Meet The Vein Care Team

guests 0:30

My name is Dr.

francois 0:31

Czestochowa Francois.

guests 0:33

I work for the Center of Vein Restoration. In terms of type of people I serve, I like to think that I serve the larger population, all types of people. My name is Laura Steenberg. I work as a physician liaison for Center for Vein Restoration. I have the privilege of working alongside of Dr. Francois in our Leesburg and Purcellville offices, as well as, um, another

laura 0:54

out in, uh,

guests 0:55

in Winchester as well. Those are the markets that I serve. And we primarily patients with chronic venous insufficiency, lymphedema, and lipedema. You

Why Education Is The Treatment

guests 1:04

both have such a strong focus on educating patients What has made

aliyah 1:08

such an important part of the

laura 1:12

I feel like I'm constantly educating which is, it's one of the things that I love most about my job because there's a lot of underdiagnosed patients that we have.

guests 1:22

And there's a lot of even referring

laura 1:24

that don't know, not only do they not know all the things that we

guests 1:27

do

laura 1:27

that we can serve their patients with, but also just not being completely

guests 1:33

educated on how to identify things in patients.

laura 1:35

Part of my job is to go into

guests 1:36

referring providers'

laura 1:37

offices, and I'll educate those providers on how to

guests 1:39

identify

laura 1:40

venous

guests 1:40

disease in their

laura 1:41

patients as well as lymphedema and lipedema. But we also do community outreach.

guests 1:46

That's part of my

laura 1:46

So I'll go into a clinic or some sort of uh, free event in the community and educate patients

guests 1:53

on what's going on in their body

laura 1:55

help them, understand what's happening and what we can do to help treat them. But it's

guests 2:00

just, I think it's much

laura 2:01

more than than what we do in our clinic. I think we've also decided to branch out into women's wellness events. That's something else we've been doing. And of course, Dr. Francois does a lot of teaching at these events where she will focus on

guests 2:13

what she

laura 2:13

which is venous disease. But these are events that serve women uh, not just with leg issues, the whole body. You, go ahead.

francois 2:22

To

guests 2:22

To that end, to expand on what Laura talked

francois 2:25

I feel like as a

guests 2:27

easy to

francois 2:28

just treat and diagnose a But I think the integral

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part of our jobs that we

francois 2:34

oftentimes can neglect

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because of lack of of

francois 2:39

billing, having to do all

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these thi-

francois 2:40

other things, is that

guests 2:42

education aspect, is entitled to not just have treatment, but also be

francois 2:48

educated

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on their bodies and what's going on,

francois 2:51

And the thing that I really like, especially working alongside Laura, is that we have the opportunity to do that, right? We've created this group of clinicians as well as other healthcare

guests 3:01

professionals

francois 3:02

whose focus is not just to treat the patient, it's to treat your family, and it's also to explain it to you so that

guests 3:09

you can treat and help to treat and manage your family member or your neighbor, right? So I don't really complete-- I don't really consider my job completed unless a patient can explain to me what venous disease is, explain

francois 3:21

to me what they think is going on as well, and then pass it on to someone else. And so one of the biggest, most rem- uh, what's the best way of putting this? Most -gratifying thing I encounter is "Hey, because of what

guests 3:36

you taught was able to help diagnose my neighbor-

francois 3:39

and now they're coming to

guests 3:40

see you." That's an

francois 3:43

and that's really why I People think of us as just looking at the legs, but we look at so much more- than just

guests 3:47

that

francois 3:53

into the community- Mm-hmm Yeah ...also to caregivers. It, It's a great way of doing it, right?

guests 3:54

Because

francois 3:55

there's such a lack of education around medicine,

guests 3:58

right? And so you get

francois 4:01

conceptions of what medicine

guests 4:02

actually is.

francois 4:03

But if you were to sit down with a lot of healthcare and actually ask them

guests 4:07

in a simple

francois 4:08

way to dumb down what they sometimes it's

guests 4:11

hard for them to do so,

francois 4:12

right? 'Cause they, very f- rarely do we think outside of our very medical

guests 4:16

literature.

francois 4:17

But the great thing about working in this clinic right? The, the procedures that we do are

guests 4:22

elective,

francois 4:23

right? So you have to choose to come into my And you have to choose to allow me to do the

guests 4:26

procedures, right? So I have to sit, and I

francois 4:28

have to be able to And furthermore, I have to be able to

guests 4:31

explain it to my colleagues as well not

francois 4:33

even really understand anything or why it's so

laura 4:38

I was just gonna touch on, I think the, the most

guests 4:40

rewarding part of this is seeing somebody's life being transformed.

laura 4:45

their symptoms have

guests 4:47

improved

laura 4:48

quality of life improves and that's what it's all about.

From ER Triage To Prevention

guests 4:53

Dr. Francois, emergency medicine background, and you still practice environment that setting?

francois 5:06

Emergency medicine, I don't know if every- anyone's watched "The Pitt" But it's very accurate. And actually lot of my mentors work a really high-paced environment, right? Where you don't always have the chance to

guests 5:21

their family, right? You're just

francois 5:23

triaging, you're treating, and then you have to move on I started seeing a lot of patients who we could help prevent getting into that emergency setting where they would have to be hospitalized

guests 5:36

with all these other playing a role,

francois 5:39

and i-it

guests 5:40

was if we could break the cycle place,

francois 5:44

then maybe they wouldn't have to seen in the emergency So in some ways, I got into this because I wanted to keep people from

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ending up

francois 5:54

And then I was also

guests 5:54

interested in the

francois 5:55

aspect. I really

guests 5:57

loved ultrasound.

francois 5:58

And it was a friend of mine who

guests 6:00

actually said to me, "Hey, I think you'd be really interested and good at this." And it was like, "Oh,

francois 6:03

I never my husband "This

guests 6:07

is

francois 6:07

so random for you to wanna go into from emergency medicine." But I actually think that my practice as

guests 6:14

a vascular medicine

francois 6:15

doctor enriches my understanding as an

guests 6:18

emergency medicine and vice versa. I was gonna say vice versa-

francois 6:21

for sure. Yeah. And I think it really helps to manage everything.

guests 6:25

And I can

francois 6:26

when a patient needs

guests 6:27

in the emergency

francois 6:28

versus not. something that I can manage in the

guests 6:30

outpatient And

francois 6:31

it's been quite the privilege because I also,

guests 6:34

selfishly enough, I

francois 6:34

s-I would say that I get the time

guests 6:36

to speak with my patients.

