Episode 34: Fix Your Pelvic Floor, with Dr. Tabatha and Erica Ziel

Hi, I'm Dr. Tabitha, the functional gynecologist. I'm a board certified OB, GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey and I'm super excited to share my wisdom and unique perspective as it pertains to women's health. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, then you've come to the right place. I want to be your functional gynecologist. So welcome. Hi friends. This week I'm mixing it up a little bit and I'm actually going to play an episode and where I was a guest on a podcast called the Core Connections Podcast with Erica Zeal. So Erica is my awesome friend who does core rehab. So she does online fitness programs that really help and focus on your pelvic floor health, your deep core, and helping women reclaim their bodies after childbirth and menopause. She, she is amazing. She does awesome work and she had manner podcast last year and I was just thinking the other day that it was really good information and you guys would really benefit from it. So instead of creating a whole new podcast talking about it, I figured I would just replay it for you. Because we talk about what is pelvic organ prolapse. That means things are falling, falling down there. I'm going to describe in detail what can happen and why. We're going to talk about pain during sex, what happens with menopause, the changes in your pelvic floor, in your vagina. We're going to talk about diet and exercise and how that pertains to pelvic health. And I'm going to touch a little bit on how to find the right doctor for you to help you treat this issue. And you're just going to enjoy our conversation because Erica is super sweet and knowledgeable and we just always have a good time together. So as you're listening to this today, I would really love for you to think about your own health, your own issues, and how this might pertain to you. What can you do to make a shift and take control of your health? Because if you are suffering in silence or you have an issue going on and it's preventing you from exercising or being intimate with your partner or playing with your kids, just doing the stuff that you're supposed to be doing in this world, then that needs to be addressed. And I promise that this, these issues are more common than women realize because a lot of times we don't talk about it. It's embarrassing or we think we're the only ones. And I will tell you, as a gynecologist, this is very common. So many of you are dealing with this or not dealing with it, actually, you're suffering in silence because you don't think there's anything that can be done. And there's tons that can be done. So I really want you to listen to this episode in its entirety and share it with your friends, your girlfriends, your mom, your grandmas, anybody who would benefit from this. Women who've just had babies, or if you're gonna have a baby. I mean, this is all just good information that we need to know as a woman. Okay? So I hope you enjoy this episode. Shout me out your questions, please. You know, connect with me on Facebook and Instagram @Doctor Tabitha, or go to my website, drtabitha.com Remember, it' three A's. No, I. And connect with me. I want to hear from you. I want to know what your thoughts are. I want to know what you want to hear about on the podcast, because I do this for you real quick. Before we get started, I just want to read one awesome five star review that CMA 2017 left me. It said, great podcast, exclamation point. So much good information and education gives us power to make the best choices for ourselves. Yeah, I couldn't agree more. That is why I went into women's health two decades ago thinking I want to help women have a voice and a choice in their care and in their lives. Because I didn't have that for myself, you know, as a young girl. When I got pregnant in 11th grade, I wasn't given informed consent. Discussions weren't had. There was no explanations. Things were just done to me. And that's not okay. You need to feel empowered to be able to ask questions and to be educated to know what questions to even ask. Right? So that is why I do this podcast.

So thank you.

CMA 2017 shout out to you. Please leave me a review so that I can shout you out and send you a free gift. All right, guys, here we go.

I'm so excited to welcome Tabitha. I'm so excited that you're here. We're gonna have some great conversation today. I know we're gonna dive into some deeper conversation around pelvic floor dysfunction, which I know we talk about pelvic floor on here a decent amount, but this is going to be different, which I'm really, really excited about. And you having been an OBGYN and now moving into the functional medicine space, and you've written a book which is amazing. I've read it. It was just an amazing story, which I know you've told me was your book was inspired by your story. So let's start there. Can you share with our listeners so.

That they can get to know you.

