Lisa Simmons on Keto for Women & Balancing Hormones During Perimenopause and Menopause #143

Meet Lisa Simmons, the latest powerhouse to join the Ovadia Heart Health team. With nearly three decades of nursing expertise and a personal transformation story that's nothing short of remarkable, Lisa brings not just skill but also a deep passion for metabolic health to the table. Her journey from critical care to embracing a ketogenic lifestyle is a master class in personal and professional growth, charting a course from significant weight loss to a holistic approach to health that's sure to resonate with anyone seeking a life-altering change.

In our conversation, we journey through the maze of modern health practices, from the intricacies of hormonal balance to the benefits of strength training. Lisa debunks common nutrition myths, advocating for a deeper understanding of our bodies' needs, particularly through the challenging stages of perimenopause and menopause. Her insights on the underestimated power of proper nutrition and hormone treatments reveal the potential for a complete health transformation, while her approach to weightlifting may just inspire you to pick up those dumbbells.

As we wrap up, Lisa shines a light on the proactive vs. reactive healthcare debate, underscoring the dire need for early intervention and individualized care. Her fresh perspective is nothing short of a clarion call for revolutionizing our approach to health, with telemedicine playing a critical role in the future of nutrition and patient care. Join us as we uncover Lisa's infectious enthusiasm for educating and empowering individuals to take control of their heart health, and discover how you too can join this transformative movement.


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Transcript

0:36

As a teenager, she'd hang out in the emergency room where her mom was working as a nurse, just to see and just to watch what was happening. She knew from very early that she wanted to be a nurse. That led to a career in critical care and acute care and long term acute care. And it also led to serious weight gain. She was by her own admission, a professional yo yo dieter. And then Lisa Simmons broke the code. Nurse practitioner Lisa Simmons tells us her story, how she got to be where she's at, and what she's doing to help people like me, and like you, get healthy, and this time, stay healthy.

Jack: 1:48

Welcome back, folks. It's the Stay Off My Operating Table podcast. Dr. Philip Ovedia. I'm Jack Heald, and we've got a first today. I think this is a first, maybe not. Is this a first,

Dr. Phillip Ovadia: 2:00

Phil? I'm not sure which first you're talking about. It's

Jack: 2:05

Introduce our guest and I think it will become obvious then why she's here.

Dr. Phillip Ovadia: 2:12

Very good. Yes, they're very excited today to introduce Lisa Simmons to our audience. Lisa is a nurse practitioner that has now joined the program. Our practice, Obedia Heart Health which is our telemedicine practice where we take care of people looking to improve their metabolic health and prevent and reverse heart disease and we are very excited that we have now expanded our clinical team in addition to my two amazing coaches who have both been on this program, Kristina Hanks, who have both been on this program, Kristina Hanks. And Jen Cleveland we have now added Lisa because we were busting at the seams, quite frankly in terms of taking care of the people who needed our help. So with that Lisa, why don't you give a little bit of your background maybe tell us how you why you went into nursing in the first place and went on to become a nurse practitioner and then and then we'll kind of get into the metabolic health. Aspect of it from there. Perfect.

Lisa Simmons: 3:12

So I have been a nurse for about 28 years. I initially went into nursing and in high school, I knew that's what I wanted to be because my mom was a nurse. So I actually went and watched her. She used to work in an ER way before HIPAA times, and I could stand out behind the nurses station. And at that time, there was not rooms. There was, you know, just curtains. And so I could hear stuff that was going on. Of course. I couldn't see it, but my mom worked nights and I was so interested in it. As a teenager when I could drive, I would go and stay up all night and watch everything that was going on. Just because I was so interested in it. I just thought it was great. And. I just always had a passion for helping people. So that's really what got me into nursing. I always knew I didn't want to do moms and babies. So of course my main background was critical care. So I went into ERs and ICUs because that's where all the action happens. I enjoyed it a lot. And then when I went into Nobody in my family had a bachelor's degree. So I wanted to go ahead and get a bachelor's degree in case I wanted to go to administration. So that's how that happened. And then after that, I said, I'm never going back to school. And the next thing I know, I enrolled in a nurse practitioner program and it's kind of how the story started and I knew I wanted to do acute care. I just never wanted to treat children because when I went to nursing school, I had two babies in diapers and I never wanted to have children be hurt. So that was never an option for me. So I went along the lines of acute care just because I could still stick with the action. And then I've done a multitude of different things to work with intensivists and I've worked in an LTAT kind of as a hospitalist.

Jack: 5:00

A what?

Lisa Simmons: 5:02

A hospitalist, nurse practitioner. Oh, is

Jack: 5:05

that the LTAC?