francois 6:38

Oftentimes I don't. Now I can forge

guests 6:41

right? So that's

francois 6:42

also

guests 6:44

That's awesome. Yeah. Which you don't get from the emergency medicine, you can get

francois 6:49

vascular medicine. Yeah, I'm cheating a little

guests 6:50

bit. Center

A Whole Body Vein Evaluation

aliyah 6:52

for Vein more

guests 6:54

what people might traditionally think of vein problems.

aliyah 6:58

How do you

guests 7:01

evaluate and treat?

francois 7:04

So I think my approach is

guests 7:07

to

francois 7:07

really remind people that

guests 7:09

even though we have multiple specialists multiple people who focus on a specific organ or body part, right? Your body

francois 7:17

doesn't work that way, right? Your body is like this

guests 7:19

really

francois 7:20

intricate biological system, and when you

guests 7:23

affect one thing, you affect other things.

francois 7:25

So usually, the first talk I have is just that

guests 7:28

And I say, "Hey, I know you're coming to me for this, but I'm probably gonna tell you that there are a few other things that are going on," right? "And so that's why I want you to, contact my colleagues in cardiology. That's why I want you to talk to rheumatology. That's why I want you to talk to your primary care," right? Because it's not just me, right? And I might those things, and that's my emergency medicine background, but I certainly don't know everything about it. So I think the best thing about Our clinic is that we, and especially with the help of Laura, we have all of these

francois 7:54

specialists

guests 7:55

who c- we can reach out to, to complete the picture, right? So the legs I feel like this is a little bit cliché to say this, but the legs really you don't think about it much, right? You walk on them. They carry you physically and metaphorically speaking, right? But we don't really care for it individually, right? But it can show us a lot of things about what's going- on in the body. And so usually I start with that, and then I say, "Okay. I see that you have swelling. I see that you have MSK issues. Tell me your history."

francois 8:23

And so at, at the end of the

guests 8:24

consultation, it's not just like a leg examination. It's

francois 8:28

a whole history of

guests 8:29

their medical history.

francois 8:30

And I still have patients who call. My, all my patients get my But I have patients who call me, and they'll just be like, "Hey, what do you think about this?" care question." I don't mean it in a bad way. But I'm honored that you're coming to me because I explained this to But I'm gonna pass on,

guests 8:46

baton and

francois 8:47

that this is something that if you need any other advice

guests 8:52

about who we can help with that as

Swelling Varicose Veins And Sock Lines

laura 8:56

And primarily, I think a lot of patients come to us specifically for swelling or because they have, larger varicosities. Sometimes they come in with skin changes or even venous ulcers.

guests 9:06

But oftentimes you don't see those visible symptoms. Sometimes fatigue. And I think more

laura 9:12

specifically with our female patients, especially those of us who are mothers you know, we're used to being on our feet all the time. We're used to being tired at the end of the day. We're used to shirking that and

guests 9:21

shrugging

laura 9:22

it off and not paying attention to our bodies

guests 9:24

as much as we should be because

laura 9:25

busy caring for everyone

guests 9:27

else. So I think I would definitely encourage listening that if you do feel leg fatigue, if you feel like your legs are tired at the end of the day, if there's a,

laura 9:35

there's also, oh, a genetic component to this. It is

guests 9:38

something that's

laura 9:39

It's passed down from generation to generation, so if your grandparents or your aunts and uncles, if you see that they have swelling or they have varicosities, you're much more likely to get that. And then- what's var-

guests 9:50

What's varicosity, versus vein?

laura 9:52

vein.

francois 9:53

does that look it's an enlarged vein. So usually it

guests 9:58

simple terms, it's

francois 10:00

you can see visible

guests 10:01

that tend out when you're standing for extended periods of

francois 10:05

even sitting for

guests 10:07

periods of time,

francois 10:08

oftentimes

guests 10:09

they

francois 10:10

So you'll feel achiness around the area, swelling. Just to

guests 10:15

piggyback

francois 10:16

some of the stuff that

guests 10:16

Laura mentioned, you'll get a little bit of a sock line at the end of the day and get cramping, those types of things. So those are just some of the symptoms. Everyone can present a little bit differently, but if you have any of those symptoms, I think to her point, that's something that should tell you, "Okay, I should at least get checked out." At the very least, wear compression socks. You know what I'm saying? Okay, that would be the biggest thing. And it's very easy to dismiss it, especially amongst our women population. Statistically, we found that they, that we c- tend to come in a little bit later and we get overall... it still varies amongst different racial demographics, but overall, we will get treated at a later stage because we keep putting it off. Similarly, a lot of married men are also the same statistically. They will come in only 'cause their wives are really- pushing them to do so. But it's just like I said, said before, it's very easy to dismiss your legs even though it's the thing that's carrying you.

francois 11:06

And so if you see it, if you are feeling anything strange- Mm-hmm ...don't just dismiss it. Just come in. And I tell people and I also tell my providers your job isn't necessarily to stratify it and be like, "Okay, is this like, necessarily a blood clot versus just simple venous

guests 11:22

Just send them to us, right?

francois 11:23

We'll help with the right? If there's a concern, then they should get checked out. I think everyone- just like a cardiologist will probably say

guests 11:29

should get an echo

francois 11:31

at least once in their whole entire lifetime, everyone should get a venous screen Because just by

guests 11:36

benefit of Earth, you're gonna have a little bit, so you just wanna know

francois 11:40

to what extent.

laura 11:41

And I think to your point, think that when you can get evaluated,

guests 11:45

not

laura 11:45

only are we going to evaluate you we're also going to educate you. That's what we do with all of our patients when they come in, so they... Even if we don't need to see you for a year

guests 11:53

and there's

laura 11:54

that can be done right now, it's just conservative management, that's fine. But now you at

guests 11:57

least have

laura 11:57

the knowledge and the tools to be able to better evaluate your own body so that when you do start feeling pain, which you inevitably will at some point, your legs are gonna hurt.

guests 12:06

This most, most

laura 12:08

folks. We I think we tend to

guests 12:10

think

laura 12:10

about venous

guests 12:11

disease being that's m- much

laura 12:13

more prevalent with older folks, and we just chalk it up to aging. I think a lot of people did. At least I did before I worked here. That's what my thought process was. But yeah, if we, if you can become educated on how to identify this in your, in yourself and your family members, then you can self-advocate

guests 12:28

yourself.

