Memory Series 3/3: all about care partners

ADM_007_Samantha Culler_1.0

[00:00:00] Dr. Mia: Welcome back to Ask Dr. Mia podcast. Today is the third of the three part series on memory. And I have a special guest, Samantha Culler, who is with me today. We work together, but neither one of us are speaking on behalf of our employer, which is atrium health, wake forest Baptist. Samantha, would you like to introduce yourself?

[00:00:23]  Samantha Culler: Sure. My name is Samantha caller and I. Clinical director of the memory counseling program at atrium health wake forest Baptist. And I have been with the program since 2018.

[00:00:38] Dr. Mia: Wonderful. And Samantha, how did you get into counsel?

[00:00:43]  Samantha Culler: I've always had an interest in helping people and in psychology and mental health. And when I graduated from undergrad, I started working in psychiatry at the wake forest university school of medicine on various research projects, providing interventions and.[00:01:00] and research assistance and ended up in different sections of the hospital.

[00:01:05]  Samantha Culler: Mainly in gastroenterology and I saw how chronic health conditions affected people psychologically. And I thought I would really love to help people through this. And so. I actually left for a little bit and then came back and worked part of my time in grad school. But but my goal was always to work with people with multiple chronic health conditions and then through my job directly out of school graduate school that is, I ended up meeting the memory counseling program and the rest is history.

[00:01:40] Dr. Mia: Wonderful. And for some of our audience who may not know the difference between a psychiatrist, a clinical psychologist versus your degree, which is a licensed clinical social worker. Can you briefly tell us what the differences are? 

[00:01:57]  Samantha Culler: this is going to be a really quick overview, but [00:02:00] a psychiatrist is typically a medical doctor who can prescribe medications, provide interventions. A psychologist typically has a PhD or a C D, and they can provide interventions to my knowledge. They still can't prescribe medications. but they can also do a lot of psychological testing in addition to counseling And then a licensed clinical social worker or a licensed clinical mental health counselor can actually, a lot of the things that psychologists can do.

[00:02:30]  Samantha Culler: However, we can't do certain testing and diagnostics that they can do. And we primarily provide psychotherapy, so different psychotherapeutic interventions.

[00:02:40] Dr. Mia: Wonderful. Yeah, that is a great explanation. And I know the memory counseling program at atrium health wake forest Baptist is a rather. Unique program where it is providing mental health and care partner support for people who are living with memory loss, including [00:03:00] various types of dementia. And this is something that I think it's oftentimes just left for the families to figure out for themselves.

[00:03:09] Dr. Mia: Do you wanna say kinda a little bit more about the type of work that memory counseling program does? Yeah.

[00:03:17]  Samantha Culler: So we provide we're. So whenever I talk with people, they'll say, what people being our clients, the care partners and the people with the diagnosis that we serve, they'll say, well, what's the difference? You know, I just saw somebody across the hallway from you guys. And you know, my answer is usually we're more of the supportive arm, meaning that we provide emotional support and resources and whatnot, and we provide individual counseling which is also known as psychotherapy.

[00:03:44]  Samantha Culler: We also provide support groups. And I think it's important to note that our support groups are unique and that people still come and talk about their successes and challenges for the week, but there's also an educational component. So Dr. Shaw who created our program created curriculum for [00:04:00] support groups, for people caring for those with dementia and a team has part of our team has also created A support group for people who have the diagnosis as well.

[00:04:10]  Samantha Culler: And we also provide educational services. So if someone doesn't want counseling or a support group, they can come one on one with us and learn more about how to help manage behaviors, how to have self or how to engage in self care. More about the diagnosis to the extent that we can help. And we also refer out to other resources.

[00:04:28]  Samantha Culler: If we can't help someone, we get them where they need to.

[00:04:32] Dr. Mia: Thank you for that great summarization. And I will put the link to the memory counseling program as well as Dr. Shaw's books in the show notes. So be sure to check that out later. So transitioning a little bit into the actual counseling part. I feel like that is oftentimes. Riddled with some misconceptions about counseling.

[00:04:54] Dr. Mia: Some, patients may feel like, well, I don't have a mental health issue or I'm [00:05:00] not crazy. What do you tell your clients who may be a bit apprehensive about counseling?

[00:05:06]  Samantha Culler: Yeah. So, you know, of course it's all voluntary and when people come in and they're not sure if they want education or counseling we do an initial consult visit with people and we really kind of fill out what they, what their needs might be. And when people are a bit uncertain about it I always ask people do you have any reservations?

