January 15, 2025 • 65 mins
I am thrilled to share this authentic and vulnerable conversation with you. My guest is Dr. Fiona Lovely. You may know her from her mindblowing podcast, Not Your Mother's Menopause.
With two decades of experience, Dr. Lovely is a trailblazer in women's health. Specifically focusing on the menopause transition, perimenopause and menopause.
Stick with us on this vulnerable and passionate conversation because in it, we share stories of our own experiences and highlight how community and connection are the bedrock for growth and healing in a health system that has only begun to prioritize women's health.
Dr. Lovely helps us understand the growing evidence and debunks misconceptions in the menopause narrative. Spoiler alert, but there's a lot in here about social justice and a little bit of swearing.
We talk about the mental and physiological shifts women encounter during this time of renovation in our bodies and in our brains, and some myths about cognitive decline.
This episode is packed with wisdom, practical advice, and a heartfelt big sister kind of conversation. Whether you're an occupational therapist, someone in their 30s and 40s experiencing symptoms you didn't know were perimenopause, or you're simply interested in understanding this vital aspect of health, there's so much here for you.
_______________________________________
Links to resources mentioned in the podcast:
Dr. Fiona Lovely's Website: drlovely.com
Podcast: Not Your Mother's Menopause with Dr. Fiona Lovely
Dr. Lisa Musconi - Neuroscience & Women's Health
AMS Menopause Symptom Scorecard
_______________________________________
Are you a therapy business owner seeking a community of support as the whole person at the centre of your business?
We will be accepting applicants to the ACTivate Vitality program and community in late January. Let's see if this is a good fit for you by visiting our site.
_______________________________________
A shoutout to our sponsor, Jane.app
Jane is an EMR with heart. Book your demo today and be sure to use the code VITALITY for a one month grace period.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Don't be confused.
That is not a weakness is not aproblem with your personality.
You are not crazy.
You're not suffering from mental illness.
You're not, all of these thingsare really important for me
to go, this is perimenopause.
The solution is not anantidepressant medication for me.
(00:20):
It is true for, this isnot a serotonin deficiency.
you're listening to the BraveOT Podcast with me, Carlyn Neek.
This podcast is all about empoweringoccupational therapists to step up,
level up, blaze some trails, and maybeengage in a little conscious rebellion.
In service of our profession, ourclients, our work, our businesses,
(00:41):
and living our mission wholeheartedly.
We are all about keepingit real, doing hard things.
Things unhustling, being curious,exploring, growing through our
challenges, and finding joy,fulfillment, and vitality as we do so.
Really, we're OT ingourselves, and each other.
I hope you love this episode!
(01:02):
I am thrilled to share this authenticand vulnerable conversation with you.
Today I'm talking to Dr.
Fiona Lovely.
With nearly two decades of experience,she is a trailblazer in women's health.
Specifically focusing on themenopause transition, perimenopause.
We will share stories that highlighthow community and shared experiences
(01:25):
can be a bedrock for growth and healing.
Fiona's insights about the perimenopausejourney and menopause bolstered
by recent research shed light onthe many misconceptions we face.
Spoiler alert, but there's a lotin there about social justice.
We talk about the mental andphysiological shifts women encounter
during this time of renovation inour bodies and in our brains, and
(01:50):
some myths about cognitive decline.
This episode is packed with wisdom,practical advice, and a heartfelt
conversation, whether you're anoccupational therapist, someone
experiencing perimenopause, or you'resimply interested in understanding
this vital aspect of health,there's so much here for you.
Today's episode is sponsored byJane, a clinic management software
and EMR that helps you handle yourclinic's daily admin tasks so you can
(02:13):
free up your evenings and weekends.
The JANE team understands how preciousyour time is and recognizes that
charting Can often be the most timeconsuming admin task for Practitioners.
That's why they're here to help.
To save you from having to start yourchart notes from scratch, you can
check out Jane's template Library,which gives you access to templates
that have been generously createdand shared by health and wellness
(02:34):
practitioners in the community.
Once you have a template you like, youcan choose to customize it further with
charting tools such as range scales,text fields, check boxes, and more.
To see how Jane can help you spendmore time doing what you love,
head to the show notes to grab thelink and book a personalized demo.
Or if you're ready to get started,you can use the code VITALITY at the
(02:56):
time of signup for a one month graceperiod applied to your new account.
Dr.
Lovely, or as I would call you, Fiona.
Welcome.
I'm so happy to have you here.
I can't wait to dig intoall of this discussion.
Perimenopause, menopause,cognitive function, let's dive in.
Could you tell everybody alittle bit about yourself?
(03:17):
Thank you, by the way, for allowingme to share this space with you.
You and I have always had greatconversations, and so I anticipate that
today will be a good conversation too,so I hope I can bring something useful
to your listeners and your community.
Thank you.
Yes, you bet, thanks for having me.
So my professional designation isas a chiropractor and I have been in
(03:38):
practice nearly 20 years and reallyearly on in my practice, like the first
month or two, I had a patient comein that was a woman in her 40s that
had recently had a child and she wasdesperate for information on menopause.
But she wasn't gettingany help from her doctors.
(03:59):
And, I happened to have the informationbecause I had taken the functional
medicine training when I was in school.
And for myself, to be honest, becauseI was gaslit by a gynecologist
in my 20s and I wasn't going tolet that happen for myself again.
And I never expected I'd be practicingthrough the lens of talking to
women about, , hormonal health andwomen's health, but they literally
(04:21):
pulled me in right from the start.
And so I can still remember veryvivid details about that patient,
and I hope she's doing well.
But she literally called me to the mat.
She was like, Nope, you'vegot this information.
And of course, I had lots of time, right?
I just had a handful of patients.
I was fresh out of school.
So I just shared what I knew.
(04:42):
And, it started something in me thatmany years later still smolders.
And in 2016, while I was busydoing my chiropractic practice and
answering questions as I could forwomen's health, I started a podcast.
And I had never listened to a podcast.
I had no idea what I was doing.
I figured it was just a lecture.
(05:03):
I was like, okay, well, I'mgoing to get behind a mic.
Cool.
I've been doing that stuff for years.
And that's a podcast.
Well, you know, what'snice is I hired a coach.
Somebody said to me,there's a podcast coach.
I'm like, I have no idea whatthat is, but here, take my money.
It was one of those situations.
And thank God I did because he reallyshowed me the way and the tech.
(05:24):
That was the thing that was themost difficult thing at the time.
And, the podcast launched in Aprilof 2016 and, nearly 2 million
downloads later, here we are.
So it's become a very popular thing.
It's a pretty coolexperience and I love it.
I love sharing thisinformation with women.
So your podcast is called Not YourMother's Menopause, which is a brilliant
(05:45):
title, like, tell us what happens
here.
Yes.
Yes.
first and foremost, there's aneuro chemical change that happens.
It's a renovation of the brain thatstarts for some women around 35 and
for a lot of us more closer to 40.
So basically anywhere from 35 to 60.
(06:08):
We're in that range.
And some, depending on what symptomswe're talking about, it can be
anywhere from 30 to 60, okay?
It's a huge range of a woman's life.
Yeah.
And then once we end, end perimenopauseand intermenopause, now we've got 40
percent of our lives that we're going tolive without the menstrual cycle, with
(06:32):
the, out the information about our bodiesthat comes from the menstrual cycle.
But also we've realized that there'sa massive knowledge gap from our
healthcare providers, certainly onthat 40 years, although now in that
that 40 percent of our lifetime,that's more managed by gerontology,
which I think in itself is a problem.
But then you've 30 yearsold to 60 years old, where,
(06:54):
here's what we think menopause,this is what we think women's
health is during those years.
Bikini medicine,mammograms, and pap smears.
That's it.
That's unacceptable.
And so we've learned recently throughan explosion of research from female
practitioners, most of them in ourage group saying, just a minute
(07:16):
now, this isn't adding up, right?
What's happening?
And so we know there's theseneurology change, massive
change to the brain function.
It's a change in function andstructure and connectivity.
And at the same time, we have thesehormonal changes that make for
some pretty uncomfortable symptoms.
(07:37):
And so we need to beaware that it's starting.
Here's something I hear a lot.
Oh, I'm, I just heard thisyesterday from my pharmacist.
Who's no more than twoyears younger than me.
I'm 51.
And she goes, Oh, I knowwhat's coming for me.
And I'm like, Ooh, girlfriend.
It's
It's so true because when you goto the doctor, like I did many
(07:58):
times with this array of symptomsthat I have, the awareness was
likely connected to perimenopause.
They ask, do you have hot flashes?
No, I have some night sweats, but I'mnot having hot flashes during the day.
do you have regular periods?
I don't know because I had an endometrialablation, so I have no periods.
(08:19):
Well, you're you're young,and here I am 45, right?
With worsening ADHD, worsening mood,increasing anxiety, feeling, socially,
less connecting, feeling like,I'm, like, am I feeling too judgy?
Am I too this?
Am I too that?
my value system's turned upside down.
I don't relate to the samepeople the way I used to anymore.
(08:40):
Like, acne.
And, I could go on and on.
And, um, Well, there's anantidepressant maybe, or, you know,
let's increase your ADHD meds.
But I mean, are you having hot flashes,
Yes.
and what you have just described is allof the common symptoms of perimenopause.
And here's the thing about it.
(09:01):
we have hot flashes, which are thething that medicine uses for the
signal that we're in menopause.
By the way, I've never had a hot flash.
Never 51.
okay I got all the other stuff, right?
But I have a friend that's justdone the research on this and she's
just presented it to the menopausesociety, last weekend in Chicago.
And she looked at the top 10 symptoms,actually looked at more than that.
(09:23):
But if you look at the top 10 symptomsof perimenopause, And hot flash
is number ten that's based on thenumber of women experiencing them.
And the other thing that's fascinatingabout that list is 9 out of 10 of them
are brain based, brain based, okay?
we're just starting tohave this conversation.
(09:46):
We're just starting to understand whatit means when estrogen, progesterone,
testosterone, DHEA, start toretreat from the brain and the body.
We're just starting tounderstand what that means.
I know one of the things that Ihave struggled with, especially in
the last year, is anxiety doing africking tap dance on my brain, which
(10:09):
then throws my confidence all off.
And now all of a sudden I'mnot connecting to the things
that gave me joy for so long.
And it's not even just my relationship.
I mean, thankfully Imarried my best friend.
So he at least is there to say.
'Are you alright?
Do you just need a bath?
Do you need to just swear up a storm?
(10:29):
What do you need?' But I recognizethat not every woman has that, right?
And so there's a lot of, guilt that comeswith those feelings and experiences.
Thankfully, I had a nurse practitionerwho said to me, if it's confidence
and esteem that is bothering you,that's a testosterone problem.
(10:51):
Fascinating, right?
Because now that's a whole other thing.
Testosterone is a man'shormone, is it not?
Right.
Right.
So there's so many frontiers.
There's new frontiers acrossthe board in women's health.
And it's no longer just aboutthat bikini medicine, but you're
describing the most common symptoms.
(11:11):
So the thing I think about, Carlyn,when I hear your story, and when I
think about what I've been throughin the last few years, I think my
mother My grandmother, the women Ihave loved and known in my life that
are senior to me, suffered in silence.
Did.
Yeah.
It's heartbreaking.
(11:32):
It is heartbreaking.
It is so heartbreaking.
I think often about, I come from this lot,very strong matriarchal line, very strong
women who had to deal with big shit inthis time of life too, that I'm in now
and think, Oh my gosh, how did they dothat with less support, less convenience?
(11:53):
Like just the world wasdifferent in so many ways.
Some of them may be helpful.
I don't know, but I think alot about they had no choice.
Right.
They just, they had no choice but to,to find a way to power through and, and
maybe piss a few people off along theway because they had to stand in their
truth and their experience and, andwere under resourced in a lot of ways.
(12:17):
Yeah.
I am aware, uh, same, same with me.
I have strong women in my life,in my family on both sides.
And I think about the things thatthey had to go through in their lives.
As you said, at a time where things wereway less convenient than they are now.
And, I think as a child I was awarethat they were strong women and I
(12:40):
was being raised to be the same.
But I have so much more appreciationfor just how strong they were.
Now that I'm going throughmy own personal journey.
Uh, graduation, let's say.
Just thinking about that.
I wish for future generations of womento not have to be so strong, to not
(13:03):
have to fight, to stand up for havingbasic health care that attends to us as
women, having the rights that we need,having, support that we need, all of us,
not just some of us, all of us.
Yes.
Agreed.
Agreed.
I am very aware that, actuallygirlfriend and I, who's, she's an MD.
(13:26):
She and I were having aconversation about this yesterday.
She does, family and maternal medicine.
And we were complaining about, betweenthe two of us, the lack of information
available and, the lack of knowledgeablepractitioners available to us.
And I said to her, I said, and we mustremember you and I have connections.
(13:49):
And we have the ability to pay for privatehealth care, and that allows us to have
better choices, but there are so many morewomen that do not have that opportunity.
And what can we do to help there?
Yes.
We didn't come up with any answers.
Why do
most of our doctors, when we first go,they'll say, okay, we could test your
(14:11):
hormones, but you're a little youngand you're not having hot flashes
and you're still having your periods.
Why don't they know better?
what are the reasons for that?
And what do they need to know?
Before I was a chiropractor, Iwas, I have an anthropology degree.
And so I always want to knowwhy and how did we get here?
Because I think historical context is soimportant for correcting in the current,
(14:34):
in the contemporary time, but also let'snot forget where we've come from, right?
Let's make sure that we don't repeatthe silly things we've done in the past.
Medicine, med school is, taught insuch a way that it is very, patriarchal
and paternalistic, and women's healthcare has been, essentially left out.
