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Welcome to the Oncology Brothers podcast! In this episode, we dived into the complexities of non-malignant hematology, focusing on iron abnormalities—both deficiency and overload. We welcomed Dr. Marina Beltrami from The Ohio State University, who guided us through three challenging clinical scenarios: 1. Anemia in Pregnancy: We discussed a 34-year-old woman in her second trimester with low MCV and ferritin levels, exploring treatment options including the safety and efficacy of IV iron versus oral iron. 2. Anemia with Mixed Etiologies: We analyzed a case involving a 78-year-old man with a history of prostate cancer, diabetes, and chronic kidney disease, discussing the broad differential diagnosis and the role of bone marrow biopsy and molecular studies. 3. Iron Overload: We examined a 47-year-old woman with elevated ferritin levels and a heterozygous hemochromatosis mutation, debating the necessity of phlebotomy and the importance of liver imaging. Throughout the episode, we emphasized the significance of a comprehensive iron panel and the clinical context in diagnosing and managing these conditions. Dr. Beltrami shared valuable insights on the use of erythropoietin-stimulating agents in chronic kidney disease and the potential risks associated with their use. Tune in for an informative discussion packed with practical insights for healthcare professionals dealing with iron-related disorders! Follow us on social media: • X/Twitter: https://twitter.com/oncbrothers • Instagram: https://www.instagram.com/oncbrothers • Website: https://oncbrothers.com/ Don't forget to like, subscribe, and check out our other episodes for more discussions on treatment algorithms, conference highlights, and FDA approvals. We are the Oncology Brothers! #Anemia #IronDeficiency #Hemochromatosis #IronOverload #Hematology #Ferritin #OncologyBrothers
A skull found in a Mexican mine 90 years ago has features that no single known medical condition can fully explain. Doctors and scientists have studied this misshapen skull for decades, but no one can agree on what it actually is.IN THIS EPISODE: If you are into aliens or conspiracies, you've likely heard of the StarChild skull – a strange skull that appears either misshapen, or – as many believe – is the skull of a hybrid between extraterrestrials and human beings. What is the truth behind the StarChild? (What Is The StarChild?) *** In the 1700s life-saving techniques were obviously not as advanced as those we have today. Case in point – one doctor wanted to know if and how a drowned person might be brought back to life. The solution? Go to a hanging and try to revive the executed man. How do you think that went? (The Hanged Man) *** We've spoken often here on Weird Darkness about shadow people – what their purpose is, where they come from, whether they are malevolent or not… but are they ghosts, or something else entirely? (Are Shadow People Considered Ghosts?) *** A Reddit user shares his true story of hiking in the wilderness and suddenly being tracked and hunted over several days by a stranger with unknown intentions. (A Strange Man Hunted Me Through The Park) *** Within the walls of one of England's most picturesque castles, a queen gave birth to her only child and set in motion a chain of events that would become one of Tudor England's most intriguing mysteries. (The Unexplained Disappearance of the Queen's Daughter)CHAPTERS & TIME STAMPS (All Times Approximate)…00:00:00.000 = Lead-In00:01:28.939 = Show Open00:03:41.187 = What Is The Starchild?00:22:20.388 = *** The Hanged Man00:30:05.929 = A Strange Man Hunted Me Through The Dark00:35:03.546 = *** The Unexplainable Disappearance of the Queen's Daughter00:47:09.487 = *** Are Shadow People Considered Ghosts?00:56:43.391 = Show Close*** = Begins immediately after inserted ad breakSOURCES and RESOURCES...“The Hanged Man” by Romeo Vitelli for Providentia: https://weirddarkness.tiny.us/32j6zyb7“Are Shadow People Considered Ghosts?” by Jacob Shelton for Ranker's Graveyard Shift: https://weirddarkness.tiny.us/uej2nyca“A Strange Man Hunted Me Through The Park” by Redditor u/ValyrianJedi: https://weirddarkness.tiny.us/436p34t7“The Unexplained Disappearance of the Queen's Daughter” by Lydia Starbuck for Royal Central:https://weirddarkness.tiny.us/bfhkxthc“What Is The Starchild?” by Dr. Elizabeth Mitchell, posted at Anomalien: https://weirddarkness.tiny.us/ewccfd5c, and from StarChildProject.com: https://weirddarkness.tiny.us/wb8daydd=====(Over time links may become invalid, disappear, or have different content. I always make sure to give authors credit for the material I use whenever possible. If I somehow overlooked doing so for a story, or if a credit is incorrect, please let me know and I will rectify it in these show notes immediately. Some links included above may benefit me financially through qualifying purchases.)= = = = ="I have come into the world as a light, so that no one who believes in me should stay in darkness." — John 12:46= = = = =WeirdDarkness® is a registered trademark. Copyright ©2025, Weird Darkness.=====Originally aired: April 12, 2021EPISODE PAGE (includes sources): https://weirddarkness.com/starchildABOUT WEIRD DARKNESS: Weird Darkness is a true crime and paranormal podcast narrated by professional award-winning voice actor, Darren Marlar. Seven days per week, Weird Darkness focuses on all thing strange and macabre such as haunted locations, unsolved mysteries, true ghost stories, supernatural manifestations, urban legends, unsolved or cold case murders, conspiracy theories, and more. On Thursdays, this scary stories podcast features horror fiction along with the occasional creepypasta. Weird Darkness has been named one of the “Best 20 Storytellers in Podcasting” by Podcast Business Journal. Listeners have described the show as a cross between “Coast to Coast” with Art Bell, “The Twilight Zone” with Rod Serling, “Unsolved Mysteries” with Robert Stack, and “In Search Of” with Leonard Nimoy.DISCLAIMER: Ads heard during the podcast that are not in my voice are placed by third party agencies outside of my control and should not imply an endorsement by Weird Darkness or myself. *** Stories and content in Weird Darkness can be disturbing for some listeners and intended for mature audiences only. Parental discretion is strongly advised.#StarchildSkull #AncientMystery #UnexplainedMysteries #AlienHybrid #MexicanMine #AncientDNA #ParanormalMystery #ArchaeologicalMystery #UnsolvedMysteries #WeirdDarkness
The DU Crew discusses Roster Abnormalities, Playoff Positioning, Cash Out Candidates, & Dynasty Trades!
Pediatrics Now: Cases Updates and Discussions for the Busy Pediatric Practitioner
Dr. Ian Mitchell joins Holly Wayment to review pectus excavatum and carinatum: how they present, typical ages of detection, and practical screening tips for pediatricians. The episode summarizes evaluation steps including when to order CT with Haller index, echocardiography, and pulmonary testing, and compares treatment options—bracing and vacuum bell therapy, Nuss and Ravitch procedures—plus timing (ideal repair ~14–15 years) and perioperative care. Listeners also hear about pain management advances (erector spinae blocks, cryoanalgesia), outcomes, psychosocial effects, adult considerations, and the Fresh Start program offering free reconstructive surgeries for eligible families.
