Meet Mary Emma Pitman, CRNP

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Announcer (00:02):
You are listening to Alabama the Beautiful with cosmetic surgeon, Dr. James Koehler and Kirstin Jarvis.

Kirstin (00:08):
Hey, Dr. Koehler.

Dr. Koehler (00:10):
Hey, Kirstin.

Kirstin (00:12):
You want to know what we're talking about today?

Dr. Koehler (00:13):
Yes, please tell me.

Kirstin (00:15):
We are introducing Mary Emma Pitman, our new nurse practitioner at the office.

Dr. Koehler (00:22):
Who's she?

Mary Emma Pitman (00:22):
So here at Eastern Shore Cosmetic Surgery, I am in charge of the hormone aspect of the practice. So all things bioidentical hormones. Before we get into it, I am 27. I'm from Fairhope, Alabama, so born and raised here and I'm married and have a dog.

Kirstin (00:46):
Awesome. How did you come to our practice? How did you meet Dr. Koehler?

Mary Emma Pitman (00:52):
So when I was working in the NICU at USA Children's and Women's Hospital, I knew that I didn't want to do the night shift for the rest of my life. And so I was kind of looking for somewhere else to go, somewhere that really made me feel good as a nurse. And I came upon Eastern Shore Cosmetic Surgery, started working as an RN for, I think it was about two years before I graduated nurse practitioner school. So I was working here the whole time I was in school and still worked full time. And the whole time I was in school, Dr. Koehler and I were discussing how beneficial hormones would be for the patients that are already in our practice. And that one thing led to another, and now we're here.

Dr. Koehler (01:39):
Yeah, we're glad you're here. I mean, this is something that we're really excited to add to the practice. We do have a lot of patients that are going to be able to benefit from this. So Mary Emma, why don't you tell us about some of the things that you, you're doing in the office here? Sort of explain maybe to the people who are listening, what the whole process is and what you're doing.

Mary Emma Pitman (02:02):
So when someone reaches out about hormones, I have a talk with them on the phone first just to see if they're overall a good patient for the program. And then to get started, what we do is draw a very, very large panel of labs. And a lot of times this is not labs that a patient has had drawn at their primary care or even by their OB GYN. These are a little more extensive. And after I receive all those labs, I bring the patient in the office and have a very in-depth consultation with them. Now the consultation includes me going over all of their lab work and looking at all of those lifestyle factors. I do a full medical history exam and give my recommendations based on all of their symptoms. And then once they decide they want to move forward with treatment, they join our program and I begin treatment.

Kirstin (02:58):
What sorts of things have you learned from listening to the patients that you've seen already?

Mary Emma Pitman (03:04):
First of all, just listening to the patients in general. A lot of times they feel like they have not been heard for a long time, and that's how they end up in our door anyways. And so they've been to other places and they just want someone to listen. And yeah, they may want to talk about their own personal life and things that are going on in their life and how they feel hormones could benefit them. It's not just decreasing hot flashes. It's way more than that.

Kirstin (03:34):
What does a typical visit look like when patients come see you for the first time?

Mary Emma Pitman (03:41):
So along with the things I said, including full evaluation, medical history and lifestyle factor exam, I also provide a lot of education to the patients. I want patients to understand that why we're treating, what we're treating, what we should see from treatment, what they should get out of treatment. So education's huge.

Kirstin (04:04):
Tell us about yourself. I know you said you're from Fairhope. What do you and Clay like to do for fun? Or do you have family here? How does that look?

Mary Emma Pitman (04:17):
Yes. So I was born and raised in Fairhope, born at Thomas Hospital. I went to Fairhope schools my whole life. So this is my hometown. All of my family is from here. So both sides of my family, my husband's entire family is from here. So I'm very blessed to have so many wonderful people around me. And I do feel like it's good that I know a lot of these patients already walking in the door because I've grown up in this town and have seen them forever. On the weekends, me and Clay like to go on the boat. Right now we live on Fish River, and so we spend a lot of our weekends there. We're down at the beach and hanging out with friends. I'm in a wedding almost every weekend right now. So that consumes a lot of my life.

Dr. Koehler (04:59):
Yeah. Mary Emma, why don't you tell us a little bit about some of the patients that you've seen recently and how you've been able to help them?