[00:05:25]  Samantha Culler: Do you have any concerns about this and we just address it head on you know, I do often hear people say I'm not crazy, or I think I am crazy. And I, my answer to people there is, I am trained to assess that. And I have yet to meet someone who is truly crazy so I tell them we don't use that word.

[00:05:42]  Samantha Culler: and that usually adds some humor to it. And I think that helps bring down some walls. I think there are a lot of misconceptions. So we try to address those that, you know, we, you, we have the picture I think about, you know, the far side pictures and whatnot of. Laying on a couch and talking [00:06:00] about their problems.

[00:06:01]  Samantha Culler: And we think of, you know, for and psychoanalytic theory and, you know, it's just so different. And I think sometimes people are very shocked when they start to talk with us. And I, think it helps too, that we bring our authentic selves. to the therapy. So it doesn't feel cold and clinical. I had someone one time, I said, you know, have you done therapy before?

[00:06:20]  Samantha Culler: What were your pros and cons about it? And they said it felt cold and clinical. And so I tried to make sure it feels warm and fuzzy. Like they're walking into their grandma's house. You know, I wish I could offer them milk and cookies, but I can't . And so I think it's really helping people and, and extending.

[00:06:36]  Samantha Culler: Really extending your heart through words to people and helping them become more at ease with the process.

[00:06:42] Dr. Mia: That's wonderful. And that's such a needed service. I know that most people cannot find a memory counseling program near where they are. Can you tell us a little bit about kind of the typical structure of caregiving support groups and what are some kind of [00:07:00] unique aspects of the type of caregiving support groups that you guys.

[00:07:04]  Samantha Culler: Yes. So the caregiving support groups that we run, we start people off with a 10 week curriculum group. So the curriculum that you're going to link the courses, or I should say the courses, but each support group session is an hour and a half, one day a week. We typically run them on Thursdays, but it's an hour and a half and people come in and within the session they check in, they talk about their successes and challenges for the week.

[00:07:32]  Samantha Culler: and then there's an educational component to it. And I need to back up a little bit too. We typically start each session with a mindful moment. So we teach people how to breathe, how to relax which I think is a very useful skill to take away. And then we do the check-in. Then we do the educational component.

[00:07:48]  Samantha Culler: Sometimes that educational component is provided by people who are you know, experts in their field or they, for instance, sometimes we have an elder law attorney. We, I know Mia, you have talked with our groups [00:08:00] before, About the brain and about what dementia is from a medical standpoint.

[00:08:05]  Samantha Culler: And then at the end of the groups, we conclude with another mindful moment. and then we adjourn. So those groups go for 10 weeks. And after the 10 weeks there are monthly maintenance groups we also have right now, a group support group for people who've been through our program, or who've lost someone to dementia.

[00:08:24]  Samantha Culler: And they can come in and have that in common to talk about. So those are our support groups. That's a quick overview of, what we offer.

[00:08:34] Dr. Mia: That's wonderful. Yeah, I think grief is so common, but oftentimes there may not be an opportunity to be led by a professional who may be able to help people go through their grieving process. And I feel like grieving in the company of other people who are also grieving may be particularly healing rather than grieving on your [00:09:00] own.

[00:09:01]  Samantha Culler: Absolutely. And I think there's something to be said about our support groups. I've done support groups in a lot of places and. And they were great. I've never seen support groups like this. It's like a treatment group meets a support group and just the cohesion that happens so quickly, you know, we talk about the stages of group development, but I just see that everything happens so quickly and people, you know, meet outside of the group, they have lunch you know, they really create these bonds and there's something to be said, I believe about.

[00:09:36]  Samantha Culler: Being around people who are going through what you're going through. And, you know, from my own caregiving experience, my mom passed away last year from cholangiocarcinoma, which is BI duct cancer. And I remember just feeling so alone in this, and it's so rare. And I think that's how people, especially with certain types of dementia feel it's really you know, it's so disenfranchised sometimes in our society.

[00:09:59]  Samantha Culler: And [00:10:00] I was personally, I was sitting at Duke university mom was eligible for a liver transplant, which is the primary treatment for that type of cancer. And you know, these ladies just pulled me in and started talking and our experiences were so similar, you know, and. You know, even some of them weren't there for COIO.

