Ep. 58 – Designing Functional Health Protocols with Dr. Alex Keller from Fullscript

Ep. 58 – Designing Functional Health Protocols with Dr. Alex Keller from Fullscript

By using artificial intelligence with a human element, practitioners can design a functional health protocol that will allow patients to maintain their treatment plans.

Fullscript’s Dr. Alex Keller and Heads Up Founder Dave Korsunsky discuss how to deliver an entertaining and informative patient healthcare experience. Allowing patients to interact with and understand their data from their remote patient monitoring tools will drive them to stick to treatment plans long-term.

Heads Up

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

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Dr. Alex Keller

Dr. Alex Keller is a practicing naturopathic doctor in Ottawa, Canada and the Medical Director at Fullscript. As Medical Director, he oversees the Integrative Medical Advisory team (IMAT) and the development of educational content for practitioners across North America.

He is a graduate of the University of Ottawa with an HBSc in Health Sciences and Psychology. Although originally planning to attend conventional medical school, Alex shifted direction and completed a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine. The shift followed a three-month internship at a rural Kenyan hospital where he worked with doctors who used local food to successfully treat patients, after which he felt compelled to practice a nutrition-oriented system of medicine. Today, he blends an evidence-based functional approach to care with his experience as an organic farmer and a passion for anthropology to serve as an expert in traditional and integrative medicine. 

About Fullscript

Fullscript supports practitioners focusing on prevention and the connected, underlying causes of a patient’s symptoms. Thousands of integrative and functional health professionals are pushing for a shift to a more proactive perspective on lifestyle, patient care, and all of medicine.

These practitioners are on a mission to provide lifelong care that helps people discover and rediscover wellness for the rest of their lives. It’s Fullscript’s mission to support them — to help people get better. From practitioners to patients, partners, and colleagues, we build frictionless technology and personalized experiences to support those on their wellness journeys, whatever that means to them.

 

In this episode:

(1:50) A discussion around how medical professionals can design a functional health protocol for each patient and how you can track that functional health protocol through remote patient monitoring.

(6:33) Dave talks about taking the funnel concept of running a company and applying that to a medical protocol. Are patients opening the products? Are they even buying them.

(8:59) Providing patients with objective data will help them stick to the recommended treatment plan. 

(11:16) How patients who have not fulfilled the treatment plan got tripped up on simple tasks like opening the plan within the email.

(12:51) Dr. Alex Keller’s team has a human care team to help clients with following the treatment plan. This team helps patients interpret the plan and ensure that patients stick to the functional health protocol.

(14:59) Platforms like Heads Up Health that track biofeedback measures like heart rate variability (HRV) help to motivate patients. Patients can become discouraged if they don’t notice symptoms improving short-term, but seeing the data of the changes happening within the body assists in making the patient maintain compliance.

(16:44) Gamifying the healthcare experience can help facilitate behavioral change. 

(18:27) Blood glucose and HRV are great biofeedback markers to look for in patients within the first week of treatment.

(21:03) Dave gives a step-by-step analysis of how patients can understand their metabolic markers.

Step 1: Give patients an actionable target.

Step 2: Design a functional health protocol and set the second stage of the funnel.

Step 3: Confirm the person actually opens the email.

(22:30) Dr. Alex Keller does not see many integrative practices including a device that can do biofeedback collection (like a continuous glucose monitor). He gives diet, lifestyle, and supplement protocols. He also can tell patients to track blood values, biofeedback, and/or other markers.

(24:19) Dave talks about how patients develop awareness by using CGMs and platforms like Heads Up.

(28:26) Dr. Alex Keller discusses how the challenge in his field is what kind of standardization there will be. There are so many products that it can be overwhelming for somebody looking to track their biomarkers. Tracking the data with platforms like Heads Up can be used for large data-driven studies. Use Fullscript to initiate that process.

(32:49) Developing large data studies can help set treatment plans by aggregating data. The basic standard has been blood tests for the last decade. The next step forward could be much more in-depth.

(37:00) Keeping patients engaged in tracking will help them stay on their functional health protocol. It encourages the patient to maintain behavioral change and the practitioner can call the patient if they start to fall off the path.

(42:25) Dave discusses how using technology and AI could help scale the remote patient monitoring functional health protocol. AI can also be used to flag patients to their practitioners or lifestyle coaches.

(46:23) Dr. Alex Keller believes that AI will never replace humanity, but it can be used to help inform decisions. By including automated reminders in Fullscript, it helps keep patients on their treatment plans. His focus is to arm practitioners with tools to provide better user experiences for patients.

(49:21) Dave agrees that you need to combine AI and the human element. He sees positive change is happening with the new CPT codes and the payer system.

References

Fullscript

Dr. Alex Keller: LinkedIn | Instagram | Personal Website | Fullscript Website

Ep. 57 – Simplify Functional Lab Testing with Rupa Health

Ep. 57 – Simplify Functional Lab Testing with Rupa Health

Are you a practitioner looking for an easier way to conduct functional medicine lab testing? 

Tara Viswanathan, Co-Founder and CEO of Rupa Health, discusses with Heads Up’s Dave Korsunsky how her company simplifies this process for medical professionals.

Dave and Tara also talk about why they believe root cause medicine will eventually become the standard of care, how Rupa Health and Heads Up are educating practitioners, and the origins of Rupa Health.

Rupa Health is a company that focuses on making the lab testing process easier for practitioners, so they have more time to focus on patient care.