Listening Shared Decisions And Trust

guests 12:39

does meaningful

francois 12:45

question. I think it's doing less and

guests 12:50

more listening,

francois 12:51

but you can only do that...

guests 12:52

And this

francois 12:52

the interesting thing, right? I really wanna impress this because oftentimes

guests 12:57

patients don't see the number of patients

francois 12:58

we have, right? And so i- there's this, role

guests 13:03

that you

francois 13:04

to play of listening, targeted

guests 13:06

listening, but also gently directing, right? "That's not something that I can deal with, but I wanna get to the crux of your story as to what I can actually treat."

francois 13:16

So it's a little bit of that. And then I think the most important

guests 13:19

part, which

francois 13:20

I really think that we try to I never go into a and say, "You

guests 13:25

need treatments."

francois 13:27

I abhor that, right? Usually I say, "How do I meet you halfway so that this fits into I

guests 13:34

come with the information, you come with your body," right? "And so we can meet in the middle and figure out what is needed. If you don't wanna go through with procedures, that's fine, but I have to give you something conservative to help you because these are the outcomes that can, occur if we don't treat it," right? And so I think the conversation aspect, which I'm sure some of my staff can attest to will take-- will result in me taking way too long is the most integral part because patients should feel like they have a say in their healthcare. That's what leads to a lot of confusion about healthcare, right? It's lacking conversation. It's like saying, "You need this, you need that," without saying this is what we think. This is why we think this. This is how you can proceed. If you don't wanna do this, then here are some other measures we have." If we don't have other measures science is only as smart as what we have in front of us, right? So that's the kind of thing that we try to impress upon people, and I think that our patients really value the conversation, even whether or not they decide to go with us. I had one patient come in and she's like, "But you never decide-- You never thought you'd see me again." I'm like, "No." I was like, "I..." And she's mean?" And I was like, just meant that right for you,

francois 14:44

you'd come back,

guests 14:45

which you did. If procedures aren't, then I gave you the guidance that you needed

francois 14:49

to be able to treat

guests 14:50

yourself,

francois 14:51

and you've come back.

guests 14:53

speaks for

francois 14:53

itself." So that's one of the things that I

guests 14:56

privileged to do, conversation. We have the time to do that. Some of my colleagues may not. Yeah. I think with regards to

laura 15:04

your question about patients being heard, I think one of the other things that our patients get to benefit from is the fact that we do have some of these support groups and community

guests 15:13

events where

laura 15:14

Dr. Francois and some of our other colleagues

guests 15:17

we get together

laura 15:18

pretty regularly. We have- That's Good we have round table dinners where we are discussing

guests 15:22

events,

laura 15:23

and we have events that we do pretty regularly. And they're

guests 15:26

patient-centered.

laura 15:27

they're, physician-centered where we're educating physicians.

guests 15:29

But

laura 15:30

oftentimes they're for patients. They're for patients to meet with other patients that also are going through what they're going

guests 15:35

through

laura 15:36

so that they can realize that they're not alone. They can learn about

guests 15:39

the different

laura 15:39

available here in Northern Virginia. They can meet some of the other providers. Because it's not just the colleagues

guests 15:44

that we work

laura 15:46

where we create these events. There's lots of other

guests 15:48

providers

laura 15:49

that come, public floor therapists. There's acupuncturists, people that, that are just in Loudoun County

guests 15:53

in general that

laura 15:54

attend these events and they can also become

guests 15:56

resources for some of these

laura 15:58

Patients get to learn from each other and

guests 16:00

develop

laura 16:00

relationships with

guests 16:01

each other. That's the really important part. Yeah. Because in certain in certain parts didn't mean to cut you off. No, you're good. But in certain, In certain aspects of what we don't have all the answer and all the research yet, right? It's, we're still actively working on it. We didn't really talk about lipedema, which I don't know if you have more questions about. I'm sure it's... I feel like it's coming. I feel like it's

francois 16:19

I feel like it's coming. I can h- I can

guests 16:20

the build-up. It's coming. But a lot

francois 16:22

us and our colleagues have had to research this on our own. It wasn't something that was taught to It was just was very more rigid way of kind

guests 16:32

But we're learning that there's a whole haven't considered,

francois 16:36

And when we

guests 16:37

don't have the answers, sometimes, a neighbor might who's further along on a

francois 16:42

path than So we really try

guests 16:44

to encourage that

francois 16:46

because we can only do

guests 16:47

so much, in all honesty. And we only have so much information. But oftentimes when one person who has it speaks to another person who has it or s- who struggles with it, there's a whole world of conversation that opens up that allows them to benefit from one another. And I think we've really found that

francois 17:01

to be the case with our...

guests 17:03

I think it's rain. Is it

francois 17:04

raining outside now?

guests 17:05

Oh. Probably.

francois 17:07

I think

guests 17:07

the best thing about being in Loudoun County is that we have really

francois 17:10

great specialists where we have a lot

guests 17:12

of educated people who are willing to learn from one another,

francois 17:16

And we just facilitate that. I think we facilitate it. I think we we do a great job of doing that. But for

guests 17:21

the most part, I

francois 17:22

think they do if

guests 17:24

being quite we do it too. Yeah. We're going

laura 17:26

Virginia Beach next weekend Dr. Prinspah and I and two other colleagues to meet

guests 17:31

two other

laura 17:31

colleagues, a, a plastic

guests 17:32

surgeon- Yeah who does lipedema liposuction, as well as another provider who treats and

laura 17:37

patients with lipedema. So we're going specifically to meet with them

guests 17:41

and learn a little bit more about this and watch a surgery and, yeah, we're constantly trying to educate ourselves. There's a lot more to learn.

Lipedema Learning From Patients

guests 17:47

Well, that leads me to my next question, which is lipedema has become an increasingly I had a number who kept coming

francois 17:59

to me.

guests 18:01

patients who kept coming

francois 18:02

me, and I remember

guests 18:03

the first conversation I had with someone who was very well educated with it

francois 18:07

because I said,

guests 18:08

I'm not a lipedema expert."

francois 18:10

And she said, "Whoa whoa. More about it than anyone else I've had." She put me through a test.

laura 18:14

It was a vetting process.

francois 18:15

It was a vetting process. A very, very

laura 18:16

rigorous vetting

francois 18:17

process. And I didn't realize I was going through it. And I was like... And she's like do you know

guests 18:20

about this thing called and blah, blah?"

