Latest / WHAT I'VE LEARNT / What I've Learnt - Dr. Ginni Mansberg (2023)

Transcript

What I've Learnt - Dr. Ginni Mansberg (2023) · WHAT I'VE LEARNT

• 0:05
  SPEAKER_02: Taking care of our brain as we age is a critical choice.
• 0:08
  SPEAKER_02: Save Your Brain is a new book by renowned Doctor Dr.
• 0:12
  SPEAKER_02: Ginny Mansberg.
• 0:14
  SPEAKER_02: In it, she provides simple steps and proven strategies to reduce your risk of cognitive decline, all before it's too late, we hope.
• 0:21
  SPEAKER_02: The evidence is clear: almost half of all cases of dementia and cognitive decline are preventable.
• 0:27
  SPEAKER_02: But sadly, none are treatable.
• 0:29
  SPEAKER_02: So, what are the lifestyle changes that really make a difference to our brain health?
• 0:33
  SPEAKER_02: What do the experts do to protect themselves from their own cognitive decline?
• 0:38
  SPEAKER_02: And what can we do right now to preserve our quality of life as we age?
• 0:41
  SPEAKER_02: Save your brain answers all of these questions and more.
• 0:44
  SPEAKER_02: As we age, dementia and Alzheimer's pose a serious threat to our health and well-being.
• 0:49
  SPEAKER_02: To give us a running start in the fight against all of these issues, GP and a claim broadcaster Dr.
• 0:55
  SPEAKER_02: Ginny Mansberg presents the very latest evidence-based research on how to protect your most valuable asset, your clever, vulnerable, powerful brain.
• 1:05
  SPEAKER_02: As the health of our brains increasingly takes centre-stage, Ginny gives up to the minute advice and strategies you can implement now to protect your brain as you age.
• 1:15
  SPEAKER_02: It really is a must-read for anyone looking to maintain their quality of life or that of a loved one.
• 1:20
  SPEAKER_02: So grab a copy, and the other thing that I think is important to mention is that Ginny is also a menopause expert.
• 1:28
  SPEAKER_02: So she's also developed a new 360-degree solution for menopause in the workplace, something that we're going to chat about on the pod when she joins me in just a few moments.
• 1:39
  SPEAKER_02: So I look forward to discussing all of the above with Dr.
• 1:42
  SPEAKER_02: Ginny.
• 1:48
  SPEAKER_02: So Ginny, so good to see you again.
• 1:50
  SPEAKER_02: You and I have had a few chats before.
• 1:54
  SPEAKER_00: And it did you just say earlier before we started recording 2017?
• 1:59
  SPEAKER_02: Yes, that's how I can't I know.
• 2:02
  SPEAKER_00: Pre-vented how has that happened?
• 2:04
  SPEAKER_00: Yeah.
• 2:05
  SPEAKER_00: What happened to the that's six years ago?
• 2:08
  SPEAKER_00: That's just wild.
• 2:09
  SPEAKER_02: I feel like I talk to you all the time, but it turns out so Ginny, yes, I think we actually had a podcast about 2018 as well.
• 2:17
  SPEAKER_02: So, you know, I'm always interested in what you're doing because you're always doing great things.
• 2:21
  SPEAKER_02: Um, and as a doctor who is in the media and very savvy in terms of communicating what are often complex issues in a very accessible, bite-sized way.
• 2:32
  SPEAKER_02: I love having you as our regular and more regular uh Dr.
• 2:37
  SPEAKER_02: Ginny Mansberg.
• 2:39
  SPEAKER_02: So come on and tell me all about what you've been doing.
• 2:43
  SPEAKER_02: This is particularly interesting because Ginny's brought out this new book um called Save Your Brain.
• 2:50
  SPEAKER_02: Is that right?
• 2:51
  SPEAKER_02: Have I got that right?
• 2:52
  SPEAKER_02: Yeah.
• 2:52
  SPEAKER_02: I love that.
• 2:53
  SPEAKER_02: Yeah, save your title.
• 2:54
  SPEAKER_02: I just love the title.
• 2:55
  SPEAKER_02: Save Your Brain.
• 2:56
  SPEAKER_02: What a great title.
• 2:57
  SPEAKER_02: So talk to me a little bit about where this came from.
• 3:02
  SPEAKER_02: Why did you decide to write this book?
• 3:04
  SPEAKER_00: So I think a lot of us at our age are starting to get parents who are maybe not as right on the, you know, the button as we used to have it.
• 3:14
  SPEAKER_00: And we're in that real sandwich generation of trying to look after our parents, look after the elderly.
• 3:18
  SPEAKER_00: At the same time, I feel like in Australia we had like the Aged Care Royal Commission, and it was just looking like life in a nursing home is actually a nightmare, only to go out of the aged care royal commission.
• 3:30
  SPEAKER_00: In fact, it hadn't even finished before COVID hit.
• 3:33
  SPEAKER_00: And all of a sudden, people in nursing homes were not just dropping like flies, but were absolutely miserable because they were being stopped from seeing any of their loved ones.
• 3:42
  SPEAKER_00: They were completely lonely.
• 3:43
  SPEAKER_00: And all I could think of is just don't want to end up like that.
• 3:47
  SPEAKER_00: Like I just don't want to end up like that.
• 3:49
  SPEAKER_00: He is.
• 3:57
  SPEAKER_00: If dementia's coming for you, it's coming for you.
• 3:59
  SPEAKER_00: And it turns out that a third of dementia can at least be prevented altogether.
• 4:04
  SPEAKER_00: And we can probably do things to delay it by about five years.
• 4:07
  SPEAKER_00: All of us can do things like that.
• 4:09
  SPEAKER_00: However, the critical piece is we've got to start now in midlife.
• 4:13
  SPEAKER_00: So there's no point in sort of hitting 65, you know, 70 and just going, oh, oops, my brain.
• 4:18
  SPEAKER_00: Now let's start doing things.
• 4:19
  SPEAKER_00: It looks like by that stage, because it takes 20 years for the signs of dementia to sort of crop up at all, by the time you're actually showing signs of being a bit forgetful or even being a bit paranoid or having some personality changes, like there's a lot of damage that's actually done.
• 4:33
  SPEAKER_00: And if you're gonna take steps to avoid dementia, the time to do it is now.
• 4:38
  SPEAKER_00: And I think that yes.
• 4:40
  SPEAKER_00: And I think that's just like, I know it's coincidentally the time of your life where you are the most insanely busy you will ever be.
