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Milestones & Functional Medicine: Dr. Jenny Quartano


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Guest: Jenny Quartano

Release Date: 2/20/2023

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Steve Washuta:  Welcome to Trulyfit. Welcome to the Trulyfit podcast where we interview experts in fitness and health to expand our wisdom and wealth. I am your host, Steve Washuta, co-founder of Trulyfit and author of  Fitness Business 101. On today’s episode, I interviewed Dr. Jenny Quartano.

You can find everything about her at all together. wellness.net Dr. Jenny is a physical therapist who was dual board certified in pediatrics and neurology, the first half of our conversation as a little bit more to do with that pediatrics and neurology, things like childhood milestones. The second half of our conversation gets more into where she pivoted now, which is more into integrative medicine with adults.

Dr. Jenny was a wealth of knowledge, both parts of the conversation were fantastic. Again, you can find her at all together. wellness.net. But I want to relay a lot of our listeners have written in and said I wish I could watch and not just listen, you can or on YouTube, I don’t really talk about it a lot. Because no one has really watched in the past. Everyone listens to the podcast, nobody watches it.

But if you want to watch, I these are all videos, all the video clips you see on Instagram, you can watch the full videos on YouTube. Just go to TrulyFitApp and subscribe. With no further ado, here is Dr. Jenny Cortana. JD, thanks so much for joining the Trulyfit podcast when you give my listeners in the audience a little background on who you are and what it is that you do in the health world.

Jenny Quartano:  Yes, well, thank you so much for having me today. So I own a company aimed at helping families thrive. We think every family needs a tribe. And so my background as a PT we bring in and incorporate into the wellness realm specifically for kids and young families and working with moms who are getting back to being themselves postpartum.

Steve Washuta: Cool. And give me some more insights into your PT background. I know sometimes PTS eventually kind of like sub specialize into certain things. And do you have some of those?

Jenny Quartano:  Yeah, absolutely. So I spent 10 years really working in the corporate medical field specializing in neuro and peds and those two together in particular. So a lot with head trauma and head trauma rehabilitation.

Jenny Quartano:  And that’s probably what really prompted me to get more into the wellness piece of it appreciating how important that was for my own life, I started to expand on that with my patients, and really have now come full circle into a more holistic approach of addressing all the things that are affecting a child, not just their physical impairments.

Steve Washuta: And I assume that’s because there is a lot of an I mean this to be a leading questions, you can tell me a lot of red tape, and the PT world. So maybe a child came in who had a particular issue that you thought you could help maybe outside of the scope of just giving the neuro inflammation, but you’re not allowed to.

Jenny Quartano:  Yeah, definitely. Right. So as a PT, particularly when we’re using insurance, right, because we have the training to use all that other knowledge and experience. But in the insurance model, they just want you to treat the impairment and specifically what is is worse, right? So we aren’t necessarily even supposed to make them better, which is just beyond crazy to me.

Jenny Quartano:  So being able to bridge that gap from not just improving to the level of back where they were, but let’s get them to the best that they can be. And so using that model outside of insurance, and outside of the medical scope to be able to do that.

Steve Washuta: Yeah, no, that’s a problem, I would say in the whole sort of health care system, not always having the ability to look like the term, you know, sometimes is looked down upon but holistically at the full body. But we know that we need to more often than not look at those things. Were there any other issues that you felt that you encountered in your sort of more corporate world that you were like, hey, I need to get out of here and start my own gig? Yeah.

Jenny Quartano: Oh, gosh, I mean, you know, so I have a lot of love for the agency I came from, but yeah, I mean, it just is it’s the limitations of the medical model, right. And so we’re so siloed in terms of who we are, as professionals, I didn’t have a lot of carryover and communication with the physicians like I would like to be able to be more holistic,

Jenny Quartano:  I didn’t have a nice Continuum of Care of places to send them once they were done with their rehab goals, or to continue learning and developing as children. And so that was really kind of the crux of getting out was I want to do this better than I can do it under the medical umbrella.

Steve Washuta:  So I have listened and read some things that you have wrote about and talked about. And I think that milestones are very interesting. I have an 18-month-old and there’s a lot of parents that listen to this podcast. And milestones can be quite confusing, because you as a parent will naturally probably tell yourself, my kid will eventually get there you hope that kid will get there.

The milestones are set in these, let’s say these parameters for that specific time, let’s say okay, between 12 months and 14 months, your child should be doing XY and Z. What do you think about milestones as a whole? Are parents either too hypersensitive to this? Are we paying too much attention? Maybe not enough attention? How do you talk through the process of milestone with young parents?

Jenny Quartano:  Yeah, man, I could get on a soapbox about this. But let me give you a little bit of perspective. So a few months ago, the CDC updated their milestones and they move them back based on when most children should be doing skills. So now the trickle down affective that is the pediatrician or whoever you’re seeing that’s kind of checking in on those things, or even as you’re reading yourself, isn’t going to necessarily flag something as concerning until much later.

Jenny Quartano: So on one hand, that could be good, because there are times where parents I think, are overly cautious, right. But on the other hand, if there are truly issues, sometimes that wait and see approaches is detrimental, because there’s so many things that happen in development that are relevant to the skills before that, right. So for example, children we know who don’t move as early, develop slower cognitively.

