Hello everyone, my name is Heather Pemberton and I'm one of the Chief Cardiology Fellows here at Texas Heart Institute and I'll be talking to you today about pregnancy and cardiovascular disease. And I just want to preface this talk by letting everyone know that pregnancy is generally very well tolerated and women soar throughout pregnancy and the hard part starts after the baby is actually born. But for those patients with pre-existing cardiac or aortic disease, we just want you to know a little bit about your risk, ensure that you have appropriate follow-up and know that you have a team behind you throughout your entire pregnancy. So let's get started. So just some background information about cardiovascular disease and pregnancy. So it is increasing in the western world affecting about one to four percent of pregnancies in the U.S. And this is mainly due to two main causes. So one, we're having babies later in life so we have to advance in maternal age. This gives us time to accumulate some of those risk factors like diabetes, hypertension and obesity. And two, many women of childbearing age have congenital heart disease and this actually accounts for about 80 percent of all pregnancies in women with known heart condition. So these patients have received operative care earlier in life and they're making it to childbearing ages and so they have some complications with pregnancy later in life. And in developed nations, maternal heart disease is the leading cause of death during pregnancy. So if you look to the graphs to your right, this looks at the deaths during pregnancy in mothers. And you can see here the red arrow highlights that cardiovascular disease is the leading cause of maternal death in the western world. So in order to understand what can go wrong in pregnancy, we kind of have to understand the physiologic adaptation to the pregnant state. So there are several hemodynamic changes in pregnancy. So pregnancy is a high output cardiovascular state that is associated with many changes including decreased systemic vascular resistance or how much your blood vessels dilate. Your blood pressure stays relatively the same although some patients with high blood pressure prior to pregnancy actually experience normal pressures during pregnancies because those blood vessels dilate. We also have expanded blood volume, increased heart rate, significant increase in your cardiac output or how much blood the heart is pumping per minute. And these changes all allow for optimal growth and development of the fetus and protect the mother from risk of delivery. There are also some major changes in the blood volume and the coagulation cascade or your clotting cascade. So there is expansion of the plasma volume and an increase in red cell mass that begins around the fourth week of gestation and peaks around 28 weeks or 34 weeks. The plasma volume or the amount of fluid in those blood in the blood vessels increases more than your red cell mass and this leads to a relative anemia of pregnancy. So it is actually normal to be anemic during pregnancy. The total intravascular volume actually increases by about 50% above non-pregnant values. There are also many changes in the coagulation cascade in pregnancy and I put this here just for your reference but the big picture is that the clotting factors or the things that promote clotting increase and the things that block clot from forming actually decrease and this leads to a pro clotting or a hyper coagulable state. So how do we risk do risk estimation for pregnancy and what is the importance of counseling? So all women with known cardiac or aortic disease who wish to become pregnant require timely pre-pregnancy counseling. This is a multi-disciplinary management plan that should be constructed and discussed with you the patient. Unhealthy habits such as smoking, alcohol intake, diet and exercise should be addressed as these directly impact maternal and fetal outcomes. So the risk of maternal cardiovascular complications depends on many things and this is a very busy slide but I'll break it down for you. So it really depends on the type of cardiovascular disease present, how the ventricle looks, how the valves look, how symptomatic the patient is if there's a presence of cyanosis or low oxygen saturation. Is there high blood pressure in those pulmonary arteries and then other comorbid conditions such as hypertension or diabetes? There's several risk calculators that we use to help determine what your risk is during pregnancy. Probably the most common ones that are used are CarPreg2, Zahara and the gold standard modified World Health Organization classification and that's the one that's probably most comprehensive and the one that we utilize the very most. So just a background about CarPreg2, so this was a study that prospectively enrolled 1,900 pregnancies with known heart disease and determined their outcomes during pregnancy. A multivariate analysis was performed to identify predictors of cardiac complications and these were incorporated into a risk index. There were 10 predictors in this study that they found predicted maternal cardiac complications. Five general predictors, which I have listed here. Four lesion specific predictors such as mechanical valves, aortic disease, pulmonary hypertension, the presence of coronary artery disease or blockages in the arteries prior to pregnancy and then one delivery of care predictor, which essentially was did we detect them early in pregnancy or later in pregnancy and later was worse. And then you added up this score and then you can calculate your risk of having a maternal cardiac event. Zahara was very similar to the CarPreg2 score. It just looked at patients with congenital heart disease and then again developed a risk classification and stratified the patients based on their risk score. The Modified World Health Organization classification is the one that we utilize most often and it's probably the most comprehensive. So I'm going to go through this for you kind of ad nauseam but it provides you a lot of information and I think it's very useful. So the Modified WHO Group 1 or your low risk group, these are the disease states that are associated with it but it's really just simple congenital lesions that have been repaired or mitral valve prolapse. These patients have no increased risk of maternal morbidity or mortality. The maternal cardiac event rate is only about two to five percent, requires infrequent follow-ups about one to two times during pregnancy and these patients can deliver at the local hospital. And when I talk about maternal cardiac event rates, this is what I'm talking about. So it's either death due to heart disease, clinically significant heart failure, vascular events such as a stroke or a heart attack, the need for an urgent or invasive cardiovascular intervention during pregnancy, symptomatic arrhythmia, requiring treatment, thromboembolic events such as a clot, systemic embolism, valve thrombosis, infection of your heart valves, or worsening of your symptoms. So that's what I'm referring to when I'm talking about maternal cardiac events. So let's move on to your WHO class 2 or your low to moderate risk patients. So the disease states and these are several but they include unoperated atrial ventricular septal defects, super ventricular arrhythmias, among others. There's a small increase in maternal mortality and a moderate increased risk of morbidity. Maternal cardiac event rate is about five to ten percent. This requires a little bit more frequent follow-up about one times per trimester. But these patients can still safely deliver at a local hospital. Now we're moving on to your moderate risk patients. So again, there's many disease states associated with this and I just left that there for your reference. But these patients have an intermediate increased risk of maternal mortality and a moderate to severe increased risk and morbidity. The maternal cardiac event rate for these patients is about 10 to 20%. These patients need frequent follow-up and many require hospitalization at specialized centered for delivery. Now we're moving on to your high risk patients. So again, several disease states but I'll point out a couple. So mechanical valves fall in this category. Moderate mitral stenosis falls in this category. Severe asymptomatic aortic stenosis and your peripartum cardiomyopathies or heart failure that develops during pregnancy without any residual impairment falls into this category. There's significantly increased risk of maternal mortality and severe increased risk of morbidity. These patients have a high cardiac event rate of 19 to 27%. They need very frequent follow-up and again, they need delivery at a specialized center for pregnancy and cardiac disease. And lastly, your extremely high risk patients. Again, many disease states, I'll point out a couple. Severe mitral stenosis, your severe symptomatic aortic stenosis. These are your pulmonary arterial hypertension patients and then anyone with really bad heart failure fall into this class. These patients are at extremely high risk of maternal mortality and severe morbidity during pregnancy. The cardiac event rate is 40 to 100%. Unfortunately, in these group of patients, pregnancy is contraindicated. And if pregnancy occurs, termination should be discussed. They require, if they choose to become pregnant, they require very, very, very close follow-up. And delivery must occur at an expert center for pregnancy and cardiovascular disease. Now that we've kind of gone over the WHO criteria, I'm gonna go over some of the more common complications that we see during pregnancy and far and away, the most common one is hypertensive disorders. So this affects about 5 to 10% of pregnancies worldwide. It's a major cause of maternal