(15:00):
And we're going to talk a little bitmore about that in just a moment,
but first, let's talk a little bitabout the context of the conversation.
Now, my research too, right?
That's a part of it.
I was just about to say, my understandingof that is, goes back to when there was
research on synthetic estrogen called DES.
And it was such a mess that not onlydid it result in women birthing babies
(15:21):
that had significant, abnormalities,but the children that they birth
went on to have children with thesame or similar abnormalities.
So literally, even though the pillswere only taken for a short period of
time, I think used for, if I remembercorrectly, for, prenatal nausea.
Okay.
(15:42):
So like for morning sickness.
And if I remember correctly,please don't quote me on that.
Do your own research.
Thankfully, Google will produceif you ask those questions.
But it was such a messthat a decision was made.
And was this in the 50s or the 60s?
A decision was made to leavewomen out of the research.
First of all, because our bodies wereunpredictable because of the nature.
(16:03):
I mean, We have a 28 to 30 day.
Circadian rhythm where a manhas a 24 hour rhythm, right?
So far more predictable and alsoWhatever goes on in our bodies could
potentially be carried on to thenext generation as it turned out.
Unfortunately the generationafter that as well.
Was that Thalidomide?
(16:24):
Yeah, it was pre thalidomide.
Okay.
Okay.
Yeah.
Wow.
I again do the research everybodyIt's been a while since I looked at
that I don't have that data, but Iwanted to know, so I went and looked.
Why is this happening?
And it wasn't until 1994 that women wereactually put back into the research.
And then, of course, it wasn't longafter that, that we had this Women's
(16:45):
Health Initiative thing that said,women cannot take hormones, period.
And I was like, wait a minute.
Isn't everybody taking birth control?
Isn't that a hormone?
the idea that progesterone or estrogencan give you breast cancer, also weird,
like we've got so much of it, right?
It turns out it's the stuff that,that the manufacturers change
(17:08):
chemically, that increases our chanceof, breast cancer heart disease.
stroke and, heart attacks.
So it was a matter of asking theright question, as it always is
when these research things comes up.
I So when it comes to the, Women's HealthInitiative, which was the study that
came out in 2001 that said that we, thatpulled our mothers and our aunties and
(17:31):
our grandmothers off their Hormones.
Yep.
it's now all been retracted.
They made several mistakes.
It was a poorly done, I don't know,it was a billion dollar study from
the National Institutes of Health.
I have no idea how they made so manymistakes in it, but they're aware of where
the mistakes were and have retracted them.
There's all kinds of informationavailable about that online.
(17:53):
When I look at thatnow, I think two things.
We must have been, here's thewoo, we must have been spellbound.
How did we not see that we were leftout and we were left to fend on our own?
we're 51 percent of a global population.
How did we not see that?
Know that somehow the blinders havebeen pulled off recently, that spell
(18:17):
has been broken, something's gone on.
But the other thing I think that's inthe same lines is this Women's Health
Initiative, we have all of theseexamples historically of how women
have been disempowered, kept small,kept weak, whether it was starving
ourselves during the supermodel era totry to think we could look like these
(18:37):
beautiful women that had body and bonestructures that were not at all like the
average person, okay, so we're starvingourselves to, to be healthy, whatever.
There's all these examples of ways inwhich we are covertly told a thing that
keeps us weak, sick, disempowered, etc.
(19:00):
And I happen to think that theWomen's Health Initiative may be
one of those not so covert things.
when you take a womanaway from her hormones.
When you deny her muscle healthand bone health and heart health
and brain health, guess what?
We're not, we're pretty compliant, right?
(19:21):
We're pretty reliant on thesystem to take care of us.
In Canada, anyways, it's a socializedmedicine, but we're not lippy.
We're not sharing our wisdom.
Ugh.
Ha!
I have tingles and tears andlike this this giant thing in
my chest, expanding right now.
And I feel this thing that in this time ofour lives, we are stepping into our power
(19:49):
as we start to be more values orientedand less caregiving oriented, right?
We come into this place wherewe're like, okay, I've done
a lot of caring for others.
And now what do I want to stand for?
What message do I wantto share with the world?
Like we stand into this power andthen we're freaking tired and anxious
(20:12):
and disempowered and then the othersmust think that we've lost it.
Like we've become a wild woman.
Like you can see why these womenwere burned at the stake because
when they stepped into theirpower and, shared their voice.
and so there's this thingwhere they were extinguished.
Yes, Yes, exactly.
(20:32):
and so as we come into this perimenopause,I felt this shift where I feel this
calling, to speak a stronger message.
And at the same time, I'm so damn tired.
And at the same time, I'm, I can't focus.
And at the same time, you know, it's justthere's, there can be that little bit
of, um, you know, like you talked aboutwhere if you feel a little bit tired.
(20:52):
Yeah, shy or are they judging meor, have I just said too much or
somebody says, how are you doing?
You're like, oh my God,like it's been terrible.
that's a little awkward.
It's an awkward socialengagement on the playground.
Yes.
But it's that push and pull atthe same time that, is so hard.
A few things come to mind.
(21:13):
First of all, I feel all of that.
As you're saying that, itgives me goose pimples, too.
Makes me want to cry too, because,keeping women tired is how
we get kept in the box right?
and I, I struggle with this, too.
Now, it's always a crapshootwhen I do these interviews.
Whether or not I'm going tohave a great night's sleep.
I had a great night's sleep last night.
(21:35):
Thank God.
But there was one I did recentlywhere the gal who interviewed
me is still emailing me.
She's like, did you getsome sleep last night?
Like I must have worried her awful.
get it.
I get it.
I get it.
Again, when we are without our strength,we cannot stand against a system that
has repressed us for a very long time.
(21:56):
So I think, personally, thatself care thing becomes, it's
not just, it used to be cute.
We used to talk about self care,take an extra bath or close the
door on your bedroom and read abook so your kids leave you alone.
that's great.
Go to, yeah, good.
Take a little girls night out.
Yep.
(22:17):
Go for a walk, have a coffee,
Right?
Yeah.
Cute.
All of those things are excellent, but thedeeper I get into my own perimenopause,
the more I recognize that my presentstate and frequency is not only the
(22:38):
thermostat for my relationship withmy husband, But it's the thermostat
for my interaction, interactions withmy patients, and that I have a social
obligation to make sure I am taking careof myself to the best of my ability.
And, as you said, we move fromcaregiver mode to values mode.
(23:02):
I would say most women haveno idea what their values are.
Absolutely.
They would guess.
They would guess, right?
So when it comes to the fatigue,this is one of those things where
I start to look at the evidence.
Maybe you saw I posted this on Instagram.
I think it was over the weekend inCanada, here in Ontario in particular.
(23:24):
They're looking at changing theiron marker as what is abnormal.
And this is one of the most common thingsI see with women in my practice for
fatigue is they have untreated anemia.
Interesting.
And what happens is women go, mydoctor said it was no big deal.
Are you kidding me?
(23:46):
Of course somebody would say that to you.
That's BS.
Let me explain to you what that means.
You don't have enough iron.
You cannot carry the oxygen to theparts of your brain, especially
the frontal lobe, which is thepart that makes you brilliant.
Of course, that's, theysay, oh, it's no big deal.
(24:08):
Of course.
Remember, the doctorsare not the problem here.
The doctors were taughtin a shitty system.
They were.
The doctors are awarethat this is a problem.
The wise ones are.
And they're like, how do we fix this?
But it's such a, it's the Titanic.
It's the Titanic headingfor the iceberg, right?
So how do you turn around something thatis so enormous and funded by big pharma?
(24:30):
And so this is a problem.
we've got the problem.
So it's left up to women like youand me and the listeners of your show
to fill in the gaps, which is whyI do not stand for one second for
somebody who has a traditional medicaleducation bashing me or my colleagues or
anybody that is outside of traditionalmedicine for talking about menopause.
(24:53):
You guys didn't answer the call.
we stepped up and tried to help asbest we could in a job that you should
have been doing all the way along.
Sorry, I got a little bit right there.
This is
Good.
This is really good.
And I have a couple questionsabout, then what do we do?
So I'm thinking most of my listenersare occupational therapists.
Yeah.
And so I'm going to ask you in a moment,how can we, when we're seeing our clients
(25:16):
struggling or ourselves, what, how canwe help them get the information and care
that they need, but I'm going to firsttell you my, how I tried to go about this.
So I switched doctors.
my doctor retired.
She was great.
And so I spoke to a colleague who I askedsomebody who's mental health oriented,
mental health aware, that sort of thing.
(25:37):
And, and so got this other doctor and shewas young and awesome, but I was talking
on and on about the symptoms I've shared.
and I kept saying, Ithink it's perimenopause.
no, your hormones look good.
And I know that the blood work thatwe do is showing if I'm within a
range in a moment in time, whichcould be any point in my cycle.
And that, blood test that they're doingisn't likely going to tell the story.
(25:59):
And after years I finally took, and I hadgone to a naturopath and I had gone to you
and I done a whole bunch of things too.
And I knew I needed some hormones.
I knew it, so I took in my bag ofsupplements, everything I've bought and
I've been trying and my magnesium andmy vitamin Bs and my vitamin D and all
the things I was trying and L theanineand L tyrosine and lots of things.
(26:23):
I took in, there's an Australianassessment I think it's actually
designed to track which menopausesymptoms are changing as a person
goes on hormone replacement therapy.
I think I found it because of,Mary Claire Haver on TikTok.
And so I took that in as my kind ofbaseline and said, here's all my menopause
symptoms, because it's not just menopause.
(26:45):
Hot flashes and, and so ticked themall off and said, if you can't help
me, can you please refer me to, andI brought in a referral form for a
local clinic that deals with menopause.
And she said, Oh, sure.
You know, actually we have somebodyin house who can help you with this.
There's a gynecologist here.
Why don't I book you in with her?
Are you serious?
Like we've been years, years goingaround this and I had to bring in my
(27:08):
bag of tricks and a referral form andan assessment form that I sourced from
TikTok and then was given the referral.
And, it was really frustrating.
It was really, I really like my doctor.
Like I, she really has great intentionsand does a lot of great things, but
so I'm curious, what, how can weget the best out of our doctors?
How can we advise our clients toget the best out of their doctors?
(27:30):
I'm going to put this backto you for a second, okay.
Did you get what you neededfrom the gynecologist?
Yes.
Eight months later.
Exactly.
Now, here's the statistics on gynecologyand gynecology's training on menopause.
One in five feels like they have adequatetraining, which means four out of five
(27:54):
gynecologists have inadequate training inmenopause and that is their own survey.
So gynecology is notnecessarily a solution, right?
I know when I first went to my ownGP, And said, I'm not sleeping, I'd
like to try bioidentical progesterone.
Of course, you say the words bioidenticalto somebody in traditional medicine, and
(28:15):
they're just like, that's not my thing.
Yeah, listen, you give it to a womanwho was, at risk of miscarrying.
It's the same thing, but you didn't knowit was bioidentical until I said, Yeah.
So she gave it to me, but she said, I'mgoing to have to refer you to gynecology.
Which never actually manifested,I don't know why, but probably
it was pre pandemic, so itwas, who knows what happened.
(28:36):
The gynecology triage probably lookedat this and went, this is not for us.
Right?
So I was left on my own to do that.
Now, I have the informationso I could do it.
Now I have a nurse practitioner, andit seems to me, where we live, nurse
practitioners have the ability topivot around these things much easier.
Again, we have the ability to pay forprivate healthcare here in Alberta.
(29:00):
And so this is what I'm talking about.
I pay out of pocket for that, but she'sdone a better job of taking care of my
comprehensive health including brain andheart because those are the two things
I'm most concerned about as I age.
I want to know those two things.
I want the preventative stuff there.
I don't just want the, oh,oops, you've got heart disease.
Here's here's the list of medicationsthat I saw people in my family have.
(29:26):
A gynecologist isn't always the greatgreatest option and quite often what
happens is women in our age group thatare sent to gynecology either leave with
the birth control pill, because at leastthat's hormones that the gynecologist
is familiar with, which by the way,are way higher amounts of hormones than
we actually need, than HRT would be.
(29:48):
Okay.
Or we're sent home with syntheticprogesterone, which is the problematic
substance from the Women's HealthInitiative that said, that synthetic
progesterone increased, breast cancer.
Breast cancer was the thing there.
That's not the answer.
There's all kinds of research thatsays the safe way to do HRT now is
(30:08):
a topical estrogen, a potentiallya topical testosterone if you
need it, and that's why we test,and a bioidentical progesterone.
There are no increased risks.
In fact, quite the opposite.
Women that are taking this sort of regimehave a much better, if they do end up with
breast cancer, have a much better outcome.
(30:29):
We live longer, we're healthier,and when I heard that first, I
thought, that's really such a pivot.
And then I started to think aboutthe older women that are in my
practice, the women who are in theirseventies and eighties, the ones
that come running in from the parkinglot, like no frailty whatsoever.
They're sharp as attack, sharperthan me in my own perimenopause.
(30:49):
And guess what?
They never stopped taking thehormones that their doctors gave
them pre Women's Health Initiativestudy or retraction, I should say.
So it's an interestingthing to ask that question.
I think ultimately you have to go in as aninformed consumer to your medical doctor.
(31:11):
I mean, look at whathappened when you did that.
By the way, doctors get, if they'relucky, they get 1 to 3 hours of nutrition.
So they don't know anythingabout your supplements, right?
They have no clue.
None, like zero.
and you walked in and said, here'show I'm tracking things, right?
This is what it's looking canwe post the link to that, I'm
(31:33):
familiar with the Australianstudy, Australian questionnaire.