Jenny Quartano:  So if you wait and see, and your child’s not walking or not exploring their environment, they’re not learning what happens when I open this door and close it, which is a big part of child’s cognitive development. So I really prefer more about like, let’s check it out and see, right? If you have a question, you have a concern.

Jenny Quartano:   And that’s kind of where we’ve gone from a wellness perspective of it doesn’t need to be Petey. But the worst thing is, I check it out and say, Hey, your child’s doing really well. But here are three things you could do to continue that on that process of developing these skills to keep them up to date on everything else we want them to learn.

Steve Washuta: Why do you think that parents are less likely to do this, and I’ll give you two potential reasons. And if these are neither of them, you can just respond on your own, but one is just the process of okay, I have to first go to my, my pediatrician. And then they have to give me a referral.

And then I have to hope that the referral process goes smoothly between the pediatric office and the PT is the PT call me any time they’re gonna say, hey, we can see you in six weeks, well, in six weeks, my child’s gonna be passed that milestone anyway, right? Or is it because parents just they want to be glass half full and say my child will do it eventually?

Jenny Quartano:  Yeah, so I think those are both really good reasons. And then a third one that I oftentimes just hear realistically from parents is I’m busy, right? Like it isn’t on my radar, or it is on my radar. But I also have the 17. Other things I have to do first, as a busy working parent, and getting off of work early to go to another appointment to get my child there where they may or may not do something, because it’s a new environment.

Jenny Quartano:  And they don’t know these people. It doesn’t necessarily bubble up to the top right. And so that is also part of what we’ve done is take the challenge out of that for families and say, we come to you, this is wellness space. So in depending on your state, a lot of states don’t require that pediatrician visit to come in and say, Let’s just check it out. It’s a direct to us, we can come directly to you, there’s no wait, you know, maybe next week, but it’s not six weeks.

Jenny Quartano:  And we can be in your home environment, if that’s where your child is going to be most comfortable. Because realistically, that’s where you’re going to work on the skills. And so from a parenting perspective, it just makes sense to me to give you the tools that you already have to make that better for your child.

Steve Washuta:  Yeah, and that might be something scary, too. You know, just thinking about using the terms PT think more clinical, I’m going to this office, there’s gonna be a bunch of these crazy machines here, they’re going to be strapping my legs in looking at certain meters, but it’s like, no, this is a child.

This is more about like, the normal play routine, but you’re just looking because you understand the body and how things should be working, you’re just looking at the little things, okay, their gait is messed up. Here’s how we help their gait a little bit, make sure you do X, Y, and Z. And it’s really just tips for the parents so they can do these things on their own. Is that correct?

Jenny Quartano:  Yeah, absolutely. And using what you already have, right? Because that’s what’s going to be most familiar to the child. And you know, you guys know to it’s not what you do, just in that time together, but what the client does in that time outside of your time together. So giving them the tools to be successful, just like you would from a trading perspective.

Steve Washuta:  Is there room in either what you do now or in the PT world to give parents advice? If you believe that if, let’s say the physical limitations are due to the parenting style. So for example, if the mom is always picking the child up and not actually letting the child go around and run and do those sorts of things, do you feel like you have that leverage to speak into that?

Jenny Quartano:  Yeah, that’s a great question. I mean, as a PT, we certainly do. I think it’s all about reading your families, though, right? Because if you came to me for advice, and I’m like, stop picking your child up, that might not be what you want to hear, right? So let’s start from, Hey, what is your routine look like? Why do you do that? You know, I’ve had a family say to me, I have six other kids, they have to be up off the floor, because they’re gonna get run over.

Jenny Quartano:  Okay, well, let’s figure out how we can solve that how we can create space for them to work in without saying, Stop picking your child up. Right? So we think that’s one realm that we definitely have worked to improve in, is just how do we provide that, you know, how do we get them to realize themselves, oftentimes, hey, this is probably something I need to do, as opposed to being told that I think we’re all better at that when we have an internal motivation.

Jenny Quartano:  And then I think the other thing is, is our playgroups and something, you know, I think we’re gonna talk about it a little bit, but that’s one of the reasons we started those is to create that environment where other parents are saying things right, it doesn’t have to come from the clinician, who, you know, for me, I happen to be a parent of a young child as well.

Jenny Quartano:  But some of my clinicians, either their kids are grown or they don’t have children yet. And so it’s easy to look at them and be like, easy for you to say you have no idea right? So when you have another parent saying it and they’ve been through it, and they have their own experience, I think that lends itself well to credibility to it.

Steve Washuta: Yeah, and I love how you kind of hinted on that client relations part of it or Patient Relations, that strategic two way communication between you and the patient trying to really read them and say, Okay, this is my, this is what I want to say, but they don’t want to hear this right now.

So I have to reframe this and rephrase this in a way where it’s going to be advantageous to the parent, maybe I have to bring them on, bring them along a little bit slower than I would another family and analyzing that.

And that takes time to develop in your career. It’s also personal trainers. Some people struggle with that, too. They understand the body, well, they can write a program out well, but they don’t quite see the nuances and maybe like the mannerisms of the client to say, well, maybe this client’s not ready for this, and I have to adjust.

