Latest / Clearly Hormonal / Ep 08: Unpacking “The Menopause Menu”: Science, Stories, & Solutions with Dr. Susan Baumgaertel

Transcript

Ep 08: Unpacking “The Menopause Menu”: Science, Stories, & Solutions with Dr. Susan Baumgaertel · Clearly Hormonal

• 0:01
  Dr. Komal Patil-Sisodia: Welcome to the Reset Recharge podcast with your host, Dr.
• 0:05
  Dr. Komal Patil-Sisodia: Komal Bhatia Sisodia, a board certified endocrinologist, internist, and obesity medicine specialist.
• 0:11
  Dr. Komal Patil-Sisodia: This podcast is focused on empowering women's health and aims to help you reset your understanding of your metabolic health.
• 0:18
  Dr. Komal Patil-Sisodia: And recharge the conversations you are having with your health care providers.
• 0:22
  Dr. Komal Patil-Sisodia: While I am a physician, this podcast is purely for educational purposes.
• 0:26
  Dr. Komal Patil-Sisodia: No individualized medical advice is being given on this podcast.
• 0:30
  Dr. Komal Patil-Sisodia: If you do find information that is helpful, please discuss it with your health care provider at your next visit.
• 0:39
  Dr. Komal Patil-Sisodia: Welcome back to Reset Recharge.
• 0:42
  Dr. Komal Patil-Sisodia: I am very excited to introduce to you Dr.
• 0:45
  Dr. Komal Patil-Sisodia: Susan Baumgartel, who I met through a colleague.
• 0:48
  Dr. Komal Patil-Sisodia: When I met her, I just felt this deep connection to her.
• 0:50
  Dr. Komal Patil-Sisodia: She's done some amazing things in the past.
• 0:53
  Dr. Komal Patil-Sisodia: perimenopause menopause space so I wanted to bring her on and talk about her journey towards creating a few different businesses for herself.
• 1:02
  Dr. Komal Patil-Sisodia: She is an internal medicine physician who practiced for 25 years It was in the pandemic, correct Susan?
• 1:08
  Dr. Komal Patil-Sisodia: When you decided to make a change for yourself, which I think a lot of physicians did but she launched, she wrote an amazing book called The Menopause Menu and then launched her own business called MyMDAdvocate.
• 1:20
  Dr. Komal Patil-Sisodia: And I want to take some time to talk about both of those because I think they're intrinsically linked.
• 1:25
  Dr. Komal Patil-Sisodia: And thank you so much for joining us today, Susan.
• 1:28
  Dr. Komal Patil-Sisodia: I'm excited to have you here.
• 1:30
  Dr. Susan Baumgaertel: Oh, thank you, Komal.
• 1:31
  Dr. Susan Baumgaertel: It's just a delight.
• 1:32
  Dr. Susan Baumgaertel: I'm so glad we can chat about these really important topics.
• 1:34
  Dr. Susan Baumgaertel: Yes, yes.
• 1:36
  Dr. Komal Patil-Sisodia: To start off with, I'd love for you just to tell our listeners about your healthcare journey for your career, and then what prompted you to make these big career changes around the time of the pandemic.
• 1:48
  Dr. Susan Baumgaertel: Yeah, so born in Seattle, grew up in Ontario, Canada, came back and actually attended the University of Washington.
• 1:54
  Dr. Susan Baumgaertel: My degree was in the School of Architecture and Urban Planning.
• 1:58
  Dr. Susan Baumgaertel: So I'm very proud.
• 1:59
  Dr. Susan Baumgaertel: Went out to med school and beyond all at UW.
• 2:02
  Dr. Susan Baumgaertel: My field was internal medicine.
• 2:04
  Dr. Susan Baumgaertel: And then I hung up my shingle, so to speak, in 1996.
• 2:08
  Dr. Susan Baumgaertel: and practice full time clinical medicine.
• 2:10
  Dr. Susan Baumgaertel: And that was back in the day before hospitalists, really.
• 2:13
  Dr. Susan Baumgaertel: So I did a lot of hospital work as well, but eventually segued to the outpatient arena.
• 2:18
  Dr. Susan Baumgaertel: And, you know, over the years, really I took care of all, all types of adults.
• 2:23
  Dr. Susan Baumgaertel: So men and women and a lot of geriatrics.
• 2:25
  Dr. Susan Baumgaertel: But I always had a soft spot for women, especially women who work in that kind of perimenopausal zone and maybe just, it was a natural affinity for them to want to see a female doctor, but along came a lot of things not just the pandemic, but really I pivoted away in early 2021.
• 2:45
  Dr. Susan Baumgaertel: Kind of reclaimed my creativity, reclaimed my sanity, and developed my own business now, which is a telemedicine platform.
• 2:52
  Dr. Susan Baumgaertel: It's called My MD Advocate.
• 2:54
  Dr. Susan Baumgaertel: It's really been a joy to be of service to patients, but in a slightly different way.
• 3:00
  Dr. Susan Baumgaertel: And so I serve really do many, doing medical consultations.
• 3:04
  Dr. Susan Baumgaertel: I can advocate for them, navigating systems.
• 3:07
  Dr. Susan Baumgaertel: I can connect with other caregivers I can help them with a myriad of topics, of course, including menopause, but all sorts of topics.
• 3:15
  Dr. Susan Baumgaertel: And of course I had time because you know, when you work for yourself, I'm better.
• 3:20
  Dr. Susan Baumgaertel: And I was able to sit down and really write the book that had been in my head for so long.
• 3:24
  Dr. Susan Baumgaertel: And so that's kind of how the menopause menu was born.
• 3:27
  Dr. Susan Baumgaertel: I had done a website in the same name, menopause menu, and so it was the springboard.
• 3:32
  Dr. Susan Baumgaertel: That's really fantastic.
• 3:34
  Dr. Susan Baumgaertel: And what pushed you to pursue the path towards my MD advocate?
• 3:38
  Dr. Susan Baumgaertel: I'm sure after 25 years in the internal medicine space and seeing how The practice of medicine has changed over that time.
• 3:46
  Dr. Komal Patil-Sisodia: I'm sure that was probably part of what led you there, but I'd love to hear more about that.
• 3:51
  Dr. Susan Baumgaertel: Yeah.
• 3:51
  Dr. Susan Baumgaertel: I mean, that could be a three hour talk, right?
• 3:53
  Dr. Susan Baumgaertel: The pressure points and the pressure cooker and the systems problems.
• 3:59
  Dr. Susan Baumgaertel: And, you know, honestly, the healthcare field is pretty much broken.
• 4:03
  Dr. Susan Baumgaertel: Everyone is a patient.
• 4:04
  Dr. Susan Baumgaertel: I'm a patient, you're a patient, but our patients has physicians.
• 4:08
  Dr. Susan Baumgaertel: They are so frustrated, you know, they can't get in.
• 4:11
  Dr. Susan Baumgaertel: This is like even pre pandemic, but pandemic blew it out of the water.
• 4:15
  Dr. Susan Baumgaertel: You know, they can't get in or they have a long wait to get in.
• 4:19
  Dr. Susan Baumgaertel: Doctors are retiring or leaving or, not taking new patients.
• 4:23
  Dr. Susan Baumgaertel: It could be the whole myriad of problems with insurance reimbursements or the cost of health care.
• 4:29
  Dr. Susan Baumgaertel: It's just everything is so complicated now and I stepped back and I thought, wait a minute, what can I do that still uses my MD, I can still care for people.
