Navigating the Complexities of PCOS with Dr. Yalda Mendoza's Whole-Person Approach

Unlock the holistic healing secrets for PCOS with Dr. Yalda Mendoza, our esteemed guest, who brings her expertise in women's pelvic health and physical therapy right to your ears. Together, we dissect the challenges of PCOS and PCOD, unveiling how these conditions differ in more than just severity, but also in the day-to-day realities they impose on women's lives. Dr. Mendoza's passionate storytelling from the front lines of female health care reveals why seeing patients as whole beings is crucial in providing relief and improving their quality of life.

Ever wondered how a well-designed exercise program or the right manual therapy can revolutionize hormonal health? We cover this and more as we discuss the transformative power of personalized care in the realm of physical therapy. With insights into deep visceral mobilization techniques and the benefits of a collaborative healthcare approach, this episode is a veritable masterclass. We highlight the need for communication and education between patients and healthcare providers, emphasizing the significance of setting realistic goals and managing expectations for conditions that require long-term management.

Finally, we nourish your curiosity on the role of diet in managing PCOS with a balanced approach that eschews extreme measures. Dr. Mendoza and I tackle the value of patient education in dietary choices and the powerful impact a supportive healthcare team can have in one's health journey. This episode is a wealth of knowledge for anyone looking to understand or manage PCOS, and it's brimming with practical advice, shared experiences, and the reassurance that you're not alone in this fight. Join us for an enlightening discussion that promises to leave you informed, empowered, and ready to take control of your health.

PCOS Nutrition Resource
PCOS Awareness Association 
Restore Therapeutic

Thank you for listening. Please subscribe to this podcast and share with a friend. If you would like to know more about my services, please message at fueledbyleo@gmail.com

My YouTube Channel https://www.youtube.com/channel/UC0SqBP44jMNYSzlcJjOKJdg

Transcript

Speaker 1: 0:19

Hey, hey, welcome back to another episode of the Simple Nutrition Insights Podcast. I am your host, Leonila Campos, Registered Dietitian, and today I am really excited to have a podcast guest, Dr Mendoza, and we're going to talk about PCOS and physical therapy. So I'll let Dr Mendoza introduce herself and then we'll start with the podcast.

Speaker 2: 0:48

Hello, my name is Yalda Mendoza. I'm a doctor of physical therapy. I co-own a physical therapy clinic for women's pelvic health here in Fresno. It's called Restore Therapeutics Physical Therapy and I did my partner with you on a couple episodes ago.

Speaker 1: 1:07

Yeah, it's been such a pleasure, you know, connecting with you both and the amazing relationship. And how much nutrition is, you know, linked and related to, like physical therapy? Obviously, right, it's the human body, so there's a relationship there. So I'm really thankful and excited that we have created this collaboration and we're doing this episode too.

Speaker 2: 1:34

I know we're so excited too One of the things we talk about therapy sometimes because sometimes we ask them a lot of questions and they're like, well, why are you asking about what I eat or what I'm doing? And I'm like it's all related. Like I promise you, it's all related. You know, and I kind of feel like you know, western medicine is a little bit like disjointed right. You go to like a doctor just for one thing and a doctor for another thing. And you know, and we know now hopefully everybody's open to their eyes to see like the holistic way is the way to go Patience as a whole body, as a whole person, and that's what helps people get better, as opposed to just you're over here and I'm over here.

Speaker 1: 2:08

Yeah, I really love that because I do the same thing with my patients and I usually tell them that disclaimer like hey, I'm going to be asking a lot of questions, it's not to like annoy you, it's just to let me learn more about you, your goals, like the entire person, because we're not separated right, like our head is not separated from our stomach or our intestines or legs, so we're all interconnected and so all these questions are essentially helping me to have a better understanding, a better picture of you as a whole person.

Speaker 2: 2:44

So I really like that, yeah, awesome.

Speaker 1: 2:46

So today's episode is about PCOS, right, and how physical therapy can help with PCOS. So I think the very first thing that I would like to ask you is, like, what interests you to maybe learn more about PCOS and physical therapy and maybe the need for those services too?

Speaker 2: 3:09

Okay. So you kind of broke up a little bit there so yeah, no problem.

Speaker 1: 3:14

So yeah, basically, just like what interests you to learn about PCOS, specifically in physical therapy, and maybe the need for your services.

Speaker 2: 3:29

So you know, I've been a physical therapist for a while now and I was working at the hospital setting and I was actually working with Dr Koshik, right, like her and I used to work together and one time we were like we have to go take some extra classes, right, because we all have to do our education. We're like, what should we do? So, you know, I'm like, hey, we should always have these conversations as, like women you know, like, hey, look at, oh, this is wrong with me. Like you know this hurts. Or you know you're having conversations about, you know I could really come to work today, or you know I'm having trouble at work because of my. It's like that. And so we were like, hey, like you know, we're women, we all have these issues. Like let's go take these classes.

Speaker 2: 4:05

You know I started talking to my women Because, you know, for those of us that live around here, we kind of know what a drive is a Central Valley is, with a lot of like resources and things like that, right. So we started taking oh my gosh, I think, like the light bulb just went off on, like both of us we like looked at each other and we're like this is what we should be doing. Like we did that and we just started, you know, we kind of went all in. Now here we are, a couple of years later with our clinic and we're just trying to like reach out and let women understand that it's normal, right, to kind of have these issues, I guess, but that it's not normal having to live with it. Does that make sense?

