S2E14 - How Health Maintenance Plays a Part in Your Estate Plan w/ Dr. Renita White

Episode 14 December 20, 2023 00:41:14
S2E14 - How Health Maintenance Plays a Part in Your Estate Plan w/ Dr. Renita White
Start to Finish Motherhood with Aisha
S2E14 - How Health Maintenance Plays a Part in Your Estate Plan w/ Dr. Renita White

Dec 20 2023 | 00:41:14

/

Hosted By

Aisha Jenkins

Show Notes

In this insightful podcast episode, we explore the essentials of being an intentional single parent, with a focus on health maintenance and legal planning. Our guest, Dr. Rita White, an expert OBGYN, emphasizes the importance of proactive health care and self-advocacy. Key topics include the need for vital legal documents, understanding family medical history, and navigating healthcare disparities, especially for single mothers by choice. The discussion also delves into fertility awareness and the role of community support in managing health care challenges. This episode offers valuable insights for anyone interested in health, parenting, and informed decision-making.

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Episode Transcript

[00:00:04] Speaker A: Welcome to start to finish motherhood, a podcast for those thinking or already single mothers by choice. Just looking for practical advice for navigating life's relationships. When you decide to have children on your own, it doesn't mean that you're completely alone. I'm Aisha Jenkins, and I'm partnering with you every step of your journey. [00:00:25] Speaker B: Hi, everybody. [00:00:26] Speaker A: I am here today with a guest, and I really wanted to have this conversation because I think it's one that we have quite often in the single mother by choice community. So when you choose to become an intentional single parent, there are some things that are a must have, because we don't want to bring these kids into the world, and God forbid something happens and we don't have them set up correctly. And so there's a lot of conversation and dialogue around getting your legal estate planning documents in place. While we have the legal documents in place, we hope to never have to use them. And one way to lower or reduce the chances of having to use those legal documents is the zero step, which is taking care of your health. And so I'm calling it health maintenance planning. And so I have a guest today, and this is a reunion of sorts. I appeared on the podcast that you have with your sister called Cradle and all, probably a year or two ago. [00:01:28] Speaker B: Yeah, that's right. [00:01:30] Speaker A: Yes. And so we had a conversation about being single mothers by choice and just being parents in general. And so this is kind of like a reunion. So I'm so happy to have you here, and I'm going to ask you, Dr. Renita White, to introduce yourself. [00:01:44] Speaker B: Yes. Well, thank you so much for having me. I am Dr. Renita White. I am a board certified ob GYN, a mother, a woman, a patient, all the things I have a passion for advocating about women's health, particularly just helping you to feel comfortable advocating for yourself and taking autonomy over your own health. And so I see that intersection every day with women who are going through transitions, whether it's becoming a parent or different stages of life. And then I have gone through a lot of these things myself. So I love talking about topics like this because it's so relevant to other women like ourselves. Thanks for having me. [00:02:24] Speaker A: Okay, so we're going to take it from the top. We're going to take our listeners on this journey with us. So let's start with high level general estate plans. I think when we last talked, we both kind of, the pandemic kind of hit us hard in terms of, oh, my gosh, we could die and these kids could be left without a boat in a sail. Right. And so I remember getting my official estate documentation done because I started with legal zoom docs, and I was okay, I was happy, and I was secure in having something in place. But then when I actually got funds, I pushed through and went to an attorney in their office and was finally signing the papers in the midst of the pandemic. And so the documents that I got were my will, last will and testament guardianship. [00:03:16] Speaker B: Right. [00:03:16] Speaker A: Because these kids have to go to somebody. Power of attorney. I think it was a medical power of attorney. I got a health proxy, and then I have documentation for a trust to set up a trust, and I still haven't done that yet because that's convoluted. But some of those documents, legal documents, are tied to medical procedures and medical emergencies. Can you take us through which of those are tied to medical emergencies and having people act on your behalf if you are not able to function? [00:03:52] Speaker B: Yeah, absolutely. So many times when you're thinking about things related to the medical setting, we're oftentimes thinking about end of care is how a lot of people think of it. So if you're on your deathbed, so to speak, or urgency, who's going to speak for you? And that is your health proxy or your medical power of attorney, which is different than the term just power of attorney because that's usually financial power of attorney. And so your health proxy or this medical power of attorney is somebody who can advocate on