In this episode, we speak with Karina Mackenzie, representative of Wanderlust. Karina shares her experience in leadership within the wellness industry and the origins of Wanderlust, including everything they do from hosting yoga and meditation festivals to running yoga studios, and more! We discuss the growth and success of Wanderlust, the challenges and opportunities faced in the wellness space, and the importance of mindfulness and community in today's world. Karina also shares insights into her personal journey and the lessons she has learned along the way. Join us for a thoughtful and inspiring conversation about wellness, leadership, and personal growth.

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In this quick solo cast, Dr. K shares everything from the new book, 10 Optimal Health and Wellness Tips. It breaks down everything you need to get on track and maintain positive well-being. Dr. K gets into some topics from the book including, nutrition and increasing your protein intake, intermittent fasting, weightlifting, yoga, stress management, improving your sleep, meditation, and more!  

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Thank you for reading Solving Healthcare Media with Dr. Kwadwo Kyeremanteng. This post is public so feel free to share it.

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In this episode, we are joined by Dr. Michelle Peris. Michelle is a naturopathic doctor with a clinical focus on women's health, pediatrics, digestive and hormone health, and fertility optimization. Michelle joins us today to speak with us about The Wild Collective and a group health approach, including some shared experiences and their focus on female empowerment. Michelle is a health advocate passionate about helping women of all ages tune into their bodies. She shares with us a bit about her background and how she now supports her patients through body literacy.

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TRANSCRIPT

KK: We are on the brink of a mental health crisis. This is why I'm so appreciative of the folks over at BetterHelp everywhere the largest online counseling platform worldwide to change the way people get help with facing life's challenges by providing convenient, discreet, and affordable access to licensed therapists. BetterHelp makes professional counseling available anytime, anywhere through a computer, tablet, or smartphone. Sign up today go to better help.com And use a promo code ‘solvinghealthcare’ and get 10% off signup fees.

SP: COVID has affected us all and with all the negativity surrounding it, it's often hard to find the positive, but one of the blessings it has given us is the opportunity to build an avenue for creating change. Starting right here in our community discussing topics that affect us most such as racism and health care, maintaining a positive mindset, creating change the importance of advocacy, and the many lessons we have all learned from COVID. If you or your organization are interested in speaking engagements, send a message to kwadcast99@gmail.com, reach out on Facebook at kwadcast or online at drkwadwo.ca.

KK: Welcome to Solving Healthcare. I'm Kwadwo Kyeremanteng. I'm an ICU and palliative care physician here in Ottawa and the founder of resource optimization network. We are on a mission to transform healthcare in Canada. We're going to talk with physicians, nurses, administrators, patients and their families because inefficiencies, overwork and overcrowding affects us all. I believe it's time for a better health care system that's more cost effective, dignified, and just for everyone involved.

KK: Kwadcast nation. Welcome back, we have another exciting episode with Michelle Peris from ‘The Wild Collective’. Why is she on the show? Number one, she's amazing human being naturopathic physician that's changing the bogey. How she’s changing the bogey? by introducing group health, looking at ways that you as a patient or client, being in a group setting, to be able to learn off each other, have that shared experience, talk about ways of getting collectively healthier, almost being a cheering section for each other. Just makes so much sense, especially when we have so many shortages and issues in healthcare right now. So really excited about this, you're going to enjoy this episode. Before jumping on though, I want you to go to kwadcast.substack.com. That's our new newsletter. That's where all our information is. I'm talking podcasts, videos of our episodes, vlogs, blogs, the latest and the greatest on healthcare solutions, right on one spot. So, you got to jump on the train baby, jump on the train. Alright, so without further ado, Michelle Peris.

Kwadcast nation - as usual, we got an exciting guest. I'm going to go ahead and even call Michelle, a friend. We met at the EPIC live event, and was very kind in terms of her messaging, but also reached out and expressed some of the amazing stuff she is doing with ‘The Wild Collective’ and I think, honestly, can transform how we approach medicine. Really, as we like to say, ‘changing the boogey’. So, without further ado, Michelle Peris, welcome to the podcast.

MP: Thanks so much for having me. I am really excited to connect with you and grateful to call you friend, you’ve been so inspiring to me. It's a wonderful opportunity to be here.

KK: Oh, that's very kind and but I mean, this is all about you. So, you started ‘The Wild Collective’ your background in naturopathic medicine. Yeah. So, maybe tell us just a bit of your background and how you landed in producing this amazing initiative.

MP: I often say our mess is our message. So, you know, it goes as far back as really struggling as a young girl of feeling that, you know, magical experience of belongingness always having a difficult time as a young girl to belong, and to feel like I fit in somewhere. That really, I guess, primed what the natural evolution of this was but I fell into naturopathic medicine largely through learning the power of food and nutrition. For the first time at that point, really learned what it meant to belong with a bunch of people who are like minded and suddenly, I felt very capable and very happy and satisfied with life. That was something that stuck with me those moments and seven years into clinical practice as a naturopathic doctor loved a very successful practice loving who I was serving. But feeling really dissatisfied with the consistency of results. At the same time, there was like this growing body of information of all of these, you know, health ramifications of social isolation and loneliness. It being the leading cause of mortality, and all these things, and I really felt like I was failing my patients. First, I didn't really have a screening process for loneliness and then I didn't have support for them on the other side of that, and I think it was really, all these moments that culminated this motivation in for me to solve this problem for my patients. Through that, we created this closed group experience where there's enough time created to not only empower and teach women about body literacy, and how to prioritize their health and why they need to think critically and be the CO creators of their health with their health care providers but also give them the benefits of community medicine and all of the beautiful consequences or side effects that happen when you engage in a community. What started to happen, what started as a very small project, it turned into a global mission, because I really do think this is how we can impact healthcare in a meaningful way how we can alleviate a lot of the burden on the system, is if we are able to disseminate health information that we know is important if people knew how important it was to prioritize their health or create metabolic flexibility or understand nutrition, then they could start to take radical responsibility for the health and start to co create that with their one on one providers and really start to alleviate the system. There are many studies that have demonstrated that that's possible that there are, you know, clinics in the US that are you leveraging this, that you have to go through a group program first. Then Dr. Mark Hyman is a great example, 80% of those cohorts that go through that group program don't require his care at the end of it. So, so much of what we do, we can really empower people to do on their own, and they don't necessarily require a one-on-one care. For me, this was exciting. I think the other things too, is that we spent a lot of time and educating ourselves on all these obstacles, secure the things that get in our way. I don't think we have enough time in one-on-one care to unpack what those could possibly be. Maybe it's not feeling connected in our relationships are unfulfilled in our work, we don't necessarily have mission and purpose that drive our day. These are huge drivers to overall well being. They need to be understood, and we need to take responsibility for them to be, like transformed in that healthcare experience. I think I think group health does that beautifully. So that was a lot. But that's what I'm doing.

KK: No, that's good. That's good. It paints a beautiful picture. Michelle, so maybe give us a sense of what a common topics that come up or common ailments that you see like, who what's the typical person that comes to see you?

MP: I know this, everyone always wants us to define this. I really want to reach every woman, but I would say women come to us typically because they're interested in learning more. Most women who are interested in something like this have been told by someone that everything looks fine, but they don't feel fine. So usually, there's some kind of overwhelm, anxiety, stress, burnout, maybe a hormonal symptom as a result, or insomnia. Or they're aware that there's a, you know, low thyroid situation happening. That's what's really prompted them to explore naturopathic medicine and get more curious about that root cause piece. Then I think what ultimately gets them interested and what has created a whole access to a different type of, of health education is once they understand what we're doing in a group health setting, so not only are we helping them understand optimal ranges for bloodwork results, or other areas to explore, I think you do a good job of highlighting this but for many people who are just learning this it's never just one symptom or one pot. It's like one system of the body that is going on, right, like they they're all They're all interconnected. So, I think when we're looking at things in a very condensed way, and we're not expanding and helping people widen the lens on what could be going on. I think health information helps individuals do that. So, We can talk about maybe the reason they came in is that they had hot flashes. But if we can educate them on, you know how their nutrition might be impacting that, or how their stress levels might be contributing to that, I think that's what really creates a lot of interest for women to want to learn that. I think the people that we tend to attract is they want to know this information, and they feel so overwhelmed by the content on Google, I think what keeps them fascinated and why they stay in this type of work, is that we like to expand the conversation and take it one step further, and really start to unpack those other obstacles that might be getting in the way are where they're feeling like, mystified, there's so many women out there, ‘I don't know why I keep gaining weight, it's not making sense’ when we start to really go a little bit deeper and look at different concepts of like speaking our truth, and trusting our intuition and just digging a little bit deeper. How our relationships are actually affecting our physical health, I think we start to make it a bit richer and more interesting for them. Now they start to see all the ways that they may have ended up in this dysfunctional health state. I think there is this growing curiosity to want to understand that I think we serve a lot of people if we're being super honest. It's probably not the thing that they come forward with, but they feel like they've checked all the boxes, and they still feel quite unfulfilled or dissatisfied. That probably comes from being lonely, or not actually being purpose driven. So, I think we tried to create a health information. So, we've done tried to do so many things, but we attract people by educating them on their health and their body. And then we take it one step further, and really get them to step into that space of also taking radical responsibility for those day-to-day things that are negatively impacting their health.

KK: I would imagine in a group setting, people learn off each other? I'm curious, Does the group specifically have common complaints? Or it’s a random number of women? Six women, you put them in one group? Or is it a common issue that they want to address? How do you determine this?

MP: I think you can do it several ways. I think this is being successfully done in both of those fashions. So, for us, we've been more about how we're a very fundamental foundational program for women. So, there's a nonspecific attraction to it. Not, we're not like, oh, here we are for autoimmunity, those groups do happen and they're fabulous, because it gives you that opportunity to really niche down in the types of conversations you want to have. I think what I've learned for doing this for the last seven years is that there always is that unifying universal normalization of the human experience that happens in any group that you're in. I think this can work in either capacity, is there are a specific condition that one is drawn to this group for or are you there, because you want to become more empowered in your health, and you want to take that radical responsibility to that next step and be in this space. If you know, we all here you become the five people you spend most of your time with. If you start to go into that like minded, health-conscious community, how do we use things that will naturally make those habits easier to embody?

KK: Mhm, it's like you get a team. When you're in a group, you want to encourage each other don't want to let each other down. So, you've got that automatic cheering squad, telling you like, Let's go!

MP: My two frustrations and one on one practice where lack of support for my patients and lack of really understanding what we were doing what why we were doing their treatment plan. That's exactly it's there's that let's go energy that's happening in that group. I remember so many patients would leave my office and they'd be like, ‘I'm so excited like you've made you've given me so much hope I see why this is important. I really want to execute on this plan’ and then they'd come back for their six week follow up. They’ll say ‘My husband wasn't in full support. I don't want to cook all these different meals that that that that that that like all the excuses’ It becomes really difficult to adhere to any plan as brilliant as it is if we lack the social support in order to override the discomfort of change and transformation. It's incredibly difficult. So, when we provide the community, that has that ‘go go rah rah rah’ support. Not only that, but the safe space also to say ‘I'm really struggling today, I don't really love this ketogenic approach, I'm here today, I'm hungry, I'm missing cookies’ whatever, you have this group that's like, I understand, I see you, I am you, and you've got this, you can make this one more day. Suddenly, it doesn't feel so hard to learn these new habits, because you're in a space that supports and understands you. It becomes a lot less scary or overwhelming when you're in that kind of health inspired space.

KK: I mean, you're selling it, you're definitely selling it, I want a stage where we got to think about healthcare delivery, you know, and in ways that they can outside the box here, because our current models and system aren't serving enough for the public. What you're proposing is ways of addressing more patients in a group setting that maybe, as you said, it's more effective because of all the things you stated. So, I think that to me is what's exciting about is that this could be a model that we should be doing at scale. I guess one of my questions for you is, do you feel like the women that see you, do they wish they would start utilizing this technique before they have problems? Do you know what I mean? Is it fair to say that when they see you there's already some significant issues that they want to address?

MP: Yeah, yeah, I agree. Where are we perfectly fit in is in that preventative phase. That's what we were well trained to talk about, and educate and empower on it's like, where we're very well suited in healthcare. Unfortunately, as it stands still because we're fighting against a system, and everyone is so primed in that way. We all think a certain way with respect to how healthcare delivery happens, and how we navigate through the system, that this is still quite a disruptive thought. So even when they're ending up in our one-on-one practice, typically there is something going on, and it's well progressed, it's well beyond the preventative phase. What I'm seeing now we've created teen programs, Mother/Daughter programs, because we to see the potential, like what if you had this information from the start?  I really do believe, and I've said this to not be so bold, I would love to support in any way, I do think this is a very viable solution that fits the gaps that are currently missing. If we're talking about disparity in health care, access to health information, a lot of the criticism with extended health care. Visits, not everyone can access and afford that. Well, Group Health really helps to solve that problem as well. So how do we get this fabulous information that we now know in terms of education, nutrition, lifestyle, or dementia, stress reduction, all these tools that will be disseminated in a very affordable fashion in a large group setting. When people have access to the information, they desire to take radical responsibility for their health, they feel supported by the collective and therefore now they can alleviate a system that is on the brink of collapse that is struggling to keep up with the pace. People are co creating their own health and they are under they understand the role that they play. That's not currently the paradigm we exist in and that was a frustration of mine. Even as a naturopathic doctor, we were still often, you know, viewed as green aloe pass like they still wanted the supplement. I still met that resistance at the very end of my one-on-one practice, you know, there are people like ‘Michelle, I just came to you for the supplement. I didn't want you to talk to me about all the things’ it's like, well, I'm sorry, I can't unsee what I know now.

KK: Absolutely. In terms of the nitty gritty of the programs, because you alluded to the idea that you have like mother daughter programs, for example. Two questions:  What are the programs available? What's the structure like? Is it all naturopathic physician, doctors that will run the program or do you have facilitators?  Walk me through how you navigate through this?

