It's a Fine Line - Collaboration Between Mental Health and Medical Professionals with Guest: Dr. Angie (TW: clinical sexual terms, medical trauma, non-traditional LS)

In this episode, Derek hosts guest Dr. Angie Stoehr, OBGYN who runs her own medical practice in the DFW area, specializing in gynecological pain, serving the diverse population of LGBT in their medical needs, oftentimes when others turn them away.  She discusses her journey into specialty medicine, her own relationship with her husband, and how she saved the life of someone very near and dear to her.  Note: Derek was extremely fortunate to have met this special human at the end of the call - not included in the episode due to respecting this person's privacy.   

Link to bio is here.

Transcript

0:03

Hi listeners and welcome back. This is the Sage in Time podcast. I am Derek Wittman, Licensed Mental Health Counselor in New York and a Licensed Professional Counselor in Pennsylvania. And joining me today is Dr. Angie Stoehr. Dr. Stoehr, thanks for being here with us. Oh, absolutely. Thank you for inviting me. We're so thrilled to have you. So we had actually touched base through a Facebook group specifically where sex therapy is discussed as providers. I think everybody in there is a provider, I hope. They might not be, but at any rate, you were kind enough to reach out to me and say, hey, I'd be interested to be on your podcast, give you a little hand, and I'm interested absolutely to hear from you. So. Um, let's get started. You are a physician. Um, tell me about that journey. Sure. So actually how I got onto that particular Facebook group page, I'm not a mental health counselor, but I kind of dabble in a lot of mental health with my patient population at work. specialty gynecologist and I specialize in pelvic and sexual pain and sexual dysfunction so I see a lot of patients that I refer to sex therapy and to mental health therapies of various and sundry types regularly so that's actually how I got onto that Facebook group page. Very good, I appreciate that. So, you know, as therapists, we often think, is this a physiological issue? And do we need to send to a medical professional? Or is this a substance induced issue? You know, whether it's an actual illicit drug, alcohol. or even a side effect of a medication. And once we're able to kind of isolate those out of the symptomology that we're experiencing as providers, we're able to then dive into what is going on. So I imagine by the time you see folks who are presenting with their issues, their pain, et cetera, that's when you determine if it's truly a physiological issue and. Even if it is, they still may need additional follow-up for therapy. Is that correct? Oh yeah, all the time. In fact, I would say the vast majority of my patients with sexual function issues or sexual pain have a huge overlap between physiology and psychology. Even if it started out as a physiological issue, every single one of them have what I like to call dog bite syndrome, which is children who have been bit by dogs don't like to play with dogs, and vaginas who've been bit by penises don't wanna play with those either. So there's a psychological component, problem, there's almost always a psychological issue that still needs to be taken care of. And if it started out psychologically, oftentimes that bleeds into a physiological issue as well. Because we all know that when you're afraid of something, natural reaction to fear is to clench or to avoid. And clenching in the female genital region causes all sorts of problems with muscle tone and then pinching off nerves and then it causes physiological problems like urological issues and constipation, etc. So I almost never see sexual problems that don't have a psychological component and a physiological component. That's interesting. So when you were pursuing your medical degree, and I mean, at what point did you decide specialty gynecology? Haha, so, um, I knew when I went into residency that I wanted to do GYN and not so much OB. Um, I- I did practice OB all the way up until just a couple of years ago, mainly because I wasn't emotionally ready to give it up and to some extent I didn't want to lose my ability to do it. I still cover labor and delivery a couple of times a month just to not lose my OB privileges, but I never really had a passion for OB like I did GYN. As far as knowing that I wanted to use specialty GYN, that came out of my passion for OB. I was really excited about OB. quickly into residency. My sister is a doctorate in physical therapy who did pelvic floor physical therapy for quite some time and when I was in training she was constantly bemoaning the fact that as a pelvic floor physical therapist she couldn't find a gynecologist or a doctor of any kind really that was willing to work up and evaluate the components that she couldn't treat. And so as I was in my training I was like, well I'll look into it. And as I got further into my training I developed a real passion for it and got more and more into that even as I got into practice. Thank you. And now just for a lot of our listeners who may not be aware of the progression through the, what is it, pre-med, you did a pre-med program, so pre-med medical program. How many years of PGY did you do? Okay, so it's four years of pre-med, which is just college, and then I did four years of medical school, and for OB-GYN it's four years of residency training. So yeah, so eight years post-college graduate. And then as far as my specialty, there's not a specific board that certifies my specialty. So there's not any specific training protocols for that either. And so if you're wanting to do what I do, and there's not that many of us that do comprehensive pelvic and sexual pain, I mean. There's a lot of people that specialize in different bits and pieces of pelvic pain, but doing it as a comprehensive specialty, there were pretty few and far between. So what I do for a living really is from having gone to residency programs and doing kind of shadowing with people that do what I do. So you picked up bits and pieces along the way. Picked up bits and pieces, intentionally did a lot of reading and going to training programs and educational seminars. That sort of thing. Yeah. Now, I've had the opportunity and the pleasure to work with medical residents as a therapist through one of our local contracts. And so I've learned quite a bit, obviously, secondhand, thirdhand, maybe. But a medical residency program requires a great deal of research. So you've actually had to do research as well, correct? Yeah, I did do some research during residency with OB-GYN, at least when I was in training. I'm not sure if it's still the same way now. We had to do one kind of big research project. So it spanned over two years. The first year we had to present a poster on it. And then the second year we had to do an actual like verbal presentation. And so that presentation that I did was actually related to GYN oncology. So cancer. Mm-hmm, yep, specifically related to cancer screening. Okay, and as the technology becomes more and more available, we're learning the importance of early screening