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Speaker 1: You're listening to I Choose Me with Jenny Garth. Hi, everyone,

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Speaker 1: welcome to I Choose Me. This podcast is all about

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Speaker 1: the choices we make and where they lead us. October

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Speaker 1: is Breast Cancer Awareness Month, and I know that many

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Speaker 1: of us have been affected by breast cancer, and as women,

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Speaker 1: I think it's something that has crossed all of our

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Speaker 1: minds at some point. Breast cancer is something that I

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Speaker 1: believe every woman thinks about at some point in our life.

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Speaker 1: I know it has personally touched my life, and because

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Speaker 1: of Breast Cancer Awareness Month, I wanted to make sure

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Speaker 1: that we had this conversation because if we can get

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Speaker 1: one woman listening today to go out and get a

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Speaker 1: mammogram or ask for a mammogram, then this episode has

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Speaker 1: served its purpose. My guest today is the medical director

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Speaker 1: of Surgical Breast Oncology at Christas Saint Vincent in New Mexico.

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Speaker 1: Please welcome doctor Amani John Bacar to the I Choose

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Speaker 1: Me Podcast.

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Speaker 2: What a pleasure it is to meet you. It's so

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Speaker 2: nice to meet you too. Who knew we'd be here together? Yeah?

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Speaker 3: I never imagined I would meet Jenny Gorth ever, so

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Speaker 3: that is amazing.

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Speaker 1: Oh my gosh, it's so funny that you say that

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Speaker 1: you'd never imagine that we would meet. But here we are,

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Speaker 1: and we're talking about something so so important, and I'm

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Speaker 1: really grateful that you're here because we're going to just

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Speaker 1: break all of these myths down. We want to know

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Speaker 1: all the details, all the things that we need to know.

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Speaker 1: I think a lot of women don't get mammograms because

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Speaker 1: maybe they think they're too young, or they're concerned that

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Speaker 1: it's going to hurt, or they just don't want to

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Speaker 1: think about it. But for someone listening today who's never

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Speaker 1: had a mammogram before, let's talk about the process. I mean,

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Speaker 1: I've had many mammograms at my age, I can I

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Speaker 1: can speak to the level of uncomfortability. But from your perspective,

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Speaker 1: does that scare women away?

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Speaker 2: And what is it like?

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Speaker 3: So full disclosure, I'm thirty seven, so I haven't yet

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Speaker 3: gotten a mammogram myself.

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Speaker 1: Amazing to know. But wait, wait, that brings me to

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Speaker 1: this question. What is the age where where women I've

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Speaker 1: forgotten it's been so long.

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Speaker 2: It's forty.

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Speaker 3: It's forty, and so for someone who is of average risk,

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Speaker 3: forty is the age that's when you should definitely start

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Speaker 3: getting your mammograms. Someone who is high risk, who has

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Speaker 3: a high rist family history should come see someone like me,

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Speaker 3: a breast specialist and get established in a high risk

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Speaker 3: breast clinic and potentially start imaging sooner in the twenties

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Speaker 3: even or thirties.

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Speaker 1: Okay, that's funny because I was just talking to someone

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Speaker 1: who is thirty seven today and she said she hadn't

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Speaker 1: gotten a mammogram, and I was concerned. But now I

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Speaker 1: know that we don't start this process until we're forty,

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Speaker 1: so that is already I've learned something, and I'm very,

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Speaker 1: very grateful. But I can sort of speak to the

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Speaker 1: comfortability of it. I mean, it's not like I want

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Speaker 1: to go get a mammogram. It's not leasant, but it's

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Speaker 1: not the worst thing ever either, And it's so quick

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Speaker 1: like when they do, yeah, they do put your boob

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Speaker 1: in a machine and flatten it down like a pancake.

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Speaker 2: Yep.

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Speaker 1: But it's momentary, and we women have endured way worse.

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Speaker 1: So even if you're uncomfortable for you know, five seconds

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Speaker 1: while they're taking the image, it's invaluable the information that

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Speaker 1: you are going to get and the peace of mind

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Speaker 1: that you're hopefully going to get knowing that you're all clear. Okay,

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Speaker 1: so we learned already something super super big. How long

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Speaker 1: does it take to get results? Like for in my experience,

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Speaker 1: it's taken about a week maybe.

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Speaker 2: Yeah, usually a week.

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Speaker 3: So I'm here in San Fe, New Mexico, and oftentimes

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Speaker 3: if patients need a biopsy, the radiologists or one of

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Speaker 3: the texts will tell them right then and there, like, hey,

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Speaker 3: we see something on your mammogram, you need a biopsy,

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Speaker 3: or hey see something on your mammogram, you need another mammogram,

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Speaker 3: or maybe an ultrasound, And so usually the.

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Speaker 2: Turnaround is pretty quick.

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Speaker 3: If it's a normal result, then they may get like

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Speaker 3: a letter or a notification through their phones, you know,

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Speaker 3: their chart on their phone that everything's normal, within like a.

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Speaker 2: Week or so. Yeah.

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Speaker 1: I've never had that moment where they say, oh, yeah,

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Speaker 1: we need to take this again, or I need to

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Speaker 1: call somebody and have them come look at this.

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Speaker 2: Well that's great, that's awesome news. Yeah, that would be

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Speaker 2: a little scarier.

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Speaker 1: I want to talk to you about the b r

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Speaker 1: C A one and b r C A two genes.

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Speaker 2: Yeah, how do we test for those?

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Speaker 3: That is a great question, because that's something that I'm

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Speaker 3: extremely passionate about.

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Speaker 2: Good.

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Speaker 3: So we have a blood test that looks at eighty

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Speaker 3: one different genes BRACO one in two, as well as

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Speaker 3: other genes like CHECK two, PALB two, other genes that

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Speaker 3: really increase the risk for breast cancer, but also other

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Speaker 3: types of cancers like ovarian cancer, pancreatic cancer, prostate cancer,

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Speaker 3: colon cancer. And that's a blood test that can only

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Speaker 3: be ordered by a physician. It's not the same thing

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Speaker 3: as a medical you know, twenty three and me or

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Speaker 3: something like that that has to be ordered by oftentimes

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Speaker 3: a genetic counselor, or it can be ordered by an

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Speaker 3: oncologist like myself, a surgical oncologist or a medical oncologist.

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Speaker 3: And I see patients for that in the office all

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Speaker 3: the time. And people who have a high risk family

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Speaker 3: history should talk to their primary care doctors about it

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Speaker 3: and say, hey, I have a high risk family history,

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Speaker 3: I have someone in my family diagnosed with none of

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Speaker 3: those cancers, especially one of those cancers under the age

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Speaker 3: of fifty. Where do I go next for testing? And

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Speaker 3: it may be different in every community and a lot

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Speaker 3: of places. They might say you need to see a

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Speaker 3: genetic counselor. But here in Santa Fe, I do a

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Speaker 3: lot of that and I moved to Santa Fe about

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Speaker 3: nine months ago and I've probably done genetic testing for

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Speaker 3: over one hundred and twenty patients so far.

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Speaker 2: Amazing. Yeah, Yeah, I think it's so important because you

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Speaker 2: need to know what your risks are. You need to

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Speaker 2: know what you're what you're starting with, I.

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Speaker 3: Mean exactly, and what you're inheriting from people.

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Speaker 2: You know.

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Speaker 3: I spoke to a patient in the clinic today who

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Speaker 3: didn't really have a very convincing family history but then

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Speaker 3: ended up having a Braco one mutation, and so it's

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Speaker 3: a scenario where we can't guess, and so the only

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Speaker 3: way to know for sure is to do the genetic testing.

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Speaker 3: And it does get approved by insurance for people who

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Speaker 3: meet the NCCN criteria to get tested, and so I

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Speaker 3: don't see a lot of problems with insurance coverage not

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Speaker 3: being there for that kind of testing. And if you

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Speaker 3: do find out you have a mutation like Braco one

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Speaker 3: or two, then you could be eligible for things like

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Speaker 3: breast MRIs to do more screening and just to make

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Speaker 3: sure that if you do develop something that we do

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Speaker 3: in fact, catch it early.

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Speaker 2: Oh thank god, the insurance is taking care of us

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Speaker 2: in this respect. Okay, So, but if you test positive.

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Speaker 1: For the BRCA gene, right, what does that mean in

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Speaker 1: terms of your risk of getting breast cancer?

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Speaker 3: So that risk depends on which Braco gene that you inherit,

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Speaker 3: and kind of also on your family history. But in general,

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Speaker 3: for the Braco one and two genes, the risk for

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Speaker 3: a future breast cancer it can be anywhere between forty

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Speaker 3: and eighty percent. And so that's a pretty high level

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Speaker 3: of risk. And as you know, you probably know Angelina

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Speaker 3: and Joelee had a braco one mutation as well. And

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Speaker 3: sometimes people do choose to remove both breasts prophylactically or

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Speaker 3: before they develop any kind of cancer. Sometimes they choose

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Speaker 3: to remove the ovaries for similar reasons, to reduce that

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Speaker 3: risk as much as possible. And like you said, those

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Speaker 3: options are only really available to you if you know

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Speaker 3: that you have one of those mutations, if you know

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Speaker 3: your risk.

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Speaker 2: I mean, that's the key. Education. Awareness, advocacy for yourself

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Speaker 2: is the.

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Speaker 3: Key, absolutely one hundred percent, because it's it's hard enough

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Speaker 3: as women right to get get our complaints taken seriously

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Speaker 3: and to get heard, and you know, going back to

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Speaker 3: your earlier point about mammograms, I know that they're uncomfortable

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Speaker 3: and for patients who have had medical trauma, they may

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Speaker 3: even be traumatic. And if that was the way that

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Speaker 3: we screened for testicular cancer for men, we would have

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Speaker 3: something better by now.

