Introduction

Kerry 0:29

All right. Hi everybody. Welcome back to the Get Healthy Tampa Bay Podcast. I'm your host, Dr. Kerry Reller, and today we have Dr. D'Wan Carpenter, otherwise known as Dr. D. Welcome to the podcast.

D'Wan 0:40

Thank you so much, Kerry.

Kerry 0:42

So excited to have you here today. Dr. D is a physical medicine and rehabilitation doctor, as well as has a lifestyle medicine board certification. So she's gonna tell us all about that. So she's also a wife, a mom of four. Is passionate about helping patients make sustainable changes that transform their health. So welcome again, and why don't you tell us a little bit about who you are and what you do.

D'Wan 1:06

Absolutely. Probably the biggest is what in the world is physical medicine and rehabilitation. Most people have never heard of that, but you probably have encountered a physical medicine and rehab doctor at some point in time. So to make it super simple what I do is see patient after their hospital stay that are still having problems taking care of themselves, they can't go home or they're not at a place where their families can help them as much. So they will come to a rehab hospital and see a doctor like me, where we help work with them, along with a team of health professionals therapists, nurses, and we help them to improve their function so they can go back home and live their usual life, at least as close as possible. But we also do a ton of other things, even outside of the hospital. Some of my colleagues are specifically trained in pain. Sometimes they are specifically trained in sports medicine. I'm general, so I all of the things. But I don't have a specific focus or certification in any of the others. So that's physical medicine and rehabilitation. And I focus on lifestyle medicine now because what I've learned in my practice of physical medicine is that we can see people and rehab them, but if they go back home and do the same things, they are more than likely to see me again, which I don't want, not for the same thing, come back and see me for something different, but not for the same thing. So we can talk more about that. But yes, I am a wife, a mom of four. Little fun fact the four was a big surprise'cause I had a girl and a boy and, there's the little saying God said, give the cocky one twins. So I had twins to add to the, the two that I already had. But it's been a joy. It really has been.

Kerry 3:04

Wow, that is a lot a lot of work for sure to have four kids in general, and then also to have a set of twins, especially as the young ones. Wow. Okay. so you mentioned like pm and RII have familiarity, with some colleagues going into the pain in sports, like you mentioned for sure. But there was something that you said that they would come back to you. Can you give me an example of what kind of condition or what thing it would what they might have? Or why would they be coming back to you if, you know you've rehabbed them and been on their merry way and they're all good now?

D'Wan 3:36

Yes. So one of them is, that's probably the biggest is stroke. A patient that has had a stroke and they have weakness on one side, difficulty talking or swallowing, and. We, go through the process of rehab. Certainly rehab continues even after patients leave the hospital, but what I found was these same people would come back and now they've had another stroke or a complication from the prior stroke. And I'm thinking. Maybe we're not doing a great job of actually taking care of these people. And I was talking with a colleague just about my frustration that, I feel like I'm not really helping people. We see the same people coming back just like it's a revolving door and I just feel like there's something that needs to be done. And that was actually my first introduction to lifestyle medicine, she said. Oh, it sounds like you wanna do more than just the rehab. Have you ever looked into lifestyle medicine? I'm like, no. What is that? And with her help, I investigated it. And really what it comes down to is stroke by itself has some things that, you can't prevent. So if there's some predispositions in your in your genes, your family history, things like that, obviously you can't change those. But a lot of the factors that lead people to be at high risk for stroke includes high blood pressure, high cholesterol, lack of exercise, smoking, tobacco, cigarette smoking specifically. Those are all factors that can be controlled, and so maybe that's where the problem is. So again, on my investigation, I found that a lot of the lifestyle factors, what we do in our everyday lives that become our habits are actually the things that are putting our health at risk. Particularly the patients that I see again, we're regarding stroke. There's a number of factors that are preventable, so how about we focus on those in addition to the physical rehab that we need to do, so that, okay, you recover from this, but we don't have this same thing happening over and over because nothing else has changed.

