The Dangerous Lie Women Still Believe About Ovarian Cancer w/ Dr. Shieva Ghofrany

[SPEAKER_00]: 15% of cancers are based on family genetics, but that number is probably low. [SPEAKER_00]: The mistake a lot of people make is getting tested one and done and they think I'm born with my genes they're never going to change. [SPEAKER_00]: But the truth is that we discover new genes every single year. [SPEAKER_01]: Dr. Shiba Gafrani is a board certified OBTYN, Ovarian cancer survivor and [SPEAKER_01]: co-founder of Tribe Called V, a platform built to raise knowledge and lower anxiety around women's health. [SPEAKER_01]: She's called it being proactive, not paranoid, and she lives it. [SPEAKER_00]: Sometimes you just got to embrace the suck and move the fuck forward. [SPEAKER_00]: I had surgery for my ovarian cancer.

[SPEAKER_00]: My bladder got perforated. [SPEAKER_00]: I had to have a second surgery. [SPEAKER_00]: Yes, it's sucked, but it's not a lot less than it could have sucked. [SPEAKER_01]: You have been an OBGYN since 1999. [SPEAKER_00]: What are women still not told early enough? [SPEAKER_00]: Women don't learn about their cycle and their period. [SPEAKER_00]: They don't learn about pregnancy loss and how common it is. [SPEAKER_00]: I don't think they learned about Perry Menoposer Menobas. [SPEAKER_00]: Often don't even know they're not. [SPEAKER_01]: You push back on calling Ovarian cancer, the silkyler. [SPEAKER_00]: Language is so important. [SPEAKER_00]: Ovarian cancer being the silent killer. [SPEAKER_00]: Totally just empowers people. [SPEAKER_00]: And that's terrible, because that's not true. [SPEAKER_01]:

Your motto is proactive, not paranoid. [SPEAKER_01]: What does it look like in women's health care? [SPEAKER_01]: First of all, [SPEAKER_01]: The content of the disruptor podcast is for informational purposes only and does not constitute medical advice, please consult your healthcare provider for personalized guidance regarding hormone therapy and all your medical decisions. [SPEAKER_01]: Some doctors treat the chart or numbers or data, but trace guests who's a fierce [SPEAKER_01]: Advocate has shared her own healthcare journey, but she treats the fear and shows women how to trade panic for power. [SPEAKER_01]: You have got this mindset that can change what you say, that mindset can change the clinical experience. [SPEAKER_01]: So, what does that look like for you

in exam room? [SPEAKER_01]: Both that's a provider and a patient because you've been pretty open about your own healthcare journey. [SPEAKER_00]: I mean, that's what I always laughed at, I'm like, okay, God, I don't need to have experienced everything in order to kind of relate and empathize, right? [SPEAKER_00]: Like, I've been through what I've been through. [SPEAKER_00]: I actually all jokes aside, though, think that what I went through helped me be more empathetic, obviously, though. [SPEAKER_00]: I feel like I was empathetic before, I think this has helped me really understand that psychological insight where [SPEAKER_00]: Women experience the thing that we see as their doctor, but then there's actually the thing that's inside that they're

experiencing, right? [SPEAKER_00]: So actually this is the most, this is the most salient example because it just happened. [SPEAKER_00]: So when I love dearly, I just mentioned it to you had a very dramatic episode literally two days ago. [SPEAKER_00]: At the end of my call week, where I kind of like, you know how we love ourselves at the end of a call, thinking like it's gonna be quiet, not realizing that the call God's don't know what's going on in our world. [SPEAKER_00]: And she had a very dramatic clinical situation that we did not expect, and she's incredibly strong, and she's in medicine herself, and she kept saying, this is bad, this is bad. [SPEAKER_00]: And

I said, okay, let's stop. [SPEAKER_00]: Because here's what this is not bad. [SPEAKER_00]: Obviously, this is not good. [SPEAKER_00]: She actually had cardiac tamponade where her heart was being essentially squeezed by 1.3 liters of fluid. [SPEAKER_00]: But while you and I know that medically speaking, that is very dramatic, truly an emergency. [SPEAKER_00]: I said, bad to me is you are in the edge, you are at the precipice and we literally are like millimeters away from you falling over the edge. [SPEAKER_00]: That is bad. [SPEAKER_00]: We are like, that is circumstances. [SPEAKER_00]: This is 30 to 50 feet back. [SPEAKER_00]: We see the edge, we recognize that we rectified it, we are fixing it right now.

[SPEAKER_00]: Of course we know that all of a sudden like a galwind could come and push us 30 to 50 feet towards the edge, but that's unlikely. [SPEAKER_00]: So to me, words like, this is bad. [SPEAKER_00]: This is terrible. [SPEAKER_00]: Am I a god should I be scared? [SPEAKER_00]: What should I be fearful of? [SPEAKER_00]: Should I be freaking out? [SPEAKER_00]: These are all places where as the clinician, we can actually help people's mindset because we know that actually, we can, we can help affect some really dangerous situations where yes, we have to work hard. [SPEAKER_00]: But we can fix these things. [SPEAKER_00]: Like I see all the time about pre-eclampsia. [SPEAKER_00]: I am not

worried about pre-eclampsia. [SPEAKER_00]: I'm constantly worried about pre-eclampsia. [SPEAKER_00]: But because I'm always worried about it, I don't actually have to be always worried about it. [SPEAKER_00]: Because I know that we will find and fix it. [SPEAKER_00]: We might find and fix it at the eclamptics seizure phase, which also happened to a patient in mind this week. [SPEAKER_00]: But then we rectified it. [SPEAKER_00]: We treated her seizures and put her in the ICU and she's okay. [SPEAKER_00]: Now, obviously, it doesn't always work out that way. [SPEAKER_00]: But I do think reminding patients that we can all do hard things. [SPEAKER_00]: We can withstand. [SPEAKER_00]: We will go through medical issues ourselves and our patients. [SPEAKER_00]:

And we're not here to sprinkle very dust and tell them it's not going to happen. [SPEAKER_00]: We're here to tell them that if and when it happens, we'll either have figured it out early or we'll have helped preempt it in some way. [SPEAKER_00]: So that's the point of the mindset that I think can be really powerful. [SPEAKER_01]: I couldn't agree with you more and so many things that you were saying will number one you get a YPTSD because both of us are both certified by Yans and I think what people don't realize is I'm a firm believer that obstetric should be its own thing like people who want to deliver babies. [SPEAKER_01]: and take care

of complicated pregnancies like you just had, we actually cross over into the ICU. [SPEAKER_01]: We are surgeons. [SPEAKER_01]: We deliver babies and it's like really two patients in that room that you're monitoring. [SPEAKER_01]: You're monitoring the mother and you're monitoring the baby. [SPEAKER_01]: There are so many things that happen critically, and I remember being on call for 24 hours and going in the next day and operating all day on my gynecologic patients for trying to do a whole day of menopause care and sexual health care and annuals, and you're half asleep, so I really think the residency should be [SPEAKER_01]: two separate things. [SPEAKER_01]: You decide if you want to deliver babies or if you

really want to specialize in gynecologic care, both surgery and in office and I think that's why we're all so poorly trained in sexual health and menopause and perimenopause because we're trained on how to [SPEAKER_01]: Um, not allow people to die. [SPEAKER_01]: Right? [SPEAKER_00]: Like, I was always trained. [SPEAKER_01]: Yes. [SPEAKER_01]: The cute care, the emergency, the thing at hand, like, that's what you need to do. [SPEAKER_01]: The second thing is, as I was trained by the pre-eclampsia Clampsia Guru, Dr. Baja Sabai himself. [SPEAKER_01]: Who wrote the name actually gives me a little bit of like the good, but like, oh So you hear the story of the studies, but I was super prepared for my

