Stay Off My Operating Table

From Childhood Arthritis to Metabolic Health: PA Mckenna Duquette 165

• Dr. Philip Ovadia • Episode 165

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In this compelling episode of the Stay Off My Operating Table podcast, Dr. Philip Ovadia interviews McKenna Duquette, a physician assistant with a unique journey. Diagnosed with rheumatoid arthritis at age 4, McKenna shares her transition from patient to practitioner, offering valuable insights into managing autoimmune conditions through metabolic health approaches.

McKenna discusses her early experiences with conventional medicine and her eventual shift towards functional medicine and lifestyle interventions. She explains the challenges of integrating these approaches into urgent care settings and highlights the importance of patient education in managing chronic conditions.

The conversation explores generational differences in receptiveness to metabolic health strategies, noting that patients in their 30s and 40s tend to be more open to lifestyle changes. McKenna also touches on the delicate balance of managing autoimmune conditions while considering cancer risks, providing a nuanced perspective on treatment decisions.

Dr. Ovadia and McKenna discuss the growing demand for metabolic health practitioners and her upcoming role in the iFixHearts team. This episode offers valuable insights for healthcare professionals and individuals living with chronic conditions, emphasizing the potential of lifestyle modifications in transforming health outcomes.

Follow McKenna Duquette on Instagram: @embri_health

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Theme Song : Rage Against
Written & Performed by Logan Gritton & Colin Gailey
(c) 2016 Mercury Retro Recordings

Any use of this intellectual property for text and data mining or computational analysis including as training material for artificial intelligence systems is strictly prohibited without express written consent from Dr. Philip Ovadia.

Speaker 1:

Chances are you wouldn't be listening to this podcast if you didn't need to change your life and get healthier. So take action right now. Book a call with Dr Avedia's team. One small step in the right direction is all it takes to get started. Contact us at ifixheartscom slash talk. That's ifixheartscom slash talk.

Speaker 2:

Welcome folks. It's the Stay Off my Operating Table podcast with Dr Philip Ovadia. My best friend loves to listen to podcasts and he tells me that you don't have to introduce it. I know it's a podcast, I clicked on it, so I'm keeping him in mind, phil. We have a kind of a special guest today. They're all special, but this one's special in a different way, so I'm just going to turn it over to you.

Speaker 3:

Yeah, thanks, Jack. I'm really excited to introduce McKenna Duquette to our audience. Mckenna, as we're going to get into, is a physician assistant. She's been in the medical system now for a bit and she now has joined the team here at IFIX Hearts and Ovadia Heart Health and I think has a good background, a good story as to what has gotten her interested in metabolic health, and we're just excited to introduce her to our audience and we're starting to integrate her into the team here. Mckenna, welcome, and why don't you give a little bit of your background, maybe what got you into medicine in the first place?

Speaker 4:

Thank you for introducing me. So happy to be here. My story was I was exposed to medicine at a very young age, so I think I was blessed in that aspect of being kind of engulfed in the world and kind of knowing my direction pretty quickly. I was diagnosed with an autoimmune disease at the age of four. Rheumatoid arthritis is what I was diagnosed with then.

Speaker 2:

Oh my gosh, four years old.

Speaker 4:

Yeah, I think that was a little bit heartbreaking to my parents, of course, because they don't want their kids going through anything like that, especially so young. But so safe to say that medicine and me became friends very early in my life. Luckily for me, most of it when I was a child was a positive experience, but it definitely kind of led me into that world quickly and I think people that had come along in my path during that time definitely gave me the kind of push towards the direction of medicine, kind of knowing. That interested me, especially since it was something I was exposed to so quickly. And then I went off into PA school and that took me towards ER and urgent care. So that's what I'm practicing now.

Speaker 3:

Yeah, and let's you know, sometimes we live. We like to give some peeks behind the curtain here into the medical world and the workings of the healthcare system. Some of our audience I would say most of our audience has probably interacted with physician assistants but may not really understand. You know what they are, what they do, what the educational process is to become a physician assistant, so why don't you go through that a little bit?

Speaker 4:

Absolutely so. Physician assistant training is essentially a very sped up and dialed in med school. It was first created to make a position in the military that they could use to kind of rapid fire doctors through school to get them out in the military, that they could use to kind of rapid fire doctors through school to get them out in the field and practicing. In terms of how patients see us in an urgent care and an ER setting, it's fairly similar because when you're seeing a practitioner you only see me. If your care needs to be escalated, then the doctor is brought on board more particularly in the ER setting.

Speaker 4:

But in urgent care and ER we do operate autonomously. So I am the person that is the one who's kind of giving you the diagnoses, running the tests, giving you those results and then coming up with a treatment plan from there. Obviously we look a little different in different settings. We cannot perform surgery on our own. We can be first assists and so that's the major difference is a doctor is super specialized in as you know, dr Ovedia, heart surgeries and everything. We obviously would not be the ones doing that, we'd be the ones assisting you in that. But in a more general practice like an ER urgent care, your internal medicine, your family medicine. You tend to be able to see just the PA to kind of take care of you throughout your treatment process.