your behalf when you can't speak for yourself. Sometimes people think that it's whoever your first of kin is or first in line based on who your husband or wife is or mother, father. But it's not always so black and white. So putting this on paper can be very important when knowing who's going to make those decisions. And are they going to make the decisions that are the same thing you would have actually made for yourself. So that's where this documentation comes into play. Examples of this could be if you are at end of life and maybe you are passing away from something you knew was coming, whether it be cancer or just old age. And so knowing whether you want certain types of treatments, if you are willing to do particular treatments that may help with just pain control, but not to stop the end of life process from happening, and it can be related to things that happen unexpectedly. So if you were undergoing a surgery and a complication happens, what happens in that complication? Do you want them to put you on life support? God forbid, if something like that happens, or would you rather have other options. So that's why these forms are important, whether you're at older age or not, because you never know when those kind of emergencies happen. And it does take a lot of talking in advance to figure out for yourself what's important to you and what kind of treatment you would want. [00:05:43] Speaker A: Okay. And then Renita, can you take us through? So whenever I fill out health forms, they will ask for your emergency contact. How does your emergency contact differ from the health proxy person? [00:05:59] Speaker B: Yeah. So your emergency contact is the person that should be called if you need assistance and you need somebody to have the information about what's going on with you. So if you are at the doctor's office and you pass out and they're going to take you to the local emergency room, they want to know who to contact to let them know what's going on with you. However, that does not give that person the permission to make decisions on your behalf. So that's where the emergency contact comes into play. It also does not give this Emergency contact person permission to know every detail about your health information. So they may know that some emergency is going on, but they don't know everything relayed behind it. Whereas a power of attorney, or a medical power of attorney, so to speak, or that health proxy, they are able to know about your health information because they're speaking on your behalf. [00:06:53] Speaker A: Okay, thank you for that. And then is there another document? So for some reason, I have a health proxy and a medical power of attorney. Are they one and the same or not? [00:07:06] Speaker B: So they sometimes can be interchanged. But truly, it's all about how the documents themselves are laid out. So when you talk about medical power of attorney, that's giving the person the autonomy to speak on your behalf with regards to your health, and you're not able to speak for yourself. A health proxy is a similar form that sometimes is used to indicate somebody who can speak on your behalf. Even if you are present. Maybe you don't have the capacity to speak for yourself, or maybe you are there, but you don't want to sign for something or you're busy. That other person can sign on your behalf because they're also your proxy. [00:07:45] Speaker A: Okay, thank you for that. So I had to wait until I had enough money to get all of my documents together. But what if I were doing this piecemeal from a medical perspective? Which should I prioritize? I know I definitely want to have an emergency contact person, but of the health proxy and the medical power of attorney, which of those should have the higher priority? [00:08:13] Speaker B: So truly, both of them are typically done around the same time. The power of attorney is one that people are used to speaking about. Your doctor's office may say, do you have a power of attorney? So whether you're doing or you're going to an actual attorney to help you with it, I would say the power of attorney would. The medical power of attorney would be the best thing to have. And the another thing, even though it is not formal documentation, knowing who your emergency contact person is, because if you're ever in a situation that you just need somebody who you can turn to to get that power of attorney or to get the person that you want to actually be able to speak for, you have that person in mind so that you can let your doctor's office know any person who's doing a service for you. Sometimes you'll see it with childcare, your daycare, or what have you. So they know who the emergency contacts. [00:09:01] Speaker A: Okay. Okay. And then, because I watch er, what does the NDR have to do with all of this? Right? It's like, do not resuscitate. [00:09:14] Speaker B: That kind of speaks to what is in your power of attorney language. So you are talking about somebody else making decisions for you, but what are those decisions going to be? So when you go through this paperwork, and you probably remember this, and I myself went through this paperwork in 2020 when we were right at the beginning of the pandemic, and I was like, oh, my goodness, am I going to need a will? Am I going to need to figure out what to do if I come home with