• 4:39
  Dr. Susan Baumgaertel: But is giving them things that they couldn't get in the system.
• 4:42
  Dr. Susan Baumgaertel: And one of the biggies is time.
• 4:45
  Dr. Susan Baumgaertel: I have time.
• 4:45
  Dr. Susan Baumgaertel: I can spend an hour with someone.
• 4:47
  Dr. Susan Baumgaertel: Oh my gosh.
• 4:47
  Dr. Susan Baumgaertel: When was the last time you spent an hour with someone?
• 4:49
  Dr. Susan Baumgaertel: Clinically probably a while ago.
• 4:51
  Dr. Susan Baumgaertel: And not been behind or felt guilty about it.
• 4:53
  Dr. Susan Baumgaertel: And so I can slow it down.
• 4:56
  Dr. Susan Baumgaertel: We can talk about simple things or complicated things.
• 5:01
  Dr. Susan Baumgaertel: We can address.
• 5:02
  Dr. Susan Baumgaertel: patient needs in such a different way.
• 5:05
  Dr. Susan Baumgaertel: The other thing I was really proud of and still am is that I'm not married to any particular system.
• 5:10
  Dr. Susan Baumgaertel: So I know everyone, including myself, when you work for an organization, they have certain policies and procedures you have to do to bring the money in.
• 5:18
  Dr. Susan Baumgaertel: It's a business.
• 5:18
  Dr. Susan Baumgaertel: It's not a hobby, right?
• 5:20
  Dr. Susan Baumgaertel: I can now be free flowing and I can help people in every different system.
• 5:25
  Dr. Susan Baumgaertel: To me, that was very gratifying because I could really come at this from a pure medical caring perspective, not like, oh, what should I be doing?
• 5:32
  Dr. Susan Baumgaertel: So that was really important.
• 5:34
  Dr. Komal Patil-Sisodia: That's wonderful.
• 5:34
  Dr. Komal Patil-Sisodia: And that sounds so freeing.
• 5:36
  Dr. Komal Patil-Sisodia: In this healthcare landscape where we are tied to, to, Systems and insurance and where patients can go and what they can get.
• 5:43
  Dr. Komal Patil-Sisodia: So it's really nice to hear that you have been able to find a niche.
• 5:48
  Dr. Komal Patil-Sisodia: And I know that I have a lot of patients that could really benefit from services like that, that I've seen over the years.
• 5:53
  Dr. Susan Baumgaertel: I might add that it was hard to define at the beginning, but now I've been in my third year now of doing this.
• 5:59
  Dr. Susan Baumgaertel: I really pride myself for collaborating with my colleagues.
• 6:03
  Dr. Susan Baumgaertel: Obviously, everyone's kind of in their lane because you're working 18 hour days.
• 6:06
  Dr. Susan Baumgaertel: You're exhausted.
• 6:07
  Dr. Susan Baumgaertel: You just head down and, you know, nose to the grindstone.
• 6:10
  Dr. Susan Baumgaertel: Now I can really reach out on behalf of a patient and maybe it's their specialist cardiologist, maybe it's their surgeon, maybe it's their primary care and just help be that safety net.
• 6:19
  Dr. Susan Baumgaertel: And to me that was gratifying.
• 6:20
  Dr. Susan Baumgaertel: I'm like the hidden team member.
• 6:22
  Dr. Komal Patil-Sisodia: Which I love because sometimes you just need somebody who puts it all together for you.
• 6:27
  Dr. Komal Patil-Sisodia: Especially when there are many complicated things that are happening.
• 6:30
  Dr. Komal Patil-Sisodia: That's great.
• 6:30
  Dr. Komal Patil-Sisodia: And what did, what was it about your experience with your perimenopausal and menopausal patients that led you down the path towards doing the menopause menu?
• 6:41
  Dr. Susan Baumgaertel: Yeah, I think, you'll probably nod your head off, constantly, but it's just hearing so many things over and over again.
• 6:48
  Dr. Susan Baumgaertel: The most frequent problem was, oh my gosh, where do I get information?
• 6:51
  Dr. Susan Baumgaertel: And they would either get it from their mother, their grandmother, their aunt, their best friend, their colleague, or God forbid all the snake oil salesmen, the websites that are woo woo and yeah, they're, you can tell, these are smart people, women, but they're frustrated.
• 7:05
  Dr. Susan Baumgaertel: And so I thought, gosh, if I can have something that is.
• 7:08
  Dr. Susan Baumgaertel: that doesn't dumb it down, but is clear, that's precise, that kind of really addresses things in the right framework, you know, evidence based, that was important to me.
• 7:18
  Dr. Susan Baumgaertel: And I think that that's something I kept hearing frequently.
• 7:21
  Dr. Susan Baumgaertel: I mean, I think about when I was younger and my mother, she's deceased, but when I was like, no one talked about it.
• 7:28
  Dr. Susan Baumgaertel: Oh my God.
• 7:29
  Dr. Susan Baumgaertel: It's a bit more in the public right now, but even so, depending on culturally or personal preferences.
• 7:34
  Dr. Susan Baumgaertel: Some people still don't talk about menopause.
• 7:36
  Dr. Susan Baumgaertel: So I thought, gosh, this is important to bring it up to the front and center to have a way to disseminate accurate information and to have women not feel embarrassed or put off by asking questions.
• 7:50
  Dr. Susan Baumgaertel: And I think that's really we have to validate.
• 7:52
  Dr. Komal Patil-Sisodia: Yeah I love that you have created that kind of a safe space.
• 7:56
  Dr. Komal Patil-Sisodia: Growing up, my mom had a lot of different health issues.
• 8:00
  Dr. Komal Patil-Sisodia: And she really struggled to navigate the health care system, not just as a woman, but as an immigrant woman in a country where English is not her first language.
• 8:07
  Dr. Komal Patil-Sisodia: I saw that barrier from a young age for her.
• 8:11
  Dr. Komal Patil-Sisodia: She didn't get that counseling around menopause, had a hysterectomy early in her life, and it just, was never addressed I've seen many women held back for societal, for cultural, for medical cultural reasons, mostly centered around the Women's Health Initiative, which you and I know is The worst thing to ever happen to women's health.
• 8:30
  Dr. Komal Patil-Sisodia: I read that study and I just think, Oh gosh, there are so many opportunities.
• 8:34
  Dr. Komal Patil-Sisodia: And I'm sure you read the JAMA article that came out May 1st, which is not a redo of the study.
• 8:40
  Dr. Komal Patil-Sisodia: It's the same thing just with all of that hysteria clawed back.
• 8:46
  Dr. Susan Baumgaertel: Well, I remember I actually, this so viscerally remember in my office.
• 8:53
  Dr. Susan Baumgaertel: Getting phone calls.
• 8:54
  Dr. Susan Baumgaertel: This was in 2002, 2003.
• 8:56
  Dr. Susan Baumgaertel: You know, blam every woman on the planet was told, get off your hormones.
• 8:59
  Dr. Susan Baumgaertel: Yeah.
• 9:01
  Dr. Susan Baumgaertel: Remember those phone calls about a month later.
• 9:04
  Dr. Susan Baumgaertel: And he's like 85 year old women who've been on parameters for like a zillion years.
• 9:08
  Dr. Susan Baumgaertel: Yeah.
• 9:09
  Dr. Susan Baumgaertel: Do this, like go back on your hormones.
• 9:11
  Dr. Susan Baumgaertel: It was just, it was crazy.