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Speaker 4: Right, Oh right, that's a good point, it is, And

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Speaker 4: so we you know, we have this kind of squishing

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Speaker 4: the breast, sort of archaic technology.

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Speaker 3: We have mammograms because it's something that mostly women need

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Speaker 3: to get done and people women are very strong, and

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Speaker 3: so we sort of just we deal with it.

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Speaker 1: Do you think there's anything and yeah, do you think

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Speaker 1: there's anything in the pipeline of experience better for us?

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Speaker 2: Absolutely?

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Speaker 3: So I can see that there are some studies being

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Speaker 3: done of some new technologies that can work as well

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Speaker 3: as mammograms, and then also of things that are a

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Speaker 3: little bit more curved, like the human breast, so it's

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Speaker 3: a little less of the squishing involved. And so some

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Speaker 3: of those technologies are being trialed right now and I

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Speaker 3: think are going to come out in the future. Not

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Speaker 3: quite there yet. So right now, the a mammogram is

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Speaker 3: still the standard of care.

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Speaker 2: And it is uncomfortable, you know. It sucks.

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Speaker 3: It's not a fun thing to do. No one looks

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Speaker 3: forward to it, that's for sure. But you're right, like

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Speaker 3: the information it gives you in just like a few

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Speaker 3: minutes of discomfort or even pain is so invaluable. And

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Speaker 3: it's peace of mind or figuring out what's next and

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Speaker 3: if you need some kind of surgery.

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Speaker 2: What you need to do, what you need action you

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Speaker 2: need to take. I just want to be clear.

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Speaker 1: If you test negative for the BRCI gene, does that

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Speaker 1: mean that you won't get breast cancer?

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Speaker 2: So that's a great question.

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Speaker 3: It It doesn't mean that you'll never get a future

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Speaker 3: breast cancer. It just means that your risk is average,

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Speaker 3: like along with the rest of the population. It's not

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Speaker 3: elevated because of a bad gene that you inherited from

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Speaker 3: one of your parents. And something else that I hear

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Speaker 3: oftentimes about the BRACA mutation is that like women are

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Speaker 3: the only ones who can inherit it, and that is

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Speaker 3: totally not true.

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Speaker 2: You can get that mutation from your dad as well. Really,

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Speaker 2: what happens with men when they have it? Same thing men,

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Speaker 2: So the men can get breast cancer. Actually, BRACA one

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Speaker 2: does increase the risk for male breast cancer. For men,

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Speaker 2: we worry a little bit more about aggressive prostate cancers.

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Speaker 2: Prostate cancer is typically not a very aggressive thing in men,

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Speaker 2: but in people who are Braca mutation carriers it can be.

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Speaker 3: And we also still worry about the pancreas as well,

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Speaker 3: and as well as like skin cancers like melanomas, and

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Speaker 3: so men who have the Braca mutation also need to

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Speaker 3: be watched carefully in you know, cancer specific screening clinics,

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Speaker 3: so that way an oncologist can keep a closer eye

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Speaker 3: on them as well.

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Speaker 1: So you heard it here. Men and women are both

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Speaker 1: affected by the barca meat and need both men and

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Speaker 1: women should get tested.

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Speaker 2: Absolutely. Wow, I didn't know that. Thank you.

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Speaker 1: I'm going to go to a question from one of

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Speaker 1: our listeners. This is from re West five to two four.

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Speaker 1: Why has there been such a huge increase in breast

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Speaker 1: cancer cases in the past twenty or so years.

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Speaker 3: That is a great question that I get all the

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Speaker 3: time and clinic and I will say, there's a lot

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Speaker 3: of different resource that's being done about it. Some of

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Speaker 3: it may relate to environmental exposure, some of it may

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Speaker 3: relate to microplastics, some of it may relate to more

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Speaker 3: processed food because it's not just breast cancer that we're seeing.

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Speaker 3: We're seeing it in like colon cancer as well.

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Speaker 2: We don't have a really.

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Speaker 3: Great answer for it right now. We're still trying to

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Speaker 3: figure that out.

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Speaker 1: Yeah, I mean, I've heard a lot of discussion about

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Speaker 1: microplastics lately, and then you start thinking about moment to

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Speaker 1: moment in your life and how much you're exposed to plastics,

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Speaker 1: like all day long. I just literally yesterday throughout my

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Speaker 1: plastic cutting boards that I've had for a minute because

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Speaker 1: I saw that when you chop into it, it releases

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Speaker 1: little microplastics and then you cook that up with your

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Speaker 1: sautee vegetables.

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Speaker 3: Yeah, it's I mean, I think the research on the

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Speaker 3: microplastics is pretty compelling, and there's a lot.

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Speaker 2: Of things that we need to do to be.

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Speaker 3: A little bit more environmentally sound that I think will

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Speaker 3: help our health as humans, not just with not developing

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Speaker 3: cancer and especially cancer at younger ages, but also in

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Speaker 3: a lot of other disorders as well. And so I

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Speaker 3: think that research is going to pan out and show

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Speaker 3: that being climate conscious will help our health in the

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Speaker 3: long run.

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Speaker 1: I just heard Katie Couric talking about breast density I

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Speaker 1: have a question from a listener here, Ashley Holliback. Where

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Speaker 1: can women get an ultrasound if they have dense breaths,

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Speaker 1: since you now need one when a mammogram isn't enough.

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Speaker 3: So this is the question I get a lot in

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Speaker 3: the clinic now, as I'm sure you've heard, when you

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Speaker 3: get your mammogram results, they have to report on how

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Speaker 3: dense your breasts are, and that just happened in the

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Speaker 3: last month or so.

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Speaker 1: Wow.

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Speaker 3: So people who do have dense breasts or category C

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Speaker 3: or D breasts, they are recommended to also have an ultrasound.

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Speaker 3: Sometimes they may even be recommended to have an MRI

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Speaker 3: for screening. Usually the same mammography place that does the

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Speaker 3: mammogram can also do an ultrasound. It just depends on

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Speaker 3: your regional location on if they can also do the MRI.

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Speaker 3: The tricky part is getting the insurance to approve it,

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Speaker 3: because insurances haven't one hundred percent caught up with those

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Speaker 3: recommendations yet, and so a lot of times I see

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Speaker 3: patients like this who do have dense breasts, and then

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Speaker 3: I order the ultrasound with the mammogram, and I order

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Speaker 3: both of them going forward, so that way they can

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Speaker 3: just get both done in one visit, but typically the

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Speaker 3: same place where you got the mammogram can do the ultrasound.

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Speaker 3: You may still need to have a doctor like your

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Speaker 3: primary care doctor or your obi juyan order it and

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Speaker 3: write that dense breast is the reason.

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Speaker 1: Why I have a question going back to the age

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Speaker 1: that we should start getting mammograms. You said it was forty,

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Speaker 1: but what if breast cancer runs in your family, maybe

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Speaker 1: it runs in both sides of your family, should you

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Speaker 1: start getting screened earlier?

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Speaker 2: Yeah, absolutely so.

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Speaker 3: I have seen many patients who have a risk of

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Speaker 3: breast cancer because they have you know, their mom, for example,

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Speaker 3: passed away of breast cancer when she was thirty six,

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Speaker 3: So that kind of patient doesn't need to wait until

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Speaker 3: they're forty to start getting imaging. Usually we don't start

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Speaker 3: doing breast MRIs for someone who's higher risked for breast

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Speaker 3: cancer until the age of twenty five. That's the earliest

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Speaker 3: we typically do those, but sometimes we'll do a clinical

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Speaker 3: breast exam with an oncologist like myself earlier than that,

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Speaker 3: depending on what the family history is. So if you

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Speaker 3: do have young people in your family in their thirties

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Speaker 3: and forties who have been diagnosed with breast cancer. My

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Speaker 3: recommendation is to check out a high risk breast clinic

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Speaker 3: in your area and talk to them about when you

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Speaker 3: should start that screening, because you're right, Jenny, it could

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Speaker 3: be earlier than forty, and waiting until forty may be

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Speaker 3: too late for some people.

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Speaker 1: Yeah, I mean they say that with heart disease too.

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Speaker 1: If you're genetically dispositioned to it correct, you need to

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Speaker 1: start having checks more frequently. Earlier on you said you

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Speaker 1: said twenty five was the age that you usually start.

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Speaker 3: Yeah, so twenty five is the earliest recommendation I've seen

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Speaker 3: for any kind of breast imaging, even for some one

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Speaker 3: with a known BRACA mutation. Usually they'll say start MRIs

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Speaker 3: at twenty five, no earlier than twenty five.

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Speaker 2: Rarely. I would say.

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Speaker 3: There probably are people out there who have had mothers

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Speaker 3: and sisters who have had breast cancer in their twenties,

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Speaker 3: and for that, I think that we would have to

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Speaker 3: take on a case by case basis.

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Speaker 1: Yeah, I mean, the statistics are crazy that, you know,

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Speaker 1: breast cancer is affecting women much younger today.

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Speaker 3: It is, and it is too absolutely and it's it

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Speaker 3: is surprising, you know, the youngest patient that I've heard of,

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Speaker 3: not that I've personally seen, but that one of my

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Speaker 3: colleagues has seen with breast cancer was nineteen. Yeah, and

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Speaker 3: it's especially hard at that age because you know, you

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Speaker 3: go and see a doctor at nineteen, you may not

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Speaker 3: have a primary care doctor. So you go see someone

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Speaker 3: at an urgent care and they say you're too young

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Speaker 3: for breast cancer.

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Speaker 2: This is a cyst.

