Beyond Clinical Walls Podcast

Ozempic and PCOS (Polycystic Ovary Syndrome)

• Dr. BCW - Dr. Curry-Winchell, M.D. • Season 1 • Episode 2

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Bayo Curry-Winchell, MD (Dr. BCW) sits down with her dear friend Jessica to talk about Ozempic.  Jessica, who has suffered from PCOS or Polycystic Ovary Syndrome, for years, was recently prescribed Ozempic in an effort to get symptoms under control.  Tune in to hear Jessica's journey to her diagnosis, the Ozempic prescription and the positive and negative impacts it has had on her over the first few months.  

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Dr. BCW
Hello, everyone. Thank you for joining me. This is Dr. BCW with Beyond Clinical Walls. And today I have a very special guest, one of my best friends, Jessica Patrick, and she's joining us because I really wanted to highlight a topic, a medication, a therapy that is really out in the forefront at this time. And it is a medication called Ozempic that I'm sure almost everyone who's listening has heard about this medication.
It's a medication that is really helping so many people across the world, whether it's in the realm of diabetes, whether it's to meet a weight loss goal or if it's for something else. And that's why I really wanted to have Jessica share her story with the medication, share her history of why she decided to seek out this medication and tell us, you know, what are her thoughts.
And so I am so excited to welcome Jessica Patrick to be on clinical while so welcome, Jessica.

Jessica
Thank you so much for having me. Dr. BCW I was a little nervous to come on and speak with you about this, but you have been in the background talking to me about this for several months now, and my situation is a little unique. So I wanted to share it because it's different from what we're seeing in the media, talking about just utilizing this medication for weight loss or using it as prescribed for diabetes.

Dr. BCW
Absolutely, Ali. And I think this is a really important topic that we need to look at that you have and I'll let you share your diagnosis. That often goes under the radar. And it's it's one of those diseases that we just say, oh, you have a condition or a disease, and we really don't hear about it a lot.
And so I think viewers are going to be really intrigued to learn about, you know, how this medication has helped a condition that has been around for four decades. So can you share with everyone your diagnosis and and and let everyone kind of know that journey even into getting diagnosed with it? Because I think that part is is very important as well.

Jessica
Absolutely. My diagnosis is PCOS, which is polycystic ovarian syndrome. Oftentimes, women who are diagnosed with PCOS come to doctors with a myriad of different issues being hormonal imbalances. They are having irregular periods, painful periods. In my case, all of this started pre diagnosis in my twenties when I was diagnosed with having ovarian cysts, although that was something that was frustrating.
It was tolerable in my twenties. PCOS really reared its ugly head for me and was a process that came to diagnosis after I had my son about ten years ago. About a year after having my son, I was misdiagnosed with premature ovarian failure, which is scary. There are a number of different reasons why women could have premature ovarian failure.
None of them are good reasons and so, of course, being a new mom, I was terrified of this diagnosis and it really took an entire team to assess what was going on with me and to undiagnosed me. I don't know what the current term is, but I had a neurologist, I had an endocrinologist, and I had an incredible gynecol I just who was specializing in a hormone imbalance, who all came together and really had to dig in.
What we find with women with hormonal imbalances is that oftentimes doctors do they always you know, you just had a baby. It's going to take time for things to regulate. It's going to take times for things to mellow out. And then as we get older, into our forties, oh, you know, you're moving to a you're a woman of a certain age and you're moving to a different phase of your life.
And oftentimes it's kind of overlooked and just kind of not really taken seriously. But for me, when I was given that misdiagnosis of premature ovarian failure, I had a team behind me to really dig in and take a look at that time, had some significant ovarian cysts that required surgical removal. And I had a panel of bloodwork done and saliva tests done to really track my hormone levels.
And at the end of all of this, it came out to PCOS. I did have two physicians work with me after that diagnosis to try to help me address this diagnosis. My hormones were all over the place. I was given different hormone replacements to try to level things out, but for me it was very hard to track and nothing seems to be a long term benefit.
You know, one month the hormone replacements would work great, The next month it would. It would make me feel as though those hormones were elevated. And so it was frustrating for me in that amount of time because we are talking about ozempic and it is highlighted for weight loss in the media right now. I was gaining weight, but that's not uncommon for hormonal imbalances, that's not uncommon for PCOS.
And it was frustrating because I had this whole team of physicians working with me to try to help me figure this out. And I don't think everybody has that when it comes to PCOS. I've talked to a number of different friends who have been diagnosed with this where they're just told there's really no way to to treat this disorder.
I was put on metformin. Metformin is also used for diabetes. And one of the reasons that metformin is used is because PCOS can cause insulin resistance. Insulin resistance can lead to weight gain. And so I have tried a number of different things, and it wasn't until four months ago that my physician said, you know what, let's try this.
And he recommended that we trials of it. I didn't go into this just seeking out weight loss treatment. I went into this frustrated, tired, exhausted, my hormones all over the place feeling like brain fog was just an eventuality every single day, going from being able to be on my toes where I could remember every detail of every little thing to having to take extensive notes when I was on the phone with somebody.
Because the minute I hung up the phone, I couldn't remember what was said. It was so frustrating and my physician had said to me, you know, let's try this, but I want to warn you, you may not get approved for this medication. It's now it's in the media for weight loss. Insurance companies are cracking down on it. But let's just put it through and see what happens.
I'm going to highlight your PCOS. I'm going to highlight the insulin resistance and I'm going to push because I believe that this medication may really be the ticket for you to lead to a better lifestyle.