Better, like a little bit of your story and what inspired you to become an OB GYN in the first place? Yeah.

Thank you so much for having me. What a blessing. I started out totally not in the world of medicine or education. I was kind of a free spirit, not really interested in school or bettering myself. I just kind of was hanging out, having a good time. I didn't have a lot of rules or guidance, and it led me down the wrong path. So I got in a lot of trouble in high school, middle school, and I ended up pregnant in 11th grade. So back then, which is now 26 years ago, my school counselor told me I should drop out of school because I was an embarrassment and she didn't want the other girls to see me. And so luckily things are a lot different now. But my education was not to thought to be a priority. So I dropped out after 11th grade and had my baby and got married. But I soon realized that that was a huge mistake. And so I went back and struggled and did everything I could and finally got my ged. And that started me down my path toward realizing that I loved learning and I loved science and anatomy and physiology. And I went to a community college, transferred to Michigan State University, and this long winding path sent me down to become a physician. So it's been a crazy life journey. And I was in conventional medicine for, you know, a good 15 years. And more recently, because of personal struggles, I have found the world of functional medicine and have really been focusing on health and wellness and trying to do that for my patients and give them more options than conventional medicine has, you know, let me give them in the past. So that led me to meeting you at Mind Body Green in Arizona, which is pretty awesome. So I'm just really excited to talk to you today.

Awesome. Yeah, Your story is very inspiring and I just, I'm going to put a little plug for your book right now. I think it is just a very inspiring story to really show that, like anything is possible. So we'll talk more about that later. But yeah, it was, it was one of those where I, like, I started and I didn't stop. So you are Tabitha. You know, your message, everything that you do is just so amazing for women and to inspire women, like, no matter Their background, where they came from, you know, the life that they've been given, that you can. You can transform any of that. So that is really amazing.

Thank you. It's so true. And the more women stories I hear, the more I get inspired to keep doing what I'm doing. So that's why I love podcasts.

Yes, me too. So, okay, let's get into our pelvic floor dysfunction conversation. So I'm going to have you kind of take it away and talk about more the medical side of pelvic floor dysfunction. Like the actual medical term of the words. I feel like if I say them, I'm going to butcher them. The different types of prolapses, basically. I know we've talked about, you know, I've talked about pelvic organ prolapsing to a degree because I want women to be aware of it, but I know you're going to take it to an even deeper level. So can you just talk more about the different types of pelvic floor dysfunction that you see, really, on the medical side?

Yeah, definitely. And I apologize about my voice. I have a little cold. But this, unfortunately, is all too common. I see this multiple times a day, every day in my practice. And sadly enough, many women think they're the only ones. So I appreciate women like you getting the message out there that this is not a normal part of aging. Just because it's common doesn't mean it's normal and that you have to live and suffer with it. There's multiple things that can happen to the pelvic floor, from carrying children, birthing children, having chronic medical issues like irritable bowel syndrome with constipation, carrying extra weight around, having stressful jobs with heavy lifting. Many contributing factors lead to pelvic organ prolapse. So that's just kind of a broad, generalized term referring to a couple different scenarios. So our vagina has three main components. The front or anterior side, the top or apical area, and the back or posterior side. So the anterior side of our vagina is where our bladder lives. And often women say, my bladder fell down, you know, or I had a hysterectomy and they tucked up my bladder. That is referring to cystocele or bladder prolapse. That's the more commonly used term in the medical world. Everything has like three names. It's quite confusing. Anyway, the posterior aspect of the vagina is where the rectum lies, so that is what's destroyed. Very often during childbirth, you get a second degree or third degree perineal Laceration, it's destroying the fascia and muscle that is between the vaginal layer and the rectum. And even though it's often repaired, you know, especially in the western world, we do a decent job of repairing women after they give vaginal birth. It doesn't always heal properly and we don't do things support it to heal. In Africa, for example, where my partner worked for seven years, those women would give birth on their own and those areas had to heal on their own. They weren't repaired properly and such. And so you end up with things like fistulas where there's a tract or a hole between the rectum and the vagina. So. So you can have major issues with these areas. But that is why OBGYNs need to be comfortable with pelvic organ prolapse. And unfortunately a lot of gynecologists don't get extensive training in it. We get some basic minimal training, but often a lot of them don't get advanced training. And so women don't have someone to go to and they suffer for too long. That's my little sidetrack. But anyway, back to, that's okay, back to the third component is the top of the vagina where the cervix and uterus live. Sometimes that entire organ can start to prolapse or come down and we call that uterine prolapse. Traditionally, gynecologists would do hysterectomies to remove the organ and think that they were fixing the problem. Unfortunately, it usually made the problem worse because they were cutting the supporting ligaments that were designed to hold everything up. So those ligaments were weakened and now we've cut them and that makes it even worse. And so even though the uterus and cervix are gone, then the top of the vagina will fall out. So women can present or have issues in all three compartments in just one in two, all to varying degrees.