programs, correct? Yeah, it was, I mean, it really has very little to do with what we're chatting about now, but it was more specifically related to patients with a certain type of ovarian cancer. And there were, there wasn't a lot of literature or research on what markers were specific to that type of cancer. And so we were doing a chart review going back through all the patients that had that diagnosis, which wasn't super common, and trying to pull out all the labs that they had done to see if we could find anything specifically related to that. Well, thank you. So kind of moving on a little bit now. How? I mean, your specialty gynecology, when I think about your patients, you know, I'm wondering, why would they seek you out specifically? How do they hear about you? of, yeah, there's any number of reasons that patients seek me out specifically. Because I do have kind of a weird specialty doing pelvic and sexual pain and sexual dysfunction, I get a lot of patients that hear about me by word of mouth or find me on my educational website or hear podcasts that I've done. I don't have my own podcast. I bless you to people that do. I'm happy to podcast with you, but trying to develop my own just seems like a huge amount of work and I'm thankful that I don't have to do that and I can just be on other people's. So yeah, people look me up for that. I get a lot of people who come to me out of sexually alternative lifestyles. I have some educational information about that and a website specifically related to education for people in sexually alternative lifestyles. So I get a decent number of patients from that. I do see a lot of patients that are non-traditional gender as well. So I see trans males in my office, which a lot of gynecologists in my area will not see those patients. I see people who identify within the LGBTQ, who are gender queer, that sort of thing. So I see a lot of patients that come to me because I see patients that nobody else wants to see. Are you as upset about that as I am? Yes, it frustrates me to no end. I work and live in Texas, the Dallas Metroplex. It's a very religiously conservative area and I'm not even gonna lie about it. Even in my own specific practice, there are providers that don't want to see these patients. We have one provider who is very openly Catholic and won't provide birth control. And she's happy to refer those over to me, but it's very frustrating to me that it's hard to find people like me who are willing to see patients that are non-traditional. Just because they're non-traditional doesn't mean they are human and valued for appropriate healthcare. Absolutely. I ran into something similar during grad school. I graduated from Liberty University with my master's, so also a very conservative institution. And one of the biggest challenges that I was facing with my peers was that they were being told through a different set of code of ethics that they did not have to treat individuals of different genders and different sexual orientations. that and I railed at that for quite a while. And then I realized. If I had a loved one. Who met within those criteria. Would I really want somebody who doesn't want to work with them to work with that family member. Oh, so very true. I have so many patients that come to me after having bad experiences at other providers because they're trans male and they walk into a GYN office and they're not addressed by their preferred pronouns or they're made to feel embarrassed or the doctor's like, I'm sorry, I just don't know what to do with you and dismisses them. And that's, I mean, to me that, I mean, I understand where those physicians are coming from, but Even if you don't know what to do with a patient that's non-traditional, look into it, find somebody who is, and refer them out. Don't just, you know, drop them off and be like, hey, I don't wanna see you. Like, they're humans too. Yeah, it's irresponsible for one, but... But as you said, you know, you don't really want your loved one going to a provider who's not going to be willing to guide them in a way that is comfortable for them. I guess is the best way to put it. I mean, I'm constantly getting asked, you know, and I'm in New York, but I'm constantly getting asked for an LBGTQ friendly or an ally therapist who works with pre-surgery, post-surgery, doesn't matter, you know, all kinds of people depending on where they are in their journeys. I am happy when I can tell these other folks, by all means, you know, if I'm full or something like that, by all means, I have a handful that I would send my kids to. My 21 and 23 year old. In a heartbeat. Yeah, oh for sure. It's, yeah, I have several people that I refer to that are also very friendly, fortunately primary care docs. I've got a fertility group that I send to regularly that understands, accepts, and is very loving towards patients that are non-traditional. So yeah, I'm glad to have some people to refer to as well, I feel you. So moving on a little bit, we had talked about different sexual practices. I don't recall the phrase that you used. Can you remind me? non-traditional sexual lifestyles? Yeah, for sure. So non-traditional sexual lifestyles would kind of include patients who aren't in what would be considered a normal social or religious relationship situation. For instance, the more common tone or a common term that most people would recognize would be swingers. familiar with the term swingers, although swingers is a very non-specific term. A lot of people use it because they don't know how else to phrase that or what else to use in placement of that, I guess. So swingers would be one thing, but people in polyamorous situations, throuples, Vs, and I mean, if you're needing any definitions of any of those, I'm more than welcome to give those to you. Or even patients who are... trans and in a relationship with a same gender or a non-gender or a genderqueer or Cisgender but homosexual or Transgender but heterosexual there's all sorts of kind of non-traditional sexual lifestyles there And and even people who just are in things like open marriages or people who sleep with other people's spouses That sort of thing Okay. So earlier this summer, I chatted with you a little bit before we started recording, and I mentioned a conversation that my wife and I were having, and it started out as, so what would be your niche population? Who would you want to serve? And I said, I use the term non-traditional relationships. Yep, that would work too. Non-traditional relationships can encompass a sexual relationship or a non-sexual relationship, yeah. So, I mean, you're comfortable with that. Yeah, I would say so. I mean, I would say there are a lot of people that are in non-traditional sexual lifestyles that wouldn't consider themselves in a relationship, specifically. Um, you know, there's people who just go to house parties or hotel parties or what have you and have sex with multiple people and then leave without ever giving their names. So they wouldn't necessarily say, oh, I'm in a relationship with somebody that's non-traditional. They would just say, well, I'm in a non-traditional sexual lifestyle. Does that make sense? I