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Speaker 3: And so my recommendation for anyone, really any age, if

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Speaker 3: you feel a lump in the breast, no one's physical

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Speaker 3: exam is good enough. I'm a surgical oncologist who primarily

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Speaker 3: examines patients with breast cancer all day long, every day,

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Speaker 3: and even I can't tell the difference between something that

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Speaker 3: is a cyst or something that's a cancer, or something

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Speaker 3: that's some other type of lump in the breast. And

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Speaker 3: so no doctor, no nurse practitioner, no PA, no one's

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Speaker 3: physical exam is enough. So if you feel a lump,

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Speaker 3: ask them to order some kind of imaging, a mammogram.

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Speaker 3: If you're too young for a mammogram, typically they won't

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Speaker 3: do a mammogram for somebody who's under thirty, ask for

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Speaker 3: an ultrasound, but some sort of breast imaging is needed

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Speaker 3: to look at that lump in more detail.

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Speaker 2: Don't let anyone.

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Speaker 3: Reassure you that by physical exam a lump is nothing.

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Speaker 1: Absolutely, such good advice, Such good advice. And listen to

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Speaker 1: your instincts too, I.

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Speaker 3: Mean absolutely absolutely. And I see it with my young patients.

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Speaker 3: I see this really awesome where they are bounced around,

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Speaker 3: you know, they see someone at some urgent care. Then

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Speaker 3: they go somewhere else and that person says, you're too

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Speaker 3: young for breast cancer. This might be an infection, and

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Speaker 3: they put them on some me inabiotics. Then this whole

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Speaker 3: time things are progressing, the lump is growing, and then

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Speaker 3: they finally get established with a primary care doctor and

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Speaker 3: the primary care doctor says, oh, and then they get

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Speaker 3: sent to me.

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Speaker 1: If you have no history with family breast cancer none,

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Speaker 1: m h. I have very very little family history of

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Speaker 1: breast cancer. And I don't remember what age I must

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Speaker 1: I may I must have been forty when they ordered

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Speaker 1: me to get my first manmigram. And you're saying that's

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Speaker 1: the age if you if you're not worried that you

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Speaker 1: have in your family.

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Speaker 2: Yeah, forty is the age.

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Speaker 3: And they there were kind of differing recommendations on that

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Speaker 3: as well. Like one governing body in the US said fifty,

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Speaker 3: and one said forty. And now everybody says forty because

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Speaker 3: we are seeing, as you commented, the incidents in young

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Speaker 3: women rising, and so it's really worth it to start

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Speaker 3: it at forty. It's a pretty safe test to do

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Speaker 3: very very very small radiation dose that is totally worth

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Speaker 3: it for the benefit.

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Speaker 1: Yeah, I was going to ask you that, Like what

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Speaker 1: I get concerned about my exposure to so much radiation.

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Speaker 1: One because I travel a lot, so I always get

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Speaker 1: worried going through those machines.

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Speaker 2: Yeah, And everybody says, oh, it's.

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Speaker 1: Fine and don't worry, but I do worry. And so

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Speaker 1: getting some sort of a screening can can cause concern

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Speaker 1: for people that they're going to get too much radiation

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Speaker 1: for sure.

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Speaker 3: And I get told that often. You know, people are like,

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Speaker 3: what about the radiation and risk with a mammogram. So

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Speaker 3: here in Santa Fe, New Mexico, we are at seven

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Speaker 3: thousand feet, so we're at pretty significant We have a

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Speaker 3: higher radiation risk anyways, because we're a little bit closer

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Speaker 3: to the sun.

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Speaker 2: Okay, But in.

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Speaker 3: Order to actually see a problem from the radiation that

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Speaker 3: you get from doing a mammogram, you'd have to get

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Speaker 3: a mammogram every single day for an entire really actually

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Speaker 3: every day for the rest of your life, and then

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Speaker 3: you might might have a slight increase in the risk

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Speaker 3: of developing a future cancer due to that radiation. But

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Speaker 3: as long as you're not getting a mammogram every day,

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Speaker 3: which no one is, it's pretty safe. The scanners in

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Speaker 3: the airport are even less radiation than a mammogram, so

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Speaker 3: totally safe.

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Speaker 2: I mean, okay, thank you, you're making totally safe like those.

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Speaker 3: I mean you could get like probably I would say

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Speaker 3: you could get like easily ten thousand of those, and

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Speaker 3: you'd be fine in terms of your annual radiation dose.

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Speaker 3: If you travel like thirteen thousand miles, you know, you

401
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Speaker 3: travel from la to Europe and back in a year,

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Speaker 3: then that's about the same amount of radiation that you're

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Speaker 3: getting from a mammogram, and mammogram is totally If you

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Speaker 3: live at sea level, the amount of radiation you get

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Speaker 3: from a mammogram is about the same amount you would

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Speaker 3: get from seven weeks of just background radiation just living

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Speaker 3: at sea level, So totally totally safe. Not really significantly

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Speaker 3: increasing your radiation exposure and worth doing despite that risk.

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Speaker 1: Yeah, what you're saying about this, what'd you just call

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Speaker 1: it background expiation?

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Speaker 2: Yeah, background exposure? Yeah, that is scary.

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Speaker 3: Well, it's just you know, it's we all get some

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Speaker 3: radiation from the sun, right if we're living at high

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Speaker 3: elevation like I am, or if we're living at sea level,

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Speaker 3: we also get radiation from minerals in our own body

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Speaker 3: breaking down. And that's totally normal, and Okay, it's a

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Speaker 3: really small dose. And so there's actually the EPA, the

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Speaker 3: Environmental Protection Agency, has a like radiation dose calculator that

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Speaker 3: you can use, which I recently used because I was

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Speaker 3: making a TikTok on the radiation exposure you get from

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Speaker 3: a mammogram, and you can calculate like how much radiation

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Speaker 3: exposure do you get in your home based on like

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Speaker 3: where you live and how many miles you travel a

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Speaker 3: year if you're an avid traveler, and if you have

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Speaker 3: veneers and if you have radon in your home and

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Speaker 3: things like that, and overall it's the amount of radiation

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Speaker 3: you get.

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Speaker 2: There are different sources.

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Speaker 3: You can get it from your right, but it's a really,

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Speaker 3: really really low dose that is not going to increase

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Speaker 3: anyone's risk of having problems from the radiation at all.

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Speaker 1: I recently decided that I didn't want any of my

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Speaker 1: do we have a microwave right that is under the

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Speaker 1: cab counter level, it's down below like right where ovaries are,

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Speaker 1: And so I recently put a big sign up on

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Speaker 1: the floor, nobody stand right here when the microwave is on.

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Speaker 2: Yeah, that's I mean, that's fair.

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Speaker 3: Although I will say in that calculator, how close you

439
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Speaker 3: stand to your micro is not in there.

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Speaker 2: So oh my gosh, I'm going crazy. I'm trying all

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Speaker 2: the things. Wow.

442
00:23:07,040 --> 00:23:09,359
Speaker 1: Another question I have for the women who are giving

443
00:23:09,400 --> 00:23:12,840
Speaker 1: them mammograms, the technicians, I know they go behind that

444
00:23:12,880 --> 00:23:16,040
Speaker 1: little wall, but they're still right there all day long,

445
00:23:16,119 --> 00:23:17,000
Speaker 1: every single day.

446
00:23:17,840 --> 00:23:19,240
Speaker 2: That is a great question too.

447
00:23:19,400 --> 00:23:23,280
Speaker 3: So they typically for those ladies, they have like it's

448
00:23:23,320 --> 00:23:26,880
Speaker 3: a little badge, a thing on their badge, and it's

449
00:23:26,880 --> 00:23:29,359
Speaker 3: something that their ID hangs from.

450
00:23:29,400 --> 00:23:30,840
Speaker 2: And what that does.

451
00:23:30,760 --> 00:23:33,520
Speaker 3: Is it actually like kind of measures the radiation dose

452
00:23:33,600 --> 00:23:36,520
Speaker 3: that they get exposed to. And that's something that they

453
00:23:36,560 --> 00:23:39,280
Speaker 3: have to like turn in and it gets counted so

454
00:23:39,320 --> 00:23:40,400
Speaker 3: that way we can.

455
00:23:40,240 --> 00:23:42,560
Speaker 2: Be sure that their radiation exposure is safe.

456
00:23:43,400 --> 00:23:45,159
Speaker 3: And then you know, any kind of job in the

457
00:23:45,160 --> 00:23:48,960
Speaker 3: hospital where you're giving X rays of any kind, they

458
00:23:48,960 --> 00:23:51,960
Speaker 3: wear those little badges that will actually help calculate that

459
00:23:52,000 --> 00:23:53,800
Speaker 3: dose and make sure that no one's getting to a

460
00:23:53,840 --> 00:23:57,800
Speaker 3: point where you know, they're getting too much radiation exposure.

461
00:23:58,240 --> 00:24:01,640
Speaker 3: And so it's that's pretty tight regulated by like hospital,

462
00:24:01,720 --> 00:24:04,720
Speaker 3: by memorgraphy centers, and so they are totally safe too,

463
00:24:04,720 --> 00:24:05,240
Speaker 3: don't worry.

464
00:24:05,800 --> 00:24:09,240
Speaker 1: Yeah, that's that's good to know. I was worried what

465
00:24:09,280 --> 00:24:11,399
Speaker 1: you were saying before. We were talking about before about

466
00:24:11,840 --> 00:24:16,120
Speaker 1: the the age being much younger. Now, Yeah, that women

467
00:24:16,160 --> 00:24:19,240
Speaker 1: are discovering that they have is so alarming. But and

468
00:24:19,400 --> 00:24:23,200
Speaker 1: in your right, they get shuffled around and they get discredited,

469
00:24:23,280 --> 00:24:27,760
Speaker 1: and they people don't believe them or want to do anything.

