Functional Medicine Stories with Mariya and Diane

Podcast Introduction and Provider Backgrounds 0:00

All right. Well, welcome to the Table Talk podcast. My name is Melody Hartzler. I'm the founder of Farm to Table and the Farm to Table team. So, we have pharmacists that are working in the functional integrative medicine um spectrum all across the country um doing consults with patients and we, you know, have this podcast. We talk about a lot of different topics, but I wanted to invite several of our providers on just to share their story about functional medicine. So often whether it's a pharmacist, a physician, a nurse practitioner, maybe a health coach, most the time they got into this world of functional integrative medicine because of their own health story and sometimes it might be someone else's story. So it might be a patient's story or it might even be their spouse or their child's story. And so um I think it's so powerful to share these stories because so often we can resonate with pieces of that or we can um say, "Hey, like that worked for them." And it's just more powerful than any um I think other like educational thing out there is really just to heal hear people's stories because um there's a lot of you know I think emotional connectivity too to our health and to our journey. So So without further ado, we're going to introduce our team here today. So we have um Dr.

Maria who's in Texas. So why don't you tell us a little bit about you and and what you're doing there in Texas. >> Hi. Thank you Melody for inviting me. So I live in Dallas, Texas and prior to that I've lived in New York, Brooklyn, um New Mexico, Rhode Island and England and so um and my nutrition is nutrition degree is from England. So I've had an opportunity to be immersed in different health care systems and um and that has led me to where I am today in lifestyle medicine, functional medicine. So, I'm a pharmacist by profession, of course, and I've been practicing for 15 years, community pharmacist, and I love to advocate and educate my community and what else we can do before we go for the pill. >> Yes. And she's a fabulous cook, too. So, she does some cooking classes locally in Texas, too. So, one of our other pharmacists has also attended your cooking class, um, which they loved. So, awesome. And then Diane, tell us a little bit about you and what you're doing right now. >> Okay, so I am in New Jersey. Um, I started on my pharmacy journey back in Brooklyn and at Long Island University.

So we have some similar roots, I see. Um, I then worked in basically acute care. I did a residency at Thomas Jefferson in Philadelphia for a year and then I worked hospital pharmacy, clinical pharmacy inpatient for probably about 10 12 years. Um, and I loved it. I love working with the doctors. I love learning all of the clinical information, being around other health care providers, um, you know, advocating for pharmacy, showing that all we can do as part of a team. Um and then basically I started kind of my own thing where um I worked doing a lot of tele medicine um with insurance companies based or um private practice-based through pharmacy tele medicine companies and what that means is basically we would call patients and go over all of their medications that they're taking. Um and we often found that there was so much polyfarm pharmacy patients are on so many medications. They have so many questions that they really have no outlet um often to ask and they also on top of that usually take many many vitamins and supplements. Um, so I did that for about two to three years and then I started realizing I really wanted to have more of my own direct time with patients and be able to talk to them fully about all of their supplements and lifestyle and help them really in prevention of, you know, cardiovascular disease, diabetes, and chronic disease.

Um, so that's kind of how I came to be where I am right now as well. >> Yeah. Yeah. So often it's like that frustration with the health care system or frustration with like not having the time that you need. I mean so many providers like if you know patients really want this functional medicine

Maria's Functional Medicine Journey and CGM Insights 4:17

services to be covered on insurance but then like if we think about the general medicine model where you have 15 minutes with someone you know in that insurancebased model it's really really hard to dig deep and get through a patient's story in that time. And so um unfortunately like a lot of the the models for you know providing functional medicine have been more cashbased which I think you know we'll be able to eventually do more group visits and and things to lower cost as far as you know even on our practice and other practices across the country. I think that's an option but it does that really like deep individualized care like has to be you know a longer period of time that we spend learning the story. So speaking of stories, who wants to go first to share just sort of their own journey of how they even found out about functional medicine or integrative medicine or food is medicine, whatever you want to call it. >> Sure. One of my um um ways I found you, Melody, was through my own journey. And um I was living my 30s like I would live my 20s and I was living my 40s like I was living my 30s, right? And then I think 40s came and I woke up and I was like, "Okay, um, you know, I had a chance to reflect on myself and and I realized there were things that I was missing about myself. Self-care wasn't going going to Sephora anymore, right?