can see the difference then. Thank you. it's the relationship word that's kind of stumbling, because a lot of people in the lifestyle wouldn't consider themselves in a relationship. They just go attend an event, meet some people there. Yep, the sex and the fun of the enjoyment of the sex without the relationship part of it even being included. Okay. So can you tell me about your relationship? Is that on the table? Okay. I am very, very happily married. We've been married for 13 years. We're going to go on 14 this summer. We have two little kids. My husband and I are in a non-traditional sexual relationship, so... the uh I'm bisexual and I actually I was telling you earlier I didn't actually even come out to my husband until several years ago um my family knows that I'm bisexual I did tell them that um several years ago but didn't go over so well um they I don't think are very accepting of non-traditional sexual lifestyles. In fact, I know that my family probably is not very happy with any of this, but my husband and I are both completely comfortable with it, and so we are in a non-traditionally sexual lifestyle ourselves. And I do see a lot of patients from non-traditional sexual lifestyles because they... look for me specifically because they've either met me, met my husband, or they have found us on some of the non-traditional sexual lifestyle websites. It is a mouthful. So going back a few minutes ago, you had mentioned some terminology. I'm familiar with some of those terms, but I may be reaching out to you later before I put together the show notes, because I'd like to put down a brief glossary or at least a link somewhere for folks to be able to look that up. I appreciate that. Yeah, and some of your listeners may not know what some of those particular terms are either, so I'm happy to give more detail. They're new to me, I'll be honest, but I am aware, I am kink aware and poly-friendly, I believe the term is, as a provider. So, I want to make sure that folks know that and I appreciate you being a resource to our listeners as well. So, how did you and your husband decide to make this exploration start? Oh, I love that sex exploration. Oh, OK, so it's actually somewhat of a funny story. Right before the pandemic, literally March of 2020, I was at a conference. It's a medical conference, the International Society for the Study of Women's Sexual Health, which is more fondly known as ISWISH. And that particular year, there was a half day that was completely devoted to non-traditional sexual lifestyles. And. my husband and I had not even remotely ever brought the topic up. Um, we were still very conservative, had only ever been with each other. And I took a couple of photographs of a couple of the slides and sent them to my husband on a text message. And it took 10 months, I believe before he even brought it up. He thought it, he thought it was a trick. So we were like radio silence on this topic for 10 months. radio silence. He didn't even respond to the text messages. I wasn't sure he'd seen them. And no acknowledgement whatsoever. So for the longest time, he was like, I think, he honestly will say that he thought it was some sort of a trick. Like I was trying to bait him into saying something that I could be angry about, which seems really weird because my husband and I are like super close and really open and honest with each other. Hmm. So yeah, no, he didn't even bring it up at all until right before the end of 2020. I think it was November, early December, late October, somewhere around in there. And we were doing date night, pandemic style at my office. We had a babysitter come and watch the kids at the house that actually was at the daycare that they went to. and so we weren't exposing anybody near anything and my husband and I had date night at my office. We just watched a movie on the television and then we actually were watching a sexual health seminar by a very good friend of mine. Her name's Dr. Celeste Holbrooke. She's got a PhD in sexology. We were watching one of her videos and my husband decided to do a sexual health questionnaire and he had brought it along with him and one of the questions is if you ever thought about having a threesome. And both of us were honest. And that very quickly probed the conversation about how to get into that. And we actually were brushing our teeth that night and my husband was like, I kind of wonder how we get into this sort of thing. And I was like, I don't know. And he's like, well, you want to look it up? And I was like, sure, go right ahead. Let's see where this goes. So, yeah. of date night. Why are we watching an educational presentation? Sorry, that's what the out of all that that's where I'm stuck. because I'm a sex specialist. The presentations are entertaining. I think the one that we watched that night was called, Make Anal Great Again. So they're educational, but they're also entertaining. And honestly, even being a sex specialist, I still sometimes learn stuff from those lectures. I mean, that's why we do continuing education, right? Yeah, for sure, absolutely. And because I'm not in the health, the medical health sphere of it, or the, excuse me, the mental health sphere of it, I'm in the medical health sphere of it, the mental health part of it, for me, I, you know, I learned something new regularly. I've actually thought about getting a, like, sex therapy degree or something, because I, like, there's just so much about that part of it that I don't know. There really is, but I think I'm done with school. Hahaha When I was almost done with my masters, I was like I'm gonna miss this I got the evil eye We're no more school I'm 13 years out from the end of my residency training and I still read voraciously. I just, I do miss that part of it. I miss the educational aspect and I love going to the conferences where I can learn. Now, part of being a physician is presentations and seminars. And you're not doing current research, are you? About to be, yeah, actually. I've been in with several research projects. There's a specific device that we use for sexual pain and pelvic pain that is near-infrared laser. I'm not sure if you're interested in hearing anything about that, but the company is just about to start a kind of final research protocol on it before applying for a complete FDA approval for the device. I know that sounds kind of weird because we've actually been using it for like six years, five or six years, and I was an early adopter of it. It was originally under like an umbrella approval by the FDA because it's a type of device that has been used in other areas of medicine for quite some time, like orthopedics, sports medicine, that sort of thing. And so adopting it to the vagina was pretty much just allowed under that umbrella kind of terminology or what have you. But now the company is trying to seek for insurance approval. And in order to do that, you have to develop enough research protocols for the FDA to approve the device individually. So we're kind of in the last little bit of that. So yeah, I'm published in, I don't know, like six or seven different... literature articles related to that device and