Demystifying Pelvic Health with Physical Therapist Kelly Knott

In this episode of the Ripple Effect, host Jen McNerney welcomes physical therapist Kelly Knott, who recently launched her private practice, Elevate Wellness and Physical Therapy, in Woodland Park. The discussion revolves around the often-overlooked topic of pelvic health, especially in the context of menopause and women's health. Kelly shares her journey into physical therapy, driven by her own sports injuries and later, personal experiences with pelvic health postpartum. The conversation tackles common misconceptions about pelvic muscle exercises like Kegels, the impact of lifestyle factors like diet on bladder health, and how pelvic floor therapy can be simple yet profoundly effective. Kelly also highlights the significance of addressing emotional traumas that manifest as physical symptoms. Along with her insights, she shares details about her practice offerings, including in-person and telehealth visits, and emphasizes the importance of investing in one’s health beyond the limitations of insurance. This episode aims to enlighten listeners about the crucial, yet often stigmatized, aspects of women’s health and encourages a more open dialogue around these issues.

Please find Kelly Knott with Elevate Wellness and Physical Therapy via her website and on socials:

https://www.kellyelevatewellnesspt.com/

Facebook & Instagram 

00:00 Introduction and Host's Welcome

00:38 Guest Introduction: Kelly Knott

01:49 Kelly's Journey to Physical Therapy

02:42 Pelvic Floor Health and Personal Experiences

04:43 Common Misconceptions and Simple Solutions

09:02 Behavioral Modifications and Emotional Connections

12:10 Trauma, Emotions, and Physical Therapy

15:38 Alternative Therapies and Techniques

17:09 Hypermobility and Related Conditions

18:09 The Hypermobile EDS Population and Autoimmune Observations

19:36 Telehealth and Private Practice Offerings

21:00 Orthopedics and Home Office Benefits

22:39 Insurance and Treating the Whole Person

24:42 Entrepreneurial Journey and Community Impact

29:12 The Importance of Vaginal Estrogen Cream

33:45 Conclusion and Contact Information

Find your host, Jen McNerney:

https://jenmcnerney.com/
https://linktr.ee/heartrootedhealing
https://www.facebook.com/jenslpNET
https://www.instagram.com/heartrootedhealing/
https://www.tiktok.com/@heart.rooted.jen?is_from_webapp=1&sender_device=pc

Transcript

PJ McNerney: 0:00

Warning, listen to this podcast at your own risk. Side effects may include joy, feeling, content, illumination, newfound senses of purpose and wellbeing. Courage, realizing you are not alone.

Jennifer McNerney: 0:18

Welcome to the Ripple Effect. I am your host Jen McNerney, sharing the unfolding stories that made us and healed us.

