#353 6 Questions To Ask Your Pediatrician Before Antibiotics with Elisa Song, MD

This week on The Less Stressed Life Podcast, I am excited to welcome back Dr. Elisa Song who is an integrative pediatrician. In this episode, Elisa tells us about her new book Healthy Kids, Happy Kids which is an evidence based guide to raising healthy kids in our modern world. Elisa bridges the gap between conventional and holistic pediatrics and delivers a clear roadmap to help kids thrive.

Loving this episode? Check out Elisa's other episode Anxiety in kids, antibiotic use, and self regulation for kids

KEY TAKEAWAYS:

• What is the state of children's health today?
• What are the most common ways our kids' microbiomes become disrupted?
• What should every parent or practitioner know about antibiotics?
• What are 6 questions every parent should ask their pediatrician before starting their child on antibiotics?
• Most important question to ask: is this antibiotic really necessary?
• Advice for post antibiotic microbiome recovery

ABOUT GUEST:
Dr. Elisa Song, MD is a Stanford-, NYU-, UCSF-trained integrative pediatrician, pediatric functional medicine expert, and mom to 2 thriving children. She is the author of the Healthy Kids Happy Kids: An Integrative Pediatrician’s Guide to Whole Child Resilience. In her integrative pediatric practice, Whole Family Wellness (www.wholefamilywellness.org), she’s helped 1000s of kids get to the root causes of their health concerns and empowered parents to help their children thrive – body, mind, and spirit – by integrating conventional pediatrics with functional medicine, homeopathy, acupuncture, herbal medicine, and essential oils. Dr. Song created Healthy Kids Happy Kids (www.healthykidshappykids.com) as an online holistic pediatric resource to help practitioners and parents bridge the gap between conventional and integrative pediatrics with an evidence-based, pediatrician-backed, mom-approved approach. 

WHERE TO FIND:
Website: https://healthykidshappykids.com/
Instagram: https://www.instagram.com/healthykids_happykids/

WHERE TO FIND CHRISTA:
Website: https://www.christabiegler.com/
Instagram: @anti.inflammatory.nutritionist
Podcast Instagram: @lessstressedlife
YouTube: https://www.youtube.com/@lessstressedlife
Leave a review, submit a questions for the podcast or take one of my quizzes here: https://www.christabiegler.com/links

NUTRITION PHILOSOPHY:

• Over restriction is dead; if your practitioner is recommending this, they are stuck in 2010 and not evolving
• Whole food is soul food and fed is best
• Sustainable, synergistic nutrition is in (the opposite of whack-a-mole supplementation & supplement graveyards)
• You don’t have to figure it out alone
• Do your best and leave the rest

EPISODE SPONSOR:
A special thanks to Jigsaw Health for sponsoring this episode. Get a discount on any of their products. Use the code lessstressed10

Transcript

[00:00:00] Elisa Song, MD: And for children in particular, especially because all of their systems are developing, their immune systems, their brains, their hormones, their metabolic systems, reproductive systems, every round of antibiotic then, with that hit to the microbiome, interferes with how your microbiome is communicating with their immune system and their brain and their hormones and metabolic system to really shape their health future from an epigenetic standpoint.

[00:00:28] Christa Biegler, RD: I'm your host, Christa Biegler, and I'm going to guess we have at least one thing in common that we're both in pursuit of a less stressed life. On this show, I'll be interviewing experts and sharing clinical pearls from my years of practice to support high performing health savvy women in pursuit of abundance and a less stressed life.

[00:00:58] Christa Biegler, RD: One of my beliefs is that we always have options for getting the results we want. So let's see what's out there together.

[00:01:16] Christa Biegler, RD: Today on the less stressed life, we have back Dr. Elisa Song. She was last year, maybe a hundred episodes ago. I don't know what episode we're on, but it was episode 277 is what I found. The topic was anxiety in kids, antibiotic use and self regulation for kids.

[00:01:31] Christa Biegler, RD: It was lovely. It was beautiful. I remember our conversation at that time, we were talking about nervous system devices and things you'd used on kids. And I could really tell at that time, there was such an alignment around. Wow. We really have to like love on our stress and nervous system piece, whether you're an adult, whether you're a child, but anyway, back to her bio.

[00:01:49] Christa Biegler, RD: She is a Stanford and many other educational places or many other university trained, integrated pediatrician, pediatric functional medicine expert, and mom to two thriving children. She is recently, I think it's the first book we were just talking about, I'm quite sure. But it's, she's the author of healthy kids, happy kids, which came out May 14th.

[00:02:09] Christa Biegler, RD: So I'm checking the date on this. I don't know what day it is, but right around this time in her integrative. Pediatric practice, whole family wellness. She's helped thousands of kids get to the root causes of their health, concerned and empowered parents to help their children thrive. Mind, body, and spirit by integrating conventional pediatrics with functional medicine, homeopathy, acupuncture, herbal medicine, and essential oils.

[00:02:30] Christa Biegler, RD: She created her online website, healthy kids, happy kids. Quite some time ago, as an online holistic pediatric resource to help practitioners and parents bridge the gap between conventional integrated pediatrics with an evidence based pediatrician backed mom approved approach. Whoo. Mouthful. Thank you so much for coming on today.

[00:02:46] Christa Biegler, RD: Welcome back. 

[00:02:47] Elisa Song, MD: Oh, thanks, Christa. We've been having, I've been having an amazing time. Just. Chatting with you offline. So I can chat with you anytime. 

[00:02:53] Christa Biegler, RD: Yeah, perfect. And now we're on video where this will be on YouTube also. So people can really appreciate how I accidentally wore your brand colors today.

[00:03:02] Christa Biegler, RD: And is that picture in the background? Sorry for, if you're just listening to this via. Audio, but is that picture, is that a painting? Did someone give that to you? Because I see that is your like logo, isn't it? 

[00:03:12] Elisa Song, MD: It's part, you know that heart, it's by an artist. Her name is Debbie Aula and she's a dear friend now, but she's called the heart artist.

[00:03:20] Elisa Song, MD: And that is a ginormous painting that, that she created into a little, I think they call it . It's beautiful. She actually will create heart paintings of families with your colors. And yeah, beautiful. I have a, I have our hearts all over my office. 

[00:03:34] Christa Biegler, RD: Oh great. I'll get that. I'll get her contact information after the fact and why that's relevant is I feel like you're a very heart centered practitioner, which you can just see in someone, and especially if you're aligned in that way. So, Why did you write this book, maybe? Let's actually start there. Like why, after the website, did it just feel like the natural progression of things? Like I must write a book now? Or were you thinking, this is my legacy that I want to lead with?

[00:03:58] Christa Biegler, RD: As I'm asking you about being a hard center practitioner. Yes. Yes. 

