Episode 130: Why Functional Medicine Is Winning the Health Game with Dr. Aimee Duffy

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Dr. Rob Whitfield, the board certified plastic surgeon specializing in explant surgery. Breast implant illness is a topic that is not often talked enough about, especially in medical community, but is something that affects many women. In this podcast, I'll be discussing the latest research, treatment options and personal stories of women who have undergone explant surgery in an effort to heal breast implant illness. In this podcast, we'll explore the symptoms of breast implant illness and delve into the latest surgical techniques for explantation and the recovery process. Whether you are currently experiencing breast implant illness or are considering explant surgery, this podcast is a valuable resource for anyone looking to take control of their health and wellness. So let's dive in. Welcome to this episode, explant surgery recovery Dr. Robert Whitfield. Today I'm interviewing Dr. Amy Duffy. She's a board certified physician and founder of Carolina Integrative Medicine, specializing in functional and integrative healthcare. With over 20 years of medical experience, Dr. Duffy is dedicated to empowering individuals to regain their vitality and wellness by addressing the root causes of complex health challenges like hormonal imbalances, chronic fatigue, weight changes and mood disorders. Dr. Duffy's experience and expertise in functional and integrative medicine is recognized on a national scale as she is frequently a guest on abc, NBC, CBS and Fox. She is known for her dedication to helping people thrive at every stage of life. Her mission is simple, to help individuals feel empowered, balanced and in control of their health. Welcome to the show, Dr. Duffy. I have a special guest in front today, Dr. Amy Duffy. We're in groups together. I've heard her speak. You've probably heard her speak on multiple news outlets. Welcome to the show, Dr. Duffy.

Thank you. This is so awesome, Rob. Thanks.

Yes, we've been chatting about getting this organized, but Dr. Duffy has an incredibly busy schedule with appearances and lectures and she was just regaling me with a a cruise slash business trip she was on recently, which sounds a lot more work than I am up for.

It was fun though too. We got to have fun while we're working. That's the bonus.

Well, certainly. And when you go back to Carolina and Dr. Duff, she has a wonderful practice in Carolina and she's very interested in sharing both how she got started with that practice and then, you know, whether it's in person care or virtual care or business coaching, she's going to explain to us how she's evolved and wants to move forward.

Yeah. So everybody always asks, I'm a medical doctor, I'm family practice by trade. And how did you get into this functional medicine, integrative medicine, hormone health path? And it goes way back to when I was little. I actually loved babies when I was little. I just wanted to hold every baby. I volunteered in the church nursery all the time. And I started babysitting when I was 11. And actually I met this family at a pancake breakfast in the neighborhood and they said, can you come babysit our, you know, our baby just loves you. And I was like, I don't know if I'm old enough to babysit. But I started just being, she called it a mother's helper. Just come hang out and play with the baby so I could get some stuff done around the house. And so that relationship continued from 11 years old all the way through college. Actually, I'd go home in the summers and babysit for them. So when I was 17, senior in high school school, they were having another baby and offered for me to be in the delivery room with them. So that was my first experience in sort of hospital, any kind of, you know, medical procedure type stuff, particularly a delivery. And I just absolutely loved it. When I saw baby Joshua get put on mommy's belly, I was like, this is so cool. I want to do this. This is the job I want. And I thought I wanted to follow the baby, but I really wanted to be part of that whole birthing and delivery experience. Then I thought I wanted to be a midwife. And some smart person talked me out of that and said, just go to medical school, that's what you need to do. So college, medical, medical school, residency, I did it when I was in medical school. I had my first baby in third year of medical school. And so you're doing lots of rotations and trying to figure out third year and be pregnant the whole time. And not only are you tired from being on call and up 24 hours, also pregnant, moving towards that OB type practice, and thought I needed to do something that maybe was more calm, for lack of a better word. So when I did my family practice rotation, like in the hospital, it's just very hardcore, you know, like there's no time on the clock. You never stop. You experience that now, right? And then I got to family practice and it's like, you know, we all work hard, but this was my imagination in the residency was like, you know, we stroll in at 9 with our coffees and then what time is lunch? And then 4pm There was like a lecture or something and then you're done for the day, unless you were on call and you stayed and it just seemed like such a more hospitable environment than. Than the hospital system. So I chose to do family practice, found a residency that was very heavy in the obstetrics. We did obstetrics for, like, the. The indigent population in a small town here in South Carolina. So I delivered thousands of babies in my residency, got C section privileges, like, loved it. So that's really where I moved forward. Then I got an offer from the OB GYN office next door to join their practice to be primary care for women's health and then share OB call with them. And I thought I was in heaven. This was the best thing ever. And I was, except that I really didn't have very much, like, GYN training. We had about two weeks in family practice of, you know, rotating with the GYN on. Here's the samples in our closet of what you might use for hormone replacement or whatever the case was. So all these patients were dealing with what we thought or what they thought were hormone issues, whether it was menopause, whether it was perimenopause, irregular periods, mood stuff. You know, you felt like you're a counselor. Like, you come in and they're just throwing all their. All their stressors and not sleeping well and depressants and, you know, all that kind of stuff. And so I really felt inadequate. We. This was around the time that the Women's Health initiative came out 25 years ago, telling us hormones were bad, right? So I'm over here going, how do I manage not wanting to kill people but also take care of their symptoms, right?

