My Journey- how did I get here?

This is how it all started.

I finished my third residency in OBGYN (having completed trainings before in India and UK, US was my 3rd residency) in 2008.

I was excited to finally be able to practice as an “attending” in OBGYN in NY. With the blessings of my department chair and vice-chair, I was given a nice office with an excellent staff to go forth and flourish!

I built up a patient base very quickly. Turns out being nice, compassionate and non-judgmental helps. It was nice to treat patients here… in the US. There were social, economic and language barriers but overall patients were more trusting (at least then).

I would see patients for pregnancy care but I also had a lot of women seeking care for regular GYN issues such irregular periods, infections, pain etc. I would do the usual work up – you know… ultrasound, blood work and then counsel them about all the regular treatment options that I knew of then…

Then… is where it started.

I would be about to leave the room and they would say—and I have just one more question, I don’t feel like doing “it” with my husband. I have no desire!

And boy… what a loaded question that was, especially when the whole “regular” visit was over. And above all, I had no one answer. Because there isn’t one single answer. I must admit I may have told some women to go have a glass of wine just like many other OBGYNS do…

So, I started looking for answers... learning and training! After a lot of research, I found a medical sex therapy certification. I completed that over 2 years and I was like... woo hoo… I know it all…

Then more and more people kept walking through the door and I tried what I learnt but they had more issues... weight gain, hair loss, chronic pain, recurrent infections, breast cancers, uterine cancers and so on. I kept trying to put them in our usual GYN buckets of PCOS, endometriosis, fibroids etc.

Patients would get better for a little bit and then they would be back and then back again and again!

For example, if someone had a straight forward BV. It was so obvious, I would treat with Metronidazole., it would be gone and then…in a few weeks it would be back. I would treat it again and again (as per the guidelines). Failure to permanently get better leads to a frustrated patient and a frustrated physician. 

Then I started wondering in my head… what is going on? Why aren’t they getting better? I started researching – I was curious why don’t we give probiotics here in the US. We used to give them all the time in India. I started advising patients to take probiotics. Some got better but many didn’t.

Same for other conditions. I got tired of seeing women get prescribed antidepressants for PMS or birth control pills for PCOS until they started gaining weight, got more depressed, started losing their hair or their libido.

I started reading more and more and couldn’t get any answers. Then I started trying to offer lifestyle changes, basic advice like probiotics, glucosamine, chasteberry, glucosamine and so on. And many patients (after a lot counseling visits), actually started to get better. 

I started looking for more training in what I called at that time “integrative” approach. I was delighted to find out that there were some other disgruntled minds like mine who were busy building training programs and researching on cutting edge approaches to help people get better through fixing the root cause approach and not a band-aid approach. 

It’s been 18 yrs, since I have been on this path and I am still so excited to learn new and mostly “old” things every day. 

Understanding the foundations on a cellular level, getting to the root physiology and biochemistry, then applying that to develop treatment approaches is how we should have been fixing ailments in the first place. This is what longevity or foundational medicine is all about!

The other day, another physician asked me if my license covers “this kind of practice”. I was so amused that I didn’t even know how to explain. All I could say is that I am not a quack. This is basic foundational medicine that should have always been practiced and somewhere along the line, medicine translated into big pharma. 

I am not anti-western or allopathic medicine. I am a trained double board certified OBGYN. I know we save people from cancers and life-threatening conditions through medications and surgery. I love operating and fixing things that need fixing. But the routine GYN training doesn’t cover any of these issues that I am talking about. It’s not like you can simply cut out the fibroid or remove that endometriosis and the patient will then be golden forever. We all know fibroids come back and endometriosis is like cancer (how it slowly eats away your organs and makes life hell). Then why shouldn’t we be fixing the causes such as inflammation, hormone imbalance, the gut-brain- vagina axis. Human body is a beautifully designed, extremely intricate and a well-connected machine. 

How did we in the world think that each part lives in its own silo and is broken due to only one reason and can be fixed only by one way?

I thought I was alone thinking along “alternative” lines and then I met thousands of physicians just like me at A4M conferences and other integrative seminars. That’s when I realized, we are all looking for answers to help our patients fully and completely!

I feel that in the current world of quick fixes and instant gratification, we have forgotten what it means to truly be well. We want pills or surgery so we can “get on” with our lives…

What we forget is that we are not really getting on with our life, we are simply sweeping away that problem under the rug and very soon when the rug gets overfilled, the causes start to seep out until we get frustrated and then start blaming our doctors and everyone else for not being able to magically cure us anymore. 

Remember, you used your body and mind for years, your body has gone through so much insult over injury (as we say it in lay terms), it’s going to need a lot of TLC to get fixed up again, for you to feel fit (mentally and physically) again…. 

Functional approach is not a one stop quick fix cure. It needs a lot of work from you and from your provider. You both need to work together closely for a long period of time. With the right regimens and the right discipline, you will start to see results – slowly but surely!

The key is to get to the right provider or the right team. You will need a collaborative approach from the practitioner, pharmacist, physical therapist, chiropractor, nutritionist, mental health specialist and more!

And then there is the matter of cost – for testing and treatment and no, insurance won’t cover it. Why would they? This is why the system is so broken. 

Knowing as much as I know now, I almost feel disingenuous when I have to offer birth control pills to someone with PCOS or endometriosis, give Pepcid for heartburn, give laxatives for constipation or pain killers and antidepressants for fibromyalgia. The more I ask people questions about the rest of the body, the more I connect the dots and less I can help them through the traditional “insurance” based approach. 

The other day I had a patient who came to me because of abnormal periods. Upon asking more questions, she revealed that she had bowel issues, weight gain, depression, hair loss, no libido, pelvic pain, breast issues, severe fatigue, mental fog, depression, insomnia, bladder issues and the list goes on. 

I was the 4th GYN physician she was seeing and she had already seen all the specialists – gastroenterologist, neurologist, rheumatologist, primary care, therapist and psychiatrist. I was the only one who asked her all these questions and connected the dots to a priming event that happened 3 years ago. I felt so bad for her, I know she might be suffering from a multisystem chronic inflammatory syndrome and I can help her. BUT… I can’t give her one medication or one cure. It will need a lot of initial testing and a long treatment plan and I know she will get better. However, insurance will be able to cover only a tiny percentage of the treatment plan… so for her, she is stuck back in the loop of insurance, specialists and antidepressants.

Sometimes, I wish I hadn’t gone down this rabbit hole. 

I would be happily prescribing metronidazole, fluconazole and birth control pills and sending the “frequent flyer” patients to psych to rule out psych issues. 

It’s a journey, both for the patient and the practitioner… the good news is that we are currently in an exciting era of precision medicine focused on in-depth targeted testing and customized and personalized treatment approaches. 

I am so glad that this movement of Medicine 3.0 and Longevity Medicine has taken off. People are finally opening their eyes to what medicine should really be! 

Treating the person, not just numbers!

The world is our oasis… if we just open our mind to it!