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Menopause comes with enough challenges without the prevalence of medical gaslighting and yet women during this phase of life can expect to be ignored by their healthcare providers. Are you fed up with feeling dismissed and unheard when it comes to your health? Do you feel like your concerns are being ignored because of your age or gender? In this week’s interview, Dr. Susan Clinton shares her personal experiences in the field of women’s health and pelvic health and how she got to the place of empowering women on their own health journeys.
During this interview, we’ll learn simple ways to make lasting and sustainable changes in your health and quality of life. Even starting with small, impactful changes like mindful eating and taking short walks for blood sugar regulation, can have dramatically positive effects on your well-being. Dr. Ginger and Dr. Susan discuss the power of mindfulness, gratitude, and self-care in optimizing your physiological and mental health.
Check out this conversation to learn as they delve into the common challenges faced by women during menopause in healthcare. You’ll walk away with easy changes you can make to live your best life and further empower women. Take the first step towards reclaiming your health and voice by listening to this enlightening podcast episode.
She is a board certified in orthopedic and women’s health physical therapy, a fellow of the American Academy of Orthopedic Manual Therapy, and a board-certified health and wellness coach. She is an international instructor of post-professional education in women’s health (including GI issues in women), orthopedic manual therapy, and business psychology.
After being part of traditional clinics for many years, she ventured out into co-ownership of a clinic to escape the confines of conventional physical therapy medicine. After moving for personal reasons, she has decided to embark on her own clinical entrepreneurial journey.
Her passion is to help people learn and empower themselves to heal through movement and an integrated approach to healthcare.
Every person is different.
Every person has a unique story.
No two stories will create the same set of symptoms or issues.
Her true passion lies in discovering your story to help you find a solution to manage your challenges.
It is important to her that you work together to find an integrative and holistic approach to your care.
She will customize each innovative solution to your particular situation. Her goal is to collaborate with you to uncover the answers to your problems and improve your health and wellness to get you back to the things you love to do. When she’s not helping others improve themselves, you can find her walking or hiking, country line dancing, or ballroom dancing. She is an avid supporter of music, the arts, and international objectives for women’s health.
0:00 Dr. Ginger Garner: Hello, everyone, and welcome back. Today, I have the amazing and wonderful, and I’m not kidding, Susan Clinton with me. Welcome.
0:12 Susan Clinton: Hi. So glad to be here.
0:16 Dr. Ginger Garner: Thanks for having me on. I’m glad I finally snagged you.
0:19 Susan Clinton: Yes, we have tried this a couple of times. I’m glad we’re finally here together.
0:24 Dr. Ginger Garner: Yeah, gosh, you guys you’re in for a treat today. We’re going to talk about all kinds of fun things related to as this season has gone, ending bringing awareness to but working towards ending medical gaslighting in women’s health and pelvic health. But first let me introduce you to Dr. Susan Clinton. She is board certified in orthopedic and women’s health physical therapy. She’s a fellow of the American Academy of Orthopedic Manual Therapy and board certified health and wellness coach. She’s an international instructor of post-professional con ed in women’s health, including GI issues in women, which we will dig into. Ortho manual therapy and business psychology. She worked as a part of traditional clinics for many years and then ventured out into co-ownership of a clinic that I had the good fortune of going to and teaching in several years ago now, what, like a decade or something?
1:23 Susan Clinton: No, it’s been a long time, hasn’t it? Yeah, I know. Time flies so fast.
1:29 Dr. Ginger Garner: Just being able to provide that kind of conventional PT medicine. And then moving on from that, she decided to start a new entrepreneurial journey, which I can’t wait to learn more about because this has been a relatively recent evolution. So I can’t wait to hear about it.
Her passion is to help people learn, to empower people, to heal through movement and an integrated approach to healthcare. Because we’re all different. We all have a unique story. No two cases are the same. And so Dr. Clinton’s passion lies in discovering, helping you discover your story and find a solution to the challenges that you experience.
She has a rich wealth of knowledge, and I’m so glad that she’s here to share today. Welcome again.
2:19 Susan Clinton: Thank you. Thank you so much.
2:22 Dr. Ginger Garner: You know, I was thinking back. When it was the first time that we met, because it’s foggy to me. Actually, and then all of a sudden, we were working on a project together and then presenting at National Conference and then stuff, right? Do you remember the first time we met?
2:44 Susan Clinton: I think we met for the first time. We probably have known about each other for a while, but I think we physically met when you came to Pittsburgh to teach at Embody with Becky and I.
2:58 Dr. Ginger Garner: You’re probably right. Um, I think it feels foggy for me because with the internet, you can meet someone, talk to them, like kind of a roundabout way, you know, for years and not ever see them in person. Right. I’ve had colleagues and friends like that for over a decade that we were just back and forth, tossing the ball, proverbial back and forth, you know, online, and then realize, wow, actually we’ve never seen each other in person yet. I don’t know if that’s a good or a bad thing.
3:28 Susan Clinton: Well, unfortunately, I think it’s a thing because there’s people I ran into at CSM this year that We were like, have we really ever met in person? You know, this is good. See you in the flesh, you know, not on a screen.
