Dr. Amy (Loden) Tiffany: How Pregnancy Complications Inspired a New Career Path

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Hello, today I have with me Dr Amy Loden.

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Dr Loden is the mother of four, a board certified physician specializing in internal medicine and lifestyle medicine, and a board certified health and life coach.

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Dr Loden is here today to share her birth story.

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You can connect with Dr Loden at VitalityMWCcom.

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Dr Loden, welcome and thank you for joining me.

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Hi Kelly, Thanks for having me.

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It's so good to be here.

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Yeah, it's good to see you again.

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I think it's been like 15 years.

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Nice.

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Let's not advertise that too loudly, don't forget about that.

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Yeah, it was just yesterday, oh, but it is good to see you and to catch up, and I really appreciate you inviting me here today to talk about birthing stories and the trauma that sometimes we carry with us emotionally or the fears we may have going into a birth that hasn't happened yet.

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Yeah, absolutely, and I'm sure you have a lot of insight.

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Sadly I do.

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My birth stories started with my daughter, who's now 10, and she really.

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The pregnancy was fairly uncomplicated I was working in the hospital full time, no real concerns, and what ended up happening was I had gestational diabetes and woke up one day and my glucose was 40, which is very bad, and we couldn't figure out why it was so low.

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It turns out my placenta was failing, so first it had caused resistance to glucose and so my insulin levels were more higher than they needed to be.

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But then what ended up happening?

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Is it failed?

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And when it failed, there was concern that is it going to stop having blood flow to the baby?

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So, of course, then I'm admitted immediately, and there's all the drama about oh my gosh, the baby's not supposed to be here for two more weeks and in the scope of things, coming two weeks early is not that big of a deal anymore, but it was certainly not what I had emotionally planned for.

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So I'm admitted on a Friday night, no big deal.

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Well, actually I was really scared.

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I was like I don't know what's going to happen.

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Even though I'm a doctor, I know what happens.

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I know part A has to come out of part B, but this is really scary.

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So we go in and Saturday, nothing's happening.

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I'm literally sitting on a whatever those bouncy balls are in the hospital to help you burn and my pitocin's like at the max dose and I'm feeling nothing.

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Nothing Like this is not good.

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So that was all day Saturday.

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All day Sunday.

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My mom finally flies in from rural Missouri where she's been I'm living in New York City at the time and she flies in.

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I'm like, yeah, this is day four and I have nothing and I'm supposedly having this child that has no placenta working.

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This is not good.

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So my anxiety level had been through the roof by that time.

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I hadn't slept for three days because in the hospital you just don't sleep, and the food sucked and then they would let me eat and I was like I'm going to become this horrible person if you don't like, either take this baby out of me or something.

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So they said fine, we're going to just try breaking your water, seeing how that helps.

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Well, that did make some contractions happen.

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That was a very nice awakening to what contractions felt like and that was probably the most horrible six hours of my life, until I figured out that epidurals might be necessary and epidurals are okay and you're not a terrible person if you use an epidural.

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Which was really, for me, startling, because, even though I was a doctor and even though I knew all these medical things, I really went into the birth experience thinking I'm not going to eat an epidural, I'm going to do this naturally, like I've got this right.

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Like when that water broke I was like, oh no, no, no, no, this is not working.

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So I'm doing the breathing, we're doing fine, they finally get the epidural.

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And then I started having a pain I shouldn't have had, despite having an epidural.

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I was like there is something wrong.

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And the doctor's like, oh no, no, you're doing great.

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And I was like there is something wrong.

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I don't know what's wrong with.

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There's something wrong.

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My mom's there, she's like you're fine, just listen to the doctor, right?

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My husband's saying the same thing and I'm in tears because I haven't eaten, I've sleep deprived, I'm in pain and I know something is wrong.

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I'm not sure enough.

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Something was wrong.

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So, instead of my daughter trying to come out like a normal child with her head, she came out with her elbow.

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You're not supposed to do that.

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And so I thought, oh my gosh, what am I going to do.

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And so I'm looking at the OB and I was like, can you promise me that my child is going to have a normal arm, no shoulder dystocia, if I let you deliver her vaginal Cause?

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They're like ready to go.