Okay, thank you for explaining all of that. No, I think that was so amazing for everyone listening to understand all of that more because there are the different types of prolapses. And I really appreciate you explaining the post hysterectomy as well, because I see, I see that and you know, in the women that I work with, because I actually, in my more private one on one practice, I tend to have conversation with women. Women tend to find me because they end up hearing, oh, I can help them with their core and their pelvic floor. And the thing that really saddens me about this, which is why I want to talk about it more and have you explain this is because so many women don't even understand that they're having these issues until they go to OB or a doctor or they see a surgeon, and the surgeon's like, we have to do a hysterectomy or. But like you just said, hysterectomy doesn't really solve the problem. Like, I say this all the time. And you mentioned the word fascia. Right. It comes down to we have to really actually learn how to correct these correctly and not just through the surgery. And I end up seeing so many women and talking to women post hysterectomy, and then they're like, the tears start coming when they realize, oh, my gosh, there's information out here that could. Could have helped me. And I've gone to all these different professionals, but they didn't know. They didn't tell me.

Right, right. It's so important to help women understand that conventional medicine doesn't have extensive training in fascia and musculoskeletal system and movement and more of how things function in health and how to prevent disease. So we are trained to remove organs that are causing problems. We are, you know, to put a bandaid on something. We're not trained to first prevent it or second, we're not trained to look at the connections and the relationships going on and stop and think, hey, why all of a sudden is she having constipation and she's having to push on her vagina to have bowel movements? Why does it hurt when she goes for a walk? Why is her pelvis out of alignment? These are all interrelated, and we're just not trained to think about things in that light. And so I think it's important to get that word out there that it's not a quick, easy fix. Surgery sometimes is the answer, but it's usually in relation or conjunction with physical therapy, major lifestyle changes, and diet changes.

So before we get into talking about diet changes with the gut, I want you to talk about pain during intercourse, because I think this has not come up on any of my episodes yet. And I'm glad that you brought it up to me. I think this is a really big red flag that women think that either they have to just suffer from it, or it's just part of life as we age and having kids, whatever it is. But that's like a really big red flag that there's something going on with the pelvic floor.

