06: Breaking the Mold of Traditional Care – Jodi Caddell on Finding Purpose in Functional Medicine

It's challenging to change your way of thinking. You've been trained a certain way to look at the symptom and treat the symptom. But this I have to think about why, why is that happening? And obviously digging deeper and finding all these, you know, looking at the gut microbiome, looking at your vitamin levels, looking at your hormones, trying to fix that so that everything else works properly. And that's been the hardest part for me, just trying to wrap my head around thinking differently.

Welco Microvalli. Today I'm talking with my friend and colleague Jodi Cadell. And we're gonna learn about Jodi a little bit today about her career, her life, what got her into functional medicine. A lot of cool questions. You can get to know her a little better if you like these videos. Please, like, follow us, subscribe this is how we share information with people, how we get the information out there. So with that, let's begin. So good to see you. Jeopardy.

Good to see you as well.

Okay, so why don't you tell us about your. This, this is going to be. Learn about you a little bit. Tell us about, you know, how you got into medicine initially. Like, what was the dots that kind of came across to get you ultimately into being a nurse practitioner. Because that was not what you first wanted to do.

No. So I, my initial degree was in music. I was working in arts management in my 20s. And then when I moved to Richmond, I couldn't really decide what I wanted to do. There wasn't a comparable type of career down here in Richmond. I was up in Northern Virginia and I had always been interested in medicine. When I was in high school, I thought about being a doctor and I thought that would be really fun. But so, so I talked with my husband about it a lot and then I decided to go to nursing school. So I was, you know, I had, I already had my children and I, I decided to go back to nursing school when I was about 35.

That's actually where I first met you was actually.

Yes. When I was a nurse.

And you were on the third floor.

Third floor, which was pcc.

Yeah. So how many years were you actually in.

I was there for five years.

Five years. So you worked in the hospital situation five years? Five years. What's from. From that. What kind of got you into thinking, I think I want to go into. To start. Become a practitioner and go on that professional route.

I think being a nurse practitioner was my ultimate goal when I went to nursing school. So I knew that that was kind of the direction I wanted to go in, I wanted to see patients and treat patients, but I really wanted to be a nurse and I wanted to have that experience of working in the hospital and learning in that environment. So it seemed like the right path.

So.

So after I finished nursing school, I worked in the hospital and then I started NP school. While I was working in the hospital.

How many years did it take for you to finish NP school?

It took me four years because I did it part time.

Okay, so you're doing that why you're working. So working full time, going to nursing NC schools and like, tell us about the hospital experience. What kind of patients did you see in the hospital? How did that kind of contribute to your clinical expertise? Like what kind of people were you working with or seeing in the hospital?

We mostly saw cardiac patients. So I feel like I had a really good kind of cardiac background. We saw a lot of patients with heart failure. We also saw more acute patients because we were a step down unit. So we would see some patients on ventilators, some patients on multiple IV medications. So I got to see a little bit of everything, high acuity and low acuity. And I had the opportunity to meet so many great physicians and practitioners there that were great about explaining things as I was always really interested in what was going on. I would always sit with the pulmonologist and say, hey, can you explain this chest X ray to me so I know what I'm looking at, or you know, I'm looking at, you know, this guy's here for a GI bleed. I talked to the GI doctor and he would explain things to me. So I was always trying to learn more about the patient that I was seeing. Not just. I didn't just want to go and give them their meds and then leave. I wanted to know what was going on with them.

And one thing just to clarify with the step down, that's patients who are in the ICU who had been ventilator sick, heart attack, you know, bypass surgery, whatever, intense things that still were pretty sick, but not, you know, well enough to go to the regular exact work. They need a higher level of care. So you had, so you basically had a lot of experience with pretty sick people, learning how to manage them, knowing when you need to call someone else in because like in the middle of the night. Yeah, when you're like crashing called you in the middle of the night, you may have. Yes. And. And so to learn that nuance of this, someone's sick, this is what's cardiac pulmonary pain. So you basically got A good, good grasp on some. Working with prep doctors on these really sick, sick people.

Yeah.

Okay. And then you finished your nurse practitioner school, and when you started deciding like, you know, hey, I want to actually develop, have a clinical practice, what fields were you looking and you're thinking about before you. Before you dived into primary care?

Well, the two examples that I gave about cardiac and gi. Those were two areas that I was interested in if I was going to do a specialty. But I wanted to really do family practice to see where. What interested me the most. And. And I felt that it would be the best place to learn and grow as well, instead of just learning one thing. And I think it's important to know one thing and know it really well, but I wanted to kind of learn about everything before I made a decision if I wanted to go into a specialty. And then I wound up loving family practice and was there for a while.

