Latest / Beyond the White Coat / Ep 45. -Stop Normalizing the Leak: Let's Talk Pelvic Health with Dr Michelle Koval

Transcript

Ep 45. -Stop Normalizing the Leak: Let's Talk Pelvic Health with Dr Michelle Koval · Beyond the White Coat

• 0:00
  SPEAKER_00: Welcome to Beyond the White Coat Podcast, where we break down myths in health, beauty, and wellness so you can look, feel, and perform your best.
• 0:08
  SPEAKER_00: We're your hosts, Sharia Mamm and Megan Del Corral, here to bring you real talk beyond the medical titles.
• 0:14
  SPEAKER_00: Before we dive in, quick disclaimer.
• 0:17
  SPEAKER_00: The views and opinions shared in this podcast are for entertainment purposes only.
• 0:21
  SPEAKER_00: This is not medical advice and does not reflect the host's roles or responsibilities at Vital Medical or Hue Aesthetics.
• 0:29
  SPEAKER_00: Now let's get into it.
• 0:32
  SPEAKER_01: All right, welcome to another episode of Beyond the White Coat Podcast.
• 0:36
  SPEAKER_01: As you see, I have a special guest here.
• 0:38
  SPEAKER_01: Um, this is Michelle Kuball.
• 0:40
  SPEAKER_01: She is a doctor of physical therapy, owner and founder of public health and physical therapy.
• 0:47
  SPEAKER_01: Did I get it right?
• 0:47
  SPEAKER_01: You crush it.
• 0:48
  SPEAKER_01: That is such a mouthful.
• 0:49
  SPEAKER_01: I'm so impressed.
• 0:49
  SPEAKER_01: I can just leave now.
• 0:52
  SPEAKER_01: Um, so excited to have you.
• 0:53
  SPEAKER_01: We just met five minutes ago and like did a quick bio on each other.
• 0:57
  SPEAKER_01: We're like, okay, so where are you from?
• 0:58
  SPEAKER_01: How many kids do you have?
• 0:59
  SPEAKER_01: How many dogs?
• 1:00
  SPEAKER_01: Because of course she comes in and I have to now I've become that person where like, so we had one dog.
• 1:06
  SPEAKER_01: Okay, fine, normal.
• 1:07
  SPEAKER_01: Didn't have to tell anybody.
• 1:08
  SPEAKER_01: Then we have two dogs, and one is a huge Siberian husky.
• 1:11
  SPEAKER_01: So I would be like, oh hey, just you know, like we have a dog who likes to like people, she kind of looks like wolf though.
• 1:17
  SPEAKER_01: And now I'm a crazy ass person.
• 1:18
  SPEAKER_01: I have three dogs where I have to tell everybody that comes to the front door, like, yeah, this is our address.
• 1:23
  SPEAKER_01: And by the way, we have three dogs.
• 1:24
  SPEAKER_01: Let me know if that's a problem.
• 1:25
  SPEAKER_01: You're like, no, that's fine.
• 1:26
  SPEAKER_03: So no, and uh, your middle one gave me the biggest hug, and it was the best entry that I've ever had anywhere.
• 1:33
  SPEAKER_01: It's one of those you don't realize how big she is, so she's on her hind legs with her paws on your shoulders, and you're like, girl, we are facial.
• 1:41
  SPEAKER_01: They're all very they're very nice, at least.
• 1:44
  SPEAKER_01: I will say, like, they're very so well behaved.
• 1:47
  SPEAKER_03: My dog is kind of an asshole.
• 1:48
  SPEAKER_03: So, like, I appreciate you saying it.
• 1:50
  SPEAKER_01: So I'm gonna need to like stop record that suited to my husband because he's like determined that our dog trainer doesn't do anything.
• 1:58
  SPEAKER_01: And I'm like, no, the fact that we have a four-month-old puppy who's like playing by himself, like is impressive.
• 2:04
  SPEAKER_01: It was so impressive.
• 2:05
  SPEAKER_01: Yeah.
• 2:05
  SPEAKER_01: Well, tell me about you.
• 2:07
  SPEAKER_01: Oh my gosh.
• 2:08
  SPEAKER_01: So where are you born and raised?
• 2:09
  SPEAKER_03: Born and raised in Columbus, Ohio.
• 2:11
  SPEAKER_03: Okay.
• 2:12
  SPEAKER_03: Um, and then my husband raised and yeah, uh, my husband and I went to the University of Dayton in Dayton, Ohio.
• 2:18
  SPEAKER_03: So go flyers.
• 2:19
  SPEAKER_03: Uh, and then uh he and I, that's where we met.
• 2:22
  SPEAKER_03: We moved to Columbus for my job, and he went to Northwestern, so we had long distance for a minute, which is a good one.
• 2:28
  SPEAKER_01: Wow, ooh, that means you're really smart though.
• 2:31
  SPEAKER_01: Northwestern.
• 2:32
  SPEAKER_01: I love it.
• 2:33
  SPEAKER_01: Okay, and so you guys headed long distance.
• 2:35
  SPEAKER_01: We did.
• 2:36
  SPEAKER_01: That was not great, not fun.
• 2:38
  SPEAKER_01: Uh-uh.
• 2:38
  SPEAKER_01: No, I wouldn't wouldn't recommend it.
• 2:40
  SPEAKER_01: No.
• 2:40
  SPEAKER_01: I don't like it.
• 2:41
  SPEAKER_01: I mean, I so it's always like a middle ground, and now he's where you know you don't want to be together 24-7.
• 2:48
  SPEAKER_01: Yes.
• 2:49
  SPEAKER_01: Like I did mention my husband's out of time for three nights, which I'm going to being on the Twilight seat, and like it's really nice.
• 2:55
  SPEAKER_01: Like, I use one little dish and then you know it's done.
• 2:58
  SPEAKER_01: But I also wouldn't want him to be gone for like months at a time, so it'd be hard.
• 3:02
  SPEAKER_03: Yeah, yeah.
• 3:03
  SPEAKER_03: My husband is a global strategic marketer for Ethicon, so he actually does travel for his not.
• 3:08
  SPEAKER_03: He's on the US team now, but when he was on the global team, he was gone for like three weeks in a time.
• 3:13
  SPEAKER_03: Like, boo, just get into this room.
• 3:16
  SPEAKER_03: So you're like an old man dog is really instigating, actually.
• 3:19
  SPEAKER_03: It's not the puppy right now.
• 3:21
  SPEAKER_01: Our 15-year-old is trying to chase Bodhi around.
• 3:25
  SPEAKER_01: He's like, hold on, I will say his endurance will will tap on eventually.
• 3:30
  SPEAKER_01: The mics can actually keep pick up on it, so you can keep going.
• 3:33
  SPEAKER_01: So wait, tell me again, what is Suba?
• 3:35
  SPEAKER_03: So he is a strategic strategic marketer for Ethicon.
• 3:38
  SPEAKER_03: What's Ethicon?
• 3:39
  SPEAKER_03: Ethicon is a medical device sales for Johnson Johnson.
• 3:43
  SPEAKER_03: Yeah.
• 3:43
  SPEAKER_01: Oh my god.
• 3:44
  SPEAKER_01: So what devices?
• 3:45
  SPEAKER_03: So a lot of bariatric surgeries, yeah.
• 3:48
  SPEAKER_03: Stuff that he's on right now.
• 3:48
  SPEAKER_03: So like what's that?
• 3:49
  SPEAKER_03: The Y.
• 3:50
  SPEAKER_03: Yeah, the little grabby guy.
• 3:52
  SPEAKER_03: Yeah.
• 3:52
  SPEAKER_03: Um, I'm sure there's a name.
• 3:53
  SPEAKER_03: A really weird.
• 3:54
  SPEAKER_01: That's the name of it.
• 3:55
  SPEAKER_01: I think that's the name of the that's the procedure.
• 3:57
  SPEAKER_03: Yeah.
• 3:58
  SPEAKER_03: He gives me so mad I didn't want he's on the stapling division now.
• 4:00
  SPEAKER_03: So like the other one was in the energy division, and I didn't know it, and now I don't have to anymore, so I forgot it.
• 4:06
  SPEAKER_03: It's okay.
• 4:06
  SPEAKER_03: It's totally fine.
• 4:07
  SPEAKER_03: It's in the back, not the front.
• 4:09
  SPEAKER_03: You're like, I are going to bring it.
• 4:11
  SPEAKER_01: Yeah, like Paul, I'm just gonna have to pull that one out.
• 4:14
  SPEAKER_02: Truly, truly, truly.
• 4:24
  SPEAKER_02: Yep.
• 4:24
  SPEAKER_02: Um 100%.
• 4:25
  SPEAKER_02: And also my badge so hard.
• 4:28
  SPEAKER_02: So like here we are.
• 4:29
  SPEAKER_01: Yeah.
• 4:30
  SPEAKER_01: So fast forward, you're in PT school, you go get your PhD.
• 4:34
  SPEAKER_01: Uh, where'd you get your Ph?
• 4:35
  SPEAKER_01: Open Northwestern.
• 4:36
  SPEAKER_01: Open Northwestern, yep.
• 4:37
  SPEAKER_03: So Dr.
• 4:37
  SPEAKER_03: Smarty Smarty, yeah.
• 4:38
  SPEAKER_01: And smarty, smarty.
• 4:41
  SPEAKER_01: And then how did you pick the vagina?
• 4:43
  SPEAKER_01: Um, this is what I want to do.
• 4:45
  SPEAKER_01: I am wheelhouse.
• 4:46
  SPEAKER_03: I was like absolutely abso fucking not that it's not my wheelhouse at all.
