Eva Sheie (00:03):
The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person because you're making a life-changing decision and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There is no substitute for an in-person appointment, but we hope this comes close. I'm your host, Eva Sheie, and you're listening to Meet the Doctor. Hello and welcome back to Meet the Doctor. I'm so happy to introduce to you a nurse practitioner today. Her name is Cassie Layne, and she's the owner of Monarch Health and Wellness in the Shot Spot in the state of Indiana, and her practice is in Crown Point, which is in northwest Indiana. Welcome, Cassie.

Cassie Layne (00:48):
Thank you. Thanks for having me.

Eva Sheie (00:50):
Tell me a little bit about your practice and what you do. I know a lot of what you're doing right now is helping people with GLP-1 medications like Semaglutide and Tirzepatide. But why don't you give us an idea of the whole thing?

Cassie Layne (01:02):
Yeah, so I created Monarch Health and Wellness a little over two years ago. I was working full time and I wanted to do something that I enjoyed and something I had interest in the evenings and on the weekends, and it just exploded and took off. We started out doing weight loss and IV infusions and weight loss. We've seen a lot of good results. We've seen over 4,000 patients already getting close to 5,000 at Monarch Health and Wellness, and we specialize in weight loss. We use several different medications, Zepbound, we have compound Tirzepatide, compound Semaglutide. We use oral medications like Contrave, phentermine, low-dose, naltrexone. So there's a wide variety of medications that we can use for weight loss just depending on the patient's history, what they've used in the past, and just different factors.

Eva Sheie (01:55):
So when you're prescribing, are you helping people figure out what's going to be both the most effective but also the most affordable, whether they're covered by insurance or not? Is that kind of how that's working out?

Cassie Layne (02:07):
Yes. Actually, when I first opened, compound medication was just compound semaglutide, Tirzepatide was just starting to become popular. And we do take insurance at Monarch Health and Wellness. So we take most insurances for your office visit. So you're just responsible for your copay or your co-insurance or your deductible. We do find that probably 80 to 90% of our patients, their insurance does not cover weight loss medication. So that means it's all out of pocket. And when I first started, Semaglutide, it wasn't crazy expensive, but I was going by what people were telling me, oh, you need to mark it up, this, this, and this. And honestly, anybody who knows me knows that I don't buy anything unless it's on sale or I have a coupon, and the medication was $250 a month to start out with, and I felt bad telling people that, oh, it's $250 a month.

(03:06):
If you want to lose weight, you got to pay this. And I felt guilty, I felt bad for charging that to be honest with you. And then one, it was January, I don't remember when it was, and I was like, you know what? I'm not charging this anymore. I'm like, we're doing $98. One of my friends was like, are you sure you want to do that? I'm like, well, I'm a nurse practitioner, that's our job. We want to help as many people as we can. Not everybody can afford $250 a month or more to lose weight. I reduced the medication considerably, and I still feel bad charging $98, but that's just what it costs. These medications are expensive, so that is a factor. Cost is a factor. Not everybody can pay a hundred or $500 a month for weight loss medications. So that's where phentermine is $25, $27 in our office. Or you can go to the pharmacy and it's probably $30 or $40. So that's a much better price because getting healthy should be accessible for everybody, it really should be. It shouldn't be only for the Kardashians on Ozempic. Right? That's not how it should work. So yeah.

Eva Sheie (04:14):
Yes, completely agree. Is it still $98 to start?

Cassie Layne (04:18):
Yeah, so in Monarch Health and Wellness is a little bit different. We don't do a vial of medication. We did that for a little bit and it was honestly a disaster. Even though we showed everybody how to draw it up and, they were shooting it up in the ceiling, they dropped it on the floor, they're injecting too much, not enough. The phone was ringing off the hook. So we went back to prefilled syringes. So we do prefilled syringes for patients.

Eva Sheie (04:43):
We appreciate that.

Cassie Layne (04:46):
Let me tell you, it was a mess. It was quite a mess. We went back to the old way of doing it with the syringes. But yeah, it starts at $98 a month for medication for the lowest dose.

Eva Sheie (04:57):
So with 5,000 ish patients now that you've helped, that's a lot.

Cassie Layne (05:02):
Yes. We've had a lot of success stories, really a lot.

Eva Sheie (05:05):
Yeah, I want to hear some of those. That's where I'm going. And can you think of any standout patients whose stories you can kind of share?

