Transcript of conference held at Nov 18, 2025 in room first_test@conference.miaiconvo.com Initial people present at 8:24:26 PM: Angie Maneesh - Patient Makul Sharma - Doctor Transcript, started at 8:24:26 PM: ________________________________________________________________________________ <8:24:26 PM> Maneesh - Patient joined the conference <8:24:26 PM> Angie joined the conference <8:24:26 PM> Makul Sharma - Doctor joined the conference <8:24:27 PM> Maneesh - Patient: it's pretty good not much to complain <8:24:30 PM> Makul Sharma - Doctor: hey Manish how are you doing today <8:24:35 PM> Makul Sharma - Doctor: country yeah um nice to or before we you know that's nice to hear about that from you can you tell me or tell me why you're in the hospital what brings you to the hospital today <8:24:38 PM> Maneesh - Patient: well I had an episode where I just couldn't breathe as well and every time I try to go up stairs to my room I am out of breath before I can even get halfway up the stairs and <8:25:02 PM> Makul Sharma - Doctor: the <8:25:04 PM> Maneesh - Patient: times I just feel like I'm choking on water when I'm sleeping and it's just it's just been a lot going on so I you know my wife was just like you know what this is it we got to go to the hospital <8:25:14 PM> Makul Sharma - Doctor: here yeah and that sounds like in and I appreciate you for sharing that how how long has this been going on for <8:25:16 PM> Maneesh - Patient: it's been gone on for you know it's initially it was not that bad about a year ago and I'd say over the last year it's just kind of gradually gotten worse and worse <8:25:35 PM> Makul Sharma - Doctor: gotcha okay so in the past you said this has been going on for the past year prior to you coming in today have you seen anyone for these complaints that you've been having <8:25:36 PM> Maneesh - Patient: yeah I've seen my doctor and like a heart doctor as well and you know they're fine <8:25:51 PM> Makul Sharma - Doctor: here okay yeah what what do you remember or what what did they discuss with you about what has been going on with you <8:25:54 PM> Maneesh - Patient: they just said you know my heart my heart's not doing too good and you know I know I'm getting older too it's just part of aging so it is what it is and you know sometimes I'm just like you know nature will run its course and I'm here during the time I've got doing the best I can with my life and <8:26:24 PM> Makul Sharma - Doctor: here yeah did they start you on any medications that you can remember <8:26:25 PM> Maneesh - Patient: you know that's that's all I can ask for <8:26:28 PM> Maneesh - Patient: yeah they they did start me on certain medications <8:26:39 PM> Maneesh - Patient: they all have funky names I don't really remember <8:26:40 PM> Makul Sharma - Doctor: do you remember what those names are by <8:26:45 PM> Makul Sharma - Doctor: you know that's okay what have you been take or when was the last time you took those meds medications <8:26:45 PM> Maneesh - Patient: mmm oh gosh <8:26:54 PM> Makul Sharma - Doctor: it's been months okay prior to you coming into today has there or what what new stressors or changes have been going on in your life that's <8:26:54 PM> Maneesh - Patient: it's been months <8:26:57 PM> Maneesh - Patient: I don't know part of me is just like there's are so many chemicals I'm putting in my body and I was just I just kind of wanted to let my body be natural and I heard that the body can heal itself and that's really all I wanted to that's kind of what I'm pursuing <8:27:09 PM> Makul Sharma - Doctor: caused you to stop taking your meds <8:27:17 PM> Makul Sharma - Doctor: okay so there's this feeling of or there's this understanding from from your perspective of I don't really know what's in these medications and I don't want to put something in my body that I don't know and how it's going to affect my body <8:27:30 PM> Maneesh - Patient: it's kind of yeah <8:27:46 PM> Makul Sharma - Doctor: yeah and when you hear that it sounds like that's a very disturbing thought to you and that's something you don't