3:43 Dr. Ginger Garner: I’m glad you’re saying that too. Um, all right. So that’s the first thing that I was wondering about, but, but second of all, you’ve made this incredible transition from being in a clinic of treating patients, you know, doing the one-on-one thing to now people can find you at LTIphysio.com. Is that right? Okay, ltiphysio.com, we’ll put that in the show notes.
Tell us all about your evolution, like your story. I don’t even know how you came into physical therapy. I certainly know how, you know, we ended up meeting at the clinic, but then this whole evolution towards where you are now. Which I think really kind of mirrors where, in many ways, our profession is going and should be going.
4:30 Susan Clinton: Awesome. So I came into physical therapy back in 1979 when I went to PT school when it was a Bachelor of Science degree. It was a 15-month program, which is crazy to think about. 18 months, I guess, really, not 15, 18 months, whatever. It was short. And the avenues that were open in those years and days were working at a rehab center, working at a hospital, or if you wanted to, you could hang out your own shingle and do private practice. Insurance was generous in those days, and therapy was well paid for, so people did well in private practice back then, and didn’t have, you know, the burden of paperwork and some of the stuff that we have now.
I stayed in acute care for a bit and went into a private practice and worked there for a little while, and then moved to New Orleans and started work a large rehab center there, which is, it’s still there, Turo. But it’s, you know, things have changed and different ownerships and stuff like that. I worked in acute care, but then I worked, I moved upstairs to the rehab ward. And there I spent many years working with clients who had brain injuries of all kinds and spinal cord injuries. So anything neurological ended up on the rehab units. And in those days in the 80s, people stayed in for a long time. There wasn’t a push to move people out of the hospital as fast.
We had people in there for a long time and you really had the opportunity to work with systems to see change in systems. So I never really grew up under the guise of a regional approach. It was always systems for me. Our clients who had brain injuries also had to go to the bathroom. They also had cardiac concerns. They had, you know, muscle and limb and joint and everything, you know.
So it was, that was just how I was, that was just the world I grew up in was, you know, the whole person and all of the things for the person and, and, you know, everything was, had an eye on function. You know, we did spend time talking about impairments. Of course, we did interventions on impairments, but it was mostly with the eye on function. How can we get this person to be as optimized as possible to reenter the community, their social strata, their family, wherever it was that they were going to be part of after they left.
From there, you know, and also my early state, you know, from there, my early stages in that area, was also working in the AIDS unit. So the pandemic before the pandemic. And so all of those clients, very integrative stuff. I started an ICU with them and they went all the way to outpatient, those that survived. And a lot of years working on just how to optimize somebody after they’ve gone through that kind of, upheaval in their life, you know, with their own physiological concerns. But, you know, again, there was a lot of pelvic health in there that, you know, I didn’t even, you know, I didn’t even know pelvic health was a thing back then. You know, to me, it was still like, people had to go to the bathroom, we were very close to the all the occupational therapists that I worked with, because we were doing it all together, you know, I could fiddle with the arm, they could fiddle with the leg, and we could, you know, our goal was just to get people going.
From the rehab unit, I had the good fortune of moving over into academic medicine at LSU and I was the director of the faculty practice and that was my entree into there. And so all of the faculty would come in one day or two days a week and see clients as well as have their obligations to the school, the students and the students’ education. We were moving into a master’s program at that time. So there was a big push for me to get my master’s degree, which I did through the school as I worked in the clinic and it was very interesting clinic to be in because there were people with double PhDs that would come in for therapy and people basically who were coming from a very, very low socioeconomic status. So we had a wide diversity of people.
And I’ll remember the first time and they talked about everybody as diagnoses, like, oh, you have two shoulders and a neck at three o’clock or something like that. I always thought that was so weird. And the first time when, you know, here I am back in the world of orthopedics, which I didn’t spend a lot of time in before. Anyway, this gentleman walked in and, you know, they told me he was going to be a shoulder patient. And all I could look at was how he was walking. And, you know, and it was interesting to me, because, you know, yeah, shoulder was hurting, and this was going on. And it was turned out to be a cervical problem. I remember that pretty clearly, like just had pain in the shoulder, but it was coming from the cervical spine.
But you know, it was all because of this posture and control thing that he had going on so his shoulder was constantly hiked up because he was loading the other side so much and he had a twist and it turns out they had this you know pretty significant history of torticollis and that set him up for all of this other stuff and so yes we treated the neck but we treated you know the whole system to see what we could do to help optimize him.
And, you know, at that time, it was kind of pretty clear to me that we have to look at all of these joint-specific things within the context of the body. Not too long after that, in the mid-90s, Dr. Lewis Wall came into the office. He was working at LSU at the time before he moved on to St. Louis. And was looking, he came in and he said, I need a physio. And for those of you who don’t know, Dr. Wall is like the grandfather of urogyne [urogynecology] medicine. He wrote the original book. Anyway, he took me under his wing. Brought me into his clinic. Taught me everything he knows about everything that he was doing, what he was doing surgically, all the different things that he was doing, why people were having problems. And then he said, I’ll start sending you clients. And I kind of just stood there and he said, you’re going to go figure it out.
