Fighting for the Underdogs, Lia Xiong-Ratley, MSN, FNP-C, RNFA

Meet Lia Xiong-Ratley, a Family Nurse Practitioner, women’s health advocate, and rescuer of the underdogs, literally.

Lia has worn many hats over the years, from pediatric ICU to cardiothoracic surgery, but after becoming a family nurse practitioner, she has found her place at Planned Parenthood.

If you think the only services offered through Planned Parenthood are contraception and abortion, you're not alone; Lia and I thought this too. However, the reality is that they provide essential services such as STD testing and treatment, cervical and breast cancer screenings, prenatal care, infertility services, vasectomies, and gender-affirming care, which Lia defines with remarkable clarity (trust me, it’s more than you think).

So, why did Lia become such a passionate advocate for the underserved? Her own experiences have shaped her. As the daughter of emigrants fleeing political persecution during the Vietnam War, Lia grew up advocating for her family as they rebuilt their lives as Americans. It’s no surprise that she roots for the underdogs.

And speaking of dogs, Lia runs a successful dog rescue through her Instagram, which initially started as a platform to showcase her travel adventures (you'll hear about those too). The dogs Lia fosters each have distinct personalities, and she has a special gift for bringing that out in them. She'll make you fall in love with each one (I know I have). 

In the five-minute snippet: Uh, yeah, you’ll just have to hear this one for yourself. For Lia's bio, visit my website (link below).

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Transcript

[00:00] Michelle: Meet Lia Xiong-Ratley, a family nurse practitioner, women's health advocate, and rescuer of the underdogs, literally.

[00:09] Lia has worn many hats over the years, from pediatric ICU to cardiothoracic surgery. But after becoming a family nurse practitioner, she has found her place at Planned Parenthood. If you think the only services offered through Planned Parenthood are contraception and abortion, you're not alone,

[00:29] Lia and I thought this too. However, the reality is they provide essential services such as STD testing and treatment, cervical and breast cancer screenings, prenatal care, infertility services, vasectomies, and gender-affirming care, which Lia defines with remarkable clarity.

[00:51] Trust me, it's more than you think.

[00:54] So why did Lia become such a passionate advocate for the underserved?

[00:58] Her own experiences have shaped her. As the daughter of immigrants fleeing political persecution during the Vietnam War, Lia grew up advocating for her family as they built their lives as Americans.

[01:12] It's no surprise that she roots for the underdogs.

[01:16] And speaking of dogs, Lia runs a successful dog rescue through her Instagram, which initially started as a platform to showcase her travel adventures and you'll hear about those too. The dogs Lia fosters each have distinct personalities, and she has a special gift for bringing that out in them.

[01:36] She will make you fall in love with each one. I know I have.  In the five minute snippet:

[01:43] Yeah, you'll just have to hear this one for yourself.

[02:02] Well, good morning, Lia. Welcome to the podcast.

[02:05] Lia: Hi, good morning. Happy to be here.

[02:08] Michelle: I'm so glad you're here too, Lia. I feel like I know you and we've only met really via Instagram. And that was sort of set up through my niece-in- law, Liz Patty, who is a friend of yours.

[02:25] And so she adopted a dog, her and Mike. And you know, I was thinking at that time, I want to adopt a dog too. And so she gave me your name and the rest is history.

[02:39] But I'm really glad that you're here because we're going to talk about what you do today. You're doing a lot, Lia, and I want to hear all about it. But I want to just first start with an introduction.

[02:53] Who is Lia and what is your story?

[02:58] Lia: I feel like I have a lot of different facets to my personality.

[03:04] I'm sure that I actually get told a lot by a lot of my Instagram followers.

[03:10] That they had no idea that I actually had a full time job.

[03:16] I, I post, my Instagram handle is @adventuresofliaa because it really is just about my,

[03:24] the things that I enjoy. And while I do enjoy my work, it is not my identity.

[03:31] So on there, it looks like all I do is I foster dogs for a living. Honestly, it is one of my passions. I'm kind of a big sucker is really what it is.

[03:41] I have a big heart for these dogs, especially these larger breeds or these sad stories. They really get to my heart. So that Instagram actually started out as me just traveling and doing kind of extreme things or off-the-wall adventures.

[03:58] I once went free diving in the fjords of Norway with killer whales because that's been like my dream. And then it eventually started getting this following in fostering.

[04:09] And so I foster dogs for fun, go on hikes, like to paddle board, like to get my body moving.

[04:17] And I just had this huge heart and compassion for women's health as well. So I guess that's kind of me in a nutshell.

[04:25] Michelle: I, I think it's so great that, you know, you said nursing is not my identity. So you're multifaceted, you have all these other things that you love doing besides nursing, you know, fostering, your adventures, your travel.

[04:47] So I love that because I'm just learning that as a sort of a new retiree that went through this period after retirement of like, oh my gosh, what am I?

[04:59] You know, I'm not a nurse anymore.

[05:02] So now who am I? And that's been really fun to try to figure out.

[05:07] So I'm glad that you, you guys are figuring it out so much earlier and I think you're going to be so much better for it.

[05:14] Lia: My journey started in cardiac surgery.

[05:18] And I don't know if you know this, but cardiac surgery is very like all encompassing. I mean, these nurses are on call 24/7. They live, breathe and eat. Being on call,

[05:30] everything,

[05:31] anything at the drop of a hat, right? They leave it behind. And I think what kind of woke me up was seeing some of my coworkers as they began to retire,

[05:42] losing their identity, being like, what do, what do I do now? I, you know, especially being on call. Not only are you limited to being within 30 minutes of the hospital, but there's really not much you can even do in terms of hobbies.

[05:55] So I think just seeing them go through it as they're retiring made me realize like, okay, so, you know, you need to find your identity now. Like, you need to, while it's great to identify as a nurse, there's nothing wrong with that.

[06:11] I think it's a very noble profession and I think that nurses work very hard, but it just can't be all that, you know.