Self-care was like, okay, I need to dig in a bit more deeper. What's exactly is happening with me?" And I'm just like any other moms, young moms out there who are stressed, full-time jobs, you know, running a home and juggling multiple duties, taking care of aging parents. And um and I was just in, you know, I was thinking I was being a super mom, doing it well, doing it right, getting things done. And I was just basically, I think, neglecting myself. And then and I would go to my regular annual doctor's visits. And my doctor is amazing. I like absolutely love her. Like I like her only because she doesn't recommend medications first, right? So, that's the only reason I like her. And she was amazing. And um and I would ask her, "Oh, hey, why is my um why am I gaining this midline weight?" Or I would ask her like, "Why am I A1C climbing? What can I do for my LDL to get down?" And she could just eat Mediterranean diet just, you know, take care of yourself. And and I didn't I kind of knew what Mediterranean diet meant, but I thought, does a normal average person know what a Mediterranean diet means? you know, just because I come from a privileged position of being educated doesn't mean everyone else knows. And I and what exactly is Mediterranean diet anyway? So, and I thought to myself, hey, you're a pharmacist. I think you're somewhat educated and bit clever. So, figure it out yourself why your lab values don't make sense. Why are you gaining weight?

And so, I just um sent her a message on my app. Can you please send me a continuous glucose monitoring device? And I don't know, I'm not quite sure what inspired me to ask that. And um I must have had heard a podcast podcast or something or read a book or something. And she said, she said, "Okay, fine. Go ahead. Take it. Um I I'll send you a prescription." I got the prescription and Melody, I ate just like normally I would eat. And what I thought I considered was healthy eating, right? I was instead of going for like potato chips, I would go for rice krispies. Um you know, rice based.

>> Yeah. and you know go for low-fat stuff like normally what you consider is healthy, right? Eat um like eat fruits and back to back and then oh my god my glucose monitor was like literally screaming at me. It was like telling me things like oh but this is healthy, this is okay. And you know as you know that more glucose spikes we have that means more insulin um is released and causes an inflammatory state. And no wonder I was feeling the way I was feeling. And then then I decided to make some shifts, some changes. And there was a lot of mindset shifting too. So you know sometimes you do know the answers Melody, right? So you know what you have to do. I tell my mom always, mom, you know what you have to do. It's this your your mind has to shift a bit. So you have to be mentally ready for it. And then you know so I made some changes and and I'm still making changes. So it's a journey. So like I tell most people Melody is like it doesn't happen overnight. You just don't wake up and say, "Okay, I'm going to eat healthy. Okay, I know what my problem is." It's a journey and you have to be okay with being in this journey and be patient. I know it could take decades before you see where you are, where you want to go.

>> Yeah. Yeah. I think that's so often like a lot what I see. I mean, I take care of a lot of patients that are, you know, similar age. They've turned 40, maybe they're even 50. They're past the menopausal change and their blood sugars are starting to get out of whack. Their hormones aren't there anymore. And you know, I think CGM is such an important piece of that discussion with patients because just seeing things on the CGM, like I can tell them all day long like you need to eat a Mediterranean diet, you need to eat less carbs, you need to maybe consider intermittent fasting if they're not crazy stressed. I think it has a little bit of issues in people that cortisol is really out of whack.

But you can talk to them about that all day long. But until they see those numbers on the CGM and they see what's reflecting from their diet, um, you know, it doesn't really click. And then once they see that, they're like, "Oh my goodness, I didn't know that this was happening in the background." So, I mean, I not only has CGM like revolutionized care for patients with diabetes, like I mean, the care we are able to provide to people is like just amazing compared to what we were able to provide even 10 years ago. Um, but even for these people and obviously this isn't off label used to, you know, use it for non-diabetes patients, but I think so often that, you know, has been really helpful for our practice to be able to see like, yes, like I I know what's going on now. And even just be I tell my patients like use it for two weeks, see like what your current diet looks like, make the dietary changes.

