good morning I’m Dr David Ferriss and I
have with me Dr Mark Lickey we’re both
physicians at Maxwell clinic and this
webinar is on the topic of first beat
life which is an assessment tool that
we’re using to help our patients
understand patterns of stress and
Recovery
so what I’m going to do is to talk for a
few minutes just to give you a little
background of the science and how first
beat life works and then pull Dr lickey
into the conversation uh he’s actually
been a guinea pig a test subject for uh
recently to I’ve asked him to use the
first beat life
assessment and to share some of his
perceptions about its ease of use and
information that he gathered from from
using first beat life
so let’s start
with uh what we mean when we talk about
heart rate variability I’ve covered this
in more detail in some of the previous
webinars that I’ve done in the past but
just a quick review uh when we look at
an EKG tracing which you see in front of
you and we measure the time in
milliseconds between each of the QRS
complexes those those vertical
Peaks that you see you can see that
those numbers are changing beat to beat
uh and what this means is that our heart
rate is actually changing from beat to
beat and this is what we call heart rate
variability there’s an extensive body of
research on heart rate variability and
it’s a very useful tool uh to help us
understand the autonomic nervous system
so as I just said it gives us a window
into the body into the autonomic nervous
system and it’s really helpful to see in
particular patterns of stress and
Recovery
the sympathetic nervous system when it
is activated It prepares the body for
fight or flight it accelerates bodily
functions as opposed to the
parasympathetic nervous system
uh which is primarily involved in
relaxation helping the body to rest and
recover and ideally what we need is uh
as an interplay of these two we we’re up
we’re all going to have uh stress and
stress is not all bad it’s only when we
have chronic unremitting stress that it
is harmful to our bodies as long as
we’re getting periods of recovery
particularly during sleep at night and
and at different times throughout the
day we can achieve a very healthy
balance and promote good health and
well-being
so what you see here is an example of a
graph a 24-hour period of time that
comes from a first beat life measurement
and you’ll see there uh their areas of
red blue and green uh you can see the
time of of day uh and it’s it’s
registered in 24-hour time along the uh
the horizontal axis and all of this red
uh as you see over here starting early
in the morning and then going throughout
the day this individual is uh is it work
um and then you see other activities
that have been labeled during the day uh
driving uh housework the dark blue
represents um uh act um physical
activity exercise and then the green
represents periods of recovery periods
in which this individual is primarily in
parasympathetic activation and you can
see the sleep is demarcated they went to
bed pretty late looks like about 11 30
p.m or so and in this particular graph
you can see what we would like to see is
solid green from early on from the time
that individual goes to sleep throughout
the duration you can see in this
particular case uh this this individual
had a lot of red a lot of sympathetic
activation the first part of sleep which
means they weren’t getting recovery uh
during that time and then they settled
down and had had a pretty good pretty
good night
this slide contrasts what we refer to as
a useful stress pattern and a harmful
stress pattern so again both of these
are 24 hour
graphs of stress and Recovery again with
the red being periods of stress light
blue is light activity dark blue is more
is moderate or vigorous activity and
again the green represents periods of
recovery and you can see during this in
this top graph while there is a lot of
red during the day and the evening uh
this individual is getting some good
moderate to vigorous exercise quite a
bit of light exercise during the day and
there’s some periods and they don’t have
to be long during the day where there’s
you’re seeing green where they’re
getting some recovery and in the evening
late afternoon and evening they had
quite a bit of recovery or for a period
of time contrast that with the bottom
graph where you see it’s almost all
continuous red not only during the day
but particularly during the critical
sleep time when they may be asleep for
seven or eight hours at night but
they’re not getting any recovery and
this is the kind of stress that’s
extremely harmful to our overall health
and and well-being
so first beat life
we’ve been using first beat uh
technology at Maxwell clinic for the
last several years but Maxwell uh but uh
first speech the company first beat
which is a Finnish company and it’s
really the the world leader in applying
the science of heart rate variability to
helping individuals see their patterns
of of stress and and Recovery uh they
introduced a a new version uh an
enhanced version of this technology
about a year ago in which the monitoring
of heart rate variability is paired in
real time with a smartphone app
um so that you can actually observe uh
in real time uh whether you are
primarily in a recovery mode a green
mode or a a stress mode uh that’s in
addition to producing a uh a three-day
report which we do on all new patients
when they start their first beat life
assessment so that we can have their
clinician can can have a report to
review with the patient uh at a a
follow-up office visit
um one of the uh really nice
um enhancements to are using the first
speed life technology is now when you
start using first beat life you not only
do an initial three-day assessment which
gives us a really good picture of your
patterns of stress and Recovery over a
three-day period but then you can do
repeated measurements on your own of
anywhere from one up to five days as you
choose for a three-month period of time
starting when you were first issued the
first speed life monitoring device so
it’s uh it’s a great way for you to
gather information about your patterns
of stress and Recovery to test out what
things can you do with the help of your
clinician to decrease stress and get
more recovery in your life particularly
with your sleep
