Season 5 kicks off with Dr. Jennifer Smith, an obstetrician and gynecologist at Consultants in Women’s Healthcare!

Dr. Jennifer Smith joined Consultants in Women’s Healthcare in 2003 after completing her residency at Washington University School of Medicine/Barnes -Jewish Hospital.  She strives to develop a personal relationship with each woman in order to individualize care.  She has particular interests in the management of abnormal uterine bleeding, polyps, and fibroids, as well as menopause.  A skilled surgeon, Dr. Smith enjoys laparoscopic surgery as well as other minimally invasive surgical techniques.  Guiding patients through pregnancy is a particular passion.  Dr. Smith knows that while every family is nervous in the anticipation of a healthy child, each patient is different in her needs and expectations.  She works hard to provide a pregnancy, labor, and delivery experience that matches her patients’ expectations while maintaining excellent care.

Phone: (314) 432-8181
(Code JSR5)

  Otter.Ai (transcribed)
Hello, and welcome to STL Active St Louis’s premier health and wellness podcast. STL Active aims to give listeners in the St. Louis area the information they need to succeed and progress with their health and fitness. This podcast is brought to you by and hosted by Doctor of Physical Therapy, Greg Judice.
Hey everyone, its Dr. Greg, owner and physical therapist at Judice Sports and Rehab. On this episode of the show, our CO hosts Jennifer Rispoli and I are interviewing Dr. Jennifer Smith. She is the obstetrics and gynecology specialist in St. Louis, Missouri, and has over 23 years of experience in the medical field. In this episode, we talk about her practice her passion, and how she helps people here in St. Louis, we also talk about some postpartum issues and how to get care postpartum. Without further ado, let’s get into the interview with Dr. Jennifer Smith. All right, welcome to the show. We’ve got Dr. Jennifer Smith with us today. Welcome. We also have a co-host, Dr. Jennifer Rispoli. Welcome. So Dr. Smith, tell us a little bit about you, your background, how you got to where you are, what’s your part of your practice, just give us a bit about you.
So I’m originally actually from Southern California, which is the unique thing about me and St. Louis. People can’t believe it. But I love it here actually, I came out here originally to go to med school after I went to UCLA for undergrad thought it would be a four-year stint checking out what life is like with Four Seasons went to wash you really liked it ended up doing residency also at Barnes. I have a husband who moved out here with my kind of kicking and screaming. But kind of six years in, he had a life and a career and we decided we liked it. So had some really nice job opportunities as residency was coming to a close. And I think I’m probably one of the few people in life who will start and finish with the same practice. Because I really got lucky and great group fell into a great group and really love my practice, which is at Missouri Baptist and love my patients. And so here I am in to my 19th practice in St. Louis for 26 years now, I think.
And so all of that has been with the consultants in women’s health care. Awesome. All right. So tell us about that a little bit.
Well, well, when I finished was finishing residency consultants in women’s health care were a group of three men. And they decided they probably should add a woman to their group, which for me was a great opportunity. I started off by taking care of a lot of their patients, daughters who wanted a woman. So that was kind of a ready little audience for me. And since that time, only one of the original partners is still there with me and Dr. David Weinstein, and we’ve added two more women and two nurse practitioners and we have, you know, a very busy practice with four doctors to nurse practitioners one full-time ultrasound, person, two other part-time, it’s, it’s a busy group, and we have a great kind of thriving practice right there. By labor and delivery in Missouri Baptist.
So you’re obviously a physician within the practice, do you have like a leadership role within or you’re mostly practitioner,
you know, our, our were very, they’ve always treated, they’ve always treated me like a partner even when I wasn’t. Since I’ve been in the practice for longer, I suppose my official title is that I’m the vice president of the corporation. I have the privilege of signing checks now. So I guess I’m the treasurer, too, by which, you know, we all have our different roles that we play, because there are four, three owners, one who will become an owner that our newest partner and so we all play a role in the things that need to be done to make our
business work because I know things can be a little bit confusing when it comes to Are you part of the hospital? Are you working at the hospital? Are you an employee of a bap and we’re in it’s a little confusing sometimes. So it’s just kind of trying to clarify that.
So we’re an independent practice. We’re self Oh, And we rent space in the hospital. But we aren’t owned by the hospital, which nowadays makes us somewhat unique. But when I joined, when I joined, I could tell that this was a well organized and well run practice. And it is. And we’ve managed to thrive independently, but working very closely with the hospital.