about to start a research protocol in my office here in a couple months. No, thanks. Yeah, I- anything to improve care for my patients. I'm- There's so little research in what I do for a living that anytime anybody kind of pulls up something new and wants to study it, I'm like, hey, I got a big population. Bring it on. You're a pioneer then. I mean, maybe a little bit. I don't know that I would say I'm technically a pioneer. I'm not the one who's ever leading the research studies, but I definitely have patients that have been included in research. Did I see you have a book or two on Amazon? Oh gosh, yes I do. Um, You're right. Yeah, I mean no, I yes, I have two books on amazon. Um, so I figured out fairly quickly as I was starting to practice more into pelvic and sexual pain that a lot of the information that I as a provider knew was not out there in the public in a way that the public could read. So there's a decent amount of research for pelvic pain, sexual pain, and that sort of thing, but a lot of that information wasn't in any way presentable to the general public because it had all sorts of medical jargon in it and it was mostly in research protocols. And so I basically took a lot of the information and made it into a format which patients could read. And then there is a lot of dietary modifications that can be made to help with pelvic and sexual pain disorders. And so the second book is actually a cookbook. I'm not a great cook. You can ask my husband. I'm a decent baker. I like to bake sweets, which I shouldn't be doing because I eat too many of them. But I have a gluten allergy. I have celiac. And so in order to get decent, yeah, in order to get decent sweets, I have to make them myself. So yeah, so my husband does most of the cooking and I do the baking. Anyway, so I didn't write any of the recipes. I actually hired a recipe artist and gave her credit. I was not about to try and take credit because all of my friends would have known that was below anyways, so yeah, they My friends would have totally called me out on it so yeah, I actually gave credit to the artist and there is a bunch of Recipes that have all of the dietary restrictions. Yeah, so I do have two books on Amazon And the recipes do include gluten-free. They do. Yeah. Most of them are gluten-free. In fact, I think all of them are gluten-free, technically. Yeah. Fantastic. I have a lot of gluten-free friends, a lot of folks with celiac that might be interested. Oh, it's pretty restrictive. If they just have gluten allergy, there's a lot of great cookbooks out there. Mine also restricts patients with irritable bowel syndrome, interstitial cystitis, and vulvodynia. So the dietary restrictions for that are a lot more intense. they could be helpful for anybody, no? now. Oh yeah, I mean they're low inflammatory, you know, gluten free. That's, yeah. And I will say I made not all of the recipes, but a good chunk of them before I published it, just so I knew that they actually tasted good and they actually, they're pretty good. I never made my own tortilla chips until then. They're quite tasty. Well, I mean, we have to participate in our own research, right? I mean... I didn't want to put a cookbook out there and find that the recipes were crappy. I mean, the IRBs won't let us do that, but for the sake of cooking, we can do that. Yeah, yeah, for sure. So... We started this pretty blind. We just kind of kicked off. So to our listeners, we are jumping around all over the place tonight. What have we not talked about that you want to address? Mm. I'm not sure. Is there anything we didn't specifically get into? Hmm. We have really jumped kind of all over the place. Sorry about that. My bad. okay. No, it's my bad too. I mean, it's almost eight o'clock here, almost seven there. Yeah. And who knows, you may be going to work right after this. I don't know your schedule. Okay. I'm not going until tomorrow morning. Yeah, if I was on call, I'd actually be already leaving for the hospital, so. Okay, fair enough. So with regard to, I mean, going back, you said early on you realized you were bisexual, or at least had an interest in, you know, being with girls, or now the turn to Ooh, okay. having the family of origin that you have. Yeah, very, very conservative family. And I adore my family. They love me. even as is, they still love me. We just don't talk about that kind of sexual stuff. I mean, it's kind of funny. My parents bless them. At church, everybody thinks I'm just an obstetrician. They don't know that I really don't do obstetrics anymore, that I predominantly do gynecology, and that I do a sex specialty because my parents can't talk about sex at church. So most of my parents' friends have no idea that I don't practice OB. But yeah, no, I knew from young childhood. My first kiss was a girl. And I... I had crushes on girls kind of all the way through high school and college and I tried to just ignore them mainly because I knew it wasn't something that was optional for me and I liked guys too. So it was kind of like, well, you know, I can't, I can't be gay. I'm not allowed to be gay because that's, it's wrong. It's sinful and I'm going to go to hell for that. So you know, even though I have these feelings, I'm just going to ignore them and only act on the feelings that I have for guys. And I had feelings for them too. And I would say, I think a lot of A lot of people that are in bi situations, and I don't say this just because it's how I am, but a lot of my friends that are bi as well have a little bit of a preference for one side versus the other. And my preference was definitely towards males and not towards the females. So I'd say I'm like, you know, 25%. bisexual and 75% straight, shall we? Or maybe 25% homosexual and 75% straight. There we go. Um, yeah, so on the bi spectrum, it was, it was something I was able to hide very easily and I never really had to do anything to, you know, kind of get over it, shall we say. But knowing that I had those feelings, there was an intense amount of self-flagellation and I worked very hard to try and pray myself out of it and, um, beat myself out. of it. I did a lot of mission work which I'm actually very grateful for the experiences that I did with that but I look back and wonder how many other people you know that I was preaching to felt the same way as I did being preached at and I just I was never able to really fully 100% be myself until I admitted to my husband and to myself really that I was bisexual and I knew it. And since my husband and I have been able to explore that side of me, it's very clear that I feel a lot more myself. I'm much more comfortable in my own skin and in my own shoes and I'm much happier than I've ever been in my entire life. So but it was a big journey getting there. sounds it and we started at eight I think you said and he's supportive you both support each other. my husband's very supportive. I swear, I think I have the world's best husband. Because my work hours were kind of nuts and I do still take some call for a B at the hospital and whatnot, I... I have a very weird schedule and my husband actually works from home and he does the vast majority