Title Pending
Off The Charts Podcast
Hosted by Dr. Bobby Parmar
[Dr. Bobby Parmar, ND] (0:00 - 0:09)
Why do we not offer pain management for medical procedures and why do you offer pain management?
[Dr. Alex Dragan, ND] (0:10 - 1:01)
Well, I'll tell you a little story, a personal story of my own in the context of IUDs. I myself have had three IUDs all without pain management and it freaking hurts. It is so painful and I'm someone who I think has a pretty high pain threshold, like almost passing out in all of these procedures.
Once you've experienced that, you never want to put another woman through that kind of pain, especially in the context of a medical procedure where it's already feeling like they're charged. I really feel like the bar is set so low in this area. It's like, why are we not using pain management?
This seems so simple to me. When people learn that one, they can trust me, but also they can trust themselves, that is where like the magic happens and I want to encourage women to trust their own bodies.
[Dr. Bobby Parmar, ND] (1:02 - 1:36)
High off the charts, we have a theme happening lately in the series of podcast guests that I've had. We're all about women's health and I brought a dragon to show us the way. Meet Dr. Alex Dragan. It's, we're like, it's the year of the dragon or the year of the fire horse, but in this studio, it's the year of the dragon. So thank you for joining us. We're going to talk about women's health and I have lots of questions because Dr. Dragan does some really cool things in her practice, which aren't done often in the naturopathic world, pioneering.
[Dr. Alex Dragan, ND] (1:37 - 1:40)
Oh, wow. Thank you so much. I'm so excited to be here.
[Dr. Bobby Parmar, ND] (1:40 - 1:59)
I mean, it's the tea. There's a lot of things that you're doing that I think even like the regular conventional world isn't necessarily doing, and I would love to understand why you do the things that you do. How come you came to the decisions you did about like how the services you offer are offered the way they are?
[Dr. Alex Dragan, ND] (1:59 - 2:00)
Yeah, go ahead.
[Dr. Bobby Parmar, ND] (2:02 - 2:21)
One of my most important things I want to get across to the female population is pain management. Why do we not offer pain management for medical procedures? And why do you offer pain management?
[Dr. Alex Dragan, ND] (2:22 - 3:42)
Well, I'll tell you a little story. A personal story of my own in the context of IUDs, right? So I myself have had three IUDs, all without pain management.
And it freaking hurts. It is so painful. And I'm someone who I think has a pretty high pain threshold and like almost passing out in all of these procedures. So it's like once you've experienced that, you never want to put another woman through that kind of pain, especially in the context of a medical procedure where it's already feeling like they're charged. I don't know.
Like I know growing up, I had a great medical doctor, but I always felt nervous going there. I never felt like super comfortable spilling all my secrets, you know? So I think that's part of the reason why I do this.
I never thought that I would do a PAP or insert an IUD ever in my naturopathic medical school. But once I kind of experienced that, like that change in women when they've experienced pain in the past and it's much more comfortable when we're managing the pain, it was like, oh, my God, I need to do this and shouted from the rooftops.
[Dr. Bobby Parmar, ND] (3:43 - 4:53)
OK, I have so many questions. Yeah. I empathize with that where you just said you don't want to spill all your secrets to your health care provider.
I just went to LifeLabs. I went to the lab just like an hour ago to get my blood taken because my provider wants me to do some tests. And if I caught myself speaking to the phlebotomist, “I was just like, oh, yes.
OK, yeah. I'll go over here. Nope.
Oh, do you want me over there? How much pee do you want? Oh, sorry, I didn't.
It feels like I'm doing like they're doing me a favor. And I'm bothering them. Yeah, I have that feeling like I'm bothering that person whose job it is to do the thing.
And I also feel that way with my health care provider. I'm just like, oh, I just have one question. Do you mind if I ask one question?
And this is in settings of just me doing like preventative screening of things. I don't actually have a concern right now. So for somebody to have that kind of feeling of having to summon a kind of bravery to bring up stuff that is our sensitive topics, and maybe it makes the provider uncomfortable.
That must be even that much more challenging to sort of like say this hurts.
[Dr. Alex Dragan, ND] (4:54 - 5:58)
Yeah, I mean, I remember lying there on the table like I am about to pass out. Can you please just shove this thing inside of me? Like, just get it done.
And she was like, did she use freezing? Because this hurts like in a weird way. It just feels wrong.
The cervix is innervated differently than like your skin. So you don't feel pain the same way. And maybe that's hard to communicate when you're feeling those feelings.
It's innervated by the vagus nerve, which, you know, governs our nervous system, fight or flight. And so a lot of people get like nauseous and [indiscernible] and just feel strange. And that's a different kind of pain.
It can be really hard to communicate that. So in my, you know, four walls when I'm with someone, I really want to make them as comfortable as possible. And consent is throughout the whole procedure.
You can say no at any time. We can stop at any time. If you say no, as I'm about to put the IUD in, we stop, right?
Like this is your procedure. I'm just here to offer you, you know, all of the options and all of the services.
[Dr. Bobby Parmar, ND] (5:59 - 6:01)
Why does that feel so revolutionary?
[Dr. Alex Dragan, ND] (6:01 - 6:04)
I don't know, because we live in a patriarchy.
[Dr. Bobby Parmar, ND] (6:05 - 6:07)
Is that it? Is that it?
[Dr. Alex Dragan, ND] (6:07 - 6:56)
I don't know. I mean, I've had patients tell me that like they've had polyps cut off their cervix and the gynecologist tells them you won't feel pain because the cervix has no nerve endings. It's like, I'm sorry, who are you to tell me how I experience a procedure that is quite sensitive?
You can't see what's happening unless you have a mirror. You know, it's so vulnerable. So I feel for any woman, even just getting a PAP test can be so hard and traumatic.
And even if you had no sexual trauma, you could be traumatized by a speculum. Right. So, you know, I think it's important because these devices and procedures such as PAPs are so important to women's health that people are avoiding them because of fear of pain or because of past traumatic experiences.
[Dr. Bobby Parmar, ND] (6:56 - 8:13)
Yeah, I get that all the time. All of my, like when I have this conversation with my female patients, I'm just like, have you considered an IUD? There's an immediate, reflexive, no, why would you even suggest that you're going to do that to me?
I'm just like, hang on. And then I always follow with, listen, I am partnered with a clinic that offers IUDs and other pelvic services like screening of things and all kinds of assessments. What if I referred you to this very special group of women who are really woke to pain, trauma, information, and empathy, and then also like really consensual along the way.