Tara Viswanathan graduated with a Master’s Degree in Management Science and Engineering. She achieved her Bachelor’s Degree in Finance and Operations Management at Pennsylvania University. Tara previously did product consulting for consumer health startups.

Functional Medicine

Functional medicine focuses on the biological systems in the body. A single diagnosis can have multiple causes. Ultimately, the purpose of functional medicine is to identify and treat the root cause of the disease. 

Heads Up

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

Click on the button below to start your free 30-day trial. Or, read on for more information about our latest podcast episode!

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“I’ve had complete conviction in the fact that root cause medicine is going to become the standard of care.”

– Tara Viswanathan

Follow Tara:

Twitter @TaraViswanathan

LinkedIn Tara Viswanathan

 

In this podcast you’ll learn:

(2:25) How Dave and Tara became interested in health through their careers in technology. 

(3:57) How Rupa Health makes functional lab testing easier. The company has over 2,000 different tests that healthcare practitioners can order within minutes. Rupa Health manages the entire patient experience including support with phlebotomy, specialized instructions, and 24-hour customer support.

(5:40) Rupa Health supports everybody from solo, independent acupuncturists to small private practices to large hospital systems. Tara breaks down how a practitioner can enroll and ease the burden of ordering patient tests.

(7:33) Patients have access to 3-month payment plans through Rupa.

(9:13) The benefits of stool testing. Dave jokes about his experience presenting the Bristol Stool Chart at a conference.

(10:12) The information you can learn from checking your urine and stool.

(11:04) Rupa Health began in January 2020. Within months the company spread to clinics in 47 states. The company is continuously releasing new features.

(12:34) Tara believes root cause medicine is going to become the standard of care. Tara wants to enable all practitioners to be able to pursue root cause medicine. Rupa first built a matching service to help pair patients with practitioners. The company then built a clinic, discovered the issues with lab testing, and decided to shut down the clinic and focus solely on lab testing.

(14:50) One of the main issues with functional labs is that many of them do not have any web-based APIs (Application Programming Interface) to pull from. These labs and patients are stuck with a bunch of PDF files. Rupa Health has helped to build services around these facilities’ current systems.

(19:00) Rupa can help doctors process all of their lab tests without having to learn everything step-by-step.

(20:10) Root cause medicine can be the future of medicine. Root causes can be microbiome environment, heavy metal toxin exposure, and more.

(22:23) Remote patient monitoring is becoming widely accepted and there are now reimbursements from the payer system. Commercial insurance covers most microbiome testing.

(24:14) Rupa Health is working on helping educate practitioners through Rupa University. These courses teach practitioners how to understand and interpret lab testing. Heads Up Health has also launched Heads Up University, which aims to serve a similar purpose.

(25:49) Dave and Tara are super involved as patients when interacting with their doctors.

(26:43) Tara’s advice to practitioners is, “It’s not easy, but it’s worth it.” You can reach out to Tara at tarav@rupahealth.com where she can explain Rupa Health to you in more detail.

 

References

Rupa Health

Bristol Stool Chart

Rupa University

Electronic Medical Records (EMRs) for Functional Medical Practices

Ep. 56 – How Continuous Glucose Monitoring Can Lead to Health-Conscious Behavioral Change

Ep. 56 – How Continuous Glucose Monitoring Can Lead to Health-Conscious Behavioral Change

Curious how continuous glucose monitoring (CGM) can lead to significant behavioral change? Kara Collier of NutriSense discusses how this happens with Heads Up founder Dave Korsunsky. Constantly being exposed to how your lifestyle affects your blood glucose increases your personal health awareness and motivation for making change.

Kara covers how NutriSense came together, how the company is reducing the barrier for patients to get CGM, and how NutriSense’s apps and services help patients understand their data.

She also talks about how most Intensive Care Unit (ICU) patients are people with immediate complications from lifestyle-related chronic conditions. Kara campaigned to the hospital administration and nutrition department for a year asking them to stop serving sodas to patients because of its negative health effects. When no action was taken, Kara left the hospital, worked at a nutrition software company, and eventually founded NutriSense with two other people.

Kara Collier is a Registered Dietitian Nutritionist (RDN), Licensed Dietitian/Nutritionist (LDN), and Certified Nutrition Support Clinician (CNSC) who specializes in glucose control and metabolism. She graduated from Purdue University and previously worked at Memphis VA Medical Center as a clinical dietitian at Providence Hospital and in a management role at Nutritionix.

Heads Up

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

Click on the button below to start your free 30-day trial. Or, read on for more information about our latest podcast episode!

START TRACKING!

Continuous Glucose Monitoring (CGM)

Continuous glucose monitoring is the practice of using a device (like the FreeStyle Libre CGM) that automatically tracks your blood glucose levels. You can view how this data changes throughout the day based on what you eat, how you exercise, and other daily activities that you do.

Habitually viewing and understanding this data can lead to substantial lifestyle changes. This data can also be shared with your practitioner, so they too can monitor your health. Your practitioner can notify you if they think you need to take action on your health.

“When you think about ICU, you expect to see gunshot wounds or car trauma – accident trauma. But more often, what you’re seeing in the ICU is actually immediate complications from lifestyle-related chronic conditions.”

