Patient Empowerment: Taking Charge in Talking Effectively with Your Doctor

In this episode, we dive into the world of patient empowerment and personalized healthcare with Dr. Gina Siddiqui MD,  founder and CEO of CARTE Medical. Dr. Siddiqui shares invaluable insights on how seniors can become active participants in their medical care, from communicating effectively with doctors to understanding the nuances of personalized medicine.

We explore real-life examples of how patient advocacy can lead to better health outcomes, particularly when it comes to managing medication side effects and fine-tuning treatment plans. Dr. Siddiqui also tackles the evolving perspectives on hormone replacement therapy for menopausal and post-menopausal women, emphasizing the importance of individualized risk-benefit analysis.

The conversation takes a heartfelt turn as we discuss the delicate balance between maintaining quality of life and pursuing medical interventions. Dr. Siddiqui offers practical advice on navigating family dynamics in healthcare decisions, especially for adult children caring for aging parents. 

Whether you're a senior looking to take charge of your health or a caregiver seeking guidance, this episode offers a wealth of actionable insights. Tune in to learn how to enhance your doctor-patient relationships, make informed healthcare decisions, and ultimately live life to the fullest on your own terms.

Link: Carte Medical

SeniorLivingGuide.com Podcast sponsored by TerraBella Senior Living

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Transcript

Darleen Mahoney [0:01 - 0:27]: And today we are joined by Dr. Gina Siddiqui. She is the founder and CEO of Cart Clinics, which is a concierge practice that empowers patients with proactive end to end health plans in line with their priorities. And I like that. And that's what we're going to talk about today on our podcast. Thank you so much for joining us today, Dr. Siddiqui. 

Dr. Gina Siddiqui [0:27 - 0:31]: Oh, thank you so much for having me, Darlene. I love this podcast and I'm really honored to be on it. 

Darleen Mahoney [0:32 - 1:25]: Yeah, thank you so much. One of the things that I know that I've advocated for myself and I advocated for my parents is their ability to advocate for themselves. I know that sometimes with like older generations, and my mom specifically, she never wanted to like question the doctor or she, she didn't want to ever make. She, she really just everything he said was like gold. And not that what they're saying isn't. I don't want to say goal, but, but you take it. But you're allowed to ask questions and you're allowed to ask for second opinions and you're allowed to do some of your own research. So I do think it's important to, to talk about that and give patients the permission to advocate for themselves. 

Dr. Gina Siddiqui [1:25 - 2:25]: That is so true. And I think something that has changed in medicine is how much we can personalize things. So, you know, maybe 100 or 200 years ago, there really was only one treatment available and you could go into the doctor's office and say, what's wrong? And maybe the doctor really only has one answer for you and there's less of reason for a dialogue. But now there are so many treatment options out there and a lot of what is right for you depends on who you are and what's important to you. So I think reframing it as you know, you're not challenging your doctor, you're not telling them that what they have to say isn't gold, but your perspective and your values and your genetic background and your family history and your symptoms, all these things that you are more of an expert in, then the doctor in front of you, reframing it as you're not challenging them, you're just enhancing the conversation by bringing what you have to the table and communicating that well. 

Darleen Mahoney [2:26 - 3:00]: Yeah, no, I definitely appreciate that. And then what's really going on in your day to day life, because I think sometimes seniors also get embarrassed to talk about what's going on, very specific things or they think the doctor's not going to be interested in that. So I think it's it really important to really focus in and not be afraid to talk about things that are personal or that are even more emotional. I mean, I think that sometimes we don't, we just want to talk about very specific things or just answer just the questions the doctor asks us without really sharing more in depth information that is going on. 

Dr. Gina Siddiqui [3:00 - 3:31]: Totally, totally. And if you're taking a medicine and you're having side effects, you know, you're not feeling that good, you got to tell them, or if they offered you some idea or treatment and you it's not going as planned or there was a hiccup for a reason, you know, that you should feel really empowered to say that. And I know it feels a little bit uncomfortable or maybe confrontational or you don't know how they're going to take it. But you know, a good doctor wants what is best for you and they want to know if something is not working and they want to tweak it to help you feel better. 