• 4:48
  SPEAKER_00: Um, people think that you're really busy as a young mum, and I agree you are, but you almost kind of accept that your career is not gonna be crazy, and your parents are, if anything, helping you out.
• 4:56
  SPEAKER_00: They're not like an emotional toll.
• 5:01
  SPEAKER_02: Exactly.
• 5:01
  SPEAKER_02: You're you know, you don't really see it coming, do you?
• 5:04
  SPEAKER_02: You don't see that you're suddenly look, you're still looking after kids because even if they are on their own behalf, they are still in need and they still need support.
• 5:13
  SPEAKER_02: But then you've got elderly parents that you're worried about.
• 5:16
  SPEAKER_02: So you're right, the sandwich generation is something we're not really that prepared for, or it's not, and it's only recently been talked about in this way.
• 5:23
  SPEAKER_00: So 100%.
• 5:24
  SPEAKER_00: And it's a peak time for divorce.
• 5:26
  SPEAKER_00: And if you're not getting divorced yourself, one of your girlfriends is, and you're sort of like you're pulled into the drama that is your best friend's divorce, the vortex, and then you're still trying to take mum to all her doctor's appointments and worried because you know dad's not taking his pills and everything else.
• 5:43
  SPEAKER_00: So I think it is really busy.
• 5:45
  SPEAKER_00: So what I tried to do was to say, yes, it's all about doing making some changes now, but it can be super easy.
• 5:51
  SPEAKER_00: And so I'm not sitting in here going, right, no takeaway for you.
• 5:55
  SPEAKER_00: You're now going to give up your gin and tonic.
• 5:57
  SPEAKER_00: You're also gonna start, you know, exercising for 45 minutes a day.
• 6:00
  SPEAKER_00: If you have time for that, good on you.
• 6:02
  SPEAKER_00: I'm excited for you.
• 6:02
  SPEAKER_00: I certainly don't.
• 6:03
  SPEAKER_00: But it's more about like what can you do to make some really simple changes that can actually really make a significant reduction in a risk of having um you know dementia when you're older.
• 6:15
  SPEAKER_00: Like it's a bit of a no-brainer.
• 6:17
  SPEAKER_02: Literally.
• 6:18
  SPEAKER_02: I mean, what is quite extraordinary is that I think only until recently people have never thought that we could be proactive and make changes that would impact that.
• 6:27
  SPEAKER_02: And something that I think is part of the context of this is that we're all talking about how we can address middle-age full stop, whether it's Naomi Watts talking about menopause with iron stripes, or which you will, you and I will also touch on.
• 6:42
  SPEAKER_02: It is definitely a great, if you like a middle-aged movement, they're actually talking about it.
• 6:48
  SPEAKER_02: Have you heard the the term genes, which I love?
• 6:51
  SPEAKER_02: And I'm really into it.
• 6:52
  SPEAKER_02: I think it's great, which is yeah, I love it.
• 6:55
  SPEAKER_02: You know, it's so cool.
• 6:56
  SPEAKER_02: Like middle-aged women taking control of their destiny, saying, I don't have to do it that way, I can do it differently, and I don't have to become invisible and and no longer vocal and no longer explore options.
• 7:08
  SPEAKER_02: In fact, whether it's Lisa Rena dancing a little tush-off on the, you know, which is hysterical, everybody is saying, wait, you know, and so you and I are privileged in some ways because the generation before us, literally before us, really almost became virtually invisible after 50.
• 7:26
  SPEAKER_02: Now it's great to see, like my daughter, you've got kids the same age as me.
• 7:30
  SPEAKER_02: My kids are saying, you know, they look to us as role models, as mentors, as people that actually do have control of our story.
• 7:38
  SPEAKER_02: And this is all part of it, what you're talking about, which is being informed, educated, and taking action.
• 7:44
  SPEAKER_00: Absolutely.
• 7:45
  SPEAKER_00: Because I think what we need to uh remember is that all of a sudden at midlife, we're earning money thanks to our mothers and our grandmothers who blazed that trail for us.
• 7:57
  SPEAKER_00: We've gone to uni, we've got good careers.
• 8:00
  SPEAKER_00: We don't, we are the biggest consumer body.
• 8:03
  SPEAKER_00: Like as a group, women like in their late 40s through to sort of mid-60s are the biggest consumers.
• 8:10
  SPEAKER_00: Um, every company wants to get us on the board.
• 8:14
  SPEAKER_00: It's really important for them.
• 8:15
  SPEAKER_00: And we actually are empowered.
• 8:17
  SPEAKER_00: We are educated.
• 8:19
  SPEAKER_00: We are, we know what we're talking about.
• 8:21
  SPEAKER_00: We know how to research, we know how to find things out.
• 8:23
  SPEAKER_00: We are not interested in just being told, you know, don't you worry, pretty little head about it.
• 8:27
  SPEAKER_00: Things that our mothers tolerated, we would never tolerate.
• 8:30
  SPEAKER_00: So we are in this amazingly fortunate position.
• 8:33
  SPEAKER_00: I think when it comes to brain research, what was really interesting is that for a long period of time, it's not easy to look at brains.
• 8:40
  SPEAKER_00: You know, you can really easily um do keyhole surgery and have a look at your liver.
• 8:45
  SPEAKER_00: You can have a look at your girly organs, you can have a look at your heart.
• 8:49
  SPEAKER_00: It's not easy to, there's no real keyhole surgery that allows you to just go in and like have a scurry around the brain.
• 8:55
  SPEAKER_00: You can pull it out after you're dead in an autopsy.
• 8:58
  SPEAKER_00: Um, you can scan it.
• 9:00
  SPEAKER_00: Scans are notoriously a little bit difficult to, you know, to work with.
• 9:04
  SPEAKER_00: So all none of this is particularly easy, but I would say that um we were learning so much more.
• 9:14
  SPEAKER_00: So we used to think that there was like dementia was Alzheimer's disease.
• 9:17
  SPEAKER_00: And now we know that very rarely do you get a single type of dementia on its own.
• 9:22
  SPEAKER_00: Very, very rare.
• 9:23
  SPEAKER_00: Mostly what you get is a couple of different types of dementia together.
• 9:26
  SPEAKER_00: And one of the big ones is what we call vascular dementia.
• 9:29
  SPEAKER_00: And that's like all your lifestyle stuff.
• 9:30
  SPEAKER_00: So all of the things that give you a heart attack and a stroke and, you know, not so, you know, slightly dodgy arteries in your legs, that's also working in the small blood vessels of your brain.