[00:10:19]  Samantha Culler: But just to know at that moment, I thought this is what our support groups are like for people. This is that aha moment. And I, and you know, you know, it and when you're leading the groups, but in that moment, you know, I just became tearful and I thought this is why we do what we do. We need people who are going through the similar journey to us.

[00:10:38] Dr. Mia: Yeah, definitely. And thank you so much for sharing your personal journey as a care partner for your mom going through her cancer treatment. But that must be a very unique perspective to be a professional counselor, helping other family members go through a life changing diagnosis, like dementia, and then have to go through a life changing [00:11:00] diagnosis, like cholangiocarcinoma with your mom. Were there aspects of that caregiving journey that you feel like was surprising to you?

[00:11:13]  Samantha Culler: Yeah. So that's a good question. I do feel like there were aspects. I think the whole thing was a shock at first because you just don't think, well, first of all, I'd never heard of it. So then there's the educational component of, you know, what is this? And mom had been sick for years and then to get news like that, I mean, we knew she was really sick.

[00:11:31]  Samantha Culler: We didn't really ever know what was going on and to get that news is just a shock in itself. And then we're, we were in the midst of pandemic. It was late August, 2020. And you know, we are just trying to survive a pandemic and now we have this thrown in on top of it. So for me, it was a bit of a shock you know, trying to learn about the diagnosis.

[00:11:51]  Samantha Culler: I think sometimes, you know, from my personal experience, there was the assumption that. You know, people know or doctors think [00:12:00] because you work in the medical field, maybe I'm making an assumption again. I don't know that, you know, what this is and you know, and I'm not even a doctor . And so, it was a lot of relying on, I was very fortunate to know people who could help me through this and.

[00:12:17]  Samantha Culler: I could give a shout out to so many people right now, especially you know, Dr. Cook was the one who found the cancer in her. He works in gastroenterology. And so, but the shock, I think, was just how fast everything happened. And then it was like, everything was hurry up and white and You know, I, think, you know, I try to relate my experiences to help other people and make meaning from that.

[00:12:44]  Samantha Culler: and just some of the ambiguity sometimes. And I think about that with the dementia diagnosis and helping care partners through the ambiguity sometimes because there can be that, that mixed diagnosis, those mixed features. And you know, I started to understand when there's, and you know, more or [00:13:00] less common diagnoses, like the.

[00:13:02]  Samantha Culler: Frontotemporal dementia or the lewy body dementia. And people will say, well, what is that? You know? And or I'm having, or there, my loved one's having symptoms of that. And so I think it's really given me a new perspective on how to I mean, of course we can always empathize, but I think it really drives it home when you're helping someone else learn about this diagnosis.

[00:13:23]  Samantha Culler: They've never heard of before.

[00:13:25] Dr. Mia: Absolutely. I think we forget how much medical knowledge we kind of come in contact with, even if we don't necessarily have a professional degree, like I don't have a counseling degree and you don't have a medical degree but we still learn a lot just by, in the company of working in the medical field.

[00:13:44] Dr. Mia: But certainly, you know, you also played the role of being a daughter to your mom going through this process. And how did you navigate the professional medical role versus [00:14:00] being your mom's daughter?

[00:14:02]  Samantha Culler: So that was difficult sometimes. And it was difficult from various. Because, you know, I was fortunate to work at the medical center where I'm just, you know, vigorously looking up journal articles and I'm looking for treatments and I'm looking for some kind of solution or some kind of answer. And I often have clients who come in care, partners of people with dementia, who come in and do that.

[00:14:23]  Samantha Culler: They're looking for this miracle cure and this answer and. You know, I hope one day that it's there for, for all of these diagnoses you know, in balancing that role is difficult to you know, there are times when, so for instance You know, sometimes I think family members will ask your advice on things that you really can't give

[00:14:41]  Samantha Culler: And because again, because I'm not a medical doctor and it's almost, you know, like you're sort of expected to know, but. Also will people take that advice because you are still family? So there's like a catch 22 there that people will ask and may or may not take the advice or may not take the help.

[00:14:58]  Samantha Culler: It was a very humbling moment [00:15:00] for me, my mom and I have always had a very close and trusting relationship and. She would turn to me and that was different. And that's when that role I realized the roles were starting to change. She would look to me for understanding or look to me to ask a question because she, was too tired to, to ask and she also had a bit of white coat syndrome.

