Facilitated

20| When It's Your Time: Life Lessons from ER to Dermatology with Lydia Prusinowski, PA-C

• The Facility Denver • Episode 20

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Lydia Prusinowski, a seasoned physician assistant, shares her journey from 14 years in emergency medicine to finding new purpose in dermatology practice. She reflects on the challenges, rewards, and life lessons of this dramatic career transition, while exploring how both fields inform her holistic approach to patient care.

• Emergency medicine can lead to compassion fatigue due to high volume and constant trauma
• COVID-19 paradoxically helped some providers reconnect with deeper purpose in medicine
• The mantra "when it's your time, it's your time" helps medical professionals accept limitations
• Career transitions can trigger identity crisis even when they're ultimately positive changes
• ER experience provides valuable perspective for addressing complex dermatological cases
• Physical appearance and wellness influence how confidently we show up professionally
• Building ongoing relationships with patients provides satisfaction missing in acute care settings

• Western medicine and functional approaches could achieve more by collaborating than competing
• The healthcare system faces challenges connecting emergency treatment with long-term care


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Stay curious, stay proactive, and we’ll catch you next time!

Mitchell:

Welcome to Facilitated, where we bring you real stories, strategies and science from the world of functional medicine. I'm Dr Mitchell Rasmussen, a functional medicine practitioner.

Kate:

And I'm Kate Daugherty, a certified nutritionist. We are the owners of the Facility, a functional medicine clinic here in Denver, Colorado.

Mitchell:

We help people improve their biology and get out of their own way. We help people improve their biology and get out of their own way. In my view, our work is about getting to know the person with the condition much more than it's about understanding which condition the person has. As I always say, diagnose the biology, not the disease.

Kate:

On this podcast we break down complex health topics, share real patient cases anonymized, of course and explore cutting-edge wellness strategies so you can make informed decisions about your health. Quick heads up before we dive in this podcast is for education and general information only. We're here to share insights, not to diagnose or treat. So if you're dealing with a health issue, chat with a qualified healthcare provider before making any changes. All right, let's get into it.

Mitchell:

Okay, third, time's the charm. It's you know what. I'm not very technical and I was doing all the setting up today and turns out I've got a lot to learn, so I'm hoping we're picking this up this time. Yeah, um brought in a friend of mine today with a, I think, a very interesting story. She has meant a lot to me in my personal life. She's helped me out a lot, and I reached out to you, lydia, about a month ago wanting to bring you on, because one of my goals with this podcast is to share stories of other providers and friends and people in the medical field who can maybe give a different perspective than what we provide. And you're so unique to me because you do what I call the most badass medicine. I did, yeah, you did, and I actually wrote a little intro for you, so I'm going to read it.

Mitchell:

Okay, today's episode is a special one. I'm joined by somebody I deeply respect Lydia Prusinowski. She's a seasoned PA who spent over a decade in the emergency room before making a bold career shift into dermatology. She's a former college basketball player, has the knee scars to show for it, a major advocate for lifestyle medicine and someone who sees patients as whole people, not just symptoms. I want to talk about career transitions, emergency room experiences, lifestyle medicine and how she sees the body and healing from both ends of the medical spectrum.

Lydia:

Great to be here.

Mitchell:

Yeah, and on a personal note, you have, uh man, you've been important in like some really scary times in my life and I was reflecting on the drive over here. I have saved so much money and time because I was able to reach out to you, and I hate abusing friendship like that, but I had my wisdom teeth pulled a couple years ago and I had a horrible reaction to the dexamethasone.

Kate:

I was not sleeping.

Mitchell:

I had horrible tachycardia and I was panicking because I was about to go spend probably $2,500 at the emergency room and I was sitting at the clinic I was actually sobbing. I had the craziest reaction to the corticosteroid and I called you and you looked me in the eyes through the camera and said you're fine and it wasn't just passing me off. You listened to my symptoms. What was your dose? How long ago did you take it? And you told me this will pass. And because you spent almost 15 years seeing emergencies and saving, I really trusted you and I was able to go home. And I wasn't feeling good. But I trusted you and I went home and guess what? Two days later, I was fine.

Lydia:

I think my favorite one was when you called me with a piece of rice stuck in your throat.

Mitchell:

I was thinking about that too. During COVID. I had COVID. I know you were like one of the first ones to have it. Yeah, I was the OG strain.

Kate:

You were.

