with Dr. David Hilden


Bonus Episode – A ride-along with Emergency Medical Services

As we wrapped up Season One of the Healthy Matters Podcast, I wanted to share with you a bonus episode – a ride-along with one of our Hennepin EMS ambulance teams. There are many components that make up a robust healthcare network, and oftentimes the caregiving starts with these first responders who you’ll meet on our ride along.

How does it work when someone calls 9-1-1?  How much does an ambulance cost?  What’s a typical shift like for a paramedic?  And how do they cope with the stresses of the job?

With 36 ambulances, 2 paramedics in each, and an average of one call every 6 minutes, these mobile emergency rooms and the teams within them see a lot of action – approximately 90,000 calls a year at Hennepin Healthcare alone!

We take a couple calls with our paramedics, but of course, we won’t get too involved with the incidents themselves out of respect for the individual’s privacy. But you’ll get a unique glimpse into the into the unfiltered reality of the world they see every day, and the incredible professionalism these teams who are always ready to provide state-of the-art prehospital care.




Breast Cancer – from Awareness to Action

The words “breast cancer” and “the possibility of breast cancer” are words no one wants to hear. Until there’s a cure, chances are that you or someone you love will experience breast cancer, which is why I  talked to Dr. Abigail Madens, a breast surgical oncologist and general surgeon at Hennepin Healthcare. In Episode 24 of the Healthy Matters Podcast, she shares insights on screening, risks, treatment and outcomes.

“As women, we like to come up with reasons we might not be as high of a risk for breast cancer,” said Dr. Madens. For example, she explains how some women might say their risk is lower because they nursed their children, which may be true, but shouldn’t replace some of the modifiable risks.

“It’s good for people to be aware of the risks. For postmenopausal women, a healthy weight is going to reduce their risk of breast cancer,” she explained. “Exercise is also really important and of course getting your annual mammogram.”

Excessive alcohol consumption – greater than two drinks per day – and diabetes can increase a woman’s breast cancer risk. There are also things women can’t control when it comes to getting breast cancer. Increased breast density is one of them, said Dr. Madens.

“Some women have more fat contained in their breast tissue and others have more breast tissue or breast cells. I think that there’s a couple different reasons why it’s a risk for breast cancer. On a  mammogram, when you have a really dense breast, it just looks like a white breast and you really can’t see masses very well because they’re also white – it’s just a dense breast tissue. And dense breast tissue actually seems to give rise to faster growing, potentially more aggressive cancers.”

In addition to breast density, we can’t control what’s in our genes. Dr. Madens said that genetic risks are more complex now, and that in the past they only tested for two genes: one for breast cancer and one for ovarian cancer syndrome.

“Now we test for 9 genes, and when I have patients that come to me with genetic mutations, I usually take them to a website established through Harvard called Ask 2 Me. You can go in and plug in a woman’s age what kind of cancers they’ve had, what gene mutation they have, and then you can see their cumulative risk.”

Estrogen exposure, atypical biopsies, lumpectomies, mastectomies and more are part of this important discussion with Dr. Madens on Episode 24 of the Healthy Matters Podcast.




Community Immunity

Who should get the pneumonia shot? Can you get multiple vaccines on the same day? Who should get the shingles shot and why? In Episode 23 of the Healthy Matters Podcast, I get these answers from my colleague Dr. Kate Hust, medical director of the Internal Medicine Clinic at Hennepin Healthcare.

We’re all accustomed to getting vaccines, but the COVID-19 pandemic brought discussion about them to the forefront of many conversations. I wanted to get the latest information from Dr. Hust about the COVID boosters, immunity and when and why we should consider getting the next shot.

“The latest booster vaccine, which we refer to as the bivalent booster, is available both from Pfizer and Moderna,” she explained. “And it prevents against additional strains of COVID compared to what our initial COVID vaccines were. It’s for everyone ages 12 and older.”

And what if you’ve already had COVID? How long should you wait before you get a booster? Dr. Hust said that you have your own protection, thanks to antibodies that your body produced, for up to about three months after getting the illness.

“You don’t have to rush out and get the vaccine. As long as you have recovered from COVID and are out of your quarantine period it’s safe for you to get the vaccine, but you also have a little space if you wanted to wait up to three months.”

We also talked about influenza and flu shots. Anyone who’s had the flu will be the best advocate for the annual flu shot. People who have had the flu tell me that it “hit them like a Mac truck.” I’ve had patients explain how they practically know they hour their flu symptoms hit. “I was fine at breakfast, and by lunch I was fatigued, had the chills and was coughing… it just hit me so fast.”

“Everybody can get the flu shot,” said Dr. Hust. “We recommend it starting from infancy and above. If you’re 65 plus, you should make sure you’re getting an especially designated flu shot that has a little bit better potency to provide extra protection. The flu shot usually becomes available sometime in September and the flu vaccine season really will run through February, sometimes later into the winter. Oftentimes it’s okay to wait I would say into October or November because we expect peak flu season to come December and after, and there may be a little bit of protection that wanes over time if you get it first thing in September.”

Patients who have seen a loved one experience the pain and rash of shingles often request this vaccine to avoid a similar encounter.

“The shingles vaccine can help prevent shingles, but what it’s actually really good at is decreasing the risk for what we call post-herpetic neuralgia — or the pain that comes after getting shingles.”

Give Episode 23 of the Healthy Matters Podcast a shot. Talking with Dr. Hust definitely boosted my knowledge about immunizations!