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Welcome to the Fire Inside Her. A brave space to share stories of navigating life transitions with authenticity. Using our inner fire to light the way and self care as our loyal travel companion. I'm your host, Diane Schroeder, and I'm so grateful you are here. Hi, friend. When I left the fire service last year, my body was not happy. I figured it was due to a lack of sleep and, of course, the stress. So I prioritize sleep hygiene, learning how to get quality sleep after decades of shift work and interrupted sleep, and discovering better ways to manage my stress.

What I didn't anticipate was the pain in my knees, the brain fog, hot flashes, and losing my libido. I told my little man who is 12, that we would give each other a lot of grace as we dealt with the hormonal soup in our house. And I promised Josh I would dig into the root causes of all my new and not so exciting symptoms. Turns out I wasn't just burnt out from the fire service. I was missing certain hormones, not fueling my body in the way she needed, and I was deficient in areas that required extra supplements. Thank goodness for my sage and OG friend, Deanna. She referred me to this week's guest. By making some changes in how and what I eat, the supplements I take, and getting some hormones, I feel like a new woman.

As a mother of 3, a wife, a friend, daughter, and sister, the struggles of balancing it all are real. Lisa needed to find more balance and to be the person she wanted and needed to be personally and professionally. She, as she said, quote, got out of her way and started dreaming of a private practice and what she wanted it to look like for herself and her patients. Encompass Women's Health gives Liisa the precious time she wants and needs, not only personally, but also for her to discover with her patients specific ways to help. Hello, fiery souls. Today, we have an incredible guest who I have gotten to know recently through a friend of a friend. And I'm really excited to talk about all things women's health related. So welcome, Lisa Wessel.

Thanks for having me. This is exciting.

Absolutely. We are gonna talk about I'm not really quite sure yet. So let's start with an icebreaker question. And my icebreaker question for you is what book are you currently reading? Or did you just read that you could not put down?

I'm currently reading the book Pussy.

Okay.

Yeah. By Mama Gina. I think it's Mama Gina is her name. It is extremely interesting. I was like, oh, that's a good question.

Got a good icebreaker. And it's been very interesting. It's about women, obviously, and how we've been there is a little bit about how we've been suppressed societally. And we're in a very patriotic type society and that if we just listened essentially to our pussy more, we would be a lot better off. And it's pretty interesting, actually. So, yeah, it's been fun to read, like, while traveling. You know, you hold it up like this and just then make eye contact with people every once in a month because, you know, they're seeing it.

Yeah. It's like the when The Vagina Monologues came out. And that was another, you know, hot book that you could read and take everywhere with you. And people would just kind of give you the side eye.

It is kind of fun to get the side eye like, and to make eye contact.

I love it. I love it. Alright, perfect. Well, that's really a great segue into telling my listeners a little bit about you and kind of your journey to becoming a nurse practitioner and then more recently starting your own business and kind of like the why behind it?

Why? The why? Well, I would tell you like the start. I mean, I don't know. It depends how far away back you wanna go. Becoming a nurse was nothing that I ever really wanted to do. My mother's a nurse. My father was a vascular surgeon. And I think I just didn't ask a lot of questions. Like, I don't think I realized there were other options for me.

You know, I see women all the time now and you'll meet someone and you ask them what they do and they're like, I record whales or something like that. And you're like, that's an option. Like you can do that for a living. But I don't know. It was kind of just a natural process. I mean, I think medicine was always in my I mean, it's just always talked about. I don't know. And so, when I got into school, I got into school through the nursing program and I wanted out like you would believe.

Like, I wanted nothing to do with it. So everyone was talking about how wonderful becoming a nurse or something. And I remember, like, raising my hand. I was like, what if you know that's not what you want to do? Like, how do I get out of here? And I did. And then I it was funny. I circled back my, I thought I wanted to be a physical therapist. So still in medicine. And I did I did my, like, intern thingy and I was like, oh, this is awful. I don't wanna do this. And so circled back into nursing, stayed an extra year, got my first job at Johns Hopkins Hospital. I was dating my husband. Well, we were dating. And I wanted to move back home because I had no money.

So I wanted to which was Cleveland, Ohio. Mhmm. And Johns Hopkins was hiring. And I asked my mom, like, hey, they offered me a job. Should I take it? And she was like, yeah, you take it. So, you know, I just I had no idea I was a kid. And anyways, so I did that and I did everything cardiac. I loved it.

And then I knew I was going to have kids and I wanted to learn labor and delivery. So I did that and loved it until I loved it and loved it, loved it until like one day you don't. And one day, you know, like as a nurse at the bedside, it's really made for the young and like they just beat the shit out of you. And I was actually in charge. I remember the day and I had 3 patients like, you're not supposed to you're awake when you're in charge. You're supposed to be, like, running, helping everyone else. And I had 3 of my own patients. I was going back to the OR for a cesarean delivery.

And I remember being like, hey, you guys are all grown ass women. Like, figure out what's gonna happen out here because I can't do it. And I remember coming home and just like it was the first time I remember being like, I provided horrible care. And it was the first like, I've always kind of prided myself on, like, not. And so I was like, that was awful. I provided the worst care. And, my husband, Matt, was like, you need to go back to school. And I'm like, I don't wanna go back to school.

He's like, you need to go back to school. And you're like, I don't wanna do that. That sounds awful.

Right.