Mitchell:

And I finally ate after like a week.

Kate:

Yeah.

Mitchell:

And a piece of rice got stuck in my throat. And I've got this ER, this lady who's working on actual dying patients of COVID, and obviously that's not funny. But what happened was I started to eat, I got rice in my throat. This ERPA tells me drink some carbonated liquid, have some paprika or something spicy and then jump up and down in the shower while it's hot.

Lydia:

And it works?

Mitchell:

I think yeah and I got the rice out of my throat. But I mean, I'm so fascinated by what you've seen and we're going to get into that a little bit today I don't know how someone with so much empathy can close their eyes at night and be at peace with the things that you've seen.

Lydia:

Yeah, I mean, I guess if we can just dive right in, I think when you work in an emergency room, I think a lot of times people compartmentalize it they start to lose that empathy. And essentially that was what brought me to Colorado was because when I worked in Flint Michigan Flint Michigan is the worst of the worst of the worst. You see kids, you see everything, the worst, you see kids, you see everything and in that, in those four years, I definitely started to lose that passion, that, that empathy, any sort of feeling, um, and that's essentially what brought me here, aside from, like, my 30th year old, like, like vision quests that I did, um, and and and. So those four years were hard. I mean, they definitely taught me a lot of experience, a lot of bad-ass medicine, for sure, um, but I think those four years were a perfect example of how you lose yourself in emergency medicine, how you lose the empathy, the compassion and even just like passion for life and and. So I don't think that those four years were a great example of that.

Lydia:

I think, especially over the past five years or six years now, and I think in some ways COVID has certainly kind of like reset that in a weird, strange kind of effed up way.

Lydia:

But it's easy when you go to work, knowing that you actually give a shit and that, like you know that you are listening to people and seeing them as a whole person and showing up for them, right, I think emergency medicine is very difficult in that way, because it's go see this patient, go see this patient, go see this patient, go see this patient and in a matter of 30 minutes you've already seen 10 patients, and so that can become difficult to actually continuously have that compassion, that empathy and actually show up for these patients. And I think during COVID you actually had to start to slow down a little bit because it wasn't as busy. But now you have patients that are much sicker and it's just them. They're scared, you can see the fear in their face and you had to actually sit down and have deeper conversations and you had to listen more. And I think once you get to that point where you realize that this is a whole person, that makes it really actually easy to go to bed at night.

Mitchell:

I love that, but I'm picturing you there in a lot of ways. In the beginning, especially of the pandemic, you were probably one of the only supports for these people in that moment.

Lydia:

I mean, I think a lot of us it was. There was so much unknown, right it was. We had no idea. We had no idea what to test for, how to test for it, really how to treat these things. And it was, I think, equally scary for us, right, because these patients would go to zero to a hundred, like this, they would decompensate in a matter of minutes to hours, and it was just like what do we do now? Um, and so I think a lot of us actually had this compassion that a lot of people, I think, probably hadn't felt in a long time, because I think we were equally as yeah, equally as uh, scared as they were, you know, and you could see it on everyone's face. It wasn't like, it wasn't like, hey, we know exactly how to do this and what we're doing. It was like, okay, well, we'll try this and see what happens and good luck.

Mitchell:

It's humbling oh yeah, and I mean I would see you, you'd come over, we'd work out and stuff, and I would.

Lydia:

I could see it on your face like the exhaustion yeah of it and I felt so spoiled that I'm doing this lifestyle medicine and you're talking about feelings and yeah pooping and stuff and meanwhile there's, you know, someone, like you said, decompensating on the table yeah, and I think you know, in the kind of piggyback of like you, like me being there for you, like during covid, my back was totally a mess and you guys opened the clinic for me, you guys dropped stuff off, you guys were working on me because I couldn't walk, I couldn't sit, like remember that it was awful, it was so bad, and so you guys, and you specifically, have just shown up for me in such huge ways also probably in ways that I've probably never expressed to you, of just being open ears and just being a place to be able to vent and to like release.

Mitchell:

Leo's here I appreciate that, uh, that gratitude. I yeah, we don't. I mean in all medical fields, I think sometimes we it's different but same in a lot of ways where we just kind of keep moving on to the next thing and then we think about, like what's not going well, right, you know, and we forget about the lives we impact along the way and I appreciate you sharing that.

