100th Episode - The Answers to Breast Health Dr Jenn Once Wished She Had

Welcome to the 100th episode of Keeping Abreast. I'm Dr. Jen Simmons, your host, and I am truly honored to be here with you. When I launched this podcast, it wasn't just to talk about breast cancer. It was to open the door to a bigger, more honest conversation. A conversation about healing, about health, about what it really takes to live well after breast cancer. Or better yet, to never get there in the first place. Because breast health is health. And what impacts the breast doesn't just live in the breast. It reflects the whole body, the. The whole woman, the whole life. Today, we're going to dive deep into the question so many of you have been asking. From what I've reimagined breast cancer screening to be and built a safer, smarter alternative with qt, to whether hormone replacement is safe after breast cancer, to the real reasons women feel worse after treatment and what to do about it, we are covering it all. You'll hear the unfiltered truth about mammograms, the tests I believe will revolutionize breast imaging, and the three part strategy I use to screen for breast cancer without causing harm. We'll talk about what's really behind your symptoms, why so many women are stuck in survival mode after breast cancer, and how Real Health MD is changing that. 100 episodes in, I remain more committed than ever to giving you what I wish I had. Real answers, a new approach and hope. Because this podcast has never just been about information. It's about transformation. Thank you for being part of this journey with me. Whether you're recovering, preventing, or trying to reclaim your health, this is the episode where I lay it all out. So let's get into it. Because 100 episodes in, we're not just keeping abreast, we're changing the conversation. So let's dive in and let's keep going. Well, it has been a minute since I did a solo podcast and people are asking and we have lots and lots of questions to get through. So I'm going to get right to it. And just remember, if you have questions for me that you want answered, that's great. You can send them to inforeealhealthmd.com and we will make sure that they get answered for you. So I'm going to start off with the first one. This is from Melissa, who's 51. She said, hi, doctor. Dr. Jen. I keep hearing about the QT scan and perfection imaging. I've had mammograms for many years, but they always leave me anxious and sore. How is QT different? That is A great question. So I want to start off by saying that I am not using QT alone as breast cancer screening. So my breast cancer screening has three arms, it's a tripod or three legs. So I first of all believe that everyone should be doing self breast examination. And this has to do with the fact that I am mostly concerned about clinical disease, about something that has developed symptoms because we are doing a terrible job with over diagnosis and we are diagnosing women with abnormalities, even some cancers, technically they're cancers that would never affect women in their lifetime. They would never become clinical disease. And so I don't believe in treating something that's never going to cause a problem because our treatments cause a problem and they cause a big problem. So I think that we all have to start with knowing our bodies and if there is going to be something wrong, we're going to develop a symptom. So knowing your body means knowing your breast and knowing what your breasts look like, knowing what they feel like, knowing what they are when they're normal so you can recognize when they're abnormal. So my, the first part of my screening starts with self breast examination. The second part of my screening is an ARIA test. A U R I A care this is a biologic test. This is telling you what your risk is, is right now it's not a risk assessment, it's not, I guess it's not a percentage, it's do you have the inflammatory precursors of breast cancer? Do you have breast cancer right now? Or are you at very increased risk of developing breast cancer in the next six months, 12 months, 18 months? Because what happens is that if you have these inflammatory proteins, the S100A8 and S100A9 proteins, and it has to be both of them and they have to be at a critical level in order for this test to be clinically significant. And if you have these inflammatory proteins, there is, there are no false positives with this test. So if you have these inflammatory proteins, you absolutely positively have the risk factors, the precursors for breast cancer. So I use the ARIA care test on everyone who is screening. It is not validated for women who have had breast cancer before because we don't know what happens with those proteins in between. We don't know if they go away with conventional treatment or if you have to resolve the inflammation, which I would imagine you do. So that is being validated for recurrence. But right now we are only using it for primary screening. So I'm using the ARIA care test in addition to self Breast examination. And if you're going to use the ARIA test, please