How many years were you doing practice?

Seven years.

Remind me real quick because I feel like for a while you're doing so. Five years nurse in the hospital, seven years in family practice. But you also were going to the hospital as well, correct? In the beginning part.

At the beginning part, I rounded at.

The hospital because you're working with a physician who saw. So you were actually not just doing outpatient, but you also were. Patients would get admitted to the hospital. You were going in and evaluating them and then working with the doctors, you know, consulting them on the patients. So. Which is a. Kind of interesting.

That was a weird thing to go in and see my old nursing colleagues, but I was sitting in the, you know, and the same chair, but, like, making the different decisions, you know, being the provider that time and putting the orders in and that kind of stuff.

And then. And then learning that under, you know, another physician. I've been doing this for, you know, I think at that point in time, 30 years. So that's a kind of a cool, interesting transition. So just learning and learning. When did. When did you first get the twinge or the inkling that, you know, doing functional medicine, like the next level. When did that first kind of come on your radar, even as a. Even if it was a thing or even if it didn't even existed?

So I didn't. I wouldn't have known it was called functional medicine. My. I think two things happened around the same time. My husband was diagnosed with celiac disease, so I started learning more and more about diet and how it can heal you. And then around the same time, another friend of mine was diagnosed with crohn's disease. And she is very well read and very knowledgeable, and she really improved her quality of life and her health just through diet alone. And that just fascinated me. And I was like, you know, why are we focusing so much on giving people these medicines to treat the disease? Why don't we, you know, change their diet and, you know, and so that. And I think that's where I got kind of the bug about it and didn't really realize it was functional medicine until you started doing it. And I said, I saw what you were doing in your practice.

So you went from being in the hospital where you'd see Crohn's and null supplies, patients being admitted, and having surgeries done and having colectomies done and all that fun stuff, and having IV antibiotics, steroids, biologics. So then seeing your husband, your friend manage their disease without exactly.

Medication, alcohol, and they have a great quality of life. Yeah, yeah.

Minus eliminating foods that make you need surgeries.

They seem to do fine without the, you know, the gluten and the. That kind of stuff.

It's a good. It's a reasonable trade off.

I agree.

And so you were doing that, doing family practice. Seven years. So we're at 7, 8, 9, 10, 11, 12, year 12, I guess work in the hospital, still managing sicker patients, but learning the outpatient. You decide, hey, I think I want to do this functional medicine. So what was going through your head at that point in time? Because you're having an inflection point. It's like you have a guaranteed job. You know, you're a nurse, you're a practitioner. How long does it get a job? Now there's this kind of, you know, are there jobs out there for this? Can I actually do this? Why don't you talk about some of that, that process?

I don't know if this is the right answer to that question, but it. I feel like I, I wanted to learn more. So I actually became a patient. And so that kind of got me into seeing what was going on during a functional medicine evaluation and seeing what labs they checked and that type of thing. After that, before even thinking about starting another job, I just started looking at the IFM website and I took a class to kind of learn some more and see if I was interested in it.

Yeah, yeah. And we were comfortable talking about. So as far as what was. What kind of health issues were you having? Like, you mentioned that. You said it, you said it, you said it. Kind of like, oh, it's. I've become patient like, but what were you dealing with? How. First. What were you dealing with first? And second? Had you seen other doctors and what had been your journey with that before you decided to try this alternative route?

Yeah, I started. I just started. Not. This is going to sound a little crazy, but I started just not thinking as well as I used to. I felt like I wasn't as quick as I used to be. I had trouble thinking of the right word to say. I was always tired, gaining weight, and I just assumed that that's what happened to women in their 40s. And I may have seen one doctor about the fatigue and they checked my thyroid and it was all normal. And then I went and I joined your practice and I saw Dr. Jensky and we discovered that I had SIRS and I had a mold in my home. And that was just mind blowing to me. Never in a million years did I ever think that there was really something wrong with me. I thought it was normal. And then doing the, doing the treatment and it. It's been amazing. I mean, some days are better than others, but I feel like I can think again. I feel like my brain is back and that type of thing.

And how long have you been working on the sirs?

Three years.

Three years.

I took a little time off.

Yes, you did.

Yeah.

We have to like remind you.

Yeah, yeah.

Please come on back.

Yeah.