MP: Yeah, so we have a 10-module foundational program that everyone goes through. That is delivered by anyone who is educated enough to articulate the fundamentals of health. So, under a good healthy understanding of physiology, symptom expression, how that shows up in our body testing options, and then natural interventions. So, we have collaborated with mostly naturopathic doctors, we have functional medicine doctors, we have MDs in the US who are teaching and educating the ‘Wild Collective’ we have very well-educated holistic nutritionist that are capable, we have pelvic floor physios that we've partnered up with, and they teach it as their whole clinic delivers certain modules. So, their naturopath delivers a thyroid module, you know, right. So, we we've seen all ways in which this program could be used. And it runs as a closed group. Because for me, that connection piece, like once that piece was well established in my mind that that was what we really needed. I didn't want it to be open, I really wanted them to create a very strong social group that was going to support them through that. So, they these sessions occur either once a month or twice a month or every week. They're two hours in duration, we spend 50% In of the time in connection. So, we ask very curated questions that are going to stimulate a very high-level health-conscious conversation that will also normalize their own human experience, just through the absorption of like, ‘oh, my gosh, I'm not alone, her story is so similar to mine’ there's just this wonderful thing that happens when people start to share and open up. That part to me is so fascinating, that has always ended up being my favorite part is that we spend so much time talking about the big T trauma, little T trauma, all these things that get in the way, you know, we can be really accelerated through a lot of those and freed up with a lot of the things that we carry, when we hear someone's story, it's so similar to our own and they overcame it, and they didn't have to hold on to it. There's just so much power and value in the story sharing part. Then we spend the other 50% in curriculum and health education. At the end of that, then they can move to other levels should they want to continue on, but that is the part that we're now making available globally, because we just want to help as many women as possible. We know that what we have is valuable. We know that it's responsible for consistent health transformation. Man, just like really helping women step up in their own life and leading others that we just wanted to make sure that whoever was capable was it was in the hands of those people and they were teaching it.

KK: Beautiful, beautiful. I'm curious, in one of these sessions when you say you ask one of these standardized questions to be able to get people to open up, do you have an example of that? Not to put you on the spot but do you have an example?

MP: Yeah, so I'll walk you through a little bit of it. So, we start off with our hormone module, which tends to be the most popular where we teach women about cyclical living and how we're different, we're fundamentally different at our different phases of our menstrual cycle. We will open up the circle talking  ‘what has your experience been like? If you could define it in a couple of words? open up the circle, very open-ended questions, we then move to the detoxification module. We talk all about our body's natural capacity to detoxify all the systems of detoxification, and we start to get the questions and it starts to get a little more interesting so that we open up the floor with ‘What are some other things that you need to detox from?’ and I always say you can say very simple things, if you're aware of alcohol consumption, or gluten. You could also be very aware that there are certain relationships, that are no longer serving you, or there are certain parts of your life or habits that are getting in the way of you living your most aligned life. What you're really trying to do is just open up that safe space. I think where we've been very successful as, as facilitators, we see ourselves as equal, so we're equally sharing and we're setting the tone of what's safe in that space. Then leaving it totally open for them to make their own connections. Because what's really beautiful is you never really know how profound the transformation is on the inside from what they're hearing and receiving and what's going on as a result of that information sharing and it's usually quite profound. So, we really try and tie in concepts of intuition and divine feminine with that question asking period. So, the next one is my thyroid, and we have a beautiful thyroid module, but we also start talking about do you speak your truth? Where maybe is a situation where you were unsuccessful and what was the consequence or what was the situation where you were successful? And what was the consequence? And we really start to open up these concepts of ‘oh my gosh, if I'm holding all this in, how is this impacting my health?’ and we really start to tie these pieces together for them so that they realize that they're holding on to things that are no longer serving them. There must be some safe space for that to move through them, so that they can really get to the real obstacles that are getting in their way of their health.

KK: Wow. Certainly, you highlight the mind body connection in terms of how we need to heal, which is grand. It makes sense when you hear similar experiences from you, how that can validate and could make the experience that much more real. This sounds good. In terms of the other programs, you have a mother daughter program. Is there any other kind of unique programs that you have?

MP: We have mother/daughter, we have teen, we have perimenopause, and menopause.

KK: What's your most popular one?

MP: Our fundamental one is our most established. So, I'd say that is the most popular and now we're stepping into like, and I'll say in my mind, I have this everybody just like gets along. I really thought that this would just attract women, no matter what diversity of age diversity of background. That necessarily wasn't the case. That's why we now are targeting certain audiences to help bring them in. Age is a big one for women, so we had to create the perimenopause, menopause, there's slightly different content, of course, that needs to be delivered. But more the real obstacle is that aging women don't necessarily feel celebrated or safe to join where there are younger women. It was a real obstacle for me, if it's going to be a barrier then we must find a different way to reach them.

KK: The answer came from them.

MP: Yeah, the answers definitely came from them.

KK: Interesting. What's the big picture vision? You've alluded to the scaling up of such and the globalization of, ‘The Wild Collective’ and I must say the idea that it could be affordable, scalable, all these things make it very attractive. Where would you love to see this goal?

MP: Yeah, if I were the queen for a day, I there would be a shift, there would be a paradigm shift in our thinking that everyone understood that we took this responsibility on and I'm happy to take this on. That we were advocating and articulating the value of where group health fits in, in the health care system. That every person understood that the health, the health care experience, included community. That it was like the first step that it was concurrent with our one-on-one care, because there were other frustrations, as a clinician, that this alleviates our discomforts, too, I was exhausted at the end of my day, because I was saying the same things over and over. I was trained for strategy, and really building all these beautiful plans and I spent most of my day talking about hydration and protein. It's inefficient, we are way too educated to be hanging out in that space in that capacity. So, let's innovate the whole model. I want to disrupt the model. I want every person to understand the value that group has in their health but also in their life. I think we would see a totally different system and a different health outcome if that were the articulation and so my mission not only moving, what we're bringing forward, but really is to stand for Group Health. The thing that's most difficult, I coach and mentor other clinicians now and building their own group programs. So, I've seen autoimmunity and Lyme and all these other group programs do amazing. We all held up against the same resistance, which is that we as a population as a as a global population, we don't understand the value of it. It's not the articulation of health care, therefore we're naturally resistant to it until we've experienced it. So, I would love to, I would love to create a lot of clarity there, so that everyone understood the value and they just prioritize that as part of the house strategy. That that for me, I think we would change a whole lot with respect to public health. It would be advantageous for everybody, I think it would care for the doctors, I think it would care for public health at a greater scale. That is what I'm set out to do and I want to be of service in that capacity. However, that rolls out. I think my biggest obstacle is trying to articulate the value to people who have only seen one on one care as the only option for health delivery.

KK: Well said, I reflect back, we did a episode, the names gonna escape me all of a sudden put on the spot. It was an episode on social prescribing, and the impact that has had on many patients. You're gonna go to cooking class or a yoga class and prescribing that. I remember leaving that interview saying like, ‘Yes! this is where we need to go’ and a lot of the patients that would be referred, unfortunately, are deep into their ailments. I think twofold, 1. leaning on the preventative side that's at scale in a group setting, I think is grand. 2. Then also just having here in a group session, can be so powerful for the reasons you've mentioned. The reason I'm sloppy is because I'm thinking at the same time, I'm thinking even for our project with metabolic health we should make sure I think I might be in the grant, but we should emphasize the idea of having group sessions. Adding this as part of the care package that they'll receive. There's too much upside, it's more efficient. It's just as glorious.

MP: I agree

KK: You've convinced me now. I love it. So, anything else that you want to give love to with ‘The Wild Collective’, I just want to make sure that we're catching all the magic that you guys are doing. As we say, many times on the show ‘y'all are changing the bogey’. We want to make sure that that bogey gets amplified, so any other initiatives or, or things that you want to highlight Michelle

MP: I just I just want to emphasize the importance of social connection for everybody who's listening. I think there's just been so much impact and impair from the last few years of being strongly encouraged to, to socially distance and fully understand why that happened. There's been a lot of impact and our brains are socially wired to connect and this this needs to be a must have, it ought to be prioritized. Certainly, we'd love to serve you we are always here in the ‘Wild Collective’ to direct you wherever is the best fit or to welcome you into our community. Social connection, the power of that with respect to overall health, well being and longevity in terms of even living eight years longer. I mean, it's just like such a no brainer. It can be successfully done with one other person in your life. So, for me, what was so exciting is this was a free tool that everyone had access to with respect to health that had a massive impact in overall health, well being longevity, anti inflammation, increased satisfaction, decreased risk of anxiety and depression. It is such a powerful tool. I love the work that we're doing, and you can check out our website. I'll give that to you for the show notes. We have facilitators all over the world. We just want to be of service and ensure everyone who wants access to this type of healthcare support can have it I really do think it is the future of medicine. The more that we stand for that and create we normalize the conversation around that I think the easier buy in we're going to have and the more people we're going to be able to help so that's really all I have to say and if I can contribute in any way. I'm happy to because this really is my life's work now. I'm super grateful to know this information now and to have actually stuck with it long enough to see the power of it. To be brave enough to stand for it and continue to scream at the mountaintops for it.

KK: This is great. You've you found your purpose, we are certainly glad you, you found your purpose. To reinforced, the lack of connection and the lack of community in the last couple of years has been significant. I could not agree more. So, thank you, Dr. Michelle Peris for coming on the Kwadcast and please let everybody know where we can get a hold of you.

MP: Yeah, thank you so much for having me. I'm most social on Instagram. So, you can follow me over @drmichelleperis. I love to personally connect, like I said, and like you said the consequences over the last few years. If you're if you're looking for resources, please don't hesitate to reach out. I'm happy to give support and we are global site is wild-collective.com">www.the-wild-collective.com. I also have a podcast called ‘Wild Medicine’ and I think we do a really good job not only explaining the benefits of the wild collective but community medicine at large.

KK: Beautiful, beautiful. Thank you so much for joining us. This was awesome. I'm feeling inspired.

MP: Thank you so much for having me

KK: Kwadcast nation thanks for listening to that episode. Follow us on Instagram, YouTube, Facebook, Twitter and Tiktok @kwadcast. Leave any comments at kwadcast99@gmail.com. Leave that five-star rating. Do it, do it. We appreciate you. Go to Kwadcast.substack.com. Paid membership gets you a membership to solving wellness gets you access to video content. You guys are going to love it! Subscribe today. Stay precious, stay beautiful, peace.

In this episode, we are joined by Dr. Ardelle Piper. Ardelle is an obstetrics gynecology specialist and works with the health community to help them learn more about menopause. Today she speaks with us about how she chose her career path and her work on midlife women’s health, pre-menopausal and peri menopause care. We also cover safe hormone replacement therapy and dissolve a few myths surrounding the concern with some previous studies. 

Thank you for reading Solving Healthcare Media with Dr. Kwadwo Kyeremanteng. This post is public so feel free to share it.

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In this episode, we welcome Janette Yee to the show. Janette is a Perinatal Athletic Therapist of over 20 years and works with athletes specializing in running and rugby injuries. Janette is focused on helping mothers postpartum, today she shares how she helps pregnant athletes and provides in-home pregnancy care. We also hear about how Janette helps moms navigate postpartum rehabilitation, bridging the gaps in healthcare to take a woman safely from conception to childbirth and returning to safe exercise, cesarean birth prep, and more! 

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In this episode, we welcome back Toronto-based author, nutritionist, and founder of the Academy of Culinary Nutrition, Meghan Telpner. Today Meghan shares a little about her past, her diagnosis with Chron's disease and how it affected her lifestyle. Meghan shares how she reversed her symptoms through meditation and culinary nutrition, focusing your mind, and more! We also enjoy a guided meditation presentation developed by the HeartMath Institute, showing us how to tune our breathing techniques and feel at ease and peaceful.

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In this episode, we welcome Marie-Josée Forget. Marie-Josée is a bilingual Pelvic Health Physiotherapist, educator, and mentor with 18 years of clinical experience. She operates a private physiotherapy practice focused on treating pelvic floor dysfunction and teaches courses related to pelvic anatomy and health at Pelvic Health Solutions. Marie-Josée Forget speaks with us about women's health. We learn about perimenopausal, and menopausal women and their pelvic health. How your pelvic health affects your lifestyle and sexual health, Kegel exercises, navigating perimenopause, menopause, and more!

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TRANSCRIPT

KK: We are on the brink of a mental health crisis, and this is why I am so appreciative of the folks over at BetterHelp. It provides the largest online counseling platform worldwide to change the way people get help with facing life's challenges by providing convenient, discreet, and affordable access to licensed therapists. BetterHelp makes professional counseling available anytime, anywhere through a computer, tablet, or smartphone. Sign up today. Go to betterhelp.com And use a promo code ‘solvinghealthcare’ and get 10% off signup fees.

SP: COVID has affected us all and with all the negativity surrounding it, it's often hard to find the positive. One of the blessings that is given us is the opportunity to build an avenue for creating change. Starting right here in our community discussing topics that affect us most such as racism and health care, maintaining a positive mindset, creating change, the importance of advocacy, and the many lessons we have all learned from COVID. If you or your organization are interested in speaking engagements, send a message to kwadcast@gmail.com, reach out on Facebook at Kwadcast or online at drkwadwo.ca

KK: Welcome solving healthcare. I'm Kwadwo Kyeremanteng. I'm an ICU and palliative care physician here in Ottawa and the founder of ‘Resource Optimization Network’ We are on a mission to transform healthcare in Canada. I'm going to talk with physicians, nurses, administrators, patients and their families because inefficiencies, overwork and overcrowding affects us all. I believe it's time for a better health care system that's more cost effective, dignified, and just for everyone involved.

KK: Kwadcast nation welcome back. We have a tremendous episode with MJ Forget. She is a pelvic floor specialist in physiotherapy and sees a lot of perimenopausal women and was really knowledgeable in terms of the issues that she sees firsthand. Many people can benefit from a pelvic floor physio, for example, if they're having incontinence, pain or with sexual health, this is such an important aspect of things. Then she dives into how holistic the approach must be how the physio can actually make some significant strides. How lifestyle changes can impact things. Honestly, I learned so much in this episode. So, we'll jump on it right away here. But first, I want to give a quick plug to our latest newsletter on substack kwadcast.substack.com. Where you can stay up to date with all our releases, our blogs, or blogs or guest appearances, courses all are on one site and it's all point. Check out kwadcast.substack.com and jump on the train. So, without further ado MJ Forget.