– Kara Collier

In this podcast you’ll learn:

  • (2:19) How Kara started as a dietician primarily in the ICUs and hospitals. She saw more chronic lifestyle conditions as opposed to gunshot wounds or car accident trauma. Those lifestyle conditions included diabetics who didn’t know they were diabetics or people with uncontrolled hypertension.
  • (3:09) Kara details the frustrating layers in the healthcare system. People are reluctant to change after four decades of bad habits. A lot of the traditional dietetic information is antiquated or biased. The hospitals were never addressing the root cause.
  • (4:56) The last straw for Kara was that sodas were served to patients even though they’re supposed to be healing them. Kara campaigned in the hospital to have sodas removed and nothing happened. She then left the hospital.
  • (5:50) Kara worked at a different nutrition software and learned more about start-ups. Her journey led her to research root causes, behavioral change prevention, metabolic health, and continuous glucose monitors.
  • (6:34) How using continuous glucose monitors and seeing the data in real-time will help fix users’ issues early on. CGM will also increase motivation to make behavior changes.
  • (7:25) Kara’s co-founder, Dan, had a sister who was a Type 1 diabetic. Dan was trying to increase profitability while working in healthcare consulting and realized that we keep putting more money into the healthcare system, but people keep getting sicker. He realized his sister’s device might help solve financial problems.
  • (8:18) The third co-founder, Alex, has a tech background and was interested in nutrition and biohacking. He used the devices on himself and built a software and app to showcase the data in a better way. 
  • (8:57) The group came together when Dan and Alex posted on LinkedIn stating that they were starting a company and needed a nutrition or healthcare expert. Kara happened to stumble across the post and moved to Chicago to help build out the company.
  • (9:44) Dave and Kara discuss how surprising it is that chronic lifestyle conditions are the number one thing bringing people to the emergency room. Those cases could have been prevented.
  • (10:48) Part of the chronic lifestyle condition issue is that a lot of people aren’t following up regularly with their primary care until it becomes urgent. There is also a lack of prevention and our society isn’t proactive with our health.
  • (12:43) How Facebook health groups are helping to spread health awareness. People are becoming more aware of their health.
  • (14:47) How Heads Up benefits individuals, healthcare professionals, and practitioners’ client bases.
  • (17:19) NutriSense’s products. Its consumer product comes with a continuous glucose monitor, dietician coaching, and NutriSense’s app.
  • (18:04) Continuous glucose monitors are considered medical devices, so patients need a prescription. If you’re not an insulin-dependent diabetic, most likely, your doctor won’t write you a prescription.
  • (18:48) NutriSense is trying to reduce the barrier to access continuous glucose monitors. You receive two CGM devices per month and access to one-on-one dietician coaching. The coach can see all your data and help you interpret it.
  • (19:57) The human body is very complicated and Kara doesn’t want users to misinterpret the data. 
  • (20:46) In the NutriSense app you can log your meals, stress, and exercise. You have access to analytics, charts, and graphs that break down the information. There is also education in the app.
  • (21:10) NutriSense is currently testing out working with clinics. NutriSense gives clinics access to the software and they can use NutriSense’s dieticians if they want.
  • (22:13) Dave’s experience on the ketogenic diet and using the continuous glucose monitor. He had a lot of success early on and was able to keep himself within his target glucose range.
  • (24:07) Roughly 40% of NutriSense’s customers are relatively healthy. The other 60% have a health condition they’re working on. These conditions include hypertension, PCOS, Hashimoto’s disease, fatty liver, and chronic fatigue syndrome.
  • (25:42) Why Dave and Kara don’t like the word bio-hacker. 
  • (26:11) Continuous glucose monitors made Kara’s experimentation with ketosis much easier. The reduced burden of the process with CGM makes it easier to motivate yourself and form a habit. 
  • (27:41) Continuous glucose monitors give you immediate feedback. They show you the positive and negative effects of what you’re doing in real-time.
  • (28:40) Continuous glucose monitors allow practitioners to engage clients with positive reinforcement.
  • (29:25) Dave enjoys using the CGM with the breath acetone meter so that he can monitor his blood pressure and ketone levels.
  • (30:20) How data from continuous glucose monitors gives people the power to master their metabolism.
  • (31:02) Healthy aging is one of the largest components of longevity. Once you make sure your blood sugar is in check every day, everything starts working better. You start sleeping better, regulating your appetite better, your hormonal systems work better, and your energy levels improve.
  • (32:00) Maximizing the number of healthy years is one of the driving motivations of NutriSense. Being insulin sensitive and having good metabolic health is the core of living a long, healthy life.
  • (33:44) Personalized nutrition and health are going to keep growing. Using continuous glucose monitors allows you to have an enhanced Mind-Body connection where you notice what meals make you feel worse. Connecting subjective experiences to objective data helps people to understand what is going on in their bodies.
  • (36:02) Continuous glucose monitors, NutriSense, medical devices, and digital health devices help people build a mind-body awareness.
  • (37:29) Metabolic disorders are everywhere. Most of the food people put in their bodies is terrible for blood sugar. Food companies use fMRI machines in a lab to see what reward centers are activated in the brain with different foods.
  • (39:11) Dave and Kara talk about how to make CGM more accessible and affordable. People in the healthcare and regulatory systems need to understand the benefits of continuous glucose monitoring. The more there is a demand for these devices, the more there will be a push for the FDA to allow these devices.
  • (41:14) NutriSense writes prescriptions for individuals to use continuous glucose monitors.
  • (42:19) Some common foods that surprisingly spike glucose include Costco rotisserie chicken, smart sweets, and oat milk. A lot of people mean well and are trying to be healthy, but something you eat every day might be having a detrimental effect on your body. You need to know how your most common foods are affecting your ability to live that long, healthy health span.
  • (46:25) The top takeaway from NutriSense clients was that they left the program with more flexibility in their diet than they thought there would be.
  • (47:26) Going on a 20-minute walk and adding MCT Oil can help to burn off some of the excess sugar or blunt the spike. 