use my code. Dr. Jen 20 D, R, J, E N N 20 to get a 20% off discount. And it makes it a very affordable test. Now, imaging and what Melissa started to ask about in the beginning, we have been so conditioned to believe that we need breast imaging and it's okay as long as it's not harmful. My biggest objection is that people are getting mammograms and they're getting hurt by them, they're getting physically hurt by them. They are being harmed by them in terms of radiation exposure and increasing your risk, increasing your risk of getting breast cancer. So the more mammograms you have in your life, the higher your risk is of getting a breast cancer diagnosis. And when we look at the population statistics, mammograms do not save lives, and they hurt exponentially more women than they help, exponentially. So I do not use mammogram for screening. That is not to say that no one will ever have another mammogram again. It is the only language right now that the doctors speak, the breast surgeons speak, the medical oncologists speak, the radiation oncologists speak. And so if you are in a situation of body diagnostics, you have a lump in your breast, or you have some reason to believe that you have breast cancer, then you might need a mammogram in order to get a diagnosis, because at that point you have developed a symptom. It is totally different. We are now talking about clinical disease. What I'm talking about is the screening population, which means that normal, healthy, no symptoms, no reason to believe that you have breast cancer. And I don't believe in using a test to screen for breast cancer that causes breast cancer. And I believe in putting women in harm's way, especially when they're healthy. So if you're going to have imaging for the purposes of screening, it better be something that does not hurt you, that does not increase your risk of developing breast cancer. And so your choices there are not mammogram, not mri, because MRI requires gadolinium. It's a heavy metal, it is toxic. It. Your choices are ultrasound, which is a very low resolution technology, or QT scan. So QT is what I'm using at Perfection Imaging. And I have two Perfection Imaging centers right now in the suburbs of Philadelphia and the suburbs of San Francisco. I am opening up 50 in the next five years. So if you don't have one near you now, you will have one near you soon. So don't worry and please don't ask me when, because I promise you that I will announce when I am ready to announce. I will not keep it a secret. I promise. I promise. So what is QT scan? This is sound wave technology. So we use circumferential sound waves that go around a bath of warm water. So it's sound waves transmitted through a water bath that creates a true 3D reconstruction of the breast. So it collects 200,000 times more data points than MRI and creates a true 3D reconstruction of the breast without pain, without compression, without radiation. So I liken it to if mammogram and MRI had a baby that was 100% safe, safe, affordable and accurate. That's what QT is. So the images look much more like mri. They can see everything that mammogram sees and more. It was designed originally for high risk women, for dense breasted women, for women with implants, for women who mammogram was failing them. And because of the way that the images are interpreted, we are able to see what's cystic and what's solid. We're able to see calcifications, we're able to see architectural distortion. We are able to see pretty much everything that all the other modalities see without pain, compression, gadolinium toxicity, without increasing your risk. Now, is it a perfect technology? No, absolutely not. Part of the downfalls are that it's new. So first of all, we're seeing things that we never saw before because we see details at a level that we never saw them before. So we don't always know what these things mean because we haven't seen them before. We are also training the radiologists who read them to try to not overread them, because what we don't want to do is create more fear, create more anxiety, create more callbacks. This is a broken system that we're not looking to perpetuate. The one thing that this technology does that the other technologies don't and can't is that it is true volumetric measuring. So I had a woman recently who said, I don't understand. The measurements are the same as last time, but you're telling me the volume went down. The other imaging modalities use measurement. Length by height by width. Now, if you're going to use that, yes, you can calculate a volume, but that volume is only real if the shape is regular. As you might imagine, things in the breast, they're not a regular shape. So a calculated volume is a guesstimate at best. So what we're doing at QT is actually volumetric measuring. And so if we see a lesion, listen, if we see something that's suspicious for cancer, obviously we just refer that that out. And that is something that I will talk about because people are concerned about having this as a screening test because what if they find something abnormal? They're