Let's post it with the show notesso that women have something that
they can take to their doctors.
Here's how I handle this as a chiropractorfor my patients because I can't prescribe.
I literally have a form letter.
That I sent to their GP.
I sent it with the patient.
I call it, well woman care.
(31:56):
Obviously they're going to understandthat this woman is between the ages
of 30 and hopefully that's enoughof an indicator to say, hey, by the
way, we should probably be lookingat some things and I can address
the labs situation here in a minute.
Remind me, because I'll go on,continue to go off on a tangent.
Unmedicated, undiagnosed ADHD over here.
You're like, oh my god,explains everything.
(32:18):
That's why I like you.
the people that I actually gel the mostwith, it's because we share that ADHD ish
ness, I wear it and enjoy it in others.
Which is good.
I know.
I just call it out now.
I'm like, sorry, there'sa magpie in the room.
Like I have to acknowledge the magpie.
Okay.
Now we can get back to the conversation.
Anyways, so I send a form letterwhere I literally check off.
(32:38):
These are the bloodtests I want to see done.
And always ask a question.
Don't make it seem, give thedoctor the opportunity to be
the last one speaking, right?
It kind of helps with the egothing that can go along with
that paternalistic system.
And, this is even thewomen in the system, right?
We were all just taught it.
(32:59):
I was taught it too, right?
I had to unlearn it.
I always say something like, would Carlynbe a good candidate for topical estradiol
and bioidentical progesterone, questionmark, and then send it off to the patient.
And I would say most of the feedbackI get from those letters, which comes
(33:19):
back to me from the patient, is thatthe doctor was so grateful that there
was another person watching, right?
And what, fine, here's the requisition.
And if that doesn't work, then for me, Ican order private testing for patients.
But again, that's anout of pocket expense.
And I can always refer to my own nursepractitioner or some others that I know.
(33:40):
Now in the States, if there are,OTs listening that are in the
States, there are great telemedicineclinics that are specifically to.
Women's Care at Midlifethat do a great job.
And I've had a couple ofthem on the show, CEOs.
I think there's another onecoming in January on the show.
But they seem to have a lockdownon the protocols and, they take
(34:03):
insurance and they can speak toyou basically whenever, wherever.
So we want to find somebodywho's done some extra training.
Ideally if we're choosing ourown practitioner, we're wanting
to have somebody who has someextra expertise in menopause.
But I'm hearing that thereare ways to request them, the
(34:23):
medical team to look at this.
And I like that way of justsaying, would they be, and it poses
that question where they have tothink, what would make them not?
Yeah.
Okay.
Like they have to actuallyjustify it as in their mind as
they're answering that question.
Yeah, it's the open ended question, right?
Yeah, it helps.
And this is good for patients, forwomen that want the care, it doesn't
(34:44):
necessarily have to go through acommunity healthcare practitioner
like the OT or the chiropractor.
It can literally just be the same query.
Am I a candidate for these things?
And I recorded an entire episodeon this because I wanted to give
women the language To use withtheir own doctors because I think
that language is really important.
(35:06):
Not Your Mother's MenopauseEpisode 102, How to Talk to Your
Doctor About HRT, I think will bereally helpful for a lot of women.
And that's the feedback I'vehad in the office as well.
Wonderful.
I will link it.
That's really helpful.
Can you tell us a little bit aboutcognitive function more specifically?
We've talked about someof those emotional things.
We've talked about a little bit,but women often report brain fog.
(35:27):
I noticed women who being diagnosed withADHD in this time, but those who already
have it to notice it worsening a ton.
Tell us a bit more about whatthe science says about it.
Yeah, so we're not 100 percent sure.
What we do know is that there'squite a few factors and for, I think
this is part of why women's healthcare at menopause can be, quite
(35:50):
difficult to practice because, everysingle woman is different, right?
So here's what we know.
We know that the fuel system changes.
We move from glucoseto another fuel system.
And with that, things slow down.
We know that most women have somesleep depravity or sleep issues
(36:12):
that happen at perimenopause.
That makes us brain foggy.
We know that there's aloss of gray matter volume.
We know that there's aloss of blood supply.
We know that the neuralconnections pare themselves down.
Again, it's that renovation.
Those are words used by Dr.
Lisa Musconi, whose research isthe best contemporary research on a
(36:36):
woman's brain at perimenopause pleaseread her books, they're excellent.
I reference her research all the time.
By the way, just as an aside here, justthis morning, I read that for the very
first time they've done MRI scans on apregnant woman's brain because we know
that the brain changes at pregnancy.
(36:57):
This is how behind we are.
And it turns out that a lot of thethings that change in pregnancy are
also the same things that happen inperimenopause with this fuel system
change in the connectivity, we've gotshrinkage of certain areas of the brain.
What's interesting about that is thatit's the same areas of the brain that
(37:17):
are involved in Alzheimer's disease.
Okay, 80 percent ofAlzheimer's cases are women.
Okay.
So it's interesting to look at thatand go, and this is Moscone's research.
She's the one who said, okay, whyall these women in my family have
Alzheimer's what's happening.
So she was the one to say, we betterstart imaging women's sprites.
(37:37):
And for some women based on genetics,there is a switch at menopause with
the decline of estrogen that starts toturn on the processes of Alzheimer's.
That's ultimately what we understand ishappening in a woman's brain at midlife.
Yeah, so yeah, it's quite something it'squite something to think about Here's
(37:58):
the thing I want to leave the listenerwith This has been critical for me for
my own thinking because as I'm goingthrough this I can feel all these things
come up You know and not all of them,but a lot of them are like, okay Fiona.
Don't be confused.
That is not a weakness is not aproblem with your personality.
(38:20):
You are not crazy.
You're not suffering from mental illness.
You're not, all of these thingsare really important for me
to go, this is perimenopause.
The solution is not anantidepressant medication for me.
It is true for, this isnot a serotonin deficiency.
Okay.
That's what I'm saying.
It's an estrogen change.
(38:43):
it's been really important for meto look at all of that and say, all
right, we need to make sure that I'msupporting all the systems that are
supporting my brain health for sure.
So once you have that lens with whichyou can see the way the brain is
changing, it's really important thatYou know, for years, I just heard women
(39:03):
say, at this age, I'm losing my mind.
My mother was dementia, my grandmotherhad Alzheimer's, like, is this
what, is this how it's happening?
So, Here's the importantthing to take away.
Within four years of the last menstrualperiod, and quite often much sooner
than that, our brain function returns towhere it was pre perimenopausal changes.
(39:28):
So this is not forever.
Exactly.
Isn't that so much?
It's so relieving, right?
and you know, there's, there'simportant elements to that to remember.
testing on women in our age group.
Okay.
You and I probably don't, I knowthis is true for me, so I won't
speak for you, but you can tellme what you think for yourself.
For me, I'm not nearly assharp as I was 10 years ago.
(39:50):
And I miss that brain.
You know, I didn't appreciate it.
Now it's Oh my God, howdo I get back to her?
I would take the brain over thebody and the lack of wrinkles.
Just bring my brain back.
Yes, exactly.
So here's the interesting part.
Cognitive testing done on womenpre, Perimenopause and Postmenopause
(40:18):
show that even though we reportfeeling like our brain is taking a
dip, function didn't change at all.
We had the same executive processing,the same cognitive function.
It just didn't feel as,maybe as quick on the inside.
Sure.
Isn't that so relieving?
That is relieving, yes.
(40:38):
Is there an objective dip in themiddle, and then it's back after, like
we get back to baseline, but we don'tfeel like we're back to baseline?
Is that what I'm hearing?
Another way to say it would be, weperceive that we're not as sharp as
we were 10 years ago, but the testingshows that there is no dip in function.
Okay.
Fascinating, right?
Even in the perimenopause.
(40:59):
Even in perimenopause.
Yep, and I'm trying to remember which ofthe books Musconi references this, and it
may actually be in her, research paper,because she went about saying, okay, so
now we can see what the changes are, butanybody that wants to know more about
this, please go read her research papers.
And it's the one in particularwhere she talks about how
(41:21):
the menopause brain changes.
She has a whole book on it that'sjust come out in February this year
called The Menopause Brain, and inthere she talks about this very thing.
We never lose that function.
We think we do.
It's a perception, but that ontesting, we don't lose functionality.
Now, that said, the brain is stillundergoing, this is how amazing women
(41:42):
are, the brain is still undergoingthe renovation of perimenopause that
signaled by the egress of hormones.
Estrogen is the big one here, butcertainly progesterone, testosterone,
DHE, cortisol are part of that.
, We have that perception, but we neveractually have that dip in function.
And you know what, the day that Ididn't have the great sleep and I
had the beautiful interview Yeah.
(42:05):
I was just praying likehell that was true.
Otherwise people are going to think I'm adip and that's the end of this discussion.
Next episode.
That's funny.
I feel like I've gotten good atwinging it based on experience, right?
That's on those tired days, I cango, okay, this might not be quite
as organized or well planned, butit's still going to be really good.
(42:25):
Whatever me and that client do, orwhatever presentation I need to do,
or something like that, that's whenit comes down to it and I'm in my
zone, it will come together, evenif I didn't have the energy to work
out all the details ahead of time.
Yes, absolutely.
And as I think I said to you at thestart of this conversation, I can't
remember if it was before you pressrecord, but as clinicians that work
(42:48):
with clientele, we are good on our feet.
Yeah, Neither of us is new at this job.
So at some point, musclememory is going to kick in.
Yeah, but here's something interesting.
I had, over the weekend, I had a patientcome in, guy I've seen for years and
years with a new shoulder injury.
And I did all the testing without writinganything down because I can remember this.
(43:11):
But then at the end of my day, whenI was tired, and I was hungry, and
I sat down to do his soap note.
Do you think I could puzzle my waythrough the shoulder exam flow?
No way.
I literally had to pull out thetextbook and remind myself of the
names of the tests because I knewhe was going on to physio and the
physio would want to know that, right?
(43:32):
So that's a pretty good example,but I just needed the clues.
The information was there,but I just needed the clues,
Can I share a tip thatsomething I've been using?
God, yes!
So I've been using, AI for documentation.
So there are a lot of them out there.
The one that I've been using isthe free version of Heidi Health.
(43:54):
I know, so Jane is a sponsor of theEMR, they're a sponsor of the podcast,
and I know they're also workingon one, that will be integrated.
But at this point, I open up my twoassistants, Jane and Heidi on my computer.
And, so Heidi it will listen and thenyou press transcribe at the end of
the session and you can request whattype of note you want it to create
(44:15):
from what's been verbalized in thesession and it will create a note.
So there are some basicSOAP notes in there.
And it's done a really good job.
I've also adjusted the template.
So it's a little bit more oriented tothe format that I like to chart in.
And, it does a really good job frommental health to phys med, I have a
client who he takes it out on homevisits and uses his phone for it.
(44:37):
And the notes are not 100%.
They still require you to give ita human touch, which is important.
Yes.
Fascinating.
Fascinating.
I will be looking into that.
Did you say it was HeidiHealth or Heidi Help?
Heidi Health.
There are a bunch of other ones so thatall meet the requirements of our privacy
(44:57):
regulations and that sort of thing.
This is not ChatGPT that's taking ourinformation and putting it into a pool.
It's you just delete it after.
You're not even keeping the recording.
It's just transactional,for creating that note.
Wow.
Okay.
Yeah.
We don't use Jane in the office yet,but God knows it's a conversation that
keeps coming up because we've got twoclinics, there's 30 practitioners.
(45:20):
It is, talk about a Titanicthat needs to be turned around
when you're switching EHR.
But it's definitely, I don't know,that's something I could do on my own
and, have my own notes, as part of that.
And Heidi health is a standalone app.
You can use it.
I just copy and paste it overinto my Jane but I know Jane is
working on an integrated one.
And I know a lot of the EMRs, that'sobviously it's the cutting edge, right?
(45:41):
They're all working on it.
They just have to make sure they'remeeting all of those, that functionality
and that, privacy and those typesof things before fully releasing it.
Jane's the bomb.
Jane's got it in beta right now.
Yeah.
Nice.
Jane's the bomb.
Talk about a good Canadian company.
I'm such a fan.
Thanks.
Yes.
I have, I've been enjoyingworking with them.
Very human, but I have, amenjoying this conversation.
(46:02):
So what is on deck for you?
What are you leaning into right now?
A couple of things.
I am writing a book on thecognitive impacts of menopause.
And, this is a book that'sbeen a long time coming.
And I think when I started writing it,it was a generalist book about menopause
and we are past thanks to TikTokand Instagram, et cetera, women are
(46:23):
getting that information much quicker.
So that's a heart contract for me, HE A R T, because it just feels like a
full circle thing that is to be done.
I have so many women that I'm so blessedto be in community with that have
listened to my show for so many years.
That feels like a gift to them.
(46:43):
So I'm working on that.
For quite a few years now, I'vetaught a menopause doula certification
and I'm taking that trainingto the next level if you will.
Which is going to be availableas a group offering Hopefully
in early 2025 is the plan.
Yes.
(47:03):
Thank you.
I'm on your wait list
Oh, good.
Well, and anybody who wants to be onthe waitlist for the launch can go to
menopausedoulasociety.
com and you can sign upfor the waitlist there.
And then as soon as, we, me and my teamhave more information about when that's
launching, you'll be informed of that.
(47:23):
so I'm excited about that because thereare many women, that do not have the
professional designation like we do.
And there are many women that do havethe professional designation that
need that basic sort of training.
How do you help a woman who is in her,what I like to call hot girl phase?
there's lots of women like us that wanta deeper understanding, maybe not to
(47:48):
go right back to professional school.
Cause here's the problem, who's eventeaching menopause medicine, right?