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And I was like, no, you promise me this can happen or we're doing a C-section.

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So I ended up with a C-section.

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It ended up being that the chief resident actually had to push my daughter back in through the vaginal canal while the OB pulled her out from the uterus.

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It was not cool.

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And then, whether it was me, whether it was the event, I don't know I couldn't connect with her, like I could not emotionally bond with my child.

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I had looked forward to this child, I had everything ready for her, I was ready to have, you know, be the mom of the year.

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And I just looked at her.

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I was like I don't feel anything for my baby.

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This is not normal.

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I was trying to breastfeed, couldn't get it.

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It just wasn't connecting, struggled with that, went home, continued to struggle with it.

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Pediatricians telling me, you know, formula is not poison.

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I'm like breast is best, you know.

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Trying to do everything we learned in medical school and feeling like a total failure and at the end of the time it ended up that for her breast was at best.

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She didn't like breastfeeding, I didn't like breastfeeding, and we ended up she's a wonderful, developed child now.

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She's everything I wanted my daughter to be, and more right.

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And there was so much in those moments, so much emotion, so much focus, that the bigger picture got lost.

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And the bigger picture was you know, healthcare doesn't always do what we think it's gonna do, but they're gonna do their best to take care of you and your doctors and your nurses.

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They may make mistakes.

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My doctor was wrong, there was something in my body that was not going right, right, and we knew this finally.

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And then she was flat wrong.

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But at the end of the day, I kept advocating for myself and I kept saying that listen to me.

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And the nurses listened to me.

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The doctors finally started listening.

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You would think a doctor listens to a doctor, right, but no, it didn't work for me.

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Maybe I did something wrong, but it just didn't work.

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And you know, I think there's a lot of commonality in that and what I've heard from other moms.

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So I'm like cool, well, I'm gonna have, you know, a great daughter.

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I probably need a son to even out the balance.

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So a year later, you know, her first birthday, my husband was like hey, you wanna have another one.

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I'm like sure let's do this again, it'll be easy.

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No, I had gestational diabetes again.

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More severe was on massive doses of insulin.

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Mind you, my body weight was totally normal at the time, which, as an internal medicine doctor, I like this is my bread and butter.

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This is what we do and it was maddening to have this diabetes be so out of control when this is what I treat.

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And then the next thing, I know, you know I'm 30 weeks pregnant and they're like your baby's not moving.

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And that is the last thing you wanna hear when you go on for an ultrasound Like we hear a heartbeat, the heartbeat's time, that the baby's not moving.

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They're like this sometimes happens with gestational diabetes.

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So I'm admitted to the hospital.

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They do this whole workup.

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They're like your blood pressure's 210 over 140.

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I'm like is that even real?

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Like people pre-measure this, you know.

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So my doctor mind is like freaking out and telling them that they don't know what they're doing to use the right technique because they're not measuring blood pressure correctly, and like I'm schooling them in my neurosis of instability here.

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And at the end of the day, my blood pressure was high, so I got pulled out of work and I was told to sit on bed rest, which I did for eight weeks.

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I understand that bed rest is debatable.

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I understand that there's lots of differences.

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That's what we chose and it worked out.

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My son was born.

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He's a wonderful human being and super happy to have him Fast forward four years and, for whatever reason, my brain is like huh, wouldn't it be nice to have a third kid?

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Just one more why why, why.

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And so my husband's like looking at me, like, seriously, how are we doing this again?

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I was like, okay, well, let's just do this, let's try IVF, because now I'm like 35.

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Let's just try it.

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We have benefits right now.

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I'm gonna leave this institution.

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I won't have benefits If we just we don't wanna do it, we don't have to, so we do.

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We ended up having three embryos, and IVF is a whole another story.

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Right, like that world is its own world.

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Craziness, ignoring that.

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And we go in for our first appointment after the embryo transfer and you know you're in there and they've got the window shades drawn for privacy and your husband's standing behind you and they insert the speculum to put in the ultrasound one right, and the tech.

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I still am mad at her about this.

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But she says, oh, this is not good, like first ultrasound.

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She tells me, oh, this is not good and that was like the absolute wrong thing to say to any mother.

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But you just don't say that, right.

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So I was like, okay, what Cause?