Yes, it's often a pelvic floor issue. Younger Women who've never been pregnant can have pelvic pain with intercourse or even not even be able to have intercourse because of something called vaginismus, where your pelvic muscles spasm and tighten down. You can get really good relief from that going through some pelvic physical therapy. There's also some cognitive therapy that sometimes needs to happen because there's an emotional component, often. But that's an example of your pelvic floor, you know, responding to your emotions and interfering with your ability to be intimate. And there is treatment out there. So I don't want women to think that it's impossible to enjoy sex. They should be able to. It's not normal for it to be painful. Another common thing I see is women on birth control pills. We don't know the exact mechanism. We do know that it causes more vaginal dryness and definitely loss of libido. But I have some women who have such bad vaginal pain while on birth control pills that they have gone off of them. They switch their form of pills to, like, an IUD or something else because it's interfering with their intimate sex life. Another issue is postpartum, especially women who are breastfeeding. That low level of estrogen causes painful intercourse. Some women require using estrogen cream for, you know, three to six months while they're breastfeeding exclusively, just because that tissue is so dependent on estrogen. And when your body isn't producing the estrogen because it's busy producing milk, that tissue is super sensitive and delicate. Tears easily. It's not comfortable. And often women chalk it up to, you know, well, I'm busy with the baby anyway. It's not a big deal. My husband will get over it. But then that lack of intimacy will go on for, you know, a year or two. And then their marriage is struggling because they've lost their connection. And so it's important for women to know there are solutions. There's reasons that you feel this way and you don't have to suffer. So please, just, like, reach out and talk to your doctor. Other painful reasons would be. Endometriosis is really common reason to have painful intercourse, and that's very complex. But it has to do with chronic inflammation in your body and excess estrogen. So that's more of a, you know, lifestyle intervention with some surgery sometimes, and then pelvic floor weakening after you've had children. Some women don't like to have intercourse because they are afraid they're going to pass stool, and no one wants to talk about that or Admit that to their doctor. But unfortunately it's common when you've had tears vaginally in that area. And if you don't heal well and strengthen that with Kegels and whatnot, you could, you know, have a rectocele and have a little pocket that holds your poop and then you release that when you're trying to be intimate. And some women are just mortified and so they have this whole avoidance pattern going on and it's just really sad and unnecessary. I don't know. I could go on. And then you get into menopause that's painful as well, for lack of estrogen as well.

Well, yeah, I have one thing to say and I have a question for you. So one thing with the tearing and pregnancy, and this is just for any woman listening who's pregnant or has a daughter or a friend, is that this is what, like the pregnancy program that I offer online, anyone can do it. But it's really, we have seen incredible results with women minimizing to completely avoiding tearing during vaginal births, which you and I both know. I mean, you know, obviously as an ob gyn, you see the difference of how a woman heals and also how that affects her postpartum recovery when she can minimize to actually prevent the tearing. And so that's what I really teach women is like it's the Kegel aspect, but it's even more than that about really how to connect with her pelvic floor and deep core. And we work with the fascia, the tissue to lengthen, but with a little bit of that connection. So there's support. So it's that fine finesse that is out there for women. And it's amazing. I'm so grateful that I get to be the one to teach that.

I would love if people would just go to your website and get your program because it's amazing and it's needed. Like you cannot go see a doctor for 15 minute appointment and get what you're going to get from your program. So I'm telling you, you have to use Erica's program for sure.

Thank you for that.

I'm serious.

So I want to jump kind of the other side because you mentioned it with menopause, I know nowadays I feel like some women tend to go into early menopause, pre menopause at a younger age than women did 20 years ago. And even if they don't, I think it's something I'm all about prevention and also teaching women who are listening that are like, that's years and years away. But we have women listening that are in that phase of life, either they're going through menopause or beyond. So, yeah, could you speak a little bit about to the pelvic floor, like you said, with the estrogen? I don't know because I hear different things with, do we want to be doing estrogen during menopause, after. And of course I know. Side note, everyone needs to go see their physician or functional medicine doctor. But what are your thoughts on.

