Latest / Beyond the White Coat / Ep 39 - Inside Look: Hormone Therapy and Cultural Perspectives

Transcript

Ep 39 - Inside Look: Hormone Therapy and Cultural Perspectives · Beyond the White Coat

• 0:02
  SPEAKER_00: Hello, we are live.
• 0:04
  SPEAKER_00: Are we on Beyond the White Coat?
• 0:05
  SPEAKER_00: This is Yeah, we're live on Beyond the White Coat podcast.
• 0:08
  SPEAKER_00: Since we've had so many meta Instagram struggle buses, I don't want to talk about it, but I'm sure we'll talk about it.
• 0:15
  SPEAKER_01: Yeah, we're gonna definitely talk about it because we need to explain why we're going live here.
• 0:19
  SPEAKER_00: Because so people can now find us.
• 0:22
  SPEAKER_00: Um and we are live on the podcast.
• 0:24
  SPEAKER_00: So for those of you just listening and watching on YouTube later, hello, it's Wednesday.
• 0:30
  SPEAKER_01: Cheers for cheers.
• 0:32
  SPEAKER_01: Thank God this was sitting here ready for me.
• 0:34
  SPEAKER_01: I know I'm so grateful.
• 0:35
  SPEAKER_00: I had you.
• 0:36
  SPEAKER_00: Um you had me at hello.
• 0:38
  SPEAKER_00: Right.
• 0:39
  SPEAKER_00: So, all right, let's dive in.
• 0:41
  SPEAKER_00: How has your last week been?
• 0:43
  SPEAKER_00: My face is done peeling like I'm it peeled so much like last time.
• 0:47
  SPEAKER_00: Yeah.
• 0:47
  SPEAKER_00: Yeah.
• 0:47
  SPEAKER_01: I love that.
• 0:48
  SPEAKER_00: Um, but Caitlin said she could tell.
• 0:50
  SPEAKER_00: So for those of you who don't know, if you go back and watch the last episode, my face is burnt orange because I did a VI peel with my tox, would you write that combo?
• 1:00
  SPEAKER_00: Yeah.
• 1:01
  SPEAKER_00: I've decided now, just every three months when I'm getting my tox, I'm just gonna do that.
• 1:05
  SPEAKER_00: But yeah, I had a really nice peel.
• 1:07
  SPEAKER_00: And it's not crazy.
• 1:08
  SPEAKER_00: Like if you're worried about getting a peel, let me just tell you, you can put enough of the recovery cream on um and just you know keep reapplying that to you know if you have to work or your face forward.
• 1:20
  SPEAKER_00: It's not you'd have to be pretty close to see it.
• 1:23
  SPEAKER_00: So you know what I mean?
• 1:24
  SPEAKER_00: Like it there's not huge downtime, I think.
• 1:27
  SPEAKER_01: And I think everybody has to know you you you peel as you need to peel.
• 1:31
  SPEAKER_01: Like, for instance, like I have very little peeling, but I also do things within the kit to reduce um the strength because I know that there's things that I like things that are important to me and how I want to like customize the peel.
• 1:46
  SPEAKER_01: So um, for you, we definitely needed to kind of suppress those melanocytes and also to get you to beater.
• 1:53
  SPEAKER_01: Yeah.
• 1:54
  SPEAKER_01: Um so and then we did the neurotoxin on top.
• 1:57
  SPEAKER_01: Yeah, it's been great.
• 1:58
  SPEAKER_00: My face is hype high.
• 2:02
  SPEAKER_00: So we were in, which we'll talk about in Nantalk in this last weekend.
• 2:08
  SPEAKER_01: Wait, wait, before you say anything, the funniest thing is I put this poll up on Instagram that basically said, How do you like your tox results?
• 2:17
  SPEAKER_01: And one of the answers that I gave the um audience to choose from was you want to confuse your emotions.
• 2:26
  SPEAKER_00: So I thought of you know save my face because even now, as I'm laughing, nothing is moving.
• 2:32
  SPEAKER_00: I went, I went to sneeze.
• 2:34
  SPEAKER_00: I was running with Martha you were talking about last time.
• 2:38
  SPEAKER_00: Yeah, I went to sneeze and I go, Oh my god, that feels so weird.
• 2:42
  SPEAKER_00: And Martha goes, Did you sneeze?
• 2:44
  SPEAKER_00: And I was like, I know you can't tell because my forehead doesn't move.
• 2:48
  SPEAKER_00: And she's 23, so like doesn't need it.
• 2:51
  SPEAKER_00: Yeah, and I was like, one day, girl, one day.
• 2:54
  SPEAKER_00: And I I was telling her, I was like, what's even worse is when you get it in your chin, and then like everything just kind of like wants to move, but it can't all in one motion.
• 3:02
  SPEAKER_01: So yeah, my face is a tight, it feels good though, it's super tight, like like the wind hit it, and it's like frozen and tight.
• 3:12
  SPEAKER_01: What's going on with this hair too?
• 3:14
  SPEAKER_01: I know.
• 3:14
  SPEAKER_00: I almost didn't recognize you.
• 3:16
  SPEAKER_00: Yeah, I so for we had to go back and look for two years now.
• 3:22
  SPEAKER_00: I've been light and I kind of got it.
• 3:25
  SPEAKER_00: Always starts like as a transition where my hair was dark, and then I got some highlights, and then the highlights became more, and then um, you know, we switched out my extensions and added more blonde, and then it would just like kind of went all in.
• 3:37
  SPEAKER_00: So I've been pretty blonde for two years, which is great.
• 3:42
  SPEAKER_00: I do love the look of being blonde.
• 3:44
  SPEAKER_00: I just feel a little bit more confident and whatnot, but it is so bad for my hair, and I just felt like the upkeep was so much, and my roots were showing all the time.
• 3:53
  SPEAKER_00: So I told Ruby, who does my hair, I was like, Hey, what do you think about a change?
• 3:58
  SPEAKER_00: And she was like, Yes, amen.
• 3:59
  SPEAKER_00: We need to do it.
• 4:01
  SPEAKER_00: So it's gorgeous, so it's dark, yeah.
• 4:04
  SPEAKER_00: I love it.
• 4:04
  SPEAKER_01: Do you know it's like you see somebody the way they look for so long and they do something like just drastic like that?
• 4:11
  SPEAKER_01: I think it looks so beautiful.
• 4:13
  SPEAKER_01: It makes your skin look really tanned.
• 4:15
  SPEAKER_00: That's what Lucy said today, too.
• 4:16
  SPEAKER_00: She's like, I think your complexion looks better, like you don't look washed out.
• 4:20
  SPEAKER_00: Um, yeah, because she was here today.
• 4:23
  SPEAKER_00: So yeah, so I have a whole new look, which is good.
• 4:26
  SPEAKER_00: The sad part is what a month before, not even two weeks before I changed my hair.
• 4:31
  SPEAKER_00: I got a ton of photos and I'm bright blonde in it.
• 4:35
  SPEAKER_00: So I was like, well, that is what it is.
• 4:37
  SPEAKER_00: We're just gonna use them anyways, who cares?
• 4:39
  SPEAKER_00: Yeah.
• 4:39
  SPEAKER_00: So what's going on with you?
• 4:40
  SPEAKER_01: Oh goodness.
• 4:41
  SPEAKER_01: Let's see.
• 4:42
  SPEAKER_01: Um, you know, I think everything seems to be pretty normal.
• 4:46
  SPEAKER_01: I do have some family drama.
• 4:48
  SPEAKER_01: Um, you know, it's just really hard for me to sometimes I I have a hard time of not trying to control a situation um because at the end of the day, I just want everybody to get along.
• 5:02
  SPEAKER_01: Right.
• 5:03
  SPEAKER_01: So um a friend of the family.
• 5:06
  SPEAKER_01: So a friend of the family, her their daughter's getting married.
• 5:10
  SPEAKER_01: Okay.