fetal and neonatal morbidity and mortality, with several maternal risks, including placental abruption, stroke, and multi-organ failure. Fetal risks include intrauterine growth retardation, prematurity, and intrauterine death. So we need to pay attention to our blood pressure during pregnancy. Hypertensive disorders comprises of many different things. So pre-existing hypertension or hypertension that exists prior to pregnancy, occurs throughout pregnancy and then continues after pregnancy. Gestational hypertension, which is just hypertension or high blood pressure that occurs during pregnancy and stops once the baby is born. Pre-eclampsia, which I will go in further, and then a combination of multiple. So pre-eclampsia is gestational hypertension or high blood pressure with significant protein in your urine or hypertension with evidence of end organ dysfunction plus or minus protein in your urine. So end organ dysfunction, I mean they could have renal dysfunction or kidney dysfunction or liver dysfunction. Pre-eclampsia is usually secondary to fetal maternal vascular dysfunction. It's often associated with fetal growth restriction due to placental insufficiency, and it's a common cause of prematurity. There are several risk factors. So there are high risk features and there are moderate risk features. Some of the high risk features include hypertensive disease during or prior to pregnancy, kidney disease, autoimmune conditions, diabetes, chronic hypertension, and then I've listed some of your moderate risk features as well. The reason why we care is some high and moderate risk patients may benefit from low dose aspirin during their pregnancy. Unfortunately, the only cure for pre-eclampsia is delivery. And this is indicated when you have visual disturbances or chemostatic disorders or if you're asymptomatic and the baby is ready to be born then you would deliver at 36 weeks gestation. So how do we manage hypertension and pregnancy? Well drug therapy is indicated when the systolic blood pressure or the top number is greater than 140 and the diastolic blood pressure or the bottom number is greater than 90. The first line agents include beta blockers except the tenolil and calcium channel blockers. If the patient has severe hypertension or if that top number is greater than 160 to 180 and that bottom number is greater than 110, you need to be hospitalized and start on IV medication to bring that blood pressure down. If you have pre-eclampsia with evidence of fluid in your lung, then the first line agent is IV nitroglycerin. Now we're gonna move on to clotting disorders. So, fiendish thromboembolism is just a fancy way of saying clotting in pregnancy is actually very common. So the risk of developing a clot in pregnancy is about 40 to 50 times greater than the non-pregnant female population with a prevalence of about one in 1600 births. In fact, pulmonary embolism or a clot in the lungs is the leading cause of maternal death in the United Kingdom and is the fifth leading cause of maternal death overall. Most cases occur in the postpartum so after the baby is born. This is actually two to five times greater than the anti-partum period. So this during the pregnant period. There are multiple risk factors associated with it, including varicose veins, diabetes, obesity, advanced maternal age, hypertension, smoking, pre-eclampsia, if you need an emergency section, or if you have an inherited clotting disorder. So why does this occur? Well, pregnancy is a state where you have venous stasis and static blood means clotting blood. Endothelial injury, this is why it's very high in the postpartum period because you damage those cells when you have the baby and endothelial injury encourages clotting. And then you have changes in the body that actually promote clotting. So these three things combined make it so that your risk of developing a clot in pregnancy is much greater. So how do we treat these patients? Low molecular weight heparin is the treatment of choice. This is preferred in stable patients because it's easy to use, effective, and has a favorable safety profile, especially for the baby. You avoid these in patients with underlying kidney disease and you stop at it at least 24 hours prior to delivery to prevent further bleeding. Unfractionated heparin is a form of IV blood thinner. We use these typically in patients who are unstable or have changes in their blood pressure that we're worried they may decompensate very quickly, or in those who are at increased risk of hemorrhage. This is because it has a shorter half life and we have a medication that can reverse it if needed. This medication, because it washes out of your system is much quicker, only needs to be stopped four to six hours prior to delivery. We avoid some of those direct oral anti-coagulants such as apixaban and rivaroxaban in pregnancy and we avoid fondoparanox. Warfarin is generally avoided in this condition during the first trimester because it can have adverse effects for the baby. Systemic or catheter-directed clot buster or thrombolysis is usually not used unless the patient is very, very unstable and we're afraid that if we do not intervene immediately that the patient may pass. Real quickly about valvular disease. So in general, stenotic or narrow lesions are not as well tolerated as leaky or regurgitant lesions during pregnancy. The highest risk lesions include moderate to severe narrowing of the mitral valve, severe aortic valve narrowing, mechanical valves which I'll go into a little bit further, or if you have a bicuspid aortic valve with associated dilation of your aorta, that's another high-risk lesion. Just a quick word about prosthetic valves. So bioprosthetic valves are preferred over mechanical valves and young women who wish to become pregnant in the future. Maternal risk with a well-functioning bioprosthetic valve or a tissue valve is very low and they tolerate pregnancy very well. This is in contrast to mechanical valves. So mechanical valves are very high risk during pregnancy and this is mainly driven by the need for anti-coagulation. In fact, the chance of an event free pregnancy is only about 58% compared to 78% with a bioprosthetic valve. So mechanical valves pose a very high risk during pregnancy. So why does this happen? So again, pregnancy is a hypercoagulable state that results in increased risk of clotting off that valve or what we call valve thrombosis. There's a lower risk of valve thrombosis or clotting off that valve among patients who are on warfarin. And it's higher among those on low molecular weight heparin. Low molecular weight heparin is something that needs to be diligently monitored during pregnancy because the amount you need changes as your body changes with pregnancy. So if someone is on low molecular weight heparin, they need very, very close monitoring of their levels. No matter what, all anti-coagulation carries an increased risk of hemorrhagic complications and miscarriages. This is higher risk among warfarin. So warfarin is actually better for the valve but worse for the baby. And low molecular weight heparin is worse for the valve but better for the baby. So higher risk of miscarriage on warfarin is really dose related. So low dose or less than five milligrams is associated with a 13 to 19% risk of miscarriage versus high doses which is over a 30% risk of miscarriage. Lower risk of miscarriage occurs with low molecular weight heparin ranging from about 9 to 12%. The real risk with warfarin during the first trimester is it is associated with embryopathies or birth defects and or fetopathies or fetal death in a dose dependent manner. So low dose is actually pretty low risk. So your low dose is associated with a 0.45 or 0.9 risk of birth defects and about 0.7 to 2% risk of photopathy. Higher doses have a prohibitive risk of greater than 10% of both of these conditions. Low molecular weight heparin and heparin actually do not cross the placenta and are not associated with embryopathies. There's rare photopathies or loss of baby reported with heparin but not with low molecular weight heparin. So this is the schema that we use to determine how do we manage anticoagulation for these mechanical valves in pregnancy and it boils down to if during the first trimester you're on low dose heparin meaning less than five milligrams or five milligrams daily then you stay on that warfarin throughout pregnancy until right before delivery when you switch over to unfractionated heparin. If however you're one of those patients who are on higher dose of warfarin so over five milligrams then the goal is to switch over to low molecular weight heparin during the first trimester and then switch back to warfarin during the second and third trimesters. Warfarin is safer during the second and third trimesters because organogenesis or the development of the baby's organs is already complete so it's much lower risk to the baby at that time. Anytime you're switching between anticoagulation regimens it needs to be done in the hospital so we can make sure you're therapeutic before you leave. Now I know I covered a lot so let's just go over some major take home points. So maternal cardiovascular disease is the leading cause of death during pregnancy in the western world and women with known cardiovascular disease preconception counseling and close follow-up during pregnancy is needed. The hemodynamic changes that occur with gestation increase the risk of clotting and make certain valvular conditions worse so like your mitral stenosis and your aortic stenosis. Proper blood pressure control is very important for both the health of the mother and the fetus. Warfarin needs to be carefully monitored and therapy must be tailored to the individual and their underlying condition. Thank you so much.


