Interview with LÉVO provider Megan Konopacke, MS, FNP-C

We had the opportunity to interview one of our amazing providers at LÉVO, Megan Konopacke, MS, FNP-C. You can read the full interview below. To watch clips from Megan’s interview, click here.

If someone has a loved one that they're trying to get help and treatment for, what are some of the first steps they can take to start that process?

So something you can do just right off the bat is just to educate yourself honestly. So going ahead and looking up and, reading into whatever eating concerns you're having for your loved one, whether it be anorexia, bulimia, binge eating, whatever, that is, just kind of going through and doing some research on your own so you can know more, some of the symptoms, you know, some of what they're going through, the mindset piece of things. I find that, you know, by educating yourself more, you're better able to kind of start that hard conversation, you know, with some more insight and kind of prepare yourself a little bit better. It is kind of tricky.

If there's someone that is resistant to getting help, are there any tips for helping them to be open to treatment or see that it's needed? Or what kind of advice would you give there?

Yeah, it’s definitely hard, right? You know, because some of that, just looking at that buy in piece is one of the most challenging parts of it, you know, not feeling like they're ready, you know, or that they need treatment or that it's an issue or something that can be super challenging. One thing, you know, is just to kind of go and express your empathy and your concern for the person, you know, and then offering yourself as like a resource and available to like, start this journey with them, you know, offer to be able to sit down with them, look for different providers, different people you can talk to and just kind of offer your assistance in any way possible. And then also, not focusing solely on appearance or weight as a reason why they need this treatment. And just kind of going with the overall idea of overall health, whether that be mental or physical. Just saying that you're concerned about their health and not necessarily drawing it back to weight or anything like that.

What advice would you give for a parent concerned about their child struggling with an eating disorder or disordered eating behaviors? 

So yeah, something they can do is the earlier you tackle it, the better, you know, the faster that you intervene and interrupt these kinds of cycles or these patterns that we're noticing, the faster and the easier it'll be to break it up. So it's not something that we're dealing with, you know, throughout the entirety of our life.

What are some resources that you would recommend?

So when you're looking for people that you want on your team to support you and help you through the process, whether you're a parent looking for it for your kid or looking for yourself as well, honestly just using something like Psychology Today and just looking through and typing in for like eating disorders, you know, you're going to look for a dietitian or a therapist that has CEDS next to their name. That means that they're certified and trained specifically for eating disorders. Now, if you want to do more research on your own kind of thing, there's a book that I really like. It's called Sick Enough. It's by a medical doctor who specializes in eating disorders. And it kind of goes through some of the medical consequences of eating disorders that can help during that buy-in process to kind of realize, you know, this is what it's doing to my body. The stuff that I actually can't see that can be helpful, you know, throughout any stage. There's also an intuitive eating workbook. It's like a ten step workbook. And that can really kind of help when we're working on changing those ideas surrounding food and, you know, the food intake. It kind of gives some of the good supportive strategies that they can use independently or along with their dietitian or therapist. Those are great.

What are some of the dangerous, harmful, long lasting effects of eating disorders?

So it affects a lot of things, like almost every system in your body. It can totally affect some big ones that we really watch out for and monitor for. You know, stuff that can cause damage to our bones or like early onset, like osteoporosis. That can happen, you know, not only because we're not getting that vitamin D and calcium through the foods, you know, if we're restricting those kinds of foods. But also, you know, if we lose our period, you know, menstruation is such an important part to the overall health of a woman. And, you know, when we become so unhealthy, we lose our period and our menstruation and that can really affect our bones as well. You know, our bones stop rebuilding themselves and getting strong so it can lead to fractures or, you know, it can also lead to vertebral fractures just from sitting down or falling down. You know, it just really places your overall risk, you know, really elevated. And that's something you can't see on a person's body. Other things, you know, it can stunt your thyroid function. Your thyroid can stop functioning as well. And that's so important overall, like metabolic issues, other things that can happen, you know, our gut, we can get a lot of damage there as well. You know, if we're not putting food into our system, it's not going into our intestines to digest it. So all those nerve endings start to die and your body can't push food through. Okay. So that can lead to constipation. It can lead to obstructions needing surgeries and things like that. So it really can affect all these things that you don't really see. 

Another part that could be affected is your blood sugar, right?

Yes, if you're not getting food into your body, then your body doesn't have fuel to keep going. So then your blood sugar can drop off. And that's really dangerous because that can lead to us, you know, like not only feeling really crappy, but also it really could lead to you passing out or things like that. And your body really needs that fuel in order just to keep going.

Do you have any myths you’d like to bust?

Yeah. So one thing about treatment, just because you're getting treatment, it doesn't mean that you're going to go into your office and your appointment and they're going to make you gain weight. That's not the goal of treatment, we don't fixate on a number on the scale or anything like that. You know, we're really looking towards improving your overall health. A lot of that is physical, right? We want to make sure that your heart's pumping okay. We want to make sure that you have your menstruation and all of those things, but we also make sure that your psychological health is good as well. You know, treating what's been going on that's leading towards using these behaviors as a way to cope. Okay. So really focusing on just improving health, not just getting to a number on the scale. Another thing is that, you know, recovery isn't possible. That gets thrown out a lot that people can't fully recover from their eating disorder. They're always going to have their eating disorder. While that may always be a part of you, it's definitely possible for you to recover from your eating disorder by having that early involvement with all of the team and working through all of these issues that are going on and really being motivated and true during your recovery period.

What advice would you give or when would you recommend adding a medication provider like you to someone’s treatment team? 

