The PGspot - Personal Introduction

In this episode, I would like to introduce myself and explain how I got where I am in both my career and my journey in sexual health.  Join me as I discuss my background, experience and what inspired me to specialize in female sexual dysfunction.  

If you want to learn more about sexual health, sexual dysfunction, or how to improve your sex life, follow me on Instagram at @thepgspot or check out my website at doctorpattyj.com for blogs and resources related to sex positivity and real talk about sexuality.  As as always, stay curious, stay empowered, and stay you.

Transcript

Patty 0:08

Welcome to the PG spot, where our goal is to take the X out of sex by breaking down the barriers that prevent open communication about sexual health. I'm Dr. Patty Jalomo. A dual certified nurse practitioner, pelvic floor therapist, and certified sexual counselor. I'm here to provide expert insights, debunk myths, and empower you to embrace your sexual wellbeing. Whether you're looking for answers or simply curious, join us as we open up the conversation around sex, intimacy and everything in between. I want to take this opportunity to acknowledge that some content may not be appropriate for all listeners. I'm a huge proponent of honest and accurate information regarding sexuality, but I'm also mindful that this should be age appropriate. Therefore, if you are under 18, this may not be the podcast for you. Additionally, some of the language used in this podcast. Maybe offensive to some listeners, please take these things into consideration before going forward with your consensual participation in this podcast. The opinions expressed by myself or my guests are just that. And these opinions are neither expected or required to be shared by all listeners. The information that is provided is for educational and entertainment purposes only, and should not be mistaken for individual medical advice if you do find the information that we cover in the PG spot. Helpful. Interesting or informative. Please rate and review the podcast wherever you're listening from. If you think this information is important, I would love for you to share it with your friends or family. This is a great way to get the information out to more people. So thank you for listening and let's get on with the show. In this first episode, I really just want to introduce myself, share some background, and explain what inspired me to specialize in sexual health. It's definitely not where I thought I'd be 30 years ago when I started my nursing career. I started off as an associate's degree nurse and worked as an RN in labor and delivery, and then later worked in an OB GYN office. Um, I really loved working in the clinic setting, and I was there for 16 years. Overall, I started out in a nursing role, but after about 10 years, I had the opportunity to learn something new, which really changed the trajectory of my career. We had a pelvic floor physical therapist who started practicing at our clinic, and for those of you who don't know what a pelvic floor physical therapist is or what they do, it's basically a provider who specializes in pelvic muscle dysfunction. Now, most often these are physical therapists because the scope of practice for physical therapists is basically working with patients, um, muscles, ligaments, how that works together for proper functioning overall in the body. Um, sometimes muscles are too tight. Other times muscles may be too loose or too weak, so a physical therapist can help with rehabilitation after surgeries or injuries. That's a lot of what a physical therapist might do. Now, a pelvic floor physical therapist is specialized even further. A pelvic floor physical therapist works with patients either to strengthen the muscles in the pelvic floor to treat conditions like urinary incontinence, pelvic organ prolapse, fecal incontinence, that type of thing, or to help those muscles to relax. So there are situations where someone may have too much tension in the pelvic floor. And this is known as hypertonic pelvic floor muscles, and that can lead to pain, nerve compression. It really plays a large role in sexual dysfunction. Oftentimes these patients have issues with painful intercourse. There's a condition called vaginismus, and that's where the muscles are literally so tight that you can't, um. Patients can't have any kind of vaginal penetration at all, so you can't get a finger in a tampon, anything like that. So really for these patients, the focus is to learn how to relax or down train the muscles and lengthen the muscles to allow for better blood flow. Eliminate any kind of nerve compression. So in a nutshell, that's kind of what a pelvic floor physical therapist does or a pelvic floor therapist. Obviously it's much more complex than that. But that just gives a general idea of what, pelvic floor therapy is. So we had the opportunity in that office to have a wonderful pelvic floor physical therapist. She started the program in our clinic and was able to treat patients there. It was really, I think, beneficial