Jenny Quartano:  Absolutely. And I think, you know, that comes back for a child and not only to how’s the child functioning, but how’s the family functioning, right? And when I’ve got a family who is constantly living in chaos, it’s going to be really hard to expect them to do XYZ with their child, right? So how do we then set the environment up so the child can do it on their own, as opposed to putting one more thing on an overwhelmed parent?

Jenny Quartano:  You know, let’s maybe spend some time talking about what can we take off your plate? Or how do you prioritize these things so that you can get the things you need for your child, your child can be successful, and you can feel successful as a parent as well.

Steve Washuta:  What a possible way that someone would go about wait and see is let’s go ahead and say the milestone is supposed to be between 12 and 14 months, okay, whatever this milestone is, whatever this activity is t

gnizing their feet and starting to kick and use their feet for more things. And you’re like, Oh, my child’s not really doing that. Wouldn’t it be smart of me to just book the appointment? And even if it is two months out, or three months out, just to have it there as sort of a backup a safety net in case my child does get to that 15 month marker, they’re not doing it?

Jenny Quartano:  Yeah, absolutely. I think part of the challenge with that is, oftentimes, if you’re, if you’re going through your pediatrician who might be your primary source for that information, they’ll say, oh, we’ll check it again at the 15 month checkup. So they’re waiting until it is delayed before they say, oh, yeah, you should go see somebody oftentimes.

Jenny Quartano:  And that that’s the way the milestones are set up. That’s the way they’re instructed. But it doesn’t always mean that that’s going to be the best for the child in that situation. So I think that check and see or put it on the calendar and see is a way better approach. But it isn’t always the one that our direct primary care does. And it’s not necessarily in line with what the milestones currently suggest.

Steve Washuta:  And in I think you referenced before it is state by state as far as if I have to go directly to the pediatrician as opposed to going, calling the PT office and just setting an appointment. And then also melodic PT is correct me if I’m wrong, you don’t necessarily even need to use your insurance, you can just pay out of pocket, if you think it’s that serious. And you have the money.

Jenny Quartano:  Yeah, absolutely. So I think a lot of that comes down to the medical model that most people are used to, right. So if you go to a big health center, they’re probably going to require, you know, just by standard, you’d have an order on file to have seen your pediatrician. And we think those are good things, right? You want those relationships.

Jenny Quartano:  But in most states, there is some form in all, but just a couple of states, there’s some form of direct access, meaning you can see a PT or an OT or speech without having to have that order and recommendation from your physician. So you know, your physician is the expert in your child’s overall development. But if you want to know about their walking, or their talking, or their ability to feed themselves, that’s where your rehab team comes in.

Jenny Quartano:  And there’s so much benefit to seeing somebody who’s truly an expert in that area. If you have questions and worries, even just to put you at ease about what else might be going on or what else you could try to be successful and feel confident as a parent.

Steve Washuta:  I had a fellow parent and friend tell me, and I wonder what your thoughts are on this. If you give your child something to do, let’s say like use a fork, and they can do it right away, you screwed up. Because you should have given them that task before they were able to do that, so that they actually have to work on it. It’s almost it’s not that it’s too late. It’s just that it would have been better if they develop that rather than already know how to do it. Do you sort of agree with that or not necessarily?

Jenny Quartano:  Yeah, you know, I think I think that’s an interesting perspective. And I an interesting way to think about it that I hadn’t before, but But I agree, right? I think so many times we’re so cautious. And so quick to say it, we’ll be careful or Ooh, not yet. Where kids learn by doing right, they don’t have necessarily that cognitive thought process to think about things abstractly.

Jenny Quartano:  So giving them the fork, putting it in their hand and letting them try and stab something with it miss and try again, is a is a great tool for learning doesn’t mean that’s how they’re going to feed themselves. Right? It might give that child a fork and also have a fork in my hand so that I can actually get the food in their mouth. But giving them that practice is an awesome opportunity. Because that is how they’re going to learn is by doing.

Steve Washuta:  Talk about the functional playgroups how you describe it personally and how you use it in your practice, and then how maybe just play groups in general are advantageous for children. Yeah,

Jenny Quartano:  so we developed play groups purely to I mean, obviously play with the child right but with the underlying goal of bringing together families to create confident and connected families, I feel like too often, either, you know, parents are busy working, or they rushing around to do their to do list and they missed that opportunity to connect with their child, which doesn’t need to be complicated, right? It doesn’t have to be three hours of this really creative play, it can be 10 minutes sitting on the floor, doing whatever they’re doing with them.

Jenny Quartano:  And it builds that relationship with the child. I think too many parents don’t have that. And you go to the internet, and you search and you find for a million different reasons about why you’re screwing your child up. And so I think we just want to bring back that opportunity to feel confident as a parent to know that you know, what you’re doing, give you some simple tricks to make parenting easier, because we’re all busy.

Jenny Quartano:  And it’s always hard. And so we have developmental lead playgroups by our experts, right. So whether it’s me or a developmental specialist, or a couple of teachers that run them, you bringing somebody in, who knows development, who understands and can help you connect with your child and understand what your child needs. That isn’t this complicated thing. I think playgroups in general are great, because it again just brings parents together.

