Dawn White, FNP | Tired, Bloated and Told Your Labs Are Normal?

Host: Joe Brown. Transcript of the published edit. Times are episode time. Auto-transcribed; minor errors possible. General information only, not medical advice.

0:00I think the biggest thing is you shouldn't go out with more questions than you had when you walked in. So if you've been tired for months, your stomach's off after eating every meal and every test comes back normal, you've probably been told it's just stress or you're just getting older.

0:16Well, Dawn White has spent more than 30 years in nursing from the ER to gastroenterology and now runs her own primary care practice in Ohio built around one question why so today we're going talk about what to look for in a primary care provider when normal labs aren't the whole story and when being tired is more than just being tired so stay with so welcome to the top providers podcast where you get to meet the doctor before you book. I'm Joe. Brown, today I'm with Dawn White, a family nurse practitioner and the founder of Rooted Wellness in Coshocton, Ohio.

0:56Dawn has more than 30 years in nursing, including emergency medicine, urgent care, hospital care, and gastroenterology, and she blends every one of those in everyday primary care with the whole person look at gut health, hormones and fatigue.

1:13Dawn, thanks for joining us. Thanks for having me.

1:16So first question for you is what should someone look for in a provider outside of a Google rating?

1:22I think the biggest thing is you shouldn't go out with more questions than you had when you walked in. So, you should always feel that the provider listened to you and that they acknowledged your questions and that you got answers to those. I mean, I might not be able to give you every answer, but I really try hard to at least get the big ones and give people tools to leave so that they are better informed for whatever the next step may be. I talk a lot about diet, I talk a lot about, you know, let food be thy medicine, then let thy medicine be thy food. And I think that is a really good concept. I we can't eat crap all the time and think that we're going to feel I do a lot of coaching to talk about how we should eat and that's not just, you know, oh, I want to be gluten free. That's not just about gluten. It's about like, are you drinking soda all the time? How much caffeine are you drinking?

2:23Are you eating fast food all the time? What kind of food do you buy and how do you cook it? So I don't think it should be cookie cutter. And I think that interaction with your patient should be individualized to meet them where they are.

2:36of people get their blood work back and hear everything's normal. And they still feel awful. So what do you tell them? So of all what did they check because Because the normal panel of labs isn't really looking as deeply as everybody thinks that it is.

2:50So I usually do a pretty comprehensive metabolic panel when people first come in and we're looking at nutrient levels. We're looking at inflammatory markers.

3:01We're looking at the normal things, looking A1C and lipid panel, those kind of things. But also looking at, like, do they have an elevated ANA, which is looking for autoimmune conditions because that if that's positive then we know we need to go deeper somewhere else and then listening to what the patient has to say do they have joint pain, do have, great. Almost everyone says they're tired. So when is fatigue something to get checked? Well, I think that's a two-part question. One is, how are you sleeping? Because if you're not sleeping well, of course you feel terrible. And if you are sleeping, how many hours do you get? Do you feel well rested when you get up in the morning? Because if you're not feeling well rested, there's definitely things that we got to look out for that. One, trying to fix the sleep problem, because if we can fix sleep, sometimes we can fix a lot of other things.

3:53the fatigue piece, that is so multi-factorial it is not, you know, there's a bigger conversation about that. When do you feel tired? and do you the afternoon slump? Or you feel tired all day long? Do you feel shorter breath. Do you Do you feel tired at only certain, maybe times of the month for women. and for men do you or well not just men, but anybody, do you wake up tired, like with a headache maybe that is more of a problem with you know the apnea because those Those are other things that we think about too, not just labs. And you spend years in gastroenterology.

4:30So when is bloating or stomach trouble just annoying?

4:33And when should someone get it looked at? We shouldn't have it all the time. We shouldn't have it after every meal.

4:40We, being in gastroenterology, we talk about poop all the time. So, you know, you should be having a conversation with someone because we should be pooping every day.

4:50And, you know, some people wake up with a flat stomach and then it gets more bloated throughout the day. Maybe they just get bloated for a little bit after meals. Maybe it's only after certain foods. So there's a lot of conversations. that symptom. It's not just, are bloated?

5:07do they feel gassy.

5:09It's talking about, you know, when does it occur, how long is it present? What have you tried for it? What things have been tested for it? And a lot of women in their 40s and 50s feel like something's changed. Maybe mood, Okay, so what symptoms are worth bringing up with the provider?

5:29All of those.

5:32So guess I'm going to speak about myself all So one you know, I've always R always person to take care of most of the things at home. So women tend to ignore symptoms until they become so blaringly obvious that they just can't ignore them anymore So the fact that they're coming and talking to you, you need to listen to what they have to say. Hormones affect all of us, they men, they women, and from our 30s, we start to see a change in that. So how does that pattern happen? You is it all the time? Is it two weeks out of the month? Is it right before they start their menstrual cycle?

6:13Do things get better after they have their period? Are their periods changing?

6:18Are they having are they having pain with intercourse? Because shouldn't. Are they having problems with lubrication? Because that's something that happens as we age, as our hormones change, we tend to have some vaginal dryness. So all of those I of those conversations all are important about that conversation, especially with women. great. And you've said that you're open to Western and holistic care and that you can be in the middle. So does it actually mean for a patient sitting in your office?

6:49I kind of laugh, so I call, instead of it being a fork in the road, like you come to a stop sign and make a fork. You want a right or a left turn, then there's this whole place in the middle and that's where I sit at because I gotta sit where the patient wants to be and where they feel comfortable and you kind of have to meet the patient they are. you offer video visits, so what works well by video and what needs to be done in person?

7:16I feel like the first appointment should always be in person because I want them to meet me and I want to meet them so that we get a feel for each other.

7:25And after that, you lab follow-up or whatever, we can definitely do a H. A virtual If somebody's coming for abdominal pain or something that I really need to actually put my hands on someone then a video appointment is not going to be appropriate. If you could get every patient to change one everyday habit, what would it be?

7:46Protein.

7:48So most of us need to do more protein. My husband has said that to me for a long time. You know, we go to the gym together and he's always lecturing me about protein and I used to kind of roll my eyes about it, being honest. But protein is important. It's important at all ages, but it's definitely more important as we age, because as we age, we get a condition called sarcopenia, and that is muscle loss related to aging.

8:12And so protein helps keep that from happening. And it's important that we have more protein because we got to have strong muscles because if we don't have strong muscles, then we're more fragile, we're more frail, and we're more likely to be injured. That's great. And last one I have for you. So after more than 30 years in nursing and taking care of patients, what do you want a patient to understand before they walk through your door or call you for a consultation. There's never a stupid question. I think that a lot of people are afraid to ask questions, so biggest advice to people is never be afraid to ask, we do not know. We do not know until you actually ask us. That's great.

8:57Well, for anyone in Coshocton and East Central Ohio, that's Dawn White, a family nurse practitioner and the founder of Rooted Wellness.

9:06Her office is at 1101 Chestnut Street in Coshocton.

9:11You can call the office at 740-202-5151 or visit rootedwellnesscoshocton.com. And you can find Dawn's profile at topproviders.com. Dawn, thank you for reminding us that people deserve to be listened to.

9:31If you found this helpful, you can subscribe to the Top Providers Podcast where you can meet your next doctor before you book.

9:37I'm Joe Brown. Thanks for watching.