And they're always just, first they're in, I have to think about this, a kind of like disbelief that that kind of thing exists. And that maybe I'm just saying that to get them to do it and that they're still going to show up and barf all over the place. How do you help people understand what you're doing with them that's different from their visceral fear of getting these kinds of things?
[Dr. Alex Dragan, ND] (8:13 - 9:50)
Yeah, I think a lot of the fear either comes from one, a past traumatic experience, like you've had an IUD or some procedure and it was horrible, or a whole lot of misinformation or no information. And so there's just a lot of stuff. I don't know why IUDs get such a bad rep.
There's stories of like IUDs wandering around the body. It's just like, where is this coming from? I don't really know.
I think number one is I'm really curious about where people are coming from and what their stories are. And so just being heard and having a healthcare provider actually listen to their experience is so, so valuable. And that immediately allows them to have more trust in the process.
And the second part, which is the fear of the whole procedure. And so there's no surprises. I'm going to tell you exactly what's happening before we even get to that appointment.
I'm bringing you through the process. First, we do the ultrasound, then we do this, then we do that, so that they kind of know what to expect when they come into the office. And I'm going to repeat it again and again and again, because when you're anxious and afraid, information is like, right?
And I'll tell people, like, did you remember when I said this? And they're like, actually, no. And it's like, that's completely normal, because your nervous system is so jacked up because you're so afraid.
And that is also part of the pain experience is the anticipation and the fear going into this. So if we can kind of like let the guard down and make you feel comfortable before we even get to the actual insertion, it's going to go way smoother.
[Dr. Bobby Parmar, ND] (9:51 - 10:13)
And the fear, like the trust is huge here. And that all the steps that you take to help encourage that trust are obviously very important. How are you finding people's response to you?
And are they like, okay, I actually feel like I'm trusting this process. Is it like 90% of the time? Is it 100% of the time?
[Dr. Alex Dragan, ND] (10:14 - 10:17)
Like trusting me to complete the insertion.
[Dr. Bobby Parmar, ND] (10:17 - 10:37)
I'm curious how many people actually are like healthfully disarmed, you know, like not just disarmed because you like massage them mentally and emotionally, but because they're just like, you know what? Yes, I will follow through. You have helped me understand that this is not going to be what I heard from so and so.
[Dr. Alex Dragan, ND] (10:38 - 11:51)
I would say it's probably still somewhere between like 50 to 70%. Even, you know, as good as I am, I really think that that back-of-the-head rhetoric that people hear all the time from their friends or from this TikTok that they saw, they still come in. It's not that they don't complete the procedure.
Other times after the fact, they're like, oh, that actually wasn't so bad or it wasn't what I expected or it was much better than I expected. But I can still see that their body is armed, right? It's like, you know, bracing for impact even when I've like explained everything.
But I really think that which is mind-boggling to me because I feel like this is not revolutionary. Like you have a choice and you get to decide and you can say, no, that should be standard. Like I really feel like the bar is set so low in this area.
It's like, why are we not using pain management? This seems so simple to me. But I don't know where I was going with this.
But basically I think when people learn that, one, they can trust me, but also they can trust themselves. That is where like the magic happens. And I want to encourage women to trust their own bodies.
[Dr. Bobby Parmar, ND] (11:52 - 12:09)
How do you help them not psychologically, not mentally? How do you physically help them not experience the kinds of pain stories we hear that people go through, through providers that say to them, like, you don't need anything. You're numb down there.
Yeah.
[Dr. Alex Dragan, ND] (12:11 - 12:14)
Okay, well, there's many different things that we do. Number one.
[Dr. Bobby Parmar, ND] (12:14 - 12:16)
I love this bit because I'm, I want to learn to read.
[Dr. Alex Dragan, ND] (12:17 - 12:49)
Okay, we start with Advil. Ibuprofen. A little Ibuprofen for you coming for your visit.
That's just kind of like a preemptive. We're going to help support cramping through the procedure. That's like the bare, bare minimum, right?
I have only ever had one person decline a cervical block, which is where we basically put Lidocaine, which is an anesthetic. So it blocks pain throughout the entire cervix. And so here's our little anatomic.
[Dr. Bobby Parmar, ND] (12:49 - 12:53)
I actually don't know how you do this. So I can't wait to see this.
[Dr. Alex Dragan, ND] (12:53 - 12:56)
Yeah. So, I mean, this is like a tiny little muscle.
[Dr. Bobby Parmar, ND] (12:56 - 12:57)
She brought props.
[Dr. Alex Dragan, ND] (12:58 - 13:26)
I'll block the sign here. So we have the vagina here. We have the cervix.
That's the opening to the uterus. And yes, the cervix does experience pain. It's different than other parts of the body.
But we basically put a little needle. It's kind of like when you get your tooth numb to get a cavity. Um, we put two needles into the cervix.
It's kind of hard to demonstrate with this. And that blocks some of the pain experienced through the cervix.
[Dr. Bobby Parmar, ND] (13:26 - 13:27)
What does that feel like?
[Dr. Alex Dragan, ND] (13:28 - 13:56)
That is so variable. Some people are like, oh, I didn't feel anything. And some people are just kind of like, oh, you know, like it's kind of just jarring.
Again, like you don't have the same pain receptors that you do in the skin. So it's not like poking your arm with a needle. So it's more like pressure, like a deep pressure feeling or like a heaviness.
But, you know, I tell people if you've ever had a cavity done, it's like the initial poke is like, oh, but then once it's in, it's numb.
[Dr. Bobby Parmar, ND] (13:58 - 14:03)
And the standard of care is to offer this or not offer this?
[Dr. Alex Dragan, ND] (14:03 - 14:18)
It's changing. So now, yes, it should be absolutely should be offered lidocaine. This was this is newer because when I had my IUDs done, which was not that long ago, like, let's say four years ago, I was not offered pain.
[Dr. Bobby Parmar, ND] (14:19 - 14:23)
Because the guidelines suggest that you don't need to and that's changed?
[Dr. Alex Dragan, ND] (14:24 - 14:34)
I'm to be honest, I'm not quite sure of like what the, um, Society of Obstetricians and Gynaecologists of Canada (SOGC) has on their guidelines, but I believe it should be offered.
[Dr. Bobby Parmar, ND] (14:35 - 14:40)
And that if you're not offered it? Find someone else. Okay.
[Dr. Alex Dragan, ND] (14:40 - 14:43)
At least you should be offered it. If you want to decline it, that's your choice, right?