want to go through <8:27:47 PM> Maneesh - Patient: I mean I yeah I just don't want to put too many unknown chemicals into my body <8:28:02 PM> Makul Sharma - Doctor: okay and you mentioned that these were chemicals what you know aside from them being chemicals which they are what else do you know about these medications <8:28:03 PM> Maneesh - Patient: I just know that that's what the heart doctor and my you know my primary care doctor kind of you know asked me about each time <8:28:21 PM> Makul Sharma - Doctor: gotcha um <8:28:21 PM> Makul Sharma - Doctor: if you <8:28:22 PM> Maneesh - Patient: sure <8:28:24 PM> Makul Sharma - Doctor: if if it's okay with you I can provide you some a little bit of information about what about why they started you on those on those medications if that is something you would like to hear now <8:28:37 PM> Makul Sharma - Doctor: yeah so some of those medications that they put you on those are called what we call gdm tier guideline directed medical therapies and they put you on those medications because it sounds like what you're experiencing is heart failure where your heart can't necessarily pump blood as well as it would like to or the walls of your heart aren't squeezing as hard and so because of that blood kind of backs up you start to feel shorter breath as you were describing you feel short of breath when you're lying down and that's a big concern because if you're heart can't pump blood then that's issues with blood going towards your brain and other parts of your body that can cause problems and so we put you on those medications to kind of help restore how well your heart kind of squeezes like I'm doing right there to help restore that flow back to your heart <8:28:38 PM> Maneesh - Patient: okay <8:29:28 PM> Makul Sharma - Doctor: after hearing that what's where what is your understanding of how of how these meds kind of help with your condition <8:29:29 PM> Maneesh - Patient: I suppose you know the medicines play their part in kind of helping what you said you know kind of help prevent <8:29:29 PM> Maneesh - Patient: what <8:29:42 PM> Makul Sharma - Doctor: yeah so we have these meds to help kind of prevent you you know to kind of prevent from what's happening today but also on the other hand you kind of you studied earlier you wanted nature to kind of run its course <8:29:47 PM> Maneesh - Patient: just said might be happening right now <8:29:49 PM> Maneesh - Patient: mm-hmm <8:30:01 PM> Makul Sharma - Doctor: do we see how those could do or from your perspective <8:30:07 PM> Makul Sharma - Doctor: would these two <8:30:10 PM> Maneesh - Patient: I mean my concern is that the body can heal itself so why not just let the body do it instead of trying to play God <8:30:10 PM> Makul Sharma - Doctor: thoughts kind of <8:30:10 PM> Makul Sharma - Doctor: coming <8:30:12 PM> Makul Sharma - Doctor: conflict with each other <8:30:20 PM> Makul Sharma - Doctor: hmm okay trying to play God <8:30:25 PM> Maneesh - Patient: yeah exactly you know when when we try to manipulate and kind of put all these things when the body you know it kind of knows what to do <8:30:40 PM> Maneesh - Patient: I just <8:30:41 PM> Maneesh - Patient: I don't know that doesn't speak to me the same way <8:30:44 PM> Makul Sharma - Doctor: and if from what I'm hearing there's this fear about you know putting these chemicals again that are already kind of you don't know what they're going to do but you also have this idea of like the body kind of knows what's best <8:30:45 PM> Maneesh - Patient: mm-hmm exactly <8:30:57 PM> Makul Sharma - Doctor: what what about the possibility of the body knowing best but also adding kind of like a dart to like an engine where we combine the two and they in those two can work in conjunction <8:30:59 PM> Maneesh - Patient: well I haven't really thought about it that way <8:31:10 PM> Makul Sharma - Doctor: okay after hearing about it what's what what's your thoughts about that how or yeah what are your thoughts about that <8:31:15 PM> Maneesh - Patient: I mean <8:31:26 PM> Maneesh - Patient: kickstarting the the heart to do what it's got to do and then letting nature run its course or letting my body <8:31:33 PM> Makul Sharma - Doctor: yeah <8:31:36 PM> Maneesh - Patient: do what it does <8:31:38 PM> Maneesh - Patient: maybe that's the route I could go that's an option <8:31:41 PM> Makul Sharma - Doctor: sounds like you it sounds like you're open to it <8:31:44 PM> Maneesh - Patient: yeah I mean I'm not I don't want to say I'm against what my doctors are saying <8:31:48 PM> Makul Sharma - Doctor: hear you with that on a scale of one to ten one being no or 10 being absolutely where would you say you are on that scale of you know letting of combining those two possibilities like we just talked about <8:31:52 PM> Maneesh - Patient: maybe seven <8:32:05 PM> Makul Sharma - Doctor: okay and why a seven in let's say not a five or why a 7 and not a 5 <8:32:08 PM> Maneesh - Patient: I'm <8:32:15 PM> Maneesh - Patient: because I do want to get better I do I don't want to be getting you know <8:32:15 PM> Maneesh - Patient: feeling like <8:32:21 PM> Maneesh - Patient: I'm joking when I'm trying to sleep or I want to be able to go up the stairs to my room without needing to take a break every five seconds <8:32:24 PM> Makul Sharma - Doctor: yeah it sounds like being Physically Active for you and maintaining your own health for your own sense of well-being is really important to you <8:32:31 PM> Maneesh - Patient: yeah I'd say that's correct <8:32:40 PM> Makul Sharma - Doctor: yeah I'm curious do you have any grandchildren or children in the area who live near you <8:32:43 PM> Maneesh - Patient: yeah I do I have three of them <8:32:50 PM> Makul Sharma - Doctor: gotcha and it sounds like if I'm you know kind of connecting those two being there for your grandkids and being active for them is something that plays onto your mind as well <8:32:52 PM> Maneesh - Patient: yeah I'd say that's correct <8:33:02 PM> Makul Sharma - Doctor: gotcha so you know kind of do you do we see how or let me backtrack so if we were to what would it look like if you were to you know kind of with what we talked about combine those two possibilities we talked about such that you take these meds for your condition well what do you think that would look like after we got you out of the hospital <8:33:04 PM> Maneesh - Patient: oh maybe I might be here longer for my grandkids <8:33:36 PM> Maneesh - Patient: that's one option <8:33:36 PM> Makul Sharma - Doctor: and hearing that how does that make you feel <8:33:39 PM> Maneesh - Patient: well I feel like maybe <8:33:46 PM> Maneesh - Patient: and I do want to be here I do want to be around <8:33:50 PM> Maneesh - Patient: my grandkids so that's definitely a plus <8:33:53 PM> Maneesh - Patient: maybe an eighth <8:33:53 PM> Makul Sharma - Doctor: yeah and it sounds like f and it sounds like or that's a very important thing for you is to be there for your grandkids <8:34:03 PM> Makul Sharma - Doctor: are we where do you think you are in that scale again kind of with everything that we kind of talked about just now <8:34:10 PM> Makul Sharma - Doctor: maybe an eight so it sounds like we've gone up a little bit <8:34:13 PM> Maneesh - Patient: here <8:34:15 PM> Makul Sharma - Doctor: okay <8:34:16 PM> Maneesh - Patient: yeah <8:34:16 PM> Maneesh - Patient: I <8:34:17 PM> Makul Sharma - Doctor: um and I think <8:34:18 PM> Makul Sharma - Doctor: your reasons for you know you you stated very clearly like you want to be still Physically Active maintain your sense of well-being but also be there for your grandkids and your kids is really important and you started to realize that oh maybe taking these medications along with letting the body kind of work its own course can help me with preventing me from coming in from the hospital <8:34:44 PM> Angie: all right McCullough I'm gonna stop you hang on one second <8:34:45 PM> Maneesh - Patient: agree <8:34:50 PM> Makul Sharma - Doctor: hi ________________________________________________________________________________ End of transcript at Nov 18, 2025, 8:34:53 PM