Heather (Host): Hi there, everyone. Thanks so much for tuning into this latest episode of Medically Speaking. Joining me today is Dr. J'Leise Sosa, who is the Medical Director of Oishei's OB-GYN Centers here in Western New York. Thanks so much for being here.

J'Leise Sosa, MD, MPH, FACOG: Thanks for having me, Heather.

Host: Excited to chat with you. And first of all, you're still relatively new, so we'll give you an official warm welcome to Kaleida.

J'Leise Sosa, MD, MPH, FACOG: Thank you.

Host: Although, I feel like you've been here for years, because you're a familiar face around these parts.

J'Leise Sosa, MD, MPH, FACOG: Yeah, I have. Though I've only recently started working for Kaleida specifically, I've been in the Kaleida stratosphere for my entire career since graduating medical school and coming here as an OB-GYN resident, having my own child at Children's Hospital of Buffalo, and then working at the hospital to do deliveries and my surgeries at Oishei and at Millard Fillmore Suburban. So, I've been around. But very happy that I am now sort of part of the Kaleida family.

Host: Well, we are very happy to have you as part of the Kaleida family. Being around the hospital and working very closely with Kaleida, did that make that transition just a little bit easier as you moved into your new role?

J'Leise Sosa, MD, MPH, FACOG: Absolutely. That ease of transition is really what speaks about, you know, how we treat our own, right? I had the opportunity to already know so many folks on the teams I'm working with now, and that made starting a new job less daunting. A lot of times I'm able to have informal conversations about what the concerns are in our clinics. And I was really, really good be able to just move right in and start working right ahead instead of having to take a lot of time to get to know folks. That familiarity before really helped.

Host: And I feel like, you know, the way we have done things, but that also gives you good insight into how you want to pave the way for the future, right?

J'Leise Sosa, MD, MPH, FACOG: I think so. In working alongside an organization, in an organization where, you saw it from different perspectives, as a trainee, as you're learning your field, then starting off in this field. And even from a patient perspective, really does give me great insight. Living in the community where our sites exist too, Kaleida is my neighbor too. So, really getting to have that perspective, I think, allows me to understand where we want to go as an organization and see what our role would be as Women's Health to partake in that.

Host: You were very busy running to clinical sites. Your work is in surgery, the clinical practice. How do you juggle it all and as a mom as well? It's a lot. I feel like we see each other in the hallways. And it's usually just buzzing right past each other. And again, thank you for making time, because I know you are so busy. But how do you tackle it all?

J'Leise Sosa, MD, MPH, FACOG: Teamwork really. I am not a one-man team at all. And I'm really grateful for our teams at the clinics. We have administrative partners, who we sit down and we think about our strategy and our goals. We have support from the highest levels all the way down to our front desk staff, to our medical assistants, to our nurses. That really makes a difference for us. And because we have teams who are invested and that are dedicated to our patients, it's easy to do the job.

Host: It's a well-oiled machine for sure. Talk about the two centers at Kensington and Niagara. I think that sometimes people don't realize, number one, that they're even there. And what do they offer to the greater community?

J'Leise Sosa, MD, MPH, FACOG: Yeah. We are here, we exist on the west side and on the east side. So on the west side, we have our Niagara Street Clinic. And on the east side, we're at Kensington OB-GYN Clinic on the ECMC campus. We offer full spectrum reproductive care from first period through pregnancy, through perimenopause and beyond. So, your entire time of reproductive care, we will take care of you. And as you transition through those different life stages, we're with you supporting you along the way.

Host: As somebody who is a little bit later in age, I love that you mentioned perimenopause, menopause and beyond, because I feel like sometimes we don't always put a lot of focus on that, right? We focus up in the reproductive years, giving birth and new moms, but it goes well beyond that as we both know.

J'Leise Sosa, MD, MPH, FACOG: Yeah, I think, this is something that's a personal interest of mine, perhaps because it matters to me personally. But it's something I'm really encountering with my patients almost on a daily basis, where folks are coming in saying, you know, "I'm experiencing these symptoms and I really don't know how to prepare for this, like this just sort of happened. Nobody warned me what is going on." And it's really important for us to start focusing on women after 35, to be honest.

And women's health beyond birth is another passion of mine and it's something I really wish that we could, in the time to come, really get into the community, share the knowledge, and really educate women and provide the care that women need and support in this time.

Host: And it's not just "I'm going through perimenopause or I'm going through menopause and that's just it, that's just life." There are things that you can do and your team can do to help people alleviate certain symptoms. What are we talking about that can help through the change, as some people call it?

