# Dr. Linda Kiley: Bladder Health, Peptides & Pelvic Repair | SNH Podcast #163

An episode of [Health Optimization Medicine Podcast](https://invisiblenetwork.ai/podcast/1663974629), 18 Feb 2026, 1 h 05 min.

Audio: https://traffic.libsyn.com/secure/672d8edf-a640-45ce-ac61-cd5f898a7b27/SNH_163_OBB_AUDIO.mp3?dest-id=3824325

In this episode of the Smarter Not Harder Podcast, Dr. Linda Kiley joins Dr. Scott Sherr for a groundbreaking conversation on functional urogynecology — exploring the real causes of pelvic and bladder pain that most conventional models miss. Dr. Kiley shares how she uses muscle exams, peptide protocols, and root-cause diagnostics to treat conditions like interstitial cystitis, chronic UTIs, pelvic floor dysfunction, and endometriosis — often without surgery or long-term antibiotics. If you or someone you love has been told "there's nothing wrong" but still struggles with pelvic discomfort, bladder issues, or sexual pain, this episode is a must-listen. Join us as we explore: • The pelvic floor as a dynamic system — not just "tight or weak" • Biofilms, interstitial cystitis, and smart testing for chronic infections • How gut health and systemic inflammation drive pelvic pain • Natural, non-invasive approaches to bladder and pelvic restoration This episode is for you if: • You experience chronic UTIs, bladder discomfort, or pelvic pain • You've been dismissed or misdiagnosed by conventional providers • You're a clinician seeking better diagnostics for pelvic dysfunction • You want to understand how muscle tone, breathing, and biofilms intersect You can also find this episode on… YouTube: https://youtu.be/JLZ5iIBFkls?si=yaoHg-qrxF2XCx1n Find more from Dr. Linda Kiley: Website: https://drlindakiley.com/ Instagram: https://www.instagram.com/drkileyurogyn/ YouTube: https://www.youtube.com/@theholisticurogynecologist3891 LinkedIn: https://www.linkedin.com/in/linda-kiley-5999462b/ More from Smarter Not Harder: Website: Smarter Not Harder podcast Instagram: https://instagram.com/troscriptions/ HOMeHOPe Virtual Symposium 2026: https://homehope.org/homehope-virtual-symposium-2026 Get 10% off your purchase of the Clinical Metabolomics module with code PODCAST10 at https://www.homehope.org/ Get 10% off your Troscriptions purchase with code POD10 at https://www.troscriptions.com/ Get daily content from the hosts of Smarter Not Harder by following @troscriptions on Instagram.

## Transcript

[0:12] Dr. Scott Sherr: Hello and welcome back
[0:13] to another episode of the Smarter or
[0:14] Not Harder podcast, where we give you
[0:15] 1 cent solutions to $64,000 questions.
[0:18] I'm your host again today.
[0:19] My name is Dr. Scott Cher and it's a
[0:20] pleasure to be back with all of you.
[0:22] So today I had a really cool
[0:24] guest, very interesting topics
[0:25] about urogynecology, Dr.
[0:27] Linda, Kylie and I actually met Linda
[0:29] through the transcriptions company.
[0:31] She actually started using some
[0:32] of our products, methylene Blue,
[0:34] Corti seven Intro Immune and
[0:35] having some really great benefits.
[0:36] And when she told me what she, what she
[0:37] did and how she was doing, and I was
[0:39] like, I need to have you on the podcast.
[0:40] This is great information that
[0:42] so many people don't know about.
[0:43] So here's a bio on Linda to get started.
[0:46] She's a graduate of University
[0:47] of California at Los Angeles.
[0:49] So UCLA School of Medicine completed
[0:50] her residency in OB GYN at ge
[0:52] George Washington University in dc.
[0:55] She's a board certified physician
[0:56] and subspecialist in OB GYN and
[0:58] uro, organicology and reconstructive
[1:00] plastic or pelvic surgery with over
[1:02] 30 years of experience and decade of
[1:05] a really devoted time to minimally
[1:07] invasive surgical procedures for
[1:08] difficult gynecologic problems.
[1:10] Um, and she's also very much involved
[1:12] in sort of the functional natural
[1:14] methods of getting people better.
[1:15] She uses peptides, she
[1:16] use, uses off-label drugs.
[1:18] She's involved in the International
[1:19] Peptide Society, uh, anti-aging medicine,
[1:22] A four M. She's been involved in that too.
[1:24] Excessive experience in training people
[1:25] for hormonal disorders, menopausal
[1:26] symptoms, and really challenging.
[1:29] Challenging patients overall.
[1:31] And she uses things like
[1:32] peptides, weight management, IV
[1:33] nutritional therapy, and very cool.
[1:35] She actually holds a fourth degree
[1:37] black belt in TaeKwonDo and as a
[1:39] master instructor, and we talked
[1:41] about that during a little bit of
[1:42] the podcast at the end as well.
[1:44] So in this podcast, we dove into
[1:46] some topics that I haven't really
[1:47] talked about a lot here, or
[1:49] really in my clinical practice.
[1:50] They don't have a huge amount of direct
[1:52] relevance, but I refer people over
[1:54] to people like Linda whenever I can.
[1:56] So we talked about.
[1:57] Many different things.
[1:58] We talked about pelvic pain, the
[2:00] musculoskeletal aspect of pelvic
[2:02] pain being the major thing that's
[2:03] underdiagnosed and actually
[2:05] sending people over to pelvic
[2:06] therapy can be transformative.
[2:08] Transformative for patients.
[2:09] And that's really amazing because
[2:11] most of these patients get written off
[2:12] and sent to psychiatrist and there's
[2:15] a lot of musculoskeletal aspects
[2:16] of here you can do a lot of good.
[2:18] Then we transitioned over to bladder,
[2:19] the bladder pain, bladder spasm.
[2:21] Uh, we talked about interstitial
[2:22] cystitis for a long period of time.
[2:24] Significant interest to me because
[2:26] this is actually a patient population
[2:27] that has the highest suicide rate and.
[2:30] Often gets sent to psych, but she does
[2:32] advanced testing, like urine culture,
[2:34] advanced urine cultures, and finding
[2:36] bugs, hiding in the bladder that regular
[2:39] doctors aren't seeing, and also looking
[2:41] at biofilms and how to break them up.
[2:42] She uses really cool ways of actually
[2:44] instilling various types of things
[2:46] like lidocaine, tobramycin, uh,
[2:49] gentamycin, other kinds of antibiotics
[2:51] and other antimicrobials, anti and also
[2:53] anti-inflammatories, like, uh, like, uh,
[2:56] like steroids as well in the bladder.
[2:58] Basically significantly
[2:59] help these patients.
[3:00] And I, you know, she gave me a statistic
[3:02] or a thought that she thinks, she
[3:03] actually thinks that about 90% or
[3:05] more of IC patients, interstitial
[3:07] cystitis patients can be significantly
[3:09] helped by this kind of pattern or
[3:11] this, this kind of intervention.
[3:13] And others.
[3:13] We also talked about gut dysbiosis.
[3:15] We talked about TMJ causing
[3:17] bladder pain and pelvic pain.
[3:18] So everything's connected
[3:20] and Linda has a great way of
[3:21] bringing it all together here.
[3:22] So we all talked about Linda's
[3:23] inflammatory stack, her three
[3:25] ways to lift some smarter, not
[3:25] harder, and her black belt as well.
[3:27] So without further ado, please enjoy
[3:29] this episode with Dr. Linda Kylie.
[3:31] If you do like it, don't forget
[3:32] to like and subscribe below
[3:33] so you never miss an episode.
[3:34] Without further ado, here you go.
[3:36] Enjoy.
[3:37] Hi Linda, it's nice to see you.
[3:39] Dr. Linda Kiley: Nice
[3:39] to see you too, Scott.
[3:41] Dr. Scott Sherr: Well,
[3:41] thanks for being here.
[3:42] You know, you and I had a conversation
[3:44] around the transcriptions company.
[3:45] You were interested in some of the
[3:46] products and you were telling me
[3:47] about your work as a a urogynecologist
[3:50] and doing functional urogynecology.
[3:53] This is something that's not very common.
[3:55] And I thought it'd be great to have you
[3:57] on the podcast, kind of talk about your
[3:59] practice, talk about some very unique
[4:00] things that you see in clinical practice
[4:03] that are not well understood from outside
[4:06] of probably your clinical practice
[4:08] and very few people that are like you.
[4:10] And so the first thing I wanted
[4:11] to talk about was pelvic pain.
[4:14] I know that you said that
[4:15] maybe three things that people
[4:16] come to see you oftentimes.
[4:18] One is pelvic pain, another's bladder
[4:19] issues, like to the, the two main things.
[4:21] Then things around the bladder and then
[4:23] and HRT might, might be the third one.
[4:24] Right.
[4:25] And so let's start off with
[4:26] the pelvis, the pelvic pain.
[4:29] Gimme a little bit of a color there.
[4:31] I don't help me understand
[4:31] your frameworks.
[4:32] How do you think about this?
[4:33] How do people present?
[4:35] And then what are some of
[4:35] the ways that you kind of
[4:37] intervene and try to help here?
[4:39] Dr. Linda Kiley: Well, you know,
[4:40] the most important thing I was
[4:41] taught this way back in medical
[4:43] school is taking a good history.
[4:45] Hmm.
[4:45] So one of the things that I like about
[4:49] my practice and my practice style is
[4:51] that I really just let my patients talk.
[4:53] I ask them questions.
[4:55] Directed questions, but I really want to
[4:58] get, I wanna try to focus in on exactly
[5:01] what the pain is, like where it is,
[5:03] you know, taking a good history, like
[5:05] a, like a physician is supposed to do.
[5:07] Dr. Scott Sherr: Sure, yeah.
[5:08] A lost art.
[5:09] Yes.
[5:09] Dr. Linda Kiley: Yeah, that's, it seems.
[5:12] Um, and that's, that's one of the reasons
[5:14] why I can't do my initial evaluations
[5:16] remotely, because I need to not only
[5:20] interact with my patients like, like
[5:23] we're doing now, and, but I actually
[5:25] need to be in the room with them and
[5:26] I see them see their body language.
[5:29] Um, and then I need to examine
[5:30] them, you know, because the next
[5:32] part is physical examination.
[5:34] So,
[5:35] Dr. Scott Sherr: you
[5:35] Dr. Linda Kiley: know, we were taught
[5:36] back in the day, history and physical.
[5:38] So, um, pelvic pain can encompass so many
[5:43] things, and it's usually multifactorial.
[5:46] It may start out as one thing, but
[5:48] then become a number of other things.
[5:50] So.
[5:51] You know, I try to identify,
[5:53] you know, when did it start?
[5:55] Are there any things
[5:55] that are related to it?
[5:56] Make it better, worse, you know, the
[5:57] usual questions that one would ask.
[6:00] Mm-hmm.
[6:00] Um, one of the things that I have
[6:01] found really, uh, seems to be biggest
[6:08] problem with pelvic pain is that because
[6:13] people are not thinking about the
[6:15] musculoskeletal system in the pelvis.
[6:18] Mm-hmm.
[6:18] You know, the pelvis is a big,
[6:20] you know, bones with a big
[6:21] ball of muscles inside, right?
[6:23] Dr. Scott Sherr: Yep.
[6:23] Dr. Linda Kiley: And then all,
[6:24] all these connective tissues
[6:25] and nerves and all this stuff.
[6:26] Dr. Scott Sherr: Yeah.
[6:27] Dr. Linda Kiley: So, you know, if
[6:29] you hurt your shoulder or you lift
[6:31] too much weight and your muscle gets
[6:32] sore, you know, whatever, you know,
[6:35] if it's your arm or your leg or
[6:36] whatever, you know what you did right.
[6:38] And you know why it hurts
[6:39] and stuff like that.
[6:40] Dr. Scott Sherr: Right?
[6:40] Right.
[6:41] Dr. Linda Kiley: If you pull a
[6:41] muscle in your pelvis, you know, it
[6:45] can manifest as urinary frequency,
[6:47] constipation, pain with intercourse.
[6:50] Just pelvic pain burning,
[6:52] uh, I mean, there's so many.
[6:54] It can seem like a
[6:55] urinary tract infection.
[6:56] It can seem like a yeast infection.
[6:58] It can seem like just a ton of things.
[7:01] And sometimes it can happen
[7:02] concomitantly with other problems too.
[7:04] I mean, there can be infections
[7:05] there and stuff like that, but, um,
[7:07] and sometimes the infection will
[7:08] incite the muscle spasm because,
[7:10] you know, the nerves are irritated.
[7:11] Sure.
[7:12] And then they get back and all that.
[7:13] But, so one of the things I, I probably
[7:16] send at at least 80% of my patients
[7:19] for pelvic therapy, and I have a
[7:21] cadre and pelvic therapist that I
[7:23] trust that I know, know what to do.