[06:19] Michelle: Yeah, I found that out when, you know, towards the, I'd say Probably the last five years of working,

[06:26] I was working with many 20 and 30 year olds and then it seemed like there was a big divide and then we had like the, the 50 and 60 year olds.

[06:36] Right. And so the younger nurses were teaching us that it's just not all about nursing. Yeah, nursing is great. I love it. But I have so many other facets to my personality.

[06:51] And so I'd say probably the last five years I really started developing some of those, getting into more art, watercolor,

[07:02] just doing different things like that, traveling.

[07:05] So I'm just, again, I'm so glad that you guys are out there to teach us.

[07:11] I guess the OG nurses that, hey, you guys gotta get other things going on other than nursing, because one day it will be gone and then that's gonna hurt.

[07:23] Lia: Yeah.

[07:24] Michelle: So you mentioned that you were a cardiac nurse, and I saw that you're an RNFA. And were you doing that as a cardiac nurse? Talk about that.

[07:34] Lia: Yeah. So I started doing cardiac open heart surgery at a level one trauma center in town. And my goal was always to also transition, transition into ICU as well.

[07:49] And while I did eventually work ICU, I did PEDs ICU for a little bit. I found that I really,

[07:56] I guess I'm an adrenaline junkie. I really enjoyed the complexities of cardiac surgery and the centers that I have worked for really encouraged nurses to scrub, which is very unusual.

[08:10] You know, a lot of places hire scrub techs instead, but they did encourage nurses to scrub. So I jumped right in and got my hands dirty.

[08:20] For like two years of my early nursing career in open heart surgery, all I did was scrub every single heart surgery that came in through those trauma doors,

[08:32] which, you know, in turn made me a better nurse of really understanding physiology, pathophysiology, the intricacies of, you know, how we bypass the heart to, to do the repairs inside the heart.

[08:47] And I think that eventually led me into my RNFA. It was just like a very easy transition to become a first assistant since I already knew how to work with the instruments and I already knew kind of what was going on on the operating room table, you know, views that you don't get as a circulating nurse.

[09:06] And,

[09:07] you know, the hospital that I ended up working for before I got my NP,

[09:13] offered to help me financially with the RNFA program. And then those doctors, those surgeons who were phenomenal teachers, were very willing to take me under their wing and allow me to do my clinical hours and training hands on in their operating room as an RNFA.

[09:33] Michelle: What an amazing opportunity. And I'm with you, Lia, on the OR nurses really needing to be able to scrub in. I didn't know anything about the OR until later in my career

[09:48] And that was just going into the OR for deliveries and C-sections really. But grew up with two older brothers and one younger brother that started out as scrub techs and then became OR nurses and one of them became an RNFA.

[10:03] Lia: Oh.

[10:04] Michelle: And yeah, and that was always their belief that nurses should be able to scrub. This is an absolute necessity. And they worked in an institution really near you that also believed that.

[10:22] And then the one that I kind of grew up in really didn't believe that. And we utilized a lot of scrub techs, but we had a labor and delivery clinical educator that was like really on a mission to get all of those OR nurses to scrub.

[10:38] It never happened. But, you know, I think it's. I think it's the institution kind of decides what they're going to do or not. But man, what a wonderful opportunity for you that you got to do that.

[10:50] Lia: Yeah. So what was your role? So you got into the OR as L&D?

[10:55] Michelle: So I worked in the NICU and I would attend the high risk deliveries and the C-sections. So I wasn't doing anything in the OR except standing over in the side waiting for the baby.

[11:09] So I see everything.

[11:11] Oh, yeah. My gosh, it was so much fun. So much fun. But yeah, I didn't, I didn't have to do anything like scrub or circulate or anything like that. My brothers always teased me because they grew up in the OR and I grew up in PEDS/NICU and they said,

[11:26] you should come over to the OR. I was like, no, I need my patients to be awake and talking. I need to be interacting with them. So.

[11:36] Lia: Yeah.

[11:37] So great. It was interesting. We. I actually got to be in a highest high risk delivery as well. When I was at the last institution that I worked for, they told us that there was a mom who had cardiomegaly and so she had an enlarged heart and she was ready to deliver and they were very nervous about her heart tanking with the delivery.

[12:03] And so the, I guess the high risk delivery team thought that it would be best to do it in the Operating room for cardiac surgery. In the event that she should tank.

[12:17] And we would have to actually put her on the cardiopulmonary bypass machine to help support her heart,

[12:25] they used one of our cardiac anesthesiologists. They actually floated a swan gans catheter down her pulmonary artery so that we could pace her heart to make sure, like, if her heart rate dropped, we could actually pace it ourselves.

[12:39] And so I remember texting my husband and I'm like, we're having a baby. He was like, we're having a baby. And I'm like, whoa, we're. We're not having a baby, but we're having a baby.

[12:51] And I'm pretty excited. It was really cool getting to see that nothing happened. Thank goodness mama and baby did perfectly fine. But it was such a really cool collaboration to be a part of.

[13:03] Having the NICU team there, having the high risk delivery team there, cardiac surgery team, just on standby. Like,

[13:11] It was really neat. The one of the nurses actually was like, hey, do you want to do me a favor? And I was like, yeah, sure. I'm just literally standing around, you know, doing nothing because we're just on standby.

[13:22] She's like, can you take photos for mom and. And dad? And I'm like, yes, please.

[13:27] Michelle: Oh, cool.

[13:28] Lia: I got to be that's impromptu photographer for them. It was really neat.

[13:33] Michelle: That's an amazing experience, that, man. If you hadn't had all that experience, you wouldn't have have gotten to do that. That's so cool.

[13:42] Lia: Yeah.

[13:43] Michelle: And I can just see, you know, your passion for women, women's health, and Is that what led you to be a family nurse practitioner? Talk about that journey.

[13:55] Lia: That was an unexpected journey.