Cassie Layne (05:13):
Yeah, and I'm sure he doesn't mind, but yeah, so probably I think he was my seventh patient. I call him lucky number seven. He doesn't mind. His name is Rich. He always battled with his weight. He was my seventh patient. I actually met him, I was doing a little event at any time, fitness handing out my brochures and things when I first started, and he got an injection and then later on he made an appointment with me and we got him on medication. He has lost well over a hundred pounds now, all while having a shoulder surgery. So he wasn't able to exercise. Just anybody who knows, rich knows his determination, and he was determined to make some life changes. And I think for some people the medication is just kind of a kick in the butt, like a start, and then it's up to the patient to kind of do more than that.

(06:05):
So I always say, no one made Rich do 5Ks and 10Ks. No one makes Rich go to the Peloton studios in New York City and work out. No one makes him do those things. The medication didn't do that, that's all Rich doing that. The medication for him, I think was just a tool to get him started, and then he just went off after that. So that's one patient in particular. And might I say, I also, when was this, maybe last year we did an InBody on him, cuz I wanted to check his muscle mass to make sure that he wasn't losing much muscle, which I kind of didn't think he was because he was exercising regularly. And the medical assistant brought it to me and I looked at it, I said, well, this is wrong, you need to do it again. And then I looked at it and I was shocked by how he had no body fat in all this muscle, and it was absolutely, it was accurate. Just glancing at it though, I told her, I said, this is wrong. You need to do it again.

Eva Sheie (07:07):
That InBody can be a little fickle. Yeah.

Cassie Layne (07:10):
So that amazed me by how much muscle mass he actually had and how much low body fat percentage that he had. So that's one person in particular. But we have lots of stories, lots of patients. Some days we'll have patients all day on my schedule of 50 pounds, 70 pounds, 42, just lots of big numbers. But again, those big numbers don't come after just a couple months. That's a lot of consistency and determination. And anybody who's battled with their weight knows that you fall off the wagon, you fall off, you eat whatever, you don't exercise, but you get back on and that's how you get the steady weight loss. You always gotta get back on.

Eva Sheie (07:53):
It's like having guardrails on your wagon, I think. Yeah.

Cassie Layne (07:58):
Actually one patient, I said, oh, I haven't seen her in a while, and she said, or no, I said, oh, you fell off the wagon, huh? And she said, I fell off the wagon, the wagon went down the street, I have no idea where that wagon is. And I just laughed.

Eva Sheie (08:10):
You can always get the wagon back.

Cassie Layne (08:14):
Exactly. Exactly.

Eva Sheie (08:17):
So have you taken the medications yourself?

Cassie Layne (08:20):
Yes, I have. I started, this was, I don't even know when, probably in 2021, I saw where Ozempic could be approved for insulin resistance and pre-diabetes. I was prescribed ozempic and I took it. I didn't really honestly know a lot about the medication at the time, cuz I did orthopedics completely different, and I lost 15 pounds. I didn't even try. And I noticed that I really wasn't hungry for dinner, I just wasn't eating a lot in the evening. And for some reason I stopped taking the medication, I have no idea why. And I gained maybe five pounds back and then several months, maybe a year later, I got back on it. But I've been on Ozempic when the $25 coupon was readily available. I've been on Zepbound and I've been on the compounds as well.

Eva Sheie (09:13):
And are you still doing it now?

Cassie Layne (09:15):
I need to. All the time, I say I need to get back on something. Over the past year, I've been very, very, very inconsistent. I'll do maybe a shot of Wegovy once a month, sometimes every two or three months, to be honest with you. And I'm on the highest dose, I really don't have many side effects from it, even being off for several months. So I think that it kind of keeps me back on track, but I do want to lose more, so I need to be more consistent with it. And I think also at this point, instead of Wegovy, I need to switch to Tirzepatide because it's a better medication and I'm not really getting much weight loss where I'm at now. I think my body's just kind of plateaued and used to it. And also too, I'm not making much of an effort. So if I put some effort into it, I'd probably see results.

Eva Sheie (10:04):
I know I never forget my numbers, but everybody's different. Do you remember your highest weight and are you willing to share that, the stats with us?

Cassie Layne (10:14):
So the highest I've ever been that I can remember was 260 pounds. I've battled with my weight most of my life as a lot of overweight people have, and I actually had weight loss surgery that's on my Facebook group as well, like my story. So I battled with my weight my whole life. It's something I'm probably always going to battle with because it's a chronic condition. It doesn't just disappear. You got to put a lot of work into it, and then in combination with medications, you can help control your weight.

Eva Sheie (10:46):
Do you find as a nurse practitioner that because you've been through it yourself that you have more empathy and a bigger heart for people who are going through the same thing?

Cassie Layne (10:57):
I think so. I also think that people who haven't battled with their weight, they can also sympathize or empathize as well, but I think maybe a little more difficult. So I think that being on the medications, struggling with weight, it does, I think help because you can relate to patients. You kind of know what they're going through. You've been in their shoes, so yeah, I do.