Dr. BCW
Now, I'm going to stop you right there. Just happy to have dropped so many great gems that I want to elevate before we continue on. And so you've shared with everyone this kind of journey that I think a lot of us have either experienced personally or I've known someone who's experience where you are trying to figure out why am I not feeling like I normally am?
You know what? What is the cause? And it's it can be really difficult, especially when there hasn't been any sort of true life changing event to pinpoint why am I not able to think like I normally do? Why am I gaining weight? What is the cause? And so I think those those elements that you just mentioned are so important because there's so many people listening right now who are experiencing that.
The other thing I want to highlight is PCOS, polycystic ovarian syndrome. And and as you mentioned, you know, this disease is they aren't really sure there might be some genetic, it might be environmental. There's a lot of pieces that they're still trying to put that puzzle together. And what we do know is there is a wide myriad of symptoms such as, you know, heavy periods, weight gain and excessive hair, sometimes not excessive hair weight, a hair loss.
And so when you have all of those symptoms, plus some of the things such as fatigue, some neurological, which we we often see in health care symptoms as well, that can really live in so many different diseases and conditions. And so it can be really hard to really unravel that and pinpoint it. And now I want to really get to the other piece that you mentioned, which I think is so powerful, which I know you're about to delve into here.
You finally have a diagnosis or a condition where you feel like, okay, this could be possibly what's happening, especially having this great team and then concern, am I going to be able to be approved for this medication and so forth. So I want you to go ahead and delve into that and share that process as well as when you first started.

Jessica
Yeah, absolutely. You know, one thing I want to say before we move on to that topic is in the beginning of this journey, because of the misdiagnosis of premature ovarian failure, I was taken very seriously. But then over the past ten years that I have struggled with this new doctors that I have seen as my weight continued to inch higher and higher and higher.
Even though I explained my history and my background in the team that I had worked with, that had gotten me to the diagnosis that I had, often times I was told, Well, if you would just lose weight, it's a weight thing. The more weight I gained, the more I felt that physicians that I had, you know, moving offices and experiencing working with new doctors, they would instantly say, well, you'll feel better if you lose weight.
Well, one of the things I want to highlight is with PCOS, it's not that simple. I, you know, did work with the physician and was in his office twice a week getting checked on his meal plan, you know, journaling my meals, working out, journaling my workouts. This is not something that I've just been sitting and hoping for a miracle cure.
Although everybody hopes for a miracle cure. I was working really hard with a team of physicians to try to overcome this or find some way that I could just feel good for myself and for my family. And so I was elated when my physician recommended also, of course, everybody has heard all these things on the news, the good, the bad, the ugly.
My physician, I both did not anticipate that I would be approved for this. And at that point I would be facing do I put money into this that is, you know, about 12 to 1500 dollars a month and not go through insurance? And if I do that, how am I going to swing that? It was my life because I want to feel better.
We were shocked because of the PCOS diagnosis. Originally, I was approved by my insurance to take this medication, and so we were thrilled and.

Dr. BCW
Want you to talk about that. So when you were approved, let's let's talk about that journey, because I think that will help kind of allow everyone to know that experience when you started it and then also the event that possibly interrupted that. So I think part is important.

