 This is Think Tech Hawaii, Community Matters Here. Aloha and Mabuhay. My name is Emmie Ortega Anderson, your host for Pinoy Power Hawaii, welcoming you once again for another great episode of Pinoy Power Hawaii here on Think Tech Hawaii. First of all, I'd like to extend my warmest aloha. Thank you very much to the entire staff of Think Tech Hawaii for giving us the privilege and the opportunity to come to your home every Tuesday live, and we discuss topics of empowerment. We aim to enrich and lighten, educate, and the big picture for us is to empower. Today we're going to do just that with another episode of Amuyukadee, or Did You Know? And with us today is a very well-loved doctor, both in internal medicine, but he is my endocrinologist. I know it's a mouthful. Without further ado, I'd like to introduce and welcome Dr. Russell Yang. Thank you, Emmie. It's a pleasure to be here. Doctor, I'm so excited because we've been building up this episode where you're gonna come in and empower us with knowledge. And like we always say, knowledge is power and education is the key. So let's start with how did you get started and your education. So I like the GI tract. I'm a gastroenterologist and I like the GI tract because there's eight organ systems from mouth to rear, and so it's kind of fun to treat all those different processes. And so I got into this because I did three years of internal medicine training at Duke and then I decided I really like the Pancras Gland and so I started to specialize in the Pancras Gland and did research and went to University of Southern California to learn that and UT Southwestern in Dallas. And so it's been a lot of fun. Wow, a lot of education and I stand corrected. I meant gastroenterologists. Yes, I understand. They're related though, right? They are somewhat related. That's right. It's related through nutrition and metabolism, which is so important. All right. So, you know, I know that you cover a big spectrum from the mouth to all the way to the rear, if I may just say it. That's right. And a lot of the diseases today can be prevented if we took the proper step. That is so true. When you look at problems that bother people, three or four of the major ones are in the GI tract, all the way from heartburn to rectal bleeding to colon cancer to hemorrhoids. Okay. So, excuse me for just a minute. I think it's important to know Dr. Russell Yang, because it's really important to know what we're going to do, what we're going to do, what we're going to do. And I think it's really important for good health, not to say optimum health, it's up to you. It's up to you. It's really important to know what's going on. Please seek the advice and also the opinion of Dr. Russell Yang. I'm plugging him in because he is my doctor. And next week, I will have the pleasure of going through that famous colonoscopy. Yes. I didn't know how to term it, other than telling it like it is. And a lot of people sometimes are afraid of the unknown, and I have a saying that what you know may heal you, but what you don't know may kill you. Does that make sense to you? I love that phrase. And it's so true, especially for Hawaii and the Filipino community, because in the Philippines, you don't really have that much colon cancer screening, for instance. And so it's a newer concept to many people who have immigrated here and who live here. But we try to make these things that are scary to some people, easy and accessible, so that they'll undergo the screening. Yes. And your office is just a central information system for good health. In fact, you are under the umbrella of TLC. Yes. I like practicing there because it's centrally located. There's parking. We try to create a very friendly atmosphere. And we speak all different kinds of languages there, and so it's kind of fun. Yeah. And you've got Pinoy power, of course. And that's what our listeners are most excited about when they ask me questions. Oh, problema, maawatangatani doktor datoy languahek. Will the doctor be able to understand my language? And I said, oh, don't worry, just make the appointment, because there are our Kababayans that speak the language, and if you have a hard time understanding, they'll be more than happy to step in. How kind of you? You know, what's interesting in our office, we have state-of-the-art graphics, and we have iPads and wallboards to demonstrate to patients what's going to happen, and we're more than willing to answer different questions, because this is an important topic. And I have several assistants who speak the Gaelic or Ilocano, so it's nice. Yes, they'll go first. And they are very accommodating, and you just feel, oh, so welcome over there, it's like one big happy family. Yes, we emphasize happy, and we want to make the whole process easy and understandable. A wonderful experience. And that's what I get, that's why I keep coming back to your office, because the people are so wonderful. And then you as a doctor, you know, sometimes people are reluctant to go in, because, oh, the doctor has such poor bedside manners, because they don't know how to put the patient at ease. In your case, you talk story, you lighten it up, and not be so serious and so morose, you know? You know, I think part of a lot of the care of a patient has to do with their relationship with a physician. And if I may not even speak their language, I can still understand them and still communicate with them, and that's important to me. And I always say that the better patient is the one who really understands what's going on, that they have buy-in, and they're more likely to get better because they understand the process, instead of just saying yes, yes, yes. That's true, but it's really, really important, your role, doctor, to make people at ease. And, you know, you exude