Inflammation: The Hidden Driver of Pain, Fatigue, and Irritability After Menopause

Intro to Senescent Cells and Menopause 0:00

There are cells in our body called zombie cells, which are senescent, meaning they refuse to die or undergo something called the apoptosis program cell death. It's like they're big blobs and they are laying around and secreting all these toxins and it's sending inflammatory messengers to other parts of the body and cells of And so we utilize the process to kill those senescent cells. And that's called senolysis, senolitic. You can do that with really high amounts of what we call polyphenols from resveratrol and then use agents that come in and say, it's time to die, target these bad cells.

Have you made it past menopause or are you going through it now? I'm Dr. Pat McShane and on the Women's Health Span Voices podcast, I'll guide you through the menoppausal transition and beyond. helping you to thrive in this powerful time of your womanhood. Hello and welcome to Women's Health Span Voices.

Guest Introduction and Practice Background 1:12

I have a wonderful guest with me today, Dr. Paula Kruppstad, who goes by Dr K or maybe we'll call her Dr Paula today. Various names, and she is a physician in the Houston area. Her practice is called Hope for Healing. She's one of several physicians and a few nurse practitioners, et cetera, in that area. And she herself is a podcast host, Getting to the Root podcast. So wonderful to have you with us today and we'll be interested to hear all your perspective on things. Thank you, Dr. Kaye. Well, thank you for having me.

May I call you Pat? You may. Please call me Paula, for sure. Okay, all right, I will do that, yeah. Dr. K, Dr Paula has trained in pediatrics but also in adult functional medicine and her perspective is quite broad and it includes a lot of emphasis on genetic factors in healing and in illness. quite a lot on inflammation, quite on toxins and detoxification, some chronic diseases like Lyme disease, and I think that's kind of a big umbrella there. And I thought we would start by just talking about the average woman in post-menopausal years who might come to your practice, oftentimes unhappy with the results of the classical medical approach in a more limited medical practice and the kinds of symptoms that you have seen.

One of things we also want to come back and talk about is neurodegeneration as a specific syndrome, but Maybe you could tell us a little bit about the

Menopause Symptoms and Hormone Testing 3:00

kinds of things that women may come in complaining of and the kind of approaches that you and your staff would take to investigating those. Yeah, you know, that's a, it is a broad question. And, I think if we look at the perimenopausal period and then the menopause period, I think it's kind of funny. One day my husband asked me, who is not medical at all, this was several years ago, he said, I know this sounds kind silly, but have you gone through menopause? And I said yes. But what prompted that question?

He said well, you know, get together with these guys. from Bible study in church and we have lunch together and they're talking about how gripey and nasty their wives are. I went, well, you know, I'm really grateful to say that yes, many years ago I did go through menopause and you don't have to be the typical bitchy woman, that so many people complain about. So I think You've heard it, I've hear it. But being very irritable, you know, having painful intercourse, dry eyes, difficulty sleeping, waking up with summertime moments or having summertime moment sweating during the night.

We, you know, ask all the questions about lifestyle, but those questions and when we see someone come in, many times they ask about pellets, they asked about testing, topical, oral, and so we'll order blood tests, But then we also tend to look at urinary hormones to get an idea of where someone's at in in their spectrum of perimenopause, menopaus, and then actually I do defer to family practice doctor here in our practice. She's our Dutch test expert and one of our nurse practitioners, but a lot of my focus is on autism and neurodegeneration.

But being a woman who uses bioidentical hormones, we set the foundation with talking about their lifestyle because if you eat crap, you're going to feel like crap. So, yeah. That's a good aphorism to remember. Remember, and in one of your podcasts you said shop around the outside of the grocery store where the fresh colorful fruits are and eat fruits and vegetables and as many different colors as you can try something new. I recall you saying that in your podcast. Yeah, and it's not a volume either.

Inflammation, Genetics, and Functional Medicine 6:00

It's just exposing your body to different colors and different seasonal things. Maybe you could talk a little bit about chronic inflammation, which affects, I'm sure, people at any age, including especially perhaps women in their later years and how that can be the foundation of so many illnesses and definitely focus for treatment. Yes, yes. So, you know, when we look at different illnesses, itises, its inflammation, and if we don't deal with the inflammation then nothing really else is able to be cared for or taken care of.