We are back on the Falcons audible presented by AT&T. We've got smiles here. DJ's ready. He's flexing Dave's punchin I'm our Cineo hauling. Okay. I know for the young people that are watching you have no idea who I'm talking about But it's okay. You've got this thing on your computer It's called Google put it in Google everybody, okay, he's the Dave Archer DJ Shockley Derek Rackley Here is the three that are in charge of this deal and we are going to talk about It seems like an eternity ago that the Atlanta Falcons played Carolina Panthers in Charlotte Dave. Do you remember that like I do? Yeah, I was I was there for it. Yeah So we're gonna talk about that game just a little bit, right? We're gonna give you our takes on what happened We'll talk about a player or a position group that through this point in the season that you know what? We've been pretty impressed with they're actually doing a pretty good job And then we will fast forward. We will talk about the Chicago Bears next opponent on the schedule for the Atlanta Falcons But first Dave, let's talk a little bit about Carolina. Let's go back to Charlotte Crappy conditions. No good rain off and on the entire game Course Atlanta comes up short.  Where did things go wrong and remember Dave? We're on a limited time here Where do you think kind of went wrong the only thing it the only thing was worse than maybe the weather was the way we played Yeah, and I think that that everybody saw that You got a block and tackle in this game as it turns out and we didn't do any of that in the game Let's let's be real Couldn't handle Derek Brown could not handle anitis in the middle that created a problem for your quarterback Now your quarterbacks run around Quarterback made some bad decisions with the football put it in harm's way, which we can't do The one thing it does fall in the quarterback One of the thing one of the many things that falls on the quarterback is your ability to minimize damage. So Yeah, things weren't going well. We weren't running with a lot of effectiveness. The quarterback was under siege Now I got to take care of the ball. I can't throw the ball the other team So that was the the last part of it that didn't work out offensively The other side of the football had a tough time of the run game This is it they gutted you in the run game and it wasn't perimeter run game It was right at you. Yep, and you could not stop the interior run game. There's some reasons for that That are fixable. I think But that was a problem as well And then some tackling issues in the back end I thought created some maybe some of the the couple plays they got out where they got explosive And they weren't overly explosive offensively either, right, but they had a couple plays where tackling was an issue Yeah, but they kind of you know again gave Atlanta a taste of their own medicine by pounding the football And and that's why so many people myself included even though we seem like we're guys in this generation of Quarterbacks chucking the ball through the air if you can run the rock if you can dominate the line of scrimmage Good things are gonna happen And that's what we've got a chance to see in this game I mean Atlanta has not been able to solve this foreman guy for Carolina in two games Like he's kind of just marched right up and down and Dave made a good point I don't want to sit here and single out one play but you know the one where Mario to scrambles and then he's going down to the ground and he and he just chucks the ball in Granted it gets replayed right and he's down. Yeah, but you're but but you're kind of you sitting there like Like why we do that? Yeah, right? Like those are some of the decision-making things that it's like if you don't feel like you're gonna get out and throw The ball about well shock talk about that because from the time we start learning to take snaps There's a ball security thing that comes into mind What what are some of the things that you remember hearing pounded in your head about taking there the ball? Well, the number one thing I was always taught was don't turn a bad play into a catastrophe Yeah, so basically like ours just mentioned the play is already dead pretty much and nothing's really there And this was I thought was the first game that I thought our quarterback tried to force the issue at times I think there were you know, he wanted to make the play so bad And I don't fault him for that, but I just you know I wanted him like arching you like you just said to make better decisions when it's just not there Sometimes you got to just pun it sometimes you just got to throw it away as bad as that feels as bad as you may just had Two three and outs. They just went down a score. You can't make it worse And I thought a couple times in his ballgame. He had ample opportunities just to chuck it in the third row Yeah, or just eat it and the decision to try to force the football and make something happen And I can understand it. I'll be honest. I've been there before I've been a guy who hasn't played a lot and I know we're you know Like all eight nine games in a season and he's played a bunch of football But it still is a guy who you know is trying to prove Not just to the fouls, but to the rest of the league that he belongs as a starter and he wants to make plays So I totally understand I totally get it just in some of those instances the idea of taking care of the football and throwing it away is a lot better than Trying to throw it from your back and you can't see the defense and that's that's a tough thing that he has to kind of get over I think in the last couple games and let's let's let's be real about this too One of the reasons he's playing is because his veteran ability to understands the game. He's been in the game for a while So with experience a shock in our talk about that we're young players and we played get early to play I got to play early my career. I made some mistakes like that, but When you're struggling offensively as a coordinator, you got to be able to trust the dude It's got the ball in his hands every snap whether you hand it off or throw it to somebody you got it every snap So I got a trust To a certain extent I've called a play and it might not be the best play in the world But now I'm I'm turning over the trust that you're gonna take care of the ball for me And this was as shock said was the first time I think this season now There's been some mistakes balls gotten out though an interception or whatever, but not to the degree of that So that's something he's gonna Marcus is gonna have to go back and check his whole card He's gonna look at his tape. He told me right after the game. I did not play well. Those are right out of his mouth I did not play well. Yep, you can bet he'll be a better player this weekend because that's just who he is So it's so but you're our trusting as a play caller that okay. Here we go. Here's the team Here's the ball. Yeah, you take care of it for me if this thing gets jacked up a little bit I need you to I need to trust you you're gonna get rid of it in the right way You talked about experience and that's the reason why he's likely the starting quarterback as it stands right now and Some of the decisions you would think maybe fall on a guy. That's a rookie, right? So there's been this conversation and I know you kind of made a joke about it I want you guys to talk about this as quarterbacks because the Questions and I'm not trying to create a controversy here But the questions about if and when is it Desmond Ritter's time to get a chance to play Do you think we're getting close to that or do you still feel like Marcus Mariota gives Atlanta the best chance to win right now? Right now. I still feel like Marcus is the guy and I feel like as much of the things that we saw that we Were not encouraged about there are tons of things that you've seen through this season That has you encouraged that has you thinking. Okay, this guy has kept us in a lot of ball games He's made a lot of plays. He's made a lot of big-time throws. We had to stand the pocket There were a couple times throughout the year where we needed a big-time play for him and he made it so I think as much as you're always looking forward to the next guy and We were talking about before we came on I've been the backup plenty of times in my career my life where this college was been NFL and You got people on the outside calling your taxi you need to be playing Be the guy and Yeah, obviously that guy's probably cuz you ain't seen him play yet So until he gets on the field and he throws another Inception or he doesn't have a bad snap of something and looking for the next guy So I understand why fans are looking forward to the shiny new toy that has been ridder Yeah, that you went out and drafted you saw some good things out of him preseason So you're like oh we could have that guy behind the thing But I believe and ultimately what we just talked about an experience factor that he brings the things that he's done this season I think Gives him the advantage right now that he still should be the guy and we gotta we gotta keep it real as bad as it feels right now And you're just coming off two straight losses You're still one game out of the division. You're still one game away from winning this division or being out in front So I still like some of the things that Marcus is done But we're talking about 70 plays on a game and there's three or four that you look at and say man I wish you did that a little bit differently. Yeah, there's so many things that never comes up in the stat sheet There's nothing there's sometimes you never hear coach talk about that. He does at the line of scrimmage We watched the game and you see him go can-can you see walking to the line of scrimmage change of play You see him the