470
00:24:28,080 --> 00:24:31,119
Speaker 1: How and you said that advocating for yourself, But what

471
00:24:31,160 --> 00:24:35,199
Speaker 1: if you're a young girl and you're in you know,

472
00:24:35,800 --> 00:24:39,640
Speaker 1: wanting to know more about your health, even if you

473
00:24:39,640 --> 00:24:43,240
Speaker 1: you know, don't have breast cancer in your family genes

474
00:24:43,240 --> 00:24:46,439
Speaker 1: that you know of, how do I get my voice

475
00:24:46,440 --> 00:24:49,040
Speaker 1: heard as a young woman in a doctor's office?

476
00:24:49,600 --> 00:24:50,960
Speaker 2: Also an excellent question.

477
00:24:51,520 --> 00:24:55,480
Speaker 3: So it is harder for women, right, the things that

478
00:24:56,280 --> 00:25:02,439
Speaker 3: get diagnosed mostly in women, get longer to be diagnosed

479
00:25:02,480 --> 00:25:05,240
Speaker 3: because they get diagnosed mostly in women. So things like

480
00:25:05,359 --> 00:25:10,200
Speaker 3: endometriosis that I'm sure you've heard of, it's basically can

481
00:25:10,240 --> 00:25:13,800
Speaker 3: cause pretty debilitating pain, abdominal pain. It takes an average

482
00:25:13,800 --> 00:25:19,439
Speaker 3: of eight years to get diagnosed in women. Why because

483
00:25:19,480 --> 00:25:22,440
Speaker 3: people will discredit women like what you're saying. They'll say, oh,

484
00:25:22,480 --> 00:25:25,440
Speaker 3: you're just anxious. Oh that pain is just in your head,

485
00:25:25,480 --> 00:25:29,000
Speaker 3: and that we see it all the time with many

486
00:25:29,000 --> 00:25:32,080
Speaker 3: different diagnoses. Breast pain, that's one that I get asked

487
00:25:32,080 --> 00:25:34,720
Speaker 3: about a lot as well. We don't have great answers

488
00:25:34,760 --> 00:25:37,359
Speaker 3: for what causes breath pain or how to stop it

489
00:25:37,440 --> 00:25:42,720
Speaker 3: because it's something that almost exclusively impacts women, and seventy

490
00:25:42,760 --> 00:25:45,520
Speaker 3: percent of women in their lifetime will experience breast pain

491
00:25:45,600 --> 00:25:46,240
Speaker 3: at some point.

492
00:25:46,960 --> 00:25:47,919
Speaker 2: So it's hard.

493
00:25:48,680 --> 00:25:51,720
Speaker 3: It's a really challenging thing. Even for me as a

494
00:25:51,960 --> 00:25:54,959
Speaker 3: female surgeon, going to the doctor and having the doctor

495
00:25:55,000 --> 00:25:59,040
Speaker 3: listen to my concerns as a healthcare professional can be challenging.

496
00:25:59,200 --> 00:26:01,040
Speaker 2: So I think it goes.

497
00:26:00,880 --> 00:26:03,280
Speaker 3: Back to what you said earlier, Jenny, trust your gut,

498
00:26:03,520 --> 00:26:06,240
Speaker 3: listen to your instincts. If you feel like something's wrong

499
00:26:06,320 --> 00:26:09,680
Speaker 3: and no one's listening to you, then find another physician

500
00:26:09,720 --> 00:26:13,600
Speaker 3: that will and right, And studies have shown that like

501
00:26:14,480 --> 00:26:17,960
Speaker 3: patients who are women tend to be heard better by

502
00:26:18,200 --> 00:26:21,600
Speaker 3: physicians who are women. So finding a physician who is

503
00:26:21,640 --> 00:26:23,479
Speaker 3: a woman who is going to take the time and

504
00:26:23,520 --> 00:26:26,000
Speaker 3: listen to you. Studies have also shown that women physicians

505
00:26:26,040 --> 00:26:28,879
Speaker 3: spend longer listening to their patients and are more empathetic.

506
00:26:29,480 --> 00:26:31,760
Speaker 3: I think that will make a huge difference as well,

507
00:26:31,960 --> 00:26:35,359
Speaker 3: if you're able to choose to see women physicians, because

508
00:26:35,840 --> 00:26:37,400
Speaker 3: it will help you be heard.

509
00:26:37,119 --> 00:26:38,480
Speaker 2: It will also help us be heard.

510
00:26:38,960 --> 00:26:41,560
Speaker 1: Oh my gosh, I know, no one really ever talked

511
00:26:41,600 --> 00:26:46,240
Speaker 1: about that, about choosing a female physician that you know,

512
00:26:46,280 --> 00:26:47,600
Speaker 1: that wasn't really a conversation.

513
00:26:47,880 --> 00:26:49,480
Speaker 2: It was just go to the doctor, and it was

514
00:26:49,560 --> 00:26:50,600
Speaker 2: usually a man.

515
00:26:50,680 --> 00:26:54,560
Speaker 1: And yeah, it was even more uncomfortable because it was

516
00:26:54,600 --> 00:26:57,000
Speaker 1: a man and you're talking about sensitive things and it

517
00:26:57,000 --> 00:26:58,440
Speaker 1: exactly what it feels.

518
00:26:58,560 --> 00:26:58,760
Speaker 2: Right.

519
00:27:00,240 --> 00:27:03,240
Speaker 3: Nowadays, we have those options though, because like more than

520
00:27:03,280 --> 00:27:06,360
Speaker 3: fifty percent of medical students are women, and so there

521
00:27:06,359 --> 00:27:09,800
Speaker 3: are more and more women in a lot of different specialties.

522
00:27:10,200 --> 00:27:13,360
Speaker 3: Now surgery is not one of them. Still overwhelming majority

523
00:27:13,440 --> 00:27:17,400
Speaker 3: are men, but more there are more coming up through

524
00:27:17,440 --> 00:27:19,720
Speaker 3: the ranks now, and so I think we'll see those

525
00:27:20,359 --> 00:27:24,400
Speaker 3: those numbers shift soon. And so choosing women physicians or

526
00:27:24,440 --> 00:27:28,000
Speaker 3: you know, women wear nurse practitioners. Women who are PAS,

527
00:27:28,040 --> 00:27:31,720
Speaker 3: like women are more likely to listen to other women

528
00:27:31,880 --> 00:27:34,840
Speaker 3: when it comes to symptoms like a lump in the

529
00:27:34,840 --> 00:27:36,399
Speaker 3: breast that just won't go away.

530
00:27:38,240 --> 00:27:41,560
Speaker 1: That's also very valuable information. So how does eating a

531
00:27:41,600 --> 00:27:47,120
Speaker 1: healthy diet and not drinking alcohol and exercising, does that

532
00:27:47,240 --> 00:27:51,879
Speaker 1: actually decrease the risks of getting breast cancer? Because we

533
00:27:51,960 --> 00:27:54,919
Speaker 1: talk so much about being healthy and eating healthy and

534
00:27:54,960 --> 00:27:58,560
Speaker 1: getting exercise, and I know that all of those things

535
00:27:58,640 --> 00:28:02,959
Speaker 1: directly affect heart disease, But what about breast cancer.

536
00:28:04,480 --> 00:28:06,120
Speaker 2: It's kind of a mixed bag.

537
00:28:06,480 --> 00:28:12,320
Speaker 3: So have I seen patients who follow a you know, vegan,

538
00:28:12,640 --> 00:28:16,600
Speaker 3: plant based, completely organic diet, exercise every day? You know,

539
00:28:16,640 --> 00:28:18,920
Speaker 3: I'm here in New Mexico, as I mentioned, so everyone

540
00:28:18,960 --> 00:28:21,400
Speaker 3: here is in amazing shape because they live at high

541
00:28:21,400 --> 00:28:24,560
Speaker 3: elevation and they're also very outdoorsy. Have I seen lots

542
00:28:24,600 --> 00:28:26,679
Speaker 3: of those patients who do end up with a breast cancer?

543
00:28:26,800 --> 00:28:27,400
Speaker 2: Yes, I have.

544
00:28:28,720 --> 00:28:33,440
Speaker 3: And I've also seen patients who, you know, who didn't

545
00:28:33,440 --> 00:28:36,439
Speaker 3: live a healthy lifestyle at all, who also end up

546
00:28:36,480 --> 00:28:39,560
Speaker 3: with breast cancer. I think living a healthy lifestyle is

547
00:28:39,600 --> 00:28:42,200
Speaker 3: important for as you mentioned, things like heart disease and

548
00:28:42,280 --> 00:28:44,920
Speaker 3: not having a heart attack or a stroke. I think

549
00:28:44,960 --> 00:28:48,560
Speaker 3: it can slightly decrease the risk of a future breast cancer.

550
00:28:48,640 --> 00:28:52,120
Speaker 3: But there's no one diet that can prevent breast cancer,

551
00:28:52,160 --> 00:28:53,960
Speaker 3: because if there was, then we would all be on

552
00:28:54,080 --> 00:28:57,360
Speaker 3: it right and we would have studies that definitively show

553
00:28:57,520 --> 00:28:59,959
Speaker 3: beyond this diet and you'll never develop breast cancer or

554
00:29:00,080 --> 00:29:01,280
Speaker 3: some other type of cancer.

555
00:29:01,840 --> 00:29:04,400
Speaker 2: And I think moderation is really important.

556
00:29:04,480 --> 00:29:07,400
Speaker 3: You know, not drinking alcohol or drinking it in small

557
00:29:07,480 --> 00:29:09,240
Speaker 3: quantities when you do is important.

558
00:29:09,680 --> 00:29:11,360
Speaker 1: Yeah, I was going to ask you about alcohol, like,

559
00:29:11,480 --> 00:29:13,440
Speaker 1: does drinking alcohol put you in a higher risk?