But I decided he had to help me. He like, I remember going to Starbucks with them writing and helping. I wrote my essay, my entry essay. Like, why did I want to do this? And he looked at it, handed it back to me and was like, try again because he's an excellent writer and I'm used to writing in facts. It was hugely embarrassing. So then I had to rewrite. I actually didn't get in the first time when I applied. I applied to University of Colorado, Denver, and they didn't have all my supposedly they didn't have all my information.

So I applied again and I got to really know my admissions person. Her name was Nikki Snortter. Snortter. Snortter. Anyways, it was kind of a cool name. I did all this stuff and I didn't get in again the second time. And I called her and was like, I wanted to thank her for all my help. And I was like, but I didn't.

You know, she was like, she's like, I know, but you're the type of person you should be here. And I was like, well, what was my, you know, what was my application lacking? And she was like, basically she like, I don't know what she did, but she got it.

Nice.

Wow.

Jesus, what the are you doing?

Right.

Yeah, it was crazy and still working. You know, you're like, I don't know how I did it, but this was supposed to be like a 2 year. It took me about 3, 3 and a half and got done. And I remember thinking the whole time I was doing it. Like, first of all, I love school. I really actually loved it. I love learning even though I didn't want to do it. But I remember thinking, like, I don't know where this is taking me, but it's taking me where I'm supposed to go.

Like this is I learned a lot about myself. I learned a lot professionally. Things come together. It's funny how I learned a lot about imposter syndrome and how as a nurse, I've been a nurse for over 20 years and you just do things because you were told to do them. And then you start like, you really do. Like, this is why you do it. And so learning the why and, like, that piece was kind of cool.

Like, a lot of things came together for me and I loved it. And then I am I going on too long? Then I got a job. I like basically I worked at a OBGYN office. I was there for about 10 years. Again, same thing. It's like you love it until you don't. Like you think it's never going to change. I was so happy to have this job like a normal person.

It felt like a normal person. You know, like I had to have lunch and I didn't have to work weekends and nights and holidays. And it was great until it wasn't. COVID happened before right before COVID, I remember thinking, like, I think I want to do telemedicine or I'll be like an online instructor. I love what I do, but I hate once I'm there. I can't leave. Like, I'm stuck. I'm here and I'm seeing a patient every 20 minutes, like, from 8 o'clock until 5.

My, before actually, it was like what was it? President's Day weekend. My brother-in-law died of colorectal cancer stage. He had stage 4. We knew that was going to happen. Like he was dying. He died like a month later. My stepmother died. 7 months later, my dad died.

Diane Schroeder [00:1:22]:

Oh, my gosh.

It was one of those things happening to our family. Right. And I'm the youngest. I have 2 older brothers and then I have a stepbrother and a half sister. Well, my half sister lost both her parents. It was her mother and my dad. And then anyways, it was one of those kind of come to Jesus of like, what do I want this to look like? I'm one of the older siblings.

Like, I want to be available to my family, to my extended family, and I can't do that what I'm doing. And so, again, my husband had been saying he was he's like the impetus of everything. Like, you got to go next to school. You should start your own business. You should start your own business. And I'm like, I'm not starting my own business. And there was like that was one of the turning points of it. And a lot of like coming to realization of like my self doubts and my insecurities and my negative self talk.

I could go into all that too. And like realizing, like, I don't know, dumber people have done it.

Yes.

Yeah. And just like I actually have a quote, a thing above my door and my opposite that my mentor gave me. It says, get out of your own way. And I read it every single day. And then you actually start to believe it. I am the biggest stopper of my life. I'm the one who, you know, like maybe see what everyone else sees. And I think that's normal.

That is fantastic. Thank you for sharing your story. That's very vulnerable. And there's parts of your story very different but similar where, you know, when I was deciding what I wanted to do in with my life at, you know, 17, 18 years old, which is a great time to make those lifelong decisions. You know, it was just I didn't know I had other options. I came from a family of teachers, and there was also the nursing option, but I was like, is there anything else I can do? I guess I'll just do the fire thing because that's what my dad did. And it was like, you know, I could do emergency medicine, which seemed more fun than being a nurse, but still that service and it was, you know, I got to the point where I loved it until I didn't. Then it's okay, now trying something different, which is hard and scary.

And, you know, I went back to school with a pregnant when I was pregnant and then had a newborn. I can't imagine having 3. Yeah. And trying to go back to school, but you do it. Right? Like you just

You do it. It's like having a kid. Like, you know, you're just like, I didn't know there was a room tonight. I was, you know, one of the older like, actually, I yeah. I was probably the oldest. I wasn't the oldest, but I was I was in the top two percent of the older people there. And people would say it. They're like, how are you doing this? I was like, listen.

We don't have our thing. Like, you're working full time and doing this. And I think what I what they didn't get is I'm like, when I would get an assignment, like I would do it. And I was like, I'm literally there have been nights where I'm in the ER with a kid. Like, you have no idea what's going to happen. And you come back to school as an adult, like very different as a kid. Even in your twenties, you're like, I remember my head because I studied all the time. And I like read all the time.

And partly because I'm a slow processor. Like, it takes a while for my brain to click and go, oh, like for it to make sense. And he was like, why are you like, I was constant. And I was like, I'm literally taking money out of my family's mouth. And I wasn't a great student to begin with before. Like, but in grad school, you have to have a b or better. Like, when I remember, I remember reading that. I'm like, what? Like, I just I didn't know that.

