Michele:
Hello, everybody. Thank you so much for joining me. I’m Michele Heyward. And tonight, we are going to be having a special discussion around National Minority Health Month. Tonight, I have one of my college friends. And we want to say how long ago, we were in college when we graduated, but we graduated, maybe two or three times. I’m just gonna say we started we were five, but I have with us Dr. Asha Bailey. She’s a South Carolina native, a Clemson University graduate, as well as a graduate of this little medical school in Philadelphia. And she has been practicing nephrology for over 10 years now here, specifically in the state of South Carolina. And so I always bring on different people on my network. But I haven’t bought on anybody that has known me before I had these gray hairs. And who has not known me since I had this much hair. So she literally she saw me the other day, she was like, what is all this hair? She’s never seen me with this amount of hair just so y’all know about this. So, Dr. Bailey, I am a call. You don’t have to call you Dr. Bailey. Okay, Asha because I like I ain’t never called you, Dr. Bailey. So Asha, thank you so much for joining us. let the audience know a bit about whatever I left out of your bio. So they know like how you let’s talk about that, like what made you decide to go and get into medicine become a doctor?

Dr. Asha:
Well, thank you, Michelle, for that introduction. Definitely, um, I like to thank you for allowing me to use your platform to talk about something I’m very passionate about with it, which is the health of our community, you know, taking care of our community, that’s a big part of what I do every day. But just to answer your question about why I chose medicine, um, you know, when I was a kid, everybody goes to the doctor. And, you know, I didn’t see doctors that look like me when I was when I was younger. And that was one of the I think one of the driving forces. And that’s one of the things that kind of keeps me I guess, kind of grounded, and, and keeps me focused on what I do, because I want my patients to see a physician that looks like them. And I also want them to truly understand and feel that I want to take care of them and I care about them.

Michele: 
Thank you for that, Asha. So you get this degree in. You got your in metal medicine, medical school, rather not medicine school, but medical school. How did you decide on the kidney? Because I know we had some conversations back in the day, the early 2000s. But how did you end up deciding on the kidney?

Dr. Asha:
Um, you know, when we go into medical school, the last two years, we do clinical clerkships where you get to experience medicine firsthand. So you’re in there with the patients attending physician and you’re kind of grasping everything that they’re doing. So from there, what I knew I wanted to do what I what I figured out what I did not want to do surgery, I knew that I didn’t want the kind of lifestyle that that they had I give more power to them. They do things that I can never do. I chose internal medicine because internal medicine, in my opinion is the gateway to everything every specialty cardiology, hematology, oncology pulmonology, that’s basically the gateway to everything. Now I went to I did my residency and fellowship at Wake Forest Baptist Medical Center in Winston Salem, North Carolina. And from that’s a big academic institution, if you don’t know. And there you have all the sub specialties. So I was able to, you know, rotate with the cardiologist, the gastroenterologist. And then there was a nephrology award service that I was on. This is a service or a specialty that a lot of people kind of look the other way they think that patients are very complicated. They’re very sick. I’m just getting and it’s just kind of hard to you know, understand all the physiology that goes with the kidneys. But this when I did this rotation, I had all those things in mind, but these are the people that I felt like these were my people. What nephrology offered me was basically I got to see all facets of medicines. I got to see patients that did well. I got to see patients on dialysis I got to see transplant patients. I got to see critically ill patients believe it or not, you know, we take care of gunshot wounds because fortunately when they Things like that happen. They these people have a whole lot of complications in the kidneys are one of the main things that can shut down. So it nephrology, along with many of the other specialties just offers you a whole variety of different aspects of medicine, but I got to practice just Critical Care Medicine along with just seeing, you know, my routine, chronic kidney disease patients.

Michele:
And I’m glad you brought that up about how people often overlook the kidneys, I would say often, when we think about major organs right in the heart first, we got to think about our skin as an Oregon sure lungs. Yeah, don’t often think about our kidney and, and I want to talk a bit about what happens early on that we may be doing to impact our kids. Sure, especially in Black, Hispanic, and other minority
communities, you know, you, you kind of you made a great point, just now, people don’t think about the kidneys until the kidneys go down.