0:29

okay, today on the ripple effect, I took a little break from podcasting and then all of a sudden I had two podcasts and one day recording. So I'm happy to introduce my next guest who is Kelly Knott, and she is a physical therapist here in Woodland Park and just pivoted to having her own private practice, called Elevate Wellness and Physical Therapy(PT). And. Kelly and I know each other kind of first through Irish dancing through our kids. And then secondly, we're like, oh, we're both healing practitioners here in town. And I, she accessed some of my services and then I was like, Hey, I need to check on my pelvic health because, I noticed genetically, like my mom had some prolapse organs going on. I was like, gosh, Kelly, will you be on my podcast? Because I like to deliver information that is root cause and have people in the know about things, especially women of my age. I'm going through menopause and it's, it's been, we don't really talk about this so much as women. And I think, I'm like, let's demystify this topic because we're, there's a whole boatload of us going through it and we can have relief and things. So welcome to the show and um, thank you. Thanks for having me. I appreciate it. I'm so excited to pick your brain on Physical therapy. And again, I love to know your backstory'cause you're very passionate about it and like how you, how you were like, I wanna be a PT when I grow up. Yeah, absolutely. So not an unsimilar path in that I was a total jock growing up. Had a lot of sports injuries, um, found. In a lot of pt. So had a huge admiration for the field as a, as a youngster basically.'cause they allowed me to continue doing the things I loved. So that was probably not an unusual path for me to follow. I did change majors in undergrad, um, because I was playing a sport and it sort of distracted me from the, uh, academic piece for a good chunk of time. Uh, but I did ultimately get back to grad. School, school in my thirties actually, to Okay. To resume that physical therapy career. Um, started out pretty traditional, ortho, some neuro, you know, your general head, shoulders, knees, and toes kind of stuff. Okay. And then, uh, after having my daughter, uh, a little over eight years ago now, decided that pelvic floor was something I needed to tap. Um, my own experience was filled both labor, birth delivery, postpartum. I had lots of questions and I was like, here I am a body expert and I don't have any of the answers. You know, it's not something we were taught in school. And I don't like not knowing things, especially when they're, they're in my field of study more or less. So that was, um, I had an experience as a student actually in PT school where I shadowed a pelvic floor therapist just briefly, probably for. Maybe three patient visits. And I was extremely fascinated at first of all her knowledge. Um, and then secondly, like her, her patients, her patients were some of the most grateful. Hmm. Folks I've ever encountered in the field. And I was like, wow, you know, she's really doing some pretty magical stuff here and I, I wanna, I wanna know more about it. That was pretty profound. Mm-hmm. So when we're talking about, I mean, okay.'cause I can speak to, like, my experience, I went in for just a pelvic floor exam because I've had a twin pregnancy. I've had, uh, well three pregnancies. One was a twin pregnancy and like the whole, I'm like, I, I, I. Thought I was gonna be weak, but that was not my case. And so like that's why the exam, I think is so I, you know, I'm having trouble now with like just the incontinence, is that the right word? Incontinence and or just at times. And you know, there was just some little tweaks that after you examine me that I'm doing and I'm like, oh, this is working and this is simple. It didn't have to be so complex. I was thinking. She's gonna gimme like 10 Kegels to do three times a day. And, and like again, I think without you doing a thorough exam, I could have assumed that and that wasn't gonna fix what was going on for me. So, yeah. So I think you've already said a couple things that I hear over and over and over again from my patients. Um, the first one being. That was so easy. Um, I think a lot of people put off seeing a practitioner like myself, whether it's embarrassment, time, uh, fear, you know? Yeah. What is, what is a physical therapist gonna do, you know? And they're not a gynecologist, like what do they need? Yeah. But I will say you did a more thorough exam than a gynecologist does. So there's that agree with most of the time. But I think that's, some people just have a hard time conceptualizing. How, or what a physical therapist does in this field. So that, that's a huge one, first of all. Um, and then much like you also said, I thought it was all just Kegels. Mm-hmm. Uh, and I can tell you, gosh, what a small percentage of my clients actually need Kegels. Mm. Um, I often, uh, see the opposite. They actually need to relax the pelvic floor muscles, relax the glutes, the core, you know, things along those lines. So there. Their incontinence or their pain