COVID So I remember going over all these forms, and there are a list of questions about, in this situation, what would you want to happen? So we hear the words DNR or do not resuscitate. And that's referring to one component of what your wishes would be, which is if you're in an emergency situation where it's truly life or death, would you want anyone to intervene, or would you not want them to resuscitate and intervene? And that's where do not resuscitate comes in. It may mean more than the actual CPR of resuscitation. It can mean giving you medicine that may help you to be around longer. It may mean give you a breathing machine that gives you oxygen. And the reason why people make these kind of decisions is because just because you are doing something to extend your life, that may impact your quality of life. So that's where we think about people talking about being on a breathing machine forever, or what will your life look like if you do go down a road that you're in this life altering medical situation. [00:10:42] Speaker A: Okay. All right. Thank you for that. Indulging that. Okay, so health maintenance. Now, health maintenance has been something that I have tried to stay on top of since I've had kids, because for anybody who has not gone through fertility treatments, that is one situation where you definitely get what you pay for. Right. And it's like, for some people, they never see the bill, but I actually got to see the bill because I was paying out of pocket for my fertility coverage. And it is one of the most thorough workups that you will have in your life as a person with ovaries. And so it was during my fertility workup that I realized I was quite something away from being into full diabetes. And I did not know. I had no clue. I just knew that I had been going through three years of fertility treatments, miscarriages, changes in hormones, what have you, and now I had slipped into a pre diabetic state. Right. But it was through my fertility workup that I was able to, one, identify it and get ahead of it. But then also I learned I had a family history of colon cancer, so that kind of put me colonoscopies in my radar. So mammograms. Also, I had a scare when I was getting fertility treatments. They had discovered her lump, and I have what they call fibrous breast tissue, so it's kind of lumpy to begin with, but they found a lump, and so they had to take me to the back room, and we had the conversation about what it could mean, what it could not mean. We would wait and see. It ended up being benign for me. Those health maintenance appointments stay at the top of my mind. A one c checks. And then I know that they have changed things with pap smears, but that was also at the top of my list. So can we go through some of the health maintenance appointments that are critical just for sustaining just good general health? [00:12:49] Speaker B: Absolutely. And I love that you're on top of this, because sometimes it can be hard to make your doctor's appointments. I mean, I used to be embarrassed to say this, but I'm not anymore because this is reality. Many of my peers, when we're in residency in medical school, working to provide the best care for others, we're so busy, we don't even get our own health care stuff taken care of. But this is the best medicine. It's prevention. It's not surprising that you said you didn't know that you were so close to diabetes and you didn't have those symptoms because many times you don't have symptoms until it does get into full blown diabetes or it gets worse. We call hypertension or high blood pressure the silent killer because you can live with it with super high levels of blood pressure and not know it until your kidneys are already making changes that could be harmful. Your heart's making changes. So that's where preventive medicine comes in. The good news is these things are covered once a year by your private and public insurance. So you should be able to see your doctor once a year and your primary doctor and your gynecologist once a year to get evaluated just for general routine care. So what does that look like? First of all, a lot of these appointments should be a lot of talking in the beginning, just getting to know what's going on with your medical history. As you talked about, you picked up some information about colon cancer and finding out what may be going on in your family's health that could impact you. So that can be a starting point to figuring out what things we need to keep a closer eye on as things are going down the line in these appointments, checking your blood pressure every visit, checking your vitals. The whole point of that is to see, are we seeing a rise over the course of each year that you come in. You may not be diagnosed with high blood pressure yet, but if you've got mom, dad, sister, who's got it, then your doctor should be keeping an eye to see what's this trend looking like, what's your diet looking like so we can make sure nothing's heading in that direction. Then there are certain tests we talk about. So you really touched on a lot of them. Some of them are blood test. So diabetes is tested by the a one c. So your doctor is going to look at different things that can look at your liver and kidney function, can look to make sure you're not super anemic or having a low blood count, which can