One thing that we do at our practice is we ask everyone if they haven't had a genetic test. I'm not talking about deletions, additions, or syndromes, All I'm talking about is how their body functions. And we look at neurologic function and we looked at inflammation. So there's different systems that modulate the inflammation in our body and depending on what other symptoms someone is showing up with like a lot of gut things, a lots of depression, physical pain. We start with those systems. There's the toll-like receptor system, something called the JAKSTAT system.

Endocannabinoid and cannabinoid. And, but, you know, 80% of people's power is in their kitchen. If they're feeding themselves very inflammatory foods, dyes, additives, not real food, like you had mentioned, Pat shopping around the periphery of the grocery store and teaching our kids the same thing and using the verbiage. You know, when we get to be grandparents, we're like, We don't want our grandchildren to suffer, but it's like Am I feeding my grandchild poison? How much do I love them? And so it's kind of like, I'm that weird functional grandma who feeds siate chips and has dark chocolate and unreal quinoa gems with no dye.

It's all these things that fuel the body. So yes, we look at those systems of inflammation. I use this little, I have it sitting on my desk. It's a little proprietary genetic test that's basically, it looks like a mascara wand that, you know, someone just colors on the inside of their cheeks. And it's like, a window into one's soul. I so wish that my parents had that when I was young too, to be able to guide my care. You have a long, interesting medical history as well, so you've struggled with some of the very issues that you are now, I'm sure, counseling and treating people about.

Yes. So chronic pain is one of aspects of chronic inflammation and I think, and arthritic pain or joint, various kinds of joint and muscle pains in older women is very, very common and maybe you could tell us a little bit about that. Yeah, you know, I like that question. So when we think about pain, is it because we have tight muscles, so using a form of magnesium that does not cause a lot of diarrhea, but then if we're dealing with either osteo or rheumatoid arthritis, there's a wonderful immune modulator that deals with pain called palmitoyl ethanolamide, PEA.

And some people say PIA. Pia soothes support, but it's not P and it is not PEa. very similar to something that our body makes called anandamide and it means the bliss molecule. And so that is one of my favorite supplements to use for pain. But when it's severe, we want to drive down cytokines. So using a limited amount of, you know, a non-steroidal anti-inflammatory if you need to, but looking at all those other systems, so using pure cannabidiols that don't have THC in them or have the less than 0.3%. And then omega-3 fatty acids to lubricate the joints, fish oil, and then optimizing vitamin D-25 hydroxy.

So using D with K so that we don t pull calcium from the bone and deposit it in the arteries and the kidneys and pushing that towards 80 to 100 and.

Chronic Pain and Joint Support 11:00

That helps so much with pain and depression and neural inflammation and joint inflammation too. So that's kind of how we approach that with menopausal women, perimenopause women. You mentioned sunshine and getting in sync with the circadian rhythms of your body, and maybe you could talk a little bit more about your experience with that. Yes, you know, we were designed to get up when the sun started shining and go to bed when sun went down, but our modern lifestyle a lot of times precludes that or we just don't do that with our crazy lives.

And sparing ourselves screens an hour before bed, It makes it a little difficult when you live in places that have limited sunshine, but that's really something to try to do to get your body on that seasonal go to bed when the sun sets and wake up when the sun rises and it's really good when we talk about the pediatric spectrum. It's so funny. The whole idea of seeing adults, it just kind of freaked me out. One of my mentors in functional medicine said, well, you're a doctor, aren't you? And I went, yeah, I am.

And since I started out looking at these precision genetics, because that's what helped me, went back to my bread and butter. So I love seeing kids, but the occasional grown up man or woman who slides in to see me. I know my boundaries, but I love progesterone because pro gesterones makes everyone feel, all women feel better. Even early on. Just to go back for a minute about the sunshine and the vitamin D and so on, I have a talk in my doctor talks and YouTube podcasts about circadian rhythms in it.

I was not very well trained in this, like most physicians probably, and I've been practicing fertility medicine for most of my career. So I, was a little surprised to learn how broadly our body is entrained. to the light-dark cycle naturally if we allow it to be and how many of our organs have internal clocks and the organs need to in synchrony. Our gut certainly has a clock in it and when we eat, you know, not eating our last meal at 9 p.m. and then going to bed at 10, this all has to do with inflammation and basically over and stress on our bodies and overall well-being.

Yeah. You know, it's interesting you brought that up because, you know they didn't train us in medical school to administer vitamin D with vitamin K and that some forms you know they're not going to clot the blood and how important it is and I just find it so interesting that well some people genetically don't have the receptors to absorb vitamin D through the skin so it doesn't even matter how brown and tan they are from being out in the sun. But if they don't have those receptors, then it's not going to get in.

