Ep 37: Total Wellness with Dr. Catherine Harmon Toomer

Dr. Catherine Harmon Toomer is a family medicine and community health physician, TEDx speaker, and founder/CEO of Health, Wellness, and Weight Loss Centers.   

In part 1 of this 2-part interview, Dr. Toomer shares:

• How she ended up serving in a rural FQHC after finishing residency.
  
  
• What her state of health was like when she finished medical school and residency.
  
  
• How she reacted when she was told she had a 50% chance of living five years.

Tune in to this episode and hear how one physician took control of her own health and wellness
 
Dare to Dream Physician Resources:

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Dare to Dream Physician on Facebook

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DreamPhysician on Instagram

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Resources for Dr. Catherine Harmon Toomer:

Dr. Toomer, The Courage Crusader
https://drtoomer.com

Total Wellness and Weight Loss Program
https://bitly.com/total-wellness-weightloss

Dr. Toomer on LinkedIn
https://www.linkedin.com/in/chtoomermd/

** Disclaimer: While Drs. Toomer and Gray are both physicians, we are not your physicians and nothing in this podcast should constitute individualized medical advice. We encourage you to seek the advice of your own healthcare professionals should you need to make any medical decisions.***

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Transcript

Note this document may have human or computer-generated errors in transcription. Refer to the audio file for the actual conversation.

Dr. Weili Gray, Host 00:00

This is the Dare to Dream Physician Podcast. I'm your host, Dr. Weili Gray. Many physicians today are feeling overwhelmed and unfulfilled living a busy life based on someone else's terms and expectations. My mission is to help physicians figure out what they really want out of life, and how to make their dream life come true sooner than they ever imagined. My fellow physicians, your time to live your only life now. Become a Dare To Dream physician. Great things are going to happen. Make sure you hit subscribe and share this podcast with another physician you care about

[00:00:48] Dr. Gray, Host: Welcome back to another episode of The Dare To Dream Physician Podcast. I am so excited. I'm also honored and privileged today to bring you our guests. Her name is Dr. Catherine Harmon Toomer. She's a community health and family medicine physician. She is also the founder and CEO of Health, Wellness and Weight Loss Centers. She is a TEDx speaker. She's just an all around amazing human being. I cannot wait for her to share her story with you. I also want to remind our listeners that while Dr. Toomer and I are both physicians, we are not your physicians and nothing in this podcast should constitute individualized medical advice. We encourage you to seek the advice of your own healthcare professionals should you need to make any medical decisions. Please welcome the amazing Dr. Toomer.

[00:01:36] Dr. Toomer, Guest: Hi, thank you for having me. 

[00:01:38] Dr. Gray, Host: I'm so excited that I get to have the chance to talk to you. I've, I've admired you from afar for a while. I'm just excited to be able to have a conversation.

[00:01:48] Dr. Toomer, Guest: Well, the feeling's mutual. Definitely. 

[00:01:51] Dr. Gray, Host: So I love to start with having you tell our listeners more about your story, because, as I was introducing you, you started off as a community health and family medicine physician working at FQHC. And then, the next role that I read is that you're the founder and CEO of  Health, Wellness and Weight Loss Center.  How did you go from working in FQHC to being a founder and CEO of a weight loss center?

[00:02:18] Dr. Toomer, Guest: Well, initially what it was is that, I, uh, in, from Michigan, but grew up in east Africa. And one of the things I noticed there was that, I had already decided before moving there that I wanted to be a doctor just because of other events that happened in my family. But, when I got to Africa, I saw that there are people with diseases that in the United States were either prevented because of vaccines or work here because of medication.

[00:02:43] And, and so I started seeing that there was a disparity between people who had means were well, and those who didn't were dying very. Or, just saying you just don't see even cases of smallpox, which you know, was eradicated, but you, I saw many people with, uh, the aftermath of that, who, who had survived it,

[00:03:03] and just River Blindness and, all sorts of diseases that we only read about in textbooks in the United States. 