Can you explain how bad that was?

It was awful, awful, awful. So this study came out, and it was, you know, two medications that are synthetic. Premarin and Prempro, or hormone replacement for postmenopausal women. Number one, the study was done on women that were way postmenopausal. Like, the Average age was 65, 66. Menopause happens at 50. So, you know, we were already well beyond menopause at that point. And we knew that these medications were very positive for bone health. A lot of women were on it just to protect their bones, basically from osteoporosis and menopause. But the study was actually scheduled to go on for years, and it got stopped early, about three to four years into it, because they saw an increased number of strokes, blood clots and heart attacks, as well as breast cancer in these women, particularly on the side that had the Prem Pro, which is a synthetic progestin. And so they stopped the study. Basically, all the bells and whistles came out and said, hormones bad. We should all stop using them. Not really recognizing that there are all different types of hormones, not just these two. But it really got a bad rep for the whole hormone menopause, hormone replacement world that hormones were bad. And still to this day, I mean, I had a patient just yesterday who was like, I've talked to my GYN and they told me, no, no hormones ever. Should I be on it for a fibroid. Fibroid. She had a hysterectomy because of fibroids and was told that she should never be on hormones. So, I mean, still to this day, and that's, you know, part of our passion of getting out there and speaking is one, we want to share the safety of hormones with our patients, but we want to help other practitioners that this crazy world of hormones being unsafe. I just spoke on hormonal decline and chronic disease and the relationship between the lack of our hormones like estrogen, progesterone, testosterone, and the increase of cardiovascular disease, of cancer, of osteoporosis, those sorts of things. And if we can replace these things naturally with topical bioidentical hormones, we can turn this ship around big time in terms of the chronic disease.

So pause there just for a minute because, you know, I'm relatively outspoken in general about what I do and things that we see. And so when I venture down, you know, and discuss this, I'm pretty careful with how I discuss this specifically as it relates to surgery, recovery, efficiency of recovery. I always communicate with my patients strongly that you have to, especially as a woman, avoid osteopenia, osteoporosis, fragility, frailty, doing things like spin workouts, hit workouts, high intensity intervals. These things are all not going to serve you in the long run. So I talk to them about walking, lifting weights, doing things that are going to preserve your muscle mass and avoid what we don't want, which is frailty or fragility. And you don't break your hip. Like, let's just speak very plainly what we're talking about. I don't want my patients falling down, breaking their flipping hip.

Yeah, the mortality rate for hip fracture is huge. And it's such a weird phenomenon, but, I mean, it's just a pain in the butt, too, to fall and break your hip. Right? And usually it's a surgical intervention, but there's like a 12% mortality rate in, you know, within a couple of years after breaking your hip, which is like higher than any other mortality rate for some other disease, dysfunction. And people Just don't put two and two together.

And I'll give you the real terrible, dirty aspect of this, that every woman listening to this or you, when you share this, should listen to this. You know how that happens, Right? So we're going to say they don't listen to you or listen to another person. Person who's more informed or informed about this, you know, to the degree you are. They avoid replacement therapy. They're already osteopenic. That's standard. They may have leaky gut, all sorts of other things. Live in a bad environment, drink out of plastic, just do all the things. Right. First their spouse dies. So their husband dies, their primary partner dies. So now they're alone, which is very common because women are alone more than men. Right. Am I making that up? That's correct. Right.

No. No. Yeah.

All right. So this is what orthopedic surgeons used to tell me. I used because I to be associate professor for the big church. They would tell me, like, hey, Rob, you know how this works is I'll get a call and they'll have found somebody sitting in their own poop. A week.

Yeah. Because they fell in the.

Somebody actually went into their home after not seeing them for a week. Not a day, not two days, literally a week. Because they've fallen. They have no device to alert anybody they've fallen. They don't have their phone on them. They can only scream so loud. They're already typically, as you know as well as I do, malnourished. They're just frail.

Yeah.

And then now what'? Your chance of survival? You've been sitting in your own poop with a fracture for a week and you're malnourished right now you're even. Basically, you're on a hunger strike and your body's like, what the hell are you doing? I'm broken and you're not feeding me and you can't sleep. Like all the things that are necessary to help a surgeon who, no matter how technically gifted they are, can't overcome malnourishment.

And there's not a whole lot in an IV you can do either at that point to load them up, right? No.

And they have to fix it.

Yeah.