Jenny Quartano:  So they get to ask questions, they get to hear what somebody else did, who’s maybe a little farther along in that journey, or went through that a couple months ago. And so it’s always nice to have other resources, we just feel that that expert bringing in that perspective of maybe why this is a better way to try them this for you, is also helpful.

Steve Washuta:  Are there recommendations. And this may be like based upon age, right? Maybe a three year old is different than a seven year old. But how many kids is best to be playing at one time? Does it make a difference if it’s just routinely two children as opposed to 12?

Jenny Quartano:  Yeah, good question. So some of that depends on the child’s age, you’re definitely right, because kids develop play at certain ages. So for example, at a year, I don’t expect them to interact with a peer, I expect him to play next to him, and maybe not even care that they’re there. But by 18 months, maybe at least paying attention to what they’re doing by to starting to socially interact and look for those pieces of interaction back, right.

Jenny Quartano:  So all of that matters in terms of of who else is present. And so you can have 50 kids that when you’re old isn’t gonna care. But then beyond that, a lot of it really is in the educational research, when you look at classroom size, and things like that. And we know that there’s a ton of association between a smaller group size in the classroom, let’s say under 15, and better behavior, better learning outcomes, and all of those kinds of things. And that’s not to say that your kid can excel in up in a busier classroom, but there is some research behind that. So we kind of take that into account as well.

Jenny Quartano:  Because what we appreciate from the playgroup as the children learn by watching others, right? So good am Dad, if I want to figure out how to get up on that play structure, and that other kid just did it. And I watched them do it, and I watched this other kid do it in a different way, I have now started to build that motor pattern of how I’m going to do it as well. And so that’s super important. The social skills are are super important.

Jenny Quartano:  And I think, you know, if you get the child in a group too large, they kind of get lost in that it’s hard to focus on what the instructor is doing what the other kids are doing, and to give them that time and opportunity. So I think it’s a balance, but I don’t know that there’s an actual number.

Steve Washuta: Yeah. And that’s what I thought the US was going to be. And I think that’s, you know, it’s interesting that the the first thing that was going through my head is, there’s so many we have, there’s two different parks that I have right down the street from me, and they’re literally across the street from each other. And I will tend to take my child to the park, where there’s no kids.

And now that I’m thinking about it, I said, Well, no, of course like yeah, now she has more opportunity to play with those, those on those slides and climbing up those stairs. But it’s it’s actually probably better that I bring her to the park where there are two or three kids so that she can watch those kids and how they develop because that’s how she’s learning. And I really never thought of it that way.

Jenny Quartano:  Sure. And now she has the opportunity to learn how to wait her turn and not you know, run over they can that’s on the slide and those kinds of things, which are important as they get closer to two as well.

Steve Washuta: So tell me a little bit more about your day to day now. So you transitioned away from the corporate lifestyle, partly because we like we talked about before, it’s a little bit more red tape. So you still work in a PT fashion with children. But you also do a little bit more of a holistic approach in a almost inter woven with personal trainers and CrossFit. Talk about that.

Jenny Quartano:  Yeah, absolutely. So I really, like I said, focus on families. But in a lot of our families. We talked about moms and pregnancy and postpartum and holistic health for that until in that context. And you know, that isn’t my sole audience. But I also then work at a CrossFit style gym where I’ve got a lot of great trainers.

Jenny Quartano:  I mean, I’ve been a member there for five years myself, but what I love about that environment is you’ve got a mom who isn’t able to lose the weight feels like she doesn’t have enough energy to workout she’s not getting the gains that we would expect based on the programming she’s doing.

Jenny Quartano:  So I might see your first session or two to say okay, what is going on with her overall health. Let’s look at gut health hormones, all of those things that are so impactful in addition to all the lifestyle things that you know, the trainers have already incorporated to get to the bottom of what’s going on.

Jenny Quartano:  So that information, I can certainly do that with the CrossFit style athlete. I do that with my postpartum moms and I do that with the kids too. So When I’ve got kids on my caseload who aren’t developing at the rate we’d expect to me one of the populations I see a lot is kids who are delayed walkers. And they almost always are constipated, right.

Jenny Quartano:  So being able to carry that over, and let’s talk about what’s going on with their gut health, that might be impacting their ability to motor plan to gain that strength to learn, and I think people forget, right. And as adults, we understand how interconnected those things are. But for kids, we forget that oftentimes, that all those things are also impacting their development.

Jenny Quartano:  And so being able to step outside of just my PT hat and wear that functional wellness hat and incorporate that for all of our clients in our, our clinic, you know, we have a team of 14 providers right now. And so, you know, they will refer back to me, when they’ve got somebody who maybe has more functional needs, and then I’ll refer back to them and they need more therapy.

Steve Washuta:  That’s fantastic. You know, as personal trainers, ideally, we would like to handle a little bit of everything, if we knew even like some personal trainers don’t have that skill set. But even if you do, really what what the client hour is what they’re paying for is for you to develop a program for them to obviously focus on their long term health, but really a lot of short term health goals, whatever those goals are, maybe they want to lose a few pounds, or they want to have the bigger biceps or whatever they’re trying to do.