Lisa Simmons: 5:07

The LTAC is a long term acute care. It's kind of. Thank you. Yeah. Sorry about that. So when people are not, they're not sick enough really to be in the ICU, but they're not well enough to go to a rehab or nursing home and they may still have trachs. And so they may still be getting weaned off of a ventilator. So I was kind of like a hospitalist nurse practitioner there for a couple years where I put out fires is pretty much what I did. Yeah, so it was, I did that. And then I just, now I've kind of graduated into things that are less stressful. Yeah I've never, I've ran a lot of codes in my career. And I

Jack: 5:51

dated a girl for a long time who was an ICU nurse. And one of the things I learned was that ICU nurses are a special thing. Special kind of, and she worked nights as well, special kind of creature. So it always it amazed me that they could a do it at all, but B do it for not just years, but decades. So I understand why you're probably wanted to reduce the intensity of your.

Lisa Simmons: 6:20

Especially as I get older and less stress is better. Let's,

Dr. Phillip Ovadia: 6:24

Yeah, let's help people understand what is a nurse practitioner and kind of differentiate, you know, that from being a nurse in general, and then, you know, how it fits in the care team when we're talking about doctors, physician assistants, nurse practitioners. I think a lot of people these days are used to kind of seeing all of these. Types of practitioners, but don't really understand maybe what some of the differences are between them.

Lisa Simmons: 6:53

Okay. There's kind of different realms. If you're an LPN, you know, you learn a lot of how to do things, but you still are under the supervision of a registered nurse. And then a registered nurse has a lot of leeway. And then what happens is now when you want to go advance past that. You go on and get a master's or now most of them are doctorate programs where you become a doctor of nursing practice. So the difference between really a nurse at the bedside as opposed to an advanced practice registered nurse is you actually have the ability to prescribe and to actually diagnose. Nurses at the bedside don't have the ability, and it's not in their scope of practice, to be able to diagnose somebody with a certain ailment. So that's what you go back to school for. And when I went back to school, it was still a master's program, but most of them have switched over to doctorate programs. So that's really the difference between the, and you go, I mean, it's further schooling, so by the time you're done, it's probably about six years.

Dr. Phillip Ovadia: 7:58

Yeah. And you know, to kind of, further explain to people, you know, nurse practitioners, as you said, have the ability to prescribe medications. They have the ability to you know, diagnose and treat condition. So do lab testing, you know, imaging, all of that. And in many States now certainly remember when I started my career nurse practitioners would always have to be working with a supervising physician. And now in many states that's no longer the case and nurse practitioners can actually practice independently.

Lisa Simmons: 8:36

Correct. So it just really depends on which state you're, that you're in. Yeah, and you just have to know all the rules for all the different stuff and that's a lot to keep up with, too. Yes, but that is very true,

Jack: 8:49

so what happened going from acute care to metabolic health? That's, I mean, maybe it's obvious to Phil, but it's not obvious to me. So explain how did

Dr. Phillip Ovadia: 9:04

you get here?

Lisa Simmons: 9:05

How did I get here? So initially when I kind of wanted to get away from stress, I was still, what happened was when I was still at the long term acute long term acute care I've had my own journey with I'm like, I like to tell everybody I'm a professional yo dieter. Pretty much. I've got it down. I've tried every diet that's been out there that you could possibly do to lose weight, gain it back, lose weight, gain it back. And I even had looked at Atkins back in the 80s. And of course, that's when they told you that if you ate protein or high protein, it was going to kill your kidneys and Bob, you know, all of that. The hype that was around that. So I thought, Oh gosh, I'm gonna kill my kidneys, you know? So I still did the Weight Watchers, the calorie counting, the, you know, the eat, the six small meals a day exercising like a banshee. But I will tell you that you can not out exercise a bad diet. It doesn't work, right? So I ended up about five years ago. I. Heard about the ketogenic diet. And so that's kind of how I got into it for my own journey, my own health. It was really kind of funny. I used to be one that would start a diet every Monday. And when you're calorie counting and you're doing that stuff by my snack time, I was starving. Cause you always doing carbs cause you're counting calories. And so I was like, Oh man, I was always like, I'd eat breakfast and I was like, Oh, I'm going to snack. Because I was already so hungry. And if I screwed up by lunchtime, I would start again the next Monday. Like I wouldn't even start again with the next meal. I'd be like, Oh man we'll just start again Monday. And cause you,

Jack: 10:48

so you dieted for one meal and just did whatever you want for 20.