• 5:11
  SPEAKER_01: And um in our culture, right?
• 5:14
  SPEAKER_01: We're Cambodian.
• 5:15
  SPEAKER_01: Yeah, I'm Cambodian.
• 5:16
  SPEAKER_01: So our culture dictates very much on how we should present and how we should support other people in our like community and our circle of like trusts, I would say.
• 5:28
  SPEAKER_01: Um, but the problem is that the daughter has not been um how can I say this?
• 5:34
  SPEAKER_01: She's just an asshole, she's been an asshole to everybody.
• 5:38
  SPEAKER_01: And at this point, like nobody wants to show up for her.
• 5:42
  SPEAKER_01: And so that's causing a little bit of rift within my family because like I'm just gonna, I'm just gonna show up for people.
• 5:48
  SPEAKER_01: Right at the end of the day, like, and I was telling Caitlin this, I was like, just be your fucking authentic self, right?
• 5:55
  SPEAKER_01: So if you feel like you want to show up for somebody, if you want to cut somebody off and it truly feels genuine, then just do it.
• 6:02
  SPEAKER_01: Right.
• 6:03
  SPEAKER_01: You know, because at the end of the day, the only person that you have to account for is yourself.
• 6:08
  SPEAKER_01: And so I might be the only person going in my family.
• 6:11
  SPEAKER_01: Oh wow to her wedding.
• 6:12
  SPEAKER_01: Yes, and so and I the thing is I don't like to answer questions.
• 6:16
  SPEAKER_01: Like I just like to be like, hey, I showed up and that's what it is.
• 6:20
  SPEAKER_01: Right.
• 6:20
  SPEAKER_01: It's not how my culture works.
• 6:22
  SPEAKER_01: It's like, oh, well, your sister didn't show up, your brother didn't show up, um, your mom didn't show up, your uncles didn't show up, you know.
• 6:29
  SPEAKER_01: So that's been kind of a source of contention right now.
• 6:32
  SPEAKER_01: When is the wedding?
• 6:34
  SPEAKER_01: Um the wedding is in a few months.
• 6:36
  SPEAKER_01: Okay.
• 6:37
  SPEAKER_01: Um, and the other thing is like in our in our community, we don't we don't do gifts.
• 6:43
  SPEAKER_01: We actually give monetary, like we give money, right?
• 6:46
  SPEAKER_01: Yeah.
• 6:46
  SPEAKER_01: And so and in the past, people have like accused people of like, oh, you're just inviting us so you can have money.
• 6:55
  SPEAKER_01: Because like my family gives like money, nice, yeah, yeah, nice amounts of money.
• 7:00
  SPEAKER_01: So I I just I'm just gonna go, you know, but I just don't want to be put in a position where like where's your where's your parents?
• 7:08
  SPEAKER_01: Where whatever.
• 7:09
  SPEAKER_00: You just set that boundary and just be like, I don't know, but I'm here.
• 7:11
  SPEAKER_01: Yeah.
• 7:11
  SPEAKER_01: Happy to be here.
• 7:12
  SPEAKER_01: Yeah.
• 7:13
  SPEAKER_00: What so what's a traditional Cambodian wedding like?
• 7:16
  SPEAKER_01: Oh my god, well, the real traditional Cambodian wedding is actually the wedding is like a month long.
• 7:21
  SPEAKER_01: Yeah, that's like Indian wedding.
• 7:23
  SPEAKER_01: Yeah, so you're like the actually the um the groom's family pays a dowry towards the bride's family, and you get gifted for a month with all types of jewels and you know, silks, money, money trees, um, and then you gotta pay for the daughter, you know, it's so different from the American tradition.
• 7:43
  SPEAKER_01: Yeah, yeah.
• 7:44
  SPEAKER_01: Right.
• 7:44
  SPEAKER_01: And so you have like you get changed like a hundred million times.
• 7:47
  SPEAKER_01: There and there's so much symbolism in the weddings.
• 7:50
  SPEAKER_01: Sure.
• 7:50
  SPEAKER_01: Um, but yeah, I mean, I'm looking for she's actually gonna be mi um marrying somebody American.
• 7:56
  SPEAKER_01: Okay.
• 7:56
  SPEAKER_01: Um, so we'll see.
• 7:58
  SPEAKER_01: And see, it's kind of stressful, you know.
• 8:01
  SPEAKER_01: You know, my family is like where we're super close, and yeah, I don't like it when we disagree on things.
• 8:06
  SPEAKER_01: But I'm also not an asshole.
• 8:07
  SPEAKER_01: Right.
• 8:07
  SPEAKER_01: You know, oftentimes I show up for people, people don't show up for me, and I'm like, whatever it is, it is like that's how I feel.
• 8:14
  SPEAKER_00: Oh my god, we didn't we should have led with this since we last spoke.
• 8:17
  SPEAKER_00: You had a birthday.
• 8:18
  SPEAKER_01: I did, I'm 21.
• 8:20
  SPEAKER_01: Yeah, cheers! First spring ever.
• 8:23
  SPEAKER_01: Um was your birthday?
• 8:25
  SPEAKER_01: It was very uneventful, but I did have the best dinner at this place called Third in Main in Aurora, Indiana.
• 8:33
  SPEAKER_01: Okay.
• 8:34
  SPEAKER_01: The best food ever.
• 8:36
  SPEAKER_01: Um, imagine the precinct, but being able to go in and like Daisy Duke's and like come in.
• 8:42
  SPEAKER_01: Oh, I love that.
• 8:43
  SPEAKER_00: What'd you have?
• 8:43
  SPEAKER_00: What's your perfect birthday dinner?
• 8:45
  SPEAKER_01: Uh so I had Wagyu steak and I had um crab legs and I had a lobster tail.
• 8:52
  SPEAKER_01: Oh, nice.
• 8:53
  SPEAKER_01: And um, sugar daddy must have been paying.
• 8:56
  SPEAKER_01: Woohoo! Yeah.
• 8:57
  SPEAKER_00: Oh wow.
• 8:58
  SPEAKER_00: And some shrimp.
• 9:00
  SPEAKER_00: Oh my gosh.
• 9:00
  SPEAKER_01: And two birthday desserts.
• 9:03
  SPEAKER_00: Hey, what's your birthday dessert go to?
• 9:04
  SPEAKER_01: Um so one was like the house if it was up to me.
• 9:08
  SPEAKER_01: I love carrot cake or red velvet cake.
• 9:10
  SPEAKER_01: Oh, David loves carrot cake too.
• 9:11
  SPEAKER_01: But they um we had like a nice little like chocolate like thing that they made, and then um some um what else did we have?
• 9:19
  SPEAKER_01: Some sort of uh lemon cake.
• 9:21
  SPEAKER_01: Perfect.
• 9:22
  SPEAKER_01: It was good.
• 9:22
  SPEAKER_01: I took about two bites because I'm really trying to um make sure that I can keep this weight off because you know that can just throw me off a whole tangent of eating desserts.
• 9:31
  SPEAKER_01: I mean desserts but that dessert, was it at Lucy's baby shower?
• 9:36
  SPEAKER_00: Oh, the crepe cake, yeah.
• 9:37
  SPEAKER_00: That Abby Divine Brah.
• 9:39
  SPEAKER_00: I know it is good.
• 9:40
  SPEAKER_00: It's funny.
• 9:40
  SPEAKER_00: We had this conversation this weekend at dinner about um your I mean, it's kind of like morbid, but if you're on death row and you get your final meal, or you know, you have your say in how you're gonna end your life and you're gonna have your final meal, what would it be?
• 9:55
  SPEAKER_00: And it sounds like that's probably a lot of what yours is, right?
• 9:59
  SPEAKER_01: It's like food?
• 10:00
  SPEAKER_00: Yeah, what's your last meal?
• 10:02
  SPEAKER_01: Who?