But it’s really difficult as a personal trainer, because you’re only getting paid by the hour. In most cases. That’s how that’s how this this works, is to handle all of those other things outside of it. So it’s great to have other people to say, Hey, listen, we’re doing everything here, right? We’re looking at sort of the big picture, you’re working out five days a week, and your sleep seems to be okay, your your water intake is okay, we are in a caloric deficit, yet, you’re not reaching these weight loss goals.

So it has to be something else, let’s ship you off to someone else who knows a little bit more about these other areas to just if nothing else, check these boxes off to make sure that it isn’t something more serious. Do you have a hormonal imbalance issue? Do you have something going on under the curtain that we just didn’t recognize? Because otherwise, you’re fighting an uphill battle as a personal trainer and the client, and you’re doing them a disservice? Because they’re paying and they’re never going to get to their goals?

Jenny Quartano:  Yeah, well, I think for my trainers to it, it makes them look good, right? Like when we get to the bottom of that, and the client starts moving forward on their goals, you know, that makes makes them feel good, right, and also elevates them in the eyes of the client, because they were able to come to that success point, which is all they really care about. I don’t care how I get there helped me get there.

Steve Washuta:  Yeah, and it’s just another networking branch off the trade, right. So just just the same thing as if my client was having severe knee knee pain, eventually, right? We need some sort of diagnosis and only get that diagnosis. It’s above our pay grade. It needs there needs to be imaging and they need to be sent to the PT, right? So this is no different if they’re having weight loss issues. I think a lot of personal trainers find it almost like it’s a slap in the face.

If they were to send them somewhere else. It’s like, No, this is what I do. I help people lose weight help people get in shape. But they have to understand that there’s a there’s sort of a cap in our ability and our understanding. And eventually, you have to have that networking community and not take it as an ego hit. But just know that if the goal is to help the client, I’m going to have to refer them up the ladder to someone who knows more.

Jenny Quartano:  Yeah, absolutely. Well, and you know, and where I got into that, in the first place was appreciating for my kids who were eating chicken nuggets and cheese every day, right and, and weren’t having good bowel movements and weren’t moving and weren’t doing all these things. When I look up the chain of what’s happening in the family.

Jenny Quartano:  The reality is, Mom sets the tone, right? She’s usually the one that does the grocery shopping. I mean, I know there are differences, but I would say majority of the families. That’s how it works. And so you know, if I can help her understand the importance of all those factors, that health then affects your own health, but it also affects the health of your family.

Steve Washuta: So give me a little bit more information concerning the I’m gonna go back to what we started with, with the milestones. So a few more questions there. So if a parent runs into a problem in which they believe the it’s a structural problem, right, they’re like, oh, Mike, my child’s not walking, I think there’s something wrong with their hip.

Do you think that’s misguided for them to sort of self diagnose? Because it could be a host of other things? But is the first step still going to your general pediatric doctor? Or do you do you send them? Do you go straight to the PT? Well, what is the first step in that process? Yeah,

Jenny Quartano:   that’s awesome. That’s a great question. You know, first of all, I think parents are always the experts in their child, you know, so when they come to me, and they say, Oh, well, you’re the expert. Well, I might be, but really, you’re the expert and your child, you’re the one that’s with them. 24/7. And so if you think you’ve done your research, you just have this gut feeling, there’s something going on, and you need to see somebody, right?

Jenny Quartano:  And if your pediatrician doesn’t seem receptive to that, then see somebody else, if nothing else, or peace of mind and to help you understand why you’re seeing what you’re seeing. So I see a lot of kids who will come in and say, you know, hey, my child’s not walking there. 15 months, I know, the new milestone is 18 months, but it just seems like they’re not even close. And, you know, we’ll start down that path of, of why is there something structurally certainly I’ll refer or went back to the physician or to orthopedics or something like that.

Jenny Quartano:  But sometimes it’s as simple as creating a plan for them to get more opportunities to practice those skills that are pre walking, right? You know, as, as non pediatric PTS, you’re like, well, they crawl and then they walk, right. But there’s a lot that happens in between their gait and balance, being able to stand on one foot, shifting their weight. Being able to not fall over, standing up from the floor. all those things that I don’t expect a parent to know, that’s my job. And so if you’re looking at them thinking, something’s not right. I think that’s a great opportunity to come in and see somebody and just get a second opinion.

Steve Washuta:  We’re not exercising with your children, what are your thoughts on that just from doesn’t even need to be from a clinical standpoint, but just from like, a family standpoint, is there? Is there an age in which you believe it could be, let’s say, deleterious? From a mindset perspective? I don’t want my kid to worry about exercise and body type and body image? Or do you think like, No, this is, this is this should be a good thing. It’s a it’s a shared experience between mother and daughter or father and so on, or vice versa?

Jenny Quartano:  Yeah, that’s an awesome question. And I think, you know, blending what I do from a functional perspective with what I do as a PT. I don’t think it’s ever too young to be active with your kids, right? And active lifestyles, you know. We live in a place where we sit 90% of the day as adults. And that’s such a problem. We also don’t play enough as adults, right?

Jenny Quartano:  So I think getting outside and being active with your kids exercise doesn’t have to look like, let’s get on the benchpress and do three sets of 10. It can be you know. Let’s play this tag game in the backyard where we’re we’re falling to the ground and pushing ourselves back up. I mean, that’s burpees and running, right? But it’s not in that context. And so I think there’s never an age that’s too young, most kids love to be outside love to run.