just going to be sent for a mammogram and an ultrasound anyway. Why not just start with that? Well, that may be true if we find something abnormal, but most of the things that are found are not particularly worrisome and we're not sending them out. But if we find something that doesn't have a symptom that we think is most likely going to be benign, then what we're doing is we're asking people to come back for a short term study. Two months, three months, we're repeating the study and we're measuring the actual volume and we're comparing the volumes. And in doing that, we can determine a doubling time. So we know that cancers have a doubling time of less than 100 days and things that are either not cancer or not important have greater doubling times. So when we are looking at these, we can determine is this something that needs attention now that we need to refer out, or is this something that is either benign or slow growing or doesn't need intervention right now? And that combined with the ARIA test gives us a really clear picture of who does and who does not need help right now. So I think that QT is absolutely going to revolutionize breast imaging, especially when it's more available, which I am working on. And that will happen in the meantime, self examination. And the ARIA test is available to everyone. And I want to say one more thing about the ARIA test, because if you have a normal ARIA test, this has a 93% sensitivity for breast cancer, better than any other imaging out there. So if you have breast cancer, this is almost certainly going to find it. If you have a clinically significant ARIA test, the specificity of this test, meaning that the people that are negative, that actually don't have disease, is around 53%. Meaning that, or I'm sorry, 58%, meaning that 42% of the time you don't have breast cancer, but you have a clinically significant result on the ARIA test. I want to go back to what I said before. There are no false positives with this test. If you have the inflammatory precursors, if you do have a clinically significant exam, clinically significant result, then you are at increased risk of breast cancer. And if you do nothing. About 11% will present with clinical disease every six months. So this is opportunity. Without question. This is opportunity. It's opportunity to prevent a diagnosis and it's opportunity to have your health. It's. It's your opportunity to take charge of your health. So the answer to the question is, how different is the QT scan? It's very different, but it's also one piece of the puzzle. And I never rely on imaging alone for anything. Breast examination, the ARIA care test, and safe, effective imaging. Okay. Danielle says, I think I'm thinking of coming for a QT scan, but I'm nervous. Can you walk me through exactly what happens during the QT scan from the moment I arrive to when I get my results? Yes, absolutely I can. So it's not scary at all. In fact, it's the opposite of scary. And I have taken painstaking measures to make sure that it's the opposite of scary. It's more like going to the spa. So you walk in, the center is beautiful, it's very calm. You are offered coffee or tea or your beverage of choice. We have healthy snacks available for you. We put you in a robe, we put you in fuzzy slippers. You go into the room, there's an ergonomically designed table that first you're going to sit on that table and talk to the technician. The technician is going to ask you questions like, do you have any symptoms right now? Do you feel a lump in your breast? Has there been any change in your breast health? Is there anything that you're following along? Have you had breast cancer before? What treatment have you had? She wants to know what your risk factors are of having an issue right now. And hopefully most of the people coming don't have an issue right now because this is really meant to be a screening test. So she asks you a bunch of questions and then she's been trained by me to examine your breast because she wants to make sure that she doesn't feel anything in your breasts or underneath your arms. Now, I do want to say, because people ask this all the time, is this a good test to screen the axilla, the underarms? The answer is no, it's not a great test to screen the axilla. We will get some of the low lying axillary nodes in the scan, but the high axillary nodes are not going to be submerged in the water, so we're not going to get information about them. That said, the number of times that breast cancer presents as an axillary problem is extremely, extremely, exceedingly low. And if you have a presentation like that, that's something that you should feel on your physical examination anyway. So not a great test for the axilla, but it is a very good test to screen the breast. So once she examines you, then she's going to have you lie face down on the table. There is a hole cut out in the table. It's an ergonomically designed table, so it's designed to be comfortable. And then your breast goes into this warm water bath. Now, several people have asked me lately about a magnet. There