• 10:03
  SPEAKER_01: Um, probably oysters.
• 10:05
  SPEAKER_01: Okay.
• 10:06
  SPEAKER_01: Like raw.
• 10:07
  SPEAKER_01: Raw oysters.
• 10:08
  SPEAKER_01: How do you eat your oysters?
• 10:09
  SPEAKER_01: Do you eat oysters?
• 10:10
  SPEAKER_01: Yeah, yeah, yeah.
• 10:11
  SPEAKER_01: So what do you put on what do you put on them?
• 10:12
  SPEAKER_00: Um, I just like a little vinegar and a little lemon juice.
• 10:16
  SPEAKER_00: I like the acidity.
• 10:17
  SPEAKER_01: And you eat it raw.
• 10:18
  SPEAKER_00: Yeah.
• 10:19
  SPEAKER_00: Okay.
• 10:19
  SPEAKER_01: So I do like fresh like cocktail sauce, lemon, pepper, tobasco sauce, um, a little bit of dill.
• 10:28
  SPEAKER_01: I mean, it's like a whole thing.
• 10:29
  SPEAKER_00: Wow, that's like a whole thing.
• 10:30
  SPEAKER_00: Yeah.
• 10:30
  SPEAKER_00: Yeah, yeah.
• 10:31
  SPEAKER_00: I mostly just eat the oyster.
• 10:33
  SPEAKER_01: But I would want your sea bass.
• 10:35
  SPEAKER_01: Yes.
• 10:35
  SPEAKER_01: Along with my wago.
• 10:37
  SPEAKER_01: I mean, I was I was sharing with somebody about seed bass, and I'm like, listen, listen, like if you ever get the privilege of eating mega, it's like a whole production.
• 10:47
  SPEAKER_00: Oh, you know what we should do now that I think about it, I'm not gonna make it, but she'll make it.
• 10:51
  SPEAKER_00: Is I guess I can marinate it at our VIP dinner for our event.
• 10:54
  SPEAKER_00: We should have the sea bass.
• 10:56
  SPEAKER_00: I'll talk to Chef Rhonda.
• 10:57
  SPEAKER_00: Okay.
• 10:58
  SPEAKER_00: Oh, wow.
• 10:58
  SPEAKER_00: I'll plug that.
• 10:59
  SPEAKER_00: That'll be great.
• 10:59
  SPEAKER_00: People like it.
• 11:00
  SPEAKER_00: Yeah, yeah.
• 11:01
  SPEAKER_00: Okay.
• 11:01
  SPEAKER_00: So when you would have, go ahead.
• 11:03
  SPEAKER_00: What is yours?
• 11:03
  SPEAKER_00: No, you didn't know we didn't finish.
• 11:06
  SPEAKER_00: So it's oyster, crab.
• 11:08
  SPEAKER_00: We gotta be specific.
• 11:09
  SPEAKER_00: Crab legs.
• 11:10
  SPEAKER_00: Alaskan crabs.
• 11:11
  SPEAKER_00: Alaskan crab legs.
• 11:13
  SPEAKER_00: Wagyu or what kind of steak?
• 11:15
  SPEAKER_00: Probably wagu.
• 11:16
  SPEAKER_01: Okay, what cut?
• 11:17
  SPEAKER_01: Medium rare.
• 11:18
  SPEAKER_00: Filet, ribeye, filet.
• 11:20
  SPEAKER_00: Okay, what are your sides?
• 11:22
  SPEAKER_01: Mushrooms.
• 11:23
  SPEAKER_00: Mushrooms, or I love mushrooms.
• 11:24
  SPEAKER_00: What else?
• 11:24
  SPEAKER_01: Just mushrooms.
• 11:25
  SPEAKER_00: Girl, you're going to heaven.
• 11:26
  SPEAKER_00: Like, what else?
• 11:28
  SPEAKER_01: Mushrooms.
• 11:29
  SPEAKER_01: You don't want potatoes?
• 11:30
  SPEAKER_01: You want anything like that?
• 11:31
  SPEAKER_00: I don't like potatoes either.
• 11:32
  SPEAKER_01: I love mushrooms.
• 11:33
  SPEAKER_01: Um, I love fucking olives.
• 11:36
  SPEAKER_01: Oh, I love olives too.
• 11:37
  SPEAKER_01: If you ever notice when you put a chocutery board out and the olives are gone, it's because I've got a lot of.
• 11:41
  SPEAKER_01: I do like olives.
• 11:42
  SPEAKER_00: I like the salty.
• 11:43
  SPEAKER_00: Yeah.
• 11:43
  SPEAKER_00: And then are you having like wine?
• 11:45
  SPEAKER_00: Are you having a cocktail?
• 11:46
  SPEAKER_00: Are you having bourbon?
• 11:48
  SPEAKER_01: If I'm gonna, I'm gonna go straight tequila.
• 11:50
  SPEAKER_00: Okay, tequila.
• 11:52
  SPEAKER_00: Like straight, none, and margarita, just yeah, just straight tequila.
• 11:55
  SPEAKER_00: Sipping tequila.
• 11:56
  SPEAKER_01: Sipping tequila, um, a big fucking glass of Kool-Aid with all the sugar in it.
• 12:02
  SPEAKER_00: I love that.
• 12:04
  SPEAKER_00: All right, what color Kool-Aid?
• 12:05
  SPEAKER_00: Blue, red, purple, the fake artificial grape flavor.
• 12:09
  SPEAKER_00: Perfect.
• 12:10
  SPEAKER_00: I mean, again, you're about to leave.
• 12:12
  SPEAKER_00: Who cares?
• 12:12
  SPEAKER_00: Bring it on.
• 12:13
  SPEAKER_00: All right, and what are you having for dessert?
• 12:15
  SPEAKER_01: Oh gosh.
• 12:16
  SPEAKER_01: Um red velvet cake smothered in warm chocolate fudge.
• 12:23
  SPEAKER_00: Oh, I love that.
• 12:24
  SPEAKER_00: Okay, so mine.
• 12:26
  SPEAKER_00: I've got I got a lot of things going on.
• 12:28
  SPEAKER_00: So I'm first gonna start with a dry, dirty gin martini.
• 12:33
  SPEAKER_00: Let's open the gates there.
• 12:35
  SPEAKER_00: And then I'm gonna have some um some kind of like raw seafood, like some kind of crude okay.
• 12:42
  SPEAKER_00: So probably like um, I love octopus or squid with like big flakes of sea salt, but some kind of raw seafood thing.
• 12:52
  SPEAKER_00: And then I'm gonna have a birata salad because I love burrata and I love cheese in general.
• 12:58
  SPEAKER_00: For my main dish, I'm gonna have grilled octopus, gigantic grilled octopus with a side of eggplant.
• 13:05
  SPEAKER_00: Yep, with eggplant parm on the side.
• 13:07
  SPEAKER_00: Not pasta or anything, just eggplant parm.
• 13:11
  SPEAKER_00: And then um for dessert, I'm gonna have a giant vat of whipped cream because I love whipped cream, and on the side a big thing of strawberry shortcake, like the biscuit one.
• 13:24
  SPEAKER_00: With that, so with sorry, we have the I forgot the drinks with it.
• 13:28
  SPEAKER_00: So we've got the dry gin martini to start.
• 13:31
  SPEAKER_00: That's with the seafood.
• 13:33
  SPEAKER_00: And then with my salad, I'm gonna have champagne.
• 13:36
  SPEAKER_00: With my dinner, I'm gonna have a big glass of emarone, which is an Italian red wine.
• 13:41
  SPEAKER_00: Then with my dessert, I'm gonna have a port.
• 13:44
  SPEAKER_00: And then you can cut the lights out.
• 13:46
  SPEAKER_00: Roll me on to the next chapter, because that's it.
• 13:50
  SPEAKER_01: Let's be a little bit morbid.
• 13:52
  SPEAKER_01: Okay, go for it.