Yeah, still figuring it out.
They're still figuring out who'sgoing to be the one to manage this.
I'm excited about that.
And those are two of the big projects.
I have such awesome experts Iget to interview on my show.
That's something else I'm just loving atthis phase in my life is just, inviting
(48:09):
other women into my community and sharingthe wisdom that they have gleaned from
their own experience and training and etc.
And that's a really fun thing.
I'm sure you know what I'm talking about.
I do.
Yes, I definitely do.
When I was also contemplating startinga podcast, I've always described it as,
(48:29):
with, if I were to go to a party, I don'tlike to be in the big room trying to get a
word in edgewise in the big conversation.
Like you're going to find mein the kitchen having a really
deep conversation with someone.
And so I kind of thought, ah, socialmedia marketing, like all the Facebooking
and stuff is quite exhausting for me.
And it feels like trying to connect withmany, and I have made some beautiful
(48:51):
connections from that, but wherebeautiful connections come are where we
go deeper, not, putting out another reelor something, though I do that for sure,
but I also have hired help for that.
I like this.
I like having a good deep conversationand that feels, almost effortless and
it feels like I'm serving at my highestwhen I can share in this intimate way
(49:11):
with people where you and I are havingan intimate conversation that's deeply
authentic and we're in some It's earin their kitchen, in their car, on
their walk as they're folding laundry.
And that is, that feels so connectingfor me, even though that person's
not right here, you and I areconnecting in the conversation.
and then I hear from the people wherethey say, Oh my gosh, I had to pull over
(49:32):
when you said that, or, I just love that,that we get to be in people's ears in
their homes and, and in their personallives as we share what is true for us.
It's so special andyou're absolutely right.
Absolutely right.
I love that too.
It feels, um, because I know howI consume that content myself.
Yeah.
Like this morning when I was driving inhere, I was, listening to a thought leader
(49:54):
that I follow, in a class that she did.
And I could have just been in the classwith her and that's the beauty of it.
Right.
I mean, She lives in California.
I'm not, I'm in Alberta.
I can't be there withher, but I can be there.
She can be with me.
It's a beautiful thing.
It is.
It is really beautiful.
I listen to podcasts inthe bathtub a lot too.
(50:16):
I don't know if the people I listen to,I don't know if you know that you've been
in the bathtub with me, but here we are.
I had a feeling.
I read in the bathtub.
I've got one of those seal pouches andI put my tablet inside it and yeah,
my husband made me a shelf for it.
So it's like my water and there's myglasses and sometimes a bit of chocolate.
It just depends on what I need.
(50:37):
A girlfriend of mine told me thata chip bowl floats in the tub.
I was like, I've never thoughtto take popcorn to the tub.
How did I not know this?
I'm glad I could teachyou something today.
Oh, this has been a wonderfulconversation and I knew it would be.
And anytime I get to talk toyou, it is a good conversation.
So thank you so much for being here.
(50:59):
Thank you for having me.
I so enjoy the time we get to visit.
we've done it twice now this year.
This is fun.
What's next?
What's next?
I don't know.
I think you need an OTon your podcast, maybe.
Oh, yeah, I agree.
I agree.
Yeah, let's figure that out.
Yes.
I have a couple questionsI ask everybody at the end.
Are you ready?
I am so ready.
What does being brave mean to you?
(51:21):
Stepping out of my comfort zone.
yeah, stepping out of my comfort zone.
It would have been really easy for meto just stay a chiropractor and focus
on nothing but spinal health for people.
But, there's some part of my programmingthat just says if there's a need
for social justice in some way, I'mstepping up even if I'm scared as hell.
(51:47):
And in a strange way, menopause,talking about menopause the way
I have, is the, is that thing.
That feels brave.
Yeah, I'm so grateful you have.
Thank you.
What is something braveyou've done recently?
I recently started working with a newtherapist specifically for grief because
(52:09):
I could feel the weight of the passingof my parents in the last few years, as
well as some beloved for family membersand the grief that we all experienced.
I think most people, I shouldn'tsay all, but most people experienced
some form of it during the pandemic.
(52:31):
And, I had a business and that literallygot put to the side and, patient
care people I couldn't check in with.
That was very difficult for me.
And so there was a lot of grief that, andI just realized one day earlier this year
that it was still all hanging in there.
And I'm like, You know what?
I know that's the stuff that makesfor disease, and I don't want it in
(52:54):
me, and I have no idea how to evenscratch the surface on bringing it out.
So, I did my research, and I founda great therapist, and I've been
working with her now for a couple ofmonths, and I feel, a lot lighter.
And that feels brave to me, because Iknow that, first of all, it's so cliche,
I show up at our visits, with a box ofKleenex under my arm, like seriously.
(53:15):
Surely she has some, butyou've brought your own.
But our meetings are virtualbecause she practices in Marda Loop.
I don't know if you'vebeen over there recently.
It's a mess.
There's so much constructionanyway, so whatever.
That's so regional to Calgary,but, that feels brave to me
because it's so easy to just go.
No, just don't look, you'll be fine.
Just don't look.
But that is not, that's not health,
(53:39):
No and if that stuff is really, itjust gets louder in other ways, right?
Like you talked about, it's your health.
The body keeps the score, right?
If that stuff is being held underthe surface, it is hard to deal with.
And so it is brave to bringit out to, to face all.
Yeah.
And this makes me think of somethingelse, just as you said, I referenced Dr.
(53:59):
Vander Kolk's book, Lots of WomenExperience Grief and Perimenopause.
there is a grieving process,especially if we're identified
strongly with the mother archetype.
And so I think starting to talkabout grief and the, that we can
feel is a really important thing.
Yeah.
Thank you.
(54:19):
How would you like to see healthcareproviders be a little bit more brave?
Yeah, it's a great question.
I think the fee for service andvolume based system that we practice
in is problematic in a few ways.
And one of those ways that Iwish to bring up here is that
(54:43):
we have time pressures aroundinteractions with other human beings.
And what I'm aware of is that there aremany people, men and women, suffering
right now with mental health especially.
And it's not easy to bring up, It's noteasy to slip into conversation, especially
(55:03):
for those of us that are Gen Xers.
We were raised by the stoic generationof you, you don't pop your head up.
Tall poppy gets chopped.
what's the term?
Tall poppy gets cut.
Something like that.
You know what I mean?
Blend in, right?
don't show your weakness.
Don't do all those things.
And, I think a brave healthcareprovider sees the humanity.
(55:25):
In the person in front of them,not just what's the diagnosis,
what's the code, what's themedication, what's the treatment.
And I think that can be really hard todo when you're pressured in a system
that pays you for your time, butnot always as well as it should be.
(55:47):
And that we have the pressure of aschedule, meaning there's probably other
people waiting in the waiting room, etc.
Yeah, so that if we're going overtime, yeah, somebody's waiting
and if we block in double thetime, we're also not getting paid.
And I don't know whatthe answer to that is.
I don't.
I've always just let my instinct tellme, my gut tell me what feels like
(56:12):
the right, compensation for my time.
And I recognize that I get massivelyunderpaid for my functional medicine
work, but I also feel strongly that itshould be affordable to most people.
Yeah.
And listeners.
You might be surprisedto hear this, right?
We're here in Canada and, thinkingabout our Canadian healthcare system in,
(56:34):
in many ways does take care of peopleand in many ways it's falling short.
So you and I both have privatepractices, where we're not being
paid by our public health system.
Some people have a little bit ofhealth care benefits, extended health
benefits that might cover some ofour services, but not all of them.
I know a lot of fundsdon't even cover OT at all.
(56:54):
And we're working on that.
And, and so there are a lot ofsimilarities to the American system, where
we are charging the individual, and then abit different too, where if an individual
is paying out of pocket, to get goodservice, some people are willing to pay.
For that extra time, right?
And, I know a lot of Canadian healthcare providers hesitate to, charge for
(57:16):
the extra, but if the extra is what thatperson needs, and you're negotiating
that, hey, this is what I think youneed, maybe we need to be, we need to
be Booking hour and a half sessions.
Maybe we need to be booking sessionswhere we're out in nature walking.
I do need to charge for my time to travelthere, or if I need to be communicating
with other people and being able topresent that as an option to people.
Some people can pay for it, not everybody.
(57:39):
and I get that.
And if I wanted to help everybody,I would probably be working more in
the public health system as well.
And so I feel, we still have some room.
We still have some wiggle room to workwith that, but there are no clear and easy
answers because we're running into valuesconflicts on at every turn as well and
figuring out how to do things ethicallyand equitably and in ways that aren't,
(58:01):
sacrificing our own integrity and healthand well being and, compensation as well.
It's a big conversation andit's a brave conversation.
How would you like peopleto reach out to you?
Yes, good question.
all roads lead to and from my podcast.
I suppose my website as well is drlovely.
com.
(58:22):
That's d r l o v e l y dot com.
the podcast is available on all of themajor networks, streaming networks.
The, the podcast is called NotYour Mother's Menopause with Dr.
Fiona Lovely.
it was named that after a lecturethat I did for many years.
I traveled around the cityhere and did those, lectures.
And so people knew me from that nameand, here we are all those years later.
(58:44):
so you can reach out through the website.
you can also send me a messageon Instagram, both Instagram
and TikTok are @drfionalovely.
And, I do have a team that helps methere, so it may not be me that gets back,
but, they send those inquiries on to me.
And the, doula training that's coming upin the in next year or sometime, people
(59:06):
want to get on that list to be notified.
It's menopausedoulasociety.
com.
Dot com.
That's right.
So yes, the menopause doula society isalso in the process of being developed
as well as the certification training.
So that will be the website.
We might as well just start sharing it.
Do you think it's kind of likegetting training to be the big
sister that we all needed in.
(59:27):
You
know,
I think ultimately that questionis going to change the framework
with which I build this program.
Thank you for asking that.
That's a great question.
I'm aware that, women that have steppedup and asked for this training sort of
one on one at this point are women likeyou and I that just want to be able to
(59:52):
essentially hold a woman's hand and sitwith her and say, you are not crazy.
You're not the only one andyou don't have to suffer.
So I think the answerto the question is yes.
I
love that.
Thanks for asking that.
You're very welcome.
I just feel it.
That's just exactly what I feel.
(01:00:12):
I think about how I talkedto my little sister.
She's 11 years younger than me.
And, about the journey ahead.
And.
That I'm grateful that I can sharewhat I've learned and I'm learning.
There's so much more to learn, butthat, yeah, our moms didn't get this
opportunity, so we didn't get it there.
No, moms were still spellbound.
So were our grandmothers.
(01:00:33):
And, ultimately we learn fromthe person in front of us.
We don't learn from school,you know, we learn from the
interaction, the conversation.
I mean, we as women healeach other in community.
What we're doing now is just returningto the way things were before the system
(01:00:55):
got in and started messing with us.
We do heal in community.
We do.
so my main sort of signature programthat I offer is called ACTivate Vitality
and so It's an interesting thingbecause when I set out to create this
online program, I was thinking aboutthe course and that had a community
(01:01:16):
with it, but I couldn't envision thecommunity without the members, right?
Until people started coming together.
And years later, I think I startedbuilding this thing in 2019.
And here we are in 2024.
And it's like, Oh mygosh, it's the community.
It's the circle of women that aretogether and spill it all and share.
We share about life.
We share about business.
(01:01:37):
We share about.
what's not working and grief andrelationships and efficiencies and how to
work maybe a little bit less and how toset boundaries and all of those things.
And it is that it's social learning.
It's that we've got these mirror neuronswhere we are influenced, so much more
easily by others who have shared asimilar mission and a similar language
(01:02:00):
and a similar understanding and comingtogether in community, We all rise.
Isn't there a, there's a cheesyquote that we could put there, right?
and true.
Cheesy and true.
And it's when, how's it go?
When the water rises in the harbor, allboats rise, something like that, right?
I'll find it.
(01:02:22):
The water rises, all boats in theharbor or something, but it's okay.
You and I know exactlywhat we're talking about.
That's.
So powerful for you to remind me of thatand our listeners as well, and that is
the shift I have seen to in the yearsthat I've been doing online offerings.
When I created the Brain HealthMaster Course, which I haven't talked
(01:02:43):
about here, but it's one of theofferings I do, usually once a year,
it's kind of getting overshadowedat the moment by the certification,
the doula certification, but I puttogether this beautiful structure.
I spent so much time on the videos,the content, and the infographics,
and the best part is always.
(01:03:03):
The Q& A sessions I hold at the end whereI think it's going to be 60 minutes.
I don't dare open it for longer than thatbecause I think people are going to be
bored and it ends up being two and a halfhours and we're still talking and we're
still inter and it's not about me at all.
It's about the interaction.
It's a beautiful thing.
It's a beautiful thing.
People need to be seen and heard,and then we co regulate, and then
(01:03:26):
we give it all the Cs, right?
Community co regulation,compassion, and caring, and we
become so much more creative.
It's this kind of buzzing hive mind.
I found the quote, by the way,a rising tide lifts all boats.
That's so much moreeloquently than I said.
Much what we said, it's evenabout the harbour and the storm.
(01:03:46):
Boats and stuff, things, tide, whatever.
I am grateful to sail with you and, andhave you in, to be in community with you
here locally and that we get to do this.
Thank you.
Thank you.
Take care of yourself, everyone.
Thank you for the time.
I really hope that something in thispodcast touched you as a listener.
(01:04:09):
There's a quote by Sark that says, Thecircles of women around us weave invisible
nets of love that carry us when we'reweak and sing with us when we are strong.
I'm very grateful to Fiona for beinga part of the circle of women I see
around me, and for being able toshare this conversation with you,
(01:04:29):
the listener of The BRAVE OT Podcast.