• 9:12
  Dr. Susan Baumgaertel: There was so much insane pressure who weren't practicing that time.
• 9:17
  Dr. Susan Baumgaertel: Don't remember, but oh my gosh, I remember that.
• 9:19
  Dr. Susan Baumgaertel: And so fast forward to nowadays, I think the pendulum swung the entire opposite direction for better, for worse, for better, meaning that, Hey, we're finally recognizing there's some interesting information we can learn or relearn about hormones.
• 9:32
  Dr. Susan Baumgaertel: And Oh yeah, it's not the hormones are all bad for you.
• 9:35
  Dr. Susan Baumgaertel: But the reason I'm saying it's like all the other way now, it's almost like the floodgates have been opened.
• 9:40
  Dr. Susan Baumgaertel: No disrespect to anyone who really knows their stuff.
• 9:43
  Dr. Susan Baumgaertel: Yeah.
• 9:44
  Dr. Susan Baumgaertel: Talk openly and accurately about hormones with their patients, but I get this flavor that it's almost like, oh, hormones in the water, everyone should be on hormones.
• 9:52
  Dr. Susan Baumgaertel: I don't think people mean it that way, but I really want to get back into the middle where we're not saying they're evil or that everyone should be on them.
• 10:00
  Dr. Susan Baumgaertel: Let's talk about them.
• 10:02
  Dr. Susan Baumgaertel: Let's dispel some of the myths.
• 10:04
  Dr. Susan Baumgaertel: And talk about the pros and the cons.
• 10:05
  Dr. Susan Baumgaertel: And let's keep it like my theory with everything, keep it individualized.
• 10:09
  Dr. Susan Baumgaertel: Cause I think that's so important for women to be heard and valued as individuals, not as a statistics.
• 10:16
  Dr. Komal Patil-Sisodia: And I love that approach.
• 10:17
  Dr. Komal Patil-Sisodia: If we can neutralize the emotions that we have around hormones, because There are people who are very firmly in either camp, depending on what they believe.
• 10:27
  Dr. Komal Patil-Sisodia: The pendulum has just been back and forth, back and forth, but it's really that neutral approach to it.
• 10:32
  Dr. Komal Patil-Sisodia: The neutral approach is also inclusive of the women that can't have hormones for a multitude of medical reasons I, if I'm sitting there listening, if I had breast cancer or uterine cancer or ovarian cancer, and I'm listening to this hormones are, the fountain of youth, the key to life, the only thing that's going to keep me great in life moving forward, I'm feeling like I have no options.
• 10:57
  Dr. Komal Patil-Sisodia: But there are so many options for women who can't have hormones.
• 11:00
  Dr. Komal Patil-Sisodia: And I think that your book does just such a phenomenal job of, this is the science, but these are some great quotes from people who are going through it so you can empathize with the experience.
• 11:11
  Dr. Komal Patil-Sisodia: And these are things that you can do, both prescription and non prescription or hormonal or non hormonal that can help you get to potentially a better place with this change that every single woman goes through.
• 11:24
  Dr. Komal Patil-Sisodia: There's no woman that escapes menopause should she make it to that age.
• 11:29
  Dr. Komal Patil-Sisodia: Pretty much not, yeah.
• 11:30
  Dr. Komal Patil-Sisodia: Right.
• 11:31
  Dr. Komal Patil-Sisodia: Exactly.
• 11:32
  Dr. Komal Patil-Sisodia: I don't know anybody menstruating into their 70s or 80s, and if they do, I'm so sorry.
• 11:37
  Dr. Komal Patil-Sisodia: I have the Guinness Book of World Records, maybe?
• 11:39
  Dr. Komal Patil-Sisodia: Yeah, right?
• 11:40
  Dr. Komal Patil-Sisodia: It's not anything anybody wants.
• 11:43
  Dr. Komal Patil-Sisodia: I really appreciate your approach that you took in your book to that.
• 11:48
  Dr. Komal Patil-Sisodia: I'd love for you to talk about how you decided to structure.
• 11:52
  Dr. Komal Patil-Sisodia: Each of the chapters, I thought it was really great that it just went from head to toe and told you about all the different things that can happen.
• 12:00
  Dr. Komal Patil-Sisodia: I wish my mom had a book like that.
• 12:04
  Dr. Susan Baumgaertel: Yeah, what resonated with me was like, ah, they're like, Top five or 10 or 15 turn out to be 16 things that are common for many women, if not most, of course it's going to be hot flashes.
• 12:14
  Dr. Susan Baumgaertel: Of course, it's going to be night sweats.
• 12:15
  Dr. Susan Baumgaertel: Of course it's sleep disruption, libido, weight gain, body image, the list goes on.
• 12:20
  Dr. Susan Baumgaertel: So I thought, okay, each of those are going to have their own chapters.
• 12:23
  Dr. Susan Baumgaertel: And then because I love food and I also had a program in the past called menu for change, which I ran from 2012 to 2019.
• 12:30
  Dr. Susan Baumgaertel: And it focused on weight management and really organically morphed into a wellness program.
• 12:36
  Dr. Susan Baumgaertel: So really embraced a lot of holistic support for women, especially women and nutrition and, and, oh my gosh, we had, we had parties with food.
• 12:45
  Dr. Susan Baumgaertel: We, I had five recipe books from that.
• 12:47
  Dr. Susan Baumgaertel: So I thought, oh gosh, this book's going to have food.
• 12:49
  Dr. Susan Baumgaertel: So I love, I've had this, 16 chapters, you get 16 recipes.
• 12:54
  Dr. Susan Baumgaertel: And I thought oh, I'm going to go one up myself.
• 12:56
  Dr. Susan Baumgaertel: I'm going to have each chapter.
• 12:58
  Dr. Susan Baumgaertel: Arranged like a fine dining experience at a restaurant.
• 13:01
  Dr. Susan Baumgaertel: It starts off with she kind of teases you into the subject.
• 13:05
  Dr. Susan Baumgaertel: Then you have what I call the benefits, which is like the appetizer.
• 13:07
  Dr. Susan Baumgaertel: And those are like real, like, if you have nothing else, like you open a chapter, you can just go to that one page and get some bullet points.
• 13:14
  Dr. Susan Baumgaertel: And then it's the entree, which of course is the meat of the matter.
• 13:16
  Dr. Susan Baumgaertel: We get all the information and there's what I call the palate cleanser.
• 13:22
  Dr. Susan Baumgaertel: That's the recipe.
• 13:23
  Dr. Susan Baumgaertel: And then the final, my favorite part was actually dessert.
• 13:26
  Dr. Susan Baumgaertel: Cause to me that was like a wild card and I love dessert.
• 13:29
  Dr. Susan Baumgaertel: So one chapter has menopause menu.
• 13:30
  Dr. Susan Baumgaertel: Bingo.
• 13:31
  Dr. Susan Baumgaertel: One, one chapter has a blooper reel.
• 13:33
  Dr. Susan Baumgaertel: And so it was just a real, it was a fun way.
• 13:36
  Dr. Susan Baumgaertel: I wanted to have humor.
• 13:37
  Dr. Susan Baumgaertel: I wanted to have art.
• 13:38
  Dr. Susan Baumgaertel: I wanted to have kind of beauty.
• 13:40
  Dr. Susan Baumgaertel: There's lots of pictures in it.
• 13:41
  Dr. Susan Baumgaertel: Yeah.
• 13:42
  Dr. Susan Baumgaertel: So in the end, I think it's, an all in one gift book medical guide and recipe book for navigating menopause.