• 13:53
  SPEAKER_01: Are you like bury me or climate me?
• 13:55
  SPEAKER_00: Okay, is that is that religion or is this just like so David used to, I mean, right now the way his will read is that he wants to donate his body to Yale Medical School for research.
• 14:09
  SPEAKER_00: But now he was saying that like the way that technology has changed, he's not sure that it'll be that useful.
• 14:15
  SPEAKER_00: So, what I'd like to do, like what we did with his parents' ashes, is that they're together.
• 14:19
  SPEAKER_00: So I would like, you know, obviously, hopefully he'll die before me.
• 14:22
  SPEAKER_00: And then I'd like for us our ashes to be together, which I think would be nice so we could be together.
• 14:27
  SPEAKER_00: But yeah, I definitely don't want to be buried.
• 14:29
  SPEAKER_00: I just like don't like the idea of like my body being somewhere decomposing.
• 14:32
  SPEAKER_00: Yeah.
• 14:33
  SPEAKER_00: Yeah.
• 14:33
  SPEAKER_00: What about you?
• 14:34
  SPEAKER_01: Um, I think I want to be cremated.
• 14:36
  SPEAKER_01: And it's like I know like where I want my ashes to be as well.
• 14:40
  SPEAKER_00: Where do you want them?
• 14:41
  SPEAKER_01: So I grew up in Oxford, and there's this like lake/slash park called Houston Woods.
• 14:47
  SPEAKER_01: Okay.
• 14:48
  SPEAKER_01: And I have the best memories from when I was younger.
• 14:51
  SPEAKER_01: Okay.
• 14:52
  SPEAKER_01: And it's with my family.
• 14:53
  SPEAKER_01: We used to go to Houston Woods and we used to like walk through the park and walk up the stream.
• 14:57
  SPEAKER_01: Oh, very cool.
• 14:58
  SPEAKER_01: And there's like this beautiful dam.
• 15:01
  SPEAKER_01: And I just remember my dad taking us there, and like we would go fishing.
• 15:06
  SPEAKER_01: Sure.
• 15:06
  SPEAKER_01: Because he loves to fish.
• 15:09
  SPEAKER_02: Oh, that's funny.
• 15:10
  SPEAKER_01: And I remember being so poor that he couldn't afford a fishing pole for me.
• 15:15
  SPEAKER_01: So he created one for me.
• 15:18
  SPEAKER_01: And it was like this little branch, right?
• 15:20
  SPEAKER_01: A little like fishing little string.
• 15:23
  SPEAKER_01: Yeah.
• 15:23
  SPEAKER_01: Megan.
• 15:24
  SPEAKER_01: And I kid you not, I put it in the water and I caught a fish.
• 15:28
  SPEAKER_01: And he made me feel amazing.
• 15:31
  SPEAKER_01: He was like, oh my god, like you're the best, like, fishing like partner.
• 15:35
  SPEAKER_01: That's so good.
• 15:36
  SPEAKER_01: Best memories.
• 15:37
  SPEAKER_01: That is where I would want my okay.
• 15:39
  SPEAKER_00: Yeah.
• 15:39
  SPEAKER_00: Houston Woods on the dam.
• 15:41
  SPEAKER_00: I'll remember that.
• 15:42
  SPEAKER_00: Perfect.
• 15:43
  SPEAKER_01: What about you?
• 15:44
  SPEAKER_01: What are you, what would you want?
• 15:46
  SPEAKER_00: What would you want your ashes to?
• 15:48
  SPEAKER_00: I think I would want the kids to have them.
• 15:50
  SPEAKER_00: And then I don't know.
• 15:53
  SPEAKER_00: I mean, if they were if they were gonna spread them in Italy, probably in Amalfi, like where we got married, that's probably where I would want them to be spread.
• 16:02
  SPEAKER_00: Now that's a good question, though.
• 16:04
  SPEAKER_00: Okay, so you had a birthday, you had the best dinner ever.
• 16:07
  SPEAKER_00: What else did you do?
• 16:08
  SPEAKER_01: Um, oh, I wanted to ask you if we could talk about this because I've been having issues with my estradiol.
• 16:16
  SPEAKER_01: So can we talk about that?
• 16:17
  SPEAKER_00: Oh, yeah, and it's a good topic too, because there's a shortage on estrogen right now.
• 16:20
  SPEAKER_00: But you were able to get yours.
• 16:21
  SPEAKER_00: I was able to get mine and you gave me the lowest prescription.
• 16:24
  SPEAKER_01: So can we talk about I mean not methods and modalities?
• 16:28
  SPEAKER_01: Yes, yeah.
• 16:29
  SPEAKER_01: And why, why, why when I was like Megan, like, do I have to do this?
• 16:33
  SPEAKER_01: Like, you know what I mean?
• 16:34
  SPEAKER_01: Like, yeah, I was feeling fine.
• 16:36
  SPEAKER_01: I was like, I so what happened if I, you know, um, just catching you up, I'm just gonna tell you.
• 16:41
  SPEAKER_01: Um, Megan had prescribed some estradiol for me.
• 16:44
  SPEAKER_01: And initially I was feeling amazing, but then I started spotting, right?
• 16:49
  SPEAKER_01: And I was like, we tried a couple different things, and I will say it was my fault initially because I did not, I did, I was living my best life.
• 16:58
  SPEAKER_01: Yeah, so first patient.
• 17:00
  SPEAKER_01: I feel like I I was not doing it as prescribed, and so it threw my body off, and basically my body couldn't catch up, and so I got off of it completely and I was fine.
• 17:10
  SPEAKER_01: Yes.
• 17:10
  SPEAKER_01: You stopped bleeding and then yeah, and you reintroduced it, and then you started spotting.
• 17:15
  SPEAKER_01: And then you're like, let's try a patch.
• 17:17
  SPEAKER_01: So let's talk about the different modalities.
• 17:19
  SPEAKER_00: Yes, there are a lot of methods and modalities to hormone therapy, and each hormone has different modalities available, like meaning like testosterone is the only one that it technically does have an oral formulation as madroxy testosterone, but it's pretty hepatotoxic.
• 17:36
  SPEAKER_00: Most people don't prescribe it.
• 17:39
  SPEAKER_00: So for testosterone, the most common methods for replacement are pellets, which is a procedure where the um testosterone is placed into the fat tissue with a trocar, um, usually in the glutes.
• 17:55
  SPEAKER_00: I don't love that you get a really high concentration of testosterone all at once.
• 17:59
  SPEAKER_00: So the DHT conversion where your body converts that testosterone into dihydroth is really high.
• 18:06
  SPEAKER_00: So a lot of hair loss, a lot of androgenic alopecia, a lot of acne, a lot of facial hair, a lot of weight gain with that as well.
• 18:14
  SPEAKER_00: So we typically don't love that.
• 18:18
  SPEAKER_00: There's androgel, which is the brand name for testosterone creams.
• 18:22
  SPEAKER_00: There's also generics, it's an okay method.
• 18:24
  SPEAKER_00: Challenge with testosterone cream, wherever you apply it, hair is going to grow.
• 18:29
  SPEAKER_00: So if it's like especially on the inner thigh, women will say they have like a patch of hair.
• 18:33
  SPEAKER_00: Some people put it like on the inner forearms or on the upper inner arm because you don't have hair follicles there, which you can do.
• 18:42
  SPEAKER_00: Um really high risk of transferring the testosterone, especially if you think about it's on your arm and anyone touches you to anyone you come in contact with, including children and pets.
• 18:52
  SPEAKER_00: And there's been hundreds of thousands of lawsuits and case studies of uh pubescent changes in children from parents being on um testosterone.
• 19:03
  SPEAKER_01: Oh, that's interesting.
• 19:04
  SPEAKER_00: And also, you know, especially with the inner thigh, if you're sexually intimate, you can spread that to your partner and and skew their hormones as well.
