136- Ways to Improve Your Pelvic Floor with Dr. April Morrison

Bryan Carroll: [00:00:15] As we age, we start to notice little issues that start to pop up in our bodies. Sometimes it's aches and pains. Sometimes foods just don't work with your gut anymore.

And sometimes you pee when you sneeze, it's pretty common to push these issues off as you you're just getting older, but there are ways to make all of those issues better. What's up everyone. I'm Bryan Carroll and I'm here to help people move more and eat well and be adventurous. And today, Dr. April Morrison is on the show to teach us how to improve our pelvic floors.

Well, we talking about both female and male pelvic floors as each can have their own issues. So let's dive into my conversation with April. Dr. April Morrison as a physical therapist, trained in both women's and men's pelvic health, and is passionate about working with the pregnant and postpartum population.

Her goal is to help you to regain control of your pelvic floor so you can return to the activities you love. Thank you, Dr. April so much for coming on to the show. 

Dr. April Morrison: [00:01:11] Hi, thanks for having me. 

Bryan Carroll: [00:01:13] Of course. And before we dive into, just about the pelvic floor and what people can do to improve their own pelvic floor, let's learn a little bit more about you, your background, what got you interested in physical therapy and then especially what got you interested in the pelvic floor.

Dr. April Morrison: [00:01:28] Sure. So, I took a long way kind of to this career field. A lot of people get into a PT right outside of college and then go right to grad school, like to kind of a detour. I was a military officer before getting into healthcare. I had nothing to do with healthcare during that time. but other than, I volunteered while I was deployed to Iraq.

I volunteered at the hospital there in the PT clinic. and I just absolutely loved it. I loved the things that the physical therapists were able to do for these soldiers. And so it kind of stuck in my head that I definitely wanted to be a PT at that point, and pursue some of that. and then from there I kind of went on to grad school and, went into physical therapy.

I thought that I would continue working with soldiers. I thought that I would, continue working with military population and even athletes because I was an athlete all through high school and college as well. But, it actually took me down a different path and it took me kind of into pelvic health and working with moms and, kind of serving him more underserved population that.

Doesn't get a lot of attention and that's, that's mom's for sure. 

Bryan Carroll: [00:02:35] Well, we definitely thank you for your service and the time you spent in the military. And, as we started diving into the pelvic floor, is there a certain part of the body that makes up the pelvic floor or is it just what we think of when it pops into our heads?

Dr. April Morrison: [00:02:50] Yeah. You know, I think the pelvic floor was, wrongly named. I wish they called it the pelvic bowl because it's more of like a bowl of muscles that kind of support the, all of your organs in your body. And so when people think of the pelvic floor, you typically think of your pelvis bones, right.

And, and just kind of that way, your sacrum and your Cox sixes in the back, and then your pubic bone in the front. But there are a whole bunch of muscles and ligaments and tendons that are, can make up your pelvic floor. And, they kind of certain kind of surround those organs and hold everything in place.

your, like your bladder and for women, the uterus, even the rectum and that part of the body, like those things are all supported by pelvic floor muscles and their muscles that people typically don't really. Think about, when you hurt yourself, you're not, you know, you might strain your back or hurt your hip.

And you're not even thinking that it could be related to the pelvic floor, but it attaches those attached to all of those parts of the body. 

Bryan Carroll: [00:03:52] So, so, what, like what percentage of the population has some type of dysfunction in their pelvic floor? 

Dr. April Morrison: [00:04:01] I think that's pretty a great question. I would say, if you have an issue with your hip or your back, you're more than likely have a problem with your pelvic floor.

So I think that the numbers, these days are 80% of the population has a pelvic floor issue, whether it is that the pelvic floor is too tight and it's causing pain or dysfunction somewhere in your body, but not doesn't necessarily mean it's in your. in your pelvis itself, it could be something that's attaching to your hip or your back.

But then, I think that also the number is 85% of women who are postpartum. do have some sort of pelvic floor dysfunction after, between, you know, six and 12 weeks after they give birth. So. The other cool or not. So cool. I guess a number is that if a woman has a dysfunction that is left untreated after, she has gives birth, if she has left untreated after six weeks, they don't do anything don't help her, or she doesn't seek treatment that in the next five years, she's still gonna have that same dysfunction.