If you're looking for more from Fiona,you can visit her website, drlovely.
com.
And if you're interested in hermenopause doula certification, that
website is themenopausedoulasociety.
com.
Her podcast is Not YourMother's Menopause.
(01:04:50):
I love that name.
And you can find her on TikTokand Instagram @drfionalovely.
I'll put all theselinks in the show notes.
Now if you're a therapy business ownerwho is really craving that sense of
community, collaboration, co regulation,a group of co conspirators to support
your creative endeavor as a businessowner, and as a whole human, We will
(01:05:12):
be reopening the doors to the ACTivateVitality program, at the end of January.
There will, of course, be a linkto that page in the show notes, and
I would love to talk to you to seeif that is the sort of thing you
need to thrive in this coming year.
Thanks for tuning in, andas always, be brave, OTs.
Don't be confused.
That is not a weakness is not aproblem with your personality.
You are not crazy.
You're not suffering from mental illness.
You're not, all of these thingsare really important for me
to go, this is perimenopause.
The solution is not anantidepressant medication for me.
(00:20):
It is true for, this isnot a serotonin deficiency.
you're listening to the BraveOT Podcast with me, Carlyn Neek.
This podcast is all about empoweringoccupational therapists to step up,
level up, blaze some trails, and maybeengage in a little conscious rebellion.
In service of our profession, ourclients, our work, our businesses,
(00:41):
and living our mission wholeheartedly.
We are all about keepingit real, doing hard things.
Things unhustling, being curious,exploring, growing through our
challenges, and finding joy,fulfillment, and vitality as we do so.
Really, we're OT ingourselves, and each other.
I hope you love this episode!
(01:02):
I am thrilled to share this authenticand vulnerable conversation with you.
Today I'm talking to Dr.
Fiona Lovely.
With nearly two decades of experience,she is a trailblazer in women's health.
Specifically focusing on themenopause transition, perimenopause.
We will share stories that highlighthow community and shared experiences
(01:25):
can be a bedrock for growth and healing.
Fiona's insights about the perimenopausejourney and menopause bolstered
by recent research shed light onthe many misconceptions we face.
Spoiler alert, but there's a lotin there about social justice.
We talk about the mental andphysiological shifts women encounter
during this time of renovation inour bodies and in our brains, and
(01:50):
some myths about cognitive decline.
This episode is packed with wisdom,practical advice, and a heartfelt
conversation, whether you're anoccupational therapist, someone
experiencing perimenopause, or you'resimply interested in understanding
this vital aspect of health,there's so much here for you.
Today's episode is sponsored byJane, a clinic management software
and EMR that helps you handle yourclinic's daily admin tasks so you can
(02:13):
free up your evenings and weekends.
The JANE team understands how preciousyour time is and recognizes that
charting Can often be the most timeconsuming admin task for Practitioners.
That's why they're here to help.
To save you from having to start yourchart notes from scratch, you can
check out Jane's template Library,which gives you access to templates
that have been generously createdand shared by health and wellness
(02:34):
practitioners in the community.
Once you have a template you like, youcan choose to customize it further with
charting tools such as range scales,text fields, check boxes, and more.
To see how Jane can help you spendmore time doing what you love,
head to the show notes to grab thelink and book a personalized demo.
Or if you're ready to get started,you can use the code VITALITY at the
(02:56):
time of signup for a one month graceperiod applied to your new account.
Dr.
Lovely, or as I would call you, Fiona.
Welcome.
I'm so happy to have you here.
I can't wait to dig intoall of this discussion.
Perimenopause, menopause,cognitive function, let's dive in.
Could you tell everybody alittle bit about yourself?
(03:17):
Thank you, by the way, for allowingme to share this space with you.
You and I have always had greatconversations, and so I anticipate that
today will be a good conversation too,so I hope I can bring something useful
to your listeners and your community.
Thank you.
Yes, you bet, thanks for having me.
So my professional designation isas a chiropractor and I have been in
(03:38):
practice nearly 20 years and reallyearly on in my practice, like the first
month or two, I had a patient comein that was a woman in her 40s that
had recently had a child and she wasdesperate for information on menopause.
But she wasn't gettingany help from her doctors.
(03:59):
And, I happened to have the informationbecause I had taken the functional
medicine training when I was in school.
And for myself, to be honest, becauseI was gaslit by a gynecologist
in my 20s and I wasn't going tolet that happen for myself again.
And I never expected I'd be practicingthrough the lens of talking to
women about, , hormonal health andwomen's health, but they literally
(04:21):
pulled me in right from the start.
And so I can still remember veryvivid details about that patient,
and I hope she's doing well.
But she literally called me to the mat.
She was like, Nope, you'vegot this information.
And of course, I had lots of time, right?
I just had a handful of patients.
I was fresh out of school.
So I just shared what I knew.
(04:42):
And, it started something in me thatmany years later still smolders.
And in 2016, while I was busydoing my chiropractic practice and
answering questions as I could forwomen's health, I started a podcast.
And I had never listened to a podcast.
I had no idea what I was doing.
I figured it was just a lecture.
(05:03):
I was like, okay, well, I'mgoing to get behind a mic.
Cool.
I've been doing that stuff for years.
And that's a podcast.
Well, you know, what'snice is I hired a coach.
Somebody said to me,there's a podcast coach.
I'm like, I have no idea whatthat is, but here, take my money.
It was one of those situations.
And thank God I did because he reallyshowed me the way and the tech.
(05:24):
That was the thing that was themost difficult thing at the time.
And, the podcast launched in Aprilof 2016 and, nearly 2 million
downloads later, here we are.
So it's become a very popular thing.
It's a pretty coolexperience and I love it.
I love sharing thisinformation with women.
So your podcast is called Not YourMother's Menopause, which is a brilliant
(05:45):
title, like, tell us what happens
here.
Yes.
Yes.
first and foremost, there's aneuro chemical change that happens.
It's a renovation of the brain thatstarts for some women around 35 and
for a lot of us more closer to 40.
So basically anywhere from 35 to 60.
(06:08):
We're in that range.
And some, depending on what symptomswe're talking about, it can be
anywhere from 30 to 60, okay?
It's a huge range of a woman's life.
Yeah.
And then once we end, end perimenopauseand intermenopause, now we've got 40
percent of our lives that we're going tolive without the menstrual cycle, with
(06:32):
the, out the information about our bodiesthat comes from the menstrual cycle.
But also we've realized that there'sa massive knowledge gap from our
healthcare providers, certainly onthat 40 years, although now in that
that 40 percent of our lifetime,that's more managed by gerontology,
which I think in itself is a problem.
But then you've 30 yearsold to 60 years old, where,
(06:54):
here's what we think menopause,this is what we think women's
health is during those years.
Bikini medicine,mammograms, and pap smears.
That's it.
That's unacceptable.
And so we've learned recently throughan explosion of research from female
practitioners, most of them in ourage group saying, just a minute
(07:16):
now, this isn't adding up, right?
What's happening?
And so we know there's theseneurology change, massive
change to the brain function.
It's a change in function andstructure and connectivity.
And at the same time, we have thesehormonal changes that make for
some pretty uncomfortable symptoms.
(07:37):
And so we need to beaware that it's starting.
Here's something I hear a lot.
Oh, I'm, I just heard thisyesterday from my pharmacist.
Who's no more than twoyears younger than me.
I'm 51.
And she goes, Oh, I knowwhat's coming for me.
And I'm like, Ooh, girlfriend.
It's
It's so true because when you goto the doctor, like I did many
(07:58):
times with this array of symptomsthat I have, the awareness was
likely connected to perimenopause.
They ask, do you have hot flashes?
No, I have some night sweats, but I'mnot having hot flashes during the day.
do you have regular periods?
I don't know because I had an endometrialablation, so I have no periods.
(08:19):
Well, you're you're young,and here I am 45, right?
With worsening ADHD, worsening mood,increasing anxiety, feeling, socially,
less connecting, feeling like,I'm, like, am I feeling too judgy?
Am I too this?
Am I too that?
my value system's turned upside down.
I don't relate to the samepeople the way I used to anymore.
(08:40):
Like, acne.
And, I could go on and on.
And, um, Well, there's anantidepressant maybe, or, you know,
let's increase your ADHD meds.
But I mean, are you having hot flashes,
Yes.
and what you have just described is allof the common symptoms of perimenopause.
And here's the thing about it.
(09:01):
we have hot flashes, which are thething that medicine uses for the
signal that we're in menopause.
By the way, I've never had a hot flash.
Never 51.
okay I got all the other stuff, right?
But I have a friend that's justdone the research on this and she's
just presented it to the menopausesociety, last weekend in Chicago.
And she looked at the top 10 symptoms,actually looked at more than that.
(09:23):
But if you look at the top 10 symptomsof perimenopause, And hot flash
is number ten that's based on thenumber of women experiencing them.
And the other thing that's fascinatingabout that list is 9 out of 10 of them
are brain based, brain based, okay?
we're just starting tohave this conversation.
(09:46):
We're just starting to understand whatit means when estrogen, progesterone,
testosterone, DHEA, start toretreat from the brain and the body.
We're just starting tounderstand what that means.
I know one of the things that Ihave struggled with, especially in
the last year, is anxiety doing africking tap dance on my brain, which
(10:09):
then throws my confidence all off.
And now all of a sudden I'mnot connecting to the things
that gave me joy for so long.
And it's not even just my relationship.
I mean, thankfully Imarried my best friend.
So he at least is there to say.
'Are you alright?
Do you just need a bath?
Do you need to just swear up a storm?
(10:29):
What do you need?' But I recognizethat not every woman has that, right?
And so there's a lot of, guilt that comeswith those feelings and experiences.
Thankfully, I had a nurse practitionerwho said to me, if it's confidence
and esteem that is bothering you,that's a testosterone problem.
(10:51):
Fascinating, right?
Because now that's a whole other thing.
Testosterone is a man'shormone, is it not?
Right.
Right.
So there's so many frontiers.
There's new frontiers acrossthe board in women's health.
And it's no longer just aboutthat bikini medicine, but you're
describing the most common symptoms.
(11:11):
So the thing I think about, Carlyn,when I hear your story, and when I
think about what I've been throughin the last few years, I think my
mother My grandmother, the women Ihave loved and known in my life that
are senior to me, suffered in silence.
Did.
Yeah.
It's heartbreaking.
(11:32):
It is heartbreaking.
It is so heartbreaking.
I think often about, I come from this lot,very strong matriarchal line, very strong
women who had to deal with big shit inthis time of life too, that I'm in now
and think, Oh my gosh, how did they dothat with less support, less convenience?
(11:53):
Like just the world wasdifferent in so many ways.
Some of them may be helpful.
I don't know, but I think alot about they had no choice.
Right.
They just, they had no choice but to,to find a way to power through and, and
maybe piss a few people off along theway because they had to stand in their
truth and their experience and, andwere under resourced in a lot of ways.
(12:17):
Yeah.
I am aware, uh, same, same with me.
I have strong women in my life,in my family on both sides.
And I think about the things thatthey had to go through in their lives.
As you said, at a time where things wereway less convenient than they are now.
And, I think as a child I was awarethat they were strong women and I
(12:40):
was being raised to be the same.
But I have so much more appreciationfor just how strong they were.
Now that I'm going throughmy own personal journey.
Uh, graduation, let's say.
Just thinking about that.
I wish for future generations of womento not have to be so strong, to not
(13:03):
have to fight, to stand up for havingbasic health care that attends to us as
women, having the rights that we need,having, support that we need, all of us,
not just some of us, all of us.
Yes.
Agreed.
Agreed.
I am very aware that, actuallygirlfriend and I, who's, she's an MD.
(13:26):
She and I were having aconversation about this yesterday.
She does, family and maternal medicine.
And we were complaining about, betweenthe two of us, the lack of information
available and, the lack of knowledgeablepractitioners available to us.
And I said to her, I said, and we mustremember you and I have connections.
(13:49):
And we have the ability to pay for privatehealth care, and that allows us to have
better choices, but there are so many morewomen that do not have that opportunity.
And what can we do to help there?
Yes.
We didn't come up with any answers.
Why do
most of our doctors, when we first go,they'll say, okay, we could test your
(14:11):
hormones, but you're a little youngand you're not having hot flashes
and you're still having your periods.
Why don't they know better?
what are the reasons for that?
And what do they need to know?
Before I was a chiropractor, Iwas, I have an anthropology degree.
And so I always want to knowwhy and how did we get here?
Because I think historical context is soimportant for correcting in the current,
(14:34):
in the contemporary time, but also let'snot forget where we've come from, right?
Let's make sure that we don't repeatthe silly things we've done in the past.
Medicine, med school is, taught insuch a way that it is very, patriarchal
and paternalistic, and women's healthcare has been, essentially left out.
(15:00):
And we're going to talk a little bitmore about that in just a moment,
but first, let's talk a little bitabout the context of the conversation.
Now, my research too, right?
That's a part of it.
I was just about to say, my understandingof that is, goes back to when there was
research on synthetic estrogen called DES.
And it was such a mess that not onlydid it result in women birthing babies
(15:21):
that had significant, abnormalities,but the children that they birth
went on to have children with thesame or similar abnormalities.
So literally, even though the pillswere only taken for a short period of
time, I think used for, if I remembercorrectly, for, prenatal nausea.
Okay.
(15:42):
So like for morning sickness.
And if I remember correctly,please don't quote me on that.
Do your own research.
Thankfully, Google will produceif you ask those questions.
But it was such a messthat a decision was made.
And was this in the 50s or the 60s?
A decision was made to leavewomen out of the research.
First of all, because our bodies wereunpredictable because of the nature.
(16:03):
I mean, We have a 28 to 30 day.