Jenny Quartano:  The worst thing I always hear when I hear family say like, I’ll ask how do you play with your child? Oh, well, they like to sit in my lap and look at my phone. It’s like, oh, that’s the last thing they need. Right. And I’ve heard that more than once. So I think, you know, I always encourage families to be silly, be creative, be active together.

Jenny Quartano:  Yeah, there is certainly an age where you know, too much training can be a problem for skeletal development and things like that. But generally speaking, unless I’m talking about the athlete population, I don’t see that it’s usually under exercise under activity. And so getting out and being active is always a good thing.

Steve Washuta:  Are there either short term or long term things that you point out to parents that they should be looking into, or at least you’ll have an understanding of if their kids are in daycare, as opposed to not in daycare? And my first thought was, well, you know, if they’re in daycare, they’re seeing kids more. They have maybe other people around them who have who see kids all day. So there’s like more risk, there’s more responses to what’s going on with your child. As opposed to if your child’s home and it’s your first child, maybe you’re not as in tune to what’s going on?

Jenny Quartano:  Yeah, I mean, I think that’s so parents specific, right? Some parents are super worried because they’re in daycare. And are they not getting enough individualized attention. And should I be doing more, and I got to do all these things outside of daycare with them, which isn’t always reality either. But then I’ve seen the other side of it. Where you know, I’m at home, they’re my first child, they’re perfect. because they’re my child, right.

Jenny Quartano:  And so I don’t want anything to be wrong. And so I think a lot of that is really parent specific. And again, coming back to really getting to know our clients and understand what their fears are. What their understanding is, where the limitations are, and starting with what they came to see us for. So I might see all these things, right. And you guys do this, too. But really, they came in for this. And they don’t care how much I know about all of this until I’ve answered this for them.

Jenny Quartano: So I think it’s building that relationship. Building that trust and then starting to have those conversations and just other things to think about. You know, as a parent. One of the things I look at every school I look at for my son is how much physical activity do they get? And I think those are things that we don’t necessarily think, to ask at daycares. And, you know, maybe not even when they get to school. But we know from a cognitive development standpoint. And a physical development standpoint, all of that movement is so important for them. So I want to make sure that my kids that I’m working with are thinking about that as well.

Steve Washuta:  Let’s close here back to adults. And I’ll throw out a scenario for you. And you can tell me .If this is something along the lines of how what you would deal with and how you would deal with it. So somebody is struggling to lose weight. Let’s say it’s a an older Mom, I don’t use the term older, I shouldn’t say that. A mom in her in her, let’s say early 40s. And she is struggling to lose weight.

She goes to your CrossFit gym, she comes to you. And the personal trainer has told you they’re in a caloric deficit. They’ve been lifting, she is otherwise healthy lifestyle. She doesn’t drink, she sleeps well or water intake is good. All these things. She’s done a lot of medications. And you say, let’s let’s let’s look at the hormones. Are you actually sending her to the physician to get hormone panels done and then analyzing them and yourself? How does that process go?

Jenny Quartano:  Yeah, that’s a great question. So I guess some of it depends, right. But I actually usually run functional labs. I find that most of the serum labs that are done by the physicians give you a snapshot of one point in time and our hormones fluctuate throughout the day. So there’s so many things that at a typical lab handle. Doesn’t tell us and usually they come to me with that, right.

Jenny Quartano:  And their and their labs are fine, they’ve been to their physician, everything’s fine, but they’re not losing weight. And so we’ll start to look at functional labs. And look at what is actually going on with their cortisol is their cortisol stealing from their sex hormones. You know, usually along with that is low libido, like not wanting to be intimate, which is a problem in their marriage, right. So there’s so many deeper things that we get into than just also this weight that I can’t lose.

Jenny Quartano:  But we look at those lats in the eyes and offer those and interpret those. And then we make a plan. Sometimes it is as simple. As tweaking a couple of supplements. Or it is black and white picture of you might be trying to control your stress. But it turns out, you’re not doing a good job. Here are some ways we can work on that better.

Jenny Quartano: And, you know, let’s continue to focus there. And so I think those pieces are so important to that overall picture. Especially when somebody is stuck, or they’ve tried all the other things, and it’s just not helping. And yet we do that and take all of that into account as well.

Steve Washuta:  So if you were to describe or if you had, let’s say two columns, and you had functional labs at the top of this column, and you have traditional labs at the top of this column, can you explain sort of the differences and how you would describe those two?

Jenny Quartano: Yeah, so functional labs are things like, you’ll hear people say, a GI map or a CSAT. But basically, those are stool tests, right? Looking at the composition of the stool to figure out what’s going on back in the gut. What’s that microbiome? Like? Are there any parasites in there? Is there pH, right? All of those things that you’ll get from serum testing? Hormones, similarly, right?

Jenny Quartano: So we’re looking at urine output and saliva output? What are the metabolites, your hormones, and and again. If you look at your traditional lab tests. Which might give you you know, thyroid panels and hormone panels and things like that, you’re getting that one snapshot in time.