[7:26] They're not gonna make 'em do
[7:27] squeezing exercises or put biofeedback
[7:30] for stimulators or anything.
[7:31] I, I don't, that's not
[7:33] what it's about at all.
[7:34] And that's the other,
[7:36] Dr. Scott Sherr: um,
[7:37] Dr. Linda Kiley: misconception
[7:38] I think a lot of people have.
[7:39] They think of pelvic therapy as
[7:41] kegel exercises and biofeedback
[7:44] and strengthening, and there's this
[7:45] crazy share that is being sold.
[7:48] I'm not gonna say the brand name, but
[7:50] don't buy a chair for incontinence.
[7:52] That's all I have to say.
[7:53] It's not, that's not what you need.
[7:56] An actual person with training who can
[7:59] also evaluate and then provide the right
[8:01] kind of therapy so that you're not, you
[8:04] know, if you pulled your muscle lifting
[8:07] weight, you wouldn't go back and lift
[8:10] a heavier weight more times, you know?
[8:13] But that's basically what's happening
[8:15] when you're trying to squeeze these
[8:16] muscles that are already in spasm.
[8:18] So,
[8:19] Dr. Scott Sherr: right.
[8:19] Dr. Linda Kiley: You know, my job is
[8:20] to explain that and then get them to
[8:22] somebody who can actually work with
[8:24] them properly and get them outta pain.
[8:26] And the percentage of patients who
[8:29] respond well is extremely high.
[8:32] I mean, at least 80% of my patients
[8:34] that I send for pelvic therapy come
[8:35] back saying, wow, you were right.
[8:38] You know, that I'm amazed
[8:39] I wasn't expecting to get
[8:40] better, but I'm so much better.
[8:42] You know?
[8:43] So, um,
[8:44] Dr. Scott Sherr: is it one of the
[8:44] things with, with pelvic therapies, that
[8:46] probably depends on the person, but.
[8:48] Giving a sense of the kinds of
[8:50] things that you're sending over to
[8:51] pelvic therapy, what kind of, how
[8:54] long it takes them to get better?
[8:55] So is it something that's people will
[8:56] get better very quickly typically?
[8:57] Or is it, I mean, obviously it
[8:58] gonna depend on the situation, but
[8:59] what's your general feel for that?
[9:01] Dr. Linda Kiley: Um, interestingly, I've
[9:04] had patients, I, I had one lady who had
[9:06] been in pain for 30 years, literally.
[9:09] Dr. Scott Sherr: Wow.
[9:10] Dr. Linda Kiley: Um, and never
[9:12] been sent for pelvic therapy.
[9:14] She, I mean, her quality of
[9:15] life was horrible 30 years,
[9:17] and she was better in a month.
[9:19] I mean, like, almost completely pain free.
[9:21] She needed to continue pelvic therapy
[9:23] like, you know, intermittently,
[9:25] Dr. Scott Sherr: right.
[9:25] Dr. Linda Kiley: But she made
[9:27] massive progress really quickly.
[9:29] I have some patients who
[9:30] have so many other factors.
[9:32] Um, you know, if you have scoliosis or
[9:35] you have o you know, back issues that
[9:37] are chronic and you have, you know, other
[9:39] types of things that feed into this, you
[9:41] may not get as much better as quickly.
[9:45] You almost always are gonna
[9:47] get a significant improvement.
[9:49] And it may take more time and it
[9:52] may take time to just figure out all
[9:54] the different moving parts to it.
[9:55] Because I mean, I've had patients
[9:57] with TMJ who had pelvic spasm, so
[10:00] they need to work out that TMJ.
[10:01] Yeah.
[10:02] Yeah.
[10:02] It's kinda interesting.
[10:03] So you never know where
[10:05] it's gonna come from.
[10:05] Dr. Scott Sherr: So, so what you're
[10:06] saying here, Linda, just to kinda
[10:07] break this down, is that pelvic pain,
[10:10] musculoskeletal etiologies are vastly
[10:14] misdiagnosed Is, or, or not even
[10:15] thought about is what it's come down
[10:16] Dr. Linda Kiley: to.
[10:16] Absolutely true.
[10:18] Um, and you know, unfortunately, I
[10:20] also sometimes see patients being
[10:23] referred for pelvic therapy, um, to
[10:27] the wrong kind of therapy, you know?
[10:30] Okay.
[10:30] There's, there's all different levels
[10:31] of training and so somebody who hasn't
[10:34] really been trained to deal with
[10:36] myofascial spasm, 'cause that's basically
[10:38] Dr. Scott Sherr: overtime.
[10:40] Dr. Linda Kiley: Okay.
[10:41] But, you know, and, and puts them on a
[10:43] program of, uh, squeezing or, you know,
[10:46] stimulation or whatever, that patient's
[10:48] not gonna get better with that person.
[10:49] So I have to trust the therapist that
[10:52] I know that they're gonna do what
[10:54] needs to be done with this patient.
[10:56] But, um, um, I'm sorry.
[10:58] I get, I guess I got off tangent, but
[11:00] yes, it's goodly, undiagnosed, and
[11:02] it often, if, if they do get sent for
[11:05] therapy, if they don't get sent to the
[11:06] right person, they may not get better.
[11:07] And I've seen it also where they
[11:09] say, oh, oh yeah, I did therapy.
[11:10] It didn't help me at all.
[11:11] And I'm like, well, what
[11:12] therapy did you have?
[11:14] You know, who did you see?
[11:15] What did they do?
[11:16] Dr. Scott Sherr: Yeah.
[11:17] So maybe you can break down
[11:17] some of those types of therapy.
[11:19] You mentioned sort of like myofascial
[11:20] therapy as being one of them.
[11:22] What, what are the major sort of
[11:23] forks in the road where you're like,
[11:25] okay, you need this type of therapy,
[11:26] you need this type of therapy.
[11:27] Like, do you have, do you do that
[11:28] kind of assessment or is it somebody
[11:29] you, you send, you send them to
[11:31] somebody for that assessment?
[11:32] Dr. Linda Kiley: Um, I do the
[11:33] assessment initially, so, mm-hmm.
[11:34] What I do is basically I
[11:36] look for, um, you know.
[11:40] Depending upon the history
[11:41] and all that stuff.
[11:42] I'll check for, you know,
[11:43] hypersensitivity to the nerves.
[11:45] I'll check for reflexes and
[11:47] then I'll check for muscle spasm
[11:49] and tenderness in the pelvis.
[11:50] So I do a vaginal exam and a rectal exam,
[11:52] and I check all the muscles and I, I go
[11:54] one by one, you know, face of the clock.
[11:56] Wow.
[11:56] Basically hit all the muscles and
[11:58] ask them, you know, and, and I'll
[12:00] press lightly, and if they say that's
[12:03] uncomfortable or ow, I mean, sometimes
[12:06] I have 'em jump off the table and
[12:07] I'm barely touching 'em, you know?
[12:08] Dr. Scott Sherr: Sure, sure,
[12:09] Dr. Linda Kiley: sure.
[12:09] And, uh, so, so that's spasm.
[12:13] So I tell them, okay, you're having
[12:15] spasm and I'll, I'll write on my
[12:17] referral where I found the spasm.
[12:20] Okay.
[12:20] So, you know, I'll give them a written
[12:21] referral to a, a pelvic therapist
[12:24] and I'll say, you know, this is,
[12:26] you need to see the therapist.
[12:27] I'm not gonna give you
[12:28] the types of exercises.
[12:30] I mean, I actually, I have a YouTube
[12:32] channel called the Holistic Hero
[12:33] Gynecologist, and I did a, um.
[12:36] A little exercise, video and time of
[12:39] like stretching and things like that.
[12:41] Just because I know there are
[12:43] people out there who get to a pelvic
[12:44] therapist who knows what they're doing.
[12:46] And so I didn't, you know, there's
[12:47] a lot that miss that's missed by
[12:49] not being able to do internal work.
[12:51] And pelvic therapists are trained to do
[12:53] internal work, but um, or a good one.
[12:55] They
[12:55] Dr. Scott Sherr: go inside, they go
[12:56] inside the vagina, they go inside
[12:57] the rectum and they're working on
[12:58] Dr. Linda Kiley: Yes.
[12:59] Dr. Scott Sherr: The muscles while you're
[13:00] doing various types of things typically.
[13:02] Right.
[13:02] So,
[13:02] Dr. Linda Kiley: yep.
[13:03] Dr. Scott Sherr: Like
[13:03] what would that look like?
[13:03] So you're doing certain sort of like
[13:05] bearing down while somebody's, you know,
[13:07] working on part of like the, the vaginal
[13:08] muscles or something like that, or,
[13:10] Dr. Linda Kiley: so generally
[13:11] speaking, it's, there's a lot of
[13:12] breathing exercise that gets done.
[13:14] You'd be amazed.
[13:15] Okay.
[13:15] I don't, or maybe you already
[13:16] know this, at how many people do
[13:19] not know how to belly breathe.
[13:20] Mm-hmm.
[13:21] And they don't breathe normally.
[13:22] You know, if you don't breathe normally
[13:24] and you're breathing just with your chest,
[13:26] you're not oxygenating yourself well.
[13:29] Um, your muscles are not moving
[13:32] the way they're supposed to.
[13:32] Your diaphragm's not working
[13:33] the way it's supposed to.
[13:34] That can disrupt how functions too.
[13:36] I mean, it's not just
[13:37] your microbiome for sure.
[13:39] You know?
[13:39] So, um, breathing, teaching them
[13:43] how to breathe is a, a really
[13:45] big part of pelvic therapy.
[13:47] Interestingly, I'm not
[13:49] Dr. Scott Sherr: surprised.
[13:49] Yeah.
[13:49] Dr. Linda Kiley: If I have somebody
[13:50] who, and I'm evaluating and I'm seeing
[13:53] that, you know, when I ask them to
[13:53] breathe and all I get is, you know,
[13:55] the chest movement and so Juan,
[13:57] okay, here's what I want you to do.
[13:58] I want you to go home, lay
[13:58] on your stomach and breathe.
[14:00] You can't just breathe
[14:01] laying on your stomach.
[14:03] So, very
[14:04] Dr. Scott Sherr: difficult to do.
[14:04] Yeah, yeah.
[14:05] Dr. Linda Kiley: Yeah.
[14:05] I mean, I guess you could, but it's,
[14:07] it's not so easy, so it's not natural.
[14:09] So, um, anyway, you know, I leave the, the
[14:14] nuts and bolts to the pelvic therapist.
[14:16] Dr. Scott Sherr: Sure, sure.
[14:17] Dr. Linda Kiley: When they
[14:17] camp, when they come back, I ask
[14:19] them, you know, what did you do?
[14:20] Especially if they're not
[14:21] getting better, you know, well,
[14:23] what kind of things did you do?
[14:24] What did they do with you?
[14:25] How did they, you know, all
[14:27] of that kinda stuff with HC.
[14:28] And if there's something that
[14:30] doesn't add up, I might actually
[14:31] send 'em to someone different.
[14:33] Mm-hmm.
[14:33] Okay.
[14:33] Um, or I might say, okay, well
[14:36] let me reassess and let's see if
[14:37] there's something I'm missing.
[14:39] You know, you're not getting better.
[14:40] What else could it be?
[14:42] And um, so, you know, I always
[14:44] backtrack and, and clearly, you know,
[14:47] inflammatory disorders, fibromyalgia,
[14:49] I mean, women with fibromyalgia will
[14:52] often have myofascial pelvic pain too.
[14:54] Dr. Scott Sherr: Makes
[14:54] Dr. Linda Kiley: sense.
[14:54] Dr. Scott Sherr: Yeah.
[14:55] Dr. Linda Kiley: Fibromyalgia
[14:55] trigger points, right?
[14:57] Dr. Scott Sherr: Right.
[14:57] Dr. Linda Kiley: So they need pelvic
[14:59] therapy, but they also need all of
[15:01] the other, you know, the mitochondrial
[15:03] look forward and the right energetics
[15:05] and the inflammation reduction and,
[15:07] you know, we have to go into that and
[15:09] then we go to the microbiome and, you
[15:11] know, so then we start digging into.
[15:14] You know, the other stuff, right?
[15:16] And that's really fun.
[15:17] I, I like doing that stuff.
[15:20] Dr. Scott Sherr: Part of the interruption.
[15:20] This episode is brought to you by Health
[15:21] Optimization Medicine and Practice
[15:23] Association, a nonprofit organization,
[15:24] training practitioners had optimize
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[15:27] For this episode, check out our
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[15:31] Dr. Linda talked about circadian
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[15:52] Now, back to the show, right?
[15:54] Dr. Linda Kiley: It's very rewarding.
[15:55] Dr. Scott Sherr: It can, it absolutely is.
[15:57] And, and so when did you decide in
[15:59] clinical practice to start adding
[16:00] in some of the more integrative,
[16:02] functional kinds of things?
[16:03] Was it something that you kind
[16:04] of, because as a practitioner
[16:07] working in the conventional world,
[16:08] you know, it's not that easy to
[16:09] start doing this kind of thing.