[00:04:01] Elisa Song, MD: So one thing that, you know, as people get to know me that, that they will, I realized pretty early on is that I am definitely not a planner. We were just talking about how we need to follow our joy and that's what I do.

[00:04:13] Elisa Song, MD: I just let joy lead the way. And I love to teach. I love to write. I love everything kids health. And so it naturally came together at the right time. It actually was during the pandemic. As we were just partially had the time, right? Because the office was so slow to think about, what I wanted to pause.

[00:04:34] Elisa Song, MD: Yeah. A great, it was a great pause. And so what was I doing here? My practice was great and I was building this online space, but what kind of a legacy would I leave? Not just my legacy, but what would I leave for my kids and my grandkids? And what do I really want?

[00:04:50] Elisa Song, MD: Parents to understand, to move beyond all the fear that was going on, right? What do I want practitioners to know so that we can break the cycle of chronic disease that we're seeing in kids? And so that's why I wrote the book. The book is really, it's everything that's culminated over the past, 20 plus years now as a practicing integrated pediatrician.

[00:05:13] Elisa Song, MD: I can say for practitioners, I wrote it to make your life easier, right? So that you don't necessarily have to explain, your foundational, here's why we think about, vegetables, here's why sleep is so important for kids, that foundational so that parents can, and kids can understand.

[00:05:28] Elisa Song, MD: And for parents, I wrote it. to make your life easier because I've had kids read the book, get a, advanced copy of the book and my own kids and It's so much easier even with my kids, if someone else says, Oh, here's the why. And, Oh, here's how you might consider doing it. 

[00:05:47] Christa Biegler, RD: I was actually having an email conversation with a mom, this happens when you get the college aged, the ones that are fresh into college.

[00:05:53] Christa Biegler, RD: So the mom's I think this will work better coming from you. Yeah. So to that point, how old are your children now? Yeah. 

[00:05:59] Elisa Song, MD: My kids, so Bodhi is 12 and a half and Kenzie is 14, so I have a teen in between. Perfect. 

[00:06:05] Christa Biegler, RD: Okay. And I was going to ask you, some questions I have for you are about the change of landscape in healthcare and in integrative pediatrics since you started.

[00:06:13] Christa Biegler, RD: And I don't know if you got right into integrative pediatrics, but you just mentioned you've been in this space for about 20 years. Will you talk a little bit about how things have changed since you started? I don't know if your practice is. It's Whole Family Wellness, I think. 

[00:06:27] Elisa Song, MD: It's Whole, yeah.

[00:06:27] Elisa Song, MD: The practice is Whole Family Wellness. I'm in Belmont, California. That's northern, San Francisco Bay Area. And the landscape on the one hand has changed quite a bit. When I started out I did start, out of residency. My goal was to be an integrative pediatrician.

[00:06:42] Elisa Song, MD: And, back then it wasn't really called integrative. It was alternative medicine, holistic medicine. And so I started my practice in 2004. So that is 20 years ago. And it was a little lonely back then because there weren't a lot of pediatricians pursuing this route.

[00:06:57] Elisa Song, MD: There were some, there were some but not a lot. And and even when I did my first training at the Institute for Functional Medicine and there wasn't even a certification back then. It was just one course. Applying functional medicine and clinical practice and nothing relevant for children.

[00:07:15] Elisa Song, MD: So I had to extrapolate all of that and shape. 

[00:07:18] Christa Biegler, RD: And before you had children, 

[00:07:19] Christa Biegler, RD: which is a huge education piece, right? 

[00:07:22] Elisa Song, MD: Absolutely. 

[00:07:22] Christa Biegler, RD: So often 

[00:07:23] Christa Biegler, RD: my colleagues don't take children. And one of the reasons I take children is I have children, so I'm just comfortable. 

[00:07:28] Elisa Song, MD: That's right. Yeah. Or, another reason is that maybe unfortunately knock on wood their child has had a health concern and they've had to pursue this and then they realize, there's a different way, there's a better way.

[00:07:38] Elisa Song, MD: And the landscape has changed because now there are more and more pediatric integrative functional medicine practitioners out there, more and more of an interest in CERN ASeq. It's still not enough. Not nearly enough but it's a growing community, which is. Awesome. What hasn't really changed is it's really not much different how our medical students and residents are getting taught.

[00:08:01] Elisa Song, MD: And so it's still a bigger lift to, as you leave residency to be able to have your mind open to other ways of thinking about healthcare and what true prevention really means. So we have a ways to go. 

[00:08:17] Christa Biegler, RD: Why were you inspired to go straight into what was then alternative and now integrative?

[00:08:22] Elisa Song, MD: Yeah, it's interesting. Yeah. As I said, I did not go into this because a family member or myself, had any sort of a chronic health concern. Thankfully, knock on wood. But it really, And as we were saying, the theme runs through, right? If you follow your joy, the joy will lead you in the way that you need to go.

[00:08:37] Elisa Song, MD: And so I always knew I want to work with children, but my mom was an OBGYN. And back then she had a solo practice and she was never home, right? So busy delivering all of our own babies. And I just thought, I don't want to do that, right? I don't want to be a doctor, but that's all I knew about being a doctor.

[00:08:54] Christa Biegler, RD: So then you went to med school. 

[00:08:55] Elisa Song, MD: But then I knew I wanted to work with kids. So at Stanford, I actually my vision at first was I'm going to be a teacher. And I thought that's going to be it's such a challenge. It's one of the most challenging jobs, right? And then I thought how can I do even greater good for kids?

[00:09:09] Elisa Song, MD: So I said, you know what? I'm going to be a lawyer. I actually took the LSATs, got my law school applications. I was going to be a children's rights advocate doing civil rights law. of my teachers, one of my professors, James Steyer, he founded Common Sense Media, which I love, right? I had such great role models, but it was just that what is something was missing, right?

[00:09:28] Elisa Song, MD: I knew if I did that I wouldn't work with kids and then they say when Yeah, when you're looking for a teacher the right teacher comes and so I just stumbled upon this conference at the you Know in Santa Clara. It was the American Holistic Medical Association and I heard, this is in the late 80s, right?

[00:09:46] Elisa Song, MD: I heard from people who are just starting to get known like Deepak Chopra and Andrew Weil and Joan Borisenko. And that was it. I was like, Oh, maybe this is what I want to do. 

[00:09:57] Christa Biegler, RD: Yeah, for sure. So that's perception of how it's changed for clinicians and in the landscape of availability. I'm curious how things have changed for the kids that you served, if there's been dramatic shifts that you've observed over time, over these 20 years, you can divide that however you want.

[00:10:15] Christa Biegler, RD: And while you're answering that, I'd like to know, and maybe you want to start here, I'd like to know also if you see shifts in the last four years and how you're serving kids now versus four years ago, not necessarily that we're doing more telemed or whatnot, but is there big changes or there are big swings as we know, adults.