 

 

References

NutriSense

Freestyle Libre CGM

 

Ep. 55 – Integrative Practices Thriving in the Payer System with Digital Interactions, Remote Patient Monitoring, and Chronic Care Management

Ep. 55 – Integrative Practices Thriving in the Payer System with Digital Interactions, Remote Patient Monitoring, and Chronic Care Management

Join Heads Up Founder, Dave Korsunsky, as he talks to Dr. Cheng Ruan about remote patient monitoring, chronic care management, and how practitioners can re-engage the payer system.

Listen on Apple Podcasts | Spotify | Google Podcasts | Amazon Music

Dr. Cheng Ruan

Dr. Cheng Ruan, MD, is the founder of the Texas Center for Lifestyle Medicine. The medical center focuses on using lifestyle modifications to prevent, reverse, and improve chronic diseases. Dr. Ruan’s primary focus is to bring evidence-based lifestyle and personalized medicine to the medical community.

Dr. Cheng Ruan is board certified by the American Board of Internal Medicine and the National Board of Physicians and Surgeons. He is a Physician Member of the American College of Lifestyle Medicine and The Institute for Functional Medicine

Dr. Cheng Ruan also hosts his own podcast, Dr. Ruan MD.

Remote Patient Monitoring

Remote patient monitoring (RPM) is the practice of using technology to monitor patients outside of a medical setting. Patients can continue with their daily lives while wearables such as Apple Watches, Fitbits, or Oura Rings report select vital signs to their medical professional.

About Heads Up

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect your favorite health devices and apps, and use the data to optimize your health (and that of your clients).

You can follow Heads Up Health on Instagram | YouTube | Twitter

Click here to start your free 30-day trial or read on for more information about our latest podcast episode!

“Who’s that one person that you want to serve? And you might think, ‘I want to serve everyone. I want to serve people who need help.’ But who’s that one demographic that you want to serve and focus on what that demographic needs.”

– Dr. Cheng Ruan

In this podcast you’ll learn:

2:04 Dr. Cheng Ruan’s background and focus on proving that integrative health can be practiced with an insurance model to serve the general public.

2:57 Having a false mindset when starting the Texas Center for Lifestyle Medicine. Why Dr. Cheng Ruan uses emerging technology to reduce the burden of administrative tasks

5:48 How Dr. Cheng Ruan’s family of Eastern and Western medicine practitioners influenced him to bring Eastern medicine to the United States.

7:34 Western medical schools don’t train doctors to help patients get off of their medications.

8:08 The rise of functional, plant-based, and lifestyle medicine around 2017.

9:17 Dr. Cheng Ruan’s entrepreneurial ventures taught him that your audience will give you the answer if you are willing to listen.

12:31 Why health professionals shouldn’t be shy when it comes to talking about money. Generating money helps professionals serve their patients better.

14:12 Dr. Cheng Ruan on the importance of delivering value to patients and making your deliverables clear, particularly when it comes to remote monitoring.

15:53 Dr. Cheng Ruan’s issue with some doctors who use remote patient monitoring and why patients need to understand what practitioners are looking for.

16:53 Remote patient monitoring reimbursement code updates and how practitioners can get reimbursed.

18:02 How remote patient monitoring is the business of delivering safety and why the technology you use needs to be efficient.

22:10 A few types of remote monitoring devices.

23:09 The purpose of remote monitoring codes and why integrating all of your data into one place is so important. Practitioners can use continuous monitoring data from their patients to better understand the underlying issues (ex. Studying sleep patterns in relation to mold toxicity).

28:02 Why remote patient monitoring is better than concierge practices. RPM or chronic care management are better because they are predictive recurrent subscriptive revenue. RPM facilities have patients automatically assigned to them through insurance companies.

30:37 Why Dr. Cheng Ruan optimizes processes in his office and the hurdles that he faced while building his practice. Issues typically arose when the technology failed.

32:33 How COVID-19 forced elderly patients to learn how to use technology.

34:15 How some practitioners struggled to adopt technology during COVID, but most of Dr. Cheng Ruan’s patients did not. His most common way of communicating with patients used to be phone calls, but is now text message. And he can make money by answering texts.

36:27 How Dr. Cheng Ruan’s practice became so successful because they were early adopters of technology. They used text messaging, phone calls, 5-minute check-ins and more.

38:29 How Dr. Cheng Ruan’s digital platform allows him to show Medicare that his practice provides value.

39:27 Dr. Cheng Ruan predicts technology adoption rates may be even higher in 2022. The 2021 coding changes were the biggest since 1993. 

40:20 Dave talks about a webinar that focused on reengaging the payer system. The recent changes in payment for extra time and reduction in documentation has made it easier for practitioners to work remotely.

41:33 Dr. Cheng Ruan’s advice for practices that are thinking about reengaging the payer system:

Who is your avatar? Who is the one person you want to serve? Hyperfocus on that one demographic.

What value do you want to bring to the world or that person? Create the actual business plan based on what you’re able to do. Build the structure on paper first before you execute.

45:30 Dr. Cheng Ruan learned to focus on one type of patient during his time as a consultant. Practices should do the same and then bring in other patients as they grow.

46:16 Dave and Dr. Cheng Ruan reflect on lessons learned through entrepreneurship. Keep building, continue learning from your mistakes, and pick yourself up when you get knocked down.