[16:11] Um, were there a couple
[16:12] of patients that you saw.
[16:14] Early on that kind of,
[16:15] kind of gave you this idea?
[16:16] Or was it, uh, additional experience
[16:18] in, in different ways that kind
[16:19] of made you say, okay, like, I'm
[16:20] gonna start doing more the sort
[16:22] of functional integrative route.
[16:24] And, and from there, maybe talk about a
[16:26] little bit like what your workup might be
[16:27] in somebody that was coming in as well.
[16:29] Dr. Linda Kiley: Okay, sure.
[16:30] Dr. Scott Sherr: Yeah.
[16:30] Dr. Linda Kiley: Well, yeah.
[16:30] So I got started with this
[16:33] out of restoration because,
[16:35] you know, so urogynecologist
[16:37] typically were surgeons, right?
[16:39] You know?
[16:40] Yes.
[16:40] Gynecology and, and urogynecology is,
[16:43] is considered a, a surgical specialty.
[16:45] Yeah.
[16:46] Um, urogynecology and
[16:47] reconstructive pelvic surgery
[16:48] is the name of the subspecialty.
[16:50] So, um, and, and you know, as a surgeon,
[16:54] when you're trained, one of the things
[16:56] that you get told is, you know, a chance
[16:58] to cut is a chance to cure and all that.
[17:00] And I've, I always love surgery.
[17:02] I have good hand eye coordination.
[17:04] I'm a musician since I was five.
[17:05] You know, I, I've always loved
[17:07] fixing things, but I like fixing
[17:09] things not only with my hands.
[17:11] I like fixing things with my brain too.
[17:13] So, um, when things didn't go as I
[17:17] expected, um, I, and I knew I was missing
[17:22] something that I, I can't deal with that.
[17:24] That's just not, that doesn't
[17:26] sit well with my nature.
[17:27] I, I'm not the kind of person to go, I, I
[17:30] don't know, you know, go see someone else.
[17:33] I can't do that.
[17:34] I might say, you know, you might
[17:35] wanna get a consult with someone
[17:36] else, but then I'm, I wanna figure
[17:38] out what it is I'm missing and why I
[17:41] didn't solve this problem for them.
[17:44] Mm-hmm.
[17:44] Or help them solve this problem.
[17:44] So, um, you know, I've always believed
[17:47] that the body wants to heal itself.
[17:49] That's something that I believe
[17:50] since, you know, before medical
[17:52] school, um, and always had some
[17:56] level of, you know, non-traditional.
[17:57] I mean, I was going to a chiropractor
[17:59] when I was a kid, when I hurt my back.
[18:00] So, you know, I learned a little bit
[18:02] about alternative medicine and stuff.
[18:04] Dr. Scott Sherr: Sure, sure, sure.
[18:04] Yeah.
[18:04] Dr. Linda Kiley: So it was a
[18:05] little more open-minded, I guess,
[18:07] than some of my colleagues too.
[18:09] Some of the more eso.
[18:11] Things in medicine.
[18:12] And as I learned about, you know, I
[18:15] learned more about hormone management.
[18:16] We were taught a very basic way to do it.
[18:18] That's very lackadaisical in my opinion.
[18:21] Um, I learned more about that.
[18:22] I learned, I started learning about
[18:24] peptides and I start, you know, I, before
[18:26] I went to medical school, I did a master's
[18:29] degree in some in molecular biology.
[18:31] Dr. Scott Sherr: Ah,
[18:31] Dr. Linda Kiley: okay.
[18:31] We spent all this time, I mean, this
[18:33] was a long time ago, but we spent all
[18:35] this time on DNA and cellular processes
[18:39] and all these things about celling
[18:41] structure and, you know, all this great
[18:44] stuff that mitochondria, the endoplasmic
[18:46] reticulum and all these great things.
[18:48] And I got to medical school and
[18:50] they're like, yeah, you know?
[18:52] Dr. Scott Sherr: Yeah.
[18:53] Dr. Linda Kiley: Yeah.
[18:53] That, yeah, this is
[18:55] what a cell looks like.
[18:55] You learn,
[18:56] Dr. Scott Sherr: then you forget it.
[18:56] Dr. Linda Kiley: You know, this
[18:56] is what Hodgkin's looks like on
[18:58] a slide, you know, and stuff.
[18:59] And it's like, okay, well that's,
[19:01] that's what the cell looks like.
[19:02] What's going on inside the cell?
[19:04] We didn't talk about
[19:04] that too much, you know?
[19:06] So anyway.
[19:07] Kind of gradually getting into, you know,
[19:10] learning about, I learned about Lotus
[19:11] Naltrexone and I went, you know, I learned
[19:13] about some, like more esoteric things and
[19:16] then it just kept me digging, you know?
[19:18] Um, I, I heard about A four M, so
[19:21] I took some courses there and, you
[19:23] know, that led me to peptides and,
[19:26] you know, it just kind of kept going.
[19:28] And the more I learn, the more I do,
[19:30] and the more things I could fix, you
[19:32] know, like people would get better
[19:34] and be like, oh, that's great.
[19:35] I can do this now.
[19:37] You know?
[19:37] And so it was a gradual thing, but
[19:40] it was primarily born of frustration
[19:43] of not being able to fix things in
[19:45] the traditional way and realizing
[19:46] that it was falling short and not
[19:48] giving my patients what they deserved.
[19:50] So,
[19:51] Dr. Scott Sherr: yeah.
[19:51] I, I get it.
[19:52] Well, I appreciate that, that context.
[19:53] And I think a lot of us, a lot of people
[19:55] in the world of integrative medicine,
[19:57] peptides, you know, these kinds of things
[19:59] are, are, are getting there because they
[20:00] got frustrated with the conventional side
[20:02] of things and the lack of capacity to.
[20:05] Do a lot outside of the small
[20:07] amounts that we can do to keep people
[20:08] from staying outta the hospital or
[20:10] Dr. Linda Kiley: Right.
[20:10] Dr. Scott Sherr: Recovering basically
[20:11] from a surgery and things like that.
[20:12] Dr. Linda Kiley: Yeah.
[20:12] Dr. Scott Sherr: Um, as far as your
[20:14] framework now, when you work with
[20:15] people, Linda and I do wanna ask
[20:16] about the bladder in a minute too.
[20:18] Dr. Linda Kiley: Sure.
[20:18] Dr. Scott Sherr: Um, but, um, do you
[20:20] have a basic framework that you use
[20:21] for everybody, or is it change, like
[20:23] if, if you're, if you're coming in for
[20:24] like a functional integrative workup,
[20:26] are there some like main things that
[20:27] you do for everybody that comes through
[20:28] the door, or is it very individual
[20:30] depending on what they're coming in for?
[20:31] Dr. Linda Kiley: It's really individual.
[20:33] Um, you know, I definitely do a
[20:35] lot of gut microbiome studies,
[20:37] but I don't do them on everyone.
[20:38] Okay.
[20:39] You know, first of all, a really good
[20:40] one is expensive and not everybody
[20:43] has the resources to do all of that.
[20:45] I mean, I have some patients
[20:46] who come in and say, I do
[20:47] Dr. Scott Sherr: everything.
[20:48] I don't care.
[20:48] I don't throw what it costs.
[20:50] Dr. Linda Kiley: Most of them don't.
[20:51] So empirically I'll do some, you
[20:54] know, I, I will do tests based
[20:57] on what I'm getting from them.
[20:59] Whatever they've had before, what they
[21:01] haven't had that I think would be useful.
[21:04] I really, I think it needs
[21:05] to be an individual thing.
[21:07] I don't have a protocol.
[21:08] I don't really, I don't tend
[21:10] to follow protocols because
[21:13] everybody's different, you know?
[21:15] Dr. Scott Sherr: Yeah.
[21:15] No, I think that's super important
[21:17] that we can't follow, like the
[21:18] ER algorithm all the time if
[21:20] somebody comes in with chest pain.
[21:20] Right.
[21:21] And this is actually where I wanna
[21:22] get to bladder pain, because, like,
[21:24] let's talk about the bladder, because
[21:25] you mentioned the gut microbiota.
[21:26] You've, you talked a little bit
[21:27] about this with me when you and
[21:29] I chatted, uh, before regarding
[21:32] the presentation of bladder pain.
[21:34] Bladder, excuse me,
[21:35] bladder pain, discomfort.
[21:37] Tell me how you think about
[21:38] this, how people present.
[21:38] What have you found over the years
[21:40] as you work this up that's maybe
[21:42] surprising for people that are
[21:43] listening that they wouldn't think
[21:45] of, oh, this is causing, you know,
[21:46] bladder pain or bladder discomfort.
[21:48] Dr. Linda Kiley: Absolutely.
[21:49] It really runs the gamut.
[21:51] So the first thing I do is, um, after
[21:55] I've taken their history and I do their.
[21:57] Exam, you know, as exam Yeah.
[21:59] For myofascia stuff, I mean, a
[22:00] huge percentage, if not a hundred
[22:03] percent, it's really, really close.
[22:05] Have myofascial, uh, component of that.
[22:08] So I know, I see.
[22:09] Pretty much they're gonna
[22:10] go for pelvic therapy.
[22:11] That may not be their only problem.
[22:13] So I also do, I do a very highly, uh,
[22:17] specific type of urinary evaluation.
[22:21] So I have them usually on, if there's a
[22:24] question about how they're emptying or
[22:26] how well they empty, I'll have them empty.
[22:29] And then I'll check a post boy
[22:30] residual using a eight French catheter.
[22:32] So really tiny one.
[22:33] I tell it's like a cocktail straw.
[22:34] It's really small.
[22:35] Yeah.
[22:36] Um, but I, what I, the reason I do that
[22:39] is there's data, there's actually papers
[22:41] that show, especially for women, not,
[22:43] not so much for men, but for women,
[22:45] having the peanut cup is a really bad
[22:47] way to do a urine culture and urinalysis
[22:50] because there's so much contamination.
[22:52] Dr. Scott Sherr: Right.
[22:52] Dr. Linda Kiley: So I
[22:53] want a pure specimen.
[22:55] So that I can send that or, so
[22:58] I, I get a catheterized specimen.
[22:59] I see what their post weight
[23:00] residual is, when that's appropriate.
[23:03] Um, and I use, uh, I'd use, uh,
[23:09] a specialized lab to do the urine
[23:13] cultures because, um, there are
[23:15] a couple of, I use p Gnostics.
[23:17] There's a lot of people can use.
[23:19] We will use MicroGen.
[23:20] Um, I, I, you spoke, but I
[23:24] generally stay with p gnostics.
[23:26] And so
[23:26] Dr. Scott Sherr: why is it necessary?
[23:27] Why is it necessary to do a
[23:28] specialized lab for urine culture?
[23:30] Dr. Linda Kiley: Because Quest or
[23:32] LabCorp doesn't very basic thing.
[23:35] And you know, they say they do an
[23:37] advanced culture, but I've never
[23:38] been able to get 'em to do it, ever.
[23:40] Okay.
[23:41] Um, so the, the idea here is like a basic
[23:45] culture that you'll get in a routine lab
[23:47] is gonna be, they're gonna take one CC
[23:50] and they're gonna plate that on Otter.
[23:53] If anything grows in that after
[23:55] 24 hours, then they're gonna
[23:56] identify it and do the whole thing.
[23:59] But, you know, if you don't get
[24:02] something to grow in that medium, you
[24:04] know, let's say you have urea plasmas
[24:05] or mycoplasma or ottum cellier or,
[24:10] Dr. Scott Sherr: I
[24:10] Dr. Linda Kiley: don't know how
[24:10] I'm interested other, yeah, yeah.
[24:12] There's a bunch of weird
[24:13] organisms like that I don't
[24:16] Dr. Scott Sherr: tum.
[24:16] That's an interesting,
[24:16] Dr. Linda Kiley: yeah,
[24:17] Dr. Scott Sherr: yeah, yeah.
[24:18] Dr. Linda Kiley: There's a, yeah,
[24:18] it's, it's had a number of different
[24:20] names, but there are a lot of weird
[24:22] bacteria and other organisms, but even
[24:24] viruses, uh, fungi, I mean especially,
[24:28] especially in diabetics or borderline
[24:29] di borderline diabetics, um, I
[24:32] found, you know, fungal infectious.
[24:33] That's not gonna show up on the standard.
[24:35] It just won't.
[24:37] So,
[24:38] so
[24:38] Dr. Scott Sherr: they're
[24:38] culturing it with the other labs
[24:39] are like, what are they doing?
[24:40] Are they doing genetics or the
[24:41] dna NA or what are they doing?
[24:42] Dr. Linda Kiley: They do PCR and then,
[24:44] you know, they'll, they'll, once they've
[24:46] identify an organism, then they'll go
[24:48] out and they'll do the sensitivities.
[24:49] Got it.