[13:58] I actually told myself after I got my bachelor's, after I got my RNFA,

[14:05] I said that I would never go back to school. I was done with school. I was over school. I didn't want to be a nurse practitioner. I had no interest in it.

[14:15] I really loved cardiac. I really loved my RNFA. I loved being in the operating room doing the high acuity, high risk surgeries.

[14:23] And I have now been doing cardiac for, like 10 years now. Luckily, I. I started really young, and it just got to a point where I was like, where do I go from here?

[14:36] I. I have no interest in being management.

[14:39] So, you know, being a manager or a director had no interest in me. I still love patient care. Right. So I still love to be in the thick of it.

[14:49] And, you know, I guess I just got to a point where I was like, okay, well I guess I'll just sign up for my NP and see where the win takes me.

[15:01] And so I secretly signed up to be,

[15:07] in my graduate school master's program working full time, still in cardiac surgery. I was actually in charge in cardiac surgery as well as like an RNFA if they needed me and then I would also help circulate.

[15:20] I took call as well with the team and also was secretly in school because I know that they also were needing an NP in cardiac and I just wasn't sure if that was going to be the path that I took anymore.

[15:36] I think it was, I think I just felt it inside that there was time for some change. I just didn't know what.

[15:43] And you know, you go through different specialties in your NP clinicals. You explore, they allow you to explore different practices, pediatrics, OB.

[15:54] And I took a specialty, women's health clinical,

[16:01] and my preceptor was just phenomenal. You can tell she had this passion for women's health. She loved to teach, she loved to educate, very evidence based. And I learned so much just following her around and then she, you know, allowed me to do within my scope as a student,

[16:22] some hands on, hands on things as well with her patients. And it was amazing to me, Michelle,

[16:30] how much actually how little women know about their bodies. And I'm not talking women who came in who were 18 or 21. I'm talking women who are in their 50s too.

[16:43] I mean, nobody talks about this. We don't talk enough about how to clean your vagina. Right. Growing up, it's just, it's. No one talks about these things. You know, I mean, I think I was only five years ago that I learned that you're not supposed to use soap to down there.

[17:02] I mean, it's insane. I, I don't think that we know enough. And I really got into learning about menopause.

[17:12] And that's another subject that we don't prepare ourselves enough for. I understand that I'm not quite there yet, but you know, we spend so much time researching how to be skinny, how to look good, how to look younger.

[17:26] And nothing is wrong with that. I think we should, you know, we should be healthy. We, if we want to feel good, we should, we should look good. We want to put all of our research and all of our pennies into fillers and Botox.

[17:37] And again, nothing wrong with that. To each their own. But yet we have no idea about the inevitable menopause. And so it just, I,

[17:47] I had no idea where I was going in my NP career until I think the last few months right before I graduated. And I was like, wait, I think women's health is my passion.

[18:01] I think I found exactly where I needed to be.

[18:06] And then I graduated.

[18:10] And just with the whole turn of events and the,

[18:15] you know, politics, the atmosphere we're in now, I, I don't think I've ever felt more,

[18:22] I guess, like, reinforced in my decision that, like, I am exactly where I needed to be.

[18:28] Michelle: Yes.

[18:30] First of all, you know, isn't it amazing when you have a mentor or an instructor in your case that just has this fire burning inside of them for what they do, and you can't help but it's, it's like, it's contagious.

[18:45] And I think that's an amazing superpower of our mentors in our institutions,

[18:52] and I think we need to definitely keep that going.

[18:56] And, you know, I have said several times on this program and to myself and to my colleagues that. Exactly what you said. Like, you were so surprised that women know so little about their bodies.

[19:10] When I was working in the NICU, one of my jobs was a certified lactation counselor.

[19:15] And, yeah, super fun. And just would talk to women every day that had no idea how their bodies worked at all. And it was so sad because when you're doing any education, obviously, like, you are starting from zero.

[19:32] Actually, you're starting from way behind.

[19:36] Lia: Right? Yeah.

[19:37] Michelle: And trying to play catch up in such a short amount of time. But, yeah, it's, it's, there's a lot of taboo things, you know, cleaning yourself, touching your body.

[19:50] Yeah. So thank God that you found your passion, because I know that you're helping a lot of women.

[19:57] So let's talk about your position that you're currently in,

[20:02] and that is with Planned Parenthood. But talk about that. What do you do there as a nurse practitioner? I'm very interested in that.

[20:11] Lia: I, I'm going to be honest. When Planned Parenthood reached out to recruit me

[20:18] I'm like, as far as what I knew, I think is what everybody knew, you can go there, get contraception, and they do abortions.

[20:27] That's all they do. Right. So I tried to keep an open mind. So I had a lot of recruiters reach out to me. I definitely did, you know, interviews everywhere.

[20:38] And the more that I found out about what they actually did, and specifically the clinic that I work for, the more I was like, this is women's health. I, as you can tell, with the way I foster and rescue dogs, I have this soft spot for the underserved.

[20:57] And, you know, I am a huge advocate for, you know, the social barriers that prevent access.

[21:06] I learned so much. I learned that they actually do all women's health. We do, well-woman visits. We do a lot of mammogram referrals. We do gender- affirming care, which actually encompasses people are like, oh, so you do trans care?

[21:24] All you do is you do hormone therapy for trans people.

[21:27] No, gender-affirming care is actually testosterone for men as well or estradiol for women in menopause.

[21:34] Michelle: Right.

[21:34] Lia: Gender-affirming care encompasses anything that affirms your gender. It's not just transcare.

[21:41] Yeah, I do a ton of education,

[21:45] like you said, on women's bodies. We do menopause care and we actually, at my clinic specifically, we actually do prenatal care and we are attached to a family practice as well.

[21:57] I am currently in the midst of learning how to do transvaginal and abdominal ultrasounds for early pregnancy complications.