Speaker 3:

Yeah, I think it's, you know, become a very, you know, important aspect of the medical system. You know that physician assistants can do a lot of what doctors do and, as you said, it's sort of a little bit of a sped up or, you know not, maybe not quite as brutal of an educational process. How long do you do people typically go to school to become physician assistants?

Speaker 4:

As a PA, you are in school for a full 27 months. There's not a break there. So you can't have a job while you're doing it at all, because you're Monday through Friday and during your didactic year, which is your year of book work, you take three tests a week and then when you're in your clinical year, which is where we go through rotations and we learn on hand training in the hospitals and whatnot, that is also full time. You're being assigned to a doctor, a PA, nurse practitioner that you shadow, and that's a full 12 months of hands-on experience. So in total, it comes together for 27 months without a break.

Speaker 3:

Yeah, and physician assistants, you know they are in all areas of medicine. You know, like you said, their role might differ a little bit depending on what area of medicine they're in, but you know I can tell you there is always a physician assistant in the operating room with me when I'm doing heart surgery. And certainly many people will have gone to their family care doctors, their primary care doctors, and be seeing physician assistants as well. So what drew you to the emergency medicine field?

Speaker 4:

I guess a slight touch of adrenaline junkie. I think I just really enjoyed the fast pace of it all and the fact that I had to use different parts of my brain throughout the day. It wasn't just the same specialty over and over again. So it kind of kept my medicine very broad spectrum, which was nice. Especially when you're coming out of school you're interested in figuring out all the zebras and nuances and putting it to use, and I think that was the main thing. I'm also someone who really loves to be hands-on and getting the ability to close up those really ugly big wounds and suture them and whatnot, that was a big draw too.

Speaker 3:

And you know how do you think your experience as a patient from a young age has kind of influenced, you know, the way that you practice medicine yeah, that's a great question, I would say, being someone who I had ups and downs throughout my medical care.

Speaker 4:

Obviously, when you're someone who's been a patient since you're four years old, you have a lot of different experiences with different types of specialists and there was definitely moments in my past medical history that I had very dangerous things happen where I had to be hospitalized and whatnot not to get too into it, but I think it really lended a hand to making me hyper aware of bedside manner. I think that is massive in regards to patient care being able to be empathetic and listen to people and absorb what they're saying like truly listen I think patients really appreciate that and then just kind of being able to deliver information that's not so nice to hear in the best way possible for that person. So I think it definitely gave me practice in that, being exposed to it, seeing what I liked and didn't like.

Speaker 2:

I would like to know how this is really a question for both of you, phil. Why did you choose McKenna?

Speaker 3:

Well, yeah, let's I think you know let's get into how McKenna became interested in metabolic health and that's what kind of led to us connecting and you know me recognizing that she could be a valuable part of the mission that we're on here and the team that we're building to deliver that. I'm going to turn it to McKenna to ask how she became interested in what we're very, I would say, upfront about on this podcast. This is not the standard of care and it takes a different way of thinking to do this in medicine. I'd love to hear from McKenna what led to her kind of opening her mind to this different way of doing things.

Speaker 4:

So, funnily enough, because I was someone who had a diagnosis at such a young age, I had a very early time in my life I would say it was pretty much around 16 that I decided that I wanted to take charge a little bit and look for alternative forms of medicine that weren't really talked about too often in the doctor's office.

Speaker 4:

I remember when I brought it to my mom she was like I don't know where you came from because she's always called me her little hippie, but it was one of those things that I think I was just fed up with modern medicine not really working for me and me being told like at one point in my life I played competitive soccer all the way through college and I did have a rheumatologist look at me and say you're not going to be able to play, and that absolutely I'm a type A semi-stubborn individual. That really didn't rub me the right way and so I think I wanted to take matters into my own hands. Essentially, I felt like I was being counted out. Before I ever was given the chance, and at that time it was back when acai and glucosamine and all that was just kind of being talked about just a little bit, and you could not even get acai in like freeze dried pill form. It was like this horrible fruit that was concentrated down and you had to take it from a wine bottle and I remember taking it every day before high school and it just tasted horrible. But I wanted to change things. I wanted to pop off the medication. I was on methotrexate at the time. It's an immuno medications. It can cause your hair to fall out and lessen the immune system, and I just didn't want to have to deal with those things at that age. So we started with that. That's where I first started to dabble, and it was something it lit a fire because it was something that I was always interested in from then on.