560
00:29:14,200 --> 00:29:16,440
Speaker 3: Lightly but not a lot. You know, it's I think

561
00:29:16,440 --> 00:29:19,120
Speaker 3: it puts you at higher risk for things like pancreatic cancer,

562
00:29:19,160 --> 00:29:22,440
Speaker 3: for example, but not as much for breast So I

563
00:29:22,480 --> 00:29:24,600
Speaker 3: mean that's not saying that you go out and drink

564
00:29:24,600 --> 00:29:28,360
Speaker 3: whatever you want. I think it's moderation is key to

565
00:29:28,480 --> 00:29:31,480
Speaker 3: having a good long life.

566
00:29:31,160 --> 00:29:32,880
Speaker 2: With a good quality of life.

567
00:29:33,680 --> 00:29:36,440
Speaker 3: But I don't think that, you know, living the healthiest

568
00:29:36,480 --> 00:29:40,040
Speaker 3: lifestyle is something that can definitively prevent breast cancer. And

569
00:29:40,080 --> 00:29:43,480
Speaker 3: so something I talk about often with my patients and

570
00:29:43,520 --> 00:29:46,280
Speaker 3: the clinic is sugar. You know, I hear the myth

571
00:29:46,360 --> 00:29:49,120
Speaker 3: all the time that sugar feeds cancer, and so some

572
00:29:49,200 --> 00:29:50,160
Speaker 3: multile get diagnosed.

573
00:29:50,400 --> 00:29:51,080
Speaker 2: Oh it's a myth.

574
00:29:51,200 --> 00:29:54,760
Speaker 3: Yeah, there's no definitive study that, like, you know, if

575
00:29:54,760 --> 00:29:57,600
Speaker 3: you cut out sugar, it will help diminish the size

576
00:29:57,640 --> 00:29:59,840
Speaker 3: of your breast cancer, help shrink it, help treat it,

577
00:30:00,000 --> 00:30:00,560
Speaker 3: anything like that.

578
00:30:00,640 --> 00:30:03,840
Speaker 2: And so there's some studies that have been.

579
00:30:03,720 --> 00:30:06,240
Speaker 3: Done that will show some kind of association, but it's

580
00:30:06,240 --> 00:30:09,040
Speaker 3: not a very strong one. And so I see patients

581
00:30:09,080 --> 00:30:11,200
Speaker 3: all the time that have been diagnosed with a breast

582
00:30:11,240 --> 00:30:13,800
Speaker 3: cancer and their family members will say, well, you have

583
00:30:13,840 --> 00:30:15,640
Speaker 3: to cut out all sugar right now, Like that's it.

584
00:30:15,680 --> 00:30:17,160
Speaker 3: You know, you're you have to be done with it

585
00:30:17,520 --> 00:30:19,320
Speaker 3: because it's going to feed your cancer and then your

586
00:30:19,360 --> 00:30:22,280
Speaker 3: cancer is going to grow. And that's that's really that's

587
00:30:22,360 --> 00:30:25,120
Speaker 3: it's that's a very simplistic way of looking at it,

588
00:30:25,160 --> 00:30:30,040
Speaker 3: and that's not it. There's no definitive causal uh causal

589
00:30:30,080 --> 00:30:32,760
Speaker 3: relationship where if you eat a lot of sugar, then

590
00:30:32,800 --> 00:30:34,960
Speaker 3: you're definitely going to get cancer, because otherwise then you

591
00:30:35,000 --> 00:30:37,959
Speaker 3: would see a higher incidence of cancer and people who

592
00:30:38,000 --> 00:30:41,880
Speaker 3: are diabetic, for example, And that's we don't see that.

593
00:30:42,000 --> 00:30:44,400
Speaker 3: And so if I have a patient who's asking me like, hey,

594
00:30:44,400 --> 00:30:47,280
Speaker 3: how should I change my diet after getting diagnosed with

595
00:30:47,280 --> 00:30:49,520
Speaker 3: breast cancer, I say, a healthy diet is important. But

596
00:30:49,960 --> 00:30:52,200
Speaker 3: you know, if you have something that you really love eating,

597
00:30:52,280 --> 00:30:54,400
Speaker 3: you know, you love ice cream, you love flawing, whatever,

598
00:30:54,440 --> 00:30:56,960
Speaker 3: I'm never going to say don't eat that. Don't eat

599
00:30:57,000 --> 00:30:59,040
Speaker 3: the things that are going to bring you joy while

600
00:30:59,080 --> 00:31:01,680
Speaker 3: you're going through treatment, because treatment is hard enough as

601
00:31:01,680 --> 00:31:02,000
Speaker 3: it is.

602
00:31:03,320 --> 00:31:08,600
Speaker 2: First of all, who would ever say I love flawn? Sorry, I.

603
00:31:11,160 --> 00:31:15,520
Speaker 3: Love it that giggly texture. I am right, Okay, yeah

604
00:31:16,440 --> 00:31:16,840
Speaker 3: it's great.

605
00:31:16,880 --> 00:31:19,120
Speaker 2: And in New Mexico here we have like really really

606
00:31:19,160 --> 00:31:19,960
Speaker 2: authentic flawn.

607
00:31:19,960 --> 00:31:21,800
Speaker 1: So okay, maybe I just need to go to New

608
00:31:21,840 --> 00:31:23,640
Speaker 1: Mexico and try the good stuff.

609
00:31:23,920 --> 00:31:25,440
Speaker 2: What about soy? What about soy?

610
00:31:25,520 --> 00:31:29,640
Speaker 1: Because I've always heard I mean, I fed my babies

611
00:31:30,400 --> 00:31:33,560
Speaker 1: once they were off breast milk. I gave them the

612
00:31:33,600 --> 00:31:37,719
Speaker 1: only option back then was to give them a soy formula, right,

613
00:31:38,240 --> 00:31:40,800
Speaker 1: and I wasn't sure if I was doing the right thing.

614
00:31:42,480 --> 00:31:44,479
Speaker 3: Also a great point. I hear that one too, Like

615
00:31:44,880 --> 00:31:47,880
Speaker 3: soy and the estrogen link is there. You know, people

616
00:31:47,920 --> 00:31:50,640
Speaker 3: will say, well, if you eat a lot of soy,

617
00:31:50,720 --> 00:31:53,479
Speaker 3: then it might increase your risk for an estrogen related

618
00:31:53,520 --> 00:31:57,000
Speaker 3: breast cancer, and really the studies are not definitive about

619
00:31:57,000 --> 00:31:57,520
Speaker 3: that either.

620
00:31:58,040 --> 00:32:00,360
Speaker 2: So I don't tell I don't advise you to cut

621
00:32:00,400 --> 00:32:00,840
Speaker 2: out soy.

622
00:32:00,920 --> 00:32:04,160
Speaker 3: I think if you like soy, great, enjoy SOI I

623
00:32:04,200 --> 00:32:07,120
Speaker 3: don't think that there's a real reason to cut anything

624
00:32:07,160 --> 00:32:09,640
Speaker 3: specific out of your diet if you've been diagnosed with

625
00:32:09,680 --> 00:32:12,160
Speaker 3: the breast cancer to keep it from growing or spreading,

626
00:32:13,240 --> 00:32:15,880
Speaker 3: or you know, to keep to prevent breast cancer. I

627
00:32:15,880 --> 00:32:18,440
Speaker 3: think if you want to prevent breast cancer or catch

628
00:32:18,440 --> 00:32:21,000
Speaker 3: it early, really the most important thing to do is

629
00:32:21,000 --> 00:32:22,360
Speaker 3: to get your mammogram once a year.

630
00:32:23,520 --> 00:32:28,080
Speaker 1: Okay, So speaking of estrogen, let's talk about hormone replacement

631
00:32:28,160 --> 00:32:32,880
Speaker 1: therapy HRT. Yeah, does it increase your chances of breast cancer?

632
00:32:32,920 --> 00:32:36,200
Speaker 1: And what do we need to know associated with that?

633
00:32:37,560 --> 00:32:41,840
Speaker 3: It does increase the chance very slightly, based on pretty

634
00:32:41,880 --> 00:32:45,640
Speaker 3: large studies that have been conducted. So when I'm talking

635
00:32:45,680 --> 00:32:49,000
Speaker 3: to patients, I have patients who are even in my

636
00:32:49,080 --> 00:32:52,200
Speaker 3: high risk clinic because they have a family history that

637
00:32:52,400 --> 00:32:55,320
Speaker 3: I do think that HRT is worth trying for them.

638
00:32:55,800 --> 00:33:00,160
Speaker 3: I think that menopausal symptoms are like many other things

639
00:33:00,160 --> 00:33:03,800
Speaker 3: that are almost exclusive to women, not talked about enough,

640
00:33:03,840 --> 00:33:07,320
Speaker 3: and sometimes they can be extremely miserable and really alter

641
00:33:07,440 --> 00:33:10,240
Speaker 3: the quality of your life, right, And so it's a

642
00:33:10,320 --> 00:33:14,880
Speaker 3: risk versus benefit situation, like, Okay, the risk of breast

643
00:33:14,880 --> 00:33:19,360
Speaker 3: cancer is slightly higher, but the benefit is that, you know,

644
00:33:19,440 --> 00:33:21,680
Speaker 3: I'll get to sleep at night, I won't have these

645
00:33:21,760 --> 00:33:24,640
Speaker 3: terrible night sweats. You know, I won't wake up in

646
00:33:24,680 --> 00:33:26,640
Speaker 3: the middle of the night and wonder what it is

647
00:33:26,680 --> 00:33:29,440
Speaker 3: I'm doing. I won't have menopause brain those kinds of things.

648
00:33:29,440 --> 00:33:32,680
Speaker 3: And so oftentimes I think that the benefit.

649
00:33:32,280 --> 00:33:34,400
Speaker 2: Of HRT really outweighs the risk.