[22:06] So if you are having, you know, you don't have a provider and you are pregnant and you have abnormal breathing, you can pop in and we can, you know,

[22:19] do a very basic ultrasound. I'm not some ultrasound expert by far, but we can do some very basic things and do referrals.

[22:30] Michelle: Wow, that's crazy.

[22:32] Lia: That's awesome.

[22:32] Michelle: Yeah.

[22:32] Lia: Things that I had no idea about.

[22:35] The training is unmatched. They put me one-on-one and are paying me to follow a lead clinician trainer who is actually in my rooms with me, doing visits with me, helping correct my technique, helping correct, you know, know whatever I need, providing the expertise and fill in the gaps.

[22:54] So they're not. I think that the, a lot of times, because of the lack of healthcare providers, that nurse practitioners, especially when they're going into specialties,

[23:06] get no support. I mean, there is such a huge lack of support. You get on, there's patients to be seen, they're inundated. They had been needing a provider for a while, so you kind of get thrown to the wolves and you get a lot of, you know, supervising physicians who are like,

[23:21] oh, you call me if you need anything. Right. But I mean, the. I love that Planned Parenthood was so very hands on, so very structured, and they really do provide you that support one on one.

[23:35] So you're seeing several types of visits with this lead clinician trainer. And so I'm not just this new grad coming into your and to the office and,

[23:45] you know, stumbling in the dark as I'm providing care. I have had a lead clinician trainer who's been doing this, who's been doing women's health for, you know, many years, who has actually trained me and helped guide me along so that I can provide the best care for my patients.

[24:03] Michelle: That's very cool. That's a really cool setup.

[24:06] And you know what? The same thing. Like you said, what is Planned Parenthood? It's contraception. It's abortion. That's exactly what I thought. And I got on the website from the

[24:19] place where you work, and I was, like, blown away,

[24:23] and I was like, why haven't we changed the name Planned Parenthood for decades? Because it has been labeled as such, and it's such a small part of what you do there, you know, And I like that you differentiated the gender-affirming care, because that's another buzzword.

[24:43] today. Whenever we hear gender anything, everybody flies off, you know, the handle. And they're like, oh, my God, you know, they're supporting trans people. It's like, yes, and we do this and we do this, and we support menopausal women, and we support men.

[25:01] Men with low testosterone. And so how do we change that narrative? How do we remove those labels?

[25:12] Lia: You know, it's all about education. And I mean, that's all I do is I'm very forthcoming with educating people. I mean, in regular, everyday conversation, I feel like I'm always educating people.

[25:27] In fact, I was at dinner and I met, you know, a couple sitting next to me at the bar, and she was like, wait. She's like, I'm going through menopause.

[25:37] You think you could help me? I said, yeah, you can go into any Planned Parenthood and they'll help you. And she's like, what do you mean?

[25:43] I'm so confused. And so it is really about, like, this, right? Doing podcasts, like, getting the word out there that, like, Planned Parenthood is not this singular entity that just, you know, is for women's health or is only for abortion.

[26:00] Like you said, testosterone therapy for men is also gender-affirming care. I mean, I think that nobody really dissects the term gender-affirming, right? I mean, it's.

[26:14] Michelle: Right.

[26:14] Lia: You affirm your gender whether you are trying to transition,

[26:19] you know, from male to female or vice versa, or you are trying to affirm your own cisgendered male or, you know, cisgendered female.

[26:29] I do so much educating,

[26:32] and I think that is, you know, it's hard to do as a provider when you don't have a lot of, you're not given a lot of time in a capitalist society.

[26:40] But I, I try my best to let my patients know all the services we offer. And I think also people don't realize that we provide a lot of services. Even if you don't have insurance, we actually will help you find ways in which to be able to provide these services.

[26:58] And we are so lucky to live in California in which that extension of insurance coverage can be given to someone regardless of immigration status, regardless of if you have a job or, or you don't make that much.

[27:16] We actually figure out ways in which you can get access to health care. This isn't just about abortions. This is access to health care. There are women that have been seeing us for years for their well woman visit who just, they don't make enough money and they don't have good health care.

[27:33] And we provide the health care at no cost to them. And every patient will always ask if you want to leave us a donation because we are donation based. But we, we will figure it out.

[27:45] If you are in a reproductive state, we actually provide you with Family Pact, which is a free program. And it, you get all of these sexual and health reproductive services at no cost to you.

[27:57] All of your medications, no cost to you. And if you are past reproductive stage, we have a program called Every Woman Counts and we can do your annual mammogram screenings and just all of the other services.

[28:11] Michelle: Wow. So comprehensive. And you know, I've been saying that a lot lately. Leah, I'm so thankful I live in California.

[28:20] Lia: Yeah.

[28:22] Michelle: For all of those reasons and more that you just outlined.

[28:27] So that's fantastic. And you know, 

[28:32] what a welcoming place that women can go, that men can go to get the, those services that are so needed. And I can't help thinking that so many people are not taking part in those services because maybe they're afraid to go into a building that says Planned Parenthood on it because maybe they're afraid of repercussions.

[28:53] What are people going to think? Are people going to think I'm having an abortion?

[28:58] Are people going to be protesting outside of there?

[29:01] So man, I'm glad that you're there and that you're changing the narrative for people to be able to get medical care.

[29:12] Lia: The protesters definitely can be a deterrent for us.

[29:16] I know at the Fresno Downtown Clinic they are very close to the street,

[29:21] so protesters can legally be pretty much almost at the front door there. So, so that one can Be a little bit scary to walk into. They're mostly. The protesters are peaceful and nice,

[29:35] and then sometimes they're very mean and aggressive.

[29:40] Luckily for my clinic that I work at, we are kind of tucked into this parking lot, and we're like this. In this corner of this complex.

[29:53] And so legally, it's actually private. And protesters can't come near the front entrance at all. In fact, they can't even come into our parking lot. They actually can only protest on the street corner.

[30:05] So I feel like the clinic that I'm, that's my home clinic. Although I actually work at all the clinics, my home clinic is a little bit different because it is set back.