Speaker 2: 4:44

So, like, we all kind of like you know, I at least I did, you know like we grew up with like things like that, like oh yeah, I know, like we have these issues, but they speak about it like it's so normal. And we're over here trying to, you know, get our patients to realize, hey, like it's common but it's not normal. I guess is what I'm trying to say right, it's common, it's happening, but it's not normal. Like help for that right and I've always been like real, like interested in just you know, like like I love babies and things like that, like whatever. And again we're talking about all these conversations that we have with women and then I started, you know, realizing that there's a who are stuff, a lot of women who are, I know, that are suffering from infertility and that kind of stuff and I'm like like, if I'm doing this and I want to help people, like why, you know what I mean like let me help with that, let me help with something.

Speaker 2: 5:32

Some women get to the point where they feel like there is no relief, there is no pain, like, no, no, yeah, we can help you with that and you know, um, we'll talk a little bit about that. But but, like you know, pcos is not something that you can cure. You know you don't have to manage. But, again, like we can help you, or we can help them and help my patients to be able to get back to like their daily lives right, to be able to work and be with their families and be able to manage, and you're not having so much pain, and that's just. You know that great feeling that comes with being able to help someone do something like that A lot of things that we take for granted Makes sense.

Speaker 1: 6:04

Yeah, absolutely, and so I think it's so important that you know you mentioned that and just the need for your services, right, because I've never met.

Speaker 1: 6:17

I mean, I knew a physical therapist right In a hospital or the clinic but, never someone that says we're going to focus on pelvic floor health or anything related to that more specifically for women. And so that is, I mean, probably someone that lives in San Francisco. Right, these bigger cities you can find more providers, but not in the Central Valley. Like this is something so new but yet so needed. And I think what you said about yes, these are common conditions that exist and a lot of people, a lot of women, are experiencing them, but not being able to know what to do, not being able to receive the help that they need. That it should be a norm, right, like it should be common.

Speaker 2: 7:07

Just like you say, like you're having a toothache, like, oh, I'm going to go to the dentist or there's something like you know. We want, like women, to know that, hey, the moment you're experiencing some kind of symptoms, you know that should do with that. Okay, I can go to, I can go to the physical therapist. I kind of symptoms, you know I have to do with that. Okay, I can, I can go to, I can go to the physical therapist. I have somewhere that I can go. Right, that will help me deal with that, because sometimes you know most of the time or you know they do, they go to the OBGYN, but they they deal with a lot of different things, right, Medication and things like go in there, we're trying to find a person help us, don't get me wrong, they help us, we work together.

Speaker 2: 7:50

Just just like you know, when you go to the surgeon and the surgeon does um, you know he fixes your up, you have something broken, you have a hip replacement, does all of that, and you come to the physical therapist right to then take that and optimize what the surgeon and the doctor did for you. I guess that's what I'm trying to say Like we're here to optimize, like what the OBGYN or you know, is doing for you, what the urologist is doing for you. We're just here to take that and optimize what then you're getting from your doctor, right?

Speaker 1: 8:22

Yeah, and that optimization is huge, right, because that's essentially what's going to help you feel better, that's what's going to help you recover and heal properly, versus like, yeah, I had surgery and then not. What right? The surgery is, yeah, to fix something, but then you have to follow up right To to get better, right, yeah, awesome. So I think I jumped ahead and I think it is important to first describe what PCOS for maybe those listeners that have no idea what that is and then how, how much that impact, um, or what's the impact in women, right? Essentially, like, how can that affect a woman's quality of health, quality of life?

Speaker 2: 9:08

Sorry, I got the last part. I thought you were going to talk about the last part of the question.

Speaker 1: 9:15

Yeah, no worries. So basically describing what PCOS stands for and then how the condition can affect a woman's quality of life.

Speaker 2: 9:28

So I think you know most common is, or most women know what like PCOS is like half of the PCOS and there is kind of like more of a breakdown. And so I think one of the reasons why it takes so long to diagnose PCOS for some women and actually it takes like quite a few years, I think it's like average is because some women like see the symptoms and they're like, oh, it's not better, like I'll have a little bit less than that. So there's actually kind of like a breakdown, right. There's what we call like PCOD, which is polycystic ovarian disease, and then there's PCOS, which is polycystic ovarian disease, and then there's PCOS, which is polycystic ovarian syndrome, and so the disease also affects women. It doesn't affect them as much as a syndrome does. The disease affects about 20 to 25 percent of women who are, you know quote, unquote childbearing or menstruating age, and so this one is kind of caused by hormone imbalances of women who are, you know, quote-unquote childbearing or menstruating age, right, and so this one is, uh, kind of caused by hormone imbalances. It's genetic tendencies. So what happens in the disease is that, you know, your ovaries are basically really seem like immature or partially immature, like eggs into your ovaries and they become like little cysts. It's like the polycystic, and because, now filled with like fluid, what happens is it starts to then um, like swell, right, and so imagine you have like a little ovary and now you're swelling. And so that is then how it starts to affect you, right, you, it starts, you start to have pain, you start to have irregular periods, and you know that kind of stuff. And so now, right, uh, we all know you know, just having a quote, unquote, regular pain is still like, you know that kind of stuff. And so now, right, uh, we all know you know, just having a regular thing is still like, you know, sometimes like hard enough. But now you're adding like irregularity, now you're adding um, pain with, sometimes, right now you're adding like um, even, uh, hair loss sometimes come with it, right, um, weight gain and all that stuff. So now you're talking about this, right, and so, again, this is for you. But someone thinks like, okay, no, some of the pcos, and it's not that bad, they could have the disease and not the syndrome. So that's too, and the syndrome is kind of like, but, like I guess I'm staring at, this affects a little bit more less women, uh, thankfully, but it's still a good amount. It's still 12% to 18% of women, right. And so this is now what we're talking about is, like, now, the metabolic condition, right? So this, then, is the same thing that we're talking about.