for patients to be able to. Come to a place where they're already comfortable. And it was just a good service that we were able to offer our patients. She did a really great job, um, after several years, I'm not sure how many years she was actually there, but her husband ended up being transferred, so she was going to be moving out of state. At that time, you know, and this was nearly 20 years ago, there weren't a lot of physical therapists that were specifically trained in pelvic muscle dysfunction or pelvic floor therapy. So basically as an rn I was able to learn how to do pelvic floor therapy from her. So, you know, she taught me so much before she left, but then as an RN doing this. Not a physical therapist. I really felt like I needed more training, uh, taking more courses, really just to validate that I knew what I was doing with pelvic floor therapy. So I started taking all the courses that I could. Herman and Wallace is a large provider of education for people interested in learning more about pelvic muscle dysfunction. So they provide a lot of educational courses for physical therapists, occupational therapists, physicians, nurse practitioners. PAs, RNs, really anybody who wants to specialize in pelvic muscle dysfunction has probably gone through some of Herman and Wallace courses. So that's what I did to start with. I just started taking basic pelvic floor courses, learning about the musculature, learning different techniques, learning how to determine if a muscle was too tight, if we needed to work on strengthening. So through Herman and Wallace, I was able to take a lot of different courses related to pelvic muscle dysfunction. I took some courses in bowel dysfunction. I learned some manual techniques, took some courses in manual techniques, things like myofascial release, visceral mobilization. I even took a course in yoga for pelvic pain. So a lot of different courses were offered by Herman and Wallace, and I just felt like when I would take a course, then I just realized that there was so much that I still didn't know. So I really just wanted to take every opportunity that I could to learn as much as I could about pelvic floor therapy and pelvic muscle dysfunction. So that took a while, you know, over the course of years when I was doing pelvic floor therapy in the office, taking these additional courses, I ended up. Becoming board certified as a biofeedback therapist in pelvic muscle dysfunction through an organization called BCIA, which is the Biofeedback Certification International Alliance. And again, I really felt like I just needed a certification just to validate what I knew about pelvic floor therapy, especially since I wasn't a physical therapist, so. Additionally at that time, when I was taking those courses and learning more about pelvic floor physical therapy, I also started taking, some courses through an online RN to BSN program just, um, working on my bachelor's degree, and that took about three years to finish my BSN. And then I was like, well, I'm kind of already used to going to school, so I might as well just go ahead and get my nurse practitioner degree. So I started looking into programs for master's degrees, specifically in women's health because really I'd only worked in women's health and I knew that I didn't really have any desire to work in family practice or internal medicine. At that time, I didn't have any interest in working in men's health. So really I was just looking for a women's health program. I kind of preferred that it be an online program. So at that time there were only two, uh, one of them was the University of Cincinnati, I believe, and the other was Vanderbilt. So I ended up applying to both and just happened to get into Vanderbilt. So, what I thought was an online program kind of turned into. Not necessarily online because we had to be there for the first week, I believe out of every month. I just decided I might as well just move to Nashville. After 16 years of working in the same gynecology office where I was completely comfortable, I decided to pack up and move to Nashville. So that's what I did. Moved to Nashville, uh, went to Vanderbilt University School of Nursing. Got my Master's of science. In nursing degree as a women's health nurse practitioner. And then they also had what was called a seamless transition program where you could just either go on and complete your doctorate. You could also get a dual certification in a different specialty. Again, at that time I wasn't really interested in treating men or internal medicine or anything like that. So I didn't really feel like I needed to get my family nurse practitioner certification, so I went ahead and opted to finish my doctorate. So, a doctor of nursing practice, a DNP degree, and so that's what I. Did through Vanderbilt and then decided to move back to the Southwest. So that's where my children were. And I kind of missed being in the Southwest. Not that I didn't love Nashville'cause it was a lot of fun too. But I ended up moving back to Arizona and, my first job coming back to Arizona, I got hired