Podcast: Integrative care for women in midlife

Shanna Konz, NP, specializes in working with women in transition

Shanna Konz, certified nurse practitioner, talks about integration of midlife care at Sanford Women's

Episode Transcript

Courtney Collen (Host): Hello, and welcome to another edition of the Sanford Women’s Podcast, Her Kind of Healthy. I’m Courtney Collen with Sanford Health News. Today, we’re talking all about midlife care. Shanna Konz is a Women’s Health Nurse Practitioner here at Sanford Women’s and we are just delighted to have her joining us for this conversation. Hi Shanna.

Shanna Konz: You for inviting me. I’m excited to talk about this exciting new service we have going here at Sanford.

Host: Yeah, I can’t wait to learn more and I want to do that as soon as we learn more about you and talk about your background, your career up to this point, and what you specialize in here at the Women’s Plaza?

Konz: So, I started off my career as a nurse, a registered nurse, where I worked in the Twin Cities area, working in labor and delivery, level two nursery. I worked there for about three years and then in an effort to be closer to my family, moved here to Sioux Falls and started working at Sanford. I’ve been here for 13 years. So three of those years as a bedside nurse in the NICU. And then I went back to school to become this women’s health nurse practitioner. I spent two years working with high risk OB, which was very fun. My first career out of nursing school, learned so much. And then just having my own experience with struggling with fertility, it was an easy transition to also help women just like me, and I worked seven years in the reproductive medicine realm. Then just this opportunity presented in January here to really help Sanford with an idea of developing a clinic, and with reproductive medicine, you deal a lot with hormones. Hormones are amazing signals. It’s how our body functions every day. And it seemed like a great transition to also transition into the next stage of life for women, which is the perimenopausal and menopausal years.

Host: Yeah. And I’m looking forward to learning more about the care that Sanford Women’s is providing and will continue to grow on as we move forward. But I want to ask you what you enjoy most? You’ve obviously had a lot of experience working with female patients, and I want to know what you enjoy most about your role?

Konz: I love I’m a relational person, so I love really knowing a patient beyond just what, his or her chart says. Being able to develop that really personal relationship with them, I feel really does help to direct their care even better to personalize it, and just be their advocate for whatever stage of life they’re at.

Host: So, let’s talk about this midlife program and Sanford Women’s is in the process of establishing a program to become sort of a one stop shop for patients at this stage in their life, this midlife stage. Tell us more about what that will look like.

Konz: Our OB GYN physicians and nurse practitioners, or PAs as well as primary care providers have traditionally and will continue to give care for the midlife patient. We also though wanted to create an opportunity to extend the length of those visits and really have that opportunity, which I love to get to know the patient better and get down a little bit deeper to what is the biggest issue that they’re facing. Menopause is an inevitable, but it doesn’t have to be miserable for women. And so we are excited to be able to spend time with them, really empower them, educate them so that they know what to expect and really help drive their care for the years ahead, some of the most problematic symptoms that women can have once the menopausal years start to approach are vassal motor symptoms. So like hot flashes, which can make it very difficult to sleep, and they can be very problematic.

Menopause isn’t just a year transition. It really starts in the perimenopausal years. So those are the years leading up to menopause. Menopause is, is defined by one full year without a period, but the perimenopausal years can last for many, many years prior to that. So to live with those hot flashes can be very problematic and stressful. So we want to go through various options with that. There can also be genital urinary symptoms that can be problematic, that can lead into intimacy issues, libido issues, sleep becomes an issue and all these kind of compound on each other, but then mood disorders are more prevalent as well. So through various conversations, we really want to see what their thoughts are in their care. And we do have a new paradigm of care we’re wanting to adopt as well. And that’s called integrative medicine. Are you very familiar with integrative medicine?

Host: No, but tell me more.

Konz: Okay. So integrative medicine is combining traditional medical practices along with more holistic or Eastern medical practices. There are evidence-based. But it does give us an opportunity to give, put more in the patient’s court. Maybe give them more tools to help with things like stress management. We’re offering guided imagery sessions, mindful meditation. Both of those really helped to stop that cycle of thought and stress that happens. Our minds run constantly. This puts that hard pause on those anxiety provoking thoughts and helps just to take a step back and even breathe. Other services we’ll be offering is just education on aroma therapy. That’s kind of hot on the market now, but there is the right way to use those as well. And so we’re excited to have that as an adjunct to other treatment. And then also acupressure. So the acupressure is basically putting pressure on different locations that can give help to different ailments. So those are the main ones we’re starting with. We do anticipate additional growth with this too. There’s talk about bringing an acupuncturist in as well. So we’re excited to see how this is received by the clients as well.

Host: Yeah, this sounds like a lot just well-rounded care for a female patient and really exciting to see how it all plays out and what that response is like. So, many questions, first of all, define midlife. And when it comes to a woman’s health, what’s that age range? What is that stage look like?

Konz: So middle life tends to be defined as between the ages of 40 to 60, if you go by different spans of life. The midlife woman though, does not necessarily have to be 40 years old. There can be other issues that can cause women to go into having menopausal or midlife type symptoms that being sometimes women who have had chemotherapy or radiation can really put them into an induced menopause. Sometimes there’s a surgical induced menopause where the ovaries are removed. And sometimes women are just born with certain genetic conditions that might make them more prone to earlier menopause. So if you’re looking at ages menopause tends to be the age of 51 and a half. And they say, you know, it can extend into the sixties as well. And our goal would be even once those perimenopausal symptoms start introducing themselves, you know, you don’t have to be a certain age. We’re ready to do that workup and figure out how what’s going on with those hormones and how to help the patient.