Jessica
Yes, I think it's important to state that right now I am starting my fifth month of Ozempic I've done for four months. All were approved by my insurance company. I wasn't sure what to expect and we'll talk about it a little bit later, but it's not all pretty.

Dr. BCW
I'll go into it. I think you should talk about it now. Let's start from the first week and then jump a couple of weeks into it. I think a lot of people would love to know about that because one thing I have seen at least often when I'm in the clinic and I'm starting a patient on a medication or or on some sort of preventative or treatment, I think the more you know in advance, even if that symptom or that that adverse effect doesn't happen to you, there's power in knowing what could happen because then you expected and then you're able to kind of go from there.
So I think this will really help people who are considering it or who are on it to kind of feel maybe, oh, okay, now I know what to expect or I'm not alone. This is happening to others.

Jessica
Yes, absolutely. You know, again, I have an incredible team of physicians around me, and I'm so grateful for that because I was able to have a very transparent conversation with my prescribing physician on this. And he gave me some. So what to expect expectations. In addition to that, me, like many patients, Googled and read and read and read before I even started my first injection.
Ozempic is a once a week injection. I started at the lowest dose, which is 0.25 milligrams, and we titrated up over four months. I was up to one milligram. I just took my next titrate up to two milligrams yesterday and in the beginning, even at 0.25, I experienced nausea, heartburn, stomach disrupt, all of the things that I listed.

Dr. BCW
It was a little bit more. What about when you said stomach, disrupt, let us know, what was that? I think it's important for people to know.

Jessica
So I it's hard to explain. I mean, part of it is, is that if I ate anything that was, you know, too fatty, it went right through me. Oily discharge, all that fun stuff. Fantastic. But more importantly, after a few weeks into it, if I even thought about eating something that was really fatty, my stomach would just churn it.
That psychological effects of this, which are still being studied, are fascinating because it really changes the way you see food. And for me, you know, through gaining weight and everybody I like I said, I have been dedicated to finding answers. So I had been to a nutritionist and every single time, whether it was with a nutritionist or with my physician that I did the weight loss program through, they assume I'm eating too much.
Everybody, that's an automatic thing. You've gained weight because you eat too much. You have to moderate. You have to not been well, doctor based, you can attest to this being my friend for over 20 years. I'm not a big eater. I really am. You know, I eat like a bird. I'm not hungry. I think part of the things that I struggle with in terms of diet is getting enough calories.
And any time I've had to do a food journal, it's clear on the board after the first week of journaling and my doctor takes a look at it, he says, Oh my gosh. And so for somebody who doesn't eat a ton regularly, I was surprised that I was even less interested in food. I didn't think that could be possible, but with the US epic in the beginning, I was completely put off by it and so I had to be very mindful of ensuring that I was fueling my body, that I was giving my body the nutrition that it needed in spite of this objection.
And so as the weeks went on and the months went on and I titrated up 2.5, I found that I was craving more of those really healthy foods, the salads, the vegetables. And for me personally and not everybody that I've talked to has had this experience, but for me personally, proteins really did not settle well in my stomach.
And I buy proteins. I mean, meat products, you know, chicken and beef and pork. And so I had to kind of change the way kind of go back to more of a vegetarian protein source to ensure that I was getting that protein, but that I was also giving my body what I needed. And I felt like this injection gave me the opportunity for my body to yell at me, This is what you need.
This is what you should be eating. And I just listen to my body and really focused on what I can do to make the best out of this experience. Now, every time I've titrated up, I've had to deal with the nausea. As a matter of fact, I'm speaking to you right now, and I feel like I have morning sickness because I just titrated up again to two milligrams.
And, you know, every time you move up, I feel like your body needs to adjust up to for me because of the results I have seen, not just in weight, but in the way I feel in my hair and my nails. And I'll talk about that. It's worth it to try to overcome these temporary inconveniences because I really feel like this is making a difference in ways I have not seen before with any other treatment plan that's been provided to me.