So over the last 19 years working in the practice are, you know, are there certain aspects of it that have changed or is it been pretty consistent and organized, like you said, and it’s been almost the same the whole time, or kind of give us a little bit of the history from your like,
when I started, when I started, you know, we were still charting on paper. And we only use the computers for billing, we didn’t have nurse practitioners, we didn’t really see how that fit into our practice. So the first thing that changed was hiring an awesome nurse practitioner who changed our perception of how much Women’s Health Nurse Practitioner could add to our practice. And we later added a second. They’re amazing and helpful, and our patients really enjoy them quite a bit, as do we. So that was the first big change. The second was the change forced upon us, which is, of course, everything has to be on an electronic medical record now. So that was a big change. It has its pros, and its cons, it’s, you know, at the beginning slows you down to learn. But on the other hand, it keeps people’s histories organized and helps you keep a running list of things. Whereas in years past and paper to actually go find it through every page to see what’s been going on. Also, it’s legible. Some of my older partners do not have good writing. So now I can actually read what’s going on. But I mean, I think we’ve maintained our same basic philosophy, which is that we treat our patients like we would treat our own family, and people who work for us from front desk, to back to billing to ultrasound, all of it in our practice, you fit in our practice, if you keep that in mind, and I think that’s patients feel it. And I think despite the technical changes along the way, keeping that at the forefront has kept us as a thriving group and allowed us really to stay successful enough that we can maintain our independence.
And that’s been my experience, too, is typically the the independent practices have that special touch, right? There’s the you have the ability to have the processes in place to where you can treat people like family. And I’ve said this 1000 times on this show, but in my opinion, most of the corporate physical therapists are great therapists in a bad setting. And I’m sure that can apply to any practice. But you know, the fact that you guys are independent, that being somewhat unique, is certainly a good thing. It allows that quality to stay high.
I think so I mean, I think these last two years have really demonstrated it, you know, during the pandemic, hospitals and hospital systems have had to make a lot of choices about furloughing, and when to bring people back and how to maintain a workforce and moving people into different positions. Whereas we were able to make the choice to keep everyone fully employed throughout. And, you know, hindsight is 2020. And boy, was that a good idea? Because, of course, we’re as busy as ever, and we still have the same wonderful, loyal, friendly employees that we had before. And if we were in a hospital system, we wouldn’t have been able to make that choice ourselves
crucial. You were saying that the bringing on that nurse practitioner, you said kind of heightened the perception of what people thought a women’s health nurse practitioner could do. I’d love to kind of hear you know what that what that means? Like, what does that look like?
I think I think that we probably didn’t understand the other dimension that a nurse practitioner could bring to our practice that especially in an OBGYN office where sometimes you’re running out for emergencies that you didn’t plan on that she can be there to just help and take care of the patients and keep things running smoothly. Our original nurse practitioner had a wealth of other experience behind her and she goes out in the community educates teenage girls, about sexual health. She research helps us run research in our office, she just brings a whole breadth of quickly, not specifically medical care that we wouldn’t have otherwise had in the office. Without her, that’s for sure. I also think that our nurse practitioners have kind of the time and the touch to make adolescents feel really comfortable in the office. And I think a lot of our younger women are really happy to be able to work with our nurse practitioners, our second nurse practitioner is significantly younger, I think they see her as someone they can relate to. And I think that’s really important. I mean, the best health care is the healthcare you’ll go to. And there’s a lot of fear in going to an OB GYN. So I think they add a dimension of personal touch and care and different perspective, that kind of help round out our sharp edges.
I mean, I think that that certainly can apply to, to anybody, you’re never going to be the perfect fit for every single person that walks in the door. So having some variety and having that variability makes things really nice. I mean, for me, there’s so many people that walk in with, whether it’s a back issue or a pelvic issue, and there’s a lot of things I can do as an orthopedic PT, but bringing on Dr. Jenn was a huge change for me, because now I have a resource within the office. Sure. Women don’t want me, you know, doing anything that’s pelvic related for the most part. So that will make it much, much easier. conversation. So I’d love to kind of your perspective on that.