And so it's something that needs to kind of be addressed early in that population. And 

Bryan Carroll: [00:05:11] so the, That 80% of the population that we're talking about is that after a certain age, or is that including children all the way up to the elderly 

Dr. April Morrison: [00:05:21] children, all the way up to the elderly? I don't deal a lot with pediatric physical therapy.

I don't have a lot of younger kids that come to see me, but there is a great group of people who does, who do work with pelvic health in, incontinence and kids and, and injuries and trauma. And, and stuff like that. So I think when people think of the pelvic floor and an issue with the pelvic floor, it's something like, you know, somebody's a woman gives birth and everything's stretched out.

And so that's the problem, but there's also sexual abuse and sexual trauma there's, motorcycle accidents that can cause you know, a pelvis fracture that's going to cause dysfunction there. you have. the separation of your diastisis, which is the, kind of where your six-pack lives in your stomach.

there's a spot there that stretches during pregnancy, that if that doesn't go get to be more functional, then that can cause problems for people and even a guy with a beer belly, it can have that same thing. So it's not just carrying around a baby. It can be, you know, the larger abdomen, if that stretches.

it can cause some dysfunction in your pelvic floor. So it's not just the pregnant moms. It's not just, you know, women who have given birth it's the entire gamut of population. 

Bryan Carroll: [00:06:31] So what would be some good symptoms that would indicate there's some type of dysfunction going on down there? 

Dr. April Morrison: [00:06:36] Sure. one of the things I think, people believe is as you get older, or if you are a female and you've given birth.

That, you're going to leak or having continents. And so if you sneeze and you leak, I call that, PCSing, right? When you sneeze, if you Pease or cough and laugh and you find yourself paying that is, an indication that you have some pelvic floor dysfunction. And I want a shell from the rooftops that that is not something you have to live with.

That is something that, can be helped. And it's not something that has to be part of your daily life. other things as pain with intercourse and sex that can be, for both men and women, that's an indication that there's a pelvic floor dysfunction, hip pain. Like I said, a lot of people. Have hip and groin pain, but pain can refer.

And so it could be from somewhere else and it can be something that is a pelvic issue. men have erectile dysfunction, that's a pelvic floor issue. there's just, there's lots of things that it can be. and the sooner you treat it, the easier it'll be to treat usually. 

Bryan Carroll: [00:07:43] Yeah, that's kind of interesting because you hear people say all the time, I'm getting older and that's why when I sneeze, I leak or IPS.

and it's also interesting because a lot of men, as they age, they start taking stuff like Viagra to help with ed. And so it could be more related to the pelvic floor and not just issues in that specific spot. 

Dr. April Morrison: [00:08:05] Exactly. And I think, you know, speaking specifically to that, ed. the big concern with that is that it's masking a bigger issue, like a blood pressure issue or, you know, something else.

And so I think that, you know, rather than throwing drugs at it right away, you shouldn't kind of investigate what, what the possibilities are, what else could be going on. 

Bryan Carroll: [00:08:26] Right. so let's walk through some of the, you know, the common issue is that each gender might have in different ways that you would go about trying to work with them, to figure out what's going on and how you would take care of them.

So, let's start with just a male pelvic floor and talk about, if there's other symptoms other than just ed or leakage of any sort. And then what would you be looking at to help them out? 

Dr. April Morrison: [00:08:50] Sure. So a lot of, gentlemen have issues with incontinence as well. they, they do, leak or, urging continents.

And I think a little of this gets is carry over from, people who don't, you know, listen to their bladders during the day. teachers, especially nurses, anybody that works with customer service, they know that they can't necessarily get to the bathroom whenever they need to. And so they ended up holding their bladder for as long as they can and kind of holding it, holding it, holding it, and then they go.

And so we call that kind of delaying the void delaying voiding. And so if you do that too long, there's a muscle that surrounds your bladder called your detrusor muscle and that muscle. Gets stretched and doesn't, act the way it should act. It's not sending the message up to your brain saying, Hey, it's time to pee.

Right. And so that message that gets down to your body saying, okay, I got to find a bathroom soon that that loop gets interrupted. And so if you do that for too long, then the body is like, forget you. I'm not going to listen to you anymore. I'm just going to go. I'm just going to do that. So. That's one of the things that both men and women experienced, but I see that with a lot of men, lately, for some reason, seeing that a little bit, a lot of men, the other is double voiding.