the aloha spirit. Did they ever tell you that you look Hawaiian more than...? Yes, until I try to pronounce their names. Okay, but anyway, you do live the aloha spirit, and that is something that is very obvious in your countenance and your relationship with others, because I've seen you interact. Oh, thank you. So it's not like the typical doctor-to-patient relationship, but the friend-to-friend with people at ease. We try to do this. We try to treat everybody like they're our family, and we understand, for instance, that because of cultural issues, there may be barriers, and we try to overcome them. Especially, you know, the Filipino community is so strong here and so prevalent in Hawaii, that it's important to address their concerns directly. Yeah, that is important, because we are the largest minority ethnic group next to the Halees, if I can say that, right? Yeah. But we are big in numbers, and certainly we seek for the best person in that profession. And this is where you can come in. Oh, thank you. Yeah. I think that's so important, is to understand the background and what the needs are of the patient, especially if you're going to do not invasive, but if you're going to do tests and procedures on a patient, that you have some sensitivity towards that. Well, in a sense where it becomes very personal, because you're dealing with personal parts of the body. This is so true. Yeah, so it's even more important to handle it with care, right, Doc? That's it, exactly. Okay. So, take us for a moment. When they come in and they have a diagnosis that is not so pleasant to hear, do you just come out? I mean, I have a doctor that just say, well, it is what it is. You know, he doesn't even butter it up and issue through the transition of hearing the quote negative or bad news. So, I think it's so important that you're straightforward with the patient. So, it's not that I won't sugarcoat it, but I'm pretty direct. But I think it's important what a patient lacks is not the knowledge, but the perspective. And I think that's the role of the physician is to give them perspective, whether it's diarrhea or constipation or heartburn or colon cancer screening, is that they have the perspective so that they understand what it means, what their symptoms mean in terms of their overall health and their life. And once you do that, patients are very accepting about their diagnosis and they understand what's going on. So, it is important to put yourself in the patient's seat, right? I always do. I don't ask a patient to do something that I haven't already experienced or that I have a lot of experience in treating. And we try to do it in a very nice and accommodating way. Well, that's really, really important. And if I may ask, Doctor, what led you to specialize in the gastroenterologist? Was there something that happened in the family or? Well, you know, I have a PhD in biochemistry and nutrition and protein dynamics. And so the GI tract is a natural extension of that research. And so I began to seek out opportunities that would allow me to do science and translate it into treating patients. And so GI was a sort of a natural thing. And plus I have extra long index finger and so. That will certainly be an important tool, right? Yes, yeah. Well, you are funny. So, I think that Doctor Yang Itatayan is really important in early detection because it's a really important understanding, specializing in that field. You know, that nutrition is a key. Some of us refuses to hear about the phrase, we are what we eat. Yes, it is so true. I always say what goes through your lips will become you. And nutrition is very important. The rate of obesity in the United States is so high. It's linked to so many different diseases like diabetes, like hypertension. And in fact, at TLC, we are focused, one of our focuses is on weight loss. And I think that's so important. Also, if you form good dietary habits, and I have a good, what I call good bowel hygiene with lots of fruits and vegetables, lots of fluids, it becomes so, it's so important and can be life changing. Especially if you have problems like diarrhea or constipation, very often it might be diet related. Well, I really believe, because even my daughter is in nutrition, she majored in nutrition from BYU. So I'm getting more educated by the facts that she shares and she stresses fiber and you would agree to that. Oh yes, I think that fiber plays such an important role. The studies are better in women actually than in men, but fiber does all kinds of things. And regular intake of fiber, and the surgeon general recommends six to eight portions of fiber a day, so it's actually quite a bit. And all fiber is is undigested plant parts. And the plant parts hold on to water. And so if you take fiber and you drink water, depending on how much water you drink, if you're constipated, for instance, you'll have better bowel movements. And if you're having diarrhea, you take the fiber with less water and the fiber will absorb whatever is in your gut lumen and you'll feel better, your stools will bulk up. And the fiber has so many good different things. First of all, it's very easy in Hawaii because we have so many good fruits and vegetables. And the fiber can pull out carcinogens, things that cause cancer in your diet, fats, sugars, and it can make you feel better by having good evacuation and elimination every day. Oh, release me. Yeah, it's so true, it's so true. Dr. Russel Yang is our guest for our segment and we need to take a quick break. We will continue our conversation about our overall health from our mouth to our rear. That is your specialty. So please stay tuned. We will be right back here on Pinoy Power Hawaii. Hey, Aloha, and welcome to the Think Tech Hawaii studios. I'm Andrew Lang, the host of Security Matters