Well, for starters, trying to explain to somebody how to do a Kegel exercise correctly is really hard. I remember after my first couple of kids, I would be driving kids around trying do my Kekel exercises because I was just so busy.

And in one 30-minute session of one of our devices, the MSela pelvic floor device, you actually get the equivalent of 11,000 Kegal exercises, which is amazing because I don't think I've done 11,000 in my whole life on my own, especially not correctly.

So in a 30 minute treatment on our device called the M Sella device, it is you get that 11000 kegel exercises just in one 30 minutes treatment. Welcome to My MD Unscripted, where healthcare gets personal and the script gets tossed.

I'm Dr. Clint Carter, ER doctor turned to direct primary care freedom fighters on a mission to challenge how our healthcare system treats patients in America.

In every episode, my expert guests and I dive into real conversations about what's broken and how we can fix it by making healthcare about people, not just managing disease.

It's time to rethink what healthcare should be and Hello y'all and welcome back to the My MD Unscripted podcast. Today is going to be fun. I'm your host, Dr.

Clint Carter, but I am also a middle age-ish female going through a consultation with my extraordinary guest today. Julie Sibley is an MA extraordinaire who has a passion for, you know, direct primary care, taking care of people the right way, loves to help with women's health.

And you know, she wants every woman to feel as good on the inside as they look on outside and enjoy intimacy and connection with their partner with a pure love rooted in respect and common beliefs and morals.

So here's how this is going to go. Julie, thanks for being fun. I'm going. introduce myself as the patient, and then you can introduce yourself properly to both me and the audience.

And we'll go through this consultation, this women's health consultation and I'll do my best not to be too ridiculous, but as a patient for those that are watching on YouTube, I'm going to put on this little hat to help me uh, differentiate when I'm talking as the patient and when i'm, talking, as, the, you know, cause I am sure I'll have things to say as Dr.

Carter as well. So, okay, let's do this. Hi, my name is Sally. I just left my visit with Dr Carter and he told me I needed to see you. We were discussing replacing my hormones and said that I should talk to you about some of my questions.

You see, I've had kids and I'm getting a little older. Of course, a real lady never divulges her true age. And things just aren't quite the same. I leak a lot when I laugh or exercise.

Honestly, intimacy isn't what it used to be. My husband blames it on the kids. First of all, who cares what he thinks. Secondly, the kid's are worth it.

Really, is this just normal or is there actually something I could or even should do about it? Hi, Sally. Thank you so much for talking to me today. For sure, this is very normal and it is nothing to be embarrassed about, nothing you feel shameful about because it's just part of getting older and more mature.

And it just, it very common. So don't be afraid to talk about this. This is definitely a safe space for you. Well, thank you. You know, I wasn't as comfortable talking with Dr.

Carter about it as I am with you and I can already get that connection with use. So thank for talking about this stuff with me. Of course, just to put your mind at ease a little bit more, I'll tell you a bit about myself.

I work here at Miami Select. Mostly with Dr. Kirby and Laura and some of our other providers. And I do a lot of procedures and just really, really enjoy taking care of women who are kind of in this same area.

Personally, myself, in a few weeks I will have been married 30 years to my husband who was my high school boyfriend. Congratulations. Thank you. And I have given birth to six children.

Yes. Six children and all vaginally, no C-sections. So that will play into what we talk about a little bit later. Also I had four grand babies, which are the light of our life.

I actually delivered our third grand baby. That was really fun. Well, okay. Well tell me, help me with this, you know, I just kind of assumed I was the only one dealing with.

And no one really talks about this stuff and it's kind embarrassing. So, Dr. Carter reassured me that I'm not alone in this. But I don't really know how to go about having this conversation really.

Well, for sure, because when you're a little bit unsure if you are the only one dealing with this or if it's just something rare, you don't ask the questions.

You don' feel comfortable asking the question. So we definitely want you to feel comfortab we want to ask all the questio that you need. We really want t get down to the bottom of this and see what we need to do to help because it is very normal for you t have.

urinary leakage, dryness, discomfort, decreased sensation, confidence issues, all of those things come with aging as a woman and we would love to help you age more gracefully.

Well, I'm definitely dealing with all of those things really. I mean, you know, the coughing, sneezing, laughing, that kind of thing. It's really even hard to work out, which is hard because I am trying to take care of myself, but you, know having to wear a pad.