Eva Sheie (11:21):
You've probably heard everything at this point, and I'm wondering if there's myths or misconceptions you hear all the time that you can kind of help us clear up.

Cassie Layne (11:30):
So like I said, we've seen close to 5,000 patients at this point, especially a while ago, you were hearing all over, oh, you're going to have stomach, what they call it, stomach paralysis.

Eva Sheie (11:40):
Oh, paralysis.

Cassie Layne (11:41):
You're going to have stomach paralysis, you're going to get pancreatitis, you're going to have thyroid cancer. We have never had any cases of bowel obstruction or gastroparesis, bowel paralysis that they're talking about related to GLP-1 medications at all. We have seen none of that. We have not seen any cases of pancreatitis. We have not seen any cases of thyroid. What have we seen? A whole lot of nausea, acid reflux, gerd, and a whole lot of constipation, just more or less GI issues that are very manageable. These medications are all the rage now, right, they're all over the place. I turn on my computer and all I see is Ozempic, Wegovy, there's stories about it everywhere. And I've seen recently where FDA is warning about these medications and no, they're not. Some of these stories, they're just half truths. It's just sensationalized. They're just putting a bunch of stuff out to get people to read it.

Eva Sheie (12:41):
This morning I had someone message me, what are you going to do about this shortage? Well, I'm not going to worry about it, cuz if there is one and they do something, then no one can get it. But I don't think that's going to happen.

Cassie Layne (12:54):
Yeah, so name brand Wegovy was next to impossible to get for a long time in my area. And it's different in different areas of the country, but in northwest Indiana, Wegovy for a long time was very difficult to get anything under the one milligram dose. It's just now starting to come back out, so we're starting to get it now. Now, Zepbound's, the big one where Express Scripts is completely out, a lot of the pharmacies are out, so that one's difficult. I have a couple of diabetics that are on Mounjaro and they're having a little more difficulty getting that now. But the good news is we have compound medications that are much more affordable than the thousand or $1,500 a month in the pharmacies. Someone asked me, actually one of our nurse practitioners, she's like, what are you going to do when they can't compound medications anymore? I said, I don't see that happening. I don't see it happening. The compound pharmacies, number one, are making a ton of money. They are not going to shut down. There's going to be loopholes, they're going to figure it out.

Eva Sheie (13:59):
Yep. I'm confident they will too.

Cassie Layne (14:01):
Yes.

Eva Sheie (14:02):
So you have a team there. Can you tell us about who the people are around you that are also doing the same work that you're doing?

Cassie Layne (14:10):
Sure. So a couple years ago, or actually no, about a year ago now, I was scheduled a month out in advance and I said, I need help. I need another nurse practitioner, so luck should have it, Paige, from Oklahoma, was looking for a position to move here to Indiana. So Paige was my very first nurse practitioner that came on board with me. Everyone loves Paige. She's really interested in thyroid optimization and hormone optimization as well, which is something else that we do. But she's very down to earth. She talks to you like a friend. I think we all do, and people can relate to her. So she actually was just on maternity leave and is coming back next week. So that's exciting. And then we have Kate. Kate's another nurse practitioner who is fantastic. Everyone loves Kate. She's really good at what she does. She actually just left last week on maternity leave.

(15:03):
We got a lot of pregnant ladies around here. So Kate's great. And then Megan, who is a physician assistant, she has a history of doing orthopedics prior to this as well as family medicine. And she's really good. She's very evidence-based, keeping up to date with all the things, coming out with medications. So there's Megan. Then we also have Desiree. She has been on Mounjaro. I think she was using the $25 coupon and has lost 80 pounds or something similar to that. And she comes to work and is showing us all the protein shakes and everything, cuz still on her journey. She's like, I think she wanted to get down to the 100 and thirties. She's petite and she's maybe five pounds from her goal. So she's also lived it. And then we have Janae. She's down over 40 pounds. She's really into functional medicine, thyroid optimization. She just actually got some pellets with us. She has not been on the GLP-1 medications, but she knows all about diet, exercise and all the things we need to do to lose weight, cuz she struggles herself.

Eva Sheie (16:08):
I didn't realize how many amazing photos were here. There's tons of 'em.

Cassie Layne (16:12):
Yes. And that's not even the half of it.

Eva Sheie (16:15):
No, of course.

Cassie Layne (16:15):
I never ask people, Hey, can I put up your before and after, just because it was just, I wouldn't want to put my picture up there if I was a patient. I personally wouldn't want to, but everybody wants something different, and so that's kind of why I put that up there so that if people want to inspire others, they can put their story out there. They should be proud of that. It's like look at those pictures. So yeah, there's a lot and a lot more that we see every day in the office.