so here you see a closer up view of what
the smartphone app looks like
Dr lickey has been doing this in a few
minutes he’ll comment on what his
experience was like seeing this but you
can actually at any time bring up the
app on your phone and uh and see what
your pattern looks like that day and at
that at that moment in uh in time
and then as part once you finish uh a
three-day measurement or any length of
measurement going forward uh you will be
able to press the analyze button uh on
your smartphone and it will give you a
number of metrics about key areas of
stress and and Recovery
um those include your stress and
Recovery balance what’s the amount of
the uh the stress reactions how much
recovery are you getting in a 24 hour
period of time gives you information on
the restorative effect of sleep the
amount of recovery during sleep the
length of sleep and the quality of that
of that sleep recovery
other metrics it gives are with respect
to physical activity we have you where
the the uh the measuring device uh for
the entire time you change the
electrodes uh once a day at least once a
day but except when you are swimming
you’re taking a bath or you’re in the
shower you leave the uh the uh the
monitoring device on and uh you just
can’t get it uh wet but normal exercise
sweat from exercise is fine because we
want to see how much physical activity
you’re getting how much light moderate
and vigorous and what are the health
effects that you get from the amount of
activity that you’re doing it also gives
you a measure of energy expenditure for
that day
and then finally uh it it shows you a a
graph of your body resources and how
those are drained typically during the
day and how you rebuild those at night
so here you see the graph of an
individual from three days a Thursday a
Friday and a Saturday and here’s the
starting point you see their graph of
their sympathetic activation and
parasympathetic activation their stress
reactions and Recovery responses during
that period of time and you see how much
like a battery would drain when it’s
being used during the day and then at
night which is represented by this
shaded area we see that curve going up
and that correlates here with what you
see during their sleep they’re getting
good recovery it’s solid green and then
the next day they’ll over the time with
stress reactions as they were work they
go about their daily activities of
living that will decrease and then you
see on this second night there was not
such good recovery it was sporadic there
was a lot of red there and so they
continued to deplete with only a small
increase and then in the third day
they’re starting at a lower Point here
than they did on the first day they
continued to deplete but then they start
rebuilding those body resources uh on
that third night because there once
again are getting very good recovery and
then it also the first speed life will
also give you an overall lifestyle
assessment score that combines
everything together to give you an
overall indicator of of how you’re doing
and how you compare with under other
individuals of your gender and your your
age
finally uh just what I said you get that
overall first beat life score and uh and
tells you how how you did or uh for that
measurement period
so I’m going to stop the slides now
and
introduce Dr Mark lickey for those of
you who don’t know him
um before I ask him a few questions I
want to show you a first beat monitoring
device this is called The Bodyguard
three it’s extremely lightweight uh it
charge it’ll hold the charge for about
six or seven days and what we do is we
simply apply a a standard electrode that
we provide for you we strip off the
backing on the back and we apply it
right here on right under the right
clavicle the right collarbone and then
we take the other lead we also attach an
electrode to it and we attach it over
you can’t see this but over on the left
lower rib cage so those two pieces you
don’t even know you’re wearing it when
it’s on it’s so lightweight and then
again you’ll replace the electrodes once
every 24 hours typically while you’re
showering or or bathing
so it’s very simple to use
um the app uh the smartphone app that
you download to your phone will allow
you to not only see real-time data
um but we’ll also step you through uh
the details of just how you do a
measurement we have an information sheet
we will provide you uh at the beginning
that will help Orient you to that but
it’s quite easy and very detailed
guidance that you get from the app on
how to conduct an assessment how to
monitor and how to analyze the results
at the end one final thing that I’ll
mention and then bring Dr lickey into
the conversation since he’s been using
this for the uh the last week or so
uh is that
um if sometime during that initial
measurement you will do what we call a
30-minute fitness walk it gives us a
very good estimate of your VO2 max VO2
max is the gold standard of measurement
of overall Fitness capability how
efficient your cardiovascular and
pulmonary system is at processing oxygen
the higher the score the more fit you
are and so by walking for 30 minutes uh
not jogging not running but just walking
at a vigorous rate
um for at least 30 minutes over fairly
flat terrain we don’t want you going up
hills and down Hills but over flat uh
terrain will give us that estimate and
will be produced as part of your report
and it’s just a really nice objective
measure to help you and your clinician
understand
just what your current level of Fitness
is and then you can monitor that over
time if you ramp up your your physical
activity and improve on your healthy
eating and uh just in general a healthy
lifestyle
so um let me ask Dr lickey here he’s
been using this for the last uh week or
so uh Mark how how easy was it to to
start using the first beat life uh
technology yeah very very simple
um you know I it was easy to get walked
through I mean the app makes it very
simple and the app walks you through
kind of the initial information that
that you need to enter and then putting
on the device is is super simple I mean
yeah it’s just two leads I’m wearing it
right now uh right here and and then
right over here so you never even think
about I mean I maybe think about it
twice during the day
um and you know wearing it at night is