francois 18:22

And I was like, "Yeah, I've read about it." I

guests 18:23

I was like, "I don't really, we don't really have the superior testing for it, but this is how I approach it, and I, go through these

francois 18:29

things first." And I of went through

guests 18:30

the whole conversation with her about it. And then it was, like, 15 minutes was up. And little did I know

francois 18:35

that she not only had it, but she was, in essence,

guests 18:39

say in essence, she was also a healthcare provider who was trying to get treatment for it actively and has now been integrated into our community- in terms patients. And

francois 18:49

sh- the only time she stopped me during the entire

guests 18:52

conversation was when I was like, "Listen, this is what I know, but I don't expert on it." And

francois 18:56

like, what makes someone an

guests 18:57

expert?" She's like,

francois 18:58

Caring enough about it to read about it- Mm-hmm, mm-hmm ...to keep

guests 19:00

learning about talk to your

francois 19:02

patients about it,

guests 19:03

and

francois 19:03

learn from both

guests 19:05

groups," right? She's like, "And you are an expert And you

aliyah 19:06

That's

francois 19:07

what- Exactly That's exactly what she said to me. I still remember that. I'm not gonna say her by name, but- she was like, "And you're..." She's like, "So you're an expert." And I'll still say that, I'm not

guests 19:15

expert because I don't feel like I

francois 19:17

directly treat it.

guests 19:19

I think a lot of can help with it,

francois 19:22

I'm sure to make that

guests 19:23

distinction,

francois 19:23

and I've, I reason it out I'm like, "This is why this

guests 19:27

can help. This is why

francois 19:28

I will start you on the right path." And my biggest thing with lipedema

guests 19:33

is I want them to have the resources so that they can keep learning and teaching me. So I'll have patients who come back, and this is also one of the best parts of my job, but I'll have patients who come back who's like, "Hey, I found this device, and

francois 19:46

only this much

guests 19:47

money, and for your lipedema patients, you should really have them try it." And it's amazing because it's like these are patients who are helping

francois 19:54

me to treat other patients. Mm-hmm, so when I go to my next patient who

guests 19:57

frank lipedema,

francois 19:58

I'm like, they're like this is too expensive," 'cause it's an expensive disease. A lot of- Yeah these disorders are not, something that you can get, you can treat

guests 20:06

easily, right? It takes thousands of- Part

francois 20:07

of that is the

laura 20:07

insurance

francois 20:08

world right now. That's true. That is the insurance world. Yeah. Which hopefully will change

laura 20:09

next year. Like 2027, yeah. Yeah. Will be an

francois 20:09

ICD

guests 20:12

ICD code.

francois 20:12

but it's... it's that

guests 20:13

part, but it's also

francois 20:15

the experts are far and few

guests 20:17

between, right? There are a

francois 20:18

of providers who don't even know about it. And I didn't know about it until

guests 20:21

I was forced to learn about it, right? But

francois 20:23

the patients will come in and say,

guests 20:25

Hey,

francois 20:26

I found this really

guests 20:27

and then

francois 20:27

can add that to my list other

guests 20:30

right?

francois 20:30

And it's really

guests 20:31

It's gratifying who start to have,

francois 20:35

resolution

guests 20:36

who are just like, "Thank

francois 20:37

you because no one listened to me." "And, but you

guests 20:39

at least listened."

francois 20:40

I never make some of the promise that I'm

guests 20:41

fix you,

francois 20:42

right? I'm glad I'm not God, right? But

guests 20:45

do make them the promise that I will give them all the resources that I have

francois 20:49

to be able to help manage it.

guests 20:51

When they

francois 20:51

come back and they've managed it,

guests 20:53

are even that more excited to spread it to other So we like create like a,

francois 20:58

this parasitic kind of like effect. It's like

guests 21:00

infectious kind of process of- Infectious. It's a good infection. process, but-

laura 21:06

I think w- specifically with our lipedema patients, most of these patients have gone most

guests 21:11

of their life

laura 21:12

not being diagnosed.

guests 21:13

They- and

laura 21:14

Yes.

guests 21:16

Yeah. Go

francois 21:16

I'll let you answer

What Lipedema Feels Like

francois 21:17

that one. So lipedema, the easiest way of describing it, it's an inflammatory connective tissue and I affectionately

guests 21:23

call it the Kim Kardashian effect is that

francois 21:26

evolutionarily it

guests 21:27

would've

francois 21:29

like, living on the Serengeti.

guests 21:30

But what

francois 21:31

start to have is you start to

guests 21:32

have kind of this fat buildup in

francois 21:34

these weight-bearing areas. So a lot of times

guests 21:37

patients will come in... And it does have a specific

francois 21:39

morphology, but it can be very easily di-

guests 21:41

confused

francois 21:42

with lymphedema or really bad cases of venous disease. So they're all like intermingled. But my patients will come in, and some- sometimes for the later

guests 21:50

stages that you can't quite make out, they'll say,

francois 21:53

Hey, this all started

guests 21:54

arthritis.

francois 21:56

and even though

guests 21:57

I get reprieve in my arthri-

francois 21:59

I still have a lot of discomfort and pain in these

guests 22:01

particular areas." And

francois 22:03

it's usually weight-bearing areas because that's up landing. And the really interesting

guests 22:08

thing is that,

francois 22:09

people will often say just lose

guests 22:11

lose weight. Just lose weight."

francois 22:13

for a lot of

guests 22:14

these people who have

francois 22:16

lipedema it's not

guests 22:18

to do

francois 22:19

because the fat that, this type of fat that they accumulate

guests 22:22

ends up

francois 22:23

increasing their fat gain

laura 22:26

also doesn't respond to diet and exercise the way that normal fat does.

francois 22:29

It... Yeah, it doesn't. But it also, it, because

guests 22:32

of the inflammatory aspect of it it causes

francois 22:35

everything to go up into

guests 22:36

o- in

francois 22:37

And inflam- inflammation is like a catch-all phrase, but that's all to just say that

guests 22:41

when

francois 22:41

have this excess

guests 22:43

inflammatory fat, makes it really hard for you to lose weight overall with the typical

francois 22:48

So even though you'll try these things like diet and exercise, it increases your stress response and makes it

guests 22:54

actually like this

francois 22:54

worsening So you have to target it in very specific ways. And you, oftentimes it's not just lipedema.

guests 23:00

It's with venous disease, lipedema with lymphedema- these types of

francois 23:05

mixtures that

guests 23:06

we see because people diagnosed early, right? And so down the line they come in and then other organ systems are also affected. So it's not just one organ system. These multiple organ systems get affected. And so when patients come to us, they

francois 23:18

have two or three organ Oh, really my goal with a lot of this is like lipedema,

guests 23:24

yes,

francois 23:24

I care about the cosmetic aspect.