oral boards because you know changeover You know like like they take care of the board I would present all my cases to him. [SPEAKER_01]: So of course when he was program director We got all the pre-eclampsia and I was practicing and Cincinnati Ohio So we were getting people from rural Indiana and Kentucky so [SPEAKER_01]: Unfortunately, I saw a lot of the Clampsia and pre-clampsia and a Clampsia. [SPEAKER_01]: It was crazy, but I knew how to take care of it. [SPEAKER_01]: And I think the third thing is I married to a board certified oncologist. [SPEAKER_01]: And, you know, he drills down on the data. [SPEAKER_01]: He's the oncologists are all about the data, but he says

to me, one of the biggest things that changes outcomes or even experience for patients during their treatment and their journey is their mindset. [SPEAKER_01]: And he knows it and so he talks about it, whether that comes in just from a positive attitude, community, spirituality, family, whatever it is, that belief that mindset, that not giving up, he says it, he is witnessed miracles and seen outcomes change, even from the trajectory of what the data [SPEAKER_01]: told him based on patient's mindset. [SPEAKER_01]: So all those three things come to mind as you're sharing your your story. [SPEAKER_01]: Yes. [SPEAKER_00]: Well and one thing to piggyback on that I think that and he probably I'm sure agrees that

he's also seen patients with amazing mindsets who have unfortunately still succumbed to their disease. [SPEAKER_00]: Right, but still their outcomes were still better because our outcome is not just life or death It's how did we get to that? [SPEAKER_00]: So another example happened literally on Sunday a patient that I'd I'd taken care of this whole family from Haiti For years since I was a resident 26 years ago long story short one of the sons comes in. [SPEAKER_00]: He's now 40 He is with his wife. [SPEAKER_00]: She is p-prom so she's for the people who don't know that means she's broken her water at 32 weeks and Is bleeding enough that we think she's abrupting, but

not so much that we need to do surgery [SPEAKER_00]: She and her husband are the calmest, kindest individuals. [SPEAKER_00]: Their Jehovah's Witnesses, they were incredibly like she walked in. [SPEAKER_00]: She was joyful, you know, and so I'm hugging them and say, okay, listen, here's what's happening because you broke your water because you're bleeding. [SPEAKER_00]: These are the things that we might have to look for. [SPEAKER_00]: And anything I would say and I tried to say it was like calm to them, of course. [SPEAKER_00]: But also, you know, the urgency of this is what might happen. [SPEAKER_00]: each time they met me with not a silly like I don't understand or that doesn't mean a truly

calm like deeper knowing of doc it's all going to be okay it's going to work out and the truth is she did abrupt she did have a 32 week baby that does have to go to the Nicky period but and [SPEAKER_00]: It was the most beautiful 32-week abruption where she bled, but we managed it because she and he had faith in us and they had faith in a different power, and I say this as someone who is not religious at all, it was so beautiful to watch because their faith and their trust in something else also imparted their own faith in themselves and their faith in us. [SPEAKER_00]: And that truly helped what otherwise could

have felt like a much more precarious, much scarier, much more anxiety-provoking situation with a lot of like, oh my gosh, the babies in the NICU at 32 weeks. [SPEAKER_00]: And again, I don't want to demean a 32 week baby. [SPEAKER_00]: Well, you and I know we'll survive and do great, but also has four to five weeks in the NICU. [SPEAKER_00]: So it's all of that. [SPEAKER_00]: Like, let's all at once recognize how challenging it would be, but also how people can manage this and do really well. [SPEAKER_00]: Despite, I would say like, I wish I could get T-shirts made, or could, I shouldn't say, I wish I would say, despite the Shite. [SPEAKER_00]: So despite

the Shite of what happened, they were, they gave us, as their clinicians, such hope and confidence, to further do what we needed to do really well, right? [SPEAKER_00]: And so, I wish every patient could be that way, it would change the trajectory. [SPEAKER_01]: I remember when my water broke with my first and my husband who was an oncologist who very calm, normally, right, was freaking out and he looked at me because I'm high energy and I usually freak out about everything else and he's like, how are you so calm? [SPEAKER_01]: And I said, well, no one's going to get this baby out except for me. [SPEAKER_01]: So at this point, I have to do it.

[SPEAKER_01]: And I used to take that same mindset into surgery, no matter whether I was going in for a prolapse cord or [SPEAKER_01]: I like to music once I was operating, but I would always tell everybody I want calm because I want the patient to fall asleep Well, it's in a very calm environment. [SPEAKER_01]: Yes, and then we can get to the business of doctoring and surgery But that calm I think put me in a great mindset put the patient in a great mindset because if she saw I wasn't frazzled or people around weren't frenetic is the good word [SPEAKER_01]: they seem to be calmer, their vital signs were better, and so I love that.

[SPEAKER_01]: So you have been an OBGYN since 1999. [SPEAKER_01]: What are women you think still not told early enough in their journey? [SPEAKER_00]: I mean, without exaggeration, I don't think women are told much more than when I started in 1999. [SPEAKER_00]: I mean, you and I know, as people who are very aggressive on the interwebs about talking, I keep thinking like, certainly no one else wants to hear me talking about vaginal estrogen. [SPEAKER_00]: They've all heard it, and yet, day after day in my practice or on social media or in cocktail parties, people are like, no one told me about vaginal estrogen, for example. [SPEAKER_00]: And that's one of millions of examples of something that

I think we are actually really vocal about. [SPEAKER_00]: I think women don't learn about, [SPEAKER_00]: their cycle and their periods and about ovulation and how a period works. [SPEAKER_00]: I think they don't learn about pregnancy loss and how common it is, and yet how most likely you're going to end up with a pregnancy. [SPEAKER_00]: I think they don't learn about how pregnancy transpires, about HPV and herpes and how common they are and how not life-threatening they are if you manage them and try to prevent them and then recognize when you get them that they're really frequent and that we can actually help get through it. [SPEAKER_00]: I don't think they learn about perimenoposer menopause. [SPEAKER_00]:

They definitely do not learn about cancer and what cancers you're screened for. [SPEAKER_00]: I mean, it's shocking to me when I say to patients, educate a patients. [SPEAKER_00]: that don't know that I did not find my ovarian cancer through a pap smear. [SPEAKER_00]: Like these are friends of mine who are super educated, like, you know, graduate level, Harvard Yale educated. [SPEAKER_00]: They don't know that the pap smear didn't find my ovarian cancer. [SPEAKER_00]: So they don't know what the screen for, what they're not screen for, what are the signs and symptoms. [SPEAKER_00]: They actually often don't even know their anatomy. [SPEAKER_00]: So without exaggeration, and this is not to disparage women. [SPEAKER_00]: This is our

system. [SPEAKER_00]: There's no place in our system. [SPEAKER_00]: for this to be taught because schools can't teach it. [SPEAKER_00]: They don't know the degree to which we know it. [SPEAKER_00]: We don't have time to teach it. [SPEAKER_00]: Certainly moms can't teach it because they were never taught. [SPEAKER_00]: So it's just this cycle. [SPEAKER_00]: And this is where I had hoped that the internet and the advent of the internet would introduce platforms like what I've tried to start, things like that where they're educational platforms. [SPEAKER_00]: But the honest answer is all people get or little sound bites and snippets. [SPEAKER_00]: They rarely can have the bandwidth to sit [SPEAKER_00]: Even, I mean, I'd imagine if you