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I thought I was dealing with a dead baby.

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I mean, I really thought when she said that there was, we didn't have a viable pregnancy.

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And she's like this is gonna take a lot longer than I planned.

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I was like because why?

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And she's like you're having twins, what, we have a tentacle voice.

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It's like you gotta be kidding me, right?

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So like, if there's bad luck in pregnancy, I am going to have it.

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So, by the way, I love my boys.

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They're wonderful.

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But yes, that was.

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I just have never really forgiven her.

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I hold grudges for a long time and I have never forgiven her for that cause.

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I really thought I was dealing with a dead baby.

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So pregnancy's fine, at this point I've just accepted I'm gonna have gestational diabetes, right, like, this is my life.

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So I tell my doctor you're not allowed to manage my diabetes.

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I'm a doctor that deals with this.

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I'm doing this and I'm gonna do it my own way, which I did.

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I don't recommend that.

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That is a terrible plan, but I did it.

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And later in pregnancy, about 25 weeks or so, I started getting weird feelings.

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Something wasn't right.

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I couldn't really place it.

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It was an emotion.

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It was like this mental feeling, something's not right and, as a very driven type A woman, like we all, know that I'm gonna have anxiety.

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So I'm blowing this off right.

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I'm thinking, I'm just amped up about this.

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I've got two kids, I'm just getting closer and you know it's the end of second trimester and I'm just starting to worry in it and I need to just calm down.

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So for three or four weeks I tried to do this.

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By the way, I was working in an OB office at the time this happened.

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So it just like right, you can't get any more craziness.

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And about when was it?

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It was 31 weeks.

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I had just made 31 weeks and my leg really started hurting and I was like what the heck is going on with?

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my leg Go home that weekend.

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I'm relaxing Friday night I tell my husband my leg really hurts, I can't get up.

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He's like what do you mean?

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You can't get up?

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So I was like okay, just hear me out.

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I'm just gonna go to bed and see how it feels tomorrow.

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Well, tomorrow didn't change.

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I sat there all day Saturday.

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It's like my leg is killing me.

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It's like my entire.

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I couldn't even specify.

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Is it my muscle?

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Is it the joint?

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I have no idea.

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And so I was like, just we're gonna have to get checked out.

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Like it's been 24 hours Saturday night.

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Call your mom who lives an hour away.

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Have her come in and be with the two and the four year old, right, or I guess there are four and six at that time.

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But we gotta go in.

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This is not cool.

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So I go in and like, yeah, we don't know what's wrong with your leg, but your blood pressure is 210 over 150.

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Like, are you kidding me?

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We're not doing this again.

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So they're like we're gonna admit you because your baby is at least viable, your baby is plural and you know we should check out your blood pressure.

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So fine, admit me, I don't care.

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Give me something for my pain, let me sleep and I'm going home tomorrow.

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Fast forward 12 hours and they're like you're not going home until your babies are delivered because you have preeclampsia.

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Congratulations, are you kidding me?

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Like I have patients to see on Monday.

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I will go home, get my schedule fixed.

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I'll be back in a week.

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They're like no, you're not leaving the hospital.

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So that did not help my blood pressure.

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The fact that I was separated from my four and my six year old, who slept with me every night, don't judge me, but they did, and this was not the life I had planned for this pregnancy.

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And all the while, like my other two babies, I can feel them moving and they're doing fine.

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So I'm like, I can feel them moving.

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I don't have bad preeclampsia.

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Send me home, I promise I'll take my blood pressure.

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Like are you out of your ever loving mind?

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You're not going anywhere.

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So it's still so.

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I'm 31 weeks pregnant and still in the antifornum unit.

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And there is I'm 31 weeks pregnant.

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They're like yeah, you're gonna be here for at least three weeks.

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We're hoping for six.

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Like what, I can't do this.

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This is not an option.

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And that was now Sunday.

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It's like okay, fine, then they really turned up the heat.

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They're like oh, by the way, we have to do ultrasound checks on your babies every few hours, every single day, until you deliver.

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No, so it doesn't help my story at all.

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I suppose that I totally blame the residents for this next part.

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And residents, you know I love them, I was one but I really think that they screwed this part up.

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I told them I don't know what happened, but my water broke and they're like, no, it didn't.