of the childcare and the cooking and the cleaning and taking care of our zoo. I joke around about a zoo but we have way too many animals that live in my house. Two dogs, four cats, two guinea pigs and six fish. It's a zoo. Yes it is. It is, yeah. So my husband is the vast majority of all of that. And on top of that, he is the world's best husband. Super supportive. He really sounds it. Oh, you have no idea. I am so blessed. And I was actually surprised, I think it might have been last week, when I got an email from him. I was like, wait, what? Who's this? So my husband works from home for me. Okay. So yeah, I know that sounds kind of weird, but he takes care of all of the business aspect of my companies. So I am part owner in my practice and part owner in the umbrella of the practice. So that part is kind of separate, but then I have secondary practices. For instance, the books, you know, that's under my secondary company. And I have a handful of other things that kind of run under that secondary company. I sell sexual devices out of my office and a lot of the educational stuff that I do. all the business stuff for those secondary company bits and pieces and I have a nonprofit as well and he runs all of the yeah he runs all of the education for that. That's mainly for residency programs that are or just community programs or whatnot who are requesting me as a speaker but have no ability to fund me for that. Can't afford to pay me to get there, can't afford an honorarium and so we pay for it out of pocket and run it through the nonprofits so that and that makes total sense to me. Yep, it made total sense to the government too when we submitted all the paperwork. You've been paying out of pocket to educate other people? No. So. Well, they approved it. We were very upfront with the application to be a nonprofit as to exactly what it was we were doing it for and there was no questions asked. Oh, that's fantastic. I know, it was, we were a little surprised. We're like, we're basically using this to funnel money for educational purposes. And they were like, you're, you know, if you're educating other people and running it through, you know, a nonprofit, that's completely legitimate. Because I'm not making any money off of it. We're spending our own money to. Here we are. We don't ask for donations or anything. I mean like it's not like people are giving us money to do this stuff. We just use our own money but we run it through the nonprofit. But there is a decent amount of like business stuff that has to go through that because my husband has to keep track of all the expenses I make at any time I travel under the nonprofit. So and taxes and whatnot. So, I mean the two of you seem like you've really got a great partnership in terms of strengths. Oh yeah, completely. I hate, hate doing business stuff. If I could just practice and do what I do for free, I would 100% do that. And here I'm actually in the process of leaving a group practice where all I have to do is provide therapy and notes and documentation to do all the business stuff myself. Oh God, if my husband were to ever pass, heaven forbid, I don't know, put it out to the universe, I would not be able to function. My businesses would go under, my kids wouldn't, I mean, I don't even, I don't know when my kids' karate practices are. My daughter went to the orthodontist today and I didn't even know about it until I got home and she was like, oh I'm getting braces again. I was like, oh you went to the orthodontist. Yeah, I literally would not be able to function without my husband. He's never allowed to die. I tell my wife the same thing. My husband's so funny, he's like, well I've written everything down, you know who to contact, you know, this is our financial advisor, and I was like, well I understand all of that, but I mean like, I don't know who the kids' doctors are. I mean, you would think I would know that, but I don't. Well, I mean you've seen all the jokes, you know, the comedians that will kind of say look I'm the third on the on the emergency contact list because I'm the stepfather If you're calling me That child had best be gone Yeah, I'm not that we're putting that we're not that we're putting that out the universe either Of course, of course not. Yeah, it's actually really funny when like, sometimes the school will call me first instead of my husband. And usually, I always answer the phone with, Hi, it's Dr. Stoehr. And you know, they'll be like, Hey, Ms. Stoehr, I'm so sorry, your son's head. And I was like, Is this the school? There is a reason that my husband is the first on the contact list because I am literally scrubbing in to do surgery right now. Would you please call him? Thank you. Click. I don't have opportunity or time to answer phone calls that, yeah, my husband's the first one on the contact list on purpose. And they sometimes still don't do that. I don't know if it's like they see that he's first on the list and they assume that was an accident. But you're the one that, well, he's the one that, as the parent, fills out those forms, no? Yes, my husband fills out those forms. I mean, I'm thinking like highlighters and stickers and the whole thing. Well, it takes one phone call each year for them to realize I am not the first contact. It's usually sometime in late August that I get the phone call, and it's pretty much every year. I'll get one phone call and I'm like, yep, nope, not the primary, and you call my husband. Yeah, we're in a non-traditional marriage, not just sexual lifestyle, but I'm the one who goes to work and takes call and is not home very often, and my husband's the one who does all the primary child care. We are backwards for most people, especially in Texas, where a lot of people are conservative. you would be the second couple that we've met from Texas in that same situation. She was a family practice doctor. He was a radiotech and once they had children, he became stay at home father. Yeah, my husband's got a master's degree in business and he worked up in management at a retail store all the way until we had kids and then It was he wasn't making enough money to pay the nanny's bills Mm-hmm. And that. actually less expensive for us for him to quit his management job at a retail location, a big retail store, to quit his management position and stay home with the kids. It was cheaper to do that than it was to have a nanny. And we had a nanny for several years because he didn't want to stop working. But it took us a couple of years to kind of like bite the bullet and say, hey, look, this just isn't working for us. We're spending more money on the nanny than you're making at work. And that's more common than we realize, I think. It's not the first time I've heard about this. Yeah, and when you work weird hours and, you know, again, when he was in management, sometimes he had to stay until 11 o'clock at night. And so we had the nanny staying overnight for us when I was on call. Hmm. and you take the OB rotation on call specifically to keep your privileges at the hospital. Yeah, it's not to keep my privileges at the hospital because I still do all of my surgeries there. It's mainly