Former PsyOps Operator Explains Modern Warfare, Cancer & Veteran Health | Stuart and Jamie Gallagher

Former Special Operations PsyOps expert Stuart Gallagher and women’s health clinician Jamie Gallagher join the Not Special Podcast with Green Beret Herb Thompson and Corrie Thompson for one of the most powerful conversations yet. From Russia, Ukraine, psychological operations, Special Forces selection, cancer survival, veteran health, testosterone, prostate cancer awareness, hormone therapy, PTSD, military medicine, and life after service — this episode is packed with raw truth, hard-earned wisdom, and real conversations every veteran and family needs to hear.

Stuart opens up about joining the military at 27 after working overseas in Russia, navigating Special Operations culture, serving in PsyOps, advising across government agencies, and watching modern warfare evolve through AI, drones, information operations, and the Russia-Ukraine conflict. Jamie  shares critical insights into hormone health, perimenopause, veteran healthcare gaps, prostate cancer screening, diabetes, longevity, and why early detection saves lives. Together, they reveal what military families, veterans, and everyday Americans are missing when it comes to resilience, performance, and health.

This episode dives deep into:

• Special Operations selection & mental toughness
• Psychological operations (PsyOps) explained
• Russia vs Ukraine analysis from a former insider
• Drone warfare, AI, and the future battlefield
• Surviving cancer while serving in Special Forces
• Veteran healthcare failures & lessons learned
• Prostate cancer awareness for men & veterans
• Hormone therapy, menopause & performance health
• Marriage, entrepreneurship & building a business together
• Life after the military and finding purpose again

CHAPTER MARKERS

00:00 Why Stuart Is Special

00:45 Working in Russia Before Joining the Military

02:00 Why He Joined Special Operations at 27

03:20 Running a Business With His Wife

04:20 Russia vs Ukraine Explained by Former PsyOps Operator

06:40 The Future of Warfare, AI & Drone Technology

09:25 Why the Ukraine War Matters to Americans

11:15 What Psychological Operations (PsyOps) Really Are

13:00 How PsyOps Works in Modern Warfare

15:10 Deception Operations & Military Strategy

17:10 Social Media, Technology & Information Warfare

18:15 Surviving Cancer During Special Forces Selection

20:00 Diagnosed With Cancer After SF Selection

21:10 The Mindset Required to Survive Special Operations

22:15 Special Forces Selection & Mental Toughness

23:45 Why Most Companies Fail at Hiring Talent

25:10 Hiding Cancer While Attending Military Schools

27:30 Admiral McRaven Story & Military Resilience

30:20 Jamie Gallagher on Veteran Health & Early Detection

31:00 How Jamie Helped Save Stuart’s Life

33:00 Why Prostate Cancer Screening Matters for Veterans

36:10 The Importance of Men’s Health Awareness

37:50 Why Veterans Avoid Going to the Doctor

39:40 Type 2 Diabetes in Veterans Explained

41:00 Problems With Military Healthcare & Prevention

45:50 Recovering From Prostate Cancer Surgery

49:40 Building Their Health & Wellness Business Together

50:40 Hormones, Anxiety & Perimenopause Explained

53:00 What Women Need to Know About Hormone Health

56:00 The Truth About Hormone Replacement Therapy

59:20 Menopause, Longevity & Modern Healthcare

1:02:00 Working Together as Husband & Wife

1:04:40 What Men Should NEVER Say to Their Wife

1:05:40 Strategic Communication in Marriage & Relationships

If you enjoy authentic veteran stories, Green Beret interviews, Special Operations insights, military leadership, resilience, health optimization, and unfiltered conversations — this episode is for you.

#PsyOps #SpecialForces #Veterans #MilitaryPodcast #CancerSurvivor 

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Transcript

SPEAKER_03 0:00

Stuart, why are you special? Why am I special? Um I I've never thought of myself as special per se. I guess I've I've had a very non-standard probably life and career. I've been incredibly fortunate. And part of it's by design, and part of it is by just sheer luck. I knew you and I talked about that a little bit. Let's like you really want this one thing to happen and it doesn't happen, but it's the best thing that ever happened to you. And you can't, you know, but the time you like when when you're young and you're you're full of piss and vinegar, like you don't understand why things don't happen or do happen sometimes, and how those end up being beneficial to you down the road, right? You know, from my time in you know college when I went to you know, study in Ukraine to you know getting a job and working in Russia to, you know, I joined joined the military late. I I didn't join, I didn't enlist young. Um, I enlisted as almost 27 years old when I enlisted in the army, already had a four-year degree. Everybody thought I'd lost my mind. They're like, you must have completely lost. Like, why would you do this to yourself?

SPEAKER_00 1:05

Because usually it's people that don't have opportunities, right? Or is how most people perceive it. It's like you can't go to college, so you're going to the military.

SPEAKER_01 1:12

If you're going later in life, or later in life, something's going wrong. Yeah, yeah.

SPEAKER_00 1:15

Or something's like so to join, they're probably like, What's going on?

SPEAKER_03 1:19

Especially as you're coming off of having your own company, you working on contract for you know, doing stuff in the space with Russia and all. It was like, but it was it really what happened, and I think um when I look back on my life, and you know, my dad died, is what I was on contract down in Texas, still doing the same work after Russia. And my father passed away, and I had to go back up to New York, take care of my family. And but I always wanted to be in the military. But my dad was a Vietnam vet, he's like, You can do what you want to do, but he was really against it. Against it. And I always wanted to work at special operations. That was always fascinating to me. It was like I just unconventional thinking and warfare and you know the way you approach problem sets and so forth. And um so after my dad died, we settled the estate and everything. And I'm like, I went down and enlisted. And my again, everybody thought I'd like, you could be an officer, why would you do that? I'm like, I want to know what it's like to be enlisted. I I wanted to be an officer, but I want to know what it's like to be enlisted um and to be at that level before I I go and become an O. I don't know because it just made more sense to me.

SPEAKER_01 2:25

I'm Herb Thompson, a green brain resolutionist.

SPEAKER_00 2:28

And I'm Corey Thompson, Herb's less hairy half and branding expert.

SPEAKER_01 2:32

Our guests come from various backgrounds, but one thing is true. They are special. You haven't even covered half of like everything, man. It's you've done so much. Like it makes me think of Forrest Gump, and not in a bad way, but how Forrest Gump like is hitting these different things. Yeah, not in dump, but just how he's like, wow, he's always at these different places. Like, I mean, you lived in Russia and Ukraine even before coming in the army. Then in the army, being a PsyOps officer, which we got some questions on. I mean, surviving cancer twice, and now running a business with your wife, parrying paws. Like, that's a lot. That's like books.

SPEAKER_00 3:17

Wait, do you run a business with your wife or do you work for your wife?

SPEAKER_03 3:21

Both.

SPEAKER_00 3:23

That's an important decision.

SPEAKER_03 3:27

She actually, so real quick backstory on that one. In order to run a um medical um company of that nature, it has to be owned by licensed providers. And um, I have I've obviously done a lot, but I haven't done that. I don't have any licensing. So um it's a PLLC because it has to be a PLC. And so uh Jamie is the sole owner of Periumpause, uh, the MedPaz Center. And I so I'm hired on as an employee and I just get a girl. I so I just work in the background. Like I always joke that she's like the director of the movie, and all of her people are her actors, and she's the lead actor. And then I I'm like the stage crew in the back, like yeah, she's like coffee. You know, can you give me some coffee, please?

SPEAKER_01 4:12

To make you feel better, Forrest Gump was not licensed either, so it's okay. You know, I like I I'm seeing it. Like, I see it. I think I wasn't even expecting to ask this, but like Russia and Ukraine going on, you have spent a lot of time living in both places, you know it is a very complex problem, but what are your thoughts on it now in 2026?

SPEAKER_03 4:36

Um that is such a loaded question. That's what I was thinking. I mean, yeah, I mean you're asking how you said you'd like to do it.

SPEAKER_00 4:45

I guess how do how does it end? How do you think it ends? And how they are strategic thinkers. Yes. Be careful what you ask for. Be careful what you ask for.

SPEAKER_01 4:52

How do you think it ends, maybe? Or well, how should it end?

SPEAKER_00 4:55

If you had all the power in the world, what what would Studio?

SPEAKER_03 4:57

I don't think it's gonna end well for Ukraine. Um I mean, I j I unfortunately I just don't. Uh I think they're at the end of the day, they're probably gonna have to give up some land. It's gonna take billions and billions of dollars to rebuild the destruction in that country. There is gonna be animosity for generations to come between those two countries. It's I don't know whether or not I don't think either side is going to get exactly what they want. I I don't. And even if like you think about like if Russia won tomorrow, Russia just straight up won tomorrow, you know, they might be the dog caught the car at that point. Because okay, yeah, you got the country, but you got this you just beat this thing with a hammer.

SPEAKER_00 5:43

That's a good analogy. What's left of it?

SPEAKER_03 5:45

And yeah, and the whole eastern side is destroyed. Like, so you just like it's like I gave you a car, I beat the crap out of it, you know, and then I I'm gonna take your car back, and well, we're gonna fix it now. Yeah, you I mean you have to invest in it if you want to drive it, right? Um, which would be doubly hard, right? Because you have now you have a bunch of citizens over there that really don't want to support you. Um, and where you get the money from? Who's gonna pay for this? Because if Russia Russia is this is a wars are expensive, incredibly expensive. And the blood and treasure they've invested in this is incredible. Um, so I I don't unfortunately. I mean, we could talk. This is a I know that could be a this is a three-hour podcast with I mean, and maybe that's what we're gonna have to do.