Mary Emma Pitman (05:05):
I would love to say most of my patients look like this, but they're all different. And so every patient that comes in the door has their own treatment plan that's completely different from others. But one of the biggest symptoms I see is sleep. A lot of women in particular struggle with sleep and they don't realize that it's related to their hormones and progesterone is huge at helping to treat that. So for example, I had a patient come in the other day, one of her biggest symptoms, which she didn't even realize was related to her hormones was her lack of sleep. And then that affected her energy the next day and everything else. And I put her on progesterone and she's sleeping like a baby. She also feels calmer. So progesterone works on the area of your brain called the gaba receptors, which helps to calm you and is one of the biggest things it does. And so when you start progesterone, it helps decrease that anxiety and depression and other symptoms that may be occurring. And so for this patient in particular, not only did it improve her sleep, but it improved her anxiety. She didn't have anything specific going on in her life, but she just felt anxious all the time. And she mentioned that it improved her quality of life because she just felt like she could handle her children and handle her husband and not be ready to snap back at 'em that she just was able to handle things.

Dr. Koehler (06:34):
Oh there's no drug that fixes that. I can tell you that right now.

Kirstin (06:37):
I was just about to say, can I take a whole tube a day? Anxiety, sleep, snapping?

Mary Emma Pitman (06:41):
Well, kind of nothing. So there's a lot of different symptoms that each hormone treats, but for progesterone, sleep, anxiety, depression, overall calmness. Now the estradiol, that one treats more of the symptoms that you typically hear about when someone's in menopause. So the hot flashes, the night sweats, all of those symptoms that's going to target that. Now testosterone, this is one that a lot of people don't really know about for women especially. So for men, that's the main treatment typically. But for men, it helps improve endurance strength, build muscle mass, help with energy and increase libido. And then for women, it's actually very, very important that women have testosterone as well. It's just a female hormone as much as it is a male hormone. So when I see a patient, I ask all of these questions to see initially what may work best for them. And then we do a trial run of a month to see if they were able to remember to take the medication every day or put the cream on, or if they had trouble with letting the cream dry for four hours before touching anything or anyone. So all those factors are looked at and then we address based on how well they did.

Kirstin (08:08):
I love that you both, I think it's important to note that you both have attended the same courses. You have a lot of the same education for this hormone replacement therapy and bioidentical hormones. So it's important for patients to know this is a physician-led program, but Mary Emma, you also have as great of an education with this hormone stuff as Dr. Koehler does. So patients are going to be in great hands. Everything's monitored by the doctor, but also you have a fantastic education on these hormones and their side effects and their effects, and I think that's great.

Mary Emma Pitman (08:44):
Yeah, so whenever I was in nurse practitioner school, the topic of hormones was avoided. And even in clinicals, other nurse practitioners didn't know how to handle the patients that were experiencing symptoms of hormone depletion. And in school, it definitely was something that whenever I learned it, I knew the difference in synthetic and bioidenticals and they were just grouped together. And so for me to receive the proper training to be able to do this, Dr. Koehler and I have both attended all of these extensive courses to learn all of our information. And we have a great group of people from that program that we attended, and I'm still attending. I'm on their side every day talking with them, getting information and any up-to-date studies, anything that is released or interesting cases to study. And so I'm continuing education daily. That is a really big part of hormone treatment because things change daily, there's new studies released, and so new medications that come out, so I think it's important to note that we are doing our part and staying up to date with all the current literature and making sure that we're able to provide the best care possible.

Kirstin (10:01):
So what is my first step if I do a little research or see an ad or look you up on social media and I see that hormone replacement therapy might be right for me? What do I do?

Mary Emma Pitman (10:16):
So it's hard for a patient to determine whether hormone replacement therapy is right for them, but that's kind of our job. And so when someone is thinking, maybe I may have some of these symptoms, I didn't realize that my sleep was related to my hormones and things like that, they can just call the office.

Kirstin (10:35):
Okay. Do you have a burning question for Dr. Koehler or me or Mary Emma? You can leave us a voicemail on our podcast website at Alabamathebeautifulpodcast.com. We'd love to hear from you. Thanks, Dr. Koehler.

Mary Emma Pitman (10:51):
Thanks, Kirstin.

Kirstin (10:52):
Thanks, Dr. Koehler and Kirstin.

(10:54):
Go back to making Alabama beautiful.

Announcer (10:56):
Got a question for Dr. Koehler. Leave us a voicemail at Alabamathebeautifulpodcast.com. Dr. James Koehler is a cosmetic surgeon practicing in Fairhope, Alabama. To learn more about Dr. Koehler and Eastern Shore Cosmetic Surgery, go to easternshorecosmeticsurgery.com. The commentary in this podcast represents opinion and does not present medical advice, but general information that does not necessarily relate to the specific conditions of any individual patient. If you enjoyed this episode, please share it and subscribe to Alabama the Beautiful on YouTube, Apple Podcast, Spotify, or wherever you like to listen to podcasts. Follow us on Instagram at Eastern Shore Cosmetic Surgery. Alabama the Beautiful is a production of The Axis, T-H-E-A-X-I-S.io.