are actually related to overuse of those pelvic floor muscles. So walking around clenched, you know, when you're not even needing those muscles necessarily. So it, it's quite a misconception. I think that kegals are the answer to everything. So I, I love those two points already that you raised because that those are just Yeah. That it's, and then, and then we. And then you and I intersect a little bit because I, I was, I'm allowed with my licensing to take, myo fascia release coursework. I chose to go the John F. Barnes Method, but there's so many different fascia release therapies out there. But yeah, like you can have your fascia restricting and, and, and tightening those organs like the bladder or the pressure. Absolutely. And um. All of it matters, but like how, you don't know until, like, I, I literally was putting that off until like I had to go help my mom with a surgery and I was like, well, I am. I'm at this age where maybe I could prevent some of this from happening. Absolutely. So much of it is preventative. So much of it is fixable. Um, I think we've been conditioned as women, so think of us as women and especially moms. Everybody is first, right? Besides us, we're always the last on the list in terms of taking care of ourself or addressing our own issues. But we've also been kind of conditioned like, oh, if you're of a certain age or you've had children, you're just gonna leak urine. Um, and then, or yeah, it being being common. It's common. It's common. So then you just accept it as normal. Yeah, and like that, like the, this stuff is life changing. Like not having to like plan out my day where there's a bathroom. Bathroom, a change of clothes. Uh, yeah, let's face it, pads things, incontinence pads are expensive. So it's, these are unnecessary things that can be addressed fairly simply. Um, and that's part of why I'm so passionate about what I do. There's, I've had patients before that, um, based on their subjective, you know, their story, their symptoms, what's going on. We may learn that. Okay, so you're sipping on a pot of coffee all day, and when you're not sipping on coffee, we're having, you know, a bubbly beverage, whether it's a LaCroix or a Diet Coke or something, and that actually your urinary urgency, frequency, and leakage are actually just tied to what you're ingesting. And if we can, yeah. Make a mild modification. Can we talk about coffee? Because that was my thing. Yeah. So, but as I take a sip of my latte, that's terrible. So there's, you know, there are known bladder irritants, right? Right. So it's your coffee and teas. It doesn't matter if it's caffeinated or decaffeinated, anything with bubbles. So a lot of people eliminate the diet sodas because they think they're terrible, awful. And go to like the. The seltzers and things. Well, those are still bubbly. Those are still gonna be irritating to your bladder. Anything with citric acid, so orange juice, grapefruit juice, um, alcohols, um. Vinegar based things. So those are like the naughty list. But I also realistically tell folks, you know, it doesn't mean you can never have those things again. It's like limit it. Yeah. It's just, yeah. So can we limit it a little bit? Can we time it to where, you know, I'm gonna have two cups of coffee today, but it's because I get to stay home and I'm gonna be close to a bathroom, so I don't really care if I have some more urgency. Can you have a glass of water with each of those? Cups of coffee to dilute it a bit in your bladder. Um, and that kind of leads me to another thought. I get a lot of folks that say they quit drinking water because they had to go to the bathroom. So that was me. Because I work with patients, it's, it's not gonna look like great. Like, Hey, excuse me, I need to go, especially with the kind of work I'm doing where it's like deep emotional stuff and you, you can't just. You can't excuse yourself all the time, but what you find is then you actually increase your urgency because the, the urine that is getting to your bladder is highly acidic and your bladder wants to get rid of it. So, okay. The bladder actually acts as that dilution factor that, believe it or not, it will make you, it feels counterintuitive, but it is. It's, it's very counterintuitive, but I mean, but that is some of the, the simple qualities of fixing some of these problems. And I did notice the difference when I was like. Doing like water when I wake up versus like a cup of coffee. Straight to coffee. Yeah. Yeah. And then, um, but can, can you speak to like this, the bladder and like, is it, if you're, you know, you mentioned if you're not around a bathroom mm-hmm. Is it actually gonna be more harmful to. Hold it like that. No, it's just, it's not, no. I mean, of course there's limits to everything, right? But if we're talking, you know, 15 minutes, 30 minutes, even an hour of holding it likely is not gonna cause problems for you. Um, and in fact, that's part of the behavior modification techniques that I teach as well, is sometimes your bladder becomes the boss of your brain, basically. Mm-hmm. And we sort