Circadian rhythm where a manhas a 24 hour rhythm, right?
So far more predictable and alsoWhatever goes on in our bodies could
potentially be carried on to thenext generation as it turned out.
Unfortunately the generationafter that as well.
Was that Thalidomide?
(16:24):
Yeah, it was pre thalidomide.
Okay.
Okay.
Yeah.
Wow.
I again do the research everybodyIt's been a while since I looked at
that I don't have that data, but Iwanted to know, so I went and looked.
Why is this happening?
And it wasn't until 1994 that women wereactually put back into the research.
And then, of course, it wasn't longafter that, that we had this Women's
(16:45):
Health Initiative thing that said,women cannot take hormones, period.
And I was like, wait a minute.
Isn't everybody taking birth control?
Isn't that a hormone?
the idea that progesterone or estrogencan give you breast cancer, also weird,
like we've got so much of it, right?
It turns out it's the stuff that,that the manufacturers change
(17:08):
chemically, that increases our chanceof, breast cancer heart disease.
stroke and, heart attacks.
So it was a matter of asking theright question, as it always is
when these research things comes up.
I So when it comes to the, Women's HealthInitiative, which was the study that
came out in 2001 that said that we, thatpulled our mothers and our aunties and
(17:31):
our grandmothers off their Hormones.
Yep.
it's now all been retracted.
They made several mistakes.
It was a poorly done, I don't know,it was a billion dollar study from
the National Institutes of Health.
I have no idea how they made so manymistakes in it, but they're aware of where
the mistakes were and have retracted them.
There's all kinds of informationavailable about that online.
(17:53):
When I look at thatnow, I think two things.
We must have been, here's thewoo, we must have been spellbound.
How did we not see that we were leftout and we were left to fend on our own?
we're 51 percent of a global population.
How did we not see that?
Know that somehow the blinders havebeen pulled off recently, that spell
(18:17):
has been broken, something's gone on.
But the other thing I think that's inthe same lines is this Women's Health
Initiative, we have all of theseexamples historically of how women
have been disempowered, kept small,kept weak, whether it was starving
ourselves during the supermodel era totry to think we could look like these
(18:37):
beautiful women that had body and bonestructures that were not at all like the
average person, okay, so we're starvingourselves to, to be healthy, whatever.
There's all these examples of ways inwhich we are covertly told a thing that
keeps us weak, sick, disempowered, etc.
(19:00):
And I happen to think that theWomen's Health Initiative may be
one of those not so covert things.
when you take a womanaway from her hormones.
When you deny her muscle healthand bone health and heart health
and brain health, guess what?
We're not, we're pretty compliant, right?
(19:21):
We're pretty reliant on thesystem to take care of us.
In Canada, anyways, it's a socializedmedicine, but we're not lippy.
We're not sharing our wisdom.
Ugh.
Ha!
I have tingles and tears andlike this this giant thing in
my chest, expanding right now.
And I feel this thing that in this time ofour lives, we are stepping into our power
(19:49):
as we start to be more values orientedand less caregiving oriented, right?
We come into this place wherewe're like, okay, I've done
a lot of caring for others.
And now what do I want to stand for?
What message do I wantto share with the world?
Like we stand into this power andthen we're freaking tired and anxious
(20:12):
and disempowered and then the othersmust think that we've lost it.
Like we've become a wild woman.
Like you can see why these womenwere burned at the stake because
when they stepped into theirpower and, shared their voice.
and so there's this thingwhere they were extinguished.
Yes, Yes, exactly.
(20:32):
and so as we come into this perimenopause,I felt this shift where I feel this
calling, to speak a stronger message.
And at the same time, I'm so damn tired.
And at the same time, I'm, I can't focus.
And at the same time, you know, it's justthere's, there can be that little bit
of, um, you know, like you talked aboutwhere if you feel a little bit tired.
(20:52):
Yeah, shy or are they judging meor, have I just said too much or
somebody says, how are you doing?
You're like, oh my God,like it's been terrible.
that's a little awkward.
It's an awkward socialengagement on the playground.
Yes.
But it's that push and pull atthe same time that, is so hard.
A few things come to mind.
(21:13):
First of all, I feel all of that.
As you're saying that, itgives me goose pimples, too.
Makes me want to cry too, because,keeping women tired is how
we get kept in the box right?
and I, I struggle with this, too.
Now, it's always a crapshootwhen I do these interviews.
Whether or not I'm going tohave a great night's sleep.
I had a great night's sleep last night.
(21:35):
Thank God.
But there was one I did recentlywhere the gal who interviewed
me is still emailing me.
She's like, did you getsome sleep last night?
Like I must have worried her awful.
get it.
I get it.
I get it.
Again, when we are without our strength,we cannot stand against a system that
has repressed us for a very long time.
(21:56):
So I think, personally, thatself care thing becomes, it's
not just, it used to be cute.
We used to talk about self care,take an extra bath or close the
door on your bedroom and read abook so your kids leave you alone.
that's great.
Go to, yeah, good.
Take a little girls night out.
Yep.
(22:17):
Go for a walk, have a coffee,
Right?
Yeah.
Cute.
All of those things are excellent, but thedeeper I get into my own perimenopause,
the more I recognize that my presentstate and frequency is not only the
(22:38):
thermostat for my relationship withmy husband, But it's the thermostat
for my interaction, interactions withmy patients, and that I have a social
obligation to make sure I am taking careof myself to the best of my ability.
And, as you said, we move fromcaregiver mode to values mode.
(23:02):
I would say most women haveno idea what their values are.
Absolutely.
They would guess.
They would guess, right?
So when it comes to the fatigue,this is one of those things where
I start to look at the evidence.
Maybe you saw I posted this on Instagram.
I think it was over the weekend inCanada, here in Ontario in particular.
(23:24):
They're looking at changing theiron marker as what is abnormal.
And this is one of the most common thingsI see with women in my practice for
fatigue is they have untreated anemia.
Interesting.
And what happens is women go, mydoctor said it was no big deal.
Are you kidding me?
(23:46):
Of course somebody would say that to you.
That's BS.
Let me explain to you what that means.
You don't have enough iron.
You cannot carry the oxygen to theparts of your brain, especially
the frontal lobe, which is thepart that makes you brilliant.
Of course, that's, theysay, oh, it's no big deal.
(24:08):
Of course.
Remember, the doctorsare not the problem here.
The doctors were taughtin a shitty system.
They were.
The doctors are awarethat this is a problem.
The wise ones are.
And they're like, how do we fix this?
But it's such a, it's the Titanic.
It's the Titanic headingfor the iceberg, right?
So how do you turn around something thatis so enormous and funded by big pharma?
(24:30):
And so this is a problem.
we've got the problem.
So it's left up to women like youand me and the listeners of your show
to fill in the gaps, which is whyI do not stand for one second for
somebody who has a traditional medicaleducation bashing me or my colleagues or
anybody that is outside of traditionalmedicine for talking about menopause.
(24:53):
You guys didn't answer the call.
we stepped up and tried to help asbest we could in a job that you should
have been doing all the way along.
Sorry, I got a little bit right there.
This is
Good.
This is really good.
And I have a couple questionsabout, then what do we do?
So I'm thinking most of my listenersare occupational therapists.
Yeah.
And so I'm going to ask you in a moment,how can we, when we're seeing our clients
(25:16):
struggling or ourselves, what, how canwe help them get the information and care
that they need, but I'm going to firsttell you my, how I tried to go about this.
So I switched doctors.
my doctor retired.
She was great.
And so I spoke to a colleague who I askedsomebody who's mental health oriented,
mental health aware, that sort of thing.
(25:37):
And, and so got this other doctor and shewas young and awesome, but I was talking
on and on about the symptoms I've shared.
and I kept saying, Ithink it's perimenopause.
no, your hormones look good.
And I know that the blood work thatwe do is showing if I'm within a
range in a moment in time, whichcould be any point in my cycle.
And that, blood test that they're doingisn't likely going to tell the story.
(25:59):
And after years I finally took, and I hadgone to a naturopath and I had gone to you
and I done a whole bunch of things too.
And I knew I needed some hormones.
I knew it, so I took in my bag ofsupplements, everything I've bought and
I've been trying and my magnesium andmy vitamin Bs and my vitamin D and all
the things I was trying and L theanineand L tyrosine and lots of things.
(26:23):
I took in, there's an Australianassessment I think it's actually
designed to track which menopausesymptoms are changing as a person
goes on hormone replacement therapy.
I think I found it because of,Mary Claire Haver on TikTok.
And so I took that in as my kind ofbaseline and said, here's all my menopause
symptoms, because it's not just menopause.
(26:45):
Hot flashes and, and so ticked themall off and said, if you can't help
me, can you please refer me to, andI brought in a referral form for a
local clinic that deals with menopause.
And she said, Oh, sure.
You know, actually we have somebodyin house who can help you with this.
There's a gynecologist here.
Why don't I book you in with her?
Are you serious?
Like we've been years, years goingaround this and I had to bring in my
(27:08):
bag of tricks and a referral form andan assessment form that I sourced from
TikTok and then was given the referral.
And, it was really frustrating.
It was really, I really like my doctor.
Like I, she really has great intentionsand does a lot of great things, but
so I'm curious, what, how can weget the best out of our doctors?
How can we advise our clients toget the best out of their doctors?
(27:30):
I'm going to put this backto you for a second, okay.
Did you get what you neededfrom the gynecologist?
Yes.
Eight months later.
Exactly.
Now, here's the statistics on gynecologyand gynecology's training on menopause.
One in five feels like they have adequatetraining, which means four out of five
(27:54):
gynecologists have inadequate training inmenopause and that is their own survey.
So gynecology is notnecessarily a solution, right?
I know when I first went to my ownGP, And said, I'm not sleeping, I'd
like to try bioidentical progesterone.
Of course, you say the words bioidenticalto somebody in traditional medicine, and
(28:15):
they're just like, that's not my thing.
Yeah, listen, you give it to a womanwho was, at risk of miscarrying.
It's the same thing, but you didn't knowit was bioidentical until I said, Yeah.
So she gave it to me, but she said, I'mgoing to have to refer you to gynecology.
Which never actually manifested,I don't know why, but probably
it was pre pandemic, so itwas, who knows what happened.
(28:36):
The gynecology triage probably lookedat this and went, this is not for us.
Right?
So I was left on my own to do that.
Now, I have the informationso I could do it.
Now I have a nurse practitioner, andit seems to me, where we live, nurse
practitioners have the ability topivot around these things much easier.
Again, we have the ability to pay forprivate healthcare here in Alberta.
(29:00):
And so this is what I'm talking about.
I pay out of pocket for that, but she'sdone a better job of taking care of my
comprehensive health including brain andheart because those are the two things
I'm most concerned about as I age.
I want to know those two things.
I want the preventative stuff there.
I don't just want the, oh,oops, you've got heart disease.
Here's here's the list of medicationsthat I saw people in my family have.
(29:26):
A gynecologist isn't always the greatgreatest option and quite often what
happens is women in our age group thatare sent to gynecology either leave with
the birth control pill, because at leastthat's hormones that the gynecologist
is familiar with, which by the way,are way higher amounts of hormones than
we actually need, than HRT would be.
(29:48):
Okay.
Or we're sent home with syntheticprogesterone, which is the problematic
substance from the Women's HealthInitiative that said, that synthetic
progesterone increased, breast cancer.
Breast cancer was the thing there.
That's not the answer.
There's all kinds of research thatsays the safe way to do HRT now is
(30:08):
a topical estrogen, a potentiallya topical testosterone if you
need it, and that's why we test,and a bioidentical progesterone.
There are no increased risks.
In fact, quite the opposite.
Women that are taking this sort of regimehave a much better, if they do end up with
breast cancer, have a much better outcome.
(30:29):
We live longer, we're healthier,and when I heard that first, I
thought, that's really such a pivot.
And then I started to think aboutthe older women that are in my
practice, the women who are in theirseventies and eighties, the ones
that come running in from the parkinglot, like no frailty whatsoever.
They're sharp as attack, sharperthan me in my own perimenopause.
(30:49):
And guess what?
They never stopped taking thehormones that their doctors gave
them pre Women's Health Initiativestudy or retraction, I should say.
So it's an interestingthing to ask that question.
I think ultimately you have to go in as aninformed consumer to your medical doctor.
(31:11):
I mean, look at whathappened when you did that.
By the way, doctors get, if they'relucky, they get 1 to 3 hours of nutrition.
So they don't know anythingabout your supplements, right?
They have no clue.
None, like zero.
and you walked in and said, here'show I'm tracking things, right?
This is what it's looking canwe post the link to that, I'm
(31:33):
familiar with the Australianstudy, Australian questionnaire.
Let's post it with the show notesso that women have something that
they can take to their doctors.
Here's how I handle this as a chiropractorfor my patients because I can't prescribe.
I literally have a form letter.
That I sent to their GP.
I sent it with the patient.
I call it, well woman care.
(31:56):
Obviously they're going to understandthat this woman is between the ages
of 30 and hopefully that's enoughof an indicator to say, hey, by the
way, we should probably be lookingat some things and I can address
the labs situation here in a minute.
Remind me, because I'll go on,continue to go off on a tangent.
Unmedicated, undiagnosed ADHD over here.
You're like, oh my god,explains everything.
(32:18):
That's why I like you.
the people that I actually gel the mostwith, it's because we share that ADHD ish
ness, I wear it and enjoy it in others.
Which is good.
I know.
I just call it out now.
I'm like, sorry, there'sa magpie in the room.
Like I have to acknowledge the magpie.
Okay.
Now we can get back to the conversation.
Anyways, so I send a form letterwhere I literally check off.