and I had three hours with each woman to kind of go through, just a survey of like, here's your life cycle as a woman, with your reproductive organs, but like, through the end of time, through your, you know, beginning until your 90s. [SPEAKER_00]: That sounds like a portion of three hours. [SPEAKER_01]: Providers dream. [SPEAKER_01]: I remember hearing because we did a longer appointment times. [SPEAKER_01]: That was our one of our critical things that we did at her MD. [SPEAKER_01]: Um, when we had the brick and mortar and we did it for 10 years and took care of women and insurance based system and longer time was the first thing I did, but going back to

women not knowing their anatomy, a lot of doctors don't even learn about the anatomy. [SPEAKER_01]: I've never learned to clitoral anatomy until I did a preceptorship in sexual health care and I'm a board certified OBGYN like you and did not learn the full. [SPEAKER_01]: Anatomy and I had a patient yesterday who I diagnosed with hormonally mediated vestibulate dynia and I gave her this compounded estrogen testosterone cream and it was the cutest response. [SPEAKER_01]: So she's explaining to me where the penis, we're talking about it as clock, I'm flying or you know inside the labianora and she's like Dr. Jibid, can you send me a picture of vestibule like an illustration? [SPEAKER_01]: And then circle it

and tell me, she's like, I know where I hurt, but she's like, I want to look at a diagram to make sure that I understand where the best of real is. [SPEAKER_01]: She's like, I've been seeking answers for 10 years and no one ever has used that word and I remember teaching someone who is at the near end of his career. [SPEAKER_01]: And he was like, I'm so embarrassed. [SPEAKER_01]: I said, what's wrong? [SPEAKER_01]: He said, I think every single case of the stipulate didn't yet, I've ever seen, and I just used to swab them. [SPEAKER_01]: And if they were positive for GBS or E. coli, which you know can be normal floor, like normal

floor. [SPEAKER_01]: He was like, I just used to give them a nano biotic. [SPEAKER_01]: He's like, I never learned how to diagnose or treat. [SPEAKER_01]: was to be laid in, yeah. [SPEAKER_01]: And he was so sad, but also excited because he was given tools now to go ahead and treat his patients. [SPEAKER_01]: So, all right, ladies or your words, from big love to fierce judo to embrace the suck and move on. [SPEAKER_01]: Where did that philosophy become from and how are you using it to better people's lives? [SPEAKER_00]: Well, the full phrase is actually embrace the suck and move the [SPEAKER_00]: forward. [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]:

I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: I love it! [SPEAKER_00]: 12. [SPEAKER_00]: He was 12. [SPEAKER_00]: And he, I was driving him to school one day, bald, going through chemo. [SPEAKER_00]: And he, he was being like, weren't

we? [SPEAKER_00]: Or like, complaining about something. [SPEAKER_00]: And I was like, you know what? [SPEAKER_00]: You need to embrace the suck and move the fuck forward. [SPEAKER_00]: Because I had just heard that phrase in a movie called Whiskey Tangle Fox Trot that was with Tina Fey. [SPEAKER_00]: Okay, I haven't seen that. [SPEAKER_00]: No, I haven't seen that. [SPEAKER_00]: Okay. [SPEAKER_00]: I thought it was going to be funny. [SPEAKER_00]: My sister and I are watching a movie to all. [SPEAKER_00]: I'm during Cabin chemo and I'm like, this will be fun. [SPEAKER_00]: Dina Fey. [SPEAKER_00]: It's not funny. [SPEAKER_00]: It's a pretty serious movie about war torn Afghanistan and this army sergeant that she is interviewing because

she's a journalist says, [SPEAKER_00]: Sometimes, you just gotta embrace the suck and move the fuck forward as he's talking about the fact that he has no legs because they were blown off in a landline. [SPEAKER_00]: And I'm like, oh my god, but that's an amazing phrase, and it turns out it's an army phrase. [SPEAKER_00]: So I say to my then 12-year-old, [SPEAKER_00]: You need to embrace the second move of fuck on. [SPEAKER_00]: And yes, I did swear because I swear with my children sometimes. [SPEAKER_00]: And I don't. [SPEAKER_00]: And I don't. [SPEAKER_00]: So I said, I'm going to get rubber bracelets made that say it to remind you. [SPEAKER_00]: And I literally got hundreds. [SPEAKER_00]:

So now I have hundreds of these that I always were one. [SPEAKER_00]: And then I periodically give them to patients who are going through things. [SPEAKER_00]: And it's not meant at all, by the way, to demean or belittle or diminish. [SPEAKER_00]: Or diminish. [SPEAKER_00]: I'm actually a huge fan of [SPEAKER_00]: All at once like good people are like, I can't complain. [SPEAKER_00]: I'm like, oh no, you can't. [SPEAKER_00]: This is a safe space. [SPEAKER_00]: Please please complain I I'm not when that doesn't complain. [SPEAKER_00]: I want to complain. [SPEAKER_00]: I want to like bitch-in-one while also Finding the beauty within the suck because and it's not that I think things happen for a reason I

don't think things happen for a reason because I don't think anything happened because some being did it to me I think things just happen because they happen and then I have to find a reason within it So I'll go looking for the beauty and the beauty might be [SPEAKER_00]: You know, I had surgery for my ovarian cancer. [SPEAKER_00]: My bladder got perforated. [SPEAKER_00]: I had to have a second surgery that was a lot. [SPEAKER_00]: But the beauty was, I'm already an OB-GYN. [SPEAKER_00]: I'm not scared of the hospital. [SPEAKER_00]: I love these surgeons. [SPEAKER_00]: I trust these surgeons. [SPEAKER_00]: I have family and friends and I'm resourced. [SPEAKER_00]: And like, yes, it's sucked. [SPEAKER_00]: It's

not. [SPEAKER_00]: There's no two ways about it. [SPEAKER_00]: It's sucked no matter what education or what how much money you have. [SPEAKER_00]: It doesn't matter. [SPEAKER_00]: It's sucked. [SPEAKER_00]: But it's not a lot less than it could have sucked with all these other things. [SPEAKER_00]: And I had to figure that out because if not, then it just plain sucked. [SPEAKER_00]: And no one was going to take away that suck part. [SPEAKER_01]: So you said that your ovarian cancer was not diagnosed on a pap smear, which you and I know it usually isn't. [SPEAKER_01]: And you talked about your diagnosis. [SPEAKER_01]: But for all the way about listening, ovarian cancer is one that we lack an

effective screening tool for in this country. [SPEAKER_01]: And it's usually found in the late stage three. [SPEAKER_01]: But how was your, how was your spound? [SPEAKER_00]: So I had mine was endometrioid, which means it came from my endometriosis, and for those listening endometriosis, this is very, very common. [SPEAKER_00]: It rarely causes a varying cancer, but there, but it can, and so I had endometriosis in my ovary. [SPEAKER_00]: And [SPEAKER_00]: My endometriosis had really gone away because I had had pregnancies birth control. [SPEAKER_00]: I was 45. [SPEAKER_00]: It had really stayed quiet for a long time. [SPEAKER_00]: It had previously been diagnosed as a 17 centimeter endometrioma when I was 28 years old in medical school.