Lisa Simmons: 10:53

Exactly. And so then you wonder why you're like. still at, you know, square one, right? And so it's this is nothing changes. So then what happened is I came across the ketogenic diet and I just thought, you know, we're going to try this out. And I started on a Wednesday, which was like, it was totally against everything I've done in the past. So I started on a Wednesday and I got real strict. And I lost 50 pounds in a period of about four to five months. And so I was like this kind of works. And wait a minute, I'm not hungry. That was like the clincher for me. It was like, I never thought about food anymore. Like now it was like, Oh, my stomach starts to, Oh wait, you need to eat. And I would plan ahead. Because I have a big thing that I, when I'm teaching patients that they don't plan to fail, they fail to plan. So then they're on the whim, you know, that you should already have things kind of available to you so that you're not having to stop and eat. So it was kind of, I was started taking my own advice and then how it all started. Down this road is I was so excited with what I had learned. I wanted to share it with the world. So I started meet up groups and I have 9 or 10 people that would meet with me once a week and we would share recipes and we would talk about, you know, Hey, I'm on a stall. What do we do now? And it just kept me researching and researching. And trying to figure out like, how is this going to work the best? And it was a lot of fun for me. It was free. People could just come and I mean, I met at a park and you know, and stuff and it was really fun. And people were really interested in it. They loved it when I brought like keto desserts because that was the best night. Eat the sweets and stuff, but it was just really fun. And it was really good for me. And then it became just more and more of a passion because I just felt like if I knew 20 years ago, what I know now, it would be like a game changer, right? I would be, I wouldn't have never had to struggle because now food to me is strictly just nutrition when my body needs to eat for fuel. That's when I eat. The rest of the time, I never think about food and it's just really been different. It's very different. So it's

Jack: 13:21

what? Aside from the obvious personal benefits. Huh. You've also taken a professional turn And I did and I realize it's I see the connection externally, but what was How did you decide that this was where you wanted to go professionally as well as personally? What's

Lisa Simmons: 13:46

I actually, I started with education. So I'm doing a lot of things through like nutrition network and educating myself more on the benefits and the science of it. Of course, I'm in a science field. So I always want to know. Why, you know, it's that curiosity that kind of got me going down that route. And then I actually went further and got a certification as a ketogenic nutrition specialist so that I could dive deeper into the science and how really when you eat something, what does your body do with it? So that kind of really sparked more interest. And then I actually met a good girlfriend of mine that was already kind of doing this professionally. And so I joined her at a local clinic and it's just kind of gone from there. You know, and still educating people.

Jack: 14:46

Isn't it really different professionally? Very. Doing this rather than acute care, or trauma care, or critical care, whatever it's called. I mean, this is wildly different,

Lisa Simmons: 14:58

I would assume. This is how it's supposed to be. That's what I think. We've gotten so far away from true medicine, And we don't get back to the basics anymore. And when you really think about keeping your body healthy, you have to think about what are you fueling it with? What are you doing to move your body? How are you dealing with stress? And are you sleeping well? So all of those things play a key role in the overall. And so it's getting back to really the basics and lifestyle and what can one person do on a daily basis to extend their life expectancy without, you know, taking a pill for this and a pill for that, you know, and having a quick fix, but really, and getting down to the basics like I wake up every day and it'll feel great. I sleep well. I feel good. Nothing hurts, right? I'm seeing people younger and younger. They can their joints say this hurts, that hurts. And, you know, but they're sedentary. They don't do anything. And then they're eating, you know, a gob of processed food, which is really not food. at all. So that's what kind of keeps me going. And it's it's just education. It's really education and listening to the patients. Now taking the time to listen, troubleshoot and help them succeed. It's, it is different very different, but at just a basic level. So I got to say from the site, from,

Jack: 16:42

I'm sorry, Phil, from the side of of Of a non healthcare professional, it's I can remember the last time I saw an MD professionally and he was wildly unhealthy and it was just really, it was deeply troubling to have somebody who clearly had no handle on their own health. Telling me what to do to get healthy, and that had been my experience. So I gotta believe that I'm not the only person in the world like that. It's got to be really cool for your patients, for your clients. To have somebody who struggled with the same thing and one guiding them. I just, I love anyway, enough with my comments, Phil, sorry.

Dr. Phillip Ovadia: 17:31

Yeah, no, I think that's a great observation. And you know, of course we've had many medical professionals on the program at this point myself included. Talking about that same aspect, that same concept. And of course, you know, one of the things that I've commented on is when I was very unhealthy as a heart surgeon and a physician none of my colleagues really said, you know, what are you doing? And I'd love to hear kind of Lisa's perspective on, you know, When she was, you know, unhealthy and then as you made these, you know, changes, which I'm sure were obvious to all your colleagues, you can't really lose 50 pounds without people noticing you know, what were some of their thoughts and on what you were doing?

Lisa Simmons: 18:24

It was, I mean, I guess it did get their attention. So then when they started asking, that's when I had the opportunity to teach. So it was always teaching and saying you know, it's really not as hard as people make it out to be. And you feel so much better. I think the biggest thing is I had so much more energy. Where I was working out, it was a, it was four stories and I wouldn't even take the elevator anymore. I would go up and down the stairs. I would run the stairs all day long. And I just, and I think that was the biggest takeaway was me. And I just, I sleep well and I just have all this endless energy. You know, and I just cause you know, I, it was, that was more, the weight loss is great, that is great, but I think the overall, how you feel is definitely a bigger takeaway. When you get to a certain age, you're like, Oh, thank goodness. My, you know, my, none of my joints ache and I can get up and down and. I can get up and down off of the floor with no problem. And, you know, you kind of have to look at things as you age to is like, what am I doing to prevent. Or, you know, things that can happen in the future, or how am I going to. I never wanted to be a burden on my Children, right? So taking care of me and being able to take care of myself is definitely taking a burden off of them. So it was hey, this was, this is what has to happen. And now I surround myself with everybody that does the same thing, which makes it a whole lot easier.