SPEAKER_00 6:25

We're gonna have to start a series with you to cover down.

SPEAKER_03 6:29

We could, I mean, we really could. We could talk for hours on that one. I unfortunately I I don't I mean, I don't have a crystal ball. I can't sit there and go, yeah, this is how it's gonna end. I know the problem set, I can honestly say I know the problem set better than most. Um, I've I spoke on it for years when I was in the military at all levels, um, including like the State Department, the agency, you know, all the special operations groups, the USAID. I mean, all uh all over the place to better educate people on what because all these organizations are involved in trying to solve this problem. And they needed again, we're back to you didn't have the depth in the bench of the personnel that actually truly understood it. So you had to give them a crash course on this is what the problem is. And like how we solve it, I don't know. Like, I didn't have answers for that. General ideas of these are things we have to start thinking about, like to try to sit there and and for me to this is definitely not a let's knock this out in 10 minutes. I mean, because there's there's so many facets of why Ukraine's doing what it's doing, why Russia's doing what it's doing, and where that story ends, I'm not really sure.

SPEAKER_01 7:33

But I think you hit on something that generations will fail. I think even in Russia too.

SPEAKER_00 7:38

I'm not an expert, but like And not only not only that, but I think look at how much it's impacted our warfare and the changes in how warfare is being conducted across the world.

SPEAKER_03 7:49

Well, don't even get me going on the drone, because the drone thing is another discussion that we could we could have all day long. That has that will redefine the battlefield.

SPEAKER_00 7:57

I think it already has.

SPEAKER_03 7:58

Yeah, it's scary. Well, I mean, for us, we haven't really gotten involved in a fight yet since if you think about it. A serious the old joke was, but it wasn't a joke. When we're in Afghanistan, Iraq, we haven't had to look up since World War II. Yeah, you have to look up now.

SPEAKER_00 8:11

Yeah.

SPEAKER_03 8:11

And you don't know what's coming at you because now I mean the stuff, the stuff they are building in garages over in Ukraine is light years beyond the kind of stuff we had even in Iraq and Afghanistan, though. Like that pales in comparison to the kind of stuff these guys are putting together in their garages.

SPEAKER_00 8:27

And that's now considered old technology. There's even more that's you know, different types of warfare through technology that's being created every single day that's beyond what we can think possible.

SPEAKER_03 8:40

It's the and when you start pairing things off with it, like quad computing, AI, and you start pairing these things off with. I mean, they have a I think they built a jet. As I remember, there is a jet drone out there. They put together, I mean, you know, it's kind of like the old line from George Carlin, you know, if if you know you nail two things together and never been nailed together before, somebody's gonna buy it from you. Yeah. Well, that's where we're at, but they're getting paired. You're talking about technologies being paired off that are can be devastating. Yeah. I mean, absolutely devastating. I literally have an entire brief on it. I could do it in a one-hour block or you could do it in a two-hour block, depending on who invited me and what what they needed. But I have a whole slideshow on this problem set and what it is and how it started and why it's a problem for us. And it basically it was I built it during during my time at State Department. And then when I wrapped State Department, it turned into just this huge traveling roadshow. I'd get called in to all these different organizations to go give it because this thing was starting to escalate even more and more and more.

SPEAKER_01 9:46

Is there an easy way to say, and I don't know, maybe there's not, why this is important to people here in the US?

SPEAKER_03 9:53

I don't know if there's really an easy answer. Um you know, if if Ukraine did fall, you're talking about possibly destabilization of Europe, I think is really where this there's a lot of fear, especially on those border states like Poland, um, even in the Baltics, even though they're NATO partners. Why would you fight this fight if you were Putin? Because I mean, you know you're gonna you know you're gonna spend a lot of blood and treasure on it. Like although maybe you didn't, maybe you pulled a Hitler on this, right? And said, now we're gonna this will be over by you know in a few months. Either way, but I think there's a lot of fear in in Europe that he would continue. And if he did continue, you're talking about destabilizing Europe. If you destabilize Europe, that will impact. We are a globalized society, a globalized country, a globalized world. And if you start impacting economies of scale at that level, we're gonna have some problems over here. We've already seen it. I mean, you you shut down the streets of Hermuz the other day, and fuel fuel spiked, right? That's just one little area of the world, and we don't even get that much fuel from it. We get a very, very small amount of fuel out of that. Most of that fuel goes to to uh Asia.

SPEAKER_02 11:05

Yeah.

SPEAKER_03 11:06

But that doesn't matter. Like it goes to Asia, but all of a sudden it spiked the market because it it feeds into the bigger picture of world markets for fuel. So now you're you're dealing with this impact in the United States on a daily basis. So I mean, all you have to do is watch the local news. It's down at the local level. So we are fully globalized. So if you have something come unglued for no other reason, if you have something come unglued in Europe, as an American, you ought to be worried about that because it will it will or very well could affect your pocketbook.

SPEAKER_00 11:36

For those unfamiliar, can you explain what PsyOps is?

SPEAKER_03 11:41

Yeah, that's that we I wish I could just come up with a real easy one. The bot the main thing we did was it's on a tactical battlefield, it's to remove the enemy's will to fight, right? So if if Herb and I are on the battlefield and he's my opponent, ideally if I can remove his will to fight, then that's one less gun I have to contend with on the battlefield, right? It's a lot cheaper to do that than it is to go toe-to-toe with Herb because one of us or both of us is just not going to end up well, right? Or and end up uh good for either of us. So ideally you're removing bad guys off the battlefield. The the mission has definitely expanded um since the older days, I guess, the good old days of Psyop.

SPEAKER_01 12:22

Was the old days like dropping leaflets? Well, they're not, and they still do that, right?

SPEAKER_03 12:26

I mean, there's still a place for that. Even though you have all these technologies, you go to a place like Afghanistan, you know what, you're gonna send out texts to everybody? I mean, I guess you can. You can send out text certain places. What's a good modern day example of, you know, you had to be careful what you put out there, like in that type of environment.

SPEAKER_00 12:42

Like or like China, for instance, who, you know, has restricted, limited access to what you can you know get through technology. There's certain things that won't exist on their phones, is I think a good example.

SPEAKER_03 12:55

Right. Well, yeah, I mean, you you you you target your audience with um the media that's going to get to them, right? And you and then you develop your media in a way that they're it's gonna resonate with them. So for example, I mean, you know, you you look out in Afghanistan out in these out in the bush a bit, a lot of these people are illiterate. So you don't send out a bunch of writing on a pamphlet that you might have dropped. You need to you need to give them like pictures that are very, hey, you know, turn in your weapons or something like that. And this is how you do it, and these are the pictures, and we'll give you ice cream, you know, and they go, Oh, if well, I do that. And they look at the cartoons and like, oh, okay, if we just we go do ice cream, you know. There's a tactical aspect of it, which is on the battlefield, but then there's a more strategic component to it, and that's you'll work in close conjunction with the country team and these embassies on programs that they want to see. So they'll do a lot of training with other forces and things of that nature.

SPEAKER_01 13:53

But what are maybe some misconceptions people may have about PsyOps?

SPEAKER_03 13:58

Like well, we are not men at steric oats.

SPEAKER_01 14:00

Like, I was gonna ask.

SPEAKER_03 14:03

Um, I have not been able to run through a wall yet.

SPEAKER_01 14:05

Bend a spoon. I gotta let's get a spoon.

SPEAKER_03 14:08

Yeah, I haven't done any cloud bursting. Um, yeah, I haven't been bending spoons in my mind.

SPEAKER_00 14:13

Who's better at PsyOps, you or your wife?

SPEAKER_03 14:16

She's getting better. She's getting better. It's getting scary.

SPEAKER_00 14:21

I don't care how much you've been trained. We as women may have a leg up on you at all times. Just a little bit.

SPEAKER_03 14:27

Yeah. Yeah. No, I always tell her she would have been really good in Intel.

SPEAKER_01 14:31

The psychological operations, it's pretty controlled by law and policy and what you could do.

SPEAKER_03 14:36

You're not just out there No, you're not out there willy-nilly. Yeah. It's highly regulated. And there's a lot of there's a lot of people that have to sign off in order for you to run a campaign in a country. So it has, I mean, it has to be signed off by your your MACOM that you're working in. Uh, and it has to be signed off by your country team that in the country that you're working in. There's a lot of wickets and a lot of people involved in that whole thing. It has to be signed off by a PAO within, you know, the the embassy usually. It is. There's a lot. And it gets something launched, is is it's a lot of bureaucracy, and it can be to the point where it can almost be counterproductive sometimes.

SPEAKER_00 15:12

Um recently, I think we saw a great example when um one of the fighter jets was struck down and they were looking for the ejected pilot.

SPEAKER_01 15:21

Well, you're talking about in Iran.

SPEAKER_00 15:23

In Iran, right. And then they mentioned post-operation that part of how that had been successful was through PSYOP tactics.

SPEAKER_01 15:31

They were saying they're going finding a different thing. Right.

SPEAKER_00 15:33

They gave a misinformation campaign to say that they had already found them, to try and spread that rumor so that people stop looking for the guy. So that's the kind of thing that you would potentially be involved in.