[SPEAKER_01]: And then so I'm 47 centimeters just to for you guys, because we are not metric in the United States. [SPEAKER_01]: And I have to... Yeah, so, right about that. [SPEAKER_00]: Yeah, it's like a large grapefruit. [SPEAKER_00]: It's like a pompomosa joke. [SPEAKER_01]: It is a very, very, at where you grow in your grapefruit. [SPEAKER_01]: That is a very, very large grapefruit. [SPEAKER_01]: So that is growing in Dr. Shiva. [SPEAKER_01]: And Dr. Shiva is not the biggest person in the world. [SPEAKER_00]: She is very, very, she's tiny. [SPEAKER_01]: So to grow something so large, OK. And so then they told you, you had a 17 centimeters. [SPEAKER_00]: Right. [SPEAKER_00]: So that was removed when I

was in medical school. [SPEAKER_00]: And then I went on to be on the pill, then I went on to get pregnant, miscarried, pregnant miscarried actually nine times, reach children, sickness carriages. [SPEAKER_00]: So from the sake of endometriosis, it was actually very well controlled from that perspective. [SPEAKER_00]: And you did not grow. [SPEAKER_00]: And then, [SPEAKER_00]: At 45, I was off for his control. [SPEAKER_00]: I had to put up my tubes cut at my c-section, and my periods were starting to get really painful, like disproportionately painful. [SPEAKER_00]: And I said to myself, okay, of course it's my endometriosis. [SPEAKER_00]: Come back, I should do a pelvic ultrasound because that's what I would tell my patients to

do, and I'm a firm believer in... [SPEAKER_00]: Covering my ass, but telling patients when I've covering my ass versus telling patients when I would make my sister or me do that, and I would have made my sister do it, so I did it truly just to prove to my patients in my sister, that I'll do the same thing you did. [SPEAKER_00]: Yeah, really, really believing it was a benign endometriol mine. [SPEAKER_00]: and it was only four centimeters, but my various student ultrasound tech said, you would send your patient for an MRI because this is a new endometrioma. [SPEAKER_00]: And she's right at, I would. [SPEAKER_00]: So I said, okay, fine, I'll do it even though

I have at the time I'd pay like $2,000 my MRI because of my high deductible, but I did it and loan behold it came back. [SPEAKER_00]: Looking at a regular they couldn't diagnose cancer on the MRI. [SPEAKER_00]: It was a regular enough. [SPEAKER_00]: I was in pain I said I'll get it removed and I got it removed and it turns out and there's a longer story behind it But it turns out that but it was staged to see ovarian cancer That was luckily endometrified which confers a slightly better prognosis But still the same treatment like full-history staging and then chemotherapy for six cycles [SPEAKER_01]: And how old were you at the time? [SPEAKER_01]: Because we

were 46. [SPEAKER_00]: Wow. [SPEAKER_00]: OK. And so it's a surgical menopause, which was its own journey, because as you and I both know, now it's nine years later, and people are starting to talk more about surgical menopause in addressing menopausal symptoms, but at the time, when I say no and address my menopause symptoms. [SPEAKER_00]: They were not. [SPEAKER_00]: My frozen shoulder that showed up three weeks after surgery and I was like seems like it must be related. [SPEAKER_00]: All of my doctors who I love, I really trust them all. [SPEAKER_00]: They're great conditions. [SPEAKER_00]: All of my doctors were like, no coincidence. [SPEAKER_00]: But I was like, well, this strange because I'm not like a

record ball player. [SPEAKER_00]: Like, my shoulder is literally frozen. [SPEAKER_00]: Now, you and I know that frozen shoulder can be a presenting symptom of menopause and certainly surgical menopause. [SPEAKER_00]: So, again, it's, I don't look at it with, like, kind of wish I didn't have it. [SPEAKER_00]: I can say that now because I'm on the other side. [SPEAKER_00]: I look at it with, like, wow, I've earned a ton from that medical experience. [SPEAKER_00]: I think you, like, I know all the medical stuff, but now I, like, really know what it's like when people describe things. [SPEAKER_01]: And I love when we, well, I don't love that that happened to you. [SPEAKER_01]: But I love when

we experienced things for ourselves. [SPEAKER_01]: Like I went through infertility. [SPEAKER_01]: I had preterm babies. [SPEAKER_01]: I was hospitalized for those kinds of things. [SPEAKER_01]: I have PCOS. [SPEAKER_01]: And so when you've been through the diagnoses that you give, [SPEAKER_01]: I think it brings not only that level of empathy which I think we should have anyways as healers and providers but that true knowing or understanding that goes way beyond the medical textbooks and the data and the papers because you've actually gone through it. [SPEAKER_01]: I mean it's as simple as [SPEAKER_01]: I remember I didn't recognize my own first hot flash because what you and I were taught, at least what I was taught, was

like a mild flushing, you know, that made you a rise from the chest and I was I woke up in a full blown, felt like panic attack, attack a cardiac, I thought I was having a heart attack, um, it hair was wet and I'm a brown girl, I normally don't sweat, so yeah, I was like, what is this and my husband's like, oh, you're probably nervous, the girls are away at camp, [SPEAKER_01]: It wasn't until my second one that I was like, oh my god. [SPEAKER_00]: I think this is the hot dish. [SPEAKER_01]: These are my hot dishes, and these are the way these are going to present for me. [SPEAKER_00]: So, anxiety, no. [SPEAKER_00]:

I described them as anxiety running through my veins because it was like, yeah, an inferno. [SPEAKER_00]: It's not, I keep telling patients. [SPEAKER_00]: You're not just like a little, like if I ask you a hot flash and you have to take a hot, millisecond to think about whether or not you had a hot flash. [SPEAKER_00]: You didn't have a hot flash. [SPEAKER_00]: It's like if you have, if I have to, if I ask you if you've had an orgasm, you have to think about a few of an orgasm. [SPEAKER_00]: You haven't had an orgasm. [SPEAKER_00]: Yeah, I haven't had an orgasm. [SPEAKER_00]: Like, you know when it's a hot flash, once you recognize, you know,

if you know something's happened. [SPEAKER_01]: So, there's something I've heard that you've built called a tribe called V. What is it and why are you building it? [SPEAKER_00]: Well, it's a long and winding story, as many people are actually tribe called V instead of a tribe called V, even though our LLC is a tribe called V. That is an interweb story of someone stealing our name. [SPEAKER_00]: But tribe called V, which was built five years ago. [SPEAKER_00]: Now, I can't believe it, because we have our pregnancy class that my business partner, Jenny Hayes Edwards, and I built together while she was pregnant with her IVF pregnancy from her frozen egg that became a frozen embryo,

and we followed her journey and used that as an opportunity to teach every, literally, [SPEAKER_00]: what might happen, what's normal, it's abnormal, little snippets like 10 to 15 minute videos. [SPEAKER_00]: And so that was the inception of Tribe Cold V and our desire has and had been to grow it into all things OBGYN health. [SPEAKER_00]: Not women's health, and I always say I'm not a cardiologist, I'm not a neurologist. [SPEAKER_00]: I wanna talk about OBGYN health, like that's a lot, and that's enough. [SPEAKER_00]: And I really want it to be a platform where people can come and learn all of these things. [SPEAKER_00]: The hard part, as you know, as entrepreneurs in the space, is

that it's so noisy. [SPEAKER_00]: There are so many people doing so many things. [SPEAKER_00]: And so we still have it. [SPEAKER_00]: It's still up and running. [SPEAKER_00]: And I use it as like a little bit of a launching pad to kind of do other things that I'm doing right now to educate. [SPEAKER_00]: But if anyone out there would like to align, I mean, it really is something [SPEAKER_00]: It's so simplistic, right? [SPEAKER_00]: Women want and need the information. [SPEAKER_00]: They say they want and need the information. [SPEAKER_00]: They often are like, oh, but I don't have time. [SPEAKER_00]: But if they could listen to little snackable, like snippets about, let me take you about your