Dr. Phillip Ovadia: 19:55

But, yeah. And you know, so obviously, I know this, the audience doesn't, but we'll tell them you know, previous to joining this practice you were working in a practice that managed primarily focused on managing women's hormones and all the challenges that go along with that. And, you know, that practice wasn't a metabolic health practice. focused practice. So kind of talk about your experience dealing with you know, the perimenopausal issues and what, you know, what you were maybe able to do or maybe not able to do in terms of giving this information around metabolic health and low carbohydrate diets with the women you were working with there.

Lisa Simmons: 20:44

Oh I still talked about metabolic health with every single one of them. Hormones are just a piece to the puzzle, but they're not the whole puzzle, right? Every patient, when I saw them for the first time, I discussed, lifestyle with them. So what are you eating? You know, how are you sleeping? How, what are you doing to exercise, move your body on a daily basis? And the other one, the huge one is stress. So I think with women, a lot of the time I would see them and they would come and they go, you know, I read somewhere that, you know, I'm supposed to be on hormones because that's why I'm not losing the belly fat. That's why, you know, I'm not sleeping at night. It's always my hormones. That's it. It may or may not be, you know, according to get your lab work and things like that, but to actually feel what I say more of quality of life and optimal health. Yes, I can balance your hormones, but what are you doing? So I would always hold them accountable. And a lot of times when we would troubleshoot, like I'm still having these symptoms, you know, my joints are aching, this is bothering me, I'm not sleeping. Then I would break it down and it always went back to nutrition always. And I think so many people are misguided on what is the appropriate I mean, There's one thing that makes me cringe is when people go, I need a really clean diet and then they have oatmeal for practice every day. And I just go, no, you don't and, you know, it's the teaching, it's getting them away from everything that they've heard, or they work out with a trainer at the gym, and they're still doing macros. And I have people that come in and they're, you know, eating 140, 150 grams of carbs a day. Yes, they're eating, you know, 150 grams of protein, but they're still eating way too much carb. And then they're wondering why, hey, I'm working out, I'm working out, but I'm not losing any weight. Or even Tony now. So when it comes to the hormones, there are, yes they benefit women who are perimenopausal menopausal perimenopause tends to be the hardest time. Everybody thinks it's menopause perimenopause is way harder on women. I think than menopause just because that's when the transition, your body's starting to do these weird things. And I think the biggest one that women notice is mood swings. They get really angry at the world and for no reason, they're just like, I don't know. I'm just spouting off at my husband for no reason. And usually there's a little fix that we can do in there to help with that. But I started doing that a couple of years ago. And of course I am. i'm post menopausal don't tell anybody really but I am and I i'm actually

Jack: 23:26

it'll be our secret

Lisa Simmons: 23:27

But yeah, so I am a hormone patient it did make a huge difference for me so I of course I am an advocate but obviously you need to be with a professional that really knows what they're doing And that they're monitoring you and me doing things accordingly. So there, there's lots of things, but yeah, they were very beneficial because nobody wants to have hot flashes and night sweats. I'll tell you, they, they stink.

Dr. Phillip Ovadia: 23:56

Have you noticed differences in you know, kind of the management of the hormones in the women who you know, Followed your other advice regarding, you know, metabolic health, diet, lifestyle versus those that really just took the hormones.

Lisa Simmons: 24:13

Yeah, the ones that really listened and took my advice when it came to, okay, this is the proper nutrition. You really need to do it like this. I had multiple patients coming back one. Man, Lisa lost 10 pounds. I lost 20 pounds. This is really working and utilizing some of the hormones because I did prescribe low dose testosterone for women, which helps with muscle mass loss. So my women that were really working out a lot, cause that, I think that's another big thing that I hear about. They don't, they're not just not able to build the muscle mass anymore but they also have to eat adequate amount of protein. So that they can build it right. And most people don't get an adequate amount of protein in their diet. You know, when you start looking at that and they're now they're really lifting and a lot of women don't, they're afraid to lift heavy weight. I do find that they, you know, they're doing these five and eight pounds and it's not really putting enough pressure against the muscle and the bone to really make a difference. So you're not going to build unless you're giving it a little bit more. And I have to remind them that they're not going to look like Arnold because the testosterone is not as high. You know, it, but it did make a difference. I had a lot of people coming back and saying that they were definitely making strides and felt a lot better. When they started realizing that, you know, you can't eat really high carb. And the misconception of you have to have carbs. To be able to exercise because you need the energy. And I mean, I worked out this morning and I worked out fasted and I didn't die. Oh, and it was a hard workout. You know, yeah, and I like it cause it, it just makes you feel better. When you say,

Jack: 25:59

when you say lift heavyweights, what does that mean for a woman? What's heavyweights?