[00:15:19]  Samantha Culler: And so she would kind of clam up whenever we were in a medical office. And sometimes, I mean, she was very sick, but sometimes It was difficult for them to assess where she was, because it was hard for her to verbalize because she was scared. So it's becoming that voice for the person you love. And that can be very difficult when we've seen our parents as these powerhouses of protection and knowledge, and now they're turning to us.

[00:15:46]  Samantha Culler: And so we wanna make sure that we're making the right decisions. And my unsolicited advice to people is, you know, Find get as many opinions as you can. Or as you, whatever makes you feel [00:16:00] good, find, you know, medical providers to partner with who you trust. I was very fortunate that her primary care doctor I've act actually in full disclosure, worked for him at one point.

[00:16:10]  Samantha Culler: And he is just phenomenal. I worked with her gastroenterology doctor and then just. The whole, just really building that team. You're building that team of support. So although I didn't have a medical degree, I tried to utilize what I have. And I also reached out, you know, someone reached out to me from another department at the hospital and you know, there's a lot of disagreement sometimes.

[00:16:33]  Samantha Culler: And I think this is a little different with dementia, but they said, you're going to get a lot of differing opinions. You need to. Hitting the ground running, and you need to call everywhere that you can in this country. And I did you wanna not have any regrets in this and you wanna make sure that you're getting the best care possible.

[00:16:52] Dr. Mia: Absolutely that role of being the advocate for your loved one. I think it's something that a lot of us. As [00:17:00] adult children have either experienced or starting to experience. I know in my personal family, I am definitely I get that juxtaposition of sort of being the expert, but not quite the expert.

[00:17:14] Dr. Mia: Like you tell them something and then they don't take your advice. So I'm like, well, why did you ask me anyway?

[00:17:19]  Samantha Culler: Yes.

[00:17:22] Dr. Mia: not quite enough, doctor. But not, you know, also more than just, you know, a non-medical siblings, so that's definitely, especially also for people who might have immigrant parents or different generation where they might not be as familiar with the medical terminologies. And you feel like you're almost translating.

[00:17:47] Dr. Mia: What the doctors have said to your loved ones, because even though everyone is speaking English I can only imagine how much more difficult that could be for someone where they're not fluent in English and [00:18:00] might, have additional. Difficulty in understanding what's happening, but that role as a family advocate, I really do think that is so important and not having someone to advocate for you.

[00:18:12] Dr. Mia: It's very scary in this very complex healthcare system.

[00:18:17]  Samantha Culler: Absolutely.

[00:18:19] Dr. Mia: And I, I do wanna get back to what you said about kind of the ambiguity of diagnoses. And sometimes I think people who don't work in dementia clinics or memory aging related research don't necessarily understand that. There are actually a lot of overlapping dementia diagnoses.

[00:18:41] Dr. Mia: In fact, Alzheimer's disease is very commonly overlapping with vascular dementia. There could also be a lot of overlapping between Alzheimer's dementia and Louis body dementia. I always get a little nervous when I try to say that people might have features of different diseases and. [00:19:00] But it does make sense that as a human being, where we are the full spectrum of our uniqueness, we don't necessarily fit completely into one specific type of disease.

[00:19:15] Dr. Mia: And even, and it goes beyond just kind of the individual. Features of a disease presentation. I think when doctors and scientists look at people's brains on autopsy afterwards, there are oftentimes features of multiple different types of dementias. And that's one of the reasons why it is so difficult to find a cure because it's not just one single.

[00:19:39]  Samantha Culler: Yeah.

[00:19:40] Dr. Mia: Yeah. I wanted to ask you kind of about what are some common resources that you would share for caregivers who might want to learn more about how to regulate their own emotions, to be the best care partners for their loved ones when they're going through [00:20:00] a serious. Illness. And if they don't necessarily have the type of memory counseling program, like you work in where would you suggest people turn to.

[00:20:11]  Samantha Culler: I would suggest, and I've, I've had to do this before, when people are out of state. We do have people because our program is so unique. We have people who come to us from all over and we unfortunately can't see people from other states for differing reasons, but I. You know, I tell them to look for someone who preferably serves older adults or people with a diagnosis, if somebody is advertising that in their area and to, you know, check their credentials, of course but find a therapist and I think it's most important too, to find a.