So they're going to take you to a hospital, this poor little, little thing who fell and broke her hip. And they're gonna basically half the time, you know, what they have to do is have to replace the hip. So now you've got somebody who is not a surgical candidate to begin with, who's in the acute situation. Who's malnourished, who's probably got no hormonal balance. Not a little hormonal imbalance, but no hormonal balance. Like, no testosterone. And that's what I tell people. Like, from my perspective, like, when I see your labs and, you know, I've spoken about at Armenia is I look at 3 and total testosterone for a reason. And when somebody has, like, almost. And this is common, Amy, undetectable free testosterone levels, they're like, can I have this? Can I have that? I'm like, no, we can give you some hormones or Dr. Amy can give you some hormones, but you're not getting surgery from me. Yeah, the surgery is not Harry Potter's magic wand hormonal imbalance. Like, I am the biggest driver of cortisol you've ever met, Amy. I make all your people look like nothing when it relates to how much cortisol I can cause because I operate on people for a living.

Yeah.

And if you have no hormonal balance, what do you think happens when Whitfield gets a hold of you in the operating room?

Right. Well, again, that person probably, you know, had a huge cortisol spike and probably had some adrenal dysfunction to begin with. You know, we can get into that whole thing, but, you know, now they don't have the ability with. With all the things you're talking about, nutrition, etc, hormones, but cortisol is really important for the inflammatory process, healing, you know, recovery, all that kind of stuff too. And they're probably tanked at that point with. With cortisol production.

So, yeah, it's a really underappreciated how the. Well, obviously, people we look up to and admire for their approach to this. A very integrative approach where you. You blend what we know versus things that we should do better, whether it's nutrition or the quality of the. The things we, you know, put in air quality, food quality, food quality, you know, things that people just take for granted, literally. I had a patient tell me this past week, you'll. You'll enjoy this. She comes in and she wants to have explant surgery with me. And I said, okay, you know, I'm listening and, you know, hearing the story. And she's like, I have adhd. All of my kids have adhd. And she's going on and on, and I'm like. I'm like, so what do y' all eat? You know, just tell me, like, what's going on? She's like, well, we got a lot of monster red bull and C4 or something in the house and the kids really like candy. And then I just kind of lost my mind. I was like, you get how old's your youngest kid? She said seven. I'm like, you give a seven year old monster. First of all, that's not okay for you to drink. First of all, that's a non starter.

Yeah.

Be a patient of mine if you do that to yourself.

Yeah.

And I mentioned this because I think it's underappreciated because people don't know what choices to make because they haven't been instructed about what's good, what's not good. And they see all the stuff on TV or social media or whatever they're getting content from, however that looks. And so a 7 year old doesn't know anything. What do they know? But if parents making a bad decision, then sorry, I had to have an intervention. Dr. Amy. I just basically said, okay, here's the deal. You cannot ever have any of those things in your house again if you want to be my patient. So you're going to take all that crap, all the soda, all the. I can't believe she's giving kids. Monster. Monster. And what was the other thing I said? Red Bull.

Yeah.

And I was like, you gotta take all that out of your house and you can have. Although this is not perfect. This is a bridge to just drinking like filtered water. I want you to drink Zevia. I know I don't support Zevia in any way or shape or form, but I'm just trying to give them a stepping stone to change a behavior.

Right.

Because now they've got everybody addicted to sugar and caffeine.

Yeah.

And then I said, you know, you cannot give ADD. Yeah. You can't give kids who have ADHD, Skittles and M&Ms. And Red Bull and Monster. That doesn't work. First of all, those things have well over 100 milligrams of caffeine and too much sugar in them and all the things. So I said, there's this company called Human Chocolate of which I have no relationship. It's just a chocolate company founded out of Austin that got sold. Anyway, give something better, like just a little bit better. And they don't have to have Skittles and Red Bull for breakfast. I mean, that's crazy. And then we have a restaurant here called the well. So anytime you're in town, or anytime my patients come in town, this is where I send everybody. It's gluten free, dairy free, no seed oils.

Yeah.

And so people mo don't really understand There's a avenue to eat better. And it does taste great. You. You just. If you don't know that, as you know, and I know you can't make decisions that are going to support your health and your family's health if you don't really have any kind of. And so it's. It's a story that won't leave my head. It, like, plays on a loop in my brain all the time. And this lady saw me the other day. So she went and listened, which I give her full credit for. She listened. She didn't get turned off. And she went and she ate at the place I told her to. And I said, hey, I want you to take some tacos and some spaghetti Bolognese home to your kids. Because kids are all like, kid food is pasta and all the junk. And I said, I guarantee you they will like it because it's really good. It tastes good, has all these natural flavors and ingredients. They're not processed by any means. They don't do that there. And so this is foundationally how you should eat. And you'll see behavioral changes in as little as a few days to a few weeks in your kid because you're not giving them this crazy amount of caffeine and sugar, and you'll feel better, too. And so, like, I know that we got a topic there, but, like, foundationally, people don't understand these very simple principles. And then, you know, they look at me like I'm high as a kite when I start to explain them. As a plastic surgeon, I'm like, doctor, I mean, knows I don't have to see or operate on anybody. I don't need that. I'm more than happy to tell you, no go. Because when people aren't ready, I'm not going to make that better. So basically, I'd like to have six months to a year Runway anyway to take care of anybody so I can clean up.