Dr. Carter told me that when we were talking earlier that they sell more adult diapers in this country than we do baby diapers, A little reassured and kind of sad.

So, you know, the vaginal dryness and some of that just not quite being the same in that area stuff has really, it's just been gradually worsening over time.

What's going on there do you think? So there's a few things going on because as we age, our hormones change and hormones are responsible for a lot of how we are feeling, especially down in our vaginal area.

So usually a lack of estrogen, lack testosterone, those things have something to do with it. And then we've got, if you've had children or you worked out, like lots of stress on your pelvic floor, we have muscle laxity and tissue that is starting to just get old and not be as moist or as flexible.

So all of those things kind of combined together, blood flow, collagen, the tissue changes, all that has something to do with how you're feeling. And there's a lot of women that feel the same way.

Well, okay. That's reassuring. What do we do about it? I understand you guys have some devices here that can be helpful. You know, I've been looking online a little bit and been trying to do some Kegel exercises and those things to, to help in, you know.

in the bedroom and stuff, but it may be even help with the leakage a little bit. It does not seem to be making much of a difference. What can you guys offer that might be different?

So in a 30-minute treatment on our device called the Emsela device, you get that 11000 Kegel exercises. just in one 30 minute treatment. So I know I've always been rushed for time and self care is something that doesn't come first for moms usually.

Being able to do that much in such a short period of time is amazing. Well, okay. Tell me more about how that works. That sounds like a lot. I know, I now.

So the Emsela is a chair. And if you have been in our office and been Dr. Carter's lounge, that's the chair that is in the lounge. It's an amazing device.

Very comfortable. Definitely doesn't look like a normal chair, but it is the share that you sit on and how it works is it uses super maximal contractions and is high FEM.

technology. The HIFEM technology is high intensity focused electromagnetic technology, so you will sit on this chair, zero pain. We don't want you to be in pain at all.

we want to comfortable sitting on the chair and we wanted you feel the contractions of the super maximal contraction that the machine is sending up through the seat of machine.

That sounds a little intimidating though. First of all, am I dressed? Am I sitting on this chair naked in your office? And then what do you mean this maximal contraction coming up through the chair?

That's sounds intimidating. Yes, so good question about that. Yes you do stay dressed. We do recommend that you wear either some thin pants or leggings or even a skirt that's kind of thin.

It's a little bit harder to get the full effect of it when you have jeans on or something that is a thicker material, but you stay dress the whole time.

You sit on the chair and when we start the treatment, we get you positioned on a chair correctly. So we want you to feel this contraction in a certain area right on your pelvic floor and so we'll have you kind of move around move to the right move the left front back and We want your feet to be flat on the ground.

We adjust the chair to that and then we just send some little test Clicks that basically help us get you right in the spot and once we get in The right spot then We start the treatment and you have a 30 minute treatment that you can sit you Can read a book you?

Can watch TV you literally do not have to do anything except just sit there Okay. So this is a, how many times do I need to do this treatment? How does that work?

So it's recommended to start with six treatments and you can do those treatments. You can them twice a week. you Can do them once a. Kind of depends. And we like to tailor it to each person's situation.

If you are really, really dealing with urge incontinence and with all of those kinds of things. We would probably want you to do the sessions a little bit closer together and try and get those sessions done quicker.

But six sessions over one week, each section, that session might be working. And some people even see improvement and results just, especially on the urinary retention and being able to hold your bladder.

Some people see results after one to two weeks, which is pretty amazing. This chair, this chair that you're sitting me on and we're doing these contractions, what is it really doing?

What's it doing that's even helping me? So it's sending up that high intensity magnetic signal up into your pelvic floor, which is strengthening the muscle because your public floor is a muscle.

It's strengthening. The pelvic. So it's not painful at all, but you will feel those contractions. You will. And it will be, when we say super maximal, that means more than you could do yourself.

so you would never be able to do that strong of a Kegel exercise, let alone 11,000 of them. S o it sending up that signal through the base of the chair.

Once we get you situated. And it sends up that signal and helps contract. And as much as we can get that muscle to contract, because it sits kind of dormant when we're not doing anything.