(32:38):
These are the bloodtests I want to see done.
And always ask a question.
Don't make it seem, give thedoctor the opportunity to be
the last one speaking, right?
It kind of helps with the egothing that can go along with
that paternalistic system.
And, this is even thewomen in the system, right?
We were all just taught it.
(32:59):
I was taught it too, right?
I had to unlearn it.
I always say something like, would Carlynbe a good candidate for topical estradiol
and bioidentical progesterone, questionmark, and then send it off to the patient.
And I would say most of the feedbackI get from those letters, which comes
(33:19):
back to me from the patient, is thatthe doctor was so grateful that there
was another person watching, right?
And what, fine, here's the requisition.
And if that doesn't work, then for me, Ican order private testing for patients.
But again, that's anout of pocket expense.
And I can always refer to my own nursepractitioner or some others that I know.
(33:40):
Now in the States, if there are,OTs listening that are in the
States, there are great telemedicineclinics that are specifically to.
Women's Care at Midlifethat do a great job.
And I've had a couple ofthem on the show, CEOs.
I think there's another onecoming in January on the show.
But they seem to have a lockdownon the protocols and, they take
(34:03):
insurance and they can speak toyou basically whenever, wherever.
So we want to find somebodywho's done some extra training.
Ideally if we're choosing ourown practitioner, we're wanting
to have somebody who has someextra expertise in menopause.
But I'm hearing that thereare ways to request them, the
(34:23):
medical team to look at this.
And I like that way of justsaying, would they be, and it poses
that question where they have tothink, what would make them not?
Yeah.
Okay.
Like they have to actuallyjustify it as in their mind as
they're answering that question.
Yeah, it's the open ended question, right?
Yeah, it helps.
And this is good for patients, forwomen that want the care, it doesn't
(34:44):
necessarily have to go through acommunity healthcare practitioner
like the OT or the chiropractor.
It can literally just be the same query.
Am I a candidate for these things?
And I recorded an entire episodeon this because I wanted to give
women the language To use withtheir own doctors because I think
that language is really important.
(35:06):
Not Your Mother's MenopauseEpisode 102, How to Talk to Your
Doctor About HRT, I think will bereally helpful for a lot of women.
And that's the feedback I'vehad in the office as well.
Wonderful.
I will link it.
That's really helpful.
Can you tell us a little bit aboutcognitive function more specifically?
We've talked about someof those emotional things.
We've talked about a little bit,but women often report brain fog.
(35:27):
I noticed women who being diagnosed withADHD in this time, but those who already
have it to notice it worsening a ton.
Tell us a bit more about whatthe science says about it.
Yeah, so we're not 100 percent sure.
What we do know is that there'squite a few factors and for, I think
this is part of why women's healthcare at menopause can be, quite
(35:50):
difficult to practice because, everysingle woman is different, right?
So here's what we know.
We know that the fuel system changes.
We move from glucoseto another fuel system.
And with that, things slow down.
We know that most women have somesleep depravity or sleep issues
(36:12):
that happen at perimenopause.
That makes us brain foggy.
We know that there's aloss of gray matter volume.
We know that there's aloss of blood supply.
We know that the neuralconnections pare themselves down.
Again, it's that renovation.
Those are words used by Dr.
Lisa Musconi, whose research isthe best contemporary research on a
(36:36):
woman's brain at perimenopause pleaseread her books, they're excellent.
I reference her research all the time.
By the way, just as an aside here, justthis morning, I read that for the very
first time they've done MRI scans on apregnant woman's brain because we know
that the brain changes at pregnancy.
(36:57):
This is how behind we are.
And it turns out that a lot of thethings that change in pregnancy are
also the same things that happen inperimenopause with this fuel system
change in the connectivity, we've gotshrinkage of certain areas of the brain.
What's interesting about that is thatit's the same areas of the brain that
(37:17):
are involved in Alzheimer's disease.
Okay, 80 percent ofAlzheimer's cases are women.
Okay.
So it's interesting to look at thatand go, and this is Moscone's research.
She's the one who said, okay, whyall these women in my family have
Alzheimer's what's happening.
So she was the one to say, we betterstart imaging women's sprites.
(37:37):
And for some women based on genetics,there is a switch at menopause with
the decline of estrogen that starts toturn on the processes of Alzheimer's.
That's ultimately what we understand ishappening in a woman's brain at midlife.
Yeah, so yeah, it's quite something it'squite something to think about Here's
(37:58):
the thing I want to leave the listenerwith This has been critical for me for
my own thinking because as I'm goingthrough this I can feel all these things
come up You know and not all of them,but a lot of them are like, okay Fiona.
Don't be confused.
That is not a weakness is not aproblem with your personality.
(38:20):
You are not crazy.
You're not suffering from mental illness.
You're not, all of these thingsare really important for me
to go, this is perimenopause.
The solution is not anantidepressant medication for me.
It is true for, this isnot a serotonin deficiency.
Okay.
That's what I'm saying.
It's an estrogen change.
(38:43):
it's been really important for meto look at all of that and say, all
right, we need to make sure that I'msupporting all the systems that are
supporting my brain health for sure.
So once you have that lens with whichyou can see the way the brain is
changing, it's really important thatYou know, for years, I just heard women
(39:03):
say, at this age, I'm losing my mind.
My mother was dementia, my grandmotherhad Alzheimer's, like, is this
what, is this how it's happening?
So, Here's the importantthing to take away.
Within four years of the last menstrualperiod, and quite often much sooner
than that, our brain function returns towhere it was pre perimenopausal changes.
(39:28):
So this is not forever.
Exactly.
Isn't that so much?
It's so relieving, right?
and you know, there's, there'simportant elements to that to remember.
testing on women in our age group.
Okay.
You and I probably don't, I knowthis is true for me, so I won't
speak for you, but you can tellme what you think for yourself.
For me, I'm not nearly assharp as I was 10 years ago.
(39:50):
And I miss that brain.
You know, I didn't appreciate it.
Now it's Oh my God, howdo I get back to her?
I would take the brain over thebody and the lack of wrinkles.
Just bring my brain back.
Yes, exactly.
So here's the interesting part.
Cognitive testing done on womenpre, Perimenopause and Postmenopause
(40:18):
show that even though we reportfeeling like our brain is taking a
dip, function didn't change at all.
We had the same executive processing,the same cognitive function.
It just didn't feel as,maybe as quick on the inside.
Sure.
Isn't that so relieving?
That is relieving, yes.
(40:38):
Is there an objective dip in themiddle, and then it's back after, like
we get back to baseline, but we don'tfeel like we're back to baseline?
Is that what I'm hearing?
Another way to say it would be, weperceive that we're not as sharp as
we were 10 years ago, but the testingshows that there is no dip in function.
Okay.
Fascinating, right?
Even in the perimenopause.
(40:59):
Even in perimenopause.
Yep, and I'm trying to remember which ofthe books Musconi references this, and it
may actually be in her, research paper,because she went about saying, okay, so
now we can see what the changes are, butanybody that wants to know more about
this, please go read her research papers.
And it's the one in particularwhere she talks about how
(41:21):
the menopause brain changes.
She has a whole book on it that'sjust come out in February this year
called The Menopause Brain, and inthere she talks about this very thing.
We never lose that function.
We think we do.
It's a perception, but that ontesting, we don't lose functionality.
Now, that said, the brain is stillundergoing, this is how amazing women
(41:42):
are, the brain is still undergoingthe renovation of perimenopause that
signaled by the egress of hormones.
Estrogen is the big one here, butcertainly progesterone, testosterone,
DHE, cortisol are part of that.
, We have that perception, but we neveractually have that dip in function.
And you know what, the day that Ididn't have the great sleep and I
had the beautiful interview Yeah.
(42:05):
I was just praying likehell that was true.
Otherwise people are going to think I'm adip and that's the end of this discussion.
Next episode.
That's funny.
I feel like I've gotten good atwinging it based on experience, right?
That's on those tired days, I cango, okay, this might not be quite
as organized or well planned, butit's still going to be really good.
(42:25):
Whatever me and that client do, orwhatever presentation I need to do,
or something like that, that's whenit comes down to it and I'm in my
zone, it will come together, evenif I didn't have the energy to work
out all the details ahead of time.
Yes, absolutely.
And as I think I said to you at thestart of this conversation, I can't
remember if it was before you pressrecord, but as clinicians that work
(42:48):
with clientele, we are good on our feet.
Yeah, Neither of us is new at this job.
So at some point, musclememory is going to kick in.
Yeah, but here's something interesting.
I had, over the weekend, I had a patientcome in, guy I've seen for years and
years with a new shoulder injury.
And I did all the testing without writinganything down because I can remember this.
(43:11):
But then at the end of my day, whenI was tired, and I was hungry, and
I sat down to do his soap note.
Do you think I could puzzle my waythrough the shoulder exam flow?
No way.
I literally had to pull out thetextbook and remind myself of the
names of the tests because I knewhe was going on to physio and the
physio would want to know that, right?
(43:32):
So that's a pretty good example,but I just needed the clues.
The information was there,but I just needed the clues,
Can I share a tip thatsomething I've been using?
God, yes!
So I've been using, AI for documentation.
So there are a lot of them out there.
The one that I've been using isthe free version of Heidi Health.
(43:54):
I know, so Jane is a sponsor of theEMR, they're a sponsor of the podcast,
and I know they're also workingon one, that will be integrated.
But at this point, I open up my twoassistants, Jane and Heidi on my computer.
And, so Heidi it will listen and thenyou press transcribe at the end of
the session and you can request whattype of note you want it to create
(44:15):
from what's been verbalized in thesession and it will create a note.
So there are some basicSOAP notes in there.
And it's done a really good job.
I've also adjusted the template.
So it's a little bit more oriented tothe format that I like to chart in.
And, it does a really good job frommental health to phys med, I have a
client who he takes it out on homevisits and uses his phone for it.
(44:37):
And the notes are not 100%.
They still require you to give ita human touch, which is important.
Yes.
Fascinating.
Fascinating.
I will be looking into that.
Did you say it was HeidiHealth or Heidi Help?
Heidi Health.
There are a bunch of other ones so thatall meet the requirements of our privacy
(44:57):
regulations and that sort of thing.
This is not ChatGPT that's taking ourinformation and putting it into a pool.
It's you just delete it after.
You're not even keeping the recording.
It's just transactional,for creating that note.
Wow.
Okay.
Yeah.
We don't use Jane in the office yet,but God knows it's a conversation that
keeps coming up because we've got twoclinics, there's 30 practitioners.
(45:20):
It is, talk about a Titanicthat needs to be turned around
when you're switching EHR.
But it's definitely, I don't know,that's something I could do on my own
and, have my own notes, as part of that.
And Heidi health is a standalone app.
You can use it.
I just copy and paste it overinto my Jane but I know Jane is
working on an integrated one.
And I know a lot of the EMRs, that'sobviously it's the cutting edge, right?
(45:41):
They're all working on it.
They just have to make sure they'remeeting all of those, that functionality
and that, privacy and those typesof things before fully releasing it.
Jane's the bomb.
Jane's got it in beta right now.
Yeah.
Nice.
Jane's the bomb.
Talk about a good Canadian company.
I'm such a fan.
Thanks.
Yes.
I have, I've been enjoyingworking with them.
Very human, but I have, amenjoying this conversation.
(46:02):
So what is on deck for you?
What are you leaning into right now?
A couple of things.
I am writing a book on thecognitive impacts of menopause.
And, this is a book that'sbeen a long time coming.
And I think when I started writing it,it was a generalist book about menopause
and we are past thanks to TikTokand Instagram, et cetera, women are
(46:23):
getting that information much quicker.
So that's a heart contract for me, HE A R T, because it just feels like a
full circle thing that is to be done.
I have so many women that I'm so blessedto be in community with that have
listened to my show for so many years.
That feels like a gift to them.
(46:43):
So I'm working on that.
For quite a few years now, I'vetaught a menopause doula certification
and I'm taking that trainingto the next level if you will.
Which is going to be availableas a group offering Hopefully
in early 2025 is the plan.
Yes.
(47:03):
Thank you.
I'm on your wait list
Oh, good.
Well, and anybody who wants to be onthe waitlist for the launch can go to
menopausedoulasociety.
com and you can sign upfor the waitlist there.
And then as soon as, we, me and my teamhave more information about when that's
launching, you'll be informed of that.
(47:23):
so I'm excited about that because thereare many women, that do not have the
professional designation like we do.
And there are many women that do havethe professional designation that
need that basic sort of training.
How do you help a woman who is in her,what I like to call hot girl phase?
there's lots of women like us that wanta deeper understanding, maybe not to
(47:48):
go right back to professional school.
Cause here's the problem, who's eventeaching menopause medicine, right?
Yeah, still figuring it out.
They're still figuring out who'sgoing to be the one to manage this.
I'm excited about that.
And those are two of the big projects.
I have such awesome experts Iget to interview on my show.
That's something else I'm just loving atthis phase in my life is just, inviting
(48:09):
other women into my community and sharingthe wisdom that they have gleaned from
their own experience and training and etc.
And that's a really fun thing.
I'm sure you know what I'm talking about.
I do.
Yes, I definitely do.
When I was also contemplating startinga podcast, I've always described it as,
(48:29):
with, if I were to go to a party, I don'tlike to be in the big room trying to get a
word in edgewise in the big conversation.
Like you're going to find mein the kitchen having a really
deep conversation with someone.
And so I kind of thought, ah, socialmedia marketing, like all the Facebooking
and stuff is quite exhausting for me.
And it feels like trying to connect withmany, and I have made some beautiful
(48:51):
connections from that, but wherebeautiful connections come are where we
go deeper, not, putting out another reelor something, though I do that for sure,
but I also have hired help for that.