Lisa Simmons: 26:05

Yeah. When you're doing heavy weights, you want to be able to only probably get to 10 to 12 reps. And then you have literally, you can't do another one. So it's going to be buried amongst who, you know, different patients or different people. But when you're lifting a heavy weight, you should only be able to get to each set that you do 10 Okay.

Jack: 26:30

It's defined by how many times you can,

Lisa Simmons: 26:32

you can do it. Yeah. And it's, I mean, and it doesn't even, I mean, so I, when I emphasize lifting weights too, of course, your muscles don't know what a rep is. It has no idea, it only knows what you're doing to it till it goes to failure. So you could do eight reps of a heavier weight. But still go to failure where you can't do one more, right? So it's just buried on what you do. I mean, I looked pretty heavy, but I've been doing it for quite a long time. So it just it's buried on each individual. So I don't want them going to kill themselves because you still have to use proper form. Sure. So because you don't want to get injured. So making sure that when you're performing a certain exercise that you know what the proper form is and you don't want to make, you know, because you definitely don't want to hurt your joints.

Jack: 27:27

What I'm hearing is you've got experience in critical care as dealing with people who are in life threatening situations. You've got experience in slightly less critical, what's it called? Long term acute care. You've got experience in whatever's less, Less acute than that. And then you've got experience helping people literally just get and stay healthy. It sounds like just from a, from an experience standpoint, anybody who would talk to you wanting to get healthy, would have someone, Listening who gets it who's probably seen just about everything that can be seen and actually,

Lisa Simmons: 28:17

I think working in acute care and seeing people that didn't take care of themselves because when I was in nursing school or in, in P school, I worked in a CCU, which is a cardiac care unit for three years. While I was in my master's program and so seeing people come in at younger and younger ages with heart attacks. Was really eye opening for me. Because I mean, you wouldn't hear, I mean, yeah, somebody in their 60s and 70s having a heart attack. Sure. That's the way it was when I started nursing, you know, 20 something years ago. But now, I mean, we're getting people younger and younger and it's oh, my goodness, you know, so what do we need to be doing? What do we need to be changing? That's going to prevent this. Yeah. from happening. You know, and then to taking care of people that were morbidly obese, I took care of a lot of six and 700 pounders. And you know, you can't turn that patient by yourself. You have to have three or four or five other nurses. That is the way you're going to be able to, you know, use your resources to help you to be able to, you know, take care of these people. Right So you know, I've really seen in this period of time just how you know, health care isn't health care anymore. It's more sick care. We you know, people just keep getting sicker and sicker, and they're not What can we do to stop this? So I really feel like going back to the basics and going back to okay. You know, what did what happened 10, 000 years ago? What did they do now? Obviously, people would die, right? They would die for certain reasons. I think the biggest problem back then was infections. We have antibiotics for those now, right? But it's convenience has really done us a disservice. Because we have gotten to the point like we're always in a rush. Life is always on a, you know, we're rushing here, rushing there. And, you know, you go, Oh, I'm starving. You know, I'm going to go through the drive thru or, you know what, that's okay. I'm just going to pop a pizza in the oven, you know, that's okay. But you know, when you really get down to what are you fueling your body with? And what does it need to actually perform the best for you? I use the analogy a lot with my patients. If you drive a vehicle that takes diesel fuel, are you going to put unleaded gas in it? No, you're not going to, because that's not what that vehicle needs to run effectively for you. So when you think of your body in the same sense, It has to be fueled with the appropriate nutrients to be able to work well for you, right? So it's, and then the people go, Oh yeah cause you know, they wouldn't think. Of doing that to their vehicle or the other one I tell them is you wouldn't put sugar in your gas tank, right? You wouldn't it would ruin the vehicle

Jack: 31:19

You'll put it in your body, but you won't put it in your car,

Lisa Simmons: 31:22

right? But the thing is you've paid what twenty thirty thousand dollars for a vehicle You don't want to ruin it. How are you going to get to work to be able to pay for the car? But when you actually put that value on your life and your life expectancy and You in the long term, right? You have to look at now and you have to look at what am I doing now that's going to affect me in the future. Sure.