Speaker 2: 11:54

Those same cysts are built up in the ovaries, but with the disease, for the most part, you'll still pass those eggs. You know when you're menstruating, and what happens for the most part with the syndrome is they don't. They stay there in your ovaries. So now imagine you're having all these little cyst-filled eggs that stay inside the ovaries and all that can cause, right? So, on top of the things that you have with the disease, like, you have now even longer menstrual cycles, right, you can have like 30 days or not that many cycles, and then now you're overproducing to kind of keep it simple like male hormones that come from those ovaries. That is not like a normal thing going on.

Speaker 2: 12:35

So that, on top of the other things that you have like weight gain, this is where you do see a lot of infertility, right, you still have that. You have the pelvic pain, you're having mood changes and sleep problems and depression, and, not to mention that, because it's a metabolic syndrome, you also have increased rates of heart disease and strokes and diabetes, and even like endometrial cancer, right? So you imagine all these things that are going on with the woman's body, like not just menstruation, but right, because we know that menstruation is a whole cycle, the whole. Right, there's different things happening in between. So, when you have all these things going on, are you still trying to live your day-to-day life, like that's what gets impacted, right? Like can you now, like pick up your kids, or you know, like I said, go to work or do all that stuff, while you're having such pain, fatigue, you know all that stuff depression, all the things that goes on.

Speaker 1: 13:34

And now you know, what do you do about it, right? Yeah, there's so much that goes into that, right? And thank you for making that difference between the disease and the syndrome, because I actually didn't know there were two different ones. So that is really important to know and to let the listener know as well, right?

Speaker 2: 13:54

And also, that is not something that is like, oh, you know, like acute right, like it happens all the time and you might not be, uh, diagnosed usually most, most, yes, well, most women start to feel it right, like right around when they start um age, like the energy they start to feel it and then, because, like you cannot feel what another person is going to normal thing, right, that's awesome, I know, it's like a normal period and you don't understand, and so that's, it doesn't take like a really long time, right? Because I regularly, like some, obviously, some people, have like worse symptoms than others, and so, and you know, sometimes you go to the doctor and you're like, no, you're not trying this. We all know that they try other things. You know, you're like, oh, it's like working, but it's not working.

Speaker 2: 14:36

And by the time you know, right, you're like down the road and you're like, you know, I have talked to other people, I'm trying to look into this, you know, because now, thank God, like we have the Internet, we're able to be a little bit more informed, to be like, you know, maybe this is something that I have, like whatever, but it does take a long time, and so that's kind of like you know the sadness of it that it takes so long to get diagnosed or to know that what you have. Because then how do you go about like trying to manage that or fix it.

Speaker 1: 15:06

You, because then how do you go about, like, trying to manage that or fix it? You don't even really know what you have to begin with. You know, right, and sometimes there's not enough guidance, right, or education as to okay, well, now I have this condition either the disease or the syndrome but what are the next steps, like, what can I do to manage this? You know the symptoms, or to manage, you know what's abnormal, and I think there is more need for that, maybe more need for that education as well. So is this something that you guys do? Restore therapeutics, the education part of it, yes we do.

Speaker 2: 15:37

So we do, we are. I think we spend a lot of time educating our patients, right One, because you're like right, because we want them to be informed, we want them to kind of know what's going on, because then it makes you less scared, right, or you're less nervous or less anxious when you kind of know what's going on. Right, and I hear it all the time where the patients will say like, oh well, I just feel so much better just knowing that that's what's going on with me. Right, because I was thinking that it was, but I wasn't so sure. And so I think sometimes just knowing makes you feel much better. And then, when you know what's happening, kind of, you're like, okay, you know, that's happened to me, that's fine, I'm at that stage, I'm accepting it, like what can I do now? And so then, right, we start talking about those things and just like, like you talked about patients, we talk to them a lot about um, ask lots of questions and talk about, like, lifestyle modification, modification, one of them being, uh, right, diet, right, is a big one and that's, you know. Yeah, on your end, but that's a very big one, you know, but increasing.

Speaker 2: 16:34

Then we're talking about what we can do as a physical therapist right is like so increasing like the physical activity is tends to be like the number one first line approach in managing PCOS. Okay, that's what kind of like the doctor will tell you. Because on one spectrum, you know like if you're now increasing physical activity, you're eating better, right? Of course, we all know that tends to lead to like weight loss, right. And so weight loss is one of the things that can help you manage PCOS, right. It just kind of gives it to you Even like a it's something and it doesn't have to be something. Sometimes patients are like oh, you know, obviously they have hormone issues because they have the syndrome and it's really hard for them to lose weight. And I'm like, I promise you, I'm not asking you to lose, you know, like 50 pounds or anything Like the research has showed that even like losing 5%, like a 5% reduction in body weight, actually makes a really big difference, right In something like that. And so when you're talking about increasing your activity, you know what I mean Like that helps going towards that and also that increasing that physical activity just helps get your body in the rhythm of improving ovulation, and it has shown that when you improve ovulation. It just kind of regulates everything, and so exercise has shown to do that right.