Yeah, I mean, yeah, I mean, just that whole well rounded, approach for sure. And, you know, they always have a great relationship with you. And just because you got another provider in there doesn’t mean they disliked the other provider, any less that I think people there, they love your practice even more, because they see that you’re interested in them as a whole person instead of just Just what you can do, right? And you’re not out to just what can the patient do for you? Right? It’s what can you do for the patient, and they really feel fully taken care of in that really well rounded approach. And I think that definitely pays off in the end when they know that they matter. And they’re not just hamster stuck in the wheel and churning people in and out just to make the bottom line. So
100%. Yeah, I really agree. People want to feel heard, cared about, like they met him in nature,
in the same time to know that they’re not the same, right? Just because you’re a woman. You’re not just a woman, right? Like you still are. There’s so many different things about you that make you who you are, and what works for one may not work for another and a practitioner who’s comes in with that, that mindset of everyone’s individual people people can tell.
Yeah, I mean, honestly, I think that’s something that I’ve really learned over the years, when people say is, do you think this is related to this? I mean, maybe it’s not something I’ve ever heard of as a side effect, or as something that goes with hormonal changes or menopause. But everybody’s different. I mean, everybody’s different. So it might be what’s happening to you. And that’s been a learning process for me as well. People really don’t just fit into little silos.
Right, right. Because you don’t fit the mold doesn’t mean you’re crazy. No, sort of variety of normal, right? And so just because you’re not in the middle, maybe more in the fringe, does that mean you’re crazy?
Art is so low, when it comes to healthcare in general, that even caring a little bit and putting in some effort for your patients goes a long way. So yeah,
I think so. I think so. And it kind of makes me sad. When people say, Oh, my goodness, thank you so much for listening to me, and I think I feel it. But it just tells me where they’ve been. So that’s it’s unfortunate, the bar should be a little higher.
I had a patient the other day just did my normal one hour eval with her like I do with everyone. And she came back the second time and she was like, I told you stuff that I have never told anybody else crazy. That’s crazy, right? I spent an hour with you and no one else has taken over time, over the years that you’ve been seeing them right to bring that up. It’s just a reflection of our rush healthcare system. I mean, I don’t think there’s any provider who’s out to provide substandard care, you know, they just don’t have the time. It’s our medical model. Unfortunately. It’s
the system To unfortunately, it can be frustrating
system. But I think there is some technique to time and work being on time and working through appointments, but still providing still providing the setting to allow people to express themselves and not feel that they were rushed. And
it’s a little bit of a trick, some do it way better than others in terms
of Yeah, yeah. And I mean, you do it some better on Sundays, when you do want others to sometimes you don’t realize that there’s more to be said. And the patient has more to say, and you realize, ooh, I did have my hand on that door handle. And I wouldn’t have done that if I knew there was more to be said. So, you know, some days are more successful than others? That’s for sure. But I do think that the model frustrates the model frustrates providers quite a bit. But I do think that within that construct, there’s a way of there’s a way of making it just takes
a lot of management and skill to to keep that consistent for sure. Makes sense? Correct. So What all do you do within your practice? I know that there’s a wide variety of things that you can do as your as a physician within this practice. So what is your specialty within medicine? And then tell me like, What exactly do you do within consultants in women’s health care?
I think it’s such a wide variety, which honestly, is what I like about OB GYN is that there is a broad, there is a broad spectrum in terms of the care that we provide things people think mostly about, oh, you’re, you deliver babies, but the majority of my day is not spent on obstetrics at all. And the majority of my patients aren’t pregnant at any one time. And so we provide care really, from adolescence, through death, really, I mean, most of our patients, of course, are in the 20 to 60, some year age range, but there are some teenagers who have horrible times with their periods. And though they may not need a pelvic exam, they certainly need help. And so we’ll see girls from the time their periods start if it’s beyond the scope of their pediatric care. And although women don’t need routine pelvic care, in their 80s, and 90s. On the other hand, problems still come up. And so there are people who we see regularly or intermittently for problems. You know, we spend a good amount of time do we doing office work, but we also do surgery, both obstetric and gynecologic. I think that also appeals to most people in women’s health care. I think for me, the draw is getting to know people across their lifetime. And being able to provide that consistency of care, but also having that surgical skill set, which I knew pretty quickly that I enjoyed. So I’m not sure that that really tells you what my specialty is, I think, in general, for me, the quality of care and the enjoyment of the enjoyment of getting to know my patients across their lifetime. facture my passion. And I enjoy the fact that OB GYN does kind of check all those boxes and spans a pretty wide spectrum. I
get that. And, you know, the question was hard to ask to because I’m looking at your bio on the website, and it’s four sentences, that doesn’t wrap up all that you do, of course, right. That’s why I’m asking it’s no it’s hard to say and just a couple of sentences all you actually can do. Dr. Jenn, you may know this, but how common is surgery among as being part of what you do among an OBGYN?