Exactly. So in that elective surgery, although breast implant illness isn't always elective, like, once you find out that this might be something, you know, stressing your system out, you want to get it out right away. But like you're saying, you know, you've got to have a foundation that's ready for healing for a major surgery like that. And I think that's a huge part of what we do, is education. I mean, my patients watch up to five or six videos at least, before they get in front of me, probably even more than that, you know, so we're constantly talking about helping them understand the why behind what we're doing, whether it's nutrition, I mean, our wellness programs, very similar to yours, focus on nutrition, on toxins and detoxing your body, on gut health, on hormone balancing, on moving your body, fitness and then stress management mindset. Like, again, you can't have somebody come in with all these issues and think that there's going to be one thing, even hormone. You know, people come in, oh, I need hormones. I'm having hot flashes. I need hormones. Hormones. You may need hormones, but we also need to deal with, you know, hot flashes can be caused by, gosh, blood sugar imbalance and insulin resistance. If you're drinking, you know, bottle of wine and margaritas all night long and then you're having night sweats, it's not a hormone issue, you know, dietary issue.

I'm glad you brought that up. Feeling low on energy or stressed out? You might be missing essential B vitamins. Introducing liposomal B complex from Dr. Rob Solutions. The blend designed for maximal absorption to fuel your body's energy production and support mental clarity. Everybody's heard of the MTHFR gene. You need a methylated B complex in order to support this. If you have this problem, which about 40% of Americans do, B vitamins play a critical role in reducing stress, boosting mood, and maintaining overall vitality. With liposomal technology, you get the nutrients where they are needed most right into your cells. Discover the benefits today by visiting the link below or visit DrRobSolutions.com and revitalize your help. So Amy and I were both at different meetings recently, and I end up getting in this picture and it's got Gary Bra and it's got Chris Williamson and Jim Quick, Josh Axe, Ben Greenfield, Max Lugave, and me and Mark Sisson. Did I say Mark Sisson?

You didn't.

Okay, so Mark's in the picture. For Everybody listening. I'm 55. Mark is 71. Mark the most ripped person in the picture. I'm embarrassed. Right. Mark is way fitter than me and I'm like, what am I doing here? Like, I'm just looking like a slug, basically. And so I end up talking to Mark about his talk. He gave a talk about walking, so he sold Primal Kitchen. He founded a company called Paluva, which is a toe shoe and I've worn toe shoes. Vibram, etc. I don't have any relationship to any of these companies. So just, I don't get paid. Just. Yeah, so I'm just telling you. So I'd been told about Paluva for a while. But, you know, I get busy like you, and I'm like, stuff loses, you know, I can't find it later on. And so I finally got a pair of paluvas. I really like them. They're super comfortable to me. I now wear them to operate in because I get a lot for everybody listening like a surgeon. Like, I will stand in a position for multiple hours at a time, which is terrible for your neck and your back. And just overall, it's bad. It's cost me probably a lot of years on my spine, but that's fine. So Mark gets up and gives this talk, and his talk is about not just being barefoot, but the whole crux of the talk is the best exercise. The same exercise. I tell everybody the same thing Dr. Amy just said was, walking is a phenomenal exercise. And you can build both. You can do it alone. You can listen to stuff if you want. You can do it to build community. You can take your spouse, your partner, loved ones, your family, whatever, and you just walk. My wife loves to do this. Amy. Like, we went to Europe recently, and she would walk for, like, days if I let her. Like, she'd just wear me out because she didn't have feet that have stood in an operating room for almost, you know, over 30 years now. So it's very different biomechanics. Mechanically, for me. Like, I can walk, but after several miles, I'm like, I'm tapped out. I gotta get out of here and, you know, sit down. But he gave this great talk about walking, so I'm gonna have him on, you know, our show just to discuss it because he's so well respected, and he. He does such a good job about the presentation and why it's super important to walk and not do all these other crazy things like run and. And do crazy amounts of cycling and all this stuff that is long endurance running.

You know, people think they need to go run miles and miles to be fit. Yeah.

And, you know, that's just dopamine release. Ultimately, that's all it is. You're just pouring out yourself for dopamine. That is it. You can eat.

Yeah. I have his books in my office still. The Primal Blueprint and the cookbooks and stuff. We talk about it all the time. I mean, I use caveman day examples when we talk about adrenals and. And as it relates to hormones. You know, I talk about this with our younger female patients who can't figure out why their hormones are all messed up. You know, where's that coming from? And I'm like, That's all stress, adrenal. Right. Like, our body's number one job is to keep us alive first before we're ready to procreate. So if we're dealing with infertility, we're dealing with women in their 30s or early 40s that are like, I think I'm going through menopause. Why is this happening early? And what I have observed in my practice is through testing. I do cortisol testing on everybody. The low progesterone happens early because our body's pushing it all towards staying alive and keeping that cortisol up. Because we're so stressed out all the time, we're funneling the pathway to more cortisol. So can you preface it.

Can you preface it to those on and off birth control? Like, what are they experiencing? That may be different because I. The birth control group is wildly.