Speaker 4:

I remember at one point in college I then sought out medical care from a holistic nutritionist. He kind of was leaned in a lot more to what we are calling functional medicine now. I'm sure that's what it was called then, but I just don't feel like it was. In the forefront of. Social. Media has helped a lot with being able to expose us to that sort of practice, and I remember being gluten-free in college, which was a time to be doing that Cause at that time it was not a trend, so there was not gluten-free product. You can find gluten-free pretzels, but that was about it. So I kind of had a hone in my diet then and I was always someone that was so disciplined based off of how things made me feel, and so I think it was just an interest that carried me all the way through life Long winded.

Speaker 4:

But then I kind of stumbled upon functional medicine and what it is now, found a course that I really enjoy, started diving into it, still doing it.

Speaker 4:

It's a lot of information and, as I said before, I'm stubborn type A individual, so I want to be really good at what I do before I go out practicing it and passing that information along.

Speaker 4:

And in that time period of exploring that, expanding upon it, surrounding myself with it social media being a lot of the following functional medicine sort of entities and talking about it with colleagues who felt the same One of my colleagues, he followed you on Twitter I actually, admittedly, did not have a Twitter at the time, I don't have very many social media accounts and he had told me that there was a doctor who definitely fell into the realm of what I'm interested in metabolic health and kind of healing your body, getting away from the standard of care and it was Dr Ovadia and he had made a post that he was looking for someone who to add to his practice, to kind of help him expand his scope of care, to be able to access more people because he was getting busy.

Speaker 4:

And so then I reached out and it kind of all went from there making it onto the iFixHearts team. So long-winded answer, but it's been something that's been near and dear to me in terms of taking care of myself and accountability and breaking away from the minimal options modern day medicine sometimes gives you, and it just kind of led me down the path to find iFixHearts and Dr Ovadia.

Speaker 2:

The acai. I don't know how to pronounce it.

Speaker 4:

Yeah, I you know what. I don't know if I do it like properly either, but acai is how I've always pronounced it, so I could be totally wrong.

Speaker 2:

What was the benefit for you? Did you actually experience a benefit and if so, what was it?

Speaker 4:

So, in terms of those medications the major ones that I'm speaking to the first three we really tried were omega-3s. Those are beneficial for multiple reasons but in terms of like arthritic and joint pain, it's helpful for joint health, bringing down inflammation and whatnot. Cosamine has the same sort of mechanism. Acai falls in there too. It's a really powerful antioxidant kind of combats free radicals and things that cause inflammation. The main thing that we're focusing on is bringing down internal inflammation, which is lending to your autoimmune disease. Diet plays a massive part of that, but those supplements help to aid in that as well.

Speaker 2:

We've had an awful lot of folks on the show who have dealt with something like arthritis rheumatoid arthritis and have experienced tremendous benefit by going to a high protein, high fat, low carb diet. Is that something that, as a child, you were able to experience? Did you experience any kind of relief from symptoms?

Speaker 4:

So I will say, in terms of when we started the natural supplements, it definitely made a difference. My main area of where it started was in my right wrist and so I have a lot of loss of mobility there just because it's been a chronic disease state area that's been affected by it for a long time. I tend to gauge it there and it definitely did help when I started those supplements when we were younger. When I was younger I obviously hadn't dived into the whole diet situation. That wasn't really until college. But when I did go into college and I did start to become gluten-free, it definitely did help alleviate inflammation. But again, at that time I don't know how in tune I was because unfortunately in college you're also drinking alcohol, which is inflammatory, and whatnot.

Speaker 4:

So, I don't think I was completely lending to it, but I will say now I truly have been full. I had also been diagnosed with celiacs in my adulthood. It's not at our autoimmune disease. Unfortunately, autoimmune diseases do tend to hold hands. Where one lurks, one's right around the corner. And so I was truly gluten free for about since two years ago, and it has absolutely made a massive difference. Along with eliminating a lot of other inflammatory things that you consume in your diet, but yes, I would say absolutely, in terms of eliminating carbohydrates and focusing on high fat, high protein, it has made a very big difference in my own personal health.

Speaker 2:

What about? Obviously, an elimination of pain or reduction of pain is huge.

Speaker 4:

Right.

Speaker 2:

But have there been any other? I guess we call them secondary benefits and I'm thinking more, maybe, of non-physical things, mental or emotional, psychological benefits.

Speaker 4:

Right.

Speaker 2:

Anything you've noticed?

Speaker 4:

So, in terms of two years of this, I will say a lot of them that you are going to register are going to be physical right, because they're just the things that you pay more attention to. I will say I was someone that suffered with a lot of GI upset and bloating and whatnot, and that was definitely very difficult. I would say I definitely sleep better now and when I fall asleep I'm out. There's not many times that I wake up in the middle of the night, and I also will say that I do not get those afternoon slumps of being tired like my significant other will tell you, like she does not sit down, it just powers through the day and I will say that I don't get those slumps in the afternoon like I did when I did consume carbohydrates and was eating gluten.