You know, that’s an interesting question because in the generation of gynecologic care kind of preceding me, we had a major tool, one major tool which was hysterectomy and so many people so many older women who had hysterectomy is have had hysterectomy is for things that could have at this point could be medically managed or managed with small outpatient procedures rather than major surgeries. So it’s, I’m sure significantly less than what it used to be also, in terms of major surgeries, if if you’re doing more major surgeries than minor surgeries, you’re probably not doing it right because there are so many minimally invasive, short outpatient procedures that can really improve quality of life. So, you know, surgery kind of comes at the beginning.
STL active is supported by rangemaster, the makers of the very best shoulder pulley in the world. Most people who have gone through therapy for shoulder issues have used a shoulder pulley in the clinic. But let me tell you, not all police are created equal rangemaster police use metal in the pulley mechanism rather than plastic allowing them to glide smoother and lasts much longer than a typical pulley, shop rangemaster shoulder pulleys and other rangemaster rehab products using the link in the description. Now back to our regular scheduled program
of a couple of my days a week doesn’t usually come in the middle of the day, unless it’s an unscheduled C section or an unscheduled emergency. But, you know, we dedicate a couple hours to it a few mornings so
it’s not a massive percentage of what you guys do for sure.
Sure, not in my practice. I don’t I don’t think that that’s the case unless you are in some sub specialty of OB GYN. gynecologic oncology is a lot of surgery because of course, cancer requires certainly an initial surgery. Someone who specializes in minimally invasive surgery is has a referral base of patients who specifically have complicated cases that need to be done laparoscopically or can be done laparoscopically. And there are a few people who really really excel at that skill set. So they’re gonna have a much more predominantly, oh are based practice, but for the rest of us, we’re doing a lot of preventive care, sprinkling a few problem visits a day, and several obstetric visits within and so that’s kind of how our day goes. deliveries come at all times of day and night. C sections may come in the middle of the day, you may schedule them at the beginning of the day, but gynecologic surgeries, by and large, are a couple hours in the beginning of your day, ideally. So go ahead.
You mentioned that say you mentioned that you feel like a lot of surgeries could be avoided or at least put off with try some more conservative management. What are some that maybe what are some examples of surgeries that you think a lot of people maybe jumped to a little too early?
So I don’t know. So I don’t know if that patients are looking to jump to them. But I think traditionally, every fibroid need every fibroid needed to be removed by hysterectomy. Every bleeding problem required a hysterectomy. But importantly, on your end of things where I nificantly do significantly less surgery than what I originally was trained on in residency is prolapses. Because first of all, your first prolapse surgery is your best prolapse surgery, so you really don’t want to have to do it over and over again. So to that end, you probably don’t want to have to have prolapse surgery in your 30s you really really want to put that off for a few decades, if it’s manageable. And so I wait have become way more proactive with my patients postpartum or when they come in with symptoms, to use pelvic floor physical therapy as a preventive measure as well as therapeutic but sometimes you can really predict that these things are going to happen down the line and patients have become more accepting of the idea that pelvic floor physical therapy is something that they’ve heard of and that interested in they are interested in doing things to help prevent having incontinence and prolapse and those kinds of things in the future. So that is something that’s really changed for me from the time of training to the to this point in time where more and more and more I can see that patients are are having success with therapy rather than needing surgery? Which is great.
Yeah, yeah, the sex success rates with PT for preventing prolapse surgery are pretty huge. I’m glad to hear you say that you’re noticing people coming in like having already heard of pelvic PT and such because I also get people that say, Oh, I, I have prolapse, I know, I’m just going to need that mesh surgery, and they just don’t want to go and see their doctor because they think that that’s gonna be what they’re told is they need surgery. So the more we can get the word out there, right, though, surgery is not the first line of defense.
You know, and I think it’s generational that because I think that younger women have heard of it, because first of all, generationally, younger women now are to each other, talking to each other a little bit more about the problems that they’re having after childbirth. It’s also on social media, and there’s nothing like a pregnant woman or a new mom, and social media, for better for worse, there’s some not so great information out there. But I think a lot of my patients have heard that perhaps they should be doing some pelvic floor work to either combat or prevent things that can happen. during childbirth, I would say that more my 50 and 60 year olds 50 isn’t that old anymore. But it’s probably true that when I see people in their 50s, and 60s, I’ve never heard of it, they’ve never heard of it. They definitely want to make sure that it’s going to be a woman. And definitely want to make sure that it’s not going to be weird, right? Who wants weird, right? But once they kind of get over the hump, and I assure them that they’re it’s common, their therapists who are specialty trained in just this, they tend to all be women. They take that leap. And they do have good results. Yeah. Very cool. Good deal.