Darleen Mahoney [3:32 - 4:02]: Yeah. And you know, even on the medication side, the prescription side, that is, you nailed it on that because I think a lot of times you get a prescription, it doesn't make you feel great, but the doctor ordered it, you think this is the route you kind of need to go. So you just suck it up, buttercup. Right. Unless it's, especially if it's something like simple like it causes like indigestion or it causes like little things that are just annoying little things. Yeah, there might be something that causes no side effects. 

Dr. Gina Siddiqui [4:02 - 6:00]: Exactly. I can think of three examples I can run through really quickly of clients of ours exactly that scenario. So one gentleman, he's on a very common medicine, a statin. Right. I'm sure many of your listeners are on a statin, atorvastatin, these kinds of medicines and statins can cause muscle aches and pains. And a lot of people, especially as they're older, sort of just dismiss that as, you know, it's just life and it is just how it has to be. And for this patient, we did some more cholesterol testing and we also looked into how his body synthesizes cholesterol. There's something called a cholesterol synthesis study and that will actually tell you whether it's sort of the production or the breakdown of the cholesterol that's causing the problem in you. And so for him, it was a very easy switch to a different medicine that doesn't have the side effects of a statin that actually worked better, that lowered his lipids more. So him Speaking up about some of the cognitive brain fog that he was feeling and muscle aches and pains actually led to a better, more effective medicine for him because we dug deeper into his kind of personalized genetic makeup. Another patient of CART clinics had high blood pressure, and he was on a blood pressure lowering medicine, also very common. Right. And this poor guy was in the emergency room from a car accident that could have gone so much worse because he was on a higher dose of blood pressure medicine than he needed, and it was making him lightheaded in the middle of the day, and he basically passed out in his car and got in a car accident. And he felt like, well, my cardiologist recommended this dose and I should just take it, even though he was having these symptoms. And so, again, speaking up about that led to a titration of that medicine and a dosing schedule when in the day to take it, so that was safer. And, you know, that could have saved his life and someone else's life who was on the road. And yet. Oh, please, go ahead, Darlene. 

Darleen Mahoney [6:00 - 6:14]: I was gonna say, you're exactly right. It just is amazing to me how medications can even be slightly off a dosage amount that all that needs to be is tweaked. You don't even have to change the entire medication. It's just a dosage amount. 

Dr. Gina Siddiqui [6:14 - 6:16]: Yeah, totally. Yeah. 

Darleen Mahoney [6:16 - 6:19]: So what was your. What else were you talking about? I'm so sorry, I didn't mean to interrupt. 

Dr. Gina Siddiqui [6:19 - 7:19]: No, no, no. I. I could ramble on forever. It was. Who had anemia and she was on iron pills, another kind of common medicine. She has heavy periods, and iron pills can be really hard to, you know, they upset your stomach and they, you know, they may give you some indigestion. And she didn't know that there's gummies, versions of them. She didn't know that they can be taken in. In shakes and smoothies. And most importantly, iron pills shouldn't be taken with certain kinds of food. They interact and actually will interfere with the absorption of the iron. So, you know, whereas some supplements, you're supposed to take on a full stomach so that you can digest them. You know, there were ways that she was taking this medicine that was making her symptoms worse and making her absorption, the effect of the medicine worse. So, you know, all of this, you really don't get to. Unless you kind of open up with your doctor and you and your doctor take some time to, you know, go through what your daily routine is and how you're taking your medicines and how they're working for you? 

Darleen Mahoney [7:21 - 8:41]: Yeah, absolutely. I absolutely agree with that. That's really great points. The medications really are. You know, you see all these commercials here in this country where you're indignated with commercials for all kinds of different prescriptions. And just like a car, just like a car commercial, all the great things are on the upfront. And then the things that are bad, they say really, really fast and teeny, teeny, tiny little print. So. But sometimes the teeny, teeny, tiny little print is all the bad stuff. You know, it's the, the negative causes of the prescription. And in a car, you know, sales, it's the high interest rate, and you're going to be paying for it for the next 250 years. So it's, it's. You need to pay attention to the small print or the small advertising or whatever the case may be when you do see these different advertisements that you're seeing that offer all these different solutions to the aches and pains or different things that you may be experiencing in your everyday life. But I do think it's good to see some of these things so you can open up a conversation with your doctor to say, hey, you know, I saw this advertised for my high blood pressure or my high cholesterol or whatever the case may be to see if it is something that maybe would be a good fit for you if you're on a different type of medication you might be having issues from. 