KK: Welcome to the show. We we've been talking more about women's health, specifically, perimenopausal and menopausal women. One of the areas that I must say it was a bit foreign to me and I didn't realize it was such a big issue was pelvic health. So MJ you've been at this for a while, like when you started? You said over 20 Maybe 25 years?

MJ: 25 years? Yeah.

KK: What lured you to pelvic health and like how big of an issue has is pelvic health ben for people?

MJ: When we graduate from university, you know, and the medical fields we get to find areas of interest when we graduate and that's kind of all that we do. And you know physio, some of them want to do orthopedics and work with sports teams. When I graduated, I went to the hospital system, which is a lot of what physios do, and I worked in ICU and I worked on the floors, I did orthopedics, post knee posts, hips, and it really wasn't where my passion lied by any means. But it was a really great introduction to all thing’s physios working in a hospital setting. So, when I thought about where do I want to go? And what do I want to do? I always had an interest at the time what we call more women's health. Now we call it pelvic health because again, all genders have pelvic health issues. I had classmates who did their thesis on incontinence. I remember thinking at the time oh my gosh “That's something that we can do?”. It really wasn't anything we were taught in university, nobody really talked about, again pelvic health, women's health, women's health issues, menopause, that was never covered in our degree. So, I took my first course and Alberta back in 1997 and I never looked back. I had no idea how much pelvic health issues was a problem. Remember 25 years ago, nobody talked about any of that. Nobody talked about bladder control issues or bowel control issues. Certainly, nobody talked about menopause, and nobody talked about sexual health, which is a lot of what we do in pelvic health. So, I started my career, like I said, I was in my early 20s and that's all I've been doing now, for 25 years. This is where I'm at.

KK: Wow. You alluded to, you didn't realize how big of a problem it was, like how big of a problem truly is it?

MJ: If we talk just about incontinence in Canada, if we just talk about general stats in Canada, 3.3 million Canadians have bladder issues in Canada. When we think about gender differences, one in four women, one of one to nine men, so it's significant. It actually gets a little worse as we age. That's an issue with menopause. So, if we think about the female population, there's about a 20% to 30% incidence of incontinence in our young adulthood. Think of like your 20s and 30s. Then that spikes up to almost 40%. By the time we get into middle age, which is kind of the perimenopausal menopausal age. Then it goes up as high as 50% in our elderly, which is a really big concern. One of the main reasons that our clients get admitted into nursing homes is because of bladder issues, and fecal incontinence rate, loss of bladder and bowel control is usually kind of an event where families then have a hard time maybe coping with taking care of their of their loved ones, and that will increase admissions to nursing homes. So, we're not talking about small numbers. It's a significant number and we have an aging population in Canada. We have a lot of people going through perimenopause and menopause. One of the biggest risk factors of incontinence is actually menopause. We have a lot of people right now who are entering kind of that phase, you know, and I think in Canada, the stats are that there's 10 million of us in this age group in perimenopause, heading into menopause in Canada. That's a big number.

KK: It's massive. And I think this is what's motivated us to cover some of this content because these are years of productivity, have high needs, like moms that are in that perimenopausal age where you're active with your family, your career paths, like a lot of people this is where they're starting to peak in their careers, a lot of demands just to be to be on the workforce, like when I think of health care workers. So, anything we could do to make them more functional and thrive. I think we need to really look at. I don't know if I realized that, like this is kind of like the peak or one of the main concerns during the perimenopausal perimenopausal menopausal timeline. What can you do? What do you do to help?

MJ: There's so much we can talk about this for hours, but we'll try to kind of keep in to keep our timeline because I can get started. I mean, if we're just going to focus on, we’ll talk the impact of perimenopause and menopause. Like you said, it's such a difficult time. You know, people going through perimenopause and menopause, like you said, are working. They are often parents, with children that still require a lot of our attention. Plus, sometimes we're taking care of our parents as well. We're kind of like in that middle group where we're busy with our careers. We may or may not have children, but we also may have parents that we help and it's a really stressful time, and quality of life really starts to take an impact. So typically, when people come to see a pelvic health physiotherapist, or a physiotherapist who's done postgraduate studies in pelvic health, what we do is we are often seeing people that come for problems of bladder control and bowel control. So that would say that's kind of when I started that was the most of what I've seen, but we also help our patients with sexual function and the ability to have pain free sexual intercourse, which is a big issue again in perimenopause and it can actually worsen and menopause as well. We help with conditions called pelvic pain, pelvic pain can be anything like you know, our patients telling me I have vaginal pain or rectal pain, and when I treat my population of men it could be prostate related type of pains. Pain in the pelvis. A lot of pain in the pelvis affects sexual function and has an impact on your bladder and bowel function. So, it's all related together. When you come and see a pelvic health physio, what's important to know is we take what they call a biopsychosocial approach to care. So that means when you come and see us, we're looking at you as a whole person. What's really great about our profession is we have the luxury of time, because when you come and see us, we have an hour on assessment with you. Follow up treatments can be half an hour, 45 minutes or even an hour. So, we have the luxury of time, and we have the luxury of talking. S o the main thing that we always want to do is let people tell us their story, you know, why are you here? What's bothering you? And how much is this bothering you? Because again, when it comes to menopause, or bladder issues, or sexual function, these are not subjects that people want to talk about easily, right? There's a lot of taboo, a lot of embarrassment. A lot of my clients think they're the only ones who cant have intercourse anymore than the only ones who are losing bladder control and can't, you know, run a marathon. Everybody thinks they're the only ones but there are in fact, not, the stats are actually quite high in terms of impact of blood, bladder, health and sexual health on our patients. So, we talk and then we address all things incontinence, bladder, bowel, sexual function, and things like constipation and pain in the pelvic area. So, we do all of that. It's quite a bit and it spans quite a lot of topics. We also talk about lifestyle because lifestyle is important. On the on, on maybe my first visit or second visit, I'm going to talk to you about are you sleeping well? Are you managing your stress well? Are you having any issues with your mental health? depression, stress, anxiety that you're not managing? Well, how are you feeling hormonally? Because part of what we do and what I've noticed during COVID a lot as well is we've kind of become a little bit of the gatekeepers, I want to see we really had to help our patients navigate the healthcare system, and a time that it was really difficult to navigate the health care system. I always tell my clients, I'm here to help build your team around you who do you need to help you navigate perimenopause and menopause so you can live your best life, because as physios, we have to stay in our scope of practice, we can't do everything. So, if I talk about nutrition, I can talk about why nutrition is important, but I'm not allowed to give you advice on nutrition because it's not in my scope. But I'll send you to the people who do that. And the biggest challenge and menopause is that for a long time, there was nobody to send people to. Right? If you think about, you know, how many menopause clinics do you know, that exist out there? Right. There's one at Mount Sinai. There's just not a lot of menopause clinics that are run by a gynecologist and maybe have a nutritionist and a psychologist all working together and maybe with a pelvic health physio, that'd be great. That could look at that whole biopsychosocial approach to care to really help our patients navigate menopause. I think that's now starting to change. I think now, you know, the tagline right now is menopause is having a moment while menopause is having a moment. I think partly because there's a lot more of us in our field talking about it on social media, there's definitely some gynecologist now that are much more vocal on social media, talking about hormones, talking about safety of hormones. When I started 25 years ago, hormones were a no go, there was so much fear around all things hormonal replacement therapy, and it was really difficult because as a physio, I could see how devastating some of the symptoms of menopause were and there wasn't really a lot of options for my patients at the time as to what to do about it. Because everybody has such a fear of hormone, whether it's topical hormones or hormonal replacement therapy, and I think that that's shifting as well. So, we talk about all of these things with our clients when they come in. Then we help navigate and say, Okay, if you're struggling with nutrition, who could we send you to? If you're really struggling with your hormones, who are the hormone, menopause, hormonal experts out there to send you to? If your mental health is an issue, who do we send you to for that so that you can kind of work on your anxiety and your depression and your stress? There's been a lot of stress, you know, in the last few years, and then as physios, we take care of more that kind of the physical kind of component of incontinence, pelvic pain, bowel health, constipation and sexual health.

KK: You know, what I'm really appreciating is you’re saying MJ is how holistic the approach is, it's not so just the physical aspects and the rehabilitation, you need to know how it's affecting your life, how you're doing from a lifestyle perspective, stress level, sleep, how well you're eating, and just approaching it that way. That's what I'm finding really encouraging about this is that you know, you're just not soloing the approach, it really comes down to how the person is doing as a whole. In my opinion when it comes to so many issues in medicine, this is the only way like, you need to really address so many of the needs outside the actual physical concern. Another thought just came to mind too, is just hearing all the, the symptoms that so many perimenopausal and menopausal women have to go through it, it just, it really is sad that so many people have had to go through without it go through all this without attention. You put it together, the hot flashes, the mental health concerns, weight issues,

MJ: the insomnia, the anxiety

KK: Then you add the pelvic pain, the incontinence on top of that

MJ: It's significant, and it's all today can be a very overwhelming time and our client’s life, because, again, they're so busy, they're under a lot of stress, they have a lot of obligations. Then they're dealing with, you know, ‘I can't have intercourse with my partner, it hurts too much. I'm leaking urine, I can't exercise. Now I'm gaining more weight. I am going through perimenopause, I got insomnia, I can't sleep’. That has huge repercussions on the human body. It's important that we all talk about those things. And it's important that we recognize the lane that we're in as, as health professionals and find the right people, for our clients so that they get better. I think you know, again, it's the tides, I think are changing that we're taking a little bit more of this kind of like sort of biopsychosocial approach, looking at the whole person. Also giving permission to our clients to talk to us about these things that it's okay to talk to me about your bladder issues and your sexual health concerns and, and your stressors in your life and how maybe you're having really hard time balancing work life balance and seeing how we can help with that. We can all help with that, in our own way.

KK: Absolutely. Give us a sense, MJ when someone walks into the office what some of the stuff you're assessing? what do you do as a physio to help patients that's within your scope? the exercises? help me understand the potential and the things that you do to help address these issues.

MJ: So, once we've listened to everybody's story, and they tell us what their main concerns are, and what their goals are, in terms of what would they like to achieve with our time together. We do a lot of education, and education can be like I said, lifestyle, sleep, how are they functioning with nutrition? Are they exercising? are they happy? Are they stressed? then we really go into the function of the pelvic floor. So, if we talk about the main concerns most of our clients are coming in with often it will be bladder issues, bowel issues, it will be sexual health issues, and maybe constipation issues, like some bowel issues, that all tends to act up in perimenopause. That's when we take out our props. I have lots of props to explain to people about the pelvis. Because again, we are not taught anything about the pelvis as human beings. And if we think about our education in our primary schools, in our high schools about pelvic health, there's none of that. So, we often don't really know about the pelvis, right? And where the pelvic what's happening to our pelvis. If we look at this wonderful pelvis has been with me for 25 years, so it's falling apart.