[24:50] You know, they do the PCR for the broad
[24:52] spectrum thing to find, you know, do
[24:53] they find anything and then after they
[24:55] find something, then they go further.
[24:57] It's one of the things I like about some
[24:59] of these labs is, you know, they, they
[25:00] do extra testing so that you're not just
[25:04] left with, well, we didn't find anything.
[25:06] Well, we, we, we found something we're,
[25:08] or we might have found something,
[25:09] we're gonna look a little further
[25:10] and or, here's the sensitivity.
[25:12] And it's a real sensitivity profile.
[25:15] You know, it's not just based on
[25:16] data, it's actually this organism
[25:18] was sensitive to these antibiotics.
[25:20] Dr. Scott Sherr: Wait,
[25:20] wait, hold on a second.
[25:21] You're saying that, that LabCorp
[25:23] requests are just doing the
[25:23] sensitivities based on data rather than
[25:25] Dr. Linda Kiley: No, no, no, no, no.
[25:26] They do culture and sensitivities,
[25:28] but you know, if you only
[25:30] likely define the big four.
[25:32] You know, e coli, enterococcus,
[25:35] Proteus, KLE and um, Klebsiella.
[25:37] Dr. Scott Sherr: Yeah.
[25:38] Dr. Linda Kiley: You know, what
[25:38] about all those other ones?
[25:40] You know, um, I mean, if I find a
[25:42] urea plasma, you know, there are
[25:43] some resistant urea plasma organisms.
[25:46] I need to know, can I treat them with,
[25:49] you know, cylin or do I have to use
[25:52] Le Quinn or, you know, et cetera.
[25:53] So.
[25:54] Dr. Scott Sherr: Gotcha, gotcha.
[25:55] Yeah.
[25:55] Dr. Linda Kiley: So my job is to get,
[25:56] and I tell 'em this, I don't use standard
[25:58] Labs for some of the things I do because
[26:03] you came to me for an answer and you
[26:05] already did the standard get an answer.
[26:07] So, you know, it's the whole
[26:09] definition of insanity.
[26:10] Right,
[26:11] Dr. Scott Sherr: right.
[26:11] Of
[26:11] Dr. Linda Kiley: course.
[26:12] Turn the same thing over and
[26:13] trying to get a different, so,
[26:14] Dr. Scott Sherr: yeah.
[26:15] Dr. Linda Kiley: Yeah.
[26:15] So
[26:15] Dr. Scott Sherr: when you do these
[26:16] advanced cultures on people, uh,
[26:18] Linda, do you find that everybody
[26:19] has something going at this point?
[26:20] Or is it, is it not that common only?
[26:22] Do you find It's like much more
[26:23] specified in the, in the sense
[26:25] of how you can interpret them.
[26:27] Dr. Linda Kiley: It's, you know, it's not.
[26:29] Unusual for me to find something
[26:31] like mycoplasma or urea plasma
[26:33] or a weird other organism.
[26:36] And particularly in older patients, um,
[26:39] who have compromised immune systems.
[26:41] It's not unusual for me to find
[26:43] something that's not in the spectrum
[26:46] of stuff that's typically cultured out.
[26:48] Got it.
[26:48] So, but you know, I get a lot of
[26:50] negative cultures too, but that's okay.
[26:51] I mean, that's, yeah, I'm okay with that.
[26:53] And the other thing is that, you
[26:55] know, sometimes I'll find a patient
[26:56] that I suspect has a bio zone.
[26:58] Yes.
[26:59] And bios are notoriously
[27:00] difficult to culture out.
[27:02] So even if I get a negative culture,
[27:04] if everything they're telling me in
[27:06] their history and everything else
[27:08] I'm seeing, and especially they have
[27:09] some weird things in their ua, but
[27:11] they're not culturing out, you know,
[27:13] I'll say, I think you have a biofilm.
[27:14] I think we need to look at it this
[27:16] way and see if, you know, I, I'm
[27:19] gonna believe your symptoms because
[27:21] you're telling me what you're having
[27:22] and I don't think you're crazy.
[27:24] I mean, one of the things that used
[27:25] to make me crazy as a med student was.
[27:28] I would go present a case to my
[27:29] resident and it would be something
[27:31] weird, you know, she would have a,
[27:33] a strange, weird symptom, whatever.
[27:35] Unusual.
[27:36] Okay,
[27:37] Dr. Scott Sherr: sure.
[27:37] Dr. Linda Kiley: Yeah.
[27:37] And they would say, oh, she's crazy.
[27:39] Send her to sight.
[27:40] And I hated that because I didn't
[27:42] think these women were crazy.
[27:44] Dr. Scott Sherr: Sure.
[27:44] Yeah.
[27:45] Dr. Linda Kiley: And the, the number
[27:46] of women that I've seen over my career
[27:49] that have come in thinking they're
[27:51] crazy, actually, having been told by
[27:54] multiple people that they're crazy,
[27:56] that were not crazy, but they acted
[27:58] crazy 'cause they were so, they kind of
[28:00] bought into it once they solved their
[28:02] problem, actually normalized and started
[28:05] to act like a normal human, human and
[28:07] realize things were crazy and, you know,
[28:09] Dr. Scott Sherr: yeah.
[28:10] Dr. Linda Kiley: They cry, they,
[28:11] you know, it's like, oh my God,
[28:12] somebody actually believed me.
[28:13] And, you know.
[28:15] Dr. Scott Sherr: Yeah.
[28:16] I mean, I think urinary
[28:17] pain is such a big problem.
[28:18] Bladder pain, pelvic pain, like
[28:20] we talked about, like why aren't
[28:22] those tests more standard?
[28:23] Like, why if you have urinary
[28:25] pain and you do the culture.
[28:26] Saying stuff, it's negative for
[28:27] the four organisms or whatever.
[28:28] Like, why isn't there the next step?
[28:31] Is it because just doctors don't
[28:32] understand what to do with that
[28:33] data or, or what's the sense
[28:35] Dr. Linda Kiley: that you have there?
[28:35] I I, it may be a combination of things.
[28:37] Um, there are a lot of things,
[28:39] you know, insurance and labs,
[28:42] although most of these specialty
[28:43] labs have some level of insurance,
[28:46] uh, you know, agreements going on.
[28:48] Um, but you know, some of 'em,
[28:51] some doctors just don't wanna
[28:52] be bothered by like, doing that
[28:54] because it's an extra hassle.
[28:55] You have to have an extra kit.
[28:57] You have to have, right.
[28:58] Dr. Scott Sherr: You
[28:58] have to have a catheter.
[28:59] Like, it's not just like you're
[29:00] taking, taking like a urine
[29:01] sample from the office, right,
[29:02] Dr. Linda Kiley: right.
[29:02] Like, here's a Dixie Cup, go pee.
[29:04] You know?
[29:04] I mean, um, but yeah, you know, it's
[29:07] really, I think some of them don't know.
[29:09] I think some of them just don't
[29:11] think it's practical for them.
[29:14] Um, sometimes you're tied into a lab,
[29:16] you know, one of the things that I
[29:18] had a problem with back when I was in
[29:20] corporate medicine, which didn't, that
[29:21] didn't last, which they wanted me to use.
[29:25] The lab that they had the agreements with.
[29:27] Dr. Scott Sherr: Of course.
[29:28] Dr. Linda Kiley: Yeah.
[29:28] And I was like, but they don't do what
[29:29] I want, so I'm not gonna use them.
[29:31] And that did not make me popular.
[29:33] Dr. Scott Sherr: Did not make you popular.
[29:34] Yes.
[29:34] They did not meet their metrics.
[29:35] Yes.
[29:36] Yeah.
[29:36] Know.
[29:36] Dr. Linda Kiley: Nope.
[29:37] Dr. Scott Sherr: Yeah.
[29:37] Dr. Linda Kiley: So, yeah.
[29:38] But yeah, I think
[29:39] Dr. Scott Sherr: like that, yeah.
[29:39] This is, I think it's
[29:41] so interesting, right?
[29:41] Because the, the biofilm
[29:44] piece is a big one.
[29:45] I've heard a number of people recently.
[29:47] Uh, I was speaking to a lady that
[29:49] specializes in interstitial cystitis and
[29:51] she was telling me all about, you know,
[29:52] a lot of these bugs can actually hide in
[29:54] biofilms and that you don't know about
[29:56] it until you start breaking them up.
[29:58] And you do the urine cultures afterwards
[30:00] and you can see all this stuff.
[30:01] Like what are your, some like, and
[30:02] from a biofilm perspective, what are
[30:03] the things you typically would use,
[30:05] uh, to try to, does that like a,
[30:06] is that a framework that you think
[30:08] about too, in similar ways or, oh
[30:09] Dr. Linda Kiley: yeah.
[30:09] Dr. Scott Sherr: How do you address?
[30:10] Yeah.
[30:11] Dr. Linda Kiley: Yeah.
[30:11] I mean, I'll, uh, I've
[30:12] done methylene blue.
[30:15] Um, I'll do like some of
[30:16] the general biofilm busters.
[30:17] I'll do, I do bladder installations.
[30:19] In fact, that's something that I started
[30:21] years ago out of desperation and, um.
[30:25] Dr. Scott Sherr: What you,
[30:26] what do you put in there?
[30:27] Dr. Linda Kiley: Um, the, well, I have
[30:29] different cocktails depending on the
[30:30] patient, but the most common one is
[30:32] usually lidocaine, heparin, triamcinolone,
[30:37] and gentamycin with a little
[30:38] Dr. Scott Sherr: bicarb.
[30:40] Dr. Linda Kiley: So
[30:40] Dr. Scott Sherr: where'd
[30:40] you come up with that?
[30:42] Dr. Linda Kiley: Um, there was a paper.
[30:44] Dr. Scott Sherr: That's
[30:44] super, it's I the cape.
[30:46] Can you, can you rattle those,
[30:47] all those off again for me please?
[30:48] It's, yes.
[30:48] Lidocaine, gentamycin.
[30:50] What else?
[30:51] Dr. Linda Kiley: Lidocaine, heparin.
[30:53] Um, triamcinolone,
[30:55] gentamycin and bicarbonate.
[30:58] Dr. Scott Sherr: Can you just kind of go
[30:59] over why each of those, just for people
[31:01] that, I mean, I think it's awesome.
[31:01] That's, that's really interesting.
[31:02] Yeah.
[31:02] Dr. Linda Kiley: Yeah.
[31:03] It's, it's, it's actually
[31:04] been really great.
[31:04] I mean, I've had patients who responded
[31:07] unbelievably well to this and, and
[31:11] had just get periodic treatments,
[31:13] you know, after the initial set.
[31:15] Um, or just come back, you know.
[31:18] Oh, it's been a year.
[31:19] I'm kind of having symptoms.
[31:20] I need to do it again.
[31:20] Some who come every week, it's
[31:22] like, you know, I'm, this is how I'm
[31:23] gonna live for the rest of my life.
[31:25] It works.
[31:25] I'm happy.
[31:26] Whatever.
[31:27] So, um, so interestingly, you know, I
[31:31] had one patient who had this chronic UTI
[31:34] thing that I just, I tried everything.
[31:37] I could not get amylin.
[31:38] I knew, I knew she had a biofilm and I
[31:40] couldn't keep giving her oral antibiotics.
[31:42] She was allergic to half
[31:43] the things in the, you know.
[31:44] Dr. Scott Sherr: Sure.
[31:45] Dr. Linda Kiley: So, um, I, I found
[31:47] a paper on, uh, tobramycin and then I
[31:50] found something on Gentamycin and I was
[31:52] like, well, you know, get Gentamycin.
[31:54] And, um, then I found another
[31:56] thing on, you know, lidocaine
[31:58] heparin and then the triamcinolone.
[32:00] And there are papers that say
[32:01] triamcinolone is not necessary,
[32:03] and papers that say works.
[32:05] And it's, it's worked for me.
[32:07] I'm not taking it out, you know,
[32:08] I know it's expensive, but.
[32:10] So, you know, reducing inflammation
[32:12] with the triamcinolone, lidocaine
[32:15] has a number of properties.
[32:16] I mean, I, I will use Prilocaine
[32:18] on occasion, especially if
[32:19] someone's sensitive to lidocaine.
[32:21] I haven't switched over to it, although I
[32:24] know that there are some interesting data
[32:26] on Prilocaine, but really to relieve pain
[32:31] initially, you know, that's part of it.
[32:32] Mm-hmm.
[32:32] Just give us some initial pain relief.
[32:35] Dr. Scott Sherr: Sure.
[32:35] Dr. Linda Kiley: Yeah.
[32:35] Um, and then it seems to have
[32:38] some, you know, augmenting
[32:42] properties with the other things.
[32:44] And then hip, and obviously is
[32:46] to, you know, open up kind of
[32:49] the, the channels if you will.
[32:51] You know, um,
[32:53] Dr. Scott Sherr: so you're breaking
[32:54] up platelets, platelet aggregation.
[32:55] Dr. Linda Kiley: Yeah.