no big deal as well
um yeah it’s it’s comfortable if you
want to put it that way and just kind of
non-existent
um and and then it’s it’s nice to just
have that that automatic feedback from
the app yeah
so talk about that feedback was that
helpful to be able to see while you were
actually doing a measurement uh
real-time data and then looking back
over the last day or so once you were on
the third day of just how your patterns
of stress and Recovery uh how that was
looking yeah it was it was definitely
eye-opening for me
um you know it this happened to be at a
somewhat stressful time in my life
um yesterday in particular was was a bit
stressful for me and it was interesting
to look at my patterns both sleep and
then what happened during the day for
example just just the last couple days
so on Monday I had a fairly busy day
here at work but wasn’t particularly
stressed out was you know enjoying my
patience was enjoying my day and it was
interesting how that played out there
was I actually was in the green which is
you know kind of a recovery type phase
um was in the green actually not a small
part of the day which was interesting
um you know with these periods of bread
which is which is the periods of stress
but you know that’s okay we all have
periods of stress during our day we
can’t live in recovery okay right
um and then sleep sleep for you know the
night before and the night after were
good there was mostly all green and then
yesterday which was definitely more
stressful it’s like my whole day was
just like it was a lot of red with not a
whole lot of green
um which was interesting and then my
sleep
um last night also was different because
the previous two nights it was like it
was very green with like basically no
red during sleep and then last night it
was like it would be green and then
there’d be these little periods of red
this the stress and then green and red
and then as the night wore on it was
more you know universally green but um I
mean it it was as I said very
eye-opening to see you know my different
days and how it affects me
um and another thing that came up was is
I wear an aura ring at night I generally
don’t wear it um during the day but
comparing what my aura ring said as far
as you know like how my sleep was
compared to
um compared to the first beat app and I
think it seemed very obvious that the
first beat app gave me a better
indication of what was really going on
I’m not saying the ordering is not
helpful but I think that that first beat
really gives a much more accurate
representation of uh of my stress and
and Recovery response and that brings up
a really good point mark in that the
first beat uh life technology The
Bodyguard three uh the the monitoring
device that Dr lickey is wearing right
now
um is Medical grade accuracy as far as
monitoring heart rate variability
because that’s what it it’s measuring
there are a lot of of helpful
um uh devices on the on the market that
uh monitor heart rate variability using
a pulse around the the wrist
um and and it’s not that those aren’t
without value they can be very helpful
but the first speech technology is
actually medical grade and so you get
the most accurate possible measurement
of of a heart rate variability and then
being able to translate that into
meaningful information regarding stress
and Recovery
um Dr leiky when when you uh did the
30-minute
fitness walk uh what was what was that
like was that difficult to start and and
end I mean it’s just pressing a button
on the on your phone on the app and when
you start and when you end I mean it’s
very simple
um you know for me I I basically just
needed to find a place that wasn’t
terribly hilly because I tend to I tend
to go and walk where it’s very hilly so
that that was a little bit more of a
challenge but it was it was somewhere
where I’ve been multiple times uh
locally and it worked out well
um so super super easy
um and you know as I said the data
coming from from the uh from the app has
been has been really uh good for me to
look at and you know my my patterns of
how my body responds to different things
and so much of it is in your head yeah
absolutely absolutely any other comments
uh before we close and we go to any uh
questions that uh viewers might yeah I
just I think it’s I think it’s really
good for really anybody to you I I think
it gives information that you would not
have gotten really any other way
I’m pretty in touch with my body and I
you know I have uh I have an Apple Watch
an oral ring and stuff and so but this
is this has given me some some
additional information that I don’t
think I could have gotten from from
those other devices that I have
um so it’s it’s been it’s been helpful
and uh I I may well do this a few more
times just to kind of see where I’m at
um you know both in kind of like the
fitness area as well as the stress and
Recovery yeah it’s it’s been good yeah
thank you
um yes like I said earlier uh we we we
want patients to do an initial 72 hour a
three-day assessment uh that will
produce a report for your clinician
which uh your clinician can then review
with you in uh in your next office visit
um as well as the information that you
get directly from the uh the app once
you’ve completed the measurement but
then we really encourage you because you
have use of the device and are given a
supply of electrodes to use we hope you
will conduct additional measurements and
those can be for a minimum of one day up
to a total of five days if you want to
look at an extended period of patterns
of stress and recovery and this is how
you learn more about your body what is
affecting your levels of stress and
recovery and you can take action uh with
the guidance of your clinician to uh to
improve your your recovery
so um with that why don’t uh we’ll go to
um
q a and see if we have any questions
doesn’t look like there are any uh any
questions here
so um I hope this has been helpful I
hope that you’ll consider using this
um and and trying it out you can contact
our office for information regarding
cost and the procedure to do that or
just talk with your Maxwell Clinic
clinician on your next visit who can
order this for you and uh and get you
started so I hope this has been helpful
uh thank you for joining uh Dr lickey
and me and uh have a good day thank you
thank you