References

Dr. Cheng Ruan’s Social Media: Facebook | YouTube | Twitter | Pinterest | Website

Texas Center for Lifestyle Medicine

Dr. Ruan MD podcast

Withings Blood Pressure Monitor

2021 Medicare Remote Patient Monitoring Codes 

American Medical Association CPT Codes

DrSummits

 

 

 

Ep. 54 – How Dr. Jessica Drummond of Integrative Women’s Health Institute is Using HRV, Functional Nutrition and Health Coaching for Better Health Outcomes

Ep. 54 – How Dr. Jessica Drummond of Integrative Women’s Health Institute is Using HRV, Functional Nutrition and Health Coaching for Better Health Outcomes

Dr Jessica Drummond, MPT, CCN, CHC, is the founder and CEO of Integrative Women’s Health Institute (IWHI). An expert on chronic pelvic pain and endometriosis, Dr Jessica Drummond is also an evidenced based practitioner who understands heart rate variability (HRV), lifestyle parameters, and how to apply this information with her patients for better health outcomes.

If you’re a practitioner listening to this, you’ll learn how Dr Jessica Drummond transitioned her practice from in-person to, now with Covid, 100% virtual. She is one of the rare practitioners utilizing HRV and wearables such as Oura and Garmin in a clinical setting to measure her patients’ baselines to watch it improve over time. With her team of health coaches, she uses a “nervous system out approach” to help her patients calm their nervous systems and balance stress, while optimizing their functional nutrition, deep sleep, exercise, and more. Learn how Dr. Drummond and her team are using Heads Up’s practitioner’s portal to track their clients’ lifestyle and health metrics.

If you’re struggling with chronic pelvic pain or other issues related to women’s health, you’ll be inspired and motivated to reduce your stress, and learn why tracking any progress to celebrate may help your own health.

And if you’re considering becoming a board certified health coach, especially for women’s health, you’ll learn how Dr. Jessica Drummond’s unique program is the first of its kind, the only Women’s Health Coach Certification in the world with over 1500 people enrolled from over 60 countries!

Join Heads Up Founder, Dave Korsunsky, as he talks to Dr. Jessica Drummond about her unique approach to women’s health, her health coaching program, and even advice for those health practitioners new to transitioning into a virtual model. 

Listen in iTunes!

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

Click on the button below to start your free 30-day trial. Or, read on for more information about our latest podcast episode!

 

START TRACKING!

“Calming the nervous system is so important to optimizing digestion function. Because you certainly can’t absorb nutrients and calm digestion and inflammation if someone is in chronic fight or flight, which is why I’ve gotten so interested in heart rate variability [HRV] over the years. Because it’s the only way we can objectively measure that.”

– Dr. Jessica Drummond

In this podcast you’ll learn:

  • How Dr. Jessica Drummond, Founder and CEO of Integrative Women’s Health Institute, first connected with Dave via their mutual friend, Aypril Porter, which led to a partnership between Dr Jessica using Heads Up with her own patients and program. [1:06]

  • About Dr. Jessica Drummond’s body of work, how she started the Integrative Women’s Health Institute over 11 years ago, and how from the very beginning, it was about training her colleagues in functional nutrition, lifestyle medicine, and the communication skillset of health coaching. [1:36]

  • How Dr. Jessica Drummond started her career, more than 20 years ago. First as a physical therapist, originally intending to focus on sports medicine in orthopedics because of her background as an athletic kid, but really quickly began to specialize in women’s health. [2:20]

  • How her focus on women’s health is from a physical standpoint. Basically, the muscular skeletal joints, muscles and nerves related to women’s health conditions. For example, shoulder injuries that happen after breast cancer surgery or rib pain, back pain, and pelvic pain associated with pregnancy, urinary incontinence, prolapse, etc. [2:40]

  • She did this for many years in a hospital based clinical setting, as well as outpatient practice [3:15]

  • How Dr Jessica Drummond discovered that the one population in women’s health that was particularly challenging was complex pelvic pain, sexual pain, or pelvic floor pain, pain in hips, back, radiation down the legs, organ structures, etc. [3:30]

  • Why anytime there is pain signaling, the nervous system is involved [4:00]

  • How she got sick in her early 30s and used the tools of functional nutrition to regain her own hormonal health. How pelvic pain can sometimes have a cyclical expression, and how to apply some things from a nutritional perspective to help her most challenging pelvic pain clients, using her own research around this [4:06]

  • What motivated Dr. Jessica Drummond to start building her own school. While working at a women’s specialty hospital in Houston, she began to teach her colleagues, offer courses, from the moment she began learning this information. [4:54]

  • That the Integrative Women’s Health Institute now has about 17 different courses and offers health coach certification that’s board-approved, with many certified health coaches come out of the program, focusing on women’s health. Not just in Dr. Drummond’s specialty, pelvic pain, but also fertility, perimenopause, period pain, and all kinds of women’s health issues. [5:14]

  • How Dr. Jessica Drummond has successfully shifted from a more in-person to 100% virtual now. [6:34]

  • Why she was ahead of her time, way before Zoom even existed, focusing on virtual appointments, telehealth, out of necessity. How she initially built a huge place in Houston, but switched to phone appointments, completely client-driven, eliminating unnecessary commutes to the doctor’s office. This also allowed her to fit in life as a parent raising young kids, as well as multiple moves (11 times in 13 years!). [7:00]

  • Advice for practitioners from Dr. Drummond if new to moving towards a digital model: why you should maintain your own office, even if it’s just a separate room in your home. [8:54]

  • Why is nutritional therapy so vital to health issues? How blood sugar dysregulation can be inflammatory? What does a functional nutrition template look like and how can it start the healing process? [9:28]