So as as can we get it to contact, that's where we are going to see the improvement. Well, you know, Dr. Carter had just started me on hormones in the last, six months or so, and I'm already feeling stronger and feeling better.

But he did mention that, there's really not an easy way to strengthen those muscles down there and that this chair could help me. And that's starting to make sense for me, I would really, really love to be able to work out, coughing and sneezing and just really like to help with.

the incontinence part, but when it comes to, he said there was another device as well, because when, you know, when comes just sort of feeling like myself down there, intimacy with my husband, there might be another devise that would pair well with this chair in some way.

Yes, for sure. So most of our people who do Emsela would very much benefit from another one of the devices. And that device is called the MFEM 360. That is for tissue restoration.

If we have some urinary issues or anything like that, That is associated with the pelvic floor and the muscle of the Pelvic floor. So like I stopped jumping on the trampoline with my kids before I used this machine, because I could not do that without having some sort of leakage.

so that's where we come with, with Emsela to get that foundation, to make sure that that Foundation of that muscle is strong. But then what most women are even more embarrassed to talk about is the lack of moisture, the lack of sensation and all of those things inside the vaginal canal.

And that's where MFEM 360 comes in. Okay. Well, thank you. I'm starting to understand how using the Mcelli chair can build some strength there that will help with the incontinence issues for sure.

Maybe help some of the other stuff, but he said there might be a second device that you guys have that would pair really well with the Msela chair that could help with some of the other changes that I've been having down in that area and some the intimacy issues that we've had over the years with babies and age and time and hormones and all the stuff that Dr.

Carter was talking about. And he's got me on hormones. I'm feeling stronger and feeling better, but he said that this other device might be just sort of that missing link.

Definitely. I'm so glad you're asking about that because I really, really love it when our patients pair these two treatments together. So we've got the foundation of our pelvic floor, which is how Emcella helps with the Foundation and that muscle layer of the Foundaiton.

And by the way, it's not just for women. Men can use it too. It's a great device for prostate issues or anything like that. But then when we go to MFEM and we combine the two treatments together, Mfem is a tissue restoration device and it uses radio frequency and HiFem, the high intensity focused electromagnetic device and we have an internal and an external treatment.

You can do one, you can, do both, but the internal treatment, I'll just start there, starts with basically it's bringing moisture back to the tissues.

It's bring in sensation back with the radio frequency and it is pretty amazing the difference that it can make in a woman's life, especially if you're dealing with any dryness or burning or anything like that when you are having sexual intercourse.

So let's go back to the part where you're using it on the inside and or the outside. What is this procedure really like? Right. So if it was a little uncomfortable to talk about the other stuff with M.cella, this even gets more uncomfortable for women because they're like, wait, what is going to happen here?

What are we going do? So we'll start with the internal treatment for MFEM. And it has a tip on it that we insert into the vaginal canal very, very slowly.

for eight minutes. It goes in and out very slowly for 8 minutes, it is very warm and actually again not painful at all, totally non-invasive, zero recovery time, but the probe is inserted into the vaginal canal for a solid minutes going in an out, very very, slowly and what this does is it brings back your own collagen, your on hyaluronic acid, you're own tissue repairing from your own body.

We're not putting anything foreign in there. we're, not doing shots. It doesn't hurt. it is encouraging your, own, body by almost creating kind of a thermal injury in your vaginal canal.

helping your body to restore what it used to have. So it's really awesome. I mean, I hear you say it. Not painful, but it sounds awkward at. worst, it just seems like, you know, this whole in and out motion too, like that's not going to be too weird for me.

So that is the question I get asked quite a bit is how comfortable is this? It's, not painful, but is it that comfortable? it's. Not that. Comfortable.

If you. Know what I mean. However, it is very comfortable, especially because it's warm. So it almost like a hot stone massage and it really, really not bad at all.

And I just talk through it. We have some music in the room. I talk to you about life, kind of like when you're getting your nails done or going to another doctor, we talk about live and we talked about things.

Sure enough, you are like, oh wait, the treatment is already over? That was amazing. So it is, it's not an uncomfortable treatment. I do these all the time and I'm really passionate about it because I myself personally have benefited from these treatments.

As I talked about before, having six kids, there's a whole lot of stuff that happened down there and both of these two treatments have really personally been beneficial for me.