• 4:50
  SPEAKER_03: My one girlfriend was like super duper into it, and I was like, okay, weirdo, I'll do wounds instead.
• 4:58
  SPEAKER_03: You wanted to do cube, but it's also cube, like a little, like, let me just get that little stage four and just whittle that down.
• 5:04
  SPEAKER_03: That was so good.
• 5:05
  SPEAKER_01: I was it's very satisfying to like watching it heal, and you're like, you have pictures, right?
• 5:09
  SPEAKER_01: Yeah.
• 5:10
  SPEAKER_01: I was, I get that part.
• 5:11
  SPEAKER_03: Right.
• 5:11
  SPEAKER_03: Um, so then I did acute carrying some moon care for a little bit.
• 5:14
  SPEAKER_03: Uh, but then we moved around a lot for John's job.
• 5:18
  SPEAKER_03: He he was again in NBA school.
• 5:20
  SPEAKER_03: Then after that, we moved to uh Wisconsin and then moved to Chicago, and then we were now back in Cincinnati.
• 5:26
  SPEAKER_03: But because of that, like the move, my job would come again these, right?
• 5:29
  SPEAKER_03: Which is nice.
• 5:30
  SPEAKER_01: I mean it's like job security.
• 5:31
  SPEAKER_01: I always tell everybody at the end of the day, I'm like a nurse, like I can get a job.
• 5:34
  SPEAKER_01: Yep.
• 5:34
  SPEAKER_01: Yep.
• 5:34
  SPEAKER_01: Yep.
• 5:35
  SPEAKER_03: Yeah.
• 5:35
  SPEAKER_03: So uh, but so I did long-term acute care when I was in Wisconsin after my kid care sent.
• 5:41
  SPEAKER_03: Then we did a patient rehab with outpatient ortho in Chicago, and then when we had moved here, we had just had my oldest, and I had such bad postpartum anxiety and depression that went undiagnosed.
• 5:55
  SPEAKER_03: Um, so I was out running two weeks postpartum, and so yeah, yeah, right, like not smart.
• 6:00
  SPEAKER_03: But then nobody tells you what to do, right?
• 6:03
  SPEAKER_01: And your lungs probably fine, but like they're like coming out at this point, yeah.
• 6:08
  SPEAKER_01: Prolapse, yeah, yeah.
• 6:10
  SPEAKER_03: Well, then that's what happened is like I don't know because I don't know about the vagrina yet.
• 6:13
  SPEAKER_03: I mean, I know I know about it.
• 6:14
  SPEAKER_03: You know where it is.
• 6:15
  SPEAKER_03: Like I can like map it out a bit.
• 6:17
  SPEAKER_03: Three holes, yeah.
• 6:18
  SPEAKER_03: Yeah, yeah.
• 6:19
  SPEAKER_01: You know, some of them don't have three holes.
• 6:21
  SPEAKER_01: Well, that's yeah, sorry for another day.
• 6:23
  SPEAKER_01: I know.
• 6:23
  SPEAKER_01: But so I just when you ask people the first day of their period, they're like the red red blood, the first big red blood.
• 6:29
  SPEAKER_01: Yeah, exactly.
• 6:30
  SPEAKER_01: The first day you meet, that's day one.
• 6:32
  SPEAKER_01: Yeah, yeah.
• 6:33
  SPEAKER_01: Yep, that's great.
• 6:34
  SPEAKER_03: Yeah, um no, so then I remember I went back from it wasn't even my first run, it was like my third or fourth run, which tracks, right?
• 6:41
  SPEAKER_03: And I was I looked down and I was in the shower and like, oh my god, there's something every everything is off my bus.
• 6:48
  SPEAKER_03: I got they got out.
• 6:50
  SPEAKER_03: Okay, do I call number one?
• 6:52
  SPEAKER_03: So right.
• 6:53
  SPEAKER_03: So they're like, shove it back in because what other like options do I have?
• 6:56
  SPEAKER_03: Right.
• 6:56
  SPEAKER_03: Um and then I call my guy and I was like, hey, I just saw my breath help.
• 7:02
  SPEAKER_03: I think I did something.
• 7:03
  SPEAKER_01: Oopsies is like, remember those like postpartum instructions that you didn't follow?
• 7:08
  SPEAKER_03: Yeah, yeah, yeah, yeah.
• 7:09
  SPEAKER_03: But no, she actually she just said just like calm it down for a couple of days, ideally a couple of weeks if you've got if you can make that work, and that just have surgery when you're older.
• 7:19
  SPEAKER_01: Uh-huh.
• 7:19
  SPEAKER_01: You but this was your first kit.
• 7:20
  SPEAKER_01: Uh-huh.
• 7:21
  SPEAKER_01: So like you want me to have that was the plan.
• 7:23
  SPEAKER_01: Oh, okay.
• 7:25
  SPEAKER_01: Okay.
• 7:25
  SPEAKER_01: Right.
• 7:26
  SPEAKER_01: So like tack it back in there.
• 7:28
  SPEAKER_03: Right.
• 7:28
  SPEAKER_03: So I decided that was maybe not the choice that I wanted.
• 7:32
  SPEAKER_03: Sure.
• 7:32
  SPEAKER_03: Yeah.
• 7:32
  SPEAKER_03: So Liz talked about earlier.
• 7:35
  SPEAKER_03: Yeah.
• 7:35
  SPEAKER_03: I was like, hey girl, I got my hands like this.
• 7:38
  SPEAKER_03: And I was like, I need you to tell me what to do.
• 7:40
  SPEAKER_03: Yeah.
• 7:40
  SPEAKER_03: Because you do this stuff, right?
• 7:41
  SPEAKER_03: She's like, Yeah, what are you telling me your exercise routine?
• 7:43
  SPEAKER_03: Like, what are you doing?
• 7:44
  SPEAKER_03: I told her, she's like, what is your actual problem?
• 7:46
  SPEAKER_03: And at this point, like, we're still not like Michelle still has to thought about her post-part of anxiety and depression diagnosis yet.
• 7:51
  SPEAKER_03: Sure.
• 7:51
  SPEAKER_03: They're just like, oh, Michelle's just a crazy runner.
• 7:54
  SPEAKER_03: Right.
• 7:54
  SPEAKER_03: And just has to do that.
• 7:55
  SPEAKER_03: Nothing full of like why.
• 7:57
  SPEAKER_03: Right.
• 7:58
  SPEAKER_03: Yeah, exactly.
• 7:59
  SPEAKER_03: Um, so she gave me some exercises, and it was all like external orthopedic stuff that I'd been working on with other patients.
• 8:04
  SPEAKER_03: I'm like, oh I can do that.
• 8:06
  SPEAKER_03: I can rehab myself, which I do not recommend for anyone.
• 8:08
  SPEAKER_01: Yeah, no, you need to you can't treat yourself.
• 8:11
  SPEAKER_03: You can't, because you think you can, especially when like you do the job, right?
• 8:15
  SPEAKER_03: But then you can't do it and not well.
• 8:16
  SPEAKER_01: Yeah, no.
• 8:17
  SPEAKER_03: And then I started uh treating patients in Cincinnati, but about here took more internal coursework at that shit.
• 8:24
  SPEAKER_03: Like I've been doing VT wrong the whole time.
• 8:26
  SPEAKER_03: Sure.
• 8:26
  SPEAKER_03: You have to like unlearn.
• 8:28
  SPEAKER_03: Yeah.
• 8:28
  SPEAKER_03: Yeah.
• 8:29
  SPEAKER_03: So I started uh one of the appolition programs at one of the major hospital systems here in Cincinnati.
• 8:34
  SPEAKER_03: Another hospital system found out what I did, and then it was like, hey, we'd love to have you at our place that's closer to your house for more money.
• 8:40
  SPEAKER_03: And yep, of course.
• 8:42
  SPEAKER_03: Yep.
• 8:42
  SPEAKER_03: I love that for me.
• 8:43
  SPEAKER_03: But when you're right.
• 8:44
  SPEAKER_03: So then we went there and then I was kind of done with the insurance side of things.
• 8:49
  SPEAKER_03: I would retire.
• 8:52
  SPEAKER_01: Some good time to retire.
• 8:53
  SPEAKER_03: No plan.
• 8:54
  SPEAKER_03: Yep.
• 8:54
  SPEAKER_03: Bye.
• 8:57
  SPEAKER_03: But then you have those like Uncle Freds at like the dinner table at like Thanksgiving that are telling you, like, you like go through the whole.
• 9:02
  SPEAKER_03: I'm like, oh like trust me.
• 9:05
  SPEAKER_03: It's a much better model to be done for the patient.
• 9:08
  SPEAKER_03: Because what was happening is at both hospital systems is I was getting in trouble because I would treat the whole person, and you can't what CD 10, can you divide?
• 9:16
  SPEAKER_01: Yeah, we're only gonna give you 20% of what you built.
• 9:19
  SPEAKER_01: Right.
• 9:19
  SPEAKER_03: Yeah.
• 9:20
  SPEAKER_03: So we just kind of kept coming to heads and like love people that I worked with, but like it just wasn't working for me anymore.
• 9:25
  SPEAKER_03: Cause I'm now leaving angry because I'm like not allowed to treat the way that I know is the best for the patient.
• 9:30
  SPEAKER_03: Right.
• 9:31
  SPEAKER_03: So thankfully my husband is a finance guy and was able to like run the numbers.
• 9:35
  SPEAKER_03: Yeah.
• 9:36
  SPEAKER_03: Because in PT school they do now, but back in the day, like oh no.
• 9:39
  SPEAKER_03: They didn't teach you how to do anything.
• 9:40
  SPEAKER_03: I'm sure you didn't get that in nursing school, did you?