because I don't want to lose my privileges to be able to deliver babies. I know that sounds kind of weird, but despite the fact of that not being my passion, I'm not ready to give it up yet. There's an emotional attachment there. I did all this training to learn how to deliver babies and manage that stuff. And it just kind of makes you sad when the idea of not being able to do it anymore. And also, I'm not going to lie, it's a decent side gig and I make money doing that. course. You would grieve that. I mean, you're kind of preparing yourself for the day that you take that away from yourself. Yeah, it's going to be an emotional journey to get there at some point. But yeah, we'll make it happen probably eventually. I just don't know when. You know what we don't need to know today? That. What's that? That? Perfect. I've got a wonderful colleague of mine that, you know, when she deals with people with anxiety, you know, they'll be talking about this thing next month or, you know, five years down the road. And her question is, so what's for dinner tonight? Yeah, no, for sure. I have no idea why, because that's where we are as today. Yeah, you should probably be thinking more about dinner tonight than something that's going to happen years down the road. Yeah, no, I get that. I had never struggled with anxiety until... I brought this up with you earlier, but I had never struggled with anxiety until my son was in an accident. And I had anxiety not really related to something that was going to happen, but it was actually medical anxiety, which is really difficult when you work in a medical community. Oh yeah. Oh yeah, no, so my son was in a drowning accident in Mexico a couple years ago. He was seven and he got his hand stuck in a suction vent at the bottom of a pool. And I watched my child die. He was under for about seven minutes. We couldn't get him out. So I watched my kid die. And then when he was finally pulled out of the pool, I did CPR on him myself with an EMT who was there. And um... He survived and he's completely intact and you would never know anything happened to him. But I rather understandably had PTSD, pretty bad PTSD related to that. And oddly enough, it was triggered by medical stuff. So the first time I went back to my office, like four or five days after we'd gotten back to the United States, because the accident happened in Mexico, we go back to the States. the third day, fourth day after his accident. He was still intubated, sedated. He'd been under the entire time we were in Mexico. In fact, most of the time we were there, they were pretty sure he wasn't gonna make it. And we got back to the States and he had fought the sedation the entire flight back to the States. And so they woke him up shortly after we got back and we realized he was gonna be all right. But I... I got back to the office just to like pick up paperwork and just seeing medical paperwork on my desktop. I lost it. And then I, no joke, I think it was 10 days after my son's accident that my CPR and my ACLS certification was due for renewal. And so I had to take a CPR class 10 days after I'd done CPR on my own child. Oh wow. Wrong, right? Just completely wrong. I warned the teacher. I was like, look, I just did CPR on my son. Hmm days ago, I will not handle this well. I have PTSD. I'm gonna lose it at some point in this training, and I did. My husband came with me to the training, blessed him just so that he could be there with me when I lost it, and hold me for a little while. And we did it at my office. My office staff was all there. They all obviously knew about the accident and kind of were able to just ignore while I was having my little meltdown. And my husband just held me while I sobbed, and they just kept doing the class. And yeah, but I... I had kind of an impressive health journey thereafter and dealt with a lot of anxiety and PTSD type symptoms, didn't sleep for a long time. I actually got to the point where I started avoiding going to bed because I had such horrible nightmares that I was afraid to sleep. And yeah, it was fun. I can't tell you how many children I resuscitated in my dreams for months and months after the accident happened. So. And they say that when we have somebody else in our dreams that we don't know, we don't get their face. Yeah, I'm trying to remember. I never resuscitated my son again in my dreams. And oftentimes when I was pulling children out of pools in my dreams, they were girls and not a boy. And I'm not sure it's because my brain was just trying to dissociate a little bit from the actual accident itself or what, but I just, and I don't know that I ever remember seeing faces or not. I just remember doing a lot of CPR in my dreams. And that's exhausting when we're not sleeping. Yeah, yeah, I, like I said, I kind of stopped, like for the longest time I was avoiding going to bed. And my husband actually at one point had to call my primary care doctor and be like, look, she's not sleeping. I mean, you've got to do something. She's, she's not sleeping. I would stay up all night just doing puzzles, like jigsaw puzzles, in the dining room table, because I was afraid to go to sleep. Eventually you'd crash though. I did, yeah. Sometimes I would be up for two or three nights in a row. When you're used to taking call and being up at night, you know, you can kind of tolerate it for a few days. But eventually I would crash, and then I would be so tired that I wouldn't dream, and so that seemed to be preferable there for a while, than going to sleep when I wasn't that tired. So yeah, that was a fun health journey and I had a wonderful therapist, still do, I still talk to her on occasion, so yeah. and your son is 100% okay. 100% intact. Every time we have followed up with a neurologist, they parade him around the office and remind everybody that this is the kid that made it that shouldn't have. There's absolutely no residual brain damage that we know of. Nothing. He's in advanced classes at school, gut-ended, GT. He was seven. He's almost nine now. Oh yeah, 100%. Yeah, he remembers it. He actually remembers up to right before the accident and he has vague recollections of being at the hospital in Fort Worth the day after he woke up. But he doesn't remember the accident itself. And you said, so he was transported back home under sedation, I think you said, on the plane. he was air flighted back to the States from a hospital in Cancun. Texas is where he got his care. Yeah, we were able to actually that was kind of a fun situation trying to find somewhere to transport my son I made phone calls. I actually called around to several hospitals trying to, you know, find a place, a NICU or not a NICU, a PICU that would take him because, you know, of the accident happening in another country. And the hospital in Cancun was absolutely fantastic. I'm not saying that they weren't, but emotionally I needed to be at home. I was doing a lot of dissociating and I, as a physician, when I dissociated in this whole situation, I turned into doctor mode and I could speak Spanish because I'm fluent in Spanish just generally, but I would, when I went back into mommy mode, I couldn't speak