J'Leise Sosa, MD, MPH, FACOG: Yeah. I think what we can do, first of all, is help you prepare. So before the change actually happens, we know it's inevitable. So, how do you optimize your health to minimize those symptoms? What are some risk factors you may be at higher risk for because of your personal genetics, your personal family history, your other medical problems.

And then, when the change happens and you start experiencing those symptoms, we have medications we could give you to treat, if that's the best option for you. We have ways we could talk about lifestyle changes, support with nutrition, exercise, things like that. So, there are a lot we could do and, you know, you don't have to deal with it alone. You should come in, have that discussion with us, and we'd be happy to help.

Host: Because it is very real, right?

J'Leise Sosa, MD, MPH, FACOG: Yes.

Host: And we're all living with it. Yes, we're all living with it, for sure. Going back to the centers, how are they working to make healthcare more accessible, more equitable and more culturally responsive for your patients? Because those are really big points that we want to hit.

J'Leise Sosa, MD, MPH, FACOG: Yeah. I think the main thing for us right now is our location, right? We are located in the communities we serve. So, women do not have to leave their homes, travel long distances. Where you live and work is where we are to serve you, and that's really important.

We have staff members who are multilingual. We have staff members that represent the cultural backgrounds of the patients we see. We not only have that, but we're consistently working on how do we improve this? How do we learn more about our communities? How do we learn about the experiences outside of healthcare that a patient may have with it? Is it a financial constraint? Is it some other housing constraint? We have a social worker-- social workers, I'm sorry-- who are there also to support life outside of purely health. Because everything affects each other, right?

Host: Absolutely.

J'Leise Sosa, MD, MPH, FACOG: Your ability to make it to an appointment has to do with transportation, childcare. So, having that sort of wraparound service is excellent. And we are soon launching or centering a pregnancy program, which also is a great program that helps women to receive prenatal care in groups. They support each other. It's shown to decrease rates of postpartum depression, decrease rates of even C-sections, which is amazing. So things like that. We continue to listen to our patients, see, we'll ask what they need and try to respond in that manner, you know, in a timely fashion. And then, consistently staying abreast of latest research, what is going on in our communities, what's specific to our neighborhoods and trying to meet those needs.

Host: In addition to very simply being able to communicate, when you have a provider that speaks a patient's language, that looks like a patient, what benefits does that offer to those patients as they seek care?

J'Leise Sosa, MD, MPH, FACOG: Yeah, significant benefits. And thankfully, we have the data to back it up. So, it's not just an opinion. We know that culturally concordant provider-patient relationships often end up with higher compliance with medication, compliance with whatever management you decide to have. Patients feel that they can trust their provider more and may then give more information about what they're experiencing that could help us provide better care for them.

Host: Because in some marginalized communities, there is still a distrust with healthcare, right? And with providers. And we want to break down those barriers.

J'Leise Sosa, MD, MPH, FACOG: Exactly.

Host: Break down those walls.

J'Leise Sosa, MD, MPH, FACOG: Yeah. That is really one of our top missions to rebuild that trust, to re-earn that trust with patients, knowing that we listen, we hear you, we respond to what you address with us. And I think that's really critical, probably a foundational step in how we provide care. You could have the best equipment, you could have the latest fanciest machines, but without that trust between your provider and patients--

Host: Nobody's coming in.

J'Leise Sosa, MD, MPH, FACOG: Exactly.

Host: Yeah. Yeah. What are some of the challenges or other challenges that you see in Buffalo when it comes to reproductive and maternal health? And what do we do to help break down some of those walls?

J'Leise Sosa, MD, MPH, FACOG: Yeah. So, we talked about caring for us when we start to age, for the change.

Host: We would know nothing about that, right?

J'Leise Sosa, MD, MPH, FACOG: No, no. I'm 25.

Host: Yes, me too. Oh, you don't look a day over 24.

J'Leise Sosa, MD, MPH, FACOG: But truly another underresearched area is fibroids. And that is something I am also pretty passionate about because we have, I think, about 80% of African-American women would be affected by fibroids in their lifetime, 70% of white women. And for some reason, unfortunately, when a patient comes to me, I still have to say, you know, "We really don't know why. We don't know what causes it, but these are the things we could do." Can we prevent it? No. Can we stop it? No. And that's not okay. And so, this is an area where we really need to focus on research.