So off to the library, I went and started looking up everything I could find. And I found a listserv through the what was at that time we were the section on women’s health, very newly formed from being the OBGYN group through APTA. Got on the Listserv so that I could show you how old I am. Does anybody know what a Listserv is? Like one big giant chat on a computer, but, you know, got on the listserv so I could start reading and listening to everything that was going on. There were very few courses in those days, and if they were, they were like a week long, and there was no way I could, I was, I had a young child, I was a single mom, and there wasn’t any way I could leave for like a week to go off to a course at that time.
So, Lucky for me, Fatima Hakim was just up the road in Baton Rouge and had come to the school every year to kind of talk a little bit about urinary incontinence. So I called her and I said, I got you to come help me. I’ve got to figure this out. And I don’t want to recreate the wheel. So she came down, we actually put together a small course, but it was basically so that I could learn as much as I could from her. And she was a lifeline in those days, which was great.
But really, the way that I learned my trade, the way that I learned the things that I do, the way that I learned my approach for clients, all came from them, the people in front of me, because I think my my gift was a lack of knowing from a course because I had to rely on my clients to tell me what was going on and they directed their care. So I just sat there and listened, asked a lot of questions, got super curious, and just started to kind of think, what do we have here? What’s going on here? What systems are in trouble? What do they need? And what is it that’s going to be relevant to them?
Because they didn’t know why they were there either. They just knew that they were having problems. And of course, they were kind of like, this is all very interesting. we’re going to be doing physical therapy for this. And it’s like, well, muscle, bones, joints, nerves, they’re all the same, you know, so we’re just gonna we’re just gonna do the best we can, let’s figure this out. So I had a number of clients that way the then there was a group, a small group of colorectal doctors in town that found out about me and started sending me clients. So I thought, okay, have the urogyne perspective.
Now I’m getting everything from the back passage. And so these clients started coming in the door and started listening to their to their stories. And I got on the phone with them and said, we need to talk. I need to find out some things here because I wanted to understand what they were doing with their protocols, because they were all coming in with diagnosis of fecal incontinence, and they were all on immodium protocols.
And I was like, OK, you’ve got to sit down and explain this to me. I’ve got to figure this out. Tell me where I can find resources. And so that’s what sent me down the road through GI issues. Because as I started learning more about what was happening with these other folks that were coming from the GI world, I started realizing that this was a main visceral driver behind the pelvic pain and bladder issue and incontinence world. And being able to put the two and two together was amazing for me because it made a lot of sense, but it also helped my other clients immensely when they started realizing that their constipation, that their gas and bloating, that their GERD, all of these had large implications, not just on their pelvic pain and their bladder issues, but in their whole body themselves. Joint issues, back issues, skin issues, autoimmunities that people weren’t talking about in those days, lots and lots of different things.
And, you know, so when people would say to me, oh, you can, you know, just start teaching, you know, when we’re going to send you some students, and it’s like, okay, that’s fine. Do they know what I do? They said, Well, we’re thinking that you could just teach them, you know, some stuff around urinary incontinence. Like the simple stuff. And I just like, just, you know, kind of like started laughing going, Oh, I used to be like that, too. There isn’t anything simple about anybody, you know, so it’s like, Okay, I’ll just teach them the systems approach, and we’ll move forward.
After I left LSU, we had the hurricane came through Katrina, and our best move was to exit. And so the professor ended up with a job in the Pittsburgh area. And so we moved up there. And I worked at a big payer company for a while, UPMC, and it was great. I learned a lot more. I was surrounded by other people who did the same type of work. We had clinicians in multiple centers and group meetings and lots of things. And I was able to create a residency program there people coming in post-university training to really, you know, get immersed into pelvic health and did that for a while and then finally decided one day that I really wanted to have my own clinic.
So Rebecca Meehan and I got together. We knew each other through UPMC very well and said it was time. So we wanted to do something very different. So we decided to open a concierge practice in a part of town that was going to give us the ability to unleash ourselves from the overburdening insurance companies and allow clients to choose what they wanted and how to pursue their own health. And for us to also hook up with a lot of integrative providers in the area. So it was an amazing journey, and we learned a lot. We learned a lot about business. We learned a lot about partnership. We learned a lot about really finding out what our clients want. During my time when I was co-owner of Embody, I spent a lot of time wondering why people weren’t getting better and wondering what I was doing.
And I was examining how I was doing things. And I switched from doing education to storytelling. That was one huge thing that I did. And then the other thing that I did was I started asking them at the end of the hour that they so generously wanted to have with me, what their take-home messages were. And that was probably the most frightening thing I’ve ever done in my career. Because the things that people said, I was like, Oh, my goodness. That’s what they’re walking out the door with. Where did I go wrong?
And then I, you know, so I it’s caused me to like, okay, but clearly got to do some other things. So I kind of delved into the world on motivational interviewing and coaching. And, you know, healthcare coaching and, you know, really started learning and working with how do you empower the client that it needs to, you know, intrinsic empowerment, which fit all the pain science stuff, enteroception and all the other pieces. And it was like, Oh, okay.