• 9:42
  SPEAKER_01: No, no.
• 9:42
  SPEAKER_01: Even in my I still remember in my graduate work and even in my postgraduate, I started NT school in 20.
• 9:49
  SPEAKER_01: And it was like I had to go to class.
• 9:50
  SPEAKER_01: There was none of like online stuff.
• 9:52
  SPEAKER_01: By the time I finished my postgrad work, it was like hybrid, you could do both.
• 9:55
  SPEAKER_01: But I still remember we had one lecture one day on like the professional side, and it was this sounds so bad.
• 10:01
  SPEAKER_01: It's like mad men.
• 10:02
  SPEAKER_01: It was all about like how to dress.
• 10:04
  SPEAKER_01: Like, no, I know for for being a professional.
• 10:07
  SPEAKER_01: Uh-huh.
• 10:07
  SPEAKER_01: And I was like, negotiate my contract.
• 10:10
  SPEAKER_03: Nope, not a thing.
• 10:11
  SPEAKER_01: I'm like, what kind of malpractice do I need?
• 10:13
  SPEAKER_01: Like, what do I have to do finding my collaborating physician?
• 10:16
  SPEAKER_01: Like, I had so many questions, and I'm like, Do you want to tell me what to wear?
• 10:20
  SPEAKER_01: I've been wearing scrubs my whole life and before that I went to Catholic school.
• 10:23
  SPEAKER_01: So I've literally been in uniform my entire life.
• 10:26
  SPEAKER_01: Oh my god, I love that.
• 10:28
  SPEAKER_01: Yeah, I did not went to co-ed, but yeah, Catholic.
• 10:30
  SPEAKER_01: So yeah, I was like consistent, meal and write really well.
• 10:33
  SPEAKER_01: It's like my specialty in life in SCRE.
• 10:36
  SPEAKER_01: But yeah, so even to this, it's so funny because I had a business meeting earlier today, and I said that because my I have a business partner, thank God, who I I love and trust, and I I've been treating him as my push for 10 years.
• 10:49
  SPEAKER_01: So I also like pull the keys, you know?
• 10:51
  SPEAKER_01: Like you don't fucking face up that hard for sure.
• 10:55
  SPEAKER_01: Um Michael, I we just talked about Michael, he's been on here a bunch of times.
• 10:59
  SPEAKER_01: I love it.
• 10:59
  SPEAKER_01: But I always say that in all the business meetings, like, listen, I don't know you're talking about like yeah, you're talking about all these PC emissions structured, da-da-da.
• 11:08
  SPEAKER_01: I'm like, I am gonna research it and I'm gonna learn, but like I also am gonna trust yeah because it's hard.
• 11:14
  SPEAKER_01: It is, and they don't treat you any of that.
• 11:16
  SPEAKER_01: No, it's so challenging.
• 11:17
  SPEAKER_03: Yeah, and so you kind of have to learn on the fly.
• 11:20
  SPEAKER_03: And that was like I drew your husband, right?
• 11:22
  SPEAKER_03: So, but he just kind of got me started and he wanted nothing to do with it after that.
• 11:26
  SPEAKER_03: He's like, I want this to be your baby, and I want this to be the thing.
• 11:28
  SPEAKER_03: Like, if you have questions, I'm happy to answer it for you.
• 11:30
  SPEAKER_03: But this is yours, and like if it fails, it fails because of you.
• 11:33
  SPEAKER_03: But if it it succeeds, it'll succeed because of you.
• 11:36
  SPEAKER_03: And I was like, that's fucked up.
• 11:38
  SPEAKER_01: Yeah, I feel like I love you.
• 11:40
  SPEAKER_01: Can it be do you want your name on there?
• 11:43
  SPEAKER_01: I'll give you a little token.
• 11:44
  SPEAKER_01: Right, I'll give you a title.
• 11:45
  SPEAKER_01: Right.
• 11:46
  SPEAKER_01: So you want to be the tiny F out, you'll get paid.
• 11:49
  SPEAKER_01: It'll be but I like HUDs.
• 11:51
  SPEAKER_01: Yeah, but you can be a tax write off.
• 11:52
  SPEAKER_01: Yeah.
• 11:53
  SPEAKER_03: Again, I need more tax write-offs in my car.
• 11:55
  SPEAKER_01: I only have three now.
• 11:56
  SPEAKER_01: I need so many.
• 11:57
  SPEAKER_01: I know.
• 11:57
  SPEAKER_01: Our youngest, when she turned 19, I was like, we need to adopt some children.
• 12:02
  SPEAKER_01: I can't do it anymore.
• 12:04
  SPEAKER_01: I know, I know.
• 12:05
  SPEAKER_01: Okay, so now you open up pillar.
• 12:08
  SPEAKER_03: Yep.
• 12:08
  SPEAKER_03: So as myself, I was just still a bolo for the first 18 months.
• 12:12
  SPEAKER_03: I was in November of 2022, so we're coming up on our four-year anniversary.
• 12:17
  SPEAKER_01: Wow, okay.
• 12:18
  SPEAKER_01: And tell me about the demographic that you primarily see.
• 12:21
  SPEAKER_03: So this is the best part is we see everybody, anybody with pelvis.
• 12:25
  SPEAKER_03: So all ages, all genders.
• 12:27
  SPEAKER_03: We typically are treating anywhere between like ages 20 through like 60-ish, mid-60s.
• 12:36
  SPEAKER_01: And what are the most common reasons someone comes to see you?
• 12:38
  SPEAKER_03: Like what how do they know there's something wrong with their no, but the usually like you can't engage your core correctly, which is a lot of what we would see with uh?
• 12:50
  SPEAKER_03: Yeah, yeah, yeah.
• 12:51
  SPEAKER_03: Or that they can that they can't feel it.
• 12:53
  SPEAKER_03: So some of our like EESers as well.
• 12:55
  SPEAKER_03: So I always know there's just like that connect tissue disorder.
• 12:57
  SPEAKER_03: Yep.
• 12:58
  SPEAKER_03: So just they have a hard time per perception because they need to have that joint end feel, and the core is all muscle end feel, so it's really hard to discern that you don't know what you're looking for.
• 13:09
  SPEAKER_03: So kind of so it's not just a bunch of key bills.
• 13:11
  SPEAKER_03: Oh my god, no.
• 13:12
  SPEAKER_03: I think that that is one of the least recommended exercises.
• 13:17
  SPEAKER_03: For sure.
• 13:17
  SPEAKER_03: Sweet, sweet, yeah, and there's uh people on can't because that's not how the system works, right?
• 13:23
  SPEAKER_03: So the system is reflexive, so it doesn't work like anything else in the body, right?
• 13:26
  SPEAKER_03: And it it has so many influences on it of like the ground reaction force through your foot, how your breathing is doing, what is this the cervical position of your neck, like so we have to look at the whole thing.
• 13:38
  SPEAKER_01: So when we're not but you do see probably urinary incontinence.
• 13:41
  SPEAKER_01: We do.
• 13:41
  SPEAKER_03: We see a lot of urinary incontinence, constipation, or if you go incontinent, pregnancy, postpartum, fertility, and all of those genres as well.
• 13:49
  SPEAKER_01: Okay, so let's take a couple avatars and break down like a typical treatment plan.
• 13:53
  SPEAKER_01: So let's start with erectile dysfunction.
• 13:55
  SPEAKER_01: Okay, sure.
• 13:56
  SPEAKER_01: Yeah.
• 13:57
  SPEAKER_01: So let's say I can I'm a man and I can get it up, but I can't keep it up.
• 14:02
  SPEAKER_01: Okay.
• 14:02
  SPEAKER_03: So we have to look at a lot of different factors, lifestyle factors, hormone, um, all of that.
• 14:08
  SPEAKER_03: But also, like, what does your poop look like?
• 14:10
  SPEAKER_03: If it is like super hard and constipated, you're not gonna be able to hold it up because your body's too busy and holding in the shit.
• 14:15
  SPEAKER_03: So yeah, I poop twice a week.
• 14:16
  SPEAKER_03: Yeah, okay.
• 14:17
  SPEAKER_03: So we gotta start on that first, right?
• 14:19
  SPEAKER_03: So you're not gonna have to do that, you can't poop.
• 14:22
  SPEAKER_03: So we need to make sure that your bundle can open.
• 14:24
  SPEAKER_03: So we're usually gonna go internally to make sure that your booting old can actually open.
• 14:29
  SPEAKER_01: So she never got like a chance in the middle of it.
• 14:32
  SPEAKER_01: Pooring out.
• 14:33
  SPEAKER_01: I'm just imagining, like I remember, I guess, especially when I was training of horses, like the intern, anytime someone needed a rectal exam, they're like, Come again, you can't, you know, like internal hemorrhoids, you got it.
• 14:45
  SPEAKER_01: You're not statitis, you got it.
• 14:47
  SPEAKER_01: Right.
• 14:48
  SPEAKER_01: So I'm just and I remember the book of dread and you're like, well, I'm like, oh the hand couch.
• 14:54
  SPEAKER_01: Yeah, I'm like, put your hands out like this, you know, bend over and here it comes.
• 14:58
  SPEAKER_01: Yeah, literally.
• 14:59
  SPEAKER_01: So I didn't have that conversation about an internal rexam.
• 15:04
  SPEAKER_03: Well, if you don't make it weird, it's not weird, right?
• 15:06
  SPEAKER_03: Right.
• 15:07
  SPEAKER_03: Yeah.
• 15:07
  SPEAKER_03: So I think that's first and foremost.
• 15:08
  SPEAKER_03: But also it's like, well, the muscles have on the inside of the body.