Mitchell:

I mean it's an interesting friendship because we we on paper ER lifestyle medicine. Like I'm not anti-medicine, what I always say is surgeries and emergencies. We have the most amazing system ever created to help save lives acutely and that's why I've always had such respect for you and we.

Mitchell:

I remember once I told you I think we mesh well together because the things that you need are more long-term and because of my health anxiety, what I need is short-term help to get through it, and my girlfriend calls me a lazy hypochondriac, but it's to know that I don't need to rush to the er and if I'm really, you know, perseverating on a problem, to have a resource that I trust and I know who cares about me and loves me. It's so valuable for my life because that's the stuff that I need right, I want to back up a little bit. What initially got you and you went to pa school just out of college? What initially got you in? You went to PA school just out of college.

Mitchell:

What initially got you into wanting to work in the emergency room?

Lydia:

Well, initially I wanted to do trauma surgery. Like everything about me was like I want to do trauma surgery, I want to crack the chest, I want to have my hands in there, I want to be doing the chest tubes, I want to be doing all this crazy shit, right. And so one of my first rotations actually was my second rotation and it got changed maybe a week before I was supposed to go up there. And they're like hey, you're going to Flint, you're going to Hurley Medical Center. I'm like what, what is this place? And I was like OK, whatever. And they're like it's one of the hardest rotations we have. It was like sweet, okay, cool, whatever, this will be fine.

Lydia:

And I remember, like the first day I'm up there I was like holy shit, I am, this is next level, right, like you get, it's essentially a trauma one center for mid Michigan, all the way north, all the way east. You're getting stuff east, you're getting stuff flown in, you're getting car crashes. And then in like, in the midst of that it's rural Michigan with like urban like you. So you have like this very kind of depleted area financially, economically it's. You know, it's not a great area and I refer to it as like a third world country in the middle of the us, um, and I think like one of the first, one of the first days, you know, I have a patient that like we're on the oh, we're on the table, and a patient just codes out of nowhere. I was like, oh shit, like this is the first time that I've seen someone die, right, but then you get your hands into the gunshot wounds, the stabbings, all this stuff and it's infectious in a way.

Lydia:

And so eventually I wanted to do trauma surgery. They didn't have a spot. They said, hey, go work in the ER and then we can transition you to the trauma service. And then, as the time kind of went on, when I was in the ER, I was like I kind of like this actually Um, you can the medicine, you still get procedures, you still get to help with the gunshot wounds, the stabbings, the trauma stuff like that. And then I started to see how unhappy the PAs on the trauma service were and I was like I don't think I want that life, like they all look very unhappy, they're all like very angry. I don't think I want that life like they all look very unhappy, they're all like very angry. I don't want that so I just stayed in.

Mitchell:

I just stayed in the ER you had the ability to pause and just consider what your future looked like. And yeah, and it wasn't even.

Lydia:

I paused. It was you know, it was like real time and how unhappy they were and I was like I don't want that. I really like ER medicine, actually actually. So I just stayed.

Mitchell:

So you had early exposures that kind of helped show you where you were meant to be. Yeah, yeah, I mean, how does that kind of stuff shape your thoughts about like life or healing?

Lydia:

I think shaping your way of life, it's any moment can be your last. Shaping your way of life, it's any moment can be your last. You know, and when I saw that patient code after they, after they called it, I'm sure that I had like this you know, deer in the headlight, look in my mentor at that time she says, sprout, what do you believe in? And I was like, uh, right now I'm not really sure, you know. And she's she's like, well, remember that when it's your time, it is your time. And I said, well, shit.

Lydia:

And I think that has followed me to this point where I think a lot of practitioners, especially in Western medicine, try to play God in a way, and a lot of people get really bent up and really sad about the things that they missed or these patients that passed. And and I think I always come back to that statement, that from my mentor, of like, when it's your time, it's your time, in a way to help me sleep at night and not to perseverate on things that I missed or didn't do the best, but also to like live life.

Lydia:

Yeah because, right because I could. You know, I might be very, very healthy, but I could go outside and get hit by a car and then, yeah, you're like a year and a half ago we were at our old clinic working out and I was giving you shit for being almost 40 because you do not look or act like a 40 year old. I still act like I'm 28.

Mitchell:

Yeah, I love that about you. Um, you'll be 41 soon, which?

Kate:

is. I look at you and it's so funny to me that you're a grown-ass woman, but you act like a 28. Yeah.