Kerry 5:52

I would add diabetes is one in there that you didn't mention but. So in their recovery and their rehabilitation just acutely after a hospital setting, it doesn't include any lifestyle stuff. Is that correct?

D'Wan 6:03

It doesn't, certainly I do what I can within the confines of the hospital, but some of, we're still evolving. Most of it is focused on the very acute things like you mentioned. Trying to get those muscles to respond and get some return of their strength and focus on, swallowing their ability to speak if that was affected. We do focus on those things, but I have not yet been able to tackle'cause one of the big things is definitely diet, what we eat and certainly I did fail to mention diabetes. That's a huge factor actually is double the risk. And in the hospital we're still trying to play catchup, at least at mine. I can't speak for all of them'cause I haven't worked at all of them, but at least at my hospital, we're still playing catchup where the nutrition and dietary services are actually on board with really what lifestyle medicine changes can be done initially, which I think is really important too.

Kerry 7:07

Yeah, I would think like having an all encompassing program though, I realize, there's acute need of things like you wanna be able to eat to even care about what you're eating, right?

D'Wan 7:16

Correct.

Kerry 7:17

But I don't know, maybe they need some sort of follow-up cardiac rehab and pulmonary rehab, that's what you do outpatient. Anytime after that you've had an event. So why not some sort of program, like what you're offering basically. Anytime where their insurance can cover it, stroke rehab in a different way, right? So it doesn't prevent, again, I don't know. Interesting. So you, you obviously talking about, how you bring lifestyle medicine into, pm and r in your practice and everything. So tell us, in review, I know we've had other lifestyle doctors on here, but what are the kind of the key pillars of lifestyle medicine?

D'Wan 7:51

Yeah, so the key pillars, it really consists of six. My disclaimer is I am a woman of faith and so I added a seventh pillar, which would be spiritual.'cause I feel like that has to be the foundation of everything. But the traditional pillars include nutrition, obviously it includes physical activity. It includes sleep, it includes stress stress management. It includes a avoidance of risky substances. So that, includes the tobacco, the alcohol, any other drugs of that nature. And then also your social connection. If we briefly take a walk. In the past, we all remember the times of shutdown during COV and how much that really impacted all of us by not being able to have our usual connections, close connections with people, and so that has a huge impact on our overall health and wellbeing.

Kerry 8:50

Absolutely. Yeah, I mean I think we know that from also like longevity studies and the blue zones, like the social connection piece is very important. Yeah. And then, adding spirituality in there I think is great. I don't know if it would go with social connection a little bit, but that's great. So how do you add that in as well?

D'Wan 9:12

the spiritual piece?

Kerry 9:13

Yeah.

D'Wan 9:14

Certainly I always ask patients, if they have any objections or things like that. But what I have found is that some patients actually just want to be able to share their own faith or in times where maybe. Their faith is not as strong having someone to just quietly pray over them with them, for them. Again, depending on where they are, if they prefer scriptures, I use that as again, a foundation and kind of a point of motivation. Again, when we're talking about physical medicine, we're essentially putting patients on a workout plan and it's tough. If you think about you decided you wanted to run a 5K and you had never run before, that's what these patients are experiencing. And so you definitely need some motivation. And so for a lot of people, prayer scriptures, inspirational quotes and things like that definitely is one that helps. And then I always ask them. What other spiritual supports do you have? Is it a pastor? Is it, just a spiritual mentor? Whatever it is that you have, let's include them as well. Let them know what you're doing. Reach out to them when you're having tough times because again, I believe we all need a village. So it, it takes more than even just the health professionals, but you need other people on your side as well. And so if they are of the same spiritual beliefs and backgrounds, they also then just add as another piece of that foundation that now patients can build off of.

Conditions That Improve Most with Lifestyle Changes

Kerry 10:50

I think that's a really important message that I haven't heard anybody say before. So I think that's a great addition to lifestyle medicine, if you will. So in your experience, what health problems improve the most with lifestyle changes?