[00:03:09] And so I decided then that I wanted to be the type of doctor who served people who wouldn't normally have access.  And my plan was always to come back to Africa. And, so when I applied for medical school, I also applied for the National Service Corps Scholarship, which is essentially a scholarship that pays for all tuition books and everything.

[00:03:31] And as, and in exchange, I would work in underserved areas to pay it back, which was a win-win for me, because I was going to do that anyway.

[00:03:40]And it also meant that I came out of med school with hardly any, uh, student loans. And so that also gave me a lot of freedom. And one of the things I learned, well, first thing I did, I met my husband on my very first day of med school.

[00:03:57] I didn't know he was going to be my husband, but he's from rural South Carolina. And when I visited South Carolina, I realized that a lot of the conditions that were in Africa are in the United States. There was still a huge disparity between, people with means that people without means and what it meant to, to life expectancy, what it meant to education, to access.

[00:04:20] And so I, I just shifted my focus from going back to Africa to then working in rural areas. And that's what I did. So my very first job was actually my husband's hometown, which is one of the poorest counties in South Carolina. And, so I worked there. And then from there a year and a half into my first job. I gave birth to my daughter and a month later I was diagnosed with what is called postpartum cardiomyopathy, which is essentially heart failure related to pregnancy. It's very rare. There's a high mortality rate. And I was told at the time I would have a 50% chance of living five years. I knew this just having treated people with it. And so I had to stop practicing.

[00:05:12] Dr. Gray, Host: Wow.

[00:05:13] Dr. Toomer, Guest: To recover. And I worked on getting my health in order and one of the things that I did at the time, I was morbidly obese from having gained weight through years and years and years of stress and school and marriage and everything. Two pregnancies in three years. And I was an insulin dependent, diabetic. 

[00:05:34] Dr. Gray, Host: Oh, wow. How old were you then?

[00:05:36] Dr. Toomer, Guest:  I was 36. Which had killed many members.

[00:05:39] Dr. Gray, Host: Oh, okay.

[00:05:41] Dr. Toomer, Guest: I knew diabetes was one of those things that killed most, most people in my family. All of …. my father's from a family of nine men. He was the only one to live past 60. All of them died from either, just poverty related illnesses, things that were preventable,  and one of the things that I had helped my father do was reverse his diabetes.

[00:06:04] Dr. Gray, Host: Wow.

[00:06:06] Dr. Toomer, Guest: And I hadn't done it for myself though.  And So I took that first six months and I just buckled down because I tried to get help and no one would touch me because of my ejection fraction. My heart function was so bad that no one would come near me, cardiologists were really the only.

[00:06:24] Dr. Gray, Host: So when you say no one would come near me, like, where are you looking for help with, diet and exercise, or, what sort of help were you looking for? The people weren't able to provide. 

[00:06:33] Dr. Toomer, Guest: Well, I couldn't exercise. 

[00:06:35] Dr. Gray, Host: Mm,

[00:06:36] Dr. Toomer, Guest: And the model for weight loss and diabetes is to increase your movement, increase your exercise and decrease your eating, especially your carbohydrates. Well, no dietician was going to recommend anything as far as eating, because they're like, we don't know what you're supposed to do as far as your heart is concerned, other than don't eat salt, that's all they do.

[00:06:56] Dr. Gray, Host: Mm. 

[00:06:56] Dr. Toomer, Guest: My, anyone who was like, we're not going to try to get you off of insulin because it might be saving your life right now. So we don't know what to do with you. So the endocrinologist wouldn't touch me. Primary care docs didn't touch me. My cardiologists were like, look, I'm just your heart doctor, all the rest you got to take care of on your own. And so that's what I did. I had trained and had studied in med school with a bio-psycho-social system. And so what I did was I just applied it to myself and I was like, whatever I do, it has to be easy because I'm too tired to do anything difficult.