Whereas we’re looking at how much estrogen Are you making? How quickly? Are you breaking it down? Are you getting rid of it fast enough, because that might be another reason you’re keeping the weight on.

Jenny Quartano: So we can look at not only are you making enough. Do you have a high enough level, but what’s happening to it. Because if we don’t more in and you’re making enough, then you’re just breaking it down faster, and we haven’t fixed anything. Whereas maybe we need to slow down how quickly you break it down. or push things back. You know, over this way when they’re over on this side. So that’s what we look at a little bit more from a functional standpoint.

Jenny Quartano: And again, this is a lot of times my clients who have come in and said, my labs are all normal. I’ve been to the doctor, or my hormones are off, and they want to put me on synthetic hormones, which can wreak havoc and health down the line, as you guys know.

So let’s try everything else first, if that’s their motivation, to see what we can get to to help them

Steve Washuta:  in when these functional labs, let’s say returned to you, is this something that a layman could analyze and read? Can I see this paperwork and have an idea of what’s going on?

Like in traditional labs. You have ranges, so anybody can look at it and be like, Oh. I fell within the range. This is, you know, it’s not below this, this number, so I’m fine. Or is this sort of like really. More intricate things that you had to study and be able to analyze and interpret?

Jenny Quartano: Yeah, that’s a great question. I mean, certainly, if somebody’s flatline note, you can look at that and go, you have no cortisol, right? But a lot of times, it’s in the context of everything else. And so even though this might look fine. It’s based on the range compared to this and the symptom you’re describing.

Jenny Quartano: So no, I went through pretty extensive training to do that. And I would say most physicians don’t even have that concept and necessarily use that. Because they don’t understand it. So I think it’s a pretty specialized. Unique tool to be able to support my clients as they’re going through those health journeys.

Steve Washuta:  Yeah, that’s a great answer. And I think there’s just there’s not enough of that. I hope it happens more, and I get why there’s not in the industry. People are specialists, because that’s, that’s what they study. They study the one thing but if you’re a hammer, everything’s a nail, and you’re only looking at it from one perspective, right?

If you’re if you go into, you know, the surgeon, he’s going to tell you. He’s going to fix it with surgery. You go into the PT, they’re going to fix it with through physical therapy, you go into the doctor prescribe medicine, he’s going to fix it with you know, his medication, and it is good to really step back and say,

Well, if there are three different ways I can fix this, that doesn’t make sense. I have to really analyze what’s going on here and maybe take an again, a more holistic approach. I know, I wish there was another word for that. Because what happens is when people hear the word holistic. They associate it with like, somebody who lives out in the woods and is trying to pick leaves off the plan.

And it’s like, no, that’s that’s not really what it’s about. It’s about understanding that everything in our health is interconnected. Physiologically speaking, and psychologically speaking, it’s all interconnected. And if we’re only looking at one area, we’re missing the bigger picture.

Jenny Quartano: Absolutely. And I think you know, I’m a great picture of that right. I went into the specialty of neuro and peds and not so specific as a pediatric neurologic physical therapist. Right, and then quickly realized. There is so much more outside of me that is impacting this client. And that’s part of where, how I got to where I am today, right.

Jenny Quartano: So I appreciate I just said to somebody this morning, right? If all you have is a hammer, everything’s a nail if all you have is this specific training and this tool. Even in rehab, you’re this kind of therapist, that’s all you’re going to use.

If you’re this kind of surgeon that’s all you’re going to do. You know the orthotist is always going to brace. And so I think having somebody who can step back and look at evidence based medicine as being what it is. Right, we forget that a big portion of that is the patient.

Jenny Quartano: And so, you know. I have a client right now who came to me and said. I went to the doctor. And they just told me I need to be on medication for this. And I don’t want that. And I don’t know who else to see. And it’s such a sad situation, that that’s where we come to. But I think people have to realize too. that some of that is driven by the insurance model, the medical model, right? The payers are what drives that.

Jenny Quartano: And so if you want something better, you’re gonna have to go outside of that system that forces us into this funnel of medication for this surgery for that. You know, specific treatment for this and look for somebody who has the more. You right holistic has a bad rap to it, but holistic approach to understanding how all of those pieces integrate to affect your health and how we can fix it.

Steve Washuta:  Well, having people like you really helps us again, I said this before in our industry, because sometimes it seems, and it is above our pay grade to tell our clients these sorts of things, right? Oh, hey, the reason why you’re not meeting your goals, you’re on eight different medications.

I don’t know synergistically how those things are even interacting. Not only in your body. but with each other to slow down our goals, right? You’re on this cholesterol medication.

Have you ever went to the doctor and said, Well, what’s happening to my cholesterol? What do you like, Okay, how is this cholesterol medication actually working mechanistically in my body? What is it doing?

No one’s asking that they just they assume that this is the solution. And that there’s there, there are no caveats. Or there’s no secondary effects coming down the pipe, and there are, but also, as personal trainers,

it is hard to have those conversations with clients, because it really is above our pay grade to sort of be able to ship them to people like you who have that approach, I think is an important networking that the personal trainer community should have in order to get their clients to their goals.