• 13:49
  Dr. Komal Patil-Sisodia: I have to say, I have it right here on my desk.
• 13:51
  Dr. Komal Patil-Sisodia: I finished reading it and it just blew me away.
• 13:54
  Dr. Komal Patil-Sisodia: Like I said, I wish my mom had a book like that.
• 13:56
  Dr. Komal Patil-Sisodia: I am glad that I have something that I can recommend to my patients now to go to learn about each of these different parts of menopause In the media you hear hot flashes, decreased libido, night sweats.
• 14:10
  Dr. Komal Patil-Sisodia: Maybe like vaginal dryness, pain with intercourse, right?
• 14:13
  Dr. Komal Patil-Sisodia: And that's it.
• 14:14
  Dr. Komal Patil-Sisodia: But in my line of work as an endocrinologist, I see so many women who come in to see me and they're convinced it's my thyroid, it's my adrenals, it's something, you know, something else is going on and you need to fix that.
• 14:27
  Dr. Komal Patil-Sisodia: And I have nothing to fix, but when we start going through the symptoms are so much more varied than we tell people, nobody talks about the mood changes or the dry skin or the hair loss.
• 14:38
  Dr. Komal Patil-Sisodia: Changes tract, the joints?
• 14:40
  Dr. Komal Patil-Sisodia: Yeah.
• 14:41
  Dr. Komal Patil-Sisodia: Oh, yeah, yeah, yeah.
• 14:42
  Dr. Komal Patil-Sisodia: just the fact that it breaks it down piece by piece that way I think is a great tool for women to understand their bodies.
• 14:49
  Dr. Komal Patil-Sisodia: Not everybody is going to have the same symptoms That's what I really loved about it.
• 14:54
  Dr. Komal Patil-Sisodia: To anybody who's listening, please go pick up a copy of this book.
• 14:58
  Dr. Komal Patil-Sisodia: I have no vested interest in it other than I just think it is phenomenal and such a great resource for somebody who's just wanting to learn enough about menopause, but not get overwhelmed with the tremendous amount of information that's out there, whether it's good or bad.
• 15:12
  Dr. Komal Patil-Sisodia: I really appreciate the evidence based approach to it.
• 15:15
  Dr. Komal Patil-Sisodia: Towards the end, you talk a bit about your menopause journey and then your journey with rheumatoid arthritis, which I thought was really touching.
• 15:23
  Dr. Komal Patil-Sisodia: I shared with you earlier that I was diagnosed with psoriatic arthritis at the start of the pandemic, and it Turned my world topsy turvy and now being in that perimenopausal age range.
• 15:32
  Dr. Komal Patil-Sisodia: I'm noticing some shifts and changes with that.
• 15:36
  Dr. Komal Patil-Sisodia: I'd love if you would feel comfortable sharing your journey about that.
• 15:40
  Dr. Susan Baumgaertel: Yeah it's been fascinating actually.
• 15:43
  Dr. Susan Baumgaertel: So my daughter's 24 and when she was born I had a zero and I'm talking zero problems with my bones or joints.
• 15:50
  Dr. Susan Baumgaertel: And within three months, literally overnight, I was almost crippled.
• 15:56
  Dr. Susan Baumgaertel: Like my hands, I could barely walk.
• 15:58
  Dr. Susan Baumgaertel: I felt like, and you know, you're a new mother.
• 16:00
  Dr. Susan Baumgaertel: You don't know what's going on.
• 16:02
  Dr. Susan Baumgaertel: It's just, you know, you just think, Oh, am I pushing the stroller wrong?
• 16:04
  Dr. Susan Baumgaertel: I mean, it just, it was really clear.
• 16:07
  Dr. Susan Baumgaertel: I had what they call pregnancy induced rheumatoid arthritis.
• 16:10
  Dr. Susan Baumgaertel: And I not that even didn't trust the medical system.
• 16:13
  Dr. Susan Baumgaertel: I think I went through four rheumatologists before I really need to take ownership of this now.
• 16:20
  Dr. Susan Baumgaertel: So, back in that era, and that was 24 years ago, right?
• 16:24
  Dr. Susan Baumgaertel: There was a paradigm shift in terms of how things like RA were treated.
• 16:28
  Dr. Susan Baumgaertel: And it used to be, you try all the simple thing, add the olive, all the over the counters and medicines years later, maybe try something like, Oh, self isolating or, Well, they were turning everything on its head and it was like, Ooh, new diagnosis.
• 16:44
  Dr. Susan Baumgaertel: Boom.
• 16:45
  Dr. Susan Baumgaertel: You start with the big guns.
• 16:46
  Dr. Susan Baumgaertel: And that freaked me out because I thought, Oh, so I did some other things too, but ultimately got started by all biologics.
• 16:52
  Dr. Susan Baumgaertel: And years later, you'd never know I have RA because I've been blessed to have, a fantastic team and really.
• 17:00
  Dr. Susan Baumgaertel: This is where I must say, bow down to the pharmaceutical industry because boy, it really saved me.
• 17:05
  Dr. Susan Baumgaertel: And every few years seems like I have to go to the next biologic, so I'm on my sixth one now.
• 17:10
  Dr. Susan Baumgaertel: But yeah.
• 17:11
  Dr. Susan Baumgaertel: I feel, I count myself lucky now, of course, interspersed in that journey was, Oh yeah, I'm on a pause, which was like seven years ago for me.
• 17:18
  Dr. Susan Baumgaertel: But you know, you started to kind of like, am I crazy, you know, think about your body while falling apart and chronic illness, you know, it could be someone else, but for me, it was all right.
• 17:30
  Dr. Susan Baumgaertel: There's a lot that happens when you have something else layered on top of that.
• 17:33
  Dr. Susan Baumgaertel: And I think that's a good message for everyone listening when you're going through peri or going through menopause, ultimately it's not like you may have other things going on.
• 17:43
  Dr. Susan Baumgaertel: And so it becomes confusing very quickly.
• 17:45
  Dr. Susan Baumgaertel: And why am I not sleeping or, why why do all my joints hurt?
• 17:49
  Dr. Susan Baumgaertel: Even if you don't have RA, it's just becomes a very confusing time.
• 17:52
  Dr. Susan Baumgaertel: So for me, I felt lucky because I had that knowledge base.
• 17:56
  Dr. Susan Baumgaertel: Okay, this is what's happening.
• 17:58
  Dr. Susan Baumgaertel: I can handle it.
• 17:59
  Dr. Susan Baumgaertel: Allowing myself to have those kind of holistic approaches as well as modern medicine, like I'm both not either, or a combination of the two was really essential for me.
• 18:11
  Dr. Komal Patil-Sisodia: And, and I think that there's so much to be said about that.
• 18:14
  Dr. Komal Patil-Sisodia: There are natural ways of helping mitigate symptoms that should be tied in with all of the pharmacologic stuff that we do.
• 18:22
  Dr. Komal Patil-Sisodia: And in my psoriatic arthritis journey, it was very similar.
• 18:26
  Dr. Komal Patil-Sisodia: Mine came on at the start of the pandemic, which I think was, yours was pregnancy induced.
• 18:30
  Dr. Komal Patil-Sisodia: Mine was probably stress induced But, right, right, exactly, exactly.
• 18:37
  Dr. Komal Patil-Sisodia: I started making shifts in my diet and I was noticing certain triggers in my diet.