SPEAKER_03 15:44

We would be involved. Yeah, deception. So a deception plan is really what you're talking about. That isn't really owned by PSYOP. PSYOP is a part of a deception plan. So deception plan is actually run at a commander level.

SPEAKER_02 15:57

Gotcha.

SPEAKER_03 15:57

Because you can't the PSYOP guys can't just go in and say we're going to run this little deception. It has to be, in order for it to be believed, you have to have a lot of other people involved in it.

SPEAKER_00 16:06

That's one of Herb's favorite sayings is before you believe anything, think about how many people it would take to tell that story, whether it's a conspiracy theory or not. It's like how many people would have to not speak up to the truth or how many people would have to lie. Right. And if you start looking at the masses, that'll help you really discern what the truth is or isn't.

SPEAKER_03 16:25

Well, that's yeah. I mean, I've joked with my wife about that a lot. About like, have you ever worked for the government? Like you know how hard it is to get your own office. Yeah. Like it try to get your whole uh own office on board for a conspiracy.

SPEAKER_02 16:40

Yeah.

SPEAKER_03 16:41

Um, and see if you can get everybody like just your office. Now you're gonna do this across the government, yeah. Across countries, yeah.

SPEAKER_00 16:49

And convince everyone to keep their mouth quiet.

SPEAKER_03 16:52

Nobody's gonna say anything.

SPEAKER_00 16:52

Everybody's on the book deal.

SPEAKER_03 16:55

Unless there's only one wittying guy, and everybody else is unwitting and they have no idea they're just following it. I guess maybe it would work that way. But I think, I mean, and Sciop has changed dramatically, like just like we were talking about earlier, because due to technology, um, and a lot of times you're talking about you know the restrictions or rules and things like that, they haven't really kept up. You know, it's hard to change those things, you know.

SPEAKER_01 17:18

And as technology evolves, the policies are still back here.

SPEAKER_03 17:21

Yeah, technology's moving exponentially right forward. And you know, you still have a bunch of people, the people that have to make decisions to change these rules, um, they're they don't move as fast. Let's just put it that way.

SPEAKER_00 17:34

And knowing all that you know, did you allow your kids to have social media?

unknown 17:38

Yeah.

SPEAKER_03 17:39

We did. We tried to monitor that. It it's you know, it's tough uh with technologies, I think, for any parent these days. The your children are better at technologies than you are. So even if you figure certain things out or whatever, they usually find workarounds pretty quick. Yeah, they do. Um they're they just they're on them more than we know our kids. They have more time to do it.

SPEAKER_00 17:58

We we're on to you. We know about spoofing IP addresses.

SPEAKER_03 18:02

So I we did, but I mean, and you know, there's a lot of we again, another show right there. You have a full show on the finer points of but hey, hit subscribe right now.

SPEAKER_01 18:12

See more great guests coming up next week.

SPEAKER_00 18:15

Going back to a moment in your health journey, can you tell us about when you were first diagnosed with cancer and kind of what was going through your mind as you received that diagnosis?

SPEAKER_03 18:28

I was getting epididymitis. I don't know if you ever had epididymitis, but it's inflammation of your epididymis, which is down in this region. And I got it a couple times and I got it really bad. It was out at PLDC, primary leadership development course. Of course, yeah. And it's a 30-day school, and I could barely walk. I mean, it hurts. I can't even tell you the pain on this. So I've I went through the day and I just gritted my teeth the whole day and got through it. And then at the end of the day, I went down to uh I called up my tack and I'm like, can you bring me down to hot? I was like, I'm they're gonna throw me at this course if I don't get this taken care of. He's like, just take this, you'll you'll be better by tomorrow.

SPEAKER_01 19:04

I love I love military doctors because there's gonna be a Motrin.

SPEAKER_03 19:07

Yeah, Motrin and it did help. And I got through the course, it kept on recurring. I think it came like a third time. And so I started seeing a doc about it. You know, what what's going on with this? I had a date to get a special forces selection. And I remember I was down talking with my doc, and he's like, we gotta operate it. I think we gotta look at, you know, what because I I don't know. I've done all these ultrasounds, I can't find anything, you keep on getting epidemiomites, I don't know, make an agreement with you. We'll let you go, but you need to come back and see me immediately afterward. Like, all right, fair enough. So I go to the course, get through selection, get picked up for 18 Charlie. I was stoked. I was like, yes. I mean, this is this is what I mean. I was I was on my way, right? And I come back and good to my word, I went in and see the doc. And the doc's like, all right, on table. When I woke up, like because he's like, I again, he's like, there's no way. You're gonna be fine. When I woke up, I can just tell this is not good. The surgery took longer. He comes in and he's like, it was cancer. And I'm like, I'm like, see, you got the wrong guy. There's just no way. Like, I just completed special course. Like, you know what that course is? Like, there's no way. Um, and he's like, no, it's true. So that kind of put me in a tough spot. When you're, what was I, 31? I mean, you're like, you're still bulletproof at 31, right? You're thinking I will never have to contend with this this discussion or this thought process. It's like, well, what I gotta do, you know, what do you gotta do? And he's like, Well, now we removed it, you know, but you're gonna have to go get you can either get radiotherapy or you can get chemotherapy, but you gotta get something because you gotta make sure it doesn't run up your lymph nodes because if you don't, if you miss some of it, it'll kill you. And so they gave me a choice. I'm like, radiotherapy, definitely. I don't want to do chemo because chemo sounded terrible. So I went in and did that for I think June. Recover from that, and then I spent July training for OCS, and then in in August I went to OCS.

SPEAKER_01 21:06

That quick.

SPEAKER_03 21:07

I I mean I was in good shape.

SPEAKER_01 21:09

Yeah.

SPEAKER_03 21:09

I mean, I was a little beat up coming out of selection, but I was in good shape. Um, so I could recover, you know. I mean, not like us old guys now. I could recover quick. I was in good shape. So we um I got it together. I mean, I started, I remember when I got done with surgery, I was like walking like I was 85 years old. I mean, I was out there in the neighborhood just walking along.

SPEAKER_02 21:28

Yeah.

SPEAKER_00 21:28

I'm convinced that it's not that you all don't feel the pain or don't have painful things. I'm just convinced that you all have trained your brain to stop firing the signal because you're just gonna keep going anyway. And like that's part of like the willful capabilities that you have to get through those tough conditions, is you just your brain is like not trying to send that signal and you're just gonna it's like I already know you're just gonna keep going.

SPEAKER_03 21:58

Well, it's it's part, I mean, it's one of the aspects. Attributes in the special operations world, when you're in assessment selection, that's one of the things you're selecting for.

SPEAKER_02 22:05

Yeah.

SPEAKER_03 22:05

You are looking for guys with grit. You're looking for guys that will not quit.

SPEAKER_02 22:08

Yeah.

SPEAKER_03 22:09

And and if a guy's gonna quit there, he's gonna he's gonna quit. Oh yeah, in more important conditions.

SPEAKER_00 22:16

Yeah.

SPEAKER_03 22:16

I did a speech yesterday at Walter Reed to some science types, and we were I was telling about the importance of attributes during assessment selection. I was like, we have these certain attributes that we look for. We look for people that have some intelligence, we look for people that have you know this the the grit, we look for the so there's all these there's this laundry list of things that we're looking for, right? I was like, we can't train those. You have to come with those, and we will find out whether or not you have them during selection. That's the whole idea of the process. It's like the skills I can train. Yeah, if you have the right attributes, I can give you the skills. If you don't have the attributes, I can't give you anything because I can't get you from A to B at that point. And that's why it's so important to assess and select the right people at the time.

SPEAKER_01 23:00

That's why I always say it starts with that. If because if you don't get that right, but truthfully, it's like a lot of companies we've talked about in the corporate world, most companies are horrible at attracting talent and interviewing, and like then you're like, oh, why do we not have what we need? It's because like that assessment selection is is the point.

SPEAKER_03 23:19

Right. And and I mean, even beyond that part, I mean, if you if you want to go a step before that, even it's also the recruiting. Do your recruiters understand the attributes that they're recruiting for? Exactly. Because if that's the other problem that we had at Special Warfare Center, was your recruiter the value sets with the recruiting side were not lined up with the value sets of the assessment and selection side. So the guys over at recruiting, they get they get points for just getting as many people to selection as they can. That does not help. The guys at assessment selection, they get points for people that pass assessment and selection. And it's not like a course where they train everybody for assessment selection and then oh look, I have a hundred percent pass rate. This is like they can only get people through that that they believe are gonna get through the training that are gonna be good at what they do. So but you have to, it all starts really in the recruiting side, and making sure you have the right list of recruits that you hand over to the assessment selectors to look at, and then ideally you end up with the right product for the training piece. Your assessors and your selectors are different groups of people.

SPEAKER_02 24:27

Yeah.

SPEAKER_03 24:28

So you're you know the guys that are assessing, they put together all the materials and they pass it off. The folder goes in front of the selectors, and those guys are the ones that that choose who goes forward and who doesn't. And it it's kind of a it's a check on learning, so to speak, to make sure that there's not a bunch of nepotism or biases that go into who you get selected. Because that's where you will start getting a degradation of your product, so to speak.

SPEAKER_00 24:51

Take note corporate America, fix it. No, not gonna happen. No, it's not gonna happen.

SPEAKER_03 24:56

I know that, but no, it's it's I mean, try it, it's apples and oranges, yeah. Comparing the corporate world to the military special operations world.