Dr. Phillip Ovadia: 31:48

So yeah. Great way to think about it. And I think the point of, you know, seeing kind of the end results of these, metabolic, chronic diseases really, you know, gives us insight. And I know for me personally you know, it, I think it helps. It's a very powerful way to relate it to the patient because when I say to someone, you know, you can deal with your insulin resistance now and, you know, Eat some less carbohydrates, or, you know, I can open up your chest and deal with your insulin resistance. That's really the message that we need to be getting to people. People need to understand You know, we, in some ways, the problem we're at is we've gotten good at taking care of sick people. So people don't really worry about being sick anymore. You're like, ah, you know, there's medication for that, there's surgery for that. You know, whatever it is, it'll get taken care of. And we really need to get back to, for people to understand that you don't need to be sick. It's not normal to be sick it's become so common, you know, that we accept it as normal these days, and you know, I think this is largely the message that all of us are trying to get to people, that you don't need to get to that point. We can do something about it earlier than that, and Those of us in the metabolic health world, I think, are focused on doing that. What have some of the, you know, kind of big challenges to you you know, both personally and professionally, I guess, been in in making the changes that you've made?

Lisa Simmons: 33:35

Challenge wise, I think I've been doing this for so long eating for me personally it's a no brainer. I'm very boring. So I have mainly I'm just a protein. Person and I used to try to do more key to four and I would buy vegetables and they would stay in my refrigerator and rot. So I quit buying them. So I mainly stick with meats and eggs. And I've even cut back on cheese just because I don't know. I just. I don't really need it. And I just like protein. And when I was younger, I would always eat more veggies than I would meet. And now I'm totally different, you know, but of course I grew up before microwaves were actually invented. That ages me a little bit, but you know, like when I was growing up, my dad would make dinner every night and they cooked it like, you know, concept. And, but then when I became a parent and I worked a lot, yeah, I went through drive thru because what it's all about convenience. And then I feel bad because I think I've done a disservice to my children because now I'm going, no, don't eat that way. Don't do what I did. And but professionally it's still, I feel like it's still an uphill battle. In some realms, because I still have patients that come to me and say my doctor says I just need to eat less and exercise more. And which is something that, you know, trying to go against and just get you like no, it's that's not the way it is. Believe me, I've tried it. It doesn't work. And then you're hungry all the time. And so I try to do to, get people to understand that it's really nice to be able to lose weight and not be hungry. Like it's a concept. And it's you know, it's, of course it still takes work and I'm still on a journey. You know, I'm not exactly where I want to be. But I have a better handle on it. And food to me is very different. Where I used to be a very bad binge eater. So if someone made me mad, I would go eat something that was really bad for me. Didn't do anything to the other person that made me mad. I just did everything to be right. And so once you get, and so a lot of it is mindset as well. So yeah, you have the tools, the proper nutrition. We tell you what to eat. We tell you like. This is how your body utilizes this. And then when we like Dr. Obedia goes over labs, it's you know, now you can see it in numbers that this is what the past years have done now, you know, now what are we going to do? What's going to be the game plan to improve these numbers, which is the fun part of this because it's really. Doing more of something that I'm passionate about. So professionally, I still feel like it's a little bit of an uphill battle, but I feel like more and more physicians and nurses and nurse practitioners are starting to really like, oh, yeah, wait, this is working. So they, I think a lot more people are starting to adopt it, especially if you've gone through your own journey. And have, you know, had where you've thought, you know, weight loss or, you know, obesity for years. And, you know, it's like you look back and you go, how did I get here? I just did everything they told me to do.

Jack: 36:53

Is there a I want to think past the first order effects or the first order causes, maybe somebody comes to you and says, I've tried everything, I'm, I want to lose weight, help me and obviously the people who do, who follow the guidance tend to get results. Is there a common second order cause with people who don't get results? Obviously, they're not following, they're not doing what they're told to do. But is there something that can we go deeper and say, Hey here's something else that always seems to be going on or usually seems to be going on in somebody's life that is, is a roadblock that keeps them from having the success they say they want to have. Does that question

