Transcript of conference held at Oct 13, 2025 in room first_test@conference.miaiconvo.com Initial people present at 3:09:35 PM: Angie - Patient Nik Shilo - Doctor Transcript, started at 3:09:35 PM: ________________________________________________________________________________ <3:09:35 PM> Angie - Patient joined the conference <3:09:35 PM> Nik Shilo - Doctor joined the conference <3:09:40 PM> Nik Shilo - Doctor: hi Angie thanks for coming and seeing us today it's always nice to see you can you tell me a little bit about why you're here <3:09:46 PM> Angie - Patient: yeah I need refills on my medications <3:09:48 PM> Nik Shilo - Doctor: okay um <3:09:54 PM> Nik Shilo - Doctor: tell me how the medication is treating you <3:09:54 PM> Angie - Patient: um yeah I hate them they're awful I feel like every medication I take gives me a different side effect <3:10:05 PM> Angie - Patient: and then I come in here and tell you about them and then I get another medication for that side effect and I just I'm tired of taking them all and <3:10:06 PM> Nik Shilo - Doctor: mm-hmm so you don't feel that the medical benefits of the medications is outweighing the side effects and the convenience <3:10:13 PM> Angie - Patient: they make me have to pee all night long and then I can't sleep and <3:10:13 PM> Angie - Patient: you know <3:10:18 PM> Angie - Patient: honestly I don't feel all that different when I take them <3:10:33 PM> Angie - Patient: yeah yeah absolutely <3:10:34 PM> Nik Shilo - Doctor: yeah and she that's very common complaint that our patients have <3:10:36 PM> Angie - Patient: here <3:10:43 PM> Angie - Patient: people <3:10:44 PM> Nik Shilo - Doctor: at the same time we're trying to take care of your health and I hope you can appreciate that what can you tell me about your health how's your health been <3:10:46 PM> Angie - Patient: it <3:10:51 PM> Angie - Patient: you know <3:10:51 PM> Angie - Patient: here yeah I feel like over the past you know 20 30 years it's just like slowly gotten worse like I'm not a spring chicken like I used to be in my 30s like <3:11:04 PM> Angie - Patient: yeah <3:11:04 PM> Angie - Patient: body starts to hurt and then you know your blood pressure starts going up and then the weight creeps on and then there's diabetes and then you got to change the way you eat but it doesn't really change anything and <3:11:17 PM> Angie - Patient: I just feel like everything's gone downhill <3:11:20 PM> Angie - Patient: it's <3:11:22 PM> Nik Shilo - Doctor: Angie <3:11:24 PM> Nik Shilo - Doctor: that's <3:11:24 PM> Angie - Patient: he <3:11:25 PM> Nik Shilo - Doctor: older is no fun but we're going to try to make it as painless as possible and you know we still want you to live enriching life <3:11:25 PM> Nik Shilo - Doctor: you know <3:11:38 PM> Nik Shilo - Doctor: 60 is still the you know <3:11:40 PM> Angie - Patient: you know <3:11:40 PM> Angie - Patient: he that's yeah I mean I really love to bake unfortunately and so <3:11:42 PM> Nik Shilo - Doctor: bring chicken from most people and we want to see you get as far as you can enjoy life to the maximum <3:11:42 PM> Nik Shilo - Doctor: you <3:11:49 PM> Nik Shilo - Doctor: and food tell me tell me what are you eating these days what does that look like <3:11:59 PM> Angie - Patient: I typically have some sweet sitting around the house and <3:12:03 PM> Angie - Patient: you know my husband he's just like a meat and potatoes guy so you know we do have some kind of protein and we do have potatoes typically every night <3:12:03 PM> Angie - Patient: you know <3:12:15 PM> Angie - Patient: in a while we'll go out to eat <3:12:18 PM> Angie - Patient: I do do typically love french fries <3:12:21 PM> Angie - Patient: um <3:12:23 PM> Angie - Patient: and <3:12:23 PM> Angie - Patient: yeah I mean like we I could have salad with my meals <3:12:29 PM> Angie - Patient: and you know but we're just kind of around the house every day so it's just kind of you know whatever I've picked up at the grocery store <3:12:38 PM> Nik Shilo - Doctor: it seems like you know a little bit about you know foods that people say are better for us and some of the foods that are worse for us and I'm glad to hear that at least you know you're paying attention to what you're eating and kind of have idea of what that looks like <3:12:47 PM> Angie - Patient: different looks <3:13:01 PM> Nik Shilo - Doctor: Angie can I ask you about activity <3:13:05 PM> Nik Shilo - Doctor: you what what do you know about staying active <3:13:09 PM> Angie - Patient: yeah I know it's good for me but you know I do a lot of like cleaning around the house or gardening <3:13:17 PM> Angie - Patient: um but yeah this this summer this fall it's just been so hot I just I can't handle the heat outside and so I've just not gotten out as much this summer as I feel like I do other times of the year just it gets so hot during the day <3:13:38 PM> Angie - Patient: I've appreciated seeing the temperature come down <3:13:42 PM> Angie - Patient: but yeah I mean you know my husband and I you know when it's not so bad we love to go for a walk or a bike ride <3:13:49 PM> Angie - Patient: um when the when it's not so hot out <3:13:53 PM> Angie - Patient: here <3:13:54 PM> Nik Shilo - Doctor: yeah luckily it's starting to cool off a little bit and hopefully we get to enjoy some of that beautiful Ohio Fall here for a couple weeks <3:14:00 PM> Angie - Patient: particularly <3:14:04 PM> Nik Shilo - Doctor: how often do you think you're you're breaking a sweat every week <3:14:08 PM> Nik Shilo - Doctor: maybe like part of me 30 minutes of exercise to get your heart beating how often do you think that's happening <3:14:10 PM> Angie - Patient: here <3:14:17 PM> Nik Shilo - Doctor: how about in a month <3:14:17 PM> Angie - Patient: yeah I would say that's not happening very much at all <3:14:24 PM> Nik Shilo - Doctor: okay on the bike's baby <3:14:25 PM> Angie - Patient: I would say maybe a couple times a month <3:14:29 PM> Angie - Patient: okay <3:14:31 PM> Angie - Patient: um yeah like definitely when it cools down like um <3:14:36 PM> Angie - Patient: you know this summer we didn't get out there very often but now that it is cooler but yeah <3:14:44 PM> Angie - Patient: by the end of the bike ride will be breaking a sweat um <3:14:49 PM> Angie - Patient: yeah so maybe not as much in the past but I could see that happening more in the next couple weeks <3:14:49 PM> Nik Shilo - Doctor: okay <3:14:52 PM> Nik Shilo - Doctor: that's wonderful I'm glad to hear that you're thinking about adding some more of that exercise to your routine from our perspective from my perspective the medical literature really supports this idea of kind of a lifestyle modification as a way to help all those kind of health concerns that you were talking about the way diabetes the heart kind of that generalized feeling of feeling awful and also the medications that you don't like the more we can optimize that that lifestyle component <3:15:19 PM> Angie - Patient: so <3:15:24 PM> Angie - Patient: here <3:15:28 PM> Angie - Patient: from 15 to <3:15:34 PM> Angie - Patient: particularly <3:15:36 PM> Nik Shilo - Doctor: less Reliant we are on these medications that make you feel so awful <3:15:36 PM> Angie - Patient: it's not just <3:15:43 PM> Nik Shilo - Doctor: what do you think about <3:15:47 PM> Nik Shilo - Doctor: really focusing on that lifestyle component of your health <3:15:52 PM> Nik Shilo - Doctor: I think those are wonderful ideas how motivated are you to you know introduce those exercises to get that treadmill on a scale of zero being <3:15:55 PM> Angie - Patient: yeah I could <3:16:02 PM> Angie - Patient: you know a few years ago when I got diagnosed with diabetes I <3:16:08 PM> Angie - Patient: and I had went to that diabetes education lady that you all sent me to you know I did make sure that I was eating different than my husband <3:16:17 PM> Angie - Patient: um and you know when I went into the office every day I made sure to kind of like pack those things along with me that didn't raise my blood sugar <3:16:25 PM> Angie - Patient: and I actually thought a lot better and it just feels like over the years I've maybe let that go a little bit <3:16:31 PM> Angie - Patient: and I think that's you know why I've gotten to the point where I can't really tolerate the heat to go outside but maybe there's some activity that I could do inside or get a treadmill or something that I could do at home <3:16:43 PM> Angie - Patient: the computer <3:16:49 PM> Angie - Patient: it <3:16:52 PM> Angie - Patient: some really <3:16:56 PM> Nik Shilo - Doctor: it's next year's problem and 10 being we're going to go to the store this afternoon <3:16:58 PM> Angie - Patient: appreciate I mean I think yeah I don't think I'm gonna go out today and buy a treadmill but I definitely think we could get our bikes out and go on a bike ride and I I think two maybe I could think about swapping some of the things out that we eat for some healthier options that I I know used to be better for me and actually that I kind of preferred a little better <3:17:01 PM> Nik Shilo - Doctor: what do you think about <3:17:04 PM> Nik Shilo - Doctor: so is it safe to say that <3:17:23 PM> Angie - Patient: it's very good yeah yeah I will definitely go for a bike ride this afternoon it's supposed to be beautiful day but <3:17:28 PM> Nik Shilo - Doctor: you're like a seven maybe even an eight on your motivation to change that food and go out this afternoon and get that heart beating <3:17:38 PM> Nik Shilo - Doctor: mm-hmm <3:17:46 PM> Angie - Patient: I I can definitely look at making some of those changes so I would say I'm a 10 I want I want to make some of these changes because I certainly don't like all this medication I'm on <3:17:57 PM> Nik Shilo - Doctor: um well I attend is very impressive and I'm glad that you're committed to you know going out and <3:18:04 PM> Angie - Patient: here <3:18:05 PM> Nik Shilo - Doctor: this wonderful day we have today <3:18:08 PM> Nik Shilo - Doctor: why not <3:18:08 PM> Nik Shilo - Doctor: why not lower <3:18:09 PM> Angie - Patient: here <3:18:12 PM> Nik Shilo - Doctor: the 10 <3:18:12 PM> Nik Shilo - Doctor: is there <3:18:14 PM> Nik Shilo - Doctor: think you're going to miss about having to go bike riding and cut out those french fries and other fatty foods <3:18:21 PM> Angie - Patient: well I think I'll miss the pumpkin muffins the most but maybe I could find some healthier swaps for those <3:18:22 PM> Nik Shilo - Doctor: that's a great idea <3:18:29 PM> Angie - Patient: and it's not be here okay um <3:18:32 PM> Nik Shilo - Doctor: yeah ________________________________________________________________________________ End of transcript at Oct 13, 2025, 3:18:35 PM