• 18:42
  Dr. Komal Patil-Sisodia: It's interesting because if you go purely science, pharma, sometimes those things are poo pooed, but people are, patients, myself, you, we're the ones that live in our bodies every single day We're the ones who know those changes, feel those changes.
• 18:57
  Dr. Komal Patil-Sisodia: And it's important to make adjustments in your environment.
• 19:01
  Dr. Komal Patil-Sisodia: I really preach to my patients because I deal with so much chronic disease in the field of endocrinology, especially around diabetes, metabolic syndrome, prediabetes is you need to work on fixing your environment as much as possible because that is going to help your disease process slow down.
• 19:16
  Dr. Komal Patil-Sisodia: But at some point when your genetics outweigh everything you're doing to fix your environment you have to take help from the other side as well.
• 19:23
  Dr. Komal Patil-Sisodia: The two can very peacefully coexist.
• 19:25
  Dr. Komal Patil-Sisodia: It does not have to be one or the other.
• 19:28
  Dr. Komal Patil-Sisodia: It can really truly be both.
• 19:29
  Dr. Komal Patil-Sisodia: And that has been a life changing perspective for me.
• 19:32
  Dr. Komal Patil-Sisodia: I love that that is really what your book is centered on because even though I'm not in the thick of menopause yet, Will be probably will be soon.
• 19:41
  Dr. Komal Patil-Sisodia: It's really helped me navigate those changes over the last few years.
• 19:45
  Dr. Komal Patil-Sisodia: That's really the message we need to put out to all of the women that are out there is know your history.
• 19:50
  Dr. Komal Patil-Sisodia: Know your family history.
• 19:51
  Dr. Komal Patil-Sisodia: Know how chronic illnesses can change, I.
• 19:55
  Dr. Komal Patil-Sisodia: often joke with my patients that, mother nature is not a girl's girl.
• 19:59
  Dr. Komal Patil-Sisodia: But as soon as we cannot reproduce or our reproductive capability goes down, all of these things that are going to take us out of the environment start marching up.
• 20:08
  Dr. Komal Patil-Sisodia: It's refreshing to find other physicians who have that same mentality and are coaching their patients in the same way.
• 20:16
  Dr. Susan Baumgaertel: Yeah.
• 20:16
  Dr. Susan Baumgaertel: And I think too another take home point is that menopause is such a, it's not just like you're one and done.
• 20:26
  Dr. Susan Baumgaertel: Many women have a lead in, the premenopause or the perimenopausal years that can go on for a long time.
• 20:33
  Dr. Susan Baumgaertel: In fact, I think that's where sometimes they feel like they're gaslit by their physicians because they're not listened to.
• 20:40
  Dr. Susan Baumgaertel: All right.
• 20:41
  Dr. Susan Baumgaertel: And just go eat healthy.
• 20:42
  Dr. Susan Baumgaertel: It's like, no, I mean, yeah, that's good advice for anybody, but you know, and when you're actually going through menopause and it's 12 months without a period and then you're going into post menopause, which is forever, you look back and say, Oh, that's what was going on.
• 20:55
  Dr. Susan Baumgaertel: It's just kind of like this, you know, and then not to, not to, you know, be Debbie Downer, but you can have hiccups.
• 21:01
  Dr. Susan Baumgaertel: So like my hiccup, if you want to call it a hiccup, was getting diagnosed with cancer.
• 21:07
  Dr. Susan Baumgaertel: Actually a thyroid cancer, which has nothing to do with my next comment, but thyroid cancer, which is like, wow, that was fun.
• 21:12
  Dr. Susan Baumgaertel: Not.
• 21:13
  Dr. Susan Baumgaertel: And then I'm now on Tamoxifen for high risk breast cancer.
• 21:17
  Dr. Susan Baumgaertel: And it's like, okay, thank you very much Tamoxifen.
• 21:20
  Dr. Susan Baumgaertel: Now I'm going through menopause again, all over again.
• 21:23
  Dr. Susan Baumgaertel: I know how to do it.
• 21:24
  Dr. Susan Baumgaertel: So hot.
• 21:26
  Dr. Komal Patil-Sisodia: Exactly.
• 21:26
  Dr. Komal Patil-Sisodia: I got you beat this time.
• 21:27
  Dr. Komal Patil-Sisodia: I have the book.
• 21:29
  Dr. Susan Baumgaertel: Do you have to keep this open mind?
• 21:30
  Dr. Susan Baumgaertel: And I think.
• 21:32
  Dr. Susan Baumgaertel: Not just the patients, but I think we need to encourage our colleagues and other physicians to get an open mind and not predetermined or pre label like, oh, she's 43.
• 21:41
  Dr. Susan Baumgaertel: Oh, she's not menopause.
• 21:42
  Dr. Susan Baumgaertel: No, you know, it can start as early as 59.
• 21:47
  Dr. Susan Baumgaertel: I'm 59 and she's over it.
• 21:49
  Dr. Susan Baumgaertel: You know, so I think be open minded and be available to listen.
• 21:55
  Dr. Komal Patil-Sisodia: That is the, that is the biggest part because so many women don't know that their hormones really start shifting potentially as early as 35.
• 22:04
  Dr. Komal Patil-Sisodia: That's a big chunk of your life that you're going through these shifts and changes and all of those things, so.
• 22:11
  Dr. Susan Baumgaertel: Isn't that crazy?
• 22:11
  Dr. Susan Baumgaertel: You go from like advanced maternal age to Yeah.
• 22:16
  Dr. Susan Baumgaertel: Geriatric pregnancy, it's a shocking transition, honestly.
• 22:22
  Dr. Susan Baumgaertel: Oh, women need to rule the world.
• 22:24
  Dr. Susan Baumgaertel: Sorry guys who are listening, but oh man, we go through it all, don't we?
• 22:28
  Dr. Komal Patil-Sisodia: Exactly.
• 22:29
  Dr. Komal Patil-Sisodia: Many, many hormonal changes, even just in one month of a normal menstrual cycle.
• 22:34
  Dr. Komal Patil-Sisodia: Gosh, I feel, I feel sorry for the guys.
• 22:35
  Dr. Komal Patil-Sisodia: I know.
• 22:37
  Dr. Komal Patil-Sisodia: I feel safe.
• 22:40
  Dr. Susan Baumgaertel: Great, great segue is that, um, when I wrote my book and actually wasn't until really after when I started to do podcasts and book parties and talk about book, I thought, you know what, this is just for women.
• 22:51
  Dr. Susan Baumgaertel: For men because they need to get a knowledge base going about what's going on with their special wife, mother, yeah.
• 22:59
  Dr. Susan Baumgaertel: Sister, whatever, girlfriend.
• 23:01
  Dr. Susan Baumgaertel: And so I think we all need to learn about that, not just women.
• 23:05
  Dr. Komal Patil-Sisodia: I agree.
• 23:06
  Dr. Komal Patil-Sisodia: It was interesting.
• 23:06
  Dr. Komal Patil-Sisodia: I was talking to my friends in the neighborhood who are moms who are around my age, and we were talking through these different health issues.
• 23:13
  Dr. Komal Patil-Sisodia: They were so sweet.
• 23:14
  Dr. Komal Patil-Sisodia: They came to my house and did a focus group with me as I was developing the idea for this.
• 23:18
  Dr. Komal Patil-Sisodia: podcast.
• 23:19
  Dr. Komal Patil-Sisodia: And one of them brought up the best idea.
• 23:21
  Dr. Komal Patil-Sisodia: She said, well, can you do an episode for partners to know how to be a good partner through this process?