And so I was just like, I don't have an option. There's like, I can't repeat any classes. Like, I don't have the time. I don't have the money. And so like, I was like, it wasn't an option. And so he was like, Oh, I didn't know you looked at it that way. I look at it that way. Absolutely.

It was very different.

That's fantastic. So explain really quick. So as a nurse practitioner, where does that fall? So you're not a doctor? It's an MD?

Thank God.

Right? Is it somewhere between like a PA and an MD or is it like I've just more for my listeners to understand.

Yeah. So the difference people ask this question all the time and when you explain it, like, it makes sense to me, but sometimes it doesn't. So the difference, number 1, it's different models. So if you kind of go like, you've got the medical model and you have a nursing model. And nursing model is based upon care and providing care. And so where the medical model is more of treatment, if that makes sense. Mhmm. Physician assistants fall under medicine, and so they follow a medical model.

And I am not necessarily up to date with this for the most part, and they work under a doctor. Like, a physician assistant can never work privately, as far as I know. So they're always under a doctor. Where a nurse practitioner is not under a medical model. So, like, for example, even when I was a nurse working on the floor, there's this misconception that I'm working underneath the doctor. I'm not. I'm a nurse. Like, I'm following it's this it's weird intricacy.

So, like, if there is a mistake made, it's under me. It can go under my license. But nurse practitioners are separate in the fact well, in the state of Colorado, and not every single state, but we can have our own. We can have our own practice. And so I'm fortunate to be in Colorado. So I don't need a medical provider. It doesn't mean that I don't consult or I don't have conversations, but I can have my I have my own practice. I can write my own prescriptions.

I don't well, I don't have to be under position. So that's kind of the difference. But I think the biggest like, you're under different models in the, like, philosophical, like, fundamental, like, where nursing comes from is caring. Mhmm. And so it's based there versus medical, versus, like, fixing or because I would I would love to say that the medical model is under prevention. It's not. It's more of like fixing disease processes.

Right. After it's happened.

After it's happened. After it's happened.

Thank you for explaining that. Again, it's another perfect segue. So you've gone through so many transitions in your life, changes from careers to changing family kids dynamics, and now they're older, so that changes. And you've decided to focus on women's health, and specifically the changes that women start to go through. Whether it's perimenopause, menopause, and kind of that later in life care that we never learned about. We didn't talk about it. We still don't. It's still kind of taboo.

I had a conversation the other day with a girlfriend, and I was telling her about hormone replacement therapy and that I was getting I got testosterone pellets in my butt and she laughed and she goes, my doctor says that's dangerous. And so there's just so much misinformation out there. Where do you start? And how is your style with patients and navigating that? Yes.

I would say to start, since I'm a women's health nurse practitioner, and I'm sure people have heard this a lot or maybe they're hearing it more, is in school, like, you don't get a ton, but you get more. Like, as like, again, women's health, I got a lot more than someone who's gonna be a primary. So as a nurse practitioner, there's all different, like, little segues. So you could be like a family nurse practitioner. You could be a psych nurse practitioner, geriatric nurse practitioner, women's health nurse practitioner, pediatric nurse practitioner. So like what I learned is more specific. Like we are talking about women's health versus family who learn a little bit about everything. And so we're kind of not afraid of hormones.

So like, oh, my gosh, I would say the navigation part of it is like you have to keep learning, you have to keep reading, you have to keep like when something doesn't make sense in my brain, like, well, why? Like, I think that's maybe the big thing is you have to keep asking the why, but why? But why?

Stay curious.

Yeah, you really do. Because conventionally what I was taught, I still use a lot of that. But there's a lot of things that I do very, very different from when I first started practicing. And partly because, you know, you're taught this is what my this is what I learned. This is what I was taught in practice. I'm working with other very conventional providers. And then you start going, but why? But why? And like, well, that doesn't make sense. And then you have to you have to do your own research and kind of dig into that.

I don't know if I answered your question or not.

No, you did. I love that navigating piece of it. And we're all different. So I think if I'm hearing you correctly, you take the conventional education that you've received and that's kind of like opening the door. And then you take your own intuition and experience and, you know, just kind of that natural healer within you to kind of combine the 2 and provide the best care.

Yeah. And then you are. You're looking at the person in front of you. Like, you know, for example, like lab works. And like lab works, like, they mean nothing. And like, if you just are looking at labs, you can make some assumptions about things, but they really unless you have a person in front of you and you can like symptomology what's going on. Like, okay, you would know this one. This one would be an easy one.

Sat monitor. Right? The monitor you put on a finger that's going to measure someone's heart rate or like essentially how well are they oxygenated. How many times have you put that thing on and it's like, Sam, their sats are 78. And you're like, no, they're not. They're pink. They're breathing and they're talking like it needs. But if you just went off of that, you would be doing something completely different.

Right. It'd be a really awkward trying to innovate someone who's telling you their life story.

Yes, exactly. And that's not what they need. It's just like this needs adjusted. So like, again, in a vacuum, that means nothing. And so you really do have to look at the whole thing. And I would say like with hormones specifically, it's a trial. You know, like, hey, this may work. This may not.

But let's try this. And I think that's the biggest thing is that we're afraid to do that a lot in medicine, too. Like, you know, like, what's the harm in trying? I mean, I know there's going to be some medications you're not going to do that with, but a lot of times it's like, let's try this and let's see how you do it. And if it doesn't work or you might like it, I usually tell people I'm like, you might find like, hey, this is really good, but then we need to make some changes. I don't want there to be a but. I kind of want there to be like, this is working great. And if there's a but, then we have to make some changes or adjustments based on that person. And everyone is different.