make you dizzy or lightheaded. So those are general things just to see that everything's ticking the way it's supposed to. And then there are certain kind of tests that you do, depending on your age. So kind of thinking from younger age to older age. When you're somebody who's 21 or older, for a woman or person with a uterus, that's when we're going to start your pap smears, which is how you screen for cervical cancer. Now, guidelines have changed, as you mentioned, where now you only need this specific test every three years to five years, depending on your age, but that's one component of your yearly visit. So you should still be seen once a year. Your doctor is still going to look at your cervix, still going to look at other parts of your body. But that's just one component of the test. Other things that are really important are breast cancer tests, breast screening. So for most women, a mammogram is going to start at age 40. For most people, the guidelines just changed from one society that now has come down to where all the other societies were saying, so now everyone's on board that 40 is the age, unless you've got any other health, family health conditions. But mammograms are just one way to screen. A very important way, but just one way to screen for breast cancer. Another very important way is you and your provider doing a breast exam. So each year that should be part of your evaluation is a breast exam done by your clinician. As you get a little bit older, we're talking about things like colon cancer screening. So colon cancer screening can be done in a couple of ways, but the gold standard currently is starting at age 45, which is also a newer screen because that used to be age 50, but 45 is when we'd say, let's get that colonoscopy. And that is gold standard, where a camera is placed through the colon to make sure they don't see any signs of cancer. But there's some newer ways to do it. So you could talk to your doctor about other alternatives, like giving a stool sample and things like that. And then eventually we talk about things like screening for risk of abdominal order and then osteoporosis, screening to check your bones. So there's so many things, and it can be overwhelming, and you don't have to know every single detail. You're not going to remember. I'm this age and I need to do this and I need to do that. But that's why it's so important to establish with somebody that you're comfortable with, so you can do talking and understand that I may be seeing you only once a year, but what can I be doing the rest of the year to make sure that I'm healthy, whether it's dietary changes, knowing my family history, and being back to be here next year to figure out that I'm not at higher risk for something else? [00:17:37] Speaker A: Okay. All right, so, good. So let's take a little bit of a step back and tell you story time. So when I went to my primary care physician and I talked about colon cancer, I left the doctor's appointment that day with a script to go get a screening at this place. It took me a year to actually get that screening. The next year, I went back to my doctor. Still hadn't gotten the colon cancer screening. Let's talk a little bit about the whys there and the disparities. So there were a few reasons that I was delayed in getting my colonoscopy. One, the screening process at the one clinic that they sent me to was crazy. It was just laborious. It was. Call us back. Try to schedule an appointment. You don't qualify for the stool sample screening. So that took me almost six months, and I kid you not, I had a reminder in my phone for every Friday, and every Friday I would snooze it, push it to the next Friday, push it to the next Friday, until I ended up at my doctor's appointment again for my annual visit. But by then, they had an in network in their facility. Doctor. And it was just easy as pie. That was one obstacle that I want to talk about. The other obstacle was when people hear about the colonoscopy, you sometimes get mixed messages from well meaning friends and family, like, oh, my gosh, you have to drink this thing. It's horrible. Then you don't eat. And so I actually had a good friend who we were accountability partners, and we laughed about that because I got mine done probably two to three weeks before she did. And I was just like, eat the jello. I was like, the tonic is going to taste horrible, but eat the jello. And then I think I was able to eat a really clear bone broth, and I found a really good organic one that tastes like steak in a bottle. So that was delicious. And it wasn't even as bad as I thought. Like, I'm not a person to take liquid medicine. So there was that. The other obstacle was the need to have a ride. And as a single mother by choice, who does not have a parent living in the house or a partner living in the house, I struggled with who's going to drive me to this appointment? It was the same type of struggle when you get, like, egg, when they do your egg retrieval, right? Because you're going under anesthesia, you need somebody to drive you, and it can't be uber, right? So then what are the alternatives? So can we go through a little bit of those three types of disparities? One, trying to get over the hurdle of even setting up the appointment, and then let's talk about a bit about the tonic that you have to