[Dr. Bobby Parmar, ND] (14:44 - 15:19)
In my head, I always thought it was like, um, there's definitely a patriarchy because like what isn't. But I also thought it was like cost. I thought maybe there's like, we're just kind of cheap in medicine with stuff that we're like, we don't need to spend money on that in the healthcare system.
So like, we're not going to provide the resources to like make this system be in place that might cost, I don't know, $15 per time. If you can just shove it in there and call it a day because nobody feels anything. I feel like that's maybe part of it, too.
There must be some accounting thing happening. But who knows, like, how are we ever going to know that?
[Dr. Alex Dragan, ND] (15:19 - 15:45)
I think it's cheaper than $15. It's way cheaper than that. But I think it's because there was this like idea that the cervix has no nerve endings.
I think that is what, and also like how we don't listen to women. And everyone is like, oh my god, this hurts so badly. And it's like, no, you know, like we're not listening.
So I think maybe cost is part of it. But I also think that there was this idea that the cervix is not innervated.
[Dr. Bobby Parmar, ND] (15:46 - 15:51)
So you then offer the Advil, the Lido. Then what?
[Dr. Alex Dragan, ND] (15:52 - 16:19)
Then we also have this right here, which is called PENTHROX. It's an inhaled analgesic. So basically another like pain management.
Not everyone uses this, but for people who are particularly anxious or have a lot of like reservations around this or have had a previous insertion that was really painful, they can use this through the procedure. So it's better than Ativan. It's more effective than Ativan, which is.
[Dr. Bobby Parmar, ND] (16:19 - 16:42)
Oh, let me tell you. I know someone who I called an ambulance on. You know who you are.
And they were in a lot of pain. The paramedics came in and I had never seen this before. And there was like, grab this whistle.
And I was like, what is that? And they're just like, make sure you like cover it, I think, because otherwise the whole room would get high.
[Dr. Alex Dragan, ND] (16:42 - 16:42)
Yeah.
[Dr. Bobby Parmar, ND] (16:42 - 17:07)
And they're just like, make sure you cover it while you're inhaling. And this person didn't do that. And they were just like, whoa, whoa, whoa.
We're all going to be high at the end of this. So like, make sure you cover it. And within seconds, they were not in pain from extreme pain before this.
So when you when you guys started offering this, I was like, really? That's amazing. Yeah.
[Dr. Alex Dragan, ND] (17:08 - 17:40)
And you know what? A patient told me about this. So I'm learning every day from patients because it's frequently used in Australia.
And for this purpose. Yeah, IUDs. And so I looked it up and I was like, oh, it's within our scope.
You know, why not use it? Let's try it. So I used it on this first patient who kind of alerted me to this.
And it was amazing. And so, yes, if you like inhale and kind of blow it out like a vape, there is going to be some whoever's in the room can like inhale some of that. If you actually put your finger on here, it just gives you a more intense dose when you inhale.
[Dr. Bobby Parmar, ND] (17:41 - 17:51)
And you're choosing to offer this. So now you've offered two things. This is the third.
Yeah. You're choosing to offer this to select people or you give everybody the choice and then it's like, no, I don't need that.
[Dr. Alex Dragan, ND] (17:52 - 18:03)
I pretty much give everybody the choice. And a lot of people will decline the PENTHROX just because they're like, I don't think I need that. Or they've had previous IUDs and they're like, yeah, it was fine.
[Dr. Bobby Parmar, ND] (18:03 - 18:11)
I would be whistling Dixie on this thing. I would be like, I would be like, why would I not take it? I'm going to take all five stages of pain management.
[Dr. Alex Dragan, ND] (18:11 - 18:21)
True. Some people choose to not have it for other reasons. You need to have someone drive you home after.
So if they don't have someone that can drive them home, you know, they're kind of considering that as well.
[Dr. Bobby Parmar, ND] (18:21 - 18:22)
Logistic.
[Dr. Alex Dragan, ND] (18:22 - 18:24)
There's a lot of logistics. I'm amazed. Yeah.
[Dr. Bobby Parmar, ND] (18:25 - 18:26)
And then this makes them feel.
[Dr. Alex Dragan, ND] (18:27 - 18:36)
It kind of makes you feel tipsy. And then you're like, can I take this home? This is great. This is better than like party drugs. I'm like, no.
[Dr. Bobby Parmar, ND] (18:36 - 18:38)
Well, let me just put it in your goodie bag.
[Dr. Alex Dragan, ND] (18:40 - 18:51)
We do take this away for so at the end of the visit. But yeah, it really reduces anxiety. It works very rapidly and it reduces also sensation of pain.
[Dr. Bobby Parmar, ND] (18:52 - 19:00)
Does it make anybody like, is there a side effect that people should be aware of so that they're like, oh, I'll get a headache later or something? And I don't want to deal with that. Or is it like, no, it's pretty.
[Dr. Alex Dragan, ND] (19:00 - 19:20)
I would say there are possible side effects, but by and large, most people tolerate it really well. And it's out of their system pretty quickly.
In BC, we don't recommend driving for 24 hours. But that's, again, more of like a ICBC insurance thing. I see. Versus it's still in your system tomorrow.
No. Oh, interesting. Yeah.
[Dr. Bobby Parmar, ND] (19:21 - 19:23)
Like you're not. It's like a DUI.
[Dr. Alex Dragan, ND] (19:24 - 19:37)
No, it's just that if you, let's say, have an accident tomorrow and you had your IUD yesterday with PENTHROX, they may not cover you for that. I know. That's crazy.
[Dr. Bobby Parmar, ND] (19:38 - 19:56)
That's such a tell, like your girlfriend's just like, I can't drive anywhere today. I'd be like, did you get an IUD yesterday? Why can't you drive?
That's weird. What a tell. So there's three things.
Are there... Okay, next, let's back up. Is this seldom used here?
[Dr. Alex Dragan, ND] (19:56 - 19:57)
Um, I would say.
[Dr. Bobby Parmar, ND] (19:58 - 19:58)
Amongst clinics.
[Dr. Alex Dragan, ND] (19:59 - 20:32)
It's becoming more common. So one of the main reproductive clinics here uses that. But again, like when I had my own experiences, never even heard of this was not a thing.
So it's I think it's becoming more commonplace. And we just had the Women's Health update with UBC and they talked all about PENTHROX.
So I'm very hopeful that this will be offered more for women, because it's just again, like that anxiety and anticipation is part of your pain experience.
And this really helps with that.
[Dr. Bobby Parmar, ND] (20:33 - 20:50)
There's this like anticipation. Yes. But there's the idea that why am I going to put myself through something that I've heard another person was tortured by?