Dr. Gina Siddiqui [8:41 - 9:06]: Right, exactly. Exactly. And, you know, I don't, you know, cars are a great example. I wouldn't want to go back to the time where we didn't have cars. You know, like, they're obviously amazing technologies, but you have to be a smart consumer and you have to figure out what's right for you. And you have to work with a car dealership and a mechanic who you can trust. Right. Who you know is going to tell you what's going on, look everything over thoroughly, but also kind of not try to sell you nonsense. 

Darleen Mahoney [9:08 - 9:43]: Yeah, yeah, absolutely. So. And as technology increases, you may be on a medication or you may be doing a treatment or you may be doing something for a very long period of time, especially if you have a chronic illness of some sort. And there may be new things and new technologies that come out that you might want to have that conversation and say, hey, you know, I've had this specific disease or illness or whatever the case may be. Is there something new that's coming out? Is there something that we might want to try? Or whatever the case may be, Is there a new study? Because There is new things coming out all the time. 

Dr. Gina Siddiqui [9:43 - 11:34]: Exactly, exactly. The blessing and beauty of the modern world we live in is how much technology and new options are out there. You know, as a person with a rare symptom on the other side of the world, you could actually learn about the workup that they got and the things that worked for them that was not available before. All of these social networks and the Internet, you know, connectivity and YouTube and that we have now. But the other side of the coin of that is that it's really overwhelming and it can feel like you don't know who to trust. And you could spend your whole day just working on different types of interventions for your health and still not get to the bottom of your to do list. So it can make you feel sort of like your, you know, not doing enough or nervous. It can, it can create some health anxiety. I think of like when, you know, Facebook first came out and people started looking at photos of, you know, someone they went to high school with, you know, many, many years ago, and they're sort of only seeing the highlight reel, you know, like the, the good moments of that person's vacation or whatever. And it makes them feel, you know, the expression that came out like fomo, fear of missing out, like what, what am I not doing that they're doing? And it kind of made people have this unrealistic expectation. And I think now that's happening with health, you know, that we all look at the seniors who are on, you know, magazine covers, Martha Stewart on Sports Illustrated in a bathing suit, you know, in her 80s, and we're all thinking, well, what's wrong with me if I'm not living that way or doing those things and what can I buy or what should I be doing to be that way? And there are new things you can do. There is a lot more options around, you know, hormones in your joints and your skin and your mood. But we also should be careful not to have kind of this rosier than reality picture of everyone else and their struggles. 

Darleen Mahoney [11:35 - 12:45]: Oh, 100%. There's a million different things that you could do, but you could also go completely broke doing them as well. Because a lot of those options that are the anti aging options per se can be completely out of pocket and they are very expensive and there's a never ending stream of, of options that are presented and who knows if half of them work, it's right. Yeah, yeah, 100%. 100%. And there'll be a great option today and that option's gone tomorrow and there'll be something completely new replacing it. As far as the. On the anti aging in the anti aging realm, I should say for sure. So yeah, definitely. So you mentioned something about like hormone replacement and things like that. I know that as our seniors age, I don't know if that's something that it's. I, I feel like that was something that people started doing and then kind of stopped doing it because there were fears. But I think we're looking at hormone replacement a little bit differently than we did even just a few years ago. Am I wrong on that? 