[00:07:29] It has to be effective. And so I started really honing in on what diabetes is. What's the past pathophysiology, how to reverse it. How did you know, just really getting into the nitty gritty of the biochemistry, the molecular biology, all of it? And I studied, I had time,I studied, and then I started looking at the psychology, it was like, I had a newborn, I had a two and a half year old and I had no motivation.

[00:07:56] Dr. Gray, Host: Right.

[00:07:57] Dr. Toomer, Guest: I still couldn't bring myself not to eat certain things. I couldn't bring myself to do, I couldn't move anyway. And I was like, what is wrong with you, Catherine? You're looking at this baby. And if you don't survive, they're going to grow up without a mother. Why can't you get yourself to do what you need to do?

[00:08:12] And I realized I was suffering severely from postpartum depression on top of chronic depression. and so that's where I focused first. I just said, get your depression under control. And I went on medication. I immediately started noticing a difference. It just so happened that the medication I chose is now used as a weight loss medication. 

[00:08:38] Dr. Gray, Host: Oh…

[00:08:38] Dr. Toomer, Guest: A lot of weight loss medications are antidepressants and actually believe it or not antidepressants and antidiabetic medications. So the combination of getting my diabetes under control, gave me the motivation I needed. Let me start getting my depression under control, gave me the motivation I needed to then get my diabetes under control.

[00:08:59] And within six months I had lost 60 pounds without being able to exercise, my moods improved, my energy improved. I, and I was off insulin. And in fact, within a few months after that, I was off all medication.  I, I went for years on no medication whatsoever. 

[00:09:22] Dr. Gray, Host: So even depression medications?

[00:09:24] Dr. Toomer, Guest: No, I was on depression... I stayed on depression medication. and I've actually continued that because I have found that as I try to decrease it, I can feel the difference. My motivation goes. And so I just have, I have chronic depression and so I just treat it. I don't have hypertension. I don't have, I, I had reversed my diabetes. So my chronic disease is depression. And so I just make sure I always treat it. 

[00:09:48] Dr. Gray, Host: Wow.

[00:09:49] Dr. Toomer, Guest: I've since then been able to use other mechanisms to treat it that aren't medication related. So it's made it easier because now I can be physical. and, but that came years later. but what I did during that time, Being, I just approached it in a scientific way because I needed to separate myself psychologically and emotionally for what I was doing.

[00:10:15] So I treated it like a project just to keep me focused. Like this is this, I treat it like a research project. And I wrote everything down. I documented everything, I would eat something an hour later. I checked my blood sugar document, how, what my blood sugar was, and then I would tweak it and see if they went lower or I tweak it and see if it went higher.

[00:10:36] And what I actually came up with was I learned what I could do for myself to maintain my blood sugar, lose weight. My weight came off just because my blood sugars were…  we know that, anyone who's read the Obesity Code understands ketogenic diets, understand why, but back then, those were not…

[00:10:57] Dr. Gray, Host: Right. And this is how long ago when you first started doing this, that was 20 years. 

[00:11:02] Dr. Toomer, Guest:  20 years ago. 

[00:11:03] Dr. Gray, Host: Yeah, I'm trying to think 20 years ago, I think carbs were okay. And, fat was the demon and, it was… 

[00:11:09] Dr. Toomer, Guest: Mm. 

[00:11:09] Dr. Gray, Host: A low fat, high carb food was the health craze at that time.

[00:11:13] Dr. Toomer, Guest: Exactly. And I knew that wasn't working for me because I was following an American Diabetic Association Diet and my blood sugars were not being controlled on that diet. So I knew it was not good for me. The carb content of it was still too high. And so what I did, I just documented everything. And then I started sharing that information with my family because I wasn't practicing at the time.

[00:11:39] So I wasn't using it with patients and family members were starting to, cause I mean, we're, we are just genetically predisposed for diabetes. It started helping my dad was improving, my mother, who is the same age as my father, just avoided diabetes altogether. Because she was always very health conscious and very plant-based diet conscious. And so she was able to prevent her diabetes and she's 90 years old now. And I think she just got put on medication.