And I think a lot of these things reduce the torture factor.
[Dr. Alex Dragan, ND] (20:51 - 20:51)
Absolutely.
[Dr. Bobby Parmar, ND] (20:51 - 20:57)
Do are there. Is there another thing on top of this or is this pain management in this world?
[Dr. Alex Dragan, ND] (20:57 - 21:22)
This is the main like devices or, you know, things that we can use physiologically from pain. But then there's other things like we have heating pads and, you know, maybe music or people want distractions like they're on their phone, TikTok, or they have a person with them like that's also part of pain management and the whole experience. But these are the main medications that we use for for pain.
[Dr. Bobby Parmar, ND] (21:22 - 22:05)
Okay. IUDs like this about IUDs right now, but we're going into other things. My curiosity is IUDs in this province became covered by the province.
They're like free basically for somebody to get. There's many choices of IUDs. There's hormonal ones that everybody wants to scratch my face off when I offer it to them.
Why would you again, why would you do that to me?
I'm like, hang on. And then there's non-hormonal ones and there's different versions in each.
Can you walk through hormonal IUDs and are there genuine concerns that people should have around hormonal IUDs that would make them not want to get one?
[Dr. Alex Dragan, ND] (22:07 - 22:58)
Again, the birth control, like the anti-birth control rhetoric. Oh my god, okay. The hormones, right?
Everyone's like anti-hormone, but there's two main IUDs that have hormones in them in Canada or other countries have other options. We have the Mirena, which is the brand name, and then the Kyleena. Both of them are a progestin, so like a synthetic progesterone called levonorgestrel. And they have different doses and physical size is also a little bit different.
There are obviously concerns with any type of birth control that we want to make sure it's safe for, you know, the person receiving it. Anatomical differences, you know, if you have the bicornuate uterus, which looks like a little heart, we can't put an IUD in that because there's another side that might get pregnant.
[Dr. Bobby Parmar, ND] (22:59 - 23:03)
Oh, hold on. Is ultrasound necessary for IUD insertion?
[Dr. Alex Dragan, ND] (23:04 - 23:13)
Ultrasound is not necessary. But it helps a lot and I think it should be required.
[Dr. Bobby Parmar, ND] (23:14 - 23:24)
Because it would identify these kinds of things? Absolutely. Because there are places that do not use ultrasound for insertion?
Yeah. Is that like a common thing?
[Dr. Alex Dragan, ND] (23:24 - 23:31)
I think it's pretty common because not every GP who's doing IUD insertions has access to an ultrasound in their office.
[Dr. Bobby Parmar, ND] (23:31 - 23:34)
So it's just blind darting. Yeah.
[Dr. Alex Dragan, ND] (23:37 - 24:16)
So ultrasound is so helpful. One, I can see the shape of the uterus before I'm putting anything in. And I can also check the placement after, make sure it's in the right spot.
Because I have had countless people come in with chronic pelvic pain. And I'm like, well, let's check your IUD. That's the first place to start.
You have an IUD. It should be helping your pain, not making it worse. Have a hormonal one.
And oh, IUD is not in the right place. It's like touching the cervix. It's moved down.
So it's not where it's supposed to be at the top of the uterus. It has moved down into the cervix, which can be uncomfortable. So check your IUDs, folks.
[Dr. Bobby Parmar, ND] (24:17 - 24:20)
And does that just happen? Or is it because it was placed that way?
[Dr. Alex Dragan, ND] (24:21 - 24:58)
Hard to say because I didn't place those ones that people coming with that. After your first period, so you get your IUD. You get a period, let's say four weeks later.
I don't know, depending on the timing. If you have a really heavy flow, you're at a higher risk for that IUD moving down or being exposed. So like coming fully out.
And that can also happen with young people or just like weird shaped uteruses. Everything's different. And that can also happen because of malpositioned IUDs.
So it just wasn't placed all the way at the top of the uterus.
[Dr. Bobby Parmar, ND] (24:58 - 25:26)
IUD placement checks. I don't really hear about those from when somebody gets an IUD. I never really hear them other than, of course, from you and the Mint Queens.
I don't know if that's a real thing. Like I don't know if like people go in to check if their IUD was put in properly two weeks prior. It's not.
Yeah. So this is like a special but needed thing that you think is should be part of the standard.
[Dr. Alex Dragan, ND] (25:27 - 26:02)
Absolutely. Yeah. I think in an ideal world, I mean, our healthcare system is obviously very squeezed right now.
And so to have someone come back to like a really busy reproductive clinic that is doing like, you know, thousands of IUDs is a pull on resources. So I get it. But at the same time, like checking your strings is not an effective way of checking your IUD.
You can have long strings, short strings. Your strings can move around your cervix and you cannot feel them. But your IUD might still be there.
So the only and best way to check it is with an ultrasound.
[Dr. Bobby Parmar, ND] (26:03 - 26:16)
Okay. My mind is very full at the moment. Okay.
So when a person presents with what symptom picture that would eventually lead you to see that their IUD was misplaced, like what are they feeling?
[Dr. Alex Dragan, ND] (26:17 - 26:37)
It can vary dramatically because it depends on what's going on with the IUD because there is a risk of embedded IUDs. So where the T, the top, oops, more props, the top of the IUD, which looks like that.
[Dr. Bobby Parmar, ND] (26:37 - 26:40)
I think you better like do the influencer thing and like do this.
[Dr. Alex Dragan, ND] (26:40 - 26:40)
Oh, yeah.
[Dr. Bobby Parmar, ND] (26:40 - 26:41)
With a camera. Yeah. Okay.
[Dr. Alex Dragan, ND] (26:46 - 26:53)
So that can sometimes get, you know, embedded, meaning it gets stuck into the muscles of the uterus.
[Dr. Bobby Parmar, ND] (26:54 - 26:56)
Oh, it's so soft. Soft plastic.
[Dr. Alex Dragan, ND] (26:56 - 28:19)
Although some people have never seen an IUD and they're getting this device in them. So I was asked if you want to see it. But some people are like, I don't want to see it.
But like, you should know what's being put inside of you, right? It's a tiny little thing. This is a copper one.
So let's say, you know, this part is embedded. It sounds scarier than it is. Embedded sounds horrible.
It sounds alien. It doesn't mean that it's like all the way through their uterus. No, it's just that like it's gotten stuck in the muscle.
So that can happen. And that can cause like increase in pain, kind of like menstrual cramping, menstrual chronic pelvic pain. That's also happening outside of the time where you're getting a period.