So people will go to the bathroom and then two minutes later feel like, Oh man, I've got to go again. They haven't really fully emptied their bladder. So there's some issues there with, with being able to avoid appropriately. And sometimes that's because their pelvic floor muscles are tight. And then the other big one that we see with, with men is prostititus or, you know, issue with their prostate.

And so as men age, prostate cancer is a big thing and something that's really on their minds. And so there's a lot of times that we see it and it's benign, which is fantastic. It's not something that's going to actually be cancer. but it still causes issues. So it can cause issue with the urgency of urination or the flow.

It could be ended up that it just takes forever to be able to avoid. And so there are treatments that we can do to kind of help with those things. 

Bryan Carroll: [00:11:00] And what would a, the treatments look like? 

Dr. April Morrison: [00:11:02] Well, you know, everybody's different. And so, I think along with most pelvic health PTs, we try to look at the whole person and the whole body.

So sometimes it includes, behavioral changes, like, scheduling how often you urinate so that you can get your bladder back on that right track that it needs to be on. And so maybe it looks like, writing down how often you're urinating, how much water you're taking in. If you're taking in any bladder irritants or things that can bother your bladder and cause problems, and then kind of be modifying those behaviors a little bit.

Sometimes we need to get people to void more frequently or not void as frequently as they go. one of the things that a lot of people do is called just-in-case peeing, right? You're you're going to go on a long road trip. So I'm going to go pee just in case, or I'm going to sit down to this movie and I don't want to be interrupted.

So I'm going to pee just in case. And that can actually be detrimental to that whole, you know, bladder function. So retraining those things kind of education around that. and then we also do, biofeedback is a big one where we can show the patient if their muscles are able to relax or contract when they're supposed to, when they're trying to.

And so it's, biofeedback is another one that we, we tend to, initiate as well. 

Bryan Carroll: [00:12:22] I'm glad you brought up the behavior part, because I think a lot of people forget that that's such a big, important piece to, working with. Just musculature and everything involved. Because a lot of times it's not just a muscular chair that you're looking at or the structure of something.

the way people act throughout the day can have a huge impact on that. So the fact that you brought that up, that's super important. because we do, we create. Different habits that can impact us over the long-term and we don't even recognize it. 

Dr. April Morrison: [00:12:52] Right. And even if you change one habit, it could have a huge cascading effect for the positive or negative in your life.

And so absolutely one little change can really make a big difference. Yup. 

Bryan Carroll: [00:13:06] Well, let's dive into what you're super passionate about and that's a female pelvic floor, so let's learn, You know, a lot of the different issues that could happen there and then what you would do to help them, especially since you like to work with pregnant people and postpartum.

So there's probably a lot that you can dive into right there. 

Dr. April Morrison: [00:13:23] Yeah. And, and actually, even before you get into that population of being pregnant and postpartum, pain with intercourse is a huge thing. a lot of women have have pain and are unable to have intercourse with their partners. And so that can lead to.

You know, obviously some mental health issues and stuff, if you're not treating it well. so vaginismus is one of the things that, we talk about and that's just pain in, in, in that area. And so we work with, kind of a lot of relaxation, a lot of mindfulness, a lot of, kind of. again, behavioral modifications.

there are devices that we use that are dilators, that kind of help kind of stretch those muscles. So it's just like any muscle in the body. If it's not working the way you need it to work, you either need it to. Get stronger or loosen up. And so we figure out what it is that's causing the problem. And with, with a patient who is having vaginismus, it's usually something that's really tight and muscle that's really tight.

So we've got to train it to loosen when we want it to loosen. so that's that kind of population. And then the pregnant moms, working on a lot of women have when, when they are pregnant and carrying their child, they have pain in their, SSI joints in their hips and their backs because they have all of a sudden this new weight on their abdomen that they never had before.

And so we often are working on ways to help support those muscles either by. You know, an actual physical support belt or something and, providing some stretches and that sort of thing. I love working with moms as they are preparing for their birth and helping them in their partners come up with ways of how to avoid.

tearing or the need for a C-section or interventions. we, we help work through those issues so that they can be prepared for, with a good birth plan of the things that kind of relax them and help them to, you know, to help the birth go and progress. And then in the postpartum period, I, you know, a lot of people think postpartum is kind of like a year after you give birth.

But for me, if a woman is postpartum, she's always postpartum. She's always had had that delivery. So, or that baby birth. And so, the big ones are, you know, right. Six weeks after you deliver a child, you're told you're ready to go ahead and get back to normal activity. Everything's good to go. And that's not always the case.