D'Wan 11:03

Definitely a big part is hypertension, diabetes, those are probably the two and heart disease, they all go together. Improve a lot with lifestyle medicine. Again, because we look at, what we're doing in terms of our food, we. at least in the US we live in a fast-paced society, so you know, we need fast food and people are stopping to grab things. And though some places have healthier options, most of the time, I'll put myself in the category. Sometimes it's me too. Okay. I like a french fry. And so those aren't always the best options, but we know that those things, processed foods, have lots of sodium. So you're getting a lot more salt that's going to increase your blood pressure, increases your risk for heart disease. The same for diabetes. Pretty much everything is packed with sugar. I looked at the bottles when I was, first getting into this just on my own health journey. And I was shocked that the salad dressing has sugar in it but I'm choosing a salad. I need a little bit of dressing, not a ton where now I'm getting additional sugar that I have to incorporate. And so those are really the top ones that we know are drastically changed when people actually start on a lifestyle medicine journey. And start changing their, food choices and looking at labels and making sure that they know exactly what it is that they're putting in their mouth. And, you gotta move.

Lifestyle Medicine and Chronic Pain

Kerry 12:38

Yeah, no, I totally agree. I love discussing nutrition labels and the importance of looking at them. And I think, I used to buy those bag salads for our family, and then finally I'm looking at the salad dressing label. I'm like, darn it, I'm trying to avoid added sugar. So I stopped buying them, but it was fun'cause my kids could help, make it better than, like a regular salad. So we'll get one every now and then, but it's definitely not on the regular anymore, yeah, I would agree. The diabetes, blood pressure, cholesterol. I think those are some things that we see that really do improve quickly, depending upon how much, people are making changes. Like it could be pretty good improvements, which I love. So I love like rechecking those in six months or something like that. What about pain? I'm sure you deal a lot with pain or chronic pain or maybe fatigue and things like that. Do you see that improve at all with lifestyle changes?

D'Wan 13:33

I do definitely. So certainly. Again, what we eat impacts our body and how it processes the inflammation. A lot of people, have arthritis complaints so when they make changes to their diet and watch what they're eating, but also when they are moving more so decreasing their weight also improves those things. And the other thing too is which I didn't mention, is definitely related to meat. So lifestyle medicine tends to focus on whole food, plant-based or plant predominant. And one of those things for some people can be hard.'cause you grow up most of us on meat, unless your parents were already vegetarian or vegan or what have you. That's a huge part of our society today, and we know just based on all of the research and the literature that has been done that our meats maybe once upon a time they were, pure and didn't have a lot of other things in them. But just the other day what was it? I don't remember what News outlet reported it, but bacon reported that bacon is, found to have some carcinogenicity and things like that. And, I learned that in lifestyle medicine it only takes three slices three slices, even little pieces of bacon in a week still increases your risk of, cancer significantly. Those all definitely still, impact your pain. And one of the things I will say,'cause my prior background, my first job actually was working in a pain management type of office. And so I will tell you that definitely there are still a lot of people that are getting put on, opioids and narcotics and unfortunately are having difficulties getting off of them. The other thing that affects pain a lot, that many people may not realize is also your mood if you are depressed, which again if you're in a rehab hospital and you know you've had a major life change, like a stroke, a brain injury, a major surgery, it's not uncommon for you to experience some sadness, maybe even into depression. But again, the research that has been done shows that even depression on a mild level can skyrocket. How you feel pain. So all of those things, again, play a part in it, which is why, we can't just focus on one. We have to look at all of the pillars in order to help to decrease a person's pain.

Kerry 16:20

Yeah, I was going to actually ask you, what about like even with lifestyle changes, does mental health improve? Like how has that affected Now you brought the mental health connection to pain, which is very important too, but. I think changing the way you eat and move and social connection and all the things that are in part of lifestyle medicine can help improve mental health. What do you think? What have you seen before?