[30:16] I feel like it's a little more protected because it is on private property, private parking lot. And again, we are one of the few that actually provided prenatal care and family practice care as well.

[30:27] Michelle: Yeah, gotta be, you know, a little intimidating for the clients as well as the providers. You know, nobody wants to walk into a place that. Where they feel threatened. So thank you for talking about that.

[30:42] So let's see. I want to know where this comes from. Where this need to kind of serve and root for the underdog and the underserved. Where does that come from Lia?

[30:59] Lia: So I am a child of immigrants. My parents came over during the Vietnam War.

[31:07] They have probably one of the most badass stories I've ever heard of. And I just hugely respect my parents for what they've gone through.

[31:17] My dad. So Hmong people live in the mountains, and they don't technically have loyalties or a little bit of, like, gypsies.

[31:25] And so when the whole Vietnam War started, Americans, they were automatically recruited by the Viet Cong. My dad, actually, still, they. They taught him their chant,

[31:37] gave him a gun, you know, told him to shoot Americans.

[31:41] And Hmong people are actually very, like, peaceful. They live out in the mountains. They, you know, have farms. And so they're like, okay, like, whatever. And my dad told me that where everything changed for him was, I guess two American soldiers must have gotten lost, lost their way.

[32:03] And they ended up in his village. So they were like, okay. And they were nice. So they. I started feeding them.

[32:10] They gave them food, actually, you know, gave them clothes to change into,

[32:15] because, again, they're like, well, they don't. Like, they didn't really have loyalties, right, to anybody. They're just like, well, these guys are nice. They're lost. Let's help. And that's kind of Hmong people.

[32:25] That's really how they are. And I Guess, you know, the Vietcong Kotwin event came to the village and made an example of the American soldiers and shot and killed them in front of my dad.

[32:39] My dad, I think, was like 16 or 17 at the time.

[32:43] And that is actually the day that my dad chose a fight. And had he, I guess not witnessed that, I don't know if I would be here today.

[32:51] Michelle: Wow.

[32:52] Lia: And, you know, of course the promise was if the US Lost City and Elmore, that they would help everybody come back over here. It was a little bit more than just that.

[33:03] They had to actually make trek their way from the whole family. My dad, his siblings,

[33:11] my. My siblings as well. I wasn't born yet. All the way to Thailand,

[33:17] cross, you know, this huge wide river called the Mekong River. A lot of Hmong people can't swim either. And so, you know, if they could make their way over to Thailand, then they would get past a.

[33:28] Over to the U.S. so, yeah, my dad was able to, you know, traverse through the jungles with families hiding from the Viet Cong with crying, hungry, starving children and make it all the way here.

[33:41] I remember asking my mom, I was like, oh, Mom, I read this book about, you know, the Vietnam War and the Hmong people and their participation in it. And I was like, I heard that, you know, to keep the kids quiet, sometimes when you guys were hiding, you guys would have to give the babies and the children opium to put them to sleep.

[34:02] And sometimes, you know, we're talking village people, okay? Like, we're not. These aren't measured. They don't have teaspoons on them to get the correct measurement and know the weight of all the kids, right?

[34:12] This isn't weight based.

[34:15] I said sometimes the moms would accidentally overdose the kid.

[34:19] And my mom is. She is like full 4, 8. She's tiny little thing.

[34:26] She looks me just dead in the eyes, just super serious. And she's like, yeah, when we don't have food and we're running and we're hiding and that we're traveling as groups, right?

[34:37] Usually these families are. Travel with other families. She's like, sometimes it's the babies or it's the whole group. And I was like, this is insane.

[34:47] But I made it. I made the tracks. It makes sense, right? You're gonna put the whole group in jeopardy. Everybody. And there's not enough food. I mean, it's just. I can't imagine what they went through.

[34:59] So they came here. They somehow were able. They tried to learn English. I don't know if you've heard But English is like one of the harder languages to learn.

[35:07] Michelle: Yeah, I'm still trying.

[35:09] Lia: Yeah, There are just so many exceptions to the rule. Oh my God.

[35:13] And so they tried. My mom tried to go to adult school, tried to learn English. My parents speak very broken English, but you know, they have tried and amazingly they were able to like get us enrolled in school.

[35:26] And I mean, it's just crazy how far we've gotten in life with my parents who came to a country that they weren't welcome to and didn't know anything and couldn't speak the language and were able to navigate the systems and I mean, I grew up healthy.

[35:42] I don't have any major issues.

[35:44] So growing up my entire life as I also grew up learning English because I was born here. I spent a lot of my childhood being my parents translator and having to be their advocate at doctor's appointments at the DMV or wherever it is.

[36:04] And I think getting to see,

[36:10] I guess the disparities and also just like seeing the gaps in like things that don't translate right, like linguistically and how much a lack of education can do for a patient who doesn't, who isn't compliant because they just don't know.

[36:31] Growing up and being that person for my parents, having to always be their advocate, their translator, I think maybe into this personality that I am now, you know, you can't really be a timid person.

[36:46] Michelle: Man, that's an amazing story. And I do see where, you know, you got your advocacy from because you were actually, you were literally raised being an advocate for your parents and, and other people.

[37:01] And what a sobering story.

[37:04] One that I think probably 99% of people in the United States would have no idea and would have nothing to relate to that story.

[37:20] Yeah, it's amazing.

[37:22] Lia: I grew up poor. We grew up on welfare.

[37:25] There were total like, probably at the time, anywhere from like 10, 9 to 10 of us living under the same roof. You know, a couple people would go to college or whatnot.

[37:40] And you know, this whole misconception of like people on welfare that just, you know, abuse the system. The people who actually depend on the welfare, they barely have enough money to survive.

[37:53] But it was interesting. 

[37:56] I really grew up to appreciate how much my parents did for us.