Speaker 2:

I, you know I'm not somebody who has an autoimmune disease at least that I know of that I've ever been diagnosed with and when I made the decision to stop eating vegetables that I didn't enjoy eating. I'm not hardcore carnivore, but I don't know, probably around the time Phil and I hooked up I had also just realized I don't like eating vegetables, and I didn't do it for this reason. But an immediate effect for me was the bloating that you talk about. I don't have that anymore and it's really nice to not be uncomfortable. That's one of those things I don't hear folks talk about that much, but for me it's just. Oh yeah, I'm not miserable after I eat and it's really fun.

Speaker 4:

Oh yeah, it's something that you do. Take that for granted. Most meals was uncomfortable, especially before I became gluten-free completely. I was uncomfortable daily and it became my norm and I'm so happy to be away from that norm and to be how I feel now. I'm definitely someone who really enjoys fruits and vegetables. I think I got that from my dad because he, my brother, always called me a gerbil, like I was always eating fruits and vegetables growing up and so I still do enjoy those things. It's just finding the ones that you do and don't and that do and don't agree with you, but it it's crazy how much of an impact those little things have. And when you find it and you realize it because you've done an elimination diet, you stripped it back, maybe reset on carnivore, and maybe you just had a hard time just on carnivore, so you included, like, maybe a few fruits and vegetables. Like it's funny to see when you introduce new things back in how much of a knee jerk reaction your body can have when it hasn't had it in a little while.

Speaker 2:

Yeah, you're the first young person that I've spoken with who suffers from rheumatoid arthritis, so I'd like to ask some questions about that, specifically as it relates to being metabolically healthy. Our guest in our previous episode, mimi Morgan. In our previous episode, mimi Morgan was diagnosed with rheumatoid arthritis around 60, and it was debilitating and she found that a essentially carnivore diet reversed everything for her. At 70, she does things that people half her age would be thrilled to be able to do, but she didn't suffer from it, I guess, with the intensity that a lot of children do. The most famous RA sufferer I know was Michaela Peterson, who apparently had several joints replaced as a before she was, I think, before she was 20. Has that have you suffered with? Suffered to that extent?

Speaker 4:

So I do have a significant loss of mobility in my wrist because that's where it started. It's called synovitis, but it's essentially when your joints do become a little bit deformed from the chronic inflammation there and so I call it my pot belly finger. But my pointer finger has a pretty big knuckle in my middle knuckle. But my pointer finger has a pretty big knuckle and my middle knuckle, my PIP, but my wrist it does not go nearly as far as my other one. I do have aches and pains in other places but luckily, as I said, I think when you're diagnosed at such a young age, you don't know any different. So for me, when I wake up in the morning and I'm sore, it kind of is my baseline, which is a blessing and a curse, right, because it's been something that's followed me through life. But I also don't know any differently. When I know differently is when it's really bothering me, like on a day where it really hurts to turn the sink on. That's when I know I'm having a bad day. But other than that, because it was since I was four, I was not someone who paid much attention to it. Like I was a very active kid, so I played soccer competitively at the same time as I played volleyball competitively. Certain times in those sports those areas definitely hurt, more so in volleyball, obviously, with my wrist being the mainly affected area, but in terms of it slowing me down it hasn't, and I hope it doesn't.

Speaker 4:

Like I said, I'm pretty stubborn so I don't know if I would kind of let it. But I will say that when it onsets for people later in life, I could see it set on later in life because eventually our body gives up that tolerance, that bounce back for all the inflammation and inflammatory things that we're consuming. And for instance, gluten is inflammatory to every individual. You are not immune to it. Every human being is, and every day it causes transient leaky gut when you do consume it. And when that happens we kind of cascade down an inflammatory pathway and that can kind of lead to intolerance eventually. And then that can lead to autoimmune diseases and turn on those genes that were there in the body that were not turned on before and or at least not turned on enough to be recognized. And so I think that's why we see a lot of that autoimmune disease stuff kind of come on later in life and I feel like that would be more difficult to handle just suffering, knowing no different.

Speaker 2:

Any idea why you ended up with it?

Speaker 4:

You know what? No, so as a child it's called idiopathic, as in they don't know. Sometimes you outgrow it. Most times you children do. They thought I would outgrow it, but unfortunately you typically would have. After puberty Mine did go into remission and then I unfortunately suffered from something called nephrotic syndrome. It's essentially like a form of kidney failure. I was hospitalized then and then after that it flared again. So I'm not really sure what had brought that on. I had strep throat not too long before I had gotten nephrotic syndrome. So the rheumatologist when my RA came out of remission was suspicious that it was because of that big jolt of inflammation and the issues with my kidneys that kind of bounced it back. So some children outgrow it. A lot of them do. I just was not one of those.