Everyone.

Right. And I think we fall into this like the doctors are always right. It's the last word. And there's a lot of faith and trust within a patient medical professional relationship. And I feel like that's how we've been conditioned as a society when I've working again on kind of the outskirts in the emergency field of it. It's practicing medicine. We're human. You're human.

Doctors are human. You know, it's that going above and beyond. So I think it's also the patient's responsibility to also be curious and have trust and faith, but also be open to that it's not an exact science.

No. Yeah. They'll say, surgeons perform surgery and everyone else practices medicine because it is a practice. I do joke around about this. I was like, I would have loved to have been a provider in the eighties. You were like hotdogging it all the time. Everyone listened to you. No one questioned you.

You said something No Internet. Yeah. No one. They were like, okay. Then that's where the Internet and Google are awesome and they're a detriment. But they are really I think the point is, is everyone needs to be an informed consumer and everyone you should. I've always loved that about, like, any of my patients, like, ask questions and be curious and, like, ask. I don't like, this is where you're supposed to ask.

You know, you're supposed to ask your questions here. And I love that. And if I know the answer, it's even better. Sometimes I don't. And so you just have to like, hey, you know what? But I know where to look. I think the difference a lot of times what I'll tell people is I'm like, I have access to places to look that you don't. And that is the difference. So, you know, you're always going to be dying of cancer.

Like that's always going to be on when you Google something.

Absolutely

Absolutely not. That's probably not what's happening. But it's good to look. It's good to get information. You know, like TikTok, you know, you can I mean, I'm on freaking TikTok? I don't necessarily like it, but it's you're getting information out there and at least it gives people like to ask the question or like and if you're with the provider that is not going to listen and going to blow you off, you just need to find another one.

Absolutely. I always say advocating for yourself is really important or having someone in your family that can advocate for you that can ask the questions that can help get the answers because at the end of the day, you're still the patient and there's some, you know, the providers are responsible for providing.

It's supposed to be a team. Yes. Those work together. And I think the biggest thing is like, you know, your body better than anyone. We really, really do. And so if something doesn't feel right, then something's not right. And so we have to figure out what it is.

Exactly. And I think it's also and I'd love to hear your thoughts on this before I ask some more specific questions. But it's there's a lot of factors in health care now that makes it kind of messy, which is I'm assuming that's one of the reasons why you don't take insurance, which I love to hear your thoughts on that. But it just like because it's when private equity companies try to make healthcare for profit, it becomes really complicated and messy and hard to maybe get care or get answers or, you know, especially for someone has no idea how to navigate that system. So how has your experience been with that? And why did you, you know, set up your model the way you did?

So I am self paid. I usually will tell people I'm very cheap. I don't like to pay for things if I don't have to. I am the type of person that if you get if I get a $5 rebate, like, I'm getting my $5 So I am all about that. So like, I understand. And I want, you know, like, I want people to use their insurance as much as possible. The reason I did, number 1, is there is like from my side of it, there's a ton of hoops and there's a ton of expectations. Number 1, all of the little things that you have to follow, which aren't necessarily bad, like stopping points.

And probably the biggest one was reimbursement. And this is one of the things I said Matt in the beginning. He was like, why don't you start your own business? I'm like, why would I start a business where I'm going to get 40% of what I go? That's just what it is. That's in general. So it's silly. Like, it really is from that perspective. I think the hard part for me is wanting to help people that maybe can't afford and that that is hard. I think like I said, I think my prices, I think, really reasonable because I'm like, what would I pay? Like if no one was listening and I felt like I wasn't being hurt, what would I pay? And that's kind of where I came up with my pricing because it was kind of like more comfort for me.

Then you're like, well, what the hell did my insurance cover?

Right. They inflate.

Yeah. And so you're like, Okay, well, I'll pay you this much now and then we'll see what It's just like not having control over it. I think that's the biggest thing. My husband's an engineer, so he's very logical and wants like, well, what is the cost? And I was like, you know, the nice thing is for my business, I can tell you this is what it's gonna cost and it's not gonna be more. And I would say in general, most patients have been really appreciative of that. Like, yeah, I'm willing like, yeah, I don't really wanna pay. I'd love to use my insurance, but I also wanna be heard. I want to like this problem solved or I wanna start working on this and I know this is what I'm paying.

And so I think that makes a difference.

Absolutely. And full disclosure, I am one of your patients and I would agree with all that. It's been worth every penny.

Well, thank you.

For many reasons and a lot you've just explained. And so I just I think there might be some worry out there if my listeners are listening like, oh, I'm curious, but who why wouldn't take insurance? That's weird. No, it's not weird. It's a choice. And, you know, I think in this day and age, it's a great choice. And it's the same with therapy when my son was small, and I had to find a good therapist for him. I went outside of insurance because that's where the good therapists were to be quite honest.

And sometimes it's like even cheaper to say you don't have insurance or not use insurance. You know, we've done that with, like, you know, when our kids have had to go to physical therapy and you're like, wait a minute. Why are we getting you know, like, not only am I paying a co pay of 40, $50 every time they come, like, now I'm getting this other bill Yeah. And they charge more. So like everything is charged more. Like you're going to charge me $120 to put ice on my kid's leg for 20 minutes. What? No.

I'll just take cash and then it's half the price.

Yeah. And so you're just like, that's the thing is, yeah, you're not paying for you. You're paying for everyone. That's the problem with insurance. I don't have an answer for it.