And with the Mirena and Kyleena, because they reduce bleeding, it can also be tricky to kind of track that because you might be getting cramping once a month. And we kind of assume that that's your period, but you're not bleeding. Whereas some people will have chronic pelvic pain that is random and intermittent, and it's kind of all the time.
And so we're like, that's not really consistent with a period cramp. So that can happen. It can also move into the cervix, which can feel uncomfortable during sex or intercourse.
Some people will say that their partner feels their IUD. That, I think, is a bit of a stretch. It's probably the strings.
You believe? Not the actual IUD itself?
[Dr. Bobby Parmar, ND] (28:19 - 28:21)
I mean, not a bit of a stretch.
[Dr. Alex Dragan, ND] (28:23 - 28:25)
So there's all kinds of...
[Dr. Bobby Parmar, ND] (28:25 - 28:30)
A male partner would feel what? Like what part of this?
[Dr. Alex Dragan, ND] (28:30 - 29:11)
So these strings here, let's pull this out. So this gets placed into your uterus, right? And then we don't leave these strings like it's in a fishing wire.
We cut them. Now, if they're cut too short, it can feel very like pokey to a penis. And sometimes, even if they're long, they'll kind of tuck in behind the cervix.
And some people will say they feel it. But I would say unless the IUD itself is all the way down into the cervix, like fully coming out, you wouldn't be able to feel this actual IUD.
[Dr. Bobby Parmar, ND] (29:12 - 29:21)
I mean, it's a lot... It's just very soft. Like nothing about this is rough or hard at all.
This is very soft. Even this is like silk.
[Dr. Alex Dragan, ND] (29:21 - 29:25)
Yeah, it's silky. But when it's short, like you can imagine like this part.
[Dr. Bobby Parmar, ND] (29:25 - 29:31)
Yeah. I mean, I'll never know. But yes, I can imagine.
[Dr. Alex Dragan, ND] (29:31 - 29:45)
Yeah. So, you know, everyone has a different pain experience. I'll never discount or say like, Oh, that's not a symptom of, you know, your IUD.
It's like, let's just check it. Everyone feels things differently. And then we can know.
[Dr. Bobby Parmar, ND] (29:45 - 29:51)
When you check it, are you then having to remove it and put another one in because it's misplaced or can you fix it?
[Dr. Alex Dragan, ND] (29:52 - 30:10)
Do not try and like push your IUD back in. Bad idea. No, if it's not in the right position, one, it may not be effective for what you're trying to use it for.
Mainly birth control. Bleeding, maybe another story. So yes, we need to remove it and put a new one in.
[Dr. Bobby Parmar, ND] (30:10 - 30:10)
I see.
[Dr. Alex Dragan, ND] (30:10 - 30:10)
Ideally.
[Dr. Bobby Parmar, ND] (30:11 - 30:25)
Is there a cost associated with that? Like if somebody has a misplaced IUD that was six months ago and now they're like, I'm in pain, something's going on and you see that it's misplaced, is that covered for them?
[Dr. Alex Dragan, ND] (30:25 - 30:27)
Yeah. Oh, OK. In British Columbia, yeah.
[Dr. Bobby Parmar, ND] (30:27 - 30:33)
OK. So there's no limit of number of IUDs that a person gets in like a year if something like that happens.
[Dr. Alex Dragan, ND] (30:33 - 30:57)
I mean, probably if you're getting like one a month, the pharmacist may be like, “What’s going on here?”. But generally, you know, if it's within six weeks and you have an expulsion, we can actually call the distributor of the IUD and get a replacement because it's kind of like a device error. But if it's longer than that, we usually just represcribe and get a new one from the pharmacy.
[Dr. Bobby Parmar, ND] (30:57 - 31:02)
I can't imagine somebody in some back lane selling IUDs because they just grab them monthly.
[Dr. Alex Dragan, ND] (31:03 - 31:07)
With the amount of anti-IUD ideas online, I don't think that's happening.
[Dr. Bobby Parmar, ND] (31:07 - 31:19)
OK, we're going to go back to non-hormonal IUDs, anti-hormonal IUDs in a second. The anti... is it Russian bots?
Like who? What do you think?
[Dr. Alex Dragan, ND] (31:20 - 31:40)
I mean, I think it's twofold. Again, I always blame everything on the patriarchy. I'm like, what does the patriarchy want?
They want women confused and afraid and not informed. So, yes, I think that's part of it. It's just like a propaganda machine.
And the other part... I forgot what I was going to say.
[Dr. Bobby Parmar, ND] (31:41 - 31:46)
The patriarchy. It's always both of them. [Indiscernible] were the patriarchy.
[Dr. Alex Dragan, ND] (31:46 - 31:46)
Pretty much.
[Dr. Bobby Parmar, ND] (31:46 - 31:49)
It deserves both silver and gold.
[Dr. Alex Dragan, ND] (31:49 - 31:50)
Oh, I remember what I was going to say.
[Dr. Bobby Parmar, ND] (31:50 - 31:50)
How?
[Dr. Alex Dragan, ND] (31:51 - 31:51)
It came back.
[Dr. Bobby Parmar, ND] (31:51 - 31:52)
Olympics.
[Dr. Alex Dragan, ND] (31:53 - 32:11)
No, I think it's because the bad experiences, people love to like shout those from the rooftops. So for every one bad experience you hear, probably a hundred thousands of people who love their IUD and are like, this is amazing. Like you have patients who are like, this is the best thing ever.
Why didn't I get it sooner?
[Dr. Bobby Parmar, ND] (32:12 - 32:58)
My patients with endometriosis, chronic pelvic pain. That probably is something like adenomyosis or endometriosis. Women with fibroids, women who just bleed heavily because that's something's going on in there.
It is so much more than birth control. It is so much more than that. It is a therapeutic device.
And we don't talk enough about how it's a therapeutic device for, because you don't need to bleed. And you don't need to bleed. Do you need to bleed?
No. There's that too. There's a lot of like, why would you as a natural approaching clinician offer me a piece of plastic with a metal coil on it and or a hormone in it?
Why are you doing that? Because it's therapeutic.
[Dr. Alex Dragan, ND] (32:58 - 33:15)
It's therapeutic. It's effective. I want people to feel well.
I want you to walk through your day not worrying about standing up and hemorrhaging. You know, these are the stories that I hear. Like, oh yeah, I get up from my job and it's just like blood everywhere.
That's horrible.
[Dr. Bobby Parmar, ND] (33:15 - 33:38)
It's not even though, it's just if you just don't want to bleed. Yeah. If you just don't want to, even if you bleed a small amount, whatever that is, if you just don't want to bleed, you don't need to bleed.