So I finally realized that what clients needed was to tell their story and really tell their story. And I needed to really sit and listen. And so I got a whiteboard. I got a lot of colored markers. And I just asked them to tell me everything. And as they did it, I would sit there with them. And we’d mark things down, the key words they would say, key pieces to the puzzle, a lot of different things. Eventually, I started handing them the whiteboard as they were telling their story so they could write their own stuff down.
But what came out of making a shift like that was I would have all of this information. We were able to triangulate it together, but what came out of it was, where do you want to start? What’s important to you? I know all of these. Well, I need to do everything. And it’s like, I get that. We can only start. We got to have a starting point. We’ve got to start somewhere. Where do you want it to be? But that kind of work there started the pathway towards turning the keys to the kingdom back over to them. And because from the very moment they walk in the door, the chairs were side by side, there wasn’t a chair in front of another chair. It was a partnership from the get-go. And it really helped because they learned in the very first time with me that they were going to be directing their care. My job was to help them keep the oars in the water. But they’re paddling the boat, they’re making the direction. quickly that a lot of things with pattern recognition, what I thought people needed and what they should be doing was not what they wanted at all.
When I let them really run the show, they really worked on like, this is the issue I’m having with trying to do the exercises. This is the issue I’m having with this. We were able to problem solve the obstacles and the barriers in their life towards their health care versus me being super prescriptive and handing them this and explaining to them over and over again why it was so important that they do it.
And the outcomes were so much better. But I will tell you, as a practitioner, the mantle of the burden, the mantle of burden on my shoulders was lifted because I no longer was attached to outcomes. I no longer was fixing anyone. And the myth, the perception of fixing people. And the most important thing of all was that I was having so much more fun I was empowered again as a clinician. My clients were empowered. And so when the professor retired, it was time to sell my portion of the practice to my lovely partner.
And then I opened up my business now, which is health and wellness coaching. And then I consult and work with other clinicians to empower them to become the best clinicians they can. And one of my missions is for healthcare workers to silence their inner critic, step out of imposter syndrome and become the healer they’ve always wanted to be. So my outward facing work is towards women at the pinnacle of their life, which is the years of menopause where we live decades, being seen, heard, and living the life that they really, really want to live.
22:37 Dr. Ginger Garner: Yeah, yeah. That’s such a learning journey, you know, you explain in so many points through each decade from the 70s forward, how much you were learning. And I think that’s probably, for whatever my opinion is worth, that to me is the most critical part of what keeps us alive and thriving is curiosity and continuing to learn and shift and say, hey, I can change my mind anytime. I can go left instead of right. I can go up the stairs or down the stairs. That’s what I’m hearing from all that.
Of course, your formative journey in helping us create the profession that we have now in pelvic health and how far it’s come. You guys who are listening, you all don’t know this, so I’m just telling you how great she is and how much influence she’s had on so many clinicians. You know, as a listener, what, what is your takeaway from, you know, listening to, Susan’s story? I know as a listener, mine is, is the point of curiosity. Mine is the point of, wanting to feel empowered when I walk into an office, which I just did this morning. Cause I, before we press record, I actually, physios need physio too. And so the right out of the gate this morning, I was in PT.
And when I walked in, you know, I want to feel that sense of empowerment. I want to be able to ask a question and lead the session into the direction of, you know, what’s most critically impacting me, which usually is driven by pain or dysfunction or something where you’re not able to do what you want. And so if you’re listening, I want you to go into your therapy appointments with that high expectation that that’s what you’re supposed to get. Because if you’re not and you feel like your therapist is a sage on the stage instead of God on the side, they’re missing something and you’re missing something. So that’s what I’m hearing out of your story.
My next question is about, you know, you’ve transitioned into this amazing kind of natural evolution that my evolution almost caused me to leave physical therapy because that’s kind of a similar feeling of just being absolutely burned out and not being able to give people what they wanted. And so I broke away from the quote system and into the integrative, you know, you took the integrative pathway a long time ago. And so there’s, I feel that, I feel that journey that you have been on because there’s such a great deal of value.
To be able to step back and kind of do a quote, kind of meta analysis, if you will, to get a little meta and step back and go, Well, gosh, I don’t like that. I don’t like the way that’s going, or I’ve changed my mind, and I want to do something different. And so for you, You’ve gone from, again, like I said, this wonderful evolution where you have the freedom and the ability and the insight and the wisdom to step back and go, this is the direction I need to go now to harness the energy for your best life. You mentioned that intersection. And there’s such an intersectionality between pelvic health, when pelvic health was kind of like the front side of things and not the colorectal back side of things.
And then, you know, I remember the first time that the gut microbiome, I was at a conference in Colorado, where I was teaching on voice and pelvic floor and just basic stuff that had to do with yoga. It was very yoga-driven. But anyway, someone was there. Her name was Dr. Sarah Gottfried. She is a functional medicine OB-GYN. She was there speaking at the same conference, and she presented research as well as another physician that her husband had done on the gut microbiome of neonates.