Spanish, I couldn't function, I mean, I couldn't eat. And so it was really difficult when I was in mommy mode and at the hospital, I couldn't understand what anybody was saying to me. And that I, sometimes I transitioned back into my dissociative mode and I was fine because then I could talk to them in Spanish. So it was just, it was... And the other thing is, bless them, the hospital only let us be with him for two hours a day. One hour in the morning, one hour in the evening. And that was abject torture. So yeah, we knew that there was some toys that they had in the US that they didn't have in Mexico, like brain cooling and that kind of stuff. At the time, I wasn't really necessarily thinking exactly straight because I was like, if we could just get him brain cooled, we have to do brain cooling immediately. But I, you know, we, at that point we were like, he's, he's going to have neurological deficits and we wanted to be in the States where we knew what the capabilities were, shall we say. So yeah, we air flighted him back and he was sedated for the whole air flight and he was in the, like I said, he was fighting the sedation, um, on the, the air flight back. I was with him in the plane and the, um, obviously the, the air flight have their own. like system and they had a nurse and a tech and the pilots and everything. But yeah, we got back to the States and he had been fighting the sedation the whole way. And so when we got back, the PICU was like, well, if he's fighting the sedation, let's go ahead and wake him up and see what we've got. none of this sounds not scary Oh, it was terrifying. And being a physician, it was even scarier because I knew, I knew how bad this was. I knew my son was gonna wake up with neurological deficits. I knew it because I know the statistics of drowning and having him wake up and know who we were, I was beside myself. So it was very unexpected to have him wake up and be completely intact. seven minutes. Seven minutes, well seven-ish, it may have been longer than that. The reason I say seven minutes, I said seven minutes for the longest time and then just about two months ago, we finally found the EMT that helped me do CPR on him. That was, yeah, we looked for him for over a year. It was about this, no, just about a year. It was about this time last year that we, I had finally kind of gone enough past my PTSD to be able to talk about the accident. on social media. I actually completely got off social media for months and months because a lot of people knew about the accident and I could not talk about it. I didn't want people to ask, I didn't want to see it, anything. So when I kind of finally got over that, about this time last year, we contacted some local news stations and told them about the story and said we're looking for the EMT. that helped save my son's life. And we put it out on TikTok and Facebook and whatnot. And via TikTok, eventually we found him just a few months ago. And I got to talk to him and I could swear that at the time, and of course memory kind of fails you when you're under ridiculous stress, I could have sworn at the poolside that somebody had said they thought he'd been under about six minutes. And that was after I had screamed and he'd been under for at least a minute before I even came up screaming because I got to him before he stopped moving and realized I couldn't get him out. I spent at least a minute underwater trying to get him freed myself. And then I came up to the surface and screamed and dove back down and other people jumped in and then spent the next six minutes trying to get him out. So I was figuring in about seven minutes when I talked to the EMT, he actually thinks it was longer than that. because he was actually going to get a beer at the poolside and heard the commotion going on, and he figured, oh, by the time I get back, you know, whatever it is, we'll be settled. And when he came back from, you know, grabbing his beer, he realized that people were still in the pool trying to figure this out, and was, you know, and he jumped in immediately. Again, EMT. And he was actually the one who was able to figure out how to turn off the suction pump, too. He turned off the suction pump for the pool and then got into the pool and was pulling on my son and... It took them several minutes even after the suction was off to extricate him. You were the first one to go in for your son. Oh yeah, no, I noticed something was wrong. I had actually, of course, there's obviously guilt involved with this and I'll try not to cry, but I was the one that told him to go down and get his diving toys and what we think happened is one of his diving toys probably went down into the suction vent and he tried to get it. because it was on the bottom of the pool. And I saw it on the bottom of the pool. And I was like, hey, if I go grab your diving toy, we're about to go back up to the room. And I turned around and threw my towels into my bag and then turned back and realized he hadn't come back up yet. I was like, gosh, he's down there a little bit. Great swimmer. It didn't really concern me. But then I looked into the pool and he was kicking his legs funny and I just knew something was wrong. And I dove in headfirst into a four foot pool, which you would never do otherwise. And when I got to him, I realized his hand was stuck and I pulled on it. and tried to get my finger in there to try and get it to come on, you know, on stock and I couldn't get it out. And kind of a long explanation, but the suction vent was on the side of a portal. So there was like a four inch deep square and the suction tube was on the side of the square. And so his arm couldn't go at a straight angle to get, to pull on it. So yeah, the four grown men pulling on him couldn't get it out. And the he and we started cutting his hand off. I mean like. I screamed for somebody to start cutting his hand off and they did. We got all the way under the tendon but not through it and that's the only scar that my child has, oddly enough. The EMT said when he jumped in the pool he was like, I was just going to rip his arm off and I was like, honestly I wouldn't be fine with that at the time. I would have been more than fine to lose the arm. But now we have a joke in our family that I have a favorite hand. That's my son's right hand. So, yep, that little scar on his wrist is the only thing we've got of that accident. How is it that you can laugh about this now? lots and lots and lots of work with my wonderful therapist. I laugh about it now because I've spent so much time working to be able to not break down, and laughter's kind of my way of handling that, I think. I'm the one at the haunted houses that giggles instead of screams, so. OK, I mean. I have all this dead air here. And I'm. beginning of this year you were going to get into my son's accident, did you? And my eyes are tearing up. Yeah, and most people when they hear it the first time, it scares the living daylights out of them and there's a very obviously emotional response. And you know, that's why for the longest time I couldn't even talk about it because I literally would shut down. One of the by the way, thank you