Speaker 2: 17:45

And so where we come in, it's so easy to be like, oh hey, just do exercise. But again, like we are what you know, I don't know, people know that that we're exercise specialists, right, like we're doctors and exercise, I think, so that we're there to help you to be able to do exercises when you have to manage them, doing them with pain, or when you have to manage them doing them with pain, or when you have to change something up right, because you can't do that because you have a hurt hip or you have things like that. You know, like that's where our expertise comes in. Because when we see you as a patient, you're like you're saying we're looking you as a whole patient, one by one, and you're like tell me what you can and can't do, tell me what you have trouble with, and I'll, you know, I'll help you and I'll make an exercise program for you, I will'll teach you, give you that education on how to do it correctly, because that's the number one thing. You know, when I go to a gym and I look at people and I'm like, oh, because they're exercising, you know that's going to be a whole other different thing, that's a whole different podcast, but you know, and that kind of thing, and be able to like help them do it correctly and what's going to work for them. And also you know what's going to work.

Speaker 2: 18:44

And also you know, trying to find again, like, something that they like to do and what's going to work for their schedule, because we're all busy, right, we're, we're moms, we have work, you know kind of things. So we just guide our patients through all of that, right, so we do that. And then on top of that is the manual therapy services that we provide. You know, as doctors of physical therapy, right, I have, on top of the, training on top of the, you know, to be a pelvic floor therapist, I have extra training, right, and manual therapy things that help also managing things like this PCOS, right, like, I have a certain certification excuse me, certain certification that's called Mercer therapy, right, it's like an approach.

Speaker 2: 19:24

So I have all these things in my bag that I've already learned from PT school in the world, but also an extra certification to like, hey, this is a thing that's been, you know, pretty, it's been out there for a while that people have heard about it but it's been, you know, like proven to help women, to reduce the pain, to again help with that improvement of ovulation. So we're doing what we were talking about earlier. We're trying to take care of the person as a whole, right like the exercise thing also, with doing manual therapy, also, all the thing together so that we're helping them manage right this um, this syndrome, this condition, so that they can be able to go on with their lives and hopefully, you know, just like better pain-free lives and not, I mean, you know, not to be able to do all the things that you want to and need to do in your life because you have to deal with this.

Speaker 1: 20:17

Yeah, I love that you talked about. You know, when someone is exercising right I mean, you're a doctor in this area and the physiology part of it you're like, oh my gosh, you gotta stop doing that because you're gonna hurt your back and so, um, yeah, I can just imagine the anxiety of like almost wanting to go and be like, hey, let me show you the right way.

Speaker 2: 20:39

I've only ever done it. I've only ever done it once, I promise you. Someone was saying something to me that was like I just couldn't say anything, but I've just corrected myself. That's the thing. Sometimes people are like this is, I won't tell you, and I don't know if you're in Canada, same thing in your practice, right? Because, again, we love the internet.

Speaker 2: 20:59

But then people look up and be like, hey, I saw this stuff and this guy told me how to get on the internet. And then you're like well, if that was true, I wouldn't have a job, right? So we were sometimes like, well, I can just look up exercises on the internet. Why can't I do that? I promise you, there's a little bit more to that, you know. And then afterwards you know, when we're going through, our patients are doctors, right, because also there's all this information, misinformation, and all this information like this diet and that diet, and then, and they don't, you know, they don't know what to do. And so that's why you're there for right, like, hey, go to the expert, then I promise you like she'll help you and then you won't have to worry about it and then it'll all be good.

Speaker 1: 21:47

Right. Yeah, it's still in a way sad, but not surprising, that a lot of the times they're coming to me because I'm the last resort and I'm like, oh my gosh, you could have saved tons of money, tons of time and frustration by just coming to me. But it could be that maybe they didn't even know that I existed or that dietitians are out there, and so you know. I think it's so important. Again, the education.

Speaker 1: 22:13

But knowing that, yes, you're going to find a lot of information on the internet and that's another thing that my patients say you know, there's conflicting information, and like I'm so overwhelmed and I don't even know what to do, and like I follow this diet or I follow this plan and I follow this other one, and like nothing works until they see a professional, an expert that is. You know, we went to school for that, and so same thing with you know, on your end too, like you know, you're the expert in this area. And I think one of the questions that came up to mind as you were talking about how you can help patients is the manual therapy. I don't think a lot. I honestly don't know exactly what that is and I think it's important to you. Let people know.

Speaker 2: 22:58

If it's okay with you, give some examples of what that is so when we say manual therapy, it's basically anything that we do with our hands. It's basically anything that we do with our hands. Right, it's hands, it's hands-on therapy, that's what we call it right. And so like, yeah, when we're teaching exercise, we're teaching you how to do and that kind of stuff, but you're doing it on your own. So when we're talking about mangal therapy in this case, um, well, I would do with the patient cos, right, um, there's, what we do is like very deep visceral mobilization of, like, the uterus and the ovaries, right, and so one of the things is that happens sometimes, you know, for whatever reasons, because you know we all have babies, things like that Sometimes the organs are not like moving the way they should be, whether you know, surgery or scar tissue, because there were inflamed you know, and there was like not so much movement.