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It's like yes, it did.

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There's water draining out of my body, like oh, you're just peeing, like no, I'm an educated person, and even if I wasn't, I know the difference between pee and something else.

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My water broke, no, no, no, that couldn't be.

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I was like, well, you're doing these dadgum ultrasounds every six hours anyway, so just put the damn probe on and look and see Did the water break or not?

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Well, sure enough, one of the babies has no water around it.

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So now we've got a pre-reducer rupture of membrane on top of pre-eclampsia and my blood pressure kept going higher and higher because it was so far out of my control.

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Everything in my life up until that point I had complete control over in the hospital.

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You have, don't?

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You don't have control, even when you advocate for yourself.

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It is the most vulnerable a person could be, in my opinion.

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So by Thursday night, if I thought I was psychotic after my first kid, with no sleep by Thursday night with the twins.

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It was awful talking to some of the people in retrospect who talked to me.

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They're like you didn't make any sense the stuff you were saying and everyone was like, well, it's the magnesium, it's this, it's that the other.

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Frankly, I think it's sleep deprivation, but you know, I'm not a real doctor, I'm not an OB, so what do I know?

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Right?

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And you're not supposed to be an internal medicine doctor arguing with an OB.

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By the way, I learned that.

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So, thursday night, and not feeling right, I'm struggling to breathe.

00:13:59.174 --> 00:14:06.284
I can't walk across my hospital room without shortness of breath and I'm talking to my mom and my sister.

00:14:06.284 --> 00:14:15.619
They're five hours away and at the time we didn't know it, but they both looked at each other after we got off the phone and said we need to go up there, something is wrong.

00:14:15.619 --> 00:14:18.306
So they're driving up this and I don't know this.

00:14:18.306 --> 00:14:21.538
They walk in and they're like Something's really wrong with you.

00:14:21.538 --> 00:14:25.178
I was like, yeah, I know it's, I'm in the hospital, that's what's wrong with me.

00:14:25.178 --> 00:14:27.889
These people are like not letting me treat this as an outpatient.

00:14:27.889 --> 00:14:29.235
I could take these medicines at home.

00:14:29.235 --> 00:14:29.716
This is.

00:14:29.716 --> 00:14:31.160
I'm not even on an IV medicine.

00:14:31.160 --> 00:14:32.684
There's no reason be help, right?

00:14:32.684 --> 00:14:37.682
So Again, I lost that argument and I'm not very good at arguments.

00:14:37.722 --> 00:14:42.455
It might seem the OB says well, listen, I don't know why you're short of breath, but it's probably just because you're pregnant.

00:14:42.455 --> 00:14:46.282
I was like no, please stop saying that, please get me another doctor.

00:14:46.282 --> 00:14:48.506
And I actually demanded that.

00:14:48.506 --> 00:14:49.908
It's like you're all fired.

00:14:49.908 --> 00:14:51.500
Something is not right here.

00:14:51.500 --> 00:14:52.485
You're not listening to me.

00:14:52.485 --> 00:14:54.283
You're telling me I'm peeing across the room.

00:14:54.323 --> 00:14:58.240
When I'm walking across the room because I have a broken water, they get me the high-risk OB's.

00:14:58.240 --> 00:15:00.446
The high-risk OB's look over everything.

00:15:00.446 --> 00:15:04.506
They're like you know why don't we just get a heart ultrasound and make sure that there's no problem with your heart?

00:15:04.506 --> 00:15:09.095
Well, you know the file, my story is gonna end right like this is obviously gonna be a problem.

00:15:09.095 --> 00:15:13.750
So I have heart failure, my heart is not working like.

00:15:13.750 --> 00:15:14.774
That is why I can't breathe.

00:15:14.774 --> 00:15:17.682
It's not a blood clot, it's not any of these other things that you know.

00:15:17.682 --> 00:15:18.825
Supposedly I was gonna have.

00:15:18.825 --> 00:15:22.315
No, my heart Just not beating like that might be a problem.

00:15:22.655 --> 00:15:28.210
So that one they got my attention with the high-risk OB comes in and she's like you have to go the operating room.

00:15:28.210 --> 00:15:30.240
It's like no, no, give me some LASIKs.