drink. It's not so bad. And then the need for a driver. [00:20:23] Speaker B: Yeah, absolutely. It can be easy to say, okay, go do this thing. But then when it's the reality of doing it, there are so many obstacles. So for one, actually, when you leave the doctor and you're given a prescription for this, go do this mammogram, go do this colon cancer screen, you may forget. For one, you're busy, you've got kids, you've got a life. And so the other thing is your primary doctor or gynecologist or whoever told you to do it, that doesn't mean that they're linked with the person who actually performs the procedure. So sometimes the barrier could be you figuring out, okay, where do I go? What kind of doctor is this? Is this person in my network? So there's some work that is sometimes on our end as the patient to figure out how to do this thing. So my recommendation is to talk to your doctor while you're in the room, if you remember, if you're able to say, okay, what can you do to help me to get to this step? Do you have a connection? Do you know a referral line? Is there a phone number? And sometimes they may not, but they can circle back and get to you. I have people ask me all the time about stuff like this, and I will say, I don't know a person, but let me ask my colleague, or let me check into it, and I'll get back to you. So that's definitely something that you can do. Or maybe they will have a connection that they didn't mention that may be easier for you to make that kind of appointment. The other thing is the drink, the fun part of doing the colonoscopy. And this can apply to other kind of tests, too. I see it with people all the time who are nervous about their pap smears. When they've heard about it before they've ever gone through it. With mammogram time, they're like, I don't want my breast to be squished. And the same with the colonoscopy. You hear that? You go the whole day without eating real food and drinking this horrible drink, and then the diarrhea and the bowel movements. It does not sound pleasant. Who wants to do that? [00:22:09] Speaker A: Like, why? [00:22:10] Speaker B: Sometimes the worry that comes with it is worse than the actual experience. So really taking the time to understand why somebody's recommended this thing to you in the office, it's easy for me to say, you should get this test. It's recommended. We don't want to make sure. You don't have cancer. You may be sitting there thinking, well, I don't feel like I have cancer. I feel fine. I'll come around to it. I heard that it's bad. So it is so important that if somebody recommends something to you that you have an understanding about why it's recommended, what your options are, because recommendations are not demands and you are in charge of your health. And so making sure that you feel comfortable with the decision making that you're going to go through. And yes, it may not be the most pleasant thing, but to get an understanding about why you're doing it and maybe see if they even have an experience of what it's like to go through it. [00:22:59] Speaker A: Okay. And then the last thing is the need for the driver. [00:23:03] Speaker B: Yeah. So with colonoscopies, just like any procedure where you're under anesthesia, like a wisdom tooth procedure, they don't want you to drive home because that medicine will stay in your system for sometimes 24 hours. So you're not safe to drive, don't purchase anything online, those kind of things. But you're right, it can be such a limiting factor that a lot of people don't think about how hard it is to get everything set up, get childcare, who's going to take care of things in the house for that period of time. But that's why knowing your options and talking about alternatives is key. Now, there may not be many options. It may be limited family history. You may not be the best candidate for something like the cologuard where you mail in your stool sample, but you might be. There's a lot of thought now that that may be one of the newer tests that people are going to be doing from now on, or if you find out that, hey, this is going to be something I need to do regularly, like every three years or every five years, you can plan ahead and say, okay, if this is what it's going to be, let me go ahead and take these steps to make sure that I can get this together instead of stressing yourself out and figuring out, okay, I was told I need to do this test. I don't really understand why and am I hurting myself by not doing it in a certain time frame? What is this time frame? [00:24:21] Speaker A: Right. So I do want to say to the single mothers by choice out there, I don't think that there is a single mother by choice that you could ask for a ride, for a medical emergency, a medical health appointment, a surgery that is going to say no. It was so simple to just ask a friend. Hey, can you drive me? And she was like, yeah, sure. When do you need me? And then when we got to my appointment, I asked her, because I knew she was getting hers, and I was like, do you need me to drive you? She said, no. I asked my neighbor up the street. But it's just, you pay it forward. You pay it forward. So I will say that, do ask your single mother by choice community. Do ask your neighbors and friends. They will gladly help you or help you find a driver for your procedure. And then