Speaker 2: 23:46

So what I do is like I don't want to make it sound like painful, because I promise like what I will go in there is with my hands is go and do deep visceral mobilization. I'm basically moving from the outside right, I'm moving and trying to bring blood flow and trying to bring movement back to, like the ovaries and the uterus and basically get them to back to the way that they kind of should be. Right, it's like a little bit of movement and that helps, um, you know, break up sometimes, right, like a lot of research needs to kind of be done in this kind of thing.

Speaker 2: 24:21

But I'll tell you, like what I see in my parents, right, like um and and again, any woman that's had gone through that knows that that's very painful but, um, you know what it happens and, uh, it also helps kind of if we're getting rid of them, right, sometimes it's just to kind of help right again, like the movement restores the blood flow, and also that the therapy my manual therapy is what it does is to help restore blood flow and help restore the movement.

Speaker 2: 24:48

That is what you need to be able to have healthy ovaries and healthy uterus is basically what it does, right. So I guess, in the easiest way to put it like this right, like if you ever had a massage, right, you've ever hurt yourself and you had a massage, like on a regular, like muscle, and you have, you know, like you don't have that kind of movement, it's very tense, that kind of thing, and you're going through there and somebody's giving you like a nice good, like workout, bringing that blood flowing and kind of releasing everything, and then you feel the difference afterwards. It's kind of like that for you, those deep organs which would be like your uterus, your ovaries.

Speaker 1: 25:26

Gotcha, yeah, and I think, wow, I didn't think about needing that right. Like when we think about internal, our internal organs, right, just our body in general, when we think about, okay, I need something hurts, like you know, this muscle hurts, or like if you work out you're like, oh, my thigh hurts or my leg hurts and you massage it right and it feels better afterwards. But I didn't think about, okay, maybe we need some manual massage in, like those, you know, the ovaries or the urethras, because, like you said, many things can happen that could maybe disalign those organs, and so you were mentioning that helping with that can help with the blood flow right and essentially help to improve some of the symptoms.

Speaker 2: 26:10

And then you know, we'll do other things, like I'll release also, again, the easiest ways to put it.

Speaker 2: 26:17

I had to do massage or also just other techniques that we use as physical therapists to release some of the muscles and things also around the pelvis, right. So we're not only I will work on the organs, but I'm working on those muscles, you know, and those tendons around the pelvis. Sometimes those are what will throw things off, Like if you have a certain part of your pelvis, you have a certain muscle that's connected to your pelvis. Like you're saying, right, we're like a whole body and I know sometimes people think like pelvic floor and they just think like that's here, you know, and it's not Like your pelvic floor starts all the way up to your diaphragm, it comes all the way down, Because all of that is connected, right, Even the breathing we work a lot of because all of that is connected. So I also go through there and work on some of those muscles or release those things. So, again, you know, everything just is moving the way it should be. We're bringing back blood flow and just restoring right that function that we had before.

Speaker 1: 27:13

Gotcha, okay, awesome, yeah, amazing information and, like all that, you do want to help your patients. You know, more specifically with PCOS. So an example like, for example, you started working with this patient and you did your work. What are some of maybe the improvements, either in symptoms or in how the patient feels as you continue to work with them and then, maybe, towards the end of the program or as you get to, like, discharge of them, if that is something that happens?

Speaker 2: 27:46

program or as you get to like discharge them if that is something that happens. So the program that I run is like basically a six-week-long program, because I do see my patients once a week for six weeks, right, seven weeks, if you want to include like, because again you know how, we're talking about a lot of information. The first time I sit down with them, we just talk. They give me all this information. Sometimes it's a lot of people won't hear it, like I want to hear anything possibly, right, it's going to help me be able to help them, right, be able to help manage this, right. So we sit down and we talk. We kind of do, you know, like a little evaluation of mobility around you know, again, the organs and the hips and that kind of stuff and then we start our program.

Speaker 2: 28:21

So mine is six weeks long and each uh session is about an hour long. It's a lot like I was. That is a lot of manual therapy, so it's a lot of me doing that mobilization. I was talking about that, going through, you know, lots of different things and then I give them exercises to go home. So it's, believe it or not, in those six weeks my patients see a lot of improvement in pain, like in pain and being able just to feel, uh, like emotion you know, like I was talking about, to be able to have that movement that they didn't have before. And usually between because it's six weeks they tend to then have like a menstrual cycle and they can see the difference in the menstrual cycle and it's a little bit like more regular, that it was lighter, that it didn't hurt as much and stuff. So I was saying before we don't have a lot of research about how physical therapy or this manual therapy like helps the pcs. But we see it in the clinic, see it in real time. You know when patients are coming to me and they're like oh, you know, I, it's so much better, like still have some pain, but it's nowhere near what it was before, right, or like during my menstrual cycle.

Speaker 2: 29:27

This time I was able to go and get up and be about my day and I didn't have to call into work, and so those are like the things that I see, right, you know that we can't really write down on a paper.

Speaker 2: 29:39

Look, I did this research, but you know I see it every day. That's what's important to me. Because you know I see it every day, that's what's important to me because you know I care more about that. You know like it brings joy when I hear someone say like, yeah, you know I was able to do this going through, and then it wasn't much pain and it was less pain than I've had in so long, and you're like, oh, you know, like I helped someone do that and it's just, you know, joy. That's why we all kind of get into these professions, you know, to be able to like say, oh, I want to help people. But you know it's a little selfish to me because it makes me feel a lot better. That makes me feel good to know that. I like just to see you know what I mean and with the difference in them and the pain reduction and just being able to just live a better quality of life is like what I do. What I do, you know right.