SPEAKER_01 25:04

But I do want to go back though. So did you get the all clear before going to OCS?

SPEAKER_03 25:09

Like, or you still were uncertain of so um no is the short word, uh short answer. Uh if you look back in that day and age, back this is 01, um, the systems didn't always align one another, right? So the you got selected for OCS system did not align with medical system. I had already had my medical done, everything was submitted in my packet. So this was new news, so to speak. I think on the reg back then, you had to be cancer free for three years, right? Before you could technically go to a school like OCS. I so I slipped through the cracks just because the system's um because if they had figured this is another reason why I was like, I might need to get out of the army because like this this could end me, you know, because this is like gonna mess up my whole plan. But no, I uh just didn't put it on the radar for them.

SPEAKER_00 26:01

And and so with that it's not funny, but it is funny, so and it might be the most SF story I've ever heard.

SPEAKER_01 26:09

I mean special operations guys are like that.

SPEAKER_03 26:11

Yeah, is it got worse. So I not only went to CS, but I went to airborne school, jump master school, Pathfinder School, Sears School.

SPEAKER_00 26:21

And I'm gonna guess you weren't telling your doctor this.

SPEAKER_03 26:23

OBC.

SPEAKER_00 26:24

Right.

SPEAKER_03 26:24

Yeah, I mean, like it was just like a laundry list of schools. Like and then did your doctor know? What doctor? Yeah, I mean, like I'm all over the place. Yeah, because you're the army, like you don't know. I don't have to go to my primary and go, hey, so here's the deal. Like, I mean, now I don't know if you can pull it off now, honestly. The the the way technology is. Um, they probably shut you down and you'd have to like back then.

SPEAKER_01 26:47

It still was like, I remember carrying the folder, it was your medical records, and you're like Well, okay.

SPEAKER_03 26:54

There's another dirty little secret in social operations where we used to have two files. You'd have your school file and you'd have your retirement file for lack of a better.

SPEAKER_01 27:03

I'm I messed up. I didn't keep the good file, I just I just turned the bird stuff so that oh wait.

SPEAKER_03 27:10

And so you pull your school file out when you're gonna go to school, and then your retirement file would have all the to make sure that you know when you left that you know you could put it in for disability. So that's that's pretty much what I was doing. Um, and that's how I got through. I mean, because obviously I I wouldn't have done a most of what I did at the military without kind of working through the system like that. But I mean, there's a there's an old story with McCraven, I think was fascinating. Um, Admiral McCraven. It's it's kind of a similar thing, not that I'm putting myself on the same level as McCraven, but uh if you out, do you know him? We're talking about him yesterday, actually, with our friends. He got injured like badly in a uh free fall accident, like broke his pelvis and like I mean at the point where like we're talking Medboard. I think he was a um I think he's an 05 at the time. And they were they were gonna send him packing. But at the same time, I mean, this is a guy that's had committed to the organization and still had a lot to give to the organization. And if that hadn't happened, you wouldn't even know the name of Kraven.

SPEAKER_02 28:13

Yeah, yeah.

SPEAKER_03 28:14

Um, but now he's like one of the most known people in the soft community and in even in the world. I mean, people know people know Admirable Craven. So I had to go back in, I did have to go back in and get blood draws. So they would blood draw, I think they blood draw you, they would blood draw you every it was every few months in the first year. Depending on the types of cancer. I'm again I'm no clinician, but it will uh indicate, you know. But it when they you know you level out like any blood test, you know, they're like, okay, cool, you're good, you're good, you're good. Um they did that for about five years.

SPEAKER_01 28:49

Really?

SPEAKER_03 28:49

Uh before you know you're in the clear. But they they said every every day that goes by, but you know, your your chances go lower and lower. The the thing about testicular cancer is that it's one of the most treatable. It's two things about it that are interesting. Number one, it happens in younger people. You know, old men don't get testicular cancer as a rule. Um, and the second thing is it's one of the most treatable if you catch it early. If you if you catch this one late, like mine kind of got caught by accident because I had another issue that was causing me. I don't think that issue in particular was causing that pain. So that saved my life. Or, you know, because if it moves into stage four, then you're dealing with like a Lance Armstrong type situation where that that could be a a game game ender. Um, so I that took about five years before I got the all clear. I was fine, you know. Like I said, I was able to train up and go to OCS within a month, and that school is is rigorous.

SPEAKER_01 29:45

Yeah, I was gonna say it's not like it's not a school like just go sit in a college class.

SPEAKER_03 29:48

No, they run, I mean, a short run at OCS is about six miles. I mean, it was it was a smoker. I mean, even where well, I lost 15 pounds of that school, you know, in the time I was there. So it's so it was like kind of like a come to Jesus moment for me to go, whoo. Oh, this is uh this is this'll be interesting. But I mean, then you move by it and I mean you can't let it own you because you won't live your life. Right? You have to you have to move beyond it and keep on driving forward. But it yeah, it does give you some pause. And it does give you that come to Jesus moment where you have to go. But you drive on. That's that's what we do.

SPEAKER_00 30:24

We've brought in your professional my clinician. Yeah, your clinician. And my beautiful, your beautiful wife.

SPEAKER_03 30:31

Um she saved your life. She saved my life. Bottom line is I was going in for my annual, uh, is what first first happened. Well, you actually did this. So that's a win. Yeah, this is my first this is my first you know, thing after I left the military, you know, it's my first uh time seeing a a doctor, and and I was going to establish care of my new priority, uh my new primary. And Jamie gave me this list of labs. She goes, go in and and just have to run some of those labs, right?

SPEAKER_00 30:59

And like you draw circles on freckles.

SPEAKER_03 31:03

No, that's a different, that's a different doc. Uh but she handed me like this list of labs, and one of them was a PSA, which I don't know what it stands for.

SPEAKER_04 31:12

Prostate surface antigen. Not a good thing. This is a PSA for PSA.

SPEAKER_00 31:16

The absolute PSA.

SPEAKER_03 31:17

This is definitely a PSA for the PSA. Yeah. So the they the doctor, you know, he's like, I I told him it's like I never had one. Never, the military never gave me one of these. He's like, oh, okay. And they have to justify all of them, then he found his way to justify it. Anyway, sent it in, it was high. Came back high, and I'm like, ooh. I'm like, well, what does that mean? He goes, means we need to monitor it. I was like, all right, well, what does it mean if it's high? Like King City, he's like, then it could be bad, but let's just, you know, monitor, see how it goes. So a couple months later, I had another one run.

SPEAKER_00 31:46

What was it that made you think to tell him to have that done? Was it just it should be done at that time?

SPEAKER_04 31:53

Or so cancer screening to me is just it's very important uh as a clinician because we don't know what causes cancer, but we know early detection saves lives. And that seems cliche, but that is a fact. And in in my mind, I was like, Oh, he's had cancer before. I was like, oh, this dude's in his early 50s. Have you had this before? He's like, I don't know what you're talking about. He wrote him a little list. It was just one of those things, prevention, catching things early.

SPEAKER_01 32:19

So maybe I'm just ignorant, Hillbilly. Why the heck isn't like everyone getting that test? Like there's screening tests like this that shouldn't every guy get it every year.

SPEAKER_04 32:29

So there are different organizations: American Neurological Association, the USPSTF, which stands for United States Preventive Services Task Force, they all have different um guidelines based on data and evidence.

SPEAKER_00 32:42

And is that what like women's mammograms are 40 and up? That's the kind of organizations that help monitor the hyper.

SPEAKER_04 32:50

Absolutely. So the the 50 and older every two years versus the 40 and older every one year. Right. So when it comes to prostate cancer screening for men, and this is not my specialty area, but it depends upon age and risk factors. So the USPSTF, which is the government, but not really the government, they want to um minimize risks. So they recommend starting testing men at from 55 to 69. So going further, like American Neurological Association, their recommendation is for is that for average risk men. And what are not average risk men? Not average average risk men are African American males or a male who's had a first degree relative who's who's had prostate cancer. If you are in either of those 45 and older. But if you have two first degree relatives who've had prostate cancer, you want to start at age 40. So we use the word in uh healthcare a lot, shared decision making. And I don't know why the PSA has kind of gotten pushed to the wayside. Maybe it's because it can affect sexual health, you know, certain interventions, if it's not cancer, it really is, you know, uh risk benefits. And then people are like, what do you mean what is there's a risk to a test? The risk to the test would be false positives that would result in interventions that aren't necessary. Or um, you know, or false negatives that would be reassurance. But in the bigger picture of things, uh fun fact I just learned is this is the most common cancer in veterans. 15,000 patients a year. Okay. I the data that I found isn't it. For prostate cancer. Prostate cancer. Do you have any hunch as to why that is? The only hunch I could think of is what makes veterans different than civilians is exposures. Various types of exposures. Yeah.

SPEAKER_01 34:42

This, like to me, shows the importance of testing. Like absolutely shows the test. And you didn't even know to ask for it.

SPEAKER_03 34:48

Well, that's that that was my concern. Like, and and Jamie and I had that discussion. Like, why and I I mean I was thinking through this in my own mind, trying to figure it out. Like, why wouldn't we? And then I thought about, you know, in the military, for the most part, most of your people are young and healthy, right? Like, you don't so why would you test a guy in his that 38 for this? You wouldn't. There's no reason to. Number one, they're not really considered in the risk pool. Number two, they're not considered in the risk pool. They're they're younger. You know what I mean? You have like, but what may throw that off is the exposure piece, right? I don't know if anybody's done studies on, well, guys that are exposed to because she's saying vets, as a rule, right? That's vets. That means you left military service at some point, right? And you're probably a little older.