also with regards to the colonoscopy and the bowel movements. For me, it wasn't a thing. Right. I think you have enough time to pass what you need to pass so that you can make it to your appointment. And so don't let that be a worry that stops you. Okay? And I love that you mentioned alternatives. So I am a woman of a certain age. I'm about to be raging. I'm 47. Yeah. I can't even be, like, raging 50, but I'm 47. And now is the time where I'm seeing a lot of my college friends and high school friends that are popping up with health related issues. And so hearing them tell their stories, like you would think. So prior to becoming a single mother by choice, the only way that I knew to do it was through IVF, because that's what you see in the media. That's what everybody thinks of when you're like, I have fertility issues. Let me go to a doctor. And the same thing goes with some of these procedures, right? You're thinking, oh, my gosh, I have diabetes. It's only an insulin shot. Like, there's a continuum. It's a range of different options that are available. I had a friend who has to get dialysis for kidney disease, and one would think, oh, my gosh, I'm going to get dialysis, like, every day. I'm going to a center. It's my entire life. She has a dialysis machine that she does at home in the evening. Right. And so there are so many different options that are available, but because we don't talk about it enough, our mind goes to the worst, the most expensive options. And so I just want to say that there are options. And I have reached the point in my life where I'm going, I don't have a partner. I like talking to adults. So when I go and talk to my primary care physician, when I go and talk to my obgyn, it is actually a conversation. We talk about the changing status of certain treatments and things like that. So I do encourage you all that as you're going utilize your entire 15 minutes of fame or whatever the amount of time is. But they will ask you, do you have questions? And please ask whatever questions you have. It's the two of you. Y'all can laugh together, even if it's a silly question, but do take advantage of that. [00:27:33] Speaker B: I have so many patients who say, I'm so sorry. I looked this thing up online. I googled it, and they're like, ashamed to say that they googled. And I'm like, no, I love this. Now, don't just rely on Google. It may be wrong, but you were trying to do research. You're looking into things, you want answers. And this is a great starting point for a conversation. So don't be shy. Look things up. Don't take it as what's fact all the time. There may be some correct things, there may not be. But start looking into things so you can get answers to help better understand your health and what you have going on. [00:28:07] Speaker A: So, funny story. I was talking to my daughter on the way to school, and it was during kidney awareness month, and there was a commercial that was saying, oh, talking about the risk factors for kidney disease. And they were like, and if you're black or african american, she was like, am I going to get kidney disease because I'm black? And I was just like, no. So I had to kind of take her through. What are some of the factors that can create health disparities in communities of color and in particular because we're black black communities? And I was just like, back in the days when they had redlining, she's like ape redlining over her head. They were dumping pollutants into areas that they were designated for housing for black people. And because of that exposure over time and passed through your genes, you open yourself up to these different conditions. So can you explain that just a little bit? What makes you a higher risk versus just, I have a family member. [00:29:09] Speaker B: Yeah. So there can be many different factors that can increase your risk for something. And you mentioned really great points about that. So some of it can be your genes. So what you get passed down from somebody else if you have an increased risk of breast cancer because of a specific gene or what have you, some of it is environment. So that could be what you're exposed to in your diet or your day to day activities. We know that people who eat bacon, for example, it's considered to be sometimes even a type of carcinogen just because of how it can trigger certain changes in your body that may lead to inflammation that can increase risk of cancer compared to eating more green, leafy vegetables. So that's a type of exposure in your diet or if you're exposed to things in your surroundings. So the example you gave with where you're located and what things are in the environment there, or if you work in a specific area. But we also know that there can be other risk factors, like socioeconomic factors, where if you live in a certain area where there's food deserts and you're not able to access the kinds of foods that are healthier, yes, your exposure is based on what you're eating, but it's also based on society and what's going on around you about, are you able to actually get those kind of foods that are good? Are you able to wellness visits every year? Are you having a hard time because you're in an area where your insurance doesn't even have doctors in your area? Finally, we know that racism and our implicit bias plays a role as well