• 9:39
  SPEAKER_00: And what we know now is that if you get two types of dementia together, get a little bit of Alzheimer's disease, it maybe wouldn't have affected you for 25, 30 years, but you will also get a bit of vascular dementia, a little bit of white matter disease in your brain because the blood supply to your brain is not quite what it should be.
• 9:56
  SPEAKER_00: You can actually one plus one equals 57, and it makes your dementia worse.
• 10:00
  SPEAKER_00: Alzheimer's disease, even in its early stages, but you add in another risk factor for depression, whether it's like high blood pressure that damages the white matter because it interrupts the blood supply to the brain, or you get depression, or you're not sleeping well, and you add those things in, what you get is one plus one equals 57.
• 10:17
  SPEAKER_00: And so what we know is while, yes, to a certain extent Alzheimer's disease, we are a little bit at the early days of understanding just exactly why it happens, what genes are involved, how to treat it.
• 10:30
  SPEAKER_00: It is early days, and we don't have great treatments for that.
• 10:33
  SPEAKER_00: But we can take all the all the other things away that actually compound your Alzheimer's disease and make it worse.
• 10:39
  SPEAKER_00: So that that means we can delay your Alzheimer's and we can also prevent, it seems, about a third of it altogether.
• 10:46
  SPEAKER_02: That's pretty extraordinary stats.
• 10:47
  SPEAKER_02: So that really, once again, lifestyle changes, and they're not dissimilar to other lifestyle changes, obviously, preventative.
• 10:53
  SPEAKER_02: So can you give us some indication of what those might be and how, I mean, clearly, as you mentioned, it's not definitive because some of it can be measured and some of it can't.
• 11:03
  SPEAKER_02: But certainly what you're saying is we're certainly uh better to implement what we can and the risk that dials down.
• 11:12
  SPEAKER_00: So one of the most extraordinary pieces of research that has come out really recently that just really blew my mind was managing your blood pressure in midlife.
• 11:23
  SPEAKER_00: So there was a really, really massive trial that looked at people like our age, we're starting to get diagnosed with high blood pressure.
• 11:30
  SPEAKER_00: And in the past, we kind of had these number targets in mind that doctors were told to keep your blood pressure at a top number of at around about 140 and your bottom level at about under a hundred under 90, let's say.
• 11:44
  SPEAKER_00: Now we know from this massive trial that if in midlife we can keep your blood pressure much lower than that to a top of 120 on that top number, that's a lower blood pressure than we've ever targeted before.
• 11:56
  SPEAKER_00: We can drastically reduce your risk of getting dementia when you're older.
• 12:01
  SPEAKER_00: But it's all about what you do in midlife.
• 12:03
  SPEAKER_00: Now, if you're going to take a blood pressure medication anyway, why would you not just take a blood pressure medication at a level that will actually keep you healthier and your brain healthier?
• 12:13
  SPEAKER_00: Yeah.
• 12:14
  SPEAKER_00: So what we know with blood pressure is it's not like, you know, at 9 a.m.
• 12:18
  SPEAKER_00: on Wednesday, your blood pressure is the same at 10 a.m.
• 12:20
  SPEAKER_00: on Thursday is the same as 6 p.m.
• 12:22
  SPEAKER_00: on Friday.
• 12:23
  SPEAKER_00: You kind of move within the range your blood pressure.
• 12:26
  SPEAKER_00: And what we know is that if we keep your top number under, let's say 120, there will be times where that top number is really quite low and your blood pressure feels quite low.
• 12:36
  SPEAKER_00: And that can make you feel a little bit woozy when you stand up, and some people really don't like it.
• 12:41
  SPEAKER_00: And as a result, doctors will tolerate a slightly higher blood pressure so that we can avoid you falling too low.
• 12:48
  SPEAKER_00: The problem with that is, as this new massive prospective trial found, is that if we tolerate that higher blood pressure, yes, we protect you from having a low number on the bottom at certain times when you're a bit dehydrated and haven't drunk enough.
• 13:00
  SPEAKER_00: But at the same time, at the times when it goes higher, it is damaging your brain.
• 13:05
  SPEAKER_00: And it's really hard for anyone to tell you how much of that time you're spending at the top of your range and how much you're spending at the bottom of the range.
• 13:11
  SPEAKER_00: Hard to measure that.
• 13:12
  SPEAKER_00: But we now know it is really hard.
• 13:14
  SPEAKER_00: I mean, we do have these 24-hour blood pressure cuffs.
• 13:17
  SPEAKER_00: If anyone's ever worn one, it's very unpleasant.
• 13:20
  SPEAKER_00: It goes off at three in the morning, it goes off at five, you know, you have to wear this big thing on your arm and it's going off all day.
• 13:25
  SPEAKER_00: It's very, very annoying.
• 13:26
  SPEAKER_00: It's very accurate, but it's very annoying.
• 13:28
  SPEAKER_00: You don't want to do that too often.
• 13:30
  SPEAKER_00: And so, but what we can tell people with a lot more certainty as a result of this massive trial is when you're in midlife, if we can keep your range lower and just be aware that there'll be times where if you stand up very suddenly, you might feel a little bit woozy, but that's okay.
• 13:47
  SPEAKER_00: There's nothing to worry about.
• 13:48
  SPEAKER_00: That's not actually going to damage anything.
• 13:50
  SPEAKER_00: But what it is gonna do is protect your brain.
• 13:52
  SPEAKER_00: It's also probably gonna protect your kidneys as well, but we know that it will drastically reduce your risk of getting dementia when you're older.
• 13:59
  SPEAKER_00: And knowing that is absolutely fantastic.
• 14:02
  SPEAKER_00: It's a real, real game changer because it's something that all of us can do.
• 14:06
  SPEAKER_00: That's one thing.
• 14:07
  SPEAKER_00: Another thing is I think a lot of us don't realize how significant depression is as a risk factor for dementia.
• 14:14
  SPEAKER_00: Depression is a brain-shrinking illness, and you can see that in different scans when you do those scanners.
• 14:21
  SPEAKER_00: You can really, really see that.
• 14:23
  SPEAKER_00: And because midlife is the peak risk time for women, not only for depression, in fact, one in three women will get anxiety and/or depression during midlife, particularly around perimenivores.
• 14:34
  SPEAKER_00: It's a really we call it a period of vulnerability.
• 14:37
  SPEAKER_00: It is, you know, we are very focused on the postnatal period very rightly, and we are very focused on teenage girls, again, very rightly, but the biggest risk time for a woman is actually midlife.
• 14:47
  SPEAKER_00: And that's actually women between 45 and 55.