00:15:30.240 --> 00:15:31.101
I'm a medicine doctor.

00:15:31.101 --> 00:15:31.702
This is what I do.

00:15:31.702 --> 00:15:33.587
Just give me some LASIKs, I'll be fine.

00:15:33.587 --> 00:15:36.908
We're gonna keep these little kids cooking until it's longer alone.

00:15:36.908 --> 00:15:40.083
She's like that's fine, we can give you some LASIKs.

00:15:40.083 --> 00:15:55.154
But here's how it's gonna play out either I'm gonna take you to the operating room tonight and we're gonna have these babies and we might give you some LASIKs afterwards to Help you breathe, or I'm gonna wait 24 hours and I'm gonna intubate you because you won't be able to breathe your lungs are so full of water and then I'm gonna take you to the operating room and do the same thing.

00:15:55.235 --> 00:15:57.475
So the question is do you want to hold your babies tonight or not?

00:15:57.475 --> 00:16:02.423
I was like well, you don't give me very many choices here, do you?

00:16:02.423 --> 00:16:11.072
So I went to the operating room that night and you know, looking at the pictures it was, I didn't think they were gonna survive.

00:16:11.072 --> 00:16:12.370
They came out they were blue.

00:16:12.370 --> 00:16:14.792
Turns out that's what they're supposed to be at 31 weeks.

00:16:14.792 --> 00:16:16.948
But it's a not OB doctor, I didn't remember that.

00:16:17.644 --> 00:16:26.414
And so they're in these look with like turkey-basting bags, right, trying to keep their body heat warm, and like I'm just convinced I've killed my voice, right.

00:16:26.414 --> 00:16:28.373
I am laying there on the operating table.

00:16:28.373 --> 00:16:32.874
I'm hearing them intubate these babies, I'm hearing them hook them up to all these machines.

00:16:32.874 --> 00:16:39.173
I'm hearing the you know these comments in a mind that sleep deprived on magnesium, right.

00:16:39.173 --> 00:16:43.851
So everything seems worse, doesn't feel right and isn't taken in context.

00:16:43.851 --> 00:16:46.712
And I just start sobbing on the operating table.

00:16:46.712 --> 00:16:56.168
I'm like I can't breathe because I'm crying so hard and I'm laying down and my heart's failing and it's like I killed my voice, I killed my babies and my husband.

00:16:56.168 --> 00:17:00.211
He was like you just need to calm down and it's gonna be okay.

00:17:00.404 --> 00:17:06.612
I'm like I'm gonna punch you, except my hands are tied down to the operating table, so I can't reach up here and punch you in the nose.

00:17:06.612 --> 00:17:08.991
Don't tell me it's gonna be okay.

00:17:08.991 --> 00:17:10.309
Go with one of our kids.

00:17:10.309 --> 00:17:15.275
I sent my mom with the other kids, so finally get back to the room and I don't have my babies.

00:17:15.275 --> 00:17:17.351
The pain medicine's making me loopy.

00:17:17.351 --> 00:17:19.590
On top of all this, somebody just give me some chocolate ice cream, right?

00:17:19.590 --> 00:17:20.788
That'll fix everything.

00:17:20.788 --> 00:17:43.214
So I have eight like six things of chocolate ice cream, just so that I could get to the next place mentally, which ended up being that I could go see my boys and I was able to hold them and they were able to respond to me, and the short end of it is that they came out fine, but they spent 11 weeks in the NICU and it was emotionally traumatizing.

00:17:43.214 --> 00:17:44.829
It was mentally overwhelming.

00:17:44.829 --> 00:17:50.907
I don't know very many women who did this, but the way I coped with it is I went back to work after two weeks.

00:17:50.907 --> 00:17:56.990
I couldn't deal with being with them all day, it was too much, and so I went back to work.

00:17:56.990 --> 00:17:58.471
It's like I feel control here.

00:17:58.471 --> 00:17:59.690
I know what I'm doing here.

00:17:59.690 --> 00:18:02.173
I can make a difference here, but I can't help my boys.

00:18:02.173 --> 00:18:10.554
And so I think, when I look back on all these different stories, it's apparent to me that, were these things gonna happen, no matter what?