BUFFALO, NY — November 20, 2025 — A new #research paper was #published in Volume 17, Issue 10 of Aging-US on October 10, 2025, titled “Developmental arrest rate of an embryo cohort correlates with advancing reproductive age, but not with the aneuploidy rate of the resulting blastocysts in good prognosis patients: a study of 25,974 embryos.” In this large-scale study, Andres Reig of the IVIRMA Global Research Alliance and Robert Wood Johnson Medical School, along with Emre Seli of the IVIRMA Global Research Alliance and Yale School of Medicine, investigated how female age and chromosomal abnormalities affect embryo development in patients undergoing in vitro fertilization (IVF). They found that embryo developmental arrest (EDA) becomes more common as women age. However, this arrest is not directly associated with the presence of chromosomal errors in the embryos that continue to develop. These findings could help improve fertility counseling and treatment strategies. The researchers analyzed 25,974 embryos from 1,928 IVF cycles, all from patients with a good chance of success. The study showed that the percentage of embryos that stopped developing before reaching the blastocyst stage increased with age: from 33% in women under 35 to 44% in those over 42. Despite this rise, the rate of chromosomal abnormalities, known as aneuploidy, in the embryos that did reach the blastocyst stage did not show a strong connection with the rate of arrest after adjusting for age. This distinction is important because both developmental arrest and aneuploidy reduce the number of embryos suitable for transfer. But this study suggests they are caused by different biological processes. In other words, an embryo may stop developing even if it has the correct number of chromosomes, and some embryos with chromosomal abnormalities may still grow to the blastocyst stage. “A very weak positive correlation was identified between EDA rate and the rate of aneuploidy (r: 0.07, 95% CI 0.03–0.11; R2: 0.00, p < 0.01) when evaluating all cohorts.” The authors suggest that other factors, such as the health of the egg's mitochondria or mutations in maternal-effect genes, may explain why some embryos stop developing. These insights could help researchers identify new ways to improve embryo quality, especially for older women undergoing IVF. Importantly, the study focused on embryos that developed far enough to be tested, which helped avoid technical problems that come with analyzing arrested embryos directly. This approach allowed for more reliable comparisons across age groups and embryo quality. Overall, the study highlights the importance of maternal age as a key factor in embryo development, independent of chromosomal results. It also opens new directions for research, aiming to better understand why embryos fail to develop and how this knowledge might lead to improved fertility treatments in the future. DOI - https://doi.org/10.18632/aging.206328 Corresponding author - Emre Seli - emre.seli@yale.edu Abstract video - https://www.youtube.com/watch?v=g0oS3HBNmuQ Sign up for free Altmetric alerts about this article - https://aging.altmetric.com/details/email_updates?id=10.18632%2Faging.206328 Subscribe for free publication alerts from Aging - https://www.aging-us.com/subscribe-to-toc-alerts Keywords - aging, ovarian aging, reproductive aging, embryonic arrest, embryonic aneuploidy, developmental arrest To learn more about the journal, please visit https://www.Aging-US.com and connect with us on social media: Facebook - https://www.facebook.com/AgingUS/ X - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@Aging-US LinkedIn - https://www.linkedin.com/company/aging/ Bluesky - https://bsky.app/profile/aging-us.bsky.social Pinterest - https://www.pinterest.com/AgingUS/ Spotify - https://open.spotify.com/show/1X4HQQgegjReaf6Mozn6Mc MEDIA@IMPACTJOURNALS.COM
This week on Family Policy Matters, host Traci DeVette Griggs welcomes Dr. Marty McCaffrey, Professor of Pediatrics and Director of the Perinatal Quality Collaborative of North Carolina, to discuss how the medical community can improve care for babies born with genetic abnormalities.
In this week's ADHD Women's Wellbeing Wisdom episode, we revisit eye-opening insights from Dr Jessica Eccles, a Clinical Senior Lecturer at Brighton and Sussex Medical School in the Department of Neuroscience. This conversation explores the fascinating connection between the brain and body in neurodivergent women. We talk about the links between ADHD, autism, hypermobility, fatigue, long COVID, and emotional regulation, and how these can impact our mental and physical health in ways that often go unseen or misunderstood.My new book, The ADHD Women's Wellbeing Toolkit, is now available, grab your copy here!What You'll Learn:The link between neurodivergence, hypermobility and long COVID.How dysautonomia connects ADHD to chronic fatigue and physical symptoms.The impact of proprioception issues and hypermobility on emotional regulation.Research exploring emotional regulation difficulties in ADHD and autism.The role of RSD in neurodivergent experiences of rejection and overwhelm.Research looking at the link between childhood neurodivergence, trauma and adult fatigue.The importance of early advocacy for neurodivergent children in schools and healthcare.Takeaways:01:32 - Hypermobility, Long COVID and Neurodivergence 02:15 - Abnormalities in the Autonomic Nervous System and Neurodivergence 03:24 - EUPD, ADHD and Autism Research 04:21 - Propioception, Emotion Regulation, Hypermobility and Neurodivergent Traits 08:00 - Hypermobility, Pain and Fatigue in Neurodivergent People09:43 - Supporting and Advocating for Neurodivergent Children15:19 - Advocating for Resources and SupportIf you've ever wondered how ADHD shows up in your body, or why you feel so exhausted despite resting, this conversation will give you insight, validation, and clarity into issues you may have never considered connected.Links and Resources:Join the Waitlist for my new ADHD community-first membership launching in September! Get exclusive founding offers [here].Find my popular ADHD workshops and resources on my website [here].Follow the podcast on Instagram: @adhd_womenswellbeing_pod Bendy Brain LinkTreeKate Moryoussef is a women's ADHD lifestyle and wellbeing coach and EFT practitioner who helps overwhelmed and unfulfilled newly diagnosed ADHD women find more calm, balance, hope, health, compassion, creativity and clarity.
Just thinking about hearing a diagnosis that we have a terminal illness sends a shiver up the spine and dampens the joy in the heart. Our life so significant, only to be snuffed out in a moment. It is a subject we'd like to avoid but it is inevitable as we experience the death of others around us and one day our own. How are we to reflect on death? In this talk we will look at how some want to suggest death is natural, necessary, and good. However, this is not the biblical view, where humans view death in all its horror as a curse, yet are not overwhelmed by that fear since Jesus himself broke the power of death by his own death and resurrection. This lead the early church to express a hope that transformed how they lived now. (NOTE: The first 3 minutes are lower volume.) The Copyright for all material on the podcast is held by L'Abri Fellowship. We ask that you respect this by not publishing the material in full or in part in any format or post it on a website without seeking prior permission from L'Abri Fellowship. Also, note that not all views expressed in the lectures or in the discussion time necessarily represent the views of L'Abri Fellowship. © Canadian L'Abri 2020
It's a bold claim, but one worth exploring.Join PMI Consultant Niall Coney as he challenges one of the most persistent misconceptions in improvement: that Lean is about efficiency.Through real-world examples and a return to the purpose behind Lean tools, Niall reframes Lean as a way to see abnormality at a glance. Not as a shortcut to efficiency, but as a foundation for problem solving.From 5S to standardised work, Andon to process confirmation, he explores how these tools expose problems rather than fix them, creating the conditions for better thinking, better habits, and better results.If Lean feels like it's missing the mark in your organisation, this conversation might just change the way you see it.More resources:Taking Out Waste May Not Make You Lean Lean tools enable change Applying Lean in Service PERFORMANCE IMPROVEMENT IN AN AI-DRIVEN WORLD.Save the Date. 17th March 2026.The only improvement conference for practitioners, by practitioners.>>> Join Priority Booking List Explore Distance Learning >>
In this podcast, recorded by InnovAiT Podcast Editor Dr Sadiya Ayaz, Dr Abdullah Lashrf, a GP in Birmingham, discusses the common abnormalities seen in general practice. This podcast is also available to view on our YouTube channel: https://www.youtube.com/watch?v=CtdyhXYikCs.