D'Wan 16:44

Yes, I've definitely seen improvements because it goes along with when you start feeling better people don't see the results I think as much initially as much as they feel them, they feel different, and sometimes don't even put two and two together that, oh, this is from all of these other changes that I've made. When you feel better, your mood improves. You start to dress a little better. You may put on, if you're a woman, little, eyeshadow that day, people start noticing men have a little bit more bounce in their step. That's a huge, that's a huge component of, improving your mood and mental health. And then again, if you're not feeling as unwell, you don't have pain and things like that, you're moving more. Now you also are more likely to make those social connections, which again are, you're increasing that, those feel good hormones. And so it's just like that, positive feedback cycle that you're doing things that are having spillover effects into everything else that makes you want to continue to do that.

Kerry 17:52

Yeah, those endorphins and serotonin and everything as well. I wanna go back to the meat for a second.'cause you mentioned like carcinogens and the risk of meats and typically we're talking about what you had mentioned was the process meats, right? So then the ones with the nitrates and nitrites I think as well. And those ones have that risk factor for cancer, especially colon cancer, I think. And then I think another comment would be that I think our meat supply is very different than what it used to be, right? I think that, moving towards if you're gonna choose to eat meat, right? Grass fed versus the one with the pig feed. And I think that's when they can pick up, or what did I say, pig feed. I don't know, I mean that is definitely gonna eliminate more of the risk and other things that may be incorporated in the meat to make it a little bit less healthy, like when they're using pesticides and things like that in food as well. So free range, grass fed, those are typically some good words to see. I think when you are trying to pick your animal products, really right, if you ha if you are gonna use them. Now, I realize lifestyle medicine doesn't like those as much, but people are going to consume them. But the point is going to be possibly moderation if they can't follow a completely, a plant-based diet. What were we gonna

D'Wan 19:14

Correct. Yeah, I was gonna say that's definitely accurate. I would also, again, depending on how strict that you want to be investigation helps because some of the places that report, not specifically with the grass fed, but I know for sure when we're talking about poultry and things like that, eggs for example, free range and things those are some buzzword that really don't always mean the same. I actually met a farmer. I guess farmer, he raises cows and chickens and things like that. And he actually walked me through how to really investigate a lot of these companies that are using these words that are not the same. So it's really important to know where you get your things from. If you can buy locally that's always a good thing'cause then you can tell where it's coming from. You can investigate are they actually doing the processes that they say that they're doing. But definitely grass fed is always better than, the ones that are getting just the, I think, what do they get? Just, feed or something, corn, meal feed, something like that definitely is always better. But yeah, if your traditional lifestyle medicine says plant-based, but at least plant predominant. So for example, I tell my patients, Hey, maybe you know you enjoy meat and that's not something that you're looking at doing. Okay, let's work on, hey, let's have a one day, or, meatless Mondays where you're starting out slow and again, people start something and then re realize, wow, I feel different when I do this. Oh, only thing I changed was no meat on Mondays. Maybe I'll try that another day. So my biggest thing for anyone is if you want to make health changes and you hear all these different things, do this. Don't do that. Focus on something that you feel is low entry. What is one thing that I could change? Just see how I feel, or am I getting changes in my labs when I go see my doctor? Because again, I think the biggest thing to maintaining any lifestyle is how easy is it to sustain? If I gotta go through counting macros and micros and, all that, the whole calculation, probably not many people are gonna stick with that.

Kerry 21:41

Yeah, we usually say the, the best diet is the one you're going to stick to, diet and air quotes, but typically lifestyle. The one you're gonna stick

D'Wan 21:50

Correct.

Kerry 21:51

Yeah. And you already alluded to this, but one of your themes is like small changes can have big impacts. So why do small changes work better than drastic overhaul overhauls for most people.