Well, that's reassuring for sure. And it only eight minutes. So I guess that pretty quick, but how many, how often do I have to do it? So the MFAM is three treatments and we usually space them a week apart.

We have had patients who have said, I'm not ready for another treatment yet because I actually feel pretty invigorated. So sometimes we can even space it a little bit more apart if you feel results after your first treatment.

I personally felt results. After my first, after my second treatment, my husband noticed results, so that was pretty exciting. Well, that's interesting that might get him off my back a little bit, but let's be clear.

I'm doing this for me, not for him. That's right. that is correct. And then you said it helps my body build up its own, you know, tissue around there.

You said something about thermal injury that sounds scary. Tell me I mean, You say it's warm, Not hot, But thermal injuries sound scary, what does that mean?

So it is warm, it's not hot, and the thermal injury was basically, so when we have an injury in our bodies, we had a cut or we've a bruise, blood flow increases to that area to promote healing.

And so this is kind of the same idea because you're actually It's warm and it's not used to having that warmth down there and the radio frequency. And so your body is going, wait, what is this?

What's going on here? And, so it increases blood flow to the area, which increases sensation and then increases your, body rebuilding and doing all of those things with all the collagen and just really regenerating the tissue.

Well, okay. So there's the MSULA chair that helps build the strength of the pelvic floor. And then there is the MFIM device, which works on some of other tissues to try to put things back together like maybe they were in my younger days.

But so. How do these two work together for a complete solution? So there's not only just the internal treatment, but there is also an external treatment as well for the MFEM, and we can talk about that in a minute.

But pairing the two together, it definitely increases sensation and it just tightens everything up down there. Because as we age and we start to get lower on our estrogen and all of that, that all starts to change down there and lots of women feel it.

And they, they just are like, what is happening to my body? Among all the other things that happen with menopause, it really. This is something that is bothersome and it interferes with a healthy sex life and interfered with just feeling good overall.

So between pairing these two together where you are building the foundation with the M-cellar chair, so you've got the Foundation with muscle, but then this is the drywall and this all the supporting tissue that's helping to rebuild everything down there.

And then why would anyone need this MFIM on the outside? What does that have to do with M? So, correct. So on outside, we would also need it just because things change.

how you look down there as well. And sensation, again, that changes. So we have the labia, which get loose and after, especially after childbirth, they get lose.

Then we different areas. I think there's four or five different that we can treat with the external tip. It also helps with incontinence because we're tightening the opening.

We're tightning all of the skin and the laxity that has been there, we are tightening that with the external tip and device. And we use a gel, a warm gel and it's very, like I said, it feels like a hot stone massage and its very comfortable and each Outer area, because that tissue is so gentle and kind of thin down there, that's the other thing that happens with dryness is your tissue thins.

And that is when sometimes you experience pain or kind like sandpaper feel, which is no fun, but that what comes with the drynes. So the external treatments for each area are anywhere between three and five minutes per area.

So you'll have, you know, your right side, left side down along the bottom. You can tell me all those names for it. And then along at the top, and you can choose how many of the external areas, or we are, we're going to do where we feel like it needs to have that treatment done.

Well, okay. So this is kind of. Completely new to me. I didn't know any of this was a possibility. Um, I'm reassured to know I am not the only one suffering with it, but I guess people just don't normally talk about this stuff.

But thank you for talking with me about the stuff I'll definitely want to, um, at least talk to my husband about it. Once again, this is really about me, not him.

I'm looking forward to having a little bit more confidence and a Little less leakage. And it doesn't sound like he would argue with the outcomes of this either, but thank you so much for spending this, all this time with me and are there any other, you know, we can talk about pricing and that kind of stuff.

You know when we talk, about doing a complete package for this. But is there anything else I need to know before we shut it down? Sure, so if, if you are interested, we don't do demos on the MFEM, but we do, demos or mini treatments on our M.cello machine.

So you can come on in and we can do a little mini treatment and see how you feel. And it really is going to be a person to person basis. If your biggest struggle is leakage, urinary leakage.

Urgent continence when you sneeze, cough, laugh, anything like that. Then I would start with the mcellow chair and do those treatments with Mcella. If your biggest issue is dryness and laxity and lack of sensation in the vaginal canal, I would start with MFEM.