is a magnet inside of the machine. The magnet doesn't have any function other than to hold the breast steady. For people that need their breast held steady, someone like me, I don't need tape on my breast attached to a magnet to anchor my breast. My breast is not going anywhere. And my tech has been trained to determine whose breast needs to be held still in the water and whose breast is going to be just fine without tape. So the magnet has nothing to do with the scan, has nothing to do with the quality of the scan, has nothing to do with the capture of the images. All it's there for is if we need to stabilize a breast, which is very buoyant, then we tape the breast to this magnet. Okay, so once your breast is centered into that, that area, then the water bath comes up, rises to meet you, we turn the lights down. The length of, of time of the scan is directly related to the length of your breast. The longer your breast, the longer the scan. The scans take about eight to 12 minutes per side and you have one breast scanned at a time. So you're not doing both breasts at the same time, it's one breast at a time. And then we're doing them sequentially. Then you, so while the scan is happening, the lights are down in the room, there's soft meditative music. You are meditating or breathing or taking a nap or spending time with God or whatever you want that time to be. That is a time of peace, of relaxation, of self care. Once the scan is complete, you dry off, you go get your clothes back on. We have lovely parting gifts for people who come into our center and you go home. The Scans take about 24 hours to process. It seems like a crazy long time. I'm really hoping that the company works hard on speeding up that processing time. And then it goes to a board certified radiologist who is specialty trained, specialty trained in reading these scans. So, so this, this is above and beyond their radiology training, their breast imaging training. This is specialty training above that and it's read on a specialty viewer. It is a new technology. It's not like anything else that's currently happening. So it goes to a radiologist who is specialty trained to read these. And then for right now, for my centers, I can't speak to the other centers, but for my centers, I am reading and reviewing every single report myself because I want to make sure not only is the information accurate, but are the recommendations accurate. Because we are really forging a new path with this. And I want to make sure that I am using all of my knowledge in the area of breast disease and breast cancer to guide people in the right way. So the results come to you in about five days, depending on how behind I am. Sometimes it's a little longer. But please bear with me as we not only perfect this process, but train more and more readers, which we're doing every single day, and also train people like me to be proper managers of breast disease and to make the right recommendations and to help you as much as we can and guide you in this right direction. Because what I, what I am intent on doing is taking the fear out of this process. I want breast cancer screening to be self care. I don't want this to be something that is feared. I don't want this to be something that people avoid or, or dread. I want this to be self care. And I know we can make this self care and we can tie this into, instead of being reactionary and just treating disease, we can talk about prevention. Are you ready for a breast cancer screening revolution? Well, I'm thrilled to introduce to you a breast cancer screening tool that I have only recently learned about, but I have universally adopted. This is the ARIA test. This groundbreaking at home breast cancer screening test is one that I believe will completely change the game. So imagine a screening test that's as simple as shedding a tear, because that's aria. It's a non invasive, convenient and perfect for all bodies and all breasts. Dense breasts, implants, no problem. ARIA makes it clear for everyone, even women as young as 30. Aria is backed by over a decade of clinical trials, thousands of samples, and it's developed alongside top breast health experts. Here's how it works. You collect a tear sample at home and then ARIA then analyzes it for protein biomarkers that can signal early breast cancer. And the best part, you get a consultation with a breast health specialist to review your results. Now, ARIA isn't replacing breast imaging. I am using it alongside qt. It's complementing it and giving you a fuller Picture of your breast health. Knowledge is power and Aria is putting that power back in your hands. It's time to take control of your breast health and ARIA is another way of doing it. Go to Aria Care a u r I a care and use my code, Dr. Jen 20 in Capitals d r j e n n 20 to get 20% off. Back to our show. Foreign. Hello, my beautiful listeners. I'm taking a quick break here to share something truly transformative with you today. If you're ready to take control of your breast health journey, then you need to get your hands on a copy of my book, the