running back having big runs a lot of time That's him getting them out of a bad play into a good play But it never comes up. So it's not something that you can tangibly touch. Yeah, that makes you say alright That's the reason why that play works So there's still a lot of things that he's doing that's really productive and good for this team Dave You know sometimes the grass is greener on the other side. Not it's not always as you mentioned, right? So it's like you pull the trigger put a guy in like Desmond Ritter Maybe it goes well. Maybe it doesn't but what I do know is You mentioned that we got a block better. We got a tackle better. Yeah, we block better Maybe Marcus plays a little bit better. So but at the end of the day This is kind of what you get yourself into if you're not Patrick Mahomes Josh Allen Kyler Murray just a herb Justin Herbert like these type of things are going to come up. It comes with the territory of being a quarterback and not necessarily a a Established big-time starter. Are you in agreement? Is he still the guy that needs to stay under center? Yeah, no question No question just because all the things shocked has talked about because of all the things He's doing for the team. Remember if Desmond gets on the field and he probably will at some point during the season They'll give him a chance maybe Providing, you know, if we keep going the way we're going then there's definitely that's we're going to trend towards that direction but This thing is still in doubt.  There's this conversation about him. Is he ready to play?  Yeah, okay. Let's clarify that now Being ready to play and being able to hold control Control everything that Marcus is controlling is two different things. Yeah, you just talked about all the things He's doing so that would be a pared down scenario for him But what Marcus is if you get think about the the end of the game even everything that went on We went into two minutes and what Marcus do right down took you right down the field through a touchdown pass Okay, and that was with with some degree of protection. Yeah, okay And he even scrambled in that one went to the left and threw one back across the bird across the field Twisting and made an unbelievable throw to bird along the sideline. So you can see it. It's there. He can get it done Yeah, help him out a little bit. Give him a little bit of help and don't put him under duress completely Like we did this last weekend and you got some things and let's be the you start talking about the NFL week to week This is a completely different matchup.  No, think about all the weeks how different they've been each week He was the he was the NFC player of the week a couple of weeks ago. Yeah, okay So let's let's keep that in perspective. That's what happens was we lose perspective a little bit. Yep. All right So let's go ahead. Let's let's put a bow on that when we mentioned that was a few days ago Let's move forward because again, that's what the players and the coaches are doing. So Chicago will be coming here Little bit of a you can call it a mini by week if you will because you had to turn around so quickly last week So maybe some guys get a chance to get their feet underneath them Maybe we get a couple more guys back out on the field that have not been recently But all that aside because we can't control any of that Dave Let me let me ask you this who is Chicago right now Who who are the Atlanta Falcons playing this weekend? Where are the Bears in the scope of their season strengths weaknesses? And and where do you feel like they can attack? Well, what you're gonna see is a very similar version offensively that we play They want to run the football David Montgomery's an outstanding run of it from Iowa State No good good running back even he reminds me a lot of our guy in Tyler Algier his ability Runs with good power. He's got more juice than you think he has and he's a good receiver out of the back Well, so a multi-purpose this guy you've got a quarterback that can run Justin Fields is ripped. He's leading them in rushing. He leads the Bears in rushing He's had two back-to-back 100 yard games the last two weeks in two losses They lost to a good Miami team and a high scoring 35 32 affair and then this last weekend They just lost to the Lions 31 30 and another game in both those games He had a 60-plus yard touchdown run in the game That can't happen. You cannot allow the quarterback to run for a touchdown anywhere on the field But let alone rip one off 60 yards for you. That's part of what you're gonna have to deal with is trying to contain him Now on the other side of the football They struggled against the run in fact there they're in the bottom four or five teams in the league It's run given up about a hundred and forty five hundred fifty yards a game on the ground Atlanta's number four in the league even after last weekend or last Thursday night in rushing the football There's your area to attack you got to get back to your roots and run the football and when we throw it Let's get a block give them to give yourself an opportunity So it stopped their run game. He's averaging about 20 passes a game and about 10 runs a game And I'm talking about Justin Fields He will affect the game very similarly the way Marcus Mario to tries to affect our game and running it with the quarterback Handing it off and play-actioning DJ. I want to ask you this question back in the day when you were playing You're fleet of foot you can get outside the pocket So when you were running with the football if you wanted to try to attack a defense with your legs What gave you the most fits what slowed you down as a quarterback, right? So we can just kind of flip the table and you put yourself in Justin Fields shoes. What makes you uncomfortable? You know what? I think the number one thing that makes any quarterback uncomfortable is interior pressure Because if you have guys who are disciplined enough and that's gonna be a big thing that actually talked about is Discipline in these rush lanes whether it's the pass or run You have to be disciplined in how you rush this guy And I think interior pressure always gives any quarterback face let alone a guy who wants to move around and run because You're taught for the longest Never go backwards. You're taught never to go backwards and then try to escape from me out Unless you have to you always want to climb climb climb up in the pocket And if you climb up in the pocket and you have interior pressure, guess what that's uncomfortable You're not gonna really be to see down feel because you got a guy bearing down He's right in your face and it's hard for you to step into a throw Oh, it's hard to throw because you may hit a hand on a helmet What if it is interior pressure is the number one killer for a quarterback inside the pocket You run or throw and if you watch Justin play you watch any other quarterback who can move like that When you don't have that interior pressure There's always a little lane that you can find if you're thinking about taking off if it's not there Because most of the times the guys in this league are pretty good when they come around the edges They know how far you're gonna get they know how deep you're gonna drop So they get to a point and then they come back or they get to a point and they fall back inside But if you got interior pressure and you're pushing from the middle and then those guys on the outside do a good job of keeping Containing they have like a cage around it. It's really nowhere to go so the interior pressure is gonna be big in this ballgame and You know, I mean TQ's played I thought pretty well this season I think you know great actually is it's who he is But if you can find a way to contain and keep him inside the pocket as opposed to him getting on the outside And creating that's gonna be a big part of the game as well So the guys on the edge have to play a huge role in how they rush up feel and then the guys on the inside have to always Keep eyes on it. So DJ likes interior pressure. No, I don't I don't like it I'm saying that we need the Falcons to bring Dave I want to ask you this question because I see this sometime in the college game when you have a linebacker that can run You'll start to see a lot more spy coverage with a linebacker Maybe a safety when they know they've got an athletic quarterback that's gonna run Probably would have been like a Dion Jones type role because of the way that he can run Do you think that's something that Atlanta could mix in there? Or does that put them susceptible in other areas that they could give up big place? Well, you have to mix it up D&P and I think D&P's will employ that because you've got three linebackers that can run Rashon Evans Troy Anderson and Michael Walker can all run Now can they run well enough to track this kid down? He's a they're very similar Troy Anderson ran what four four at the combine. That's what this guy ran Okay, so it's gonna be close and this is a big dude now. He's six three about 225 pounds So it's not like you know, you're dragging down a frail quarterback But you can't let him escape through the middle if you can shove him to the sidelines now that extra defender The sideline comes into play The past game is one thing when things break down their first play in the game against the Lions is zone read He runs 25 yards off the left edge for on a zone read play So when you start talking about edge players playing a huge role in this to mush rush him and keep kind of keep him In a pocket they're gonna have to be really disciplined and maybe even go back to their college days of how option football works in the zone Read because if you crash he's he's gonna get at least 15 yards on you before you're gonna touch him Yeah, so if you can keep him him then you can see