with risks, because if you're going to see even a well meaning provider, but they don't understand that some of the things that they have already thinking may apply to how they interact with you or the kind of questions that they ask you, the time that they spend with you, or if they brush off some of your concerns, that may, in itself, increase your risk or delay diagnosis of things. Examples that I think of are, like fibroids for black women, where fibroids happen to everybody, black women are more likely to have them. That may be a gene component. It may be a dietary or an environmental change that may cause that. But we know that black women are also more likely to have hysterectomies or more likely to have a delayed diagnosis. That part could be due to their interactions in the healthcare system. So maybe their symptoms were ignored. Maybe there were fears about going to the doctor, based on our history with health in the black community. So all of those things can interchangeably affect our risks depending on what the condition is. [00:31:43] Speaker A: Okay, so some of the things that you mentioned we might not be able to impact. I think attitudes are changing with regards to getting more education around unconscious bias in the healthcare system. But one of the things that I appreciated that came out of the conversation with my daughter and that came out of my experience with my a. One c was that I'm now more open about having conversations about family health history. So my daughter was like, oh, my gosh, I'm black. Does that mean I'm going to get cancer, kidney disease? And I was just like, no, it's an increased risk. It doesn't mean that you will have it. It might be coupled with something else. So kidney disease does not run in my family. So that increased risk might just be that. An increased risk. Right. So you get screening for that or what have you. But we do talk a lot about food choices because kids like sugar, and I'm like, sugar is a poison, right? It's a necessary poison, I guess. But I try to couple that with, I had gestational diabetes. I had issues with my body processing sugars, and so that's something that I'm aware of. And so when we put food on the plate or we make food choices, we pair proteins with a carb, we pair veggies with a carb. Their snacks are apples and oranges. And so it's opened the door to having those conversations about family health history. And then also a subset of family health history is fertility history. Right. Because when I was pregnant with my first, one of my sisters cautioned me about sharing the news early, because your mom has a history of miscarriages, and it's just like, what does that mean? Right? And so just kind of having those conversations. So can we talk about the importance of knowing your family medical history? Because doctors ask you that at every appointment and every pediatric appointment for your kids. [00:33:40] Speaker B: No, that's so true. And it's interesting. I don't know if it's something based on certain groups, certain society members, like, if we don't talk about our health, but I know for me and my family, I'm black. My family's from Guyana, South America. Like, no one talks about their health at all. And I see that a lot in the black community, but it's so important and not, maybe it's because we don't want to put our business out there, but the reason it's important because it can help prevent it in the next generation. So understanding what those health diseases mean and knowing how to change it, I think, is the most important thing of all. So it may be one thing to know that mom and dad have high blood pressure, but when you're younger, you're like, I don't really know what that means. What do I do about it? But in the setting of going to see your healthcare provider, they can talk to you about some dietary changes, explain why that's important. If you know that somebody here had cancer, somebody here got cancer, and mom, uncle, and an aunt, it may not connect to you that that actually could be something greater than you think it could be prostate cancer over here, breast cancer over there. Well, there's a gene like the braca gene that actually has been shown to cause prostate cancer and melanoma and pancreatic cancer. And somebody else may be able to see that connection and be able to recommend increased screening. Talk to you about doing self breast exams. Or if you're a black male who is already at higher risk for prostate cancer, maybe you should consider getting the gene for bracker, even though you don't have breast and ovaries. So knowing this information helps the next generation to not only be healthier, but live longer, make decisions that keep you out of the emergency room and take you away from your family and loved ones earlier than you think. [00:35:25] Speaker A: Okay, good. So I'm going to. Good job, mom. High five, mom. [00:35:31] Speaker B: Okay. [00:35:31] Speaker A: And so last but not least, having gone through fertility treatments, having dealt with secondary infertility, there are certain screenings, certain tests, certain results that you could get back from your general practitioner, your primary care physicians, your annual visits that can give you keys or indicators for fertility health, egg health, ovarian health and things, uterine health and things of