of. Uh, we do the, what we call just in case piece. So you're getting ready to leave the house. Oh, I should go to the bathroom. Even though I have zero urge at this point to go. We start to tell our body that we're gonna go to the bathroom at certain times just because we're afraid we may have to go later. Yeah. So your body sort of s. Quit sending you the normal signals from your brain, so then it can almost train you into, every time I pull into my driveway, massive urgency, you know, I can barely make it to, right. There's like associations or water's running, you know, there's all those associations for sure, but it, you can actually. Um, you know, when people, when I say be behavioral modification, they're like, oh, you're saying it's in my head. And it's like, well, yeah, but from a neurological standpoint, not a, yeah. A safety neurological. Well, and that's, that leads me to think of, um, in some of the modalities that I have learned that deal with the emotions is that the bladder is. The holder of all unresolved emotions. So like that urgency. And then if we're in the water element, the bladder and the kidneys are about like paralyzed. Well, I can't do something. Like if you can't go to the bathroom right away or like, what are you? Or, um, there's fear or there's these unknowns. It's all about this unknown. So it makes sense too that like. People could, we manifest different issues in different organs and different emotions that maybe we haven't looked at yet. So, um, and that's where I've loved meeting you. Yeah. Yeah. Because it's like, because you, if you like look at all, if you're looking at all the things and you've done all the things and it's still not getting better, then you gotta look at the emotions. That's kind of like how I feel too. Is that like maybe there's an emotional component there too? Absolutely. And I can't tell you how. So a, a lot of patients I see as well have a, a background of trauma of some sort. Mm-hmm. Whether that's sexual trauma, physical trauma, uh, emotional trauma, you need and the body hangs onto that as well know. Right. That is, that is the kind of, you know, almost the root of your practice. But, um, those do manifest very often in bowel and bladder symptoms, whether it's urgency, frequency, pain. Constipation, things along those lines. So I have, you know, felt confident in getting patients to a certain level by the treatment that I can provide. But again, meeting you and being like, oh my gosh, you like. Physically get into that emotional component. Um, and as you described, and I've used this phrase numerous times, you take the charge off that trauma. Yes. And to me, that is huge for my patients because I often recommend mental health therapy talk therapy mm-hmm. As a cohort with. Dealing with the trauma that we're dealing with the pelvic floor.'cause it's not one dimensional. It's definitely not. No, and that's partially why I went to more like in your realm with the the fascia too, is because you can do so much with like maybe one of my modalities as a neuro emotional technique where it's like using a muscle test or a. To show congruence or like if something is out of balance and seeing where your stored stress is in the form of emotions, but also like the work you're doing, like it gets stored in those tissues. And so then you know you're gonna, you're gonna break. You don't want, we don't like to feel pain or revisit mm-hmm. Uh, painful past emotions, but if you can do so in a way that's. Is safe and taking the charges. Yes. And simple. I think that maybe you didn't know what to expect when you came to see me and mm-hmm. Was that as hard as you thought? I mean, it was literally processing it in a very non-invasive way. Yeah. And I also feel like the I, I came with complete openness. Which is wonderful. Trusting you Yeah. And the modalities that, you know, um mm-hmm. To, to allow things to happen. Yeah. And it, yeah. Honestly, you know, a couple visits with you probably took me further than some 10 years of some topic. Yeah. I think it's because it's more of a, um, it's, it's has. Physiological aspect. That neuro aspect, right. Where, which my brain registers as well. Right. Because that's my background in training too, so. Absolutely. Yeah. Um, but it's, um, you mentioned another thing in terms of, uh, safety or, you know, trust with appointments. And I, that's another thing I like to bring up commonly. So. If you do have that history of trauma mm-hmm. Um, I get patients that come in to see me and when they're sitting in front of me, you know, the arms are crossed and the legs are crossed and they're kind of hunched over and you can just tell by the posture that this is not a comfortable interaction. Um, so I start every appointment with. You are safe, you are in charge. Everything is, and you do you, you have such, such beautiful safe space. Like I appreciate that it's awkward and you know it's, yeah. And I don't ever want somebody to come in here and like I just took charge and directed things and they didn't have any say in what was going on. So I do have