I know in the federal level, there have been attempts to create bills and have more funding towards fibroids, which would be great as we expand research and treatment options. But here in Buffalo, a lot of women are affected by it and not realizing how serious it is. It could cause severe anemia that could affect your quality of life, your heart health, organ health. They live in pain and normalize it. As a result, because they're told, "Oh, it's no big deal. At least it's not cancer--"

Host: "It's normal."

J'Leise Sosa, MD, MPH, FACOG: Yeah. Yeah. And we can't normalize things like that. And I think it's something we really need to spread awareness about.

Host: So, we don't know what causes it exactly?

J'Leise Sosa, MD, MPH, FACOG: We sort of know. We know a few things.

Host: Okay.

J'Leise Sosa, MD, MPH, FACOG: So, we know that there are a few genes that mutate, one of them being the MED12 gene. And you may be born with that mutation or because of environmental factors such as products we find in makeup and hair products, they could over time cause that mutation to occur. And then, someone could grow fibroids.

So, the way our uterus responds to the hormones or ovaries makes will change when that gene turns on and instead of the uterus acting like it normally would, it starts creating these cells that don't follow the rules and turn into fibroids and grow over time. So, we're getting there. We just need to continue that momentum.

Host: What can you do to alleviate the symptoms or fix the problem altogether? And to tack onto that, I was looking at your Instagram and you were wearing a T-shirt that said "Hysterectomy is not the only option." And I've found that to be really interesting.

J'Leise Sosa, MD, MPH, FACOG: Yeah. I have to thank my lovely patient, who made that t-shirt for me.

Host: I love that.

J'Leise Sosa, MD, MPH, FACOG: Because she had been dealing with her health issues for such a long time and was being told over and over that the only thing she could have done is a hysterectomy.

Host: Which is very invasive. Recovery time, complications. And I feel like even mentally and emotionally, there is something that goes along with having a hysterectomy too, right?

J'Leise Sosa, MD, MPH, FACOG: Oh, absolutely. And, you know, for us women, our uterus is our womb, it's where we grow our children, i'ts how we grow our families. And to take that away is no sort of simple thing. That sort of is no big deal. It is a big deal.

Host: And to be told that's the only option, which again, you're saying is not. What other things can we do?

J'Leise Sosa, MD, MPH, FACOG: Yeah, there are other surgeries you could do to remove the fibroids only. In several cases, I think patients are told, "Oh, your fibroids are big, so we'll have to do it this way." No, you don't. We can take out large fibroids in minimally invasive procedures. You can use medications to help treat those symptoms. There are other medications where you could even burn the fibroid from the inside out, rendering it ineffective. And there's an even more minimally invasive procedure done by radiologists called a uterine fibroid embolization, where it's just a catheter that runs through the vessels that supply the fibroids and block those. So, there's several options and it's important that you know what's the right option for you. Every option isn't right for every patient, but I don't think it's reasonable to tell someone hysterectomy is the only option. That should be the last option.

Host: Now, let me rewind a little bit because we're talking about fibroids, but how would one know if they have them? How would you, discover that you have them? How do you know what symptoms might be connected to that? And how do you start from a diagnosis, so to speak, to a procedure or something to fix it down the line?

J'Leise Sosa, MD, MPH, FACOG: I think it's really important to stress how important it is to see your gynecologist yearly. That's your step one. Because you see your gynecologist yearly and you have a pelvic exam. We discuss what you're experiencing, things you might think are normal, we might then tell you, actually this is not. So again, a lot of women normalize heavy periods or painful periods. Those are the most common signs of fibroids. But a lot of folks come in and say, "Oh, this has been ever since I was a teenager. This is how it's been." So, they think that's just how the way they are.

Host: Do you sometimes look at them and go, "Really? You have been living with this for 10, 20, and 30 years?"

J'Leise Sosa, MD, MPH, FACOG: Exactly. And they think it's normal. And so, they never complained about it because like, "Oh, this is just how it is, and then this is how we find out." So, bleeding and pelvic pain are usually the main symptoms. There are a few others. Some people may present with constipation, frequency with urination. You may be laying on your belly and realize, "Oh, why does it feel like there's something in there?" And some patients, if you have a really large uterus, you could even have symptoms like heartburn because it's pressing on your stomach.

Host: Wow. Yeah. That's really interesting. We know, as women and also, you know, as moms, sometimes we worry about everybody else before we worry about our own health. What is your message to, you know, anybody who might be putting their own health on the back burner? Because you'll get to it at some point. You know, you've got to worry about something else and instead you're too busy. We make the excuses, we hear the excuses. But what is your message?

J'Leise Sosa, MD, MPH, FACOG: My message is it's important to focus on your own health. You can't help your family. You can't do your job well, if you are suffering, if you're in pain, if you have other medical problems.