And so there can be tearing or something that occurred during the childbirth process. there can be a pain associated with trying to return to intimacy with your partner. so all of those things, and, and again, your body had just had this infant inside it. Right. And then all of a sudden things are kind of going back to.

Where they were ish before. And, unfortunately that doesn't always go smoothly. And so a lot of times we have to help with stretches and strengthening and kind of getting the joints and the muscles back to where they need to be. So that's kind of the reader's digest version. 

Bryan Carroll: [00:16:32] What about for, women that are going through their first pregnancy and all the actual structural changes that happen to the pelvis.

So, what, what are the different things that you help with that? Those changes? 

Dr. April Morrison: [00:16:43] Sure. I think that, every pregnancy is different. So even if it's not their first pregnancy, a second pregnancy can look so differently from the next, the widening of the hips, which is a great thing because it allows for the passage of the child to go through.

eventually when it's ready, the laxity of the ligaments and kind of near the end of the pregnancy, that's something that can be an issue for a lot of women, because if they're especially hypermobile already, then they can have some issues and need extra support with that. back pain is a huge one with a lot of women.

So kind of figuring out what is the driver of that back pain and trying to help balance their bodies so that they can, kind of reduce those symptoms as much as possible. the changes in the breasts are another one. So supporting women and showing them what kinds of things that they need to be doing for that, with bras and all that stuff.

there's just so many changes that go through the body and it's a miraculous thing that happens. But yeah, I would think, you know, with all the stuff that happens, you would think we wouldn't have all these babies around, but we do the world is populated. 

Bryan Carroll: [00:17:50] Yeah. That's actually really interesting because, when you're pregnant, you gain, what about 40 pounds right there in your belly region?

Is that about average? 

Dr. April Morrison: [00:18:00] That's around the norm. 

Bryan Carroll: [00:18:03] So you have all of those gravitational pole on the front side, but then like you mentioned, the enlargement of the breasts that also adds more weight on their front. Right? So are you also having to work on strengthening, like different back muscles to be able to support.

Those massive changes on the front of the body. 

Dr. April Morrison: [00:18:20] Absolutely. Yeah. We always are trying to achieve balance. Right. And so trying to work with, you know, maybe widening your stance when you're walking, working on back muscles and shoulder muscles for strengthening also, educating women that they don't necessarily need to be gaining a ton of weight during pregnancy and how to do it healthily.

But, but to keep moving during the pregnancy as well. And how that is just so important for, for women is to, to keep active, keep moving don't necessarily decide, okay, I'm pregnant. I'm going to go run a marathon. I've never done it before. I'm going to start training, but know that if you're active and moving, you should be able to do the same things during your pregnancy about that, that you were, you were doing before.

So yeah, we, we got to get the whole body going. 

Bryan Carroll: [00:19:09] And do you notice what the pelvis itself does it become more anteriorly rotated or posteriorly rotated depending on the time of the pregnancy 

Dr. April Morrison: [00:19:20] play with women? your pelvis does with the weight of the abdomen, right? It tips kind of forward a little bit.

So you get more of a spinal curve at your low back. and you'll see women just kind of trying to balance themselves a little bit better. and that's kind of where you get that pregnancy waddle. it's cause it kinda everything's tipping forward. I think it's adorable, but most people don't like to be called that.

Bryan Carroll: [00:19:44] So w would you say in most cases that has a lot of the impact on the low back? So they're going through so much, 

Dr. April Morrison: [00:19:51] curvature there. Yeah, absolutely. Things are pulling on the other side. I think a lot of people forget that your core. Is made up of not only the front muscles of your body, but those back muscles and the deep back muscles of your spine, like your , those are the ones that are helping support on the backside.

So it's not just the front of your body that you need to be worried about what that core and that whole body girdle really it's it's the back muscles as well. So yeah, you got to get those. goes those working appropriately and firing as they're supposed to. And then also the muscles that run along either side of your spine, your erector spinae, those muscles help keep you upright and they can get super tight on women and during pregnancy.

So keeping those relaxed and loose is really, really important. 

Bryan Carroll: [00:20:38] So right after, giving birth, is there a lot of trauma to the, pelvic floor? And then how long does it take for that to heal so that you can actually start working on it before that six week Mark? 