Lisa Simmons: 37:48

make sense? Yeah. There's a couple things that I've come across. I think one that is not treated as readily as food addiction food addiction is difficult for some people. It's like having an addiction to alcohol or drugs, but you can, you know, abstain from alcohol and drugs. Your body doesn't need those things, but we have to eat. So sometimes people need a little bit more help and it might be more psychological help in that aspect. And it's very it's individualized. Obviously, because we're all any equals one. That's just the way it is. When I'm troubleshooting with patients, a lot of them I find, they don't want to put the work in too. They, you know, they'll tell me, Oh I'm doing this and this. But they're not really making any strides or, you know, that, or they get mad because they lost a pound in a week. And I go if you knew how much a pound really was, or being a woman, we hate when we've lost five pounds. But when I tell them five pounds is like five pounds, you know, from everywhere, then they go, oh yeah. You know, cause we think the number is so little, it should be this high number. So when it really comes to troubleshooting with different patients, a lot of them is it is troubleshooting because what works for me may not work for somebody else. So you kind of have to scale it back and either keeping a food diary and really tracking their food or what it usually comes down to what I've seen in practice is they're still not eating enough protein. And so I'm, you know, bump the protein up, right? And that's going to keep you full. And I always tell them to eat protein first because protein keeps you full. It fills you up quicker, takes longer to digest, and then you're going to eat less of whatever else you paired it with. Because you're going to get full. So you really want your emphasis to be on your protein so that it's going to do the job it's supposed to do, which in turn is going to keep your insulin and your glucose levels very stabilized, right? So we've always heard about glucose, but now that we know that it's really an insulin glucose problem, that's how we become insulin resistant. So getting people to understand that. Stand that, that it's not, and I love it when I break it down and I tell people like do you know how you became a type two di? No doctors ever tell them what, how they became a type two diabetic. They have no idea. You know? It just happened. It just happened. Yeah. And so when you break it down and then you kind of explain this is how it happened. over a period of time. And so what I love is talking about insulin resistance more than obviously diabetes, because more people in the world are insulin resistant before they ever, you know, get to type two diabetes. And that can happen 15, 20 years prior to ever becoming a type two diabetic. And they don't realize that the damage is being done all that time before they ever get diagnosed with type two diabetes. Now they have type two diabetes and they go. Or put the brakes on. I have, I'm diabetic now, right? But if we started doing more, it didn't happen last night. Exactly. They think that it did, right? The part of it is too, is if more primary care physicians would do some of the testing, that is the simple testing, not as deep as we do at I fix hearts, but it's more at you know, it's so easy just out of fasting insulin onto their blood work. I literally went and reviewed a friend's labs the other day, and he hasn't had a hemoglobin A1c ever, like it never was checked. And I mean, these are things, simple things that can be checked to really better educate a person and actually see where they're at. I really think if we kind of could get a lot of primary care doctors, if you're ordering labs, just order a couple extra, they're going to get their blood drawn anyway. And start really looking, you know, looking at these things so that you can really see, you know, is my patient metabolically healthy? Because we all know you can carry. Like adipose tissue on the outside, right? And really, honestly, yeah, you have it on the outside, but you can still have, you know, an insulin less than 10. You can still be insulin sensitive. So you don't know these things unless you start like paying attention and checking for things that maybe we can look at more prevention instead of aftermath treatment.

Dr. Phillip Ovadia: 42:31

Yeah, let's Let's talk about another kind of aspect that we do differently here with Ovadia Heart Health and iFixHearts. And I know you have experience with this as well prior to joining us talk about telemedicine. Again, I think it's something that maybe people. If they haven't experienced it, may not kind of understand it and you know, understand the advantages of it and what we can do with telemedicine because one of the challenges that we hear about most often from people is they can't find a local doctor who thinks this way, who does this stuff and We now have a great tool to solve that problem for

Lisa Simmons: 43:11

people. Yeah, so I've been doing telemedicine for about four years, obviously, since since 2020. Everything's kind of gone to that because we're kind of pushed into that. But what I love about telemedicine is, The ability to take the time with a patient to the end. It's convenient for one thing. They can do everything from the comfort of their home. I have. I've seen many a patient. They're there in bed. They're just sitting in bed or they're laying in bed and they're talking to me. I mean, you can't get any more convenient than that. But the thing is you. I think a lot of people are afraid of technology and it's really pretty simple. And the benefits of it is we can take more time. We can actually, you know, delve into things, but I think the biggest one for me is convenient. They don't have to go and drive to the doctor's office and you know, they're always late. And I'm just going to say, and then you have to sit in the waiting room and then you have to, then you're waiting. So all of this time where telemedicine wise, if you have an appointment at one o'clock, I'm going to be on the screen at one o'clock. That's the way it goes. And it is easier. And so then their time, which is valuable, just like my time is actually Makes it a lot easier. Those are my ideas of benefits of telemedicine. But most of the time I get to spend more time with the patient. So that, not five minutes.

Jack: 44:37

Speaking as the person on the patient side it's way more important to me that my health care provider. Actually spends time with me.. I'd be, i'd, I have been more than happy for the last, literally 20 years to go get in my car, drive half an hour to go see my doctor, because I know he's gonna spend somewhere between 15 and 30 minutes with me every single time I go. And I love that.

Lisa Simmons: 45:03

Then you have a great provider because I do usually like that.

Dr. Phillip Ovadia: 45:10

And, you know, the difference between Jack's provider who I know about and similar to what we do here versus You know, perhaps most positions out there is besides the telemedicine aspect, the other thing we do differently is we're not in the insurance model. You know, we're doing what's called concierge care, or you might hear it called direct care. But we have made the intentional decision for, Our patients benefit not to accept insurance and sometimes patients don't understand that they say, wait, I have this insurance. And, you know, that pays for everything. And Yes, it pays for everything, but you get what they pay for, and what they pay for is typically going to be a 15 minute visit 10 minutes of which the doctor needs to dedicate to doing the paperwork to make sure they get paid for that visit. And it leaves you with a very minimal interaction and restrictions on testing and other things. And you know, we've made the decision not to take insurance that allows us to have, you know, usually one hour appointments with patients. And that's our standard appointment time here in the practice. And you know, and then we get the testing that we think is indicated for the patient, as opposed to the testing that the insurance will allow us to do.