[32:56] Yeah.
[32:56] You
[32:57] Dr. Scott Sherr: kind of thing.
[32:57] Dr. Linda Kiley: You know,
[32:58] interestingly, heparin and PanIN
[33:00] are related to one another.
[33:02] Um, there's some similarities.
[33:03] Dr. Scott Sherr: Mm-hmm.
[33:04] Dr. Linda Kiley: And so I
[33:04] think that it does have some
[33:05] anti-inflammatory properties as well.
[33:07] Mm-hmm.
[33:08] So it's.
[33:09] And you don't need a lot.
[33:10] Um, different people who use these
[33:14] have different cocktails that,
[33:16] you know, proportions and stuff.
[33:18] Um, and then the triamcinolone obviously
[33:21] is, you know, strictly inflammation.
[33:23] The antibiotic.
[33:24] If I, if I can open up these channels
[33:26] with these other things and I can get
[33:27] the antibiotic in there, hopefully, you
[33:31] know, gentamicin's usually pretty good
[33:32] 'cause they haven't been exposed to it.
[33:34] Dr. Scott Sherr: Sure, yeah.
[33:35] It'ss not an antibiotic
[33:36] use very often anymore.
[33:36] Yeah.
[33:37] Dr. Linda Kiley: Yeah.
[33:37] It's cheap.
[33:38] Dr. Scott Sherr: Yeah.
[33:38] You know, and I suppose it'll
[33:40] be safe, I would imagine, in the
[33:40] bladder compared to orally or iv.
[33:42] Dr. Linda Kiley: Yeah.
[33:42] Typically.
[33:43] I mean, you're not, you know, you're
[33:44] not really absorbing, absorbing a
[33:46] significant amount of it, so, mm-hmm.
[33:48] Mm-hmm.
[33:49] Unlikely to have any blood levels.
[33:51] One of the reasons I resorted
[33:53] to it also is like, you know,
[33:54] I'm not trying to destroy your
[33:55] gut microbiome at the same time.
[33:57] Right, right, right.
[33:57] So if I can really get it into
[33:58] the bladder, there's not gonna
[34:00] be that much that's gonna get
[34:01] to the rest of the system.
[34:03] So hopefully I'm not gonna be
[34:04] killing off your microbes in your.
[34:07] Um,
[34:07] Dr. Scott Sherr: mm-hmm.
[34:08] Dr. Linda Kiley: So it's,
[34:09] Dr. Scott Sherr: so you ins and you
[34:10] instill it with like a small catheter
[34:13] like that you were describing.
[34:13] You have to do like a full, you're like a
[34:15] full like cystoscopy and things like that?
[34:17] Dr. Linda Kiley: No, no, no, no.
[34:17] We just use a 14 French, uh, catheter,
[34:21] like in and out cath kind of thing.
[34:22] Dr. Scott Sherr: Mm-hmm.
[34:23] Dr. Linda Kiley: Yeah.
[34:23] Yeah.
[34:23] With a little syringe.
[34:24] So there's usually about 30 ccs or
[34:27] so depending on what we're doing.
[34:29] And so it's not too much for, you know,
[34:31] even a really, I mean, interstitial
[34:34] cystitis is a, is a spectrum.
[34:37] I've seen everything from a more milder
[34:39] case where it's, it seems to be, um
[34:44] Dr. Scott Sherr: mm-hmm
[34:44] Dr. Linda Kiley: related to, you know,
[34:45] chronic infection kind of thing to so
[34:49] severe with the a hundred ulcers and
[34:50] scarring and, you know, stuff like that,
[34:52] that the bladder capacity due to scarring
[34:54] and fibrosis is down to like 30 ccs.
[34:57] I had a patient who came in
[35:00] who had been given multiple.
[35:02] Hydro dissensions, which is one
[35:04] of those old timey traditional
[35:06] treatments for interstitial
[35:08] cystitis that I'm not a big fan of.
[35:10] Every now and then, I might do
[35:11] one, but I don't do it very often.
[35:14] Dr. Scott Sherr: What is that procedure?
[35:15] What is that?
[35:15] Just, just extend,
[35:16] Dr. Linda Kiley: that's blowing up.
[35:17] That's under anesthesia.
[35:18] So basically is a cystoscopy and then
[35:20] you overinflate the bladder, you know?
[35:24] Got
[35:24] Dr. Scott Sherr: it.
[35:24] Dr. Linda Kiley: Yeah.
[35:24] And then you, you leave it like that
[35:26] for about a minute or two, not too long.
[35:28] Um, and then wash it out, you know?
[35:31] Got it.
[35:32] Okay.
[35:32] And that will show you these inflammatory,
[35:34] you know, usually you'll get these
[35:36] cascading bleeding areas and you'll
[35:38] see ulcerations and stuff like that.
[35:40] Those are a hundred ulcer.
[35:41] So, you know, you can see there's a
[35:42] really bad inflammatory condition here.
[35:44] Dr. Scott Sherr: Mm. Yeah.
[35:45] Dr. Linda Kiley: But I see
[35:45] patients who had a really, a
[35:47] bladder capacity of 30 ccs.
[35:50] Wow.
[35:50] That's rare, fortunately.
[35:53] Um, but you know, putting 30
[35:56] ccs in somebody's bladder,
[35:57] usually they can tolerate.
[35:58] I try, I tell them, hold
[36:00] it as long as you can.
[36:02] Try to hold it at least an hour, but hold
[36:06] it as long as you can and then pee it out.
[36:09] Don't worry about it.
[36:10] So
[36:10] Dr. Scott Sherr: yeah, 36
[36:11] Dr. Linda Kiley: days in the bladder
[36:12] is usually something just about
[36:13] anyone can tolerate even with a
[36:16] minuscule amount of, uh, capacity.
[36:20] So I tell them to hold it as long
[36:22] as they can, at least an hour.
[36:24] I try to do that at least
[36:25] a minimum of an hour.
[36:26] They go longer.
[36:28] Go for it.
[36:28] Even better.
[36:28] Yeah.
[36:28] You know?
[36:29] Yeah.
[36:29] Keep it in as long as you can.
[36:31] And, um, and then I'll look, depending
[36:34] on what I'm trying to do, I'll say, you
[36:35] know, let's do this every day for a week.
[36:38] Um, or sometimes even two weeks,
[36:40] depending on what you know
[36:41] it is we're trying to get at.
[36:42] Uh, or I'll do it, you know,
[36:44] a couple times a week, you
[36:45] know, let's see how you do.
[36:46] Let's see how your first responses
[36:48] come back in a couple days.
[36:49] Let's try it again.
[36:51] And if they come back and say, wow, I
[36:52] had like 24 hours of just, I felt great.
[36:57] You know, then I feel vindicated
[36:59] that okay, we got, we're getting
[37:00] to it, so we just need to do this.
[37:03] So I kind of have them do
[37:05] a package of, you know,
[37:06] Dr. Scott Sherr: sure.
[37:07] Dr. Linda Kiley: Recurring ones.
[37:09] And, um, so that's one way,
[37:11] Dr. Scott Sherr: right.
[37:11] Dr. Linda Kiley: You know, um, I
[37:13] use low-dose naltrexone, uh, keto,
[37:17] I use, um, uh, I use peptides.
[37:22] I, you know, depending upon what I think
[37:24] the underlying issue is, like, I'll use
[37:26] the CINs or, uh, BPC, you know, especially
[37:29] if there's a gut component to this.
[37:31] And almost everybody with IC has IBS or
[37:34] Dr. Scott Sherr: that's what, and
[37:35] that's what I was gonna ask you
[37:36] next is like, so I see interstitial
[37:38] interstitial cystitis, right?
[37:39] So talk about the gut component
[37:41] to this that you see oftentimes.
[37:43] What do you typically see present, and
[37:44] how do you, and, and how is addressing
[37:46] that affect your ability to treat the,
[37:48] the IC in this ca in this capacity?
[37:50] Dr. Linda Kiley: Well, so, you
[37:51] know, there's some interesting
[37:52] data showing that, um, first of
[37:54] all, there is a bladder microbiome.
[37:56] Uh, the, the fallacy that the bladder
[37:59] is a sterile environment is a fallacy.
[38:01] Dr. Scott Sherr: Yes.
[38:02] It's
[38:02] Dr. Linda Kiley: proven false.
[38:02] Dr. Scott Sherr: There's very few
[38:03] sterile places in our body, I think
[38:05] that I don't think they really exist.
[38:06] Right.
[38:06] So, yeah.
[38:07] Dr. Linda Kiley: So one of the things that
[38:09] has been found in some of these elegant
[38:12] studies is that women even have overactive
[38:16] bladder, if you wanna call it that.
[38:19] Um, and who have other kinds
[38:22] of urinary dysfunction tend to
[38:25] have a dysbiosis in the bladder.
[38:27] Dr. Scott Sherr: Hmm.
[38:28] Dr. Linda Kiley: And so, you
[38:30] know, I feel that the gut and
[38:32] the bladder go hand in hand.
[38:33] And so most of the time they will
[38:35] have some sort of IBS symptom,
[38:37] whether it's just constipation,
[38:38] diarrhea, bloating, you know, reflux.
[38:42] It's something like that.
[38:43] Sometimes it's really bad and they're
[38:44] like, oh my God, my gut is the worst.
[38:46] And sometimes it's just like bad.
[38:50] I mean, yeah.
[38:51] Sometimes I'm pu pain,
[38:52] sometimes I'm, you know.
[38:53] Dr. Scott Sherr: Yeah, sure.
[38:53] Dr. Linda Kiley: But.
[38:54] Once we, once I establish that
[38:56] connection and we start talking about
[38:58] it, you know, I tell them, you know,
[39:00] I think that it might be well for
[39:02] us to spend some time on your gut
[39:04] because inflammation starts in the gut.
[39:08] And that's, you know, once you've got
[39:11] a leaky gut, um, because everybody's
[39:14] heart, leaky gut at some point, I think.
[39:16] Mm-hmm.
[39:16] Mm-hmm.
[39:17] So once that, once you've got
[39:18] that leakiness right, that's
[39:20] inflammation leaking over into your
[39:22] body, well, where's it gonna go?
[39:23] It's gonna go to your brain.
[39:24] It's gonna go to your bladder, it's
[39:25] gonna, you know, other bladders,
[39:26] close proximity parts to your body.
[39:28] Yeah.
[39:28] Yeah.
[39:29] So we need to make sure that we have
[39:31] your gut working properly so that we
[39:34] can address your bladder and Yeah.
[39:35] I'm not forgetting about your bladder.
[39:37] I'm definitely gonna address that.
[39:39] Dr. Scott Sherr: Mm-hmm.
[39:39] Dr. Linda Kiley: But we gotta do
[39:40] something about your gut too, if
[39:42] we really wanna get you better.
[39:44] You know, if all I do is focus
[39:46] on one little thing for you,
[39:48] I'm gonna miss the big picture.
[39:50] The big picture is it's your
[39:51] whole body that's got a problem.
[39:54] That's just manifesting in one spot.
[39:56] Dr. Scott Sherr: Right.
[39:57] Dr. Linda Kiley: But if there's all these
[39:58] other things, and once we start delving
[40:00] and I start asking questions and we start
[40:02] talking about it, you know, we start
[40:05] getting into these other things and, and
[40:07] the light bulb goes on and they're like,
[40:09] oh, these are all related to one another.
[40:11] Yeah.
[40:12] And you know, sometimes it's Lyme
[40:13] or chronic EVV or chronic herpes.
[40:15] I mean, you know, how's your sleep?
[40:18] What are you sleeping?
[40:19] Oh no, I have horrible sleep.
[40:21] I can't sleep at all.
[40:22] I take sleep medication.
[40:25] Um,
[40:25] Dr. Scott Sherr: yeah.
[40:25] Dr. Linda Kiley: You know, it's a,
[40:26] so that's hence the holistic, hence.
[40:30] Yes, exactly.
[40:30] Functional,
[40:31] Dr. Scott Sherr: you know, it's the
[40:31] thing like, and I, I love the way you
[40:33] described that because it's like there's
[40:34] so many factors at play and then some,
[40:36] for some reason you are manifesting
[40:38] symptoms specifically in this area,
[40:40] and that's why you're seeing me.
[40:42] But if I just.
[40:43] Try to address what's happening in
[40:44] this specific area without looking at
[40:46] the bigger picture, like your sleep
[40:48] or your stress or your gut function.
[40:51] You're going to miss the
[40:51] forest from the trees and like,
[40:53] Dr. Linda Kiley: yeah,
[40:54] Dr. Scott Sherr: they might get better
[40:54] for a short period of time, but long
[40:56] term, those symptoms are gonna come back.
[40:58] And I'm sure you've seen
[40:58] that time and time again.
[40:59] Dr. Linda Kiley: Absolutely.
[41:00] Absolutely.
[41:01] So, yeah.
[41:03] You know, I, I try to impress upon them,
[41:05] my goal is to give them better quality
[41:07] of life so that everything gets better.