Yeah. And I think a lot of people think that that's messing with nature and Gaia is going to come with a vengeance in 15 years and say, well, now you're talking about a baby because you didn't bleed and that's not reality.
[Dr. Alex Dragan, ND] (33:39 - 34:10)
And IUD does not work the same way that birth control, like the pill works. They work in different ways. So I think that's also part of that misinformation that any hormone is bad for me and the birth control is the same as IUD is the same as the implant.
Like they all work differently. They're all different hormones and everyone, you know, has different experiences with all of them and it's kind of like you need to find what works for you. So even if something didn't work, it doesn't mean that another option is not going to work for you.
[Dr. Bobby Parmar, ND] (34:10 - 34:12)
Only if there's somebody available to walk you through that though.
[Dr. Alex Dragan, ND] (34:12 - 34:13)
Oh my.
[Dr. Bobby Parmar, ND] (34:14 - 34:37)
I thought. The year of the dragon. So let's go back to the hormone IUD and the copper IUD.
Yeah. The copper IUD, as a clinician, I always, unless there's a contraindication to getting a hormonal IUD, like a cancer, I always am just like, go get the copper.
[Dr. Alex Dragan, ND] (34:37 - 34:37)
Yeah.
[Dr. Bobby Parmar, ND] (34:38 - 34:42)
Am I right or wrong or somewhere in the middle of that?
[Dr. Alex Dragan, ND] (34:42 - 35:37)
I think it's definitely a nuanced conversation because we know that the copper IUD typically makes periods heavier, potentially longer, and more crampy. So who wants more? It's horrible, right?
But for someone like myself who doesn't really bleed a lot and, you know, is like, okay, well, let me try this. It can work. And I have many patients with the copper IUD that love it.
And also you have people who don't experience those side effects that are like, I actually, my period's the exact same. I haven't had an increase in that. So I definitely see a lot more hormonal IUDs happening just because maybe that's just the population that I see.
But a lot of people have heavy periods. They don't want heavy periods. And I would not give a copper IUD to someone who already has really heavy periods or fibroids or endo or any of these conditions that you were talking about.
[Dr. Bobby Parmar, ND] (35:38 - 35:57)
If somebody comes in and they're like, which one would you tell me to choose? If you could help me understand which one's going to be better for me, would you, do you want to sway towards a hormonal one because it has these extra benefits? Or are you just like, no, you can totally go.
And then if you end up having a problem with the copper one, then we can just switch it.
[Dr. Alex Dragan, ND] (35:58 - 36:42)
I mean, I definitely obviously, you know, take a little bit more like gravitas towards that conversation because we don't want to have to switch out your IUD, you know, six months in. Because again, that procedure requires a lot of thought and, you know, anticipation. So if someone comes to me and is like, I want a copper IUD.
And then we kind of talk about, okay, your periods are really heavy and they're long. And I don't think that this is the best option for you. And I think, you know, the hormonal is a better option, but they still want to try the copper and they're informed about all the risks.
That's their choice. So I'm still going to provide them with that option. And if they want to come back and switch it after, great.
But they need to know what they're walking into.
[Dr. Bobby Parmar, ND] (36:43 - 37:34)
One of the things that I think is very important, again, as a referring clinician, is I've seen many women. So please comment on this whole scenario. I've seen many women get an IUD and they have lots of side effects from it.
They're like bleeding every day for three months. One woman, she was bleeding every day for eight months. Oh gosh.
She came in and she was like, nobody will remove this. Because they said, wait a year. Her hemoglobin was like 95 at this point.
She had a ferritin of three or something to that effect. And we're just like, sorry, the person who inserted this needs to remove this. And she's like, no, they keep convincing me that I should just keep going.
A year is the threshold to let me know that I've passed it and they'll probably be over this chaos of that first year.
[Dr. Alex Dragan, ND] (37:35 - 38:18)
That seems very long to me. You know, what I learned and what I believe the research says is three to six months is the average time for your body to get used to the device. Yes, you can expect some intermittent bleeding and spotting and cramping with any IUD, Mirena included.
And that's just as your body gets used to it and it changes the lining of the uterus. If it's past six months, I think another conversation needs to be had where maybe this is not the right device for you. I've even had women come two months after and they're like, I really don't want this.
And I explain that three to six months and they're like, I still don't want it. Out she comes.
[Dr. Bobby Parmar, ND] (38:18 - 38:56)
See, I think the reason that like outside of your world, they maybe want to dissuade women from having it removed because one that now adds another person's appointment into a system that's already overloaded. So it's just like, no, like you'll be fine. Don't worry.
And that would involve like a culture change to allow for women to think that they can just have it removed within a two month to three month period. And then you'd have this whole like maybe ocean of women who are like, get it out of me. And they kind of want to be like, don't just don't prematurely make them.
But it's your body. It's your choice.
[Dr. Alex Dragan, ND] (38:56 - 39:30)
That's informed consent. That's literally what informed consent is. You understand the risks, the benefits and what's going on and all of that information.
And you still decide, I don't want this. Then you can not want it and take it out. Like it just drives me up the wall.
To hear these stories that people are denied medical care when they are like smart individuals that understand what's going on and people are like trying to convince them otherwise. And that again, goes back to like the trust in one's own body, trust in the healthcare system and their healthcare provider.
[Dr. Bobby Parmar, ND] (39:30 - 40:23)
And I think just the healthcare fails us all the time because the decisions that go into what somebody says to a patient are often not based off of like right here, right now for you as a person. It's the accounting department, the ministry, the budget and then the culture of your specific clinic, the culture of your hospital, the culture of like colleagues being like, we don't do that. So why would you do that?
You don't want to be this like black sheep amongst people who judge the shit of you all the time. And so you just kind of just like, oh, I guess this is what I'm doing. This is how it is.
But then, you know, weirdos like you come along and are just like, no. And then so people like me question, are you really weird? Are you like really so different?
Or are you representative of a year from now? Things are going to be different because you're just like a year ahead of the curve.
[Dr. Alex Dragan, ND] (40:24 - 40:58)
I have no idea. All I know is that I was raised by a very strong mother and yeah, it was no means no. Yes means yes.
And like you decide. And I think that I'm very lucky and grateful to be in this position because I get to like empower my patients and give them that opportunity and spread that message through their visits to say like, oh, you should come to her and telling your friend because she actually listens and she's actually going to like help you feel better versus deny you what is needed.
[Dr. Bobby Parmar, ND] (40:58 - 41:00)
Do you call your mom Mother of Dragons?