KK: People listening, you might have to be extra descriptive, extra descriptive

MJ: Okay, so when we look at the pelvis, if I take the muscles out of the way, this is the front of your pelvis. So that's your pubic bone. By turning the pelvis around, that's your kind of your spinal column and your tailbone would be right here. And if we look at the bottom, while the bottom is all muscular, it's just muscles down there, and you have layers of muscles, and we call it because we're not very clever. We're calling it the pelvic floor muscles. There's a lot of fancy terms in anatomy, so we won't go through that but for the sake of purpose, the pelvic floor and there's layers. The first layer, which is the most superficial, so meaning that you can touch it from the outside. These muscles here go from your pubic bone to your tailbone here at the bottom, they wrap around your clitoris, and your vaginal opening, and then they also wrap around the anal opening. All of these muscles here, the main function of these little muscles are that the vaginal opening or for sexual function, which is why sometimes we can have difficulties with maybe having an orgasm, libido, desire orgasms, and maybe we have pain with intercourse. These muscles which are under voluntary control, so we can learn to use them, they must contract, but they must relax. When things go in the vagina, all these muscles must have the capacity to stretch into expand, and that should never cause us pain. So that's this first little group. We'll maybe dive into kind of sexual function a little later. But that's the first little group. Then deeper inside your pelvis, you have another group of muscles that are deeper inside your body. These muscles, they're quite big, quite large, they wrap around your vaginal opening and your anal opening all the way from your tailbone at the back to your pubic bone at the front, those are your bladder and bowel control muscles. So if I take that muscle out, just to show you how big it is, the big muscle, front to back. When you laugh, when you cough, when you sneeze, when you lift things that are heavy, these muscles tighten around your urethra, or tighten around your anal opening so that you don't lose bladder control, you should be able to hold on to those muscles to get to the bathroom on time. Then when you sit to go to the bathroom, they relax this stretch the expand to allow us to go to the bathroom. So, when people come to see us for bladder issues, bowel issues, or sexual health issues and sexual pains, what we're trying to determine is what's happening to that little group of muscles, what's happening to that pelvic floor. I always tell my clients, there's two groups of you. There's a group that come that comes to pelvic health physio, where when we evaluate the function of their pelvic floor, they just lost a lot of strength and endurance. We see that in perimenopause and menopause because this is my hormones are important. When you go through perimenopause, your hormones are starting to dip down. They're not gone yet. But your estrogens are dipping your testosterone and your DHEA, which are your androgenic hormones are decreasing. We need estrogen for muscle strength, and protein synthesis and collagen. When we have a loss of estrogen, we start to lose muscle strength, we start to have what we call sarcopenia. Right. And that starts to increase as we age if we're not moving and exercising. So, estrogen is really important for muscle function to testosterone, which we have, we don't maybe have as much as our male counterparts. We do have some in it, it is important because it helps with muscle strength and muscle tone. That impacts the pelvic floor. So, I may have someone who has never had babies never, never could not have children or decide not to have children who come to see me, and perimenopause and menopause and they'll say, Why am I having incontinence, I never got pregnant. Well, that's because even if you have not had children, you're gonna go through menopause, you're gonna have those hormonal fluctuations. You can still have some symptoms of menopause and one of them could be incontinence. And the other thing what these pelvic floor muscles do, which is really great when they're working well, and you're able to use them properly, they help decrease the sense of urgency and frequency, right. So, some people say I go to the bathroom all the time I'm peeing every half an hour, I'm getting up three, four times a night to go to the bathroom. When we help regain function of these pelvic floor muscles to reduce incontinence can also reduce urgency and frequency and the need to get up at night. So, group number one may have a lot of weakness and loss of strength in their pelvic floor. Again, that happens in menopause with the loss of our hormones. A lot of the symptoms tend to worsen about seven to 10 years after you're done having your menstrual cycles remember that you are menopausal if you've gone 12 months without your menstrual cycle, usually symptoms of menopausal peak a kind of that seven to 10 years. I's about honestly, they're saying about 50 to 65% of the population may have actually some symptoms, you know, at those seven years, post menopause. Second group of people that often come in is when we evaluate their pelvic floor, they have all the same symptoms will have bladder issues or going to the bathroom a lot. But then they tell us they have pain, they have pain with sexual activity. Then when we look at their pelvic floor, they actually have too much tension. Okay, and that's a problem because if you look at this little layer of your pelvic floor, these muscles that wrap around the vaginal opening and your clitoris, so these are your clitoral muscles. So important to have orgasms if you have too much tension in these muscles like this when things going in the vagina start to hurt. Again, that can start to be a problem in perimenopause and into menopause, again because of hormonal changes. What happens is, you're going through perimenopause, or menopause, or maybe you're in menopause, your estrogen levels have dipped down. Estrogen is like the fountain of youth, estrogen plumps up our tissues, it increases blood flow to the area, it provides elasticity to all of our tissues, and that's your labia, and at the vaginal opening. This area is really, really rich in what we call estrogen receptors. And of course, when we go through perimenopause and menopause, that's a decreasing, and so things get a little thinner, things get a little drier, and things lose the elasticity. What often can happen is, my clients will have intercourse, and it hurts, and maybe they bleed a little bit, because again, you know, when estrogen goes low, everything gets a little drier and more sensitive, and they've been prone to maybe even some tearing, well, then that pelvic floor is actually very clever, these muscles here, they're there to protect us as well. So, if you have pain, then the next time you think about engaging in sexual activity, your brain is going to say, You know what, that really hurt last time and right away, we start to tense up our pelvic floor. And then we get caught in this vicious cycle, where we have that episode of pain because of hormonal changes, then it hurts and then our pelvic floor tenses up. Then we keep trying to have intercourse, but then we keep irritating that area, then the pelvic floor just increases in tension and increases in tension. That can lead to more pain, with sexual activity as well. So, I always tell my clients that we need to figure out which of the two groups do you belong to? Do you have a pelvic floor that just needs strengthening? Or do you have a pelvic floor that maybe requires a little bit more stretching and relaxation, to help you regain proper sexual function? You know, having sexual function without pain? In everything that we do, you know, we always take that step back and go, Okay, well, you know, what are the stressors in your life that also increases muscle tension, right? So, stress and anxiety, and lack of sleep, all increase our fight or flight response. And that's why sleeping is so important to kind of really get you restorative health, you know, and to make sure that we're refreshed in the morning, managing our stress is really important, because when you're under stress through the day, and you're in that fight or flight responses, all your muscles tense up, including your pelvic floor, right? So, then what we do is we do a physical exam. This is kind of where, you know, doing a really good explanation of the pelvic floor is really important. So, I have these really great models that I've designed over the years. And what I do is I show all of the muscles, so you've got muscles at the vaginal opening, that can be the reason you have pain with sexual activity, you've got deep muscles inside that your bladder and bowel function muscles. So, when we do a pelvic exam, we do not use speculums. We don't have you in stirrups, it's not like kind of a pap, we're going in manually with one finger and we start on the outside and we just have a look at all these muscles to see are they causing you any discomfort that could actually explain some of your pain with sexual activity. If we're able to do that, then we can go in. We can look at all of these bands, all of these muscles that you see here that's colored, these are all your pelvic floor muscles. We can evaluate all these bands of muscles right side left side to determine Are any of these muscles causing you any pain, because pain with sexual activity can be pain at the opening? or some people will tell me you know, it's deep inside. ‘It's like I can't like we have to stop it hurts so much deep inside’. Then we evaluate these muscles I say, ‘Okay, if I said to you try to contract, try to squeeze those muscles, especially with people that have incontinence, bladder or bowel, I'll say try to contract your pelvic floor’. That's where we're assessing strength and endurance, okay, how strong are your muscles? You know, how much endurance and power does your muscles generate? And if that's lacking, we're gonna work on that. So that's kind of the physical exam and the physical exam is as per our client's comfort levels. So, some people on day one will say, I'm not comfortable with a pelvic exam, maybe they need a visit or two to get comfortable with the idea. You know, some people are not aware that that's what a pelvic health physio is trained to do. We are trained to do pelvic exams for the purpose of evaluating what's happening to all these layers of pelvic floor muscles. So, you can regain bladder control bowel control, and sexual function. The other thing that this pelvic floor does, it's like a shelf, it holds up our organs and so a lot of our clients will say, ‘I feel like feel like something's falling out of my vagina’. They get diagnosed with something called the ‘prolapse’, which is everything kind of softening up and estrogen is important for that because estrogen is what we need to have strong ligaments and strong tendons. A lot of times heading into perimenopause or menopause, somebody may have had a prolapse when they had their, two, three children in their early 20s, and did absolutely fine. But now they're starting to have symptoms because their estrogen levels are decreasing. That's really altering kind of the function of what we call the collagen fibers in their tendons and in their ligaments. We have a lot of ligaments that hold up our organs, and everything just kind of soften. So obviously, nothing's ever going to fall out of your body. It's never going to happen but everything softens a little bit and part of what we have to do is strengthen that pelvic floor if needed to kind of create that supportive system from the bottom. It really is all about exercise. It's about exercise.

KK: That was going to be my next question, maybe with that first option of picking up someone that is having issues with incontinence, assuming you're addressing the lifestyle issues, and so on. But what's an example MJ of exercises or type of exercises that they will be using to try and rectify the problem?

MJ: Everybody's heard about those famous Kegels right? Everybody's heard about Kegels

KK: I’m doing them right now

MJ: Kegel, he was a physician; he was a gynecologist back in the 50s. Dr. Kegel and who's who had done kind of a lot of research on the field of the pelvic floor. We call them pelvic floor exercises. So yeah, we teach our clients how to properly contract their pelvic floor. What's important to know is that you can read online on how to do cables, and how to engage your pelvic floor, but they're not easy to do. It's important to see a pelvic floor physio, because a lot of people think they're doing them properly. Then they come and see us and they're confident ‘Oh, no, no, I’ve been doing my ‘Kegels’ fantastic, I think I'm good’ and we test them, and they're not doing them properly. We tend to cheat a lot. When we try to engage your pelvic floor, we're holding our breath, maybe we're squeezing your bum, or we're sucking in our belly. Really, you should be able to squeeze your pelvic floor, you can think about I was kind of give the example to my clients, I'm like, imagine a little ping pong at the opening of your vagina and just try to grab and pick up your ping pong and for my patients that have penises, I'll say try to lift up your penis, right. Those are some of the things that we explain. That's how you think about engaging your pelvic floor or think about stopping gas. The reason it's so important for us to do a pelvic exam is from the outside, I can't tell if you're doing a proper pelvic floor exercise. When we do a pelvic exam, it really tells us how well you are using those muscles. If you have pain, then we're at least kind of finding out that there's too much tension and if you have too much tension, I'm not giving you Kegels to do. That makes sense, right? So, if you're coming in just for incontinence, I evaluate your pelvic floor, there's no discomfort, when I'm palpating those muscles and you're good to go. Yeah, then we're going to work on some strengthening. If you're already here, and then you've got pain, with intercourse, maybe it hurts to go to the bathroom, you're not peeing really well. So the muscles are not relaxing, and I evaluate your pelvic floor and there's too much tension, well, I'm not going to give you more Kegels to do. So, in that case, we're doing things to relax the pelvic floor, and this is where we do breath work. And we do yoga-based movements, a lot of pelvic openers and yoga, a lot of breathing, maybe some meditative type of practices to help relax that tension. Once we relaxed that tension, once the pain goes away, then maybe we can do some strengthening, if that's what your body needs at that time. That's why it's so important for us to do an exam because again, I can look at you and I have no idea if you've got a pelvic floor that's too weak or a pelvic floor that has too much tension but when we palpate it we can see and then we can give you the proper exercises

KK: This is good because once again I think there is a lot of women that are struggling with these concerns and with that are maybe at a loss. Are there a lot of pelvic specially physios out there? for example if people want to get access to someone of your caliber and this is not something you could be doing virtually either right?

MJ: I did a lot of virtual; I still do. Virtual is really good for is sometimes even just the initial assessment like the first time because we do talk so much and we do a lot of education. So during COVID we did quite a lot of virtual and I continued to do so and sometimes that day one. Maybe you know if you've got COVID You can't come into the clinic well then, I'll just do a virtual with you do all the education and then you come back in to see me for kind of an in person visit when you're feeling better you know when you're not sick, things like that. So there's a lot of us doing virtuals as well. The best place to kind of find a physio in your area that has the qualifications to do a pelvic exam and to do pelvic health, is to look at the website called pelvichealthsolutions.ca and there's a find a physio feature there. You can actually click in your area, look at people's names, it shows all the courses they've done, so then you can kind of look at, oh, this person's done a menopause course, great. This person's done a hormonal health course. That can help you choose a physio in your area. That's a really great feature that we have. pelvichealthsolutions.ca is a great resource. There's a lot because we're, when I started 20 odd years ago, there was four of us in Ontario doing pelvic health. Now we have hundreds of physios who decided to take pelvic health courses as postgraduate training. We are not without pelvic health physios out there to help anybody who has a pelvic floor, anybody who has incontinence, anybody that has any problems with sexual health, anybody with constipation, there's so much we can do. Like I said, we've become resources for our clients to help them find the right people to go see whether it's nutrition, stress management, mental health and whatnot is really part of what we do to help her patients navigate perimenopause and menopause.

KK: Wow, MJ, pure gold. In terms of knowledge and resources I must say, this was some of the best explanations of the issues when it comes to pelvic health. This is the stuff as a physician, you hear about these concerns, but the way you just simplified it, using language that all of us can understand, conceptualizing it in ways that we will understand. Putting it into, for example, two frameworks, or two patient populations that you typically see, you're the GOAT.

MJ: Thank you! That's why we say to people, if you're not sure at least come in for the first visit. So, you get a chance to chat, you know, and that's a nice thing about doing virtual, you're not sure about it, we'll do a virtual and we can talk through and I think a lot of people then realize, ‘Oh, there is help for me, oh, sexual, sexual dysfunctions and payment sexual activity’. That's not okay. No, it's not okay. It's not okay, that you're not sleeping through the night because of hot flashes, right. Then really talking about the research and the evidence behind what we do. And we have a fairly high level of evidence in what we do in terms of treating incontinence and prolapse and pelvic pain. Having a chance to talk to our potential clients about that is good. Again, to make everybody feel more comfortable with topics that are not comfortable to talk about. I mean, there are still a lot of taboos around bladder and bowel health. There's a lot of taboos around sexual health. There's a lot of taboos about talking about menopause. Because we've been told, while menopause is just part of life and deal with it, suck it up, right, suck it up, you know, don't complain about it, you know. I think, I think our clients are starting to get fed up with feeling so poorly, and so discouraged about their quality of life. Like I said, it's not insignificant, there's over 30 symptoms of menopause. If we can improve any one of them, I think we're doing well, to help navigate, you know, and these challenges that our clients have. We have great research, I was just reading, just to get ready for today, that strength training again, we're physios you know, we're all about exercise motion is lotion. We encourage our clients to even get out like I always tell my clients, even your pelvic floor loves to go for a walk, just walk outside. The thing with walking is that you're outdoors in the fresh air in the sunlight, you're getting your vitamin D, you're setting your circadian rhythm, there's good research to say that if you get outdoors in the morning and bright sunshine for a good walk, you're gonna sleep better at night. Right? But strength training, which we again love to encourage your patients to do reduces hot flashes by 44%. you know, again, this is kind of in the purview of a pelvic physio or any physio is we're all about, you know, strength training to help mitigate the effects of losing estrogen and testosterone, right, strength train to reduce your hot flashes by 44%. Wow, you know, strength training to reduce osteoporosis because that increases when we hit menopause as well, because of all the hormonal changes, strength training to improve your insulin resistance so that you can lose weight and strength train for your pelvic floor because when you're strong, your whole body, everything's strong, even these little muscles here, and so kind of giving permission to your clients to exercise, but it's hard, right? because, you know, it's time, you know, and part of what happens in menopause is that people are overwhelmed with stress, and people are not taking the time to do the things they, you know, that we all get told to do, you know, eat well, sleep well ,exercise. So, it's kind of helping our clients navigate, you know, where could they find time to sneak in a little bit of exercise? What can they cut out? Right? What can they let go? What's not important, you know, and, you know, talking about the importance of strength training, I think, again, it's an eye opener. So that's why the education is so important, because when we educate people go, ‘Oh, okay, well, that's a good reason to act’ maybe that's the one thing you needed to hear, to allow you to go and think about strength training, and it doesn't have to be a lot, you know, just a couple of, you know, 10-15 minutes a day can maybe be a good start. Because the impact is so amazing, just like the impact of yoga and osteoporosis and yoga and constipation and it doesn't have to be an hour of yoga, you know, I can help find a video, that's like, 15 minutes, maybe you do that before you go to bed, right to help you sleep and so education is really key, and to, to really help our clients navigate all of these crazy symptoms they have and making sense of it all. Hopefully, get that buy in that motivation that something that speaks to them that says, okay, I am going to try to make a change. When it's hard, you know, you know, one of the things that happens with our clients and menopause is they stopped exercising because they're losing bladder control.