• 15:11
  SPEAKER_03: If you want me to look at your shoulder and look at the shoulder, it's something I do all day, every day.
• 15:15
  SPEAKER_03: You're not the first butthole, you surely will not be my last.
• 15:17
  SPEAKER_03: So anyone have a poop time yet?
• 15:19
  SPEAKER_03: Well, yeah.
• 15:20
  SPEAKER_03: I get so many coup balls out.
• 15:21
  SPEAKER_03: I'm like a couple queen.
• 15:22
  SPEAKER_03: It's a weird card.
• 15:24
  SPEAKER_01: Digital stimulation, yeah.
• 15:27
  SPEAKER_01: Oh my god.
• 15:28
  SPEAKER_01: That might say of like fecal infections because totally.
• 15:31
  SPEAKER_03: Yeah.
• 15:31
  SPEAKER_01: Yeah.
• 15:31
  SPEAKER_01: We used to get all the time.
• 15:33
  SPEAKER_01: And so if you get them to relax the nerves and their colon, which is what we're talking about, yeah.
• 15:38
  SPEAKER_01: Then the pelvic floor can release and then they can have better nerve intervention to the shaft or the penis, right?
• 15:43
  SPEAKER_01: I'm just thinking like downstream.
• 15:45
  SPEAKER_03: Sort of.
• 15:45
  SPEAKER_03: So it depends on if they're on any sort of medications as well.
• 15:48
  SPEAKER_03: Like, can they sort of taking one or are they taking it?
• 15:50
  SPEAKER_03: If they can get it up, but they can only get up at that.
• 15:52
  SPEAKER_03: Like, okay, well, that's the blood flow is working, but the muscular function isn't.
• 15:56
  SPEAKER_03: Okay.
• 15:56
  SPEAKER_03: But they're having a hard time even with the harder time because now we know it's both blood flow and muscular function.
• 16:04
  SPEAKER_03: Okay.
• 16:05
  SPEAKER_03: A lot of times, if we can fix that muscular function, that the muscles can actually start to actually create the constriction that we need, but they sometimes don't know how to do that.
• 16:13
  SPEAKER_03: And oftentimes it's because the front part of that pelvic.
• 16:16
  SPEAKER_03: So again, looking at like your bodybuilders, which is like, oh, it's because I'm on these hormones or whatever.
• 16:19
  SPEAKER_03: I'm like, or it's because you're using your butthole to help you lift this continuated down the weight.
• 16:24
  SPEAKER_01: Yeah, that's true.
• 16:25
  SPEAKER_01: Like they tighten instead of relax.
• 16:27
  SPEAKER_01: Correct.
• 16:28
  SPEAKER_01: Yeah.
• 16:28
  SPEAKER_01: Yeah.
• 16:28
  SPEAKER_01: Okay.
• 16:29
  SPEAKER_01: So what do you do for them?
• 16:30
  SPEAKER_01: How do you help them relax their butthole?
• 16:31
  SPEAKER_01: I just yell at them a lot.
• 16:33
  SPEAKER_03: Moving on.
• 16:34
  SPEAKER_03: Okay.
• 16:34
  SPEAKER_03: No, so a lot of it's figuring out why is it not relaxing, right?
• 16:37
  SPEAKER_03: Is it because the hips are really tight and the pelvic floor is mimicking what's happening?
• 16:40
  SPEAKER_03: Is it also because they don't know how to relax it, right?
• 16:43
  SPEAKER_03: Yeah.
• 16:44
  SPEAKER_03: A lot of men in particular, penis owners in general, tend to have a really tight pelvic floor.
• 16:50
  SPEAKER_03: The cue angle of the hips are a lot more narrow.
• 16:52
  SPEAKER_03: So that also contributes to it, but they also just hold their stress there a lot more, but it presents as low back pain.
• 16:59
  SPEAKER_03: Interesting.
• 17:00
  SPEAKER_03: So when we fix the low back pain, we're gonna air quote here, right?
• 17:03
  SPEAKER_03: Then all of a sudden I'm the dye been a little bit more.
• 17:07
  SPEAKER_03: My rims are moving a little bit better.
• 17:09
  SPEAKER_03: So it's kind of taking it like one.
• 17:11
  SPEAKER_01: Let's move on to our to a postpartum.
• 17:13
  SPEAKER_01: Let's say I'm six months postpartum.
• 17:16
  SPEAKER_01: I'm not breastfeeding anymore and I'm having urinary incompetence.
• 17:21
  SPEAKER_03: So we want to see what's left over from pregnancy, uh, because it takes you know 10 months to grow a baby.
• 17:28
  SPEAKER_03: And then there's a lot of changes that happen biomechanically during that time, also more modally to the body, which is more typical.
• 17:36
  SPEAKER_03: Okay.
• 17:37
  SPEAKER_03: Yeah.
• 17:37
  SPEAKER_03: So if that's the case, we want to make sure that the connection to the pelvic orb and the abdominal wall, same thing as with the rec shouldn't die.
• 17:45
  SPEAKER_03: I know it's different issues, but it's a lot of the same stuff we're looking at, is that connection back together.
• 17:50
  SPEAKER_03: Because we want our pelvic floor, especially the front part and our abdominal wall to be best friends.
• 17:55
  SPEAKER_03: And sometimes they have friendship bracelets, but they like throw them in the trash for a second.
• 17:59
  SPEAKER_03: Fronti Central, yeah, yeah, yeah.
• 18:00
  SPEAKER_03: I hate this.
• 18:01
  SPEAKER_03: Especially if the belly wall's been expanding for a really long time and the back muscles started taking over.
• 18:05
  SPEAKER_03: And if the back muscles are still working overtime, because your body still thinks, like, hey, well, these are the first guys such a bad thing.
• 18:10
  SPEAKER_03: Right, right.
• 18:11
  SPEAKER_01: You're not fired.
• 18:11
  SPEAKER_01: You have to really figure that out first.
• 18:13
  SPEAKER_01: And what would the treatment plan look like?
• 18:15
  SPEAKER_03: Uh so we're usually from uh which I again, like what is happening, how often is it happening to get that tincture to turn on a little bit more.
• 18:23
  SPEAKER_03: So if it's just your like laugh coughs, needs that under pressure, under duress, then uh usually getting the bitches.
• 18:28
  SPEAKER_03: Can you then like get on?
• 18:30
  SPEAKER_03: Like, can you jump?
• 18:31
  SPEAKER_03: Can you because I don't think anyone should be discharged from therapy ever because we're always aging and growing and all the things.
• 18:39
  SPEAKER_03: But I personally don't think you should be discharging ever if you are still camped up on a trampoline.
• 18:45
  SPEAKER_03: Yeah, because you now have like a very young child, but that young child will love that trampoline in just a minute, and everybody has one.
• 18:51
  SPEAKER_03: Right.
• 18:52
  SPEAKER_03: They're such a hazard, they are such a hazard.
• 18:54
  SPEAKER_01: And when we were kids, there was not a net.
• 18:57
  SPEAKER_01: I never knew a nut.
• 18:58
  SPEAKER_01: Uh-uh.
• 18:58
  SPEAKER_01: Not even one.
• 18:59
  SPEAKER_01: I remember you were like trying to bounce people off of it.
• 19:01
  SPEAKER_01: Hundred I was yeah, I remember like there were these two boys in the neighborhood, like they're our backyards faced each other, and all the time my sister and I would go and play with them, and the game because it would be the boys, the games were to try to bounce each other off with it.
• 19:15
  SPEAKER_01: Yeah, popcorn.
• 19:16
  SPEAKER_01: Yeah, right.
• 19:16
  SPEAKER_01: Like, I'm like, how did no one break their neck?
• 19:19
  SPEAKER_01: Like, and my mom was like, Great, have fun.
• 19:21
  SPEAKER_01: Now now you see all of them, it's like a cage.
• 19:23
  SPEAKER_01: Yeah, and you're like, Oh, it must be nice, fancies.
• 19:26
  SPEAKER_03: Just kidding.
• 19:26
  SPEAKER_01: No, it's actually super safe.
• 19:28
  SPEAKER_01: It is super safe.
• 19:29
  SPEAKER_01: We were talking about this the other day, though, that like with like self-driving cars and like the progression things are going, like the next generation is gonna look at us like, why did you guys drive?
• 19:37
  SPEAKER_01: Do you know how it's like you you know what I mean?
• 19:39
  SPEAKER_01: Like, yeah, no, you actually drove a car and we're on your phone and we're doing all this stuff, like yeah, that sounds ridiculous.
• 19:45
  SPEAKER_01: So yeah, and you're like life will evolve.
• 19:47
  SPEAKER_01: You're not wrong, right?
• 19:49
  SPEAKER_01: Not wrong, yeah, because like human error is the biggest thing.
• 19:52
  SPEAKER_01: Okay, and then let's take our postmenopausal woman who GSM moments.
• 19:59
  SPEAKER_03: Yes, they have a big hot moment in the media right now, so I'm big fan.
• 20:03
  SPEAKER_01: Yes, and that's like all my patients are post-menopausal, not all of them, but a lot of them are post-menopausal.
• 20:08
  SPEAKER_01: It's like, and so I let's say I'm on hormone therapy, like I'm doing that from my bones, but I had six kids and uh Amish.
• 20:16
  SPEAKER_01: And I had six kids vaginally, all eight pounds, and now that I'm menopausal, like I'm having some, I think, bladder prolapse, sure, all the things.
• 20:27
  SPEAKER_03: Yeah, so first and foremost, we're gonna call you and be like, hey, get your own vaginal estrogen if she's not already on.
• 20:33
  SPEAKER_01: Oh my god, right.