Jenny Quartano: Absolutely. And you know, I don’t think it’s above your paygrade at all to ask those questions, though, right? Like, have you ever considered how this medication might be affecting your health? Yes. And you you have not told them anything? You know the answer to that, right. But you can at least get their wheels spinning to go. Maybe I should know more about that.

Jenny Quartano: And who else can I talk to? And then that opens that conversation and that door to see who else is out there? I think one of the benefits of being functional medicine practitioner. Is it falls under wellness and wellness isn’t restricted to state lines.

So I see a lot of clients virtually. You know, across the country, and so being able to be open. whether that’s for Child Development for a child who may be a parent has a question about their milestones, or, you know, they’re not pooping, or I can’t lose the weight. All of those can come to us under a wellness hat. Which I guess is the blessing of the way the insurance model is set up.

Steve Washuta: All right. Now, here’s fear for the hardest question. I wasn’t planning on asking you this. But I have to now. Because this is the question I asked almost everybody in the start of my interviews, and I didn’t ask it with you. But I’m going to now at the end.

I don’t have an answer for this. By the way. I I sort of waffled back and forth all the time on this? Should there be more or less oversight in the industry as far as giving advice like this?

So giving a nutrition advice, giving health advice? Do we need more certifications? Do we need less? Should it be the wild wild west sort of libertarian ask run your own business? Should it be all government oversight? Should we have one one outstanding business doesn’t function good as it as it is? Now? We don’t need to touch it. What are your thoughts?

Jenny Quartano: Well, it’s definitely broken. I mean, let me start there. Right. And I think there are so many reasons, right?

We’ve tried to, for good intentions, control it right. We’ve got government agencies in place to make sure that Joe isn’t hanging out a shingle and giving people bad medical advice.

Jenny Quartano: I appreciate that 100% However, we’ve oversight, controlled it to a point where people who have the experience and training our head of where we are in licensing and you know, I feel like I fall into that boat, right?

It’s spent a ton of time studying this. I have advanced training in it, but there’s not a license and functional medicine.

Jenny Quartano: So on the good side, I can see clients. I can treat them under a wellness perspective. that opens me up to be able to help our people to achieve those goals.

On the other side, it opens up the ability for anybody to do that. Right. So you don’t know what you’re getting is good. And so I’ve had clients come to me, and you know, and PT is regulated. I had them come under this as well. I had a bad experience already.

Jenny Quartano: I’m like I get it because not everybody has the same quality of training. Not everybody has the same understanding. And there’s not a regulation to say you’re practicing at a level that is good or not. So I don’t know, I don’t know what the answer is. I don’t think that government oversight is necessarily the answer. And yet I appreciate why that’s probably the best route we have in some perspectives. But I think it’s broken and we need to do something to fix it.

Steve Washuta:  Yeah, I’m with you there. There doesn’t seem to be one great answer. But whatever’s going on currently, also doesn’t seem to be the right way. There needs to be some sort of fixes and maybe maybe the fixes that. It’s just going to take time. It’s not that anything’s going wrong. It’s just that eventually the cream will rise to the top.

There’s a lot of good information being put out there. And hopefully the good information just beats out the bad but There are unfortunately, a lot of bad voices out there.

There’s a lot of bad information. And sometimes that bad information is simple. And it’s easy. And that’s what people want to hear. Oh, all I have to do. Is this all I have to do is this. When really, you know that the answer is typically always more complicated than then it’s put out there.

Jenny Quartano: Absolutely. Well, and I think the benefit, like you said is there’s so much information out there now. So you can really do your research. You can get out there you can dive in, you can learn more about why a technique may or may not be appropriate.

And I think that’s, you know. What’s the benefit of great podcasts like this are is being able to come on and share information. With more people get the word out there that yeah, the quick fix isn’t usually the right fix.

Jenny Quartano: And you need to put in the work. If you really want to see the results in the success long term and not create more problems. A pill for every ill certainly isn’t the answer.

And that includes wellness, right? There’s not a pill for weight loss, it’s going to not give you problems down the line. But people want that quick fix. So learning as we go.

Steve Washuta:  There are no solutions only trade offs. Jenny, this has been a fantastic podcast. Give my listeners not only some information about where they can find you specifically. Let’s say what you’re doing for moms and for families.

And then that sort of the PT side, but also what you’re doing in a functional medicine side. Is it a website? Is it an Instagram account or anywhere they can reach out to you directly?

Jenny Quartano: Yeah, absolutely. So we’ve got a website. If you want to go and learn more about our practice. It is altogetherwellness.net There’s some free tools on there for moms, for kids. Also for the functional medicine side. if you want to learn a little bit more. About how maybe toxic and potentially problematic your your health really is. We’ve got some tools on there that should get you started just to get you thinking.

Jenny Quartano: We do have an Instagram account. At @altogetherwellness and we actually just started a new one altogether wellness. well, woman separating out the kid’s stuff from the functional medicine stuff, so follow us on both of them.

Just to keep in the loop both of those are interesting for you. But if one of those is more important than the other, then you can find us there as well. And we’re on Facebook too.

Steve Washuta:  My guest today has been Jenny Quartano thank you so much for joining me Trulyfit. Thank you.

Steve Washuta: Thanks for joining us on the Trulyfit podcast. Please subscribe, rate, and review on your listening platform. Feel free to email us as we’d love to hear from you.

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