KK: Yeah, that was actually one of the things you're mentioning the resistance training. To create the habit, it's not about the result always. You got there, you did your part of the process, even if you get to the gym for that five minutes, and you didn't do all the exercises you were planning to do, but you're getting that that habit developed. So, yeah, as you alluded to, it's hard to do all these things. But to develop the habits, I think is, is where, if you could develop the habits, you'll be moving in the right direction.

MJ: Yeah. And I think the more information people have about the benefits, beyond what we already know, right? I mean, we kind of go, weight loss, and I gotta quit smoking, but sometimes you can actually reduce your symptoms of menopause this way or that way, you know, again, that might be enough to persuade someone to say, okay, you know what, then I do need to carve out time in my day, I need to let go of the things that maybe are not that important, and really spend time on myself, and really improved my sleep, and improved my nutrition, and improved my stress management and try to think about exercising, because again, it doesn't take a lot to make a really big change. It doesn't take a lot to go for a walk, I'm happy if you start off with 10 minutes, I'm happy. If we decide Yoga is the best way for you to manage your stress or to help with your IBS or osteoporosis that you're doing even 10 minutes of it. 10-15 minutes of it. We start small, and we build on that. We provide encouragement, because again, we all have bad days where we fall off the rails, and it's okay, we're humans, we're human beings. As long as you just keep at it, you'll start to see some changes. And, and like I said, it's building a team, because our clients need to have the right people helping because MJ can't do everything for everybody like that, you know, if we're only one person, so who are the menopause experts out there who are the nutritionists out there who have a really good interest in menopause and Hormonal Health. Who do you go see if you're having insomnia, right? Because there's CBT there's cognitive behavioral therapy for insomnia. Okay, who are the people for that? Do you want to get hooked up with a personal trainer to kind of motivate you to strength training? Okay, let's find you someone to do that. It's all about building a team and it's all about dialogue, and always talking about these things and giving our patients permission to talk about what's bothering them, and to be open about their frustrations and you know, if they're having frustrations with their weight loss and okay, let's see who's out there who can help you with that.

KK: MJ, this has been grand, it's been grand! How do people get a hold of you? I am working right now, I'm in downtown Ottawa. I'm at a clinic called Killens Reid physiotherapy, killensreid.com, we're three pelvic physios at that clinic. There's myself, my lovely colleagues, Natalie and Sophie all of which can help you with menopausal issues. You can look at that pelvic health solution website to find people in your area. It's a great resource. That's the group that I'm one of the teaching instructors for pelvic health. You can see how many great pelvic health physios we have all across Canada. There are also naturopaths, who have taken our courses that are listed. So, if you want to maybe work with a naturopath who has a knowledge of pelvic health, they're listed on there as well. We have some nurse practitioners that have taken our courses, who again have developed an interest in pelvic health. You can find all those people on the pelvichealthsolutions.ca website. Killensreid.com to reach the clinic that I'm at, you can I have a website as well mjforgetpt.ca. I'm on Instagram ‘mjforget’. There's lots of different ways to find us and, and to kind of help you with all your symptoms.

KK: I love it. I love it. Thank you, MJ, for the knowledge that you threw down the holistic approach the benefits of seeing the likes of you, I really appreciate you coming on. This is awesome. I appreciate any opportunity to talk about all things pelvic health, and I appreciate all of you've done again, because you've taken quite a holistic approach yourself as someone in medicine right in really thinking about nutrition or sleep or stress or you know, exercise mindfulness and it's always nice to talk to kindred spirits, I say.

KK: Thank you so much. Alright, well, I hope you've enjoyed that episode. Please follow us on Instagram YouTube, Facebook, TikTok, Twitter at kwadcast. Please leave any comments kwadcast99@gmail.com. Leave a five-star rating on wherever you listen to podcasts. Leave a review. Check out our newsletter at kwacast.substack.com. Everybody stay beautiful

In this episode, we are joined by a fantastic group of employees from Bayshore HealthCare. A Canadian-owned company, Bayshore HealthCare is one of the country’s leading providers of home and community healthcare services, providing customized care plans and solutions that allow clients to remain in the comfort of their own homes. Today, we get to hear from a few of their dedicated employees about their health and wellness journey, wellness in the community, personal care, challenges faced through the pandemic and more! Our panelists share with us their diverse backgrounds and how they impact their community as well as their amazing experience working with Bayshore HealthCare.

Thank you for reading Solving Healthcare Media with Dr. Kwadwo Kyeremanteng. This post is public so feel free to share it.

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Sign up today: http://betterhelp.com/solvinghealthcare and use discount code “solvinghealthcare"

In this episode, we are joined by Dr. Alfred Atanda. Alfred is an orthopedic surgeon specializing in sports medicine. Today Alfred shares with us everything about his initiative, Sports Link MD, a telemedicine service for youth athletes, connecting them with specialists efficiently. Alfred also shares with us some of his past, how he balances work and his personal life and talks about physician wellness, physician burnout and his work to help optimize the physician experience, racism in the workplace and more.

Thank you for reading Solving Healthcare Media with Dr. Kwadwo Kyeremanteng. This post is public so feel free to share it.

Solving Healthcare Media with Dr. Kwadwo Kyeremanteng is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

In this episode, we welcome Neil Pasricha. Creator of ‘The Book of Awesome’ Neil is a New York Times bestselling author and journalist. His work has spent over 200 weeks on bestseller lists and hit over 2,000,000 copies sold across dozens of languages worldwide. A proud Canadian, currently living in Toronto, Neil holds degrees from Queen’s University and Harvard Business School, his first TED talk gained notoriety as one of the 10 Most Inspiring of all time. Today Neil shares with us his journey toward happiness and bits of his past that inspired him to focus on mental health and well-being. He gives us incredible tips on how to start and end your day and how he continues to help people live healthy, purpose-led lives through intentional living.

SPONSOR

BETTERHELP

BetterHelp is the largest online counseling platform worldwide. They change the way people get help with facing life's challenges by providing convenient, discreet, and affordable access to a licensed therapist. BetterHelp makes professional counseling available anytime, anywhere, through a computer, tablet or smartphone.

Sign up today: http://betterhelp.com/solvinghealthcare and use discount code “solvinghealthcare"

Thank you for reading Solving Healthcare Media with Dr. Kwadwo Kyeremanteng. This post is public so feel free to share it.

Solving Healthcare Media with Dr. Kwadwo Kyeremanteng is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

TRANSCRIPT

KK: We are on the brink of a mental health crisis. This is why I am so appreciative of the folks over at BetterHelp everybody the largest online counseling platform worldwide, they change the way people get help with facing life's challenges by providing convenient, discreet, and affordable access to licensed therapists that are helped make professional counseling available anytime, anywhere through a computer, tablet, or smartphone. Sign up today go to betterhelp.com And use a promo code ‘solvinghealthcare’ and get 10% off signup fees.

SP: COVID has affected us all and with all the negativity surrounding it, it's often hard to find the positive. One of the blessings that is given us is the opportunity to build an avenue for creating change. Starting right here in our community discussing topics that affect us most such as racism and health care, maintaining a positive mindset, creating change, the importance of advocacy, and the many lessons we have all learned from COVID. If you or your organization are interested in speaking engagements, send a message to kwadcast99@gmail.com, reach out on Facebook at kwadcast or online at drkwadwo.ca

KK: Welcome to ‘Solving Healthcare’ I'm Kwadwo Kyeremanteng. I'm an ICU and palliative care physician here in Ottawa and the founder of ‘Resource Optimization Network’ We are on a mission to transform healthcare in Canada. I'm going to talk with physicians, nurses, administrators, patients and their families because inefficiencies, overwork and overcrowding affects us all. I believe it's time for a better health care system that's more cost effective, dignified, and just for everyone involved.

KK: Kwadcast nation my goodness, we got Neil Pasricha show on the show man. I don't know if you guys know how balling this is. He is a New York Times best seller, TEDx speaker, entrepreneur, podcaster, public speaker right now. His latest book, ‘Our Book of Awesome’ is out. It's on my nightstand. In full effect. I am so excited to bring this episode to you folks because Neil encompasses the changes we need to make, the mindset changes to be happier, to live a more fulfilling life. Especially in a time where we're struggling, a lot of people are struggling healthcare providers are looking for that sense of purpose. This episode is so much fun, we talk about how to start your day, how to end your day, how to how to be intentional and be purposeful throughout your day. And all these little things I think they just add up into living a more fulfilling life. He also talks a lot about not taking anything for granted, which I think is so important in terms of living a more fulfilled life. Talk about gratitude, all these things that we just need to appreciate and at the end of this episode, you will feel hope, you will feel that there is light at the end of the tunnel. I won't lie to you man; this episode was strait up gangster. Before jumping into it make sure to jump on our kwadcast.substack.com Essentially, it is all things kwadcast, we got videos, blogs, all our podcasts on one platform, one stop shop, essentially for healthcare solutions. So, jump on kwadcast.substack.com. That's where we'll be changing the boogie. Alright, without any further ado, Neil Pasricha. 

NP: Thanks so much for having me on. I really, really appreciate it. I love the work you're doing and it's a thrill to finally connect.

KK: Oh, man, this is thank you for that. This has been a long time coming. The reason Neil I wanted to get you on the show is because you are creating the change as so many of our youth so many of our health care providers need right now. How do we get well, how do we find fulfillment? How do we get happy again? How do we get awesome again? Honestly, I think the best place to start is just your story like this is this is not a typical story in terms of someone that ends up on the bestseller list. How did how did we get here?