SPEAKER_02 35:31

Yeah.

SPEAKER_03 35:32

Does it start to to show itself, you know, over 50, or does it do guys get it early because of the exposure? I mean, I don't know. I like that's something that would require a study. But the bottom line is your population is younger and they're lower risk because they're in good shape.

SPEAKER_04 35:45

So then that begs the question: why is it the most common cancer in veterans? Yeah and where is the study and funding and things like that?

SPEAKER_00 35:52

Because policies can influence like making those like decision changes of when that test do you start.

SPEAKER_04 35:59

It's just a simple conversation initially. Do you have risk factors at age 40? Do two of your family members have, you know, first degree or otherwise have prostate cancer, any family history. If anyone saw the Super Bowl this year, I was freaking stoked because we were dealing with that at that time. And it was Kansas City Chiefs uh coach and it was commercial about prostate cancer. And it was about, you know, you see the guys all relaxing. It was like, relax your whatever. And it's literally just a blood draw. It's just a blood draw. But an elevated blood draw, the the best care for that is what is that? And then a repeat. So it was it was treated appropriately, you know, but the rise in that warranted a biopsy and a biopsy is not without risk, it's MRI guided or sure can be ultrasound guided. I'm not sure based upon the the surgeon or clinician who's doing that. Just the fact that that one commercial got out there at that time, I thought that was huge. Because we talk about women's health, or that's all I talk about all day, every day. But what men's health, absolutely like bring that to the forefront. And it was during the Super Bowl. I haven't seen the commercial since, but I was so stoked about that.

SPEAKER_01 37:03

I'm I'm horrible. I am the example of what not to do. Because I when I got out of the military, I didn't go to a doctor until she made me and I had uncontrolled diabetes. My body was falling apart. It was a big deal.

SPEAKER_00 37:13

And he had every textbook signed to where I'm I'm not a clinician, but I've been around enough people that have diabetes. Yeah, I knew without a shadow of a doubt. Oh, I knew he had type two diabetes. I called it. I said, This is what this is, beyond a shadow of a doubt.

SPEAKER_01 37:28

And then he came back and shot out Doc Klein, my numbers.

SPEAKER_00 37:31

Um, set some records in the bed with it. It was type two diabetes. Yeah. And then not shocked, but thankfully But then I started going regularly. Yes, I was gonna say that was the term. Three years, you know.

SPEAKER_01 37:46

Three and a half years after retirement. I hadn't been to a doc.

SPEAKER_04 37:50

Fascinating. I would say not better than the tables, but I mean that's so common.

SPEAKER_01 37:54

I can't speak for all guys, but like I'll be honest, I just did my colonoscopy clean as a whistle, by the way. Yes, um, pictures are upstairs for anyone who wants to see them. But I was scared. Like, I'm gonna lie, it's gear-based. I was um scared of what was because I was certain they were gonna find something. Yes. I'm like, all the stuff I've been through, like they're gonna find something.

SPEAKER_04 38:13

He may have said something along those lines when I kept pushing the buttons just to help things.

SPEAKER_03 38:17

It's it's it's really fascinating, right? You're like, you're talking about guys that have gone into you know, incoming fire. Yeah, that's okay. I can I can deal with that one. But then it's like, hey man, you have to get a blood draw after you're like, yeah, and you're like backing away, like you won't say anybody say anything, especially with the history, with the history, which I do understand that that history came up like all of a sudden, 31 years old, it's in his face on top of my father was this age.

SPEAKER_04 38:46

It was a significant emotional event.

SPEAKER_01 38:48

It was scary for me. Just when I mean, just hold on. I did the colonoscopy. I was scared when I woke up and when the doc walked in and she was smiling, and I was like, okay, that must be good. What? And she's like, Oh yeah, everything's great. It's fine. And I was like, I was convinced, I'm convinced every time I go to the doc, they're gonna tell me you're losing a leg or like something. It's I don't go to the doc for them to go, you're great. It's I go there and they're like, hey, you got extra whatever or this is here. So it's I'm scared.

SPEAKER_00 39:14

And I think a lot of guys are that way of like, I just before you move on to anything else, want to just talk about like the fact that so many veterans do also have diabetes. We learned um, as he was going through like his reanalysis for his disability, he was kind of like, Oh yeah, whatever. Uh, because they said, Do you have any other, you know, medical conditions we should be aware of? He said, Yeah, you know, type two diabetes, that doesn't have anything to do with military. And thankfully that that person was like, Stop. Yes, it does. Because when you're going extenuated periods without eating, it changes your insulin patterns. And then that can be a long-term impact on your body. So I just want to shout that out as PSA for people that may not be able to do that.

SPEAKER_01 39:58

Yeah. I should have had someone tell me to get some blood tests and stuff because I retired and I had to have been diabetic at that time or definitely pre-diabetic, and no one told me.

SPEAKER_03 40:12

This is the one of the benefits of you know being married to an M nurse practitioner because, like, but I I mean that's that's a huge benefit. And I mean, what scared me even more about this is our daughter-in-law, or our her dad, during this time when I'm going through this whole process, he died of colon cancer.

SPEAKER_04 40:31

He's 50, he was diagnosed a 47 veteran. Found at stage four by the VA.

SPEAKER_03 40:35

And that was and so that was like another cum gesehen.

SPEAKER_04 40:38

Our whole family was in it.

SPEAKER_03 40:39

But it goes back to the whole thing when you find it at stage four, it's yeah, you're trying to but then you know, why didn't he, you know, then it then it begs the question, why wasn't he getting it before? Was it that he was scared and want to go in and or was it that he didn't know?

SPEAKER_04 40:52

Yeah, yeah. He had the screening actually, colorectal cancer screening, not to digress, but since we're on the cancer topic, has gone from age 50 to 45 because it's younger and younger and younger, and I think the general population is aware of that. He was two years late. Again, veteran exposures, all the things, off of a cola guard, which is the simple poop in a box. It's not the um, and and then that's what what prompted that. But veteran care during active duty, maybe you should step it up a little notch. Are you are we just not looking for things because you know, thank you for your service. That's what I was gonna say.

SPEAKER_00 41:29

It even sounds like some direct policy action needs to be made to, you know, use these statistics to drive, you know, more uh I'm gonna pack act all day long, but hello, early detection safe.

SPEAKER_04 41:42

So I have some back to that little cliche.

SPEAKER_01 41:45

This is just my opinion. Military medicine is not meant for you to have a great life. I don't mean it negatively, but like what's the point of the military? It's we could say all this nice fluff, but like I need to have this person physically fit, ready in uniform for as long as I need them, and then when they're gone, well, who cares? Like I mean, just at the end of the day, like it becomes another department's problem.

SPEAKER_03 42:05

No, there is a very practical aspect of military medicine. It's there's it's really what it comes down to. But you're not gonna get the soldier if you don't take care of the families, it's just not gonna happen. So, but I mean, on on you know, related to that, like I would say with military medicine, if I walked in and said, Hey doc, I want a PSA, they would have run it.

SPEAKER_00 42:23

You just didn't know taxes. I didn't know.

SPEAKER_03 42:24

So a lot of a lot of my mind for this is at least raise the awareness. So you don't have to have a policy, a policy is probably more trouble than it's worth. Sure. But you could have a campaign that just said, hey guys, when you get to see about this, because they do it for all sorts of other things in the military.

SPEAKER_00 42:38

Yeah.

SPEAKER_03 42:38

Like you got to get your flu shot or whatever. Or COVID. And you will get your flu, you know, that type of thing. Like, but for something like this, if you just raise awareness that, hey guys, you're about the age, just get the thing. We're on, we're just gonna draw the thing, you know. Then it would then it would be so.

SPEAKER_00 42:53

Do you think it needs to be more doctoral awareness?

SPEAKER_03 42:56

That would probably be on the clinician side, I would say that would be more of a Jamie question. I think on the the soldier side or the military member side, I'd say it defin they definitely need better awareness. Now, your your population of people on that window are not huge. Most are younger. You know, if a guy came in in the army at 18 and he goes to retirement, he's probably somewhere around 40. So that's kind of that yeah, unless you're high risk, you're not even looking at stuff.

SPEAKER_00 43:22

But listen, with targeted ads for marketing and all the work that the military is doing through tech innovation.

SPEAKER_01 43:30

Hello, that just put up a sign-up base. There's enough signs for other minutes. Don't even gotta be fancy, babe. Like peanut extra.

SPEAKER_00 43:37

But you could literally get right into their phones with me if if I wanted to, just by targeting, you know, these types of individuals.

SPEAKER_01 43:44

They put a sign by the gate saying don't do drugs or all these other stuff. Buy Girl Scout cookies. No, but you're waiting there until your ID, just say, get your test done under because we know that they are there.

SPEAKER_04 43:56

I'm wanting to answer that question as a clinician. I think it's our responsibility. I do not expect the public to know what their cancer screening is when you know that would be so unacceptable. Well, you didn't ask for a PSA. What the hell is that?

SPEAKER_03 44:10

Well, it goes back to like I didn't know. She knew. Yeah. She told me to go do it. So, like, if I had known, I would have done it, right? Because like, what's the big deal? Like, get it run another blood test.