Speaker 1: 30:23

Um, and I think you hit the hit the nail right there with the pain right, because when you think about well one, when you think about having menstrual pain right, that literally can put you to bed because there's so much pain there. And so I can imagine, you know, having that pain plus having the PCOS pain and just being able to see that transition right, that progress to you when you see them the first time, to you, like when they finish or as they continue to progress, and just having that quality of life right, just pain in general. Number one it affects your quality of life, it affects your day-to-day, it affects those cortisol levels, right, inflammation, and it can affect, if you have blood pressure. It will affect your blood pressure because you're so tensed and you have so much of this pain, and so it can really affect, you know, your entire body and your entire health. And so even just having reduced pain can really improve your quality of life. And so I don't think it's selfish to be happy when they, you know, when you see them, and like, yeah, I helped, you know I was able to help this patient feel better and to improve the quality of life and just to reduce pain.

Speaker 1: 31:39

I think that is just obviously another factor to hey, I'm doing this work and I love doing this work.

Speaker 1: 31:46

And I think, as private practice owners and as business owners, we come into these fields because we want to help somebody, right? Because, in my case, like I want to be able to give my patients the tools, the nutrition tools, to make these healthy decisions long-term right, past the time when they're with me, and I feel that that's the same way with Restore Therapeutics, right? Like being able to give these patients the tools that they can continue to use for the rest of their lives and not just like oh, let me find this plan that someone said that it was good for me, and it's like, like, no, like this is literally personalized specifically for you, right, and I think that is a huge difference when you come to see, no two people are like right, like no two people are like and when you do that, you're like all this work, like you said before you mentioned like this worked for my friend or this worked for that person, but that and it doesn't work for me.

Speaker 2: 32:44

And it's like, oh, and then you're just like, well, why didn't it work for me?

Speaker 2: 32:47

and it's like because you're a completely different person, right, you need something tailored for you, right? And like you're saying, like that, that's what we do, we have that personalized care. You know, like we sit down and we listen to our patients, right, like, uh, I hear that all the time. Like I see my patients say you thank you just for listening to me, thank you for listening to me, you know, because I feel like you know, not everybody does that, you know, and it's like, yeah, you know, I'm listening to you because I want to help you and I know that the way to help you is to listen to you and know and look at you as, like you're saying that whole person, this individual person, needs this care for you. Like, so now, let's take this everything that is you, and let's let's tailor it into a way that we can help you, right.

Speaker 1: 33:30

Yeah, exactly, and, like you said, there's not one plan that you create is not going to be the same plan for the next person, because they are completely different, they have completely different needs and they're going to need different things, right, and so, uh, understanding that is huge. And so the same thing, right, like, whatever's going to work for you might not work for the next person, right, even if it's like twin sister, um, because I guess they're different people, right, it's like you know you need to be able to. Um, yeah, do you have, and I agree with you with, like, listening to the patient. Right, they are the experts, we are the experts in the field, but they are the experts in their bodies, right, like they know their bodies more than anybody else.

Speaker 1: 34:24

And so that's one of the things I also talk to my patients about like, tell me if this is difficult, right, tell me if this plan is difficult for you, because I can create this amazing plan. But if you tell me, hey Leonila, hey Leo, this is like really difficult and I'm not going to be able to do it, then tell me that, because I need to make sure that you are able to follow the plan to see your results, right, and so I love that they're honest with me, because that makes sense, that's a great thing, right, and the way that you're in your practice, like you said, as business owners or small private companies, like we're able to do that, you're able to give that special care to your patient, because it's the same thing.

Speaker 2: 35:06

Right, we tell our patients again, you know, like we're experts, but again everybody responds differently and things happen. But then when they come back and they're like, hey, you know, like that really didn't work for me, or I can't do that certain thing, like it's too much, it's like, yeah, like let me know and then we'll change it, we'll make adjustments, right, because, again, it's always perfect the first time around, but we're able to give our patients that time right, that year, that time, to be able to like, yeah, give me all that feedback, because, like you're saying at the end, we want to be able to help you. Right, and if I'm not taking your feedback and I'm not able to listen, then what good am I doing?

Speaker 1: 35:42

Right, exactly. And to build on that right is having that feedback, for sure, but also sometimes the expectations right, like. Sometimes it may feel more difficult, it may feel like you're not doing, not progressing at all, before you start to see progress Right. So I think keeping the patients that expectation helps them to be like okay, yeah, this is what's happening, it's normal, but then we're going to start seeing progress. I think that is also important to mention.

Speaker 2: 36:43

Yeah, of course you know that's why we have such long, what we call them. Our evaluations are so long, right, because we talk about those things. And you know, and we are very big with our patients' goals, right, like when I'm talking to you and I'm like, okay, you know, like I can do all this to help you, but you tell me what your goal is right, like what is it that you want to be able to do? Right, and I'm going to help you work towards that goal. And so then that way, when you have goals right, they have goals it can see like, hey, you know I'm getting closer to that goal, or you know, whatever it might be right, like I want to be able to have, you know, two or three days without pain or less pain, 50%, that kind of thing. And then they are able to like, yeah, you know we can do that.