Mitchell:

You really make sure and it's interesting to think how much that sprout went into your time. I didn't know that about you to know that that can really shape you. I mean, you've had to face some hard truths about life, just what you've seen, yeah. Seeing how temporary this all is, seeing how quick it can be gone in a moment. What do you think? Some of the hardest truths you've had to face working in the er working in the ers.

Lydia:

You can't save everybody, um, and that's um, like in that moment, but it is also a moment of you can't save your friend that's going through this.

Lydia:

You can't save your uncle, you can't save your whatever. It is right like you can't, um, you can show up and you can try and you can support um, but at the end of the day, you can't save or fix everyone a if they're not ready and b if they're not willing to kind of meet you right in the middle, um. So I think that one also helps when you know, I think it just helps in life in general, but also in medicine, which can be so type a, so perfectionism kind of driven, which makes sense, right, but at the same time, like you can't help everyone, you can't fix everyone. There's gonna be people that don't like you and there's gonna be like be people who tell you that when you're in the room, when you leave the room, they're gonna be people that don't necessarily agree with your lifestyle, aka being gay, right, there are people who are like very blatant about it. Um, I'm like okay, cool, well, like I'm the only person here to help you right now.

Mitchell:

So like sorry, um let's hope that, yeah, who I choose to sleep with doesn't bear impact on my ability to practice medicine right?

Lydia:

um, sad that we still have that correct. Yeah, and I think those are the biggest ones. I mean, yeah, those are just like, those are the ones that just stand out the most.

Mitchell:

A hundred percent you know you're really dialed in with physical fitness and growing up as an athlete and your nutrition and stress management and sleep and all the stuff that we always talk about, right. But you've also advocated for people that have come to see you to think bigger and I'll and to think about their lifestyle and root cause, and I'll just just leave it at that. But I mean, I'm so blown away at the way that you've helped bridge the gap for people who are sitting in a cold ER at 10 o'clock at night with migraines and all these things, and you just like have an inkling, this like thing inside that says I know there's more going on here and it's not just take more Zofran or you know get some morphine.

Mitchell:

So I mean, I love that you've in some ways, ethically, morally, done the exact right thing that might be frowned upon in a what would you say, in like an X's and O's way of being in the emergency room, but doing what you know is right, right, which I love about you.

Lydia:

And I think it's one of those things where you kind of judge and feel out the patient and you kind of get an idea of where they're at too, and meeting them and putting down little hints and little subtle kind of hey like what do you really want? Kind of hey like what do you really want, and um, and just slowly kind of coming together, figure out what's best for them, rather than a prescription for xyz and that's got to be hard.

Mitchell:

Like you said, you might see 10 people in the first hour of your shift, or half hour your shift. So it's, you've got to be very quick to make decisions and also selective. This person seems like they keep coming back for the same thing, but they are asking questions and you, as the PA, I'm assuming you're doing most of the actual care, which I have a huge issue with. Why is the pay so different for the PAs versus the physicians?

Lydia:

Same. I have the same thoughts.

Mitchell:

All right. So you spent over 10 years working in the ER. Was it 14 years? 14. 14 years how hard was it to kind of leave that all behind and make such a massive transition in your career?

Lydia:

You know I think it frustrated with the bureaucratic corporate medicine model. Like it's frustrating. You know you have these CEOs that are making a lot, a lot, a lot of millions, and you have your nurses that are not, and you have your they're working their bums off and you have the EVS staff that are, you know, working just insane hours and you have people who are busting their tails just to make these things work and and it just seems like more and more and more and more gets added on with very little acknowledgement. But also, again, like the pay. You know, um, I think the PAs that I worked with and the PA group that we worked with, like we got paid pretty well and like that was great, um, but it was just seeing everything else around us, um, just how the nurses were being treated, how everyone was being treated, and just more and more on the plate. I was like I can't do this anymore, like I don't want to do this anymore. Um, that made me just be like I'm done.

Lydia:

You know, and actually, interestingly enough, before PA school, I worked in a dermatology clinic with my dad, who's a dermatology PA, and my idea was always in 10 years I I'll circle back to like dermatology.