Well, so there's two reasons someone's prescribed birth control, in my opinion. It's, I need a contraceptive support because I don't want to have babies right now. Right. So that's a separate entity, I guess. And that certainly can play a role, too. I mean, and the. The hormones that are in birth control are generally synthetic hormones. And their job is basically to suppress your own hormones so that you're not ovulating. It can regulate your cycles. Basically, kind of shuts everything down. Right? So that's how it works and how it keeps you from getting pregnant because it keeps you from ovulating. What happens in our traditional medicine world is. Is someone in there? I'm talking, you know, someone who may be done with birth. Let's say they. They're 42 and they've. They've had a tubal or their husband had a vasectomy, that they don't need contraception. Okay. Go to their doctor, and they get put on birth control to control a symptom. I'm having irregular periods. I'm super moody during my cycle. You know, something like that. It's just like, oh, well, let's just throw birth control on you. Yeah. It's not. Birth control was created for contraception and not hormone replacement to band aid. A symptom that we can control. But my point is, you know, I talk about it from a caveman perspective, is like, you know, if our job is to survive from a female, we talk about libido. We can go on and on about all these different examples, right? It's like, if your cortisol level. Let's talk about that for a minute. Your adrenal glands make Cortisol, you could also call that adrenaline to some degree. So when you're stressed out, you're, you're a caveman, you're out walking, everything's nice, and you see, see saber tooth tiger crouching over here. You know you're going to get this message from your brain that you better start running. We're going to run really fast, we're going to jump really high, we can lift heavy things out of the way. We sprain our ankle, we don't feel the pain. We got to run until we can hide in a cave, right? Outrun the tiger, hopefully survive, catch our breath for a little bit. The tiger gives up and goes off on their own. And then you go back to your village and you tell a story and you're like, cool, look what happened to me today, right? And life goes on. Well, we have things, you know, coming at us all the time that are quite the level of the adrenaline rush you need from a saber tooth tiger. But we've got dr, we've got traffic, we've got text messages coming in and work related stuff and everything that's stimulating our brain to raise our cortisol initially. And our bodies were not meant to do that. So over time your cortisol levels start to decline because your adrenals don't have all the ingredients it needs to make more and more and more cortisol all the time. And over time then the brain goes, well, if you're not going to respond, I'm not going to listen. And so we get this suppression of cortisol over years and years of chronic stress. So a lot of people think their cortisol levels are going to be through the roof when we measure them and they're actually low. So back to this caveman analogy is like, you know, you're going to stay in your cave because if you go out of that cave, you're not going to be able to run from the tiger. You don't have the ability to kick up that cortisol in order to run from the tiger. So it says, stay in your cave, right? And then it says, if we can't make sure that this own, this woman, this own body is going to survive, why in the world would we put a baby in there and hope that the baby is going to survive too? So infertility happens at that point. Libido, right, goes downhill because it's like we're not going to procreate if we got, if we got to worry about survival first. So everything gets shunte to, down to Survival. And we don't realize that because we don't feel like our lives are in a state where we're trying to survive every day. Like, we're not Hunger Games. We're not, you know, something like that where the world's ending and we gotta, you know, carry our guns and our bows and arrows around everywhere but this constant bombardment. We can go back to the food we were just talking about. I mean, that stuff that we put in our body is just as bad as the stimulation that we're getting from the outside world. So all those chemicals, all that sugar, all that caffeine, all of that stuff is a stressor to our internal environment as well. So even you just. I know it sounds complicated, but it's really not. Like, it's very simple. Your body's trying to keep you alive, and it's going to do everything it can to stay alive. So it's going to not do normal stuff in order to shunt everything to staying alive, basically. So that's really where we get to the basics of what do we eat. And that's why I go primal blueprint, right? Like, what did the caveman like? They didn't go package stuff, and they didn't even really grow things, right? It's like, you know, there was an apple or a nut or a berry, and then we ate some meat. Meat and like, happen.

And then if they couldn't find it, what did they do? They just. Fasting.

And then, yeah, they fasted or they walked, you know, for a long time until they found something, right?

So I used to always ask that question. I mean, I'm sure you've done this too. I'm like, do you. I would ask people, I'm like, do you feel better if you're fasting, have not eaten, and they're like, oh, yeah, I don't feel good. I'm like, there's your answer, right? You know, what you're putting in. Your body's like, well, unless they ate.

Skittles and monster, and then they feel like crap two hours later. And so then they get grouchy and they got to go find more.

More, right. Those food to fulfill that. Those choices. When I had problems with a little bit because I have non celiac gluten sensitivity. And before I knew it, I always felt better if I was fasting for obvious reasons, because I just didn't know when I ate things, like what was going to happen. Obviously, now I'm very intentional and I'm. I mostly have just like, I like protein and I Eat a lot of fruit and that's how I get fiber. And that's totally suits me. I'm super happy. I went to dinner at the place I told you about the well and you know, in my neighborhood in Westlake Hills. And I don't necessarily have like a, a what you would consider the entree on any menu. Like if I just want to have protein, I'll just get a couple sides of salmon or I'll get a couple sides of wagyu and that's what I'll eat. And people look at me like, ah, you're not getting a vegetable. And you know, he goes, no, yeah, I just get what I want. I don't get what you think you want or think what you think you need. I just eat intentionally on how I want to eat. Like, you know, don't project your nonsense on me. That's not okay. And you know, at this place that I frequent all the time and you know, they got great bone broth and sometimes I'll, you know, if I'm feeling it, I'll get some vegetables. But most of my doubt, I just don't sell my thing.