Speaker 3:

How do you, I guess, how do you view this view? You know RA and maybe autoimmune disease as broader topic now, differently than maybe you did. You know experiencing it as a child and then you know going through your education.

Speaker 4:

And then you know, going through your education, you know maybe talk about what you sort of learned early on from your doctors or whatever about this disease functional medicine in terms of when I was younger obviously not being versed in medical terminology and all that yet have, this is how we treat it, and a lot of times in modern day medicine we follow a cascade, right? So, like you're positive for your rheumatoid factor, let's run these tests. Okay, this is where we start with medication. So you start with anti-inflammatories and then, if we want to get your immune system down, we start with a DMARD and we're doing like methotrexate and all those things. So you kind of fall into a category. You learn it the same way in school, in terms of when you're in school, that lifestyle modifications should be tried first.

Speaker 4:

They just don't really dive into what that means, and so I would say that, since experimenting with things on my own, it's a lot of accountability on yourself, like monitoring the things you eat, what you do a lot. There are things obviously out of our control, like we cannot control our genes, but we can definitely taper down or taper up which genes we're trying to get to activate or deactivate. Right, in terms of everything that I've learned now in my view on it. Now I will say, even from personal experience, controlling those factors that I have the ability to, controlling those factors that I have the ability to what I eat, how I exercise, who I surround myself with in order to control stress, my lifestyle, holding myself accountable to keep those things in check, have definitely made a massive difference in how I feel and in my health, when I did not necessarily focus on them at the beginning, when I was told you have this, here is this medication, and kind of followed that route. So I will say it's been enlightening and it has been only beneficial.

Speaker 2:

I want to. I'd love you to kind of expand on that comment you made about being selective, about who you surround yourself with and the stress that causes you. That's not something that we hear a lot of on this show. I'd be interested to. Why did you say that? What's that all about and how does that manifest itself in your life?

Speaker 4:

Yeah.

Speaker 4:

So I feel like a lot of times when we're focusing on stress like when you ask someone about stress their mind immediately goes to work or the things they have going on at home and whatnot.

Speaker 4:

But I think in terms of relationships and the people that we choose to have around us, that also has a really large role in the in our brain chemistry, right, and it's as simple as being around people who fill your cup up that you don't leave feeling drained after you've been around them, because that's going to take a toll on you.

Speaker 4:

It doesn't end up making you feel better necessarily, and I also feel like that really plays into you surrounding yourself with like-minded people so you're not constantly having to justify yourself and your practices and your ways, like I mean, that's why we formed a community on I Fix Hearts for people to be able to kind of come together and have those same like-minded individuals to bounce ideas off of talk about challenges. When you have people surrounding you that have the same goals in mind and also your best interests in mind, I think it's very undervalued because you are no longer feeling like you're navigating on your own, you have a team of support around you, and so that innately is going to lessen that stress, better your mental health and thus make your lifestyle a lot better too, cause stress, as we all know, plays a very big role in our health plays a very big role in our health.

Speaker 2:

Well, phil, it's got to be challenging for you. No-transcript. I love to hear you talk more about being very careful about the people that you surround yourself with. I'm fortunate, you know I work for myself. The only people I'm with regularly are my beautiful wife sitting right there, and she's 100% on my team. I don't have to explain and justify why I choose to live the way I do, but the idea of having to do that, especially in a professional situation, it sounds like that could be extremely stressful.

Speaker 3:

Yeah, I mean, you know it's certainly a challenge when you're constantly, I would say, viewed as an outsider, viewed as the different one, you know, when you're not going along with the program, and that's not an easy thing to do. And you know, one of the things that I certainly commend other clinicians you know, like McKenna, who have been able to, you know, who have opened their minds to the possibility that we might be wrong about some stuff and start to do things differently. And I think you know, for the most part, that is stimulated by our, you know, sort of desire to get better outcomes for our patients and, quite honestly, for a lot of people, a lot of the practitioners in the metabolic health space, it started with trying to get better outcomes for ourselves, right Treat our own problems and, you know, having followed the advice of the system and seeing that it wasn't working, we start to seek different answers and that oftentimes lead us down this pathway. For the, you know, for the people out there trying to do this, I do think it is, you know, it is very important to have a community that can support what you're trying to do. You know, one of the things that I think is most predictive when new patients are coming into my practice, coming into our practice, you know we usually ask them. You know what do your family? You know what does your family, what does your spouse? You know what do they think about.

Speaker 3:

You know these changes that you're trying to make or that you've been making, and probably you, and probably one of the greatest predictors of long term success is having people around you that are supportive of this and that's an impetus behind the community that we have established at iFixHearts that people can come and join and be around supportive people.