• 20:34
  SPEAKER_01: All my patients, everyone, and all of these.
• 20:38
  SPEAKER_01: Oh, I had a woman yesterday who was like, it keeps getting stuck under my finger now.
• 20:41
  SPEAKER_01: And I was like, it came with an applicator to like, oh, I'm supposed to use that.
• 20:45
  SPEAKER_01: And I was like, It's like you finger, and I prefer a finger because that way you're rubbing that crap into everything to everything.
• 20:52
  SPEAKER_01: I had people put it inside.
• 20:54
  SPEAKER_01: It comes with an applicator, you insert like a champ on, then I tell them as you're pulling it out.
• 20:58
  SPEAKER_01: And you need to rub it in like sunscreen, yeah, right.
• 21:00
  SPEAKER_03: And that's where like I think people get it right.
• 21:01
  SPEAKER_03: Not like let it like they just put it on and they're like, Cool, I'm like ready for the game.
• 21:05
  SPEAKER_01: Yes, under percent.
• 21:06
  SPEAKER_01: I was like disappear.
• 21:07
  SPEAKER_01: Uh-huh.
• 21:08
  SPEAKER_01: Yeah.
• 21:08
  SPEAKER_01: Yep.
• 21:08
  SPEAKER_01: Okay.
• 21:08
  SPEAKER_03: Might five minutes when they like put it in and then like the next day, like, oh, I used my estrogen cream last night.
• 21:12
  SPEAKER_03: It's like cool because I can tell.
• 21:13
  SPEAKER_01: Yeah, it's like that.
• 21:15
  SPEAKER_01: Yeah.
• 21:15
  SPEAKER_01: Yeah.
• 21:15
  SPEAKER_01: Yeah.
• 21:16
  SPEAKER_01: I agree with that.
• 21:17
  SPEAKER_01: Okay.
• 21:17
  SPEAKER_01: Vaginal, I love vaginal estrogen.
• 21:19
  SPEAKER_03: Yeah.
• 21:19
  SPEAKER_03: So because we gotta get those tissues better, we gotta get microbiome.
• 21:22
  SPEAKER_01: Your patch is increasing the estrogen in your blood.
• 21:25
  SPEAKER_01: What we need to do is deliver estrogen directly to your vagina, to your tissues.
• 21:29
  SPEAKER_03: So then we want to see what is actually because sometimes that dryness can actually feel like vaginal prolapse, which is tricky, right?
• 21:35
  SPEAKER_03: Because it feels like a ball in the vagina, and like anything feels like that when it's really so when we get like nice and moist and like feeling her best cell, then we get to see all the muscles working because like you might have had really crap mechanics for the last 40 years.
• 21:49
  SPEAKER_03: We don't know.
• 21:50
  SPEAKER_01: Which is really common.
• 21:51
  SPEAKER_01: Like, even when I talk to like my 60 and 70 year olds, I mean it's just true that everything has changed where I think the women now, like in our age demographic.
• 22:00
  SPEAKER_01: And you know, probably a decade younger, they're gonna be in better shape because CrossFit became popular, high rocks became popular.
• 22:06
  SPEAKER_01: But my little old ladies, I mean, I love them, but like they don't know how to resist this training.
• 22:11
  SPEAKER_01: They don't know how to engage their core.
• 22:13
  SPEAKER_01: Right.
• 22:14
  SPEAKER_01: So I I honestly I told all of them just to get a personal trainer.
• 22:16
  SPEAKER_01: I'm like, listen, I can't help you in that.
• 22:18
  SPEAKER_01: You need someone who's gonna watch you move, watch you swap, watch your deadlift.
• 22:22
  SPEAKER_01: Like, yeah, that's how you, especially because I do a lot of JEXA scans and I'm worried about phone density.
• 22:27
  SPEAKER_01: And I talked to all of them about you need to load your axial spine, like you doing a thousand bicep curl.
• 22:32
  SPEAKER_01: And same thing with your pelvic floor and your hips and all the strength from there.
• 22:36
  SPEAKER_03: Yeah.
• 22:36
  SPEAKER_01: And that that is actually so I was so passionate about that.
• 22:40
  SPEAKER_03: Sorry, we've been off on our second, but uh, so there is a crew here in Vincennet called the Mental Health Care Collective.
• 22:47
  SPEAKER_03: They are a very great Can I join the Mental Health Care Collective?
• 22:51
  SPEAKER_03: You sure so it is a group of there's a neuropsychologist, there's psychiatry, there's sorry, neuropsychiatry, psychology, there's sexual health, there's obviously pelvic form physical therapy, uh, there's nutrition, and so there's a there's a group of us that kind of go on talking about all of these things.
• 23:09
  SPEAKER_03: Yeah, anything so we went to one of our first events at the mercantile library to great well attended.
• 23:16
  SPEAKER_03: And one of the people after is like I wonder if how to load myself.
• 23:18
  SPEAKER_03: I'm like, I can't like do this all of them.
• 23:20
  SPEAKER_03: It's crazy.
• 23:21
  SPEAKER_03: So I actually created a program for it.
• 23:23
  SPEAKER_03: And so it is in person because I also find that the stuff that is online.
• 23:27
  SPEAKER_01: I sold in the I'm like, I would say because I didn't know if you program, but I see people all over the country.
• 23:31
  SPEAKER_01: I'm like, just hire.
• 23:33
  SPEAKER_01: I don't care if you hire like the little teenager at the gym, but someone needs to watch you correct basically in person, where it's one-on-one.
• 23:39
  SPEAKER_01: Yeah, just you guys and let them help you.
• 23:42
  SPEAKER_03: Right.
• 23:43
  SPEAKER_03: And so it's like how to do it in your house, how to go to a gym, how to do the whole thing.
• 23:47
  SPEAKER_03: But we start really small with little baby weights that you're very comfortable with.
• 23:51
  SPEAKER_03: But how do we then move your body to actually get the load?
• 23:54
  SPEAKER_03: Yeah, to do an actual load correct, and then making sure you're not like fucking up your floor in the process, like bearing down.
• 24:01
  SPEAKER_01: Yeah.
• 24:02
  SPEAKER_01: I mean, that was the thing that for me for sure Pilates helped with a lot was learning how to breathe.
• 24:07
  SPEAKER_01: Yeah.
• 24:07
  SPEAKER_01: And even in diaphragmatic breathing, yeah.
• 24:11
  SPEAKER_01: I'll have like I mean, that that's the thing I love is running.
• 24:14
  SPEAKER_01: So, like, I've been video running, I'll have my husband video, Eric's video of me running, all this stuff.
• 24:19
  SPEAKER_01: Because I'm always like, okay, I always tell myself, don't look like an idiot when I run.
• 24:23
  SPEAKER_01: And he's like, No, you he's like, You look really good.
• 24:25
  SPEAKER_01: I'm like, no, don't lie to me.
• 24:26
  SPEAKER_01: Like, are my shoulders up in my ears?
• 24:28
  SPEAKER_01: Right, right.
• 24:29
  SPEAKER_01: Are my arms and even when I see pictures, and there's one thing when I'm like in a race and I'm struggling, right?
• 24:34
  SPEAKER_01: But on the day to day, it should look relaxed, it should look fluid.
• 24:37
  SPEAKER_01: Like, I've got in the 10,000 hours, like I should be able to biomechanically do this.
• 24:41
  SPEAKER_01: Well, right, I've still fucked up my Achilles, but as one does, as one does, as one does.
• 24:47
  SPEAKER_01: I haven't been injured knock and wood in three and a half years.
• 24:50
  SPEAKER_03: Okay, it's usually like something that's tied up the chain, so that's where you get your really hate it.
• 24:54
  SPEAKER_01: I did run a marathon two weeks ago, but it doesn't matter.
• 24:56
  SPEAKER_01: You did that it was messed up before, and I just I literally got on my knees and was like, God, just get me through this the Berlin Shut the hell up.
• 25:05
  SPEAKER_03: You didn't lead with that, by the way.
• 25:07
  SPEAKER_03: New planation is like wear your metal and just add at the door like we're here.
• 25:11
  SPEAKER_01: Um yeah, I really wanted to I yeah, I love running.
• 25:15
  SPEAKER_01: I mean, I I love it in the sense of like I don't think of it like exercise.
• 25:19
  SPEAKER_01: Like, I love the sport of running.
• 25:21
  SPEAKER_01: I am in love with running like all the USATF track meets, all the world major marathons.
• 25:26
  SPEAKER_01: I know everyone in the sport, like that's like my cash, it's not my gift, it's not what I do for work, right?
• 25:30
  SPEAKER_01: I actually say for work if a lot of people in my space hate running, they think it trashes your adrenals, like a whole nother conversation.
• 25:37
  SPEAKER_02: Yeah, kind of a lot of fun.
• 25:38
  SPEAKER_01: Yeah, and but like it can also be done smart, exactly and all and also can be great.
• 25:44
  SPEAKER_01: And for me, it is again something that I love and that I'm willing to put in the work every other fast train a time.
• 25:50
  SPEAKER_01: Like I don't run too much, like I'm immediately psycho about it, but I still don't mind pillows.
• 25:55
  SPEAKER_01: Oh spot.
• 25:56
  SPEAKER_01: Right, okay.
• 25:57
  SPEAKER_01: All right, so let's let's do that though, let's do that avatar.
• 26:00
  SPEAKER_01: Uh-huh.
• 26:00
  SPEAKER_03: So then I want to make sure that we understand like where is the misstep coming from.
• 26:05
  SPEAKER_03: Because again, usually it is because if we look at where generations are now, right?
• 26:09
  SPEAKER_03: So if I have somebody who's in their probably late 50s, early 60s, they are likely sucking in their stomach for the last 30 years.