vagina and vulva, and why you need vaginal estrogen as you go through parrying post-medibles. [SPEAKER_00]: That would be so simple, so impactful, but they need to listen to it. [SPEAKER_00]: And they need to listen to what I always say preemptively. [SPEAKER_00]: Before they go to the doctor before they've experienced it, they need to hear that HPV afflicts 90% of us, unless you've been vaccinated and still then you might get it. [SPEAKER_00]: Don't freak out, you're likely not going to get cervical or hadn't that cancer, but know about it. [SPEAKER_00]: Like they need to hear that preemptively so that when they see the portal message, they don't flip out. [SPEAKER_00]: There's so much preemptive knowledge we

could give people, but we know that people have very short attention spans, and a lot of information being shown at them. [SPEAKER_01]: And there is a lot of information, but I still feel like all of the information is in the menopause, and the Perry menopause space because that's what differentiated the company that I started 10 years ago, which now there are so many companies. [SPEAKER_01]: Yes, space. [SPEAKER_01]: But I would remind investors and patients and other people would be like, Oh, yeah, you're this company. [SPEAKER_01]: That's companies. [SPEAKER_01]: No, actually, we're not because our patients are 13 till end of life. [SPEAKER_01]: I said, we do gynecology, routine screening. [SPEAKER_01]: I said advanced gynecology, surgery,

parymentopause, metapause, and sexual health care beyond fertility, contraception, and treating STI. [SPEAKER_01]: So I still think that advanced gynecologic, anatomical, knowledge is missing. [SPEAKER_01]: I still think it's missing. [SPEAKER_00]: Oh, it's definitely missing. [SPEAKER_00]: But the question is, are [SPEAKER_00]: And I say this to all the ladies listening, you all say you want to know and that no one ever told you, no one ever told me I never knew. [SPEAKER_00]: And yet this is the truth. [SPEAKER_00]: I say this a lot, I ask for maturity with my patients because even though they'll say no one ever told me I never knew, but are you willing to listen? [SPEAKER_00]: Because doctors like you and I are

willing to talk. [SPEAKER_00]: I am more than willing to educate. [SPEAKER_00]: I love preemptively educating people. [SPEAKER_00]: But patients tend to do a lot of the like, oh, God, you're freaking me out. [SPEAKER_00]: Like you and I know we dip our toe into like hearing them say, my period 32 days apart and I'm getting like a little bit more happy and hair and we already know that they might have PCLS. [SPEAKER_00]: So we want to dip our toe, but they get wide eyed and anxious and oh, my God, you're freaking me out. [SPEAKER_00]: You're showing them never going to get pregnant. [SPEAKER_00]: When the answer is no, that's not what I'm telling you. [SPEAKER_00]: I'm

telling you, I want to educate you on the entity I think you have. [SPEAKER_00]: Now let's do some tests so that we can make sure that you're going to, you know, live healthily be able to do the things you want. [SPEAKER_00]: And so we need the public to kind of align with us on this, I think. [SPEAKER_01]: I do. [SPEAKER_01]: But what I like that you do, and then I do, and I've been a part of a couple of campaigns, is maybe changing the language so that it doesn't feel because I have a language in gynaecology. [SPEAKER_01]: I did a campaign with Pinat, the social media company, where the social community company I should say,

where we did a renaming and a reframing revolution. [SPEAKER_01]: We took harmful medical terminology out and replaced it. [SPEAKER_01]: Things like infertility. [SPEAKER_01]: Because those are the ICD-10 codes or 9 codes we were taught, right? [SPEAKER_01]: A habitual aborter for someone who has multiple miscarriages. [SPEAKER_01]: That's like so, you know, harmful, poor maternal effort. [SPEAKER_01]: I mean, failed induction. [SPEAKER_00]: Yes. [SPEAKER_01]: Geriatric pregnancy, you know, overuse it. [SPEAKER_01]: So I did, like when you know, when I was in medical school and residency, like I picked those codes, I put it in, but when I'm speaking to a patient, [SPEAKER_01]: don't use those words, right? [SPEAKER_01]: But I definitely do get that pushback and people are

afraid to know. [SPEAKER_01]: My dear mother, do I almost lost at 45? [SPEAKER_01]: I, you know, to a cardiovascular disease was like, I was fine before I went to the doctor. [SPEAKER_01]: I was like, no mom, you still had the cardiovascular disease. [SPEAKER_01]: She's got diagnosed. [SPEAKER_01]: When you went to the doctor, she was like, I was fine before I went to the doctor. [SPEAKER_01]: I was like, but I think the pushback I get is when [SPEAKER_01]: cancer testing. [SPEAKER_01]: And I believe in bodily autonomy, I believe on making choices based on evidence and data not myth. [SPEAKER_01]: So if I've identified my patient and she still doesn't want it, I get it. [SPEAKER_01]: But

a lot of those decisions I see it in their eyes, it's in fear. [SPEAKER_01]: They're like, well, what, because then they push back and say, well, what can I do? [SPEAKER_01]: And then they tell them to modify screening that may be covered through insurance. [SPEAKER_01]: And I say, well, then you'll be a candidate for this. [SPEAKER_01]: So we can do this or you may want to do this. [SPEAKER_01]: And they're like, no, no, no, no, no. [SPEAKER_01]: So then I, I just know to market. [SPEAKER_01]: And then just give them a gentle nudge or reminder again and say, hey, [SPEAKER_01]: six months ago we talked about this I haven't forgotten you know it's still your

choice but you know can you tell me how you're feeling about it and if there's still like no Dr. Jibbed absolutely not tell me no I respect that choice but as long as my patients are making an informed decision [SPEAKER_01]: You know, I've done my job right because I'm a partner in their care. [SPEAKER_01]: I'm not telling them what they have to do I'm just giving them the information that maybe they didn't have before and so on that same topic We, you know, talked about your cancer journey and we were talking about language and known culture But you've pushed back on calling ovarian cancer the silent killer Why do you think that that label has

hurt women? [SPEAKER_00]: I'm like, there's so many, my patients laugh and my kids and family get annoyed at me. [SPEAKER_00]: But language is so important. [SPEAKER_00]: It is so, because even going back to what you're saying about the patient who gets scared that if she does genetic testing, we know, oh, look, you can do prophylactic measures like get a mastectomy to us as surgeons, really, it's not a big deal. [SPEAKER_00]: To her, it's a big deal. [SPEAKER_00]: But it's a big deal because the world has made surgery, scary. [SPEAKER_00]: The world has made cancer, scary. [SPEAKER_00]: We use words like fear and scared so readily and so easily. [SPEAKER_00]: And to say, Patoken, Ovarian cancer

being the silent killer, totally disempowers people. [SPEAKER_00]: It basically is like, throughout your hands, there's nothing you could do about it. [SPEAKER_00]: It's going to hit you and you are going to be dead. [SPEAKER_00]: And you and I know that's not true. [SPEAKER_00]: And in fact, if we keep saying that, [SPEAKER_00]: then the studies that show that two thirds of women are diagnosed as stage three or four, which is where it's harder to treat, although we're getting better, but harder to treat, that will continue to happen. [SPEAKER_00]: If instead we educate women and say you're not screened for it, here are the signs and symptoms that are vague that are common. [SPEAKER_00]: that mean that

if you have the pelvic bloating or pain or pressure that lasts more than two weeks, you have to mindset yourself and know it's likely nothing dangerous. [SPEAKER_00]: It's likely not a varying answer, but you need to present to your doctors so that they can send you for some kind of pelvic imaging usually an ultrasound. [SPEAKER_00]: That ultrasound is likely going to be fine. [SPEAKER_00]: And you need to maturely not be annoyed that you're going to pay for that test because it's not the doctor's fault. [SPEAKER_00]: You need to recognize not to get fatigued because I might check 10 times in its normal and on the 11th time, it's abnormal. [SPEAKER_00]: Because you might be bloated