• 19:11
  SPEAKER_00: So not a great method, plus like sweat rate, right?
• 19:15
  SPEAKER_00: You can sweat it off.
• 19:16
  SPEAKER_00: Um, if you wear like leggings, you know, the transdermal application isn't always the best.
• 19:22
  SPEAKER_00: So then we have injections, which for testosterone, I would say probably 85 to 90 percent of people that's what they use, and it's pretty easy, subcutaneous into the fat tissue.
• 19:32
  SPEAKER_00: You don't run the risk of any of the cream stuff, can be dosed, you know, one to three times a week, so it's pretty simple.
• 19:39
  SPEAKER_00: It's not a daily thing with a small insulin needle for estrogen.
• 19:45
  SPEAKER_00: There is an oral estrogen, an oral estradiol.
• 19:48
  SPEAKER_00: I don't prescribe it very much, has a again is pretty hepatotoxic and has a high risk of increasing the risk of blood clots.
• 19:56
  SPEAKER_00: So similar to like oral birth control.
• 19:59
  SPEAKER_00: Um, there's creams, kind of the same rules apply.
• 20:02
  SPEAKER_00: I'm not against estrogen cream, it's a little bit safer, you don't get as quite as harsh of a hormonal milieu, but it is what patients always tell me is like it's pretty messy and they have to do it every day, and they don't love that.
• 20:16
  SPEAKER_00: There are trochies, which is like a gummy that goes under your tongue, so it's a lozenge.
• 20:20
  SPEAKER_00: We have probably I'd say 10% of our patients choose to use that, and people do like that.
• 20:27
  SPEAKER_00: And then you have injection, which is what you had started with, and then you have patches, and patches are great.
• 20:33
  SPEAKER_00: I will say they're probably like my number two method.
• 20:35
  SPEAKER_00: First it would be an injection, and then two would be a patch.
• 20:38
  SPEAKER_00: There has been though this national freak shortage.
• 20:41
  SPEAKER_00: It sounds like I think pharmacies are catching up, but we've had so many patients who are like we've tried four different pharmacies and nobody has their patch.
• 20:48
  SPEAKER_00: We try to compound it, they don't have the patch, it's just been a thing.
• 20:52
  SPEAKER_00: The downside, some some people do react to the transdermal adhesive adhesive, yeah.
• 20:59
  SPEAKER_00: So so for some patients, those aren't an option, but yeah, so it's it's interesting, and I do have I mean a lot of patients that especially at the beginning when you're starting hormone therapy, if they have you know a uterus still, that they do you you can spot that tissue's been dormant for a while.
• 21:17
  SPEAKER_00: You start reintroducing hormones, it kind of wakes back up.
• 21:20
  SPEAKER_00: Sometimes there's a uterine polyp that is just really sensitive to the hormone that can bleed.
• 21:27
  SPEAKER_00: You know, mitigating factors, we can increase progesterone to thin out the uterine lining, decrease the dose of the estrogen.
• 21:35
  SPEAKER_00: Um, and then I have some women that you know, estrogen is just not for them, and any dose makes them bleed.
• 21:40
  SPEAKER_01: So it might be a thing.
• 21:42
  SPEAKER_01: We'll see.
• 21:42
  SPEAKER_01: We'll see.
• 21:43
  SPEAKER_01: I'll keep you guys posted.
• 21:44
  SPEAKER_00: I felt like we kind of hit our limit with the injection, we just weren't getting it under control.
• 21:50
  SPEAKER_00: So, you know, the definition of insanity is doing the same thing.
• 21:53
  SPEAKER_00: So I was just like, let's try something different.
• 21:56
  SPEAKER_00: Okay.
• 21:57
  SPEAKER_01: So the other day, I know I tell my Patience not to do it.
• 22:01
  SPEAKER_01: But the other day I came across a kind of informational reel about peptides, and I wanted to ask you.
• 22:08
  SPEAKER_01: Oh my god, and their account didn't get shut down.
• 22:10
  SPEAKER_01: I'm so mad.
• 22:11
  SPEAKER_01: No.
• 22:12
  SPEAKER_01: So I want to ask you a question because there was, and I forgot what um what IG handle I was watching, but they were talking about the inception and the beginning of peptides and how peptides came to be.
• 22:25
  SPEAKER_00: Yeah.
• 22:26
  SPEAKER_01: So baby and starling.
• 22:28
  SPEAKER_00: Hopefully, did they talk about them?
• 22:29
  SPEAKER_01: Um, well to fact check these people.
• 22:32
  SPEAKER_01: So this is that this is why I brought the 1921.
• 22:34
  SPEAKER_01: Secretin was the first peptide discovered.
• 22:37
  SPEAKER_01: So this is what they said.
• 22:39
  SPEAKER_01: Okay.
• 22:39
  SPEAKER_01: This became a thing when during the Olympics, and the Russians were looking for a way to cheat because they knew Girl, that wasn't peptides.
• 22:50
  SPEAKER_00: They were giving them TRT, testosterone.
• 22:53
  SPEAKER_00: I I know, but and probably peptides and like growth hormone and all the stuff.
• 22:57
  SPEAKER_00: Yeah, yeah, yeah.
• 22:58
  SPEAKER_01: These Russians.
• 23:00
  SPEAKER_01: Yeah, it was Putin.
• 23:01
  SPEAKER_01: Yeah.
• 23:01
  SPEAKER_01: These Russians were looking for a way to cheat, and they knew that they could detect the hormones.
• 23:06
  SPEAKER_01: Yeah.
• 23:07
  SPEAKER_01: So it was so they, yes, they so they broke up the hormones and they created the short amino acid chains.
• 23:14
  SPEAKER_01: The short amino acid chains, which is now known as the peptides, and this became a thing.
• 23:19
  SPEAKER_01: So I was like, ooh, I can't wait to ask in this.
• 23:22
  SPEAKER_00: So is this really true?
• 23:24
  SPEAKER_00: So I mean, partly.
• 23:25
  SPEAKER_00: So how peptides started the science is not that's not true.
• 23:29
  SPEAKER_00: That's how it, that's not how it started.
• 23:30
  SPEAKER_00: So again, there are these two scientists.
• 23:32
  SPEAKER_01: See, this is why I have a question for Megan.
• 23:35
  SPEAKER_00: And secretine, which is a gastric peptide, was really the first identified amino acid chain.
• 23:40
  SPEAKER_00: And as far as we know, there's probably other people who are going to claim something different, but that's the history of peptides.
• 23:46
  SPEAKER_00: Where they were first applied outside of we have to remember insulin.
• 23:51
  SPEAKER_00: Remember, they used to study the pancreas of dogs and pigs, and they would extract the insulin and then introduce it into patients.
• 23:59
  SPEAKER_00: Eventually they figured out the amino acid sequence from gastric bacteria and whatnot.
• 24:04
  SPEAKER_00: So really insulin is the first peptide that was used for pharmaceuticals.
• 24:09
  SPEAKER_00: But from a performance standpoint, probably true.
• 24:12
  SPEAKER_00: Um what's that um blanking on the movie?
• 24:16
  SPEAKER_00: But it's about a guy who he's a journalist, but he also did like some amateur cycling, and he worked with the main uh physician for the Russian, it was a winter Olympics team, and the guy's now like in um asylum here in the United States because he was totally outed.
• 24:36
  SPEAKER_00: I'll think of it and I'll I'll drop it, but um, because he has a he has a second movie called The Dissonance.
• 24:41
  SPEAKER_00: I don't know why I'm blanking on the first one, but he exposes all this and he interviews the again the physician who worked with Putin, because that's who it was, who was in charge at the time, because they wanted to win, and how they literally um would have these like secret tunnels where they would like put urine through and like how they you know dodged the tests and whatnot and when to use the hormones when not, and they were using EPO and all this.
• 25:06
  SPEAKER_00: And I always remember it was really funny because he was talking about how they gave testosterone to all the athletes except the figure skaters because it made the women too big and they couldn't like lift them up.