• 26:17
  SPEAKER_01: Oh, for sure.
• 26:18
  SPEAKER_03: Right.
• 26:18
  SPEAKER_03: So that messes up how the policy moves, how the mechanics work.
• 26:22
  SPEAKER_03: So that polyfloor's been hanging on by a thread for three decades.
• 26:25
  SPEAKER_03: So should we be pushing our stomach out, or what should we be doing?
• 26:28
  SPEAKER_03: Let it go.
• 26:29
  SPEAKER_03: Just like it goes breathe, let it relax.
• 26:31
  SPEAKER_03: Let it I mean you can let it hang out, you can do whatever you want, right?
• 26:34
  SPEAKER_03: But then we don't have to have that perfect like silhouette or whatever.
• 26:38
  SPEAKER_01: Like I can't even do this another, we're gonna go down a rabbit hole for a second.
• 26:42
  SPEAKER_01: Like so again, uh I I don't know anything about social media.
• 26:47
  SPEAKER_01: I thank God Aaron Ramirez, she does all the content, but like the posing and like all the mm mm mm.
• 26:54
  SPEAKER_01: I'm always like, how did you get your body to do that?
• 26:57
  SPEAKER_01: And also like so much work and so much embert, and I don't have to do that.
• 27:02
  SPEAKER_01: And then Robin and I always laugh because again, it's a generational change, and again, I get it and Roman's super like the large booty thing, like I get it.
• 27:11
  SPEAKER_01: Your boots are important, they need to be huge.
• 27:14
  SPEAKER_01: I mean, all three, all my friends make fun of me.
• 27:16
  SPEAKER_01: When I get into a highlight, it's like I'm a pancake, like there's not and I don't care because I used to train with surgery and so she's always telling me, you know, muscles expensive, and shit.
• 27:26
  SPEAKER_01: I don't care at all.
• 27:27
  SPEAKER_01: But when I look at those girls on Instagram, then I look at my little pancake spot, I'm always like, girl, um, okay.
• 27:34
  SPEAKER_01: Save some rest of us.
• 27:36
  SPEAKER_01: I don't I did tell Lucy today, my trainer's my best friend, uh, who is like a perfect peachy gut.
• 27:43
  SPEAKER_01: I was like, okay, so I'm like in an off system because I'm not because my Actilles is in the trash.
• 27:48
  SPEAKER_01: I was like, so maybe we can like try to grow a glute.
• 27:51
  SPEAKER_01: And she's like, that'll never happen.
• 27:53
  SPEAKER_01: Mr.
• 27:54
  SPEAKER_01: Liz.
• 27:54
  SPEAKER_01: I know even Robin was working on me today.
• 27:56
  SPEAKER_01: She's like, Well, well, what's there is really tight.
• 27:59
  SPEAKER_01: And I was like, okay, yeah, it's so sad.
• 28:01
  SPEAKER_03: So it's Robin.
• 28:02
  SPEAKER_03: She's starting to get a little bitty though.
• 28:03
  SPEAKER_01: She's trying.
• 28:04
  SPEAKER_01: Yeah.
• 28:05
  SPEAKER_01: She doesn't have a lot, but she's got a little more than me.
• 28:08
  SPEAKER_01: I mean, literally, it's like a flat pancake.
• 28:10
  SPEAKER_01: Oh, it's really sad.
• 28:12
  SPEAKER_01: But okay, not making this.
• 28:13
  SPEAKER_01: Yeah, no.
• 28:14
  SPEAKER_01: Um, so just rabbit holes about the posing on Instagram.
• 28:17
  SPEAKER_01: I just don't even understand it.
• 28:18
  SPEAKER_03: And honestly, like, it's not necessary, right?
• 28:20
  SPEAKER_03: And I think it's funny because there are people who do the pose and then they do like what they actually look like afterwards.
• 28:23
  SPEAKER_03: And those are my favorite people.
• 28:24
  SPEAKER_03: Those are my favorite people.
• 28:25
  SPEAKER_03: Because it's like fit for actually showing us what you really look like and not what we're trying to find in a magazine, right?
• 28:32
  SPEAKER_01: Yeah.
• 28:32
  SPEAKER_01: And the filters, and yeah, and then now we don't know what's AI and what's real.
• 28:36
  SPEAKER_03: Oh my god, that's so much worse.
• 28:37
  SPEAKER_03: And like, we're living in a GLB1 world.
• 28:39
  SPEAKER_03: Yeah.
• 28:40
  SPEAKER_03: So, like, if you have any amount of body fat, you are fat right now.
• 28:43
  SPEAKER_03: Like, it just it makes you feel fat and it's like and you're not like trust me, like you're not.
• 28:47
  SPEAKER_03: You're just a normal human.
• 28:49
  SPEAKER_01: That's why I make a lot of people get dexas scans.
• 28:51
  SPEAKER_01: I'm like, if you really want to understand your body composition, let's get numbers.
• 28:54
  SPEAKER_01: I got one this morning, that's why I was thinking about it.
• 28:56
  SPEAKER_01: I got my because I'm like, I told Rob, like, I gave my shit together, my Achilles is all epit up, I got my blood scan, I got my DUX scan.
• 29:02
  SPEAKER_01: Nothing.
• 29:03
  SPEAKER_01: Now they've told me why my Achilles mess up.
• 29:05
  SPEAKER_01: Um, but anyways, so I always tell my patients that I'm like, let's get blood work, let's look under the food.
• 29:10
  SPEAKER_01: Like, if there is metabolic disease, yes, then we should treat it.
• 29:13
  SPEAKER_01: Like, there's because there's something about health, performance, and longevity.
• 29:18
  SPEAKER_01: Correct.
• 29:18
  SPEAKER_01: But they're they don't all work together.
• 29:20
  SPEAKER_01: No, because usually if you're pushing in one direction, you're gonna sacrifice.
• 29:24
  SPEAKER_01: So, like the marathon is one example where I tell people, like, I was chasing performance, so I sacrificed my health.
• 29:32
  SPEAKER_01: It's a conscious decision.
• 29:33
  SPEAKER_01: Yeah, and that's why, you know, when it's done, the switch flips and like, okay, like I need to get my shit together.
• 29:40
  SPEAKER_01: I need to understand like how much muscle did I lose, what's my body fat percentage, what's my bone, you know, so I don't waste time and just do the same thing again, you know, another six months.
• 29:50
  SPEAKER_01: Um and then, you know, so you pull back performance, wealthy.
• 29:54
  SPEAKER_01: So I I always try to tell that to my patients.
• 29:56
  SPEAKER_01: I'm like, you know, don't I rarely ask anybody what they weigh because I just don't care.
• 30:00
  SPEAKER_01: Yeah.
• 30:00
  SPEAKER_01: I'm like, how do you feel?
• 30:02
  SPEAKER_01: Do you feel puppy?
• 30:02
  SPEAKER_01: Do you feel in plain?
• 30:03
  SPEAKER_01: And I usually can even see it in their face if I'm like, oh, they should use a jokey one.
• 30:07
  SPEAKER_01: Or I'm like, they probably shouldn't do one.
• 30:09
  SPEAKER_03: Yeah.
• 30:09
  SPEAKER_01: And then again, I let the blood work dictate.
• 30:12
  SPEAKER_01: But we are living in this world of just like convoluted medicine, and never before until now could you also get research chemicals, which is so scary, which is like another diet tribe that I have about like when did it become okay that you ordered medications through the mail and then you're mixing powders and stuff in your house and injecting it into your body?
• 30:35
  SPEAKER_01: Yeah, like there are so many red flags from start to finish on that that are just so scary.
• 30:41
  SPEAKER_01: I know.
• 30:42
  SPEAKER_01: Sorry, it's like it's a whole thing for me because I'm like, Yeah, that's so good though.
• 30:47
  SPEAKER_01: What are we doing?
• 30:48
  SPEAKER_01: If you had hypothyroidism, would you order it from India and then mix it in your kitchen and inject it into yourself?
• 30:55
  SPEAKER_01: Like, or would you go to an endocrinologist and let them prescribe you your medication?
• 30:59
  SPEAKER_01: Like it's so strange.
• 31:00
  SPEAKER_03: And I think part of that is like the US health system too, is kind of just fucked, you know?
• 31:04
  SPEAKER_03: So like an intercologist is gonna take you six months, and then that blood worker is gonna take you four months, or like it's gonna be a year later before you have like a but yeah, you go to a concierge practice, and like you're in a sleep in a week, yeah.
• 31:15
  SPEAKER_01: You get your script the same day.
• 31:17
  SPEAKER_01: Yeah, yeah.
• 31:18
  SPEAKER_01: No, I I agree.
• 31:19
  SPEAKER_01: So, what can we do as amateur aging menopausal runners?
• 31:24
  SPEAKER_01: I like you called us amateur aging.
• 31:26
  SPEAKER_01: That was my new favorite thing.
• 31:28
  SPEAKER_01: I am an amateur aging.
• 31:29
  SPEAKER_01: I'm talking about myself.
• 31:30
  SPEAKER_01: Amateur aging 40-year-old runner repeats of herself when she runs.
• 31:35
  SPEAKER_01: What do I need to do?
• 31:36
  SPEAKER_01: Well, I have a very tight butthole.
• 31:39
  SPEAKER_01: No, so I do poop, I will say I poop all the time.
• 31:42
  SPEAKER_01: Like very twice a day, very regular.
• 31:45
  SPEAKER_01: I don't strain, I have no issues.
• 31:47
  SPEAKER_01: I when I run, I'm depending on the duration run, I may have to poop once.