And I don't think any well, yes.

Anyone does. I don't know.

Let's talk a little bit about pre-menopause and menopause. And just like a real kind of high level overview, but really like what age can it start again? Everyone's different. It happens different, but what happens to your body? Why is it important to get ahead of the symptoms as soon as you start feeling them? You know, you're not going crazy. There are solutions to manage the symptoms, even though we all go through that change to no longer having periods and a little bit about that.

Okay. A little bit about that. Alright. Let's do like the 5 minute run. I'm kidding. Alright. So perimenopause can start as early as 35. If you were like, you know, we used to draw those timelines in school.

35 is when it can start. And then menopause is usually 51 in 4 months in the United States. So that's your timeline. It can happen before that. It can happen after that, anywhere in between. But that's kind of the timeline. There's early perimenopause, which is essentially would be kind of like 35 to maybe 45 ish area. And then there's late perimenopause and then there's the transition and then there's menopause and then you're postmenopausal.

And so most people have heard this like menopause is 12 consecutive months of no period. And so that's just like we had to put a time line on there because like for some women it might be 13 months, it might be 4, but it's around a 12 months of no period. But before that, like we'll move back, then you're postmenopausal. So most people, you don't know you're in menopause until you're like you've gone through the 12 months and you're like, oh, that was that was menopause. Now I'm postmenopausal. Like the transition phase tends to happen about 4 years prior to menopause. And that would be also kind of the late perimenopause. And this is usually where women everything else I would say like prior to that is more these like subjective things where we as women blow them off or we make excuses.

So like, remember when your kids were little and you were like, yes, but they're like they're being acids. Yeah, but they're teething or they didn't sleep well or they're sick or we had a lot of stuff going on. I mean, there's always a reason. I remember thinking that when my kids were little, like, this is just my life. Like, it's always going to be something. It's never going to be like smooth sailing. So we do that as women as well. So we'll start to be like prior to, like, having menstrual period issues, we might start to be like, I'm becoming forgetful or like I'm having maybe I'll have an occasional night sweat.

Maybe I'll have a hot flash during the day. But like, I'm fatigued. I'm so freaking tired all the time. I'm having trouble staying awake. I'm having like, my skin is changing. My hair is changing. Like all these different things that will kind of blow off. But I really until they get significant enough or they're happening all the time, really, a lot of times what brings people in is what is going on with my period? Like, I'm skipping periods.

Like, somehow we've got that like, we've got that ingrained in women that, like, you're supposed to have a period every 28 days. Yeah. And when that doesn't happen, it's like, what the hell is going on? Right. And the reality of that piece, too, is like normal period is 20 to 45. Like everyone's got a variation of that. But a lot of times women's periods will start to get closer together first and then they'll space out and they'll start missing them. And that's usually when people start to come in. And then they'll actually tell you all this other stuff.

I have no libido. I have no energy. I'm gaining weight. My ears itchy ears. Those are fun ones inside the ear. Or, like, I feel like there's a bug in my hair. You'll get, like, a weird sensation there. Joint pain, heart palpitations, trouble sleeping.

What else? I mean, moody. Oh, like body odor?

Yeah. Yeah. Things change.

You know that? Things will change. So those are all signs. I always felt I always feel like it's like that could be COVID. That could be COVID. That could be perimenopause. That's the thing. There's so many different things. But the problem is, is when you say like 35 and on, I was like, I don't know.

That's a lot when a lot of women are having kids or you have young children at home, like, we're building your career. Like, all these things are happening at the same time. And it's first, like, all of this shit is falling on top of us and we are just going and going and going. So it's interesting because it can be hormonal, but it can be your thyroid. It can be your adrenal glands. There's so many different things it could be. So that typically is why? Why do something? Because things don't get better typically. And like, we have to evaluate them.

I usually if I could go back and tell everyone at age 35, start doing blood work, do blood work every year, like get your blood work done every year, do it the same time of your cycle roughly every single year so you have something to compare it to. So that when women go in with complaints, like you have stuff to compare it to because we get so gaslighted. So I mean, it's awful. Like, I'm amazed at this day and age, like the amount of women that come to see me and they're like, oh, I was told this was normal and they're like, but it's not.

Yes.

It's not. And I'm going off on a little tangent now. Like, reference ranges of labs are not like they are again, everyone has their own personal little reference range essentially. And where we look at reference what's within normal limits versus optimal are 2 very different things. And anyone who has a child, I'm sorry, I keep going back to kids, but like remember when they changed the grading system? No longer A's and B's and C's like we grew up with. It's like meeting expectations.

Yes, ? number.

Yeah, exactly.

Exceeds expectations. Could use a little more help or?

Yeah, but like there's that difference of like, oh, look, they met expectations barely, but we're okay with that. And we have to look at our labs the same way. Like, where do I want to be? Like, where should it be? Like, is this something that we want on the lower end of normal? Like, maybe we want hemoglobin a one c, which is what's our blood sugar been over the past 3 months? Maybe we want that on the lower end. I don't want that close to being normal. Like, so you have to look at it and that makes a huge difference. So but that's the whole thing is getting lab work and seeing and, like, making sure you're being heard. Like, it shouldn't just the answer cannot just be, that's very normal for women your age. There's a difference between, like, common.

Like, what do we see? This is common. Like, this happens a lot. Yeah. Because we're all perimenopausal. Like, this is common. But is it not is it normal? It does not have to be. Like, no, we can fix that. I think that's the biggest thing.