650
00:33:35,000 --> 00:33:38,280
Speaker 3: The only patients that I really say should not be

651
00:33:38,360 --> 00:33:42,240
Speaker 3: on HRT are the patients who have already been diagnosed

652
00:33:42,280 --> 00:33:44,880
Speaker 3: with breast cancer, and it is a breast cancer that

653
00:33:44,920 --> 00:33:47,800
Speaker 3: responds to estrogen. In that case, not a good idea

654
00:33:47,880 --> 00:33:50,800
Speaker 3: to be on hormone replacement therapy. But for others, I

655
00:33:50,840 --> 00:33:53,560
Speaker 3: do feel that in general, the benefits outweigh the risks,

656
00:33:53,560 --> 00:33:55,760
Speaker 3: and I think that it's something that more women should

657
00:33:55,760 --> 00:33:57,040
Speaker 3: be on. Mm HM.

658
00:33:57,760 --> 00:34:09,600
Speaker 2: I agree.

659
00:34:05,480 --> 00:34:10,400
Speaker 1: Breast implant illness has been getting talked about more openly.

660
00:34:10,960 --> 00:34:13,279
Speaker 1: More and more women are having their implants removed. Are

661
00:34:13,320 --> 00:34:17,480
Speaker 1: there any correlations between breast implant illness and breast cancer?

662
00:34:18,200 --> 00:34:19,120
Speaker 2: Not that I know of.

663
00:34:19,400 --> 00:34:23,000
Speaker 3: I have not seen any correlation between breast implant associated

664
00:34:23,040 --> 00:34:27,399
Speaker 3: illness and breast cancer. Breast implant associated illness is kind

665
00:34:27,400 --> 00:34:29,680
Speaker 3: of You're right, it's getting a lot more traction in

666
00:34:29,719 --> 00:34:33,399
Speaker 3: these last few years, but it's still a diagnosis that

667
00:34:33,719 --> 00:34:36,080
Speaker 3: they will do a full work up and make sure

668
00:34:36,120 --> 00:34:38,840
Speaker 3: that there's not something else that's causing these symptoms before

669
00:34:38,880 --> 00:34:41,799
Speaker 3: removing implants. But I think there's a growing body of

670
00:34:41,800 --> 00:34:45,719
Speaker 3: evidence that it's its own thing and should be considered earlier,

671
00:34:45,880 --> 00:34:48,239
Speaker 3: you know, before doing the whole million dollar workup in

672
00:34:48,320 --> 00:34:49,600
Speaker 3: women who have implants.

673
00:34:50,000 --> 00:34:51,640
Speaker 2: I can't believe. I was told.

674
00:34:51,680 --> 00:34:55,360
Speaker 1: I would remember hearing messaging when I was younger that said,

675
00:34:55,680 --> 00:34:59,759
Speaker 1: if you get breast implants, it reduces your chances of

676
00:34:59,760 --> 00:35:00,840
Speaker 1: get breast cancer.

677
00:35:01,480 --> 00:35:01,840
Speaker 2: Yeah.

678
00:35:02,000 --> 00:35:04,520
Speaker 3: I I've heard that as well from a few patients.

679
00:35:05,120 --> 00:35:06,879
Speaker 3: It really it doesn't change.

680
00:35:06,560 --> 00:35:07,319
Speaker 2: The risk at all.

681
00:35:07,840 --> 00:35:10,800
Speaker 3: Yeah, I think you know it doesn't, right, And when

682
00:35:10,840 --> 00:35:13,440
Speaker 3: someone has an implant and then they get a mammogram,

683
00:35:13,560 --> 00:35:15,959
Speaker 3: they sort of move the implant out of the way

684
00:35:16,040 --> 00:35:18,719
Speaker 3: and then get the native breast tissue in for the

685
00:35:18,800 --> 00:35:21,080
Speaker 3: mammogram and they're still able to see what's going on.

686
00:35:22,000 --> 00:35:24,799
Speaker 3: Sometimes having an implant, you know, that was placed for

687
00:35:24,840 --> 00:35:29,000
Speaker 3: an augmentation purpose, can change the treatment options that are

688
00:35:29,000 --> 00:35:31,640
Speaker 3: available to you if you do get diagnosed with breast cancer.

689
00:35:31,680 --> 00:35:34,879
Speaker 3: But it's not that's not a reason not to get

690
00:35:34,920 --> 00:35:37,959
Speaker 3: an implant for someone who wants one.

691
00:35:38,200 --> 00:35:43,520
Speaker 1: Speaking of moving the implant around, if someone's considering or

692
00:35:43,560 --> 00:35:47,880
Speaker 1: having to face being considering a mass sectomy or a

693
00:35:47,920 --> 00:35:53,120
Speaker 1: double mass ectomy, can you walk us through that process

694
00:35:53,320 --> 00:35:57,319
Speaker 1: and what that entails and the recovery. I mean that

695
00:35:57,480 --> 00:35:58,800
Speaker 1: sounds very scary.

696
00:35:59,440 --> 00:36:01,440
Speaker 2: Yeah, sure, I'm happy to do that.

697
00:36:01,640 --> 00:36:04,960
Speaker 3: So I do see a lot of patients who have

698
00:36:05,320 --> 00:36:08,759
Speaker 3: chosen to remove one breast or both breasts, and that

699
00:36:08,840 --> 00:36:12,080
Speaker 3: decision is really a very personal decision, you know it.

700
00:36:12,360 --> 00:36:14,680
Speaker 3: I think that there's some patients that have a larger

701
00:36:14,760 --> 00:36:17,880
Speaker 3: cancer for which it would be a good idea, But

702
00:36:17,960 --> 00:36:21,279
Speaker 3: there's some who have small cancers that just, you know,

703
00:36:21,320 --> 00:36:23,359
Speaker 3: they don't want to get a mammogram on that side again,

704
00:36:23,440 --> 00:36:25,359
Speaker 3: or they don't want to get mamogram on either side,

705
00:36:25,400 --> 00:36:27,399
Speaker 3: and they just want to, you know, for their own

706
00:36:27,440 --> 00:36:29,640
Speaker 3: peace of mind. They tell me, you know, doctor Jambacar,

707
00:36:29,719 --> 00:36:33,320
Speaker 3: I'm going to be awake at night thinking about potentially

708
00:36:33,360 --> 00:36:36,359
Speaker 3: having to get another biopsy sometime in the future, and

709
00:36:36,400 --> 00:36:38,600
Speaker 3: I want to remove both breasts. And if that's the case,

710
00:36:38,640 --> 00:36:41,359
Speaker 3: then you know, that's your decision now, you know.

711
00:36:41,400 --> 00:36:43,400
Speaker 2: For me, I have a lot.

712
00:36:43,239 --> 00:36:46,680
Speaker 3: Of different tools to help my patients have the best

713
00:36:46,719 --> 00:36:49,440
Speaker 3: recovery possible, and one of them is something called an

714
00:36:49,520 --> 00:36:52,920
Speaker 3: experal peck block, which is like a numbing injection that

715
00:36:52,960 --> 00:36:55,600
Speaker 3: gets done to the muscle, the peck muscle, which is

716
00:36:55,600 --> 00:36:59,799
Speaker 3: the muscle that's behind the breast, and that medication lasts

717
00:36:59,840 --> 00:37:03,520
Speaker 3: for like seven days, and so typically my patients go

718
00:37:03,640 --> 00:37:05,680
Speaker 3: home the same day after a two to three hour

719
00:37:05,719 --> 00:37:08,680
Speaker 3: surgery and they're able to do their normal activities shower,

720
00:37:09,440 --> 00:37:12,359
Speaker 3: wash their hair, et cetera. The next day, and most

721
00:37:12,400 --> 00:37:15,920
Speaker 3: of them take zero opioid pills at all because of

722
00:37:15,920 --> 00:37:16,560
Speaker 3: that medication.

723
00:37:16,880 --> 00:37:19,160
Speaker 2: It blocks the pain receptors.

724
00:37:19,360 --> 00:37:21,880
Speaker 3: It blocks the muscle, it numbs the whole muscle, and

725
00:37:21,920 --> 00:37:24,560
Speaker 3: so it numbs the breast tissue in front of the muscle.

726
00:37:25,480 --> 00:37:28,960
Speaker 3: And it's really something that's been used that most places

727
00:37:28,960 --> 00:37:33,240
Speaker 3: in the country, but not everywhere it should be used everywhere.

728
00:37:32,800 --> 00:37:33,480
Speaker 2: In New Mexico.

729
00:37:33,640 --> 00:37:36,080
Speaker 3: Mine is actually the only hospital and the only surgeon

730
00:37:36,120 --> 00:37:39,560
Speaker 3: who's doing it, and I'm hoping to spread that message so.

731
00:37:39,560 --> 00:37:41,520
Speaker 2: More people do it. I know in La quite a

732
00:37:41,520 --> 00:37:44,360
Speaker 2: few people are doing it, but I think.

733
00:37:44,200 --> 00:37:47,640
Speaker 3: That it is It's something that has been a huge

734
00:37:47,680 --> 00:37:51,080
Speaker 3: game changer, especially in the last couple of years since

735
00:37:51,200 --> 00:37:56,080
Speaker 3: the pandemic started, to make the recovery better for patients

736
00:37:56,120 --> 00:37:59,319
Speaker 3: who have breast cancer. And then you know, the next

737
00:37:59,400 --> 00:38:02,399
Speaker 3: day you could be walking around, showering, moving your arms,

738
00:38:02,400 --> 00:38:05,520
Speaker 3: doing all of your normal stuff. Usually you will feel

739
00:38:05,600 --> 00:38:08,640
Speaker 3: kind of sore for probably two or three weeks, but

740
00:38:08,760 --> 00:38:11,640
Speaker 3: this helps tremendously because it really takes the edge off

741
00:38:11,680 --> 00:38:15,520
Speaker 3: the first few days, and patients do sometimes need ice

742
00:38:15,560 --> 00:38:17,879
Speaker 3: pads or tilenyl and advil to kind of get them

743
00:38:17,880 --> 00:38:18,200
Speaker 3: through that.