Even if you don't want to like continue using one for, you know, forever buy, you know, get a couple sensors and then use it later on, you know, right? Like check in like a month later, two months later with the sensor and then compare sort of that pre and then post dietary change. Um, and it's phenomenal to look at, you know, the results for people and, you know, see like how much more motivated I think they are to make those changes because they've seen the effect of it, right? Because normally you take make dietary changes, you might feel a little better, but really like seeing the underlying effect really has a lot of power I think. >> Yeah. And like as I am educating myself and seeing more clients, I realize that insulin resistance is the root is the problem that we need to address first. And and I you know we talk about inflammatory diet. Yes, that's good. That needs to be done as well. But really getting that glucose under control is the key to preventing cancers even right preventing autoimmune conditions. So there's so much benefit in just looking at your blood glucose. >> Yeah, absolutely. And you know weight gain like you said you know so many people we talk about weight gain a lot.

We've come up with a you know weight loss diabetes prevention program that we're launching next year. And um you know so often it's just like eat less right? That's what the message that you're getting from your provider. eat less, eat maybe like you're getting the standard message of low fat and like all the media is telling you telling you that, but in reality, if we're, you know, eating low fat, most likely we're filling the rest of our meals with more higher carb things, which is further worsening the glucose picture and the insulin resistance picture. So, um, but yeah, getting to those root causes. Even the conference that I was at last weekend, which was, um, looking at anti-aging and integrative and functional medicine, like it's amazing like how much of that conversation is about metabolic conditions and the the root cause of, you know, the insulin resistance being sort of the forefront, like you said, of of getting to that longevity, the optimal health even into your 80s and 90s. So, all right, Diane, tell us a little bit about your story.

>> Okay. Well, my story started about 16 years ago, which is exactly how old my daughter is. And that is because like many mothers, um, autoimmune conditions seem to unfortunately pop up postpartum. Um I though I was in pharmacy and you know loved the medical field and I guess knew a lot about what I was practicing at the time but I was really not in the know um just about my own health, my own underlying autoimmune condition. And what happened was I had my daughter and probably three months in my knees basically turned into the sizes of cantalopes. Um they were so swollen. I I it was one knee actually first. Um so of course you know you're thinking am I sitting too long feeding my baby? You know what am I doing? Did I fall? Did I not remember you know what happened to me? Um and you know you're half asleep. You're trying to figure out how to raise a baby and all of a sudden this happens. So you go down the normal path of conventional medicine. go to your primary doctor. Okay, he's they're not sure, you know, you didn't get hurt. You don't have an infection. What's going on? You know, then you go to the orthopedic doctor. They do some tests.

They rule out this and that. Then they start with rheumatology and autoimmune, you know. So, here I am going under the sun. Meanwhile, I'm in the thick of having a baby and that's what I really want to focus on. um the stress is accumulating, the lack of sleep is accumulating and without me realizing obviously you know everything's getting worse. So um I basically did get into pharmacy because I don't love taking prescription medicine. I've always been interested in food as medicine, natural supplements as as medicine first. Um so I really try to figure this out and understand where this is coming from and that was just my natural thought process which is really the foundation of functional medicine you know like what is going on even if you label me with something how why and how did I get this? So um after about four doctors I went to one rheatologist who basically after a gamut of many many labs said you have um seriatic arthritis because you have an inflammatory arthritis that is non-rumatoid and serotic arthritis really doesn't show up very well on any lab test. Um so it's kind of a rule out disease. Um, obviously you have psoriasis and that's how that you know is linked together. So I have had psoriasis my whole life but so minor that I never even really thought of it as something that could cause such a drastic other condition.

Um, so he basically literally I was nursing. Um, he gave me three scripts and said, "Stop nursing. Take this." And I said, "Well, you know, I'm so stressed and I'm I haven't slept. Like, maybe if I balance my hormones and I get my body back together, you know, it'll go away. Maybe I don't have to take these medicines." And I specifically remember, and I think I'll never forget this. He said, "No, you'll be on this for the rest of your life." And I just started hysterically crying in the office, like not even understanding how someone could talk to a patient that way. Um, I was blown away. I literally went home and ripped up my prescriptions and I told my mom, "Well, I'm not taking those. This is crazy. My body is so out of whack that I know something's going on." Um so I actually started researching researching discovered the world of naturopathic doctors because you know back then there there really wasn't to my knowledge must quote functional medicine um and naturopathic physicians really just tie so well into functional medicine. So there I started my journey of um acupuncture supplements seeing him um he was in the city New York City at the time and he was wonderful and I started on a lot of p um supplements and anti-inflammatory um then I found a nutritionist and I guess what started a detox diet and an elimination diet which is like still exactly what goes on um in functional medicine. And in about 3 months, no joke, I probably dropped, I don't know,