• 14:50
  SPEAKER_00: That's the highest risk time for suicide for women, which is an extraordinary number.
• 14:53
  SPEAKER_00: People don't talk about it.
• 14:54
  SPEAKER_02: It's an extraordinary, yeah.
• 14:55
  SPEAKER_02: And it's something that I'm surprised, yes, people don't talk about it.
• 14:58
  SPEAKER_02: And there's a little bit of a philosophy, like when I think about what you're saying, there's a philosophy of, well, you know, I'm a mature woman, I've had my children.
• 15:07
  SPEAKER_02: What, you know, people that talk about it and go, I don't know what's wrong with me.
• 15:10
  SPEAKER_02: Or, you know, women, I'll hear women say, uh, you know, over a coffee, like, I actually don't know what's wrong with me.
• 15:15
  SPEAKER_02: Maybe it's menopause, but but some of them are actually struggling with what you're saying is a very real, not only biological transition, which we're aware of, but it it is certainly that those stats would support that notion of was it 45 to 55 that you mentioned?
• 15:33
  SPEAKER_00: 45 to 55, highest risk for suicide in a woman's life, highest risk of anxiety and depression.
• 15:39
  SPEAKER_00: And a lot of women, we are still a little bit in the pulley socks up generation where we think that you should just get on with it.
• 15:46
  SPEAKER_00: Yeah.
• 15:46
  SPEAKER_00: And meanwhile, your parents are now all of a sudden a massive emotional suck and a massive time suck.
• 15:53
  SPEAKER_00: Your children, if they are teenagers, it can be a really difficult time, particularly during the pandemic.
• 15:58
  SPEAKER_00: Parenting teens was really difficult.
• 16:00
  SPEAKER_00: I don't think it's got, you know, in the era of social media, it hasn't got any easier.
• 16:04
  SPEAKER_00: And then on top of that, you know, we've got issues around job security, which I know we're going to talk about later, but there's a lot of things that happen to women in men's life.
• 16:13
  SPEAKER_00: If you don't take your mental health seriously, you put your brain at risk as well.
• 16:18
  SPEAKER_00: So we used to know that there was this huge kind of association between depression and dementia.
• 16:25
  SPEAKER_00: And we thought that maybe depression was an early sign of incoming dementia, that it would often precede the first signs of dementia by about six years.
• 16:33
  SPEAKER_00: And in fact, if somebody had uh dementia that didn't respond to medication, possibly that's a sign of incoming dementia.
• 16:41
  SPEAKER_00: And we we now know that, but it's not that simple.
• 16:44
  SPEAKER_00: And definitely depression causes dementia.
• 16:47
  SPEAKER_00: And in fact, you can see antidepressant medication if that's what you need, rather than trying to soldier on, rather than trying to tell yourself, oh, look, just pull your socks up, like seriously, what's wrong with you?
• 16:59
  SPEAKER_00: You actually can accept help because it's really important for you to have, to get that help, to help, to get yourself the help that you need to preserve your brain, not just avoid suicide and stay in the workforce and stay connected to your partner.
• 17:14
  SPEAKER_00: It's a peak time for divorce as well for women in midlife.
• 17:18
  SPEAKER_00: They get cranky and they leave their husbands, but it's uh it's a good time to look after your brain for the dividends now, but also for your dividends in the future.
• 17:27
  SPEAKER_02: Oh, that's really interesting, Jenny, because I think it's not that that um connection between the two is not always so clear.
• 17:36
  SPEAKER_02: And I think there's a lot of women who are juggling very much those two, like it sounds so familiar.
• 17:43
  SPEAKER_02: And so in terms of depression though, and that's an interesting measure because depression is something that can come and go, as you say.
• 17:51
  SPEAKER_02: I mean, it's quite, it's not always like somebody could be depressed because it's circumstance or it's situational.
• 17:57
  SPEAKER_02: But what you're actually saying is sometimes that midlife is the situation itself, which is the combination of all those factors leads to this sort of feeling of slight insanity.
• 18:08
  SPEAKER_02: But also it makes sense why they disconnect and dislocate from family or husband or whoever, because they feel a sense of isolation and inexplicable, uh, they can't explain what is going on.
• 18:22
  SPEAKER_02: So that's really interesting.
• 18:24
  SPEAKER_02: So in terms of getting that sort of support and diagnosis, how hard is it for women to go like presenting to the doctor, they'll let's say they'll say, Oh, well, I'm anxious, depressed.
• 18:36
  SPEAKER_02: And usually to be honest, they'll say, Well, it's menopause, right?
• 18:39
  SPEAKER_02: To most, which it may be, but what you're saying is there might be other factors that need to be reflected.
• 18:46
  SPEAKER_02: And we have to make sure not only does that, um, if it's not treated properly for those issues, that it also has potential to treat us for future issues like dementia, which is incredible.
• 18:57
  SPEAKER_00: Yeah, absolutely.
• 18:58
  SPEAKER_00: And I think what's really interesting is the relationship between hormone replacement therapy and dementia, because of obviously they're two areas of passion for me, the menopause and you know, preserving your brain.
• 19:10
  SPEAKER_00: So, you know, given that it is a period of vulnerability for poor mental health and some of the work that's coming out of Monash University, Professor J.
• 19:17
  SPEAKER_00: Shrikul Khani, who's amazing.
• 19:19
  SPEAKER_00: If you haven't seen her work, she uh specifically looks at the relationship between depression and uh menopause in women.
• 19:27
  SPEAKER_00: And her work has really shown that a lot of women will actually benefit from hormone replacement therapy over antidepressant medication.
• 19:35
  SPEAKER_00: And in fact, you should probably pull out your HRT first for depression in midlife, particularly if you're having unsymptoms of menopause or perimenopause.
• 19:42
  SPEAKER_00: And that that's been a real game changer for a lot of doctors and for a lot of women to get the treatment that they need.
• 19:48
  SPEAKER_00: But on top of that, um, what we see in terms of this um period of vulnerability is that we are seeing vascular changes, so changes to your arteries, changes to your brain that start to happen around midlife.
• 20:03
  SPEAKER_00: And the hormone replacement therapy, it seems that if you start it early enough, there's a possibility it can help prevent dementia in the same way that it can help prevent heart disease.
• 20:16
  SPEAKER_00: But if you start it too late because you think that hormone replacement therapy is dangerous or it has a stigma attached to it, or that you just couldn't cope or whatever, that it actually could potentially do more harm than good.