Hawaii. I'm airing here every Tuesday at 10 a.m. Hawaii time and I'm trying to bring this community information, security information specifically that will help you live a safer life, help keep our community safer and help keep our businesses safer. So join me because Security Matters, Aloha. I'm Yukari Kunisue. I'm your host of New Japanese Language Show on Think Tech Hawaii called Konnichiwa Hawaii. Broadcasting live every other Monday at 2 p.m. Please join us where we discuss important and useful information for the Japanese language community in Hawaii. The show will be all in Japanese. Hope you can join us every other Monday at 2 p.m. Welcome back to the second portion of Pinoy Power Hawaii. Our guest today is Dr. Russel Yang and he is my gastroenterologist. Very good. Did I say it right, doc? You did. Very good. I will have the procedure next week, Wednesday, colonoscopy. Very good. You're getting better with this. Hey, I'm trying to understand, man. This is one, Tita, you're talking to, who grew up on Lanai. Did you? Oh, wow. So I'm learning, doctor, but you make it such an easy adventure. Voyage, because listening to you is just like telling stories. Oh, good. So earlier we were talking about the importance of fiber and along with that, the importance of drinking the recommended six, eight, 10 glasses of water. Yes, the surgeon general recommends the more fluids the better, but starting around six glasses of fluids a day would be wonderful. And I think even in addition to that, it's important for you just to do that directly with the fiber intake that you do. So if you take a preparation like metamucil or citricil, it's important to take the water directly with it. If you're eating salad and vegetables and fruits, it's important to drink the water directly with it. Wash it down. Yeah, and you know, if you do it properly, you might even lose some weight because you'll feel so full and satiated that you won't want to eat much more. So a lot of my female patients like to change the habit and they actually lose a few pounds. So it's kind of nice. I've learned that from TLC, from the weight loss and you know, Dr. Lisa and Dr. Yo, Dr. Kai, make it an overall pleasant experience to... It's nice to work in an environment where we're all united towards helping patients and improving their lives. And the word TLC, you provided with... I interpreted tender loving care from wonderful doctors that really care about your health. Thank you. Yeah, so let's go back to our main focus, which is our intestinal tract, the health. Take us on a journey, Dr. So most of us are focused in preventative health and one of the most common cancers out there is colon cancer. Colon is of course your large intestine and it's the third most common cancer. It leads to a large number of cancer deaths. So we're all focused on trying to get even normal healthy patients screened for colon cancer. Usually we start at the age of 50, but we're realizing now that colon cancer starts even earlier and so the new national guidelines in a few years will even start earlier at age 45. If you're African American, you might even start earlier. It's even higher. So that's important. Yeah, so Dr, the rate is alarming. What is the ratio? Because my mother has had parts of her colon taken out. She's lucky that they were able to sew it back together. My husband, who is 90 years young, was lucky to be able to connect the healthy intestines back together to where he doesn't have to wear a bag. But for 90 years of his life, his intestines has been working right there for him. Yes, you know, you bring up a good point. That is that you can live a long time. If you take the right steps that prevent this kind of cancer. In addition, the colon cancer is a little unusual in the sense we can find the precursor lesion, the lesion that starts the cancer early, remove that lesion and thereby prevent cancer. And that's the name of the game in my mind. That's the key. Yes, that's why I think everybody over the age of 50 should go get tested for colon cancer. Okay, if this is a doctor, the first important thing is that we are 50 years old, 50 years old, some are infected, especially black Americans, because they are infected, they have been checked up, this is a warning. But you would say how many out of 10 would end up having problems or challenges with their intestines, though? So, well, intestinal symptoms very often predict whether you have colon cancer or not. So if you have blood in your stool, or if you lose, or you're losing blood, so you have an anemia, or you're losing weight and don't understand why you're losing weight, or if you have thin, I always say doodoo, but if you have thin doodoo or flat doodoo, in other words, a change in the shape of your bowel movement, then those are important indicators that something has changed. So a normal one would be the big normal round, like sausage? So I always say, yes, basically it's like bananas. Bananas? If you wish. Oh boy. Yeah, King Kong sausage. I don't want to ruin that for that. But I think it's important, it's whatever your natural habits are. So some people go a couple of times a day, some people go once every two days. And so the pattern of normal varies. But that's not normal if you go once every two days. Well, it's not normal if you're suffering from gas and bloating and you feel uncomfortable, then that's not normal. But some people do. And so I think it's just important to understand that if there's a change in your bowel habits, so let's say you go to the bathroom once a day, every day for years. That's normal for years. All of a sudden you stop going and you only go every three days. That's a pretty dramatic change. Alternatively, if you go three times a day, then that is also a big change. And so you have to just