on and off throughout 15 years. [SPEAKER_00]: And we can't keep, we can't just say, well, it was fine 10 years ago now. [SPEAKER_00]: It should still be fine. [SPEAKER_00]: So there's a lot that goes into it. [SPEAKER_00]: But right now, as it stands, everyone just knows ovarian cancer. [SPEAKER_00]: Silent killer done. [SPEAKER_00]: No tests can't do anything. [SPEAKER_00]: And that's terrible, because that's not true. [SPEAKER_00]: Right? [SPEAKER_01]: No, when it takes away, I agree with you, one of the core pillars I see on top of which is, you know, empowerment. [SPEAKER_01]: It makes you feel powerless or invisible. [SPEAKER_01]: So your motto is proactive, not paranoid, give me or give all of us, listening, three

examples of what that looks like. [SPEAKER_01]: Yeah. [SPEAKER_01]: Not just, you know, the question was mid-life care, but I think just we've been talking about gynecologic care. [SPEAKER_01]: So what does it look like in women's health care? [SPEAKER_00]: Also, because I actually just did a little class on this for that company, there's a wonderful company called Mentors. [SPEAKER_00]: Because I said, this is what women don't know. [SPEAKER_00]: So I want women to know what are you screened for from a cancer perspective, your screen for breast cancer, once you're age 40 or earlier, if you're a nurse factor, your screen for cervical cancer with your pets mirror starting at. [SPEAKER_00]: 21 to 25 depending on which

guidelines you listen to all the way through 65 or above depending on your risk factors. [SPEAKER_00]: So it's breast cancer and cervical cancer and then colon cancer, starting in age 45, whether you're a man or a woman because of the risk of colon cancer. [SPEAKER_00]: So those are the three cancers we are screened for. [SPEAKER_00]: All the other ones were not screened for. [SPEAKER_00]: You might get skin care screening, but it's not exactly a test as much as people are looking at things. [SPEAKER_00]: You certainly might have other screening tests that are outside of cancer based on your risk factors. [SPEAKER_00]: but those are the three cancers we are screened for as women. [SPEAKER_00]: And

if we don't recognize that, then we are walking out of the doctor's office being like, Clean Bill of Health, I'm fine. [SPEAKER_00]: Who cares that I just noticed like, you know, this pain or that pain? [SPEAKER_00]: So first of all, know what you are screened for. [SPEAKER_00]: Second of all, know your family history because to your point. [SPEAKER_00]: we can do genetic testing which of course you and I know that only about at most right now 15% of cancers are based on family genetics. [SPEAKER_00]: But that numbers probably low because we used to say 10 now we're at 15. [SPEAKER_00]: We're probably discovering more cancers that have a familiar component. [SPEAKER_00]: And you and I

know that when we say to a patient like, do you have any field in the history of cancer? [SPEAKER_00]: Their answer is almost always no. [SPEAKER_00]: And then if you do the second layer, I always joke of like, mom, dad, and so close grandparents, cousins, siblings, breast cancer, colon cancer, ovarian cancer, uterine cancer, melanoma, pancreatic, prostate, kidney, you know, it's like a laundry list. [SPEAKER_00]: Then they're like, oh, well, I had two uncles and a nephew with prostate cancer. [SPEAKER_00]: And then, oh, it turns out my mom had melanoma, but like, or like, oh, well, my dad had, you know, [SPEAKER_00]: prostate cancer when he was older. [SPEAKER_00]: So they've got all these different histories

that we've now missed the opportunity to send them for genetic testing. [SPEAKER_00]: So that's the second layer. [SPEAKER_00]: So first is know what your screen for, know your family history, and then the cancer's you're not screened for. [SPEAKER_00]: understand the signs and symptoms. [SPEAKER_00]: If you have persistent itching on your vulva. [SPEAKER_00]: Please go see your doctor and don't just keep treating yourself for yeast infection. [SPEAKER_00]: It's probably not vulva or a vaginal cancer, but it could be. [SPEAKER_00]: If you have persistent bloating or pain or pressure, it's probably not ovarian cancer. [SPEAKER_00]: But it could be. [SPEAKER_00]: If you have persistent uterine, if you have persistent vaginal bleeding, it's probably not uterine cancer. [SPEAKER_00]:

It likely is parry menopause or a PCOS or something else. [SPEAKER_00]: But go see your doctor because it could be cancer. [SPEAKER_00]: So there are so many things that we could do [SPEAKER_00]: mitigate risks by either, you know, if we know what we can prevent, then we can take those measures, or at least know how to fix it and find it, or as they find it and fix it early. [SPEAKER_00]: But people get so scared, they're like, in denial and then they freak out. [SPEAKER_00]: They're either both like, I'm fine, I'm fine, I'm fine, and then they pendulum swing to like, I must be dying. [SPEAKER_00]: Like, just everyone needs to calm down, be proactive,

not be so paranoid. [SPEAKER_00]: Let's figure the shit out together. [SPEAKER_01]: So you mentioned the fact that, I mean, head to toe, honestly, women are screened for three cancers. [SPEAKER_01]: And that's assuming that they're going to their doctor and taking the time to take care of themselves. [SPEAKER_01]: I'm just wondering because of what you've been through and as a provider, what you're feeling is on, so we know about cancer and genetic testing and as long as you've been tested after 2015 with the updated panels, you should be good, because your genes don't technically change. [SPEAKER_01]: But how do you feel about the multi-site early detection tests in your blood and how do you feel about

Hedge to screening? [SPEAKER_01]: I know the cost. [SPEAKER_01]: It's coming down because now there are competitors There's a company doing a head to hip for $495, but how do you feel about that? [SPEAKER_01]: Yeah, how do you feel about whole-body? [SPEAKER_01]: Because I get asked these questions. [SPEAKER_01]: You know, how do you feel about that? [SPEAKER_01]: And I'll tell you what I do, but how do you feel about those? [SPEAKER_00]: Let's first go back a little bit to genetic testing, because as you alluded to after 2015, we changed some of the rocket genes and things like that. [SPEAKER_00]: But the mistake I think a lot of people make is getting tested one and done, and

they think, well, my genes have not, I'm born with my genes that never going to change, which you and I know is both true. [SPEAKER_00]: But the truth is that we discover new genes every single year. [SPEAKER_00]: So I say to patients, I don't care if you got tested once. [SPEAKER_00]: Ideally, you get tested every year, but that's not likely. [SPEAKER_00]: And often, [SPEAKER_00]: Not so costly, because by the way, Genetic Testing is probably the cheapest thing you could do in America. [SPEAKER_00]: They cap the cost of $250, almost every Genetic company. [SPEAKER_00]: It's bizarre. [SPEAKER_01]: But in the companies, we'll actually check. [SPEAKER_01]: I learned this. [SPEAKER_01]: They will check to see if there's

been any updates since you're less testing to make sure. [SPEAKER_00]: So they're not always, I say to patients, I wouldn't rely on the company calling you. [SPEAKER_00]: The company didn't call me. [SPEAKER_00]: And I don't know. [SPEAKER_00]: Absolutely. [SPEAKER_00]: Yes. [SPEAKER_00]: If the orders put in. [SPEAKER_00]: Yes. [SPEAKER_00]: Yeah. [SPEAKER_00]: every year you could get retested but that seems challenging. [SPEAKER_00]: So I tell patients every three to five years and keep it in your own calendar y'all carry these phones so keep it in your calendar. [SPEAKER_00]: Don't wait for some of the call you call back to the genetic counseling company Call back to your doctors office who did the genetic counseling or make an