• 23:28
  Dr. Komal Patil-Sisodia: Your book is great reading material for that.
• 23:31
  Dr. Komal Patil-Sisodia: And then to take it one step further, I think it also benefits men because we don't talk about that when men lose their testosterone they go through very similar symptoms.
• 23:41
  Dr. Komal Patil-Sisodia: A lot of my patients who've had prostate cancer and have to be on testosterone blockers, they describe the same symptoms that women have going through menopause.
• 23:50
  Dr. Komal Patil-Sisodia: So it becomes, almost like a parallel track for knowledge base in terms of how your body is going to be changing, or at least the moods, the hot flashes, some of the physical symptoms that are not related to our reproductive tracks become very similar.
• 24:10
  Dr. Susan Baumgaertel: Yeah, no, I think it's I love that.
• 24:13
  Dr. Susan Baumgaertel: It seems like not a day goes by when I don't see it's the Washington Post or the New York Times or some splashy, national paper that is talking about menopause.
• 24:24
  Dr. Susan Baumgaertel: Yeah.
• 24:24
  Dr. Susan Baumgaertel: It's like menopause in the workplace.
• 24:26
  Dr. Susan Baumgaertel: That's a very common topic.
• 24:28
  Dr. Susan Baumgaertel: And I feel like every time I see those articles, like, yeah, you know, it's good.
• 24:32
  Dr. Susan Baumgaertel: Whether it's written well or not, at least it's getting it into the subject matter that people can talk about.
• 24:38
  Dr. Susan Baumgaertel: And I think that's, that's a win win.
• 24:40
  Dr. Komal Patil-Sisodia: I would agree with that.
• 24:41
  Dr. Komal Patil-Sisodia: I'd love to talk a little bit just about, around your perceptions about, the quality of information that's out there, right?
• 24:47
  Dr. Komal Patil-Sisodia: You took a very evidence based approach to your book, which I appreciate.
• 24:53
  Dr. Komal Patil-Sisodia: And like you said, there's a lot of, Ooh, that is out there and unfortunately taking, taking advantage of people who are in vulnerable places When you feel gaslit by the medical system, when you feel like you're not getting answers from going the traditional route, you're going to be more apt to go seek alternatives, which may or may not be safe for you, depending on the person that's administering them.
• 25:21
  Dr. Susan Baumgaertel: Yeah.
• 25:22
  Dr. Susan Baumgaertel: You know, it's interesting.
• 25:23
  Dr. Susan Baumgaertel: There is a lot out there now.
• 25:24
  Dr. Susan Baumgaertel: Mm-Hmm.
• 25:24
  Dr. Susan Baumgaertel: And of course books coming out.
• 25:26
  Dr. Susan Baumgaertel: Right.
• 25:26
  Dr. Susan Baumgaertel: Left.
• 25:26
  Dr. Susan Baumgaertel: You know, mine came out last, last August.
• 25:28
  Dr. Susan Baumgaertel: Yeah.
• 25:29
  Dr. Susan Baumgaertel: And then there's been quite a few since then.
• 25:31
  Dr. Susan Baumgaertel: I feel like.
• 25:32
  Dr. Susan Baumgaertel: And it's not a competition, but there's quite a lot that is, that has some substance on the surface.
• 25:38
  Dr. Susan Baumgaertel: But then you dive into it now has a very different theme.
• 25:42
  Dr. Susan Baumgaertel: Mm-Hmm.
• 25:42
  Dr. Susan Baumgaertel: Or somehow, you know, I'm gonna say it is connected to somebody who's selling you something, yeah.
• 25:46
  Dr. Susan Baumgaertel: Selling you supplements.
• 25:47
  Dr. Susan Baumgaertel: Oh, get my potion, get my whatever.
• 25:49
  Dr. Susan Baumgaertel: And you know, it's the best thing.
• 25:51
  Dr. Susan Baumgaertel: That's where it's a total turnoff to me, whether it's going to help you or not, and usually not.
• 25:55
  Dr. Susan Baumgaertel: So I feel like a good book is less proscriptive or prescriptive, like do this, do that.
• 26:02
  Dr. Susan Baumgaertel: It's less of that and saying here's the lay of the land and here's some ideas you can think about, but there's no preaching involved.
• 26:10
  Dr. Susan Baumgaertel: Not to discredit any of the hormones because we're in an exciting time now where we're going to be shy about recommending hormones.
• 26:17
  Dr. Susan Baumgaertel: But there's a lot of very emphatic, references that just, you know, take your hormones.
• 26:23
  Dr. Susan Baumgaertel: Don't ever apologize.
• 26:24
  Dr. Susan Baumgaertel: Take until you die.
• 26:25
  Dr. Susan Baumgaertel: I just think that that's, yes, that's one perspective, but that's not everything.
• 26:29
  Dr. Susan Baumgaertel: And you know, I'm not going to be in hormones, so I mean, there are many women who either for right or for wrong are not going to be in hormones.
• 26:36
  Dr. Susan Baumgaertel: So again, it shouldn't be right or wrong.
• 26:38
  Dr. Susan Baumgaertel: It's just, it's individuals.
• 26:40
  Dr. Susan Baumgaertel: Really I think that there's you have to be careful social media and dare I say the word influencer, but you know that the influencers of social media are almost always wrong.
• 26:51
  Dr. Susan Baumgaertel: They're speaking to the millions to the masses, and you should not crowdsource your healthcare.
• 27:00
  Dr. Susan Baumgaertel: I understand.
• 27:01
  Dr. Susan Baumgaertel: I see that completely understanding that not everyone has a physician that can trust or sorry, a physician that they feel comfortable talking to that's available to them that has a time and the knowledge base.
• 27:12
  Dr. Susan Baumgaertel: I know many docs who, Oh, this is great.
• 27:15
  Dr. Susan Baumgaertel: Well, I'll just refer to GWM because I don't know that stuff that's, you know, so, so again, it's, it's not, it's the systems are not set up to help patients.
• 27:23
  Dr. Susan Baumgaertel: So I get that, but that doesn't mean you just go off to the internet and figure out who's talking the most, the loudest about hormones or whatever.
• 27:30
  Dr. Susan Baumgaertel: I think you have to be discerning and So it's still a quagmire.
• 27:34
  Dr. Susan Baumgaertel: It's still a bit of a trick to, to figure that out.
• 27:37
  Dr. Susan Baumgaertel: And let's hope we just get a bit more substance.
• 27:40
  Dr. Susan Baumgaertel: There's a lot more research now happening, which is incredible.
• 27:43
  Dr. Susan Baumgaertel: Yeah, we have needed that for 20 years, energy and effort to get good new data, not just reanalyze data.
• 27:51
  Dr. Susan Baumgaertel: That's now 20, 20 plus years old, but getting This is great.
• 27:55
  Dr. Susan Baumgaertel: This is great.
• 27:56
  Dr. Susan Baumgaertel: So I think we're going to see better options for getting good dissemination of information.
• 28:01
  Dr. Komal Patil-Sisodia: I love that.
• 28:02
  Dr. Komal Patil-Sisodia: What I really loved also about your book, there's many things I love about your book were the quotes that you included from women who are going through it,.
• 28:10
  Dr. Komal Patil-Sisodia: They were funny and at the same time a little heartbreaking, just to hear this different experience.
• 28:16
  Dr. Komal Patil-Sisodia: I told you earlier that your book reminds me of another book that I've read.
• 28:20
  Dr. Komal Patil-Sisodia: It's one of my favorite books.