a multitude of trauma patients that I've treated over the years that. Internal exam was off the table. That was just not a consideration for them. That was not something that their body would allow. Um, and that is fine. Yeah. In that case, like what's in your wheelhouse of like not in there like that, like that still gets to some root issues I'm sure you have a huge wheelhouse of Yeah. So a lot of crossover I think with what, you know, some of the modalities that you practice. So myofascial release, massage. Deep breathing techniques, meditation, distraction, I mean, you, you name it. It's like you kind of tap into any area. We figure out what movements are safe and we start with that.'cause typically someone with pelvic pain isn't without pain elsewhere in their body. Mm-hmm. So if we can start to relieve jaw pain mm-hmm. Um, head or neck pain, you know, that, that has a strong carry over to the pelvic floor. So you can actually. Absolutely treat the pelvic floor without ever accessing it necessarily. So, I mean, I always like to make sure that that is very clear if anybody has hesitation about going to pelvic floor therapy, that yeah, internal exam is not a must. It's not, oh gosh, no, you can't come see me if that's, if that's not something you're comfortable with.'cause it is far from the truth. Right. And um. I will say, do you have, like you, you do when you say orthopedics, when it's on your, or neuro, yeah. Mm-hmm. So that's like stroke patients. Is neuro TBI concussions like sports injuries? Possibly. If it has a, a neuro, if it has a, a neuro component coordination component, always. Comes into play. Um, I have also kind of deep dived over the last few years because my pelvic floor patients have led me to this, to, um, Ehlers Deli Hypermobility syndrome. Um, I don't, I'm not diagnosed with it, but I definitely have it. Yeah. Yeah. So they, or they'll call a hypermobile. Spectrum disorder is like, you know, technically not EDS, but that is often associated with other neurological conditions including pots. So your post postural orthostatic tachycardic syndrome, um, your orthostatic intolerance. So those come with a whole host of, of issues as well. So just again, learning from my patients because I kept seeing patients with these hypermobility spectrum disorders who had pelvic floor issues and then I'm looking at'em going. Huh. You know, your, your head turns like an owl. Like you're, you can, yeah, I think my owl Find your back and grasp your fingers. Yeah. Elbow extension, the knee extension, you can tell you put your hands flat on the floor. Well, that, that all contributes to, you know, the whole, the whole person basically. Mm-hmm. So, um, that has become also a passionate area of mine because I don't know that the hypermobile EDS population, I'm not sure there's a num, another population that gets gaslit. I know. And I feel like. And I don't know, this is just something, obviously this is anecdotal. I don't have any studies or anything, but just noticing from the patients is that, and, and even my own like journey is that some of those patients with the hypermobility usually have like the autoimmune stuff. Yes. Or like, and I've had headline empathic, like it's all a similar type. They're like the healers, um, that, or, you know, they're in healing professions that they don't, you know, they don't consider quote unquote call themselves healers. They might be nurses. PTs speech. You know, it's, it's an interesting observation. I kind of made, um, I actually had it summarized by a, an instructor in a course at one time. They said, if you see bendy, dizzy, and itchy. Um, all in one person. So bendy is that hypermobility, dizzy is kind of the pots, the orthostatic intolerance and then the dizzy, um, I'm sorry, Benny. Dizzy. Itchy. Itchy. Itchy. So that's the allergies. So they're commonly, you know, very allergic to whether it's very sensitive to whether gut allergies, things along those lines. Um, and of course all of which I can't help all of them, but that's where you bring you a dietician on board. Yeah. This is why a functional practitioner on board just to kind of address. Them as a whole person again. Yeah. And so tell us a bit about your offerings, because do you also do telehealth? I can't say I've really, uh, did a deep dive into telehealth, but, um, I do have that available. That's certainly something I could offer to for someone that is, you know, unable to come to see me. So I do typically about a 75 minute initial evaluation. That is part of going into private practices, allowing me to set my schedule to allow for that time. But they, because that would not happen in the hospitals. How much time do you have in the hospital? No, it really would not, but that gives me enough time to, to meet a stranger and, and hear their story and fully listen and fully and there's such healing and telling the story, right? Yes, absolutely. A hundred percent. And then being, you know, having that time available to you then to do a full assessment as appropriate. Um, so I do in-person visits, I do. Um. I have