appointment because if new genes were detected which within three years I can almost guarantee new genes will have been detected for our breast colon ovarian uter and melanoma all of those [SPEAKER_00]: they will retest your blood or they'll ask you to come back in and do your blood tests a second time because we discover new genes. [SPEAKER_00]: Now the downside is we discover new genes that we don't know and not about. [SPEAKER_00]: Sometimes we have the weird variants of undetermined significance and that might freak people out which is why I keep saying I ask for maturity. [SPEAKER_00]: We can't be proactive if we're constantly thinking that anything abnormal is like oh my god I'm about

to die. [SPEAKER_00]: It just can't work that way. [SPEAKER_00]: Now so if you're [SPEAKER_00]: if that's going to happen, then don't do it. [SPEAKER_00]: But again, so if you've had genetic testing, please revisit every few years to make sure. [SPEAKER_00]: I think these other things like gallery or some of these other, so gallery separate than the MRI. [SPEAKER_00]: Let's talk with the MRI because it's a little bit easier. [SPEAKER_00]: I'm so torn because in my younger years, when my husband was like, why don't we all get head to toe CTs and head to do MRIs? [SPEAKER_00]: And I was like, wow, you know, incidental illness. [SPEAKER_00]: I was like such a purist like, we don't

want to go searching for things. [SPEAKER_00]: And then of course, like, I had my thing and I've had my husband had another thing. [SPEAKER_00]: I'm like, well, maybe we should just like put our kids through like an MRI machine. [SPEAKER_00]: Like any opportunity to get like head imaging or something, I'd be happy. [SPEAKER_00]: But the honest answer is as clinicians, [SPEAKER_00]: My concern is that when we talk about these things, we're actually only talking to the privileged and resource people who not only have financial privilege, but also time privilege, like I know plenty of very wealthy women, but they are working like dogs in a time to go get these, where they don't have time

for the follow-up. [SPEAKER_00]: Or they don't have the ability afterwards to digest the information and be like, what do I do it this? [SPEAKER_00]: Or there's the downstream effective, can you're insurance, legally and not supposed to be able to drop you, it legally and not supposed to change because of pre-existing conditions, but we know that the premiums can go up. [SPEAKER_00]: Life insurance can change. [SPEAKER_00]: So, on a very personal level, what I maybe do it, maybe, although I haven't yet, and I'm being very honest about that. [SPEAKER_00]: on a nationwide level, I see where there's so many problems and so I do feel all at once like, I feel lucky when I can do

things because of my education and my privilege, but I also feel a little bit reluctant to extrapolate that to the masses because I think it can bring a lot of concern. [SPEAKER_00]: It's just like egg-free things. [SPEAKER_00]: Like, do I wish everyone could egg freeze on one hand? [SPEAKER_00]: Yes. [SPEAKER_00]: On the other hand, that brings a lot of, like, that's time commitment and motions, like all these things that it brings into. [SPEAKER_01]: Well, and it breaks a lot of the rules of a screening test, right? [SPEAKER_01]: That it should be a valuable act. [SPEAKER_01]: Oh, yeah. [SPEAKER_01]: It should be applicable to the masses, right? [SPEAKER_01]: Exactly. [SPEAKER_00]: And should they able to pick

something up in a preclinical phase where we can change? [SPEAKER_00]: Yeah. [SPEAKER_01]: Yeah, but for me personally and I do, I use it nuanced for people who maybe have an elevated territory to explore or a strong family history, but not enough where they meet the screening changes, right? [SPEAKER_01]: So you're higher than the averages of breast cancer, but you don't meet the 20% criteria. [SPEAKER_01]: And so for some of those patients, I say there's a cash option. [SPEAKER_01]: You can do a screening breast MRI, which in most cases is about $495. [SPEAKER_01]: Some patients who [SPEAKER_01]: Well, this person had melanoma and this person had pancreatic and this person had this and the genetic testing

is negative. [SPEAKER_01]: You know, I do say, hey, there is this multi-site test that you can do. [SPEAKER_01]: Prices are finally coming down. [SPEAKER_01]: Or a, not head to toe. [SPEAKER_01]: Because that one is really expensive. [SPEAKER_01]: But now there's a head to hip, which covers a lot of adult cancers. [SPEAKER_01]: So I will offer that to patients understanding and telling them, [SPEAKER_01]: that it is out of pocket expense, but when they ask me Dr. Javay, there has to be more. [SPEAKER_01]: That's where I love innovation. [SPEAKER_01]: I get to sit on, I'm like you, I'm at the forefront, I get to sit on a lot of medical advisory boards, but then the girl in

me is like, there's people who can't get a pap smear. [SPEAKER_01]: Like, so we have all this kind of so amazing innovation. [SPEAKER_01]: But then we don't or like you said, I didn't think about that people who don't have time because they are just on that never ending work cycle. [SPEAKER_00]: Right. [SPEAKER_00]: Well, that's why I think a lot of it's interesting when we talk about privilege and resources. [SPEAKER_00]: And I'm obviously very cognizant of people who have far fewer financial resources and privilege than you or I or anyone who is, you know, able to have a job and a career and education. [SPEAKER_00]: But again, I think we forget that even like you would

I when we're working at our peak. [SPEAKER_00]: I had financial privilege. [SPEAKER_00]: I had no time. [SPEAKER_00]: I mean, I had no time. [SPEAKER_00]: I was an exercising. [SPEAKER_00]: I wasn't getting my own doctors. [SPEAKER_00]: I barely went to a doctor when I was pregnant because I was the doctor. [SPEAKER_00]: Like, I used to joke with my parent partners who delivered me like, I'm your best patient because I haven't come in for a visit. [SPEAKER_00]: You're going to, you know, you're going to get the global fee no matter what. [SPEAKER_00]: So I do think we have to be recognized all that and that's hard because there's no way for our system to support that because

it does a poor job as it is. [SPEAKER_01]: Oh, I wrote an op-ed about how I lost sight of my own healthcare, while building a women's healthcare company. [SPEAKER_01]: I was at my heaviest. [SPEAKER_01]: I had my blood pressure, I had high cholesterol, I wasn't exercising, I was having, why was COVID, I was drinking wine, way too often during the week. [SPEAKER_01]: And so I finally sat down and said, okay, I need to start practicing what I preach because I don't feel good anymore. [SPEAKER_01]: And this doesn't feel good. [SPEAKER_01]: So, I had to have an aha moment and be like, I need to really start practicing what a peach because the same thing. [SPEAKER_01]:

I was fundraising and seeing patients and all the sudden three kids are at home because the schools are closed and it was not, it was a crazy period in my life, but as professionals I agree with you, even if you have the means, sometimes you don't have the time. [SPEAKER_01]: So moving into 2026, what is the one myth you want retired and what would you want? [SPEAKER_00]: Oh, gosh. [SPEAKER_00]: There's so many. [SPEAKER_00]: Okay, I'm going to give you two. [SPEAKER_00]: Give me two. [SPEAKER_00]: Hit me with that. [SPEAKER_00]: That breast cancer is a death sentence because you and I know it's so far from the truth. [SPEAKER_00]: I mean, I always say that the

minute you are, I call a patient with an abnormal mammogram. [SPEAKER_00]: Not even a biopsy that's come back. [SPEAKER_00]: Just an abnormal mammogram. [SPEAKER_00]: The ticker tape in their mind is abnormal mammogram equals cancer equals death. [SPEAKER_00]: Right? [SPEAKER_00]: That's it. [SPEAKER_00]: That's a foregone collusion. [SPEAKER_00]: That's what they've been taught. [SPEAKER_00]: And it is so untrue because you and I know the data that abnormal mammogram actually is likely to yield a normal follow-up and even if you yield a biopsy and even if the biopsy comes out abnormal and cancer, you've caught it at an early clinical phase if it's a screening mammogram over 90 percent, if not 95 percent, five years survival, you're fine.