Smart Woman's Guide to Breast Cancer. I wrote this book to make a massive impact in the world of breast cancer, empowering women everywhere to make informed choices and educated decisions. You have so much more power and control over your health than you might think and this book, this is a roadmap to harnessing that power. Inside, you'll uncover the truth about conventional treatments. They're often overestimated benefits and underestimated, under explained and under disclosed long term side effects. But more importantly, you'll discover the true drivers of health and how the choices you make at home every day can lead you to the best health, the breast health of your life, even after a breast cancer diagnosis. Whether you're looking to prevent a diagnosis, avoid recurrence, or simply live your healthiest life, this book is for you. Join me on this journey to empowerment and health. Grab your copy of the Smart Woman's Guide to Breast Cancer today and let's revolutionize the way that we approach breast health together. Okay, so I hope that that answers all the QT questions. Next up, we have Brittany, who is 39 and she says, I've been following you for months, but still don't totally understand what you do at real Health. MD Am I a coach, am I a doctor, or both? Woo. All right, I just got put in my place. I'm a doctor and I've been a doctor for, I don't know, 20 some years now. And I've taken all of my experience as a breast cancer surgeon and combined that with my experience as a patient, which I became in 2016 whether I liked it or not. And I combine that with my experience as a functional medicine physician because it was my own diagnosis that led me to learning about functional medicine and completely shifting my approach. And what I learned in being a patient and experiencing medicine from that side of it is that we are entirely focused on the wrong thing in conventional medicine. All of our focus, especially in the area of Cancer, all of our focus is on the symptom, but the symptom's not the problem. The tumor is not the problem. The tumor is the symptom of the problem. And the real problem problem is why do we have the symptom? What is causing the symptom? What is causing the tumor? What is causing the cancer? And these are questions that are not asked inside of conventional medicine. And I wanted to make sure that I offered people an avenue to not symptom management, which is happening all day, every day. I wanted people to have an avenue to recover their health, to restoring their health, and to getting to their root cause and to actually creating health. Because when you create health, disease goes away. And so at Real Health Maryland, under the guidance. Under my guidance, I have doctors, I have nurse practitioners, and I have FDNs that are all working together in my programs to help people to recover their health after a breast cancer diagnosis. Some of them are helping them to prevent a breast cancer diagnosis. So I have prevention programs, I have treatment programs. And where our focus is now is in survivorship, because what survivorship has become is, you know, ringing the bell but not really feeling alive. And. And when people go back to their normal, normal is what got them there. And you can't get well in the same environment that got you sick. So what we want to do is take survivorship and turn it into thrivership, if that's even a word, I don't know. But we. We want women to truly thrive. We want them to live their best life, and we want them to really know what it is to be healthy, even after our breast cancer diagnosis. And that is possible. We are reimagining what breast cancer screening looks like, what breast cancer diagnosis looks like, what breast cancer treatment looks like, and what breast cancer survivorship looks like. So am I a coach, a doctor, or both? I'm all of those things. But mostly what I am is changing the conversation around breast cancer. Okay, Karen, who is 57, says she's two years out from treatment, and she honestly feels worse now than when she had cancer. And no one talks about this part, and what am I supposed to do now? Karen, I hear you, and you are not alone. Because what happens is that women get treated for breast cancer and they get told that they should be grateful to be alive. And they are grateful. They are grateful. However, it is very hard to feel grateful when you can't think. You're depressed, you're exhausted, you can't sleep, you're anxious, you're scared, your bones ache, your Joints ache, You have palpitations, you've gained weight, your clothes don't fit, you've lost your confidence. Your breasts are deformed or absent. You have no libido. Sex is unwanted and painful. Your hair is dry, your skin is dry. Everything is dry. Your relationship is suffering or absent. It is very hard to feel grateful when all of this is happening. And yet this is how we are leaving most women who, quote, unquote, survive breast cancer. Now, you will recognize a lot of these symptoms as the symptoms of menopause. And the treatments for breast cancer pretty much catapult women