Simplification is everything - that's the message for the latest issue of the journal. Assisted by a cast of characters including Albert Einstein and deep sea sponges, your editors Phil Smith and Geraint Fuller take on topics from hyponatraemia to health anxiety. You'll also find bread and butter epileptology, somatosensory evoked potentials, creatine kinase, and a guide for exploring the hinterlands of essential tremor. Read the issue: https://pn.bmj.com/content/25/4/297 Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. Production and editing by Brian O'Toole. Thank you for listening.
Dr. Mohleen Kang chats with Dr. Anna Podolanczuk and Dr. Gary Hunninghake about their article, "Approach to the Evaluation and Management of Interstitial Lung Abnormalities."
Have you or someone you've known experienced a pregnancy where a genetic abnormality is detected? Alex Greene is with me this morning to discuss her difficult, sensitive, and very sweet experience with her baby, Iris, who was born with Trisomy 18. She is very clear and transparent in relaying her unfolding story, or I should say, God's story, for Iris. Alex is willing to meet with anyone who would like to talk. I am setting up a Zoom call soon. You will need to contact me if you are interested. Laurie@KidStrength4Life.com 00:00 Intro02:24 Would you change anything you did in this experience?03:55 Take pictures!05:22 I wanted to honor God the right way06:20 Everyone's story is different07:44 Find your support08:19 Lean into God09:01 Two emotions can exist together09:57 Find joy and normalcy where you can12:00 It is a continual process12:54 Invitation to chat15:00 Final Words Alex is willing to talk to anyone who would like to discuss this further. If you or someone you know would be helped by a group conversation with her on Zoom, be sure to contact me if you are interested in meeting with Alex to receive encouragement or to answer any questions you might have. Laurie@KidStrength4Life.com This is a free call. Find more helpful things at https://KidStrength4Life.com Be sure to rest in the Lord this week. It is our only hope!Laurie
Have you or someone you've known experienced a pregnancy where a genetic abnormality is detected? Alex Greene is with me this morning to discuss her difficult, sensitive, and very sweet experience when she carried her baby, Iris, with Trisomy 18. She is very clear and transparent in relaying her unfolding story, or I should say, God's story, for Iris. Alex is willing to meet with anyone who would like to talk. I am setting up a Zoom call soon. You will need to contact me if you are interested. Laurie@KidStrength4Life.com 00:00 Intro01:53 Bringing Iris home02:41 Iris and her own story05:15 A part of the Greene family05:45 Alex's spiritual response09:03 Effect on relationships11:05 Grief with family and friends13:40 What Scripture was helpful? 17:17 Closing Be sure to return next week as she continues to unfold her family's story. Be sure to contact me if you are interested in meeting with Alex to answer any questions you might have. Laurie@KidStrength4Life.com Find more helpful things at https://KidStrength4Life.com Be sure to rest in the Lord this week. It is our only hope!Laurie
Tanzira Zaman, MD and Elizabeth Volkmann, MD, MS discuss the new official American Thoracic Society Clinical Statement on the diagnosis and management of interstitial lung abnormalities which Dr. Podolanczuk presented at ATS 2025.
This week Zorba and Karl look at a study showing ultraprocessed foods will increase your chance of an early death, and they look at research that found brisk walking pace plus time spent at this speed may lower risk of heart rhythm abnormalities. Plus, they share a delicious recipe for a Spring Salad with Goat Cheese.
This week Zorba and Karl look at a study showing ultraprocessed foods will increase your chance of an early death, and they look at research that found brisk walking pace plus time spent at this speed may lower risk of heart rhythm abnormalities. Plus, they share a delicious recipe for a Spring Salad with Goat Cheese.
Professor Gareth Baynam is a globally recognised clinical geneticist, researcher, and advocate for rare diseases. He is the Director of the Rare Care Centre at Perth Children's Hospital and the Head of the Western Australian Register of Developmental Anomalies. With a career dedicated to improving the diagnosis, management, and care of individuals with rare and genetic conditions, he has been at the forefront of integrating cutting-edge technologies such as genomics, artificial intelligence, and precision medicine into healthcare. Professor Baynam is also a leader in Indigenous health initiatives, championing equitable access to rare disease diagnostics and treatment. Through his work with organizations such as the Global Commission to End the Diagnostic Odyssey for Children with a Rare Disease and the European Rare Diseases Research Alliance (ERDERA), he continues to drive global collaborations and innovations that aim to transform rare disease care.
The Real Truth About Health Free 17 Day Live Online Conference Podcast
Robert Whitaker discusses the failures of psychiatry's disease model and explores alternative approaches to mental health care. Learn about new paradigms for understanding and treating mental health issues. #MentalHealth #PsychiatryReform #AlternativeCare
Find holistic dental care at Denver Dentistry (303-988-6118), a trusted integrative dental clinic. The team offers airway management and sleep disorder treatment solutions for patients. Learn more at https://www.denverdentistry.com/ Denver Dentistry City: Littleton Address: 5920 S Estes St #200 Website: https://www.denverdentistry.com/
In this episode, we review the high-yield topic Craniofacial Abnormalities from the Ear, Nose, & Throat section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In this episode, Dr. Valentin Fuster dives into a groundbreaking scientific statement from the American Heart Association and American College of Cardiology, providing updated clinical considerations for competitive athletes with cardiovascular abnormalities. The statement, which integrates 40 years of research, focuses on preventing sudden cardiac death and improving shared decision-making strategies for athletes facing heart conditions, offering expert guidance across 11 key task forces.
Editor's Summary by Linda Brubaker, MD, Deputy Editor of JAMA, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from March 1-7, 2025.
Dr. Mohleen Kang chats with Dr. Margaret Salisbury and Dr. Anna Podolanczuk about their articles, "Progressive Early Interstitial Lung Abnormalities in Persons at Risk for Familial Pulmonary Fibrosis: A Prospective Cohort Study" and "Big Things Have Small Beginnings: Clinical Implications of Early Interstitial Lung Disease."