Diane's Autoimmune Diagnosis and Recovery 16:48

20 lbs. I have never been healthier. My joints, everything got better. Um, I felt amazing. I had energy. I was happy. And like I was so proud of myself. I couldn't I couldn't really believe like I was so determined to heal this, you know, naturally. Um, but it literally took an army of people. I had a physical therapist, >> an osteopathic. >> Um, I mean, name it, I I probably went and I just drastically changed my life. And, um, I found that I had some sensitivities to food and I unders I started understanding the impact that stress and sleep have on people with autoimmune conditions. Um, I found another rheatologist who is much more holistic. Um he basically did give me like very short burst of um a prennazone which for anyone out there just you know it's a steroid that does help that acute inflammation. But he told me which was the opposite of the other rheatologists like I'm going to get you out of this you know the weeds and you're gonna work on yourself and your health and that's exactly what happened. So, you know, I was able to go the next, you know, 15 years not on any prescription medicine for my seratic arthritis, which is amazing because I see so many patients that have joint issues, rheumatoid arthritis, seroriatic arthritis. um you know and it's and you know even weight gain like metabolic health is tied into you know triggering these autoimmune and joint related arthritis. Um, so that's truly like where my passion just started, just me seeing it, like getting my results. And I mean, I'm, you know, seeing it, doing it, believing in it, and now able to just share it with people. And I realize when you look at how it's not just autoimmune joint issues, you know, that this kind of >> lifestyle change will help. I mean, it's basically any chronic disease. Um, it helps. So that's, you know, that's my story.

>> Yeah, that's awesome. I think like it's a really good example of having to advocate for yourself as a patient because so often people are handed those three prescriptions and they just go to the pharmacy and just listen to what the provider says without really any thought to it. Or maybe they have reservations, but their physician is very adamant and they trust their physician. And you know, there's this whole conversation about like medical gaslighting and all of this kind of stuff going on. But, you know, I think that you as you were a very knowledgeable, you know, you knew some of these things were not maybe the right path for you and you sort of took that into your own hands. And I think that's a really good strong message for people out there that are just frustrated with the system and they're getting that handful of prescriptions to say, "Okay, you have to you have to do this yourself. You have to be the one in charge of your journey." Certainly, you're going to have guides along the way, like we're going to be your guide if you choose to work with us or another healthcare provider that does functional integrative medicine. But ultimately, your improvement in health was related to you as a, you know, decision maker, the decision to get up every day and and change your diet and to do the work and maybe go to the acupuncturist. I think, you know, in our society, a lot of patients are like, I want that quick fix. They want the they want the natural option, but they want it to work as fast as the drug, right? They want it to just be be better. Like even though likely you know your situation and others like most of the time we get into this poor health or chronic disease standpoint from like years of poor diet, stress, you know, and in a little bit the pregnancy and you know my journey also was postpartum and so there is that like very you know immediate effect of the hormone changes and the stress and the lack of sleep that sometimes precipitates things faster than other things. But it probably was also set up prior to that, right? like gut health and you know whether it's antibiotic use or you know pesticide exposures poor diet like poor sleep even beforehand or stress I mean we all went through pharmacy school and residency so like that's like a next level stress as well so I think you know not like giving yourself grace too that like you didn't get here overnight and so it's not going to be like tomorrow this is going to be resolved just because you change your diet or even 30 days I mean so many people like when when am I going to feel better when am I going to feel better I'm like well you're going to feel better like somewhat quickly, but like is it actually going to reverse in 30 days? Like probably not, right? Like it's going to be maybe 6 months to a year depending on like what we're dealing with. So I think you know 3 months for you is fabulous that you were so much better within the 3 months. But you were taking it like really strong there with acupuncture, the nutrition, the supplements, like all together. So you know sometimes if you dive in full force and go really deep early on it it really can make a bigger impact faster. For sure. Yeah. And I do find more severe you know the person's symptoms are um you know the more motivated and they are to find more people to help them and more things you know >> more strategies to make themselves feel better. And so I think I was like well I just need to take care of my my baby and I could barely walk. Um, so I mean I it was my job like it became my new full-time job, you know, to to basically get better. Um, and I think, you know, that's what happens like when people just have maybe milder symptoms or flares or intermittent problems. Um, you know, it it is for them good to know that, you know, it does take a long time to to improve. you know, when you are really when you are in a more severe state, maybe you are more likely to get a little bit better quicker, but that's because you're going from so severe to just >> Yeah. >> Yeah.