There have been discussions pushing that upper limit of normal to around 100 or even 130, and it goes down so rapidly. So Yeah. And you know what you mentioned about internal clocks. It's so true. Our adrenal glands kind of coming online and how there's that peak and trough and two peaks during the day with our adrenal gland. When we still administer steroids, if if people need to have it for croup or for asthma or those kind of things to hit it in the morning so that they aren't

Circadian Rhythms and Vitamin D 15:00

up all night long too. So I'm glad you brought that up. Yeah, I think measuring vitamin D levels has actually made it into mainstream medicine and I forget what percentage of us are deficient, but it's It's huge and especially in older ages because we are not as active outside or active in general as younger people typically. And we have been indoctrinated into the use of sunscreen, which I totally believe is the right thing to do for most of us to prevent wrinkles and skin cancer more significantly, but that on the other hand, even if we have normal vitamin D receptors and so on, it means that we are walking around with low vitamin d levels and that in turn is associated with many, many downstream illnesses.

Most recently, I think the folks who had the higher vitamin D levels in the COVID epidemic were more likely to survive their hospitalizations than the people who have deficient or low vitamin-D levels. So that's something that our audience, even if you're in a conventional medical practice and you haven't had your level checked, that you might want to check into that. You do check vitamin levels as a routine and you ask people in your practice in detail about their behaviors and probably about the sun exposure is my guess.

I haven't been through your paperwork, but yeah. Yeah, we do. Someone talked me, one of my mentors, when I kind of transitioned out of mainstream allopathic pediatrics and went all functional. He brought up, and this was interesting, the Northern Europeans and McShane, I assume that's Northern European. Yes, yes ma'am. And me too. I've got like Scotch, Irish, English, is that individuals who survived the plagues. They, you know, they tend to have more autoimmunity and they're wired to actually have much lower vitamin D levels.

So the green-eyed, the blue- eyed people with strawberry blonde red highlights, You know you've got those strawberry red, red highlight yourself. We start checking vitamin d levels on our babies. In fact, we have infants from zero to four months take a thousand international units of liquid D3 plus K2 every other day. And then when they hit four months, They do a thousand every day and in almost 11 years, I'd say I've only had maybe 15 kids that have a vitamin D 25 hydroxy level that's over a hundred out of all those years.

And you know, we add a D into our one year CBC for our 1 year olds that start weaning off the breast if they wean off at that point in time. So we make it part of our. normal one-year labs and it is an epidemic like you said it really really is and people just don't spend as much time outside like, you and I probably growing up we spent so much outside growing, up barefoot in the sunshine but now it's the mineral zinc containing sunscreen that we recommend with a really good rating on ewg.org, environmentalworkinggroup.

org to protect the skin there. Yeah. Yeah, so too, it is possible to take too much vitamin D. So I don't encourage people to over overdose themselves. But, um, as you said, with the kinds of dosing that you're talking about in infants, you didn't see a problem. No. Certainly don' take to much because all the fat soluble vitamins are possibly toxic at certain levels. Right. And just to go back to inflammation for a minute, it sounds like that the major approach that you would have with someone in whom you made a diagnosis of hyperinflammatory state has to do with their nutrition, their dietary choices, but perhaps there are other things that one might do as well.

Yeah, you know, and I know too, though, when people come to you, their history is unique. So that's why we asked for that foundational genetic panel. And we look at all their lifestyle modifications and what they eat, has so much influence. But a big thing here in Houston and in so many parts of the world and the US is water damage. And within the interior of a water damage building, it's not just mold. There's only five molds that make mycotoxins that tend to make people sick because we get good stuff from mold like penicillin and- Cheese.

Yeah. Yogurt and cheese. I like those. But then there's bacteria like gram-negative bacteria and then also gram positive bacteria that are within interior water damaged building. So there are certain tests and certain questionnaires we screen them for, for something called biological toxin illness. And I'm not talking lead, mercury, cadmium, arsenic, you know, those are toxins, but they're not made by living organisms.

Water Damage, Infections, and Senolytics 21:00

So we look for those and then also for infections that have gone undiagnosed. So people that are in pain, do they have reactivation of Epstein-Barr? Or a lot of folks are carrying around a lots of antibodies from COVID and also spike antibody And we measure their IgG for COVID. And this is something that's relatively new on my radar. But when we think about all of us, COVID is now endemic. When we about ongoing inflammation and pain, There are cells in our body called zombie cells, which are senescent, meaning they refuse to die or undergo something called the apoptosis program cell death.