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So what I'm hearing, because I don't know your individual case store as well as others, but you felt like this is normal. I'm a 40 year old female, I'm a mom, my wife, I'm Professional. This is normal. This is my friend. This is where my experience was. Right. What else could there be? And so it wasn't until you decided to like try something a little different, you realized, wait a second, this normal amount of fatigue and waking up and hormonal dysregulation and we having other issues like sleep issues or non restorative sleep?

No, I like to sleep. I'm a good sleeper.

Any, Any like gut issues?

I had a lot of gut gut issues. I don't know how much you want me to get into that, but those are so much better. So what like IBS type of symptoms?

So technically like more ibs. Not, not inflammatory like with your.

No, not like my husband and friend. Yeah, terrible IBS and that I never even realized, like it was just so normal to me. It, it, I, I've had it for, since, since I could remember. When I was a teenager I probably started having it. So.

So you had IBS issues since teenage, since you started, you know, cycling or whatever?

Yeah, yeah, yeah. So all your adults. All my adult life and that I don't have it anymore.

So you had that from beginning your cycles to a couple years ago and you thought that was the normal thing?

Yeah.

It's really kind of interesting how much things like pcos, endometriosis, infertility, a whole bunch of typical normal female issues actually revolve around the gut microbiome, gut bacteria detoxification. And because so many young women deal with it, it's like I'm just like the rest of my friends and people don't realize this is actually not. I mean it is normal, but it's not optimal. Unfortunately it is quite, quite normal. And so now your guts never been like this in your adult.

No.

Or child?

Yeah, yeah. It's much nicer and you still love.

Sleep, but, but your brain's working better, you feel better. Which is kind of cool that you as a nurse in hospital for five years and as a primary care person working still in the hospital around a lot of experts in the field working with GI doctors. It took a different way to realize that what you're dealing with, which this was normal, really wasn't.

It wasn't.

Yeah. So cool, cool, cool. So you said you took a couple classes with functional medicine, so started learning side you wanted to go into it. What's challenging about functional medicine? What do you find challenging?

It's challenging to change your way of thinking. You've been trained a certain way to look at the symptom and treat the symptom. But this I have to think about, well, why? Why is that happening? And obviously digging deeper and finding all these, you know, looking at the gut microbiome, looking at your vitamin levels, looking at your hormones, trying to fix that so that everything else works properly. And that's been the hardest part for me, just trying to wrap my head around thinking differently because I still. A patient will come in and tell me something, and my immediate thought is, oh, this is the medicine we can give them to fix that. And I'm like, no, that's not what we do anymore. That's not what we're doing here. Not that that's not important. I think that, you know, sometimes those medicines are necessary, but that's not. It shouldn't be my first thought. And that's what I'm having. You know, that's the hardest part for me right now.

What's. You know, when I first started doing this, what was difficult for me was like, people sometimes refer to as imposter syndrome, but it wasn't. It was more like, like, is this real? Like, can you really change someone's diet? Can you really do an advanced stool test on them and look at bacteria in their gut and pick up these crazy markers and then basically add in what they're lacking and remove some inflammatory foods? Will that actually change their thyroid antibodies? And the way they're thinking, like, you kind of see that. You're like, wait, is this real? And you see it over and over and over again. It's amazing. Like, it took me a couple of years before I was like, this is my new normal.

Yeah.

Because it was so much like, it's this happening. And then you're like, wow, how come other people aren't seeing this? How come no one else is doing this? Like, in Richmond, Virginia, we have 1.2, I think, 1.3 million people in this area. And there's really not. It's really. This is really not happening anywhere else. You know, who's doing. At the level we're doing it here. And you realize that this should be the standard of care. Like Dr. Jensey says. This is. This is good quality medicine.

Right.

But it's still unheard of and still not that you see your friends and other, you know, healthcare colleagues, other nurses, other physicians, people, you know, what have their thoughts been about your transition to our practice? Because you're still early in your transition.

Yeah, yeah, they think it's cool. They're. I mean, they're interested in it. I think a lot of my friends are, you know, nurse practitioners or or PAs, or they're just fresh out of school. And I think, because I used to train a lot of students, too, so I have a lot of friends that are just fresh out of school. I think they. I think. I think they're starting to think about things differently in school now. And so this kind of stuff isn't so outside of the norm for them. So I think that's good for the future because they definitely are thinking more about the root cause and that type of thing.