And how vaginal birth versus C-section and all those things, it blew me away. I had, that was brand new, right? So now here we are knowing that everyone’s heard gut microbiome, right? Everyone knows that things are connected and the stuff matters, but you know what? Not all practitioners are still recognizing that. Right. So that’s where the gaslighting comes in.
And I have a personal story that, you know, I’m telling you the story about way back in 14 years ago, when I first heard the phrase gut microbiome, and I was like, wow, that just blew all my hair off. I’m going to think about things differently now. Last year, I was in a physician’s office. And I said to them, I was just mentioning some of the symptoms I was having, to which they said, which I knew they were wrong, but, you know, you just want to hear what practitioners are going to say. Are they going to validate, you know, what we already know is true in the evidence base, which is pelvic pain and gut health are inextricably linked, right? They matter. They go together.
And so what I heard this physician say, and you already know what I’m going to say, is they said, and you can probably finish my sentence, all that got your gut health has nothing to do with, you know, gynecological health. And I was like, Oh, my God, I can’t believe I’m still hearing this. Right.
28:21 Susan Clinton: So that’s a shame, isn’t it? It really is.
28:24 Dr. Ginger Garner: And so I’m thinking if I know that it’s connected and I’m already like treating it. And anyway, long story short for y’all that don’t know the story, I went on to finally get a diagnosis of endometriosis like so many women do, like decades, decades, decades late. Just simply because every time something would happen, they’d find a valid thing, but they were never really looking for root cause. Anyway, long story short. That was just yet another mile marker on the road that drove me towards dedicating this whole podcast toward ending medical gaslighting.
Tell me about some of the stories, because I know you’ve got them. You’ve got a whole suitcase treasure trove of the way women are gaslight around gut health and their pelvic health.
29:18 Susan Clinton: So yeah, there’s a lot in there. And your story is very powerful. Just to piggyback on to the ending thing that you said was that my integrative work and the way that I changed my practice and the way that I kept growing as a clinician, you talked a lot about patriarchy in your course that you did at Embody. And it was like, oh, that’s something I’m not really thinking about a lot here. You know, really digging into that a little bit more and top down. And I thought, I’m a really top down clinician wonder if what would happen if I really, I wasn’t as much as I thought I was, but I was. My conformational bias was I was a manual therapist as well. And Antony Lowe said to me one day, I wonder if what would happen, Susan, in his way that he talks, if you did a whole day of patient care and you didn’t touch anybody.
So it was like, OK, you’re on. But it really, it was good. It challenged my conformational bias that how much do I really need to put my hands on and how much do I really need to listen? So listening to stories is what we’re talking about and what we’re moving towards. One of the most distinct things that I think I’ve ever heard from, I mean, the largest intersection of group of people that I’ve ever heard that have the most similar stories, and there’s many, many, but this is the one that stands out the most, is women who feel like they have nothing to say because they have entered a certain age.
And they were probably, and still are, a big section of the most dismissed people I’ve ever seen in my life. One of the research things going down the GI rabbit hole, women more than men suffer from syndromes such as IBS and bloating and distention. They did a study, 89,000 American women, over 58% of them had these complaints. And out of those 58%, 49% would not speak to a healthcare provider about it. Wow, what does that tell us about what people are saying to them?
And the reasons that they gave was, you’re older, your system has slowed down, just eat less. you know, don’t worry about it. You’re older. I mean, they keep saying that you’re older, you’re older, you’re older. So I started asking people what the word menopause means to them. And it doesn’t have any kind of a happy connotation. It just doesn’t. First of all, the word pause is a problem because that’s the, you know, that’s the stem of the word. And, you know, so to, you know, it’s like pausing from what, you know, it’s not a pause. It’s a transition. Yes.
But they don’t understand that they’re going to live decades in this wonderful world of reproductive you know, not needing to be, you know, I call it reproductive freedom in a way.
32:43 Susan Clinton: That’s what I was about to say.
32:45 Dr. Ginger Garner: They’re no longer having the physiology for reproducing. It’s no longer part of their life. They’re free. Right. It’s a wonderful part of life. But it’s not. We lived without estrogen before. We can live without it again. Yeah, you know. It just takes the transition to do it. And so, I would love to see, I call it crossing the fiery bridge. Because we have to have a physical or a physiological transformation in order to wake us up and move us forward to become the spiritual people that we were meant to be on this earth.
We can’t have that if we don’t shed the other part. And so, but we don’t, but here’s the thing. We need to shed the other part, but we don’t need to be miserable because of it. Right? You don’t need to be told, “oh you know just drink a glass of wine, it’ll be fine.” We don’t need to be told that you know, “just stop eating sugar, you know.” “Hey you know don’t worry everybody goes through it you’ll get over it.”
Dr. Ginger Garner: There’s a big part of the history. And I think that to go back to that stat for a second, that half of the half wouldn’t speak to their doc about it. I was just listening to a colleague who has her PhD in women’s studies, specifically looking at women’s health and the history of women’s health in the US. And I think part of the reason is that there’s this genetic, epigenetic ingraining social conditioning that has us believing that we only have value if we’re fertile.