[00:10:32] Christa Biegler, RD: There were big swings post COVID, right? So what are you seeing, since 2004 to 2024 in the children you serve and even just from 2020 to 2024 and the children you've served? 

[00:10:44] Elisa Song, MD: One of the things that has, I think, most significantly changed, and I don't know if it really is a reflection of the overall landscape, but when I started my practice I remember when I was at UCSF doing my developmental pediatrics rotation, I saw a one child with autism and I remember my developmental pediatrician attending saying that if I saw, a handful of kids with autism in my career, it would be a lot.

[00:11:11] Elisa Song, MD: And that way, and that wasn't, I finished my residency in 2000, and so fast forward, I'm starting my practice. And I no advertising, no nothing opened my doors as a, functional medicine, pediatrician. And all of a sudden my practice was. Flooded. I didn't have a problem of trying to build a patient base but it was flooded with parents of kids with autism, right?

[00:11:33] Elisa Song, MD: And that's where I think in the earlier days, the functional medicine approach is biomedical approach was really applied to supporting the underlying, clinical imbalances, the symptomatic needs for kids on the autism spectrum, right? And so I think that awareness then, eventually now, over the past 20 years, has, had a ripple effect or this this I guess a, ripple effect on the awareness for parents with other health concerns.

[00:12:05] Elisa Song, MD: to recognize that, huh, maybe this biomedical approach could help my kid with eczema or asthma or autoimmunity or, anxiety. And so I see more and more parents now seeking care for their kids who have other issues. a multitude of other health concerns so that now my practice is not just, a practice for kids with neurodevelopmental concerns, but really, kids with any particular set of health concerns, which is great.

[00:12:32] Christa Biegler, RD: Nothing like throwing you into the deep end, right? When you get started on like a neurodevelopmental, that's pretty intense. Really. I know this is not a quick thing, but quickly how, what are some of the possible pieces, not necessarily all inclusive pieces you might add to a workup of a child with autism?

[00:12:50] Elisa Song, MD: Yeah. And I want to, back up a little bit and tread a little kind of lightly and respectfully here because there's been a lot of concern about labeling autism as a disease, right? What I really want parents to understand is when kids have autism, just like when kids have ADHD or kids have anxiety or kids have whatever it is neurodivergence.

[00:13:11] Elisa Song, MD: We want to celebrate that beautiful brain and some of the gifts that come along with it. However, there are also for many kids underlying, significant issues with eczema or, asthma or autoimmune phenomena. GI for sure. Kids on the autism spectrum are more likely to have inflammatory bowel disease.

[00:13:30] Elisa Song, MD: So we need to uncover some of those underlying imbalances. And for kids on the autism spectrum, some of those kids are just so either sensory seeking or sensory averse that they're not thriving in their own bodies, right? They're not comfortable. And so helping us support that.

[00:13:49] Elisa Song, MD: And some have such crippling social anxieties or simply can't express what we know is inside. So need support in either getting the fine motor control to use a letter board, or, actually be able to speak and communicate, with words. But, one of the things we look at is methylation is a big factor.

[00:14:06] Elisa Song, MD: In fact, in surveys of, parents who have children who have benefited from a biomedical approach, methylation, B12 shots is one of the number one. Also going on a gluten free, dairy free diet. Gluten and casein, can cause these drug like compounds for certain susceptible kids and adults that can just have you in a total brain fog.

[00:14:26] Elisa Song, MD: And then environmental toxicity is another big concern, so trying to uncover, what might kids be exposed to. Now from a mom's standpoint, we know that for kids there has been a correlation with differences in infants gut microbiomes early on that might increase the risk later on for developing autism or ADHD.

[00:14:46] Elisa Song, MD: And, especially loss of a whole, genus called bifidobacteria. So for listeners, for infants, bifidobacteria should be the primary probiotic, genus inside your infant's gut. And we're losing that. So there's so many things that we can look at to help support kids to, to really thrive.

[00:15:06] Elisa Song, MD: And I care less about. Really from a functional medicine standpoint, the emphasis should be less on a diagnosis and I tell parents all the time, I don't really, it's not that I don't care what your diagnosis is, I do because it can sometimes really help me dive into the literature and understand what pathophysiologic imbalances I might really need to look into, but at the same time, it's just, a label that might change or might not.

[00:15:33] Elisa Song, MD: And unfortunately for conventional, pediatrics, if treatment is going to be recommended, there has to be some sort of a label, but it doesn't always fit. It doesn't always fit the classic picture. But really, with truly personalized medicine, we can identify what is unique about the, whatever imbalance, is going on for your child.

[00:15:51] Elisa Song, MD: And how do we correct that? 

[00:15:52] Christa Biegler, RD: I think since we're talking about kids, there's never been a better time to talk about the human experience and I like to make light of this quite often in practice when talking to clients that, oh, that's not actually a nutrition problem, but it's a human experience problem.

[00:16:09] Christa Biegler, RD: And we all struggle with those things. So to your point, I agree wholeheartedly that the diagnosis is important, but not important, right? What it does. Is in the human experience makes us feel really good that we have an answer. And so therefore, when people don't get a diagnosis, they're like, I don't know what's wrong, right?

[00:16:26] Christa Biegler, RD: Because they don't feel validated by that. So I mentioned that because that same feeling will cross over to testing. And so something I'm really careful about, and I think I take decent care of on this podcast is I'm careful about how I talk about things because I, every day people come in and say I learned that I should do stool testing.

[00:16:46] Christa Biegler, RD: So I did this like consumer stool test. I'm like, that's cool. I don't find it very clinically useful. And they will say yeah, I didn't really tell me anything, unfortunately, because what I want to say here is that we want to be validated. The human experience is we want to be validated. It's so reasonable.

[00:17:01] Christa Biegler, RD: We're all human. And so we may look for that in a diagnosis and feel better initially and then not. And then we may feel good or not good if we have a test valid, validate something or not. And a lot of things you talked about with a workup, there's a lot of evidence and proof we can create through labs.

[00:17:17] Christa Biegler, RD: And then there's some patterns and things, especially with toxic burden, there is some testing, but I just get more out of the symptoms and the patterns and helping people. Yeah. with the patterns. And I think once you've been in practice for a while too, you could make some solid guesses in general where people 

[00:17:31] Elisa Song, MD: are.

[00:17:31] Elisa Song, MD: I love that. I love that you say that because really, part of what I do in the book is give clinical clues as to whether, what are some of the signs that your child might need more magnesium or more zinc or more iron? Whatever it is, but there are often, if we listen to your child's body or for an adult, if you listen, truly listen to your body and your brain, it's often telling you, Hey, This is off or I think I might need more of this or oh, I think I may be being exposed to that.

[00:17:59] Elisa Song, MD: Whatever it is, but one of the now I've been at this for so long. I'm like, huh, one of the OG, right? But really what I caution when I teach pediatric practitioners who are just starting out, We all do this when we start and, it's part of learning about the testing and learning what clinical patterns but we want to make sure that we're not chasing the lab values, right?