744
00:38:20,239 --> 00:38:20,719
Speaker 2: And then the.

745
00:38:20,680 --> 00:38:23,879
Speaker 3: Reconstruction process, which sometimes can be started at the same

746
00:38:23,960 --> 00:38:28,160
Speaker 3: time as removing one or both breasts, sometimes needs to

747
00:38:28,160 --> 00:38:30,200
Speaker 3: be done in a separate surgery. It just sort of

748
00:38:30,239 --> 00:38:33,239
Speaker 3: depends on what type of reconstruction the patient chooses.

749
00:38:33,400 --> 00:38:35,880
Speaker 1: I see, so in some cases, if you have to

750
00:38:35,920 --> 00:38:38,720
Speaker 1: have your breast removed, you can have the reconstruction done

751
00:38:39,080 --> 00:38:40,920
Speaker 1: in that same operation.

752
00:38:40,880 --> 00:38:41,360
Speaker 2: You can.

753
00:38:42,040 --> 00:38:44,640
Speaker 3: But something I always counsel patients is, even if you're

754
00:38:44,680 --> 00:38:47,680
Speaker 3: able to start it at the same time, oftentimes there

755
00:38:47,760 --> 00:38:50,320
Speaker 3: is a second surgery or maybe in an office procedure

756
00:38:50,360 --> 00:38:54,239
Speaker 3: or something that's needed because remaking breasts is a work

757
00:38:54,280 --> 00:38:58,440
Speaker 3: of art and making sure everything's symmetric, either with the

758
00:38:58,480 --> 00:39:00,600
Speaker 3: side you still have left or making both sides of the

759
00:39:00,640 --> 00:39:04,640
Speaker 3: same like this not like this right, Like that's that's

760
00:39:04,640 --> 00:39:07,440
Speaker 3: a work of art, and it takes it takes a

761
00:39:07,560 --> 00:39:11,520
Speaker 3: very skilled plastic surgeon who's extremely dedicated to reconstruction to

762
00:39:11,560 --> 00:39:12,440
Speaker 3: do a good job.

763
00:39:13,080 --> 00:39:14,880
Speaker 2: And sometimes it can take.

764
00:39:14,719 --> 00:39:16,759
Speaker 3: You know, up to a year to do all the

765
00:39:16,760 --> 00:39:21,120
Speaker 3: procedures that are done to where the patient and the

766
00:39:21,120 --> 00:39:23,919
Speaker 3: plastic surgeon everyone's happy with how things are.

767
00:39:23,960 --> 00:39:25,520
Speaker 2: And so it's an art.

768
00:39:25,800 --> 00:39:28,480
Speaker 3: We don't want to rush that process, but sometimes it

769
00:39:28,520 --> 00:39:30,600
Speaker 3: can be started and most of it done, you know,

770
00:39:30,640 --> 00:39:32,319
Speaker 3: at the time of the mask stept tomy.

771
00:39:33,239 --> 00:39:37,320
Speaker 1: Wow, so interesting. Well, first of all, how often should

772
00:39:37,320 --> 00:39:41,560
Speaker 1: we be giving ourselves self exams, which means feeling around

773
00:39:41,680 --> 00:39:45,960
Speaker 1: the breast for any unusual lumps that are new.

774
00:39:46,200 --> 00:39:49,960
Speaker 3: Right, I'm kind of like, I'm not a huge proponent

775
00:39:50,000 --> 00:39:53,600
Speaker 3: for self breast exams. I think that it's important to

776
00:39:53,640 --> 00:39:56,319
Speaker 3: be kind of aware of what your breasts feel like,

777
00:39:56,480 --> 00:39:58,920
Speaker 3: you know, once every few months, kind of examine yourself

778
00:39:58,920 --> 00:40:02,359
Speaker 3: in the shower. But you know, I think that the

779
00:40:02,480 --> 00:40:05,280
Speaker 3: old teachings that you should be doing a self breast

780
00:40:05,280 --> 00:40:09,000
Speaker 3: exam once a month isn't really what we follow now

781
00:40:09,080 --> 00:40:14,120
Speaker 3: because self breast exams don't catch cancers very often, and

782
00:40:14,480 --> 00:40:17,799
Speaker 3: more often than not is the imaging that catches it.

783
00:40:18,360 --> 00:40:20,560
Speaker 3: So for me, you know, with my patients, I really

784
00:40:20,560 --> 00:40:25,040
Speaker 3: stress the importance of regular mammograms and if you are

785
00:40:25,160 --> 00:40:27,520
Speaker 3: high risk, getting enrolled in a high risk breast clinic

786
00:40:27,560 --> 00:40:30,520
Speaker 3: where they can watch you more often. But just in general,

787
00:40:30,560 --> 00:40:33,319
Speaker 3: having an awareness of what your breasts feel like, you know,

788
00:40:33,320 --> 00:40:37,239
Speaker 3: once every few months, I think is totally okay. And

789
00:40:37,280 --> 00:40:40,520
Speaker 3: I also often have patients that come seeing me after

790
00:40:40,560 --> 00:40:42,640
Speaker 3: having being dinosed so the breast cancer say, you know, Douc,

791
00:40:42,680 --> 00:40:44,920
Speaker 3: I didn't feel anything. I don't really do breast exams,

792
00:40:44,920 --> 00:40:46,839
Speaker 3: And I tell him, you know, no reason to feel

793
00:40:46,880 --> 00:40:48,960
Speaker 3: bad about that, Like that's okay, you went and got

794
00:40:48,960 --> 00:40:51,360
Speaker 3: your mammogram and now we're here, so I'm really happy

795
00:40:51,400 --> 00:40:52,360
Speaker 3: that you got your mammogram.

796
00:40:54,120 --> 00:40:57,640
Speaker 1: Yeah, because sometimes it is an indicator to someone that

797
00:40:57,800 --> 00:41:01,239
Speaker 1: something might be awry, so it is the impetus for

798
00:41:01,280 --> 00:41:03,120
Speaker 1: them to go into the doctor. What are some other

799
00:41:03,840 --> 00:41:07,839
Speaker 1: warning signs, say, we're not checking our breast warning even

800
00:41:07,880 --> 00:41:10,520
Speaker 1: if we do, we didn't feel Are there other signs

801
00:41:11,120 --> 00:41:12,319
Speaker 1: that women should be aware of.

802
00:41:13,360 --> 00:41:18,319
Speaker 3: Yeah, so nipple discharge, like new onset nipple discharge on

803
00:41:18,320 --> 00:41:22,080
Speaker 3: one side in particular, especially if it's bloody, that's something

804
00:41:22,120 --> 00:41:25,200
Speaker 3: that you need to get some breast imaging for. And

805
00:41:25,320 --> 00:41:27,879
Speaker 3: oftentimes breast pain. You know, if you feel a new

806
00:41:27,960 --> 00:41:30,920
Speaker 3: pain somewhere, especially if it's just in one spot not

807
00:41:31,040 --> 00:41:34,520
Speaker 3: the whole breast. Whenever I see patients with breast pain,

808
00:41:34,680 --> 00:41:36,839
Speaker 3: I go ahead and order an ultrasound just to check

809
00:41:36,920 --> 00:41:38,960
Speaker 3: it out and make sure there's nothing going on as well.

810
00:41:39,719 --> 00:41:42,360
Speaker 3: And then also if you have any kind of skin changes,

811
00:41:42,520 --> 00:41:46,080
Speaker 3: so skin looks kind of stick in one spot, nipples,

812
00:41:46,160 --> 00:41:49,160
Speaker 3: kind of itching and scaling, all of that stuff should

813
00:41:49,160 --> 00:41:50,880
Speaker 3: be checked out with breast imaging.

814
00:41:52,600 --> 00:41:54,839
Speaker 2: Such a good information. I didn't know any of that.

815
00:41:55,360 --> 00:41:55,719
Speaker 2: Thank you.

816
00:41:57,120 --> 00:42:00,400
Speaker 1: What is the one thing you would say that you

817
00:42:00,520 --> 00:42:04,120
Speaker 1: hope our listeners take away from this conversation that we've

818
00:42:04,120 --> 00:42:05,160
Speaker 1: had today.

819
00:42:05,200 --> 00:42:07,719
Speaker 3: I think you've already sort of touched on it, which

820
00:42:07,760 --> 00:42:11,480
Speaker 3: is that it's so important for women to advocate for themselves.

821
00:42:12,360 --> 00:42:16,879
Speaker 3: So if you have a high risk family history, ask

822
00:42:16,960 --> 00:42:19,080
Speaker 3: your primary care doctor to refer you to a hig

823
00:42:19,120 --> 00:42:21,920
Speaker 3: risk breast clinic so you can talk about genetic testing,

824
00:42:22,000 --> 00:42:25,680
Speaker 3: maybe get diagnosed with something like Bracco one and two

825
00:42:25,840 --> 00:42:27,640
Speaker 3: if that's running in your family.

826
00:42:27,400 --> 00:42:29,160
Speaker 2: Or just be watched more closely.

827
00:42:30,440 --> 00:42:34,000
Speaker 3: And if you feel a lump, advocate for yourself to

828
00:42:34,040 --> 00:42:37,120
Speaker 3: get some type of imaging, a mammogram, an ultrasound, something,

829
00:42:37,200 --> 00:42:40,120
Speaker 3: because no one's physical exam is good enough. So it's

830
00:42:40,160 --> 00:42:42,680
Speaker 3: really important for women to use our voices because we

831
00:42:42,719 --> 00:42:47,880
Speaker 3: already don't get heard enough. So advocate for yourself, educate yourself.