• 28:20
  Dr. Komal Patil-Sisodia: It's called The School of Essential Ingredients.
• 28:23
  Dr. Komal Patil-Sisodia: Erica Baurmeister and I'm going to put links to Susan's book, her website, if you're interested in taking a look at that, but then also to this one, just because I love it so much.
• 28:33
  Dr. Komal Patil-Sisodia: But it's about, well, it's also about food, which is a shared passion of ours.
• 28:38
  Dr. Komal Patil-Sisodia: I also really love to cook, so I'm excited to try out some of the recipes in your book.
• 28:43
  Dr. Komal Patil-Sisodia: But this book, The School of Essential Ingredients, is written from the perspective of a woman who opens a cooking school and is telling the stories of the people that are coming through.
• 28:51
  Dr. Komal Patil-Sisodia: And there was one about a young mother that I had read prior to having kids.
• 28:56
  Dr. Komal Patil-Sisodia: kids and it was about how she felt herself fundamentally shifting and changing but externally she looked the same to everybody else they thought she was the same person and in the moment that she gave birth her former self shatters into thousands of pieces which she has to quickly gather because she's got this human to care for this new little life and she puts herself back together in a way where everybody still thinks she's the same person but she's so different.
• 29:23
  Dr. Komal Patil-Sisodia: When I read it again after I had my son, I cried and cried and cried because the first time I felt seen read it again last year and, starting to navigate this perimenopause and cried again, because, again, we go through so many of these different Metamorphoses as women.
• 29:39
  Dr. Komal Patil-Sisodia: We're constantly shifting and changing as we go through our lives.
• 29:44
  Dr. Komal Patil-Sisodia: I felt like that was such a beautiful descriptor in that book, but then when I read all of the quotes in yours, I couldn't help but feel the same.
• 29:54
  Dr. Komal Patil-Sisodia: Like, Oh, I feel seen.
• 29:55
  Dr. Komal Patil-Sisodia: These women get it.
• 29:56
  Dr. Komal Patil-Sisodia: I really think that anybody who picks up your book is going to have that same, I feel seen.
• 30:02
  Dr. Komal Patil-Sisodia: How much of that, plays into how they then navigate the healthcare system is going to be really impactful.
• 30:09
  Dr. Susan Baumgaertel: Yeah.
• 30:09
  Dr. Susan Baumgaertel: Oh, that's really a wonderful comparison.
• 30:11
  Dr. Susan Baumgaertel: I'm thinking like there's a sisterhood.
• 30:13
  Dr. Susan Baumgaertel: What I've done since my book came out is doing these book parties and for people who are not local, I can do it by zoom, but it's more fun if it's local.
• 30:20
  Dr. Susan Baumgaertel: And I go to someone's house and they have a nice, nice so nice, delicious food.
• 30:24
  Dr. Susan Baumgaertel: And then we sit around as a group of women talking for two hours.
• 30:27
  Dr. Susan Baumgaertel: I mean, how often do you do that problem for and it's all and I always say the sky's the limit.
• 30:32
  Dr. Susan Baumgaertel: I, this one woman at one of the earlier parties who said like, Oh, I was like, what are you talking about?
• 30:37
  Dr. Susan Baumgaertel: And she's talking about libido, but she was afraid of being uptight.
• 30:39
  Dr. Susan Baumgaertel: I said, look, nothing's off the table here.
• 30:42
  Dr. Susan Baumgaertel: Yeah.
• 30:43
  Dr. Susan Baumgaertel: Had a 20 minute talk about sex and this and that.
• 30:45
  Dr. Susan Baumgaertel: You know, it's a relief.
• 30:47
  Dr. Susan Baumgaertel: It was palpable.
• 30:48
  Dr. Susan Baumgaertel: Another one who, and this was interesting.
• 30:51
  Dr. Susan Baumgaertel: There were two that were sitting next to each other.
• 30:53
  Dr. Susan Baumgaertel: And this one woman said she was very frustrated.
• 30:55
  Dr. Susan Baumgaertel: Basically she was quite angry but very annoyed at her doctor who had not listened to her, a woman and who had said was very honest with her.
• 31:04
  Dr. Susan Baumgaertel: They said, look, I never got this training in med school.
• 31:06
  Dr. Susan Baumgaertel: I didn't get this training in residency.
• 31:08
  Dr. Susan Baumgaertel: I don't know much about menopause.
• 31:10
  Dr. Susan Baumgaertel: You're just gonna have to so go see your, her GYN.
• 31:12
  Dr. Susan Baumgaertel: And so she felt very brushed off.
• 31:14
  Dr. Susan Baumgaertel: Yeah.
• 31:15
  Dr. Susan Baumgaertel: And so I interjected and said, you're right.
• 31:16
  Dr. Susan Baumgaertel: I think your doctor was being very frank and very honest with you.
• 31:20
  Dr. Susan Baumgaertel: But where did this woman go?
• 31:22
  Dr. Susan Baumgaertel: She went off the netherworld to get care that was really off the beaten trail.
• 31:26
  Dr. Susan Baumgaertel: And I'm not going to say whether it was good or bad, but just, it's not what you want to hear.
• 31:31
  Dr. Susan Baumgaertel: When here we are, we come into this profession, wanting to help people and to care for them and to listen and to be available to them, to realize it's very off putting if we're not eager to learn.
• 31:41
  Dr. Susan Baumgaertel: And so I think it's, it behooves everyone to be able to learn a bit more about menopause.
• 31:47
  Dr. Susan Baumgaertel: I completely agree.
• 31:49
  Dr. Susan Baumgaertel: Are you still doing those parties for people?
• 31:51
  Dr. Susan Baumgaertel: Wonderful.
• 31:52
  Dr. Susan Baumgaertel: How do people find that?
• 31:53
  Dr. Susan Baumgaertel: So on my website, they can just email me and I, from time to time, I've put some little flyers up on my menopause mini website, but really they can just go to my, mymdadvocate.
• 32:04
  Dr. Susan Baumgaertel: com and my email's there.
• 32:06
  Dr. Susan Baumgaertel: They can say, Hey let's do a party.
• 32:07
  Dr. Susan Baumgaertel: I just find it's fun.
• 32:08
  Dr. Susan Baumgaertel: I don't charge for them as long as people buy my books.
• 32:11
  Dr. Susan Baumgaertel: So that's kind of, you know, That's a little funny.
• 32:14
  Dr. Komal Patil-Sisodia: Yeah, that's fantastic.
• 32:15
  Dr. Komal Patil-Sisodia: It becomes probably very much like a book club, which I love.
• 32:18
  Dr. Komal Patil-Sisodia: My other questions for you would be around, where do you think as a medical system, we need to move towards to better support women.
• 32:28
  Dr. Komal Patil-Sisodia: You're in a great space for advocacy, you have this wide reach to look across all of these different systems, how can we as you.
• 32:39
  Dr. Komal Patil-Sisodia: Physicians, especially as female physicians better advocate for our patients.
• 32:43
  Dr. Komal Patil-Sisodia: How can women better navigate the system?
• 32:46
  Dr. Susan Baumgaertel: Yeah.
• 32:46
  Dr. Susan Baumgaertel: Well, there's a lot of overlap.
• 32:47
  Dr. Susan Baumgaertel: I think that one of the common denominators is time You have to have time because if someone's zipping in for a quick blood pressure check and you have, by the time your medical assistant maybe has put them in the room and check their blood pressure, done their vitals and gone over their med list, you waltz in and maybe have seven minutes.
