Dr. Eugene Kim will never forget the words of a woman with stage IV cancer that he met during medical school, “Remember my face,” the patient said, “when you have a tough day in the hospital because you have changed my life.” In the final podcast of the 2018-2019 season, Drs. Eugene and Mackenzi Kim tell us about being newly minted medical doctors and how tomorrow, they will begin the next phase of their clinical training as residents. “Having those moments of connection with patients where you know you made an impact on them, and they made an impact on you…” is what Mackenzi recalls as one of the reasons she went into medicine. Mackenzi adds, “I love science and I love people…the perfect marriage of the two”.  In this podcast, Eugene and Mackenzi share with us why the chose their particular specialties, tips for other clinicians working with residents, and some of the reasons we should all ask for a resident during our next medical visit. One of the reasons: it’s a two-for-one deal!

Health Stories

The Future of Medicine

This week’s podcast guest knows a thing or two about delivery. Having delivered three children using three different methods—including a breech baby and ECV (version) procedure—Jackie shares her experiences regarding labor and delivery. From a private birthing suite with a midwife to a team of 10 obstetricians and nurses in a teaching hospital, Jackie provides listeners with tips for recovery after a C-section, reasons to consider a VBAC, questions to ask at your next OB/GYN visit (e.g., use of pitocin), conversations about your birthing partner’s role during the delivery, and how to have a dialogue with your clinical team in preparation for your upcoming birth.

Three Ways to Deliver

Sixteen-year-old Tess vividly remembers the day she was diagnosed with Type 1 Diabetes. “I’m scared…I think I’m terminally ill…my life is entirely different.” As a teenager, she longs for independence and wants to manage her illness on her own; she orders her own supplies and picks up prescriptions on her own. “All of that preparation is making me feel better about the transition from high school to college”. Five years after her diagnosis, Tess provides tips and insights for other kids living with Type 1 Diabetes and offers advice for concerned parents, “If you want your Type 1 Diabetic [child] to succeed, you should help them succeed on their own…and trust goes a long way.”  

The Backseat Driver

“So you’re more than just drug pushers?” asks the podcast host in this week’s episode about the unsung heroes of medicine. Drs. Katrina and Elie Jabbour—the podcast’s first clinical couple—reveal to listeners the relatively unknown world of pharmacy and how little we know about the profession beyond the prescriptions we get filled at the local pharmacy. As Elie states, “We are the invisible healthcare provider behind the scene” and adds, “What you may not know is that pharmacists are reviewing every medication order that comes across in the hospital…” and helping to keep drug costs down. The Jabbour duo strongly recommend asking more questions of your pharmacist and reconsider checking the “No” box to decline counseling with a pharmacist the next time you pick up your prescription. The primary questions you should be asking about your medications: 1) “How should I take this (medication)?”, 2) “What side effects should I expect?”, 3) “What do I do if I miss a dose?”, 4) “How do I take it (e.g., with food)?”, and 5) “When should I call my doctor?” And Katrina reminds us, “There’s a lot of behind-the-scenes work…be patient [when getting your prescription filled], there are multiple steps that go into it.”

A Profession of Unsung Heroes in Medicine

Billy, a local activists, recounts his experiences as a member of the LGBTQ community since the 1970s. As Billy describes, “There were many doctors that wouldn’t even see you…if they knew you were gay or thought you had HIV.” Billy refers to the 1980s as the “Lost Years” where he buried several of his ‘brothers’ from AIDS and reflects on the current state of healthcare: “56% of LGB people and 70% of transgender and gender non-conforming people reported experiencing discrimination by health care providers” (www.hrc.org). Throughout the podcast, Billy shares some of the surprising encounters he’s had with clinicians and urges all of us to take action to change healthcare legislation and improve the quality of care for everyone.