Lydia:

And then about the 10 year mark is when COVID hit, and so 10 years became 14, 15 years, very, very quickly. And so when I was just when I made that decision of I can't do this anymore, it felt like it felt like a full circle moment to come back to dermatology and actually easy. It felt like a full circle moment to come back to dermatology and actually easy. And it was interesting because some of the first comments that I got were ER is who you are and you can't leave the ER. This is where you're at, like this is what you were made for. You're going to get so bored, you're going to be back in three months. And I was like y'all don't even know, you know, and um, and so it's been hard to leave the medicine aspect, their critical care, the bad-ass procedures. That was hard to leave for sure, because it just stimulates my whole being. Is the critical care, the thinking, the thinking, five steps ahead, um, but it's, it's been great.

Mitchell:

Yeah, and I mean just from just from a health, you know, work-life balance, health, sleep, circadian rhythm I mean I feel like so much was able to fall into place for you personally once you made that decision and you didn't make it light. I mean we talked about it for a while, we did, and I hated that you were having people like, oh, you'll miss it, you'll be bored, and it's like I did this. I've done this for 14 years, yeah.

Lydia:

Right, like I don't need to put this tube in this tube in this tube in anymore. And there came a point where I texted one of my friends and I said, well, I just like intubated some guy and it doesn't like okay, whatever you know. It doesn't like okay, whatever you know. It was like doing like these, like fun things that everyone not everyone, but you are people aspire to be able to be proficient at. You're just like okay, like I tube some guy and like whatever you know. Um, and that's when I was like I made the right decision.

Lydia:

Um, but interestingly enough, I'm having to re-educate myself and learn all kinds of new crazy stuff now. And it does turn out that all the things that I saw in the ER, the things that I did in the ER, have kind of come from also full circle to the dermatology office, where it's like, oh, you're telling me all about all this other stuff that's going on. And I remember that one patient in room 11 who had this weird thing, who did this weird thing, and then we did this, this, this and this, we found out this, and so it's fun to be able to put all that experience to use now in the office. And it's like now I'm having like so much fun in the office. It's wild, like it's absolutely wild.

Mitchell:

And you bring such a useful aspect to a team, like does this need to be sent out, this leaking wound or an abscess or something? I mean you bring such value. I mean, yeah, you have had to work hard, you had to go back to school, essentially to learn dermatology. I mean because you think about it. You go to a dermatology clinic. You're seeing the PA. You don't expect them to be like um, I don't really know what it is. Let me go ask someone.

Lydia:

You, you are, you are the specialist, yeah, yeah, so you gotta know your stuff. You have to, and in some of the other PAs will will still text me pictures and ask me questions, um, and it's just it's fun to be able to like provide them with answers now. It's a fun kind of full circle moment for sure, and it is. I have 15 minutes with patients now and so we're laughing.

Mitchell:

You know, my dad always says he's like dermatology is two minutes of dermatology and 15 minutes of bullshitting and I was like that seems about right, actually, Human connection, yeah, I mean you've answered a few of the and I was like that seems about right. Human connection, yeah, I mean, and that's you've answered a few of the questions I was going to ask, like how does your experience in the ER shape how you practice now and you know how has that transitioned? But I mean, you've clearly spent a lot of time thinking about this.

Lydia:

Yeah, I would say the first December, january, february was just kind of getting my feet wet, getting my toes wet, getting my footing, and then I would say end of March, april, may were probably some of the hardest times of my life actually, which is weird thinking about the past 14 years, because it felt like such an ego death in a huge way. Um, and even though we talk about having the routine and like sleep in a routine and all these things like that was actually really, really difficult for me. Like having a routine was very, very difficult for me because I was so used to not having a routine. You know, I was so used to being able to fly to wherever for four or five, six days and not have to worry about it. I was so used to be able to go to wherever for four or five, six days and not have to worry about it. I was so used to be able to go to SoulCycle whenever the hell I wanted to, or go to Whole Foods in the middle of it, like Wednesday or whatever it might be.

Lydia:

And now I'm like shit, I'm getting up at five o'clock every day. I get home, I work out, I eat, I go to bed like is this all there is to life? Like, is this my life now? And that was a really hard struggle for me, because I was like I like I, this is, this is not who I've known for the past 14 years. Do I ever get to this point where things feel a little like spontaneity, like spontaneous again, um? And so that was really really, really hard. But then there was just kind of like an aha moment and things just seemed to flip, and now we're grooving.

Mitchell:

So You're enjoying it. I am yeah.