Yeah, so you are right on that. It's an individual decision, you know, with you and your practitioner that there's risks to taking and using estrogen after menopause. So that's a discussion that you should have before you decide. In general, the studies show that there are benefits to using estrogen within the first five years of menopause and that the risks are. Are minimal if you don't have any special increased risks. But vaginal estrogen is different than estrogen pills or patches that you would take for, say, hot flashes, night sweats, mood swings. Vaginal estrogen is more of a localized treatment for the vaginal tissue, the vulvar tissue and the bladder tissue. We do know that a little bit gets absorbed systemically, but overall it's more of a localized effect because the dose is so low. So that just prevents the vagina from getting very atrophic. That's the medical term for vaginal dryness or thinning of that tissue. So the vagina is very elastic and mobile. It moves a lot, especially with intercourse. And when you don't have that estrogen, you lose all that mobility and that elasticity and moisture of the tissue. And so any kind of penetration is obviously going to be painful or rubbing or stimulation on the outside is going to cause tiny tears in the tissue and just in general not be comfortable. So it can cause a lot of painful intercourse and such. That is where I see most of my prolapses in menopausal women, although I am seeing it in younger women now because we're having bigger babies as a country. We are overweight as a country and we have more diabetes and diseases that don't help our bodies heal after, you know, vaginal tears from the deliveries. So we have more complications and more women are having prolapse problems earlier and earlier. And it's really sad.

Yeah. And it's also. I also think we're talking about it a little bit more too, so. Oh, definitely that is helpful, but I'd like to talk about it more so we can actually help women to Prevent it. Because you and I both know prevention is just like, that would be great.

Yeah, that's where it's at.

So if you have any words of wisdom, how do you teach a woman who doesn't know what she doesn't know to really understand the pelvic floor? It's interesting because I look at it and I'm like, I'm very grateful for the knowledge that I've had because I haven't had to have to deal with the pelvic floor prolapsing and the things like that. But for a lot of women, when they don't even really maybe even understand, I mean, obviously they're listening to us today. But to help, to just bring more awareness to. Because again, it seems like it always comes up in women, like, way down the road. They're like, oh, yeah, I've always been dealing with this symptom, whatever that symptom is, for, like, so long. And they don't even know. Because this is something that girlfriends don't even talk about with each other. Like that. So shocking to me that it's like, we can have really good girlfriends and you talk about whatever else, and maybe we even talk about intimate parts of your life. But, like, this doesn't ever come up. And you would think it would. I think it needs to start coming up. Like, if you're listening today, like, you be the one to initiate this conversation because you never know, right. How it could literally transform someone's life. Because our public health really can determine, like, the quality of your life. Right. It's. I mean, oh, totally, completely. I see that all the time.

I see women avoiding activities that they love, not going out with friends, not doing things or worrying about where the bathroom is. So thinking about it, we do talk about certain things a little bit, but we usually joke and brush them off. Urinary leakage is the biggest one. Women will joke, oh, yeah, I peed my pants if I go in the trampoline or do jumping jacks. So I just don't do that anymore. And they chalk it up to, that's what's supposed to happen. That's, you know, my new normal. And they don't think that there's anything that can be done about it. And every time I hear that, I just cringe. I'm like, you do not have to live like that. You can still go do your jumping jacks at boot camp. You can jump on the trampoline with your kids. Like, come see me. Those little symptoms, like leaking urine or not feeling like you can empty your bladder or feeling like there's something in the way with inner court or like something's, you know, getting pushed on those types of things. Yeah, they're mild and you can adjust your life and ignore them, but those are like warning signs. Like, hey, you need to strengthen your pelvic floor. Take time and, you know, do something to address those issues because they will get worse.

Thank you for saying that. Because I say the same thing. And I see women all the time that end up finding me, hearing me talking about pelvic floor, one way, shape or form, and we talk about incontinence and hands down, the inspiring stories of women that completely reverse their incontinence. If incontinence is. If that's all you have right now. Well, no matter what you have, whether it's prevention or you're dealing with incontinence or you're dealing with some prolapsing, but the incontinence, it can be reversed a hundred percent. I have had so many stories of women that said, Erica, I worked through the core rehab program and restrengthened my core, my pelvic floor, and the incontinence goes away. So when anyone tells me that, like, oh, the whole incontinence, I'm like, that is 100% reversible. I've seen that time and time again with women who. And especially that's kind of like that beginning stage of Right. If we don't fix the incontinence, then someday the prolapsing can happen.