So I wanted to kind of jump back just a hair, you mentioned that possibly part of what sets you apart, is that relationship side the building the trust over the years that someone might work with you over a lifetime? Is that something that came naturally to you? Is that something that you have to work towards? Like, because for me, it was kind of natural to, you know, start to build relationships, what I hear within some coaching calls with other physical therapists that they’re like, Well, you know, I treat the patient I go home, and they’re not necessarily as accessible or not necessarily in to sharing personal details to build that personal relationship. So I just kind of hear, I’d like to hear your perspective on that.
I think, I think it comes in a way it comes naturally. I’m naturally relatively chatty. When I was younger. It was something to my detriment. I feel like I’ve kind of honed it. But I don’t mind sharing personal details. And I do think that for people to know they’re not alone, and that this is common, and it’s not something to be ashamed of, and lots of people go through it, I think that’s really helpful. And I’m, I don’t mind sharing those details at all. I enjoyed bonding with my patients and seeing the relief that they’re not alone. And this is, you know, unpleasant, but not unusual. Honestly, and, honestly, I actually really enjoyed surgery and thought a lot about orthopedics. And the thing that made me decide to do OB GYN, among others, I suppose, is the fact that it’s a long term relationship. And there are some orthopedic patients who are long term relationships. But by and large, it’s just episodic care. And I knew that that’s what I liked. And so it’s a little bit a little bit by nature. I will also say kudos to the group that I joined, and the men who were my mentors when I joined that group, because they really, really, really pushed the model of treating our patients, like our family. And I think having those good role models, when I was new in practice, really pushed me to do the right thing and to develop that part of my personality and my skill set. I’m sure with different mentors, it could have gone in a different direction. But I think it was probably a combination of all of those things that It was kind of naturally what I was drawn to. And I was very fortunate to have had that gut feeling that this was the right place for me to go and practice. And, you know, these guys really helped me develop myself professionally and personally within the field is it’s obvious that you have a passion for this, like, easy to tell just by watching your body language talking about this, but it’s got to feel rewarding to know that, you know, your your nature fit this, this business as well as this profession. That’s really cool.
Yeah, I feel, honestly, I really do feel lucky, because I think you guys know, working with people all the time that you love what you do, but not everybody gets that when they wake up in the morning, a lot of people are going to jobs that they don’t like, or working with people that they don’t like, and not every day is a great day, you never you don’t wake up 100% of the time, happy go lucky. But when I walk in the door, I’m surrounded by good people. I have patients who are amazing and tell me amazing stories. And I really to feel privileged to have a job that I love to work with people that I like, and to have really kind of an amazing group of patients.
Yeah, you know, I was thinking about this the other day, I’ve got a patient that I had seen for months and months dealing with this chronic thing. And, you know, when they were done, it’s like somebody’s missing from your life, you know, you get to spend at least an hour or two a week with them. And it you know, it’s somebody that you get to know as a human, not just as a client. So it makes a difference. Yeah. Makes a difference. For sure. Yeah, for sure. So we had talked about this before we started recording, the importance of care postpartum, I’d like to kind of have you guys get into that a little bit to tell us what are some of the difficulties that women might have postpartum? And then what should they be doing after having a kid?
Sure. Jeff, do you want to start?
Yeah, I mean, I, I always like to say, my favorite all-time thing is common, is not normal women. So women who have incontinence or pelvic pain after childbirth, it’s well common, it’s not normal. And I think it’s like 92% of women, something like that, that have incontinence, three months postpartum. So 12 weeks, we’ll still have incontinence five years later. And somehow they think it’s just going to get better. And the more I’m all about being proactive, right? That the sooner you start taking care of your pelvic floor, that you’re going to decrease pain with sex, decrease peeing in your pants, wants to cross your legs every time you sneeze, you know, he wants to do that. And we were talking earlier, kind of about the prolapse right? 99% of the time due to poor support. A lot of times from the pelvic floor sometimes we ligaments, of course, but I think that’s that’s my Yeah, so I think that’s what I’m, that’s my favorite population to work with. They feel like you just nip off so many problems right in the bud before they even come a problem become a become a problem. Perhaps one of the things that, for me is a little frustrating about our medical model in the US. I know in Europe, like mainstream, you go to your six week checkup with your OBGYN, you get the thumbs up, and then you go to pelvic floor PT. In the US, it’s like, well, you might have a problem better. It’ll get it’ll get better. Or if it doesn’t, it’s just normal. You know, I had a woman here the other day. I’m sorry, I talked her on the phone. She’s coming in next next week, but she told her doctor, she was having pain and leaking after her baby and the doctor told her to sit on a tennis ball. That was the solution.