• 33:02
  Dr. Susan Baumgaertel: Cause you're behind.
• 33:03
  Dr. Susan Baumgaertel: You're not going to have a substantive caring, compassionate, long discussion about menopause stuff in that seven minute blood pressure check.
• 33:12
  Dr. Susan Baumgaertel: It's not realistic.
• 33:13
  Dr. Susan Baumgaertel: But if you allow a little bit of a moment, allow a listening, nurturing kind of environment, maybe you schedule them back for a talk about their vaginal dryness or their libido or, their weight gain.
• 33:28
  Dr. Susan Baumgaertel: And then you have a more, a bigger chunk of time.
• 33:31
  Dr. Susan Baumgaertel: On the flip side, I've encouraged so many people to bring.
• 33:35
  Dr. Susan Baumgaertel: One page, not 12 pages, right?
• 33:38
  Dr. Susan Baumgaertel: Typed and not with 42 problems on it, but maybe like three or four and you can hand it to them.
• 33:45
  Dr. Susan Baumgaertel: And maybe if there's not enough time, they can say, Ooh, let's pick off what's the most important one to you?
• 33:51
  Dr. Susan Baumgaertel: Let's talk about that one.
• 33:53
  Dr. Susan Baumgaertel: And then your eyes scan down Whoa, there's a lot going on here.
• 33:55
  Dr. Susan Baumgaertel: Then they can get you back because this way, maybe there is time, maybe they're going to go over all those issues.
• 34:00
  Dr. Susan Baumgaertel: This way, you've organized your thoughts as a patient.
• 34:03
  Dr. Susan Baumgaertel: You've prioritized what's helpful for you.
• 34:05
  Dr. Susan Baumgaertel: And you've told them, look, I, this is really important.
• 34:08
  Dr. Susan Baumgaertel: I want to talk about these things.
• 34:09
  Dr. Susan Baumgaertel: So it's a two way communication.
• 34:11
  Dr. Susan Baumgaertel: And if you're not comfortable doing that, I hate to say this, but you might have to find another doctor.
• 34:17
  Dr. Susan Baumgaertel: If you're not comfortable bringing up some things.
• 34:20
  Dr. Susan Baumgaertel: The sad thing, and I think this is a lot, I see this a lot more because of the pandemic, people get referred to so many different places.
• 34:27
  Dr. Susan Baumgaertel: Oh, your toe hurts.
• 34:28
  Dr. Susan Baumgaertel: Oh, see podiatry.
• 34:29
  Dr. Susan Baumgaertel: Oh my gosh, I can take care of toe pain, or, you have one bad period.
• 34:32
  Dr. Susan Baumgaertel: Oh, see GYN, you don't need to see.
• 34:34
  Dr. Susan Baumgaertel: Yeah.
• 34:35
  Dr. Susan Baumgaertel: This referral and then of course, you know where that goes, you have to get the whole thing processed insurance and then maybe you live far away.
• 34:41
  Dr. Susan Baumgaertel: It's inconvenient.
• 34:42
  Dr. Susan Baumgaertel: And then maybe they're booked out for six months.
• 34:44
  Dr. Susan Baumgaertel: So learn to communicate better, stay organized, offer an olive branch.
• 34:50
  Dr. Susan Baumgaertel: In other words, don't force 42 problems in a five minute visit.
• 34:54
  Dr. Susan Baumgaertel: Allow that position to say, let's get you back and talk about it.
• 34:58
  Dr. Susan Baumgaertel: But the position needs to be open minded.
• 34:59
  Dr. Susan Baumgaertel: And so I think we just need more of that.
• 35:01
  Dr. Susan Baumgaertel: Okay.
• 35:01
  Dr. Komal Patil-Sisodia: I love the tips around organizing your symptoms, your thoughts, your concerns.
• 35:06
  Dr. Komal Patil-Sisodia: I, I find it so helpful when my patients do that.
• 35:10
  Dr. Komal Patil-Sisodia: And I also love your point about if you're, Getting the brush off, even if you do those things or you don't feel comfortable doing those things, it's important to find somebody that you gel with.
• 35:20
  Dr. Komal Patil-Sisodia: I will always tell my patients, if you seek another opinion, I am not offended by that.
• 35:25
  Dr. Komal Patil-Sisodia: You and I need to have that trust and that connection in order to take care of your health in the best way possible.
• 35:31
  Dr. Komal Patil-Sisodia: So I love that you're pushing people to realize that as well from an advocacy team.
• 35:37
  Dr. Susan Baumgaertel: To harp on this point, we're trying to get a knee replacement.
• 35:41
  Dr. Susan Baumgaertel: Yeah, you to maybe even three orthopedic surgeons, and then you finally decide I'm going to go with surgeon be not a or c.
• 35:48
  Dr. Susan Baumgaertel: That's because maybe they've listened to you, maybe got a good vibe from their staff, maybe they have a different technique, basically you've chosen them for a reason.
• 35:56
  Dr. Susan Baumgaertel: Well, not every relationship and primary care is the best either.
• 36:01
  Dr. Susan Baumgaertel: And when it comes to menopause, I think women need to really advocate for themselves.
• 36:05
  Dr. Susan Baumgaertel: Get someone that's going to be interested, who listens, who cares, and actually has maybe some of the knowledge base instead of just referring for everything.
• 36:12
  Dr. Susan Baumgaertel: That's really important.
• 36:13
  Dr. Komal Patil-Sisodia: I was really excited to hear within my system.
• 36:15
  Dr. Komal Patil-Sisodia: There were a few primary care providers who had gone to perimenopause and menopause CME and were starting to open that conversation with their patients in a very proactive manner.
• 36:26
  Dr. Komal Patil-Sisodia: One of my friends in the neighborhood told me that her doctor talked to her about all of that as soon as she turned 40.
• 36:32
  Dr. Komal Patil-Sisodia: So I just turning a little.
• 36:35
  Dr. Komal Patil-Sisodia: So I'm excited.
• 36:35
  Dr. Komal Patil-Sisodia: I'm hopeful.
• 36:36
  Dr. Komal Patil-Sisodia: I'm cautiously optimistic that we're making progress in that direction.
• 36:40
  Dr. Komal Patil-Sisodia: Susan, thank you so much for your time this afternoon.
• 36:44
  Dr. Komal Patil-Sisodia: I really appreciate the time you took to, to talk about your book, about your advocacy.
• 36:50
  Dr. Komal Patil-Sisodia: I think you are brilliant, lovely, and a wealth of knowledge for both patients and providers alike.
• 36:56
  Dr. Komal Patil-Sisodia: So thank you for doing what you do.
• 36:58
  Dr. Komal Patil-Sisodia: For anybody who's listening, you can find Dr.
• 37:01
  Dr. Komal Patil-Sisodia: Baumgartel on her website at myMDAdvocate.
• 37:03
  Dr. Komal Patil-Sisodia: com.
• 37:04
  Dr. Komal Patil-Sisodia: And I believe that has links to your book as well as the potential to book one of these lovely parties, which I might end up having to do a book club for my neighborhood.
• 37:11
  Dr. Komal Patil-Sisodia: I'm in, I'm in.
• 37:13
  Dr. Komal Patil-Sisodia: Thank you so much again.
• 37:14
  Dr. Komal Patil-Sisodia: I really appreciate it.
• 37:16
  Dr. Komal Patil-Sisodia: Thank you for having me.
• 37:16
  Dr. Komal Patil-Sisodia: It was a great chat.