with Dr. David Hilden


Gender-affirming care and why it matters

In Episode 19 of the Healthy Matters Podcast, we talk about transgender health issues with my colleague at Hennepin Healthcare, Dr. Haylee Veazey – who in my opinion is a leading physician, not only in clinical care, but in education about transgender health and gender health in general.

During her second year of training, while the rest of us are usually trying to figure out how to write an order for Tylenol, Dr. Veazey was developing a whole new clinic model for those seeking care for gender and sexual health. Overachiever?

“We started our first day of clinic in 2016 and started with one single patient showing up,” she said. “And since then, throughout the rest of my time as a resident, and now as a faculty for the last few years, we’ve got a full panel of patients and we’re booking months out.”

Dr. Veazey sees patients with a variety of care needs in the Adult Gender & Sexual Health Clinic.

“We have patients that come to us for just regular primary care – for blood pressure management or to have their blood sugar and lipids checked every year, but we specialize in gender-affirming care. So we do gender-affirming, hormone replacement therapy to help people align their physical body with their gender identity. We do referrals for gender-affirming therapy for mental health and surgeries. We help people with pre-exposure prophylaxis to try to prevent HIV and sexually transmitted infections (STI) testing and treatment. We also help with some limited family planning as well. It’s a great place where people who are members of the LGBTQ community can come and get their normal primary care but also take care of gender and sexual health.”

Throughout this podcast, Dr. Veazey used some terms that I’ve become familiar with, but only because I hang around with people who use them a lot. I asked her to explain, “what is ‘gender’ and how is it different than the sex you were assigned at birth – and are they different?”

“They’re very different,” Dr. Veazey explained. “It’s kind of like talking about a house. A house has plumbing and electricity and they’re separate systems, but they’re still part of the same house. And when we talk about sex assigned at birth, that’s the physical structures that we can observe with our eyes that tell us that a person has more masculine or feminine physical structures to their body. And there’s a huge range of that. That’s one part of someone’s identity and personhood. That’s an example of extreme diversity in the human species – and it’s like everything in nature. It’s not binary. There’s not just black and white, X and Y. It’s a huge range from the most maleness that a body can have to the most femaleness that a body can have. And it’s completely separate from someone’s gender identity.”

We sort out many questions you may have about what it means to be transgender, providing gender-affirming healthcare, and addressing health disparities related to people whose inner concept of themselves does not align with the gender assigned to them at birth in Episode 19 of the Healthy Matters Podcast.


Sit Up Straight – We’re Talking to a Chiropractor

We’ve all experienced back pain, and I’ll venture to guess that a few of us have even had a headache or two. These are some of the reasons patients seek help from my guest on Episode 18 of the Healthy Matters Podcast, chiropractor, and colleague Dr. Richard Printon. He explains what patients can expect at a visit to his clinic:

“We start by taking a history. How did you hurt yourself? Did you sleep wrong? Did you bend and lift something? Did you fall? Was there some sort of trauma involved? At Hennepin Healthcare, we’ve got the access to all the different types of treatments that the patient has already had. For example, if Dr. Hilden refers a patient, I can see his assessment, find out what happened, and what’s already been done to help me determine a plan of care.”

That’s right – Dr. Printon’s practice is embedded in the same place where I work at Hennepin Healthcare, and he sees patients on the 3rd floor of our Clinic & Specialty Center – alongside colleagues in physical therapy, occupational therapy, massage therapy and more who work with neurosurgeons and all the other specialties related to physical medicine. Talk about convenient care! It just doesn’t get any better than this.

Dr. Printon and I discussed the many things that can affect neck and spine health and I mentioned how my wife is concerned that humans are going to suffer permanent damage from always being hunched over cell phones. I learned this is already a condition called “tech-neck.” He also mentioned how neglecting neck and spine care isn’t new.

“Posture is the biggest underlying cause of back pain,” he said as I sat slouched in my chair. “And one of the best ways to prevent back pain is movement, exercise and correct posture.”

Dr. Printon answered a question from Kim in St. Paul (as I dutifully readjusted my posture). Kim said she was playing tennis and in a twisting motion, seemed to have pulled something in the inside muscles of her back. She asked if she should use ice or heat to help relieve the pain.

“Start with ice,” he advised. “Usually, those types of conditions will resolve within a couple of weeks, but if it persists more than two weeks, a chiropractic evaluation would be recommended. In that situation, especially tennis, it’s a twisting type of motion of the back so you could have strained or rotated a joint in the back.”

Dave from Eagan asked about a shoulder injury, which led to a conversation about this amazing joint and its miraculous range of motion. From being able to comb one’s hair to throwing a baseball at 90 mph. Seriously! We also talked about the warning signs that accompany back pain to be aware of that would indicate the need to go seek care immediately.

So sit up straight – and enjoy Episode 18 of The Healthy Matters Podcast where we break down the benefits of chiropractic care.


Hilden’s House Calls – from Polio to Pickled Probiotics

It’s another informative Hilden’s House Calls on Episode 17 of the Healthy Matters Podcast where Dr. Hilden answers questions from listeners about everything from polio to pickled probiotics.

Marie from White Bear Lake heard about a recent polio case near New York City. Yes – it’s true. A case of poliomyelitis – which was thought to have been eradicated – was recently diagnosed. Unfortunately, polio still exists in the world, but it is indeed rare. There are two types of polio vaccines: one is a shot, and one is an oral liquid. The oral one is no longer used in the United States because it contains a live virus; however, it is used in other parts of the world. We’ll learn more about this but it’s likely that the individual with the virus came from another country where they received a vaccine that we do not use in this country.

John in Minneapolis (who is also our unpretentious podcast producer) loves pickles and apparently comes from a strong paternal line of pickled food enthusiasts. Herring, beets, onions, mushrooms – no preserved item is safe within his grip. He asks if there is a health risk associated with his fervor for the fermented.

John might be the first person I’ve met with this degree of pickle passion. Pickling basically marinates and preserves food – usually with vinegar and some salt (brine). Kimchi, for example, probably contains lots of probiotics because as items ferment, they develop beneficial bacteria.  That can be good for your gut, and it might contain other vitamins and nutrients. The only downside that I’m aware of is the salt content. If you’re someone with heart failure or high blood pressure, you should monitor your salt intake – wherever it comes from – even if it’s a homemade jar of pickles.

Steve from Kansas City called in to ask us a question about grilled foods. Is there such a thing as too much barbecue? I tread lightly on this answer for our friend from one of the famous barbecue cities in the United States. And it made me hungry.

Claire in St. Cloud asked about monkeypox. Diane, from Champlin had questions about the shingles vaccine. Sarah in Hudson wondered about Paxlovid antiviral pills for treating COVID.

Cathy from Coon Rapids asks about the new 988 number for mental health. Everybody knows to call 9-1-1 for emergencies, but now we have another number to call specifically for mental health concerns. When you call this number a live, highly trained counselor answers. It’s best used by people in a mental health crisis, specifically those who are at risk of hurting themselves.

Kevin from East Grand Forks wrote in and asked us about the connection between exercise and mental health. Is there any connection between exercise and cognitive decline, such as Alzheimer’s?

Right now, there are millions of people who have cognitive problems like dementia, Alzheimer’s disease, etc. We don’t know how or why it develops in some people, but lots of research is being conducted and what they are finding is that exercise – both physical and mental exercise – have been shown to help.  I share more specific information about this in the podcast. So take a listen and go for a walk – exercise your brain AND your body with Episode 17 of the Healthy Matters Podcast!