[41:09] And we're not just gonna sit in this
[41:11] one little space because they have a
[41:14] urologist, they have a gastroenterologist,
[41:16] they have a, you know, cardiologist,
[41:17] every neurologist, you know?
[41:19] Dr. Scott Sherr: Yeah, totally.
[41:20] Dr. Linda Kiley: Yeah.
[41:20] They have all these different people
[41:22] and, and one of the things that's
[41:23] unfortunate, there are not, there
[41:25] are some, but there are not a lot
[41:26] of holistic gastroenterologists.
[41:29] No.
[41:30] All I wanna do is, you know, a
[41:31] couple Look here, look, look there.
[41:33] And, you know, I didn't see anything.
[41:35] It looks gray.
[41:36] Dr. Scott Sherr: Yep.
[41:36] Dr. Linda Kiley: I don't see, you know,
[41:37] I don't, I don't see anything wrong.
[41:38] It's like, well, but they're still
[41:40] having all these dysfunctional problems.
[41:43] So then we do the gut microbiome study
[41:45] and I found, you know, amoebas and
[41:49] weird parasites and horrible dysbiosis
[41:53] Zulu levels up, you know, the wazoo.
[41:55] Sure, sure.
[41:55] Protected, uh, MMP nine, you
[41:57] know, all these crazy things.
[41:59] And I'm like, okay, let's do a
[42:02] little work here and see if we can
[42:04] get this thing straightened out and
[42:06] we'll keep working on your bladder.
[42:08] Dr. Scott Sherr: Sure.
[42:08] Dr. Linda Kiley: And we'll, we'll work
[42:09] on your sleep, we'll work on, you know.
[42:11] Yeah.
[42:11] Dr. Scott Sherr: And,
[42:12] Dr. Linda Kiley: you know,
[42:12] Dr. Scott Sherr: yeah, I get it.
[42:13] I get it.
[42:13] Yeah.
[42:13] It's fun.
[42:14] Dr. Linda Kiley: Yeah.
[42:15] Dr. Scott Sherr: And this is actually,
[42:15] it's interesting because I, I, I was
[42:18] involved and I still am in hyperbaric
[42:19] oxygen therapy for many years, and
[42:21] it's a great tool in technology and
[42:23] I get people to come in to me, come
[42:24] in initially I remember like, I have
[42:26] migraines, I wanna use hyperbaric therapy.
[42:28] And like initially I'm like, yeah, let's
[42:29] put you in the chamber, see how you do.
[42:30] Right.
[42:30] And then maybe they got better,
[42:31] maybe they didn't, but their
[42:32] symptoms would always come back.
[42:33] Right.
[42:34] Because it's not like it was fixing
[42:36] was actually underlying, just like if
[42:37] you fix their bladder, but they still
[42:39] have a significant dysbiosis like.
[42:41] You're still gonna get that
[42:42] coming back at some point.
[42:44] Right.
[42:44] And then, you know, one of the things I
[42:45] would just, I was just curious about your
[42:47] answer to this question I was thinking
[42:48] about as you were talking, Linda, I
[42:50] know that interstitial cystitis has the
[42:52] highest sui suicide rate of any condition.
[42:55] Um, I think of any medical
[42:56] condition, um, which is crazy.
[42:59] I mean, what, what is your sense of
[43:00] the percentage of those people that
[43:02] have it, that likely have the capacity
[43:04] to have significant improvement, um,
[43:06] that are walking around with it now you
[43:07] think it's 90%, do you think it's 50%?
[43:10] Or what, what do you think
[43:11] Dr. Linda Kiley: I would,
[43:11] from your experience,
[43:12] would
[43:12] Dr. Scott Sherr: say
[43:12] Dr. Linda Kiley: at least,
[43:13] at least 90, I mean,
[43:15] Dr. Scott Sherr: at least 90%.
[43:16] Dr. Linda Kiley: Yeah.
[43:16] Yeah.
[43:16] I had one, I've had one patient in my
[43:19] career who came in, um, who had, it
[43:24] was very long standing for her, and she
[43:26] was the one with the 30 cc capacity.
[43:28] Sure.
[43:28] Her husband had in install,
[43:30] installed the toilet in their van
[43:32] so that she could, and, and she
[43:33] would just sleep on the toilet.
[43:35] I mean,
[43:35] Dr. Scott Sherr: Jesus.
[43:36] Dr. Linda Kiley: Yeah.
[43:36] This, you know, and, and she came to
[43:38] me and at that point, you know, I said.
[43:40] I don't know.
[43:41] I mean, the, your bladder
[43:43] is scarred down now.
[43:44] I, you know, you may actually
[43:47] need to consider a SA cystectomy.
[43:49] Dr. Scott Sherr: Yeah, sure.
[43:50] Dr. Linda Kiley: Yeah.
[43:50] Um, um, but, you know, she was miserable.
[43:54] It, it was, it was horrible.
[43:56] Um, so she needed radical treatment.
[43:59] Something more than I would be
[44:01] doing, you know, that's not,
[44:02] that's not the procedure that I do.
[44:04] Right.
[44:05] But, um, I don't think there's a
[44:08] single person who can't be helped.
[44:12] Can, can we completely eradicate it?
[44:14] I mean, you know, one of the things
[44:16] I've been doing lately too is genomic
[44:18] studies on people and, um, genomic
[44:22] studies on people and, you know,
[44:25] looking at their hotspots and their
[44:26] detoxification and their inflammation
[44:28] and all of this other stuff.
[44:30] And that's really opened
[44:31] a lot of doors to Okay.
[44:35] Let's see, we can, I think it's
[44:37] even better than food sensitivities,
[44:39] you know, because I think food
[44:40] sensitivities change over time.
[44:42] Dr. Scott Sherr: Sure.
[44:42] Dr. Linda Kiley: I don't know
[44:43] that they are, with the exception
[44:45] of maybe celiac disease.
[44:46] Um, I think other things tend to
[44:48] be more mutable and have a lot to
[44:53] do with how the immune system is
[44:54] sampling and sending information to,
[44:58] you know, in the gut, into the body.
[45:01] So I don't think that food sensitivity's
[45:04] necessarily all stay the same.
[45:05] So I don't just wanna take people
[45:07] off, you know, all these foods.
[45:09] Dr. Scott Sherr: Sure, sure.
[45:09] Dr. Linda Kiley: I really want to kind
[45:11] of come to the other side of it, of
[45:13] where's the inflammation coming from
[45:14] and how can we that down and Sure.
[45:17] Yeah, sure.
[45:17] We're probably gonna have to
[45:18] avoid, you know, you're gonna have
[45:20] to back off on a few things for
[45:22] a while, but maybe not forever.
[45:25] And, uh, we can get this other
[45:27] stuff under control and get your
[45:29] dysbiosis fixed and all that.
[45:31] Probably gonna be able to eat more things.
[45:33] Probably gonna have less
[45:34] inflammation and less pain.
[45:35] So, so, but I, I think by doing that,
[45:39] the likelihood is that the vast majority
[45:41] of IT patients will better, well
[45:43] they completely better will maybe ob
[45:45] cured Well, there's so many factors.
[45:49] Dr. Scott Sherr: Sure.
[45:49] Dr. Linda Kiley: Maybe
[45:49] not, you know, right.
[45:50] I mean, I, I tell people the
[45:52] Dr. Scott Sherr: significant
[45:52] improvements you see
[45:53] Dr. Linda Kiley: most across
[45:54] Dr. Scott Sherr: the board.
[45:54] You
[45:54] Dr. Linda Kiley: know, chronic
[45:54] conditions are chronically for a reason,
[45:56] Dr. Scott Sherr: part of the interruption.
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[45:58] to you by transcriptions.
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[46:27] Right, right.
[46:27] And they kind of take of
[46:28] the life of their own.
[46:29] Over time as well as a result of that.
[46:31] But over 90% think it have
[46:33] significant improvements.
[46:34] And that's, that's a big deal because
[46:35] it's one of the most painful and most
[46:37] challenging conditions out there to
[46:40] treat and to also to to live with.
[46:42] I mean, that's why the, the suicide rates
[46:44] are so high, this particular condition.
[46:47] Um, and it's, you know, it's so
[46:48] interesting how this multifactorial
[46:50] approach, this approach where you have
[46:52] multiple things you're doing at the same
[46:54] time, really can have a huge, huge impact.
[46:56] You know, one of the other, uh,
[46:57] conditions that I, you know, that I
[46:58] see a lot, I used to see a lot when
[47:00] I was in, in training that was, uh,
[47:02] sent in a psych is endometriosis.
[47:04] Right?
[47:05] Which is another one.
[47:06] So do you, do you just kind of see
[47:07] it in the same framework here as you
[47:09] do for IC and for, and for bladder
[47:11] pain or, or for pelvic pain too?
[47:12] Dr. Linda Kiley: Yes, yes.
[47:13] So, uh, I have this list of things that
[47:16] I consider to be related to one another.
[47:18] So.
[47:20] Uh, endometriosis because I did a
[47:23] lot of that before I did the other,
[47:25] you know, I did a lot of gynecology
[47:27] before I really got into urogynecology.
[47:28] Mm-hmm.
[47:29] I tended to really, because again,
[47:32] endometriosis is one of those things
[47:34] that is woefully underdiagnosed,
[47:36] undertreated, poorly understood.
[47:39] Dr. Scott Sherr: Yep.
[47:40] Dr. Linda Kiley: Um, you
[47:40] know, with pelvic pain.
[47:42] Um, so anyway, endometriosis, interstitial
[47:45] cystitis, i irritable bowel syndrome or
[47:48] whatever, you know, inflammatory bowel,
[47:49] however you wanna call it, migraine
[47:51] headaches, fibromyalgia, long COVID,
[47:53] or, you know, post-viral syndrome.
[47:56] I consider the all to be
[47:58] related to one another.
[47:59] The, the etiology may be a little
[48:01] different, but the underlying
[48:03] problem is still inflammation.
[48:05] Right.
[48:05] It's, it's a generalized inflammation.
[48:06] It's manifesting in a particular way, but
[48:09] a lot of times these will go together.
[48:11] I see, I see.
[48:12] An endometriosis or endometriosis and IBS
[48:15] and I, you know, you see it all the time.
[48:18] So you have to kind of, at first of
[48:21] all, the most important thing that a
[48:24] doctor can do is validate the patient
[48:26] and say, I believe I understand you.
[48:30] You have these symptoms, right?
[48:31] Are they're, they're not weird,
[48:32] Dr. Scott Sherr: right?
[48:33] Dr. Linda Kiley: You're not weird.
[48:34] You're not crazy.
[48:35] There's, you know, yes.
[48:36] There's really something
[48:37] wrong with you and yes, it's
[48:39] affecting your quality of life.
[48:40] Let's figure out what it is.
[48:42] I mean, like, yeah, I was having a
[48:44] conversation with someone I'm close to
[48:47] not that long ago, who's been having some
[48:49] health problems, and she just said, you
[48:52] know, sometimes when I stand up I get
[48:55] so dizzy, I, I have to sit back down.
[48:56] I like, and I go, oh,
[48:57] you have pot syndrome.
[49:00] And, um, it was like this light bulb,
[49:04] the whole, and the entire li her entire
[49:07] life changedd with just that sentence.
[49:11] Mm-hmm.
[49:12] Because nobody, no gastroenterologist.
[49:15] Internal medicine, you know, nobody else
[49:18] had said a word like that or even tested
[49:20] or, you know, done anything about it.
[49:22] It was just like a simple
[49:23] statement, you know, like this.
[49:26] Dr. Scott Sherr: Yeah, yeah.
[49:27] Dr. Linda Kiley: Thought in
[49:27] passing kind of things, right?
[49:28] Like
[49:29] Dr. Scott Sherr: Yeah,
[49:30] Dr. Linda Kiley: I know what that is.
[49:31] Dr. Scott Sherr: Yeah, it's amazing.
[49:32] I mean, I think you're right in a
[49:33] sense that there's so much that sort of
[49:35] underlies the base of inflammation, right?
[49:39] In the sense that like, there's a lot
[49:40] of things that can cause inflammation,
[49:42] but in the end there's inflammation.
[49:44] So obviously you wanna try to find out the
[49:46] cause of the inflammation as much as you
[49:48] can, whether it's an infection or if it's,
[49:50] um, you know, there's some significant
[49:52] mitochondrial or sort of nutrient
[49:53] deficiencies and, and things like that.
[49:55] Like as far as like, not personalized,
[49:59] but more of like an inflammatory
[50:00] or anti-inflammatory stack.
[50:02] Um, what are the main
[50:03] things that you use there?
[50:03] You mentioned already LDN for example,
[50:06] and kein is two things that you use.
[50:08] Like what are your kind of,
[50:09] your base inflammatory, like
[50:11] anti-inflammatory things that you
[50:12] typically use in most patient?