  • Dr. Jessica Drummond’s approach to functional nutrition: “It’s about optimizing systems. Instead of chasing the symptoms, we always say, optimize physiological systems.” [10:19]

  • Why Dr. Jessica Drummond is so interested in her patients’ heart rate variability (HRV). And why she takes a “nervous system out approach” instead of what she used to do, which is to start with digestion. That although digestion is used early in the process, she is realizing more and more that “calming the nervous system is so important to optimizing digestion function. Because you can’t absorb nutrients, calm digestion and general inflammation if someone is in chronic fight or flight.” HRV is the only way she “can objectively measure that.” [11:11]

  • On endometriosis, and how symptoms often begin for girls as young as 8 and 12 years old. How girls and women begin to learn to push that pain down and show up anyway.  [11:27]

  • Why the number one reason girls miss school is due to period pain [12:09]

  • How many people learn how to push through the pain, to suppress it, and no longer can even recognize when they are physiologically stressed, which is again why HRV can be so valuable, whether looking at a Garmin, Biostrap, or Oura. “Now you’ve got an objective measurement that you can then start to make changes, which will allow you to use the nutrition therapy to calm the nervous system.” [12:16]

  • How using HRV can help you as a practitioner to spot those who have a sympathetic overload, then begin to use other strategies such as mindful eating, chewing. [13:40]

  • Why an anti-inflammatory diet is important, yet how to create flexibility in that plan as there is no one-size-fits-all endometriosis diet. Or pain diet. [14:00]

  • What she does with the majority of clients who have bloating digestive issues, starting with blended soups, cooked vegetables, etc. [14:42]

  • Why a lot of times, women are lacking absorbable protein, and struggle with low neurotransmitters. Not only do they have pain signaling because of inflammation, but they may have low serotonin, low tryptophan, L-theanine, and GABA support, not actually absorbing the protein they are eating. Why healthy beneficial fats are important, etc. [14:53]

  • Using the urinary organic acids testing to make sure that people are absorbing nutrients. [15:44]

  • Why Dr. Jessica Drummond starts with what people CAN eat, because if you have a lot of digestive issues, and you’ve been afraid of food since you were a ten-year-old girl (there are a lot of eating disorders), this is important. Eventually we’ll move away from inflammatory foods like sugar and dairy. But we focus on EXPANDING what they can eat, so they don’t feel like it’s a restrictive diet.[15:53]

  • On how the auto-immune paleo diet is kind of a backbone for most people, but it varies: some plant-based, some leaning towards keto. [16:53]

  • Why endometriosis has auto-immune properties, often co-morbid with lots of other auto-immune diseases. After endometriosis surgery, auto-immune markers tend to drop, which is important for fertility and overall health, and how Dr. Jessica Drummond tries to support that both pre-op and post-op to improve the immune system.

  • On Dr. Jessica Drummond’s published research around vulvodynia, her focus on gut healing, immune healing, restoring the small intestinal barriers, taking out those inflammatory and processed foods, how the vulvodynia never came back.

  • What auto-immune markers she looks for. And why you usually see co-morbid things like Hashimotos, thyroiditis, celiac disease, or elevated ANA. Sometimes associated with psoriasis or lupus. Or elevated thyroid antibodies. [18:50]

  • How with her virtual clinic, she does a personalized nutrition plan, potentially looking at the gut microbiome, using urinary organic acids testing, sometimes hormone tests, depending on the client’s needs. Why clients have twelve sessions of health coaching to help them implement behavior changes that can be challenging, disordered eating issues, anxiety. [20:22]

  • Another reason why tracking can be so helpful: “Because not only is it motivating, but for most women in our programs, they never feel like they’ve done it well enough. So being able to see good progress, to kind of look back and celebrate ANY progress, makes a difference.” [21:18]

  • When you’re someone who has had chronic pain for a long time, there’s always a focus on pain (i.e., when, how much, how often, what’s causing it). Instead she has her clients journal and track those times when they feel better. “That’s how we shift it by using the tracking to demonstrate more objectively how things are starting to improve.” [21:53]

  • How Dr. Jessica Drummond personally uses HRV and interprets it in a clinical setting with her clients, a basic explanation of HRV for those practitioners listening, and how some clients are already using wearables such as the Oura ring, Biostrap, Garmin, and already have access to their data. [22:25]

  • How she’s looking for that number (HRV) to increase over time. Why the Oura ring is a great option for those wanting to track their raw data. What during the day happened for that person to have a higher HRV during the night? And over time, from Day 1 of their program to Week 12, is that raising the baseline. Why they use in their clinic the Garmin, which gives biofeedback during the day, looking at the “Body Battery.” (But it doesn’t give the raw HRV data, unfortunately, right now.). [24:15]

  • How looking at HRV helps people to build associations themselves, which may not have been there before, a huge part of the process, empowering people to reconnecting to signals in their own bodies that they may otherwise not notice. [25:42]

  • Why it’s also important to teach people to get comfortable with being in some stress, knowing they’re going to recover. How she looks at HRV, exercise, but also Deep Sleep. [25:54]

  • The biggest things Dr. Jessica Drummond looks for. Over time, is that baseline HRV increasing? And if there’s a great night of sleep, what contributed to that so we can replicate it more? How much time in Deep Sleep, especially between 10pm and 2am, when your brain is recovering. During the day, is someone recovering from exercise? What may they be stressing them out that they’re surprised about? And what can we dial-in when it comes to nutrition, personalized to that particular client (example about client who thought she was eating healthy by choosing organic sugar but was still pushing her “into the orange,” which prompted them to look more into that). [26:40]