Eva Sheie (16:44):
Yeah, this is great. It's such a great idea for a post too, to just ask everybody else. Cuz yes, once we get down here, we love showing our photos. The challenge is actually, I mean, we don't have that many before photos. We didn't let anyone take pictures of us for sometimes decades.

Cassie Layne (17:02):
Or you take pictures and you hide 'em. You don't want anyone to see 'em. But also too, looking back at my picture in particular, I knew I was overweight, right? When you're overweight. But then looking at that picture, I don't think I realized how overweight I really was and what I really looked like, you know?

Eva Sheie (17:20):
Do you think we have a coping mechanism in our brains that helps us not see the truth when we reach that point? I've sort of wondered this for a long time.

Cassie Layne (17:31):
I definitely think that's possible. Sure.

Eva Sheie (17:34):
Yeah. It's a whole new world we're in.

Cassie Layne (17:36):
Yeah, and I think when you're overweight too, I was talking with someone about this not too long ago that, when you're overweight, you're always thinking about, oh, this doesn't fit. Or You're pulling your shirt down, or you're always thinking about your size, whether it's in relation to what you're eating or going on a diet or your pants are too tight or whatever. And then when you lose weight, you don't think about that stuff anymore. You have more room in your brain for other stuff. You're not thinking about that all the time.

Eva Sheie (18:07):
It's almost instantaneous when you start the medication.

Cassie Layne (18:12):
True.

Eva Sheie (18:12):
Which that's one of the miracles about it, is that you get your brain space back before you get anything else.

Cassie Layne (18:19):
Yeah.

Eva Sheie (18:20):
Because you're not thinking about food. That immediately goes away. And I found that to be just so unbelievably freeing.

Cassie Layne (18:28):
Yes. I had one patient, and I still tell this to other patients as well, that this medication works very well for food noise for a lot of people. And she had always struggled with her weight, struggled with some eating disorders when she was younger, and I put her on, I think she was on Semaglutide, and the next month we followed up with her and she looked at me just straight, just serious. She's like, is this how normal people feel? Because she wasn't constantly thinking about her next meal or snacking or food. It was an afterthought.

Eva Sheie (19:04):
Game changer.

Cassie Layne (19:05):
Yeah, for sure.

Eva Sheie (19:07):
Well, what else do you like to do other than take care of people? What do you do outside of work?

Cassie Layne (19:13):
There's stuff to do outside of work?

Eva Sheie (19:16):
No, when you love work this much, maybe you don't need anything else to do.

Cassie Layne (19:18):
Yeah, we're just a very busy practice. I feel like I'm always working, but no, I actualy have three children at home. I have a 21-year-old daughter, and then I have a 5-year-old and a just turned 7-year-old little boys. So very busy outside of work. Yeah.

Eva Sheie (19:34):
Yep. You've got enough to do.

Cassie Layne (19:36):
Yes.

Eva Sheie (19:38):
If someone's listening today and they would like to find out more about you or possibly coming to see you or doing telehealth, how do you suggest that they go about doing that?

Cassie Layne (19:49):
So if you're in the area, Northwest Indiana, so you can just go on our website, MonarchHealthandwellness.net. You just go and make an appointment. You can also follow us on Facebook and Instagram, Monarch Health and Wellness. If you are in the state of Indiana and you're not close to Monarch Health and Wellness, we also do telehealth. It's called the Shot Spot, so that is theshotspot.net. We have Nikki and Debbie who are fabulous, who've been doing weight loss management for quite a while. Everyone loves them. So I think that's really good for people who maybe have already been on the medications, they're going to a med spa paying $600 a month for medicine, or that just don't need the accountability and the support that an in-office appointment would need. So that, that's great for that. And then we're also on Facebook and Instagram as well under The Shot Spot. I think The Shot Spot Indiana.

Eva Sheie (20:44):
I'll make sure we put all those links in the show notes so they're easy to find.

Cassie Layne (20:48):
Okay. Sounds good.

Eva Sheie (20:49):
Thank you, Cassie. It was so nice getting to know you today. I am really glad that we got to meet you.

Cassie Layne (20:54):
Thank you. Thanks for having me.

Eva Sheie (20:57):
If you are considering making an appointment or are on your way to meet this doctor, be sure to let them know you heard them on the Meet the Doctor podcast. Check the show notes for links including the doctor's website and Instagram to learn more. Are you a doctor or do you know a doctor who'd like to be on the Meet the Doctor podcast? Book your free recording session at MeettheDoctorpodcast.com. Meet the Doctor is Made with Love in Austin, Texas and is a production of The Axis, theaxis.io.