Dr. Asha:
It’s just one of those things that and it doesn’t have a lot of symptoms, kidney disease as a present what a lot of symptoms early on. So that’s why it’s important, you know, for anybody, regardless of how you feel how you take care of yourself, everybody needs to go to the doctor on a routine basis, because that’s where we pick up things early. And that’s the goal with medicine, you have to pick up things early, because if we can pick it up early, there’s a good chance that maybe we can salvage or preserve what you got. Okay. And I know you mentioned the arm just wait kidney, we’re gonna call it what it is it’s called chronic kidney disease are different varieties or different degrees of kidney disease, there’s a little bit of kidney disease. And then there’s people that have a lot of kidney disease, meaning they don’t they’re on dialysis or close to it, or they’ve had a kidney transplant, those kinds of things. So kidney disease has a very wide spectrum, there are a few things or a couple of different risk factors. Unfortunately, I have to talk to patients about on a daily basis. So when we talk about kidney disease, kidney disease, in essence, just means your kidneys are weak, they’re not doing everything that they should be. And our goal as kidney doctors is really, honestly try to figure out what the problem is, and hopefully preserve a lot of times, we can’t go back in time and make things better. A lot of patients think that the goal when you come and see me, we’re just trying to hold on. That’s it because you don’t have to have 100% kidney function, you just need enough. And, and but the goal is to figure out what is causing it. So when we talk about kidney disease, again, there are two main things there are actually two, two to three main risk factors for kidney disease, things like diabetes, everybody knows what diabetes is, you have hypertension. And then there’s another thing that I think a lot of people overlook, it’s kind of the elephant in the room. And it’s obesity, that is a major contributor, especially in our community to kidney disease. You know, when we talk about and I’ll just kind of give a little spiel on each one of those three things. Let’s talk about diabetes, just briefly, diabetes, 10% of the US population, or 32 million people have diabetes, that’s an astronomical number. But when you look at African Americans, 12% of African Americans have diabetes. That is huge. Diabetes is the seventh leading cause of death in the US. Um, you know, again, we all know what diabetes is. We know some risk factors, risk factors have diabetes, unfortunately, a lot of it is genetic. When you think about it. African Americans and Hispanics, unfortunately, have a
higher incidence of diabetes. Anybody in their 40s 45 and myself included is at risk for diabetes. So the older we get your risk of diabetes goes up. Anybody that has hypertension, anybody that is overweight, or obese or obese, but also another thing and I think people may not realize gestational diabetes is a risk factor down the road, what gestational diabetes is diabetes that develops when you are pregnant. A lot of times once you have the baby, the diabetes resolves, and everybody’s fine. But usually about eight to 10 years later, that person will come down with full blown diabetes. So that is one of those things where if you have a diagnosis of gestational diabetes, when you are pregnant, you got to be super aggressive about trying to reduce your risk that mean meaning exercise, a good diet, watching your weight, you know, all these things that are really honestly just common sense. You got to do it. Okay. Um, As you know, there are a lot of signs and symptoms for diabetes, that’s why it’s very important to go on to your doctor. But if you’re experiencing like going to the bathroom a lot are going to urinate that that should really be checked into, okay? weight loss and weight gain or signs of diabetes, more advanced cases, or when you have diabetes for a long period of time, and sometimes people just don’t know what they missed the signs, but they can have vision problems, or even on nerve problems, you’ll hear people say that they have numbness and tingling in their fingers and their feet, all of those are symptoms, you know, we have to recognize when things are not right, and then go and investigate it. Okay. But you know, that’s diabetes is a huge risk factor. And the thing about when we talk about kidney disease and diabetes, we’re not talking about necessarily the immediate, you know, the present, what I’m trying to do is, when I get consulted to see a patient that got diabetes, usually there’s some signs in their blood, blood work or urine that that’s the reason they refer to me, you know, I’m not really that concerned about a president, what I’m trying to prevent is 510 years down the road, where your kidney function, we don’t want to see your kidney function get worse, okay? So that’s why it’s super important for us to go to your doctor, know your numbers, ask questions, don’t just let us tell you to do this and do that you got to, you know, tell us if a medicine isn’t, you know, if you’re not tolerating a medication well, but I encourage you to ask questions be actively involved and educated in your own health, especially with diabetes. Okay. Um, you know, I can, we can talk about hypertension and hypertension is the number two cause, I can’t tell you how many young African American males that I see in my dialysis clinic, I mean, I’m talking about people in their 20s and 30s, primal ly, they had this horrible blood pressure, they haven’t been going to the doctor for whatever reason. And all of a sudden, they get these horrible, you know, symptoms where they’re swelling up, they’re having chest pain, and that’s what causes them to go to the doctor. And then we get the numbers back and it’s showing that your kidney function is, is quite reduced, or, you know, you’re having signs of, you know, other sequelae, from poorly controlled blood pressure. Again, I’m going to emphasize this throughout, you know, the time that I’m here, you got to go to the doctor, you don’t go to the doctor, just when you’re feeling when you go to the doctor, when you’re not, at when you’re away, you got to go to the doctor, just just like you go to the dentist to get up every six months for your routine cleaning, well, we shouldn’t be you got to go to the doctor for us to check these things out because I can’t die. Hypertension is a silent killer, you are not going to have symptoms of your blood pressure being super high. Until you know damage is done until you’re on the verge of having a heart attack your coronary artery disease is not their kidney function. Now, you know, this is the scenario that I see quite often in, you know, when I see these young guys that come in, you know, they’re on dialysis in their 30s, or, you know, late 20s. And, you know, it’s just a situation that can be prevented if we have early detection and early detection is honestly going to the doctor, but it’s also doing your part as far as your diet, your exercise, cutting down on the salt, cutting down on the not even cutting down but eliminating the tobacco. That’s a major issue. Also, excessive alcohol use contributes to hypertension. But usually, there’s an easy remedy for hypertension or high blood pressure
is really taking your medications and a proper diet and exercise. That’s really the usual remedy for hypertension. Okay. Um, I think I also want to mention obesity, a lot of times people just don’t want to talk about it, but you know, we have to talk about it because obesity is a contributing factor to diabetes and hypertension. There are many things within that you know, can go wrong with the body and a lot of things we can’t necessarily cure. I always tell my patients, you know, you can have your diabetes, you can have high blood pressure, you can even have kidney disease, but you can’t have let these conditions have you. We have to, you know, rectify or fix what we can fix and a lot of times and 90 person 80 90% of the time, we can do something about weight we can do something about smoking, decreasing our alcohol intake, you know, improving our our diet and exercise Those are things that we can do. Now, we cannot do anything about the genetic, you know, the genetics, like things that run in the family, like we all have diabetics in our family, all people with high blood pressure. And unfortunately, that’s there’s no change in that. But we have to modify the things that we can modify.