Speaker 3:

Ultimately, I always think about that. You know the saying that you know you're the, you're the average of. You know the five people that you spend the most time with, and I think it's very relevant and I think it holds true when it comes to your health as well. And you know, even expanding upon what McKenna was saying about you know choosing. You know your friends. You know to the extent that you can choose your family, I guess you know. If you're not, you know necessarily in a committed relationship you're going to choose who you get into relationships with, but just choosing who you spend time with I think is very important and it's the stress part of it, and it's also the support part of it, and ultimately, finding people that are supportive is going to make your life a lot better than constantly being around people that are trying to bring you down or trying to tell you you're wrong about what you're wrong about what you're doing.

Speaker 2:

Yeah, I guess so. Is there like a? Is there a support community for RA sufferers? Is there? How do you do this, you?

Speaker 4:

know, jack, I haven't really looked into that, if I'm being honest. I'm sure, like I said for I'm sure there is there's a Facebook group for everything I feel like, but I feel like that'd probably be a good place to start. But in terms of for me, because I was introduced at such a young age, it was something that I just kind of motored along with. It wasn't.

Speaker 2:

When you stumble onto somebody who's got, who also has a rheumatoid arthritis, is there like this instant sense of deeper connection and have you been able to share about the metabolic dietary things that help?

Speaker 4:

You know what? A friend's mom of mine. She was diagnosed with RA as a child as well and she's actually gone through two knee replacements. She's in her 60s and she's an incredible human being and she is tough as nails and she has been someone who hasn't really let it affect her either. But she's definitely had a lot of those joint changes where she's been now needed surgical interventions because it's gotten far enough along. Obviously, even further back there obviously was not a lot of resources talking about different metabolic ways to help your inflammation and your disease state. So now she absolutely does partake in that.

Speaker 4:

And, yes, it was very nice to come across someone who understood right, because there's not that many people that have had RA from when they were young. She was the only person I've ever met in my life that has. I think she found out when she was seven and it was definitely. It felt like you found a needle in a haystack, for sure, and it was nice to be able to openly communicate about it. But I think, once again, both of us were diagnosed when we were so young. We don't think about it, but someone who was diagnosed later in life that's now changed their world and I empathize with those people because it's they lived normally and now they have to live a little bit differently or not have to, but now they're experiencing something that's forcing them to live a little bit differently, and so I feel like those are the people that would really benefit from a community to be able to talk to.

Speaker 3:

And putting your sort of patient hat back on. What do you experience now when you go and see your doctors regarding this and how much do you talk about how these dietary and lifestyle changes have helped you and you know kind of what's their response to that?

Speaker 4:

Yeah, you know what I'm, despite being a practitioner, can be a bad patient, so I don't tend to make it to my appointment more often than I absolutely have to. But when I do go in there, I'm super transparent. I had gotten off of methotrexate when I was 16 and I did not get on another medication, and I'm still not on one. I had gone to a rheumatologist and unfortunately I had also suffered from melanoma. Not to get too deep into my past medical history, but it obviously really limits what medications you can be put on when you've had, when you need to dole down your immune system, but you're also not trying to make a melanoma, or like the remnants of one, worse, and so I was walking a really fine line there, and so for me, I it wasn't. I was not feeling like I needed to be put on a prescription medication that could put me at risk of worsening, like my chance of cancer, when I was following a diet that was really helping me, but there's some practitioners that don't really want to hear that, so it was still.

Speaker 4:

You are this disease state. This is the protocol. This is where you fall. You're moderate to severe. This is a medication we put you on and I wasn't really budging from that, and I did end up seeking out a different clinician that was a specialist and is someone who's a lot more open about, like me, letting them know how I feel and whether or not I feel like I need to be on a prescription medication, because I'm still I'm a very active individual. I work out five, six times a week, a bunch of different types of exercise as well, and so for me, I don't feel like it's affecting me at this point to then add a medication to my body when I feel okay. And some people just don't handle that response well, and others are very open to the fact that you are not doing it out of defiance. You're more doing it out of what you've informed yourself on and how you felt throughout your own process.

Speaker 2:

I can see that Wow.

Speaker 3:

Yeah, I think unfortunately, too commonly practitioners do take it as sort of a challenge when the patient isn't listening to us right, isn't doing what we tell them to do. You know some unfortunately the tendency is to kind of take that as a challenge. And you know, maybe not pay attention to to all does not apply to all practitioners, but I see it more often than I certainly want to see it these days. Maybe then we'll wrap a little bit back to. You know you still practice in the urgent care setting and so maybe talk about you know how the new knowledge you've gained, you know the functional medicine and holistic approaches and dietary and lifestyle approaches, how you've been able to, you know, integrate that into your urgent care practice very much of it's like a horrible way to say it, but it's a more of a treat and street situation.