• 25:16
  SPEAKER_00: So my god, didn't that find it?
• 25:18
  SPEAKER_01: That makes sense, though.
• 25:18
  SPEAKER_00: Yeah, yeah, yeah.
• 25:20
  SPEAKER_00: Because they were too anabolic.
• 25:21
  SPEAKER_00: But yeah, I would imagine they were doing all the sauce and and all the things with with peptides at that time.
• 25:28
  SPEAKER_00: And it's true also because you know, now that peptides have become popular with wada and usada, which are the drug testing bodies for Olympic athletes or or for sanctioned athletes, I should say, they ban a lot of these really I mean, all the peptides BPC 157, MOS C, whatever it is, glutathione, which are very harmless, but they look at it as you know, it's whatever is going to help them with performance.
• 25:56
  SPEAKER_00: But no one really understands, I I don't know how you would detect it.
• 26:00
  SPEAKER_00: Like it doesn't show up on blood work, so I don't know what they're doing, but I mean I'm sure they're trying to figure that out.
• 26:06
  SPEAKER_00: But yeah, so interesting.
• 26:08
  SPEAKER_01: So just from um the perspective of you said that you don't think you don't you think it's harmless, right?
• 26:16
  SPEAKER_01: Yeah.
• 26:16
  SPEAKER_01: Do you think that an athlete who is on the appropriate peptides and somebody that's not, right?
• 26:23
  SPEAKER_01: Has a competitive edge.
• 26:24
  SPEAKER_01: Yeah.
• 26:26
  SPEAKER_00: I mean, maybe the question is if you made peptides okay and like you do other medications, then everyone could use them.
• 26:34
  SPEAKER_00: So then you were, I think one of my dogs farted.
• 26:37
  SPEAKER_00: I can smell it, just letting you know.
• 26:39
  SPEAKER_00: Um then you that's okay.
• 26:42
  SPEAKER_00: Then you're not me.
• 26:45
  SPEAKER_00: Oh yeah, she's right behind you.
• 26:47
  SPEAKER_00: Nova, oh my god, she just crop dusted us so bad.
• 26:50
  SPEAKER_00: But it's kind of like with the area of Lance Armstrong where there was so much doping going on that eventually to find from first place when they were like, okay, you're no longer in first place because you know you were caught doping, to find the next clean athlete was in the 80s.
• 27:07
  SPEAKER_00: Like the 80 plus people were dirty.
• 27:11
  SPEAKER_00: So everyone was doing it.
• 27:12
  SPEAKER_00: So then it's still like, okay, these are still the best of the best.
• 27:15
  SPEAKER_00: They're all and and part of the game is like figuring out what else are you using, kind of like what shoes are you using, right?
• 27:22
  SPEAKER_00: Some people claim that super shoes in in running are is cheating.
• 27:28
  SPEAKER_00: Who cares?
• 27:28
  SPEAKER_00: Like who knows, right?
• 27:29
  SPEAKER_00: It also makes the sport more exciting because you know, better performances.
• 27:34
  SPEAKER_00: So, do I think there's a competitive edge?
• 27:37
  SPEAKER_00: Probably.
• 27:37
  SPEAKER_00: Um, do I think that all athletes should have exposure to these again naturally occurring chains of amino acids?
• 27:44
  SPEAKER_00: Yeah, I mean, just let them do it, it'll make it'll make more entertainment, which is why we you know monetize sports so it would make it more exciting.
• 27:53
  SPEAKER_00: Obviously, you want to protect the safety of the athlete, so I don't think things like growth hormone are okay because that's how Lance Armstrong got testicular cancer.
• 28:02
  SPEAKER_00: So, you know, it has to be done mindfully.
• 28:05
  SPEAKER_01: So I just lectured one of my patients the other day because um they told me that they were using peptides, and I said, Well, from what pharmacy?
• 28:15
  SPEAKER_01: And they're like, I don't know, I just order online and I inject myself.
• 28:18
  SPEAKER_01: Oh my god.
• 28:19
  SPEAKER_00: So that's like people ordering Botox online, being like, I inject my face.
• 28:22
  SPEAKER_01: But this thing is like they injected this um peptide that gives them like um it increases melanocytes in their skin.
• 28:30
  SPEAKER_01: Oh, melanocytes, because yes, because I sh I lectured them.
• 28:34
  SPEAKER_01: So please you can give yourself skin cancer doing that too, because it it you know it non-selectively turns on the melanocytes.
• 28:42
  SPEAKER_01: Let's talk about this because I think this is really, really important for us to speak on.
• 28:47
  SPEAKER_01: Is that you have to go see and authorize like a provider that knows very much like Megan, they do not understand that it is it's non-selective, right?
• 29:00
  SPEAKER_00: Yeah, it's just turns on those melanocytes.
• 29:02
  SPEAKER_00: Yep.
• 29:03
  SPEAKER_00: And when you're buying a product that hasn't been, you know, tested for sterility and purity, and the dosing is efficacious, you could really hurt yourself.
• 29:12
  SPEAKER_00: So imagine if you if you had it's like having unlimited sun exposure.
• 29:19
  SPEAKER_00: And you can't take it back.
• 29:20
  SPEAKER_00: Yes.
• 29:20
  SPEAKER_00: Once you put it in, right?
• 29:22
  SPEAKER_00: Yes.
• 29:22
  SPEAKER_00: It's not like you can come out of the sun and slap some aloe vera on and get a peel and start you, right?
• 29:28
  SPEAKER_00: It those melanocytes are turned on switch.
• 29:31
  SPEAKER_01: And I and I and I was sharing with him because I didn't know how to relate it to him because he's in bodybuilding, so it's huge in the body.
• 29:39
  SPEAKER_01: So they want to be tan.
• 29:42
  SPEAKER_01: It makes them look more like cut up or whatever.
• 29:45
  SPEAKER_00: But I said I would rather them go in the tanning bed, which I know is terrible for you, then then take this that peptide, especially from a rogue place.
• 29:51
  SPEAKER_01: Oh my god.
• 29:52
  SPEAKER_01: I like when he told me, I sat there and I looked at him and I'm like, how do I continue to support like your needs?
• 29:58
  SPEAKER_01: I'm like, go get a spray tan.
• 30:00
  SPEAKER_01: Right, exactly.
• 30:01
  SPEAKER_01: Yeah.
• 30:01
  SPEAKER_01: You know what I mean?
• 30:02
  SPEAKER_01: It's like probably cheaper than so much safer.
• 30:05
  SPEAKER_01: So much safer.
• 30:06
  SPEAKER_01: And I said, listen, imagine if you had a pile of grapes, right?
• 30:09
  SPEAKER_01: You have some baby grapes and then you have like old grapes that are like mildew, right?
• 30:14
  SPEAKER_01: And I said, Okay, I'm going to substantially increase what you have in your hands.
• 30:18
  SPEAKER_01: You know, so your baby grapes grow and you're like, oh, this is luscious, is beautiful.
• 30:23
  SPEAKER_01: But also, the left side of your hand is gonna have these old, fragmented, like mildew.
• 30:29
  SPEAKER_01: Right, right.
• 30:29
  SPEAKER_01: I said, both, I said, can you control that?
• 30:32
  SPEAKER_01: He's like, No.
• 30:33
  SPEAKER_01: I was like, so what is the risks and benefits?
• 30:36
  SPEAKER_01: Like, do you want skin cancer?
• 30:38
  SPEAKER_01: And he was just like, You're gonna get it.
• 30:40
  SPEAKER_01: He's like, I always feel like every time I come here, I have to take something away from what I love.
• 30:45
  SPEAKER_01: And I'm like, you don't have to do anything, you don't have to take my advice at all.
• 30:50
  SPEAKER_01: But my job.
• 30:51
  SPEAKER_01: Yes, my job is to make sure that you're always and this is not at least informed.