And the fertility of women really, a lot of endometriosis care was based on that, just fertility, just managing fertility. And without that fertility, then you didn’t even need any treatment for endo anymore, which we know is not true. So I think that that shedding that you’re talking about, that crossing the fiery bridge, we actually have to take off that coat that was put on us the day that we were born. That, oh, you have such value, you’re beautiful, you’re et cetera, et cetera, et cetera, until… menopause until you’re not fertile anymore. And then you’re, it’s, you’re paused, you’re discarded it, there’s no value anymore.
So if we just say, if we just call, we can swear on this podcast, by the way, if we just say bullshit to that, right. And just shed the social conditioning, which is easier said than done. I think that’s a first step to know that, no, you have value, you have a voice, when you’re crossing that bridge, that there’s so much health and vibrancy there that has historically, we’ve been fed a big fat lie that it doesn’t exist. That you’re supposed to have the aches and the pains and the leakage and all the stuff when actually, no, you don’t have to have that.
35:53 Susan Clinton: Yeah, and I know a lot of people have talked about generational trauma, Yes. And I think that there’s, in certain sectors, there’s a ton of generational trauma, because it’s not only been our grandmothers, it was our grandmother’s grandmothers, and our grandmother’s, grandmothers before then, and grandmother’s, grandmothers before then. And forget it if you are a minority.
36:16 Dr. Ginger Garner: Yes, absolutely.
36:16 Susan Clinton: And it was not only those stories, but the trauma that was induced upon women in the name of learning, and whatever other names we wanted to give it. You know, so it’s, it’s so much. But the thing is, is that I think the term becomes like, almost like the expected, it’s time for me to suffer. What? Like, we don’t need to suffer. We need to and we don’t need to be silent. This is the thing when people I hear this all the time, and I’ve experienced it.
But when people say to me, well, they’re not going to really listen. And it’s like, then we need to be effing louder. That’s right. We need to stop saying, well, they’re not going to hear me anyway, so I’m just going to be quiet. No, we need to cut the volume and get nasty loud about it.
37:08 Dr. Ginger Garner: Right, and that there are clinicians, and we’re sitting here as two clinicians, but also as women who’ve been through it, to say, nope, there are clinicians that care. There are clinicians that are going to help you with the evidence base that’s out there that aren’t going to dismiss your gut health symptoms because they are related to what else is going on in your pelvis. So I think that’s a big message of hope for you guys, for all of us, really, is that, yes, there is evidence, there is science, there are clinicians, there are people to help. And that’s what we’re here for. That’s what we’re talking about.
37:44 Susan Clinton: Right. And some of this stuff is so simple. This is what I’d love for everybody out there to really, really understand. You don’t need fancy, fancy, fancy things all the time. If we can just really look. So to me, the idea of being on the, I call it the pinnacle of your life. I don’t like to call it menopause anymore because nobody likes that word. So get rid of it.
But when you’re standing on the pinnacle of your own life, you have the ability to illuminate the corners and the crevices. So you can make some changes that can be very, very, very powerful. And some of them may be something very simple, but maybe I need to just take 10 minutes to meditate every day or to do whatever spiritual practice I need. We do something like that consistently every day. We have good evidence to show that our heart rate variability improves, which means our general health improves.
38:40 Dr. Ginger Garner: Pain increases, sleep improves, yep.
38:45 Susan Clinton: And if we can look at our circadian rhythms and get some sunshine in our eyeballs in the morning, we’re going to have a bit of a better sleep at night. You know, we can turn a fan on at our desk. We don’t have to suffer and be hot.
39:01 Dr. Ginger Garner: There’s a lot of- I have a giant fan next to my bed.
39:04 Susan Clinton: Exactly. We need to normalize this. We need to say that this is what’s expected, that this kind of self-care is not only expected, it’s demanded. And it’s going to come from us. So I’m partnering with everybody out there that I will help, I will do whatever I need to do to help us keep moving the message forward. Because this is an absolutely amazing time of your life where you can live for decades. And listen, some women enter this time way before their time. And I reach out to all of you to know that you are not dismissed because you no longer have the organs to be fertile. You know, for whatever reason.
39:50 Dr. Ginger Garner: I’m going to take that message personally, because I was one of those women to undergo that far earlier than I should have, in part because of mismanagement, medical mismanagement. That just, that’s devastating. I think any woman who goes through a surgical menopause, especially when it was unnecessary, It’s a, I don’t know that there’s a word that we could like adequately describe that feeling and what it does.
40:20 Susan Clinton: But it’s sudden, it’s brutal, and it needs care completely. The entire person needs care from the top to the bottom. And you talked a lot about the societal kind of blanket and the other pieces as well. But just to know that you don’t need to feel this way. There’s support. Yeah, there’s support and we need to, if you can’t find somebody who will support you, we will help you find somebody who will.
40:52 Dr. Ginger Garner: We will have that in the show notes, y’all. So just don’t forget to read those as well.