in an o actually it wasn't even OB it was just a gynecology office in Phoenix. And, um. It was quite an interesting position. You know, I was a brand new grad, thank God I'd worked in an O-B-G-Y-N office for 16 years and also had labor and delivery experience. So I was familiar with the female pelvis, um, because basically I was just thrown in. I think I had like 16 patients scheduled on my very first day. And, you know, this practice, I didn't even use electronic medical records, so it was definitely interesting. But hey, sink or swim, right? So I started working there and. You know, as you get into the working world, and I'm sure this is true for any career, but I think especially as a nurse practitioner, I feel like you really just learn so much more on the job. And that's what was happening. I remember I had a patient who came in, she'd been getting hormones from another provider, and she wanted me to give her prescription for testosterone. And you know, at the time I was just fresh outta school. I had still in my head all this book's, knowledge that they teach in school. And in our program they didn't even talk that much about menopause or hormone therapy. I think we may have had one lecture on menopause. Which come to find out is not necessarily unusual. I feel like nurse practitioner programs, physician programs, residency PAs, nobody, uh, really covers menopause well, so. In that situation, you have to go out and get further education on your own about those things. But at that time, I had no idea how to prescribe testosterone. Uh, I didn't know the doses. All I knew was that testosterone was not FDA approved for women, and therefore I could not prescribe it. So basically that's what I told her and I felt really bad that I couldn't help her. And the worst thing is I didn't even really know where to send her, where she could get help. So it was just, you know, kind of one of those patients that you just leave hanging. And still to this day, I always think about that. I wish I would've been more prepared. Um, I. Knew, what I know now about hormone replacement, not about hormone therapy, but again, those are things that they don't really teach in, your general education as a nurse practitioner or physician. So it wasn't until I started working in another practice, it was a urogynecology office and one of my colleagues that I worked with there, she came from a clinic that did a lot of compounding hormones and she was really well versed in hormone therapy. So, interestingly. This is how much, even as a medical professional, they don't teach you about menopause. I was having massive hot flashes. I was 47, I think, and I didn't even know that I was old enough to be in menopause. I'd had a hysterectomy so I wasn't having periods. So, it's not like I could tell by that, but I. She's like, well, we better get your labs drawn and see where you're at. So I get my labs drawn, get'em back, and I'm like, zero estrogen. So, definitely menopausal. Right. So prior to getting my labs drawn, I was thinking, yeah, maybe I'm menopausal. Maybe I'll just start taking some samples of, premarin, which was a medication for those of you who are older maybe who have mothers that went through menopause earlier, like in the sixties, seventies, probably eighties. Um, that was really the gold standard for estrogen therapy. So everyone who was menopausal was on Premarin. It was a conjugated equine estrogen, so a synthetic estrogen. And that was the norm up until the early two thousands when. There was a big study, the women's health initiative study that came out and put the fear of hormone therapy in everyone. And so, you know, then everybody got off their hormone therapy. So then we have a whole generation of people that kind of got screwed out of, hormone replacement. But that's another tangent. So anyway. I started learning more at this time about hormone therapy, hormone replacement. I started looking into courses because, I felt like this is something I really, need to figure out. I got introduced to the Menopause Society, which is, at that time it was called the National Association for Menopause. I believe nams, uh, are the initials for that. And they offer trainings. They offer certification as a menopause, specialist. And then as well as that, I was also looking into other organizations. I was a member of an organization called NPWH, which is the, nurse practitioners for. Women's health, professional organization. And so basically just trying to start looking for courses or conferences and getting more knowledgeable about menopause and hormone replacement. And during that time also, there is another organization that's paired with the NPWH and that is called ISSWSH. ISSWSH is the International Society for the Study of Women's Sexual Health. So I went to an ISSWSH course, that year. It was conference, I believe it was in Scottsdale, so it was close by and it was one of their annual conferences. And after going to that, I was really just blown away by how much pelvic floor therapy, sexual dysfunction hormones, how all of that is