Michele:
Thank you for that we do have a question. What are the primary testing that primary care doctors can test just like the kidneys is, is it the general information from your normal blood lipid panel, it truly is,

Dr. Asha:
um, your regular doctor or primary care physician is checking the same labs, I just go a little bit more in detail when you arrive at my office. But there is a lab called the creating. This is a blood test that measures your kidney function. If your kidneys are working, okay, that number is around one or less anything over one is considered to some degree abnormal and should be checked out. But the other thing about when you’re looking at your kidneys, is also a blood and a urine test. So we talked about the blood test, which is the creating the urine test. So that’s just a simple urine dipstick, you go into the doctor and ask for a urine sample, we’re not necessarily testing it for drugs or anything, what we are looking for is evidence of blood and protein, because we shouldn’t see any of that in your urine. If that is present. That is honestly an automatic referral to a nephrologist. So it’s actually two tests that we utilize to determine how well your kidneys are doing as a blood test, specifically is called the creating, okay, and other tests is a urine tests. And those are tests that honestly, if you’re going to the doctor every year, or, you know, if you have other ongoing medical problems, and you go more frequently, they’re going to check those every three to six months. And we we can pick those, those patients quite frequently. A lot of times, it is a simple remedy to you know, modifying, you know, the diet exercise, but maybe incorporating a special medicine that really targets this issue.