Dr. April Morrison: [00:20:49] Sure. I think that the best answer is always, it depends, right?

If there's trauma or not. So some women can have a. A childbirth, session and it's completely fine. No issues. The baby pops right out. They didn't have to push for very long and it was nice and easy peasy and they were made for that. And then other women have to push for hours and they labor down really hard for a long period of time.

And they need either forceps to help assist the baby come out or there's tearing or there's need for an episiotomy, which helps kind of give space for the baby. or then they have to have a C-section a lot of women have to have a Syrian section to, extract the baby as well. And so it always depends, someone who may not have had a long delivery could still.

Tear. And sometimes it's because it's happening so fast and the baby comes out quick and then, you know, then things have torn because the body hasn't had the adjustment period to prepare for that stretching. so that kind of depends. And that's why there's, a checkup and a follow-up usually at about six weeks after the birth to, with the OB to see, you know, how are things healing and that sort of thing.

Usually at that six week point, things are starting to improve and look a little bit better, but they're not always healed for sure. And it takes some people two or three more months before they feel like everything's getting close to back to normal for them. So, and some women, it takes a lot longer than that.

So it really just really all depends on what that birth story looked like. 

Bryan Carroll: [00:22:21] Yeah. So how does that work with people that get pregnant right after each other? And it's like second, third, fourth pregnancy, all within a couple of years, 

Dr. April Morrison: [00:22:31] just think about the changes your body has to go through right during pregnancy.

So your hormones are kind of cursing out of control and going crazy. and then you deliver your baby and those other hormones are going crazy. And then all of a sudden you're pregnant again and your body really hasn't had time to adjust and adapt to. You know the way it was before, before you're already starting to introduce another pregnancy into it.

It can throw people's bodies, you know, out of whack. But again, some women are made for that and they just, you know, they thrive on that and their bodies just are wonderful and they're fine. other women have a harder time and so it's kinda hard to speak in generalities. but it's, it's basically, that's why they recommend you wait a little bit so that your, your body has a chance to calm down.

Bryan Carroll: [00:23:19] Yup. And he can catch up on, taking care of yourself and getting everything back on track. 

Dr. April Morrison: [00:23:25] That's the plan. 

Bryan Carroll: [00:23:27] So is there anything that we missed that we should have talked about with the pelvic floor? 

Dr. April Morrison: [00:23:31] It just feels so bad when I hear about these people who are dealing with incontinence and they don't really need to be.

so just because you get older, doesn't mean that that's your life sentence. That doesn't mean that that's, what's going to have to happen for you. So, knowing that I want to make sure people understand that. and then also with that, the recurrence of UTI, this happens with, especially with the older population that does have incontinence.

And so if things aren't getting cleaned up the way they need to be, and they're not able to be near their hygiene may be not as great because of that issue. Then it introduces infection. And that can be a big deal for a lot of people. It can be the reason that people are hospitalized. So, making sure that it's not just about, I don't want to wear an adult diaper.

It's about, you know, taking care of the possibility of introducing an infection and, and trying to eliminate that as 

Bryan Carroll: [00:24:24] well. Perfect. Well, people can find more about [email protected] You also have a Facebook group that you support women in. Can you talk about 

Dr. April Morrison: [00:24:35] that Facebook group? Yeah, it's a private Facebook group.

It's called the Idaho women's pelvic health. And, it is for women in it. I do have people who are not in Idaho in that group. so if you're in Washington or Oregon or wherever it is that you may be, feel free to request to join, but it's a safe place for women to ask questions and to learn and really share their experiences.

And I tend to just jump on there and brain dump and, you know, give a bunch of information about stuff. And I'm trying to, I believe that knowledge, our, so the more we know about our bodies, the kind of the better we're able to. you know, work, work with them, working on a bunch of those things right now with menopause.

And, and so I think that, if you're interested in joining while you, unfortunately, can't because you're a male, but, women who are interested in joining should definitely reach out. 

Bryan Carroll: [00:25:24] Okay. And you also have a couple of podcasts of your own coming up. So you want to talk about 

Dr. April Morrison: [00:25:28] those? Sure. I have a podcast called the Idaho physio and that is a podcast about health wellness, and high-performance in all areas of life.

So it is not necessarily just physical therapy. I talked to the people who are kind of at the top of their career fields and at the top of their games. And I try not try to parse down and find out what are the habits that have helped them get there. And what are the things that the people that they surround themselves with?