[Dr. Alex Dragan, ND] (41:00 - 41:11)
No, Victor. It's funny because my mom's, well, we're from Quebec. So they don't take the last name of the husbands.
Oh, yeah. It's very matriarchal. They keep their maiden name.
[Dr. Bobby Parmar, ND] (41:12 - 41:12)
It's to me.
[Dr. Alex Dragan, ND] (41:13 - 41:18)
Oh my God, the French. Yeah. So my mom is still [indiscernible]. Yeah.
[Dr. Bobby Parmar, ND] (41:19 - 41:20)
So it's the father of dragons.
[Dr. Alex Dragan, ND] (41:21 - 41:30)
Actually, my dad goes by X-Man Daddy-O. Long story. But yeah, Mama Dragon.
Okay.
[Dr. Bobby Parmar, ND] (41:31 - 42:26)
You could be, you could be Mama Dragon. Yeah, Mother of Dragon. No other IUD has to do to say about her?
So when we're talking about women's health care, we're talking a lot about the options IUDs, to me, are so representative of what's happening in the world, right? Like it reveals all of the misinformation, the patriarchy and its influence in everything, like freedom of choice, my body, my choice, pain management. It just reveals so much about what the state of affairs are.
And so I think it's such a great like microcosm of like what's actually happening. Absolutely. How else do you see this kind of like, what else are you doing that you see similarly?
Like, are you doing other services that are just like, yes, I'm trying to forge or change the way things are done outside of IUDs being offered?
[Dr. Alex Dragan, ND] (42:27 - 43:36)
Any sort of birth control counseling, I think is super important because I mean, birth control is feminism. It's like, it gives us our power, you know, that, I mean, that's not why birth control was created. It was created for heavy bleeding.
They discovered that, oh, side benefit stops babies from happening. But that allowed women to then go into the workforce and, you know, have our own lives and make our own money. So I think that empowering women to have these choices is so important.
I also think that any type of sensitive exam, like a pelvic exam, a PAP, or, you know, even just like looking at some skin that people are worried about, oh, I have this spot. Approaching that with care and compassion and understanding is so important because again, like it all comes back to me as a little girl going into the doctor's office and for some reason feeling so like nervous, almost as if I was going to write a test that I had to say the right thing and then I can't just like spill my guts like this is what's happening to me. You can do that in my office.
Tears are welcome. Everything is welcome. Let it all hang out.
There's no judgment.
[Dr. Bobby Parmar, ND] (43:37 - 43:51)
What are the like most common or like even examples of people coming in and saying something to you that you have to really correct about birth control or any of this world? Like what are you hearing yourself saying just like that is not it?
[Dr. Alex Dragan, ND] (43:52 - 44:33)
I think that like all hormones are bad. Blanketing, all hormones are bad. People are afraid or icked by the IUD because it's in the uterus and it's in the place that it shouldn't be.
You know, just I think it's a lot of like ideas that people create in their mind. Even the implant. It's very interesting actually.
I find that like you have two camps of people. So you have the implant, which is like a device that goes into the arm. Is that that?
That's what this is. Yeah. So it's this flexible rod here.
I'm going to pull it out.
[Dr. Bobby Parmar, ND] (44:34 - 44:34)
Oh, yeah, OK.
[Dr. Alex Dragan, ND] (44:35 - 44:44)
And it gets placed under the skin. Like a little mustache. I know.
Smile. And they get placed into the arm and you have some people.
[Dr. Bobby Parmar, ND] (44:44 - 44:51)
Ari, not a mustache. Not the patriarchy just spilling out of my mouth. Well, like a mustache. Well, I've been getting a mustache too.
But that's not what I was going for.
[Dr. Alex Dragan, ND] (44:53 - 45:08)
You have some people who are like so for that and so against IUDs. And then you have the opposite. People are like implant.
Like, I don't want that in my arm. And some people are. I don't know.
It's like these ideas that we create of like where things should be in our body.
[Dr. Bobby Parmar, ND] (45:08 - 45:08)
Right.
[Dr. Alex Dragan, ND] (45:09 - 45:27)
And I just think that like we live in a modern world. This is modern medicine. I love herbs and traditional herbalism and all these kinds of things.
Why can't we like meld the two and get the best of both worlds and feel good and have efficacious, you know, devices for our modern.
[Dr. Bobby Parmar, ND] (45:27 - 45:30)
Tell me about that device. Like, what does it do?
[Dr. Alex Dragan, ND] (45:30 - 45:40)
This is similar to the IUD, except it doesn't go in your uterus. So it's actually you can feel it under there. That's what it feels like.
[Dr. Bobby Parmar, ND] (45:40 - 45:43)
Oh, just like a like a hard muscle.
[Dr. Alex Dragan, ND] (45:43 - 46:16)
Yeah, it goes in the arm. It's called the the brand is Nexplanon, but it's etonogestrel. So similar to the IUD progestin.
It's a little bit of a higher dose. So works in a slightly different way than the IUD does. Similar, but different.
And it's still used for birth control. And some people also use it for bleeding, for bleeding control. So I do find that a lot of people from different countries, like I'll get people from like Africa or Australia, like love this device because I think it's more commonplace.
[Dr. Bobby Parmar, ND] (46:17 - 46:17)
Oh, okay.
[Dr. Alex Dragan, ND] (46:18 - 46:21)
But Canadians are like implant in my arm.
[Dr. Bobby Parmar, ND] (46:21 - 46:45)
So it does feel very like Neuralink. It feels very Elon. And like, is it going to start beeping?
Just call my mom. Or like one day, like I can, I can understand that to be like, just the word implant. Yes.
Like the word embed that you said earlier, like those leave a little bit of a mark.
[Dr. Alex Dragan, ND] (46:46 - 46:46)
Yeah.
[Dr. Bobby Parmar, ND] (46:46 - 46:50)
Like when you say them, so like implanting something, you're just like, oh, that sounds serious.
[Dr. Alex Dragan, ND] (46:50 - 47:12)
But again, it comes back to the culture because why are there like hordes of women from Africa and Mexico that are like, whatever, like, yeah, that's totally normal, right? Like everyone has it. So I think it's just, we need to kind of catch up here with some of these devices and that they're not scary.
They are what they are. And they're not for everyone, but a lot of people can benefit from them.
[Dr. Bobby Parmar, ND] (47:12 - 47:49)
Right. Can you talk a little bit about something that I see a lot and I would love your understanding on in perimenopause and menopause, the idea of using an IUD or birth control in these times to help with symptoms. How do you approach that with patients who are like a 48 year old woman who has heavier bleeds, they come every three months or whatever, they're regular.
