In August 2020, Karen’s endocrinologist sent her my way. Karen arrived at our first virtual appointment with a few “must-have” health outcomes top of mind:

Relieve debilitating pelvic pain. Karen experienced excruciating pain during sex and for days after, making the prospect of intimacy with her beloved husband a source of anxiety. Periods led to worsened pain and pelvic floor tightness that irritated her bladder – she felt like she spent half her days urinating around her period. She suspected inflammation was a barrier she needed to address.

Set self + body up for a healthy pregnancy. Karen saw addressing pelvic pain as the first step toward a healthy pregnancy. She was aware her lifestyle was not a good match for a healthy pregnancy but was struggling to make the necessary changes, and knew she needed customized guidance and an empowering partnership.

Cultivate new habits given by a commitment to vitality (vs an obsession with the scale). Karen had spent over a decade living the broken, inherited “all or nothing” approach to nutrition and exercise – sustaining fad deprivation diets and using self-aggression to force herself to the gym. And she was DONE with this approach. She was certain there was a different way – one that would leave her empowered with sustainable outcomes and mastery of her Middleground. And she was correct!

Karen started smoking at 17 and at the time of our first appointment was smoking 10 cigarettes daily. She was also drinking up to 10 alcoholic beverages weekly and struggling with her relationship to alcohol – feeling the impact through weekend days lost to hangovers, increased anxiousness, increased pelvic floor pain and poor food choices.

First stop…gather data.

In Karen’s first 90-minute virtual appointment, I began gathering puzzle pieces on her current health, health history, lifestyle and family health history, reviewed her supplements and recent lab work, sent her to Quest for specific blood tests, and had her complete a Comprehensive Microbiome Assessment (a “poop test”) to unearth any connections between her gut microbes and the chronic pelvic pain.

What did we learn?

Karen’s hunch that inflammation was elevated was correct – high sensitivity C-reactive protein (hsCRP) was off the charts at 9.8 (high inflammation = more pain and reduced fertility). Omega 3 Fatty Acids were severely deficient (required to build the brain of a developing fetus). Zinc was lower than optimal (linked to pain and hormonal imbalances). And Karen’s microbiome was “a hot mess,” which plays an important role in pain perception and regulating inflammation.

What did we do with this information? We got to work!

NUTRITION: Karen tracked her nutrition on a shared document. I identified her “low hanging fruit” – targeted shifts focused on replenishing nutrients, reducing inflammation and fueling a healthy microbiome – moving gradually from a “SAD” (standard American diet) to a “GLAD” (growing, living, antioxidant-rich diet) that worked for her taste buds and busy life.

SUPPLEMENTS: The three supplements Karen was taking were well-marketed, low quality options. I customized a targeted supplement prescription based on her lab work and body’s unique needs, and we agreed on follow-up blood work every 10 weeks.

LIFESTYLE: Karen wasn’t yet ready to tackle cigarettes and alcohol, so we focused on two achievable actions – normalizing her sleep schedule and walking on her treadmill before work.

INTENTION: Through a process I call “creating your Vision of Vitality,” I guided Karen in giving words to her intention, getting crystal clear that honoring her health and creating resilience is access to fully experiencing life and being a contribution. Over the following months we met weekly, and rather than shame, we used Karen’s challenges to fuel her forward progress.

REAL + MEASURABLE OUTCOMES

Karen gave up drinking and smoking completely in January 2021. Her inflammatory marker hsCRP dropped from 9.8 to 3.9. Pelvic pain, previously regularly 8/10 and frequently “off the charts,” now hits a high of only 4/10 a few times a month – and she can now actually enjoy sex with her honey and no longer experiences worsened pelvic floor pain during her periods. Her endocrinologist reported her thyroid labs looked the best they ever had. And Karen is now expecting her first child!