[00:18:21] Elisa Song, MD: Because what happens then is we train our patients to do that. Because I'll have, sometimes parents come in and their kids are doing awesome, right? They're thriving. Like they're, they've recovered from whatever we were trying to heal from. And then they come in and their lab, maybe their ferritin is a little low or something is a little off on a urine organic acid test.

[00:18:42] Elisa Song, MD: And. They want to do something about it instead of just saying, look, now let's set the foundations for, resilience for a nourishing diet and lifestyle so that all of these things can balance out on their own. And I think, we've lost sight of that. And I really want to caution new practitioners and, new parents who are new to the functional medicine scene.

[00:19:03] Elisa Song, MD: space. We really want to create a different paradigm, right? We don't want to create the same conventional medicine paradigm where, it's, just looking at the tests and then, Fixing the test, right? We're looking at the child in front of us, right? 

[00:19:17] Christa Biegler, RD: Don't whitewash functional medicine with our conventional model, right?

[00:19:22] Christa Biegler, RD: Yes, absolutely. And we do see that happening. And so that would be a change I have seen in the last four years, maybe. And it's not, it doesn't probably have anything to do with the pandemic or not. It's just awareness. To your point, you started, you were originally an alternative medicine provider, now you're an integrated medicine provider, but what the change that I'm seeing is that sometimes people come to me after seeing, I'm sure as you do, many integrative professionals and so I have to dig through and figure out, was this whitewashed functional medicine?

[00:19:49] Christa Biegler, RD: And I'm not saying I have ever been perfect in life or practice. I've made all kinds of mistakes myself because that is, we are practicing and that's what you learn, right? That's the sweet spot. Okay. Thank you. I love the statement, I think sometimes we find these Terms that really work. Freaking love clinical clues over the word symptoms.

[00:20:07] Christa Biegler, RD: Thank you. Beautiful. It's, there is so much little tiny language that really makes that hits people differently. And I like clinical clues better than that. I think that we can learn much more from clinical clues. And if we understand how to piece those together, I agree with you and don't chase lab values.

[00:20:23] Christa Biegler, RD: It's why when people ask me, am I going to retest this? I just educate by saying you can. It's never going to be perfect because there is no perfection. And so you're just looking for this dramatic improvement by doing all these foundational pieces. If you're doing foundational and to your point with clinical clues, like people may identify that they have magnesium deficiency and that may be related to many things.

[00:20:45] Christa Biegler, RD: And so that's the cool part is what's fun as you get going is like you may do one intervention and it creates three positive results. Cool. That's awesome. Absolutely. I love that. Yep. So we're looking at the positive here. For you, is there anything significant that you've noticed, from four years ago to today as your clients walk into your practice?

[00:21:06] Elisa Song, MD: Yeah, you know what I would say is I noticed this more in my adolescence. We know that children and teens mental health was in crisis long before the pandemic, but through the pandemic, the reports of the increasing rates of ER visits for suicidality even in eight year old, younger and younger. And the number of teenage girls who have seriously thought of suicide or, and even have a plan nowadays it's alarming and we need to have our eyes open to it. One shift that I could, it was starting even before the pandemic, but I can see, A little more clearly now is this expectation for many teenagers, especially teenage girls that, of course, they're going to have anxiety, right?

[00:21:55] Elisa Song, MD: Yeah, of course, they're gonna, eventually be on medications because, my friend is on Lexapro and another friend's on Wellbutrin. And so it's just a matter of time. So like this expectation that this is the path they're heading towards and that, having. Anxious feelings and, being anxious is going to lead to an anxiety disorder, right?

[00:22:19] Elisa Song, MD: And trying to unravel that for teenagers can be challenging because then like a parent, right? Once you have an adult, once you have your mindset that you're that, of course, you're going to need medications for your high cholesterol, or your high blood pressure or your whatever it is, then it makes the other stuff a little less important in your mind.

[00:22:38] Elisa Song, MD: Because then there's this belief that the medication is going to take care of it, right? And helping kids understand, look, maybe medications are going to be needed at some point, but they don't work 50 percent of the time. And even then, if they do work, they often stop working.

[00:22:53] Elisa Song, MD: And there's so many things that we can do to help you feel better and stay feeling better. I 

[00:22:58] Christa Biegler, RD: wonder how many kids are on a medication.

[00:23:00] Elisa Song, MD: That would be an interesting question. because you know my population of course is skewed. Even like a lot of my kids who have ADHD or anxiety or depression they're not on meds or they're just on a, A very low amount, and our goal isn't necessarily to keep them on meds, right?

[00:23:16] Elisa Song, MD: And what I see for a lot of kids is and I'm sure this is the same for adults, you start a med, no medication is without side effects, so then eventually, maybe they're on another medication to counter the side effects, right? And then eventually they're on, three, four different medications, and you're like, I don't know what's doing what now, right?

[00:23:36] Elisa Song, MD: Yeah. So. It's the same thing with what I really try to educate kids about now is, with choosing, with thinking about medications, you should have the same due diligence when you're, going in to ask for medications as you would when you're buying your first car.

[00:23:53] Elisa Song, MD: You would never just go into a dealership and trust that the dealer is going to give you the best car for you and, make sure that, you're, you don't have a lemon and that you're not going to have any problems with it, right? You need to ask questions about your, be empowered to ask questions.

[00:24:08] Elisa Song, MD: about to your physician about, Hey, how do you know that this medicine is going to be the appropriate one? Are there other options? Are there other non medication options? What are the side effects? How can I mitigate those? All of those. And I, fortunately I'm now, because I've been in practice now for, 20 little, 20 years now.

[00:24:27] Elisa Song, MD: It's so great. Last year through the pandemic, I had this cohort of kids who are graduating onto college. And last year I just had a bunch of kids who flew the nest and are off in college. And for the most part, it just, it makes me feel like I've done my job that they can call me or send me a message and, ask me about, how they're feeling their symptoms like, Hey, is there something I can do about this?

[00:24:49] Elisa Song, MD: Is there, and if I recommend something, Oh can, is there anything I should be concerned about if I start this? I love it. I got, I want them, I want all kids to, have that. Yeah. Very important life skill, to really be their best advocates, whether they're talking to a doctor or their boss or whatever it is.

[00:25:10] Christa Biegler, RD: That is a skill. So you went over those questions and you brought this, I have this as a question for you about the questions. Parents should ask their doctor before starting antibiotics for a kid, and I think they're probably the same one, so it's any medication. Are they the same questions? Just double checking.

[00:25:24] Elisa Song, MD: Yeah, they're a little different. So the first and foremost, similar. They're very similar, right? But the first most important question that anyone should ask, whether you're a parent for your child or whether it's you yourself, right? Because, adults get plenty of antibiotics too, right?