Lydia:

I enjoy the patient interactions. You know, like I really look forward to seeing a lot of the patients that I have now and, like you said, being able to sit down, have that human connection is wildly important and, um, and I think it just makes people feel like I am showing up for them and they're not just another number and they're not just, you know, another person that's in and out, in and out or whatever.

Mitchell:

So we've talked a lot together throughout our friendship about root cause or systems biology versus a conventional approach. How do you feel like you're able to walk that line?

Lydia:

Oh, that's a deep one, I think. Personal experience, you know, I've had a lot of weird medical stuff too, in which the MRIs, the MRAs, the echoes, the CTAs none of it could explain why I had a stroke and none of it could explain why it happened. And I think that was the point when I realized, like there has to be something different than you know, getting charged all this money for all these tests that just say, hey, you had a stroke and we don't know why. Like here, take some aspirin, good luck.

Lydia:

And I think that I think it was like 2017, was when I started to really kind of dive into like there has to be a different way, there has to be a different approach, there has to be a different approach. Something else can explain this. Um, and so, like you said earlier, it's the long term for me, right? I, if I break a leg, okay, I'm gonna go to the ER. If I'm having a heart attack, okay, I'm gonna go to the ER and they'll fix it, and then we'll get back on how to make these things better long term and I think for me personally, it's just always been the best way is this other way, and that might not be the same for everyone, but it has been for me and I think for me showing up authentically and showing that to other patients and to kind of advocating for patients for hey, like, look at this or look at this, or I'm going to leave this piece of paper here and you can do your research.

Mitchell:

Um has allowed me to kind of walk both both paths, and I mean you do that for friends and loved ones yeah too, which I love about you. It's like always advocating for like okay, we know there's no structural pathology, so now what right? Let's look into how systems are connected let's look into, you know, sleeping pooping, blood sugar control, like we always talk about and things like that, um, and I think like sorry to cut you off.

Lydia:

I think that's where it can get frustrating for a lot of people in medicine both, both as practitioners and as patient. Because you can have an ultrasound, that's totally normal. You're like, why am I still bleeding all the time? You can have all the labs, that are completely normal, and you're like why am I bleeding all the time? And that can be frustrating. And I think people don't realize when they go to the ER that as frustrating it is for them to not have the answers, it's equally as frustrating for us to be like I don't really know, but like good luck. You know, in the ER, like, specifically, medical Center of Aurora or Flint, no one has PCPs right, like no one has follow-up, and that's what's really really really, really, really frustrating and a struggle, because it's like you want these people to get the things that they need, but then it's like you, they get stopped at every every kind of, they get a roadblock at every kind of yeah, yeah well, and I have to walk people, I people that go to the ER, and then we see them after.

Mitchell:

Well, you know, what did you learn? Well, I didn't learn anything.

Kate:

And.

Mitchell:

I have to and knowing you and even Liz like knowing you know practitioners in the ER has helped me Like, look, their job is to make sure if you're dying or not right now. Right, you haven't seen a doctor in four years, Right you know?

Lydia:

seen a doctor in four years? Right, you know they're not going to talk about your elevated cholesterol, right, they're not even testing for your.

Lydia:

They're doing a chest x-ray and making sure that you don't have bacteremia, yeah, or a blood clot right, you know they are there to save your life, not to organize the pieces afterward and I think that was that was also frustrating and very difficult, because you would say, hey, follow up with this person, follow up with this person, and then you would see them in like two or three days and like, well, I still have pain. I'm like, I know you still have pain because I, what you have, I can't diagnose you with, and so here's some meds that I don't think are going to actually do anything.

Mitchell:

But good luck, you know, and that was hard, yeah and the lack of the ability to see a patient through. One of the things I love about what I do is the relationship building which now you get and I didn't think that I would actually enjoy that.

Lydia:

Like I thought, oh, it's fun to like just build a discharge. I'm going to have to deal with them anymore. But now I look forward to like the biopsy results and how we're going to, how we're going to treat this and what we're going to do for this. Uh, and then seeing them a feel better about themselves. Um, and then be like oh my gosh, thanks for listening. You're like oh, yeah, like that was easy.

Mitchell:

Well, and dermatology is so important here because it's so sunny, everyone's outside all the time.

Lydia:

And it's so dry, everyone's like why can't I stop itching? I'm like like yo get some lotion gosh.

Mitchell:

I'll walk you down to Walgreens yeah. I know you need to. You have to get to work soon and I hate that because there's so many other questions I wanted to ask you, you can do a part two okay, but I am curious from a personal perspective, how do you feel like fitness and nutrition play a role in your life?