offerings that are kind of a hybrid model. You can come see me in person and then I can prescribe exercises through an app for which we can communicate through. So you could upload videos like, Hey, am I doing this right? Does my form look correct? I can comment on that. So there's, uh, access between visits available. Nice. Um, I do see some folks in their home, so it's not a ton of folks that I see that way, but folks that are having difficulty getting out of the home. Um, do not have transportation available, things along those lines. Uh, that, that is another offering that I have as well. So is orthopedics, like if you've had surgery or hip replacement or like torn injury? Possibly injury. Injury. Injury. It just depends. Injury management things along those lines. Yeah, and I, I am currently operating out of a home office here, um, which I have loved for kind of that privacy component, especially for the pelvic floor patients. You know, to not have to go into a busy hospital building and say. I'm here for incontinence, you know, in front of a, right, in front of, at the check-in counter, right? Really nice hipaa. And you realize like, and then I'm also gonna be pairing with a, a trainer if you folks are familiar with, um, grit to greatness in town. Um. He's, uh, opening a performance center probably end of January or early February or so. So I'm gonna have some office space there too. Oh, wonderful. So that's gonna find nicely with, I'll still have my private space for patients that like that, but then I'll have access to more honey, because you even gave me a tweak for lifting weights and I was like, oh, I need to focus on my breath. And like, and like, you know, there's so much. Yeah. It's, it's, it's nuanced, but it's simple, yet profound shifts that happen when you have the right form or the right breathly, or you're absolutely, again, I would say most people come in doing those things wrong, you know, not because they are intentionally doing that as they don't know. They've never been taught, and just a few of those minor tweaks can really make a huge difference in, in, yeah, your, your bowel, your bladder, your. Your sensation of your strength and your ability to lift things and, you know, all of that matters. You're not being afraid to go to the gym because you're not leaking anymore, or, you know, picking up your kids or your grandkids. Things along those lines. Um, and then new, actually probably since I talked to you last, I am gonna start taking a couple insurances. So I'm gonna start taking Medicare and Medicaid. Oh, wow. That's, so that I can continue to see. You're gonna be helping so many more. Yeah, I don't, you know, in, in the idea of going to private practice, it was, it was very much because. Uh, I wanna, I wanna treat the whole person. You know, you may come to me for a bladder issue, but as we're going through assessment, it's like, oh wow, this hip is a little wonky and, you know, part of that upper back doesn't look like it's feeling so good either. And previously I would be tied to the prescription. Uh, they're there for pelvic floor, so therefore you can't, so like anything that would help that was maybe not related to that. Yeah. And as you know, there is not, you know, nothing happens in isolation. There's not, there's a lot of causes for various things. I, I had a gal this past week that it was like. Oh my gosh, your gait pattern is what's affecting your shoulder, you know? So it's like mm-hmm. So you're looking at the whole person, think outside the box, look at the whole person, the whole body, and be able to address those things. So, um, you know, I didn't, I didn't get into private practice to be elitist. And only people with money can come see me. So that, that been love, that kind of plug on my heartstrings and I was like, I need, I need to get back to some of my Medicare and Medicaid patients too. So, um, coming in, I know that takes a process, right? You probably applied for it. Oh my gosh, yeah. It was very, uh, I think it was a new degree just to get through. No, you might need some NT about that application process. No,'cause I went to go through it with speech and then I ended up getting a job and they did it for me. And I'm like, okay, great. I know I've never had to do it on my own. So that's been a whole new appreciation for all my folks that have done that for me before too. Yeah. So, um, so yeah. So in 2026 you're looking at, um, doing like a hybrid office in pairing with, um, a trainer. Yeah. Personal trainer. Personal trainer. Yeah. Uh, and, you know, different, you're taking on some insurance patients. Yeah. Sounds like. And anything else on the horizons we should know about? Oh, you know, I'll tell you what, it's, I started, started very, very, very part-time, a little over six months ago. I've been doing this now for. Um, just over three months full time. And I'm probably on about the 17th iteration of my business idea.'cause I think any entrepreneur can say this too. Yes. It's a lot of trial and error. You don't know until you try. You don't know what you don't