And I see women get in this vicious cycle of they don't exercise because they leak or feel like they're going to pass gas or things like that. And then they gain more weight, and the weight adds to those symptoms. It makes their symptoms worse. So we really have to just like, cut this cycle off and reverse it. We need to just start exercising, just start losing weight, working on that pelvic floor, and those symptoms will go away. And just know that you don't have to live like that.

Absolutely. I could not agree more. Okay, so can you talk a little bit more about diet and exercise and its role on pelvic health? Because especially with ibs and I see interstitial cytitis. Cystitis, cystitis. I was like, I almost got it.

Yeah. I would say ibs, or irritable bowel syndrome, is super common. And it is a condition where most women have intestinal dysfunctional. They feel crampy, gassy, bloated, especially with eating. And then they have to either run to the bathroom because they have more diarrhea or they are constipated and only going once a week and having some fear pain from that. Or you can have a mixture of back and forth. So what it usually comes down to is these women need a ton more fiber in their diet. You need to eat your plants, you need to eat plants. Plants, plants, vegetables, fruits, you know, get those veggies in there, some grains, and have more regular bowel movements. You need to exercise, you need to stimulate the gut. You need to make more short chain fatty acids like butyrate, which help digest your food and your fiber and get your guts moving. But what I see in the office is women will come in with the complaints that they're usually sent by their primary care, actually saying they have a rectocele that was seen on exam. And so the patient has a bulge into the vagina. And when I start to ask her questions, she says, yeah, I have trouble having bowel movements. I have to push on the vagina. I only go like every three or four days. I have to use stimulants and laxatives all of the time. I take Miralax every day. And I stick. Still don't have bowel movements or I have diarrhea and can't hold it and have fecal accidents. Like I have a lot of older women who stop doing activities because they're afraid of having an accident and not being near their home. It comes down. I mean, it's multifactorial, but a huge part of it is their diet. Too much caffeine, stimulating their bowels too much, not enough fiber to bulk up their, their stool and get things moving. And then that rectocele, it's either there from childbirth or whatever, but it's made worse by straining and having large bowel movements. And it destroys that pelvic floor, that fascia. And so, you know, we have to tackle this issue from all sides. So I, as a surgeon can go in and repair your rectus, but if I don't talk to you about changing your diet and your lifestyle, in two years, it's going to be right back where it was and it's probably going to be worse. So that's what I see quite often. And the same goes for the bladder. You have something called interstitial cystitis. That's a diagnosis for women who have either painful bladder or frequent urination. They just feel like their bladder is of kind. Constantly irritated, they're going to the bathroom, like every hour. They lose sleep over it. They don't do stuff because of it. And it's often diet. It's from the diet or we think from high histamines. It's associated with seasonal allergies, eczema, asthma, things like that. And we know that there's an IC diet that women can follow that often helps those symptoms. But if you have bladder prolapse, where things are falling down and you're not emptying your bladder because it's physically hanging, that can worsen the situation and put you at risk for bladder infections. So it's so multifactorial and it's not anything that just surgery will fix or just your diet will fix or just doing pelvic physical therapy. I mean, you just, everything's connected. You have to work on all aspects, but know that you can and that there's help.

Absolutely. And that's the most important piece. Everything is connected in the body and you can change and improve anything about your body. I firmly believe that. I see it all the time and I've experienced my own stuff with my body and you have too. So it's just absolutely. I mean, the body is really amazing. We just need to be talking more and communicating with each other and medical professionals. Okay, I want to ask you this because I know I'm going to get this from our listeners. Is okay, Erica, how do I find the right doctor to go to? That's a big open ended question. I know, but what is your advice?

Oh, that's such a tough question for me. I have women who will ask me for referrals just around, you know, the town I live in. Do you know a good primary care doctor in, you know, the next town? Like, you would think it would be a lot easier to have those answers.