Wow. Yeah. Yeah, I was I haven’t heard that was like, either try to think that went through maybe to work on Kegel or she was
really trying. She comes in, I’m gonna try and ask her like, did they tell you how that was supposed to work? Because I don’t even sometimes I can see it. You know what they’re trying to get. At that time, I was like, Yes, I think that’s yeah, one of my loves is that the postpartum period because there’s so so much positive that can be accomplished in a short period of time. And the sooner you get something, the easier it is to fix, of course.
Yeah, it is. It is. And I think, again, it’s part of being in the US is a lot of times people only have that six week postpartum, and then they’re back to work. And they’re trying to juggle this new life of working with the baby, and everything that comes along with it. But I think for some of these women who have 12 weeks, you really can get a lot done in that six to 12 week mark. And I think a lot of women are fair I’m happy to do it in that period of time that they have a little bit of flexibility. And you know, of things that are wrong with our system. Availability, the availability of pelvic floor physical therapy, you know, you guys aren’t every incredibly
Yes, sir. Getting more, it’s more it’s more common now than it was.
But certainly, yeah, it’s
still definitely a specialty that not a lot of people are in.
Yeah, I mean, there’s a lot we could do for postpartum women. I think in Europe, they have a midwife visit them at home after they go home, wouldn’t that be great to someone to make sure you’re not depressed that breastfeeding is going okay, that you’re buckling the baby in the car seat appropriately, that you know, all the things that we try and talk about on your way out the door when you’re sleep deprived and overwhelmed, and all of that, that it’s sticking and working when you get home? Those are really great things. And, you know, we think we just don’t emphasize these preventive measures. Enough. Yeah.
You think about like when you’re pregnant, the whole time you’re pregnant is focused on getting the baby into the world like labor. And then we spent all this time talking about something that lasts average labor, what’s it what’s the average labor last 24 hours?
Be a long one, but not so abnormal? If it was your first
time basing that off? Yeah, but so 24 hours or less, most likely, right all the time, then we have to live with the results of this for the rest of our life. And we spend a minimal ton of time on that. It’s just kind of funny how the focus is on this less than a day-long event. And then there’s something that addresses what you’re going to deal with every minute of every day for the rest of your life.
Yeah, it is some stuff. It is unfortunate. And I say yeah, I say things similar to people. This isn’t abnormal. This isn’t unusual. But it doesn’t mean you shouldn’t want it fixed yet, doesn’t mean you shouldn’t aim for better.
So I know how many times a day I say that it’s common, not normal, but fixable. That’s my schpeel, over and over.
Dr. Rispoli, and I were talking about a client that was referred to her. And after her six week follow up, the doctor said, oh, let’s wait another six weeks for PT. And so, again, I don’t know enough to even have any clue as to what the answer to this question might be. But why would that? Or what situations would that be the case where six weeks is not enough time of recovery or not enough time of you know, healing to be ready to go to PT, because from a orthopedic side of things, we’re seeing people the day of surgery at time, so and that’s a term
right. And I mean, it might be a lack of training on our part, honestly, I mean, in my training, I was lucky to come across at WashU and amazing pelvic floor physical therapist who really opened my eyes to how many pain issues really are of the pelvic floor can be related to your back that how everything, you know, kind of lumbar spine down can work together. But even still, I think despite the fact that I have that amazing experience, and really have learned to utilize my pelvic floor physical therapist, I think by the same token, we also learned well, if you’re breastfeeding mom, and your postpartum every month, your incontinence will get better, and it’ll get better through six months. And if it’s not better by six months, then it’s probably not going to get better. And I actually was just thinking to Jen, what degree of getting better on its own still requires early intervention, physical therapy, everyone.