Michele:
Thank you for that Asha. A question. Or as we’re talking about, the things that lead to kidney health or kidney is not functioning normally. Let’s look at the impact of COVID 19 On Black and Hispanic communities. And how has How is that also impacting kidney health?

Dr. Asha:
You know, COVID has been an absolute disaster for all communities, not just you know, the minority communities, but it is what it has done. And it’s something that we’ve all known, we know that, you know, medical care is not the same for, you know, different populations. There’s a highly underserved population, like I work in Colombia in a very urban area, and it has bought out things that, you know, we’ve actually tried to, you know, we’ve tried to make some changes. But granted, we haven’t, we haven’t done enough. But COVID In general, I have seen it affect every body system in everybody’s system. It is wreak havoc, um, I was talking to Michelle on several days ago, about, you know, we have patients that have you know, their kidney function is a little bit weak, people have gotten COVID And it’s tipped them over to needing dialysis chronically meaning going to a center three days a week and getting your blood cleaned by machine. That’s how severe COVID has been. You know, we we’ve had a lot of, you know, dialysis patients that have, unfortunately succumb to the illness, because when your kidney function is quite weak, you’re on dialysis or even have transplant, you’re at a very high risk for, you know, if you catch pneumonia, you catch any, you know, any type of, you know, infection, it can really tip you over and cause a whole host of complications, whereas you compare it to someone that doesn’t have kidney disease or doesn’t have some of these other risk factors. They may it still may wreak havoc, but it may not wreak, it may not be as severe and patients that don’t have these other risk factors, but I have seen, you know, COVID You know, I can honestly tell you, probably, at least you know, 10 of my dialysis patients, unfortunately, are no longer with us, because we have COVID And I have a clinic of 80 patients and throughout the Columbia and the surrounding cities. We have probably between two I would say 12 to 15 dialysis clinics that have 80 plus patients. So I’m telling you, I’ve lost probably between eight to 10 patients out of them 80. That’s a, that’s a staggering number. You know, I can’t even count how many patients that don’t really unfortunately had to, you know, start out, it’s because of exposure to this virus. So when we tell you to get the vaccinations, we are truly trying to minimize your complications associated with this virus. It has been devastating, as you all know, if you look at the news or social media, to many communities, but it’s definitely been horrendous for the African American community.

Michele:
When it comes to testing, do doctors need to look at testing results differently for black communities, Hispanic communities, Asian communities, and, and mixed race people differently because of genetics.

Dr. Asha:
Um, so to a certain degree, we do that, but actually, you brought up a great point, because all before up until like, maybe six, nine months ago, there was a difference in the way you interpret the kidney numbers for African Americans. And it’s not necessarily for Hispanics, or Asians or anybody, but it was specifically, when you look at African Americans, the number was interpreted a little bit differently. However, most labs and or practices are, are now not doing looking at race whatsoever, the number is the number, we’re going to look at that number the same if it was a Caucasian, Hispanic or African American, which is actually, in my opinion, a good thing, because I think, all before, there may have been a slower reaction time to African Americans with that test. But now everybody’s on the same level, what that the test kind of looked at body mass, African Americans, a lot of times are a little bit more muscular. So that’s what the test kind of took into consideration. But now I feel like with everything on a level playing field, we’re going to actually see patients being referred to me sooner. And I hope that we can sell, you know, say their kidney function.