[50:13] Dr. Linda Kiley: So I, I'm
[50:15] very fond of BPC one by seven.
[50:17] Okay.
[50:17] Because it can be taken orally and I,
[50:19] I do the gut types a lot, so the B cbo.
[50:22] Dr. Scott Sherr: Mm-hmm.
[50:23] Dr. Linda Kiley: Mm-hmm.
[50:23] Um, so I put a lot of patients on that,
[50:25] 'cause it tends to be very well tolerated.
[50:27] Dr. Scott Sherr: Mm-hmm.
[50:28] Dr. Linda Kiley: And, um, it often
[50:29] makes, you know, a difference.
[50:30] It may not be a big difference.
[50:31] I mean, in some people it makes a huge
[50:33] difference in some, just a little.
[50:34] But, you know, I, I'll do that.
[50:36] Dr. Scott Sherr: Mm-hmm.
[50:38] Dr. Linda Kiley: Um,
[50:40] then, you know, uh, depending upon,
[50:43] I, you know, I might, there are some
[50:46] supplements that I might go to, you
[50:47] know, sane or, or dim or, um, turmeric,
[50:52] curcumin, you know, sometimes I,
[50:54] you know, I, I use those things too.
[50:56] Um.
[50:58] Late, I've started using some cord deps.
[51:00] Nice.
[51:00] I like fats.
[51:01] Nice.
[51:01] Yes.
[51:02] I like that.
[51:03] Dr. Scott Sherr: I like that.
[51:03] The cord seven from Ute
[51:04] Dr. Linda Kiley: like this.
[51:05] Yes, I do.
[51:05] Nice.
[51:05] I do like it.
[51:06] Yeah.
[51:07] Yeah.
[51:07] I've been using it, I use it.
[51:08] I like it for the deep sleep thing.
[51:09] So
[51:10] Dr. Scott Sherr: it does
[51:10] increase deep sleep.
[51:11] Yes, that's true.
[51:11] Dr. Linda Kiley: Yeah, it's nice.
[51:12] Which is, to me, that's like one of
[51:14] the most critical things about reducing
[51:15] inflammation's, getting the deep sleep.
[51:17] So yeah,
[51:18] Dr. Scott Sherr: that's a big
[51:18] Dr. Linda Kiley: one.
[51:18] And then, um, yeah.
[51:20] Yeah.
[51:20] And, and then the thymosin, um, I've
[51:24] had just tremendous success with the thy
[51:26] thymosin alpha one, thymosin beta four,
[51:29] you know, in the properly chosen patient.
[51:31] Uh, so, and then depending upon
[51:36] what else, you know, if there's
[51:37] mitochondrial dysfunction, you
[51:39] know, you can't get mut C anymore.
[51:42] Um, SS 31 if you, you know, if you can.
[51:46] Dr. Scott Sherr: Right.
[51:46] Dr. Linda Kiley: Um, there are a
[51:46] lot of things you can't get anymore.
[51:47] So we're just sort of
[51:48] stuck with what we've got.
[51:51] But what we have is still pretty good.
[51:55] Um, doesn't work for everybody.
[51:56] And then, you know, again, the right kind
[51:58] of probiotics, either empirically or if
[52:01] I could do a gut microbiome study that,
[52:04] you know, the, um, study in butyrate.
[52:07] Mm-hmm.
[52:08] Also help the gut, you know.
[52:09] Mm-hmm.
[52:10] A lot of that inflammatory
[52:11] stuff on the gut.
[52:12] Solen and lox.
[52:13] I've been using a lot more in Lexi Mix.
[52:15] Dr. Scott Sherr: You have been using that?
[52:16] Okay.
[52:16] Interesting.
[52:16] Yeah.
[52:17] Dr. Linda Kiley: Um, I, I like it.
[52:18] I like it.
[52:19] It seems to be really well tolerated.
[52:20] It's not expensive, um, compared to
[52:24] some of the other stuff that we have.
[52:25] Right,
[52:25] Dr. Scott Sherr: right, right.
[52:26] Dr. Linda Kiley: Um, and I think it,
[52:27] you know, it because it's well tolerated
[52:29] and, and not highly costly, it's easy to
[52:33] incorporate with other things that we do.
[52:36] And so usually I use a cocktail and, and
[52:39] I'll start, you know, I usually start
[52:40] with kind of one or two things at a time.
[52:43] Um, so often depending on the
[52:46] patient and how bad it is and what
[52:48] I'm really thinking about, um.
[52:51] You know, I'll start with like the
[52:52] oral bbc, the ides, and then, um,
[52:58] m lox, tuti, you know, I'm really
[53:01] thinking a lot of get inflammation
[53:02] and, you know, the permeability
[53:04] Dr. Scott Sherr: issue.
[53:05] Yeah.
[53:05] What's your experience
[53:06] been with LoRa Tide?
[53:06] Have you had good experience
[53:08] with that one, or?
[53:08] Pretty much,
[53:09] Dr. Linda Kiley: yeah.
[53:09] I have some patients who
[53:10] are like, I'm never going.
[53:13] Yeah.
[53:14] Dr. Scott Sherr: So RAs Tide, for
[53:15] those people that know, maybe you
[53:16] can just describe what that is.
[53:17] I think that's a relatively
[53:18] Dr. Linda Kiley: new one.
[53:18] Okay.
[53:18] So, so first to, first of all, zonulin
[53:22] is something that's a normal substance
[53:24] in the gut that allows nutrients to pass
[53:27] through the gut lining into the body.
[53:31] So, you know, we want to have some
[53:34] lin, but one of the things that
[53:36] seems to happen, and some people
[53:37] are much more susceptible is
[53:39] Dr. Scott Sherr: mm-hmm.
[53:39] Dr. Linda Kiley: Zonulin
[53:40] levels go really high.
[53:41] And so everything's getting through,
[53:44] you know, the, the bacteria produce
[53:47] something called lipo, which
[53:48] is an inflammatory substance.
[53:51] And if you get a lot of that
[53:52] going across, you are going
[53:54] to create brain inflammation.
[53:56] It's gonna go hit wherever it's gonna
[53:58] hit, you know, cardiovascular system, um,
[54:02] you know, bladder, uh, musculoskeletal, I
[54:05] mean, a lot of places that you can get it.
[54:06] So, um, you don't want your zolin levels
[54:09] to be through the roof, you to be normal.
[54:11] So Loratab is a zonulin blocker and
[54:14] it doesn't block it a hundred percent.
[54:16] We're not trying to turn it off,
[54:18] we're just trying to turn it down.
[54:19] Dr. Scott Sherr: Mm-hmm.
[54:20] Mm-hmm.
[54:20] Dr. Linda Kiley: And usually I'll start
[54:22] by really turning it down, and then
[54:25] I'll kind of go back off a little bit
[54:27] and, you know, just give it, I'll do
[54:29] the day and then maybe intermittently
[54:33] cyclic, you know, kind of thing.
[54:35] Mm-hmm.
[54:35] But
[54:35] Dr. Scott Sherr: mm-hmm.
[54:36] Dr. Linda Kiley: Initially I try to
[54:37] do like twice, two doses of a day and
[54:39] Dr. Scott Sherr: mm-hmm.
[54:40] Dr. Linda Kiley: You know, like it's
[54:41] Dr. Scott Sherr: oral.
[54:41] Correct.
[54:41] It's an oral peptide, right?
[54:42] Dr. Linda Kiley: Yes.
[54:43] It's an oral, which is really nice.
[54:44] Dr. Scott Sherr: Right.
[54:45] Yeah.
[54:45] That's the other
[54:45] Dr. Linda Kiley: thing
[54:46] Dr. Scott Sherr: that's nice to be, yeah.
[54:47] And the lox tell, maybe you can just give
[54:49] people a quick, um, description of what
[54:51] that is and what that does if you know.
[54:53] Dr. Linda Kiley: Sure.
[54:53] So, um, lox, you know, it, it was approved
[54:56] in this country, uh, as an eye drop for,
[54:59] um, um, like allergy symptoms and stuff.
[55:03] Mm-hmm.
[55:04] In, in Japan it's approved for
[55:05] use in asthma, but I think it gets
[55:07] used for a lot of other things.
[55:08] It's an orphan drug here because it wasn't
[55:10] popular enough, it didn't sell well.
[55:12] So, uh, the company that got the
[55:14] approval stopped making it, but
[55:16] we can get it compounded and we
[55:18] can get it, you know, orally.
[55:19] It is effective and, um, seems to really
[55:22] be beneficial for reducing information
[55:24] in the gut as well as I've had patients
[55:26] say, eczema got better taking it.
[55:29] You know, eczema seems to go along
[55:31] with the inflammatory gut thing too.
[55:34] Dr. Scott Sherr: Sure, sure, sure.
[55:34] Dr. Linda Kiley: So, um, it's, it's
[55:36] interesting that I've seen that improve
[55:38] in some patients who wear on in like Xox.
[55:40] So, yeah.
[55:41] Dr. Scott Sherr: Cool.
[55:41] Dr. Linda Kiley: You know, because
[55:42] it's well tolerated and because
[55:43] it's, it's just also damping
[55:45] down some of that inflammation.
[55:46] Dr. Scott Sherr: Mm-hmm.
[55:47] Dr. Linda Kiley: Um, and it seems
[55:48] to do it in a very nice way.
[55:50] Um, I I, I've become really fond of it.
[55:53] Dr. Scott Sherr: I can tell.
[55:54] That's cool.
[55:54] Yeah.
[55:55] Yeah.
[55:55] I mean, I don't have a lot of personal
[55:56] experience with it in my, in my clients,
[55:57] but I do know I had Dr. Elizabeth Y on a
[56:00] podcast not too long ago, maybe about a
[56:02] year ago now, and we talked a lot about
[56:04] on ox, we talked about some of the other,
[56:06] or, um, orphan drugs that are out there,
[56:08] excuse me, that she's using as well.
[56:10] So, really cool stuff.
[56:11] But, but it has been a great, I think,
[56:13] overall conversation about like,
[56:14] some really challenging conditions
[56:15] like, you know, bladder pain, pelvic
[56:17] pain, um, interstitial cystitis,
[56:20] endometriosis, IBS, dysbiosis, TMJ
[56:23] causing bladder, like causing pelvic pain.
[56:26] And, and so it's kind
[56:28] of amazing to me that.
[56:29] These resources aren't more
[56:30] available to people to think about.
[56:32] And so I'm really happy you're doing
[56:33] this kind of work and kinda bringing
[56:34] it out there and like getting more
[56:36] exposure so that, you know, it's amazing
[56:38] to me, like you, you also said to me,
[56:40] 90% of people with IC can get better.
[56:43] Right.
[56:43] And like, that's like not heard of in the
[56:45] medical world and the conventional world.
[56:46] You have ic, you get to
[56:47] get, you go to psych.
[56:48] Like that's what happens.
[56:49] Right?
[56:50] And like there could be a component there,
[56:51] don't get me wrong, like where people have
[56:53] that psychosocial emotional piece, right?
[56:55] And like that needs to be addressed.
[56:56] But you, you see real changes by
[56:58] actually addressing the bladder, taking
[57:00] out those biofilms, doing the advanced
[57:03] urine cultures and all that stuff.
[57:04] Dr. Linda Kiley: Absolutely.
[57:05] And, and just really
[57:06] believing the patient.
[57:07] I think one of the things that
[57:08] is, is the most therapeutic is the
[57:11] acknowledgement of the reality of the
[57:13] symptom and that they're not raising.
[57:16] Dr. Scott Sherr: Mm-hmm.
[57:16] Dr. Linda Kiley: You know, once
[57:17] I acknowledge, yes, you know, I
[57:19] understand you have this condition and.
[57:21] I have a number of things in my toolbox.
[57:23] I have a much bigger toolbox than
[57:25] I had, you know, 10 years ago
[57:27] or, or certainly 20 years ago.
[57:29] Dr. Scott Sherr: Sure.
[57:30] Dr. Linda Kiley: Um, and so I'm gonna
[57:32] bring out as many things outta that
[57:34] toolbox for you as I can possibly
[57:36] come up with, and we will try to find
[57:40] something that gives you some relief.
[57:41] I can't promise you, you're
[57:42] not gonna have flareups, right.
[57:44] You know, this sense, chronic
[57:45] condition, but we will try
[57:47] to get to the bottom of it.
[57:48] And whatever it takes to give you a better
[57:51] quality of life, we're gonna do that.
[57:53] Dr. Scott Sherr: I love it.
[57:54] I love it.
[57:54] So, uh, we ask one last question
[57:56] for everybody on the podcast, Linda,
[57:58] and, uh, I love your emphasis on
[58:00] history and physical, by the way.
[58:01] It's like such a big deal, fab, because
[58:03] like it's very, it's, it's, it's a lot.
[58:05] These are lo lo losing arts, right?
[58:06] I mean, I don't do many physicals
[58:07] anymore, but I still do.
[58:09] I have pretty good history.