• 20:28
  SPEAKER_00: So it has this, what we call this timing, we have this timing hypothesis where if you're going to start it the earlier you start it, probably the better, and particularly for women who are actually in that perimenopausal period, who are at peak risk for both insomnia and also for brain fog, which often makes them feel like they've got dementia, and also for mood issues, that in fact you might get a lot of benefit from HRT that might also help to preserve your brain.
• 20:52
  SPEAKER_00: And while it's not recommended that you take HRT simply to avoid dementia, because we don't have enough conclusive evidence, different trials show different things.
• 21:02
  SPEAKER_00: Most doctors believe that if you have some of these other symptoms of um perimenopause, that it may well help as well to prevent dementia.
• 21:12
  SPEAKER_02: So is that so is that an age bracket?
• 21:14
  SPEAKER_02: Like how how do you determine when it's too late and too, like, do you know what I mean?
• 21:18
  SPEAKER_02: It's because it's quite a hard uh measure because it's so different for everybody.
• 21:25
  SPEAKER_00: So if you remember the Women's Health Initiative, which was that massive study that came out in 2002, it was a great study because it was of so many women, 110,000 women in the US.
• 21:36
  SPEAKER_00: And so just a quick uh history lesson, the whole thing that they had uh worked out from a number of big studies in the US was that uh going on women on HRT seemed to have less heart disease than women who went on HRT.
• 21:49
  SPEAKER_00: That was sort of back in the like 90s.
• 21:51
  SPEAKER_00: And so they did this big study where they took women average age of 63 and they said, if we give you HRT, what will happen?
• 21:56
  SPEAKER_00: And it turned out that those women on a form of HRT that we don't use anymore.
• 22:00
  SPEAKER_00: Because it's sort of we've got safer options around at the moment, that they, after six years, had a higher risk of getting breast cancer.
• 22:06
  SPEAKER_00: So just to put numbers around that, for every 10,000 women on a placebo, there were 30 breast cancers.
• 22:10
  SPEAKER_00: And for every 10,000 women on HRT, there were 38 breast cancers.
• 22:14
  SPEAKER_00: So it wasn't a massive increase, but there was a bit of an increase.
• 22:16
  SPEAKER_00: And there was also a little very minor sort of a 16% increase risk of heart attack, which came in at the six-year mark.
• 22:24
  SPEAKER_00: So we don't really know because those women in that study were an average age of 63.
• 22:28
  SPEAKER_00: 25% of them were 70 when they started HRT.
• 22:32
  SPEAKER_01: So now what we study is probably 60.
• 22:36
  SPEAKER_00: 60 is probably your cutoff.
• 22:38
  SPEAKER_00: And if you start it after 60, the risk is that some damage has already happened to your arteries as a result of menopause.
• 22:45
  SPEAKER_00: And at that point, estrogen transforms from a really helpful hormone that helps preserve the youth and vitality of your arteries to becoming something that's potentially dangerous.
• 22:55
  SPEAKER_00: And it's really interesting.
• 22:56
  SPEAKER_00: The same thing that is so beneficial when you're young is actually harmful when you're age sort of 16 and older.
• 23:02
  SPEAKER_00: So that is the age at which it's very difficult to start.
• 23:05
  SPEAKER_00: The other age, the other sort of thing that we use is potentially six years after the start onset of menopause.
• 23:11
  SPEAKER_00: Now that's a little bit more controversial because we don't really have good hard data around that.
• 23:15
  SPEAKER_00: We don't have good hard data over any of it because we're relying on this old study that, you know, used as a form of HRT that we don't really use anymore.
• 23:24
  SPEAKER_00: And they didn't actually ask the women in this study, do you have menopause symptoms?
• 23:28
  SPEAKER_00: When did you go through menopause?
• 23:30
  SPEAKER_00: Because it was not about that.
• 23:31
  SPEAKER_00: It was about whether estrogen could prevent heart disease.
• 23:33
  SPEAKER_00: That was only all of it was about, right?
• 23:35
  SPEAKER_00: So they didn't even ask people if they're on menopause.
• 23:38
  SPEAKER_00: When they took that subset of women who were in the trial who actually started it in their 50s, which is kind of typical when women would start it now, they actually did pretty well and they didn't have any increased risk of breast cancer and they didn't have an increased risk of heart disease, potentially the opposite.
• 23:54
  SPEAKER_00: But it's just hard.
• 23:55
  SPEAKER_00: We don't really know.
• 23:55
  SPEAKER_00: But we generally say six years from the day of menopause, which as a reminder is the first day of your last period, uh a year since the first day of your last period.
• 24:05
  SPEAKER_00: So if it's been a year since you've had a period, that's menopause.
• 24:08
  SPEAKER_00: Very few of us know about that because you just can't remember when you last had to be.
• 24:11
  SPEAKER_02: No, exactly.
• 24:12
  SPEAKER_02: Like, and so so this is so important because so so just to clarify, so as well as the age measure, there's also, I mean, I suppose it there's a blood test, I'm assuming, that you can have to go, well, like if if menopause started, as you said, the last day of your period was let's say six years ago, then is there a blood test?
• 24:31
  SPEAKER_00: You don't need a blood test.
• 24:32
  SPEAKER_00: No, you don't need it.
• 24:33
  SPEAKER_00: So once so the blood test has a very specific use because I get patients coming into me all the time saying, Oh, my my dermatologist says that I need a full set of hormone levels.
• 24:42
  SPEAKER_00: And I'm like, that's because your dermatologist doesn't know anything about menopause.
• 24:46
  SPEAKER_00: Like so many doctors don't know anything about menopause.
• 24:48
  SPEAKER_00: The blood tests are really unhelpful.
• 24:50
  SPEAKER_00: When you're impairing menopause, what you'll see is that your estrogen levels at 10 o'clock on Tuesday are entirely different from your Eastern levels at 4 p.m.
• 25:01
  SPEAKER_00: on a Thursday.
• 25:02
  SPEAKER_00: They have no relationship to each other.
• 25:04
  SPEAKER_00: So a blood test is a point in time, it doesn't tell you anything.
• 25:07
  SPEAKER_00: And your blood test can look like you have gone through menopause because at that moment your estrogen is low, but the next day it can be excessively high.
• 25:16
  SPEAKER_00: So it's a very unhelpful thing.
• 25:18
  SPEAKER_00: It doesn't tell you anything.
• 25:19
  SPEAKER_02: It's confusing otherwise.
• 25:21
  SPEAKER_02: Yeah.
• 25:22
  SPEAKER_00: Yes.