41:01 Susan Clinton: Well, the other thing to consider is that, okay, you know, the opportunity and gift of the pandemic, because there’s gift and opportunity in everything, The opportunity and gift of the pandemic is that we have broadened the world of being able to access advice, access care, access a lot of different things that we did not have possible before. And we can really keep pushing that forward.
So if you’re somewhere where you don’t have the kind of support that you want, we can help you get it. And there’s a lot of places that will work with people, you know, over telehealth and things, you know, to help them maintain and get the care that they need, and that they want so that they can feel their best. To still be this best person that they’re on this earth to be.
41:46 Dr. Ginger Garner: Yeah, absolutely. So let’s talk a little bit about some kind of take home clinical pearls, or what we call in continuing education, y’all, we call them clinical pearls. When you take home something that you’re like, I’m going to take that back into my practice, and be better. But I want to talk about clinical pearls in terms of what you guys can do now.
So, you know, if you there, obviously, it is inexcusable if you go to a practitioner for pelvic pain, and they tell you that the gut doesn’t matter. It’s wrong. So we’ve established that. And we can move on from that point. Yeah. Now, like, you know, what do we do specifically? What are what is the next step that someone can take when they are you know, a, there are resources for finding, you know, physical therapists, of course. Obviously, we’ll have links in the show notes for that. But are there some specific clinical pearls that people can take home right now that, you know, I think you and I having been through this whole process already can pick out a couple of the big kind of the symptoms that you would have related to gut health, what those are and what they can begin to think about, you know, their treatment options are because there are many there’s multifaceted.
42:59 Susan Clinton: Yeah. So, you know, the, the biggest, the biggest thing is constipation. Right. Everyone complains about it. We worry about it. I don’t have a bowel movement. I don’t feel good. Um, what can I do? I don’t, you know, so I’ll tell you there’s, there’s a few very easy things you can do that can start to right the ship with whether you just have constipation or whether you have constipation and belly pain.
The first thing, and it’s so easy is to chew your food as lovingly and as carefully and as holistically as you can possibly dream of. Which means turn off the news. Which means put your phone down. Which means, what’s your favorite music? Which means, what are you putting your food on? Are you eating food on a paper plate with a plastic fork because you’re in a hurry and don’t want to do the dishes? Or in the car. Yeah, pull out your China. Come on. China is not just for Easter. It’s for like, now.
But anyway, present, you know, make it make your food experience and experience again. And that and I get this out there. Everybody always asks me how many times does somebody chew and the answer is 40. But here’s the thing. No one’s going to count 40 chews. You will you will once maybe twice. Yeah, maybe a third time some other time, but you’re not going to do it. Yeah, not really relevant. So I just tell people, here’s the thing, slow it down, and here’s how you slow it down. Put your fork down with every bite you take. Or put your hand down with every sandwich bite you take. Put your soup bowl, that’s the spoon, down with every bite you take. And be aware, just be aware of that. So again, it’s just being a little mindfulness on eating.
But when we slow, and here’s the reason why, when we slow down and we chew our food and we slow it down like this, like just even the pausing, you know, food in mouth, fork on plate, you know, this is something you can teach your kids too. But when we do that and we slow it down, we actually are able to get the right kinds of enzymes from our saliva to start going down to the stomach. And when that happens, we get the stomach to be able to turn on the acid pumps and actually pulverize the food so that when it enters the small intestine, it’s in the shape to do it.
And it also, when we eat slower, we actually can turn the GI system on lower because we have a reflex that tells us when we stretch our stomach, it tells everything down below that there’s something incoming coming in. So it’s easier to go and move your system after a meal. So that’s like the number one thing, you know, everybody’s always thinking about what can I do down below?
And to me, it’s like, start at the top, start at the top. Start at the top to your food and eat in such a way again, that just eat and really enjoy every bite. You know, then you’re now, this is what makes this so lovely. You’re getting a mindfulness practice in, you’re optimizing your physiology for your whole GI system. And you’re also increasing your opportunity to get those happy love hormones coming because you’re doing it with gratitude.
And, you know, so, and then it’s kind of a training thing. If you’ve got a family, like during this time, we, the nothing, comes in here. This is our time to break bread together. You know, not to break knives together, to break bread together.
46:50 Dr. Ginger Garner: And then you can also think about the carryover between, uh, the most important, um, moment of the week from a psychology side. So if we’re talking about psych informed physical therapy and physiotherapy and pelvic health is that for, um, in psychotherapy, the most important moment of the week for your children and teenagers is a meal. Right. And we have the opportunity to improve their mental health. as well as their physiology just by setting that time aside. And I’m guilty of if I’m coming in between patients and a lunch, I’ll do what a lot of us will do as clinicians, right? What we shouldn’t do. I’ll answer a few emails and take a bite of my food and answer a few emails, or I’ll read this new paper that’s out while I’m eating my lunch, you know? So just there’s a message in here for everyone.
47:43 Susan Clinton: The second thing that’s so easy to do that everybody can access is some of the newest literature we have out about blood sugar regulation. And so we’re talking about being in the pinnacle of your life means, you know, really making sure we have good metabolic health. And the best way to fight GI issues is to regulate your blood sugar. It makes a difference.