[00:20:40]  Samantha Culler: Therapist who understands that journey, or even if they haven't worked in it, who is willing to learn you know, if you bring them some material or you tell them about it, they're willing to read up on it or learn more. But also someone that you have good, that you would have good rapport with. So sometimes you have to shop around a little bit.

[00:20:57]  Samantha Culler: It doesn't mean that this person's a bad [00:21:00] therapist. It doesn't mean that you're a bad client. It just means that it's not a good fit and it's not where you're supposed to go at that. You know, I'd also say to not be afraid in that counseling to address things in the past. I've actually had conversations with several people this week who were shocked that along the caregiving journey, that they realized that some other things were UN surfacing other past traumas.

[00:21:26]  Samantha Culler: And they're like, why is this so triggering? And so we work on that. We don't happen in a vacuum. We can't compartmentalize our life all the time and sometimes things just happen in tandem and other things start to come up. You know, I'd also suggest too you know, a lot of times people come to us and there's a lot of guilt and typically it's inappropriate guilt.

[00:21:46]  Samantha Culler: You know, really when you're having those negative thoughts, challenging having caregivers care partners, challenge themselves. Challenge those negative thoughts because you know, I'm sitting with clients and I'm hearing these [00:22:00] wonderful things they're doing for the people they're caring for. And I don't know that they always see it the same way, because we are so hard on ourselves.

[00:22:07]  Samantha Culler: We're tired as one of our caregiving And I'd also recommend too looking for help before you need it, filling out paperwork when someone can, you know, advance directives and whatnot power of attorney, paperwork, living wills estate wills, before you really need all this stuff. But especially these advanced care documents you know, doing these things and thinking about getting help in the home or.

[00:22:31]  Samantha Culler: Living communities before you need it. You know, care partners are at least 40% more likely to have a major medical event or die before the person they're caring for. And so, you know, that's a large number and sometimes I use that statistic to help drive home self-care because often care partners cancel their own appointments.

[00:22:50]  Samantha Culler: They don't take care of their own needs and that can really lead to some serious complications down the road. So helping people with that, I would say, take care of your. You know, if [00:23:00] the tanker doesn't come to fill up the gas pumps, then you can't get gas from the pump, you know, . And so, we, you have to make sure that the tank's full before you can refuel even someone else.

[00:23:11] Dr. Mia: Yeah, absolutely. I think it's, I think we, people here. That they need to take care of themselves. It's definitely something that they intellectually hear, but I don't know if people actually make that into real actions or if they really believe that they're doing everything they possibly can. Obviously, hopefully caring healthcare professionals are.

[00:23:36] Dr. Mia: Saying validating words, like, I always try to tell my care partners that they're doing a great job and it's almost always something that brings them to tears. And I make a joke that I make people cry because they oftentimes never hear that they're doing a wonderful job from. Anyone much less their loved one’s doctor, which is [00:24:00] really sad because I think if you ask someone to list out all the things that they're doing for their loved one, with memory problem, or with other serious medical illness it can go on for pages and. And it's oftentimes women, whether it's spouses or daughters daughter-in-laws, who are oftentimes the hardest on themselves, even when they're doing the most that they possibly can, in a very challenging situation.

[00:24:31]  Samantha Culler: Absolutely. And I think about when you're saying that Mia, I think about you know, Alan Wolfelt's eight central needs of care partners. And I know Ed has used this in, in his book for dementia care partners, but. You know, one of the big things that we work with people on is asking for and accepting help, so that accepting help piece from others.

[00:24:50]  Samantha Culler: That's a really hard thing to do because sometimes we don't know what we need. We know we need something, but we don't know what it is. And what I have found is that when I work with families and I'm [00:25:00] making out plans and goals, the more specific we can be, who's going to do it. When are they doing it?

[00:25:05]  Samantha Culler: How often? Is there a specified time? And, you know, is there a schedule creating that? You know, a personal example I have is when we were caring for my mom, my dad and I, and you know, we had family, you know, asking to help. And we really, at first weren't sure what to ask for, you know, I, I have one aunt who It's just like this born caregiver and we had multiple aunts who helped.

[00:25:26]  Samantha Culler: But so if they're hearing this, thank you. to all of them, but I'm thinking about one aunt. I called her one day because dad and I were arguing a little bit, you know, nothing major, but I didn't really want to develop, but we were tired. Mom was so sweet and kind and not really difficult to care for.