>> You can recognize the change so much easier than the people that are just like, well, I don't feel great, but I feel a little better, you know? And that's one of the reasons why with our patients, we have them fill out what's called the MSQ or the medical symptom questionnaire, so that we can see like their because it's so subjective, right? everyone's symptoms and you know we it get helps us to you know have an objective score to that so we can track along with the patients. So if they have you know a huge score in the GI category and they come back in a month they're like well I feel a little bit better but not perfect. You're like oh my goodness look at your score like last month you looked like this month you're only reporting you know a little bit here and there. Um so sometimes even just that having that the same thing with the CGM right we saw like you know drastic improvements in the CGM people are like wow this is but so sometimes looking at numbers on scoring systems can be helpful to like really objectify that wow I am getting better but it's hard in the dayto-day to see to see all that. >> Yeah 100%. I think sometimes people don't even realize, you know, like some of my I would and also like it's even though I did feel so much better in three months, you know, these kind of things flare up and down over many, >> not forever. And the whole goal is to reduce flares or just minimize how severe they are. Yeah.

>> Able to carry on with your your life, you know. Um so yeah, it's all so important. >> Yeah. Diane, were you able to um bring your family along in your health journey? How did that go? >> Um let's see. Well, you know, I don't know. I >> progress. >> I know. I think my husband at the time was like, "Oh man, like you have to get better because I'm not waking up in the middle of the night." And you know, like, so yes, he was very, you know, supportive and encouraging. and when I had to go to physical therapy, you know, or when I had to do this or do that, um he was very supportive and I yeah, so of course it's very important to have people in your house that understand um you know what you're going through and that it's not going to be a quick fix. Um and that it's real struggles.

you know, just if you're tired, like people don't understand like sometimes like exhaustion from autoimmune conditions is like it's not just I'm tired. Like people you're so tired that you know you can barely make it through the day functioning. Um and I think that's another thing that like unless you track like we were saying your energy level or how you feel, you don't realize that once you start feeling better, you said, "Oh my gosh, I made it this whole day and I didn't even feel like I needed a nap." you know, like so it it is so important to just like track how how you're getting better and that you don't forget what you did because then you're going to fall into old habits, you know, and there comes another flare.

>> Yeah. Yeah. And I think too like like the flare piece like so many people obviously stress can precipitate that lack of sleep you know other things but also even just like working constantly on like the gut health component because I've got I had some patients that one um gentleman presented with psoriasis and he so another autoimmune condition which similar to your experience um he didn't quite have the swelling or anything like this uh serotic arthritis but plaques like on his eyelids on his arms arms and his legs and he had gone to another practitioner and did allergy testing. So had done some food sensitivity testing, pulled out those foods, all the plaques went away and so that was like very drastic improvement in his symptoms within like four weeks or so of being on this modified diet. But the other practitioner did not teach him or look deeper at the gut level things that were going on contributing to creating those food allergies because the food sensitivities really aren't the root cause, right? the food the root cause is the gut and the gut microbiome. So, so he came he came to me after another probably year or so that he had been you know starting to work on you know since he had started to work with that other provider and his symptoms are back. So he's got you know the full-fledged seroriatic plaques um all over his body um a lot on his face. So obviously that's you know you know if it's on your arm and you can cover it up with a shirt. Sometimes men aren't as interested in you know working on things as they are if it's like all over their face. Um but for him like you know I did a stool testing and did food sensitivity testing because he got such improvement with the food sensitivity. Well let's see where you are with the foods. But what happened was because they didn't fix the gut then he actually developed more food sensitivities. And so he now had other food sensitivities, things that he wouldn't even have thought of, like random things like white fish or different things like that. But he pulled those out again. Seris plaques went away. But the key is finishing the the job and like actually improving the gut health and, you know, helping it to not develop, you know, further food sensitivities. So we did stool testing, addressed his microbiome imbalances, and you know, we're continuing to work on that process. So, I think it's so important for people to know that like like we said, like it's a journey. Like it's not just like this one time I'm going to do this diet for four weeks and I'm going to feel great and I'm going to be done. Um that it may be even a lifelong journey like like you were talking about of just continuing to optimize our health in the best ways that we know how. Um and so yeah and I think along with that like we also have to like you know acknowledge that there are sometimes people need medications and like they should not feel like a failure if they do need medication right like this is you know some some of our world is out of our control the toxins we're exposed to the genetics we were