It's like they're big blobs and they are laying around and secreting all these toxins and it's sending inflammatory messengers to other parts of the body and cells of And so we utilize a process to kill those senescent cells, and that's called senolysis, senolitic. You can do that with really high amounts of what we call polyphenols from resveratrol and then use agents that come in and say, it's time to die, target these bad cells. So I'm encouraged we've been doing this with a lot of folks that have come in with uber high amounts of inflammation and sky high amount of COVID immunoglobulin G and then spike antibody and watching those antibody titers fall using these agents in a cyclic fashion.

So these days when folks come in, when we look at chronic pain and chronic inflammation, COVID is one of the biggies. And then we also have to think about like Lyme disease or Bardenella, those kinds of things, depending on what part of country you're in and what your symptoms are. So that's kind of our approach. It's a lot of stuff that it's tailored to the person who shows up on our doorstep. Mm-hmm. Yeah. Yes. And a lot of the symptoms, I'm sure, are pretty nonspecific and may warrant you, you know, three or five prescriptions to deal with your depression or your insomnia or various aches and pains and so on.

So folks may have had little relief in spite of multiple various approaches and seeing different specialists and So that's, I'm sure a treadmill that people have been on many, many of the folks that, that you see. We've talked about sleep and diet. we haven't talked specifically ultra processed foods and some of known harms that result from, from those. And in my series so far, we hadn't really talked in any detail about the definition of ultra processed foods, which can be a little tricky and some of the known and presumed harms from ultra-processed foods.

But maybe you would care to say a few words about that. Yeah, you know, when you pick up a box or a can or container, and if you can't pronounce the names, then it's like, there's something wrong here. Or if you don't have it in your kitchen is another way. I've never heard of sodium bisulfite in my kitchen. Yeah. Yes, yes. So I think some of the big things are and you know the food industry with their labels and that kind of thing they get away with a lot and actually you would think that you, know people think Chick-fil-A it's a great option but they actually add more monosodium glutamate, MSG, to a lot of their products, along with McDonald's and other places.

Monos sodium glutame causes brain inflammation. It hides in names like yeast, hydrosalate and the dyes. I'm really glad, regardless of what people's political inclinations are removing red dye. We've known for years that that's a problem. There was a guy named Dr. Feingold years ago that said take out the dye, take our salicylates and take the refined sugar and see what happens for kids. and adults with ADD, ADHD, they thought he was crazy and they laughed at him. And now the fine gold diet is part of the medical school curriculum, you know, removing those things and it's like, all of data coming to light that was there.

But yes, if you can't pronounce it, If you cant pick it from a tree, I just tell people, whole foods, grass-fed beef, bison, chicken, fish, poultry, fruits, vegetables, things that you could pick from a tree, catch, those kind of things. And even going so far as using the verbiage with our grandkids, you know, I'm a grandma and I say, my grandson says, is a poison grandma? Like it sure is, you know, it's poison. And so, and you see it all the time, these kids with juice boxes, or you're walking through a store, all these children with dark circles under their eyes, we know that it is interesting.

The grains in the United States, glyphosate, which is Roundup, it's ubiquitous in European countries outlawed eight years ago. It's considered carcinogenic in Europe, but we're not so sure here in U.S. whether it is carcinogenic. Even our organic stuff, you have to be careful and know where it comes from. ultra-processed foods, things that you cannot pronounce, and the dyes, preservatives, those kinds of things. That's concerning. Whoops, excuse me, I'm not tired. Another thing is fortified with folate.

Actually, fortification with synthetic folic is not a good thing. It should be bioavailable, what you find in natures. try to ask people to avoid that because it literally binds to and junks up the machinery for getting the right kind of folate that you get from dark leafy

Ultra-Processed Foods and Dietary Triggers 28:00

greens and a nice, rare ribeye into your body. Another food item that hides under many labels is sweeteners. Sucrose, glucose, and they're all pretty much in the same bucket as far as they are not healthful, health promoting. And I'm not sure if I saw this in one of your materials or just in general, but it's like, how do you feel after you eat certain things? Do you have afternoon drowsiness after that hamburger with French fries and soda for lunch versus a salad with some chicken or whatever? you know, listening to our bodies is part of this.