[00:12:06] Dr. Gray, Host: Wow. 

[00:12:07] Dr. Toomer, Guest: And if even That's like half a pill of some, of a Sulfonylureas, if it's like barely nothing, anything. And so she, and then, over the years I improved, I, there, and then I homeschooled for a little while I did, we moved a few times. My husband became a partner of his radiology group. And so it was like, all these things started happening and so work wasn’t really that important for me, I was still focusing on surviving.

[00:12:34] And then about eight years after that, after I stopped, I was like, I can't do this anymore. I gotta get back, get my hands back in this.

[00:12:43] Dr. Gray, Host: Hmmm

[00:12:44] Dr. Toomer, Guest: And so when I did, I started helping my patients doing the same thing and we started seeing the same results. people  getting their hemoglobin A1C is the measure of diabetes, like half, walking in with a 14. And I was getting them down to six, and it was just over and over and over, and it was just happening.

[00:13:02] Dr. Gray, Host: Was this in the context of just the, like a FQHC family medicine practice. Okay. So you were able, I'm just more curious about that cause you, you, you had this health issue that's preventing you from working. Was it hard getting back into practicing clinical medicine or what was that?

[00:13:18] Dr. Toomer, Guest: My biggest hurdle was fear. I was worried that I had gotten rusty and that there was no way I could get back in, I'd only been out of residency a year and a half when I stopped. So I hadn't really gotten to the point where I was confident in my abilities. While I was in residency, I could tell my patients were responding to me when I graduated, I was working in my husband's hometown. So a lot of the people I was seeing were relatives. And so they were just like, anything I did was wonderful, cause I was there. They're just like a hometown girl, even though I didn’t grow up there  they were just so proud of the fact that they're there when their home grown had come back and brought someone with him.

[00:13:59] And so you know that with that. But, so when I decided to go back in, I was very, very nervous. I had talked to my husband. I was like, maybe I should go through some type of refresher course, or I should do something over the years. We've always discussed medicine. He was still practicing in radiology.

[00:14:16] We would talk about cases. He would see everything from everybody. And he would just say, Catherine, I'm telling you, you are fine. You could, you'll, you'll hit the ground. study the few new meds that have come out, which I had been doing. I'd been kind of keeping up on the new medications and which don't really change a whole lot for primary care. I mean, what we treat is the same, the names of the medications changed a little. And he said, you'll be fine. He goes, you're gonna, you're going to look back and say, you're right. And so when I started, it was just like, light bulb and I really, I, it just really was just seeing. 

[00:14:51] Dr. Gray, Host: Hmm,

[00:14:52] Dr. Toomer, Guest: I went right back in. And because most of what I do, a lot of family medicine, especially using what I, my bio-psycho-social background, the biology doesn't change. Human body biology stays the same, no matter how, whether you practice or not, the psychology doesn't change and being empathetic to the social aspects of what people are going through was me. That wasn't what I learned in medical school. That was who I am as a person. And so I found that there was very little of a learning curve when I went back. And mostly that was just because people were on medication and sometimes I had to look them up because I wasn't familiar with the name. I was familiar with the class of drugs, but I wasn't familiar with the new name of the drug.

[00:15:38] And that was, and I'm very comfortable saying, I don't know what that is. Hold on. Yeah. or having a book saying, I'm going to look that up because the last time I practiced that wasn't, we didn't have that drug. And so I'd look it up and I'm like, oh, it's a calcium channel blocker, I know what that does. So it really wasn't that bad. 

[00:15:53] Dr. Gray, Host: Yeah. I also want to just go back to that moment when you know, you, you had your pregnancy and then you realized that you were, you were sick, that there was something was going on. What did that, what did that feel like? I mean, cause I think most people, after they have a baby, don't expect to hear that kind of diagnosis.