D'Wan 22:01

Because it's not sustainable when you go from zero to 100. Okay? I'm doing no meat, no sugar, no this, no that. Re the reality is your body craves the things that now you're telling it no. And some of that also is a mental thing. You have to make a mental shift. I say trick your brain sometimes that it's not so much what you can't have. Because that puts it more in a negative light. I tell people to focus on oh, look at what you're adding. We're adding this thing to your diet. We're adding this exercise or this activity that you can do as opposed to taking it away. And what I really love introducing people to is making this little shift. If you are somebody who did white rice with every meal. Let's switch it to brown rice. Don't like the taste of brown rice. Let's mix the two and slowly, gradually do it. Because again, over time, and your taste bud, what do they say? They change every seven years. So it does take time for you to get adjusted, but once you've been doing something for so long, it becomes habit, it becomes natural, and you're like, oh yeah, I used to not ever do that, but now like I don't mind it. So it takes away that shock factor and really the body's naturally wanting to put the brakes on it. Oh no, it's different. I don't like different, I don't wanna do that. So it gets you out of your comfort zone without being so shocking to the system that everything in you just says, I don't wanna do this.

Kerry 23:43

I like the idea of, mixing the two rices together. Typically I'm having someone cut down on the quantity of white rice in general, but I didn't really think about mixing the two together to try to move toward brown. But that's a, that was a fun tip that I like from that. I always learn stuff from everybody I'm talking to, so that's one of my favorite things. what would you say are some other daily small habits that they can dramatically improve their health?

D'Wan 24:09

Oh yes. So let's talk about physical activity. I try to incorporate it into what people are already doing. So for example, if you are going grocery shopping, you can do one of two things. Depending on your comfort level, you can park a little bit further then you get some additional steps in before you even get into the store. You can also just do a lap around the store before you actually start shopping for your products. So again, you're not going out of your way, you're not doing anything that you ordinarily wouldn't do. You're just taking advantage of where you are. And so a lot of people that I work with are busy and, it's how I don't have time for a 60 minute workout and things like that. You don't have to, you can still get the benefits all throughout the day. If you sit at a desk. You can get a standing desk, you can, get one of those little walking pads. I know sometimes Amazon puts them on super deep discount where you know you can take advantage of your life how it is, I believe that you shouldn't have to change your whole life just to, try to live better and improve your health. Let's see how we can make changes with what your lifestyle is and incorporate different things. And so that's what I, try to tell people is, again, small changes. What's that book? Atomic Habits? Open that whole thing up for me.

Kerry 25:41

That just came up with last episode and we talked about how I gave it to my staff for Christmas and how much I liked it too. That's so funny. Yes, it's an excellent book. I highly recommend it and we'll put it in the show notes again. That's awesome. Yeah. I think that's because what, it's one of my mantras as well, right? Because small, tiny habit, what can you change? And sometimes it's something as simple as taking, as that giant teaspoon of sugar you're putting in your coffee and making it much less or eliminating it. And I find that people, oh my gosh, your prediabetes is better now. Yeah. So how would you say you move from helping patients they always know what to do, but how do you get'em to actually do it?

Overcoming Barriers & Building Habits

D'Wan 26:19

Oh, so that's always good. I first start with I like to use the questionnaires. I've found that when you ask somebody what is their goal, and then you ask them. How committed are you to that? They also get to see oh, I really wanna lose a hundred pounds, but I'm about a two on really committed to doing that. So I like to include them in the awareness of really where they are again,'cause we can start wherever you are, but you gotta know where you are in order to get to where you wanna go. So I always start there and including them and then I kind of feed their words back to them. If you tell me that, okay, I wanna lose a hundred pounds and I know that I need to eat right and this, that, and the other, then we start, okay, why don't you. Why are you not eating right? Oh I'm busy. Da. Okay. All right, so let's take that You're busy. What things could you do that could change that wouldn't take any additional time? So again, I work with people where they are because again, I feel like simple is so much better than all the complicated whatever. Even for me, I would love to meal prep. I hate it. Now, will I pay somebody to meal prep for me? Absolutely. So it's eliminating the barrier to entry, whatever that is, and every person every person's barrier is different. So I start there with focusing on what is the barrier to entry and then work around that.

Kerry 27:56

So you mentioned a lot of things, what people should do and adding things for their, changing their habits. But is there anything that you can think of what they should stop doing?