Dr. BCW
I remember you sharing with me before you started, started as a pack, and you were like, I just want to be able to have my energy back. I want to be able to bend over. I remember you saying, and just how my shoes and not have any issues with that. And I think weight gain can inhibit that quality of life.
Those things that we don't really think about for some people. And again, I am very mindful in the fact that everybody's journey is different with weight. So it's important that we highlight that. But for those who want to make a change that they feel like this is preventing their best quality of life, it's amazing to be able to just have those little things that often people take for granted.
And another thing that you said, Jessica, as well that I think is important, that everyone here, whether it's patients or providers, is taking note about seeing people and hearing what they're telling you and not just having this preconceived notion that when you come into the room you are overweight, weight, losing weight will solve all of your problems. And and that's not the case in any it doesn't matter the medication or anything.
But I also want to mention that when someone comes into their clinic and says, you know, I have this issue, you shouldn't be bypassed or discounted, that it's just your weight. We need to do better and we need to make sure we look at all of the things that could be causing this and not just go based on unconscious bias or just, you know, our thoughts surrounding what the person looks like and and attributing that to all of their problems.
And I think that's that's an important thing that we need to look at in our health care system.

Jessica
I agree 100%. You know, we live in a world that is body positive. We are encouraging people to love themselves for the way they are and the way they look. And I think that's beautiful. Prior to this prescription of the Ozempic, I have worked really hard over the past several years to really love who I am, regardless of what I see in the mirror.
And to be quite honest, because I have had such a good team behind me and I still wasn't seen any movement. I still wasn't feeling any better. I had almost come to the point of just being okay, being heavier and being tired all the time and having the brain fog and having to adjust to my life. I had subscribed to the notion that this was my life and there were no other options.
And so I think that you're right that you should love your body regardless. But I think that regardless, you should have the ear of professionals who may be able to help you move into a healthier, better lifestyle. And the truth of the matter is, is that before I had my son, I was very active. I enjoyed going to the gym and I enjoyed working out.
My bike was my main mode of transportation, and I loved that. And let me tell you that it is really heavy on your mind when you gain weight and things that you did for joy leave you breathless and leave you feeling like you, you know, 15 minutes into a workout. You have to sneak out of the back of the room because you're embarrassed that you can't breathe.
You know, you have all these people who are very active and in the gym in a very healthy. And some of those people like to pass judgment of those people struggling in the back. And I implore you to put on a £40 weight centralized in your stomach and try to do the same activity that you're doing now. It's not easy.
It's, you know, simple things. A lot of the weight that I have lost and for everybody listening right now, I have lost £43 in four months. A lot of the weight I have lost has been stomach fat. And a lot of that stomach fat is if you look at PCOS, one of the main symptoms is weight gain and particularly weight gain in your stomach.
So things as simple as bending over to buckle my shoe weren't now difficult, which seems ridiculous, but that was the life that I was living. And now £43 lighter. I can happily say that I can buckle my shoes.
And I'm excited to go to the gym. I'm excited to work out. I you know, I'm doing things that I haven't done in a long time, which is like going outside and playing football with my son, being out there and being active snowshoeing and and I can't wait for this summer to my son. And I love to kayak and paddleboard and it's going to be a whole new ballgame now because I have the energy to do more.
And I hope that if I am able to continue this medication, I will continue to lead down that healthier path and get to a point where the regular workout regimens that I did before are just a normal part of my my daily activities. Once again.

Dr. BCW
This is a perfect time to kind of talk about when you say, if I get to continue this medication and this was something else that I felt was really important that we highlight, can you share with viewers that recent notice that you heard from your insurance company about this medication and your possible ability to continue to use it?

Jessica
I received a letter a few weeks back from my insurance company that said, as of April 1st, I will be reassessed for the coverage of Ozempic. And so my doctor will need to once again submit a pre-approval and it will once again be under review to consider whether or not they will cover it and cover this medication. For me, which is extremely frustrating to me and is scary for me because I've lost £43.
But let's talk about the more important things that are happening. Part of PCOS you had mentioned is hair growth or hair loss. I have experienced both. Hair loss where I want to keep hair hair growth, where I don't want it. And my nails had become so thin and brittle and my energy levels were down and I had the brain fog, which we've already talked about in the past four months.
I have had my hairstylist say to me, What are you doing? Oh my gosh, you have so much new hair growth on your head. Oh, my gosh, your nails are amazing. Like they're stronger than I've ever seen them before. All of this is in line with, you know, this medication really treating my PCOS, or perhaps it's the weight loss caused by the medication that is in turn changing my hormone levels and getting me to a place.
Studies are still ongoing for ozempic and treatment of PCOS with OZEMPIC, so we're not certain yet. But I can tell you firsthand what my experiences are. And many of the symptoms of PCOS are getting better because I'm on this medication. And so the idea of going off of this medication and going back to the way things were before is terrifying to me.
I have spoke to my physician. I have researched wildly online of how can I continue this medication if my insurance is not going to cover it? Because as much as I would like to have 1500 dollars a month just be something that I could easily cover as a single mom, like that's that's really not a logical option for me.