Lisa Simmons: 46:34

And that's what I love, right? I still work in an insurance model. Yes, I have to see a patient over 15 minutes and it makes it really hard, especially when you're trying to troubleshoot with a patient and you're, you know, I now have another patient waiting. And that's not the chart on this patient. And I said, so it snowballs and that's why we end up being late to see people because it snowballs. And it's very stressful on the provider because, you know, you're trying and I'm still trying to troubleshoot or talk and. I like to be able to take the time to listen to the patients, which I think that doesn't really happen anymore because, you know, you don't have time. So the doctor will come in and see you and in seven minutes he's out of there and he's okay, what's the thing? And I've even had patients tell me they go to see their doctor and they tell them that you can only pick one thing that's wrong with you. I don't care if you have five things wrong with you while you're here, you can pick one. That's all the time I have. And I've had patients tell me that. And it's very sad because it's, They have five things. Why should they have to make another appointment and come back? But the doctors don't have the time because their schedules are so booked. Because insurance dictates care and they insurance. It's, you know, it dictates reimbursement. So it's yes, people have insurance, but it's really, you only need insurance for catastrophic because it's just not giving you much of anything either. Is it really helping you? But that's just my personal opinion.

Jack: 48:02

You're not alone in that particular opinion. Oh, man. Phil, I approve. I mean, I know you didn't ask my opinion, but.

Dr. Phillip Ovadia: 48:15

Yeah. I think you got a good one. No, I think this is good. I know that we have been very excited to have Lisa joining the team and you know, she is now actively seeing patients as part of the practice and like I said, it's going to allow us to continue to grow upon what we've been doing here you know, at Ovadia Heart Health. And we're very excited to have her. Lisa, why don't you I guess, just talk a little bit more about you know, where you see your career going from here? What, you know, what does the future look like for you? What would you like to see you know, in terms of. You personally, but also maybe the professional environment around us as to what you're hopeful for about the future.

Lisa Simmons: 49:06

Oh I'm pretty sure we're going to keep growing. So that's really exciting. I think what I really like about it is It's much more of a passion for me. So if you're really following something that you're passionate about I'm not really doing work. Yes, I'm working, but it's different because I love the I've always wanted to educate. I enjoy that part. So I like getting people to really understand how things really work. And not just saying, Oh, here's a pill for this. Here's a pill for that. Nothing makes me shudder more when I see young people on 10, 13 medicines a day just because we've been conditioned that there's a pill for everything. But my Vision for Ovadia Heart Health is really to add more, you know, providers as we grow, I just see it growing because more people are really like, Hey I'm just noticed more people are looking towards prevention. And so now I think it's in the realm of, especially when it comes to heart health because. I'm like, I'm telling you I've seen 20 and 30 year olds, you know, in the CCU having heart attacks. And, you know, it shouldn't be like that. These people are in the prime of their life. They shouldn't be thinking, Oh, I'm going to have a heart attack, right? They should be like, Hey, just living it up. Not, you know, helpfully. Let's get that help. We should be loving it up helpfully. But you know, being able to just help more and more people. So I just really see. Yeah. Because it's such an awesome team. Everybody's passionate. Everybody wants to grow. I mean, it's been a joy to really be here. Just because everybody is on the same page. It doesn't matter who, which part of the team you're talking to. Everybody has the same passion and desire to help people and to get them healthy. But I just see that it's going to keep booming and growing and we're going to have more and more providers that can help grow it. And, but yeah, I just think it's great.

Jack: 51:07

Well, Phil, this is the point where we normally say, tell us how folks get a hold of you if they want to know more.

Dr. Phillip Ovadia: 51:16

Yeah yeah, people should go to Obediahearthealth. com and hit the button that says talk to us. You can also go to ifixheart. com which kind of covers more of our educational programs and coaching. But there's a talk to us button there as well. And that's the best way to have a conversation with us about what the best way that we can because we do have a lot of different ways that we work with people these days. And the goal is to kind of match up how best we can meet your needs. But we're excited. I'm excited to be able to say we have room to take more patients into the practice because prior to hiring Lisa, we, we were kind of at capacity. But I. I'm pretty sure that Lisa is going to be very busy very quickly and she already is, and there's just a big demand out there come join us on this mission.

Jack: 52:13

Yeah. All Lisa, it's good to meet you. I'm sure we will we'll cross paths again probably in the not too distant future.

Lisa Simmons: 52:21

Okay. All right, Jack. So thank you guys so much for having me.

Jack: 52:26

This has been Lisa Simmons the first of the, I'm sure many nurse practitioners that are healthcare providers at Ovadia Heart Health. Thanks for joining us. This has been the Stay Off My Operating Table podcast with Dr. Philip Ovedia. We will talk to you guys next time.