A Leap of Faith

Physician, business owner, and patient, Dr. Lorraine Dickey takes listeners on a journey about the moment her life was turned upside down. Lorraine explains the many difficulties that resulted from her traumatic brain injury that took her out of medicine. During the next 2.5 years, Lorraine had to redefine her identity. And when she did return to medicine, “it was terrifying, absolutely terrifying…I didn’t want to be defined by my head injury”. Lorraine is no longer the same physician she was prior to the accident. “It is a true privilege to stand with people at times of their greatest crisis and greatest joys. I don’t think I appreciated that enough before I fell off that mountain…” She adds, “I learned…(that) feeling cared for is what I wanted to start providing my patients and families.”

What I Learned from Falling Down a Mountain

There are more the 29 million nurses in the world and approximately 4 million in the United States...and it’s not enough.  The American Nurse Association projects that over the next 4 years there will be more available positions in nursing than in any other profession.  Mark Petrole, RN is an outpatient nurse at a clinic that services mainly low income and underinsured patients.  In describing the multiple roles he plays, Mark says “I’m like a case manager, a nurse, their own personal pharmacist” as well as a provider of emotional and logistical support.     Mark feels that nursing is a calling; a wide and varied profession with specialties for caregivers of all backgrounds.  May 6-12 is National Nurses Week and Mark urges us to ‘thank a nurse’ and be appreciative of the many services they provide even when it means skipping lunch or holding their bladder for an extra few hours.  

A Nurse's Calling

In the U.S., 20.4% of adults (50 million) live with chronic pain (https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm). The recommendation? Add chiropractic medicine to your usual medical care for treating back pain (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2680417). As Dr. Paul Braadt explains, patients with chronic pain often travel up the hierarchical healthcare ladder through a referral pattern—seeing multiple specialists for pain management. If your treatment journey is not producing the results you want, Dr. Braadt recommends “a different kind of spine specialist…a mechanical [one]…since most spine pain is mechanical in nature.” For the skeptics of chiropractic care he states, “…studies indicate chiropractic is one of the safest modalities in healthcare…” and “if people are not 50% improved within 6 weeks, we know we’re on the wrong track.” With chiropractic medicine, we are moving from the current “business of medicine” model back to the “art of medicine”.

Chronic Pain, Chiropractic Care & the “Art of Medicine”

“Anybody who’s sexually active should be thinking about HIV….it’s not going away”. In this moving and candid interview, Steve shares his 14-year journey living with HIV. He recalls the phone call informing him he was HIV positive and the supportive response he received from his partner.   Steve explains how the face of HIV and AIDS has changed since the 1980s, “HIV doesn’t look the same way that it did back then. You don’t see bodies walking down the street that look emaciated like I was…you generally don’t see that; it’s hidden…we have great medications that work really well to maintain that semblance of what passes for ‘normal’ health.” For individuals who are newly diagnosed, Steve provides words of support, “know that you are not alone!” and strongly recommends getting tested, “getting a diagnosis sooner rather than later…[can] eliminate passing on the virus to someone else.”

HIV Identity: Who Are We?

For years Joanna was mis-diagnosed with anxiety and depression and placed on anti-depressant medications that didn’t work for her. After a mental crisis, however, she saw a psychiatrist who diagnosed her with Bipolar II Disorder. “The terror of the diagnosis turned into a gift,” Joanna recounts. She educates listeners about some of the characteristics of Bipolar II such as 1) “mixed features” of hypomania—heightened emotional or energetic state—and depression which present simultaneously, and 2) rapid cycling which is four or more episodes in a year. “It’s easy to ‘pass’ with Bipolar II and the world not know you’re suffering,” she adds. Joanna touches on the difficulties people may face receiving a correct diagnosis due to stigma, gendered bias, and similar symptoms with other mental disorders. For those living with mental illness, Joanna offers numerous suggestions for navigating through the healthcare system and the importance of finding support and trusting your gut.  