So, yeah. Yeah, if you're falling asleep an hour after meal, by definition, you've got a leaky gut for sure. But I liked what you had to say about artificial sweeteners. You know Truvia, people think they're doing a good job with Truvida, but that actually has Splenda. which is sucralose and it's carcinogenic and its added and It's a labels game, you know, if it so small that it is not a certain percentage. So I'd much rather people have coconut sugar because it does not. It is a one-to-one swap for refined sugar as far as when you're cooking, but it Does not cause an increase in blood sugar like refined Sugar does and then mess with your insulin, so that's kind of a nice thing to be aware about.

Coconut sugar, it's just a little more yellow or brown, organic, of course. I haven't heard of that, but I'll have to look into it a bit more. We talked about habits a bet, and again, in one of your materials it says, progress, not perfection. And let's say I'm somebody who's, you know, eating the average American's diet of 60% ultra processed foods. And I want to, I wanna move away from that. I say, yeah, do feel kind of sleepy when I have that hamburger and french fries and soda for lunch. How do you advise your patients about moving in the right direction rather than, January 1st, so I am going to stop.

ultra-processed foods completely and then January 15th, you're like, well, I'm miserable and you know, whatever. That is a phenomenal question. It's pick one thing, pick on thing. And that's why it's really good to work with a health coach. This is one things that I work, with parents of kids with autism, but the principles are the same that gliadorphin, which is from barley rye, oats wheat spelled gluten from gluten binds to cerebral folate receptors and that is a very common problem and I'm sure you having been a fertility specialist everybody and their brother talks about MTHFR but that's those are two enzymes out of seven And you don't have to have MTHFR to a profound methylation issue, but it's a pretty common problem across the autism spectrum.

But picking one thing, and a lot of times I'll start with dairy, because casomorphin does the same thing, binds to cerebral folate receptors and getting children off of cow's sheep or goat milk, because we're not maybe cow sheep for goat. You never see a bull sucking mama's titties when you drive by a meadow. But for parents, it's so overwhelming, especially when they're eating dogs, chocolate milk. goldfish and peanut butter and jelly sandwiches. You have to pick one thing that you're going to remove and the same principle goes for adults.

We tend to be so hard on ourselves, but we extend so much grace to other people. And then two, I don't know about you but as a medical professional, i'm so than I am on my patients or my team members. I'm like, it's okay, you know, we all make mistakes. But then I like in my mind, so that's something that I had to discard a long time ago. And certain things are so tempting. That just can't be in our household or I'll eat it. or drink it. You know, it's too hard for me because I struggled with addictive tendencies and I know what is too hot for my.

So it is all about creating a sanctuary for yourself and you know if somebody wants to start with you using up everything in your pantry that has dye in it, using everything up in the pantry with crazy names and then not restocking the fridge with whatever and replacing it with maybe almond coconut or that kind of a thing. Just whatever affects certain people and some people it doesn't affect them like it does maybe the population of folks that I work with. Interesting. One person came to us. It's a gentleman who was struggling with crippling anxiety and insomnia and he removed dairy.

And he increased his sleep almost immediately by an hour and 15 minutes every night. And it was almost like the anxiety was gone. Who would have thought? I mean, who would've thought something as simple as taking that out? For him, that's what worked. I'm sure he had been on five different kinds of anxiety medications for many, many years and therapy and whatever. Yeah, it's sad. Yeah. Well, good to know that approach, yeah. Talk a little bit more about sleep. We've recently had a sleep episode that I highly recommend from a asleep physician who talked more the higher end of sleep, but it's good remind ourselves at times of some of the simpler sleep hygiene as it is called, methods that we should all be doing on a regular basis.

It's always good. I'm glad you asked that. One of the simple hacks is elevating the head of bed because our brain has something called the glymphatic system.

Sleep Hygiene and Environmental Factors 35:00

It's like the lymphatic system. I talked to parents about this. So if your child, if you can raise the head of the bed by a quarter to a half of an inch, so those furniture movers they have at Home Depot or Lowe's that are elevated a little bit just at the ahead of bed. If your kid's a starfish and they're all over the bad and then wrapped all their covers everywhere, you just do your best. Then not having artificial light, blue light before bed, And a way that parents can do that, you can take your phone and you change the color on it and it's not attractive.

It takes a little finagling to do. Also eliminating electromagnetic fields. So you see my phone is in a cover, radio armor that blocks electromagnetic field, putting your phones six to eight feet away from you, also having a cool room. and where all the light is blocked. So if you're an adult using an eye cover, potentially earphones, if it's a child covering even the little light on the carbon monoxide detector that might be just above their grid, If there's router in their closet or their room covering that with say copper to make like a little fairy day cage copper cloth, so that they don't get that exposure and not eating close to bed like you brought up.