Dr. BCW
And I remember you mentioning your concern was I could gain all of this weight back. And I remember you telling me why would they want to stop something that is helping me get healthier, that is helping me really decrease or reduce my risk of complications or additional diseases. And I think that part is really important because we often forget about how when one disease or condition is treated and all of the success that comes from it and the preventative care that comes from it, if that's stopped and insurance company decides, nope, we're not going to cover that anymore, where does that what does that patient do and what are those outcomes and how does it
impact it? You know, every single day?

Jessica
Absolutely. It's it's terrifying because I do read that, you know, studies that show that Ozempic is a maintenance drug. It is not something that you should be put on with the expectation of going on it to just to lose a few pounds and then going off of it. It is meant to treat different ailments. The one that has been covered by the FDA, approved by the FDA right now is for diabetes.
But PCOS causes insulin resistance and this is a drug that can treat insulin resistance. So for me going on it, I went on it with the mindset that this is a maintenance drug I would likely have to take for the rest of my life, similar to when I was taking metformin. It was a drug that was given to me as a maintenance drug that I should similarly take for the rest of my life.
It made no changes in my health that I could see. This has. And as somebody whose mother and grandmother has diabetes, I am terrified that if I continue on the path that I was continuing on, I would likely get diabetes, at which point I would be eligible for this prescription. But if we could prevent that, wouldn't it make more sense?
With my genetic background, with my PCOS, to put me on a preventative medication that would keep me from getting those additional medical diagnoses? I think that there's no guarantee that I won't get diabetes, but I think that if we have a drug that could possibly prevent it and it has been shown from the four months of me taking it that my body responds well to it, why would you then now say, Oh, wait, even though your cholesterol was down, your blood work looks great, you no longer have brain fog.
Everything is lining up to see that this drug is making a very positive impact on your health because it's been in the media and because it's an expensive drug. Just kidding. We may not no longer cover it. That's frustrating to me. And and when I say terrifying, I don't want to go back. I, I love that. I can think clearly for the first time in a very long time that I'm sleeping better than I have in years.
So if I have to go to Canada or Mexico or somewhere else, as crazy as that sounds, to be able to get these prescriptions, I will absolutely do that. We should have the right to have doctors prescribe in a way that they feel is necessary for their patients because after all, they are the ones who are educated to make that decision and have the insurance companies not make them four months later say, okay, you said this and we agreed with you, but now you need to prove it again.
Why does this patient need.

Dr. BCW
I think that's really important. You know, when you look at the trajectory and how things work currently in our system, where we we see you in the office, I get to see you and and do a physical exam or lab work and then decide based on all of those findings, what your diagnosis is. And that is a true science.
It's a combination of so many different things. When we talk about how we deliver care, how we diagnose, and from there giving a treatment based on all of those pieces, and then to have an outside source say, nope, not okay, we're going to just reevaluate if you should be on this and even more, let's take a look at when the patient is actually doing quite well on the medication.
But you still want to reevaluate. You still want to see if this is the right medication. I think this is something that so many people are experiencing, and I'm glad that we're highlighting it. The other part that I want to mention is you had mentioned, Jessica, that, you know, as you would go into the clinic and everyone would say if you just lost weight, it would get better.
And you you shared you're like, this is what I want to do. So full circle, you're loving this medication. You're living your life and the things that are happening in your doing that. So that core was always there. And so that part needs to be seen. It needs to be more visible just in general when someone goes and seeks care.
And that part I want to make sure. And then the other part is when you see all these great results, don't take it away. Look at the blueprint, Look at the playbook of all of the great women that individual is doing, how they're actually progressing. And that should allow that decision or the outcome to just speak for itself and not save your house.
Your evaluation.