00:18:10.554 --> 00:18:13.772
Yes, am I fortunate that it happened to me as a doctor?

00:18:13.772 --> 00:18:26.311
Actually, I think it was, because now my entire career is focused on how do we prevent disease, how do we help moms that are going to become pregnant or who had pregnancy complications reduce their risks, and it really opened my eyes a lot.

00:18:26.684 --> 00:18:31.291
After my first pregnancy, I said to my OB okay, what do I need to do so that I don't get diabetes?

00:18:31.291 --> 00:18:33.569
And she looked at me and she says you delivered the baby, you're done.

00:18:33.569 --> 00:18:38.851
And so then I was like okay, I know that's not right, because I'm a medicine doctor, right, we know these women are at higher risk.

00:18:38.851 --> 00:18:44.769
We know that within five years of a pregnancy, that half these women are gonna have type two diabetes who had gestational diabetes.

00:18:44.769 --> 00:18:56.749
So I go to my internist, who doesn't do anything with women's health and this is in New York City, at one of the most elite academic institutions in the country and I asked him okay, what do I need to do so that I don't have type two diabetes?

00:18:56.749 --> 00:18:59.507
And he looks at me and he's like well, you're not pregnant anymore, you'll be fine.

00:18:59.507 --> 00:19:01.288
Are you kidding me?

00:19:01.288 --> 00:19:05.030
And then I just started paying more attention to what my patients were telling me.

00:19:05.030 --> 00:19:09.111
They were hearing the same stories Like this is not acceptable.

00:19:09.111 --> 00:19:10.207
This is not.

00:19:10.207 --> 00:19:12.173
This is a first world country.

00:19:12.173 --> 00:19:14.972
We have the resources to help these moms.

00:19:14.972 --> 00:19:16.751
We know what they need to do differently.

00:19:16.751 --> 00:19:20.490
Their pregnancy has unmasked a problem and it is time to do something about it.

00:19:20.490 --> 00:19:39.035
So gestational diabetes I started paying a ton more attention to After the twins were born and the whole preeclampsia thing and I realized, wow, there's a whole different side of this too, which is that women who have preeclampsia are at four times higher risk of dying from heart disease before they age of 60, just from that one risk factor.

00:19:39.505 --> 00:19:42.790
You add to it any multiple pregnancies that have more than one risk factor.

00:19:42.790 --> 00:19:44.832
So high blood pressure and pregnancy.

00:19:44.832 --> 00:19:50.894
During my second one, gestational diabetes and all three I realized I'm a really high risk of dying before I'm 60.

00:19:50.894 --> 00:19:53.392
And I don't have traditional risk factors.

00:19:53.392 --> 00:19:57.211
I don't smoke, I'm active, I eat a fairly stable diet.

00:19:57.211 --> 00:20:00.089
It's gotten a lot better since then after I've changed things.

00:20:00.744 --> 00:20:03.951
Everything about doctors were telling me to do, I was doing and it wasn't the right thing.

00:20:03.951 --> 00:20:11.671
It wasn't enough, so I decided to be my own doctor and not tell anybody else, and it's worked just fine.

00:20:11.671 --> 00:20:13.371
My numbers look amazing.

00:20:13.371 --> 00:20:17.551
My total cluster was like 130, which it has never been in my entire life.

00:20:17.551 --> 00:20:23.290
My glucose is totally normal, but it took a lot of intentional changes and it took a lot of awareness.

00:20:23.290 --> 00:20:47.693
And because I'm a physician and because I have training in turtle medicine, I have a platform to tell women that there are choices, there are options, there are things you can control, and every one of my birth stories was about being out of control and it was teaching, not just as a patient how to navigate a broken healthcare system, but teaching as a person and as a mom how to make my world better, my kids world better.

00:20:47.693 --> 00:20:52.426
Like all, four of my kids have higher risk for diabetes just because I had gestational diabetes.

00:20:53.204 --> 00:20:58.618
I would love to have every pediatrician in the country Tell that to every mom who had gestational diabetes.

00:20:58.618 --> 00:21:10.077
I guarantee you these moms would take different steps if they knew they had the risk, if they knew that they were going to die before they could see their grandchildren because they didn't change the risks for heart disease.