[38:01] I never went hungry. You know, we got the basics. We had clothes on our backs. I had, you know, hand me downs. But I think just like growing up in that environment and having to be an advocate for my parents has made me have much more compassion and a bigger heart for helping those that are underserved,

[38:24] those that don't have the education,

[38:26] and especially people who can't speak English. I really huge on trying to make sure that we get an interpreter and they understand what we're doing to help solve their problem and why we're doing it and where we're going with all these tests and exams and where my ultimate goal is.

[38:47] I remember having a patient in my clinical that wasn't my patient. It was a male doctor who was running behind schedule. And I was like, yeah, sure, I'll see this patient.

[38:56] She. I think she's Cambodian,

[38:59] and she was having pelvic pain. And I got an interpreter on the line, and I said, okay, well, you know, and I'm not doing anything above and beyond. I'm explaining to her, well, okay, so these are the tests that I want to order.

[39:11] This is where I want to go first. And. And, you know, let's roll these things out, and then once I get these results back, then we can discuss further and do test xyz.

[39:20] And she started. She literally got down on her knees in the exam room and started bowing to me. And she was like, oh, my goodness. She was like, no one's ever really explained to me, like, what's going on or the.

[39:34] The test that I'm going through. So, like, they just keep sending me to go get tests, and I'm not really sure why or for what. And I'm doing was just.

[39:44] It wasn't like I even did anything,

[39:47] you know, extraordinary. And at the time, like, we don't. I don't even know if we found out what was going on, because, again, I only saw her for that instance.

[39:57] But, you know, just basic care and explaining to patients, like, what we're doing and why. She was just overly grateful. And I was like, this. This is sad. You know, I guess nobody's explained to her before what we were doing and why.

[40:11] And. And that's another reason why I think I was. It further, like, propelled me into women's health. Our symptoms are always so waved off, Right? Oh, oh, that's just menopause.

[40:25] No, it's really not that big of a deal. So, you know, there's a multitude of things that have happened and that I witness, whether it is growing up, you know, or what I've seen in clinicals that has led me to be where I am today and to choose the path that I've chosen today.

[40:45] Michelle: Yeah, I can see that it's really shaped you and you're just perfectly suited for what you're doing, and I'm so glad that you're doing it. Lia, do you think that the same passion, the same compassion that you were raised with has led you to all your work that you do with dogs?

[41:09] Lia: Yeah, I would probably say that it is that very same, you know, want to help the underdog, literally.

[41:18] Michelle: Yeah.

[41:19] Lia: I think that is what led me to this. I've always loved animals growing up, so that's a given.

[41:27] And my husband and I have chosen to not have children of our own.

[41:35] And I initially looked into fostering human actually,

[41:44] and I just had a lot of foster children actually that came through the ICU when I worked in the PICU Valley Children's. So that's actually kind of what sharded my interest.

[41:58] And then I think just not being in a place or age at the time in which my husband and I were suited for fostering and he was gone a lot on fires.

[42:12] So I started fostering animals.

[42:16] And yeah, some of my first fosters were.

[42:22] Had diabetes, seizures,

[42:24] just large breed dogs that had behavioral issues, needed some training and reinforcement.

[42:32] And I found that I, that's where my love in fostering animals is, is in the underdogs, in the dogs that only have one eye or blind.

[42:48] And I have found that I am a really good storyteller that I've been able to tell these dogs stories really well. And it's not just about, you know, a cute dog.

[43:02] There's thousands of cute dogs all over the Internet that need home.

[43:06] And it is, I try to portray these dogs and tell their stories, but also portray the personalities right, because they all have these funny, quirky, unique personalities. And I think that's really what gets people to engage with my posts and my fosters and gets them adopted, is that they're not just seeing this cute,

[43:28] funny dog. It's that this funny dog is kind of a, you know, a little brat, but she's also like the sweetest brat in the world. And it's kind of funny when she does this little thing, you know.

[43:39] But yeah, I would probably say that's probably from my upbringing. Right.

[43:43] Just always trying to help the underdog.

[43:46] Michelle: Yeah, I really love watching your Instagram and, and seeing all those dogs and, and their personalities really coming to life. You definitely have a knack for that,

[43:58] for your photography and your video skills and your storytelling skills. That's a really important piece.

[44:05] And you know, I could say one day I hope to see your kind of the same Instagram in maybe a women's health format where you could do so much education through that.

[44:22] You could tell so many stories through that. Lia, I think that would be amazing. What do you think people misunderstand about dogs?

[44:32] Lia: I think that in my experience,

[44:38] I think first and foremost, owners may not research the type of breed they're getting. Right. So I think again, when we talk about these cute pictures of these adorable puppies or beautiful, gorgeous breeds, we need to understand what these dogs were inherently bred for and to be prepared.

[45:00] I'm not saying every breed is going to always have the same exact traits, but just be prepared to understand that they will most likely have those traits that they were raised and bred for.

[45:12] You know, all these thousands of years that they have been around, that's what they were used for. They're probably going to do that and be prepared to either try to help work with it or, like, try to curb it out of them.

[45:28] My own doggies are Queensland Heelers. They nip heels. They were bred to nip heels of cows to herd them.

[45:34] Michelle: Oh.

[45:36] Lia: So guess what he did to people is he would try and hurt people. But it's funny, because they're very smart dogs, and he would only do it to people that he felt were herdable,

[45:52] like personality. He could pick out soft personalities that he knew he could boss around.

[45:59] Michelle: Oh, wow, this is tripping me out right now. My sister has a dog that she rescued, and the dog looks sort of like a. Maybe has some German shepherd.

[46:13] Every time I go over to her house, the dog nips at my heels.

[46:19] Lia: Yeah.

[46:20] Michelle: And it completely freaks me out to the point where I. When I. When I call her, I'm like, okay, I'm coming over. Can you put Marley out? Because she scares me.

[46:31] She's never bit me or hurt me or anything like that. And she's super loving.