That's it. Well, you know, we often go to restaurants. I mean, I'm gonna throw Mexican out there. You know, you got Tex Mex everywhere. And like, you know, you start the meal with your chips and salsa and your margarita and like you, you've got, you know, more carbs in the snack, you know, before your meal even came. Then you should eat in three days. So yeah, we're.

People come visit Austin and they want to go have Tex Mex. And I'm like, no, I'll sen to this place. You can get some tacos. But I don't want you eating Tex Mex. And this is not the time to go have sushi. You're going to have surgery. Like, this is not, you're not going on a Michelin star retreat here stick from eating a bunch of stuff.

Well, I think people get scared of fasting a little bit because they feel like it's so extreme. And what, you know, am I going to get hungry and all that kind of stuff and, and you know, we're not talking about doing a, a 12 day fast, even a three day fast. Like you're just talking about, about don't eat breakfast. Right? Or it doesn't have to be quite.

The master plans or anything.

And it can also be, you know, again like you're saying, just, just fasting from the things that we don't need to be putting in Our body. So it doesn't mean you have to be on a complete calorie deficit. But how about fast from sugar? How about fast from, you know, those complex carbohydrates, the gluten, the bread, you know, that kind of stuff. So, so you can fast without it being this scary withering away.

Bread freaks people out when I tell them not to do that. So there's a company called. It's All Good.

Good.

And they have this great sourdough product they deliver to us now because that's what they use at the restaurant we go to. And it's really good. And I don't, you know, I'll go out on a limb and say, you know, we try to avoid, you know, seed oils. We use like avocado and we use olive oil. And then I like grass fed butter. I don't care if you don't like it or not. I like grass fed butter. I like it on my sourdough bread. That's what I do. Yeah, that's what I like.

When you're going to indulge in something like that, then again, make sure that we, we're, you know, we're getting the right ingredients and the right sources and there's so much out there now that, that we have available to us that we didn't used to have.

You know, I mean, so I like ghee and some grass fed butter. Big whoop. I mean, that's my choice. I feel like that suits me best. And that's, you know, if I'm trying to help guide people along, I'll try to get some subs in there, you know, what they cook with and what they use just to create more of a, a lower inflammatory burden for them. And, and that's the perspective. And Lynn's like, I'm sure you and I both approach similarly.

Absolutely. I mean, again, it's just, what can we get from nature that doesn't have to be too messed with, you know, And I think we did, you know, not only did we do a huge disservice and hormones are bad, but we did a huge disservice in the low fat craze. Right. So, you know, everybody starts to want to eat healthier and they immediately go, I've been eating low fat cottage cheese.

And I live through that with my mom.

Yeah. Yeah. I mean, just, you know, everything. Low fat, low carb, all packaged stuff, you know, even gluten free. I have a little bit of nail biting on the chalkboard. Like, you know, I eat everything, everything gluten Free. And it's like all packaged stuff, right? So just because it says it's gluten free doesn't mean it's healthy. And in fact, you know, you go to, you know, something like Mellow Mushroom, we have it in our, in our parking lot basically in my office. And so, you know, everybody wants to go to Mellow Mushroom. Well, their gluten free pizza has more sugar and more carbs in it than their regular pizza does. So just because it's gluten free doesn't always mean it's, it's healthier. So, you know, I have a hard time helping people find substitutes for things and just kind of say, let's just, you know, stick to the basics. What's your protein, what's your source of fiber? So whether it's veggie, whether it's fruit, then that's about it. Like we don't. And then what's your fat? Right? So whether it's seed oil, you know, non seed oils or whatever, healthier type stuff. Love grass fed butter, love real dairy, you know, that kind of thing. And not being afraid of eating fat because this whole low fat thing is so crazy.

Yeah, it's, I mean it's been debunked. And I met Aseem Malhorta, Dr. Malhorta from the UK. He basically is the guy who came out and said, butters, there's nothing wrong with butter as a cardiolog, you know, which obviously got him and a bunch of eyeballs on him. And yeah, I mean it's like anything that whole low fat and you know, trying to be careful and having really the wrong, you know, perspective. Dr. Malhort is also the person who described how Simvastatin, the statins are so bad for you. And Dr. Amy, you know, when there's so much money involved, this information, whether it's from the food industry, the pharma industry, whatever, you know, there's, they want.