[SPEAKER_00]: which doesn't mean you are breast cancer, but it's not a death sentence. [SPEAKER_00]: It's like the farthest from a death sentence. [SPEAKER_00]: It's like I'd rather have early stage breast cancer than a million other clinical entities. [SPEAKER_01]: I think people are so shocked when they hear over that 90 number. [SPEAKER_01]: Yeah. [SPEAKER_01]: It's almost a sigh of relief because that's not what they think or see. [SPEAKER_00]: No, and it actually gets such disproportionate funding. [SPEAKER_00]: because of that fear, which is great for breast cancer, except that like now we've overfunded it almost. [SPEAKER_00]: We need to figure out what's causing it, but from the treatment perspective, we're doing really well. [SPEAKER_00]: I don't want

to take away money from breast cancer, but there's so many other entities that need the money. [SPEAKER_00]: So there's a lot of trickled out of fact. [SPEAKER_00]: So that's one. [SPEAKER_00]: The second is what you and I talk about a lot, I think, which is that hormones are bad and cause cancer. [SPEAKER_00]: Whereas, we both know, home ends are not bad. [SPEAKER_00]: They can be amazing. [SPEAKER_00]: Are there side effects, just like birth control pills and hormone replacement, which have two totally different roles and overlapping roles at the same time? [SPEAKER_00]: They both are life-giving in so many ways and amazing, and also have risks and side effects and downsides. [SPEAKER_00]: So it's like anything

else. [SPEAKER_00]: Like you have to go through it. [SPEAKER_00]: One of the analogies I like to say to patients a lot when they're like, but I thought this is bad. [SPEAKER_00]: I'm like, [SPEAKER_00]: I might get into a car and get to a fiery crash and die right now. [SPEAKER_00]: Like, could you imagine if every time you got in your car, you had a pop up from the auto industry that said, you might get to a fiery crash and die. [SPEAKER_00]: Like, that is the truth. [SPEAKER_00]: It's actually statistically more likely that I'm going to get to a fire crash and die. [SPEAKER_00]: But that's not what we've been modeled. [SPEAKER_00]: We have tacitly been

modeled. [SPEAKER_00]: that when we get to our car, we're not drunk, we're not texting, we're wearing our seatbelt, we have our side, our airbags, we're in a safe car, probably other people are following the rules of the road, we're probably not gonna get into an accident and if we do, it's like a fender bender and it's unlikely a fiery crash, but if it is a fire crash, we're gonna accept that we need to get to work or go to the party or go pick up our kids. [SPEAKER_00]: So we've already been modeled that, but no one has modeled that in medicine when it comes to risks and benefits. [SPEAKER_00]: So we overload the risks of

so many things. [SPEAKER_01]: I felt that way the first time I went to California you know in restaurants and public places where they're smoking and drinking they have all those signs about births effects and like cancer. [SPEAKER_01]: I was like I think this is the only state I've ever been in where I actually am cognizant of the risks of second-hand smoke and I mean I know them as a doctor but you're not reminded about them so you say that about getting in the car or every time we got a plane if we saw that I was like oh I don't want to see that either no I would never take that again. [SPEAKER_01]: What are

three concrete moves this month? [SPEAKER_01]: One, I'm going to ask you one at a time. [SPEAKER_01]: So these are concrete moves. [SPEAKER_01]: One change to make this month for health. [SPEAKER_00]: I'm always, I'm a little reluctant to say this, but I'm not reluctant. [SPEAKER_00]: I think an easy one, I would say the easy gamey is, and I think this is still really true. [SPEAKER_00]: There will be a couple of purists who roll their eyes and I say this, but I think it's still largely true. [SPEAKER_00]: Try to get vitamin D. Ideally from the sun, but realistically, we're not walking around naked in the sun. [SPEAKER_00]: So it's like an easy, cheap, you could get any

brand supplement to take. [SPEAKER_00]: Like that's an easy one. [SPEAKER_00]: Because of course, I should say, build more muscle, but everyone's already saying that. [SPEAKER_00]: So like, whatever. [SPEAKER_01]: Yeah, no, I like that one. [SPEAKER_01]: One conversation to start. [SPEAKER_00]: Oh, talk to your family. [SPEAKER_00]: Thanksgiving's coming up. [SPEAKER_00]: Hey uncle so and so and so and so and so. [SPEAKER_00]: Tell me about your history. [SPEAKER_00]: Let's talk about our family history of cancer's pregnancies and for women who are getting pregnant, what happened with your mothers or sisters with regard to hypertension during their pregnancies? [SPEAKER_01]: No, your family is true. [SPEAKER_01]: We should all be talking about it. [SPEAKER_01]: We should be open about

it. [SPEAKER_01]: You can tell you just came out of that. [SPEAKER_01]: A lot of pre-eclampsia shows. [SPEAKER_00]: We have so much pre-eclampsia nowadays. [SPEAKER_00]: It is shocking. [SPEAKER_00]: Since COVID, we have seen so much more. [SPEAKER_00]: Not a week goes by where I don't have three to five patients with pre-eclampsia, and that's not an exaggeration. [SPEAKER_01]: I did, but only because I was trained by Sub-I. [SPEAKER_01]: So they were all coming to us. [SPEAKER_01]: But yeah. [SPEAKER_01]: And one habit to track. [SPEAKER_00]: Oh, sleep, which, of course, I say that having just not slept very well for seven straight nights, but sleep, I mean, right, like if all of our, and this isn't just period

postmenopausal, pregnant women, period menopausal postmenopausal women, college people, [SPEAKER_00]: If we could get every person to sleep well for six to eight hours, oh my god, the downstream effect we would decrease anxiety, depression, insulin resistance, heart disease, dementia, like all of it, right? [SPEAKER_00]: And women are constantly like, well, I mean, of course I know it's like, isn't that normal? [SPEAKER_00]: Yeah, it's become normal, but it shouldn't be. [SPEAKER_01]: mean sleep is one of your best protections. [SPEAKER_01]: It's who your overall protective mechanism, so much repair occurs. [SPEAKER_01]: And I agree with you, negative sleep impacts so much mood, your sex drive, your confidence, everything. [SPEAKER_01]: No, sleep is so important. [SPEAKER_01]: So where can

listeners learn from you? [SPEAKER_01]: Give me all your social handles, tell me where they can find you. [SPEAKER_00]: I mean, I'm really only on Instagram. [SPEAKER_00]: I've tried TikTok, I did my toe, but I'm not over the very much. [SPEAKER_00]: So I'm on Instagram and my tag is Doc, so DR. [SPEAKER_00]: So it's Dr. Shiva G, which I think is so fun because it's DR, S-H-I-E-V-A-G. [SPEAKER_00]: I was born with that name, that was my dad, given name. [SPEAKER_00]: So, Dr. Shiva Jeeva, the vaginid, and my website is samedoctorshivajee.com, so they can come get educated. [SPEAKER_00]: I love to, I'm not as good about answering my DMs, but I love to educate, and I really

do love to connect. [SPEAKER_00]: And I love that I get to deliver babies and take care of Perryman Apostle, Liman and Postman Apostle, Liman and my separate private practice that's telehealth. [SPEAKER_00]: So if anyone's in Connecticut, Florida, and they'd like tell a health-parry menopause, menopause, mid-life care, that really talks also about cancer screening and all that stuff than I am there. [SPEAKER_01]: So I loved this conversation so much with you. [SPEAKER_01]: And if this gave you language, you can use share with a friend who needs that little lunch to get in, subscribe to the director and follow us on social media at Dr. Somi on Instagram, Facebook, and YouTube, thank you so much for listening.

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