Balancing Natural Care with Medications 28:38

given the you know um whatever happened to us in childhood whether it's an adverse childhood event like a trauma or you know other things that really affect how our genes are expressed um It may be that that we do need the additional tool in our toolkit, but we're just speaking to the fact that there's so many other options before we fill that three prescriptions, right? And then the other thing I wanted to say about that is that also if you're in sort of like an urgent situation, like sometimes the tool is necessary, like you said, you were using the steroids like to get you out of that danger zone. Um I because I've had a patient that came in who had ulcerative colitis which is another autoimmune condition um affects the GI system causes bleeding and can cause like dangerous anemia if people continue to bleed. And he was bleeding constantly.

Liquid stools all day long and he just wanted to take the natural approach. And I was like I want to be your biggest cheerleader for the natural approach but I need you to stop bleeding first. I need you to you know have this get out of the danger zone. We're not even talking biologics. I'm talking about simple like, you know, oral medication, ethical, whatever, you know, whatever we choose to do. But, you know, we want to get out of the danger zone and then work on, you know, reversing with lifestyle. So, I think there are times where people are so like in this like separate spectrum. I mean, everything in the world is you're either on this side or this side at this point in time. Um, that people are like so afraid of the pharmaceutical industry because they've been taught, you know, all these natural approaches. But really like sometimes we have to come into the middle and say yes I need to use this piece right now and then you know I can journey on this side as I you know you know get things under control a little bit. So have you guys had other experiences like that where people are like resistant to maybe doing doing the pharmaceutical thing but really maybe need to at that point in time. I once met a girl um met a mom whose daughter had very severe eczema and um you could see that it had she was affected for several years. I think she was like 8 n years old and her mother didn't believe in any medications and she had red scaty patches. Some were old, some were new, and she was itchy. And um and I was quite shocked by her by her hesitance and resistance to like conventional treatments. And and I think talking to her and explaining to her that she needs this right now to help her get out of it, but yes, you're right. There's something else is affecting her which we need to find out together. >> Right. Mhm.

>> And I think having that conversation, having that talk because I sometimes I think the conventional medicine um dialogue is somewhat more prevalent in some areas of our community. So having that conversation, yes, you're right, but right now your daughter is hurting and she needs this and then we can figure out what is causing this so it can go away from the um from the root. >> Having that conversation piece is very important with people like that. >> I mean, I understand. >> Yeah. Yeah. I mean, from eczema standpoint, I mean, like, they need to sleep, right?

These kids are itching all night. They're waking up at night. They're probably waking you up at night. Like, sometimes calming it down with some creams and maybe not even a steroid cream. There's all kinds of other cool things on the market now. Um, but yeah, figuring out a way to help them be comfortable while you're addressing and peeling back the layers of of what's going on, the root causes can be, you know, helpful for people. Sorry, Diane, I interrupted you. >> Oh, no, no. I just had an example too.

Um cuz I actually think it's very very common. Um a lot of the patients that I see, you know, they're coming to me because they want that natural approach first. Um and so recently I had a patient who didn't want to start on a statin. Um and a you know, it's just it's interesting. A lot of people I do find are scared of statins. Um, and of course there are side effects to every medication, but you know, when you get to the point, I think her her LDL was like 170. It was very high. Um, and you know, she was in her 60s and I was explaining to her that, you know, her cardiologist has been pushing it for some time. She was hesitant, resistant. Um and she came to me and she you know we were talking about it and I said listen um I really think that conventional medicine has a very important place you know without it half of us would not be men most of us would not be alive um and the thing is that you have to weigh the risk and benefits and if you're going to say to yourself is the risk of actually not taking this worse than taking it then that's when you you take it you know if the if you are going to put yourself in more danger by not taking it because um you know your heart is you're in a very high risk for you know the number one unfortunate killer of women which is like heart disease. Um it's something that you know I also feel like as pharmacists we're perfect to kind of be that middle person because we love natural medicine, we want you to be healthy. We love lifestyle medicine, but we're trained in also pharmaceuticals and we know when they're safe and when you should use them and when you should use them first and when you should wait.