Yeah. So I think that's going to come a lot from your therapist in itself, you know, like seeing if we're hitting these barriers towards our recovery that are preventing us from getting where we want to go. A lot of times medications can be helpful not to make you gain weight, but just to allow a reset for those chemicals in your brain so that you're able to take what you're learning in therapy and all that hard work and actually make it a little bit easier to, you know, do some of these challenges they're doing at times. There's medications that you can take to decrease some anxiety, around certain foods, whether it be fewer foods or certain meal times or, you know, after meals. There's a lot of medications that can help not only decrease your anxiety, but also help with some of those physical symptoms as well that are getting in the way. Basically, we can just help make the process more comfortable for you. It's already so hard to recover as it is. If we can decrease any barriers that are coming up, that’s just kind of what we're here to do.

Is there anything else you’d like to share?

Yeah, something I get sometimes is when I'm going through and talking with a patient, trying to figure out what's been going on. Parents get worried that we're giving them ideas on ways that they can further or new strategies they can use to worsen their eating disorders or pick up a new eating disorder. But I can guarantee your kid has already thought of it. You know, it's better for somebody to ask those harder questions just so that we can make sure that we're tackling and treating everything that we need to. You worry a lot about, you know, they're going to learn something they didn't know and they’re going to find something else to add into their disordered behaviors. But honestly, unfortunately there's so much access to things right now, on the Internet and TikTok, Instagram, things like that. So it's better just to ask those questions so that we know whether certain things are going on or not.

How do you connect with your patients or help them to feel comfortable with you? 

I think a lot of times going to the doctor, everyone's really, like, stiff and uptight and you just can't find that way to, like, actually talk to the person and connect with them, which is so hard and especially with mental health because you talk about such personal things. So I just go in and I just talk to them like they're anybody else on the street. I find things I have in common with them and just have normal conversations and talk to them about their life, because that's how we’re going to figure out the best way to help them.

Are there any other specialties or populations you’re passionate about other than eating disorders? 

I love helping treat people with anxiety and sleeping issues. I feel like there are a lot of people that deal with sleeping in particular. Lots of people, I feel have a really hard time just being able to fall asleep, stay asleep, whatever that is, and they’re scared of different medications because they don't necessarily want to take a pill that's gonna make them wake up and be really tired or feel kind of crappy or whatever that is. There's a lot of stuff you can do at home, just naturally, you know, with your routine, with sleep hygiene, making sure you turn off electronics a couple hours before bed, and do the same thing each night. And then also, different supplements that you can take that can help calm you down that are natural and aren't necessarily coming from a pill or medication or something like that, too. Magnesium and l-theanine are both really calming agents that can also help promote sleep.

Would you touch on the negative, more serious things that people don't realize a lack of sleep can cause that are more harmful than just being tired every day? 

Yeah, sleep is so important, right? Sleep is when your body gets a chance to reset itself. Cases of people who have chronic, like sleep deprivation, you know, we see a lot of increased anxiety and cortisol levels because your body's not getting that chance to like regenerate and come back down and get ready for the next day and it can also really impact your ability to like, focus and concentrate throughout the day. Something that a good night's sleep can really help you with is being able to focus and get all the attention you need to kind of get through your workday and school and all of that.

Would you give some advice for someone who’s trying to figure out if their anxiety is normal or needing additional help? 

Yeah, I think a lot of times if you're even asking that question, you know, is this normal? That's kind of an indication that maybe there is something going on, kind of taking it down a little further there. But, other things that can kind of clue you into the anxiety is not normal is, you know, if you're sitting there lying awake at night and you can't fall asleep, your mind's racing. It's not shutting off. If you can't identify why you're feeling these moments of panic or anxiety, it's not necessarily related to a certain stressor going on in your life or if it's negatively impacting your ability to like, go through day to day life. You know, if it’s hindering me going out and seeing friends or calling people, answering texts, things like that, that's kind of a clue into, hey, maybe there's something I need to deal with here.

Sometimes people have the belief that if they come into LÉVO, they’re immediately going to get put on medication. What would you say to that?

Yeah, so it's really not like that. Everyone has a different patient care plan. And just because someone comes in, that doesn't mean, okay, we're going to throw you on a bunch of medications. There's a lot more to it than that. Like not everybody needs a medication. There's not a medicine that's going to fix everything either. You know, we're going to take each person individually and see what you really need, and talk about it and just try to figure out what's the best thing that's going to get you to feel the way you want to. Therapy does wonders. There's lots of supplements out there. There are lots of things you can do that aren't medicine. And I'm not a pill pusher. I'm not going to just dole out a bunch of stuff. That's not something you need. Now, there is a time and place when you do need it, but that's not everybody. 

We know you were working in ICU during COVID, which is a pretty hectic time to be in the medical field and treating people. From the mental health side of things, what do you feel are the lasting impacts of COVID that people today maybe aren’t acknowledging? 

I've seen so much anxiety come out of COVID in social situations because everyone was kind of drawn back and put back into their own little bubble and taught to be scared of other people. So I've seen a lot of anxiety come out from that. But so much depression has come out too, just with that isolation factor, people losing loved ones, health care workers seeing all of those traumatic things that they saw in those hospital settings, like it was a really tough time for health care workers. So there's definitely been a lot of that that a lot of people are kind of like pushing down because everybody went through it. So they don't think that their situation is any different from anybody else's. But there's been a lot of stuff that I've seen just from my friends that worked in health care during that time. And then also just like the adolescents and the teens that have come in here who were in school during COVID and how much that really screwed up their mental health. And it's just it's really sad to see. Because that was a huge thing that I just observed from a distance. I’m so glad I wasn't in school during that time because it was just really hard and still is now. Now with the changes to school and stuff, there's a lot of kids who rely on going to school for safety and escape and it’s just really so sad.