Dr. Gina Siddiqui [12:46 - 14:58]: No, I think you're absolutely right. There has been a pendulum swinging, I think, from doctors and the medical community around what advice they're giving women, especially around hormone therapy. But it's happening with men also. And it's a process that all women go through as they're basically perimenopause. And then in menopause and post menopause, the hormones that their ovaries are releasing, changing and a big change in all the receptors across the body that that affects. There was a very firm crackdown on hormone prescription after a study called the Women's Health Study came out. What we basically now have realized is there was a little bit of an over interpretation of some of those outcomes that I think led to not a balanced view or conversation with women about the risks and benefits. To put it very succinctly, women were told that they had an increased risk of cancer and cardiovascular events when the statistics and the data from that study actually didn't show that or prove that definitively. Now, I think you're right. There's a lot of enthusiasm around menopause care, including hormone treatment. And there's a whole spectrum of that. You know, there's topical hormones that really have no systemic impact and then there's systemic hormones that are going to affect also your bones and your heart and your uterus and all these areas. And I think the truth as often as in medicine is nuanced and it's not sort of one or the other. I don't think it's true that every woman needs hormone treatment and is doing themselves a disservice if they don't when they go to menopause. And I also don't think it's true that there's no place for it and a woman is misguided to ask about that or pursue it for her symptoms or for her bones or whatever reason she wants to pursue. So I think we're coming to a better place in America where women are feeling more empowered to do their research and understand the options. And both options are open to them. 

Darleen Mahoney [14:59 - 15:10]: Yeah. So let me ask you this. On hormone replacement. So if you're a senior and you're probably in your 60s or what have you, and you've never had hormone replacement, is it too late to consider that? 

Dr. Gina Siddiqui [15:10 - 16:32]: Yeah, great question. So there are sort of two different groups and different risks. So if you start hormone therapy when you are perimenopausal and basically you never have that drop in your hormones, and you kind of take the hormone therapy to keep a consistent level throughout that process, that's one path. And, and there's a kind of a body of research that you should look to for whether that is right for you. That will sort of help people who are having some symptoms around perimenopause or have some risk factors for if their hormone levels drop that they want to limit. And then there's a second group of people who, you know, went through menopause and they have been on very low levels of estrogen, testosterone for a long time. And them starting hormone therapy is a different cohort of people and has different outcomes. And what's important for those women to know is that there actually may be some increased cardiovascular risk in that first year of resuming it. So that's a really important kind of risk. Benefit discussion to have with your doctor. I do fear that right now there are some companies that are just focused on hormone therapy that are sort of, you know, rightfully identifying that, you know, women were turned this. Turned down this option, which is wrong. But now they're sort of just saying it's for everybody without, like I said, having a nuanced conversation about what's right for each person. So it's a great question that you asked. Timing is everything. 

Darleen Mahoney [16:32 - 17:09]: Yeah, exactly, exactly. And I do like the fact that those conversations are becoming more and more prevalent because I, I do think that women specifically on the hormone, it's. It's such an important conversation that I think doctors, I almost feel like sometimes doctors, just general doctors don't always want to talk about it or they just don't have the. They want to. They want to do a quick fix instead of really. Yeah, a really intense conversation about what's really right long term versus Just let me get you through the. Let me get you through this phase to the other side kind of conversation. 

Dr. Gina Siddiqui [17:09 - 17:33]: This is a huge decision. It impacts like every. Like you have these receptors on your brain, in your bone, on your sex organs, on your skin, every organ of your body. So if you're hesitating and you have a million questions for your doctor to answer. I mean, I think that's your right. I would feel that way, you know, about making a choice like that on my body. So don't ever feel like you don't have a right to kind of think that over and exhaust your research before choosing. 

Darleen Mahoney [17:34 - 18:10]: Yeah, exactly. So when seniors are going to the doctor and they're having these conversations about what's best for them, and we did talk about them really advocating for themselves when it comes to little things, when it comes to big things, even if, you know, like, when you're talking big things, cancer diagnoses, Parkinson's, Alzheimer's, dementia, all those different types of things, those are really big diagnoses. I think it's always good to be able to have those conversations and ask for second opinions. What are your thoughts on that? 

Dr. Gina Siddiqui [18:11 - 20:12]: Yes, my thoughts are absolutely. You know, I had one of our doctors who we collaborate with is an oncologist, and we did an interview with him about what are things that you wish every cancer pa