where if you keep him him then against the Lions There's some indecision and where he wants to throw the football He tried to make some off balance throws that weren't very good He put the ball in harm's way a couple of times because he's trying to make off balance That you want to make him uncomfortable like shock said, but it's gonna be that whole mush rush that that front four or front seven We're gonna have to be really good this weekend Just to add one more thing to what archers talking about when they get into that zone read I think Dean's is gonna do a really good job of changing the looks of who he has to read Because when you think about his own read something think about okay I just read the end if he crashes I pull it and go well You could also use the end where he crashes and you got the linebacker to loop around or you can keep the end and Have you know the backer on the inside? You got to find ways to make it look different to him to make him be a little bit indecisive when he has it So you can do that and change up that look like I just talked about in that part of the game Then you got something to the other thing I'll add to is the defense gets Justin Fields in Chicago into third and long situations You can't go to sleep. I mean I'll remember DJ you around like third and 15 when we had Mike Vick around Like there was people on the sideline that was just like I just run it Yeah, right because you got somebody that's got the speed and elusiveness you can't think oh on third and 15 We good right because this guy can tuck it down and he can get it Whereas 99% of the NFL is probably not gonna pick it up So third down got to get off the field and part of the problem now that Chicago has is There's a dude on this side. That's just like that. Mm-hmm if it Marcus gets out of the pocket He's a problem. Okay, so they're thinking their conversations up in Chicago are very similar to our conversations down Here I say, okay. Yeah, he had a tough day this last Thursday, but let's look at the other games He's got now the pocket. He's bought time. He's found guys. He's also taken off and run with the football So they've got the same issues with there and their defense is not playing overly well They're the strength of their defense is brisk or the safety. He leads them in sacks To go on brisk or the safety from for their their rookie safety from from Penn State Is they're leading sack or with three? Wow, they've got a rookie middle linebacker that it lead the sandborn out of Out of Wisconsin that's played well. Roll corn swift never gone. Yep And so they've had to rely on some young players to make plays. What happens to young players better Have I discipline and you can get those guys going where they're not supposed to go and you take advantage of that So Chicago is up next three and seven oh and three in their division and again Don't necessarily want to judge an opponent by the record because I think you could have done the same thing with Carolina last weekend And we saw how things shook out for Atlanta on that one if you just want to look at win-loss record This episode in part brought to you by the Home Depot Everything you need for your next home improvement project is just a tap away on the Home Depot app The Home Depot app digital toolbox gives you access to how-to guides project calculators and image search So you'll know exactly what you need to pick up with the tap of the finger You can rent and reserve the right tools for the job Also browse through millions of items from top brands that you can have delivered right to your door Whatever your project find exactly what you need with the Home Depot app download the Home Depot app today I wanted to ask you guys this question We're at you know obviously well past halfway in the season and I want to ask you guys like who do you think is a Surprise player or somebody that has developed or maybe it's a unit that you felt like has been pretty solid all season long and It's it's a player or a position group that we can continue to count on as we finish out the season You know what it? There's one guy that came to mind when we started talking about this and Obviously, it's hard to be clean at this spot because it's an every single down Type of position you got to be good. Yeah, you're gonna have some mistakes here and there But one guy who I thought has kind of rose to the occasions Caleb McGeary I mean you look at a guy who came into this season. Obviously Didn't pick up his fifth year option a Lot of people thinking okay. This is his last year. He could be gone. He couldn't easily powder He could have easily said okay. Well, this team doesn't believe me, but there's been games I thought this guy's played to a level that they thought he would when they get when he got drafted So I'm I'm really encouraged by the way. He's played of course. He's had moments where you know He's been beat or you know, if he had some bad times in a game But I thought he's you know kind of rose to the occasion and said okay I'm gonna give you guys something else to think about this season with how he's played Yeah, and I think it's probably good that I go next to piggyback on that because yeah We want to sit there and pick at at the Marcus Mario to his performance last weekend And and maybe that he didn't get the blocking the protection up front but I'm gonna stay kind of in that same realm because a guy like McGeary has played well enough that the Running game has been really solid this year And we've seen a guy like Caleb Huntley take advantage of an opportunity and take his game to the next level and really Provide a boost with with his power with his physicality even he's got some burst now I mean he's a bigger back But he's still got some burst and and I I really like the rotation Because it's like you see Al Geer come off the field and he hustles off and Huntley runs These guys are very unselfish right now. They understand that this collective group is what makes them good CP being healthy Obviously helps this collective group But I feel like Huntley is taking advantage of an opportunity And he is he is really taking his game to the next level and provided an area that has been a strength all season long Dave, what's a player or position group that that is stuck out to you? Huntley's built like a fire if fire One of those ones yeah, it's this thick. I Think that it's been tough on the safeties. I think Jalen Hawkins and Richie Grant have really kind of taken their game to another level I think that you now was expected. I think you needed it to happen. They I think they've done that I mean think about what they've had to deal with though. I mean both corners are gone You've had a nickel out. I mean so they're the only constant in the game with have been the two safeties They've been asked to cover in the slot. They've been asked to blitz They've been asked to come down in the box and defend the run and the thing I like about them and they're really to me the future of what the secondary is going to be with AJ When he gets back and hopefully he might be back this week at the corner spot But their ability to kind of last time you say So So those two guys being able to fluctuate back and forth, okay I'm gonna come or come up and cover in the slot whether it's tight in back out of the backfield I'm gonna blitz but their ability to both do kind of the the back end and well as the front end their versatility To me that that really bodes well for this defense moving forward from a future standpoint as you begin to build around some guys I think the two safeties have played a pretty high level I just want to add one quick thing to that and I think it's a great point because you look at this season You watch the things that Dean piece does with his defense And if you don't have those two guys back there who can make the calls or who can get guys in position It's gonna be tough on your defense and Dean has so many different looks at his defense It's so multiple weekend and week out and if those two guys don't have it It's gonna be really tough on a coordinator trying to make those calls Yeah, and I don't want to throw a guy into the bus here, but he's not here anymore. So I'll throw him under the bus Jalen Hawkins in the guy they got beat on that deep shot. Okay. That's that's Jalen Hawkins His replacement was in the game at that time we get beat over the top by DJ more for the touchdown in the Carolina game here I don't think that happens if Hawkins is in the game. So And that's just just my just a couple of two cents worth there I just think the two safeties have played pretty solidly. Yeah What final thing I wanted to discuss sometimes we get so in everybody else we get so dialed into X's and O's results wins losses and Every once in a while you forget that like NFL players are still human beings They still have real-life situations that's going on go back to last Thursday Jake Matthews Him and his wife were expecting a baby. Yeah, and if I read it correctly, they had it scheduled for Sunday So they were playing on Thursday. They're gonna be back late Thursday night early Friday morning should be just fine on Sunday to have his baby. Well, that's not the case gets a phone call Thursday morning from his wife Apparently he had missed like 13 calls on his phone His phone rings in his hotel room and you guys know this like when the phone rings in the hotel, you never have a way Yeah, excuse me. Well, yeah, so this Jake says he's like I'm wondering why my hotel phone is ringing Picks it up his wife in to go to the hospital Has his bed has his boy has his baby comes back gets to the game in time Basically runs into the stadium with shorts and a t-shirt But an exciting moment for him and his wife But I want to ask you guys like you ever have any stuff like this happen or to teammates when you guys were playing where it was like somebody all of a sudden had to leave town because of Expecting a baby or something along those lines. They had to run back in the last second first off Let's let's say thank you to Arch for allowing Jake to use his plane That Jets good good deal.  