And I what I tell my patients is just because you start something doesn't mean it's forever even. You know, like you can go on something and then implement all of your changes and guess what? Maybe you're going to lower your dose or maybe you're going to get off of it and that's just as good, you know? So like you said like we have to make patients >> don't feel like failures because I think people think >> oh if it's stress if it's only stress or only lack of sleep then it's my fault you know that this is happening but that's you know everyone gets stressed and everyone had you know everyone can experience sleep issues and like you were saying there's things completely out of our control. So th those are the conversations have with my patients when they're very scared to start something that really is necessary in terms of like a very like life and death situation like or um you know it's just going to really make them feel better in the short term and then they could work on themselves and I think like anti-depressants or you know psychmes is another great area where people a lot of people are very very resistant to anything because they feel ashamed too that they can't just be happier. Um and sometimes when you know you tell people who are on this more severe end who maybe have tried natural things and things aren't working and things are getting worse. Um, you know, sometimes you might need a boost to get your mindset into positive thinking and work on that that strength, you know, strengthening positive thinking and not ruminating because and then you get out of the weeds, you know, and then lower the dose or maybe you're going to get off of it in a year and then people just feel so much better when you're not because I feel like a lot of times I've had doctors say to me twice >> in my life that you will be done this forever. And I'm like, how do you know? Like really, you know, like me, that's just like so silly to tell someone you're going to be on this forever because not only is it take away hope and and makes you discouraged and and feel that you have no control over your health and it's just not the case.

>> I think that's a good point. >> I think that's a good point because >> when I asked my clients, did the doctor tell you the end point? you know, how long will you be taking this medication? And they say, "No, I I think it's forever. I think it's for life." And it's kind of like shocks me and stuns me like they haven't been told. If you get an LDL of this, we will stop this medication, right? Or we will do something else. Um, not knowing the end point is kind of scary and I think everyone should advocate for themselves and say, well, how long am I expected to take this and what results do you hope to see? You know, some of these questions I think we can empower our clients and empower ourselves to to that we should be able to com be comfortable asking these questions. How long do I need to take this? What do you hope to see from this? What is data out there? Do you have any evidence on this? You know, how many clients have you given this medication to? Has it worked for them? So, these are important questions. >> Yeah. Yeah. That whole statin conversation could be a whole another podcast just on you know the primary prevention versus secondary prevention and you know obviously the cholesterol itself isn't causing heart disease but the damage to the cell that's caused by inflam or the vessels caused by inflammation and glucose regulation and all that are really you know the main root cause. But if you've got that going on and you've got the high cholesterol then you're you know creating this perfect storm. So um but yeah that could be a whole another podcast. There was a really good picture that Dr. Oz actually showed at the conference I was at last

Closing Thoughts on Advocacy and Longevity 37:48

weekend of like he it was actually a picture of Rosie O'Donald's like he had like her story as an example um and then had this like little image of her and like what was happening in her heart and like the heart it was really cool but I don't know if he'd be willing to share that. I don't know even how to contact him other than social media like hey can I share your your image of Rosie? Um but yeah so I think we've covered a lot of awesome things today. Thank you guys so much for, you know, being part of our journey here and helping patients to thrive. And, um, you know, hopefully the message was just really clear today that, you know, being an advocate for yourself, pulling alongside your guides and your team, um, can be really, you know, helpful to really, you know, balancing out what you're hearing from conventional medicine because everybody needs a PCP, a primary care provider to rule out all the crazy things and to um, really keep them out of the danger zone. like we've talked about, but really to optimize health, um, we really want to dig deeper and, you know, go into that functional and integrative medicine side of things and and get you on your path to that longevity, um, side. So, thank you guys and hope you guys have a great rest of your