[00:25:41] Elisa Song, MD: So the first, most important question to ask

[00:25:43] Christa Biegler, RD: if you're urinating a lot when you're drinking water, maybe you're not actually hydrating that much. Or, in other words, getting the fluid and nutrients into the cell. Electrolytes are minerals that help fluid and nutrients get into the cell. I recommend all of my clients start by drinking electrolytes when we begin our work together, so to improve energy.

[00:26:03] Christa Biegler, RD: And then we get even more strategic with our electrolyte recommendations as test results come in. Now, generally electrolytes are potassium, sodium, and chloride. One of my favorite electrolyte products is pickleball cocktail from jigsaw health, because it's one of the only products you can get with an adequate dose of potassium to meet my recommendations, which is critical for blood sugar, which everyone should care about hormone health.

[00:26:26] Christa Biegler, RD: And digestion, huge thing for relapsing, digestive issues. Jigsaw health is also maker of the famous adrenal cocktail made popular by the pro metabolic corner of the internet and root cause protocol, as well as a multi mineral electrolyte for recovery called electrolyte supreme. You can get a discount on all of jigsaw's amazing products, including pickleball, electrolyte, supreme, and adrenal cocktail at Jigsawhealth.com

[00:26:49] Christa Biegler, RD: with the code less stressed 10. That's three S's less stressed. Ten.

[00:26:56] Elisa Song, MD: is Hey doc, is this antibiotic really necessary? And it sounds like such a weird question to ask, it's, one study found that doctors were, up to twice as over two times as likely to prescribe an antibiotic, even if they believe that it wasn't really necessary.

[00:27:17] Christa Biegler, RD: Human behavior. It's like you're trying to fill, you're trying to give someone an answer because that's what you've been called to do. That's right. That's right. 

[00:27:26] Elisa Song, MD: It's just human nature and, there's a lot of wiggle room, but if they believe that you want the antibiotic, they're more likely to give it to you.

[00:27:33] Elisa Song, MD: All right, so then just by asking, Hey, is this really necessary? Not in an adversarial way, but just in an inquisitive I just, I really want to do the best thing for my child. Is this really necessary? Then the doctor immediately knows, Oh, you're not, One of the parents who came in just to get the prescription and go out the door because there are some parents, who really just want the prescription, right?

[00:27:54] Elisa Song, MD: But now they know that's not you. And so it opens the door for that conversation, right?

[00:28:00] Christa Biegler, RD: I like that little nuance. It's here's the reason for the question. 

[00:28:04] Elisa Song, MD: Yeah, so that's the most important one. And then the other questions are similar, right? Are you sure it's bacterial, right?

[00:28:10] Elisa Song, MD: Are you prescribing it just in case or is there any testing to confirm? That's why with throat infections, 100 percent every single time, if you're concerned that it could be a bacterial infection like strep throat, you need to have a culture for confirmation. Because Epstein Barr, the monovirus, can look exactly the same as a strep throat, or sometimes even worse.

[00:28:32] Elisa Song, MD: Some of the most horrible sore throats I've seen are viral. So we don't want to take unnecessary antibiotics, and, and that goes to really helping kids. 

[00:28:41] Elisa Song, MD: Could they have both strep and anovar? They actually could. They could have 

[00:28:43] Elisa Song, MD: both. Yeah. Just like with ear infections, right? A lot of ear infections are a mixed picture of virus and bacteria.

[00:28:49] Elisa Song, MD: But, that, for parents and kids to really understand. Why don't we want to use unnecessary antibiotics? Cause some people would think what's the harm? It's just a round of antibiotics. That's how I grew up. My mom was a doctor, right? Every little like sore throat or whatever.

[00:29:05] Elisa Song, MD: Oh here's some antibiotics. I had lots of antibiotics as a kid. And so now. What's the harm? We know, they can instantly disrupt your gut microbiome. And in fact, some antibiotics may preferentially kill your beneficial microbes and preserve, your pathogenic ones, which is why we'll see C.

[00:29:22] Elisa Song, MD: diff infections after antibiotics, right? 

[00:29:25] Christa Biegler, RD: And now you have eczema. 

[00:29:26] Elisa Song, MD: Yeah, exactly. And for children in particular especially because all of their systems are developing their immune systems, their brains, their hormones, their metabolic systems reproductive systems And, every round of antibiotic then, with that hit to the microbiome, interferes with how your microbiome is communicating with their immune system and their brain and their hormones and metabolic system to really shape their health future from an epigenetic standpoint.

[00:29:56] Elisa Song, MD: So it's really that important. One study found that antibiotic, just, antibiotics or antacid medications, which also disrupt the microbiome, given in the first six months of life, could, almost double the risk of virtually every single allergic disease by the time kids are four.

[00:30:13] Elisa Song, MD: We have an explosion of allergic diseases. I don't, haven't, when I was starting out in my career, anaphylactic food allergies were exceedingly rare. And now, I'm, filling out medical EpiPens. Every school season, there's several kids now. So when parents and kids understand that, And, even if it's not just from a personal standpoint, from a public health standpoint, I really, I want all people to really understand we need to be really good antibiotic stewards, because the crisis of antibiotic resistance is, really is worldwide.

[00:30:49] Christa Biegler, RD: I think years ago, the FDA put out like a call please don't give antibiotics unless needed. That's right. I don't know that we really change our behavior very easily sometimes as humans again. Yeah. 

[00:31:00] Elisa Song, MD: Yeah. And 

[00:31:00] Christa Biegler, RD: that's, it is what it is. Cause you know, some people just want that.

[00:31:03] Christa Biegler, RD: And so it's hard to, my friend who went through, she's still going through a cancer journey. She has some really beautiful thoughts on how to survive cancer and it's befriend your oncologist. To the point, it's be a human and open to the point that you said. Open the door for conversation, right?

[00:31:22] Christa Biegler, RD: Once you open that door for conversation, it's Oh, cool. You're one of the few and cool ones that I came to be a doctor for, so be that person. You have a big toolbox, so I'll use this example of. Some of the worst sore throats are viral. And so when we're talking about other options besides antibiotics, when kids are sick, how do you coach people through that?

[00:31:43] Elisa Song, MD: Yeah, my toolbox is just the one that I've learned over the years, right? And other people have other tools for instance, I would love to learn more about Ayurvedic medicine, but I don't know enough yet to recommend, Ayurvedic treatments, but I incorporate homeopathic medicines, herbal medicines, essential oils.

[00:31:59] Elisa Song, MD: I love acupuncture for kids. It's way more doable than it sounds. But I teach parents acupressure. And one of the reasons Why? I talked to parents about the importance of using your integrative tools when your kids are sick are, first of all, that in conventional pediatrics, often there's not much we can do in those early stages, right?