SPEAKER_00 44:19

So, what do you say to those that push back because it's not the age standard? Because speaking from experience, I had to fight for an early mammogram.

SPEAKER_04 44:27

It is your right to choose. It is insurance right to deny. That's fine based upon your policy. But your symptoms, your preference, we should always and you could cash pay for whatever at any time. But I think it is our responsibility as clinicians to like when Stu talks about right and lift limits guidelines, guidelines are just guidelines. Just guidelines. You have to have individual, nuanced care for every human. And just a simple test, you know, a campaign is great, but like Epic, which is the biggest medical record system civilian world, I think, unless military has it too. In this lower left corner says care gaps. And the care gaps are designed and put in place based upon your age, your gender, what you're at risk for, when your last PAP was, when this was, is the PSA on there. I am not sure because I don't know what the softness around doing PSA testing is. Now that it's a reality in our life, it's like, why is it? Well, it's discuss with the man how long does he have to live? It's a slow growing cancer. If it's a slow growing cancer, intermediate level, he's had it for years. All that to say it is 100% the healthcare system's responsibility, but it is the individual clinician as well, because we're the ones nobody cares what goes on behind me in a business setting. What what I care about, what you care about is what happens between me and you in that exam room and our conversation, our relationship, and our level of trust.

SPEAKER_03 45:54

That's another reason why I wanted Jamie to be here for this. Because number one, she can speak to the clinical side of this way way better than obviously I can. And number two, I mean, she's got a wealth of knowledge um on other subjects that could be of value. Absolutely.

SPEAKER_01 46:08

How are you doing now though with it?

SPEAKER_03 46:10

I'm good now. I mean, they're still they're gonna have to draw my PSA for the next few years. Um it's kind of like the other one I had done with the cancer markers. I think you said every three months for the first year. It's it's the same type of thing. The further you get away, the more out of the woods you are. But they gotta make sure there's they call it you know the house, the the how the horse leaving the barn. If the horse would leave the barn, you're good. Which in this case, did it stay localized within the prostate? If it did, you're good. But this is where early detection counts, right? Because if it goes too long, it doesn't stay in a barn anymore. The horse is out meandering around the field now, and that causes problems because then it starts to spread. So as far as what he told me, he's like, horse didn't get out of the barn, you're good to go. But we're gonna test you just to make sure because if it gets into your lymph nodes, then it starts going other places. That's right, yeah. That's where you really start out.

SPEAKER_04 47:04

I noticed a little escapy during the surgery.

SPEAKER_03 47:07

Yeah, but they do check your lymph areas to make sure there's nothing else, and if they can find it and pull it, they will. But he said we're good, so we'll I should be good. It's just you have there is a level of recovery. I mean, like you know, you gotta you gotta wear like a catheter for two weeks, and that's boy, you want to be humbled in life. Go ahead and do that for a little while. They carry your bag of pee around with you everywhere you go, is like and it's uncomfortable as all hell, whether you're a man or a woman. So in this case, it would only be a man, but that's no fun. And so there's a level of recovery after this. Um you know, you gotta learn how to pee again, which is something I never thought I'd have to do.

SPEAKER_02 47:46

Right.

SPEAKER_03 47:46

Because you know, once they remove that, you know, it's kind of game on, you know. So you know, the the bladder gets lazy. It does get lazy. So you just yeah, it's like I said, a humbling, humbling experience. Um, but again, we're at the point now where like I'll do what I gotta do, I'll get my tests done, and they'll pull my PS. But I it's time to drive on and live life. Not keep on looking in a rearview mirror going, is this gonna catch up with me?

SPEAKER_04 48:14

I mean so knowing that can be so beneficial because early detection, right? There are other I had a patient ask for Alzheimer's genetic testing, for example, and I'm kind of segueing off of cancer, but I think that's where the risk benefit comes out. What you know, if you know, you know. She said, Can you do that? I said, It's the Apo E gene, I believe. And can you do that test? And I looked it up because she had uh no insurance. I found it on a um a site where you can cash pay. And I said, I can, and it's like $66. I said, but let's talk about that. Yeah. Let's talk about that. If you are positive, which means you are at a significantly higher risk for Alzheimer's, do you want to know that today? And before the end of our visit, she said, you know, I'm gonna wait on that. Yeah. But I again had to say to her, let's talk risk and benefits of knowing. If she's like, I do want to know because I want to do all the things that are new and cool now, and and the GLP ones, that emerging evidence with that that that's you know, being studied right now for Alzheimer's. But when it comes to cancer detection, if you have a higher risk of pancreatic cancer, imaging, imaging, catching, early detection, getting you connected with studies, you know, Duke University or or other places that are doing things like that. Breast cancer, how do we reduce that risk? Ovarine cancer, um, or ovaries removed. Yeah. And all day, every day with your estrogen and your progesterone, and that's fine. Because you know what? You don't have ovarian cancer if you don't have ovaries. What they do now is remove the uh fallopian tubes for ovarian cancer risk reduction for all women.

SPEAKER_01 49:42

Your business, perimpause. Can you talk about it?

SPEAKER_04 49:45

Yeah, I can talk about it all day long.

SPEAKER_03 49:47

That's another show by itself. Absolutely. This is gonna spawn about five shows in one whole discussion.

SPEAKER_04 49:54

To keep it short and sweet on that, uh, my own experience being aware that changes that I was happening or having that impacted my ability to think clearly during the day, sleep well, anxiety's up. He's coming and going, and I'm we're back in America, and I'm like, I stress I cannot handle very well, and I don't know why it's impacting me being back in America, being in my NP role again.

SPEAKER_03 50:17

We were in Germany.

SPEAKER_04 50:18

We were in Germany. Yeah.

SPEAKER_03 50:20

And then I came back and I had a three-year assignment in Germany and and Jamie had been a higher gun working for UNC. Um, and she would come back periodically to keep her license alive, you know, with in that world. Well, when we came back from Germany, you know, she got back with UNC and said, Hey, I'd like to start full-time again with you. And the only job that they had for at the time was a women's health clinic under UNC.

SPEAKER_04 50:43

So just so that was interesting. It was primary care still, but it was just women. So that was unique to me. I did a lot of learning there too, because I have done birth to death ever since I became a nurse practitioner. My personal physical changes, things like that. That's what I thought it was. Went to my primary, eh, here's your antidepressant, went to my GYN, and I the words that came out of my mouth, and I appreciate him being so honest. I said, Do you know anything about hormones? Literally. And I was like, God, why did I say it like that? He goes, I really don't. I kind of, you know, I birth the babies, I do the procedures. I was like, appreciate that. Then I called a retired women's health nurse practitioner under the back porch. I was like, I'm effing. Are there little e's on this? Little ease on your podcast? I don't want to say bad words, but ears.

SPEAKER_01 51:26

Oh no, you can't say.

SPEAKER_04 51:29

So I was like, I'm losing my effing mind. I think it's this. And I this is not working, and I cannot live like this. He's like, you need this, you need that, just tell your primary. So I did, and he's like, because I when I walk in there, sometimes he's like, What do you want?

SPEAKER_00 51:45

I've heard in the medical field that you are the scariest person to see. Not you personally. Oh, he might be.

SPEAKER_01 51:51

Like other doctors and nurses.

SPEAKER_00 51:54

Doctors, nurses, nurse practitioners, people in the medical field that have the knowledge. There's actually all kinds of social media funnies out there that we kind of see. We can see our own health.

SPEAKER_04 52:03

We cannot see our own health. And we have to understand that.

SPEAKER_03 52:06

It's an us and them mentality.

SPEAKER_04 52:07

I will look at him and sometimes and be like, just talk to me, just let me be the patient or whatever. It is an interesting dynamic. But so started my own nice generic insurance covered bioidentical hormone. Anxiety got better, brain fog got better. Um, still had to understand the physiologic changes. Well, not physiological, well, yes, but the physical changes too, body composition changes happen to every single woman. There are a lot of women with a lot of us grieve the changes in our body physically and how we thought. If I had a glass of wine, holy lord, you're gonna pay for it the next day. Or why does coffee make me like this now? It's just everything, everything was not right.

SPEAKER_00 52:47

But and what age does paramenopause start? Because this is such a a misconception. It blew my mind when recently my women's health doctor shared. Go ahead, go ahead.

SPEAKER_04 52:59

So if the average age of menopause is 51, and it is in the United States, that means 50% of women are on either side. So 45 to 55 is considered normal when your periods normally stop, it's between 45 and 55. So perimenopause studies show in white American females about 7.2 years prior to the final menstrual cycle. For African American females, 10 years. So if she's gonna stop at 45, we're looking at a 35-year-old. So when people say, When should I be looking? I'm like, 38. They're like, What? I'm like, I'm so serious. Your first symptoms are brain fog, insomnia, and new anxiety. I have stories upon stories. I had a woman last week come in at 49. Yeah. She said, My physician told me I was too young for this. And what I tell women, I'm like, your healthcare providers, all of us, and we're all on the same team, and we all care for people, and this is always a calling. We tell you what we know.

unknown 53:53

Yeah.