832
00:42:48,719 --> 00:42:51,279
Speaker 3: And that's really my mission. I try to post a

833
00:42:51,280 --> 00:42:54,000
Speaker 3: lot of stuff on social media so that way I

834
00:42:54,040 --> 00:42:55,840
Speaker 3: can help women advocate for themselves.

835
00:42:56,160 --> 00:42:58,799
Speaker 1: Yeah, I mean it's so easy. I've been in this

836
00:42:58,880 --> 00:43:01,560
Speaker 1: position to be in the doctor's office and them to

837
00:43:01,640 --> 00:43:04,879
Speaker 1: tell you whether something's wrong or something's not wrong. Either way,

838
00:43:06,280 --> 00:43:09,440
Speaker 1: I think to myself, well, they're the doctor, they must know.

839
00:43:10,320 --> 00:43:11,759
Speaker 1: I guess I'll just go with that.

840
00:43:12,440 --> 00:43:16,080
Speaker 3: Well, here's the dirty little secret we don't know. And

841
00:43:16,239 --> 00:43:20,160
Speaker 3: as a doctor, like we you know, physical exam and

842
00:43:20,239 --> 00:43:22,719
Speaker 3: looking at how a patient looks and trying to put

843
00:43:22,719 --> 00:43:25,520
Speaker 3: the pieces together with what they're telling you. It's those

844
00:43:25,560 --> 00:43:28,799
Speaker 3: are great tools, but they're not everything. And if you,

845
00:43:29,280 --> 00:43:32,640
Speaker 3: as someone who's seeing a doctor, feel in your gut

846
00:43:32,719 --> 00:43:35,000
Speaker 3: that you know they're not hearing me, they don't know

847
00:43:35,040 --> 00:43:37,560
Speaker 3: the whole story, something must still be wrong. Like, don't

848
00:43:37,560 --> 00:43:39,400
Speaker 3: be afraid to get a second opinion. You know what

849
00:43:39,400 --> 00:43:43,440
Speaker 3: we talked about earlier. Find a female physician that will

850
00:43:43,480 --> 00:43:44,520
Speaker 3: be willing to listen to you.

851
00:43:45,120 --> 00:43:49,040
Speaker 2: Yes, go, ladies. We need more female doctors, more female surgeons,

852
00:43:49,840 --> 00:43:51,919
Speaker 2: more females everywhere we do.

853
00:43:52,160 --> 00:43:55,319
Speaker 3: We absolutely do in every field, we will benefit from

854
00:43:55,360 --> 00:43:56,240
Speaker 3: having more women.

855
00:43:56,760 --> 00:44:00,520
Speaker 1: Before I let you go, doctor Amani, I want to

856
00:44:00,560 --> 00:44:05,040
Speaker 1: know what was your last I choose me moment.

857
00:44:05,960 --> 00:44:08,960
Speaker 3: I would have to say that it was today doing

858
00:44:09,000 --> 00:44:14,680
Speaker 3: this podcast. So I spoke to my clinic team and

859
00:44:14,760 --> 00:44:18,200
Speaker 3: I was like, listen, I have this really exciting opportunity

860
00:44:18,280 --> 00:44:21,560
Speaker 3: to be on Jennygart's podcast. I'm really excited about meeting her.

861
00:44:21,760 --> 00:44:24,680
Speaker 3: So if you can just make sure that I can

862
00:44:24,680 --> 00:44:27,399
Speaker 3: get home on time so I can participate. And that's

863
00:44:27,440 --> 00:44:30,960
Speaker 3: how I'm choosing me. And they made it happen and

864
00:44:31,040 --> 00:44:33,120
Speaker 3: I was able to be here today. So I'm so

865
00:44:33,200 --> 00:44:35,880
Speaker 3: excited for this opportunity. Thank you so much for having

866
00:44:35,880 --> 00:44:36,200
Speaker 3: me on.

867
00:44:36,640 --> 00:44:37,360
Speaker 2: Oh I love that.

868
00:44:37,600 --> 00:44:40,400
Speaker 1: I love that because this is the greatest opportunity for

869
00:44:40,440 --> 00:44:42,680
Speaker 1: you to educate more women, and I know that that's

870
00:44:42,680 --> 00:44:43,360
Speaker 1: so important to you.

871
00:44:44,120 --> 00:44:44,680
Speaker 2: Yes, it is.

872
00:44:44,760 --> 00:44:47,319
Speaker 3: That's definitely my mission, not just in my clinic, but

873
00:44:47,360 --> 00:44:50,640
Speaker 3: also the women out there on social media to try

874
00:44:50,680 --> 00:44:54,640
Speaker 3: to help them, help empower them to advocate for themselves.

875
00:44:55,440 --> 00:44:59,160
Speaker 1: As the mother of three women, I thank you from

876
00:44:59,200 --> 00:45:01,439
Speaker 1: the bottom of my heart for all that you do

877
00:45:02,040 --> 00:45:04,520
Speaker 1: and the education that you're dispensing to people.

878
00:45:05,040 --> 00:45:07,920
Speaker 3: Well, I really appreciate everything you're doing and all of

879
00:45:08,000 --> 00:45:12,400
Speaker 3: the information you're providing through your podcast and helping me

880
00:45:12,520 --> 00:45:16,040
Speaker 3: have this platform to talk to women and so we

881
00:45:16,120 --> 00:45:18,680
Speaker 3: can get more women to get their mammograms.

882
00:45:19,000 --> 00:45:21,719
Speaker 1: Yes, yes, thank you so much for your time. I

883
00:45:21,760 --> 00:45:26,600
Speaker 1: hope you have a great night you too. All right,

884
00:45:26,760 --> 00:45:28,120
Speaker 1: take and enjoy your flown.

885
00:45:28,960 --> 00:45:31,160
Speaker 3: Oh, thank you, just delicious. You got to give it

886
00:45:31,160 --> 00:45:31,840
Speaker 3: another chance.

887
00:45:32,239 --> 00:45:33,799
Speaker 2: I'll come and see you and we can have some

888
00:45:33,840 --> 00:45:35,799
Speaker 2: flawn together. I think that'd be a good idea.

889
00:45:36,160 --> 00:45:39,440
Speaker 3: That if you haven't been to Santa Fe recently been

890
00:45:39,480 --> 00:45:40,120
Speaker 3: to Santa Fe.

891
00:45:40,360 --> 00:45:42,200
Speaker 2: Oh my gosh, you're missing out. It is such a

892
00:45:42,239 --> 00:45:42,879
Speaker 2: magical city.

893
00:45:42,920 --> 00:45:45,040
Speaker 3: I got to tell you I moved here from Houston,

894
00:45:45,160 --> 00:45:47,680
Speaker 3: and I was like, oh my god, I strongly recommend

895
00:45:47,680 --> 00:45:48,000
Speaker 3: you come.

896
00:45:48,320 --> 00:45:52,359
Speaker 1: I love that of ringing endorsement. Yes Santa Fe, yes okay,

897
00:45:52,440 --> 00:45:55,560
Speaker 1: and mammograms yes both okay.

898
00:45:55,600 --> 00:45:58,080
Speaker 2: Thank you so much, thank you for having me on.

899
00:46:01,400 --> 00:46:04,000
Speaker 1: I want to thank doctor Ramani John Bacar for coming

900
00:46:04,120 --> 00:46:07,920
Speaker 1: on our podcast today. I know none of us like

901
00:46:08,000 --> 00:46:11,640
Speaker 1: to talk or think about cancer, but it is important

902
00:46:11,680 --> 00:46:15,200
Speaker 1: for all of us to understand the warning signs and

903
00:46:15,400 --> 00:46:18,759
Speaker 1: understand why it's crucial for us to get our mammograms.

904
00:46:19,320 --> 00:46:22,840
Speaker 1: As we continue to choose ourselves each week, I want

905
00:46:22,880 --> 00:46:25,200
Speaker 1: to challenge you this week. It's going to be an

906
00:46:25,239 --> 00:46:28,920
Speaker 1: obvious one, but maybe this conversation has inspired you. I

907
00:46:29,000 --> 00:46:32,360
Speaker 1: want to encourage you to have that I choose me

908
00:46:32,480 --> 00:46:37,080
Speaker 1: moment and get your mammogram. Or maybe you and a friend,

909
00:46:37,239 --> 00:46:39,640
Speaker 1: or you and your sister, or you and your daughter

910
00:46:40,480 --> 00:46:44,440
Speaker 1: go get them together, make a mammogram date out of it.

911
00:46:45,640 --> 00:46:48,799
Speaker 1: I encourage you to share your story and your mammogram

912
00:46:48,840 --> 00:46:51,320
Speaker 1: experience on our social media and use the hashtag I

913
00:46:51,400 --> 00:46:54,640
Speaker 1: Choose Me. Let's all inspire each other and be brave

914
00:46:54,840 --> 00:46:57,640
Speaker 1: and look out for each other and for our bodies.

915
00:46:58,200 --> 00:47:00,560
Speaker 1: Thanks for listening to I Choose Me. You can check

916
00:47:00,560 --> 00:47:03,080
Speaker 1: out all of our social links on our show notes,

917
00:47:03,239 --> 00:47:05,560
Speaker 1: rate us, review the podcast, give us your comments, tell

918
00:47:05,600 --> 00:47:07,720
Speaker 1: us everything you want to tell us, and don't forget

919
00:47:07,760 --> 00:47:10,640
Speaker 1: to use the hashtag I Choose Me. I'll be right

920
00:47:10,680 --> 00:47:12,960
Speaker 1: here next week. I hope you choose to be here too,