Speaker 4:

Like I do not have the time to sit down with patients, especially when I'm seeing 40 to 50 of them every single day. I'm in there and so it makes that part a little bit difficult, right Cause you want to be able to sit down. Like I love teaching people about what I've grown so interested in, the things that have worked for me. But a lot of people are coming to me for smaller things that are meant to be talked about and fixed in that moment. So you coming in with an upper respiratory infection or pneumonia and we're taking x-rays and we're figuring it out from there. I always try to give people the blurb of what natural things can help boost your immune system, focusing on your gut health being something that's really major to contributing to your immunity. Some people love to hear about it. I will say that the generation of the 30s to 40s are super open and into that and I think social media plays a major part there. But in certain situations I would say in that setting it's difficult because it's a lot more limited in time, but also in what certain complaints are coming into me, for I would say that it plays most apart with people who are complaining of they can't get into their primary care. Where do they start?

Speaker 4:

I've had noticed that a lot After COVID. It made it really difficult for patients to be able to get into their primary care, and so they're asking questions like my blood pressure has been elevated, I cannot get into them. They're not changing my medication until I do. I don't have an appointment for three months. What do I do? And then having to really sit down with them and take the time to strip it back, despite having a whole waiting room of patients, but just giving them the tools to know what they can control on their end in order to try to better themselves prior to seeing the primary care. And then that's where the functional medicine and metabolic health education comes into play.

Speaker 3:

Yeah, I mean, and ultimately, you know the medical system, and especially the urgent care system, is not set up for these sort of lifestyle discussions and interventions, and so it is challenging and obviously that's what has led you to look for other ways of practicing. Look for other ways of practicing, and you know we are certainly fortunate to be, to have you as part of our mission to make this type of care available to more people, and that really is the challenge that care like this is difficult to find for many people. That's what we are working on.

Speaker 4:

And I'm really excited too as well. Like 40 to 50 patients a day, like I said, does not give you the time to be able to sit down and really dive deep with people, and I'm really excited about being able to do that.

Speaker 2:

You have an advantage that an awful lot of the practitioners that we interviewed don't have, and it's the flip side of your disadvantage the opportunity to maybe draw conclusions about various cohorts of patients that you wouldn't be able to do with a smaller sample. You made a comment that I thought was interesting and that's why I'm following up on this. You said people in their 30s and 40s. Can you make any generalizations about other cohorts? So I will say- and remember, you're talking to a marketer here, so that's what's driving my questions.

Speaker 4:

Yeah, so when I mean the 30s and 40-year-olds, tend to be more receptive. They're the people who because I mean they're all on Instagram and whatnot, and the information becoming more readily available to people, which is great but they're more the ones to question me on, let's say, they have a sinus infection. I'm explaining to them that there is no signs of a bacterial infection, so thus we don't want to use an antibiotic at this time, because they come with their disadvantages killing both good and bad bacteria and they can mess with your gut health and whatnot and they're a lot more open, or up to that, In terms of other More open compared to I would say like the older generations.

Speaker 4:

Once you get into a lot of patients in their 70s, like when they come into me, they say I have the sniffles and I want to nip it in the bud. It's like the most notorious statement that I hear on a daily basis, that they want their z-pack. It's been a day of the sniffles and their doctor always gave it to them and it's made it better and so that's what they want and you do go in circles explaining to them and when they leave without it they are very upset and so that's a generalized cohort. That is definitely there. The nip it in the bud statement is a widespread statement among the a little bit older population.

Speaker 2:

Okay.

Speaker 4:

But yeah, I will say in terms of you can definitely tell the people who have also done their deep dive on what they can control on their end, enlighten themselves on inflammatory things and beauty products and all that stuff, because those are the ones that tend to ask a lot more questions about the medications they're being prescribed, why they're being prescribed it, which is great. I think that's so awesome, because medicine illiteracy is very widespread. I really notice it a lot in the emergency department, too, when you're serving patient populations that unfortunately don't have access to insurance and so then they're end up in the emergency department for their healthcare which is health.

Speaker 4:

illiteracy becomes a lot more apparent there, and so I feel like it's wonderful for patients to start to advocate for themselves and ask those questions, because it's only going to help them in the future.

Speaker 2:

Have you got any other general observations about generalizations of any kind of cohort that you can make? That's a good question, I realize that's a provocative question, but it could be really useful information.

Speaker 4:

Yeah, I would say that there's definitely certain patient populations that come in that are readily open to help themselves, and then there's ones that are absolutely not. So when you're calm, it's hard to say who plays into that, though, because there's it's not like a certain race, sex age you definitely, as a practitioner I'm sure Dr Ovedia could speak to this. He's going to have some of those people that end up in his office that are not going to make that diet change.