(SPOILER) Your Daily Roundup covers tomorrow's podcast guest, DONDI with a statistical abnormality last night, the Joe Schmo Show, Love is Blind had more engagements that weren't shown, & Paradise on Hulu has their best episode yet. Music written by Jimmer Podrasky (B'Jingo Songs/Machia Music/Bug Music BMI) Ads: Factor Meals - 50% off your first box PLUS free shipping at https://factormeals.com/realitysteve50off Promo Code: realitysteve50off Learn more about your ad choices. Visit megaphone.fm/adchoices
Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Hepatic Biomarker Abnormalities in the Cardiac Intensive Care Unit: Proposed Criteria for Cardiohepatic Syndrome.
Understanding Amniotic Fluid: What's Normal and What's Not Amniotic fluid is the protective liquid contained within the amniotic sac that surrounds a baby during pregnancy. This vital fluid plays a critical role in fetal development, providing cushioning, regulating temperature, and enabling the baby to move and grow within the uterus. It also facilitates the development of essential systems like the lungs, digestive tract, and musculoskeletal system. What Is Amniotic Fluid Made Of? Amniotic fluid begins to form around the 12th day of pregnancy and is initially composed of water from the mother. As the pregnancy progresses, it includes fetal urine, nutrients, hormones, and antibodies, creating a nutrient-rich environment for the growing baby. What's Normal? The amount of amniotic fluid changes throughout pregnancy, peaking around 34 weeks and then gradually decreasing. Here's what's considered normal: Volume: Typically, the amount of amniotic fluid ranges from 500 to 1,000 milliliters at term. Clear or Slightly Tinted Fluid: Normal amniotic fluid is clear or slightly yellow-tinted. Healthy Fetal Movement: Adequate fluid allows the baby to move freely, which promotes muscle and bone development. Doctors assess amniotic fluid levels using ultrasound and measure the Amniotic Fluid Index (AFI) or the Deepest Vertical Pocket (DVP) to ensure levels are within a healthy range. What's Not Normal? Abnormalities in amniotic fluid levels can indicate potential complications: Low Amniotic Fluid (Oligohydramnios): This condition occurs when fluid levels are too low and can lead to: Restricted fetal growth. Increased risk of umbilical cord compression. Complications during labor, such as reduced cushioning for the baby. Excess Amniotic Fluid (Polyhydramnios): Excess fluid can result from issues such as gestational diabetes, fetal anomalies, or infections. It may cause: Preterm labor. Difficulty breathing for the mother due to uterine overdistension. Increased risk of placental abruption or cord prolapse. Discolored Fluid: Green or Brown (Meconium-Stained Fluid): This indicates that the baby has passed its first stool in utero, which could signal fetal distress. Bloody Fluid: This may suggest complications like placental abruption or injury. Monitoring Amniotic Fluid Routine prenatal care includes monitoring amniotic fluid levels. If abnormalities are detected, your healthcare provider may recommend additional tests, interventions, or close monitoring to ensure the safety of both mother and baby. Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners. For additional resources and information, be sure to visit our website at Maternal Resources: https://www.maternalresources.org/. You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: Twitter: https://twitter.com/integrativeob YouTube: https://www.youtube.com/maternalresources Instagram: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB Thank you for being part of our community, and until next time, let's continue to support, uplift, and celebrate the incredible journey of working moms and parenthood. Together, we can create a more equitable and nurturing world for all
Commentary by Dr. Jian'an Wang.
Better Edge : A Northwestern Medicine podcast for physicians
Join Larissa Pavone, MD, Mary Keen, MD, and Anton Dietzen, MD, as they discuss the significance of muscle tone in young pediatric patients. They explore the causes and manifestations of high muscle tone, including hypertonia, and share insights on managing spasticity, dystonia, and rigidity. Learn about the latest diagnostic approaches and therapeutic strategies to support early development in children with muscle tone abnormalities. Dr. Pavone is associate chief medical officer of Northwestern Medicine Marianjoy Rehabilitation Hospital; Dr. Keen is a pediatric PM&R specialist; Dr. Dietzen is medical director of Pediatrics at Marianjoy Rehabilitation Hospital.
Listen to today's episode to hear Meagan talk all about bicornuate, unicornuate, arcuate, and septate uteruses, uterine didelphys, and more.Though there can be complications, research is limited, and vaginal birth is often possible. Chat with your provider about your birthing desires, and don't be afraid to get multiple opinions!A Case of Vaginal Birth after Cesarean Delivery in a Patient with Uterine DidelphysUterine DifferencesSuccessful Vaginal Delivery after External Cephalic Version in a Woman with a Large Partial Uterine SeptumNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to The VBAC Link. This is Meagan, and I am solo today. We will not be sharing a VBAC or CBAC story, but we're going to focus on our topic of the week. That is uterine abnormalities. So if you haven't listened to Flannery's episode last week, or I should say earlier this week, go check it out. Flannery has a bicornuate uterus, and we talked a little bit about the different types of uteruses, and her journey, and what happened or what was most common with her bicornuate uterus. But today, I wanted to talk a little bit more about the different types of uteruses. It's kind of weird to think about, but we do. We have multiple shapes of our uteruses. I don't think it's really talked about a lot, so I thought it would be cool to jump on today and talk a little bit more about the uteruses. But, we do have a Review of the Week, so I wanted to jump on and share this review. It says, “I now recommend this podcast to every mom who will listen, even first-time moms. I tell them this is the podcast I wish I would have listened to before our first traumatic birth. It helped me process, learn, and heal so much after my son's birth. Two years later, pouring into numerous books, online courses, and more, we are preparing for our October VBAC. Their podcast has by far been the most favorite resource hands down. Thanks, Julie and Meagan, so much for what you do.”Thank you guys for your review. That review was left on Google, so if you wouldn't mind, press pause in just one moment, and go leave us a review. Your reviews help other Women of Strength come and find this podcast, find the blogs, find the course, find the doulas. You guys, I love this community so stinking much and believe that every mom, just like the reviewer said, and even first-time moms should be listening to this podcast. These stories that you guys share are absolutely incredible. The information that we share is invaluable. If you can, go to Google. Type in, “The VBAC Link” and leave us a review, or leave us a review wherever you are listening to your podcasts. Okay, everybody. Like I said, we are going to be diving into uterine abnormalities. We talked a little bit about Flannery. She had a bicornuate uterus. What is a bicornuate uterus? A bicornuate uterus is a heart-shaped uterus meaning the uterus has two horns making it look like the shape of a heart. With bicornuate uteruses, there are some things to know. There can be a higher chance of a breech baby. I'm going to share my source here with you. It's pregnancybirthbaby.org. We're going to have this in the show notes. I think that it is just so great. It's such a great visual and understanding on the different types. So yeah. They've got two horns. It doesn't reduce your chances of having a baby or getting pregnant. It can increase things like early miscarriage or an early preterm baby, or like I said, it can impact the position of the baby. But it's possible. VBAC is possible with that. The hardest thing about uterine abnormalities is there is not a ton of evidence or deep studies to dive into how it's impacting people who want to go on and have a vaginal birth or go for a, in the medical world, TOLAC or trial of labor after a Cesarean. If you have a uterine abnormality, it's something to discuss with your provider. Know you don't have to go with that first