And the coolest thing is you can actually do them simultaneously. So you come in and get your MfEM treatment and your MSELA treatment, and you just do those right alongside each other and just get the maximum effect, which is really exciting.

I would love to do the demo on the chair for sure. I think that would take a lot of the anxiety out of it because, you know, trying to picture what that feels like is really hard.

And thank you Julie so much. So I'm looking forward to maybe being able to address some things that I just didn't know were even addressable. Thank you so for your time.

You bet. All right. Well, thanks Julie. I took off the hat. Um, Dr. Carter again, I look better with a hat on. And I admit even, even a woman's hat, so, um, yeah, Thanks for that.

This technology creates more muscle strength than people can do. Even if they know how to do Kegels well, even if you had nothing to sit around and do 11,000 Kiegels in a day, it'd be nearly impossible and you wouldn't get the same results.

So the Imsela chair is fascinatingly effective. The continence incontinence piece is. It's amazing for women. Men with prostatectomies are trying to gradually get back that urinary control.

It always ends up with incontinence initially. This chair has been amazing. Just enlarge prostates for men and go into the restroom more, but it does stress incontinence is the cough, sneeze, workout incontinence.

Urge inccontinents is just having to go, I got to, go right now. Just, you know, not making it to the rest room in time. It helps that getting up at night to pee, it helps with that stuff.

it's been really transformative for a lot of our patients. And then combining it with the MFIM, we've had some things I didn't even see coming. We've some women say that their sexual intercourse was improved, but also their libido, their desire for inter course.

had been dramatically increased. And I didn't see that coming at all, but it's just been fun to watch how this can work in a woman's confidence in the relationship.

That's an important part of any marriage. I think it has been a really fun addition to the practice. We didn´t used to ask about incontinence because there was nothing we could do about it.

And now we have a tool and when we ask, everybody has it. And so I feel bad for being a bad doctor for the first 20 years of my practice, but doctors don't like to ask about things they can't fix, I guess.

So. Well, and especially if you don't experience it yourself. Like I'm sure most women can relate to me. You pull into the driveway and you literally have 10 seconds to get in.

I, it's like the coming home syndrome. you just be like, Oh boy, oh boy. Okay. And you gotta get there as fast as you can. and that helps so much with all of those things.

It's really, pretty awesome. That's pretty awesome. And I know that, you know, we've had multiple staff members have really good testimonies. We've heard multiple patients have great testimonials on both devices.

So thank you for doing this consultation with me. I You know, a little weird probably having a dude asking about all this stuff, especially if you're just listening to the podcast and going, God, I hope you, hope, you started at the beginning of the podcasts.

You're going to be really confused, but it was, it, was fun. And I think super informative that technology is groundbreaking and. It's just fun to be able to offer something that works and works so well for something, that we had, you know, pelvic floor therapy with physical therapists, which was not nothing, but it was, not everything.

And so it's fun, to have something really, really works. Did, wanted to show you for our May special, because this is for, for women and men, but for May's special.

Um, those of you who are just listening, we are running a special for MFEM. So if you buy Mfem, M Fem you get Mcela free, completely free. Which that's a $2,000 value just in and of itself.

Yeah. We're gonna, We are gonna be running that all of May for Mother's Day, Because that makes perfect sense. And we're, Once again, proud to be able to offer it.

You don't have to a MIME Deselect Direct Primary Care member. This is really being offered through our functional aesthetic company, Liv, for further information there, but really it's less of a commercial than it is a public service announcement that this exists and it exists all over the country.

This is IMCELLA and IMFIM are part of the offerings from BTL and, it's just a, a special thing to be able to, to change lives. And that's kind of what we're doing here.

So, thanks again, Julie. Thanks for coming on. You bet. We'll have you on and we'll do more fun things later. And in the meantime, guys, thanks for joining us on My EMD Unscripted and will catch you guys next week.

Thanks for joining me today on My MD Unscripted. I hope today's conversation opened your mind and inspired you to imagine a better path for your health and therefore life.

If you found value in this episode, be sure to subscribe, leave a review, and share it with someone passionate about transforming healthcare. Real change starts with real conversation, so let's keep them going.

Until next time, stay well, Stay curious, And never stop pushing for better.

Julie Sivley

Undressing the Secret: A Real Patient Consultation on Women’s Intimate Health