Lydia:

I mean it's like absolutely paramount. I have to do it, I have to work out. It is a huge stress reliever for me. I'm also, you know, a little body dysmorphic, but we'll keep that out. But it's important to me to feel good, to look good. It's important for me, like I heard once and this is actually from my dad's boss many, many years he's like to look good. It's important for me, like I heard once and this is actually from my dad's boss many, many years he's like when you look good, you feel good, when you feel good, you do good. Um, and so I think for me that is also like if I'm, if I'm feeling unwell, if I feel big in my body or uncomfortable in my body, then then I'm going to show up in a different way than when I'm feeling fit, when I'm feeling rested, when I'm feeling like I have good stuff in me, rather than when I'm eating crap.

Lydia:

You know, like it was in the ER, I was like okay, like I'm gonna go down to the lounge and get a bag of chips, and then I feel like shit, and then I'm going to have some coffee and then I'm gonna have a Celsius and I'm gonna be wired and then I'm gonna go home to bed and I'm gonna try to sleep at midnight and I probably will fall asleep, but it's, it's not great sleep, um. And so those things are very, very important to me of just making sure you know what you're putting in your body. Um, granted, I love an ice cream every now and then I mean, come on, who doesn't? Um, and you know, my soul cycle is just. I think that is the place where I can just let go and release and cry and lose myself in a way. Um, I mean, those are just like number one and two. I have to have them yeah, absolutely.

Mitchell:

I mean, people always say you are what you eat. I always say you are what you can digest, absorb and assimilate. You know, but it's. I had a teacher and undergrad a psychology professor, who was the whole reason I got a minor in psychology because she was so inspiring to me. But she said, and I took a psychology of food abuse class and she said the most intimate thing we do is what we put in our mouths. She's like you think sex is intimate. Talk about taking the outside world and making it.

Mitchell:

You and I say that to patients and I was like do you want elbows made of cheetos? Like, do you want brain tissue made of, you know, hydrogenated fats and trans fats and things? It's like no, we, our body becomes what we feed it and it's truly the most beautiful thing you can do is honor that biology. And the same way, you know, same same but different. I struggle with. You know, when I eat bad, I get more anxious, I get more uh, this inflamed brain. I don't have brain fog, but I get anxiety, I get joint pain, joint pain. You know, I've had so many surgeries right in my past, similar to you, and it's part of the reason that I show up for myself in that way is because I love what I do and I never want to not feel sharp right, you know it's funny.

Lydia:

The other day I was, my parents were visiting and and my dad was like what?

Kate:

are you gonna do?

Lydia:

I was like I don't know, I'll probably go lift for like heavy today, you know. And he was like what are you gonna do? I was like I don't know, I'll probably go lift for like heavy today, you know. And he was like what are you doing? Do you want me to come with you? I was like no, dad, I got it like I don't, you don't, you can stay home, you know.

Lydia:

And and I was like guess how much I'm leg pressing dad? And it was it's an absurd number, right for a woman, like it's an absurd number. And he was like, oh, that can't be like really good for your knees. And I was like actually, oh, that can't be like really good for your knees. And I was like actually, it's very helpful for my knees, it's actually making my knees feel very great. And so the fact that I'm leg pressing almost 600 pounds as a 41-year-old female who's had bilateral knee construction or reconstructions, it's like it feels great. And then you kind of also have like this little ego thing of like am I pressing more than all these guys in here?

Mitchell:

Oops, thing of like. Am I pressing more than all these guys in here? I'm trying, though, mom, okay, oh, okay, well, yeah, I do think a follow-up would be great, because I've got so many other questions. Um, I think and I'm curious how you think our fields could do a better job of collaborating, and maybe you know how my field, one of my complaints in my field, is and we've talked about this on previous episodes there's not a standardization of the field. So you can say you do functional medicine, but you could essentially just run a bunch of labs and give a bunch of supplements or do none of that and talk all about magnetic healing or like weird things like that. And I'm very and I think that's why we get along, because I'm very analytical and I want to see the details of what's happening- and you like it.

Lydia:

You're a data guy, Right?