• 25:23
  SPEAKER_00: Whereas if you've had if it's been more than you know 12 months since your period and you're absolutely sure of that, we don't need a blood test.
• 25:29
  SPEAKER_00: We know that you're post-menopause, or the blood test had does nothing to help us.
• 25:33
  SPEAKER_00: There are some circumstances where a blood test will help.
• 25:36
  SPEAKER_00: So, just for example, if women who had a hysterectomy, let's say for a severe bleeding issue, so they had horrible fibroids, or they had some cancer, or they had, you know, some other reason where, you know, heaven forbid something terrible that happened during a pregnancy and you know, they've had to have a hysterectomy, it's an emergency situation, they won't know whether they've gone through menopause because they don't miss periods.
• 26:01
  SPEAKER_00: Similarly, women who've had a process called like an endometrial abilation, which can take out periods for a lot of women, or who have an arena, which is an IUD that stops periods altogether, they don't really know.
• 26:16
  SPEAKER_00: And because we want to sort of see where you're at in terms of, you know, do you need a bone density test, then a blood test can be really, really useful to know whether you've gone through through menopause proper.
• 26:27
  SPEAKER_02: So this is a very important, uh, you've really opened up a very interesting discussion about menopause and its impact on all of the above.
• 26:36
  SPEAKER_02: So, can you you did mention when we talked earlier that you have developed a new uh solution that may be of help to businesses.
• 26:46
  SPEAKER_02: Can you talk me through that with regards to addressing obviously the generic notions around menopause and the challenge for women, particularly in the workforce?
• 26:56
  SPEAKER_00: Deb, this is uh just something that I and I've worked in menopause for a long time, but these statistics are horrific.
• 27:04
  SPEAKER_00: So, so listen to this 10% of women leave the workforce because of their menopause symptoms that they simply can't get addressed, and that's on us doctors, but it's also on the sisterhood not talking about this enough.
• 27:17
  SPEAKER_00: 14%, in addition to that 10% who leave, just say, you know what, I am gonna go part-time.
• 27:23
  SPEAKER_00: I can't handle full-time work anymore.
• 27:26
  SPEAKER_00: An additional 8% either refuse a promotion or ask for a demotion.
• 27:30
  SPEAKER_00: So, how many of your girlfriends do you know who say, I was CFO of a major company, I just want to go work in the tub shop?
• 27:37
  SPEAKER_00: I just, you know, I just want to go be, I want to be a receptionist now, and they take a massive hit to their income.
• 27:43
  SPEAKER_00: Plus, firms are losing these women with this unbelievable corporate knowledge, experience.
• 27:50
  SPEAKER_00: The ones who stay, often because they have to financially, the ones who stay have this very high prevalence of a mood disorder, but they also face what we call the confidence cliff.
• 28:01
  SPEAKER_00: And in some US research, 80% of women feel like their productivity is off.
• 28:06
  SPEAKER_00: We know that 80% of women experience brain fog, not every day, but at least some point, and they feel like they are not performing at work.
• 28:12
  SPEAKER_00: It makes them second guess everything that they do.
• 28:15
  SPEAKER_00: And it means that their direct reports, but also their uplines, are just going, what the hell is going on with you?
• 28:19
  SPEAKER_00: Like you are not the person I knew.
• 28:22
  SPEAKER_01: And it's the brain cliff.
• 28:23
  SPEAKER_00: Yeah, it's quite an Oh, and the confidence cliff.
• 28:27
  SPEAKER_00: It's it's insane.
• 28:28
  SPEAKER_00: So you what and and the Australasian Association of Superannuation Trustees, which is, I guess, the peak body of all superannuation funds in Australia, did some research and they found that Australian women, the menopause is costing Australian women at least 17 billion, possibly up to$21 billion a year because they are retiring earlier than they intended to, or they're taking a lesser job.
• 28:50
  SPEAKER_00: They're just going, you know what, I think I'm just going to give myself a demotion and go it.
• 28:53
  SPEAKER_00: I still want to work, but I'm just going to be a receptionist.
• 28:55
  SPEAKER_00: Now, when I was a CFO or I was like a manager, um, they are women who are um working part-time.
• 29:02
  SPEAKER_00: That costs them in income, it costs them in super.
• 29:05
  SPEAKER_00: And it's really reinforcing and entrenching that gender gap in terms of income equality and retirement savings, which is we know that women of retirement age are some of our newest poor.
• 29:18
  SPEAKER_00: That is, as a group, they are growing in homelessness, they are growing in poverty.
• 29:23
  SPEAKER_00: And there's such an easy solution.
• 29:26
  SPEAKER_00: Plus, firms need these women to stay.
• 29:28
  SPEAKER_00: And they're really easy.
• 29:29
  SPEAKER_00: And so, looking at all of that data, um, one of my girlfriends, Shelley Horton and I just said, we're going to do something about this because we were seeing a whole lot of menopause in the workplace kind of courses, but they were often run by like wellness warriors or people who are eats of vitamins, or you can solve all your metaphors problems by going gluten-free.
• 29:48
  SPEAKER_00: And I'm like, no, you can't.
• 29:49
  SPEAKER_00: And so we just thought somebody in the evidence-based space has to be in there helping women, which is my passion, but also helping firms.
• 29:57
  SPEAKER_00: Like it's just, it's a it's a win-win.
• 29:59
  SPEAKER_00: It's a win for the Australian economy, it's a win for women, it's a win for firms, it's a win for all these firms who are losing people and people, you know, like us have got them in our superannuation.
• 30:09
  SPEAKER_00: Everybody wins by retaining women in the workforce at their full potential.
• 30:14
  SPEAKER_00: And a lot of this is simply helping women understand what's going on.
• 30:17
  SPEAKER_02: So, Judy, so menopause, as you say, in the in the workplace, I mean, some of these stats that you've just outlined are really quite confronting.
• 30:25
  SPEAKER_02: And the fact that we, as particularly midlife women, it makes sense what all of what you're saying.
• 30:31
  SPEAKER_02: The, you know, the challenge of trying to maintain and sustain uh the you know, your role in a in a high-powered workplace or even in any workplace, it doesn't have to be high-powered, whatever it is, concentration, um, ability, all of the things that impact women, and it's never really been talked about.
• 30:51
  SPEAKER_00: I I have never I had never heard of this before.
• 30:54
  SPEAKER_00: And I guess, you know, a lot of my girlfriends when we were in our 30s, I felt like they were doing leadership development training and full with the idea of improving um women's participation in the C-suite and going, taking on senior leadership roles and moving up to like even board level.