[00:25:42]  Samantha Culler: It's just that sometimes people's needs are 24 hours a day and you're not getting consistent sleep. So I called my aunt and I said, I know how you can help. I need you to come over around two o'clock. I need to go home and get rest. And dad needs to go to a different room and sleep. Whether it's the [00:26:00] bedroom or wherever it might be, he just, we both need to get sleep.

[00:26:03]  Samantha Culler: Can you come over? And she said, I'll be there and I'll bring lunch too, you know? And so, it, sometimes people are happy to really to get involved and. You know, the other thing I wanted to add is helping people grieve their losses. We think of grief and mourning as it relates to death, but there are a lot of changes, you know, there's adapting to these changing relationships.

[00:26:23]  Samantha Culler: And the dynamics, whether they, these are intimate partners or a friend or relative caring for someone or adult children and the parental role is changing. and you also want to grieve those agree, the various losses that you have along the way too, but giving yourself time and space to do that.

[00:26:41]  Samantha Culler: I want to add one more thing, Mia, I'm sorry to dominate so much. I'm just really passionate about this. The self care piece. When I talk with people about. The first thing they say is, well, I don't have time to get a massage. I don't have time to get my nail. I wish I did. And you know, I think it's good to clarify what self-care [00:27:00] looks like for every person, because I wish everyone could get a massage.

[00:27:03]  Samantha Culler: If I could send people to do that and write a prescription for it, I would. But I can't. But what I can do is help people define what it looks like for them. And sometimes it looks like getting a shower because you've not been able to get that shower. you've not been able to pull away long enough to do that.

[00:27:18]  Samantha Culler: And sometimes it looks like going through that stack of mail, that's piled up something just so simple. But that can become really hard to complete.

[00:27:28] Dr. Mia: Absolutely. And I think I think people who want to offer help really should try to offer. Potentially specific ways that they're willing to help, because it's very difficult for the person who is going through, you know, a serious medical illness or dementia and their immediate family members to kind of come up with all of those options.

[00:27:50] Dr. Mia: And people might be asking, you know, when rather than, you know, let me know if you need anything. probably a better question would be [00:28:00] when would be a good time for me to bring over dinner or when would it be helpful if I pop over and keep your loved one company for a couple hours while you run out and go to the grocery store or just, you know, not be.

[00:28:13] Dr. Mia: Caring for someone for a couple hours. I think those could be really very helpful ways for other family and friends to, to be caring partners. So.

[00:28:26]  Samantha Culler: Absolutely. And I, you know, I think about some of the things that we were asked one of my mom's nurses actually turned out to be one of my friend's husband. And we. Pretty much grew up together and he called one day and he said, Sam, I'd love to come over and help you change your mom's bed. And it's so specific.

[00:28:43]  Samantha Culler: And I. Yeah, we really need help with that sometimes, you know, and so, you know, to accepting those things and for people to know what to ask was just was great. Or, you know, I think being direct too, I'm at the grocery store and I'm picking up this and [00:29:00] that. I'm gonna pick up things for you. So just tell me what you want.

[00:29:03]  Samantha Culler: And I've done that for people before, too. And so instead of getting something they won't eat you know, They're more likely, I think, to tell you at that moment, because you're there and you're on the way, you know, you're, already in roots.

[00:29:14] Dr. Mia: Right. It seems less like an in. To have someone run to the grocery store, but if you're already at the grocery store might as well. Yeah, exactly. Well, I know we can definitely go on for hours because it's something that we're both very passionate about, but I do have to conclude I will definitely post the eight central needs of care partners.

[00:29:39] Dr. Mia: into the show notes, cuz that's new to me too. I think that would be really helpful. As people thinking about how to be the best version of themselves to be the best version of a partner in support of their loved ones. Is there anything else that you like to say in conclusion?

[00:29:59]  Samantha Culler: [00:30:00] No, I just really thank you for giving me this opportunity and I could probably talk all night about it. So, but thank you so much, and I'm glad that you're going to post our information. If people are interested in our services, they can call and talk with our patient experience coordinator, Beverly Ingram.

[00:30:15]  Samantha Culler: And we would love to help people if they need that.

[00:30:19] Dr. Mia: Absolutely. Thank you so much. And if you enjoy listening to this episode, please share this. With someone you love or add a review on apple podcast. That's usually how other people who might be interested in certain topics get exposed to new podcasts and turn in for the next one. Thank you so much.