SPEAKER_04 53:54

And if it doesn't sit right with you, it's okay to find someone else. I have women that come, they're like, he delivered my two children, and I went last year and told him these symptoms, and he just blew me off and patted me on the leg and said, Your mother got through it, so did your grandmother, and so will you. Do you want birth control? And she was, she's like, it just crushed me. She goes, I love this man. I don't want to go back to him. Yeah. So back to your original question, late 30s. And but these these are the typical women that go in and they are given an antidepressant. I was, it shouldn't work. It didn't work. You know why? Because that wasn't the problem. I don't have a sertraline deficiency. Yeah. I have estrogen that is high as eczema for one day, and in the toilet the next. Yeah. And the progesterone's going up. How fun is that?

SPEAKER_03 54:37

This is important, guys. This is important. So here's my other show there. Here's my other show. We're gonna we're gonna start the men's the men's menopause support group. There you go. And we need to.

SPEAKER_04 54:47

And the B and Fuque is gonna be the first meeting of the house.

SPEAKER_03 54:50

We need to start interviewing, doing interviews online and having discussions about this.

SPEAKER_04 54:54

Yeah, there you go. I love when a man comes to visit with his wife.

SPEAKER_00 54:59

Oh, yeah.

SPEAKER_04 55:00

And then I had a man come in, it looked like he just left a gym. He came in, he was like, hey, we were at lunch in the back. My wife uh sent me over here to pick up some samples. We were like, you're welcome.

SPEAKER_00 55:11

Yeah, this is gonna help you as much as it is her.

SPEAKER_01 55:14

It's it's fun. We talk a lot about how, like, when I was younger, oh, that's old people stuff.

SPEAKER_04 55:20

Yeah. African American women that are in this age experiencing this are raising their grandchildren.

unknown 55:26

Yeah.

SPEAKER_04 55:26

Because it's that's a cultural norm, which is this beautiful thing, generations caring for generations. Now, how do we we get this care? Number one, to all providers, and that's gonna come over decades. But how do we get interventions now to African American females to improve their quality and longevity? And it's not just longevity. We use that, throw that that's a cool word now, longevity, long time. Yeah, my grandmother lived to 94, but dude, she didn't say my name for the last four years of her life. What is that? Yeah, like I want health span, not longevity. And that's a a buzzword, a marketing word right now that I have emotions on. So can you speak to me?

SPEAKER_00 56:04

Can you speak to the fact that the FDA black box was recently lifted for hormones? Can you speak what that's all about?

SPEAKER_03 56:13

She actually got interviewed on that specific uh couple days after it. A couple days after it happened. Nice. They called Jamie. That's interesting.

SPEAKER_04 56:21

With the lifting of the black box warning, those of us who've been praying for that for years were so excited about that because it it was estrogen, which is one of the most predominant hormones went during our fertile years, goes away, becomes chaotic, it affects us and pretty much a ripple effect. That's given the arm had um a type of estrogen and a uh a synthetic type of progestin. So what happened then, of course, all from the goodness, oh my goodness, we may be causing harm with this, let's stop it. But rather than looking further into that, it it just hit the media and all hormone therapy is bad. When the reason for the study was they knew hormone therapy wasn't bad, they were trying to study heart risks or and improvements because they saw it. See it anecdotally. Okay, let's put this in numbers, let's make this evidence-based. So for the last 20 years, hormone and hormone therapy has been like fear-based, it's going to harm. And what I say in almost every setting is we've done so much harm in the name of not doing harm by withholding women's hormones that are beneficial based upon that fear. And when it comes to the significance of that study, it specifically says in the study that it was almost statistically significant. So, see what we've done to an entire generation based upon that. And I don't think it was bad intention. It just was misinterpreted data that just grew hair and legs and just kind of know.

SPEAKER_00 57:43

And let me tell you from the conversations I've now recently had with every woman that has had hormone replacement therapy, they've said the same words. It changed my life. Absolutely. Not one of them has said, Yes, oh man, this was a bad idea. This wrecked me. Right. It changed my life.

SPEAKER_04 58:00

The expectation management that I tell my patient, I'm like, if your neighbor said, Oh my God, it's the best thing ever, and they come back in their eight-week follow-up with me, and they're like, I feel a little better. I'm still not, I'm like, sis, it, we, it's a moving target, and we're gonna, we're going to get it right. Don't give up on this. Like we are with you every step of the way because it is very nuanced, especially in the peri stages. After the fact, you got your hormones are bottom. And we can we can make them where we want them, where evidence is going to show that is it's a benefit at a certain level. What are we testing? So we are you will get a typical blood count called a CBC, a metabolic panel, which is blood sugar, liver function, kidneys, some electrolytes, maybe your proteins, and your cholesterol level. But if you're feeling bad, you're having central weight gain, your hair's falling out, breaking, whatever, then here's your TSH, TSH only, thyroid stimulating hormone. That's normal as well. Are you tired? Maybe your vitamin D is, I don't know, 30. Maybe you could use a little more, but that's normal. You go further and you look, and the paramenopausal woman of the actual hormones, so you it what your labs tell you on that day is at that moment. I had mine tested recently. I had a 367 and two weeks day, two weeks later I had a 60, and this is just of my estrogen. So super interesting to me. And could I feel that? Oh, yeah.

SPEAKER_02 59:20

Yeah.

SPEAKER_04 59:20

Um, so peri is still peri, and it is difficult because you're not going to get a snapshot at this point during those seven, 10, 4 years before your final menstrual period, that there is no lab value that goes perimenopause. It is your constellation of symptoms and a clinician that understands patterned recognition and connecting the dots. Girls say that again. Pattern recognition, connecting the dots with a clinician who understands that. I just had to throw that out there. And I love data, don't get me wrong. Yeah. But like you have to know what you're you're looking at. You have, you have to. And that what is what midlife women's care is right now, is the pattern recognition. Now, just because I have a menopause hammer doesn't mean everything's menopause. Your thyroid, all the way down to thyroid antibodies, I find commonly women have thyroid antibodies, and the thyroid has yet to go, you know, it's fighting a good fight. It has yet to fail, I guess. But other things like insulin, normal A1C, normal fasting glucose. I check her insulin. It's 19. It's in the green zone. Oh, she's already developing insulin resistance. Yeah. Let's intervene right here at 45 years old. And it is not, it is completely wrong to think a woman cannot use hormone replacement therapy or hormone therapy or menopausal hormone therapy. We fight in big circles about what the acronym should be when you're still menstruating. You absolutely can support a woman's hormones. And then you also need to teach a woman, this is an entirely new body. Everything that has told your body what to do and be is vastly different for ever and ever. Amen.

SPEAKER_01 1:00:54

I got questions of how you guys work together, but what's it like for you to see this is y'all's business, right? Like you see this everyone.

SPEAKER_00 1:01:02

Are you working at the front? Do they see you right away?

SPEAKER_03 1:01:06

Like I joked about earlier. Like my I'm I always joke that like Jamie's like the the director and the lead actor in the in the film, and and all of her, she's got all of her actors up there with her, and she's leading all that.

SPEAKER_04 1:01:16

And we're not acting, by the way. Yeah.

SPEAKER_03 1:01:18

But they're not acting, but I I'm I'm basically the guy that runs the stage career. You know, I got I make sure the lighting's right, we got the sound up, we got the yeah, do we have all the props to run? You're the Charlie.

SPEAKER_04 1:01:28

He is the brains behind this. Like I am the clinician. Yeah, and he has taught me so much. I am like, dude, I'm a freaking business owner. How in the hell did that happen? This guy, because he, you know, yeah. Dude, did you hear your coffee? Pat me on the head, do good things today. Yeah. Yes, sir. You know, and he I come back with like, this is a problem, and this is a problem, and what about this? And how do we grow? And, you know, I I'm outgrowing the space already. We just opened it. And he's like, okay, babe. And we just we talk about this, and he is a strategic thinker. Absolutely.

SPEAKER_01 1:01:59

What's that like to work together? Because we we obviously as you know, we work together.

SPEAKER_04 1:02:03

Describing our dynamic. We are so different, but so many people have said we are just this puzzle piece that is just yeah.

SPEAKER_03 1:02:08

Yeah, I mean, it's I mean, you have your ups and downs. I mean, you guys know that you can't. Wait, you don't fight? You do the same thing.

SPEAKER_01 1:02:13

99% amazing, 1% oh my god, I got more gray hair.

SPEAKER_03 1:02:18

Never a disagreement. No, I mean, we have different ways of approaching certain things. That doesn't mean there's a more right way or a wrong way to do it. I mean, I mean, sometimes you get there it's the right way, the wrong way, and Jamie's way. We do have those discussions every now and then. I mean, we have to have you have to have both in order to make it work. Like if you did everything the way Jamie wanted to do it, it probably wouldn't work. If you did everything the way I wanted to do it, it definitely wouldn't work. Where do you where do you go? Like we were talking about earlier, you know, like who do I gotta talk to to do this? Like you you said you mentioned that you have a guy now that does all the editing lane because that was just something you guys like you know, I can't do that one. Like we're gonna kill each other when you're gonna do it.

SPEAKER_00 1:02:55

As you know, as you're doing your your growth and your scaling, you've only got so many hours in the day. And there's so many tasks in a small business that fall on.

SPEAKER_01 1:03:04

And for us, it's usually when it's like there's not a differentiation of skills like, oh, we both can do this. Then that's where we we have rubber.

SPEAKER_00 1:03:12

But that's really yeah.

SPEAKER_01 1:03:13

I always joke and tell people like it becomes whole different when you have a fight with their coworker and then you go to bed with them. Like you you better figure life out. It's true.