guests 23:26

I'm a female, I understand that, right? But

francois 23:29

people with lipedema

guests 23:30

have higher

francois 23:34

Because you're not gonna wanna move if you have this

guests 23:38

Makes

francois 23:38

sense, right? So i- insomuch as we can stop

guests 23:41

that

francois 23:42

and prevent that from worsening, you're talking about really

guests 23:45

affecting women's

francois 23:46

right? We're more likely to die of a heart attack, silent heart attack. We're more likely to have strokes, right? We're more likely to keep going despite the fact that we're getting all, we have all these other

guests 23:55

right? And so stopping the cycle at one point is really important. Important.

francois 24:02

that's why I think the lipedema aspect is important, not just because and there's

guests 24:07

a cosmetic aspect, b- but because of what it'll affect down the line. I understand. Sounds like a lot fun.

laura 24:12

fun.

francois 24:13

Depends

guests 24:14

on

francois 24:14

day.

guests 24:15

it depends on the day. You guys have actually started growing a community the broader What have you learned from cre- creating that community? So much, honestly. That hormones play a really large role Dr. Cruz, which who you should definitely have on your show next- She's been on she's amaz- she's amazing. She's, has she

francois 24:38

on?

aliyah 24:38

entire

guests 24:38

crew has been. were talking about her

francois 24:41

I'm just throwing out words.

guests 24:43

down the list. Yeah, the, it, there's just so much more than you would think is involved that plays a role. And that, Like, when it seems like a mountain, the biggest thing I talked about this a little bit on the podcast another podcast that we did that you just have to take one piece and just work on one piece, the one piece that you can change. Some of my patients will come in and say, up ice cream." And I'm like, "Okay. Can you do a little bit of the

francois 25:07

diet

guests 25:08

with that ice cream? Can you get into a pool three times a week for me?" And they're like, "I can do that." I'm like, "Okay, that's a place where we can start." Can you get in the pool with the ice cream?

aliyah 25:16

with

francois 25:17

cream? I think that would

guests 25:18

make it the best. Actually, I I was like, "I go to the

francois 25:21

pool. I go, I do older

guests 25:23

calisthenics in the pool 'cause

francois 25:25

the grandmas will give afterwards." I was like, "That's the real hustle." I know, exactly. I was like, "That's the real way to go." And you make new friends, and they love you like that. This is the best. The why, I love it. Right? It's a great way to go. I love

laura 25:37

it. I was going to share I, something that I've

guests 25:40

learned

Hormones Menopause And Medical Gaslighting

laura 25:40

with these,

guests 25:41

the

laura 25:42

community that we've created here is that every single patient's story seems to be eerily similar in the sense

guests 25:49

that they've

laura 25:50

been medically gaslit. They've all been under-diagnosed or misdiagnosed. Most of them have been told to just lose weight. And they've also a lot of the changes have happened during menopause, perimenopause. There's hormone hormones that affect this being exacerbated or presenting itself. Everybody just seems to kinda have the same experience which is why I think having these support groups and educational events is so important because this is a group of

guests 26:19

primarily women who underserved. And so

laura 26:24

to your point earlier, you were asking about patients feeling

guests 26:27

heard. These... We're

laura 26:29

creating a space for

guests 26:30

to feel heard. Not

laura 26:32

are they being given

guests 26:32

actual diagnoses

laura 26:34

but also resources, education,

guests 26:37

support,

laura 26:37

friendships, mental

guests 26:39

health support. Patients now feel they're not alone. Exactly,

laura 26:43

yeah.

guests 26:44

is important. It is.

francois 26:46

And I think

guests 26:46

it's really

francois 26:48

to remember I

guests 26:52

say being on both ends of the

francois 26:55

I've

guests 26:55

been a patient, and also There is much To know as a clinician

francois 27:04

in any field

guests 27:05

specialty,

francois 27:06

everything is

guests 27:08

right?

francois 27:08

And people will present with vastly kind of different And I think that's why there's an Or to empower Not because they, were not, Let me put it this way. It's when a patient comes in

guests 27:26

with a Google, y- diagnosis, right? I'm not just "Why are you googling?" I'm like, "Tell me why you think you have this." Teach me something that I don't know. Because we are fallible. We as clinicians are fall- fallible. I think that's really easy to think that we should know

francois 27:43

everything, and we don't. I'm just gonna

guests 27:45

put that out there. We do not.

francois 27:47

And so sometimes when we don't diagnose lipedema, it's because we've never seen lipedema, right? It's because

guests 27:53

how do

francois 27:54

you diagnose something you've never seen, right? How do you, like, when your training just has these specific things-

guests 28:00

and that's

francois 28:01

you have in your toolbox

guests 28:02

everything kinda looks like a

francois 28:04

if all you have is a So I think that as we

guests 28:07

expand, as we learn more things, you'll have a lot of clinicians who will be like, "Oh, I have a lot more in my toolbox now," right? Which is, I think, the benefit of kind of the community

francois 28:16

we've created of clinicians as

guests 28:17

well, 'cause things in my toolbox, right? the, there was so

francois 28:22

hormonal things that were that

guests 28:25

kind of related to lipedema.

francois 28:26

But now if I have a patient who, has a little bit more kind of rigid lipedema, I'm like, "Hey

guests 28:32

let's

francois 28:32

more of a hormonal

guests 28:34

review of what's going on." Right? I it's wonderful are not stuck in your ways. Because I think it happens Don't come in here with Dr. Google

laura 28:52

anything." I think

guests 28:53

in

laura 28:53

specialty- providers too, I think a lot of specialty

guests 28:56

providers stuck in

laura 28:57

their one la- they wanna stay in their one lane. And I think part of that, I'm grateful for your ED background because I think you, you are unable to look at just the one thing, yeah. You look

guests 29:06

at the

laura 29:07

as a whole,

guests 29:08

and, Short of like puppies that can't keep our attention on one thing. Yes, 100%. And that is a, benefit of my specialty.

francois 29:16

I will say that

guests 29:17

there are things that I

francois 29:20

And I have called "Hey," like I have patients who could attest to this, who I'm just like, "Hey, I think I

guests 29:25

might have missed something," or, "I think there's

francois 29:27

else."

aliyah 29:28

Are you like one

francois 29:29

And I'm like- then something- Yeah. clicks and you're like- Yeah, 100% 100%, And that's,

guests 29:34

and it's funny because it's not just me. Like I've had other of my

francois 29:38

other providers who are just like, "I realize that I've been treating patients in a certain way-" probably had this, but I just didn't know that they And so how do you make up for that deficit,

guests 29:48

right?