And it's not.

Because even though we all do the same training, we all have different experiences and biases. And just because someone is a surgeon doesn't make them a good surgeon. Or if someone's an amazing surgeon, it doesn't mean they necessarily understand the other aspects that are so important to your healing process. So I would say word of mouth from your friends is usually the best referral source. Like that's why it's so important to talk to your girlfriends and say, you know, I'm having this problem. Do you know anyone who's gone through this and who did they go to? Because a good physician is going to address all those aspects. So you want a gynecologist who is comfortable with pelvic floor repair and who is comfortable with lifestyle changes and knows the latest research on the gut microbiome and, you know, how the diet impacts our health. And don't be afraid to ask questions. And even though they're, quote, unquote, the experts, a lot of physicians practice the way they were trained. And if they trained 20 years ago, they could still be practicing in that realm. So just be cautious and don't be afraid to ask questions. It's your body. And rely on your friends and open those conversations for sure. And go to Erica's website.

Thank you, Tabitha.

Yes.

And I think just one thing to add on that, because I talk about it a lot, is trusting your knowing and your intuition. And if you, you know, even if, you know, if you've had a physician, you may love that physician, but you have that gut feeling that something's just like, like. No, but there's more like question things, ask great questions, will help you get better answers. And I think sometimes it's easy to, you know, go with what's almost easier, like, oh, I've been going to this position, or I don't know one around here. But nowadays you can find so many different professionals where you can work with them online via, you know, and sometimes just for, obviously you can't do internal exams and things like that, but sometimes just having conversation with someone else that has a different perspective and like you said, different life experiences that could just be that little nugget that you needed. I mean, I can tell you, I'm sure you do the same thing.

Like you.

And especially being where you're at, you have opportunity to talk to so many, so many people in the functional med world, which I love. I was like, so geeking out at our event, I was like, oh, my gosh, this is so amazing to, like, have incredible conversation with, you know, functional medical professionals. Right. Because that's who was there at our Mind Body Green event. It was, was so amazing to have that energy. So just getting all those different perspectives or getting one other perspective just can be so powerful. Right?

Yeah. And one other little thing I thought of is a good physician is going to admit their limitations. They are going to say to you, hey, this isn't my area of expertise. Let me find you someone, you know, to help you because we're not good at everything. Like, I'm not going to help you with your ear, nose and throat, you know, or stuff like that. So if they act like they can fix everything, be a little weary and just ask questions.

Yes, absolutely. So is there anything else you're dying to add here on everything we've talked about. So make sure I haven't missed anything that you're really wanting to share.

No, I'm just really excited to connect with someone who understands the pelvic floor so well and is really passionate about helping women heal that because it's so important and it touches every aspect of their lives. It's not, you know, something that should be a secret or not dealt with. So I just appreciate knowing you and I think it's pretty awesome. Well, thank you.

And I am so grateful that our paths crossed. Like it was just one of those meant to be things, so.

Yeah, exactly.

I want to let everybody listening know. So you are going to be speaking at the BE events on September 4th in.

You want to share a little bit more? Yeah. So September 14th in Muskegon, Michigan. It's at the Frohenthal Theater. It's a big historical theater. The BE event is a women empowering and leadership event. And it was born out of kind of a tragic event that happened to my friend and myself five years ago. And we had an amazing friend. She was the dentist. And she just strongly believed in community and sisterhood and like building each other up. And so she was always volunteering and helping out in the community and making a difference. And she actually passed away unexpectedly while I was caring for her. She was in labor with her daughter and she had an amniotic fluid embolism and passed away. I worked on her for three hours trying to save her. But I did save her baby, who's now five years old. So. So my friend Megan Heritage wanted to honor Elizabeth's life and legacy by creating this event where we just be. We be women together, we support each other and lift each other up. And she is a frickin rock star. And this event has just grown year after year and this is gonna be the biggest year yet. She is bringing in a speaker. Her name is Jean Houston. She sat on the stage with Oprah on Super Soul Sunday. She's written multiple books. The most recent is the wizard of Us. And it just really talks about community and bringing women together and what it means to be you original, you like, deep down inside and how you can reconnect with that and be authentic in this crazy world and, you know, help other women out. So I'm super excited. I get to speak on health and wellness. There are six other speakers speaking on different topics like finance and spirituality and such. And so it's just an awesome event and I'm really excited for our community to just keep working together and growing. And I'm so proud of my friend for everything she's done. So I envision her to take this nationally at some point. I know she just did an event on the other side of the state, so she's already expanding and so be looking for her because she's pretty freaking awesome.