Host: So, one thing I never thought about was that transition from OB GYN care to maybe a primary care physician or family medicine, you know, internal medicine. So at what point would a woman start to think about maybe moving on from an OB, a gynecologist and into something else? And what would that something else be for a woman who is approaching that 40 years old range?

Konz: Right. That’s a tough question because every woman loves her OB GYN, cause there’s lots of good memories that are bright and very good care to get them through those years. Some might say that you may want to consider doing that after the reproductive years are over, especially if you have a different chronic medical condition. The OB GYN group here though, is definitely able to continue to care for women beyond just the pregnancy years. They do see a lot of women for menopausal type symptoms as well. Even Dr. Landin has an intimacy clinic that is very helpful for women throughout the lifespan. I would say once those more chronic conditions start to come in, and maybe when you’re looking at other screening things like exams such as like a colonoscopy, that might be a good time to get established with someone who can also organize your care when chronic conditions, if they do start to step in.

Host: So, let’s talk about COVID-19 now that we are months into this pandemic, what are you hearing from middle aged women? Women in that midlife space on this pandemic right now? Are they, are there, are they fearful? What are they asking you?

Konz: I think everybody of course has a sense of fearfulness of the unknown. Midlife is particularly a stressful time because if you look at where that woman is, she tends to be of the age where she’s caring for her family. Kids may be going off to college. So that woman is worried about, are they going to start school? They might even have grandchildren or children who are pregnant and worried about that side, but then they may still have parents as well that they’re worried about their safety and their health. So that’s what I hear is just the extra stress and worry that women have just surrounding keeping their loved ones safe. But it seems, you know, that I think that they don’t mind wearing masks, which is nice, cause that is one of our requirements coming into the clinic. And at the same time they have been, I think, happy to be able to reenter our walls again and have some sort of sense of normalcy. At this time too, that the clinics are functioning and able to see them.

Host: Yeah. And on that note, health doesn’t stop when there’s a pandemic care is still being given, especially here at Sanford. Women’s how important is it that women in that midlife age range really pay attention to how they’re feeling mentally, physically, emotionally during this time and continue to get the care that they need?

Konz: Oh, it’s very important. There’s important screenings That kind of happens between the ages of 40 to 60 just screening for chronic issues. And the one thing that women tend to do, especially with families, is not prioritize themselves when it comes to taking care of others. So I think self-care is of utmost importance, paying attention to your symptoms and even letting yourself have five minutes to yourself, even to relax and kind of recuperate. We always talk about exercise and diet, but exercise truly is an important key to long-term wellness as is the food you put in your body. So really focusing on what is nutritious, that gets harder and harder, the busier and busier you are, but I think COVID gave a good picture to how important it is in times of needing to make sure you are your healthiest. Starting now is the best time to start.

Host: Great information. What are you most looking forward to about really integrating these new services for women in that space? Sanford Women’s in general, when can women start to see that and what are you most looking forward to?

Konz: I am really looking forward to empowering women and educating them on. There are things they can do to truly make themselves feel better and have the best outlook on life now that they can. I I’ve read so many books as I’ve been preparing myself to be able to care for women. That really focus on now is the best time as ever to live your best life. Focus on health focus on honestly, massage helps to reduce stress and helps to make you feel better. So it’s okay to live your best life now. And we’re just hoping to give you those tools to help women to know how to do that. Cause when you’re chronically, I’m using that term, being a great mom and watching out for others, that’s when sometimes you forget, how do I care for myself now? What did I do again for fun? So I’m excited to help empower women that it’s okay to take a step back and think, think about yourself. And also really, I love giving the educational piece on what’s going on. They’re not going crazy. If they forgot groceries at the store or that they maybe feel a little more irritable, we’ll help fix that for them. We are currently taking patients so you can either ask for a referral through your primary doctor, OB/GYN, or you can be a self-referral as well, just simply by calling the clinic number as well.

Host: Is this something that women across the Sanford regions can find? Or is this something you are starting in Sioux Falls first?

Konz: We are starting in Sioux Falls first. There’s really large integrative medicine communities throughout various health care services, Mayo Clinic, Beaumont Health in Michigan. And the advice that they give clinics just like us is start with the seed of an idea and plant it, and let it grow as you determine what works best for your clinic and for the enterprise as a whole. So it will be exciting to start here and take this to primary care perhaps as well. Because women aren’t the only ones who are burdened by stressful times, and different health ailments. So yes, we will be starting here at the Plaza and as we grow, we’ll be able to extend the services throughout hopefully more of the Sanford enterprise.

Host: I love what you said earlier. Live your best life now, words to live by for sure. And I always believe that women in that age range, that midlife stage of their life are heroes. A lot of them are moms, superheroes, and of course you know, women and folks in health care are heroes as well. Nurses, you’re included in that. We thank you for all that you do. And we look forward seeing how this program evolves and how women in the Sanford communities can get that care. Very exciting, isn’t it?

Konz: Yes. Thank you. It is. We’re excited. Ready to go with this!

Host: Yes. So we can’t wait to see what comes next. Thank you. Shanna Konz for joining us for this edition of Sanford Women’s podcast, Her Kind of Healthy. And thank you, of course, for all that you do for women in this space.

Posted In Midlife, Sioux Falls, Specialty Care, Women's

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