  • Alcohol and its impact on HRV (hint: it can be disastrous). And how it can be an important KPI to notice. [28:37]

  • About how work and general life stress impacts many of their clients who are women, especially right now with many simultaneously working from home and home-schooling their kids, how that is all being reflected in their numbers while in quasi-lockdown related to the Covid pandemic. [28:37]

  • Why tracking can be helpful during stressful times. “The good news is that when you start to track, people are motivated to do the recovery.” Example of her assistant who wasn’t able to change everything about her busy week, but found her own outlet to recover, restore and rejuvenate. For her, taking a hike helped her, in less than 3 days, go from a ‘8’ to a ‘100’ (body battery from her Garmin). How Dr. Jessica’s mode of recovery is clocking out at 5pm every day and meditating with her paddle board. How important it is for people to find what recovery looks like for them. [29:09]

  • Use cases of HRV in the clinical setting, how it’s mostly used in health and wellness high performance, yet how Dr. Jessica Drummond is using HRV in her clinical practice related to inflammatory issues is important, helping to encourage clients and reinforce positive behaviors, watching the baseline increase, a win for everybody. [30:30]

  • How a lot of her women clients are high achieving. And when they see their numbers not looking so great, they don’t like to accept it. So she and her team of health coaches will coach them through that. It’s also validating. We remind them that they are doing great, are talented and smart, yet whether it’s postpartum, post-op surgery, that their bodies need recovery for longevity. “Using these numbers are helpful for showing us what our body has to go through to really recover.” [31:45]

  • How Dr Jessica Drummond is starting to use Heads Up to get some data on her clients remotely.  Dave and his team at Heads Up have started building customized dashboards for her and team of health coaches to collect those peripheral metrics. [33:17]

  • Why when it comes to chronic pelvic pain, it’s really important to collaborate with a skilled pelvic physical therapist as well. How important it is for people to really tune into the messages of their own bodies, to know when they’re physically relaxed, activated and strong, taking a holistic team approach, both conventional and integrative. [33:45]

  • How the Integrative Women’s Health Institute offers the only board certified health coaching program focused on women’s health. The program starts with the skillset of health coaching, helping people to have immediate buy-in, become excited about their plan to get healthy. Why this communication skill is new to most clinical professionals who are taught in their training to fix people as though they are mechanics. [34:27]

  • Why behavioral change is important; Dave mentioned other past podcast guests utilizing similar services in their clinics or programs, such as Brandy Wiltermuth of Three Health with medically supervised weight-loss and Dr. Sandi Scheinbaum who trains her health coaches to operate in that support role when it comes to lifestyle changes. [36:06]

  • How important it is for someone to want to take ownership of behavioral lifestyle changes and ask for help. While the nutrition and sleep plan is important, it won’t be executed without lot of support to making those lifestyle changes. Such as taking things off their plate and off their calendar. [38:05]

  • Ways to get in touch with Dr. Jessica Drummond and the Integrative Women’s Health Institute [40:30]

References

Integrative Women’s Health Institute (IWHI)

Where to contact Dr. Jessica Drummond on Instagram

Outsmartendo.com (If you struggle, or have patients who struggle, with endometriosis or other pelvic pain issues, this is a great place to get information)

Outsmart Endometriosis: Relieve Your Symptoms and Get Your Career Back On Track by Dr. Jessica Drummond 

Organic Acids Test (OATS) 

Dr. Jessica Drummond’s published study on vulvodynia (“Functional Nutrition Treatment of Vulvodynia, Irritable Bowel Syndrome, and Depression: A Case Report”)

About Heads Up 

Heads Up is a website designed to empower individuals who want to take a self-directed approach to managing their health AND we offer health professionals a way to centralize their clients’ health data and optimize their outcomes.

Want sustainable weight loss and better metabolic health for your clients? Take a page out of ThreeHealth’s playbook and learn how to start optimizing health outcomes now. Join the data-driven health movement and see why functional doctors, nutritionists and health coaches love to use our health data analytics and remote-monitoring platform to save time, attract more clients, and optimize their outcomes with ease.

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Ep. 53 – Using Continuous Glucose Monitoring (CGM) To Optimize Your Diet and Lifestyle – Dr. Casey Means from Levels Health

Ep. 53 – Using Continuous Glucose Monitoring (CGM) To Optimize Your Diet and Lifestyle – Dr. Casey Means from Levels Health

Ever wonder if there’s another option to lowering blood glucose than the ever-popular keto diet? Then you’ll definitely want to stick around to the end of this episode. Dr. Casey Means, co-founder of Levels Health, drops some truth bombs about metabolic health, carbohydrates, and the insulin response and how you can make your own meal program to optimize your metabolic health using continuous glucose monitoring.

Dr. Casey Means completed her medical degree at Stanford Medical School, became a Head and Neck Surgeon, and then transitioned to functional medicine after finding the underlying causes of illness was not being supported in her patients through the use of surgery and medicine only. She is also one of the founders of Levels Health – a company making direct-to-consumer continuous glucose monitoring (CGM) devices and putting patients back in the driver’s seat of their metabolic health.

Join Dave Korsunsky, founder of Heads Up as he gets nerdy with Dr. Casey Means about Levels Health, continuous glucose monitoring, and all things metabolic health. Even learn some great tips on how to lower glucose spikes, whether you are using continuous glucose monitoring or not!

Listen in iTunes!

This podcast is brought to you by Heads Up, a web app designed to help you centrally track your vital health data. Instantly synchronize your medical records, connect your favorite health devices and apps, and use your data to optimize your health!