NP: Well like it as you say, it's not typical. My parents are Indian immigrants. My mom is from Nairobi, Kenya. My dad is from Amritsar, India, they had an arranged marriage in England, they came to Canada in the 1960s. I was born in a suburb of Toronto called Oshawa, Ontario, which I'm sure some of your listeners know and many of your listeners probably don't. For those that don't know, this is like a GM blue collar kind of town. I was born there in 79. My mum worked as an accountant at General Motors my dad was a high school physics teacher, the very first one in the in the region. You know, I didn't come up into the world of arts being a thing that you could even do you know, at all. For me, it was about getting good grades in math, how's the chemistry marks? you know, what did you get? and 92 on the paper, tell me about the questions you got wrong, you know, so my whole life philosophy was oriented towards, you know, academic achievement. For me, the wheels didn't fall off until my late 20s. I'm happily married. I'm living in Mississauga, Ontario. I've got a steady job. I'm now working as a manager of leadership development, Walmart, Canada, I got the job, I got married, I got a house, I've got potentially going to have kids. Everything's going according to plan. Then the span of a couple of days, the wheels fell off. Two things happened. Number one, my wife told me, she doesn't want to be married anymore. She's like, I've fallen in love with somebody else. I don't know how to tell you this. I really don't want to break your heart. But like, this isn't working for me. We'd been together four years. We've been married for two, we just bought this house. We're talking about having kids. It was like, you know, I'd say it was shock. But it was it was before that it was like I couldn't even comprehend what she was saying, I was like kind of miffed, you know, I was like, what are you talking about? but at the same time, I didn't have time to even start to process that shock. Kwadwo because three days later, my very best friend Chris, sadly took his own life. We need to talk about suicide more. You guys are on the front lines, your healthcare professionals, you know that the suicide numbers are off the charts. 18 per 100,000 murder rates are 6 per 100,000; meaning we are three times more dangerous to ourselves and anybody else is to us. I lost my best friend, I lost my wife, I lost my house, so we sold the house. I'm like losing, I lose weight. I even lose 40 pounds due to stress. Everybody at work at Walmart was like, ‘You look great. What's your secret? What are you eating?’ You know, we have this preoccupation in our society you and I could probably go deep on this topic where like, we take anyone losing weight as like some sort of proxy for wellness, you know, which is totally unhealthy but we have this preoccupation. So, I'm like trying to answer questions about how I why I look so good, even though I just did literally not eating not sleeping, you know, that's the recipe… don't recommend. In the throes of this like overwhelm and anxious depressive place. I decided one night to start a blog. Why? Well, I had written when I was a kid, I was the, you know, elementary school newspaper editor, the high school newspaper editor. I even went to Queen's University and helped edit the newspapers are called ‘Golden Words’ which is a weekly comedy newspaper there. For years after I graduated, I wasn't doing anything like that. So, I was like, writing was a place for me. I looked for it again, I started a blog called ‘1000awesomethings.com’ with the goal of writing one awesome thing for every day for 1000 days. What's an awesome thing? I don't know, I didn't even know I just said, like, I picked the blog title in like 10 seconds. I don't know. I wrote my first post was called brocco flower, the strange mutant hybrid child of nature's ugliest vegetables. No one liked that post, including me. You know, no one liked that thing. I was just like, put something up there. That's a lesson by the way, just start just do something. The next day number 999. The last crummy triangle of potato chips in the corner of the bag and I talked about cutting the bag open pouring into your mouth and licking your fingers sticking it in. Again. Nobody liked it. Nobody read it. Number 998. The next day getting grass stains running around getting grass. Again. Nobody. Eventually my mom was very nice. One day I'll tell you she sent it to my dad and my traffic double. It was unbelievable. I got like two hits. Then one day I started to get 10 and then I got a comment from someone I never heard of. Then I started getting 50 hits and then 100 hits and then a 1000s and I'm not kidding you it started hitting the front page of websites like ‘FARC’ and ‘Digg’ and ‘Reddit’ and I know we're about the same vintage so you might remember these kind of like, you know, original kind of pre social media websites that were sort of building up link sharing as a thing right. I know Reddit is still around but digg.com and FARC.com , we're also huge back then. So, I wrote a post number 980. Keep in mind this is 20 days after I started the thing, and it was called ‘Old dangerous playground equipment’ and I wax prophetic about burning your legs and hot slides, falling into cigarette butts and milk vessels getting a cast on your arm and have everybody sign it. It was like a, that was like saying, remember how good it was. That post got 50,000 hits in one day and for me, as somebody who's getting 50 hits a day, I was like, ‘What's going on?’ and then the people didn't leave that 5000 stuck around and then 10,000 stuck around and then 50,000 stuck around and like I said, I started getting millions of hits. 1 million, 2 million, 5 million 10 million, I get a phone call. Yhe voice at the other end of the line tells me this is like nine months after I started the blog now. The voice says you just won the best blog in the World Award. Which no one's heard of that before. It doesn't even sound like a real award. It sounds like saying you won the Best Tiktok or award like was that even a thing? Is that even who's making this up? Right? Turns out there's an ‘International Academy of Digital Arts and Sciences’ they fly me down to New York City a parade on stage accept an award for best blog in the world sounds like nothing but I get home to Toronto. Now I live in downtown and then by myself for the first time in a big city for the first time in a bachelor apartment for the first time lots of firsts here. I'm still like distraught depressed, I'm not dating. I'm not leaving my apartment. I'm just like hunched over my keyboard writing blogs at night, eating takeout. But you know, I didn't even have salt and pepper shaker. I remember when I had somebody over and they were like, where's your salt pepper. I don't even have the salt and pepper. When you get takeout. They give you a little packets of salt and pepper. I didn't even have bowls. I didn't have oven trays. I had like one fork. You know, I was like living like a cave dweller. Then this blog, you know, won this award and then they turned that all these people came out of the woodwork to turn it into a book. Well, that book was probably how you know me in the first place came out in 2010. It's called ‘The Book of Awesome’ and no one thought this thing would be a hit. They printed 6000 copies, but a kind and lovely woman named Heather Riesman who is the CEO and founder of Indigo Books are decided to make it a ‘Heather's Pick’ She started a propulsive momentum swinging change that I'm still feeling 12 years later, the repercussions of the book ended up selling millions of copies. It became a number one best seller for like years, it wasn't even weeks it was like it was the number one book in Canada for 2010, 2011. Up to that, like it kept going and all the sequels and spin offs started and then I'll tell you what happened is I realized a few years later I'm like ‘The book of even more awesome’, ‘the book of holiday awesome’  in ‘the journal of awesome’, ‘the calendar of awesome’. I was like this is starting to feel like krusty the clown imitation gruel, you know the Simpsons joke like 9 out of 10 orphans can't tell the difference. So, I thought and by the way, heads up I'm still working the job of Walmart despite all the I'm like this isn't gonna last like East Indian immigrant parents. You can't even quit your job to go write calendars about farting and elevators that's not gonna work. I'm like, this is like a 15 second of fame and stuff. Okay. It's a 15 minute of fame. Okay, it's an hour of fame. Well, eventually, after eight years from starting my blog to the day I finally quit Walmart. Eight years later, I wrote five books in the middle. I finally quit that job. I realized I got to figure myself out. I started dating. I started meeting people, I fall in love with a wonderful woman in downtown Toronto. Her name is Leslie. She's a teacher in the Toronto District School Board. We fall in love. A year later we move in together a year later, I get down on one knee I asked her to marry me. Well, you know what happens after that she plans the wedding. I planned the honeymoon, we ended up going to Southeast Asia. But on the flight home from that honeymoon, guess what she tells me I'm pregnant. She bought the pregnancy test and the six-hour layover in the Kuala Lumpur airport; she did the pregnancy test 30,000 feet above sea level in the tiny airplane bathroom in the front of the airplane. So now I got a new thing to think about. I'll tell you what happened is for me, my wife, the muse and my ideas. I had this early success. So, I stopped chasing it. theoretically, I stopped chasing. Then I spent the last five years of my life writing about things that interest me. The books didn't sell as well, but I think they're better. I wrote the ‘Happiness Equation’ about finding happiness. I wrote ‘You are awesome’ about how to develop the muscle of resilience. Now I'm working on a book all about trust. So, I'm chewing on these big, gigantic themes. Why? Because I'm writing the books I want to read. I'm trying to figure out how to live this one tiny, short finite life that we all have a 30,000 days on this planet. That's the end. That's all you get.  115 billion people have lived on this earth. If you're listening to this right now, you're one of 8 billion people alive today. You already won the lottery. 14 Out of every 15 people will never see another sunset, have a bowl ice cream, or kiss the kids ‘good night’. So, there is one of the 15 lottery you want. If you are in Canada, Canada like you and I are Kwadwo, you know, that's another lottery, right? Because there's 35 million of us in this country and there's a billion in the world that's another lottery. That's a one and 200 Lottery, we're at the top of the happiness rankings, we trust our neighbors more, we have clean water out of our taps, we can marry who we want, we can live where we please, these freedoms are not common around the world, let's say. So, we've won this other lottery. I'll tell you, if you make more than $6,000 a year, you make more than the world average income. If you make more than $50,000 a year, you make more than 99.9% of people around the world. If you have a post secondary education of any kind, any size, shape, color, whatever, of any kind. Well guess what? 94% of people in the world do not have that. You’re the 6% of people that do and I could go on and on and on and on. I think of my life as having won the lottery. I think all of us need to feel that way. I think news media and social media punish us and tease our brains and cajole us into thinking the opposite is happening. I know I'm not on the frontlines of healthcare like you are. You can slap me silly right after I go on this finish this rant you can tell me I'm all wrong about this. But here's what I'll say. We got 30,000 days. That's it, boom, we're done. So how can we spend our lives as best we possibly can, living the deepest, richest, most intentional lives possible? I've dedicated now 10 books and journals to exploring this topic.

KK: Neil, my friend, number one, rant of the century, throwing that down - thank you for that. But I gotta say one thing that that really resonates with me. I truly believe is a reason why I feel kinship to you is that appreciation that we are not here forever. I see this every day, my friend, in the ICU, palliative care doc. I see patients in their last days. It is hard. In this day and age to appreciate how lucky we are. We truly are blessed. The ability for you to bring it out and others to say, ‘Hey, this is where the beauty is’ ‘This is where awesomeness is’ ‘This is where happiness is’ is truly a blessing. It really is.

NP: Dead people are quiet; they don't say much. Well, we can’t hear the 110 billion voices of people that aren't here. But if you could ask them one question, ‘what would you want? What would you want?’ I know that most of them would say just one more day, give me another couple of days.

KK: Doing stuff that meet that's meaningful, the stuff that they want to do. Because if you think about it, what percentage of effort do we put into not improve our overall well being to please others to do things that we're supposed to do? You got to Indian parents, I got West African parents’ man, the same same flow, you know, I mean, same flow, but I got two sisters that are dentists. You had to go into medicine son or something along those lines. The other point I was going to make his point I think is critical for a lot of folks, you leaned into that creative side when you were struggling that story about going through the loss of your best friend, which I'm sorry that happened and also having your wife leave. You leaned into that creative side and there's something there's something healing about that. I don't know if you found that in the moment or could reflect on that or you just automatically do that. But there's something healing about that.

NP: Yeah, absolutely. Well, there's a few things here number one is I want to talk to you about regrets you probably heard of nurse ‘Bronnie Ware’ who wrote that she was with over 1000 people as they died, and she wrote a very famous book called ‘The Five Greatest Regrets of the Dying’  I cite it in my book ‘The Happiness Equation’ but the number one overall regret of people dying, according to this nurse who has been with 1000s of people as they've died ‘I wish I lived my life true to myself. Not the life others wanted me to live’ that's the number one regret. So if you're listening to this right now it's the top regret people have when they die. I wish I lived the life more true to myself. So, if you're listening to this, what is it? What's what, who is that person you want to be with? What's the city you want to live in? What's that job you want to try? What's the small business you want to start? What's the person you want to tell you love them? What's that food you want to eat? Just do it like you got you don't how much time So it's not like you can plan this whole bucket list concept. I don't like that. I don't like the bucket list. I'm against the bucket list. I'm against this idea of a future later, forever thing that you're going to like, come on that is that's capitalism. That's what it wants us to do to delay gratification to move things, you will be the greatest version of yourself if you are purpose led today and purpose that I mean, ikigai, that's what I'm talking about. When I say purpose. People might say stop me right now say ikigai. What are you talking about Neil? I'll tell you this. The longest living people in the entire world those from Okinawa, Japan, studied by National Geographic researchers led by Dan Buettner, who lived healthy lifestyles over the age of 100. Higher than anyone else in and around the whole planet. And they don't have a word for retirement. They don't have a word for quitting stuff completely. Instead, they have a word called a ikigai that spelled I-K-I-G-A-I. I'm gonna write it down on a piece of paper.

KK: Let's see it. Let's see. Let's do this.

NP: It’s ikigai. Roughly translates as the reason you get out of bed in the morning. So, what I say to people, the conversations I have with people are, what's your ikigai? What's the reason get a bed in the morning? If you can't answer that, that's good. Because now we get to have a conversation. Now we get to have a conversation about ‘what is your ikigai?’. I'll give a great present to my wife Leslie, before we were married. I'm going to give the here anyone listen to this. It needs a good Christmas present. Here's a good tip. On Christmas morning, I had her watch a video called ‘How to live to 100’. On TED talks by Dan Buettner, who I mentioned earlier, the National Geographic researcher. In that video, he gives all these examples of things he's learned from studying Blue Zones, like, you know, people in Sardinia, Italy only drink Cannonau wine, right? It's better for your heart. One of them is the use of small plates, not large dinner plates. Another one is, they all have an ikigai. Well, it's the cheapest present because really what I'm buying my wife is a bottle of wine, a small plate, and these little cue cards, just like this, I got each of us one, I fold them into tents. I said ‘Okay, let's spend some time on Christmas morning writing down what we think our ikigai is’. So, I wrote down ‘helping people live happy lives’. My wife wrote down, she wasn't my wife at the time, she wrote down ‘building community empathy’, okay, as an inner city school teacher, and as somebody who does kind of community groups and stuff. It's great, because what you do is you leave these little ikigai cards on your bedside table. That should be the first thing you wake up and see in the morning, not your cell phone. It should be your ikigai card, it just gives you a little bit of a Northern Star, an orientation. Why are we talking about this? Because we're talking about purpose led lives. Why are we talking about that? Because purpose led lives are one of the ingredients to living an intentional life. Why are we talking about that, because life is tiny, short and finite and beautiful. It's always always always fleeting. So come up, conjure up, an ikigai card that you can leave at your bedside table that you look at when you first wake up. By the way, I'll tell you, you can change it, you know, your ikigai for a while could be ‘I really want to make it through this week’ It can be ‘taking care of my mom in her last days’ It can be you ‘showing up for my child, this summer the way I didn't last summer’ because I was working all the time. You can see I now in a podcast, I'm starting to process my own issues. So, that is why I'm saying this just you write it down, then it's you giving yourself a purpose lead day, right? When you open your eyes, get the phones out of the bedroom, I'm telling you,

KK: For real, the phones need to get out of the bedroom. The point about being more intentional, is something I think people could take away, almost like the number one thing to take away as far as I'm concerned. Having that ikigai because even I think about my health care professionals with the amount of burnout. What was it that got you to that job? What made you want to be that nurse? What made you want to be like that?

NP: Well, I just watched your video you just posted a few days. It was great.

KK: Thank you - because it's real. I see it every day about you know our colleagues thinking about leaving the profession. How much in a time right now we need them the most. But it is that being more intentional. So let me ask you this. How do people become more intentional? Yes, you can write that ikigai card. Is it a matter of looking at that on a regular basis is about journaling about your ikigai like how do we create that for more people?

NP: Okay, so first thing I want to say at a high level is watch your inputs, watch your inputs. If you're listening this conversation right now you're already doing it you've choosing your inputs. Remember, we live in a capitalistic society the orientation of capitalism is to come constantly feed us advertisements to cajole and convince our behavior change to buy more stuff. That's the purpose of all news media. That's the purpose of all social media. I'm telling you all news media, all social media, the whole point is to keep us addicted so that we buy more stuff. Remember that that's the world we live in. Now within that you can decide to sleep with my phone next to my bed or is it just going to show me like Apple news on add on the weather? How many times you woken up at 530 in the morning just to see if there's going to snow and all of a sudden something's blaring telling you to buy ‘Tide’. I mean, come on, get that crap out of the bedroom. Instead, inputs people start your day with something I call the two-minute morning practice. I even turned it into a journal there it is my best-selling book of all time has nothing in it. Seriously, it is just three points every single day I start my day with it every single day on a posted up here if you're watching on the video, if you're not I'll say it out loud. ‘Number 1. I will let go of. Number 2.  I am grateful for. Number 3.  I will focus on.’  I'll tell you a Kwadwo everybody's awake for 1000 minutes a day. I didn't make that number up. It's an average, average time you're awake per day is 1000 minutes you got 1000 minutes a day, you got 1000 Is tomorrow you got 1000 minutes the day after by the way, you only got 1000 month total surprise. That's the that's the length of life. 1000 months 30,000 days. So how do you start your day on the right foot you take two minutes to write down I will let go of you don't there's a reason why Catholics go to the Catholic confession chamber. Bless me father for I have sinned. But did you know it's not just Catholicism, Buddhism, Mormonism, Judaism. Did you know almost every world religion has a form of confession or repentance in the in the religious practice. I'm saying religions all around the world for 1000s of years, all have the same idea that you should get to get stuff out here. Meanwhile, the fastest growing religion in the world right now by far is none. According to National Geographic, the fastest growing religion in the world is none. Don't got one no religion. Don't throw the baby out with the bathwater people. I do not ascribe to a particular faith, but I'm studying what we've learned for 1000s of years and realizing this is important. You can look at science magazine, too. There's been wonderful reports published that shows if you can write down something you're stressed about, you take it off your brain. You take it off your mind. I will let go of yelling at my kids to tie his shoes last night. I will let go of the fact that I haven't seen the bottom of my kitchen sink in two years because there's always dirty dishes in it. I will let go burning my kids brains on Paw Patrol. I will let go the nasty thing I said to my sister oh my gosh, I wish I didn't say that. But you're thinking of these things subconsciously, so you got to process what I'm telling you. The first way you start your day is I will let go of. You are wiping a wet Shami across the Blackboard of your mind. Then I am grateful for, the research from Emmons and McCullough shows if we write down five gratitudes a week. We're not just happier. We're physically healthier. Don't buy an AB don't buy a stomach shaker off the late night shopping channel. Just write down gratitude. Here's the problem. Nobody knows how to do this. Everybody. Oh yeah. Oprah told me this and 98 Well, everyone, if you look at anyone's gratitude journal, first of all, they got one page filled out, the rest is empty. I'm speaking from experience here. Then what they write on the gratitude list is, oh, yeah, my husband, my kid, my dog. That ain't gonna do it. I'm telling you, you're actually trying to get area 17 And your visual cortex to light up again, that's an area in your brain that re-lights up when you experience something again, but your brain doesn't know where it is. So, all the insight is that you got to be specific. Don't write down my husband. Say when my husband Neil put the toilet seat down. Don't say my kids and my five-year-old daughter Sonya learned how to write the letter s Don't say my dog say when the rescue puppy. We've gotten the pandemic's up peeing on the pillows. All I'm doing is taking an extra minute to come up with the detail required to actually conjure up an image that actually happened over the last point for hours of my life. Remember, the research says you only need five. By the way those researchers compare gratitude writers to people that wrote down hassles and people who wrote down events. So, the study is done. It's legit, it's works. You gotta write down five a week. You're priming your brain for positivity. Why is this important? You know this, the neural pathways in your brain are oriented for negativity. You got an amygdala in there, secretes fight or flight hormones all day and it's why we all rubberneck. It's why we always look for the high cholesterol in the blood. That's why we all look for the math question we got wrong. Our brains are oriented to look for problems and for 3 million years of evolution that's been awesome. We don't need it today. You can press a button on your phone and get a meal on your doorstep in 20 minutes. We got a good. So, what we need to do is remember how good we got it. I am grateful for and the last point on my list and I'll shut up after this is I will focus on decision fatigue is leading to a nation of overwhelmed people. I will focus on, as a one item checklist that you do every day. I will focus on spending 10 minutes with my baby I will spoke I will focus on taking my car in for that oil change the lights been on for three months. I will focus on finally calling the dentist, finally donating blood. I'm going from here to donate Blood. Because I've been saying, I will focus on this for a year haven't done it. So, I wrote it down, I will focus on making an appointment to donate blood. Guess what? They had an appointment available today, they need blood. I'm gonna go do it. Finally, I get across it off my list tomorrow morning to gather these three prompts provide a two-minute morning practice, I cell phone free way to wake up and control your inputs. You start your day off happy; your day is happier. What happens if you're happier 31% more productive. 37% higher sales 300% more creative. Everything gets better.