[00:16:12] Dr. Toomer, Guest: Well, first I was in denial. I knew beforehand what I had. It took me a month before my symptoms got so bad that I had to address them. I recognized very early on when I got home that I could not lie down to sleep… orthopnea. I knew that that would mean one of three things. Either my lungs were compromised or my lungs and my heart were compromised or I was fluid overloaded still from pregnancy as I was, and then I started noticing when I would drink coffee, my symptoms would alleviate and then I would think to myself, okay, coffee has a substance in it that also helps lung function, uh, it's used in asthma medications, but it also is a diuretic, which is used in heart treatment. And so I was just like, kind of watching to see which one was with, which was happening. 

[00:17:12] I knew my symptoms. I knew it was happening as though two weeks later, I was like, okay, enough is enough. And so I went to the hospital, I called up one of my colleagues.

[00:17:24] I actually had privileges at the hospital. I called them up. It's like, I'm short of breath. I need you to check me out. And I called the pulmonologist. I was still in denial. I was not about to call the cardiologist. I was 36 years old. I didn't mind having pneumonia, but there was no way I was going to admit to having something wrong with my heart.

[00:17:41] And he listened to my lungs. He did a chest x-ray. My husband was a fellow at the time and my, I didn't really look at the x-ray that's how much in denial I was, I didn't want to look at it. And my, the pulmonologist said, you have pneumonia, we're going to put you on this antibiotic or give you this nebulizer and inhalers.

[00:18:03] And my husband was like, Catherine, to me, it looks like failure.  He was like your chest x-ray. It looks more like failure than pneumonia, he goes, but I'll defer to the more experienced radiologists. Well, neither one of us ever went and looked at the report. 

[00:18:17] And two weeks later I did because I was in the hospital with,  I ended up going to the hospital by ambulance when I was, so my lung capacity was so severely compromised, I couldn't urinate. I couldn't produce enough pressure to urinate and I knew then something was wrong and that I was beyond the point where I could be in denial anymore.

[00:18:41] uh, I called 911, and an ambulance came. My oxygen level was in the seventies. My heart rate was like the one 140 and the strange thing was, is usually what the type of heart failure is. I have the first thing that happens, your lungs fill up, true, but then also your legs. Well, my legs never did. They still don't.

[00:18:59] Even when I go into…I’m symptomatic, they never had. And so there was still this level of denial that I could possibly have some type of pneumonia and, but a good friend of mine was the cardiologist at the hospital. And he was just like Catherine, I was still nursing. It was that early after my daughter and I was nursing. I had, I had nurse, my older daughter until she was two and a half. So a month in, I never used formula. Didn't know what formula could, and there looks like you have to stop. Now, we've got to put you on a medication that's toxic to your baby. Stop. And I'm like, what do I give her? So I was sitting in the emergency room, terrified, crying, nursing my child for the last time.

[00:19:46] And the nurse was like, give her to us. We'll figure out what she can take. Fortunately, I was in a place where people knew me and they respected me and they just really rallied. But, I could tell that everyone else was scared for me. And so that scared me and I was, I just knew, I knew that I knew the statistics that I had, that, a lot of, many of the women who are diagnosed with what I had die. Uh, my first patient that I lost as a resident. I was on my pediatric rotation. She was 17 years old and had just had a child, was diagnosed with postpartum cardiomyopathy, went into an arrhythmia and died. So I knew that could easily be my history. And, of course my husband being a physician also knew. And so we were just scared and very overwhelmed.

[00:20:42] And I, but I had a two and a half year old who started talking very early. So by the time she was two and a half, she understood any conversation that was going on around her. And so we kept her out of the hospital initially, but then she was just like, look, she, in her mind, I had gone back to the hospital to have another baby because I had just come out of the hospital with the baby.

[00:21:02] So her thing was, Ooh, goody, mommy went back in the hospital, I'm going to get another sibling. 

[00:21:06] Dr. Gray, Host: Uh,

[00:21:08] Dr. Toomer, Guest: So they eventually let her, brought her to see me and. She just kept saying, mommy, what's wrong? What's wrong, what's wrong, what's wrong? And she could tell something was wrong. And so I just explained to her that I wasn't doing very well, that I may be sick, but I was going to get better and not to be worried.