So with your mold expansion, sirs, what was the biggest. Actually, we'll talk about that next one. We talk about your personal journey. Dump that. What's been the most difficult thing with you? Because you're literally changing. You're changing the career style. You're not, you know, physical's not 15 or 20 minutes now. It's an hour. When your typical patients come in, you're having half an hour, a little more time with them. You know, you have other modalities and few, you know, cool IV things you can do with patients. You know, like, what's that been like to all of a sudden, like, in my mind, just almost like, you know, Alice in Wonderland, where you kind of go from this black and white world to color, and you're like, like, how's that been as far as.

Like, that's been the best part of the transition. I mean, seeing 20 or 25 patients a day in family practice, I mean, you have to figure out what's wrong with that person in two minutes and then get out of the room. Now I get to have a conversation with somebody. I get to find out how, you know, just really delve into their symptoms and other things about their lives that might. Might be going on that could be contributing to what's happening. Like you said, I can, oh, you're sick. Well, let's go have an iv. This will make you feel great. And I can take him into the other room and give him an iv and so things like that, and then they call the next day and they feel so much better. So that's been so amazing. So it's a different pace, but I love it. I love to really connect with my patients and talk with my patients. And this gives me the opportunity to do that where I feel like I didn't have that before.

One thing as well is, like, the whole margin. People don't think about, like, as a practitioner, physician, nurse practitioner, specialist. Like, you need margin in your life. Time to think, to process the patient. Like, what's going on? Connecting dots, having time. They all These labs come back and you get, you know, 20 vials with labs back and having time to think about. But when you're like going from room to room to room. I remember we were talking before, you would be at the office till 6 o' clock doing paperwork and it's like you don't have time to actually think about your patient's story, to review the chart because you're just, you're kind of, you're always in crisis mode. Yeah. You know, and so like versus this kind of medicine, it's like. No, you have the margin to like sit and ponder a patient. You have your own personal margin to be the best you you can be. Because if you're not the best you you can be, how can you take care of these really complicated patients?

Right.

What are your thoughts about what I just said about that as far as like, that aspect of things?

That aspect has been fantastic and super challenging at the same time. So the, you know, I get all these labs back and I really want to spend a lot of time with them, whereas I couldn't do that before. But it's also, it's also challenging for me because it's new for me. So I'm, I'm learning as I'm going. So it takes me, I feel, you know, twice as long to go through it. But I have the, the great thing is I have that ability to do that and I feel like what I'm giving to my patients is very thought out and planned and hopefully really beneficial to them.

One thing is that we have a very collegial environment here. It was like that, you know, you know, you have, Dr. Jensky has, er, experience. If I have a question about something super acute, you ask him. You know, I'm, I'm. That primary care experience will ask me about questions. So it's really, I think, a great environment in that here we have the ability to ask people who have different clinical experiences. I mean, between the three of us, you know, I mean, he's probably. We have like 56, almost seven years of clinical experience combined.

Yeah.

So if you look at like that, there's a lot of time between the three of us and it's at the same time, it's like, you know, there's things that you would have seen as a nurse in the hospital at the step down that I would have never seen because I was usually there for my 20 minutes.

Right, right.

I was leaving and then I might get a call about something and literally the nurse is a person making it all happen. And that Just gives you a different perspective that you don't have on the other side. And then Dr. Jinsky and the ER, that perspective. And so we have like a very diverse kind of mix here. But typically between the three of us, we kind of have a good idea of what to expect from different.

Right.

Super emergent icu, step down primary care. It's pretty, pretty broad swath. If someone, if there was one of your nurse practitioner colleagues, doctor colleagues, someone else who's like listening to this right now, who's like, that's kind of cool. Like she did that, she's transitioned from, you know, the only couple of medicine I know to this. Like, what would be your words of encouragement as far as if someone's thinking about getting into this deeper medicine?

You know, don't be afraid to be open minded. I mean I, I feel like one of the biggest things that frustrated me in conventional family practice was patients that we see here. But those type of patients would come to me and they'd be frustrated because they, they couldn't figure out, no one could figure out what was wrong with them. You know, in the conventional practice we didn't have time to spend with them and we also didn't have, I didn't have the knowledge. Nobody has the knowledge. So take the AFMCP introduction class. It's really mind opening and it's, you know, you get this basic knowledge and you can apply it in your practice where you are at that moment.

Well, thanks a lot for sharing with us about your personal development. I think next time we're going to talk about your health, your house.

Okay.

Get a little more personal, but also in the weeds. Because I think ultimately people need to understand that all of us are not just highly educated individuals. We're also real people who have real families, who actually have our own personal struggles. And just because you find the magic bullet doesn't mean it fixes itself automatically. So we're going to dive into that a little bit next time around.

Okay, sounds great.

Thanks a lot. Take care. Bye.