00:21:10.077 --> 00:21:14.882
There's not a sane, normal person in this world who wouldn't do something different?

00:21:14.882 --> 00:21:19.500
People don't know, and because they don't know, they can't change.

00:21:19.500 --> 00:21:21.938
The medical system is not telling them.

00:21:21.938 --> 00:21:24.317
We know in the literature, it's there.

00:21:24.317 --> 00:21:28.430
There's so much clear evidence that it's there and no one's telling these moms.

00:21:28.430 --> 00:21:29.253
So that's what I do.

00:21:29.253 --> 00:21:32.142
I spend my days working with moms, telling them.

00:21:32.142 --> 00:21:39.596
Sometimes it's future moms, right, they're not even pregnant, but maybe they have PCOS, maybe they are overweight, maybe their mom has diabetes.

00:21:39.890 --> 00:21:47.506
But we're working on how do we intervene in a lifestyle mediated way, not a medication way, but how can we teach you the right things to do?

00:21:47.506 --> 00:21:49.576
What does a healthy diet even mean?

00:21:49.576 --> 00:22:00.198
What does it mean to be regularly active, like all these things that you read about on these websites that are supposed to be telling and teaching us, they're not doing it in a way that makes it easy.

00:22:00.198 --> 00:22:01.234
It's not practical.

00:22:01.234 --> 00:22:06.999
Telling me to eat more fruits and vegetables means nothing if I don't know how to cook them, if I don't know how to prepare and store them so they're not wasting.

00:22:06.999 --> 00:22:10.480
It does nothing if I can't access them, if I can't afford them.

00:22:10.480 --> 00:22:16.450
So there has to be other conversations that are being had, not just well, you want to lose a little weight.

00:22:16.450 --> 00:22:18.719
So why don't you move more and eat less?

00:22:18.719 --> 00:22:20.454
That's nonsense.

00:22:20.454 --> 00:22:22.374
There's a reason it's not working.

00:22:22.374 --> 00:22:23.778
Show me how Exactly.

00:22:26.211 --> 00:22:27.970
So, that's what we do here at Vitality.

00:22:27.970 --> 00:22:39.309
We spend time working with people one-on-one, having much longer appointments, but really helping them, coaching them, showing them how to use food as medicine, and really that's the whole crux of this.

00:22:39.309 --> 00:22:52.315
80% of the problems that we experience, whether it's in these pregnancy type situations or as adults, the internal medicine problems I treat 80% of them are related to diet and people simply don't know, and that is unacceptable.

00:22:52.315 --> 00:22:55.740
So I digress, but thank you for listening to my story.

00:22:56.571 --> 00:23:09.181
No, I think that's really important because that was inspired, like your complete career change was inspired by your pregnancy and what potentially could have been prevented or at the very least, mitigated during your pregnancy.

00:23:09.181 --> 00:23:18.119
We don't know that we can completely stop the nature from happening, but you can mitigate those symptoms.

00:23:18.119 --> 00:23:21.420
You can do better when you know better Exactly.

00:23:22.356 --> 00:23:23.730
And some of the most rewarding things for me.

00:23:23.730 --> 00:23:27.857
I think of a woman who she had gestational diabetes in her first pregnancy got pregnant again.

00:23:27.857 --> 00:23:29.009
I worked with her.

00:23:29.009 --> 00:23:33.230
I saw her every single week for second and third trimester.

00:23:33.230 --> 00:23:34.474
So we're talking what is that?

00:23:34.474 --> 00:23:37.596
20-something weeks she didn't use insulin at all.

00:23:37.596 --> 00:23:41.577
She was well-controlled with diet because someone could show her how.

00:23:41.577 --> 00:23:45.608
People tell me every day I know what to do, I just need to do it.

00:23:45.608 --> 00:23:46.990
And that partly is true.

00:23:46.990 --> 00:23:48.836
We do need to do what we think we need to do.

00:23:48.836 --> 00:23:52.777
That's healthy habits, but people really actually don't know what to do.

00:23:52.777 --> 00:23:54.895
I went to medical school, don't know.

00:23:55.096 --> 00:23:55.317
Right.

00:23:55.317 --> 00:23:59.381
I mean, yes, I totally get it, because it's like we studied the stuff.