[00:21:22] And her thing was okay and so getting all the help I needed suddenly became her new normal. And of course my depression worsened. And because. I was told not to do anything that I was to rest. It was very easy to hide because I could just sit and do nothing.

[00:21:42] Nobody I didn't have to get up to go to, I mean, the only time I needed to move was to go to the bathroom, to bathe which I needed help with because I was too short of breath to bathe myself… 

[00:21:53] Dr. Gray, Host: Wow.

[00:21:54] Dr. Toomer, Guest: to take care of. Children so I would sit and read to my daughter, which he loved. So that was nice because I could still do an activity that she loved with her, but I was still a little short of breath. I mean, when reading to her. And I started getting very good at understanding my medications. I, when using cardiac meds, there's an order. That in taking them that maximizes their efficacy. And so I started doing that. I started playing around with the order in and say, I started realizing I didn't have high blood pressure, but a lot of the medicines I had to take affected blood pressure.

[00:22:37] And so I had to figure out ways of splitting them up so that they were still effective, but they still didn't drop my blood pressure too low. And I still do this today. I'm still on medication 20 years later. 

[00:22:46] Dr. Gray, Host: Hmm.

[00:22:47] Dr. Toomer, Guest:  And I still do that. I split them up based on side effects. I can sleep through some, some I have to have during the day. And then I have some in the middle of the day. And, and, and I that's what I've just done from that. It just made me one, very grateful. The other thing I learned was that my emotions are directly tied to my symptoms.  The calmer I am, the less symptomatic I am. More upset, I get my symptoms worsen. And so I learned very, very quickly how to choose my battle.  I had no choice. I realized what was going to kill me was not going to be some out of some unknown event that was going to come out of nowhere. It was going to be an event that I created by not getting my, keeping my emotions under control because every time I got upset, my palpitations started  I could tell and I became very Zen…very, very Zen.

[00:23:52] Dr. Gray, Host: Wow..

[00:23:53] Dr. Toomer, Guest: And it worked 90% of the time, it works. There's still those moments, I'm still but I mean, I got very good at counting my blessings. In most situations I can look at the situation and say, because of this, this is what happened. And even as I was going through it and I was documented, I was like one day, Catherine, you're going to rely on this for something.

[00:24:17] And so what happened as I was using the, my program that I had developed with my patients, I could tell I needed more time with them to get him to really get the full benefit of it, but I couldn't do it in the system I was in. And so I opened up my own office. So Health Wellness And Weight Loss Centers developed out of that experience.

[00:24:41] And so every time I see the name, it reminds me, what a blessing of a life I've had and I'm 56 years old right now. I still have congestive heart failure. I still have chronic depression, and yet I am happier, stronger, feeling better than I ever have in my life. And, the only thing I have to fight sometimes is that feeling of running out of time.

[00:25:16] Dr Gray, Host: Wow, Dr. Toomer, what an amazing story and what an amazing human being. I'm so inspired by your story and by how you took control of your own health. I can't wait to share part two of this conversation. Stay tuned. That will be next week's episode. 

Dr. Weili Gray, Host 

Thanks for listening. Make sure you hit subscribe so you don't miss another episode. If you liked this episode, please share it with a friend and give us a five star review so we can help more physicians dare to dream and create their most abundant lives. There's also exciting news at the Dare to Dream Physician. For those of you who wish to get clarity on your own why and get energized as you explore, envision and create your dream life. I'm so excited to announce that I'm taking on a limited number of one on one clients for life planning. To get the complete details and sign up for an exploration meeting. Go to my website, daretodreamphysician.com. I really look forward to working with you. And it would be such an honor and privilege for me to be able to help you create your life plan. I truly believe that life planning will transform your life and will give you that energy to pursue your dream life sooner than you ever imagine. See you next week