francois 29:49

Physicians can

guests 29:50

know so much. Healthcare providers can only know so much, and so we have to empower the patient to advocate for themselves. I always tell this to my parents. I'm like, "Listen, you should know what medications you have. You should know what they do, and you should know the side effects," right? Basic things to know, and you should ask about it. If you feel like a s- a physician, and this part you can choose, you feel like a physician's unwilling to sit there and talk to you about it in some capacity, whether whether it's like, giving the information by their staff, right? Then that's not the physician for you. I'm not the physician for everyone, right? Find the you. And luckily we're in an era, especially that there's a lot of great clinicians that you can find a physician for you. You don't have to just stick with one who you're like, "We're not on the same vibe." I've gone doctor shopping. I really have. We all do. We all do,

francois 30:35

Okay, not just

guests 30:36

based on the reason, but I have definitely gone doctor shopping. So I encourage people to go and meet their doctors. Know them, right? Just be like, "Hey, I know you, that you can't account for everything. What do you do when you can't account for everything?" my s- unless they're watching a video like this and they really know you. But outside of that, really just like a headshot and an About Me bio, 'cause you probably don't want to-

aliyah 31:03

Yeah. Um, there's

guests 31:06

medical info What do you think patients should look for

francois 31:16

their provider? That's a good question.

guests 31:17

I'm curious to see what you would say-

francois 31:19

I mean- 'cause I have a thought, but-

laura 31:20

I think it's all,

guests 31:21

I think it's all

laura 31:21

worth bringing to your provider. I think it's the more information that you can share about what's going on in your

guests 31:27

body with

laura 31:28

your provider, the better.

guests 31:29

I think

laura 31:29

the reality is

guests 31:30

that and I think you, you touched

laura 31:31

about this earlier, she can

guests 31:34

only treat what she knows So

laura 31:36

need to give her as much information as

guests 31:40

humanly

laura 31:40

possible for her to be able to make an assessment, right? Because she does... we do ultrasound in our clinics. That's diagnostic. She also does a clinical evaluation. But y- you can't

guests 31:49

see the pain in the leg, right? That's

laura 31:51

something that patients have to describe.

guests 31:53

They to

laura 31:54

communicate to her,

guests 31:55

My legs hurt

laura 31:57

at the end of the day. They hurt,

guests 31:58

they throb when I'm trying to go to sleep," or whatever it looks like, right? That's communication about what they're feeling and their experience in the world.

laura 32:05

So I think if there's any questions that

guests 32:07

patients

laura 32:08

or any concerns that they have, I think bringing it up

guests 32:10

to

laura 32:10

your primary care provider, specialty providers,

guests 32:13

bring it

laura 32:13

all up. And I think,

guests 32:16

that you receive from, hopefully from your primary or from

laura 32:18

any specialty providers,

guests 32:20

will help you determine the sorts of things

laura 32:22

you wanna bring up to them. But I would say everything

Self Advocacy And Finding The Right Doctor

guests 32:25

I think that's a loaded question. It's a to answer. I think that's the me thus far.

francois 32:30

I think we treat medicine

guests 32:33

as into a provider the answer, right? We- you treat it as a okay, I go in and you should have the answer for me, right? I think a more appropriate

francois 32:43

way of treating

guests 32:44

medicine is of exclusion,

francois 32:47

right? Oftentimes, there's

guests 32:49

a bunch

francois 32:49

of different things

guests 32:51

that can be

francois 32:51

going on at the same time

guests 32:53

or that hasn't

francois 32:54

just hasn't declared

guests 32:55

itself, right? So in the

francois 32:58

emergency room, I am-- it's very much

guests 33:01

triage-based, right?

francois 33:03

I deal with the people who are the sickest first, right? And then I

guests 33:05

move on from there. But sometimes the people who are actually sick as well don't declare themselves immediately. It takes time for So it's

francois 33:15

like we have this mentality

guests 33:16

medicine, like it's almost like fast food, right? You want you want it now, right?

francois 33:22

and that's the most

guests 33:23

conven-- I hate to say it that way, but it's not Burger King. It's

francois 33:26

I've said that. We are--

guests 33:28

it is... medicine

francois 33:29

at its core is a science, But at

guests 33:33

its crux, it's an art form, right? You're not

francois 33:36

gonna rush an You just wait for them to come

guests 33:39

up with a Picasso, right? And saying that you should take... some things are time sensitive. I understand that. But

francois 33:45

I think that there's that, I don't wanna say patients put that pressure on. I think it's

guests 33:48

just pressure like insurance company, things like that, to make a diagnosis. And so I think more than anything else, instead of bringing everything,

francois 33:55

like, I think

guests 33:56

the most

francois 33:56

important thing I can

guests 33:58

impress upon patients is to start with the thing that bothers you the most. We may not get to everything, right? I may not get to your years of hand pain. I'm sorry. It's just, it's not specialty, right? I'll try to address it at some point or address it. But start

francois 34:12

the thing that's bothering you the most, the thing that was just like, "I

guests 34:14

have to see this provider," right?

francois 34:16

And then see how they respond to

guests 34:18

you. See if they dis- just

francois 34:20

your questions

guests 34:20

offhand say, "Okay, that's something I can work with," right? And

francois 34:24

if they're just like, "I'm so

guests 34:25

sorry, I patient,

francois 34:28

will

guests 34:29

keep

francois 34:29

addressing these issues," or see if they're just like, "That doesn't matter," Because it-- at the very least if it matters to you, it should matter to the provider. Whether or not they believe that's a real issue it should matter

guests 34:39

to them, right? That

francois 34:41

they have to educate you And

guests 34:43

so I think that's the most important. I know I gave you a lot of things with that. But like I think just ultimately remembering that medicine is an art form,

francois 34:49

right? That you're gonna make some blemishes, that there's gonna be some things that may not look right, that you have to zoom in, zoom out, right? You have to like- That's really what really good clinicians are. They practice it as Right? It's the time. Ex- it's a final version all the time, and everyone has a bit of a different masterpiece. So for some of my patients, it takes me

guests 35:10

a year.

francois 35:10

I one patient in particular, it took me a year to dwindle everything down. I was like,

guests 35:14

Just stick with me stay with me with this," and sometimes it

francois 35:17

happens. And not everyone loves my art.

guests 35:19

Not... It's true, okay?

francois 35:21

But I try to ins- I try to impress

guests 35:24

upon them that what is

francois 35:25

important to them is important to me. You can ask Cindy.

guests 35:27

I will see a patient no matter what. I'll be like,

francois 35:29

If you really need to see me, if you're telling me that you have to see

guests 35:32

me today,

francois 35:32

and that I'm gonna... I will

guests 35:34

squeeze you in."