For you to thrive, you need to take care of yourself first. And when you do that, you actually can do better for the entire family. You can do better at your job. I strongly believe that women are the fabric of our communities. Like you said, we take care of our entire families. We get everybody else to their doctor's visits. And without you being there, and without you being there for a long time to come, then our community or families will break down. So if you're really thinking about your family, your friends, and all those other things that matter, taking care of you first is important.

Host: I also think of the community as a whole and being a good role model, and especially going back to marginalized communities. If we can be the ones that step up and say, "Hey, I did this. I took my health into my own hands," maybe other people see it and they pay closer attention.

J'Leise Sosa, MD, MPH, FACOG: Good modeling.

Host: Yeah. Exactly. That can go a long, long way. We still have to go a long way when it comes to pregnancy mortality rates, and especially when it comes to black women, women of color. I think about it sometimes. I'm like, "Here we are in 2025 and we are still unfortunately talking about this."

J'Leise Sosa, MD, MPH, FACOG: Yeah, yeah. I want us to move from just talking about it to doing something about it. The awareness is there. We know how stark those numbers are, four to five times more likely to die in childbirth.

Host: Why is that?

J'Leise Sosa, MD, MPH, FACOG: That's not okay. Because black women have been exposed to chronic stress because of bias that exists in all communities. We are not listened to always. We don't trust the system, so we may be hesitant to engage with the system. And like I said at the beginning, it's really our job as healthcare providers to earn that trust back and then listen to those patients and respond when there is a concern. If you have athletes like Serena Williams who know their bodies inside out, know what works, and when they have problems, they're not listened to on labor and delivery, then what are we saying for the average woman? So, I think the onus is on us as healthcare providers to be able to know that this exists. Don't deny it, don't ignore it, address it face on, and really listen and respond to patients.

Host: Yeah. What is your vision for not only the centers, but just your care in general and where we go at Kaleida as a whole when it comes to women's services?

J'Leise Sosa, MD, MPH, FACOG: I think investment in women's health is paramount if we want to be at the forefront of healthcare. There's no moving forward without moving forward with women. Again, we are the foundation of families and communities. And my vision is that we are a model for a community-rooted evidence-based, healthcare center where you have the best care right in your community and your quality of care does not depend on your ZIP code.

Host: Absolutely. Anything new on the horizon, exciting on the horizon? You talked about centering pregnancy. Anything else that we should be on the lookout for or know about in the near future?

J'Leise Sosa, MD, MPH, FACOG: Well, we're really excited to start our ultrasound program or our advanced ultrasound program where we're able to diagnose endometriosis even before surgery.

Host: Oh wow.

J'Leise Sosa, MD, MPH, FACOG: That is a game changer because so many times women with endometriosis have to have this sort of surgery where you look in, is it there, is it not? Your surgeon may not be prepared to actually handle it completely at that time, so then you have to rebook the surgery. I am really excited that we will have the opportunity to do the ultrasound ahead of time, which allows us to plan well. So if the bowel is involved, I'm able to get the colorectal surgeon involved. If the lungs are involved, as endometriosis affects all organs, we get the cardiothoracic surgeon involved and we're all there at one time doing the right surgery the first time without having to do multiple surgeries and put patients at increased risk.

Host: And it's obviously fewer surgeries, fewer risks, quicker healing.

J'Leise Sosa, MD, MPH, FACOG: Complete. Yeah, complete the first time.

Host: Yeah. And closing that circle. You touched on a great point. Having all of those different resources, again under that Kaleida umbrella, what does that mean for the work that you do? Because people might not normally think OB-GYN, why would I need a thoracic surgeon? Why would I need a gastrointestinal? But I think you explained it. We're all one team.

J'Leise Sosa, MD, MPH, FACOG: Exactly. We're all one team. Your GYN might be sort of the gatekeeper who assembles that team and gets everybody together. But it is really important that we treat the whole patient and we're not just a series of organ systems.

Host: Yeah. Well, we are so happy that you were a part of our team, Dr. J'Leise Sosa, who is the Medical Director of Oishei's OB-GYN Centers. I would love to have you back on in the future again. The future is bright. There are so many things on the horizon here at Kaleida Health, so maybe we will put some time in your busy schedule to come back and hang with us another time.

J'Leise Sosa, MD, MPH, FACOG: I would be happy to, Heather.

Host: All right. Thank you so much.

J'Leise Sosa, MD, MPH, FACOG: Thank you.

Host: And thank you for listening.