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“The fact that changing our thoughts, changing the way we perceive stress, the food and molecular information we put in our mouths, the composition of our microbiome, how much sleep we get, exposure to different traumas (low-grade and high-grade). All these things actually change the expression of our genome. This is radically empowering. When you know this information, you realize there are actually levers to change the outcome. Health is not deterministic.”

– Dr. Casey Means

In this podcast you’ll learn:

  • About Dr Casey Mean’s journey to founding Levels Health [2:30]
  • Epigenetics and how even thoughts can affect our genes [3:50]
  • How modern medicine is about pattern matching of signs and symptoms to diagnose and prescribe, and how bio-individuality is much less a part of things [5:45]
  • About her experience as an ENT doc and how she noticed the connection of inflammatory conditions that were being treated with surgery, rather than investigating the underlying contributors [7:00]
  • How Dr. Casey Means shifted her practice from surgery based to a longevity and metabolic practice [10:00]
  • Continuous Glucose Monitoring (CGM) and how it could help course-correct metabolic issues [12:16]
  • How Dr. Casey Means saw symptoms greatly decline after a lot of upfront support in her appointments as her patients began buying into the changes and doing what was suggested [16:44]
  • Blood sugar dysregulation statistics [17:02]
    • 74% of American’s are overweight or obese
    • 128 million American’s pre-diabetic or diabetic
    • 88% of American’s are metabolically unhealthy – recent study out of UNC
    • About the connection between COVID-19 and metabolic health and how it appeared in April 2020 in over 100 publications that obesity, diabetes and metabolic health were the key driving factors in COVID-19 mortality [17:50
  • How Virta Health in 10 weeks, can get a patient from a diabetic HbA1c to a non-diabetic HbA1c in a program that only involves diet and exercise [18:30]
  • Diabetes is a driver in Alzheimer’s dementia which is now being called Type 3 diabetes as the brain becomes insulin resistant [20:10]
  • The effects of hyperglycemia include things such as PCOS, Peripheral Vascular Disease, gout, acne, mental health – depression and anxiety which is twice as high in people with metabolic disease, circadian rhythm disruption, and even NAFLD in children [21:23]
  • Sleep, stress, movement, and food are the four contributors to metabolic disease and about Dr. Casey Means’s shift to make her process scalable for metabolic improvements [22:30]
  • About how people have to close the loop between their actions and what is happening. Nutrition is an open-loop system and if you don’t have any direct 1:1 reaction to what’s happening, it’s really difficult to take ownership of which food(s) caused a problem for you [23:50]
  • How continuous glucose monitoring (CGM) works, what it is. It works by reading the interstitial fluid between cells and taking readings every 15 minutes automatically and sending the information to your phone [25:45]
  • Levels is an FDA approved device for type 1 and type 2 diabetes continuous glucose monitoring [26:45]
  • That insulin has a second action – to block cells from burning fat which signals the body to burn glucose, never allowing the body to dip into the fat stores for energy [29:30]
  • Most weight loss studies show failure at the 2-year mark because they’re not approaching it from a metabolic standpoint and the fact that you cannot burn fat without having a low insulin state [30:00]
  • Glucose spikes can be lowered through reduction of carbs in a meal, timing of carbs (eat them last). Use cinnamon, apple cider vinegar, or berberine as insulin sensitizers. Deep breathing can also affect it, keeping the glucose low by reducing the stress response in the body. Walking for 20 minutes after meals or even 2 minutes every 30 minutes throughout the day can also lower glucose response [31:03]
  • How to get a CGM through Levels Health – about the process and the device [33:50]
  • Dr. Casey Means describes what it’s like to wear the device and how it feels like having a superpower to be able to get immediate feedback on whether she’s feeling a particular way due to blood sugar fluctuations or a food she ate [36:16]
  • How interoception (similar to somatic awareness) helps people connect how they are feeling to what’s happening in their body [36:55]
  • About the hyper-palatability of food products and how the Levels Health CGM can help you make better decisions when the brain is hijacked by food chemicals [38:40]
  • How you can train your body to recognize blood sugar signs and signals to be able to tell what your blood sugar is by utilizing tech while you’re learning the signs from your body [40:20]
  • About the study out of Israel where they gave 800 people CGMs and provided the same meals for them all and found vastly different responses in blood sugar [41:20]
  • With the keto movement we can tap more into the fat burning because the substrates aren’t even there for burning glucose for fuel. But with CGM monitoring, you can monitor how specific carbs affect you personally. You can have a higher carb quantity in your diet and not significantly raise your blood glucose to bring a more balanced way of eating back into your life [43:40]
  • Discussion around food: how combining fats and proteins with carbs can help lower the metabolic response [46:00]
  • How long does it take to reverse metabolic issues? And how to achieve metabolic fitness [47:40]
  • About the importance of metabolic flexibility for athletes [52:15]

References

Levels Health Website
Levels Blog 
Levels – Twitter 
Levels – Instagram
Dr. Casey Means Instagram 
Dr. Casey Means Twitter
Virta Health Clinic
Israel CGM Study
Wired to Eat – Robb Wolf

About Heads Up 

Heads Up is a website designed to empower individuals who want to take a self-directed approach to managing their health. Instantly centralize your medical records, connect your favorite devices and apps (e.g., Oura, MyFitnessPal, Keto-Mojo, FitBit, Apple Health, MyMacros+, Withings and many more) and use your data to optimize your health.

Click on the button below to start your free 30-day trial now!

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