I always like Yeah, I mean, I always like to say that there are so the key goals like the no all exercise, right? Everyone’s heard to just keep it. However, most women don’t do them correctly. They’re either bearing down like doing the opposite of what they’re supposed to be doing. Or they get the contraction part of it and not the relaxation portion of it. So it’s like having a muscle on all the time. Right. And that’s no good. I always so I always say it never hurts just to get one visit. Just make sure you’re doing right because it is the foundation and I know women in my same field who have tried to tell a treat or a person who wasn’t comfortable with the exam, just hey, this is how you do a kegel and they thought they were doing them right but then they end up coming back later because they had created a problem because they weren’t doing it properly. So yeah, I was thinking it’s a good just like a wellness check, you know, Don’t wait, you know, they say, women wait an average of seven years to go get help. You’re cured out I’m aware of. Yeah, that is true. Yes, yeah. And then you’re cured of stress incontinence most of the time in six weeks. It’s pretty straightforward. Stress incontinence for our listeners, when you cough when you have leaking with coughing, sneezing, running, jumping, those kinds of things. So, I mean, it’s probably my bias, because this is my field. But like, why would you want to keep waiting and seeing if it’s gonna get better on your own, or you can just go, and I get some that are
very clearly abnormal at six weeks. Yeah. And there are some that appear to be headed in the right direction, just kind of by nature, I would say that mostly when I send people is when I can tell that they have no control of pelvic floor muscles at six weeks when I say, squeeze, and they think they’re doing it and I maybe feel nothing, maybe feel a little twitch, then I know, I can’t, there’s nothing I can tell you to do. Because you need someone to help you find those muscles again, right? And you’re going to feel like things are falling out even when they’re not actually falling out. Because your pelvic floor is weak. And so it’s tough. Your brain is telling you that things are falling out, but they’re not really right. So I think a lot of a lot of that has become very obvious over time that that early intervention is well received by patients. Yeah. And super helpful. Right?
And even in those instances, you know, your question was how, how long have you wait to see if people get better on their own? I think sometimes even just to see your six weeks, and you’re like, you know, maybe maybe not, but you could get better on your own? Because the truth is, yes, some women do get better on their own. It’s even just the fact even just having maybe a follow up call, like, hey, we were supposed to be kind of working on this, you know, 1012 weeks, is that better or not? So I think it just gets the craziness of the postpartum period gets shoved to the side. And their mom’s telling them what’s normal, you know, and then they just forget about it for years, until their friends that they’ve been talking to are like, Oh, hey, I finally got this fixed. So I think even just a little bit of follow up, sometimes just to bring it back to the front of their mind, because the truth is, no woman wants to be peeing in their pants, right? Nobody wants that. But it just gets pushed off and out of sight out of mind.
And I was gonna say the education part is, even if there’s no intervention, and it’s just a lot of questions and education on what to expect. And if you’re not doing this by this date, and if you’re not experiencing these, you know, achievements or whatever, then then you need to seek more formal intervention. And physical therapists are fantastic at educating people or they should be. I think we are. That’s yeah,
and most of our time doing right, way less
of hands-on treatment and way more education when it comes to what we do. So I think that’s certainly an intervention that’s different than just formal physical therapy, which can be scary.
Yeah. Yeah. And you know, and I think, really, it’s something that I’ve learned more about as time goes on, and really utilized more frequently as a tool in my tool chest because just really much nicer when people feel better, rather than coming back later to say, ever since I had my kids this horrible, you know, I can’t go running because I’m paying the whole run. That’s, there’s nothing like having to start something that you enjoy. Because physically, you’re not capable of it anymore. To make you feel pretty down.
Makes sense. Yep. So I want the listeners to know a little bit more about you. So do you have any awesome hobbies that we need to know about? Or maybe want to tell us your favorite thing to do in St. Louis, just to kind of learn a little bit more about you.
I like to play tennis. Unfortunately, I’ll probably never be on the tour, but a lot less stressful. But I play tennis as much as I possibly can. And things around St. Louis, obviously I love honestly, I love biking. We love going to Cardinals games. I’m excited for the new soccer stadium and lie enjoy all the delicious restaurants around town. So you know it’s probably changed quite a bit. Since my kids were little, and we spent a lot of time at the magic house in the zoo, and all the great parks with them, there’s so many things to love about having small kids in St. Louis. But now that the kids are older, we probably indulge in Sure, a different set of things because they’re fun to go to a hockey game with and they’re, you know, we don’t have to write in the third inning of the Cardinals game. Really kind of have enjoyed the whole spectrum of things. As our kids have gotten older,
what got you interested in medicine to start with? Usually, I asked that earlier but kind of forgot, so I kind of want to hear.