• 30:57
  SPEAKER_01: That's what I tell the patients.
• 30:58
  SPEAKER_00: I'm like, yes, you can make your own decisions, but absolutely I'm gonna give you the information.
• 31:03
  SPEAKER_00: Absolutely.
• 31:04
  SPEAKER_00: Um what other crazy things have you seen lately?
• 31:07
  SPEAKER_01: Just lately.
• 31:08
  SPEAKER_01: Oh, um, I had a patient who came in today, and um, you know, I always lead with this is an elective procedure, right?
• 31:19
  SPEAKER_01: Yeah, your life is not in danger.
• 31:21
  SPEAKER_01: Your life is not in danger, and you know, I our businesses are concierge, but when I know that I am tapped out in regards to the modalities that I have, and the next step is me referring to plastic surgery, yeah, I don't know if I need to get one of those like huge like megaphones that says I am referring you to plastic surgery.
• 31:45
  SPEAKER_00: Don't come back, don't ask me for anything.
• 31:46
  SPEAKER_01: And also that I'm giving you my my ability, like I'm capped off at my abilities, right?
• 31:53
  SPEAKER_00: So, what's the unrealistic expectation?
• 31:55
  SPEAKER_00: Lay the table.
• 31:57
  SPEAKER_01: I think for I think it's always like me referring to you.
• 32:01
  SPEAKER_01: Like there are certain things you have facial fat pads, there's deep fat pads, there's superficial fat pads, and we don't know why, but in some cases, the superficial fat pads can expand and you can have so the inferior part of your jowl, I mean your inferior part of your nasolabial fold as you age, it increases, and your inferior part of your lower jowl also can increase.
• 32:29
  SPEAKER_01: Right.
• 32:30
  SPEAKER_01: On patients who are already heavy, it's substantial.
• 32:34
  SPEAKER_01: Yeah, you see it more.
• 32:35
  SPEAKER_01: It you can see it more.
• 32:37
  SPEAKER_01: So me stuffing your face with fillers and trying to get that lifted for you is is not going to be the ideal thing.
• 32:48
  SPEAKER_01: Well, also you may want to consider a weight loss journey because that's gonna be cheaper and healthier than me sticking 20 syringes in your face and trying to lift that up.
• 32:58
  SPEAKER_01: I am like super realistic, you know?
• 33:00
  SPEAKER_01: Yeah, and so when I look at like somebody's face, and now that we've aligned and I understand like inflammation I call it inflamm inflammaging, right?
• 33:09
  SPEAKER_01: Yeah, inflammation.
• 33:11
  SPEAKER_01: Inflammaging, right?
• 33:12
  SPEAKER_01: So I'm sharing with them like the things that are happening, the changes in histology and the fat pads, and like fat pads can even become fibrotic at times.
• 33:22
  SPEAKER_01: Right.
• 33:22
  SPEAKER_01: Like I think the first thing is can do we have a better option for you to get the results that you want, right?
• 33:29
  SPEAKER_01: Because regardless, at the end of the day, aesthetics is medicine.
• 33:32
  SPEAKER_01: You're going to need to see me because we all age and we have goals.
• 33:36
  SPEAKER_01: Sure.
• 33:36
  SPEAKER_01: Right.
• 33:37
  SPEAKER_01: But for her, it was more or less like do I refer to Megan?
• 33:42
  SPEAKER_01: Or can can does she have realistic expectations to even get the results that she wants?
• 33:51
  SPEAKER_00: You know, subcutaneous fat, if we can get that to go away, even if the jowl droops, that's actually easier than to fill out and lift, yes, than going against all that superficial inflammation and and macrophages and all the stuff that's going to be built into the skin tissue.
• 34:08
  SPEAKER_01: And inflammation in the extracellular, like people don't understand, like this is a whole thing.
• 34:13
  SPEAKER_01: Like inflammation in the extracellular matrix looks different than somebody who has cortisol issue, hormonal fluctuations and changes, right?
• 34:22
  SPEAKER_01: Yeah.
• 34:23
  SPEAKER_01: I almost want to like stabilize their extracellular matrix first, and then they get better results because the environment in which the filler or sculptor can live is actually um more um manageable and sustainable if they have better like overall cellular matrix.
• 34:41
  SPEAKER_00: Yeah, they're just healthier.
• 34:42
  SPEAKER_01: Right.
• 34:43
  SPEAKER_01: So it's a whole thing, and sometimes it just goes over their head, right?
• 34:47
  SPEAKER_01: And so this is what we're this is why the B3 Summit is so important.
• 34:51
  SPEAKER_00: Oh, yeah, let's talk about it.
• 34:52
  SPEAKER_01: So um I think that I am so today we um we launched that yeah, it looks so beautiful, it looks amazing.
• 35:02
  SPEAKER_01: It's our landing page, so this is where you can um click on and you get to see the speakers, you get to see their background.
• 35:09
  SPEAKER_00: Can we just give a quick shout out to Matt Delman?
• 35:12
  SPEAKER_00: He will probably won't listen to this, but I will make him.
• 35:15
  SPEAKER_00: So Matt Delman is he works for Vital Medical and our Vital Ecosystem, but he has a company called Go Irenic.
• 35:23
  SPEAKER_00: Um, it's I R E N I C.
• 35:25
  SPEAKER_00: And he specializes oh my god, she farted again.
• 35:28
  SPEAKER_00: I can smell it.
• 35:29
  SPEAKER_00: It's so bad.
• 35:30
  SPEAKER_00: Sorry.
• 35:31
  SPEAKER_00: Uh he specializes in like uh information platforms, what are called CRMs.
• 35:36
  SPEAKER_00: So when you go to a website and you click on it, it's like contact us, and it pops up, and then you fill out your information, you schedule an appointment online, like that's part of a CRM.
• 35:47
  SPEAKER_00: And he graciously built our landing page and doing our CRM, and it's so beautiful, so beautiful.
• 35:54
  SPEAKER_00: And I just love him.
• 35:55
  SPEAKER_00: He's such a nice guy.
• 35:57
  SPEAKER_01: And I want to say to all of our patients and all of our um followers out there who have um shared their thoughts on the beat.
• 36:05
  SPEAKER_01: I can't look at you right now.
• 36:07
  SPEAKER_01: Thank you guys for um giving feedback because we wanted your opinion about the branding, and we've gotten some incredible feedback.
• 36:15
  SPEAKER_01: Yes, we have that was like a team effort with Aaron.
• 36:18
  SPEAKER_01: Aaron, yeah.
• 36:19
  SPEAKER_00: Shout out to Aaron Ramirez, yes, Olivia Horton, Libby Reed Miller.
• 36:23
  SPEAKER_00: Thank you for all your hard work.
• 36:25
  SPEAKER_00: Yeah, um, we love you.
• 36:27
  SPEAKER_01: And it is hard because we all have different opinions.
• 36:29
  SPEAKER_01: Today was spy, I feel like today was a little spicy because we went back and forth, right?
• 36:34
  SPEAKER_00: Yeah, with the with the website or with the landing page.
• 36:37
  SPEAKER_00: I mean, there were just some tweaks.
• 36:39
  SPEAKER_00: And I mean the thing about especially Olivia, I've known her long enough.
• 36:42
  SPEAKER_00: I mean, she just everything rolls off of her.
• 36:44
  SPEAKER_00: She definitely doesn't get her feathers um ruffled easily.
• 36:48
  SPEAKER_00: And rigid, you can be honest.
• 36:51
  SPEAKER_00: I don't think you're rigid, I think you're opinionated.
• 36:54
  SPEAKER_00: And they're also used to me where I'm pretty beta.
• 36:57
  SPEAKER_00: Like, I give the girls enough rope to hang themselves.
• 37:01
  SPEAKER_00: And Olivia will always tell you this story too, and I don't even remember what it was for, it was so long ago.