answer. You can get multiple opinions. Okay, another uterine abnormality or shape is– oh my gosh, you guys. Don't quote me on this. I will butcher how to say these. I will try my best. It's a didelphys uterus. It means that your uterus is split in two, and each side of your uterus has its own area. it also can increase your chance of having a premature birth, so if that is something that you have, I think that's something you want to discuss with your provider knowing that you could have a premature birth. We also know people who have premature VBACs all the time, but it's something to discuss. There's acruate, and that is a uterus that actually looks really similar to a normal-sized uterus but has a deeper dip in the top of the uterus in the womb. It doesn't affect your fertility. It can increase just a little bit of a later miscarriage. That is something to discuss, although sometimes providers will want to induce if everything is looking well at an earlier gestational age. Also, this one can impact the position of your baby, so being aware of that. Then there's septate. Again, I don't know. Sorry for butchering this, you guys. If you're a medical professional, sorry. It says, “A septate womb has the wall of a muscle that comes down the center of the uterus, and then it splits into those two areas and is divided by a membrane or a tight band of tissue.” It reminds me of a rubber band. It splits it down. It can also impact fertility and, again, increase the possible risk of miscarriage in the early stages or cause a premature baby. Once again, discuss with your provider if you have this what that means and what that means for VBAC birth in general. Then, let's see. There's also retroverted. That's a uterus that tips further back instead of that forward stage. Again, there are so many different types and shapes of uteruses. Sometimes we don't know what we have until we have a baby who is born. Sometimes it's once we have a Cesarean where they are like, “Oh, hey. You have this type of shaped uterus.” If you really feel like you need to know or you are having issues or anything like that, dive in with your provider and see if they can tell you what shape of uterus you have.Like I said, little is known about the outcome of VBAC with uterine abnormalities, but there is an article and it was back in 2019. It's called “A Case of Vaginal Birth After Cesarean Patient Who Has a Uterine Didelphys”. I want to talk a little bit more about that. As a reminder, that is the one that is split in two. If I recall, I think they even have their own cervixes. That can be interesting. But this is going to be a little bit more on this. They talk about it. There are only a few studies. The studies are low, like 165 women in the one study. It shows that those women with abnormalities found were statistically less likely to have VBAC. Again, we know that a lot of the time, these people have babies who are in less ideal positions or they are going into early preterm labor. There are things to be said about that. But the other small study is literally teeny tiny. It had 25 women with uterine abnormalities reported, and a VBAC rate was similar to women with a “normal” uterus. There are things to say there.Now, the other study showed that they were less likely to experience uterine rupture than women with normal uteruses, but then this one said that the uterine rupture rate was higher. So such little information. I mean, really, it's little information that I have been able to find so far. I'm going to dive in deeper and update you, but yeah. It says, “The actual rates in VBAC and uterine rupture in women with uterine abnormalities are more likely to be similar or less favorable than those women with normal uteruses.” So, keep that in mind. It goes on and says, “Some authors hypothesized that uterine abnormalities, especially unicornuate uteruses, are associated with decreased uterine muscle mass. So when we have decreased uterine muscle mass, that means it may not contract as effectively or strongly as it needs to, so that can lead to other things like arrest of descent or we were not getting into that active phase of labor, needing things like Pitocin and things to augment labor or they may have a harder time pushing out the baby because the uterus isn't helping as well. So we may have a higher chance of an assisted delivery like a vacuum or forceps. With all of this said, you guys, I want to leave it here with you to encourage you to speak with your provider, and get multiple opinions. If you have been told that you can't VBAC because of a certain situation, dive a little deeper with questions with your provider because again, the hardcore evidence is not really there. It's just low. I mean, it's there, but it's low. There's another article that says that uterine abnormalities are common in the general population with an estimated range of 1-15 per 1000% women. We know that there are people out there who have uterine abnormalities. I don't feel like it's talked about a ton, and that's why I wanted to come on today and talk a little about the different types, and of course, share with Flannery's episode with a bicornuate uterus showing that she still did go on to have a VBAC and it is possible. So if you have a uterine abnormality, please know that it doesn't mean you're just completely off the table. It still can be an option. Discuss it with your provider. Check out the links. I will include them in the show notes today more on those uterine abnormalities, and what it means, and what these studies are showing. There was another one that said that a septate uterus is clinically significant because it has been shown to be associated with adverse pregnancy outcomes including, like I said, that preterm labor and malpresentation. So it's a thing that can cause malpresentation and can cause preterm labor, and even miscarriage. But does that mean that you can't have a vaginal birth? Another thing to ask your providers if you have any of these things are, “Okay, if my baby is in a less than ideal position, say, breech or transverse, does my uterine abnormality or my specific case rule me out of having something like an ECV?” Varying rates of ECV success have been reported, and we're also not doing them enough. We are not seeing them being done enough, even though they have a lot of success. But the question is if you have a uterus that is a little different, do you qualify? Ask the questions. Be informed, and if you have any questions, let us know.And hey, if you have a uterine abnormality and you are listening, and you had a VBAC, I would love to hear from you because we have people who are searching for stories with uterine abnormalities. I know that our community would love to hear your story. You can message us at info@thevbaclink.com or if you are a provider who maybe knows a lot more and specializes a lot in uterine abnormalities, I would love to chat with you and discuss a podcast episode in the future. Thank you guys!ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
Flannery joins us today from Connecticut sharing her story of an unexpected C-section at 35 weeks due to oligohydramnios, breech presentation, and concerns with her baby's kidney functions. She was also transferred to an unfamiliar hospital for its surgical capabilities. Though she was terrified, her anesthesiologist was calm and reassuring. The toughest memory of Flannery's birth was not being able to kiss her baby before he was swept away to the NICU. She was determined to do everything in her power not to have that happen again the second time. Knowing she had a bicornuate uterus, she worked hard to keep her baby's head down from the very beginning of her second pregnancy. She switched to a midwife practice, carried her baby past her due date, went into spontaneous labor, and had an intensely beautiful unmedicated hospital VBAC!NICU Free ParkingTypes of Uterine ShapesAFI ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. We have our friend from Connecticut. And you know what? I didn't ask. How do you say your name? Flannery: It's Flannery. Meagan: That's how I was going to say it. Flannery: Yes, good job. Meagan: We have our friend, Flannery, here from Connecticut and she has a bicornuate uterus. This week's focus is on different shaped uteruses or uterine abnormalities as I'm air quoting. We know that people have them. People have different-shaped uteruses. Sometimes that can impact things like breech babies