00:23:59.381 --> 00:24:03.558
Full disclosure was at medical school at one point.

00:24:03.558 --> 00:24:09.036
It didn't amount to anything, but I mean I studied it again.

00:24:09.036 --> 00:24:12.065
You know, I had to when I pivoted and went to nursing school.

00:24:12.065 --> 00:24:20.949
I studied it again and but still today I have to sit down and like if I have to do diabetic teaching, my gosh, I mean it's just, it's a lot.

00:24:20.949 --> 00:24:27.269
It is a lot For even if you're in the medical profession and then it's not just teaching the carb counts and all that stuff.

00:24:27.530 --> 00:24:41.577
It's the hardest part is teaching how to do it, and you have to get into someone's lifestyle and get into their head and their habits and all of that, yes, to be able to even begin to make a difference and helping them make healthy choices Correct.

00:24:41.577 --> 00:24:46.134
And so that's why I think it's just so fascinating that the path that you've gone on.

00:24:46.134 --> 00:24:59.410
I think it's amazing that you've been able to integrate medicine and the preventative part and then also the mindset and health and life coaching and all of the stuff that you're doing.

00:24:59.410 --> 00:25:02.996
It's like it's exactly what every doctor needs to do if they want to prevent disease.

00:25:03.016 --> 00:25:05.603
Right, but honestly, most doctors don't want to prevent disease.

00:25:06.307 --> 00:25:06.849
They want to treat disease.

00:25:06.849 --> 00:25:09.394
Or they don't know that they want to, you know, because we don't.

00:25:09.394 --> 00:25:13.926
We don't learn to prevent disease, necessarily, we don't, and that's one of the things I really admire about the nursing profession.

00:25:13.946 --> 00:25:16.778
actually, they do a wonderful job at teaching and education.

00:25:16.778 --> 00:25:25.663
One of the things I'd love to see improved in the medical system is, you know, why, is payment linked to treating a disease, prescribing a medication and doing a test.

00:25:25.663 --> 00:25:27.390
That's wrong, right.

00:25:27.390 --> 00:25:28.277
It needs to be.

00:25:28.277 --> 00:25:34.130
How long are you spending with the patient and how much has the patients impact changed because of that time?

00:25:34.130 --> 00:25:34.815
It needs to be?

00:25:34.815 --> 00:25:44.861
Yes, I understand what the do valuable work, but it needs to be things that have a measurable transformation and not having gestational diabetes and a second or third pregnancy is a pretty good marker of that.

00:25:45.430 --> 00:25:49.320
Not having diabetes five years after your pregnancy pretty good marker.

00:25:49.320 --> 00:25:54.474
But we have to be willing, as a country, to invest in long-term health, and right now we're not willing to do that.

00:25:54.816 --> 00:25:57.780
Right, yeah, unfortunately that's not where people are making money.

00:25:57.881 --> 00:25:59.167
No, it follows the money.

00:25:59.167 --> 00:25:59.932
That's where we have to.

00:26:00.900 --> 00:26:06.201
We have to, we have to pivot, because we need to make people want that Exactly, and then that's where the money is going to go Exactly.

00:26:06.201 --> 00:26:07.388
Yeah, it's frustrating.

00:26:07.388 --> 00:26:08.634
Yeah, Even as nurses I mean.

00:26:08.634 --> 00:26:16.448
Then there's the whole like okay, well, you're technically doing your job, so then we can decrease staffing and you can give you two patients or three patients.

00:26:16.468 --> 00:26:16.608
Right.

00:26:16.710 --> 00:26:19.089
Like, well, okay, how are we supposed to educate those patients?

00:26:19.089 --> 00:26:26.930
Because that's the main, like that's, we have to do the care plan, we have to do the education plan, like all that stuff that we have to do in the charting and whatnot.

00:26:26.930 --> 00:26:32.076
But are we really doing it if you're taking away all our time and you're telling us to manage more patients?

00:26:32.076 --> 00:26:34.755
Like, come on, that's not nursing, that's paperwork.

00:26:34.755 --> 00:26:35.236
It's not.

00:26:35.236 --> 00:26:51.838

Dr. Amy (Loden) Tiffany: How Pregnancy Complications Inspired a New Career Path

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