that nature. What are those tests that we should be kind of clued in on? Like, I know about the link with the a one c, but then there's also like vitamin D and then there's like thyroid screens that they do. Can we talk a little bit about that? [00:36:18] Speaker B: When people come into my office, they'll oftentimes say, can I get a fertility test to see if I can have a baby? That's for me. As an obstetrician, gynecologist, when you're going to your fertility specialist, many times it's because you're ready to have your baby, or maybe you've been having a challenge. So first there's no test that's like, yes, fertile, no, not fertile. But we have several different tests that we can see. Does it have any impact on fertility? Could this lead to any problems with getting pregnant? Or maybe you're already having a hard time getting pregnant and it may help to explain why. So one of the most popular tests is something called amH, or antimullarian hormone. So for people with ovaries, it helps us to see, do you quote unquote, have enough eggs? There's no tests that say if you have enough eggs, but the ovary is like a little place that stores every egg you'll ever have and it sends out a little signal called amh. Well, when we look at that number, if it's on the lower side, maybe you may have a bit of some decreased ovarian reserve, so you might have some trouble getting pregnant. And if it's normal, then great, you probably won't. So that's a common test that we look at. Vitamin D is oftentimes looked at because though we think of it with regards to bone health and immunity and things like that, we do see that there's some impact with fertility. So if your vitamin D level is low, taking a supplement is not going to suddenly help you get pregnant. But if you are having challenges with fertility or you're trying to get pregnant by optimizing your vitamin D levels, that in itself can help support a healthy pregnancy and the role to getting pregnant. Same thing with thyroid. So the thyroid is this gland in the neck. It puts out the thyroid hormone. That kind of helps regulating different hormones, including the hormones related to getting pregnant. So there is this number that we say is a normal range of pregnancy or normal range for people who don't have thyroid disease. But for pregnancy, we like it to be an even tighter control. So sometimes if you're having miscarriages or you're having a hard time getting pregnant, that little number, even though it's normal, it could still impact fertility. So that's why they check to make sure that it's in a nice range to help support pregnancy and decrease risk of miscarriages. [00:38:36] Speaker A: Okay, so I think we are wrapping it up. Is there anything that I missed in this? Anything that you want to add? [00:38:46] Speaker B: No, I think this is so great. And at the end of the day, I think key is prevention. We talked about those yearly visits and I cannot stress them enough. There is something to be said about having a relationship with your healthcare provider, because if you see them yearly, you may feel like, how do they know me? Do they remember me? If anything comes up. But for one, it takes away the barrier of finding somebody. If you're in an emergency, if you suddenly have a horrible cold, you don't know where to go. You already established with somebody so that you don't have to end up in the emergency room or urgent care. So having that established connection is good, but also having somebody that you trust is even more important. So it's okay to play around with different people, try different offices until you find the right person for you, because you want somebody on your team, just like you would want them on your team in other aspects of life. It's the work project or whoever your partner is or your family members. You want your health team lined up and you want to make sure that you're the key player of this team with all the people on the bench that they are ready to roll for you. So that's my biggest takeaway from all. [00:39:52] Speaker A: Of oh, well, thank you, Dr. Renita. Okay, so where can my listeners find you to ask more questions, to reach out, to follow you? Where can they find you? [00:40:03] Speaker B: Yes, absolutely. So if you're in the Atlanta area, my practice is called Georgia O yn in Atlanta. You can also find me on my website, Renita Whitemd, where I do a lot of educating there. I have a podcast called Cradle and all that you can listen to on any platform. And if you have any questions, email me at [email protected]. [00:40:27] Speaker A: Well, thank you. Thank you so much for spending this afternoon with me. Thank you for all the valuable information you shared. And to everybody else. We'll talk to you soon. Bye now. Thanks for listening. To start to finish motherhood with Aisha. If you want to keep the conversation going, follow start to finish motherhood on Instagram, email me at [email protected] if you love this episode, please share it with anyone who's thinking of becoming a single mother by choice, anyone who's already parenting as a single mother by choice and just looking for advice on navigating it all, or a friend or family member who's looking to support someone else's single mother by choice journey. Until next time. Bye now.

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