Dr. Carolyn in Cleveland: A Women's Health Podcast

Dr. Carolyn begins this episode with a personal story about a surgery she had that resulted in a serious complication. She shares what she learned from this difficult experience so you won't make the same mistake she did.

SOME PRE-OP IDEAS to help you prepare for surgery:

• Ask about anesthesia options
• Confirm who will be doing your surgery
• Decide on Medical Power of Attorney
• Create a Living Will

https://www.ohiobar.org

SCREENING TESTS

Various pre-op screening tests that you might need include: an EKG, Chest X-ray, Cardiac stress test, and Pulmonary Function Tests. There is also a special questionnaire to see if you are at risk for obstructive sleep apnea (OSA).

http://www.stopbang.ca/patient/screening.php

NEW RECOMMENDATIONS from several groups include:

The American College of Cardiology and the American Heart Association now recommend that every patient needs to be assessed to determine their risk for a post-op cardiac event. In other words, it's important to find out if you are at high risk of having a heart attack during or after surgery. There are also new recommendations regarding certain medications to stop prior to surgery, including SGLT2 inhibitors, like Invokana, Jardiance, Farxiga or Steglatro.

https://www.acc.org/Latest-in-Cardiology

If you're taking a GLP-1 agonist like Ozempic, Wegovy or Trulicity, the American Gastroenterological Association, along with several other medical societies, now recommends that you follow a liquid diet 24 hours prior to your surgery.

https://www.asahq.org

As of 2025, the American Society of Anesthesiologists has new recommendations for patients over age 65 to prevent delirium (acute confusion) after inpatient surgery:

• Screening older patients to identify those at risk for developing delirium
• Choosing type of anesthesia with your anesthesiologist
• Minimizing certain medications that might increase your risk for delirium
• Considering the medication dexmedetomidine during the immediate post-op period to prevent delirium in high risk patients.

https://www.asahq.org/about-asa

SUMMARY

The more prepared you are for surgery, the better your chances will be for a good outcome.

Discuss the details of the surgery with your surgeon. Ask about anesthesia options.

Schedule a pre-op visit with your primary care doctor. Ask about recommended screening tests and assessments. If appropriate, ask about getting tested for a metal allergy.

Be sure to have your list of questions answered prior to surgery. It helps to take someone with you to these appointments.

Take charge of this important pre-op time period. You'll be glad you did.

Note: The information included in today's podcast is not meant to be used as personal medical advice. Always consult your doctor or nurse practitioner before making medical decisions or making any changes in your medication.

"I think I have a sugar addiction." In this episode, Dr. Carolyn talks candidly about her difficulty saying no to carbs. She grew up in a "baking family" and has many happy memories attached to homemade cookies and birthday cake.

The thing is, too many carbs can lead to elevated blood sugar levels that might develop into diabetes, fatty liver disease, and even Alzheimer's. Plus, high blood sugars (blood glucose) can make you gain weight, feel tired, and give you brain fog.

In this important episode of Dr. Carolyn in Cleveland, we listen to Gretchen Spetz MS RDN LD IFNCP, a functional dietician and nutritionist, tell us how we can put an end to carb cravings.

• Why Gretchen thinks that protein and fiber are the key
• The reason to eat carbs at the end of a meal (Reference: Diabetes Care 48: e15, 2025)
• How to use a glucose biosensor to track your glucose levels (For info on the Stelo biosensor, visit https://stelo.com. For info on the Lingo biosensor, visit https://www.hellolingo.com)
• How Dr. Carolyn found out that eating a bowl of cereal increased her glucose more than a piece of cake

Join us to find out how you can have your cake and eat it too! To learn more about free programs from Gretchen Spetz, including How to Kick Your Sugar Cravings, visit: https://www.gretchenspetzrd.com/freebies

March is Women's History Month, and today we interview a true trailblazer in the field of women's health, a physician who paved the way for many women who came after her.

In this episode, we enter the world of Dr. Nancy Johnson who tells us what life was like at a time when there were very few women in OBGYN, a time when male physicians weren't always offering adequate care to their female patients. Dr. Nancy tells us how she fought to improve care for women, and in the end, how men came to accept her as a respected colleague and friend.

WHO IS DR. NANCY JOHNSON?

She's a family practice physician who, at age forty, decided to enter an OBGYN residency.

She was the first female board-certified OBGYN physician in private practice in Cleveland, Ohio and who, over the course of her career, delivered over 7,000 babies.

She's also

• a mother who cared deeply about her children.
• an athlete who skied in Aspen (and around the world).
• an adventurer who hiked in the Himalayas.
• a creative who enjoyed sculpting and playing the piano.
• a physician who, in her nineties, continues to work on improving the care of women by focusing on osteoporosis prevention and enhancing the practice of geriatrics.