48:12 Dr. Ginger Garner: Yeah. And your hormone health.
48:14 Susan Clinton: For sure. Like for your night sweats and hot flashes and things like that, they go on. Yeah. So how can I do this? Pick one meal, but usually it works the best after the evening meal. And after you eat, take a five to seven minute walk. That’s all you need to do. If you want to walk longer, fantastic. You know, there’s something about an evening constitutional.
48:40 Dr. Ginger Garner: Yes, I love that phrase.
48:43 Susan Clinton: Because it helps them move their bowels better. Yeah, I love that phrase. And my dog, who is actually sleeping on the sofa next to me right now, she needs her evening constitutional too. Yes. And there’s really multiple levels of benefit to that.
48:59 Susan Clinton: So if the weather’s bad, I live in the Upper Peninsula of Michigan on the Canadian border. The weather, so I get it. the weather’s bad, it doesn’t take anything to walk five minutes in your house. Yeah, that’s true. You know, most of you are already wearing some sort of wearable anyway, counting your steps. True. Just five to seven minutes after a meal really keeps the blood sugar from spiking and makes your sleep better. When we sleep better, we actually get better digestion. Yeah.
So here’s the third thing you can do for your GI. And you notice none of this is about food, about what I should eat or any of that stuff. You know, that always comes later. But the third thing that you can do is improve your deep sleep. And the best and most simple way to improve your deep sleep is optimize going to bed between 10pm and before 1 a.m. I used to say two, but you really need to get to bed before midnight.
And the reason being the circadian rhythms, whatever growth hormone we have left, which we still have, will drop in, but that’s one of the big precursors to having a much better, deeper sleep. And when we have a deeper sleep, we have much better organ function and digestion. So as much as it’s fun to watch that second or third binge show on Netflix, I don’t care because I don’t have to get up in the morning with little kids anymore or whatever it may be. You really should, you know, optimize your sleep by getting your eyes closed before midnight.
50:36 Dr. Ginger Garner: Absolutely.
50:37 Susan Clinton: People who are younger with younger kids, get them to bed and get yourself to bed. Even if you have to get up in the middle of the night, optimize that sleep between 10 and two so that if nothing else, you get four hours. you’re going to get some good deep sleep in those four hours. And that’s going to help along the way quite a bit.
50:55 Dr. Ginger Garner: Yeah. And I will tell you, I’ll tell you guys, particularly with the last one, but all three of them, all three of the tips. If I, when I used to put the kids to bed when they were little and they’re not anymore, now they’re staying up past me when they shouldn’t be. I would put the kids to bed, and in effect, I was sleepy by the time I put them to bed, because it’s an exhausting process to get young children to bed. I would actually just go straight to bed myself, and that gave me the seven to nine hour solid that I would need, unless they were really small and getting up. But that is the critical piece. If we can all get that good night’s rest, and you wake up feeling like you can, instead of like, I can’t do this today.
51:39 Susan Clinton: Yes. Right, because if we don’t sleep, we don’t get a rise of the hormone that we need to think. And that’s called serotonin. Whether you know that or not doesn’t matter. You need your thinking hormone, the one that helps you make good choices and, and like solves problems for you. When we’re exhausted, we eat more, we eat more food that’s fast and quick and processed that we all know. I don’t preach any of that, you know, because our brain simply needs the sugar.
So we have to take care of our brain if we’re going to take care of our gut, because a happy brain is a happy gut. A happy gut is a happy brain. It goes both ways. So those are the if you want three simple things to do, you start putting those into your life consistently. Message me and tell me how much better things are in a month, but it’s got to be consistent. So yes, pick one, pick one and just really put it in and get it going. Then you can pick the next one and then you can grab the next one. Awesome.
52:42 Dr. Ginger Garner: Thank you so much. You’re so welcome much for being on today. Tell everybody how they can find you. And we will also put it in the show notes.
52:52 Susan Clinton: Sure. You can find me. You can email me Susan@ltiphysio.com. LTI is learn, think, innovate. My website is LTIphysio.com. So it’s all pretty easy to do. I’m available for consultations. I’m available for, for coaching. My coaching practices for, um, is for women. who are crossing and have crossed the fiery bridge, standing on the pinnacle of their life. So happy to help in any way. You can find me on Instagram and LinkedIn @sclintonpt.
53:30 Dr. Ginger Garner: Thank you. Mm hmm. Thank you again, Dr. Clinton for joining us today. And I cannot wait till the next time that I see you in person. I know we just saw each other at our annual PT meeting, which we call CSM. And one more clarity point because you mentioned the professor twice, but I don’t think most of our listeners know who that professor is.
53:53 Susan Clinton: That is your professor is my husband. He’s my he’s he was he was my second choice. Which I chose wisely the second time around. But yeah, he’s my husband and has been my partner since my time. I met him in new Orleans and we married in new Orleans before we left and moved to Pittsburgh and then to Michigan.
54:17 . Ginger Garner: So, yeah. All right. Now that we’ve cleared that up. All right. Y’all can go on with your mindful day of eating and get a good night’s rest tonight. Thank you again.
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