• 37:06
  SPEAKER_00: Where she's like, I still remember the one time when I got really upset with her, which doesn't happen ever.
• 37:12
  SPEAKER_00: And she's like, you know, I laid down the hammer so hard that it like petrified her.
• 37:17
  SPEAKER_00: And like since then, she's never done anything.
• 37:20
  SPEAKER_00: Um, so I I try to give you know the my staff or anyone who's working with me a lot of autonomy.
• 37:27
  SPEAKER_00: I'll give my opinion or my thoughts and you know, whatever, but for the most part, I try to support them.
• 37:33
  SPEAKER_00: And in my head, I always think like I hired them for a job because I see talent and I see potential and and I know that they're willing to grow.
• 37:40
  SPEAKER_00: And as you've seen, like you've worked mostly one-on-one with Libby.
• 37:43
  SPEAKER_00: Like, the thing I love about Libby is one, she's so nice all the time.
• 37:47
  SPEAKER_00: She always says, No problem, I don't mind doing that.
• 37:49
  SPEAKER_00: And I'm like, Okay, she always shows up, she's always on time, she's so good with patients and people face.
• 37:58
  SPEAKER_01: My patients that come to you, and vice versa.
• 38:00
  SPEAKER_00: They have talked about her specifically, and yeah, and she's incredible.
• 38:04
  SPEAKER_00: Always like on it kind.
• 38:06
  SPEAKER_00: So I trust the girls inherently, and I know even if they're little things, like we're the schedule, like wasn't what it was supposed to be.
• 38:16
  SPEAKER_00: A lot of times I let things go because I'm like uh we're net positive, which probably isn't great from like a micromanaging, which that's the line I always use with my staff is I don't micromanage, I macromanage.
• 38:26
  SPEAKER_00: So, like if a problem is big enough to get to me, that means it's like really gotten bad.
• 38:31
  SPEAKER_00: Otherwise, I try to let you, you know, self-resolve conflict, I let you manage your own time.
• 38:37
  SPEAKER_00: I'm not gonna sit there and like make you punch a clock, right?
• 38:41
  SPEAKER_00: Which is good and bad.
• 38:43
  SPEAKER_00: And you know, kind of leads into uh because I know we're gonna get pressed for time here.
• 38:47
  SPEAKER_00: Our last topic, which as to entrepreneurs, you know, I think we're always continuing to evolve, and really the landscape of medicine with AI and all these different things is changing.
• 39:00
  SPEAKER_00: Grateful that the human touch will always need to be there because at least right now, presently, I'm sure it will change.
• 39:07
  SPEAKER_00: You still have to have someone write a prescription and diagnose and all that.
• 39:10
  SPEAKER_00: So gratefully we have job security.
• 39:14
  SPEAKER_00: But um, what are some challenges just from a high level that you're facing in business, whether it's collaboration with peers or systems, and how are you navigating that?
• 39:23
  SPEAKER_01: I think for me, it's going up against the big private equity firms, it's hurting us.
• 39:28
  SPEAKER_01: We're a small concierge practice, and we really value time, we route value conversations.
• 39:36
  SPEAKER_01: Um, we value coming in and having a one-on-one discussion.
• 39:41
  SPEAKER_01: I really value quality time, which people don't have time for.
• 39:45
  SPEAKER_01: They don't have time for me to sit there and talk about the fucking histology of the skin.
• 39:50
  SPEAKER_01: Sure.
• 39:50
  SPEAKER_01: They want results, they want just do it.
• 39:53
  SPEAKER_01: They don't want me to sit there and give them 10 articles of evidence-based practice at this point.
• 39:58
  SPEAKER_01: And these bigger practices, you feel like they're getting better or they get more patience because it's cheaper, they get better pricing.
• 40:06
  SPEAKER_01: And for some patients, they they just want to go in and get what they want, and that's it.
• 40:11
  SPEAKER_01: Where I'm trying to develop personal relationships, I'm trying to make you feel educate my patients, make you feel like home, make you make you part of my pro make you part of the decision-making process, which is how it should be.
• 40:24
  SPEAKER_01: Yeah, the patient model is changing, uh, especially in my area of medicine.
• 40:28
  SPEAKER_01: Sure.
• 40:29
  SPEAKER_01: So that's been a little bit hard for me to swallow.
• 40:32
  SPEAKER_01: Um, I had a patient um that came in and I told her everything.
• 40:38
  SPEAKER_01: I educated her, I explained to her about um treating the root cause of the disease and then the symptoms, and she literally took my plan of care and got treated somewhere else with everything that I was gonna do for her.
• 40:52
  SPEAKER_00: I have had patients do that to me as well.
• 40:54
  SPEAKER_00: I even had a patient, I kid you not recently, who was like, Can you?
• 41:00
  SPEAKER_00: I think she reached out to Libby and Libby sent it to me, but since she can you ask Megan, can she write out and it's it's in her patient chart, she can access it, so it's not like I'm trying to hide for it, but can she write out again the medications she recommended and the dosing?
• 41:14
  SPEAKER_00: Because I'm gonna have my doctor here write for it.
• 41:16
  SPEAKER_00: And I'm like, Good luck, they're not going to, you know, and I'm like, no, you can access it in your patient chart.
• 41:22
  SPEAKER_00: Then I had another patient who she was like, I need a letter of explanation as to why I made these medical decisions for me to take to my other doctor to prescribe.
• 41:34
  SPEAKER_00: And I was like, No, I'm not doing that.
• 41:36
  SPEAKER_00: Like, yeah, absolutely not.
• 41:37
  SPEAKER_00: Either I support you or I don't.
• 41:39
  SPEAKER_00: We gotta fly in here.
• 41:40
  SPEAKER_00: Right, right.
• 41:41
  SPEAKER_00: Parting words for our audience B3, September.
• 41:47
  SPEAKER_01: We are dropping our guest line of speakers uh today.
• 41:51
  SPEAKER_01: We rolled out.
• 41:55
  SPEAKER_01: Smoke show.
• 41:55
  SPEAKER_01: Yeah, she is gorgeous.
• 41:56
  SPEAKER_01: Smoke show.
• 41:57
  SPEAKER_01: Can I tell you the response that we we've gotten just um you know, rolling her out?
• 42:02
  SPEAKER_01: People are really excited to hear her speak.
• 42:04
  SPEAKER_01: Beautiful.
• 42:05
  SPEAKER_01: I just love her so much because we started you know that song by Drake.
• 42:09
  SPEAKER_01: We started from the bottom, now we're here.
• 42:11
  SPEAKER_01: So it's really amazing because we started our aesthetic careers together at our first practice.
• 42:16
  SPEAKER_01: Oh, it's exciting.
• 42:17
  SPEAKER_01: It's gonna be a fun event.
• 42:18
  SPEAKER_01: It's so fun.
• 42:20
  SPEAKER_01: Um, so we will be rolling out more guest speakers to come, and we have some heavy hitters.
• 42:25
  SPEAKER_01: I know we're excited.
• 42:26
  SPEAKER_00: And if you haven't booked and um secured ticket, in the show notes, we'll have a link to where you can buy tickets and our social media handles.
• 42:36
  SPEAKER_00: I have a new social media handle.
• 42:38
  SPEAKER_00: I'm still figuring that out.
• 42:39
  SPEAKER_00: Hopefully, we can recover the old one.
• 42:40
  SPEAKER_00: I know.
• 42:41
  SPEAKER_00: Then so for right now, it's Megan Delcarral.np.
• 42:44
  SPEAKER_00: So follow me on Instagram, please, because poor Aaron is again starting from the bottom.
• 42:49
  SPEAKER_00: We're just slowly rolling things out.
• 42:51
  SPEAKER_00: But otherwise, like, subside, subscribe, and share and subsidize, and we'll see you next week.
• 42:58
  SPEAKER_01: See you next week.
• 42:58
  SPEAKER_01: Thanks for joining.