Jessica
That should take precedence is, you know, this is this medication that I have prescribed for my patient. If you have to reevaluate, don't reevaluate what you evaluated initially. But evaluate now the four months that they've been on the medication and how there is solid proof that this medication is working. You're welcome to look at my labs. You're welcome to look at, you know, all of that.
And do these insurance companies look at the fact that I have tried a number of different things to get this under control in the last ten years that had no positive impact. So, you know, what is a better outcome here? And it frustrates me because I feel like the insurance companies don't care what the better outcome is for me.
I feel like it comes down to the dollar amount and I feel like in the United States that physicians push for their patients as hard as they can, and oftentimes it's overruled by an insurance company that does not have that whole picture that you talked about, who hasn't been treating this patient for years, who doesn't have the understanding of the in-depth, unique situations that each and every patient comes to their physician with.
You know, this medication has worked great for me. There are other people it hasn't worked well for each medication is different based on each individual. But for me, this is a life changer. This has made so much of a positive impact on my life, and I just can't even imagine what it would be like to go back to only four months ago and how terrible I felt back then.
It's amazing to me that this drug in four months has wildly changed my life where I want to look at CrossFit and I want to go back to the gym and I, I am getting back into the cardio and all those things that 15 minutes into four months, that girl made me feel like I was going to die.
I was going to hyperventilate because I was carrying all this excess weight and my knees hurt, my ankles hurt. After an hour workout, I felt like I was wrecked and now I have the energy and the ability to do those things to provide myself with a life that I had four months ago didn't think I would ever get back.

Dr. BCW
Well, you know, I am so glad that we had a chance to highlight this journey and really amplify by your journey. But all of the steps that are a part of it, when we talk about weight loss, when we talk about diagnosis and just overall advocacy and the challenges within our health care system, you have been able to, and I know, help so many people just by sharing your story, Jessica.
And I know there's so many people out there who have experienced this, whether they have PCOS, hypertension, diabetes or some other condition that is often one of those invisible diseases or conditions or elements we need to continue to to advocate for ourselves and also share those things within our system that are barriers to achieving the whole goal of preventative, healthy lifestyle goals.
I am so glad that you came on and I appreciate this vulnerability that you put forward in hopes of just helping others talking about this. It's hard. And so I just want to say thank you very much. I know everyone is listening. Is had the opportunity to have so many takeaways that they can help themselves or someone that they know.
So I really appreciate you joining me on Beyond Clinical Walls.

Jessica
Well, thank you so much for encouraging me to be here because it wasn't easy. But I think there's so much in the media about this drug and it's two sided. But things in this world are not just one way or another. There is a myriad of gray. And I think that this is something I haven't seen a lot about, is that this drug can be useful in other ways.
And, you know, it's not just weight loss or diabetes. The studies are still out. And I'm just so excited to see what comes from these studies because if I were a case study in and of myself, I don't have diabetes and I hope that I won't because I have this opportunity now to take this medication that hopefully will prevent some of those things in the future that I was quickly working my way towards because of the health hurdles that I had.
So I hope that people hear this and think it's not just one or the other. Every case is individual and unique and it really should be looked at that way. I'm grateful for the opportunity to have tried Ozempic. I think that it's a disservice that insurance companies are so quick to decline this medication for those who could really have an impact, a positive impact in using the medication.
So thank you for having me and letting me share my story. I know it's interesting, but I do hope that people took something away from it positive.

Dr. BCW
I'm sure they did. I think those personal stories need to be heard more by you sharing all of the thing with your weight loss journey. And even before, I think talking about how you were in your twenties and then thirties and so many people can relate to what you've had to experience and I'm so glad that you shared it.
It's going to help a lot of people, just so thank you.

Jessica
Thanks, Dr. BCW. Like I said, thanks for thanks for encouraging me. I wouldn't have been here without you.

Dr. BCW
Well, thank you for going beyond clinical walls. This is so important. And that's what this podcast is about, really talking about issues that are affecting people across the world and hopes of sharing that health literacy, things that are out in the forefront that are impacting lives every single day. And when we talk about reducing health inequities and disparities, this topic that just has brought forward, this is a part of it.
We know diabetes, hypertension, are affecting people disproportionately at a higher rate. So we have the opportunity to reduce it, but it's been thwarted. It's been stopped or prevented, all for financial gain. We need to look at it and continue the conversation and continue to advocate. So this is Dr. BCW, as always, I am grateful for you tuning in and excited to bring the next episode.
Thank you.

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Dr. Bayo Curry-Winchell, M.D.

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