Right. Thank you for sharing. I you know, when you were talking about the weird periods and the, you know, all of a sudden, you know, you're bleeding for 3 weeks at a time or you're not bleeding at all. I think for me, I was like, am I pregnant again?

You know, when you start missing those periods, I feel like that's really the wake up for women. Because if you have kids, you're like, Oh, no, no, no, no, no, I'm too old. I don't want to do this again. Or you're like, Wait a minute, is this you know, so I feel like listening to your body is so important. And we all have that intuition within us, that if you peel back the noise, and again, the gaslighting, I would love to talk a little bit more about that. I don't know that it's intentional a lot of times with the gaslighting. But can you give any tips, I guess, for women who feel like they're being gaslighted by their medical professional when they're telling them all these symptoms?

I think the biggest thing is Well, you could do it We can handle it a couple of ways. You could either be like, You're not hearing. Me. I think it's okay to have like, you're having a conversation. You're having an actual intimate conversation. Because if you're willing to open yourself up about what's going on, which some people do and some people won't, but if you're willing to open yourself up, number 1, if someone's not listening to you and they think, oh, you're just depressed or this is normal or again, like, I think I was in my forties when someone was like, oh, that's women your age. And you're just like, no one wants to hear that. No, no one wants to hear that.

But if you're feeling that way, number 1, it is either confront like back at them. Like, that's not an answer. You're not giving me an answer. And then it's, you know, then it's like asking for what you want. Like, I would like blood work and this is, you know, these are the blood this is the blood work I'd like to have done and or finding another provider. I think the biggest thing that people don't get in medicine is it's okay to have more than 1 provider. And it's actually really smart. This is like no fault of anything.

It's just what's kind of happened in medicine is everyone kind of has their specialty. And, you know, like, again, mine's women's health and hormones. Can I treat your sinus infection? Yes. There's certain things I can do, but like, do you want me taking care of your cardiovascular health? No, you don't. Like, I want you to see someone who that is what they do. And it's okay to have a lot of people in your network and to have them all talk to and share. You're not going to have everyone's going to always be on the same page. And then it's part of my job to give you the education, to send them the education.

This is why we're doing this. But I think that's the other thing is if you're not feeling that you're being heard or you're not like this doesn't feel well, I always say people smell funny to me. If there's sometimes we're not connecting, I usually that's all. I'm like, they just smell funny. I don't have a reason why I don't like you. I don't have necessarily anything particular. But then it's just like you just you find someone else and it's okay to do that. And I think we haven't taught maybe women, maybe just people in general, men and women that like, you don't have to do that.

Find someone that you trust, that you can actually have a conversation with, that you can talk about sex with, that you can talk about. Like, is this normal or this is happening and this doesn't seem right? I always kind of feel like if your women like your gynecological like, if you're going to your gynecologist and they're not asking you about sex, then they're missing a huge piece of your health care.

Yeah.

Because that's a huge part. Like, where else are we supposed to talk about that?

Right.

Where is that supposed to come up? You know, so like and if you can't have that conversation or, for example, I forget how old I was. I left a tampon in. It was mortified, like mortified. And I didn't wanna go.

Toxic shock syndrome.

Yeah. I know exactly. We were that's yeah. That's very rare. But, you know, like, we were you're an 80 if you're an eighties kid, that was Yeah. But I remember, like, I was first of all, I was so humiliated and so embarrassed. And so I didn't want to go. Like, you should be able to go to another provider and be like, is there anything I need to be worried about? Like, should we, you know so I think that's the thing is if you like some of those embarrassing things, like, if you can't if you're gonna get naked in front of these people and put your legs in stirrups and have a pap smear, like, you should be able to have these conversations.

Right. But it's hard. It's hard. And it's not for everyone. But, like, you also you have to feel comfortable. So I think you've got to find a provider that you feel comfortable with and that you could actually say anything. And, you know, you're not going to be judged. And, like, we've all done like, things have happened to all of us that were like, I don't really want to talk about that.

Right. Well, I think too, when it comes to like, sex in particular, and going back to what you talked about the book that you're reading, what the patriarchy, there's just a lot of shame and stigma around sex and women and getting tested for STDs or whatever it is, regardless of how old you are, it's your health that you're taking care of. It's not the judgment. And I think that's, I feel like that's maybe getting better. I don't know.

I don't know. No. I would say no. I would say the thing is, is I try with my young girls when they come in. Like, we have not come far at all. Like, we like to think we have, but we're taught for such a long, hard part of our life. Like, in this comes it does come from the home whether you like it or not. Like, sex is bad.

Like, you're not supposed to have sex and you're not supposed to get pregnant. And so that we're supposed to like so somehow it's a bad thing, potentially. And then all of a sudden you get married and now it's okay and you're supposed to turn in you know what I mean? Like, you're supposed to have all of this sexual all these different things. And it's really, really challenging. One of the things I always teach when I have when I have my platform, my little soapbox with my teenage girls are I have my three things because usually if they're there for birth control, I'm like, it's consent. Sex should be consensual and it should be between you and your partner, not anyone else. And I was like and usually if a mom is there or dad is there, I usually I will say to them, like, you've got this great resource who wants to help you and wants to they're here for you. They're obviously here because they're bringing you here as well, too.