KK: What I like about this, you're priming yourself. You're priming yourself for a quality successful, joyous day. It really is true when you think about how much input you're getting throughout the day, like our brains aren't meant to be stimulated this much. You know, like, why kids are never bored? Our three lads. Problem? You know what I mean? Like it is a problem. So, what do we what do we? What are we going to do to really allow them to create the space and over all of us collectively create the space in this way? I really, I like this, his way of approaching the day. This is my question might come out of left field for you. But is it working for you? Are you happy? Are you achieving your goals of being? Awesome? Joyful?

NP: Yeah. So two things, I'm much much much happier than I was - so absolutely, but two there is no such thing as perfectly happy. Happiness is a North Star. It is a journey, not a destination. The goal is not to be perfectly happier. Happy is just to be a little better than before. Every tool, every resource every tip I provide is meant to help someone take a step towards that Northstar. Am I ever going to be perfectly happy? No. Does anybody? No. The point is I am in a in a positive frame of mind, I am showing up as a better husband, as a better parent, as a better son, as a better brother than I was even just two, three years ago. Why? Because I've implemented a set of systems that get don't get me wrong. Do I fall off the rails all the time? Absolutely. But I don't beat myself up. I just get back on it. That's it. That's all I do. I just get back on it. That the two-minute morning practice is one of my core systems. That's one of my crucial systems. I have a litany more we could talk about do you want to go through the day we can go through the day?

KK: Yeah, Let's do it.

NP: By the way, on the boredom thing, I want to just echo that. I love when my kids say I'm bored. I say great. What are you going to do? I limit screen time. Okay, so I am one of these parents that limit screen time. What I do is we limit it to Sunday, because daddy also wants to watch football.

KK: What’s your team?

NP: I gotta go with the bills just because I live closest to them in Toronto. But really, I got into it through fantasy football with my college friends from 20 years ago. Yeah, so basically for me, though, I like when my kids are bored. How do you make your kids bored? You get them outside. Kids these days are spending 7% of their childhoods outside. 7% is the lowest level in recorded history. If you multiply 7% a day times seven days a week, it adds up to 49%. Seven times seven. Well, that means it takes a kid these days a whole week to spend half a day outside. This is the lowest level in history. There is so many ways the brain works that we don't understand. One thing we know is you can't learn it playing pinball. Okay, so you got to get aside break sticks, play with bugs, stare at the clouds, build things, let things fall, fall yourself like it's just all that shrapnel that scaffolding that that that sort of like building up of yourself happens when you have less structure around you. So, I'm all in favor of that doesn't mean I'm perfect. Doesn't mean I'm great. It just means it's another Northstar for me. Okay. Now, on the topic of daily routines, I gave you one to start the morning with let me go all the way to the end of the night. First off people listening you might have maybe you have a partner, maybe you're married, maybe you're not maybe you have a kid, maybe you don't. But is there someone in your life that you could close off the day with? Here's how you close it off. First off, you got to turn your phone off an hour before bedtime. When I say turn your phone off, I'll tell you this. People don't know how to do it. In fact, the new iPhone when you buy it doesn't even the screen doesn't even dim anymore. So, you know how you turn your phone off? Listen to this. Don't ask Siri by the way, Siri has no idea. Hey Siri, how to turn her phone off. I do not know that she knows everything right? She doesn't know how to turn herself off. So, what you must do just for people is I'm going to do a little education, your PSA. You got to hold both buttons on the side of your phone at the same time for longer than three seconds but shorter than five. If you hold it longer than three a sliding thing comes up that you can slide to the to the right if you hold it longer than five it your phone calls. 911. So you see it's we've we have set the device manufacturers have created a device where it's nearly you need like three hands to turn it off. So, but it's the ultimate power move you want to take control your day, turn it off. I don't care if you turn it back on five minutes later, just show yourself that you can do it. Now turn it off an hour before bedtime, why an hour before? Why not before? Truthfully, I'll be honest with you. The research says it shouldn't be two hours before because if you look at a brain screen within two hours of bedtime, your brain does not produce as much melatonin overnight. This is the sleep hormone secreted by your pineal gland. Research in Australia found that why? Well, because evolutionary biologists say you know what, what happened when the sun went down 3 million years ago, you got to run to the cave built. You got to get stuff set for bet like you gotta get a burst of energy they say now if you turn your phone off right before bed, which many people including me sometimes are guilty of, then you get a jolt of energy for anyone listening to this right now. If you ever lie in bed, you're like why am I so awake? Why am I so wide awake right now? Well, did you just turn your phone off? If so, your brain thinks the sun just went down? It's time to build your cave. This is a problem. So, turn it off at least one hour before bed off. I told you how to do it already. Now, what do you do that hour? Get to know your family. Hey, son, how long have you been living above the kitchen? You know? Get to know the people in your life and your family and your circumstances? Just reconnect with your family. Well, what am I going to do with my family play a board game? I got a game for you. It is called ‘Rose, rose, thorn, bud’ whether you do it on dinner table, whether you do it while you are brushing your teeth, while you do over Pillow Talk with your partners. What I do with sometimes when my wife is Hey, honey, what was your rose from the day? It always feels silly strange and awkward when you start, I've been playing this game for years. It still feels silly strange and awkward when you start.  My rose… they got a new flavor of Timbit. What about you Neil? Oh, my rose I don't know, my rose I met this amazing TikToker emergency room doctor he's well you know one of the very few interviewers that has energy that makes me energetic. He was just a great guy. So, I tell her and then we do it again another rose, the game's called ‘Rose, rose, thorn, bud’ you do roses twice. Well, the second Rose is inevitably easier by the time you get to you kind of want to go three and four because your brains now working your prime in the neural pathways or you're taking the machete in hacking through the bushes and brambles for positive thinking right, then a thorn. What's the thorn? Thought? You got to make space to vent. Got to make space to vent. Oh my gosh, I had a headache all afternoon. Oh, the bus went by, and I got slush all over my pants. Whatever. Right? You know, I called I you know, I emailed the boss two days ago, they haven't emailed me back yet. Do you think they hate me? Do you think they want to fire me today? Like, you know, everyone's brain does this kind of thing. So just say it out loud. The other person's goal here is just to listen. ‘Ah, that sucks’ Remember those three phrases you guys ‘Ah, that sucks’. Don't try this. Oh, you should email them. Don't try to solve their problem. We don't want any of that problem solving stuff. We just want you to listen. Then the finally the last thing is a bud. B-U-D ’Rose, rose, thorn, bud’. A bud is something you're looking forward to. I can't wait to have pancakes on Saturday, I want to I want to rent and ice and sauna hut and Finland when I'm 90, whatever it is something in the future. I'll tell you this, it's always awkward to play at the beginning at the end, everyone's in a good mood, every single time, you want to guarantee a finish. I'll tell you what it is. Everyone's in a good mood every single time you play this game. Then if you want to kind of wrap it up before you go to bed. I'll tell you what to do read a few pages of fiction from a real book. Why fiction? Well, because the annual review of psychology says only reading fiction opens up the mirror neurons in your brain responsible for empathy, compassion, understanding. My last job of Walmart was director of leadership development you know what skills you can never grow at work? empathy, compassion, understanding these you cannot ship people off to empathy class, doesn't exist. There's no there is no empathy class. When you read ‘Their eyes are watching God’ by Zora Neale Hurston. You are a slave in Alabama in the 1800s and you are there. You're there. You're in that gender, you're in that heat. You are there. Our brains have evolved to feel like we're there. When we read our reader lives 1000 lives before he dies. The man who never reads lives only one. Yes, I stole that quote from Game of Thrones. Even despite this, this is the greatest form of compressed wisdom we still have ever invented. That's why when you read the TED Talk transcripts, it takes three minutes but watching the movie takes eighteen. I'm just saying it's still it's you can still read faster than you can consume anything and fiction is a great place to go because you go into another world. You're another gender you know, the time of the one, you know the place throw you another. You're not just getting like tips, which is like, don't get me wrong. I'm guilty of reading nonfiction a lot, right? Like, I'm a nonfiction junkie too. But fiction people, it's fiction. It's fiction that we need to get back into. It's not just you. It's not just me, it's all of us. 57% of Americans read zero books last year.

KK: That is an incredible stat to be honest with you. If you think about even 20-30 years ago, pre phone that number would have to be minimal. Reflecting on that now.  Neil, honestly this is gold.  I think we need to be a little bit prescriptive in terms of guiding a lot of folks. Great way to start the day, great way to end the day. Is there any advice to keep yourself on track during the day, like in terms of well?

NP: People ask me, why did you write this book? Right? Like, why did you write another book? Awesome. I mean, I wrote, it's called ‘Our Book of Awesome’ as the time of recording, it's been a global bestseller all seven weeks, since it's been out, it came out in December 2002. I don't know when you're going to hear this, but we're recording this kind of like on the precipice of February 2023. Well, because I made this book as a tool to leave on the back of the toilet, to leave on your bedside table, to leave on the corner of your teacher's desk. So, when you do feel uninspired, overwhelmed, anxious, negative, it's going to happen to all of us every day, you just grab the book, you flip it open any page, and it says, the core of the cinnamon roll. Next page says, When the crosswalk changes to walk just as you approach it, the next page says, go into the movies by yourself. The next page has gone through a revolving door without having to push. But why do I keep making these books? I'll tell you why. Because I need the I need the provocation myself. So, the books of awesome are, and there's a new one, that's the new one, ‘Our Book of Awesome’ is a way to keep us on track. It's just meant to be like, this book doesn't tell you how to do anything. I'm the one yelling at you today. But there's none of me yelling at you. The book is just a pile of awesome things. As a reminder to reframe and retrain your brain. That's one tool to keep on track. We can talk about more if you want.

KK: You've been on a roll,  more tools I want to hear more.

NP: Yeah. Yeah, well, well, one big tool is no screens in the bedroom. I've already talked about I've already admonished people, including myself, if you ever bring a screen up, you know, your phone upstairs. People say ‘oh, yeah, well, you don't know me. You know, I'm very, very important. I get a lot of calls at three in the morning’ Really? Do you really get a lot of calls when your morning? So, then people say, Well, you know, my sister's really sick. Plus, I have a boss that, you know, they're kind of all my case. I say, Oh, here's what you do you get a landline don't you call up your telecommunications providers say you want a landline. They're like, hello, hello, like, know what they don't expect anyone to ever ask for this product ever again. However, all our homes are outfitted for them. That's why they're only $10 a month. When I pay my $10, I don't get call waiting. I just get the landline number you know, I get that landline number to my sister's not well, the boss might my text me, the boss the urgent, I give that number to the five urgent calls. That prevents me from taking a screen into my bedroom. Now I know that when it is a true emergency, I can be reached by those people. Yet when I open up the app, I won't get distracted and fall into an endless Twitter hole. You know, so that's a really big kind of system for me right there. Here's another system. I'll give you lots of systems. Now this system is installed a bookshelf as close as possible to your front door. Billy bookshelf -  99 bucks. Okay, it's that IKEA. It's the cheapest, most effective bookshelf they ever made. Right? If you want to get fancy, go ahead and get fancy. But there you go. You put one at your front door what happens when every single day you got to walk by your bookshelf on your when on your way out? You stop for a minute you pick someone up you read the back of one now they're settled Garfield cartoonists like wow pick that up. There is no book shame. There's no book guilt. I don't believe in reading the classics. I don't even believe there are classics. I believe in reading what you love in order to love reading. I have a whole podcast about this. I call it three books. I've read a single chapter, which is every single new moon and full moon I asked people like just interviewed Daniels who did that movie everything everywhere all at once I interviewed Quentin Tarantino, Brene Brown, Malcolm Gladwell, Roxane Gay, Benji Thomas,  David Sedaris. I asked him ‘Which three books most changed your life?’ and why do I do it this way? because I have found that the world again conspires not to give us good books, we end up picking up whatever's in a pile at the airport, those books are all paying to be there. By the way, we ended up doing whatever's on the Amazon recommendation engine. Those books are all paying to be there, by the way. So how are you? Good, we got to go back to the tribe. We got to go back to each other. We got to go back to community. You know, Dunbar's number you trust 150 closest people to you. We gotta go back. Ask people. What's one book you loved when you were a kid? Is it Charlotte's Web? Read Charlotte's Web. What's one book you wrote when you were a teenager is a ‘Catcher in the Rye’ read Catcher in the Rye. This is a graphic novel. Are you really into dog man? Go ahead, get dog man. Like, there's no book shame. There is no book, I can't emphasize this enough the entire education system which was created, as you know, in the industrial revolution to create cogs for the economy. This system has essentially taught us how to read wrong. That's why my friend kids love reading until they go to school. Every single kid that's 2/3/4/5, they're flipping around with books all over the place. They got flip books, card books, they love books, they love books, and you ask a grade nine kid you like books? I hate it. Because I had to read The Great Gatsby cover to cover followed by Hamlet. That's a great way to make someone hate reading is to force them or it's like saying ‘You like food?’ Here. Let me just shove a bunch of dry oatmeal down your throat. Read what you love, and tell you love to read.