In 1977, as Dr. Nancy completed her training, a wave of young women entered the field of OBGYN and changed the entire culture. But at the start of her residency, she was the only woman. Here is her story, in her own words, beginning with those first difficult days in the OBGYN clinic…

DOMESTIC VIOLENCE is more common than you think. Worse yet, physical injuries are often missed, even by medical professionals.

TRAUMATIC BRAIN INJURY or TBI doesn't just affect football players and boxers. Women who are hit in the head by abusers can develop TBI, too. Again, often an invisible injury.

STRANGULATION during sex is also being reported. An alarming new statistic: one in three young women describe being strangled during a recent sexual encounter.

In this podcast, Dr. Carolyn talks with Carol Carbary who tells us what we need to know:

• What is "domestic violence" (vs intimate partner violence)
• How to recognize injuries (traumatic brain injury and strangulation)
• What are the signs that someone is an abuser (red flags)
• What to say to someone who's in an abusive relationship (and what not to say)
• How Cleveland's Journey Center for Safety and Healing can help (and it's free)

About Journey Center

For nearly half a century, Journey Center for Safety and Healing has been a leader in Cuyahoga County, Ohio around issues of domestic violence. Journey's mission is to provide services that foster safety and healing to those affected by child abuse and domestic violence and to prevent abuse through education, advocacy, and systemic change. Journey is the most comprehensive domestic violence agency in Northeast Ohio and is unique in combining the issues of both domestic violence and child abuse in its mission.

Journey's services include a 24-Hour helpline, emergency shelter, housing, trauma therapy, justice system advocacy, support groups, supervised visitation, parenting classes, education and training events, community advocacy, and special services for the Hispanic community.

• Call Journey Center 24/7 at: 216-391-4357 (HELP)
• Live Chat online at: Journeyneo.org
• Carol L. Carbary can be reached at: 216-229-2420

This episode is personal. I always thought I was at low risk for a heart attack, but I was wrong. I want to share with you the story of how I found out I was at high risk. With this important information, hopefully you can learn how to protect your own heart. Today's show will include information from Dr. Leslie Cho, Head of the Women's Heart Center at the Cleveland Clinic. She is an international expert who carries out research on women's heart health. If anyone knows how to protect our hearts, it's her. We are now living in a time when access to medical information is becoming increasingly limited. Women's health websites are being taken down. The funding of research that includes women is being frozen. My mission is now threefold:

1. To continue to provide you with a space to hear women's stories and concerns
2. To give you access to critical women's health information
3. To process feedback from you in order to improve the podcast

Please feel free to send feedback to [email protected]. And please use "Heart Health" in the subject line. Here are two references for today's show:

1. Mesi O, Lin C, Ahmed H, and Cho L. Statin intolerance and new lipid-lowering treatments. Cleveland Clinic Journal of Medicine 2021, 88 (7) 381-387. https://doi.org/10.1016/j.ajpc.2023.100579
2. Sukkari M, et al. Is there a benefit for aspirin therapy for primary prevention to reduce the risk of atherosclerotic cardiovascular disease in patients with elevated Lipoprotein (a)––A review of the evidence. American Journal of Preventive Cardiology 2023 Sep1; 15:100579. https://www.ccjm.org/content/88/7/381 or for pdf https://www.ccjm.org/content/ccjom/88/7/381.full.pdf

Do you ever think about how hard your heart works for you––the strong muscle in your chest that beats every second of your life? If not, maybe it's time to think about taking care of this vital organ.

When an artery to the heart muscle becomes blocked, the flow of blood is interrupted, and a small piece of this muscle can die. We call this a heart attack (also known as a myocardial infarction or MI). This is what happened to Jan Jones, a Cleveland TV celebrity, and she didn't realize it right away.

In this episode, Dr. Carolyn Nemec sits down with Jan who shares how she saved herself from a serious heart attack. We also discuss the warning signs of a heart attack and how these symptoms are different in women. Instead of chest pain, women can develop nausea, back pain, sudden fatigue, or "something that just doesn't feel right."

Later in the show, we share the secret of making lifestyle choices like changes in diet and exercise. February is American Heart Month, the perfect time to be inspired by the warmth and wisdom of Jan Jones. For more information about heart disease, please go to Heart.org, a website sponsored by the American Heart Association.

Join Dr. Carolyn and Dr. Marisa G. Franco, author of PLATONIC, as they explore how non-romantic friendships can help us be healthier.

We each have "attachment styles" that influence how we make friends and it helps to be aware of these styles.

A book like PLATONIC can guide us as we do the work of healing ourselves, resulting in relationships that are deeper and richer. Good friends also help us live longer. Friendship truly is medicine!