You just can't eat a big meal because you don' want to stimulate, you know, repress growth hormone release and all these healing factors that come out when you sleep. So raising the head of the bed, not eating too close to bed, you know, allow two or three hours, blocking blue light, locking EMS and having a good bedtime routine, routine predictability. And for adults that may use the CPAP, make sure it's not growing garbage inside of it like mold. They could be actually making themselves sick if your CPAP is messy.

So that's kind of like my little sleep spiel that I give to folks. Okay, well, that's good. And maybe a few words about activity and exercise, which again is so foundational to health. Again, as we get older, we tend to be less active, not like our younger selves. How would you advise an older woman to approach being more active? Yeah, you know, walking is free. It doesn't cost anything and it gets you outside and, choosing to park away from buildings so that you get a little movement in. This actually kind of dovetails with sleep, but getting an aura ring, my husband and I kind go, well, let me see your score last night versus my score.

How much REM did you got? How deep sleep? That kind And, you know, it's so important to the older we get to have weight bearing and for our bone density and optimizing testosterone. and DHEA and those kinds of things so that we don't lose bone density. So small weight. And again, that kind of dovetails in with the progress, not perfection. I'm preaching to myself on this because exercise to me, it has a bad connotation instead of movement and movement. Choosing to go on that walk with my daughter and my granddaughter and her stroller and just get a little movement through the neighborhood.

and time to walk, time, to pray, and stick your earbuds in and talk to your friends and just get out there and move a little bit. It's so important. In my brain, I think about the centenarians that everyone's always studying, and most of them have never set foot in a gym. You know, they have just been active. So I call it activity, usually movement and exercise. If you're very, very busy and you in an sedentary work environment and that's the only thing you can do is half an hour in the gym, great, do it, but otherwise for most of us in our later years, we have more options and we're not stuck sitting in a chair all day or behind a computer anyway.

Movement, Detoxification, and Prevention 40:00

Anything else you would offer to our menopausal women about maintaining their health and the kinds of issues that might be worth looking into more? Yeah, you know, when you're working with someone, remember that your hormones are downstream. They're downstream from the inflammation in your body and inflammation is from your environment, maybe from interior of a water damaged building or a seapap that's growing garbage in it. and an infection and then the hormones come after that so hormones don't fix everything as you know and I know you can take all the Hormones in the world but it'll never take care of a crap diet either so we want to be giving ourselves you Know the colors of the rainbow but that guy is very very important and the postmenopausal woman The other thing that tends to come out are toxic metals.

You know, we grew up with lead pencils before they switched over to graphite. And leaded gasoline when I was a child, yeah. Yes, and it's still in the environment. Yes. That's right. And now with refineries and all those other things, I mean, we are the most toxic, our toxic generation right now. So I think that working with someone who could help someone detoxify, well, there's a lot of Simple supplementation and things that you can do, looking at these genetics and how you detoxify, but also looking, at foods that are in the cruciferous and mustard brach of vegetables, you know, mustard, broccoli, Brussels sprouts, asparagus, You know, those are just a few.

Those are so good at helping our body detox by chlorella, cilantro, parsley, a lot of the spices, you know the things that we have available. And it's just matter of spicing up what you're eating and giving your body what it needs. You and I know Pat that when we give our bodies what they need and we take away what we don't need, it is innately able to heal itself, but it might need a little oomph and a push, depending on how beaten up we are. The flip side of that, which is particularly relevant for we older individuals, is that our bodies can maintain a steady state for a very long time, even in spite of various insults that we throw at it.

So if you feel well, you still have things that probably need to be fixed or changed. Don't wait until you have that heart attack or you can't breathe anymore when you walk up a flight of stairs. So that's the flip side of our body's amazing ability to heal is to hide problems until they become severe sometimes. Yeah. I think women are the worst. You know, you just shove that and you ignore it until it's so bad. Yes. It's very important. We're taking care of everyone else, our children, grandchildren, parents, and spouses.

I hear you on that one for sure. Wonderful, wonderful information and thank you so much for sharing your experience and your wisdom with us, Paula. And I hope this is helpful information for our listeners. If so, please tell your friends and we'll see you again soon. Thank you. Thank you for having me. I sure appreciate it. If this episode spoke to you, please share it with a friend ready to take charge of her health. And please leave a review. It helps more people to find us.