You can't have a kid during the Work on a But the kids gotta come in the off-season you can't have to kick her in the air. That's a complete blow-up on his Fall wedding my kids were in March and April so it worked out I would like I would like to throw out a big kudos to brand and brand and Ruth who handles our Logistics on the road for us because Brandon went over time here Okay, so Jake's leaving. You don't know when Jake's coming back Okay, so now they have to get Harrison a guy They just signed and Shae for the kid out of Georgia were back in Atlanta. They had to get them to the game Okay, so he had to rent a car and have the car delivered here to it here to flowery branch Within an hour to get them driven up. They couldn't get a flight for him or anything So they drive them up there to get them to the game in case Jake can't make it back So we have enough people actually play right on the offensive line, and then of course you give an assist to the big guy Mr. Blank, he's the guy that got him back here Brandon have a car to get him there So Brandon Ruth who does an amazing job with all his travel stuff man That's great with all the things that go on with the team This was above and beyond dude metal of honor for you phenomenal effort to try to get everybody where they needed to be Jake sees his yes, he's his baby born and gets back for the game Just a correct incredible effort now the game didn't turn out that we wanted to but that was a W for brand Unbelievable you see him running in at seven o'clock with his flip-flops on I mean, it's unbelievable I've never had anything close to that in my career of anybody done something like that and maybe turn it around So I'm glad we weren't on the West Coast or something like that Didn't happen to me either But if I remember correctly I didn't have a chance to get to Finn But I almost remember one time I was getting on a plane and Brian Finner and his wife called one of the seven And we were literally walking down the jetway and he turned around and went back out And I think it was because one of his kids was was about to be born and and he ended up flying and make it to the game Then I'll text you later. I'll make sure I'm right on that one Alright, that's gonna do it guys because me and shock and arch have a flight to catch on Dave's plane here Let's do it. I don't know where we're going, but we're Vegas baby. Let's just gonna cruise The dogs the dog have qualified for the championship game against LSU dare we revisit this man's championship moment Was a monster in a game a sec player of the year Shock went off for the dogs beat LSU in the building right down here now. It's a George's dome at a time. That's okay But my guy my guy went off.  I appreciate it. I know we're gonna pay. Yeah, I'll pay. Yeah So, yes, LSU will be the SEC championship got to give DJ a little bit of love and maybe we'll revisit some of those highlights On the next couple of weeks leading up to the SEC championship All right Atlanta got Chicago Bears on the docket next Let's see if they can rebound after a couple of stumbles get back in the wind column and continue to make a run at this NFC South division that's gonna do it everybody even the Falcons audible presented by AT&T. That's arch. That's DJ I'm DRac. Those are nicknames for you today. We'll see you next time Thanks so much for watching on whatever platform you check us out on


So today is a celebration. It's my 10 year vegan anniversary. Everyone said, you know, Joey, you won't make it to 10 years. You're going to start to deteriorate. You're going to start to dissolve your body.  Well, that hasn't happened because it's a load of conspiratorial nonsense. But in today's video, I'm going to give you the absolute truth about being vegan for 10 years. And I got some tips today to make sure you don't make the same mistakes that I did when I first went vegan. There is some advice that you might not want to miss, so make sure you stay to the end. And don't forget to subscribe, leave a like if you like this content, and let's get into it. So I'm going to briefly go over my vegan story. If you've been following me for a while, you know that I was arrested with a loaded firearm when I was involved with gangs. I used to be involved with drugs as well as 10 years vegan. I'm also 10 years sober. But whilst I was on house arrest, I was overweight and I was looking for a diet to lose weight. And I come across a guy named Dan McDonald, the life regenerator who was doing all the raw foods and raw vegan kind of lifestyle. I did it for a little while, drunk a lot of green juices, lost a lot of weight, felt amazing, understood that plant foods are extremely healthy. He planted a few seeds about karma and what happens to animals and eating that suffering and how it's bad for you spiritually. And I kind of did have a belief about karma at that point. Anyways, I'm on house arrest for about 18 months. I go to prison.  I see my life from a bird's eye perspective, from a whole new point of view. I realised I didn't want to be there in prison with the other gang members who were doing long stretches. And I just saw that that was like a dead end and I started really evaluating my life. But I was also eating a lot of raw fruits and vegetables, especially when I got down to a medium security prison. I could buy my own shopping, but I was still eating chickens. I was still eating skin milk powder. I thought I needed it for protein. Now I got out of prison probably around October 2013. It was today, 10 years ago, when I was having a conversation with my mum about smoking. You shouldn't be smoking cigarettes. What are you doing, mum? And she's like, looked at me like, what about you kind of thing? Like, we've all got something about us and you've just put me through 12 years of hardship through your addiction and through your violence and for your gang behaviour and stuff like that. But when she said that, I kind of reflected and I always felt like a massive hypocrite for claiming to care about some animals whilst eating others. And I said, you know what, mum? You're absolutely right. There's a lot of things people have about them that they don't change that they know are like inconsistent. So after that conversation with my mum, the next day, literally, I went completely vegan. What was my first mistake? Well, my first mistake is I didn't even know what to eat. I knew I wanted to be a vegan.  I knew that I just wanted to make this kind of change. So the first thing I did was started looking up. I was like, well, I can't be a raw vegan. I mean, raw vegans, where do they get their protein from? So I'm like looking up raw vegan bodybuilders and they're like eating all these almonds.  I'm thinking I'm going to get protein out of it. And then I'm eating a massive watermelon afterwards. I remember I had to nearly go to hospital because, well, I actually did go to hospital because I ate all this watermelon on top of all this other food. And it like passed through my digestive tract and gave me like watermelon belly. And I was like in the emergency room like, oh my God, what's the matter with me? And it just went away. And I was like, what was that? So the first mistake I made was just smashing in too much raw food. I mean, I just my stomach wasn't used to it. It was all this fiber and water is extremely healthy. I felt really good, but I like just shocked my digestive system. And I also went on like something like a super high calorie as many calories as I possibly could eat. And I basically can eat out, eat most people I know. So that was a very bad idea for me. And I was just, I just put on like 10, 15 kilos from eating nothing but just sugar and carbohydrates and just overstuffing myself. Just stuffing myself until like I wasn't even hungry. And I was just stuffing all this food in sugar and that. And I could just literally keep eating and eating and eating. And I was eating no fat, nothing. It was just terrible. Be careful of fad diets when you go vegan. Just eat normally. I remember making a few mistakes at the start, like looking at the back of the containers and realizing, oh my God, there's dairy in there. Oh my God, there's honey in here. So like getting to know the products that were vegan took me a little while because I didn't have a bunch of vegan friends. I didn't have a bunch of vegan resources back then. I didn't know anything about the vegan animal rights community or this, that, the other. There was no veganuary back then. It was 2013. Not that I knew of anyway. So I didn't know about any of this stuff. I just come out of gang. So I was kind of finding my feet myself and doing my own research on YouTube and things like that. But after a little while, I started to find my feet. I started thinking, okay, well, just how much food do I need to, to satiate myself? And maybe I'll just eat like a normal amount of food and then maybe I'll eat more protein and things like that. And I started measuring how many calories I should be eating and, and then I just felt a lot better. I started losing weight again and I felt better and felt didn't feel as stuffed. And I just, if I want a burger or have a burger, if I want vegan ice cream, I just find some vegan ice cream. I just started eating like I normally did eat with a bit more of a focus on health than I did in my past. Then I started realizing, well, maybe my blanket has like feathers in there. Like I don't like that. So I remember just getting rid