But like so ask questions. Like, number 1, consensual sex and making sure it was your decision, because then it won't be wrong. If it's your decision, it won't be wrong. But if you've been talked into it or personally, you know, then it will that you're being safe. And, you know, I usually talk about condoms and how until we're willing to have that conversation and I will say this, I was like, I have 40 year old women that will not have this conversation. So I'm not you know, like, how many sexual partners have you had? Like, when was the last time you were tested? If we're going to have sex with someone and we're not going to use protection, you should have that conversation and you should use protection and like get on a birth control. We don't want you to get pregnant. And number 3 for young women is sex is supposed to be enjoyable.

It is not about the boy. It is not about making them comfortable. It's not about them. It should be about both of you. So, like, we as women tend to think it's for the boy and we're doing something for them. Like, you know, our clitoris has 8,000 nerve endings. That's its only job. Its only job is for orgasm.

Like, that's it. And so really and truly, like, we can focus on ourselves. It's not supposed to be uncomfortable. It's okay to stop. It's okay to be like this. Maybe this position isn't working for me. And we've all done it. We're all like, no, it's fine sort of thing.

And if you had sex here, you were a slut or guys were fine. Like, so we still and that hasn't I don't know that that's really changed. And so how do we change that? How like being sex positive, and it's okay for girls to have sex. And it's normal.

Right? Well, and how many it wasn't that long ago, girls were getting married at 14, 15, 16 years old. I mean, not that that's a proud moment. But our bodies are wired for that. I know, you know, my son, he rolls his eyes. From the time he could talk, he knew gender appropriate, whatever. It wasn't his wee wee, it was his penis. You know, and we consistently are talking about sex and to the point where he's just like, mom, like, how was the talk at school? He's like, nothing that surprised me because you've been beating it into my head for years.

For all you like with the growing and changing, I always asked. I said, I know I know the curriculum. I I know what they're teaching you. I was like, I want to know the questions that what like, what questions came out of the little box? What did someone ask? Because those are the interesting ones.

Yeah.

And, like, teaching our boys that as well, too. I think that's the biggest thing is, like, I have a, you know, a teenage son. He's 16. And as far as I know, he's not sexually active. I don't, you know. But you're just like, you know what? It's not all about you. Right? You know, make sure you need to make sure that your partner is enjoying this and wants to you know, all of that, too.

And so, like, we have to teach our young men that aspect of this as well too. And it's not but it's constantly you know, like, I also have 2 girls that I have to make sure, like, the goal. I don't want you getting pregnant. Like, it's totally normal. But I also don't want you getting pregnant and having to make decisions that are gonna affect the rest of your life.

Exactly. You know, my best friend, she's such a mentor and bestie to me, and her kids are older than my son. And she always is like, there's not you know, I would encourage if they wanted to make mistakes, fine. It was the things I focused on were they're gonna be the life changers, getting someone pregnant, getting killed in a car, you know, making those choices that, you know, a lot of choices, you just gotta screw up and figure it out. But those are the big choices that you don't wanna figure out.

Right.

If you make the mistake. Then now that you have your own business and, you know, we talked about this a little bit offline, running your business is a challenge. It's hard. It brings a different set of challenges, which are, you know, fun and exciting and terrifying. And that could be before 10 o'clock in the morning on some days. But what do you do to take care of yourself? Now that you have your business, what does your self care look like? And do you find that freedom with your family and just to fill your cup?

Yes. And I also think it's age related too. So I this year, it's been in the back of my head. Like, I wanted to I've done a fair amount of things. Like, I started cold plunging, and I really enjoy that. And I've always been a runner, so I've always made time for that. I would say I I have more time to think than I ever have. I I usually joke around.

I'm like, I have more time than I've ever had in my entire life, and I have no fucking time.

Yes.

Like, what the hell? But I have more time to think. I have more time to like, I'm a knee jerk person, so I have more time to kind of think about things and move forward. But for my self care, I mean, I definitely have always exercised. The cold plunging has been new. But my newest thing has really been meditation. I've been wanting to do that for a while, but, like, also, like, this brain can't sit still. Like, I was like, there's no way I'm going to be able to like, I can't. I can't.

So I anyways, I feel like the serendipitous world of when you start your own business or like things just you know, let's say it like you close a door and jump out a window kind of thing. And I have gotten the pleasure of meeting so many cool, interesting women on this pathway that I'm like, even if this all fails and goes to shit, like, it's been awesome. Like, I have met you know, like, even just being here, like, this is like, how cool is this? And one of them is her name is Catherine Davis, and she opened, it's called Welcome Goddess, and it's in Golden. And it's basically a center for women and does a lot of trauma release and sensual flow and meditation, different types of meditation. So it kind of came to me like someone like a patient of mine was like, you should talk with her. Like, she's starting you know, that sort of thing. And I did not really knowing that it was like, oh my gosh, this is what I've been wanting to do. And I feel like it's like the universe.

You know, when you ask for things, if you believe in, like what's that called?

Serendipity. The universe conspires to help you when you are committed.

Yes. So, like, when you put it when you put it out there. Right? When you kind of make this happen Manifested. Yeah. Manifested. That was the word I was looking for. It really did. And so, like, I signed up and I've been taking classes and it has been hugely helpful.

Like, to find that inner love, inner like, if it's your chakras, you want to like, whatever it is, like, that inner energy that we all have within us is, like, pretty amazing. And I'm fascinated not enough to, like, read about it or know enough, but I'm like, I just you know, you're like, I just like going. And I do that. I started during COVID. I started getting massages for myself and I do that once at least once a month, sometimes twice now. And my massage therapist does energy work on me too. Sometimes I walk out of there like, what have you done?