To get it in front of our faces anyway way we can. So, you know, scaring people is a good way to get people to change their behavior too. So we can relate. I mean, I, I relate everything back to hormones. I just again had a patient whose cholesterol came down after working with me for six months. And she said, well, what did we do to work on my cholesterol or what was the thing? You know, she's like wanting to know what supplement she needs to stay on because her cholesterol got better. Right? And I'm like, okay, well let's talk about all the things that affect Your cholesterol. But part of it is hormones. I mean, she came into me again, undetectable hormones. She's like 63. So you know, of course we replace her hormones. And I'm very visual person. I have a screen in my office and so I'm pulling up the hormone cascade and I just love it. I mean, I do this every day and I'm like, you know, I got Cs in biochemistry in both medical school, in College, I got Cs in biochemistry. Like, absolutely hated biochemistry. And I'm like, every day I have the steroid hormone cascade on my screen. Like I'm doing biochemistry. Like, but when you explain it with pictures and not all the, the actual biochemistry of the molecules, but you know, all of our hormones are made from cholesterol as their base. And so, you know, cholesterol. And when our hormones go away and our body's like, we kind of like those, like they were helpful. Can we make more? So you get this feedback loop that increases your cholesterol to, to potentially make more hormones. But then the ovaries and the testes and the pituitary aren't making the signals to turn that cholesterol into hormones anymore because we're done procreating at age 50 and so that those signals go away. Right. So low hormones get us higher cholesterol. We see it in both women and men, probably more intense in men, I think with low testosterone for sure. But and then if you follow up with that, when you replace these hormones, you see cholesterol go down, you see inflammation go down. All of our hormones are anti inflammatory for multiple reasons, whether it's at, at the joint, you know, again, in surgical world, like, you know, you get somebody who's got tap tapped in, hormones that are at their best place, their, their skin, their collagen, everything is going to be so much more viable and supportive when we get to that place.

So absolutely, you know, when I know this is going to be a little controversial, but somebody who shows up and has a slightly elevated total cholera cholesterol level and they asked me like, you know, do I need to be on a statin or something? I'm like, hell no, you don't need to be on a statin. Just calm down. There's very specific things that we're not going to go into. About what the ratios and specific things in terms of HDL and LDL and all the things. But I don't even pay attention to those things, honestly. Now if you had a wildly elevated triglyceride level. Yeah, we'd have a chat about that because that's, that's going to get you.

Into probably insulin resistance. Right.

So I mean, exactly. But that's.

That was cholesterol, right? Yeah.

Right. That deserves a bigger discussion. Somebody's got, depending on when you checked mine or whatever, I may have an elevated total cholesterol. So what? Who cares?

Well, yeah, in this integrative functional medicine world, like we, you know, we go way in depth. Like we're looking at, like you said, the ratios, we're looking at sticky factors. We're looking at plaque activity. So there may be handful of times that I can count that I've prescribed a statin for a short period of time in a brand new patient that comes in, in is, you know, and they don't have to have high cholesterol. So 50% of people who have heart attacks have normal cholesterol. So you've got to look deeper at. It may not just be amount a total cholesterol issue, but if they have a marker that we can measure called plaque activity and if that plaque activity is high, the benefit of statins is to stabilize plaque at that moment. Right. So we don't want to be on statins forever to lower our cholesterol. We actually want to stabilize that plaque. So I will put somebody on a low dose Rosuvastatin, which is the healthiest one, that we can at least make better choices. Right. For, you know, about four to six months or so while we're getting all this other stuff worked out. And then, you know, once we know we've seen all the other things that could create this cholesterol and this inflammatory process to happen, we've recovered and repaired those issues, then we can come off the statin.

Yeah. And you're talking about a very, you know, specific indication for you medications.

An example is, you know, we don't, you know, again, you're not going to just look at total cholesterol and prescribed like there's so many other reasons.

Yeah. For everybody listening. Doctor, Amy's giving you her very specific approach in a set of patients that she sees but on the majority of the people she sees. She's never going to put anybody on a statin. It's going to be very nuanced in how she approaches it versus. Oh, there you go. Your cholesterol's elevated. See me in six months and we'll, you know, recheck it without any, I don't want to say this in a negative way. The hardest thing always is to change somebody's Behavior, their habits, their lifestyle choices. And although Dr. Amy knows this, nobody gets paid for preventative care. And that's, you know, basically what we're talking about is trying to, I always say prepare rather than react because I operate for a living. And Dr. Amy's trying to prevent you from getting sicker and sicker and sicker. And that's our goals, are not to react to all the things with medication.

And you use medications to band aid things. Then, then you're not. You're reacting like you said, but you're not fixing the underlying reasons why these things happen in the first place. So, you know, you can go band aid with 5, 6, 10 different medications, but the real reason why, you know, high cholesterol is happening or inflammation is happening or whatever isn't being addressed, whether it's hormones, whether it's gut, it's probably a combination of both. You know, we talk about things that are layering up to fill up your bucket. It's not going to be one thing that we're magically going to do. And that's why, why it's so important to find somebody who addresses all of these things.

That's. I mean, I have a patient in, in the city from. In Austin, from Europe I've operated on. And you don't travel from Europe to have just the surgery. A lot of competent surgeons all over the world. You don't need to come to Austin for surgery. It's really about our programming and, you know, the content we produce that resonates with patients just like your patients, and they want to engage agent. Somebody's trying to treat and take care of all of it at one time versus maybe farm it out to different subspecialists or providers of whatever, you know, care. And I feel that's obviously the big differentiator for us. And, you know, we have hyperbaric in our office. We have things that help with grounding that are very intentional, like the human regenerator. We have red light therapy. We have nandav therapy. And I would be remiss, like, I think an underappreciated thing is lymphatic decompressive massage. And we have these devices from New Zealand called flopresso. And they're really very, very efficient, improving lymphatic drainage, but they're also helping get you in a more parasympathetic state and help even with a little bit of warming on the trunk area, which helps get people into a more parasympathetic state. So trying to get people out of the fight or Flight out of the high cortisol state after surgery as quickly as possible is one of my main.