intertwined. And, then again, just the more I learned, the more I realized how much I didn't know. Right. So at that point, when I was at the ISSWSH conference, I saw a table that was sponsored by another organization called AASECT. So AASECT is the American Association of Sexuality Educators, counselors, and Therapists. And again, just noticing that interplay between sexual dysfunction and pelvic floor therapy. So I'd gotten onto the AASECT website and was looking at some of the resources that they had, and really just started thinking about potentially becoming certified as a sexuality counselor. This is something that. I felt like, you know, I've been doing this for 20 years. I have patients that I see for pelvic floor therapy that we really just take a lot of time. Just getting to know each other, getting comfortable with each other, having that rapport and I found that patients just really started opening up to me when I got more comfortable talking about sexuality and sexual dysfunction. Things like pain with sex, inability to orgasm, any of those things that I talk. With patients about on a daily basis. So, you know, the more you talk about it and the more you discuss it, it just becomes so much more natural for you to talk about. So at that point, it wasn't even weird for me to talk about sex. So I realized, I should look into getting certified as a sex counselor because that really is where my passion's at. I felt like I had the medical knowledge about it, but I really wanted to learn more about the, psychosocial aspect and working with patients, in that aspect. So I didn't make that decision right away to do this. It's just something that I have been working on for like the past three or four years or so. But I finished, last year and so now as a certified sex counselor, I'm offering virtual sex counseling slash intimacy coaching visits for the OB GYN clinic that I'm currently working at. So also while I was learning more about hormone therapy, I really did start developing an interest in transgender hormones and as a women's health nurse practitioner. My scope didn't necessarily allow me to treat people of all genders. It was kind of a gray area, especially when you get into sexual health. But just, so I didn't have to navigate that gray area. I decided to go back to school and get dual certified as a family nurse practitioner. So I did that and then started looking into, just other certifications to learn more about hormone therapy and, uh, planning to take the certification course through the Menopause Society, later this year to be certified as a menopause specialist. So really what inspired me to create a podcast like this about sexuality and sexual health is. The overwhelming amount of misinformation, the stigma, the silence that surrounds these topics. So many people grow up internalizing shame, may be rooted in cultural or even religious beliefs, and often teach that sexuality is something to be hidden or feared, as opposed to being understood. So I think especially women, I feel like women experience additional barriers in exploring and expressing their sexuality. Oftentimes due to a lot of patriarchal norms that continue to devalue the equality of sexuality, you know, the media, social platforms, those things further complicate it by promoting really just unrealistic expectations about bodies, behavior, relationship. You know, those things that can distort healthy perspectives, especially when you're looking at intimacy and self-worth. So my goal with the PG spot is to really just offer honest, inclusive conversations that challenge these harmful narratives and help people reclaim their right to sexual knowledge. Empowerment and really just normalize the conversations around sex. So that is my introduction. That's how I got to where I am today and my journey in women's health, sexual health, menopausal health, hormones, all the things. So I truly hope that you enjoy what's to come in future episodes, I hope to have a variety of different options. Some of the episodes, I'll just be talking solo about some of the common problems that I see in practice. I also plan to have episodes where I am interviewing with other specialists, experts in a variety of sexual topics. So if there are things that you would like to hear about, if you have any. Questions, concerns, anything that you're struggling with personally, you can always send me an email. And my email address on my website is email@doctorpattyj.com, and that is Dr. Spelled out, D-O-C-T-O-R-P-A-T-T-Y j.com. So until next time, stay curious, stay empowered, and stay you.

18:49

That's it for today's episode. Thanks for listening, and be sure to rate and review the podcast on whatever platform you're listening from and share it with your friends. That's a great way to help reach new listeners and make this a more sex positive world. Also, I'd love your feedback and questions, so send me a message. It's at email@doctorpattyj.com, and that's doctor spelled out, D-O-C-T-O-R-P-A, tt y j.com. Until next time, stay curious, stay empowered, and stay you.