• 31:13
  SPEAKER_00: And these companies are just going, well, hang on, we've spent like$10,000 ahead getting these women through a leadership um meeting or leadership course, and we're still losing them anyway.
• 31:23
  SPEAKER_00: What's going on?
• 31:24
  SPEAKER_00: And when you look at what's actually going on, you just go, well, it just kind of makes sense.
• 31:29
  SPEAKER_00: But I guess I it's to my mind, I'm not sure that companies weren't investing in the wrong stage of life for women and women just need more support.
• 31:37
  SPEAKER_00: And we've got some evidence about what works.
• 31:40
  SPEAKER_00: I mean, you know, just like menopause mentors in the workplace, chat rooms um just to support women in the world.
• 31:46
  SPEAKER_00: Women, you know, so that they know they're not alone.
• 31:48
  SPEAKER_00: Simple, um, you know, menopause policies that allow women, like a lot of women need to work from home.
• 31:53
  SPEAKER_00: If you are have if you're one of the one in three who have very, very, very heavy periods, it can be really awkward at work.
• 31:59
  SPEAKER_00: You know, you've got, of course, you've got to go sort it out, um, but you just can't keep tapping into your sick leave.
• 32:04
  SPEAKER_00: You're gonna lose it all, right?
• 32:05
  SPEAKER_00: So I and plus you've got to, you've you're gonna have to take your mum to the doctor and you've got your teenage daughter who might be having some depression.
• 32:11
  SPEAKER_00: And there's a lot of pulls on your time at that time.
• 32:15
  SPEAKER_00: So just understanding what is going on and a simple like education course that just sort of goes like mental health stuff.
• 32:22
  SPEAKER_00: This is what's happening, this is what's going on for her, and here's how to have that conversation.
• 32:26
  SPEAKER_00: So easy.
• 32:27
  SPEAKER_00: And here's how to get evidence-based treatments so that you can actually not put up with this because this is garbage.
• 32:32
  SPEAKER_02: I think the other thing that's very important here that we should mention is I think that for many years um women were embarrassed and felt awkward to talk about the fact that they just they were experiencing menopause symptoms.
• 32:45
  SPEAKER_02: Obviously, as I said, it's become, you know, all over Instagram, it's the thing to talk about.
• 32:49
  SPEAKER_02: It's so far now.
• 32:50
  SPEAKER_02: Apparently, you know, people are much more, but even, you know, when I speak to friends, they're only just being much more open about it because the dialogue is starting.
• 33:00
  SPEAKER_02: But I do think there's a factor there about, you know, women not wanting to feel aged or therefore, and all the correlation that goes with that imagery or perspective or perception that somehow they're over a certain line.
• 33:15
  SPEAKER_02: And whereas we know that it's actually quite a thriving time of life if it's managed properly.
• 33:21
  SPEAKER_00: 100%.
• 33:22
  SPEAKER_00: If you don't have these, um, I mean, we were just talking before we came on air, if you don't have all these symptoms, um, I've got an empty nest.
• 33:28
  SPEAKER_00: I'm absolutely loving being an empty nest.
• 33:31
  SPEAKER_00: I love my kids, but I'm what what a great stage of life.
• 33:34
  SPEAKER_00: You know, I don't have to think every weekend, I'm not devoting myself to my kids.
• 33:40
  SPEAKER_00: Yeah, or who am I driving to win?
• 33:42
  SPEAKER_01: To basketball, yeah.
• 33:44
  SPEAKER_00: Yeah.
• 33:45
  SPEAKER_00: Or I have to get up at 6 a.m.
• 33:46
  SPEAKER_00: to get them to gymnastics or whatever.
• 33:49
  SPEAKER_00: You don't have to do any of that.
• 33:50
  SPEAKER_00: Your life is very much your own.
• 33:52
  SPEAKER_00: And also I think you get a certain kind of confidence where you just go, I don't give a rat anymore.
• 33:58
  SPEAKER_00: Like, you know, I don't care what people think about me.
• 34:00
  SPEAKER_00: So you don't have, you don't like you don't have put up with toxic friendships or or garbage from anyone.
• 34:06
  SPEAKER_00: You're probably a bit more assertive in your relationships, which can be really good.
• 34:10
  SPEAKER_00: Um, sex, great sex can begin at 50.
• 34:12
  SPEAKER_00: There are a whole lot of things that can happen that are really good.
• 34:15
  SPEAKER_00: But I think if you don't, if you've got some really nasty symptoms, and very few women will get away with zero symptoms, if you've got some nasty symptoms and they're holding you back, well, that's just garbage.
• 34:25
  SPEAKER_00: And particularly if it's costing you that much financially.
• 34:28
  SPEAKER_00: So when Shelly and I started don't sweat it, it was really um, we just thought it's a win for women, it's a win for firms, it's a win for partners who don't know anything about this, it's a win for young people who are just going, I don't know what's going on with my boss, but like she's a psycho now.
• 34:44
  SPEAKER_02: So, so don't sweat it.
• 34:45
  SPEAKER_02: Talk tell tell me about that and what it actually is, because I uh this really resonates with a lot of my listeners, I have no doubt.
• 34:52
  SPEAKER_02: It's also good for men who who listen to the pod.
• 34:55
  SPEAKER_02: I have a lot of male listeners too, it who basically can also get an insight into the real impact and why women might be feeling marginalized.
• 35:03
  SPEAKER_02: Because actually that's what happens.
• 35:05
  SPEAKER_00: Absolutely.
• 35:06
  SPEAKER_00: So we know that, for example, when it comes to hot flushes, which I think is what we all think about when we think of menopause, we think it happens to like 65-year-old women who should be basically popping off into retirement anyway.
• 35:16
  SPEAKER_00: They're sitting there with their cardigans, they're twirling their pearls and they're having a hot flush, right?
• 35:20
  SPEAKER_00: The reality is that the average age of menopause, which as we've already said, is 12 months since you've had a period, the average age in Australia is 51.
• 35:27
  SPEAKER_00: But as Australia becomes more ethnically diverse, that number's getting earlier because it's really whiteys that have a later uh menopause.
• 35:33
  SPEAKER_00: And your perimenopause, which is the average sort of seven years leading up to menopause, where things start to go a bit awry.
• 35:40
  SPEAKER_00: You don't sleep, you have brain fog, you can start with your hot flushes, but really peak time for mental health issues.
• 35:46
  SPEAKER_00: That's seven years before 51.
• 35:48
  SPEAKER_00: Now, I am not great at maths, but that tells me that we're this is happening to women in their mid-40s.