I want to come there. I don't need surgery, I don't think yet. Hopefully, knock on wood. But like, I want to come there just to hang out and get all the things.

And that's part of. I mean, basically that's. That's the situation. I've done several thousand, you know, explant surgeries and my gosh, I've been operating for. Next year it'll be 30 years. Seems crazy. I'm now operating on people that graduated. I'm sorry. That are born the same year I graduated high school, which is just. It doesn't sit right with me, honestly. It's just kind of weird what happens.

When our kids get older, Right. You keep looking at the. I'm like, wait a minute. Yeah, you're now the same age I was when I had you like that. I can't.

It's weird. I got to somehow sort that. I don't know if that'll ever work out for me.

I'm going to go back for a second to the very beginning of our conversation. We're talking about bone health and hormones and things like that and how, you know, we want to prevent fracture for sure. But one of the things I love. And your listeners may know, Tina Moore, and I think she's awesome. Dr. Tina. Right. And I just remember hearing her talk and she's so funny, but. But she's like, you know, I want to bounce and not break. Right. So, like, you're going to fall. Like, we can try to prevent falling all day long, but like, you know, hopefully you're out hiking and you trip over a stump or. A stump or something like that. Right? But we're going to fall at some point. But we be in this place where our body, our bones, our musculature, everything, our. Our core is stable enough that it's going to catch us. And so we're just going to bounce right back up again. And we might get a scrape on our knee or something like that, but off we go. And we're going to bounce and not fall. Right? So when we think about all these preventative things that we can do, if we're adding stuff to our diet that's stressing our system out, it's not getting us the nutrition, then our gut's not happy and we're not absorbing. But hormones play a huge role in supporting your bone health. So they stay strong, your muscles stay strong. And when we think about exercise, like, we're talking about walking, which is absolutely important. But some of the things that people don't even do is like, they don't get down on the ground and just try to get back up again.

Like, right.

It's an exercise you can do. I mean, it seems silly, but it's just like it. People go, oh, I'm not going to get on the floor. I may not get back up. Well, maybe you should try that. Like, get. Have somebody there that can help you get back up if you functionally can't do it yet. But, like, just get down and get back up again. Because if you do fall, you can prepare yourself for that so we can get up again.

Yeah, it's all about. You're discussing and kind of, you know, when I speak about, you know, being frail, but you're kind of the undertone is just being resilient, making sure you're taking care of yourself in a way that makes you resilient. So if something happens, you can resolve it. You can push your fall down.

I think our world, you know, I mean, it sounds a little like prepper, right? But you should be prepper for your body to some degree. And I think what happens is we are reactive. Like, people don't do anything until something happens. Right? Until I get the diagnosis, I get sick, I get the fracture. Then it's like, oh, what do I need to do to, you know, heal my bones? You know, let's start now with like, thinking about what can we prep for, you know, to make sure that. And. And if you're doing that, you're really doing what we call anti aging. Right. We use this term longevity, anti aging. All these things is like, you know, let's keep our bodies from getting to that frail state so we can not only live longer, but we want to live optimally. So we don't want to live longer in a nursing home. We want to live long and still be active and fit and doing all the things we love, especially when we get old and have grandkids.

Well, I think Dr. Amy and I share a lot of core principles that are relatively in alignment. And if you want to learn more and become a patient of hers, or if you're a business looking to. To learn from her, I'm going to let her share her contact information and we'll close that way. But I really appreciate her coming on my show.

Yeah, this was great. So you can reach me@carolina integrativemedicine.com that's my practice in. In Clemson, South Carolina. And if you're interested if you're a practitioner or somebody looking for some more support in how to run your business from a coaching perspective. Amy Duffy MD is my website for business coaching or personal speaking engagements, that sort of thing. So that's how you can find me. And I'm on all Facebook, you know, Twitter, all that kind of stuff you.

Can find me is in all the places look for her. Thanks again for coming on the show.

Thanks Rob. We'll see you soon.

Thanks for joining me today. I hope you found the information and stories shared on this podcast helpful and informative. Remember, taking control of your health and wellness is key to recovery from breast implant illness. If you're looking for additional resources and support, be sure to visit our online store, Dr. Rob's Solutions at drrobsolutions.myshopify.com you'll find a wide range of wellness products and supplements to support your journey to recovery. From specially formulated detox supplements to personalized skincare products, we have everything you need to aid your recovery. Visit Dr. Rob's Solutions today at Dr. Rob RossSolutions, my Shopify.com thank you for listening and we'll be back with another episode soon. Remember, you're not alone in this journey and together we can overcome breast implant illness. Take care.

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