[46:36] And you know, my sister has grandkids that are small, and she's, like, super loving around them. She only does it to me, and I don't know what it is. And you know, what I started doing recently is taking some.

[46:50] Some treats over there. And it's like, I feel like I have to make peace with this dog,

[46:56] but I haven't gone back since. Since I did the treat, so we'll see what happens next time I go. But that. That's fascinating. That is fascinating.

[47:06] Lia: Yeah.

[47:07] Michelle: And, you know, what you said about the breed is. Is a hundred percent. My daughter was a vet tech for a while in Denver, and she said they used to have People come in and want to know where to give up these dogs, because they got a dog like a border collie,

[47:24] and they live in.

[47:26] In a 700 square foot townhouse, and they work Monday through Friday, and they don't understand why the border collie is shredding their sofa and ripping up this and chewing up that.

[47:41] And, you know, my daughter's like,

[47:44] this is a super high energy animal that needs to run. And. Yeah. So I think that's a huge misunderstanding. And it's really sad when humans and dogs don't. Don't mesh.

[47:58] Right?

[47:58] Lia: Yeah. Yeah. I think I spent the first year that I had him, Baloo, trying to curb the nipping because I was like, you know what? He's just. All it takes is him nipping the wrong person for me to have to put him down.

[48:14] So I did. I spent a whole year trying to curb the nipping. And then I also realized that with him,

[48:20] it wasn't me having to, you know, stop him from nipping my guests or friends. Although, of course, I would. He. He knew that I didn't allow it. I mean, he would do it when my back was turned, so I would.

[48:34] I would have to tell my friends. And the funniest part is he would do it to, like, the sweetest people, too. The people he knew that he could, like, you know, control, because he hates chaos.

[48:44] He's like, let me purge you over here and make sure you're safe. He's very watchful.

[48:49] I had to tell them. I'm like, you need to be more stern when you reprimand him for that because he doesn't do it when I'm looking. He only does it when I'm not looking.

[48:58] But funny story, he's actually. When I was single, he. He actually was a really good judge of character in men.

[49:05] Michelle: Oh.

[49:06] Lia: And love it.

[49:08] And one time a guy came to pick me up for a date, and he actually,

[49:15] before he could cross over the threshold,

[49:18] he peed on him.

[49:20] Michelle: Oh, wow.

[49:21] Lia: He just straight up peed on him. That's the guy. Turned out.

[49:25] The guy turned out to be very emotional, a little bit aggressive. He was a little bit, you know, we weren't a good match. Let's just say that. Yes. And, you know, I think that maybe maturity wise, we're on different levels.

[49:39] We did not work out.

[49:41] And I was like, dang it, Baloo is right. So I actually had to change my dating profile to read, if my dog doesn't like you, this isn't gonna work out.

[49:50] And it wasn't a joke. Like, I meant it.

[49:53] He liked my husband, so I had to marry him.

[49:58] Michelle: If you get along with my dog, you're gonna have to marry me. I love that. Oh, my gosh. I can't wait till my sister hears that, because her dog does the same thing.

[50:08] She only does it when Jen's, like, not in the room or her back is turned,

[50:14] so. Wow, that's fascinating. Well, you have such a.

[50:19] great relationship with people and dogs, and I think it just says so much about the type of person that you are, Lia, and all the adversity that you've seen in your life and how you've grown through that and really persevered and blossomed into this person that you are today that just provides women with so much hope and care and compassion and education.

[50:52] And I'm so glad that you're there doing what you're doing. And I. I just. I love seeing everything that you're doing on Instagram and hopefully one day we'll get to meet in person.

[51:05] Maybe go out to beers with Liz and Mike or something like that.

[51:09] Lia: Yeah, I mean, probably would have met had they actually had the baby shower.

[51:14] Michelle: I know, I know. Well, I'm hoping for that, you know, maybe summer-ish. We'll see.

[51:21] Lia: Yeah, no, I'm a huge believer in that. There's enough sunshine for everyone.

[51:28] I'm not really competitive. I really love to be everyone's cheerleader. I want everyone to do well. And even if you're doing better than me, I want you to do well.

[51:40] Right. Because you doing well takes nothing from me. Right. You're not taking anything away from me, but you doing well. So I'm a huge proponent of, like, there's enough sunshine for everyone.

[51:49] So I think that applies to humans and dogs and everything.

[51:53] Michelle: I love it. And, man, thank you so much for what you do. Thank you for.

[51:59] For being here today. I'm going to put some of the links in the show notes, so I'm going to put Mel's Mutts Dog application in there.

[52:08] Also your LinkedIn and your Instagram for people that want to contact you.

[52:14] You know, Liz kind of sort of said you should have Lia on your podcast.

[52:20] And is there someone that you recommend as a guest on this podcast? Lia?

[52:24] Lia: You know, actually, I've been thinking about this, and I will have to get back to you on that. I had some people in mind, but I kind of wanted to meet you and gauge how things are so I could better match in terms of like now, like having a conversation with you and seeing your personality.

[52:45] But yes, I do have, I do have people in mind.

[52:48] Michelle: Yes. Sweet. We will talk about that offline. I'd love to hear it. Well, where can we find you?

[52:56] Lia: You can put my email down if people want to email me as well. I actually have.

[53:03] It's an outdated blog, but I do. When I used to travel a lot more than I do now, I used to go to really offbeat places and I would have people be like, oh, hey, how.

[53:14] How did you get those permits from Machu Picchu? Or,

[53:18] you know, you backpacked the Lost Coast trail. Like, how did you go about doing that? What was your planning process? And I got so tired of constantly like, okay, rewriting the whole process for everybody that I made a blog that's a website for that so people can also contact me there called adventuresoflia.com.

[53:37] I haven't posted on there in a while, but I've updated some of the posts because I just recently backpack Havasupai Falls in Arizona again for the second time. So I updated that post.

[53:49] So I do try to keep some of the old posts on there updated, but if people can also contact me on there.