of my blanket, getting finding that my shoes still had some leather on there from when I was not vegan and just getting rid of them because I didn't want to support that or like, I didn't want to promote that. So I didn't want to wear it, especially if I'm going to sanctuaries and advocating. So I just, you know, started to clear out everything in my life slowly that wasn't vegan. And I was like learning along the way. So for me, without all these resources around, I still managed to like slowly learn and look into this stuff. And then I become an advocate for animals too. So like, I was really kind of dialed in the food thing happened straight away unless there were like some accidents along the way. But the rest of the products sort of like was like, oh, really? That's not vegan or what? They test on animals or what the this isn't vegan. Oh my God. Okay, I get rid of it all. Okay. Find vegan versions of everything. That's how I did it. Like it was more of like a step by step thing. I didn't really have the knowledge or resources or even like, I didn't really know what to look for. So luckily now there's plenty of resources around for what isn't is not vegan and, you know, how to be vegan. And I use challenge 22 for people. There's also the January. There's also a bunch of organizations who focus on helping people be vegan. And, you know, you can find so much information now. It's amazing. It's all at your fingertips. I'm going to share with you some of the best apps for you as a new vegan. And these ones we still use to this day use them all the time. Like it's really like easy for me to be vegan these days. I don't even think about it. It's not even a choice. It's like, yes, I'm vegan. I don't like go, oh, I can't be vegan here. So I'm not going to eat. No, that's never the case for me. I always use an app called happy cow. Now happy cow is great. You can find vegan restaurants near you. You can find vegan options near you anywhere in the world. It's it's one of my travel companions. It really is amazing. Definitely support happy cow use happy cow download the app. It's free and there's also an app called veg safe. It just finds if there's any additives that are made of animals or whatever stuff like that is also one called the vegan passport. So basically it will have like whatever language translated. Like let's just say you're in Cambodia and you want to tell the person at the restaurant that you're a vegan. It will explain what a vegan is to the person who's not an English speaker and whatever language it will translate it. Hey, I don't eat honey. I don't eat this. I don't eat that and then they will understand it. So then you don't have to worry about translation issues when you're overseas. You can go to this page called accidentally vegan. I think they've got a few social media pages. Reading labels becomes like second nature now. Like I suppose there are a couple of derivative things that you might not know, but there's so many things that that don't say vegan on the packet that are just just default vegan. The vegan section at the supermarket is only small, but the whole supermarket is filled with vegan friendly products that are just not labeled as vegan, but they just don't contain animal products, which is a revelation. The longer that you're vegan, you're like, oh my God, that's vegan. That's vegan. Wow.  You can find biscuits and cakes and this and that like no problems at all. With meal planning, it's simple. How did you plan your meals before? Veganize those meals. You know, for me, I eat a lot of pasta, eat a lot of beans, I eat a lot of rice and bread. I love bread. Wholemeal bread, super healthy for you. I like mock meats and some people don't like them. I think that they're absolutely fine. Some are healthier than others. But yeah, I love mock meats. Eat a lot of soy. We'll be talking about soy in a sec. Just whatever I want. I eat whatever I feel like. If it's pizza, if it's vegan cheese, if it's a cheeseburger, I eat whatever I want whenever I want. Sometimes I'm more healthy than other times. I just make sure that I'm keeping a good balance and that's it. But if you want to know what to eat, if you want the best advice for meal plans, check out what I eat in a day. YouTubers and Tik Tokers and recipe people like Bosch or like Brian Turner or you've got like cheap, lazy vegan or you've got all these people on YouTube that are specifically creating recipes for vegan food or vegan meal plans and they're everywhere. You will have no issues. Whatever you want. You want a vegan lasagna? You want a vegan this? You want a vegan, I don't know, wedding cake? Anything you can possibly conceive in any culture, there's a vegan version of it. So you'll never miss out on anything. You only miss out on violating the rights of animals, which is definitely a good thing to miss out on. There's a couple of concerns. And one that I think is something that you really, really should think about. Vitamin B12, obviously everyone should be supplementing with B12. There's a lot of fortified food. Nutritional yeast is fortified. There's a lot of fortified cereals and milks with B12. B12 is an extreme nutrient of concern. Make sure you're supplementing B12. The next one I want to talk about is one that I completely missed out. You know, I felt like so foolish for this. I'm from Australia. I've got kind of olive skin. I'm half Italian and I've always been in the sun. Australia, there's sun all the time. It's sunny place Australia, isn't it? But when I come to the UK in 2018 and I've been here for five years off and on, there is no sun in the UK. There is hardly any.  I'll spend a lot of time in the office and I did develop a vitamin D deficiency. I didn't actually know that if you're in a cloudy country. Well, I did know it, but I never really took it seriously. And yeah, developed a vitamin D deficiency from lack of sunlight. It was nothing to do with diet. There are seldom real foods with enough vitamin D in there anyway. I mean, there's some in murdered salmon or something like this, but there's fortified vegan foods with vitamin D. But really you need to be supplementing vitamin D if you're in a cloudy country. Or even if you're in a sunny country, like I went from an outdoor job, bricklaying, traffic control, like working on construction sites to an inside job editing and da-da-da-da. You know, so you're not going to get sun. Even if you're in a sunny country, if you've got an inside job, let's just say you get up at six in the morning, you go into work in the office and you get out at six p.m. And you don't get sun. So everyone should be supplementing with vitamin D3. If you don't, it can affect your bone health because vitamin D promotes calcium absorption. So your bones can become thin, brittle or misshapen. Like that's what rickets is in children. If you have vitamin D along with calcium, it can prevent osteoporosis when you're an adult. The RDA for vitamin D is 400 IUs, but I actually take 8,000 IUs. I want to show you what I take. Vitamin D3 and K2. 4,000, I take two of these. I take two. This is a vegan one because there is non-vegan D3, which is made of sheep's wool, lanolin. So make sure you get the vegan D3. You might think 8,000 IUs is too much. I don't actually think that based off of this study here. Long-term supplementation with vitamin D3 in doses ranging from 5,000 to 50,000 IUs a day appears to be safe. So I just went for 8,000 because I was already a bit deficient and I thought, you know, I'm not letting that happen again. Actually, when I started dosing with vitamin D, I started feeling heats better, could concentrate more my mood, got better. I think there's a link with immunity and stuff like, too, you've got to be really careful of this. And I honestly think this is one of the main reasons we get ex-vegans, or that's probably, it is probably one of the reasons, especially in the UK, if you start feeling crappy. I want to show you this other supplement that I use, multivitamins and minerals. So I take this for B12, but it's a multivitamin. So it just covers me for iodine. I'm not going to go through it all. There's a bunch of stuff in here. Really cool, really cool vegan tablets, vitamin minerals. It's a multivitamin and a vitamin D. That's it. I'm not going to get the vitamin D deficient ever again. I'm feeling amazing, I'm feeling focused, feeling switched on. So just be careful of it. Trust me, supplement. Use Chronometer. This app here is amazing. It will tell you your nutrition scores, your vitamins, minerals, electrolytes, calcium, iron, all of the nutrients that are in certain foods, the calories that are in certain foods, because let's face it, a lot of people, they don't eat enough calories when they go vegan because they go from eating calorie dense food to calorie dilute food when they should really be matching the calorie density. So basically different foods contain different calorie densities like lettuce will be less calorie dense than cheese, for example. So you have to be mindful of that. And I think, you know, I personally think like getting into Chronometer, it's a free app. Use it so you understand what is in certain food. And that's how I know, I know how many, how much protein is in tofu now and how much that tofu is really good for you. We're going to talk about tofu in a sec. But yeah, use Chronometer to make sure you get enough calories, get enough protein, get the nutrients down pat. You actually see, oh my God, I'm not getting enough vitamin D. Oh, that's right, I got a supplement. Like Joey said, just use it.  