KK: I love it. I love I love this hack. You brought up a point that we try to address often on our platform was community. Especially we lacked it for too long. Now I feel I do not know if you find this too. But I do feel people are still a bit injured. People are getting together again. But it's not, personally I’m finding that it's not the same energy. It's not the same joie de vivre pre pandemic, but how do we, in your mind, create that community to really foster wellness

NP: I couldn't agree with you more. Trust in all levels of society is down. We have lower than ever levels of trust in business, media, and in government and in each other. So what's happening is, it's creating a destabilization of reality effect. When you combine that with the increased use of AI, and the deep fakes, it's starting to feel very hard to know what to trust. I've actually been fascinated by a business that opened up in Toronto a year ago and I want to tell people about it. It's really, you know, and again, I'm in Toronto, so I'm going to talk about a particular business, but it's really the spirit behind it. Okay, so this place is called ‘Othership’. It's in Toronto, and you pay, like 50 bucks. So, it's not cheap. You know, it's like a really super crazy expensive yoga class, let's call it and you go in and what ends up happening is everybody changes into their bathing suit. It is a gender neutral and co-ed change room, which again, is that's the first time I've ever seen that. So, there's little stalls where you can change in and out of your bathing suit. But otherwise, there's a community that already happens in you're not naked together, but you're changing together. Then you go and you have a cup of tea by a fire. I'm not kidding. You have a cup of tea by a fire, which we've been doing for millions of years. People start to talk guides calm and they start to ask you questions. I went last night to you know, a couple's class there they ask ‘what's one thing you love about the person you're with?’  So, they start to lead you into some thoughtful conversation. Keep in mind you can't bring your phone in. Then they take it to a sauna. So now you've got this sauna, sit seats, 50 people in it. So, they have a big sauna, you spend time in the sauna. Again, it's guided, there's music, there's meditative people purpose, and then you go to an ice bath, which was totally scary to me. But I did it. And because I'm doing it together with community, people are cheering you on and you feel totally, I don't know, if you I don't know if you're an ice bath person?

KK: Cold shower at the most

NP: Then you feel totally rejuvenated and you've got a physiological reset and what's happening in this place. Of course, you can’t take a phone into a sauna, you cant take a phone into an ice bath, so you have no phones. So now you've got eye contact. Now you've got people looking at each other and you've got guides who are navigating the space with you. It's no wonder that this place that just launched less than a year ago is like you can't get in now because it's we are so in need of this type of community and connection. Could you find that a yoga studio? Could you find that in an independent bookstore? I personally think independent bookstores are like hidden gems in the world like this is annexing every single, every single person who's ever lived to today in the little room right here. You can hear other voices. Like it's unbelievable. It's right there these independent but they're right there, right and our streets like support your independent bookstore. Can you find that at a gym? Could you find that at a park? Could you find that, you know, there's a Park in downtown Toronto where I went there like midnight on like a Monday and they're playing like severe Ultimate Frisbee like hardcore. It's like midnight on Monday and it’s ultimate, but that's a tribe. There's a community of people that jump in the lakes together in the frozen lakes, there's a community of people that that goes bicycling together, if you go on a website, like meetup.com, or even OKCupid, you know, you can go on this on the kind of Platonic side, if it's platonic, you're looking for. You can find groups of people doing like minded things, get out of your house, put yourself in uncomfortable situations and reconnect with the people around you.

KK: Amen. Honestly, Neil, I feel like right now, what we need is healing and anything that is empowering people to get better, I think is so important. So honestly, I think the advice you thrown down the books, the podcast, the public speaking engagements, you've taken a significant dent into this, and it's so appreciated. I have I have a selfish question for you. I don't know if this applies so much to our listeners as much as it is to myself, but I'm going to ask anyway. When did you make the pivot to stop chasing? How did that happen? When you said, he said earlier in the interview that you stopped working at Walmart. When you said ‘stop chasing’ I took it as external pressure or validation. What you want to do?  What makes you happy? How did you make that happen for yourself?

NP: There's a few things. Some of the answers are healthy and polite and perfect. Some of them are just a little bit odd. But they're all true, at least to me. One is making money. Okay, so I will just be open about that. When I was working the eight years at Walmart, and newly divorced, ie, no partner, no children, no minivan. You know, I had eight years where I was working at Walmart and writing books and starting to give speeches. So, I was able to feel financially comfortable to make this leap or to stop chasing things. The financial comfort is something, it is real. There has been a study by Daniel Kahneman at Princeton University that showed that, at the time they did the study, which was I think, 2007 it was at the time $70,000. So, you want to put that in today's money, you might say it's $100,000. They said that there is a certain amount of money that people get incrementally happy and more comfortable with, because they're starting to meet their hygiene needs. Then above that, this was the big insight from the study. There is no better, there's no benefit. Everybody's numbers going to be a little bit different. It's based on how you grew up; it's based on your culture is based on your fears, it's based on your traumas. My number was probably way higher than it needed to be. That's why I was working two jobs right here. I'm literally coming home every night and then starting another eight hour job like blogging, writing books, answering emails, doing media interviews, you see them saying, so there is an aspect of that, and I don't want to shy over as I have done in the past. I want to just call that out there and say for everybody, that number is different. But you need to have something. I'm not going to be one of the people that says just ‘Burn the boats move to move to Colombia, you'll figure it out’ I understand the anxiety that comes in with financial security because I have lived with that my whole life. My dad's an Indian emigrate came here with eight bucks. Like, of course, I got some of that trauma, right? Of course, I got some of that worrying to make sure I'm okay. That's one. Second thing is there's a model that's backwards in society, that model is so glaringly obvious after you hear it. But we grew up think thinking and being taught that great work leads to big success, leads to being happy, right? You study hard, then you get good grades and you become a doctor, or you work hard, then you get promoted, then you're happy. It's not just parent parents saying this to our kids, we say it to our own kids, don't we? Come on, we want you to get into good school. Come on, we want you to get a good job. People talk like this all the time. They have their history. Unfortunately, it's backwards. Backwards. It was totally wrong. Because this model was backwards. It's not great. We're big success, be happy. It's the opposite. You got to train your brain to be happy first. Thinking of happiness like a practice, like a habit like something you can invest in, everyone's got a plastic card in their pocket, you got a gym membership who's got the same for their mental health? The place I just told you about ‘othership’ that's a mental health place, right? It's bringing mental health to the forefront. You invest in your mental first then guess what happens? Then you do great work. So, University of California Davis together with King and Diener did a study that shows if you show up to work happy, everything's better. We like working with happy bosses. We'd like happy peers, you're 31% more productive, you have 37% higher sales, you're 300% more creative. It goes on and on and on. The appendix on this study is like here is all the things that went up when you were happier, and it is all a lot. Then what happens the big success, it actually comes at the end, it actually comes at the end happy people live 10 years longer. University of Kentucky did a research study on nuns, if you're happier in the common the 1930s and 40s. You live 10 years happy people live longer. They live longer, we go back to our very beginning conversation. Why should you invest in app? Why should you do the stuff? Why should you get your screens out of your bedroom? Why should you start your day with two-minute mornings? Why should you put your bookshelf at the front door? Why should you spend more time outside? What? Because it's gonna get you 10 extra years of this. It's worth it. Now I got 30,000 days, I told you could press a button and get 3000 Bonus days would you press it? Here's the button. It's called invest in your happiness. How do you do it? I just gave you a bunch, I can give you a bunch more. There's lots of stuff about it. I wrote a whole book about it the Happiness Equation. That's just one book. There's lots of books, I can recommend many books about it. You can read the Happiness Project by Gretchen Rubin you can read The Happiness Advantage by Shawn Achor. There’s wonderful, there's lots of books out there, there's watching your content, right? There's lots of people out there trying to show you this, the hard part is doing them. It’s not knowing what to do, it’s doing them. The secret is to just start. That's it. That's the secret if you just start see we got another model backwards. We think motivation leads to action. You want to run a marathon you need good shoes, you want to write a book, you need a moleskin notebook, that ain't true. Motivation doesn't lead to action, action leads to motivation. You're under the stop sign in your dress shoes. Tomorrow, you run a little further you write tonight on a pen and a sticky note to next day you write two sentences. Action leads to motivation. It's the other way around. Now the hard part, then there's an old Einstein quote, I won't butcher it or paraphrase it. But it's like the hard part of everything is just getting started. That's it. Start, that's it, you'll suck, you'll fail, you fall off. But if you can just start you can keep on these paths I'm talking about.

KK: Oh, man, Neil is straight up gold man, this really is straight up gold. This is what people get hung up on, they get caught up on how do I achieve these goals? They get stuck in their minds. Not enough of us are telling our preaching action. Just do it. It's the love with the process, the fact that you got up and went to the gym even for three and a half minutes. Yeah, that's a W. The fact that you wrote in that blog, a couple sentences and it was shitty. Don't matter. You f*****g stepped up. That's a W. You know, I'm saying like, this is what it's gotta be all about. We got to be in love with the process. This is what's going to help achieve happiness and wins. My friend, we covered a lot. Is there anything, especially for our healthcare providers, you think that we left out in terms of leading a more purposeful, intentional, joyous life?

NP: Well, I mean to healthcare providers specifically, like just thank you. It's been unbelievable once in a century, you know, few years, and there's just no way there's any possible words to describe the level of tribal community based gratitude, we feel for those of you on the frontlines waging these battles for us, as our species has had to grapple with an entire new form of danger that we had never experienced before and hadn't wrestled with it and has had, you know, seven different levels of incoherent government saying different things at different times. Remember the World Health Organization ‘hey, no thing, no big deal guys, nothing to see here’ Like you remember that, like we you have had to navigate that in the frontlines. The thing is that I love as at the frontlines when I'm in the frontlines of health healthcare as a patient or when I'm on the front. We're just people. We're all people. We've all got hearts. We see each other with their eyes. We hold each other as best we can. If you're there and you're on the frontlines of health care. Thank you.  Hanging in there. Thank you. If you're thinking about going into this profession, you're wondering about it. Well, don't worry, the salaries are all about to go up. Because we need these people more than they want to do it. That's called supply and demand, you know, I just spoke to 5000 health care workers down in Louisiana, burnt out, overwhelmed, stressed, you know, large, large hospital system down there. Well, they can't find people. Then so then they hire temps, and then the temps, you know, aren't as good and they're more expensive, and then they get clunky, you know, then there's clunky processes. Well, there is only one solution, that markets gonna solve it, and it's to pay them more, that's just pay then more. Of course, you should pay them more. You should also pay teachers more, right, our society has over prioritize people that can wield technical financial instruments and made those people billionaires, whereas the people that are educating our children and taking care of our infirm are not compensated accordingly. So, when my dad became a teacher in India, he was born in 1944. So it's like 50s, and 60s is decided to become a teacher. I said to him growing up, I'll leave you with this. I said to him growing up 10 year old, like, ‘Dad, how come all our Indian friends in Oshawa in the 80s? How come? They're all doctors?’ they're all doctors, but you're a teacher. And you know what he said? Because they got paid the same in India. He was like, when I had to pick it was like those jobs, they got paid the same. You know, it's not just Neil going on a rant about just kind of, you can't just fix everything by yelling about a lot of podcasts. We need to be healthy. We deserve that. We owe that to ourselves. And we have the medicine and the systems and the tools. We know that. So right now, we're experiencing at a high level from a distance I'm not in the system. So, like if I say the wrong thing, like please don’t hold me to it. But from a distance. This is this is a big transition point where we're recognizing and realizing just how crucial and important these roles are, and our pipelines and our education pipelines and our compensation, but they gotta they gotta catch up. They gotta catch up.

KK: This is it. This is it. Neil, thank you. Thank you for agreeing to do this. This was honestly, this is a lot of fun. I know somehow, whether it is in T dot, somewhere down the line, we got to connect. Brothers unite. I really appreciate you jumping on the show my friend.

NP: It's a pleasure. Thanks for what you're doing. It's a gift to I'm an art of what you're doing and that you're doing that while you're doing you know, you're I know what it feels like to be doing two things at once. So thank you for putting out that's great, great content and vibes and energy for the world is much, much, much appreciated.

KK: Oh feeling's mutual my friend.

KK: Kwadcast, that was freaking awesome. So awesome. Feeling inspired folks. I hope you are too. If you enjoyed that, please leave us any comments at kwadcast99@gmail.com Leave a five-star rating after that shows leave a six star rating. Dammit. That was so dynamic and juidy. Follow us on TikTok Instagram, YouTube, Facebook, Twitter at kwadcast. Jump on our newsletter upon our community. At kwadcast.substack.com, all things health care solutions all on one site. You're gonna love it. All right, people hope you're feeling local more jump in your step after that episode. Thanks for listening. Talk real soon.