Special Episode: Overcoming Mental Health Stigma

In this podcast, Matt Neifert, owner of Agape Blends, shares the medicinal benefits of hemp CBD. Cannabidiol (CBD), found in hemp, is a chemical compound that effects our body’s cannabinoid receptors “…found in the parts of the brain that handle cognition, memory, psychomotor skills, feelings of rewards, and pain perception…CBD cannabidiol interacts with the receptors to reduce feelings of pain or anxiety” (https://cbdoilreview.org/cbd-cannabidiol/cannabinoids/). Matt explains the difference between hemp CBD and medicinal marijuana and how people have found relief from hemp CBD when other pharmaceutical medications did not work. Matt offers advice for how to talk with your clinician when taking hemp CBD and provides crucial tips for asking about third-party testing regarding the quality and purity of a product. 

Cannabis, Hemp and Healing

In this week’s podcast, Health Stories’ host Nicole Defenbaugh shares her personal journey with ulcerative colitis (UC) and provides listeners with the reason for starting the podcast. Jerry Petrole, the IT wizard behind the podcast, takes his turn as the host for this unedited interview.

The Host Speaks

After 13 surgeries, all for different conditions (e.g., brain surgery, C-sections, appendectomy, car accident), Emily has learned a thing or two about pre- and post-surgery preparation, asking questions, types of anesthesia, and caregiver support. With her 3rd upcoming C-section, Emily shares the steps and un/expected moments she experienced and reminds listeners that “Patients are not standard.  Different people respond differently to different drugs” in discussing her adverse reaction to anesthesia. Surgical procedures and recovery processes have also changed over time in healthcare, as Emily recalls the speedy and fairly easy recovery from a recent sinus surgery compared to sinus surgery from a decade ago. In providing insights, Emily suggests asking the surgeon any and all questions, calling the surgeon’s office with additional questions, finding patient narratives to understand others’ experiences, and mental preparation techniques such as meditation. The podcast ends with advice for your caregiver so they can be effective in their caregiving role.

Surgical Wisdom from C-Sections to Brain Surgery

Having had multiple roles in healthcare (i.e., employee, patient representative, researcher, teaching associate, standardized patient) and as a current Stage IV cancer survivor, Ariane provides listeners with a myriad of experiences about how she has learned to navigate the liminal spaces in the U.S. healthcare system. With a hopeful attitude, Ariana suggests not to affix fault and blame when faced with a diagnosis. She suggests bringing someone with you to appointments, finishing necessary paperwork, completing a living will and assigning a surrogate, meditation and/or prayer, and finding others to connect with. The most pragmatic advice Ariane has for listeners, “don’t accept what the system gives you….ask for what you want and don’t give up until you get it!”

Navigating the Liminal Healthcare Landscape

Ten years after being diagnosed with gestational diabetes, Melanie faced another diagnosis, Type 2 diabetes, and recounts the symptoms: thirst, frequent urination, dry skin, forgetfulness, occasional blurred vision and slow-healing wounds. As she states, “…those things are such a normal part of aging, we don’t think to connect those to diabetes until you get a diagnosis”. Melanie also addresses a common stereotype of diabetes, obesity, and shares the story of a physician who assumed Melanie (who weighs 135 lbs.) weighed 400 lbs. based on her blood sugar levels and hypertension diagnosis. Regarding diet, Melanie informs us that “healthy” foods such as granola, dried fruit, and refined sugars: bread, pasta, and rice are, in fact, not good for controlling diabetes. With a genetic predisposition to having diabetes, Melanie chose to manage her condition through diet, exercise, and lowering her stress levels, addressing her diabetes holistically. Over the year she learned what works for one person doesn’t work for others—you need to figure out what works for you.

Living Well with Diabetes

In this podcast we invite you to listen in on the real-life stories of clinicians and patients. In these interviews, our guests reflect on their experiences and share with all of us their insights and suggestions for how to navigate our complex U.S. healthcare system We would love to hear your feedback!  Please drop us a line at nicoledefenbaugh.com/blog or on our facebook page @healthstoriespodcast Music composed by Ike Minton

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Health Stories

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