know. Right. So I think it's, it's an ever evolving and learning process and I, I never would've seen myself as an entrepreneur. Entrepreneur, especially at 50. Hey girl. Never too, it's always, yeah. Just came to like. I, I want, I, I've been practicing a long time. I mean, I probably average eight to 10 patients a day for, you know, more than 12 years. Mm-hmm. So you've seen the volume of patients a lot of experience and, and I really wanna hone into some of those specialty areas and just provide. Absolutely the best quality care I can for folks. So, and you do. And I felt so safe and comfortable in your care. That's why I wanted more people here in Woodland Park or Teller and even beyond, we have a little special community here of a lot of very gifted. So we have amazing healers in this town. I don't, I don't know. Yeah. I don't know what I mean. Maybe because it's so gorgeous. We're all drawn, drawn to this area. Yeah, yeah. Something along those lines. But you know, I, if I can bring it up too, I just, this has been on my brain all week for some reason. Um, you know, and I'm sure you get this as well in your practice as people like, well, you don't take insurance. Hmm. Um, and I don't know, so I, I've been thinking a lot about the insurance and, and what I came down to was like, do you think your insurance company wants you? Well, um, do you think their primary motivation is for you to be well? So why are we putting so much faith and trust in that insurance company for making, you know, right. They're the ones limiting the amount of business. That you can see a physical therapist, a speech therapist, to heal, you know, so they're, it's like, we'll help you, but only to this point where we're no longer making money on you and then Right. And then we're gonna discontinue your services. So, I mean, I just, I think, I think healthcare is going this way anyhow, but I just really hope some folks will start to consider the investment in themself. You know, it's, it's, don't rely on your insurance company to get you Well. Well, and, and coming from somebody who. Was very much how, like that was only how many months ago that you were very much in the system. Right? A hundred percent. And so I think that's super profound. I mean, obviously I've had my own journey with healthcare and, and just everything that, um. Has worked for us. Root cause is not covered by insurance. Right. So even when we had the cream of the crop insurance, yeah, I was still paying out of pocket. But I will say that, here's the reframe. To piggyback off, off of what you're saying is that we don't have the best insurance. And I knew you didn't at the time when I saw you a couple weeks ago, you didn't take insurance. And even if you did, I don't even know that my insurance would cover it. But I will say that it wasn't like. I had to come, like literally got the exam. You gave me some tweaks. It's working and like, it's kind of like you have this concierge care now, like where you don't, it's not that you're gonna need you once a week for whatever, but in insurances, they almost make you. The standard script is two to three times a week for six weeks is the standard insurance based script. Um, and it, it, it's unnecessary, quite frankly. It really is. Yeah. And if you were to, you don't need to be seen that much, especially if you have an ounce of motivation and willing to do something on your own. Yeah. And, and you bring up a good point. Yeah, I do. I do very much respect the investment that folks are making in me. And even if I had somebody come in for, um, a first visit and said, Hey, look, I can't afford to come see you six or eight times. Mm-hmm. Um, I kind of need to know what I need to know right now. And it's not like you're gonna, you Yeah. I feel like know and just be like, I know. And the same thing. Good luck. I don't take insurance either here. Yeah. Um, but I'll work with people on a sliding scale. I have a, a handful of people that I. Do that for, because it's like, sure. We're interested in people feeling, getting well their best selves and Absolutely. Yeah. Because that's ultimately why we all get into healthcare and it's, it is been very liberating to, to be allowed to treat people. Yeah. Right now. And speaking of healthcare, because I will say that, um, this has been making a difference for me, and they just removed the black box warning on it. Is the estrogen cream. Oh, yay. Yes. So can we talk a little bit about that? Because I feel like women our age need to know about this estrogen cream and like why some people might need it going through menopause and like in the tissues and'cause you felt my tissue and like you had your whole assessment and your, your lens. So I'd love to hear your take on all that. Yeah. So, uh, vaginal, estrogen, topical cream. Um, quite inexpensive. Mm-hmm. Usually applied two to three times a week at night. Um, it is about the easiest thing to have some miraculous results from. So what is it addressing? It's addressing the dryness of the tissue once we get into perimenopause or menopause. Mm-hmm. Um, there's