Well, it sounds like an amazing event. I was reading up on it and I was like, I will definitely have to get to one of them for sure. Yeah. And then let's let everybody know about your. So it is called From White Trash to White Coat. It is just an amazing. Again, just your story. It's amazing. And if you want to speak a little bit more about your book and then where our listeners can find it and learn more about you and all.

Of that, well, thank you. I'm so humbled that you read it. That's pretty awesome. I've had so many struggles in my life, and I finally learned the lessons that I need to learn. And so I wanted to share my story because I just think it's so important to share stories with each other, to help learn from each other. So I did fictionalize it a little bit just to protect all the people I love in my life, But I wanted the message to still be able to come through. And it's essentially about my life growing up and not having. Not knowing where I was going or what I was doing, but having a little bit of faith deep down inside of me. And that faith kept me going and put me back on the right path so that I overcame all my struggles and going through high school pregnancy, ridicule, stigmatism, all those things. Going into medicine as a woman and dealing with all of that, it was difficult. And I just felt like that was kind of my way of healing was by writing this book. But I also want other women to know, hey, if you've gone through this crap, like, you're not alone. So I've had a lot of women tell me that it made them laugh, made them cry, and made them think they couldn't put it down. So I thought that was pretty awesome that some other women, like, actually read my book and gave a crap. So it feels pretty cool.

It's a good read. Absolutely. And you have some great messages to share in it. I definitely would say I had all those emotions reading it as well.

Thank you.

Well, thank you so much, Tabitha. This was such amazing conversation, so I'm so grateful that we have the opportunity to have you share.

Thank you. I know. Thank you for messaging me at Revital Lies. Thank you, Erica.

So thanks for listening I hope you got something out of that today. And I just wanted to tell you that since that has aired, I have bought a vaginal laser to use in my office. And that has been life changing for so many women. That corrects mild prolapse. It helps helps a ton with urinary incontinence and that urgency feeling. It helps with dry, painful intercourse. It's been a game changer for so many women. So it's really awesome to have more tools in my toolbox and not just relying on surgery or a pessary. I do think that Erica's program is so amazing and you should really check it out out. It's called Core Rehab. I'll have the links in my show notes and you can also check her out@erica zeal.come e r I c a z I e l.com I'll have that link in my show notes. But please think about something that you can take from this episode that you've learned or that you've remembered about yourself or you realize or and make a change. Make a shift toward wellness to reclaim your health. Because if you do that every week when you listen, these things add up. Okay? I want you to take the time for yourself and believe that your body can heal and change. Give it the love that it needs to do those things right. I would love for you to follow me on Instagram or Facebook. Dr. Tabitha, shout me out your questions. I want to hear from you. And if you're feeling like you're getting something from this, I would love for you to hit the subscribe button and give me a review. Five stars would be amazing, right? But my greatest ask is that you share with another woman in your life, someone that you think would benefit from it. So if you know someone who's dealing with this, or maybe you don't even know if they're dealing with it, but you are thinking maybe, but they are too shy to talk about it or it's awkward. Just shoot them the link for this podcast and that might be enough to help her change her life for the better. So let's support each other, ladies. You know, go out and have an amazing week.

Bye.