[58:10] But I just wanna say that before
[58:11] I get to the last question, which
[58:12] is, um, we ask every guest at on,
[58:15] on the podcast, what are three ways
[58:17] that all of us can live smarter, not
[58:19] harder, meaning like, what can we do?
[58:21] Smarter and not work as hard
[58:23] to get the outcome right.
[58:24] So it could be like, you know, work
[58:26] four hours and take four hours off
[58:28] and then do another four hours, like
[58:29] whatever, like everybody's got all their
[58:30] crazy patterns and things like that.
[58:31] Or it could be things in health
[58:32] and wellness or in your life.
[58:34] So from everything that you can
[58:36] think of, like what are three
[58:37] ways that you feel like everybody
[58:39] can live a little bit smarter and
[58:41] a little bit less hard overall?
[58:44] Dr. Linda Kiley: Okay, well
[58:44] first of all, you have to find a
[58:47] physical activity you have to do.
[58:49] Dr. Scott Sherr: Okay.
[58:50] Dr. Linda Kiley: So I've been a
[58:51] martial artist for about 24 years.
[58:53] I just went today.
[58:54] I was there for an hour this morning.
[58:58] Um, it is part of my life
[59:02] and I, I love doing it.
[59:03] I can't imagine not doing it.
[59:05] And I think everyone
[59:06] needs something like that.
[59:08] It doesn't have to be martial arts.
[59:09] I think martial arts are great
[59:10] 'cause they do a lot, you know.
[59:12] Dr. Scott Sherr: Lot effect.
[59:13] Yeah, sure.
[59:13] Dr. Linda Kiley: Fast twitch
[59:14] muscle weight bearing exercise.
[59:16] Dr. Scott Sherr: Got it all,
[59:16] Dr. Linda Kiley: you know?
[59:16] Dr. Scott Sherr: Totally.
[59:17] Yeah.
[59:17] Dr. Linda Kiley: Mental,
[59:18] like the halt the end.
[59:19] You're
[59:19] Dr. Scott Sherr: convincing me, me
[59:20] Dr. Linda Kiley: to start this.
[59:20] Pick things.
[59:20] Dr. Scott Sherr: Okay.
[59:21] Dr. Linda Kiley: Yeah.
[59:21] Yeah.
[59:21] It's great.
[59:22] But anyway, but so you have to find
[59:24] Dr. Scott Sherr: yeah.
[59:25] Dr. Linda Kiley: A physical
[59:25] activity that you like to do.
[59:28] Dr. Scott Sherr: That's beautiful.
[59:29] I like that.
[59:29] Yeah.
[59:30] Dr. Linda Kiley: Um, and then, you know,
[59:32] everybody talks about work life balance
[59:34] and you know, there are different phases
[59:35] in your life where you are working
[59:38] more and you, you know, you're not
[59:40] taking care of yourself as much 'cause
[59:42] you're focusing more on your career and
[59:43] whatever, what kind of career you have.
[59:46] We know what it's like in medicine.
[59:48] It so, you know, we do,
[59:49] Dr. Scott Sherr: we do.
[59:49] You
[59:49] Dr. Scott Sherr: just
[59:49] Dr. Linda Kiley: give up a certain portion
[59:51] of your youth and that's just what it is.
[59:54] Um, but you know, find something that
[59:57] fulfills you, work that you enjoy because
[1:00:00] we all need to work and feel needed.
[1:00:02] Yeah.
[1:00:03] Purposely.
[1:00:03] Yeah.
[1:00:03] We need to feel like what
[1:00:05] we're doing, purpose.
[1:00:05] Yeah.
[1:00:05] What we need to find purpose,
[1:00:06] I guess that's the word.
[1:00:07] Yeah.
[1:00:08] Is purpose.
[1:00:09] And you know, I think, I mean there are.
[1:00:11] Lots of data out there about how
[1:00:14] purpose is primary driver of longevity,
[1:00:19] and when people lose their sense of
[1:00:20] purpose, that's when they start to dump.
[1:00:22] Dr. Scott Sherr: Yep.
[1:00:23] Yep.
[1:00:23] Dr. Linda Kiley: So, um, so
[1:00:25] that, you know, find your, find
[1:00:28] your purpose and pursue it.
[1:00:30] Not to the extent that you're
[1:00:32] killing yourself, but maybe for
[1:00:35] the first three years when you're
[1:00:36] young and you can deal with it.
[1:00:37] If it's something that you really need
[1:00:38] to deal like that, you know, if it's
[1:00:39] your calling, I tell people who are
[1:00:41] interested in going into medicine.
[1:00:43] If it's your calling, do it.
[1:00:45] If it's not your calling,
[1:00:46] go into something else.
[1:00:47] Finance, whatever, find whatever,
[1:00:49] Dr. Scott Sherr: something else.
[1:00:49] Yes, totally.
[1:00:50] Dr. Linda Kiley: Yeah.
[1:00:50] Do
[1:00:50] Dr. Scott Sherr: something else
[1:00:50] I to say about surgeons too.
[1:00:51] If, like, if you don't love any
[1:00:52] other specialty, then be a surgeon.
[1:00:55] If you only love being a surgeon,
[1:00:56] but if you find anything else
[1:00:57] that you like almost as much,
[1:00:58] you should do that instead.
[1:00:59] That's what, that's what
[1:00:59] everybody told me in, you
[1:01:00] Dr. Linda Kiley: know, the, it's funny
[1:01:01] 'cause the advice that I got was a
[1:01:03] little, he said my, it was my, one of
[1:01:06] my OB g YN instructors, and he said,
[1:01:09] it's really easy to pick your specialty.
[1:01:11] Are you a surgeon or not?
[1:01:14] If you're a surgeon, then you have to
[1:01:16] do a surgical specialty because he won't
[1:01:18] be happy in a non-surgical specialty.
[1:01:20] If you're not a surgeon, don't do it.
[1:01:22] You know, if you, you'll know, you
[1:01:24] know, you already know you walked into
[1:01:27] the OR and one of two things happened.
[1:01:29] You went Yes.
[1:01:30] Or you went, ah, you know,
[1:01:33] and, and I went, yes.
[1:01:35] So that was it.
[1:01:36] You know, I, I was a surgeon and
[1:01:38] I did not go into medical school
[1:01:40] thinking I was gonna do that.
[1:01:41] I thought I was gonna go
[1:01:42] into family practice and
[1:01:43] Dr. Scott Sherr: Wow.
[1:01:43] Dr. Linda Kiley: You know, be Marcus Weby.
[1:01:45] Actually, Steven, Kylie, my last name was,
[1:01:48] you know, and he rode a motorcycle and I,
[1:01:50] Dr. Scott Sherr: and that was pretty cool.
[1:01:51] Yeah.
[1:01:51] Dr. Linda Kiley: That's neither here that,
[1:01:51] Dr. Scott Sherr: yeah.
[1:01:52] I love it.
[1:01:52] Yeah.
[1:01:52] Okay.
[1:01:52] So do you have a, a
[1:01:53] third one, like a number
[1:01:54] Dr. Linda Kiley: three, A third thing.
[1:01:55] Dr. Scott Sherr: Yeah.
[1:01:55] Dr. Linda Kiley: Be good to yourself.
[1:01:57] But by doing that, I mean, you
[1:01:59] know, we know what's good for us.
[1:02:01] We know what kind of food is good for us.
[1:02:02] We know, we know whether or not we
[1:02:06] should be drinking or, you know, do
[1:02:08] doing all these other things, you know.
[1:02:10] We need to be good to ourselves.
[1:02:13] And that means, you know, get
[1:02:15] the sleep that you need and
[1:02:16] you're not gonna always get it.
[1:02:18] You're gonna give it up
[1:02:18] for good reasons sometimes.
[1:02:20] Dr. Scott Sherr: Sure, sure.
[1:02:20] Dr. Linda Kiley: But, but don't let
[1:02:21] that go be, you know, do, do the right
[1:02:25] things for yourself, because that's
[1:02:27] gonna really help you function when
[1:02:31] you're stressed out and when the chips
[1:02:32] are down and all that kind of stuff.
[1:02:33] So,
[1:02:34] Dr. Scott Sherr: I love it.
[1:02:34] Yeah.
[1:02:35] Dr. Linda Kiley: Yeah.
[1:02:36] Dr. Scott Sherr: And something, and that's
[1:02:36] something you figure out over time, right?
[1:02:37] It's not something, you know, typically
[1:02:38] when you're younger, but as you get
[1:02:40] older, you understand, you know, the
[1:02:41] gut feeling is there for a reason.
[1:02:43] Right?
[1:02:43] Like, there's nerve endings
[1:02:44] in that, as we know.
[1:02:45] Well, Linda, this has been great.
[1:02:46] Where can people hear more about
[1:02:48] your, your work or learn about more
[1:02:49] of your practice or what you do?
[1:02:52] Dr. Linda Kiley: Well, so, um, I
[1:02:53] practice in Palm Beach Gardens, Florida.
[1:02:56] Um, the name of my practice is
[1:02:58] Ultra Health and Wellness, but,
[1:03:00] um, and, and I, I have a, I have
[1:03:04] a Facebook and uh, Instagram.
[1:03:08] Page and, um, so they could go on either
[1:03:11] Dr. Scott Sherr: yeah,
[1:03:11] Dr. Linda Kiley: Facebook or
[1:03:12] Instagram and look up ultra health
[1:03:14] and wellness, or they could look
[1:03:15] up, you know, dr linda kiley.com.
[1:03:17] That's my website.
[1:03:19] And, uh, and I'm not too hard to find,
[1:03:21] I actually have that YouTube channel
[1:03:24] that I haven't really added a lot to
[1:03:25] in a while because I, you know, like
[1:03:28] Dr. Scott Sherr: I I've heard of it.
[1:03:29] I've heard of it.
[1:03:30] Yeah.
[1:03:30] Yeah.
[1:03:31] Um, well I think those are all great
[1:03:33] resources and, and Linda, I really
[1:03:34] do appreciate you spending the time.
[1:03:35] Dr. Linda Kiley: Thank you.
[1:03:36] Dr. Scott Sherr: Thank meeting with
[1:03:36] our audience to, like, to discuss
[1:03:38] some of these more challenging topics.
[1:03:40] This is also very self-serving for
[1:03:41] me in the sense that like, these
[1:03:43] are topics that I care a lot about
[1:03:44] that not a lot of people know about.
[1:03:45] Um, and that there's great people
[1:03:47] to refer to like you, to help.
[1:03:50] And I'm sure you have an, a cadre of other
[1:03:51] people that you know around the country.
[1:03:53] If people have issues, you know, they
[1:03:55] could potentially reach out to you or your
[1:03:56] team and they could potentially, you know,
[1:03:58] find some people in their local areas.
[1:03:59] So, uh, so thank you for spending.
[1:04:02] Time from with me today and, uh,
[1:04:03] I'm glad you got your martial
[1:04:04] arts training in earlier.
[1:04:06] Dr. Linda Kiley: Thanks a lot.
[1:04:06] Well, thank you for having me on.
[1:04:08] You know, I, I love being able
[1:04:09] to spread the word because I feel
[1:04:12] like I, I don't want this to,
[1:04:14] you know, die or retire with me.
[1:04:16] And yeah, at some point I am gonna retire,
[1:04:18] so I, I want, I want people to know
[1:04:20] about this stuff, you know what I mean?
[1:04:21] No,
[1:04:21] Dr. Scott Sherr: it's good.
[1:04:22] It's important.
[1:04:22] Yeah.
[1:04:23] Okay, well enjoy the rest of your
[1:04:24] day and we'll, we'll talk soon.
[1:04:24] Okay.
[1:04:25] Thank you.
[1:04:25] Dr. Linda Kiley: Alright, great.
[1:04:26] Thanks a lot.
[1:04:28] Dr. Scott Sherr: Thanks so much for
[1:04:28] tuning into another episode of the Smarter
[1:04:30] Not Harder podcast, where we give you
[1:04:31] 1 cent solutions to $64,000 questions.
[1:04:34] In this episode, Dr. Linda went
[1:04:35] through some amazing ways of really
[1:04:37] approaching some very difficult
[1:04:39] conditions, pelvic pain, bladder pain,
[1:04:41] interstitial cystitis, inflammatory
[1:04:43] stacks, dysbiosis, and much more.
[1:04:45] I learned a ton.
[1:04:46] I hope you did too.
[1:04:47] If you have these kinds of symptoms
[1:04:49] or have patience with these
[1:04:50] kinds of issues, refer them over.
[1:04:52] That's what I do all the time.
[1:04:53] Linda or her office may be able
[1:04:55] to help you if you're not in
[1:04:56] Florida where she's located.
[1:04:57] So check it out.
[1:04:58] Really great information.
[1:04:59] So if you like this podcast, don't forget
[1:05:01] to like and subscribe below so you never
[1:05:02] miss an episode, and we'll see you next
[1:05:03] time on the Smarter Than Harder podcast.

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