So yeah, really good app. Chronometer for new vegans, 100%. In my 10 years, it's been very, very helpful. Could probably live without it now. But at the start, like I really needed to understand what's in food, I needed that. And now, like, I won't run into any issues. Now, the great soy debate. If you are a vegan, new vegan, vegan for 10 years, going on vegan, I personally have the belief that you should be eating soy if you don't have an allergy.  There's a lot of myths been spread about soy and I've got a conspiracy about that. I honestly think it's the dairy industry because they know that soy could put them out of business.  Soy and milk, you know, soy is such a versatile being and it's honestly so healthy, but they're eating it for thousands of years.  No, I'm joking. So let's talk about some of the fear mongering on soy by conspiratorial loony people. I said that soy increases your estrogen because soy has a plant estrogen in it called phytoestrogen. Big problem with that because when you look at actual outcome data, just because something is in something doesn't mean it does something to your body. You have to actually like look at outcome data. Now, there's a big meta analysis and 41 studies were included in the meta analysis. And basically they found regardless of the statistical model, there are no significant effects on soy protein or isoflavone intake on any of the outcomes measured. So basically regardless of the dose and study duration, neither soy protein nor isoflavone exposure effects, total testosterone, free testosterone and whatever this is, estradiol 2 or estradiol. That's basically estrogen. All right, so there we go. Very high quality study, meta analysis of clinical studies, very high quality data, high on hierarchy of evidence, nothing to be afraid of with soy. In fact, soy is associated with many positive health outcomes. There was also this umbrella review of 114 meta analysis and systematic reviews which are like meta analysis, just like a study of studies. And soy and isoflavone consumption seems to be more beneficial than harmful for a series of health outcomes including cancer and heart disease. Isoflavone is a plant-based compounds found exclusively in beans like soy beans that mimic the action of hormone estrogen. So these isoflavones in soy that people say, oh, they've raised your estrogen, you know, phytoestrogen, all this stuff. They're actually associated with positive health outcomes including cancer and heart disease. Wow, do not fear the soy. Become a soy boy. There is a study too. Vegans have 13% higher testosterone when compared to meat eaters. And also, it's nothing manly about abusing, torturing, harming innocent animals.  Ex-vegans, look, after 10 years, I've seen so many people come and go and they're always these flaky, hippy people who lack principles, lack basic moral principles. They're always, they're always apologists as well.  These are the kinds of people who turn out to be ex-vegans. The journey has just begun. And going through the journey, and his journey had a lot to do with my journey because obviously a journey. This is just my own personal journey. Journey. This is just a journey. Well, they're easily susceptible to conspiracy theories and lack critical thought. That's been my experience.  Oh, I had a sore tummy. Oh, basically I felt like I had brain fog or this, that, the other, but provide absolutely no evidence that veganism was the cause of it.  I tried it all. I drank main urine for two years, almost every single day for two years. Or lacking proper supplementation because some people, they report, oh my God, I ate some salmon and I felt good and salmon and it's got vitamin D in there. A lot of these like natural spiritual, like yeah, no offense to anyone who's liked that out there, but I'm just saying that people who use this as a justification to murder animals deserve to be ridiculed because they're murdering animals.  Three, don't make my mistake, but I would never, never in your wildest dreams think, oh, you know what? It's probably veganism.  I should have been supplementing vitamin D. Have a blood test. There's something called the nocebo effect. It's basically the reverse of the placebo effect.  Ludicrous, pseudoscientific, personal anecdote, rabbit hole of lunacy. Nocebo effect is basically, oh man, I think that this is doing this to me. So, and it's very powerful. They have to actually account for the nocebo effect in studies and they also account for the placebo effect in studies. The placebo effect is actually so strong that, you know, they can give people a placebo drug and it can actually have an effect on them that is similar to the outcome that they're trying to study. So they have to be very careful of the placebo and the nocebo effect in research when they're doing like crossover trials and they're giving people like a placebo drug that they account for the placebo effect. That's how powerful your mind is. What these people should have actually done is gone and got a blood test. If people are going to claim, okay, I had a blood test since I've been vegan, I'm deficient in something. Then you have to have a blood test before you went vegan to compare it to. You have to have a before you went vegan and after you went vegan and say, look, since I've been vegan, this has happened. Okay, well then what is it? Well, let's B12. Okay, we'll supplement it. Okay. Oh, it's vitamin D. Okay, we'll supplement it. Oh, it's iron. Okay, we'll increase your iron rich foods or supplement it. But it's funny. They always say that there's some, oh man, I'm not getting enough iron. We'll show us your bloods. I wouldn't got my bloods done straight away. If I feel something's right up, go and got my bloods done. Okay, bang, done, sorted, finished. If you have something that doesn't feel right, go and get your bloods done. It might be vitamin D. It might be something simple. Just don't self-diagnose would be my advice. Speak to someone who knows what they're talking about and it's not Sean Baker or any of these carnivore quacks. Honestly, I believe the number one reason for people to become an ex-vegan is to disregard the plight of the animals. They start seeing animals as nothing again. They start thinking that they're more important than animals. They're so important that they get to stab them in the throat because they've got stomach issues or whatever. It's pure disregard for the rights of non-human animals. They think they're special. They might think they're godly or spiritual.  But if you maintain your respect for the animals rights, if you be careful of the nocebo effect, don't go down conspiratorial rabbit holes. Get your bloods tested. Watch dominion from back to front. Make sure you're making decisions not on personal anecdotes or cool stories but on high quality health outcome data, okay? Now, once you realize the scale of the horror that animals are going through, you realize that this movement has nothing to do with us. It's a movement of justice for them. If you make everything about you, oh my God, this, that, the other, then you're going to lose sight of what veganism was actually founded for. A movement to recognize the rights of animals and to respect them and to start exploiting them and treating them as commodities. So if you keep that in your mind and even get involved with activism, activists, it will solidify your commitment and also you'll be doing a moral good by not just removing your support for these horrific industries by being a vegan which is more of a neutral position but by actually actively helping animals which is what I do and what I've done for the last going on. Well, essentially the whole 10 years I've been doing something to help animals but the last eight years full-time activists and gone through amazing highs and terrible lows. I am not going to stop. I'm going to keep going obviously. This has been 10 years. My primary focus is the animals. It is always the animals because that's what veganism is. It's a focus on the animals and they are suffering terribly right now. We're the only one who have that kind of power in this world to try to stop what's happening to them. Have perspective. Don't be so self-centered. Don't focus on yourself all the time. If you've got an issue, sort it out. Be mindful of your diet planning. My advice to new vegans is it doesn't take much. Get chronometer. Get happy cow. Get a few vegan resources. Find some new recipes. Don't be afraid of soy. You can do a cheap diet. You can do expensive diet. You can do extravagant. You know, you can do like desserts and chocolate. Whatever you want vegan. No matter, you know, you can get everything vegan and you don't miss a thing and it really has changed my life for the better. Like I start thinking, I think of issues of injustice differently. I've stayed sober. I have a purpose to help those who are less fortunate than me and it really has made me into a better all-round person and honestly like I do really believe that the way we treat animals emanates out to the way we treat each other and if we begin to respect the rights of a chicken and a fish then obviously then that's going to make for a more peaceful world because we're going to apply consistency here and see that hey, you know, will we ever have peace while we're doing this to these animals in this way? I mean this horrible, horrifying, like mass murder and torture. How can we ever claim to be a moral race while we're doing this to the most vulnerable beings on this planet? So there you go, there's some pitfalls. Be careful of calories. Be careful of fad diets. Be careful of supplementation. Don't be afraid of soy. Plan your diet well. Be careful of the nocebo effect and conspiratorial nonsense. Focus on the plight of the animals and I'm sure you'll be vegan for 10 years in no time and here's to another 10 years for me. So I hope you all enjoyed that video. If you found it helpful, leave your comments down below and I'll see you all in the next video. Peace.