Speaker 2: 37:00

And this tells me I have to tell patients like, hey, you know that's kind of like not reasonable, you know it's not going to work that fast. Or also, you know, I like, again, the disease is a little, it's easier, right, To be able to kind of get to a point that you can manage and not have symptoms. But when you have the syndrome, that's not going to happen, right, and so we're talking about more managing the symptom. And so sometimes I would be like, no, hey, you know, I'm here to help, help, but we can manage because we can't cure that right, there's not like a cure for that, in a sense. And so we do have to give them the expectations, because you know what kind of practitioner would I be if I'm saying like, oh, yeah, no, I'm going to help you with that, I'm gonna get rid of that. And then the patient is like, wait, you, you know, you said that no.

Speaker 2: 37:32

And so we do have to sometimes, you know, kind of bring down those expectations. And it's a hard conversation to have sometimes, because it's like, of course, I would love to help everybody and get rid of all the pain and like cure, you know, but you can't, and so, but you're right. Like giving them expectations, knowing like, hey, this is how you can see how you're making progress. Like expect this, you know, this is normal, this is not normal. That like again brings down that anxiety. Right now they have that knowledge and they're able to take and say, you know, yeah, she did say that this might happen. So like it's take and say you know, yeah, she did say that this might happen, so like it's okay and it helps, you know, with anxiety and stuff like that while you're, you know, having to manage when you're dealing with these kinds of things.

Speaker 1: 38:06

Right, yeah, exactly, I love that you guys also focus on the goals and like let's figure out together how we are going to get you to that goal, because that is something that I do with my patients too. Like the first thing, I ask them, like tell me about your goals, and like why you want to get out of the sessions with me, and then let's create this plan together. Right, because we are a team. Right, I guess I'm the expert, but we are a team to help you get to the goals that you want to get. So I love that as well. Let's see. Okay, so we're talking about PCOS, right, and how physical therapy can help with PCOS. I think it is also important to mention a little bit about the relationship of PCOS, right, I guess and you can correct me on that, right if it's different for the disease, but how it is linked to infertility or fertility issues, and maybe also how working with you can help somebody improve maybe their chances of maybe getting pregnant, if that is something that they want to do.

Speaker 2: 39:16

Yeah, so the disease, like I said, is not as bad as like it's a syndrome, right? So when we you come to me and like you're bringing up this plan, you know and we're able to make those lifestyle changes right now we're exercising, we're having a healthy diet, you know we've lost weight um, and you're coming to me and we're doing our manual therapy, we're doing and you're able to regulate your periods and that kind of stuff more. That's always going to be the best way to be able to get you pregnant, right? Because, basically, you know that stuff that you learned in science class, like, oh, there's a 30 day cycle and this has to happen, and you know, in order for you to be able to be fertile.

Speaker 2: 39:52

It's a very, very big, complicated thing, but what's been the number one is going to help you is to be able to regulate that cycle, to put it in as much as what, quote-unquote, we call normal and a normal cycle, to regulate it.

Speaker 2: 40:08

So when you come to me and we're able, again, you know, through the therapy, through the exercises, to help regulate that cycle, to bring it to the most normal that we can, whether we're starting because, like I was saying, some women won't have a cycle at all, right, don't have PCOS, and so how do you get pregnant when you don't have a cycle right? So what we help and again the body weight and all this regulation what helps is start a cycle, then regulate a cycle right, and so when you have that more normal, regulated cycle, that is, then is what's going to help someone who's like suffering from infertility? What's going to help someone who's like suffering from infertility then be able to up their chances of getting pregnant, because now your body is going through that cycle in the way that it, you know, quote unquote should be, and that's what's helping you perfect.

Speaker 1: 40:51

Yeah, um and uh. In the, the one of the topics that keeps coming up is nutrition by diet and exercise. Yes, again, because they are strongly linked, and I actually created a resource for the listeners about PCOS and nutrition and maybe some starting points to help them. So I'll add that to the show notes, the show notes. But if you know, if nutrition is something that is so difficult for you and, again, there is so much information out there using these resources to get you started right, and then you know if you continue to have difficulties with your meals, with your nutrition, there are things that you have to optimize in terms of minerals, vitamins.

Speaker 1: 41:38

If there are, you know, deficiencies, we want to make sure that we are addressing the deficiencies. But working with a registered dietitian is going to be super important to make sure that, one, you're optimizing your nutrition, you're getting the nutrients that you need, and then, if weight loss is something that you need to do, that you're doing it the healthy way. Right, because we don't want to go into streams because, right, ok, we have the goal of weight loss, but now I'm not going to eat. Right, because that diet society says that in order for me to.

Speaker 2: 42:13

You don't eat, yeah, and like we were talking about it all comes back in a circle, Right. Like because if you're doing this and your goal is to then get pregnant while you're having a baby, like if you're starving yourself about what kind of environment are you creating in your body for them to be able to carry that pregnancy right? And so those are the things that you have to talk about. Like you know, we're saying it's not like just like, oh, I'm going to lose weight loss just because I lost weight, that's going to help me control my PCOS or get pregnant. No, because, like you said, if you're not doing it the right way, you're going extremes, you're hurting your body. It's not going to then regulate anything or help you in any way. You're almost making things worse because you're doing these things to your body and it's going a little crazy and it's like how do you then expect that right Then to be able to get better on the other end, if you're not doing it correctly that way?

Speaker 1: 43:05

Yeah, exactly.

Speaker 1: 43:08

And so, yeah, you have to be clear with your goals, but also, by having a plan and just knowing that one, you're not alone in this journey.