for sharing that it's You've obviously done a lot of work and hats off to your therapist really she's fantastic. She worked with me a lot. My therapist, not that I would ever expect other therapists to do this, but she was at the hospital in Fort Worth waiting for me when we landed the plane. She knew which hospital we were going to because I called her from Mexico and I was like, look, and I didn't ask her to be there or anything. But when we came through the emergency room, my therapist was standing there. I'd never met her in person. It had been completely online. And as soon as I saw her, I lost it and fell into her arms as if she was a loved family member. And she spent time with me at the hospital and now that's going to make me tear up. I was so thankful for that. my parents came to bless them, but having my therapist there to be able to talk me through the feelings and the guilt and, you know, all of the things that, you know, for the longest time I was like, what kind of mother tells somebody to chop their child's hand off? And it's the funny little things like that were so hard for me to get past. Because you know that's like the right thing to do. It's what you're supposed to do. But I felt horrible guilt related to that for the longest time. I mean, to that end, sometimes the best thing to do is the most painful. If we think about like the wildfires out in the West, what do we do? We put a fire around them to contain them. How stupid is that? yeah, like I said, it was, that was one of the things that took a very long time to get over and it took a lot of work and a lot of time with my therapist to get past a lot of the guilt, which, you know, and a lot of the dissociation, I did a lot of dissociating for a long time. My daughter parentified, I know you know what that means, but. Mm-hmm. She basically turned into the parent and we still have her with a therapist working on that because even now when I start crying my daughter turns into mommy immediately and starts comforting me and holding me and I'm like baby girl mommy's okay I'm really I'm fine I'm just sad about something but my daughter still parentifies the second she sees me upset. Yep, takes 100% over. wants to know what she can do for me if I'm okay, she'll hug me, she'll stroke my hair. I'm like, baby girl, you don't have to do that for mommy. That's not your, that's not your role. That's mommy's role to do that. But yeah, when she sees me upset, she still does it. So, you know, that's another thing that I still talk with my therapist about is the guilt of what I put my daughter through with that whole situation because she shouldn't have been the one having to hold us together, but she was because my husband and I were distraught. She learned how to do that because she sees the management when you and your husband need to manage things. Just instinct. Yeah, yeah. And my therapist told me that too. She's like, the reason your daughter did that is because she's seen good examples. I was like, well, I appreciate that. So anyways, yeah, there's a lot of still, you know, work to do. My husband still talks with his therapist regularly because he still has a lot of guilt about the fact that he wasn't there when it happened. He and my daughter were in town. I'm thankful they weren't there. I didn't want anybody else to have to witness that. But. My husband had a lot of guilt that he wasn't there at the time. And I was like, there's nothing you could have been able to do. Like what, what could you have done? The one person who could save our son was me. I'm the one who knew CPR. You know, I was the one who was able to do what needed to be done medically. And he didn't, he didn't have the know-how. You know, all he would have done is just lose his mind at the pool side. From what you said, he would have done his darndest to comfort you too. Well, and he did once he got there. He actually, he and my daughter came back just before the ambulance got there. So my son was already not conscious by any means, but breathing, coughing up froth, when my husband and daughter showed up at the hotel getting back. Because despite multiple phone calls, it was rural Mexico and they didn't have any cell service. So they didn't even know anything had happened until they got back to the hotel and my husband's phone just exploded. and he came down to the pool trying to figure out what was going on. and why there's medics there. Yeah, but the ambulance showed up like just after he got there. So he was there before the ambulance, just barely, like maybe two minutes before the ambulance showed up. So again, thank you for that. Really, really, as a therapist, I leverage what we call patient-centered therapy. And aside from the intake, the evaluation, I make it a point. I'll only bring up something traumatic if it's relevant to something we're already processing. I'm like, it's your trauma, it's your timing, your readiness. So I really appreciate you going there, especially tonight. We had, neither one of us had any idea. Ha ha, we weren't planning on getting into that. Now, my therapist told me at one point that, and again, I told you earlier, I'm a big puzzler. I love to do jigsaw puzzles. I pretty much have one going at all times. And she said that the trauma's kind of like a thousand piece puzzle. And the more you talk about it, the more pieces get put together and your brain can kind of coalesce it into a picture and make something meaningful of it. And so that actually was how I started talking about it. It was because I had to in order to be able to process the trauma. So. And I've heard that analogy before several times. Yeah, and for me that was a perfect analogy because I do puzzles all the time and kind of, you know, the multiple pieces all kind of sitting out and you don't really know what the picture looks like. If you didn't have a photograph to put it together it makes it really difficult to try and put puzzle pieces together and you don't even know what the picture is and that's kind of where my brain was is I had all these puzzle pieces of this trauma floating around in there and didn't know how to put it together and the only way to do that really was to talk about it. So. It's still, there's probably an eight or 10 puzzle pieces still hanging out there. So keep telling the story when people ask. You've got a really good idea of what the puzzle looks like though. I do, yeah. I handle a lot better than I used to. I still get emotional, but it's not near as traumatizing as it used to be. Well, Dr. Stoehr I just want to, again, thank you for your time. It's been so delightful to talk to you and for sharing a lot, a lot of emotional, a lot of your history, kind of where your heart is, really. I really look forward to getting this thing online pretty soon, hopefully. But I'm glad we were able to connect. It's really been wonderful. I do have some things I want to discuss with you, you know, before we put the show notes together and whatnot. So we're just going to cut the tape now and hopefully I won't hang up on you this time. You hit the end stop button, yeah, not the leave button. Right. Because it's not a cell phone.