I like this.
I like having a good deep conversationand that feels, almost effortless and
it feels like I'm serving at my highestwhen I can share in this intimate way
(49:11):
with people where you and I are havingan intimate conversation that's deeply
authentic and we're in some It's earin their kitchen, in their car, on
their walk as they're folding laundry.
And that is, that feels so connectingfor me, even though that person's
not right here, you and I areconnecting in the conversation.
and then I hear from the people wherethey say, Oh my gosh, I had to pull over
(49:32):
when you said that, or, I just love that,that we get to be in people's ears in
their homes and, and in their personallives as we share what is true for us.
It's so special andyou're absolutely right.
Absolutely right.
I love that too.
It feels, um, because I know howI consume that content myself.
Yeah.
Like this morning when I was driving inhere, I was, listening to a thought leader
(49:54):
that I follow, in a class that she did.
And I could have just been in the classwith her and that's the beauty of it.
Right.
I mean, She lives in California.
I'm not, I'm in Alberta.
I can't be there withher, but I can be there.
She can be with me.
It's a beautiful thing.
It is.
It is really beautiful.
I listen to podcasts inthe bathtub a lot too.
(50:16):
I don't know if the people I listen to,I don't know if you know that you've been
in the bathtub with me, but here we are.
I had a feeling.
I read in the bathtub.
I've got one of those seal pouches andI put my tablet inside it and yeah,
my husband made me a shelf for it.
So it's like my water and there's myglasses and sometimes a bit of chocolate.
It just depends on what I need.
(50:37):
A girlfriend of mine told me thata chip bowl floats in the tub.
I was like, I've never thoughtto take popcorn to the tub.
How did I not know this?
I'm glad I could teachyou something today.
Oh, this has been a wonderfulconversation and I knew it would be.
And anytime I get to talk toyou, it is a good conversation.
So thank you so much for being here.
(50:59):
Thank you for having me.
I so enjoy the time we get to visit.
we've done it twice now this year.
This is fun.
What's next?
What's next?
I don't know.
I think you need an OTon your podcast, maybe.
Oh, yeah, I agree.
I agree.
Yeah, let's figure that out.
Yes.
I have a couple questionsI ask everybody at the end.
Are you ready?
I am so ready.
What does being brave mean to you?
(51:21):
Stepping out of my comfort zone.
yeah, stepping out of my comfort zone.
It would have been really easy for meto just stay a chiropractor and focus
on nothing but spinal health for people.
But, there's some part of my programmingthat just says if there's a need
for social justice in some way, I'mstepping up even if I'm scared as hell.
(51:47):
And in a strange way, menopause,talking about menopause the way
I have, is the, is that thing.
That feels brave.
Yeah, I'm so grateful you have.
Thank you.
What is something braveyou've done recently?
I recently started working with a newtherapist specifically for grief because
(52:09):
I could feel the weight of the passingof my parents in the last few years, as
well as some beloved for family membersand the grief that we all experienced.
I think most people, I shouldn'tsay all, but most people experienced
some form of it during the pandemic.
(52:31):
And, I had a business and that literallygot put to the side and, patient
care people I couldn't check in with.
That was very difficult for me.
And so there was a lot of grief that, andI just realized one day earlier this year
that it was still all hanging in there.
And I'm like, You know what?
I know that's the stuff that makesfor disease, and I don't want it in
(52:54):
me, and I have no idea how to evenscratch the surface on bringing it out.
So, I did my research, and I founda great therapist, and I've been
working with her now for a couple ofmonths, and I feel, a lot lighter.
And that feels brave to me, because Iknow that, first of all, it's so cliche,
I show up at our visits, with a box ofKleenex under my arm, like seriously.
(53:15):
Surely she has some, butyou've brought your own.
But our meetings are virtualbecause she practices in Marda Loop.
I don't know if you'vebeen over there recently.
It's a mess.
There's so much constructionanyway, so whatever.
That's so regional to Calgary,but, that feels brave to me
because it's so easy to just go.
No, just don't look, you'll be fine.
Just don't look.
But that is not, that's not health,
(53:39):
No and if that stuff is really, itjust gets louder in other ways, right?
Like you talked about, it's your health.
The body keeps the score, right?
If that stuff is being held underthe surface, it is hard to deal with.
And so it is brave to bringit out to, to face all.
Yeah.
And this makes me think of somethingelse, just as you said, I referenced Dr.
(53:59):
Vander Kolk's book, Lots of WomenExperience Grief and Perimenopause.
there is a grieving process,especially if we're identified
strongly with the mother archetype.
And so I think starting to talkabout grief and the, that we can
feel is a really important thing.
Yeah.
Thank you.
(54:19):
How would you like to see healthcareproviders be a little bit more brave?
Yeah, it's a great question.
I think the fee for service andvolume based system that we practice
in is problematic in a few ways.
And one of those ways that Iwish to bring up here is that
(54:43):
we have time pressures aroundinteractions with other human beings.
And what I'm aware of is that there aremany people, men and women, suffering
right now with mental health especially.
And it's not easy to bring up, It's noteasy to slip into conversation, especially
(55:03):
for those of us that are Gen Xers.
We were raised by the stoic generationof you, you don't pop your head up.
Tall poppy gets chopped.
what's the term?
Tall poppy gets cut.
Something like that.
You know what I mean?
Blend in, right?
don't show your weakness.
Don't do all those things.
And, I think a brave healthcareprovider sees the humanity.
(55:25):
In the person in front of them,not just what's the diagnosis,
what's the code, what's themedication, what's the treatment.
And I think that can be really hard todo when you're pressured in a system
that pays you for your time, butnot always as well as it should be.
(55:47):
And that we have the pressure of aschedule, meaning there's probably other
people waiting in the waiting room, etc.
Yeah, so that if we're going overtime, yeah, somebody's waiting
and if we block in double thetime, we're also not getting paid.
And I don't know whatthe answer to that is.
I don't.
I've always just let my instinct tellme, my gut tell me what feels like
(56:12):
the right, compensation for my time.
And I recognize that I get massivelyunderpaid for my functional medicine
work, but I also feel strongly that itshould be affordable to most people.
Yeah.
And listeners.
You might be surprisedto hear this, right?
We're here in Canada and, thinkingabout our Canadian healthcare system in,
(56:34):
in many ways does take care of peopleand in many ways it's falling short.
So you and I both have privatepractices, where we're not being
paid by our public health system.
Some people have a little bit ofhealth care benefits, extended health
benefits that might cover some ofour services, but not all of them.
I know a lot of fundsdon't even cover OT at all.
(56:54):
And we're working on that.
And, and so there are a lot ofsimilarities to the American system, where
we are charging the individual, and then abit different too, where if an individual
is paying out of pocket, to get goodservice, some people are willing to pay.
For that extra time, right?
And, I know a lot of Canadian healthcare providers hesitate to, charge for
(57:16):
the extra, but if the extra is what thatperson needs, and you're negotiating
that, hey, this is what I think youneed, maybe we need to be, we need to
be Booking hour and a half sessions.
Maybe we need to be booking sessionswhere we're out in nature walking.
I do need to charge for my time to travelthere, or if I need to be communicating
with other people and being able topresent that as an option to people.
Some people can pay for it, not everybody.
(57:39):
and I get that.
And if I wanted to help everybody,I would probably be working more in
the public health system as well.
And so I feel, we still have some room.
We still have some wiggle room to workwith that, but there are no clear and easy
answers because we're running into valuesconflicts on at every turn as well and
figuring out how to do things ethicallyand equitably and in ways that aren't,
(58:01):
sacrificing our own integrity and healthand well being and, compensation as well.
It's a big conversation andit's a brave conversation.
How would you like peopleto reach out to you?
Yes, good question.
all roads lead to and from my podcast.
I suppose my website as well is drlovely.
com.
(58:22):
That's d r l o v e l y dot com.
the podcast is available on all of themajor networks, streaming networks.
The, the podcast is called NotYour Mother's Menopause with Dr.
Fiona Lovely.
it was named that after a lecturethat I did for many years.
I traveled around the cityhere and did those, lectures.
And so people knew me from that nameand, here we are all those years later.
(58:44):
so you can reach out through the website.
you can also send me a messageon Instagram, both Instagram
and TikTok are @drfionalovely.
And, I do have a team that helps methere, so it may not be me that gets back,
but, they send those inquiries on to me.
And the, doula training that's coming upin the in next year or sometime, people
(59:06):
want to get on that list to be notified.
It's menopausedoulasociety.
com.
Dot com.
That's right.
So yes, the menopause doula society isalso in the process of being developed
as well as the certification training.
So that will be the website.
We might as well just start sharing it.
Do you think it's kind of likegetting training to be the big
sister that we all needed in.
(59:27):
You
know,
I think ultimately that questionis going to change the framework
with which I build this program.
Thank you for asking that.
That's a great question.
I'm aware that, women that have steppedup and asked for this training sort of
one on one at this point are women likeyou and I that just want to be able to
(59:52):
essentially hold a woman's hand and sitwith her and say, you are not crazy.
You're not the only one andyou don't have to suffer.
So I think the answerto the question is yes.
I
love that.
Thanks for asking that.
You're very welcome.
I just feel it.
That's just exactly what I feel.
(01:00:12):
I think about how I talkedto my little sister.
She's 11 years younger than me.
And, about the journey ahead.
And.
That I'm grateful that I can sharewhat I've learned and I'm learning.
There's so much more to learn, butthat, yeah, our moms didn't get this
opportunity, so we didn't get it there.
No, moms were still spellbound.
So were our grandmothers.
(01:00:33):
And, ultimately we learn fromthe person in front of us.
We don't learn from school,you know, we learn from the
interaction, the conversation.
I mean, we as women healeach other in community.
What we're doing now is just returningto the way things were before the system
(01:00:55):
got in and started messing with us.
We do heal in community.
We do.
so my main sort of signature programthat I offer is called ACTivate Vitality
and so It's an interesting thingbecause when I set out to create this
online program, I was thinking aboutthe course and that had a community
(01:01:16):
with it, but I couldn't envision thecommunity without the members, right?
Until people started coming together.
And years later, I think I startedbuilding this thing in 2019.
And here we are in 2024.
And it's like, Oh mygosh, it's the community.
It's the circle of women that aretogether and spill it all and share.
We share about life.
We share about business.
(01:01:37):
We share about.
what's not working and grief andrelationships and efficiencies and how to
work maybe a little bit less and how toset boundaries and all of those things.
And it is that it's social learning.
It's that we've got these mirror neuronswhere we are influenced, so much more
easily by others who have shared asimilar mission and a similar language
(01:02:00):
and a similar understanding and comingtogether in community, We all rise.
Isn't there a, there's a cheesyquote that we could put there, right?
and true.
Cheesy and true.
And it's when, how's it go?
When the water rises in the harbor, allboats rise, something like that, right?
I'll find it.
(01:02:22):
The water rises, all boats in theharbor or something, but it's okay.
You and I know exactlywhat we're talking about.
That's.
So powerful for you to remind me of thatand our listeners as well, and that is
the shift I have seen to in the yearsthat I've been doing online offerings.
When I created the Brain HealthMaster Course, which I haven't talked
(01:02:43):
about here, but it's one of theofferings I do, usually once a year,
it's kind of getting overshadowedat the moment by the certification,
the doula certification, but I puttogether this beautiful structure.
I spent so much time on the videos,the content, and the infographics,
and the best part is always.
(01:03:03):
The Q& A sessions I hold at the end whereI think it's going to be 60 minutes.
I don't dare open it for longer than thatbecause I think people are going to be
bored and it ends up being two and a halfhours and we're still talking and we're
still inter and it's not about me at all.
It's about the interaction.
It's a beautiful thing.
It's a beautiful thing.
People need to be seen and heard,and then we co regulate, and then
(01:03:26):
we give it all the Cs, right?
Community co regulation,compassion, and caring, and we
become so much more creative.
It's this kind of buzzing hive mind.
I found the quote, by the way,a rising tide lifts all boats.
That's so much moreeloquently than I said.
Much what we said, it's evenabout the harbour and the storm.
(01:03:46):
Boats and stuff, things, tide, whatever.
I am grateful to sail with you and, andhave you in, to be in community with you
here locally and that we get to do this.
Thank you.
Thank you.
Take care of yourself, everyone.
Thank you for the time.
I really hope that something in thispodcast touched you as a listener.
(01:04:09):
There's a quote by Sark that says, Thecircles of women around us weave invisible
nets of love that carry us when we'reweak and sing with us when we are strong.
I'm very grateful to Fiona for beinga part of the circle of women I see
around me, and for being able toshare this conversation with you,
(01:04:29):
the listener of The BRAVE OT Podcast.
If you're looking for more from Fiona,you can visit her website, drlovely.
com.
And if you're interested in hermenopause doula certification, that
website is themenopausedoulasociety.
com.
Her podcast is Not YourMother's Menopause.
(01:04:50):
I love that name.
And you can find her on TikTokand Instagram @drfionalovely.
I'll put all theselinks in the show notes.
Now if you're a therapy business ownerwho is really craving that sense of
community, collaboration, co regulation,a group of co conspirators to support
your creative endeavor as a businessowner, and as a whole human, We will
(01:05:12):
be reopening the doors to the ACTivateVitality program, at the end of January.
There will, of course, be a linkto that page in the show notes, and
I would love to talk to you to seeif that is the sort of thing you
need to thrive in this coming year.
Thanks for tuning in, andas always, be brave, OTs.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
The Breakfast Club
The World's Most Dangerous Morning Show, The Breakfast Club, With DJ Envy, Jess Hilarious, And Charlamagne Tha God!