into menopause on steroids, whether you were in it before or not. And they really suffer. And the treatments for breast cancer accelerate heart disease, accelerate bone disease, accelerate brain disease. These are by and far the greatest threats to a woman's life and by far and away the greatest threats to a woman's life. And yet we are somehow celebrating that we've gotten women through their breast cancer diagnosis, but we're not leaving them with a life worth living. And I have opened up a conversation that was not happening before and needs to happen and needs to happen again and again and again. Because what we need to unlearn is that estrogen causes breast cancer. Estrogen is protective. And we know now from the revised outcomes of the Women's Health Initiative that estrogen is protective and that women who take estrogen have a decreased incidence of breast cancer. And I think that there is no better book out there than Estrogen Matters by Avram Blooming and Carol Travers. I have no idea what I did to Dr. Blooming, but he won't speak to me, despite the fact that I think that he's a genius. And what he's put out there is truly amazing. I think that that book, I know that that book changed my life. And it has thousands and thousands and thousands, if not millions of women's lives. So I think it's required reading for everyone. Estrogen Matters by Avram Blooming. And I think that we need to start having this conversation that women who have had breast cancer, the operative word had, they've been treated, they no longer have breast cancer, even if it's, er, positive breast cancer. These women are people too, and they deserve the same opportunities that everyone else has with the knowledge that you can have hormone replacement even after a breast cancer diagnosis, as long as it's done by a hormone literate provider who is giving you a safe form of hormone replacement and monitoring you properly. And so, you know, that's what holistic doctors like me do. That's what we do, and that's what the doctors that work for me do. Because breast cancer, a breast cancer diagnosis is not forever. And there is an other side to it. And we have to give these women an opportunity to live full, meaningful lives afterwards. And that often means hormone replacement. Okay, that leads into Lisa's question, who is 48 and struggling with hot flashes and memory issues? Is it actually ever safe to do hormone replacement after breast cancer? She's hearing mixed messages and she doesn't know who to trust. Yes, Lisa, I hear you, but the data is clear that there is no increased risk of breast cancer with hormone replacement. And even after breast cancer, it does not confer an increased risk of dying. And in fact, there is improved all cause mortality. Because if you do hormone replacement after breast cancer, there's less heart disease, there's less osteoporosis, there is less dementia. So the all the benefits for women who didn't have breast cancer are still true for women that did have breast cancer. The operative word is had breast cancer. So once a woman completes treatment, I think that the opportunity to live a rich, full life should be offered to her. And it is perfectly safe as long as it is done safely, correctly, by a hormone literate provider. Okay, next question. How do I even know what's causing my symptoms? I've had breast cancer. I'm postmenopausal, I'm on meds. I can't tell what's hormone related, what's medication, side effects, or just aging. So, Angela, who is 62, I hear you. I totally hear you. And it's confusing. And it's really confusing to figure all of this out on your own. That's why I developed the Breast health blueprint, so that you could learn about what comes from what, what causes what. So many people are not able to make educated decisions about treatment, about how to live their life, because they don't have the information. And the information is not readily available out there. And my approach to who gets what and who needs what and whose plan is what is unique in that I'm not doing one course that fits everyone. We are doing individual genetic testing on everyone so that I know what's the right diet for you, what's the right exercise for you, what's the right movement for you, how do we optimize your sleep, how do we support you in terms of supplements? Because who here doesn't have a supplement graveyard, right? So we don't want a supplement graveyard. We don't want to just throw darts at the wall and see what sticks. We want to do what's meaningful for us, and that's what I'm doing inside of my breast health blueprint is that people are getting an individual. So we can answer those questions for you and we can tell you what testing you need, and we can tell you how to nurture your nature while at the same time helping you to examine what got you to the diagnosis in the first place, or what's causing your symptoms, or how to recapture your health and live the life that you want to and deserve to live. So Jasmine asks, what are the best tests to figure out exactly what's going on with my body? I've done so many blood