Speaker 1: 43:19

Right, you have physical therapists to help you with your exercises and making sure that you know you're getting the need in that area. But then you also can have a registered dietitian on your team to make sure that you're optimizing your nutrition and your health, and you know that you're changing things as you go along and making sure, again, that you are getting those nutrients that you need. And then you know your medical team to make sure that your levels, your hormone levels, are you know where they need to be, and then, pretty much, you have this team right supporting you and helping you, and that way, you make sure that you feel supported and while you're getting the services that you that you need, yeah, and that's when you get the best outcomes is basically what it is right, like when you're taking care of yourself, like I said, as in the whole, like what right you, your doctor, your team, all that, all that just brings that everything together in sync as a whole and that's when you get to the goals that you want.

Speaker 2: 44:18

That's when you're then able to. You know, whatever it is that you're working to, but that's what's going to help you. Piecing here and there, like whatever is just, I mean, it works for some people, for you know reasons. But if you, like you said earlier, right, if you're coming to us sadly, kind of you're coming to us because you're coming to us as a last resort, right, which is really sad, and you know we want, and I know you want the same thing, like, we want to be able to get that out in the world, to be like, please don't use us as a last resort, right, like we can help you and save you so much, like anguish and pain and like time and money and things like that.

Speaker 2: 44:53

Like you're saying, you know, like, and hopefully you know we get to the point where we're out there screaming to the world and when people start thinking about like PCOS or like fertility or things like that. Like, hey, you know, like our physical therapists, right, like people like us, when we tell the health specialist, it's something that they also think about, right, just like you know, I think it's a little bit power with you. Like, hey, I know I need to work on this. Like, oh, you, that, like you said, is what's going to help just bring everything and optimize everything for us to help, you know, your listeners, our patients, get to work to reach their goals.

Speaker 1: 45:28

Right, yeah, and I love what you said about essentially getting them to where they need to be with the support of all the team members. Right, because they, they, they, they. You have to make sure that you have that on on your side. Um, yeah, okay, so this has been so amazing. I mean, I have so many other more questions, but I want to make sure that I respect your time. Um, oh, we definitely need to have I'm always here.

Speaker 2: 45:54

I love this. This is great. I talk on and on about like 50 million other things that you know because, just like you're saying, I know it's the same thing you know in your work. It's not just like, hey, this is what I'm telling you. It's like so much more right, and we get so excited because we want to tell people like what we do and how we can help you, and so that's why I'm a podcast. No, it was good, Thank you.

Speaker 1: 46:23

Yeah, I, yeah, I love. It's so funny because when you are a true expert, right, and you know your area of expertise, you can talk about a topic for hours without feeling like, oh, I have to talk about that and I don't know what I'm gonna say. Like, literally, you have the knowledge, you're an expert in that area and you can spend hours talking about that specific topic. Um, so I love that. But maybe now let's tell the listeners where can they find you, how they can reach out to you, and do you do virtual appointments? Can you do that in case there's someone that lives far away?

Speaker 2: 46:51

So yeah, like if someone was a little bit farther away we could always do like our first appointment, like virtual. But anything right like that we do is like we're physical therapists, we love to put our hands on people and that's what we do, right? So we want to come, reach out to us and say, like to see if, like, hey, what you do can work for me. That's, we could always do that virtually or over the phone. That's great, you know, but eventually you're going to have to come into our office because in order for me to be able to work, man, I have to put my hands right.

Speaker 2: 47:26

So, like I said, our clinic is called Restore Therapeutics Physical Therapy. Right, we are here in Fresno. Our phone number is 559-515-6465. Or you can find us on Instagram at Restore underscore therapeutics, like, where they, you know, like reach out to us. You can send us a direct message. You can go onto our website and that's restoretherapeuticcom. There's like we're out there. You can Google us. We're there on Google, if that's the easiest way to just Google our name and we'll come up and then you can go through our website there or just reach out to us, right, like we want to help everybody.

Speaker 1: 48:01

That's our goal in life. Yeah, thank you, and make sure to add that information in the show notes so that way people will have it Any final thoughts, any final advice or information that you want to provide to the listeners, that you want them to maybe remember?

Speaker 2: 48:19

You know, I just want them to remember that they're like not alone, right? You know, I mean like sometimes when you go something like this, there's a piece, so it's like you, it's isolating, right, because you feel like maybe no one else knows what you're going through or you just can't. You know the people around you don't understand, like you know that you're not alone, right, that there's other people who are going through the same thing as you. I think there's a website that I provided for you to put in the show notes, which is kind of like a thing to kind of show you so you can see that other people are there. You know their support groups, that kind of thing. But also know that you're not alone in the sense that there's people like me and you, professionals that are out here to help. Let us help you get your life back and get quality a lot, because that's what we need to do. So just know that you're not alone and that we're here, waiting and eager for you to reach out to us yeah, awesome.

Speaker 1: 49:08

Thank you so much, dr mendoza, for your time. Um, and anyone that welcome. Anyone that you know that is listening to to this podcast episode or, if you don't know, if you don't, if you don't have PCOS, but you know somebody that does, please share this episode with them. You can definitely change their lives or at least give them some hope.

Speaker 1: 49:29

So that's my ask for you, but again, thank you so much to you, my listeners. Thank you, dr Mendoza. All right, my friends, thank you for your time. I'll see you in the next episode. Bye-bye for now.