And they're just like, I'm done. Can I just be done? How do you help them?
Be done bleeding with all of this?
[Dr. Alex Dragan, ND] (47:49 - 48:46)
Yeah, there's many ways. Birth control can be an option. Doesn't work for everyone.
And you can have breakthrough bleeding. But if someone's like, I don't want to have heavy periods that are inconsistent and all over the place. It's like you're in puberty all over again.
Like when I was in school and you're like, oh my God, there's blood on my pants. Like run to the washroom. Nobody wants that when they're 48 and they're like an executive CEO.
So we've got options, right? The IUD is a great option. It lasts for eight years.
So it can take you through menopause and beyond. You don't need to bleed. It protects the uterine lining.
So we can use it as hormone therapy and in addition to hormone therapy. So that might not be sufficient on its own to control all of the symptoms of menopause. And same with the birth control pill.
So again, it's kind of like finding the right recipe for you. Everyone's different and you have to try different things to see what works.
[Dr. Bobby Parmar, ND] (48:46 - 48:54)
Is it becoming more popular to for women in their 40s to get things like this to help with perimenopausal bleeding?
[Dr. Alex Dragan, ND] (48:55 - 49:11)
I think so. I think the message is spreading and these are the types of people that I get that are like, why didn't I put this in sooner? Like this is a game changer.
I hear that all the time. I feel exhausted because I'm like not iron deficient anymore, right? That plus an iron infusion.
It's a whole new world.
[Dr. Bobby Parmar, ND] (49:11 - 50:01)
I hear that all the time that women in their 40s who get IUDs. So like we're thinking about this from the perspective of a woman in her 20s or in her 30s who doesn't want to conceive, etc. But there is the therapeutic benefit for women in their 40s and their 50s to have this thing in and that prevents all of their tornado chaos that happens with your hormones affecting your uterus in really just unhinged ways that you don't need to experience. And so when I talk to women in their 40s and 50s to go talk to you and the Mint queens about IUDs for this purpose, they're always just like never even thought about it. Nobody brought this up to the point that they're all like, they're like, if nobody brought it up, is this not a thing? Yeah.
Do you know what I mean? I know.
[Dr. Alex Dragan, ND] (50:02 - 50:02)
Yeah.
[Dr. Bobby Parmar, ND] (50:03 - 50:04)
Is it not an option?
[Dr. Alex Dragan, ND] (50:04 - 50:05)
There's lots of things like that.
[Dr. Bobby Parmar, ND] (50:06 - 50:35)
Yeah, if nobody brought this up to me, are you bringing it up because you're weird and you're like saying I should do something like this because you're sort of fringy? It's like, no, honestly, it just maybe give it five years. It'll become just part of our society where women in their 40s and 50s are offered IUDs and they just don't need to experience the uterine effects of perimenopause. I hope that becomes more normalized too because it's life changing. It is.
[Dr. Alex Dragan, ND] (50:35 - 50:36)
It is life changing.
[Dr. Bobby Parmar, ND] (50:36 - 50:59)
Okay, a couple more questions. I am conscious of our time. So when we're talking about also hormones and how the word hormone, you just said that, is so scary for some people and you're dealing with hormones and you're like putting hormones in people's bodies.
How are you having that conversation with them and what are they asking you? What are they asking you that's like, but I'm going to get blank.
[Dr. Alex Dragan, ND] (51:00 - 52:35)
But I'm going to get cancer. That's always a concern. I think because of the WHI really put a damper on hormone therapy.
If we're talking in the context of hormone therapy, I would say that the young patients that I see, like the teens and the early 20s, the Gen Zers and the Gen Alphas, this is not even on their radar. They're like, whatever. Yeah, sure.
IUD. Cancer is not on their radar. So nothing is on their radar.
They're just like, can I have sex? So I do think that that is changing because the new generation is more proactive on this. And I think that that's because their moms are the ones that are like suffering and are like in their 50s or are just like, this is horrible.
Do not suffer. So the people in their 30s, 40s, 50s always ask about cancer, always ask about the stories that they hear about the IUDs wandering all over the place. I think that's a major concern when it comes to a device.
The hormones themselves, they just don't understand how it works. So when I educate, I mean doctor is teacher right this is one of our pillars of naturopathic medicine. When I explain people how it works and what it does, they're like, oh, that's not so bad.
It's not as bad as I thought. Because again, it's just like, they get one piece of information and then their brain extrapolates. And it's like, oh, it's going to stop ovulation and this and that.
And like, that's going to cause cancer and that's so bad to stop your ovulation and affect your brain. And I don't know, like with these ideas.
[Dr. Bobby Parmar, ND] (52:35 - 52:39)
I mean, you don't know because you know they don’t make any sense. So you're trying to make your brain make sense.
[Dr. Alex Dragan, ND] (52:41 - 52:50)
Yeah. So, you know, we have very intelligent people in our offices. If you explain to them the mechanisms and how these things work, you know, they're more game to try them.
[Dr. Bobby Parmar, ND] (52:51 - 52:52)
Where do you work? Where's your office?
[Dr. Alex Dragan, ND] (52:53 - 53:07)
I work at Mint Reproductive Health, which is just down the street on West Broadway. And I also have my own practice at Coquitlam at ReGen Holistic Therapies. So I'm there most of the time, but I do love my days in the city.
[Dr. Bobby Parmar, ND] (53:08 - 53:19)
Yeah, she does. I am so grateful for this conversation. It like led to all kinds of really important things to discuss.
Lastly, would you show me your ovaries?
[Dr. Alex Dragan, ND] (53:20 - 53:22)
Here's my ovary. Only one of them.
[Dr. Bobby Parmar, ND] (53:22 - 53:23)
Oh, is that so cute?
[Dr. Alex Dragan, ND] (53:25 - 53:26)
And here's the uterus.
[Dr. Bobby Parmar, ND] (52:26 - 52:39)
Shhh. It says Ova Achiever. Thank you so much, Dr. Dragan. Thank you. Mother of all dragons. This is great.
Yeah, we'll have you back. Bye, everybody. Thank you so much for joining me today.
I really had a great time and I hope you did too. Please share this with a friend or a lot of friends and leave me a review. It really helped promote this podcast.
Thanks so much. Bye.
Disclaimer: This transcript may contain errors, omissions, or inaccuracies. It should not be considered a verbatim record of the conversation. For context or clarification, please refer to the original audio or video recording.