francois 35:34

I've had people walk into my office, and I'm

guests 35:36

like, "Hey, with?" Because I, that's the same care that I would want for my family. But similarly, I

francois 35:42

think that the way that patients

guests 35:43

can help protect themselves is to do those things, and just to remember that, right? That, we have bad days, too. days where we're just trying to keep people alive. And when we see a patient, we always want to give them the best care we can, but sometimes that takes time. I think the challenge too, Most of us are caring I

francois 36:11

would, I I tell

guests 36:12

but I'm... What are

francois 36:13

shaking your head for?

aliyah 36:15

just like, "No."

guests 36:16

people are active listeners and other people are,

aliyah 36:21

professionals

guests 36:22

are more of "I know what's going on," Mm-hmm. they don't necessarily give the speak. So I could see being a sat down and they wanted to talk about 20 about the pain they've been in, and we're

aliyah 36:36

pause right there.

francois 36:38

Mm-hmm.

guests 36:39

these issues first, and then round two we'll get to." And I'm gonna

francois 36:43

super honest with you, I've had to do

guests 36:45

Yeah. I've

francois 36:46

had to be like, "Hey,

guests 36:47

listen,

francois 36:47

I care." And I'll sit them

guests 36:48

there and I'll be like, "I

francois 36:49

care

guests 36:50

about the story. The story matters, right? I also have 20 other people with a story." Yeah. "And what I wanna do is make you feel and make you get to, we can address some part of your story today. We can continue

francois 37:04

it another day. You can email me.

guests 37:05

You have my number. I'm not closed that if people feel

francois 37:09

like their doctor

guests 37:10

isn't closed off from

francois 37:12

a route

aliyah 37:13

they can

francois 37:13

still- There's a

guests 37:14

wrapping and still contact, right? Yeah. My

francois 37:15

patients will come and call me for accidentally or on purpose, I don't know which it is, for scheduling. And I'm like, "I have no idea how to do this." You just, like I... You've gotten the most useless person in the clinic. For that's not...

guests 37:27

S- But I'll be like, "Okay, frustrated about this.

francois 37:31

I'm gonna find a way to

guests 37:32

schedule you." And they're like, "Oh, thank you so much, Dr. France." I'm anything." I literally just punted it to the next person,

francois 37:37

right? Like I did nothing.

guests 37:39

And there are a lot of other people who make m- the abil- my ability to sit with a patient. They allow for me to do that by doing work that's a lot harder. Laura is one of them, right? Like it's a really takes a village, right? I s- I come there, Cindy's She's off-screen, but me the time to do so. So I think that I have the affordability to be kind and be able to sit and talk to them a little bit more, because I have staff that allow me to do that, right? So I think that would be another piece of advice is find don't just judge a doctor's office by the doctor. Yeah. Judge them by their staff, right? sits with you and is like, "Hey, let me explain this to you." "Let me talk to you about this." Like there have been a number of times that I've said to Laura, "Hey, you should call this patient- and explain all this stuff." I mean- Or she'll yank me into a room. I- "I need you to talk to this patient about this." 100%,

francois 38:27

I'm not the physician

guests 38:28

for every day, right? But I can usually

francois 38:30

somebody

guests 38:31

to it clearer for them, right? Yeah.

francois 38:34

Yeah. And it's about using all the st- the resources you have, and so I will 100% use

guests 38:39

sometimes other persons. That's the whole point of having a good team. It's-

francois 38:42

whole point of having a good team. It's- a great team. It is, yeah So look at their staff, too.

aliyah 38:46

After

guests 38:47

patients, your community, and each other, what do you wish more people understood about advocating for their own health? I know we touched ...is there anything you wanna add to that?

Be Kinder To Your Body

guests 39:01

time for yourself to pay attention to your

laura 39:05

is really important. I think most of us are really busy in

guests 39:08

life. Everybody going on. We Most of us work full time, most of us have kids, most of us have, maybe we're taking care of, all sorts of things going on. Life doesn't stop. And I think it can be

laura 39:20

really easy

guests 39:21

to go through life and not pay attention to your

laura 39:24

and what's happening.

guests 39:25

Sometimes it's like a frog in boiling water. Some of it happens slowly over time, and you just kinda get used to it.

laura 39:31

so I think if we can

guests 39:32

make

laura 39:32

time to

guests 39:33

go see

laura 39:34

primary care doctor once a

guests 39:35

year, I don't think

laura 39:36

There's a, the va- a lot of

guests 39:38

Americans that do not see primary cares. At the least. Yeah. Once a year, at the least. Yeah. Yeah. But if you can make time to do that, and if you're a woman, go to your OBGYN, go get your regular

laura 39:47

go get your colonoscopies. Yeah. Go do all the things, and then pay attention to your body. And you're in any pain, then

guests 39:52

bring it up to your doctor because usually your body

laura 39:54

is trying to

guests 39:55

you something.

francois 39:57

My husband once said this to me about like, "I gotta

guests 40:00

lose weight."

francois 40:01

have an was like, "I'm not losing weight. I lost a bunch of weight beforehand, but now I'm not losing I don't know what's happening." And he's a bariatric I usually make He's a very nice

guests 40:12

though. He really is. Very nice. He's very nice. Very sweet. But he's very straightforward, right? So he said to me, he's "If you were your body and yourself as you were on your patients, do you think anyone would come to you?"

francois 40:23

and I was like, I

guests 40:24

You're not helping." And then he goes, he says to me along the lines of, he's body is just this small creature-

francois 40:30

that is

guests 40:30

desperately trying to keep you alive. You me-" Oh, that's so so sad.

francois 40:36

Isn't it so sad? Isn't that like the most heartbe- from a surgeon of all people. He's like, "This poor little creature has

guests 40:40

carried you. It

francois 40:42

has, taken care of you when you were cold. It has it is your shelter. It is your home,"

guests 40:46

right?

francois 40:47

And you just,

guests 40:48

you just-" Pardon my French, shit on it. Yeah. He's like, "You shit on it." You don't understand that every scar is

francois 40:55

it protecting you. It tells a

guests 40:57

story, right? It's really important to remember that. And

francois 41:00

I just thought that was the most profound

guests 41:01

thing to ever come from a surgeon's mouth. like, wow, that was, it was so deep. That took three brain cells for you to say. And he was like,

francois 41:10

Nah, I'm joking." So he said that, and he's "Just, it's just trying to keep you

guests 41:14

alive," right? "Just

francois 41:15

be kinder to it." "Just be nicer to it. So fine, you had a burger.