SPEAKER_03 1:03:23

You're gonna be on the couch for the god knows how long. Yeah, I mean, like the kind of one of the upsides is we do have very different roles. Like I the as much as I would want maybe to do what she does, there's no way I ever can do what she does. I'm not a licensed clinician, I'm not female, I don't have the like there's no way I could do any of what she does.

SPEAKER_00 1:03:43

You're an incredibly nice guy, but you would not be the one that I would go to for hormones. And I wouldn't expect that you would. I mean, we're not like he knows more than any other guy I know. Right.

SPEAKER_03 1:03:51

I am the only male in the company. Yeah. It will probably be that way for a long time.

SPEAKER_00 1:03:56

But I think there's some power to that. As you mentioned, like there's so many men that want support. I have a loving, wonderful, supportive husband. So many men call it survival.

SPEAKER_01 1:04:05

Support, survival.

SPEAKER_00 1:04:07

So many men want additional survival tactics in their toll belt. So do you all have some kind of like programmatic built-in, or are you guys looking to expand that?

SPEAKER_03 1:04:16

We do not. We have I I have joked about it a lot. I do not really have a game plan on what that looks like right now. I think right now it part of part of I think the only thing we really got going on right now is kind of an awareness campaign. Like it's okay to be concerned about your wife. It's okay to be supportive, it's okay to learn more about this. She's going through a really difficult time and it's not you.

SPEAKER_00 1:04:37

Can we talk about what's not okay for a minute? Yes.

SPEAKER_03 1:04:40

Of course you can.

SPEAKER_00 1:04:41

You know what I'm gonna say.

unknown 1:04:43

No.

SPEAKER_00 1:04:43

Is this your time of the month, or is something happening with you? Are you going through that thing?

SPEAKER_01 1:04:50

I'll see you guys later.

SPEAKER_00 1:04:51

Yes.

SPEAKER_04 1:04:52

When that is the only reason we're pissed off. Oh, I know where you're pissed off. You must be getting ready to start. No, but like are your hormones and open A.

SPEAKER_03 1:05:02

Well, and you see, on the and that that would be a fair question. Um, like you walk in, your wife's throwing pots and pans at you, and you do I mean that's an obvious the hormones. You didn't you didn't put the, you know, you didn't put your glass away. There's this this might be see, there might be something off.

SPEAKER_01 1:05:16

I'm smart enough to not go, oh, is it that time of the month? We'll have an argument and then she'll be that time of the month. That makes sense to me.

SPEAKER_00 1:05:25

You'll never be stupid enough to say that, or else you would have to be a little bit more than a little bit.

SPEAKER_01 1:05:29

We had a disagreement over it.

SPEAKER_03 1:05:30

No, but that's a very one-dimensional look at and a very probably a misogynist way of looking at the problem set, right? Being you know, somebody trained in strat you know strategic thinking and understanding communications and how they work, you probably want to be a little bit more diplomatic in how you approach this. I think a lot of it too, again, going back to it's it's lack of knowledge. I mean you have women that don't understand what's going on, you have clinicians that don't understand what's going on. How in God's name are you gonna expect? Men to truly understand what's going on. It's almost not even fair, right?

SPEAKER_00 1:06:04

Yeah, I thought that menopause was hot flashes and your period stops in the end.

SPEAKER_03 1:06:09

That's all I thought it was.

SPEAKER_00 1:06:11

It was only that, right? I had no idea.

SPEAKER_04 1:06:13

It is, it is a fundamental shift and a neuroendocrine shift that is one direction only.

SPEAKER_03 1:06:19

We have had women come into the clinic after after seeing Jamie and they're like, you have saved my job. You have saved my relationship. In some cases, they've said you saved my life. Yeah. Like it's it is that dramatic. It's so serious. I think when the men get involved and truly understand what's going on, they're like, oh my God, I didn't realize Did I not say?

SPEAKER_00 1:06:37

I felt like I was getting Alzheimer's. I was losing urgent.

SPEAKER_04 1:06:40

You felt like you were and then but also like having full workups. So full workups for um multiple sclerosis because of these random sensations. Yeah. I'm having tingling. I feel like there's little drops of water every now and that come in my legs. When we're like, are you was that it? Itching, the itching in the lower abdomen.

SPEAKER_00 1:06:58

Itching in the ear. The itching in the ear. Just the itching. The itching. All the itching. Everything. Estrogen dry and itchy.

SPEAKER_04 1:07:05

Estrogen's going, hey lady.

SPEAKER_00 1:07:08

Maybe this happens so that the kids want to leave home.

SPEAKER_04 1:07:13

I don't know. I agree. We are at the top of our game professionally. We have raised kids, or we have issue, we have women who will have late-in-life children, and those children are now starting their periods. And he's, you know, wanting to the husband's like, Jesus, I know what is happening. But not just that, it's it's um late-in-life pregnancies in the early 40s, and women come, they're like, My child is four years old. I have never felt like myself. I have been exhausted. You know, that is real. If you're having a late-in-life child and you do you flip from postpartum to perimenopause? Absolutely. Don't anyone tell you, let them tell you, or whatever I'm trying to say, that that does not exist because it absolutely does. But yeah, you're right. It's it's this intersecting point where I find a lot a lot of clarity. I don't have this desire to hold an infant. Like it just kind of it shifts. And we've done for others so much that at this time we find ourselves going, I need to do for me. And in the right andor wrong relationships, that's um seen as selfish, as you why aren't you doing this for me? You don't love me. Kids, the same thing. And but you're like, I but I want to do all the things because that was my identity and that made me feel good, but I can't because I can't get out of bed this morning. Or I I'm so irritable that this one thing just sends you off the deep end. It's it's over.

SPEAKER_00 1:08:37

On the opposite of that, it can depress you off the deep end where depression is so common. Things that just in hindsight really weren't that traumatic. And the moment they seemed very traumatic.

SPEAKER_04 1:08:50

And then you feel guilty about it. Then you're in the spiral, and then I'm a bad mom, I'm a bad wife, I'm a bad whatever, I'm a bad this. But if if you fully understand that it is a chemical change in you, does it make it easier? Not necessarily.

SPEAKER_01 1:09:02

And this isn't like, hey, this might happen.

SPEAKER_00 1:09:05

It's oh, it's gonna happen. Oh, it's gonna happen. Yeah.

SPEAKER_03 1:09:08

If you live and that's another interesting part, I think like her and I have talked about this a lot. Like people go, why, you know, why is this happening? Why is it happening? You know, why is this becoming more prominent? Really, it's it's kind of a medical medical technology discussion, right? We live longer now. And like if you think about it a lot, like if you go back 300, 400 years, right? People did not live as long as and live that long. So now you have people living a lot longer, and you have women in the workplace that have become very successful and prominent. And do so this is legitimately an issue now. You know, it's 51% of your population plus, right?

SPEAKER_00 1:09:43

And several times in in this conversation, you all have said the words um, this is now happening earlier than what has been studied in the past. And I think that we may be seeing some of that as well because it feels like more and more people are having these conversations of these symptoms much earlier than ever before. We're seeing a lot of shifts.

SPEAKER_01 1:10:04

As we wrap it up though, Stuart, deep question for you. Deep question. Given all you've been through, what do you value most in life?

SPEAKER_03 1:10:12

You start to really understand how important your time is and how much I don't know if you ever heard the term of quality days remaining, but they they use that one a lot. You start really thinking about how many quality days remaining do I have when you start kind of seeing or being threatened with your own mortality. I mean, you know, when we spent time in combat zones, it's a survival mechanism that you have is like any day can be my day. You don't sit there and dwell on it anymore. Like a mortar lands about five, you know, 50 feet from you, you you just you keep on moving forward. And then you get by all that stuff, and then you get back and like you get threatened with things like this, and you start having mortality thoughts again, you know, and then you start thinking, well, how much time do I have? And what do I want to get done between now and the time I get my my ticket punched, you know? You know, time is probably one of the most important things to me. Um, time I spend with my family, time we get to go and you know, meet with folks like you. You only have like I think Jamie mentioned it earlier, you know, that how much health do you have. You know, my dad, my dad used to tell me when I was a kid, and I never really gave this much thought until I got older. He's like, in order to do what you want to do in life, you have to have the time, the money, and the health. He's like, unfortunately, usually usually missing one of the three. And when I was younger, I didn't think much about it. But when it, you know, as I got older, I started seeing it. Like when you're young, you know, your time is cheap and your health is there, but you have no money. Yeah, you know, and then you get older and you start making some money, but you have no time anymore because you're too busy doing all these things, right? And then when you finally have the time, you finally have the money, now you don't have the health anymore. So you can't go out and do all these things that you want to do. So those conversations with my father come back a lot as I get older on the time, the money, and the health. And um they're all three are really important, but they're also mainly health and time. They're interrelated, they become more interrelated as you get older. And um, I'm I definitely value my my time uh more than anything else.

SPEAKER_01 1:12:11

So I appreciate it.

SPEAKER_00 1:12:12

I'd love to ask the same question of you, Jamie. What do you value most?

SPEAKER_04 1:12:16

Definitely time and relationships and the ability to share what I have learned as a midlife woman with other midlife women.

SPEAKER_00 1:12:28

Love that. Thank you both for being well in touch with us. Subscribe, like, and comment, and don't forget to set those notifications. We'll see you next week with another special guest.

SPEAKER_01 1:12:43

Until then, get on your journey.