[00:32:21] Elisa Song, MD: Let's take a cold, for instance, Sudafed, Benadryl haven't been found to work, right? They can do some harm. And yet that's what we, a lot of docs still tell their patients, right? Oh, try this, right? So it doesn't work. And our kids can be really uncomfortable. Let's take fevers also.

[00:32:39] Elisa Song, MD: We know that reducing fevers artificially with things like, Tylenol or Motrin might help your kid feel better temporarily, but They don't help them fight the infection any faster, and in fact, some studies have found that they can make your infection last longer and make your kids more contagious which is the exact opposite of what we want.

[00:32:56] Elisa Song, MD: And we use our integrative tools so that we can help our kids feel comfortable, yes, And can compress the time, can help their body not suppress the symptoms, but do what it's trying to do, mount an, a healthy inflammatory response and antimicrobial response from our immune system so they can recover faster and hopefully avoid the unnecessary use of antibiotics.

[00:33:21] Elisa Song, MD: So for sore throats, for instance, I do, if there's been strep exposure or it just, it looks like a the classic strep picture with the kind of really beefy red tonsils with white spots and the red spots up, up on your upper palate. I always do a culture because I do treat strep with antibiotics.

[00:33:38] Elisa Song, MD: This is, the reason why integrative is such a better word is because it's not an either or we use antibiotics when they're appropriate. And we know how to restore and recover the microbiome when they are needed. And I do treat strep with antibiotics because I'm seeing too many kids now with with something called PANDAS, right?

[00:33:57] Elisa Song, MD: The Pediatric Acute Onset Neuropsychiatric Disorders associated with strep, which is an autoimmune brain inflammation that can happen after strep. And so I don't want that to happen. And yet, most surfers are still going to be viral. And what can you do? One of my favorite, like as a parent, I think just having this in your cupboard all year long.

[00:34:17] Elisa Song, MD: And we travel with this. There's a, an African bush herb called pelargonium sidoides. Okay. But you can find it on Amazon or Whole Foods or, whatever health food store. It's called umka, U M C K A, so umka, cold care syrup. As a practitioner, if you sold it in your office, it would be called V Clear.

[00:34:37] Elisa Song, MD: And so that's 100 percent my go to. It's tasty, really easy to give, and it's been found to have in vitro activity, so in the test tubes. In vitro activity against many different viruses, including your common cold, adenoviruses, rhinoviruses, your human coronaviruses Epstein Barr, Coxsackie, which is a hand for the mouth virus different herpes viruses, and also some activity against strep and staph and some other bacteria.

[00:35:06] Elisa Song, MD: Amazing, right? It's amazing. So I always start that because that sometimes can nip things in the bud. And then from symptomatic relief, I don't know if anyone's as an adult has ever had hand, foot and mouth, but it is truly one of the worst sore throats. 

[00:35:19] Christa Biegler, RD: I was actually going to ask 

[00:35:20] Christa Biegler, RD: you to expand upon it because it's so gnarly.

[00:35:23] Christa Biegler, RD: And I have a handful of people where like they were maybe had a little eczema before and post hand, foot and mouth. It's like a nightmare, right? It looks like everything sucks after that. 

[00:35:32] Elisa Song, MD: Yeah. And I thought, my hubris, right? I'm like, Oh, I've had all the colds and whatever.

[00:35:37] Elisa Song, MD: Because I knock on wood, I rarely get sick through the winter, because we as pediatricians, the first couple years out, you're sick all the time, right? But then you build up that immunity. And so that memory, right? And but I did get hamfootermath. And I actually got my daughter, right?

[00:35:51] Christa Biegler, RD: Oh, no. 

[00:35:51] Elisa Song, MD: And yep. And this is when she was a baby. And she sailed through it, right? It was over in two days. And it was the most insane sore throat I could imagine. And, Tylenol, Ibuprofen. I was like, I need to try something, right? They weren't doing a thing, right? So here's what helped though, right?

[00:36:12] Elisa Song, MD: Drinking a ton. Of throat coat tea with your demulcent herbs, right? They coat your throat with and your stomach. So marshmallow root licorice slippery elm even making like jello with that. If you can't swallow or making a smoothie and mixing and making a popsicle with it and homeopathic medicine.

[00:36:34] Elisa Song, MD: It was homeopathically diluted borax and belladonna. Those two things, I couldn't believe it because I had to go up to Oregon. I was giving a talk and I didn't have a fever, but my throat was killing me. And I thought I might have to cancel. I started these things. Within, literally within a few hours, my throat was feeling pretty good.

[00:36:51] Elisa Song, MD: And then by the next day when I had to talk, totally fine. So that's where using your integrative tools, just learning how to use them. First of all, it saves you a trip to the ER or to your doctor's office where your kid might pick up another thing, right? And can really, help you recover faster.

[00:37:08] Christa Biegler, RD: I love, so I grew up on homeopathy. I kind of wish, I was trained in herbs, so I use that more. I will occasionally bring homeopathy in, but I always say, I really want to bring in more homeopathy, but I think it's a perfect place for someone to be their own child's best friend. Provider, right? Because I feel like homeopathy is so safe.

[00:37:27] Christa Biegler, RD: It doesn't taste bad. It's so gentle. 

[00:37:29] Elisa Song, MD: Yeah. 

[00:37:30] Christa Biegler, RD: I can't really even think 

[00:37:31] Christa Biegler, RD: of a negative, honestly. And when you were choosing that for hand, foot and mouth, was that already in your toolbox or were you making a great guess based on mechanisms? Because I don't know enough about homeopathy. 

[00:37:40] Elisa Song, MD: Yeah, no, it was in my toolbox.

[00:37:42] Elisa Song, MD: And the thing is as a pediatrician we're often our worst patients, right? And also as a pediatrician mom, right? Because sometimes when the kids are sick, I'm like, you guys are fine. Just lay on the couch and, sleep it off. So oftentimes when things really start to get a lot worse, this is what I do in my mind.

[00:37:59] Elisa Song, MD: I step back and I think, okay, Elisa, what would you tell a patient to do? And then it's Oh, yeah, I would tell them to take the borax and drink this throat coat tea. And because here I was in this kind of, with this pain and delirious state, or sometimes with the kids when they're sick, or my husband, I'm like, you guys are fine, right?

[00:38:17] Elisa Song, MD: And then I'm like, No, okay, what would I tell a patient? Oh, 

[00:38:20] Elisa Song, MD: yeah. 

[00:38:21] Elisa Song, MD: Start these things. 

[00:38:22] Christa Biegler, RD: I've had a lot of people have lots of symptoms post hand, foot, mouth. And since this is a virus and we think about viruses hanging out in the body and kind of continuing to shed, do you think that using this post virus could still be helpful?

[00:38:34] Elisa Song, MD: Yeah. For sure. Yeah, absolutely. Yeah. And there are, for, and even for, because sometimes with post viral symptoms, yes, there may be some virus lingering, but a lot of times it's your own immune system that hasn't settled down. And using there, there are some homeopathic, there's a remedy called sulfur iodide.