guests 41:19

Tomorrow salad. Just

francois 41:21

think of your body that's struggling to just,

guests 41:23

do everything to keep day." You other things in your life, right? You take care of your children, you take care of your parents, you take care of, your spouse. You don't even

francois 41:31

think twice about But how

guests 41:32

often do you actually think about taking care of

francois 41:35

Like a little

guests 41:35

that you have to take

francois 41:36

of."

guests 41:37

Aw.

francois 41:38

that Oh my God, it makes me

guests 41:39

tear up even now. It makes me tear up even now. It makes me cry to- Like a little creature it also makes me cry to know that a surgeon had to tell me

francois 41:46

It

guests 41:47

It really did, but it's the best thing he's ever said. when you're just an amiable baby. Come on.

francois 41:51

Oh, yeah. No, I

guests 41:52

was just- Right? I was really, I was, like, real, I about it.

francois 41:55

And he was like, "Yeah, it's just be kinder." "Because sometimes that's where it starts." And

guests 41:59

especially for women we're one of the statistically it's higher for us, but we can get, we can actually get a broken heart. We can get a stress cardiomyopathy, right? It's nicknamed broken heart syndrome. It's because of our caring, right? It's because of our sense of nurturing. We can die from a broken heart. How crazy is that, right? That's something that's a thing. legit thing. It's a legit thing. It's a l- it's called Takotsubo's cardiomyopathy, but it's a legit thing, and it kills women, right? And when I heard about that, I thought it was, like, really romantic at first. I was like, that's really, that's really- it's really sad. It's like a Heathcliff kind of, like- But I was also like, that's you've things for yourself, especially my women patients. Because

francois 42:37

we tend to not, and we t- we can die of a

guests 42:41

broken heart, right? Isn't that really profound of- Yeah that's something that can affect And so taking care of ourselves,

francois 42:48

you spa days,

guests 42:49

and that we

francois 42:50

are, in the house of a creature that's

guests 42:53

trying to keep you alive desperately.

francois 42:55

Desperately trying to keep you alive.

aliyah 42:57

visual, and now it's like, "Do you want me to die of a broken heart? Let me go to my spa day, Exactly. like-

francois 43:02

on a shopping trip? Is this your wife? Like,

aliyah 43:05

me

guests 43:05

do- I don't wanna die of a broken heart. I don't wanna die of a broken heart. Tell, I tell you, look it up. Are you married? Yeah. Yeah, so look it up and show it to your husband. Okay. Guilt him forever. You guys, just to before

Women’s Health Event Details

guests 43:16

we wrap this up, you guys have an event

aliyah 43:20

little about that?

guests 43:20

We do. We have an November 7th. That one, that

francois 43:24

I just

guests 43:25

show up where they tell me. Yes. So event, and we have nine providers. Dr. Francois is- I love how she's saying this to me just to remind me good as we go through. Yep.

laura 43:36

Yeah. So nine providers, Dr. Francoise is

guests 43:38

one of them. And it'll be a women's health

laura 43:40

event

guests 43:41

here in Loudoun County. It will more than likely be a few hours long. We're still

laura 43:47

nailing down the times. I'm gonna

francois 43:48

show up for a few hours. Like,

laura 43:49

I It's gonna be great. Just

francois 43:51

a few hours. long.

laura 43:52

But these are gonna be all specialty providers, so we'll have a cardiologist, a mental health therapist,

guests 43:56

pelvic floor

laura 43:57

therapist somebody who does

guests 43:58

hormones, so many more. This sounds like a good opportunity

laura 44:05

Yes. by-

guests 44:07

by getting information. And I will not toot my own horn, but all of the lineup that

francois 44:12

I've seen so thus far- they're all

guests 44:15

intelligent people who care, who have families- who I think it's really important to see physicians yourself,

francois 44:21

in all diversity sexuality, all those types and they are the

guests 44:26

spectrum. It's really

francois 44:28

awesome. And they-

laura 44:30

They c- they care enough to take time out on a Saturday to- Exactly. Yeah educate people- Mm-hmm ...which is amazing. And a lot of the, the providers that gonna be speaking are, were part of our last event which we had back in May. yeah, the fact that they're... these are repeat speakers people who are just as passionate about educating the community as we

guests 44:46

are. They take great pride in the way that they care for their patients, and

laura 44:49

those are people we like to send our patients to, other specialty providers who care as much as we do, you know? We're all in it together.

aliyah 44:58

that?

laura 44:58

So actually on mywellnessphysicians.com

guests 45:02

that's Dr. Cruz's

laura 45:03

office, so at that we'll have the Eventbrite link open hopefully at the

guests 45:07

of this week. Awesome. And then in future

aliyah 45:15

you like this

guests 45:17

We

francois 45:17

do I suspect that it's gonna always be through my wellness physician. so- Yes.

laura 45:20

yes I think- Yes, Dr. Cruz is the spearhead she's the- Yeah, she

guests 45:23

all of this. Yeah, she's definitely the, the planner in terms of all these things. We've gotten many a 2:00 AM text from her- about "I have an idea. You guys gotta get on board." So- Yeah we get on board. It's good that you guys all support each other that way. Yes. We do. It's wonderful. We're friends by necessity, one might say. It's, it's nice. Mutual respect. As we wrap to add that I'm really glad that this kind of

francois 45:47

platform exists.

guests 45:48

Yeah. I think it's really

francois 45:49

important, especially that, if you were male, it but especially that you're a woman as well. So I think that the

guests 45:56

asked are really

francois 45:57

relevant well

guests 45:58

thought and I think that a lot of women will listen to this, and

francois 46:04

maybe men

guests 46:05

who are

francois 46:05

married will end up coming to our clinic most

guests 46:08

likely. But I think that having more forums like this to be able to spread the word out so that people aren't misinformation don't have a reason to

francois 46:18

fear medicine

guests 46:21

mistrust it, right? They the right-

francois 46:24

clinical team for them. That's what people to walk away from

guests 46:29

There is a team out

francois 46:30

there for me. There are physicians out there

guests 46:32

me. I don't have to be scared of my body or things that are going on." "And I'm empowered to learn more about this." That means I've done something well.

laura 46:42

Thank you so much

guests 46:43

for having us. It's been such a, a pleasure both before and during the podcast, just learning a little bit more about you. Being

laura 46:50

to spread information about what we do, the types of patients that we treat, and the events that we have going on, because we're here to serve the community.

guests 46:58

Thank You so much

laura 47:05

Thank you so much for having