or even a provider's ability to support– I don't want to say ability. It's their willingness to support, especially in VBAC. We're going to be diving into that. She's also a NICU mama so for other NICU mamas, she might have some tips for you along the way. She just told me before this that she was a labor and delivery nurse before she had her first. Flannery: Yep, and then I switched over. Meagan: Now she switched over to postpartum. She knows the field, so we might talk a little bit about labor and delivery nursing and the postpartum world. Flannery: Yeah, definitely. Meagan: Awesome. Okay, well let's get into your stories. Flannery: Okay, thank you. I'm so excited. I would listen to this podcast all the time when I was pregnant. At the end, when they say, “If you'd like to share your VBAC story–” and I would say, “I will be sharing my VBAC stories someday.” Meagan: I love that. “I will be sharing my story”, and here you are sharing with all of the other Women of Strength coming to learn and grow and feel empowered. Flannery: Yeah, I loved it. My first pregnancy was actually an unplanned pregnancy. I had just gotten married. I just started a labor and delivery nurse job. I was noticing that I wasn't feeling great, that I had some bleeding which I thought was my period, so I just was like, “You know what? Let me take a pregnancy test just to reassure myself because there is no way that it will be positive.” It was, and I was so shocked. I remember taking the tests, seeing the two lines, and my heart dropping. I thought to myself, “I am not ready to be a mom. I can't believe that I am having an unplanned pregnancy. This is so crazy.” I was only 25 which I know is not that young, but up here in Connecticut, it's pretty young. Meagan: Is it really? What's the average for first-time moms? Can I ask?Flannery: I'm guessing 30-32. Meagan: Okay. Flannery: None of my friends had babies yet or anything, so I felt very alone and obviously very shocked. Yeah. I had no idea how far along I was. I went to the dating ultrasound with my husband at the hospital where I worked, and they put the wand on my belly. There was a full baby in there. It wasn't a bean. It wasn't a little heartbeat, but it was a baby. They said, “You're 11.5 weeks along.” Meagan: Oh my gosh. Really?Flannery: Yeah. I was beyond shocked. Meagan, I had no idea that I was pregnant. I didn't have any symptoms. I was having some bleeding, so I thought that had been my period, but nope. Meagan: Oh my goodness. Was it implantation bleeding? But then that would be too late. Flannery: I don't know. I think maybe just how some people get first-trimester spotting or bleeding after sex or exercise or something. I'm thinking that's what it was. Meagan: Crazy. Flannery: I know. I had skipped the first trimester, and that terrified me because I wasn't on a prenatal. I was having some wine. I was just like, “How could I have missed this? This is embarrassing. I'm a nurse.” Meagan: “I'm a nurse.” Hey, listen. It happens. People talk about it. I'm sure that was such a shock not only to see those two pink lines and that you were not having babies with any of your friends, but then you skipped the whole first trimester. Flannery: Crazy. It was crazy. It took a while to wrap our heads around it. Then during the ultrasound, hearing the ultrasound tech saying, “Have you ever had an ultrasound of your uterus before?” I was like, “No,” not thinking anything of it, just focusing on the baby, and then I got a call from my doctor a few days later, and she was like, “So, it looks like you have a bicornuate uterus. Have you ever heard of that?” I was like, “No. I've never heard of that before.” She said, “Basically, your uterus is shaped like a heart, and it should be shaped like a balloon.” I was like, “Okay. That doesn't sound too bad.” We hung up. I went on Google and Googled “bicornuate uterus”, and let's just say the stuff that comes up is not reassuring at all. It's so scary. It says things like, “Risk of preterm delivery. Risk of stillbirth. Risk of infertility. Risk of malpresentation.” It just went on and on. Postpartum hemorrhage, and all of this stuff, so I really broke down. I remember just crying and crying to my husband, “I've had this crazy birth defect my whole life, and I've never known it.” I didn't know how it was going to impact my birth or anything. That was definitely scary.Meagan: Did they tell you anything about how it could impact your pregnancy or your birth? Flannery: Not really. This was a general GP doctor that I was seeing, so she didn't really go into it with me, but I definitely spoke about it to the midwives that I was seeing once I established care with them. They were just like, “Yeah, it can cause baby to be breech.” That was all they told me about it. Meagan: Okay. Flannery: Yeah. I was doing a lot of research looking for podcasts and everything about bicornuate uterus and all of the things that go along with it, but I couldn't really find much. This was a few years ago, so maybe three or four podcast episodes about bicornuate uterus, breech, and malformation. I think now there are more, but at the time, it was really hard to find information. Meagan: Yeah. I still feel like it's 2024. What year are we in? We are almost in 2025. We are in 2024, and it still is. There is still not a ton. It's not a beefy topic. Flannery: No, it's really not. I think that some people don't know they have it until they get pregnant which was in my case, and they have an ultrasound. It's hard to tell later on in pregnancy if you have it because your baby will stretch out the uterine space, so you can really only tell in the first trimester if you have an ultrasound. Meagan: Interesting. Good to know. Flannery: So my pregnancy progressed pretty normally after that. I was very stressed at this new job in labor and delivery that I was working in. I was seeing really scary births all of the time, traumatic births, and some good ones too, but it put this idea in my head that you cannot plan your birth. Things are so out of your control that there's no reason to have a plan because you're just going to be disappointed anyway. All you can do is go with the flow. That was my attitude at the time. It's definitely changed since then. It was definitely interesting trying to be a first-time mom and also learn how to be a labor and delivery nurse and reconcile the two experiences that I was seeing. Meagan: I bet. Flannery: Yeah. Meagan: I bet that would be really challenging. Flannery: It was. It was interesting. I established care with some midwives who I worked with. They were highly recommended, but I didn't really feel like they were giving me the midwife experience that I had heard so many people rave about. I felt like they really treated me like a coworker instead of a first-time mom when I was going to their appointments. I was fine with their care. I wouldn't say it was the best or the worst by any means. Then I realized around 25-26 weeks, “Gosh. I'm really feeling this rock under my ribs all the time. I think that's the baby's head. I think the baby is breech.” Then at 28 weeks, I had a growth scan because you have to have growth scans if you have a bicornuate uterus, and they were like, “Yeah, sure enough, the baby is breech.” The midwives told me, “Okay, you can do some Spinning Babies and put an ice pack near the baby's head and play music down low,” and all of those crazy things that you hear. I was like, “Yeah, sure. Okay, I'll try it.” I did a few inversions, but they gave me terrible heartburn, so I was not super consistent with that. The baby just wasn't budging week after week. Eventually, it came to about 35 weeks, and I was getting another growth scan. I had just worked a very tiring shift at work. I went to get my ultrasound. I was dozing off as she did it. She stopped the ultrasound, and she said, “I'm going to send you over to your midwife's office. Go over right now.” I walked over, and the midwife was like, “Girl, what's going on?” I was like, “I don't know. I just had this pit in my stomach, but I had no clue what was going on.” She was like, “You have no fluid. Get back to the hospital. You're going in as a patient now, and we're going to try to rehydrate you.” I was like, “What? What is going on? No fluid? What does that mean?” I guess they had found in ultrasound that my baby's left kidney was super dilated, and my fluid was low which is called oligohydramnios. I know you've talked about this on