panels, but I still don't feel well. Yeah, Jasmine, you're on the line of fine, right? Because most doctors, you go to the doctor and you tell them you don't feel well or you're tired and you get the answer that, well, what do you expect? And you had breast cancer and you had treatment and you know, this is just what happens, or this is normal, or you're fine, fine, or all your labs look fine. And you know, when all you do is measure perfunctory labs and then you allow the, the standard lab result values to dictate who is fine and who isn't, then you know you have 95% of people falling within these guidelines. And of course you, you're not going to feel well because it's less than ideal. Right? Except in functional medicine, we are looking for ideal. And we're also looking at labs in a way that most standard practitioners are not. We're looking at labs that most standard practitioners are not, and we are analyzing them in a different way and we are giving you the tools to correct them. So there are some, like, non negotiables for me. So first of all, I think everyone should know what your vitamin D level is. It is so important in terms of nearly every function that you do. So most practitioners are not even measuring a vitamin D, or if they are, and your score is above 30, you're told that you're fine. 30 is not adequate, especially for someone who has had or is at risk for breast cancer. So I tell everyone that I think the minimum vitamin D level people should have is 60, somewhere between 60 and 100 nanograms per deciliter. And you need to measure your vitamin D and follow that. So if you have a low vitamin D, which most women with a breast cancer diagnosis have abysmal vitamin D levels like 10 or 20 or 30, if you have a low vitamin D level, you need to supplement up until you get it within range, somewhere again between 60 and 100. And then you need to continue to supplement and monitor. Supplement and monitor. So that's the first one I think that everyone needs to know. A high sensitivity C reactive protein, an HS CRP, or if you're using LabCorp or cardiac CRP, and that is talking about the inflammation in your body. And the higher the inflammation, the higher your risk is of either having breast cancer, having a relapse, developing breast cancer, any of those things. So ideally we want to see a high sensitivity CRP, less than 1. They call the range of normal between 1 and 3. But if you're trending up 1, 2, 3, you. You have something going on and that needs to be mitigated, that needs to be acknowledged. I also check homocysteine, because homocysteine is tied into our methylation ability. And I think that that is an important indicator for who is at risk for breast cancer and who's at risk for relapse. So I am ordering a homocysteine on everyone. I order a CBC on everyone because I want to see where your white count is, where your white blood cells are. Most of us walk around immunocompromised, so we have white cells in the twos and threes, even, even the early fours. This is not adequate. And it means that you have some kind of ongoing immune challenge that eventually will rob your immune system of the ability to fight off cancer. So I believe a white blood cell count should be above 5.5. And this isn't just for people with cancer, this is for everyone. Everyone should have a white cell count above 5.5. Other labs that I am looking at for, from a functional standpoint is I'm measuring some kind of microbiome measurement. So either the GI effects or a GI map or one, one of those tests so that we can see what your microbiome looks like, we can see what your markers of digestion look like. Do you have any chronic infections? Is there anything happening in your gut? Since gut is probably our biggest contact with the outside world, is there inflammation there that needs to be mitigated? So I'm looking at that, I'm looking at a toxin panel because I think that people need to know what their toxic burden is and specifically what needs to be mitigated. And I'm also looking at nutrigenomics because I think it's important for people to know what kind of diet is right for them, what kind of movement is right for them. What kind of supplementation is right for them? We want to test and not guess. So these are, these are kind of the foundational tests. But remember we talked about in the beginning, as far as screening is concerned, I am using the ARIA care test, the tears test, in order to determine who is at risk for breast cancer right now. Okay, so that's like a brief blurb on testing. Marina says that I've done all the nutrition and detox work, but I still feel stuck emotionally. Do you think healing trauma really matters in recovery? Marina, I. I unfortunately have seen too many cautionary tales of people doing all the right things but not dealing with their trauma. And the body is keeping score. And something that hurt you 10, 20, 30, 40, 50 years ago and is still hurting you today will continue to hurt you into tomorrow if you don't deal with it. So I think that absolutely, positively trauma matters and that we need to have