Lydia:

And I think like that is why I respect you and appreciate you so much, because you are a data guy. You have probably done more education than a lot of the people that, like I have worked with, and that's what's important to you. And I think the hard part is is like you have western medicine that's like we're the best, we know everything and then you have even like the functional medicine side that's like we're the best and we know things that are different than what you think and then they just clash right. There's just like this ego of like ego, the pissing contest, and it's like homies, like we can all like work together and use these things to help each other.

Lydia:

Yeah, and I've said for the longest time, I think there is a role to bridge the two. Is it difficult? Yeah, do I know what that answer is? No, because again, like you still have this ego here and this ego here and we're better than you and we're better than you and you're not doing it right and you're doing too much, and it's just, it's conflicting and it's difficult, and like there has to be a different way. Like there has to be a way of like, hey, like I can do these things, these things, and you can do these things, and like we can come together and figure it out but we still haven't figured that one out yet.

Mitchell:

So it's always. For me it's yes, and yeah you know, but I just I just had this this week. We've got a gal with chronic recurrent migraines and we saw her, we did a workup. She just came back this week and she said I'm gonna get emotional. I got emotional on the drive over reflecting. It's been two months since we talked and I've had three migraines and she was getting them daily. I've had to take my rescue medication three times. I mean I had goosebumps because you know me, I'm right there emotionally you did it to me today.

Mitchell:

Um and I I asked her you know how's your neurologist? And she said she's great, she's really open. You know, talked about stress a lot, but she was a little bit concerned about some of the changes you have me make and there was an ego part of me and I let it sit. And then I simply said I wish that all of our goal could just be for you to get better. I said what would she think of the fact you went from 20 migraines a month to three and two months? Within a month of changes your bloating's gone, your heartburn's gone, you're sleeping.

Mitchell:

You went on a hike with your dog and you started crying because you realize you can do this now yeah, you know, and it was just, it was frustrating because it's like oh, I'm on your side, we need, I love, neurologists, yeah, but like look what we're working together right 100.

Lydia:

And it's like stupid, because I love page becker so much and I just saw this post that she just said of, like, I play basketball the way that, like I want to live life and it's to make everybody, like everyone around me, better, and I was like what would happen if, like, we all approach life in this way, like, could you imagine? And I think, like that is the bridge, you know, like that's it's hard.

Mitchell:

That should be the goal. That should be the goal. She's a Minnesota girl.

Lydia:

I know she's a midwest, know, I love the way she plays ball. She plays basketball the right way. Yeah, yeah, for sure.

Mitchell:

I mean that's beautiful and I mean we're both doing our best, right? It takes more, so I'm hoping that you know we're young enough.

Lydia:

I'm hoping that.

Mitchell:

You know, and we're already practicing it every day, and you know, working with a team, working with other perspectives, I mean I think that's the only way forward. It's getting in these echo chambers and thinking that we know all this stuff is tough. I mean, even you know you and I will go back and forth about things but it always comes from a place of like.

Mitchell:

I've established friendship with you, so I know that I can share and you know that I care about you. Right, but we might not agree. Right, but we approach it with respect.

Mitchell:

Yeah, and we always come back, but we're both strong people, right, you know and it's like I get nervous sometimes when I say this, but it's like I care. I want to know your perspective. We come from very different treatment in our world and how our lives have been, but then there's so much similarity and I love that about our friendship that I can openly, graciously, get a perspective where I know she cares about me, she's not going to hate me.

Lydia:

And I'm going to give it to you very brutally, honestly.

Mitchell:

I love that about us. All right enough about us, our love fest. I want to keep give it to you very brutally, honestly, yeah, and I love that about us. All right enough about us, our love fest. Yeah, I want to keep talking, but you've got to get out of here. I do. You have an hour, so you need to go.

Lydia:

It's okay, yeah.

Mitchell:

Thanks for listening, thanks for doing this.

Lydia:

Well, thanks for asking. I mean, this has been awesome.

Mitchell:

So I think we'll listen back and then we'll kind of see, like, what else we missed that I want you to be able to share.

Lydia:

Yeah, it's hard when you hit record I think it's actually been easier than I thought. Good, I feel like we're just having a conversation, yeah yeah, nobody's listening no one's listening all right well, thank you, lydia.

Kate:

Thank you yeah for more about what we do at the facility, check out our website, wwwthefacilitydenvercom you. You can also follow us on Instagram at the facility Denver for extra tips behind the scenes, fun and updates on new episodes. Thanks for listening. Now go facilitate your own health and we'll see you next time.