharynx. It humidifies, it warms it before it gets to the… So it has a lot of positive purposes. So one of the things, like these tapes and mouth appliances, there’s all kinds of things that go into that. And I was at a seminar not that long ago, and they were really talking about how our cranial structure has evolved to a place where breathing disorder is probably more likely. Our jaws have changed because we don’t eat the same things we would have eaten generations ago. Our jaw structure is different. So that means that the jaw sometimes is further back, and that means that it’s closing off some of your airway.
They’ve got a new technology out there called cone beam. It kind of looks all the way across and into your neck. It can tell you whether you have a nice, well-structured airway when you’re standing up, and then if you’re lying down, if you have a poorly structured airway, it collapses. And when it collapses, you can’t breathe well. That’s when people have, you know, these episodes at night, apneic episodes where they stop breathing. They’re on CPAP, they’re on these other devices. So, you know, we’ve changed—our anatomy has changed. And we need to be breathing more through our nose and not be mouth breathing.
So that’s something also is that if you wake up with headaches, if you don’t sleep well, it’s probably in your best interest to go and get checked out to find out if your airway is in a bad way. And there are things you could do to make it better. There’s some appliances that move the jaw forward and open up the airway. I mean, in a radical sort of situation, there are people who have what’s called double jaw surgery where they cut the top and the bottom and they move the jaw forward.
Emily: That’s an extreme sort of…
Dave: Yeah. And, but it changes people’s lives. I mean, I was with somebody a couple of weeks ago who said that, you know, he went through the majority of his teenage and twenties, never sleeping well, never breathing well, goes and sees, has his kids go and see this oral maxillary surgeon who says, “Oh, your kids have this problem, but so do you, and I can fix it.” And he said once he had the double jaw surgery, his breathing is so much better. And he said it was like I had never taken a breath before. It was that kind of sort of life-changing thing when you finally get to breathe.
And it’s all kinds of different reasons why you can’t breathe well. And most of us think, “Oh, I can breathe just fine.” But I think for people like that who have gone, you know, the majority of their life never really understanding what it feels like to breathe normally, to breathe like you’re supposed to, they say it’s a life-changing sort of thing.
Emily: Wow. That’s amazing. Well, it’s interesting because we were talking at the beginning about, you know, people who may, from the military, who may have those closed head injuries and that possibly can contribute to them not sleeping well or different things with not sleeping well. And it’s interesting that this, you know, could be another dynamic potentially that’s contributing to that as well.
Oh, I think you mentioned that a lot of times post-transition people find themselves not sleeping very well. So this might be another thing that someone who, you know, maybe is getting ready to make that transition or, you know, if they’re going through all of those VA appointments or things like that, maybe think about how they’re sleeping, how they’re breathing, and if it might not be optimal, might be something to mention as they’re getting ready to transition. Get it checked out, you know, and see if there’s any help that they can go with those things. Cause you want to take advantage of those resources when they’re available and know how to advocate for yourself.
Dave: I think most of us don’t realize that we have a breathing problem. We’ve never known the difference, right? So you’re like, “Well, do I have a breathing problem? I seem to be okay. I’m not congested or anything like that.” But when you’re lying down, that anatomy changes, and it contributes to loss of sleep. I mean, you’re constantly waking up, or you have these micro events where you’re waking up throughout the night and you never get a deep restorative sleep. And the constellation of things that that leads to for your health, for your brain health, for your heart health, for everything, is I think just being appreciated a little more fully now. And there’s a number of specialists around the country now that just specialize in airway, even dentists. They’re airway dentists. And they spend a lot of their practice trying to optimize someone’s ability to breathe and to all these different kinds of dental devices and such. And then you’ve got ENTs and maxillofacial surgeons that do all this constructive work to make it better.
But, yeah, if you find that you don’t wake up refreshed and you still feel kind of fuzzy, it’s probably a good idea to check your airway. Make sure that’s in good shape, right? Because if that’s in good shape, your brain health is gonna improve. Cognition’s gonna improve. You’ll get that inflammation out of your brain if you’ve ever had a trauma in the past, and it’ll help. All your other symptoms will be improved if you just had a little bit better breathing at night and a little more restorative sleep. I mean, I run one of these watches, right? I think most of us have these watches. This one keeps track of my sleep.
Emily: OK.
Dave: Even though I have all of this awareness of how important sleep is, every morning when I check it, it’s still not optimal. So I know that there’s more to work on.
Emily: Right.
Dave: Is it a pillow? Is it taping? I mean, what is it that’s going to move me from a sixty in my sleep to an eighty or an eighty-five or ninety? And how much better do I feel when I get to those days that are nineties? And they’re few and far between, honestly. And that’s despite the fact that I know some of this. By far not an expert in it, but at least I know enough to go, I need to get a good night’s sleep tonight. And tomorrow morning, I wake up and I still feel fuzzy. And so I know that there’s work for myself to do.