So, honestly, my dad’s an orthopedist. And maybe I’m just a daddy’s girl. I don’t know. My brother certainly had no interest in medicine. So it wasn’t like he pushed it any but I was always just at home, going to the hospital with him rounding with him, he would take us sometimes and we’d visit his patients. It was always something that I felt comfortable with. So I kind of always thought I wanted to be a doctor. And I think initially it was just from a very childish perspective. And I think as I got older, I entertained other thoughts. This is the one that just stuck a little bit. I think it’s just lucky. Because what did I know when I was young? And I think most people find themselves in college, I certainly expect my kids to try and try something else and try something else. Because in retrospect, I think it was just lucky that this really did turn out to be the right thing. I think I hardly knew what options the world held. When I was young. I mean, when I started medicine, I didn’t even know what occupational therapy was, you know, and it’s such a big part of the spectrum of medical care. And I mean, I didn’t even know that it existed. There’s so many things that I really didn’t know much about. And I think I was just fortunate that I kind of felt like this was a place that I was comfortable. And it worked out.
I love it. That’s funny. I didn’t know that physical therapists worked in hospitals. When I started PT school, had no clue. I’ve never known a hospital stay. So never saw that. And I had had so much outpatient PT myself that that’s, that was my scope of knowledge of what PT was. So had no idea that’s really funny.
Yeah, I mean, there’s nothing like having kids yourself, to realize how young you are when you’re a teenager. You know, when you are a teenager, you think you’re old and your parents are kind of getting dumb. And you’ve got the world figured out. But when you’re looking at your children, and people say, Oh, what do your kids think they want to do? I think, seriously, I mean, they’re 1415 We know they’re 18 and almost 16. But even so I think that’s a big ask because your life has such a small scope. And I really hope my kids go to college and try a little bit of everything. And really make sure that they find what they’re passionate about whatever it turns out to be. But it’s so interesting. How in looking back at how old I felt single-minded I felt at such a young age and really it’s just good fortune that it worked out because I didn’t know anything at that time.
Looking back because I mean, my program, it was a six-year program that you started as a freshman so I mean, I had to decide as a right STL active is supported by Lydecker. My DEXA is a physician formulated St. Louis based CBD company. They have a huge variety of CBD products, including isolettes, tinctures, gummies, and my personal favorites, CBD gel and CBD Epsom salts. I’ve personally use these at home and in the clinic, go to to shop all of these great, great products. Our listeners can use code JSR five at checkout for a special discount. Again, that’s slide decks co JSR five for a special discount a young senior late junior in high school what I wanted to do for a doctorate degree. That’s crazy. That’s crazy to think about, you know,
it is crazy. So don’t you feel
I do know there’s a lot that I love about what I do. And I’m glad that I was able to start a business to only do the parts I like you know, I made my own fate to an extent so it’s a good thing
right but it is it’s a lot to ask of really a 161-7 year olds when you start making those choices and looking at where you’re gonna apply.
I was 12 when I thought I wanted to be a PT, and I’m like, Wow, amazing. That is
still the case. 20 years.
That’s right. Yeah. And I kind of wanted to be an OBGYN is anything I floated around, but I didn’t want to go to school for 25 years and pay off my debt for the next 80 years. Whatever it’s like these days.
It’s not worse now than it was. Yeah. than it was when I went, that’s for sure.
So I just blend it, you know?
I mean, right. That’s perfect. Exactly what I thought Yes. Oh, look at you. You’re helping that exact clientele? Yep. From the PT standpoint.
Right. Dr. Jen, any other questions for Dr. Smith?
No know off the top of anything else you want to share? Anything else?
I think the most, I think the most important thing for our listeners is to just make sure that your doctor knows what’s going on with you. I do think that most of us really want to help. And we may try something and it may not be the right thing. But then come back and tell us that that didn’t work, don’t give up. Because we really don’t know everything. You know, we know what it might be. And then what it’s not that we can cross that off the list and move on to the next. But it does really require that conversation and don’t be afraid to tell us don’t be afraid to tell us that it didn’t work. Because that you know, really in the end, we want what’s best, but it may take us a few tries to get it right. We’d love to get right on the first time, but it’s not always the case. Right.
So if someone wanted to find you, listening to the show here, how would they get in contact with you guys?
You can find us on the web. See w h consultants in women’s health care is our phone number for the office is 314-432-8181 put
that information in the show notes everyone so please feel free to check them out. Any last thoughts guys?
No, I really appreciate it. Talking to me. Appreciate you coming on the show. Thank you so much.
This has been STL Active.
Thank you for listening to the STL Active podcast from If you enjoy the show, please spread the word. Thanks again and see you next time!