• 35:53
  SPEAKER_00: These are women who are starting to hit their strides in their careers.
• 35:56
  SPEAKER_00: So, what we uh have created is a very simple and very cheap one-hour online course.
• 36:02
  SPEAKER_00: It's not overly scientific, it's not overly icky.
• 36:06
  SPEAKER_00: We don't talk about what happens below the belt.
• 36:08
  SPEAKER_00: It's very much workplace focused.
• 36:10
  SPEAKER_00: So your brain fog, your depression, your heart flushes, and how to combat that.
• 36:14
  SPEAKER_00: And a lot of it is um Shelly, my business partner, she has always done like a lot of um workplace training.
• 36:21
  SPEAKER_00: So she talks about how to have that conversation in a sensitive way, how to get your needs met, how to talk to your manager if it's happening to you, but also if it's happening to someone you're working with, how to have that conversation sensitively.
• 36:34
  SPEAKER_00: Yeah.
• 36:35
  SPEAKER_00: Yeah, you know, um, sorry, are you menopausal?
• 36:37
  SPEAKER_00: Is that why you're just being a complete cow?
• 36:39
  SPEAKER_00: Probably won't go down that well.
• 36:40
  SPEAKER_00: But there are other ways of doing it.
• 36:42
  SPEAKER_00: And how to get help.
• 36:44
  SPEAKER_00: There's a lot of practical solutions around um, yeah, just being um, I guess, you know, just how to get your hot flushes under control, how to get your sleep under control, um, how to get your mental health under control, what works, what doesn't work, and with a lot of how to find the right doctor for you, that kind of thing.
• 37:00
  SPEAKER_00: So that's the one-hour course.
• 37:02
  SPEAKER_00: So we also do menopause workplace policy because look, it's coming in the UK House of Commons.
• 37:08
  SPEAKER_00: Uh, it was strongly recommended uh that workplaces over a certain size need to have a workplace policy.
• 37:14
  SPEAKER_00: Um, I can tell you that I'm speaking at federal parliament in another few weeks, and um, there is a group of menopause specialists around Australia who are caused calling for a whole lot of changes, more research, more money, but also we're looking at encouraging workplaces to have a policy.
• 37:30
  SPEAKER_02: Yeah, no, this is so good.
• 37:31
  SPEAKER_02: It's like the mental health movement, but it's the menopause movement, and it is what what I love is it's not just people talking about it, but you're actually actioning things and making change, which really does need to be, and it also makes people feel comfort, comforted.
• 37:45
  SPEAKER_02: It's like, wow, I'm not alone, I'm not crazy, I'm not feeling it's a very um, I just I'm surprised it hasn't happened before.
• 37:53
  SPEAKER_02: So it's great, you're spearheading.
• 37:54
  SPEAKER_02: 100%.
• 37:55
  SPEAKER_00: And and especially so what we are doing in September, the September the 16th, um, for the first time ever.
• 38:02
  SPEAKER_00: I'm so excited, is we are going to do a menopause or a midlife women's retreat.
• 38:06
  SPEAKER_00: So we are going away to Hamilton Island.
• 38:09
  SPEAKER_00: Um, tickets are available from the Don't Sweater website, but it's just uh an amazing opportunity to network with other women, share your story, hear other women's stories, also get evidence-based information about what really works.
• 38:20
  SPEAKER_00: Um, you know, there will be a little weak bit of yoga early in the morning, completely optional.
• 38:25
  SPEAKER_00: Do not expect to be told you're not drinking.
• 38:27
  SPEAKER_00: We will be drinking, we are we'll be partying, we will be dancing, but not going gluten-free.
• 38:32
  SPEAKER_00: So fun.
• 38:33
  SPEAKER_00: Yeah, you've got to come and be fine.
• 38:35
  SPEAKER_00: It's a if kale is happening, it's a side salad.
• 38:38
  SPEAKER_00: It's definitely not the main thing that we're gonna be doing.
• 38:40
  SPEAKER_00: It's just gonna be actual proper bona fide information, but with enough time to go and get massages, go to the sum up bar, you know, have an April, what in you know, in the gorgeous sweet Sundays, it's gonna be an opportunity to connect amazing party, like amazing party bags, seriously good stuff.
• 38:57
  SPEAKER_00: And so, yeah, we're we're gonna have this thing happening in September, the 16th.
• 39:01
  SPEAKER_00: Yeah, don'tsweat it, uh.com.au, and you can find all the information there.
• 39:05
  SPEAKER_02: Well, that is just wonderful.
• 39:06
  SPEAKER_02: And Ginny, as usual, you're always such a gem to speak to.
• 39:09
  SPEAKER_02: You're always doing something new and exciting, you're always pushing the boundaries and making sure that women are nurtured and take taken care of because it's very much been your mission.
• 39:19
  SPEAKER_02: And we're, you know, I'm very we're very grateful that you you do do this work and that you use your skill set.
• 39:25
  SPEAKER_02: And you too, right?
• 39:27
  SPEAKER_00: Well, well, you do, and it's your your thing as well.
• 39:30
  SPEAKER_02: Yeah, well, I'm a big believer that, you know, we I mean, this is a platform and the things that we learn on it, which is hence the title, What I've learned, you've just exemplified.
• 39:40
  SPEAKER_02: I have learnt so much from you today, and I hope my listeners will too.
• 39:44
  SPEAKER_02: And I look forward to you coming on and doing more regular spots on the What I've Learned podcast because you resonate very much with our listeners.
• 39:53
  SPEAKER_02: Well, you take care and have a Lord.
• 39:56
  SPEAKER_00: Save your brain.
• 39:57
  SPEAKER_00: That'd be great to save your brain is out on February the 28th.
• 40:00
  SPEAKER_02: Wonderful.
• 40:00
  SPEAKER_02: Well, congratulations on the new book and look forward to seeing you soon.
• 40:04
  SPEAKER_02: See you soon, Jeff.
• 40:05
  SPEAKER_02: Bye.
• 40:10
  SPEAKER_02: Thanks so much for listening.
• 40:12
  SPEAKER_02: The What I've Learned podcast will now be coming to you weekly, with new episodes released every Tuesday.
• 40:18
  SPEAKER_02: I'm blessed to have so many wonderful guests coming on the show.
• 40:21
  SPEAKER_02: So check out my What I've Learned Instagram for updates.
• 40:25
  SPEAKER_02: Meanwhile, stay tuned, kind, and curious.
• 40:28
  SPEAKER_02: Love Deb.