[00:38:50] Elisa Song, MD: That's really good for recovery and the kind of that Convalescent stage where you're having this ongoing fatigue. I just, I'm just not back to myself. And then as, as you do, right from the, from that functional medicine standpoint, recovering the mitochondria, recovering the microbiome, all those things are so important.

[00:39:06] Christa Biegler, RD: For sure. All right. So thinking about. illness, having that toolbox. We were talking earlier about anxiety, microbiota. I want to ask you about if things just keep coming back, because to me, I go to terrain theory and we may have even talked about this 100 episodes ago.

[00:39:24] Christa Biegler, RD: I'm not really sure. But for a while I was just, I was asking every smart person I could their opinions on train theory, and you know what happened? Lots of the same answers, which was fun. So sometimes when people say I just can't clear this X, Y, Z thing. 

[00:39:38] Christa Biegler, RD: And 

[00:39:38] Christa Biegler, RD: then let's give the caveat of I'm doing an effective protocol thing.

[00:39:42] Christa Biegler, RD: Then I bring up the con, and train, it's we only care about what affects us sometimes as a human. 

[00:39:48] Elisa Song, MD: Yeah. 

[00:39:48] Christa Biegler, RD: So I'd love to hear your thoughts on. Terrain theory. And I also want to make sure I interject a question that's separate but related to antibiotics that I just remembered. I want to ask you about post, if you are using antibiotics, if you're educating your parents to do something post as well.

[00:40:06] Christa Biegler, RD: Okay. Maybe we should start there. 

[00:40:08] Elisa Song, MD: Yeah, let's start with, so with the post antibiotic microbiome recovery, absolutely, right? And it works best if you start it while you're taking your antibiotic course but even if, let's say you're thinking, Oh my gosh I wonder if my child's eczema is related to the antibiotics that they had when they were toddlers and now they're in middle school.

[00:40:25] Elisa Song, MD: You can still recover your microbiome, right? There's just, it just takes a little longer, likely. So. And in fact, one chapter in the book is really dedicated to that recovery plan because so many of us need to recover our microbiomes, right? And really and truly the recovery plan the foundation of it is the foundational, getting your microbiome off to the right start anyway, right?

[00:40:45] Elisa Song, MD: Because, probiotics, they're part of it. They're probably the smallest part of it, to be honest, right? I tell kids and parents, recover your microbiome is not like Jack's magic beanstalks. You can't throw 100 trillion, colony seeds in your gut and expect this beautiful, microbiome community to establish itself doesn't happen that way.

[00:41:04] Elisa Song, MD: and more is not always better either. Because sometimes doing more, that's such the American kind of Western way 5 billion can't be enough. We need 450 billion or 900 billion. But there is some evidence that giving too much, even if it's a good thing, can crowd out some of your own, native flora, right?

[00:41:21] Elisa Song, MD: And then I used to think I knew a lot about the microbiome. And now I think I know some, but there's so much more to know. The more you realize we are just at the tip of the iceberg of understanding microbiome science.

[00:41:32] Elisa Song, MD: And when we think about microbiomes, we have to ask, it's a tangent, but we do have to ask okay, when you're restoring your microbiome, Who's microbiome are we restoring, right? Because your microbiome is very different than my microbiome. What's ideal for us, given our ages, our genders, our ethnic backgrounds we're just so many different factors.

[00:41:51] Elisa Song, MD: So there is not one perfect microbiome. So just in that sense, there's not one perfect probiotic to restore your microbiome, right? So yes, I do. There are some strains that have been found in the literature and I really look for pediatric studies because that's, pediatric studies are so far behind adult studies in general, but there are some good some good studies in kids looking at specific strains that help to restore your microbiome after antibiotics.

[00:42:17] Elisa Song, MD: Certain strains that can reduce the likelihood of antibiotic induced diarrhea Lactobacillus remnosus GG and Saccharomyces boulardii, which are easy to find. But and most of the studies have found that taking, starting a probiotic alongside your antibiotic course, so if you're starting, a 10 day round of amoxicillin for strep throat, you start the probiotics during that same course, but you take it at another time of day.

[00:42:43] Elisa Song, MD: I've heard all sorts of, myths that parents have been told if you take probiotics now, it's going to make the antibiotic less effective, which does not happen. You do that, but your probiotics need something they need a reason to stick around. So we need to help support, this goes to that terrain theory, we need to support a thriving ecosystem for your microbiota.

[00:43:03] Elisa Song, MD: Your microbiome is the ecosystem and microbiota are just a part of it, the organisms, and so saying that foundation, you could take a probiotic supplement with prebiotics, but the foundations for that ecosystem are, really, truly come back down to the foods, how we're nourishing our microbiome with the fiber and the fermented foods and the phytonutrients, how we're keeping out, the neighbors we don't want, right?

[00:43:26] Elisa Song, MD: That means, eating, getting rid of the ultra processed, emulsifiers that disrupt our microbiome and the artificial colors. And it also comes down to how we're living because how we're thinking, engaging our vagus nerve, how we're sleeping, how we're hydrating, how we're moving our bodies.

[00:43:43] Elisa Song, MD: All of those help to support your microbiome for better or for worse, right? And so if we really want to restore healthy microbiome, we need to think about, how am I going to move and drink and sleep? And also, have the mindset that encourages those beneficial bacteria, all of my friends to come back and live around me, right?

[00:44:05] Elisa Song, MD: Not the neighbors that I don't want, right? 

[00:44:07] Christa Biegler, RD: Yeah. I love, so you said in different words, we're just getting started on our knowledge about microbiota. It feels like we always learn and then we realize we don't know everything. And then on the other side, we also have a lot of ancient wisdom that we can lean on, that we can choose to either lean on or not lean on.

[00:44:23] Christa Biegler, RD: And that's a. And it's a beautiful opportunity as well. It's we can also lean on things that are always safe. So two things now, so we'll talk about terrain theory and then also you just brought up Vegas nerve. I think these are all intertwined. So I'm gonna let you intertwine them however you want and you have an entire chapter in your book about the Vegas nerve.

[00:44:41] Christa Biegler, RD: Why? Okay. What changes have you seen when you've had kids start to stimulate optimized vagus nerve? 

[00:44:48] Elisa Song, MD: So you know, they're so intimately connected, right? Your gut and your brain and your microbiome and your brain, communicate via the vagus nerve. And when we start working on our vagus nerve and, by working on our vagus nerve, what I really mean is like the day to day, how are we engaging in a way of living that supports nervous system regulation.

[00:45:07] Elisa Song, MD: That's it's got to be, it can't just be, Oh, I'm going to go to the gym and exercise my vagus nerve for 15 minutes, half an hour. It's got to be the way that we are living. And that is the terrain, right? If we create a system, a whole connected system between our brain, our vagus nerve, our gut, and all of our other systems in our body.