D'Wan 28:05

I could probably think of a ton. Again, I work with a lot of people who the big thing is I'm busy. I don't have time for fill in the blank. And what they should stop doing is saying yes to everything and feeling obligated to do certain things. I learned a long time ago, no is a full and complete sentence. It is okay to say no if whatever it is that you are being asked to do or feeling obligated to do is going to cost you more in the long run. We gotta, you gotta take care of yourself first before you can be of benefit to anybody else, whether it's workplace, family and so that would be the first place is look at what you can eliminate. I just did this with a she wasn't even a patient. It was actually just in a consultation. That was the big thing. I'm taking care of this person and I gotta help my grandkids and my brother and my sister, and dah. I said, the one thing I want you to do is look at what you could cut out. Because I'm not gonna work with you if it's something, she was making it like it was these were the things that needed to happen and she needed me to help her. Let's stop for a second. What can you eliminate? And she came back and said, oh my goodness. I eliminated some things. I told some people, no, I'm not able to do that at this time. And now she's oh yeah, so I'm going to the Y and I'm doing the pool twice a week. And these were all things that she said down the line months later, she would be able to do i, I think that busy isn't really a great thing for

Kerry 29:41

That's a great

D'Wan 29:42

and busy. No.

Kerry 29:44

Great. Yes, I agree. Great story. Great advice. Learning to use the word no, like not everything is going to serve you way you want to be and that you can, reach your own goals. So learning to say no is really important. I like that.

D'Wan 29:57

Yes, definitely.

Final Takeaway: Start with One Small Thing

Kerry 29:59

Is there any one message you want listeners to remember about their health?

D'Wan 30:03

The one message I want listeners to remember is that really you literally have one life to live, and it's so much better when you actually are well enough and healthy enough to be able to enjoy it. So start with one small thing and keep adding from there.

Kerry 30:25

That's great advice. I love it. Where can people find you if they, they want to work with you and tell us a little bit about your practice?

D'Wan 30:33

Yes. So you can find me pretty much on all platforms I am on facebook, Instagram, I have a YouTube channel. You can find all of them are by my name, Dr. Dwan Carpenter, and it's doctor with DR and then DWAN Carpenter, just like the profession. Also that is the same as my website, dr dwan carpenter.com. Everywhere there you can send me a message with asking, requesting, I do free consultations'cause I want to make sure that, we are a good fit. I think that is extremely important. And just to briefly describe my practice, so I operate a hybrid practice, which means that I still do some general physical medicine and rehabilitation. And. That in post-hospital visits, things like that, people that are looking for therapy things like that. So I still can, I still do that. The biggest focus is on the lifestyle medicine again,'cause I feel like that has the greatest impact even on my rehab patients. And so the lifestyle medicine side is mostly membership. I do have, one-off visits and things like that. And again, free consultations. But I know that it takes more time, so I don't wanna, say, oh, okay, you can come in, there's a few visits and we're gonna get you all on the road. That just doesn't work. So I'm very upfront and realistic about that. I also do within the office have IV vitamin therapy again, because I know that some people don't like certain foods they, are not getting some of the things that they need. So I pride myself on offering that with a physician on site, which is not, often seen at many places. And one of the newest services that I've offered is for people that have lost weight. And there are some people that I have seen that have been on GLP ones have lost a significant amount of weight in a short amount of time, and they wanna feel great about their body, but now they have this excess skin, they don't wanna do surgery. So I am one of only two offices in the Tampa area that has t-shaped to body sculpting, and so we do offer that in the office as well.

Kerry 32:57

Cool. Okay. Great. So dr dewan carpenter.com, and then all the other social locations as well. And you are in Tampa. Your physical location we'd said about Carwood area.

D'Wan 33:09

Yes, roundabout Carol Wood.

Kerry 33:11

Awesome. Thank you so much for coming on the podcast. This was a great discussion. I'm sure our listeners learn lots and lots of good information and everybody please stay tuned next week for next week's episode.

D'Wan 33:23

Bye. Thank you so much, Dr. Kerry.

Kerry 33:25

Thank you.