• 31:51
  SPEAKER_01: But it is not not, you know, some runners like have a lot of gut disgust for that.
• 31:54
  SPEAKER_01: I don't have any of that.
• 31:55
  SPEAKER_01: No, I'd like a pretty good, I know what to eat.
• 31:57
  SPEAKER_01: I've been doing this forever.
• 31:59
  SPEAKER_01: Like I'm pretty a machine, but for sure I will pee myself when I run.
• 32:05
  SPEAKER_03: I hate that.
• 32:06
  SPEAKER_01: It's not like a ton, I definitely pee.
• 32:08
  SPEAKER_01: Okay.
• 32:08
  SPEAKER_01: Usually I just like accept it, depending on the duration of the run.
• 32:11
  SPEAKER_03: Like where that's a fail in the system, right?
• 32:13
  SPEAKER_01: Yeah, yeah.
• 32:14
  SPEAKER_03: So is that the beginning of your run?
• 32:16
  SPEAKER_03: Is it the middle of your run?
• 32:17
  SPEAKER_03: Is it when you change pace?
• 32:18
  SPEAKER_03: Is it when you change shoe wear?
• 32:20
  SPEAKER_01: Is it uphill, downhill?
• 32:21
  SPEAKER_01: No, it's like probably the middle of my run, definitely not the beginning, not not really pay.
• 32:27
  SPEAKER_01: It's not like insertional, like I'm pushing, and then if he gets just kind of like it's like happens, almost like when I'm more into a closed state of OS.
• 32:35
  SPEAKER_01: Yeah.
• 32:35
  SPEAKER_03: Okay, yes.
• 32:36
  SPEAKER_03: There's a lot more we'd have to like deep dive with that.
• 32:37
  SPEAKER_03: So we do have what's called a cornepair ultrasound in our.
• 32:39
  SPEAKER_03: Yeah, that's a good one.
• 32:40
  SPEAKER_01: Oh my god, that means it's a transvaginal ultrasound.
• 32:42
  SPEAKER_03: It is not.
• 32:43
  SPEAKER_03: I know, sucker.
• 32:44
  SPEAKER_03: Um, so no, it's uh they're super pubic and then perineal.
• 32:48
  SPEAKER_03: No, so it's all on your taint, but we can see are you actually closing the urethra or you're using the uur levator ani?
• 32:54
  SPEAKER_03: So your urethra and the bladder itself.
• 32:56
  SPEAKER_03: So like the bladder has the support of the elevator ani, right?
• 32:58
  SPEAKER_03: So the muscles are kind of pull people up.
• 33:00
  SPEAKER_03: The urethra has to have the sphincter actually close, close in a certain mechanism.
• 33:05
  SPEAKER_03: Um, and it sounds like a one-way door, right?
• 33:07
  SPEAKER_03: Correct.
• 33:08
  SPEAKER_03: But if you're using your levator ani to actually create that functionality, which you technically kind of can-ish, but then you go and relax those muscles, then you're gonna lose that stabilization, actually being helpful.
• 33:20
  SPEAKER_01: So, how do I fix it?
• 33:21
  SPEAKER_01: Come see us fitness over.
• 33:23
  SPEAKER_01: Are you supposed to stick your finger in my butt though?
• 33:24
  SPEAKER_03: Oh my god, I can't wait.
• 33:27
  SPEAKER_01: The tightest buckle.
• 33:29
  SPEAKER_03: Well, also, but think about like how tight the buckle is, and right, it's all a bowl.
• 33:32
  SPEAKER_03: So if that bowl is really like tipped towards the back, what's gonna happen to the front, right?
• 33:37
  SPEAKER_03: Like there's no support up there anymore.
• 33:38
  SPEAKER_03: So, like if you're in a flow state, you might just get a little bit more on that anterior toe, which is totally fine.
• 33:43
  SPEAKER_03: Yeah, but I might just put a little extra pressure on my urethra.
• 33:46
  SPEAKER_01: So that's the one you're told what Robin about the wand.
• 33:49
  SPEAKER_01: Yes.
• 33:50
  SPEAKER_01: She made me get one, which I I've honestly never used it.
• 33:52
  SPEAKER_01: I have it sewn the box.
• 33:54
  SPEAKER_01: It's in my in my closet because my husband was like, Did you buy a vibrator?
• 33:58
  SPEAKER_01: It's like, no, technically, kind of.
• 34:00
  SPEAKER_01: I was like, Robin told me to buy this because I've been peeing myself when I run.
• 34:05
  SPEAKER_01: She told me it's not because my sphincter isn't tight, it's because my I'm too tight and that I'm not relaxing, but I don't know how to use it, so it's safe box.
• 34:12
  SPEAKER_01: Bring it to you.
• 34:13
  SPEAKER_01: It's literally on a god, I cannot wait.
• 34:15
  SPEAKER_01: Here, fix it.
• 34:16
  SPEAKER_01: I will say it's gotten somewhat better, but I mean, I'm a little bit of a unicorn in conventional way, not a unicorn is running in that I have a long I have a long history of uh almost what I would call hypogonautism.
• 34:31
  SPEAKER_01: The like punchline is I never went through purity.
• 34:34
  SPEAKER_01: I did, but I didn't I was put on birth control before I started my period because I was 17, had a low BMI, had my first boyfriend, my parents didn't want me to get pregnant, like that whole thing.
• 34:45
  SPEAKER_01: They didn't wait for you to have your first no, so the idea was they could induce it with birth control.
• 34:52
  SPEAKER_01: Okay, got it, got it.
• 34:52
  SPEAKER_01: Because I was 17.
• 34:53
  SPEAKER_01: Okay, yeah.
• 34:54
  SPEAKER_01: Um again the bigger story is like why she why is her BMI so low.
• 34:58
  SPEAKER_01: Right, yeah.
• 34:59
  SPEAKER_01: Different now.
• 35:00
  SPEAKER_01: This was in the 90s.
• 35:01
  SPEAKER_01: So everyone's BMI was like zero.
• 35:05
  SPEAKER_01: Yeah, exactly.
• 35:06
  SPEAKER_01: Exactly.
• 35:07
  SPEAKER_01: So they were like, just take birth control because then we'll force a period.
• 35:10
  SPEAKER_01: Even on birth control, I was on birth control for 16 years.
• 35:12
  SPEAKER_01: I probably had less than six kind of spotting and so it's it's a long thing.
• 35:18
  SPEAKER_01: And I I kind of like let that part of my life close.
• 35:20
  SPEAKER_01: But I went through the million dollar workup.
• 35:22
  SPEAKER_01: I had two lacroscopies where them just tell me I have ovarian atrophy, like every she said, like, you know, my uterus is like a deflatable balloon, which is fine.
• 35:30
  SPEAKER_01: Yeah, I don't need an eye face, right?
• 35:32
  SPEAKER_01: Yeah, it's fine.
• 35:33
  SPEAKER_01: So so then I was like, Why don't they were like, well, just I so I catapulted into menopause when I stopped my birth control?
• 35:39
  SPEAKER_01: I was sweating all the time.
• 35:40
  SPEAKER_01: I mean, like, I had a femur fracture, like I was actually like having 20.
• 35:44
  SPEAKER_01: I was 28.
• 35:45
  SPEAKER_01: Holy start.
• 35:46
  SPEAKER_01: Yeah, which is when you have femur fractures like a lot of wear, right?
• 35:51
  SPEAKER_01: And so that led everyone down the rabbit hole of like, okay, now we'll figure out what's going on.
• 35:55
  SPEAKER_01: So then I was like, we'll just go back on birth control.
• 35:57
  SPEAKER_01: And I was like, that sounds redundant since my shit doesn't work, right?
• 36:01
  SPEAKER_01: Remember that one time I already said that.
• 36:02
  SPEAKER_01: Yeah.
• 36:04
  SPEAKER_01: So I then I switched to hormone therapy, which is how I do what I do now.
• 36:07
  SPEAKER_01: Because at the time, and I still remember the same, my husband and I were just together, and and he's a pretty well-known physician.
• 36:14
  SPEAKER_01: So he was like getting me into all these endocrinology, like, but she doesn't have like you have to do something, like you can't just tell her no.
• 36:21
  SPEAKER_01: Yeah.
• 36:22
  SPEAKER_01: So I wound up finding kind of like this charlatan of a guy who was like kind of a car apologist, kind of and he was like, Well, I treat men, but I'll treat you.
• 36:33
  SPEAKER_01: And then I wound up taking over his practice, yeah, fixed it all.
• 36:37
  SPEAKER_01: But it doesn't matter.
• 36:37
  SPEAKER_01: So that's how I started hormone therapy.
• 36:39
  SPEAKER_01: Okay, and then we do what I do now.
• 36:41
  SPEAKER_01: So I've been on HRT for 12 years.
• 36:43
  SPEAKER_01: Okay.
• 36:44
  SPEAKER_03: Well, it's funny because like now there's so many like Casperson and Ruben who are out there who are like violent screaming to the friggin' like rooftop.
• 36:51
  SPEAKER_03: They're like the FTAs assistant.
• 36:52
  SPEAKER_03: Yeah, I'm giving a talk with Helicarian in November.
• 36:56
  SPEAKER_01: Yeah, our company is actually sponsoring her event.
• 36:59
  SPEAKER_01: Yeah, yeah, yeah.
• 36:59
  SPEAKER_01: Oh, that's amazing.
• 37:00
  SPEAKER_01: Yeah, she's amazing.
• 37:01
  SPEAKER_03: Yeah, so I mean, like her stuff just it the map maths there, which is so nice to finally have somebody mixed.
• 37:08
  SPEAKER_01: You know, organically your choice to like decide how you want to be sexually active and not quote great.