Emily: That’s interesting, you know, because I think your oral health and your sleep are two things that can often be overlooked, right? You’re like, oh, I’ll drink a little more coffee, or I’ll do a little mouthwash, or I’ll do, you know, things that might mask some of the things that are really going on. But it’s really good and important to think about these underlying foundations to our health, our wellbeing, and like you said, to feeling our best—not just functioning, but feeling really great.
You know, it’s interesting. My mom uses one of those Oura rings that tracks your sleep and your oxygen and stuff. And I think she found that my parents actually just moved from Colorado to Virginia where I live, and she found that her oxygen at night was super low and just happened to realize when she came to visit one time that it was significantly better when she was here out of the altitude in more humid air. For whatever reason, she just breathed much better and felt so much better and had a huge difference. And it was a motivating factor for my parents in making a move—just wow, how much better do you feel when you just get a much more optimal night’s sleep because you’re just breathing better, which is fascinating, right?
So it’s those things that I think, like you said, you don’t realize how big of an impact it makes until you’ve experienced the change. But it’s important to pay attention to so that we can function well in our lives, which is awesome.
Dave: Yeah, and having people take an assessment. Hey, do I feel like I’m sleeping well? You know, if you can’t say, “Yeah, I feel like I sleep great every night,” then, okay, that’s something to put on your little watch list. Maybe my sleeping needs to get better. Do I feel like I’m, you know, refreshed? You know, when I breathe, do I feel like I’m open and I’m getting oxygen? If not, then that’s another little tick. Okay, I’m going to work on that, right? And then when you go to the VA or you go to your doctor, you go to your dentist, you bring up those little things that you didn’t think too much about. But, I mean, I think it’s those small little things that have a tremendously large impact on how we feel the rest of the time, right? Even if you go out and you exercise and you run and you do all those things and you take good care of yourself, you probably maybe don’t always sleep well, and you probably don’t always pay attention to your teeth.
Emily: Right, absolutely. And, you know, it’s interesting, something that kind of ties into what you and I were chatting about before the show, just with advocating for yourself. I’d be curious to hear what you think about this thought. But I would say if you go to a provider and you tell them, “Hey, you know, I feel like something might be going on with my oral health, could you run some of these tests for me?” or, “I feel like I’m not sleeping or breathing well,” and they brush you off or, like, don’t really pay attention, don’t really try to take you up on those things, you may want to consider finding a new provider or advocating for yourself, figuring out who you can go to up the chain or besides that person to get the care that you feel like you need. Because I feel like we have intuition about our bodies. Like you were saying with little kids, you know, they know, “I need to taste things, I need to touch things, I need to experience with my whole body.” Like we have intuition about our bodies to know when something’s wrong.
And I think a lot of times maybe just because someone isn’t as familiar—that’s not their specialty, or they’re not totally sure what to do. I’m not going to say it’s malintentioned, but it can be easy sometimes to be brushed off when you’re not an expert in something, even if you feel like something might not be right. So it can be important to make the effort to try to get those things looked at, because they do have such an impact on your daily life. What do you think about that, coming from your side of the coin?
Dave: I mean, that’s my thought. I agree a hundred percent that you kind of know. You know your body, right? You know when you feel good. You know when you don’t feel so good. You can maybe pinpoint some of it. Maybe some of it is still just kind of out of your grasp. But there is a lot of help. You know, there are a lot of specialists. There are a lot of groups. There are a lot of people who are trying to advocate for the patients. And there’s more education that’s coming out.
We’re trying to be a little more proactive about putting out small bits of information that someone can say, you know what? I don’t ever feel like I get a good night’s sleep. I should ask that the next time I’m there. Or I do feel like something’s just not quite right.
But I think we do get in a situation sometimes when you go talk to your doctor, and you say, you know, I’m feeling a certain way and they don’t really know how to deal with it. So it kind of gets, well, “You’re just getting old,” right?
Emily: Right.
Dave: Now you say, “Oh, my vision’s a little bit off.” “Well, you’re just getting old.” Well, maybe yes, maybe no. Maybe there’s something else going on that needs to be investigated further. My mom was like that. I mean, she was very in tune with how she felt. And, you know, she had vision problems, and she had balance problems, and she just talked to her doctor, and the doctor said, “Oh, you’re just getting older. You need a new set of glasses, or you need this or you need that.” Well, it turned out she had a brain tumor. And it was her intuition that something’s not right here.
But the problem was she didn’t get to the right doctor to express those things so that someone put it together in a way that made sense and went, “Oh, it’s not just getting older. It’s not just that you’re readjusting from military life to civilian life. It’s not just—” I mean, it could be something. Maybe it’s nothing, but it could be something.
So when you feel like something’s not right, when you don’t feel yourself or feel normal, I mean, I think you have to push hard sometimes. And if the person you’re talking to is like, “No, it’s just, it’s not a big deal,” or “I don’t do that,” or “I don’t understand that,” find somebody else. And if that person doesn’t listen to you, find somebody else. And eventually, you find somebody, and you get the right message across to this person where they say, all right, I have to listen to my patient. My patient understands my patient better than I know my patient, right?
Emily: Right.
Dave: And it doesn’t matter how many letters you have off the end of your name. That doesn’t mean you’re an expert on you, right?