[00:45:30] Elisa Song, MD: We create, we restore balance, right? We restore that balance and we restore the way our body should be working. To your point in your question about, what if parents, kids, adults, we're doing all the quote, right things, right? The supplement plan should be, spot on, right? They're on an elimination diet.

[00:45:48] Elisa Song, MD: They're sleeping, eight hours a night. They're exercising every day. But there's still not, there's something stuck, right? Very often that thing is the vagus nerve. If you go back to, Dr. Navio's work with the cell danger response and the healing cycle it's so beautiful.

[00:46:07] Elisa Song, MD: But I think it explains so much of why and how we get stuck in chronic health concerns. Because the final piece, when we have whatever hit, whether it's an infection or psychological trauma and environmental toxin or physical trauma, our cells go through that same healing process, inflammation, all the clinical imbalances that go into motion as a normal part of healing, right?

[00:46:32] Elisa Song, MD: The final piece to kick back into health is reengaging your vagus nerve. And so if that last piece isn't kicked in, it's, we're not going to be able to get back into that fully healed state, or maybe we'll move into it, but we keep sliding back that kind of push pull. And when we think about engaging our vagus nerve, it really has to be how do we on a moment to moment basis, regulate, keep our nervous system regulated.

[00:46:59] Elisa Song, MD: And when we have those moments of, Oh my gosh, I'm running late and in that sympathetic or I have this deadline I'm thinking about, or, Oh, I just got this awful text from my friend, right? And you're tail spinning that way. That sympathetic response is appropriate.

[00:47:14] Elisa Song, MD: We need that kind of fight or flight Oh, I'm getting ready for something. But we need to turn off too. And that's the turnoff piece is what a lot of us don't have. And so when we can learn to balance and use our vagus nerve at any moment that we need and throughout the day, that's when I think true wellness occurs and true healing occurs when people are sick.

[00:47:38] Christa Biegler, RD: Yeah, I think because we don't often turn off, we don't even know that we're turned on. 

[00:47:44] Elisa Song, MD: Yes. 

[00:47:44] Christa Biegler, RD: I would say it just takes, it's so hard to make this tangible to people, but it just takes an unlayering. So here's the really good news that there's always an opportunity for us to work on our nervous system, which is going to influence our vagus nerve, which influences kind of our stock.

[00:48:00] Christa Biegler, RD: If we're stuck in a thing and we've been doing something really good, then there might be time for a great pause. To step back to really look at that, 

[00:48:09] Christa Biegler, RD: and I love that you said sometimes we're so stuck. We don't know, that, and 

[00:48:15] Elisa Song, MD: yeah, and what's fascinating.

[00:48:16] Elisa Song, MD: It's actually a story of one of my favorite vacations ever to Glacier Park. And I remember, so in California it was one vacation that we had and my then boyfriend now husband at the time, we thought, Oh, let's go to I wanted to go to Glacier Park. It was always one of my dreams because I'd seen in college, one of my friends had a poster, a calendar poster of Glacier Park and this is the most beautiful place in the world.

[00:48:40] Elisa Song, MD: I have to go there one day. And we drove up because his dad lived in Sun Valley and his sister. So we drove to Sun Valley and then we made our way to Glacier Park, right? And it was just a magical time. We were camping. It was light until 10 o'clock, 11 o'clock at night and just so beautiful, so fresh and we were moving our bodies every day, sleeping our film.

[00:49:01] Elisa Song, MD: And then I distinctly remember. As we were driving down back home we got closer and closer to Reno and then we were in Tahoe. And it was fascinating because I could feel this pit in my stomach starting to grow. And I realized Oh, my God, for a whole week, I didn't have this pit in my stomach.

[00:49:24] Elisa Song, MD: And I only realize it now because I didn't have it. And so now I'm going to go back and sadly, I'm like, I'm sure it's going to come back. And then I will forget that it's there because it's always there. Right. 

[00:49:35] Christa Biegler, RD: That was like me coming home from Arizona a couple of weeks ago and I was out, in this like very carefully curated space, waking up to birds chirping and beautiful and everyone's just.

[00:49:48] Christa Biegler, RD: In a great mood, right? Like it is just what it is. And then I got home quite late later than expected the night I flew home. And the next morning I woke up at six or 7 a. m. To 40 mile per hour winds into your point, I felt so jarred. I was like, Oh, I'm going to need a second. Yeah. Oh, this is the baseline.

[00:50:12] Christa Biegler, RD: You don't know, you don't know that all this wind is like, so stress. And it's just I can't go outside. Everything's lit. It's just such a dumb thing. But to your point, it's you don't know what's there until you turn it off for a second. And then, you. get the opportunity to have that.

[00:50:29] Christa Biegler, RD: So I always wish for people that they have the opportunity to pause. And I think maybe everyone just such a tangible takeaway. So to your point, it's like you cannot complete the healing or the kind of the starting the ignition on cell processes happening again without vagus nerve stimulation, right?

[00:50:49] Christa Biegler, RD: There's this whole process and you can't turn it back on without that. And Something I think that's useful or something I've been like digging through this whole unconscious stress topic for a while because it's like, how do you talk about something that's not always tangible to people until you tell a story like that, right?

[00:51:03] Christa Biegler, RD: And something I think that's useful is have you ever tried to sit in silence? And just saw what happened, noticed your discomfort or your ideas or need, I've got a really popular podcast episode from the beginning of time called for people who can't meditate. And I used to be that person.

[00:51:19] Christa Biegler, RD: So anyway, these are just, these are all of the signs, and sometimes it's not obvious until it hits us. And sometimes we can also be, someone's going to slap me for this one virtually there. Sometimes it's also okay that we run into a real roadblock because that's. Where you like have your next epiphany, it's like everything is just like easy peasy. And it's I'm fine with this, like anger that I've stored in my liver. Until you hit a roadblock, you can only get so far in your thyroid journey or whatever. It's then start unlayering the pieces of the emotions. 

[00:51:48] Elisa Song, MD: It's all an opportunity.

[00:51:50] Christa Biegler, RD: All an opportunity. Louise Hay, that one of my, I used to say all failures are good experiences, but I think she said all experiences are a success, which is okay with me as well. I like that. Oh, Dr. Song. So you've got a book. It teaches us everything we need to know if we want to have healthy, happy kids.

[00:52:07] Christa Biegler, RD: Where can people find you online? 

[00:52:10] Elisa Song, MD: So the best way to find me is on my website, which is healthykidshappykids. com. And also I'm most active on Instagram. That's healthykids underscore happy kids. 

[00:52:20] Christa Biegler, RD: Perfect. Thanks so much for coming on today. 

[00:52:22] Elisa Song, MD: Oh, thanks for having me.