sort of pay attention to that to something's changing. And especially if you're in the 50 range and something changes like that, then you want to seek medical care to get checked out. So in other words, be aware and be constantly checking of the changes and what's going on. And then you have to just sort of decide because you can have a cancer, colon cancer, and never have any symptoms. And so I think it's important just to decide at age 50 I'm gonna have a colonoscopy. Okay, so how often should that occur? The colonoscopy. So you have a colonoscopy and if I look inside and you don't have anything, then I say 10 years. Really? Yeah, oh yes. If you have polyps. But a lot of things can develop within that period. So if you pay attention to symptoms or if you have polyps, then we do it sooner. As often as a year or maybe three years or five years we'll repeat it sooner. Remember that because we can find the change before it turns into cancer, we can look and prevent cancer. And so we know it can be a slow process. And so that's why we decide what interval it will be. But we'll make that judgment once we do a colonoscopy. The most important is to look and to know. Go inside. So then you can make a decision. Yes. Wow. I'm glad I took the step to make that appointment. Because for a while, I said as long as I'm eating right I'm making the right choices, I'm eating lots of fruits and vegetables. I think I'm gonna be okay, but it's really, really important to go in and put a screen. And just get checked out. We have tried to design an easy system, if you will, in a pleasant system to have your test done. The only uncomfortable situation is you have to drink a preparation that gets you really pretty flushed out. But yeah, people are afraid of that too. So let's explain the process real quickly. So basically what you do before colonoscopy is that you'll drink a solution the day before you'll drink nothing but liquids. It's 100% covered by the way. I went to pick up my kid yesterday. Yes, that's how important it is. Even in the era of Obamacare, colonoscopy is covered. So that's how universally everyone recognizes. So it doesn't cost them anything to have that screening. And I try to change the prescription so whatever the medicine is that they use for the preparation isn't covered out of their charge. Yes, I was surprised because normally I'm used to paying some kind of a copay and said, oh, they don't know anything. I said, wow. That's right. So it's covered. So the patient, if it's covered, the patient only has to decide to have it done. And that's what's important to me is to make sure the patient understands what they need and go through it. And then once you go through it and you have polyps or we have a finding or nothing, then your mind is at ease. Then you can say, okay, 10 years, five years, three years, one year. So then you're, and also you fall into the care and very often patients have gas and bloating or they feel comfortable or they have a little nausea and so they sort of figure out what goes on. Because besides changes in bowel habits like diarrhea or constipation, heartburn is also very common. And so you get in under the care of a gastroenterologist and you can do pretty well that way. You can get these common symptoms to take care of. I know that we have a picture of the colon if... Oh, no images. Okay, anyway. But describe to us, doc, how long is the average? So your colon is six to eight feet long and it's your large intestine. And so it's the final stop before you process whatever you ingest comes out. And it's, so that's why you ask questions about the change in shape or the change in color or how you feel because that's the final stop. And colon or large intestine, the cancer affects both men and women equally. And so that's why there's no... No discrimination. There's no discrimination. Okay. And it is age related so the longer you go, like your husband, you tend to collect cancers as you get older and colon is one of them. I was told, doc, that we all have cancers in our system, right? It's just a matter of when that is awakened or when it flares up. Explain that thinking. So that's very interesting. It's so true. You know, your cells and your metabolism change over all the time. And if you get, as you go along and you're exposed to a chemical or exposed or have some habit of eating a certain kind of food that may not be good for you or too much fat, for instance, then you begin to change your genetics of those cells. And cancer is nothing more than cells that grow or rise. So they're normal cells, but they grow without control. And then they grow into a mass or growth. Or something triggers it. Right, and then they spread and that's when you get into trouble. With the loaded time that we have remaining, doctor, how could they contact you or how could they make an appointment? So we are at 1650 Lalija, essentially located. We have a nice parking lot in front of our building. And the phone number is 376-2100. And I have a Filipino operator who will take your information. And she's very nice and she'll explain things. And you'll get a flavor for our practice. And we also have nurses there and we're more than willing to just answer questions. If you have questions, you just leave a message. Okay. Mahe Bigen, you heard the contact number 376-2100, Party ATT-LC Medical Center, near Dr. Russell Yang. And again, his specialty is gastroenterologists. And he is my doctor. Happy to say that I am very pleased with the services that he provides as well as the many other doctors that make up the LC Medical Center. Thank you again for giving us the opportunity to come into your home Tuesdays live, 12 noon, here on Think Tech, Hawaii. And I'm gonna close by saying, Mabuhay Maraming Salamat Poh from Pinoy Power, Hawaii.