the podcast before, but I think they measure it with an AFI. It's supposed to be over 8. Mine was a 4. Meagan: Really low. Yeah, below 5. But they were just going to rehydrate you. They weren't going to induce you? Flannery: Not yet, no. They wouldn't have induced me anyway because my baby was breech. Meagan: Which is good. They wouldn't. Yeah. Flannery: They were going to try to rehydrate me first and see how that went. It did, and they decided to give me some steroid shots too. My favorite midwife came in, and she said, “We're going to do these steroid shots, and we're going to see if the rehydrating works. I know you've been working hard. Maybe this is just a dehydration situation because you haven't been able to take care of yourself properly.” I was like, “Okay”, then she made a comment about delivery at 37 weeks. I was like, “Oh, this is a delivery-type situation.” It had really not sunk in with me yet that this was that serious. She was like, “Yes. Oligohydramnios can cause stillbirth. It's very serious. Probably what we are looking at is two weeks of monitoring, and then delivery at 37 weeks which will be a C-section unless your baby flips.” I was like, “Oh my god. Okay.” Meagan: Yeah. But with the fluid, did they want to continue giving you fluid? Did they encourage your hydration with electrolytes and everything? Flannery: Yes, they did. I was chugging water like a maniac for a few days and coconut water and all of this stuff and getting IV fluid. It did come back up a little bit to a 6, maybe. Meagan: I was going to say, did it fix it at all?Flannery: I was still getting a bunch of ultrasounds, then it went right back down to a 4. They said, “We're going to have you consult with maternal-fetal medicine at a bigger hospital on March 9th. My baby was due April 11th, but this was a lot earlier than I was expecting anything to happen. We went to this appointment to get this more detailed ultrasound, and the doctor comes in. She seems very nervous. That's not what you want. You don't want a doctor to seem nervous.No. She's like, “It looks like your baby's left kidney is non-functional. It's just a cluster of cysts.” Meagan: Oh no. Flannery: I was like, “Oh my god.” I was so terrified. I just had no clue. This didn't show up on the 20-week ultrasound or anything. She was like, “And your fluid is still super low.” We did an NST. They sent us home, and I was just waiting around at home with my husband for my midwife to call to make a plan. I was like, “Am I going back to work tomorrow? Am I going to be having this baby?” She called me, and she was like, “So, this isn't what I was expecting to tell you today, but I've been consulting with the neonatologist here and some OBs. Since you've already had your steroid shots, we want you to go to the hospital now to have your baby tonight.” She was like, “Don't rush down the highway in the snow. This is an urgent, not an emergent situation. You'll be in good hands.” I was like, “What in the world?” I was so taken aback. I didn't believe it. They were also transferring me to a different hospital from the one that I had worked at and had planned to deliver at. Meagan: Is it because of the NICU situation?Flannery: Because of the NICU, yeah. This bigger hospital had the capability for surgery, and my hospital did not. It was a situation where it was a small hospital and a situation that they weren't really comfortable with. We hopped in the car and drove through this big snowstorm. I was just crying and shaking. We had no idea. We were both terrified. We had no idea what we were about to walk into.When we met our OB, she walked into the room. She just radiated calmness and kindness and peace. She was just an angel. She made us feel so safe. They were monitoring the baby and putting my IV in. I was still trying to wrap my head around the fact that I was having a baby tonight. Meagan: Yeah. Flannery: I was wondering, “Is this baby going to be okay? What is going on here?” We walked down the hall to the OR. I kissed my husband goodbye. I remember just thinking, “Okay. Here we go. There's no going back now.” The only way I could stay calm was to surrender any of the control that I thought I had and really just trust in God and trust in the people who were going to do the surgery on me. I lay down on the table and the anesthesiologist was so kind. He was petting my head and talking to me. My husband came in and they were setting up the drapes. My doctor who I had just met leaned her head over and she said, “This is where I had my first daughter.” That just made me feel so happy. Things are going to be normal again. She had a C-section too. It made me feel very safe. Everything went really well during the operation. I remember I could see the reflection of the operation in the lights that they have above you. I bet other moms will know what I am talking about, but they have these big OR lights, and I could kind of see what they were doing which was crazy.Meagan: You can. They're like mirrors. Flannery: I know. They should come up with something better. Meagan: Yes. For those who don't want to watch or see anything, just turn to the side. Flannery: Close your eyes. Meagan: Close your eyes. Turn to the side. Flannery: Yeah. They said, “After a few minutes, okay. Here he comes. Then he's out.” I didn't hear anything. I heard someone say, “Okay. I need to take him.” I could tell that was the neonatalogist saying they needed to work on him a little bit. They took him over to a corner where we couldn't see or hear anything that was going on. We could just hear people talking. Eventually, we heard a little cry. My husband started to cry. I looked at him, and I smiled. I just felt relief that he was alive, but I didn't feel anything. I just felt this nothingness. Meagan: I can so relate to that. Flannery: Yeah. It's so strange. It's just not what you're hoping to feel in this big important moment. Meagan: Mhmm. Flannery: I remember the neonatalogist after a while, he was breathing on his own. He had peed and pooped. They showed us pictures of him. She walked over with him in his arms in this little bundle of blankets. She stood pretty far away, maybe 6 or 10 feet away. She was like, “Okay. You know the plan. We need to check his kidneys in the NICU. What's his name?” I said, “I don't know. I need to see his face.” She flashed the blanket at me and flashed it down so I could see his face. I couldn't see anything. I said, “I don't know. I don't know what his name is,” and she walked out with him. That is just the worst memory from that whole experience. The surgery itself was really good. The care I had was great, but I'll never get that moment back. She could have brought him over to give me a kiss or see his face. It was hours until– Meagan: Touch or kiss his face.Flannery: It was so long until I could see him and meet him in the NICU. I just think about that all of the time. I did get to go meet him after a few hours. He was doing great. I didn't recognize him at first when my husband rolled me over to his isolet in the NICU which was hard, but as soon as I held him, I just had this overwhelming rush of love. It hasn't changed to this day. He's just such a joy.He turned out to be fine. His kidney was normal. It's resolved on its own, and it wasn't a cluster of cysts like they had thought. Meagan: Yay.Flannery: Yeah. He's doing great. He's a very rambunctious, very smart 2.5-year-old now. Meagan: Good. Flannery: Yeah. I'm so grateful that I have him now. I'm so grateful that I accidentally got pregnant with him.Meagan: Yes. He was meant to be, and he was going to make sure that he was.Flannery: He totally was. Yeah. Yeah. Meagan: I'm sorry that you had that experience. I want to say it's unique, but it's not. That sucks. Flannery: It's totally not. Meagan: I hope that as people are listening, if they are in the birth world of labor and delivery nurses or OBs or midwives or whatever it may be, please be mindful of mom. Please be mindful of mom. Don't forget that she doesn't feel these things because does. She needs to see her baby. She needs to touch her baby. She needs to kiss her baby. If it is a true emergency, true emergency, understandable. But in a sense of this, it doesn't sound like it was a true emergency.Flannery: It wasn't. It wasn't. Meagan: They went over, and they took a lot of time with your baby, and then came and left. They didn't need to just come and leave. Flannery: Right, right. Especially when baby is breathing