Speaker 4:

You could tell them to blue in the face. What kind of a difference it would make. But they're going to be the patient population. That is the cohort that is like Nope, give me the medicine. I'm not giving up the same as cookies, it's not going to happen. I'm going to be a diabetic for life, like I'm just going to do insulin so my kidneys fail and I'm on dialysis. You just have a few of those patients that are just stubborn and they're not going to change the way that they live, and it's pretty quick that you're going to be able to tell that. But it doesn't lend to a specific, like I said, race, sex, anything like that.

Speaker 2:

That was.

Speaker 3:

Yeah, Ultimately, you know the the patient has to want to change. They have to be open to hearing this information and willing to put the work in. I mean, again, I think we're very transparent about this not being the easy approach, necessarily, but it's the one that really pays dividends in the end. And so if people are willing to consider that and then willing to put the work in themselves to do that, that's what we're here to support ultimately.

Speaker 2:

Cool, this is fun. So I'm going to ask a question that we may have to edit out the answer to how much of your work is as Phil's PA and how much of it is as whatever else it is that you're doing.

Speaker 4:

So right now I am full-time urgent care, pr and emergency department and I also do um some work with I fix hearts nothing in the PA capacity yet, for I have two too many jobs at this point. But in terms of transitioning, transitioning like I had mentioned earlier, I am currently going through a course in functional medicine and learning that while working both those jobs. So it's been kind of like a slow and steady I'm still doing that, growing closer to finishing, and so the plan with iFixHearts was, as you guys know, lisa has now been brought on as another practitioner that patients can see in the Ovadia Heart Health realm. Once she was kind of up to speed and booked up that then hopefully my next move was in that direction as well, to then be a practitioner that patients can see for metabolic health and functional medicine.

Speaker 2:

Oh, wow, yeah, Wow and functional medicine.

Speaker 3:

Oh, wow, yeah, wow. I'm sorry, phil, I did not realize that was. That is seriously cool. You know again a little peek behind the curtain that Jack doesn't necessarily insight into what's going on in the medical practice, but the medical practice is growing. The demand is literally off the charts and we're trying to grow to meet that demand. We look forward to having McKenna as a more integral part of the team and, honestly, by the time this podcast comes out because there is a delay between when we record and when we release she very well may already be there, but come look for her over at iFixHearts and she's going to be bringing some expanded not only just expanded capacity, but bring some you know, unique practice aspects, some unique you know aspects of to the practice and we are looking forward to that.

Speaker 2:

Let's see. This one looks like probably first week of October, so if you're listening to this, you're listening to this in October or later, and, gosh, maybe McKenna's already doing that. Okay, I sound like a complete idiot, because when it comes to the business side of the medical practice, I know absolutely nothing. But that may make me more qualified to ask the stupid questions. So that's what I'm here for, okay, are there any important questions that should have been asked that I haven't asked yet? And I'm asking both of you now.

Speaker 4:

I think you did a phenomenal job yeah.

Speaker 3:

I think we covered it pretty well. Do you want to? I know you don't do a lot of social media, but do you want to drop any plugs or anything for people to follow you? We can do that and then edit that into the end of the episode if you want.

Speaker 4:

Oh no, I mean in terms of just to kind of expand upon, like once I do dive into the functional medicine, kind of making a few videos on my own. There's a Embry Health account that I haven't really gotten any posts up on yet, but that will be in the works as well. But other than that, no, just it's Embry Health and that's just. On Instagram. It's M-B-R-I.

Speaker 2:

Health? Okay, I would not have. I would have not have guessed that. All right, very good. Mckenna, it is a pleasure to meet you. I'm so glad you are part of Dr Ovedia's team and obviously going to be a much more important part going forward. So that'll be cool and I'm sure as a result you and I will end up talking more than we would typically talk with our guests, phil. Really cool, I love it.

Speaker 4:

Exciting stuff.

Speaker 2:

Okay, I'm going to ask where are you?

Speaker 4:

I am in St Petersburg, florida, dr Ovedia and I actually don't live that far from each other. Oh my Lord, yeah.

Speaker 2:

Wow, that's even better. I'm thinking it's going to be one of those. Ah, okay, so that's cool.

Speaker 4:

All right, I'm a Florida girl, born and raised Well good. Yeah, okay, it's quite unusual.

Speaker 2:

Yeah, we'll give you a. We'll figure out how to build a thriving local practice one way or another, but I'm a big fan of that kind of thing. All right, there's going to be some editing here. Yay, all right for mckenna duquette and dr phil Ovadia. This has been the Stay Off my Operating Table podcast. Thanks for joining us. Show notes check them out and join us next time We'll see you.

Speaker 1:

Chances are you wouldn't be listening to this podcast if you didn't need to change your life and get healthier. So take action right now. Book a call with Dr Ovadia's team. One small step in the right direction is all it takes to get started. Contact us at ifixheartscom slash talk. That's ifixheartscom slash talk.

People on this episode

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Dr. Philip Ovadia

Host
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Jack Heald

Host