great illustrations. If you Google, I know Google search about a vagina is always a little bit risky, but. You can look at good, fair warning your PSA estrogenized versus de estrogenized vaginal tissue. Yeah. Um, when you look at estrogenized vaginal tissue, you'll see this pink, plump healthy, like vibrant looking. Vibrant, yeah. Moist tissue. Everybody loves that word. Um, but. You know, if you have issues of, uh, painful, um, intercourse, if you have, even just your clothing rubbing on you is painful. Um, sitting, you know, things along those lines, vaginal, estrogen, make a huge difference. Mm-hmm. Uh, vaginal estrogen has been shown to reduce and, and or eliminate. Uh, UTIs. So if suddenly in perimenopause menopause you're getting UTIs and you've never had'em before in your life mm-hmm. It's because that pH of that vaginal tissue has changed. Mm-hmm. And it just leaves you a much more susceptible to UTIs. Um, there's a Dr, Dr Rachel Rubin, who is a great one to follow. I think she said it was in the, in the realm of like 20 billion with a B dollars are spent annually for Medicare. On UTIs. Well, and I mean my, that was where antibiotics, that hospitalization, that sepsis are dying from UTIs. Right. And we could prevent it with a$30 a month, uh, topical vaginal cream. I know. Yeah. So it really. It really should be given to every woman probably at around 45. You know, maybe perimenopause me. It was like preventative even just because, and they, they refer to it as then you should have a pride out of your cold dead hands. Like you should just be on it for the rest of your life. Um, so it, so if that's, if anybody's like, if that's one takeaway from this podcast, I think it's a big doctor, huge thing. But even though even I will say. There are ways around like asking the doctor, there's a website that I got mine off of, uh, a lo, it was like a Loy brand. I just looked at the, the brand and um, I had to answer a few questions and then they were able to send it out. But, um, I think there's even another like mid, mid IDI health, I believe doctor that are Meno. Specialist that you can online Yes. This was a similar concept that, yeah, get subscribed to one of their physicians that can order those for you because you will, um, you will not be without pushback if you bring up the hormone conversation to many practitioners. Mm-hmm. I don't really fault the practitioners, you know, personally, because the majority of them were not ever educated. Um, and there's another statistic that. 5% of gynecologists coming outta med school feel adequately trained to treat menopause. 5%. Yeah. You know, I, and that's the specialist I think that you would go to if you were having menopause symptoms. So they often just do not, if they've not sought education on their own, um, you know, and that's all I, I didn't get taught any of this in, no, none of this stuff. No. I did the whole labor and delivery thing after I had my daughter and I was a. Geriatric pregnancy. So I pretty much went from pregnancy to per and was like, whoa, what was this? Oh my gosh, your body is slowly in so much shock. Right, exactly. So that was another deep dive learning curve that I jumped into too, because it was like, gosh, nobody is talking about this. So if you wanna bring up awkward subjects at the dinner table, I'm happy to come anytime and well, it's like me, I'm like, I'm talking about what did your poop look like? Because you can, I mean like all this stuff like you, you know, but, um, yeah, no, thank you so much for this even this is very helpful. I think. I think a lot of the listeners, a lot of the listeners are about my age and or parents or, you know, yeah. Moms. And so going, maybe going through perimenopause or about to be, and, and there's so much you can do and, and obviously I, your website is, is it, can you let us know your website? It's gonna be in the podcast notes. I'm gonna put where to find you, but Yeah, absolutely. So it's Kelly Elevate wellness pt.com. And then you can do all the scheduling and booking. Yeah, I've got a booking there. I've got a Facebook page, Instagram page. Um, formulating a YouTube. I'll put that YouTube page. Yeah. Learning all the technologies. I know, right? Oh my gosh. And so I get better about uploading to socials too, so that people can get a little idea of, you know, services I offer my personality, what my life is like, all of that. Yeah. Just so that they knew me a little bit better before, you know, potentially signing up for an appointment. Awesome. Well, thank you for your time today, Kelly, and thanks for all the healing you put out into the world in Woodland Park and beyond. So, yeah, no, I appreciate it so much, Jen.

PJ McNerney: 34:51

All content by Jennifer McNerney and guests are for educational and informational purposes only. Listeners acknowledge said content does not constitute medical or professional advice or services. This podcast is for private, non-commercial use Only guests on this podcast do not necessarily reflect any agency, organization, company, or potentially even themselves.