safe ways of. You're not getting rid of the trauma. Right? But. But we can do things, exercises to change its meaning in today so that it doesn't continue to hurt you today. And you know, that's what forgiveness is about. It's not about condoning bad behavior. Forgiveness is so that that person that hurt you before doesn't continue to still hurt you today. Forgiveness is for you. Okay, next, if you could tell every woman listening just one thing about breast cancer prevention or healing, what would that be? Oh, wow. I think never have another screening mammogram again would. I'm pretty sure that that's my catch all because, you know, it's just another toxin. It is absolutely designed to get people into the system. And what ends up happening is that when you use a test like that, a test that causes cancer, to screen for cancer. And believe me, I am not saying that one mammogram causes cancer. Of course it doesn't. And I am also not going to allow that total lie that mammogram isn't that much radiation or it's comparable to a cross country flight. And you would never tell people to not fly cross country even if it was comparable to a cross country flight. There is a vast difference between the scattered radiation that you get during a cross country flight and the focused cone down radiation that you get to the vulnerable tissues of the breast during a mammogram. So I think that the number one thing that we can do, we can all do starting today, is to not use mammogram for screening. It would reduce breast cancer rates by 20 to 30%. These are staggering numbers. In the US alone, in 2024, we diagnosed 310,000 women with breast cancer. If we did not use mammogram to screen, that would be 60 to 90,000 less breast cancers. Last year, there are 4 million women living with a breast cancer diagnosis in the United States right now. A million of them didn't need to be diagnosed. A million of them didn't need to be treated. A million of them didn't need to suffer. We are harming way more women than we're helping, and it needs to stop. And the only way that it's going to stop is with you. Okay, I'm going to get off my soapbox now. I. I'm overwhelmed. Where do I even start if I want to work with you or just get my health back on track? Taryn, I hear you, and I know that this is all so confusing. So if you've been following me for a while, then you know about Real Health MD and you know that I offer programs that I work with women to get your health back on track. And you can find all the programming@realhealthmd.com and sign up for a call. Taryn, if this is new to you, if you're just meeting me, if we are quote, unquote, dating, then I wrote a book last year called the Smart Woman's Guide to Breast Cancer, which has helped thousands and thousands and thousands and thousands of women to understand breast cancer, to understand breast cancer treatment, to understand how to prevent breast cancer, to understand how to reclaim your health after a breast cancer diagnosis. So you can find that book, the Smart Woman's Guide to Breast Cancer, on Amazon. You can find that book on my website, realhealthmd.com and if that's where you need to start, then start there. And just know that we at Real Health MD are here for you whenever you're ready. To help you not feel overwhelmed, to help you not feel confused, and to get you on the path to health and wellness. Just remember, health is not a destination. Health is a journey. And it is a constant journey. And I can tell you that as a provider, I can tell you that as a patient, I can tell you that as a fellow human being, that the journey is not easy, it's not linear. But once you get on the right path, like I always talk about the fact that, you know, if you start in Pennsylvania and you want to go to Florida and you're going fast, fast, fast, but you're headed due north, you are never getting to Florida, right? What you need to do is be pointed in the right direction. And remember that it's the little things that we do every single day that push the needle forward. And these little things become truly gargantuan over time. And I give people the tools, the building blocks for their health. But the most important thing I do is point you in the right direction. The most important thing I do is help you shine the light so that you can see. And that is what we are doing at Real Health md. And if you, if you need help and want help, just go to realhealthmd.com and sign up for a call so that we can start you on your path to health and wellness. So I think I'm gonna call it a wrap for today, but I promise you to do another one soon. Please, please, please send in your questions because I want to make sure that I do answer your questions for you. Because the last thing that I want you to do is feel overwhelmed, feel alone, feel confused, not know what to do or where to get help. Because I want you to know I'm here for you. Thank you so much for joining me today like this. Share this Send it to someone who needs to hear it and know that I will be back next week, same time, same place. It's Dr. Jen. Bye for now.