• 37:15
  SPEAKER_01: I think that's fine.
• 37:16
  SPEAKER_01: Because I do think there's a point of like telling a 19-year-old girl to like use condoms every time is probably also not the answer.
• 37:26
  SPEAKER_01: Right.
• 37:27
  SPEAKER_01: Or to say like be absent until you're married, like probably also not the answer.
• 37:30
  SPEAKER_01: Right.
• 37:31
  SPEAKER_01: But good on paper, probably not good in application.
• 37:34
  SPEAKER_01: So, but I mean we didn't have IUDs or something.
• 37:36
  SPEAKER_01: Right.
• 37:36
  SPEAKER_01: In fact, it was on all the things.
• 37:39
  SPEAKER_01: So, you know, I think we're starting now.
• 37:41
  SPEAKER_01: So I I never want to demonize the fact that I was put on control or that someone did something wrong.
• 37:46
  SPEAKER_01: I just think it's what they knew to do at the time.
• 37:49
  SPEAKER_01: What did I tell my mom?
• 37:50
  SPEAKER_01: Because every time I give that speech, they're like, I didn't know any better.
• 37:52
  SPEAKER_01: I was like, it's not your fault.
• 37:54
  SPEAKER_01: Like nobody knew, and nobody knew what to do.
• 37:57
  SPEAKER_01: And also like mental health and like eating disorder and all of that.
• 38:01
  SPEAKER_01: So it just like wasn't talked about as much as it is now or accepted, right?
• 38:06
  SPEAKER_01: Yeah, so it was just like, here you go, we'll fix this.
• 38:08
  SPEAKER_01: Because again, all my parents could think about I was gonna get pregnant.
• 38:11
  SPEAKER_01: Sure.
• 38:11
  SPEAKER_01: I was like, I think you have to have a period to do that, but okay, great.
• 38:15
  SPEAKER_01: Just because I'm having intercourse doesn't mean you know we're actually a baby.
• 38:20
  SPEAKER_01: So, anyways, so that's you know, part of I think what plays into now of like hormone depletion and like my pelvic floor, and like yeah, like we always laugh, like when we see in our time at least the other day, like when I get a pap smear, I always ask you tight down there.
• 38:35
  SPEAKER_01: It hurts.
• 38:36
  SPEAKER_01: I know.
• 38:36
  SPEAKER_01: Also I don't love it.
• 38:38
  SPEAKER_01: Yeah, we're not friends before, but I know.
• 38:40
  SPEAKER_01: Yeah, I definitely have I'm tight everywhere, but then I'm also buried with CD, which is why I brought my yeah.
• 38:45
  SPEAKER_03: So, I mean, like there's so many things, there's so many things on that, but like also if those if the muscles are just really tight in general, there's no way that they're gonna fire appropriately, right?
• 38:53
  SPEAKER_03: Think about if your bicep was completely contracted the whole time.
• 38:55
  SPEAKER_03: Like, how would that ever work appropriately?
• 38:57
  SPEAKER_03: Right now, imagine that the it's reflexive.
• 38:59
  SPEAKER_03: Yeah, you're not gonna be able to do anything with that arm, yeah.
• 39:02
  SPEAKER_03: So the same thing with the pelvis, you're gonna have to do anything with that pelvis without it being compensated for in some way, shape, or form.
• 39:07
  SPEAKER_03: Sure.
• 39:07
  SPEAKER_03: Yeah, you would actually mess yourself up more.
• 39:09
  SPEAKER_01: I think I've never done aftermation, it's not that you're in tight, it's that you're too tight.
• 39:15
  SPEAKER_01: So Goldilocks situation.
• 39:16
  SPEAKER_01: Oh, it's why I was telling my patients and hormones like you don't want too much, you don't want too little, and you know, dysfunction on both sides of the spine.
• 39:24
  SPEAKER_01: Exactly.
• 39:24
  SPEAKER_01: Yeah, because people are like hearts flying around your face right now.
• 39:30
  SPEAKER_01: Because they they don't understand it because always like a little bit is good, more has to be better.
• 39:35
  SPEAKER_01: And I'm like, oh no, no, no, no, especially with the thyroid.
• 39:38
  SPEAKER_01: Always the thing where they're like, oh my god, I feel so great on 30 milligrams, and I'm gonna take three, and then then they're like, I'm having chest pain and my hair is falling and I can't sleep.
• 39:46
  SPEAKER_01: It'll make yeah, because you're on speed.
• 39:48
  SPEAKER_01: Yeah, you need to let's fall back.
• 39:50
  SPEAKER_01: Better what I prescribe.
• 39:51
  SPEAKER_01: You 30 prescribes that and then only take three milligrams, not 120.
• 39:56
  SPEAKER_01: That's I have like conversation with some patients.
• 39:59
  SPEAKER_01: I'm like, oh, I made a mistake.
• 40:01
  SPEAKER_01: What does the prescription say?
• 40:02
  SPEAKER_01: And they'll be like, oh no, it says, why did you take two cups of coffee we're gonna get all the day?
• 40:09
  SPEAKER_03: Yes, I was seeing button awake all day.
• 40:11
  SPEAKER_03: Yeah, then you're gonna shake your pants.
• 40:17
  SPEAKER_01: Yes, no, that's so funny.
• 40:18
  SPEAKER_01: I love that.
• 40:19
  SPEAKER_01: Well, what do you want our listeners to take away with?
• 40:22
  SPEAKER_01: What are like our top three things we can do about public health?
• 40:25
  SPEAKER_03: Um I guess like big take on this don't try to get by can't.
• 40:28
  SPEAKER_03: Yeah.
• 40:29
  SPEAKER_03: Uh speaking from experience, you can't do it by yourself.
• 40:31
  SPEAKER_03: Everyone, everyone has a coke.
• 40:34
  SPEAKER_03: There's no kingle game when it comes to public.
• 40:38
  SPEAKER_01: That was something I was gonna ask.
• 40:39
  SPEAKER_01: Do you remember there was a girl, she got really like she could like lift kettlebells?
• 40:43
  SPEAKER_01: Yeah, wasn't jealous, absolutely.
• 40:47
  SPEAKER_01: And also, who wants to see that though?
• 40:49
  SPEAKER_01: It's kind of straight.
• 40:50
  SPEAKER_03: I mean, that was good for it, but that's also my facts for getting that little Riley delicate.
• 40:54
  SPEAKER_03: So I'm I think first of all, just don't do it by yourself.
• 40:56
  SPEAKER_03: Secondly, is that it's a system approach.
• 40:59
  SPEAKER_03: If you just look at in an isolation as a kegels or pelvis, like you're missing a little bit.
• 41:03
  SPEAKER_01: Like you're just in the RP, you're missing every yeah.
• 41:06
  SPEAKER_01: Like I can't get an erection, you're missing everything.
• 41:08
  SPEAKER_03: Correct.
• 41:08
  SPEAKER_03: And then the last thing is don't feel like you need to have a problem with the BC.
• 41:12
  SPEAKER_01: So I was just thinking about that when we were talking.
• 41:14
  SPEAKER_01: So I was like, what am I gonna ask for about in terms and it's IP when I but you're right in that like just like I tell my patients sometime, like, let everyone should get blood work.
• 41:24
  SPEAKER_01: Like if you're over the age of like 25, you should get lamps once a year.
• 41:27
  SPEAKER_01: Yep.
• 41:28
  SPEAKER_01: And doesn't mean something is long, but that way you often have a baseline.
• 41:32
  SPEAKER_01: Well, that's a lot of it, right?
• 41:33
  SPEAKER_03: Because if you don't know what is your actual baseline tone, then if you see me again in five years and maybe you'll want to just completely pull it off the face here.
• 41:41
  SPEAKER_03: If like I don't know if that's your baseline, right?
• 41:44
  SPEAKER_01: Or are you actually significantly different than as healthcare providers?
• 41:49
  SPEAKER_01: Like, we love we love to see you when you're not sick.
• 41:51
  SPEAKER_01: Honestly, best time, yeah.
• 41:53
  SPEAKER_01: Because then it helps us like address dysfunction so much better.
• 41:57
  SPEAKER_01: So I always remind patients, I'm like, hey, I love nothing more than a consult where you walk away with truly keep doing what you're doing.
• 42:03
  SPEAKER_01: Do me in a year, like all all suspends.
• 42:05
  SPEAKER_03: It's never a waste of time, right?
• 42:07
  SPEAKER_03: Something like, well, I just wasted your time.
• 42:08
  SPEAKER_03: Well, it's never a waste of time.
• 42:10
  SPEAKER_03: I think you showed the hell up.
• 42:11
  SPEAKER_03: Yeah, you listen, we had a good conversation.
• 42:13
  SPEAKER_03: You now more safe than it ends up about.
• 42:16
  SPEAKER_03: Yeah, 100%.
• 42:17
  SPEAKER_01: All right, these dogs are feral.
• 42:20
  SPEAKER_01: Oh so much.
• 42:21
  SPEAKER_01: Where can everybody find you?
• 42:22
  SPEAKER_03: So we at pillarpublichealth.com and we are uh so we're at pillar public health on Instagram and Facebook, and then uh we have webinars every other month.
• 42:34
  SPEAKER_03: We have a men's health one coming up.
• 42:35
  SPEAKER_03: So if we look into that, we've had prolabs, we've had us, so we've talked a lot about GSM there.
• 42:41
  SPEAKER_03: So there's a lot we learned to follow up and more about it.
• 42:44
  SPEAKER_01: Perfect.
• 42:45
  SPEAKER_01: All right, like, subscribe and share.
• 42:47
  SPEAKER_01: Thanks.