What do they do? and so that's the Idaho physio and then that, my other one is called the girl power happy hour. And so that is going to be more talking specifically about pelvic health and women's health. I'll, I'll sides of women's health, mental health, breast health, all of that stuff. And so, that's going to be super relaxed and chill and where I talked to, other.

Really, really smart people who know what they're doing, in, in healthcare. And so that we can get some more knowledge out there to, to the women that absolutely need it. 

Bryan Carroll: [00:26:26] Awesome April. Thank you so much for coming on to the show. I'm excited to hear your podcast and hopefully, other people go and check it out as well.

And like I said, thank you. This information is definitely important, especially if 80% of the population is dealing with some type of a pelvic floor issue. so that just means you got to keep spreading that information. So more people know about it. 

Dr. April Morrison: [00:26:50] Great. No, I appreciate you having me out here so that we can get more knowledge out to the people.

Thank you so much. 

Bryan Carroll: [00:26:56] I hope you were able to learn some tips and tricks from this episode with April, and there are lots of resources available for you in the show [email protected] slash one three six. You can find other episodes about the pelvic floor in the show notes as well. Next week. We will not have an episode because of Thanksgiving, but the following week we will be talking about a pretty important topic trauma to the brain.

So let's go learn it. Who Dr. Kabran is? I am here with Dr. Kabran Chopek. what is one unique thing about you that most people don't know? 

Dr. Kabran: [00:27:31] I'm a gardener. I don't think anyone at amen clinics knows work in the garden. I've been trying to build this Coltrane for the past month. I'm not doing too well, but yeah, I'm, I'm an outward gardener now.

Bryan Carroll: [00:27:44] And how long have you been gardening? 

Dr. Kabran: [00:27:46] Ever since I was in a little kid, I remember I'm from Kansas. My parents were into it. I remember my dad, especially at tilling. I just loved that dirt and digging up worms and planting seeds and seeing them grow. It's just fascinating. This love the process 

Bryan Carroll: [00:28:03] it's therapy, or are you a gardening with just traditional veggies and stuff like that?

Or are you doing like an ARB garden and all that type of stuff as well? 

Dr. Kabran: [00:28:11] All of the above, mostly vegetables I'm interested in growing like. Fruit and vegetables and herbs. I really like growing herbs. I love that. And I'm really been interested in regenerative farming and permaculture and systems of how to re retain water on the, the land and not, you know, keep it renewable.

so that, I think super interesting. 

Bryan Carroll: [00:28:35] And what will we be talking about in our interview together? 

Dr. Kabran: [00:28:40] It's going to be a great interview. So this was, or it was a great interview. It was all about, concussions, brain injury, tips and tricks on how to, heal the brain and how to think about your brain, if it's been injured and how to protect it.

Bryan Carroll: [00:28:57] In a, what are your favorite foods or nutrients that you think everyone should get more of in their diet? 

Dr. Kabran: [00:29:02] I think everyone should get more fat for the first one. yeah. And, our brain is mostly fat, 70, 80% fat by dry weight. And, doesn't get enough credit, but, Avocados coconut oil. It really helps stabilize blood sugar.

If you have enough fat, the other one is not a food, but clean air. You know, I th when we had the fires and such, I took for granted, like just breathing clean air in Washington, it's like, Oh my gosh, this is then we had smoke. It's like, Oh, I can't go outside. It's just. So, so deep breathing, getting your brain enough oxygen and just having non polluted air.

In fact, indoor air typically is less healthy than outdoor air. So you should go outside more at the same time. If it's smoky outside, you want to be inside, but with a nice air purifier. 

Bryan Carroll: [00:29:55] And what are your top three health tips for anyone who wants to improve their overall wellness? 

Dr. Kabran: [00:30:01] I would suggest, keep in mind you want, I would say meditation or having some quiet time for your brain to reset.

We have so much stimulation coming at us all the time that we need to reset. And so many ideas will come to you. So many creative ideas, thoughts, and you'll be able to reset your, Just sort of orient yourself for your day. I think with the lone time protein at each meal, stable blood sugar equals stable mood and stable focus.

And I would suggest exercise some form of exercise to get the blood moving, get blood flow to the 

Bryan Carroll: [00:30:40] Dr. Kabran. And I worked through some really interesting scenarios and different ways to improve circulation to the brain. So until then keep climbing to the peak of your health.