Emily: Absolutely.
Dave: Years ago, we were trying to do some stuff again for the military on especially people who are having, you know, like anxiety and depression, that sort of thing. There’s a field of genetics called pharmacogenetics, where we can take a little bit of saliva and we can tell you whether or not you will or won’t respond to a drug.
Emily: Right.
Dave: So if you were going to get prescribed a drug, I think you and I would both say, “Well, I want to know that it works. I don’t want to just take it for the sake of taking it.” And that’s a field that’s been around for fifty years, but it’s a field that hardly any doctor uses before they write a prescription for something. And if you’re a psychiatrist and you’re writing for anxiety or you’re writing for depression, I think it’s in your patient’s best interest to do something to help them optimize the chances of that being successful. And I think that’s something that everybody should have. It’s a once-in-a-lifetime test. And you know that any time you get prescribed something, you bounce it against those results and go, “Oh, you know what? This isn’t going to work for me.”
An example of that, and it kind of touches on what I was telling you before, where I was kind of talking through the chain of command in the VA, is the VA has had a tendency for a long time of writing for statins, these cholesterol drugs. And they give the prescription to everybody, right? They give every single veteran gets a prescription for statins.
Emily: Right.
Dave: And a fair number of them do not respond well to it. So my father, in particular, was having really bad leg pains, which is a side effect of certain types of statins. So he was having trouble getting out of the chair. He was having trouble walking around. And it was because they were giving him a statin that was not appropriate for him. And it’s an easy way of solving the problem. And they moved him to a different one. After some advocating on my part, they moved him to a different one. No more muscle pain. He gets around great. He’s eighty-four years old.
So it shows you that arguing for yourself, “Hey, this doesn’t feel right. This drug’s not suiting me very well. Need to be doing something else” is something that I think should be foremost every time you go to the doctor, dentist, chiropractor, pharmacist, whomever.
Emily: Absolutely.
Dave: Physical therapists, any of those.
Emily: One last thought that I want to ask you—I know we’re getting close on our time here, but it came to mind, and we’ve kind of come close to this but haven’t exactly touched on it. I just want to get your opinion. So is it possible for an underlying, let’s say, dental infection, mouth infection, or even something coming up from your gut that could have been influenced by those things to impact your mental health?
Dave: Absolutely, yep.
Emily: Because I know that, you know, there’s obviously a huge concern with veteran mental health and those type of things. So maybe something that could be looked into—I just, as you were mentioning, like if you’re not feeling like yourself or not feeling optimal or you’re not getting to sleep, you’re not getting this or that, you know, if you’re not finding any other root causes for mental health challenges that you may be having, then checking into some of those things may be really impactful for people. So I just wanted to put that out there.
Dave: Yeah. One of those pathogens that we’re most concerned with in the mouth can move from the mouth and into the brain. And when it does that, some of the products that it makes can be inflammatory. They can cause cognition problems. You’re not thinking very well. They can contribute to Alzheimer’s and Parkinson’s and other things. And then there are bacteria that need to be in our gut that produce things like serotonin. And they produce things that help us feel better, help us balance our anxiety, help us balance our potential depression.
So it is very much an issue with things in the mouth and things in the gut that can impact the brain. There is a very solid connection between the gut and the brain. And if things are dysregulated in the gut, if they’re out of balance or off-kilter, they affect the brain. So getting tested for stuff, even if it’s on getting probiotics. I mean, there are all kinds of great probiotics on the market that help to rebalance the gut. And people find that some of their mental fog goes away. Some of their depression goes away. Some of their anxiety goes away because that gut-brain access is very much operative with us all the time, especially when we’re stressed.
Emily: Right.
Dave: So you’re certainly stressed in a military environment if you’re deployed somewhere. And then you’re stressed when you’re transitioning. Right? You’ve spent twenty years or ten years or whatever the time is in the military with a certain structure. And now you’re coming out of it. There’s stress in adjusting and adapting to that. I think when you feel like you’re not yourself, find somebody that will listen to you and take steps to help you move forward in a good way.
Emily: Absolutely. I think that’s a great place to wrap the conversation. We always like to end—maybe we can do this in, like, thirty seconds—but we always like to end by asking, “Why Nashville?” You know, it looks like you’ve been in Nashville for quite a while. What prompted you to put down roots or stay there? What do you really enjoy about being in the Nashville area?
Dave: Nashville is a very collaborative place. You know, we have a lot of great institutions here, training institutions, medical institutions. There’s a lot of very smart people here and a lot of people who have a very deep connection into healthcare. Collaborating with them, networking with them, I think gives you not only just Nashville reach but nationwide reach. And plus, you know, I grew up in West Texas. The landscape here is so different than West Texas. It’s just been a place we have a lot of trouble trying to move from.
Emily: That’s awesome. Well, thank you so much for your time today. I really appreciate it. And I feel like you shared a lot of insights that are going to be really valuable for our audience. So thank you so much.
Dave: I hope so. I hope so. Thank you. Appreciate the invitation. It’s been fun.
Emily: Absolutely.