Michele:
So we’ve talked about what is kidney disease? Or what leads to it the impact of COVID? What can people do to prevent kidney disease
in the one thing you can do to prevent kidney disease, there’s a lot of things that you can do to prevent kidney disease,

Dr. Asha:
I would say the number one thing is that you got to get it in your mind that you know, and you got to value your health, you got to get that in your mind that you’re only given us one body, we got to value and we got to take pride in our health. And we got to learn to be educated. We, you know, you don’t have to learn the medical lingo, like I know it, but you need to go into office and not let someone per se dictate to you, you need to understand what these numbers mean, you need to understand the medications, you need to also tell us I can’t tell you how many times I see patients, and they you know, they you know, I’m telling them, oh, we’re close to dialysis, they don’t have a question. It’s impossible. Not have a question. If I’m telling you that we’re approaching dialysis, I love when, you know, especially with my arm, the males that come in I love when their wife or significant significant other, or the kids come with them, because they really tell the story. Hey, you know, I always tell people bring bring your family members. So weak. So, you know, four years are better than two. But the main thing is that we got to number one value our health, your health is not guarantee, you got to you know, become educated to some degree, if I’m talking to you on a level that you don’t understand, you got to you got to let me know, we got to bring that down. Because my number one thing, when I tell my patients when we’re finished with our interaction, I was like I need for you to be able to tell your wife, or tell your kids what we talked about. And I’m gonna make it as simple as possible because I’m a simple person. I don’t you know, we don’t need all that. All that, you know, high tech language to get the point across. And you know, those are the main things but, you know, again, it comes down to common sense to, we know that we can eat fast food every day. We know that we need to do some form of exercise. No, you don’t have to run a marathon. That’s not necessary. I got a bad knee. I can’t do it. But what I do is make a concerted effort to do some form of physical activity, at least five, five to six days a week, and that’s usually about 3030 minutes. I’m not I have to do much more than that. But I also you know, watching my diet, you know, I don’t do a lot of carbs, I don’t eat out as much. I actually do a lot of meal prep. And so I don’t, that’s just the way but I think you know, being healthy means different things to different people. You don’t have to, you know, do it like I do it. But I think you know, cutting back increased and cutting back on, you know, high fatty foods to solve the fast food, all that processed foods, and incorporating diet and exercise. I think you’re well on your way.

Michele:
Thank you for that, Asha. So everybody. If you are joining us with this live on the replay, I’m going to give you the opportunity to connect with Asha. So Asha, where should they go to connect with you? on Facebook?

Dr. Asha:
I have a Facebook page is basically Dr. Asha Bailey.
Oh, it is Dr. Asha Bailey.
Michele:
Yeah, I saw Yeah. Well, somebody
sent me this. I don’t know who it was. Yeah,

Dr. Asha:
you can actually pull if you do it that way. On Facebook. I’m just saying I’m just speaking in general, you can actually pull me up that way. Also. I pull up names. Even just putting my full name Asha Bailey, and you’ll see probably like two profiles.

Michele:
You okay, cool. And what do you speak about how can people get you to come and do a paid speaking engagement with with their organization?

Dr. Asha:
I’m just, you know, I mean, I’m pretty easy to contact. I had an organization a couple weeks ago, reach out to me and they just wanted basically, information on you know, chronic kidney disease prevention and risk factors on is about an hour talk. But no, I’m really accessible. Email is the best way I’ve, I am usually on Facebook a few times throughout the day. So yeah.

Michele:
So y’all know where to reach her. If you’re in the state of South Carolina, and you’re looking for a black doctor who specializes in kidneys. Now you have a referral, if you’re in a low country is a little bit of dry that you in Upstate is a little bit of drive. But I would say you have an option if you want to look, you want a doctor who looks like you, and can understand some things about you on a cultural basis. So Asha, thank you so much for joining me tonight. And everybody. I really appreciate it. Everybody. We will be back later on this week. On Thursday. On Friday, ei Thursdays, they are back. I took a hiatus because I needed a break. We’ll be back and we’ll be talking about barriers to really a cultural change in organizations. So I have two guests that will be joining me talking about that and what white management teams can do should be doing an organization so definitely, definitely come join me. Everybody have a great week and until Thursday. I’ll see you then. All right.

Dr. Asha:
Thank you Michelle.

Michele: 
You’re welcome.