[53:56] Michelle: Oh, sweet.

[53:57] Lia: Yeah.

[53:57] Michelle: All right, thank you so much.

[54:00] Okay, Lia. Well, we've reached the end and so that means we're ready for five minutes of fun. We're gonna do the five minute snippet. Are you ready to play that?

[54:09] Lia: Okay.

[54:11] Michelle: Okay. It's a lot of fun.

[54:52] All right. Convince me to live in Madera, California.

[54:57] Lia: Madera.

[54:59] I absolutely love the fact that it is quiet.

[55:03] I can see the stars out here.

[55:05] And honestly, when I walk outside, especially during this time of year, you can. All you hear is bullfrogs.

[55:13] And you are smack dab in the middle of all of the best adventures you have. Yosemite, Sequoia.

[55:22] You were close enough to all of the big city events in Fresno and my new current obsession Is that they built this little community out here called Tesoro Viejo.

[55:34] Michelle: Yes.

[55:35] Lia: And they have a really cool. They call it a cafe, but it really is a restaurant. They have really great food, and they have rotating local taps for beers,

[55:47] and they usually serve a lot of local wine or wine from just California in the area.

[55:53] They have trivia nights. They have farmers markets every Thursday and every Friday they have live music. And it's also dog friendly. The cafe itself you can actually bring your dogs into.

[56:03] So I actually use it for socializing. A lot of my foster dogs.

[56:06] Michelle: That is so cool. I see their commercials and I go, yeah, maybe in five years, right? I'll sell my house and go buy into Tesoro Viejo. It looks awesome.

[56:18] Love that.

[56:19] Okay.

[56:21] I sometimes prefer the company of dogs over humans because.

[56:27] Lia: Because all they are is love.

[56:30] Oh. That's all they are. Even. Even the mean, aggressive ones are really more so just understood. And it requires a little bit of caring, compassion. And they'll love you.

[56:40] Michelle: Love that. Okay, what's one thing that keeps you up at night?

[56:46] Lia: That's a loaded one.

[56:49] Michelle: I know. Because it's just one thing, right.

[56:54] Lia: That women don't know that they can't use soap down there.

[57:01] Michelle: That's the best. That's the best. First. Okay, finish this sentence. If I had a million dollars, I would.

[57:11] Lia: I'd probably invest in. Honestly, it'd probably be something foster related. Foster dogs, foster children. Yeah.

[57:23] Michelle: Okay, let's see. You're so adventurous. Would you rather hike to the bottom of the Grand Canyon or bungee jump off the Royal Gorge Bridge, which is in Colorado and it's 970ft high?

[57:39] Lia: I'd probably go with the bungee because I'm a little bit of an adrenaline junkie.

[57:44] Michelle: You did say that. Okay. The first thing I do when I get to my travel destination is I.

[57:52] Lia: Find the nearest local bar or restaurant and I talk to a bartender or the way I sit at the bar so I can talk to the bartender and get cool, like, local knowledge.

[58:07] Like, cool places that only locals would know.

[58:10] Michelle: That's great. My daughter does the same. Okay. On that same line, I. I know you went to Norway. I saw all your stories.

[58:18] Did you have a favorite restaurant there or a favorite cuisine?

[58:24] Lia: I want to say really enjoyed 

[58:30] the town that I actually stayed in, it was a hotel.

[58:35] Gosh, I'm. I'm like blanking on what the name was. But it was up in the northern circle. And the bartenders and the waitresses were so very friendly and nice and kind and they found out that I was from the US and they were like, hey, what's something that you missed from the USA that we don't do here?

[58:58] And I said,

[59:00] potatoes. Crispy. Hash brown.

[59:03] Michelle: Hash brown.

[59:04] Lia: Hash browns. I was like, I miss hash browns. Because a lot of their potatoes were like boiled potatoes.

[59:11] And they're like, what are hash browns? And I kind of explained it to them. And on the last day that I stayed, they actually googled hash browns and how to make it, and it made me their version of hash browns.

[59:27] Michelle: That's amazing, man. That's hospitality at its core, right?

[59:31] Lia: Yeah, it was really sweet.

[59:33] Michelle: Okay, last question. We're in your home and there's a picture on the wall of your favorite travel destination. Where is it and who is in the picture?

[59:44] Lia: My favorite travel destination, it's probably hard.

[59:48] Michelle: To pick a favorite.

[59:50] Lia: It really is.

[59:53] I mean, my favorite travel partner is. And this is going to sound cheesy, but this is because I genuinely enjoy it. My husband, him and I have a lot of the same.

[01:00:03] We travel the same. We like to go to more offbeat places.

[01:00:06] So he would probably be in it because he's also very adventurous, easygoing travel destination.

[01:00:15] I mean, are we talking for relaxing or are we talking like the coolest place I've seen?

[01:00:20] Michelle: Yeah, just something that you are like. This is awesome. I love this. This is cool. Maybe one of your offbeat adventures.

[01:00:28] Lia: Okay, so this is going to sound so weird. Bosnia.

[01:00:32] Michelle: Wow, that's cool.

[01:00:35] Lia: So Liz and I actually went to Bosnia.

[01:00:39] Michelle: Oh, my gosh.

[01:00:40] Lia: And the adorable cobblestone street and the history and everything is so fresh. And everybody was just so kind. Everybody was so kind and so much history there.

[01:00:55] Michelle: Wow. What an amazing experience. Okay, I'm going to have to pick Liz's brain about that one. Lia, thank you so much. This has been so much fun today. I feel like I knew you before and now I know you so much after we've had this conversation.

[01:01:10] And again, thank you for being the underdog for people everywhere, for dogs everywhere. Thank you just so much for all your behind the scenes work that you do that people don't know about but is making a difference in so many people's lives.

[01:01:28] Lia: Thank you so much for having me, Michelle.

[01:01:30] Michelle: Have a great rest of your day.

[01:01:32] Lia: You too. Bye.