Things have shifted.

Yeah, exactly. Like, those are probably my 2. I go to physical therapy for my leg. I've decided, like, I've got some hip issues that I've had and like, I'm keeping my mobility. And so if I have to do this, this is what I have to do. And then every once in a while, I'll buy myself flowers because they make me happy. Like, I'll just go and get the cheap ones from Walmart and put them in a cute little vase. But I would say those things.

But the newest really the biggest thing has been the meditation and kind of like diving into that more spiritual side of myself that I think needs nurturing and I need to get rid of trauma. I think we all need to get rid of trauma. Like, even though you don't yeah, even though I don't necessarily know what it is, I could make some guesses. It's not affecting me on the daily, but I think it's I do believe in that we hold on to that. It imprints on us. It makes a difference. And so, like, we have to let that shit go.

Absolutely. Thank you so much for sharing that. I think, you know, it is part of it is age. You know, I was a couple of years younger than you, but it is the age and it's that for me, it's striving for peace. Like, what can I let go of to slow down and really just, you know, you're on the back hill slide of life? And that very being intentional about what you give your time and attention to, I think is just it's gorgeous. I would also say that starting your own business is a beautiful form of self care because you took your, you know, you empowered yourself to create something that matters to you that nurtures you and your soul and that feminine side of you that feminine energy in a world of such masculinity. And I just so I think that's fantastic.

Thank you. I guess I never looked at it that way. But yeah, I love it. Like, you know, you're just like, I've said, I'm like, I'm never going back. Like I love what I do. I love spending the time I love being available. I probably have to put some boundaries on that at some point. You know, you're just like figuring that piece out, but I just love it.

I love educating people and helping them and like make it like, you know, I want people to understand.

Gift and another perfect segue. How can people find you? How can my listeners I'll put everything in the show notes, of course, but what's the best way to kind of reach out and get in touch with you for anyone who has more questions and just wants to learn a bit more?

Thank you. So my business is Encompass Women's Health, and you can find me at least well, you can email me lisa@encompasswomenshealth.com You can go to the website and then it has my number on there. You can always give us give me a call if I don't answer. I usually call back that day. But I would say probably email is the best. Or there's like a chat, like you can send me a message if you're on the website, it will come to me. But when people chat, it's only if I get back to them while they're on the chat.

So usually, like, I like them to sign up and then I get there. They send it's an email. Like, what is their question? Usually what I like to do or I don't have to, but I offer it is when people have questions, I usually like, let's just set up a quick phone call at some point and we can talk Like, what's going on? Don't waste your money if you don't think I'm the right fit. So far, I've only had I think I had one patient or client who called and she wanted to lose like, nothing was wrong. She just wanted to lose £10. And I was like, I don't think I'm your person. You know what I mean? I was like, I could take your money and we could do blood work. And but I was like, that sounds like maybe a trainer.

You know what I mean? Like, let's put her in that direction. And so if I think, you know, like or if after talking to me, you're like, oh, this isn't not gonna be my person either. So but I can help find you someone. And I think that's the biggest thing is I don't usually it's like, I don't care where you're getting like, just be getting care because there's plenty of providers out there and whether it's proximity or costs. And if it's not me again, I know people that I can send you to as well, too.

Perfect. Fantastic. And then you also have a blog on your website where you post articles and you mentioned you're on TikTok. So I'll put your TikTok handle in there.

So Yeah, I think that one's like @encompass_womens_health.

I'm not on TikTok. I know I probably need to be, but I just haven't made that leap yet. Anyway Yeah.

I don't know how I feel about it yet. Like, I feel like there's days where I think it's great because you're getting, like because information's out there and there's not always great information. But I also I struggle sometimes with social media and the fact that like what it's doing to our young women and how much it's well, and our young men and like how much you're just like, should I be contributing to this? But that is a hard one because it's like, we really need to be getting away from it. But I don't think that's gonna happen. But, you know, it's just increase in depression and anxiety.

It's changing the relationship with it. Yeah, I don't know how to figure that one out either.

Yeah. To me, it's like, it's like anything else. It's sometimes it's like alcohol, and it's like food. And we all have to find our balance. And that's really, really hard for teenagers, though. Young kids.

It is. That's why mine he asked. He's like, Mom, Snapchat's for 12 year olds. I'm like, absolutely not.

Yeah. And it's you know, it is. And it's like, I used to use the line or when my kids are older now. But like, I want you to know this is I'm not you're not being punished. Like, this isn't I'm not letting you not do this. It's not a punishment. I'm doing it because of this. And yeah, as long as you can, I would not?

I'm trying. I'm trying. He's pretty persuasive.

They figure it out. Like, I think that's the hard part is once it's introduced, at some point they do have to figure it out.

Exactly.

What is their balance and It's a whole different we'll have to talk parenting next time. Lisa, thank you so much for spending time and so much information. Again, I'll link all your information in the show notes. This was a lovely conversation. And, you know, if you have any questions and you're listening, I highly recommend reach out to Lisa. She's amazing. And I know that on my journey, she's helped me more in the last few months than most doctors in the last several years.

Oh, thank you.

Thank you for joining us. I am grateful you are here. If you're curious about how speaking to ourselves is a form of self care, head over to thefireinsideher.comforward/audio for a free recording on self care. Until next time. Be safe, be kind, and be authentically you.