on its own and stuff, you can take 10 seconds to let mom give baby a kiss.Meagan: It will impact mom. Flannery: It totally will. Meagan: Here you are 2 years later still feeling mad. You're like, “I still think about that.” I saw it. I saw it in your eyes as you were telling that story. You feel that still. That's there. I hope that people can remember that protocols and what you think needs to happen and all of these things do not trump mom. Flannery: Totally. Totally. Meagan: Right. Yeah. So, having a NICU baby, how long– what was the exact gestation?Flannery: He was 35 and 5. Meagan: Okay, so it was a preterm Cesarean as well. Flannery: Yes. Meagan: Did they have to do any special scar or anything like that because it was preterm? Flannery: No, thankfully not, but he was very stuck up in my ribs. He had the cord around his neck, and there was meconium. I know that he needed to come out that way because I don't think he could have flipped if they did an ECV. I don't know if he would have tolerated labor if he was head down even. Meagan: Yeah. That's definitely an early baby, but good that all is well for sure. Flannery: Yeah. He did great. It was a rocky start, but he's doing great now. Meagan: Yeah. Yeah. Do you have any advice for NICU moms listening? Flannery: Yes. There is this foundation that will pay for your parking costs while you're in the NICU. I didn't know about it in time. Parking can get very expensive when you are visiting your baby. If you just Google, “Parking Foundation for NICU parents,” I'm sure it will come up because I can't remember the exact name. Meagan: I'm going to look it up. I'm going to look it up while you start your next story. We'll make sure to have it in the show notes if I can find it. Flannery: Yes. Yes. Meagan: Okay, keep going.Flannery: My next pregnancy, I was determined to do everything right this time. I was like, “You know what? The last pregnancy was so rocky and so unexpected that this time, I'm going to do everything right, and therefore nothing can go wrong.” I think people have that feeling a lot which is so irrational, but we can't help it. I did go back to see my OB who delivered Freddy, my son. I just loved her. I thought she was wonderful. I just wanted to see what her opinion was about why I had those complications in my pregnancy and see what she thought about a VBAC because even though I wasn't sure if I could have a VBAC, I was interested in it. She listed out all of these rules that she had about VBAC, about, “You can't be preterm. You have to go into labor naturally,” and all of the things that you say are red flags on the podcast. Meagan: I'm like, all of the normal things, but they are all red flags. Flannery: Yes. I mean, I loved this doctor, and I think if I was going to have a repeat C-section, I would have gone back to her because she is awesome, but that wasn't the experience that I wanted to have this time. I did a little research, and I found this midwife practice that everyone recommended to me. I decided to go with them instead. This pregnancy was super uneventful. I was very conscious of taking care of myself and taking walks a lot and prenatal yoga and being on top of my vitamins and all of that sort of thing. I was very religious about positioning and Spinning Babies because I was like, “If I can just get my baby head down from the beginning, I think that I can do the VBAC,” because with a bicornuate uterus, you have less time to flip them, so with a normally shaped uterus, baby can flip up until the very last minute if they are breech, but with a bicornuate uterus, first of all, you have more of a chance of baby being breech and less of a chance for them to flip based on the shape of your uterus. There's just not as much room. I was trying to sit on my yoga ball and doing all of these stretches. I was thinking, “Gosh. This is so unrealistic. Who's not going to sit on their couch for 9 months? I have to be sitting on my couch. I can't be walking 3 miles every day,” but then I'd go back and forth in my head like, “Do you want a VBAC or not? You have to be religious about this.” You don't have to do everything I guess is what I'm trying to say. You'll try your best, but you have to do what's right for you, but you can't go to the extremes.Meagan: I love that you pointed that out. With my second baby, I was doing the red raspberry leaf. I was doing the dates. I was doing all of the things, and even with my third baby, I was the one who didn't sit on the couch for 9 months. I still had a posterior baby. I will just say that I still had a posterior baby. I had a head-down, but still a posterior baby. Actually, he was still going breech too throughout pregnancy. Yes. He was such a stinker. But, I did do all of those things. I did the dates. I did the tea. I did all of it. For me, With my third, I had to dial back a little bit and say, “Okay. I'm going to do everything I feel is right for this pregnancy.” Dates wasn't one of those. I actually didn't do the dates thing. I know there is some evidence on that, but I just didn't do it. It didn't feel right to me, but I did other things like chiropractic care. I did drink tea. I hired a midwife and decided to go out-of-hospital and hired a birth team. I did birth education. I think the biggest thing is to do all of the things that stick out and call to you. There are so many things. We give so many tips. Some tips might not apply well to you. Walking 3 miles is a lot. Flannery: It is a lot. Meagan: It's a lot, but if you can walk a mile, that's better than not walking any. Flannery: Right. Meagan: Right? So trying to go and find what is sitting right for you in this pregnancy, this baby, and in this birth, and doing those things and then knowing you did all of the things you could that felt right for you. Flannery: Yes. Totally. I totally agree. Meagan: I knew I could do all of these things and baby might still be breech. Baby was breech at my anatomy scan, and then again at 28 weeks at my other growth scan. I remember going into the midwife and just saying, “What can I do?” She was kind of saying, “Nothing will supersede the shep of your uterus. You can do everything. Why don't you just visualize because at least then you will feel like you're doing something?” I was so mad after I left that appointment. I was like, “You can't tell me that I can't do anything to make this baby flip and that it's all down to the shape of my uterus.” I kept trying. I was 28 weeks and I was going to the chiropractor and acupuncture and inversions. This time, I was really good about the inversions even though it gave me heartburn. It worked. The baby did flip. I remember actually listening to a podcast episode from The VBAC Link, and it was about someone who was trying to flip a breech baby. She flipped her breech baby. I was like, “Okay. This gives me so much hope. I can do it.” It paid off because baby did flip. I was so happy. Yeah.At one ultrasound, they did pick up an issue with the kidney. I remember being so upset because it was the same issue that my son had, but very mild. The baby had been breech at that point. I was like, “I'm trying so hard. I'm doing everything right, and it's not working.” History is just repeating itself. That's what it felt like to me, but we ended up finding out that the kidney resolved at the next ultrasound and the baby had flipped. It was like, “Oh, my prayers are being answered.” I couldn't believe it. I was so happy when we got the results from that next ultrasound.We just continued doing the prep. I had planned. I was planning to deliver in the hospital. I had a doula who was amazing. She was just with me every step of the way talking me down when I was anxious and telling me all of the different things I could try and come up with plans for repeat C-section or vaginal birth. I had really wanted to go without the epidural because I didn't mention this, but I had gotten a spinal headache from my spinal last time, and that was just awful. It was almost worse than the C-section pain. Meagan: I've actually heard that because nothing really takes it away full-on. Flannery: Yeah, except lying down. Meagan: Lying down, yeah.Flannery: I was trying to visit my baby in the NICU. I couldn't just be lying in the hospital bed all day. So I was like, if I can avoid an epidural just so that I don't even have the chance of having a spinal headache again, that's what I'm going to do.I was reading Ina May. I was watching all of the YouTube videos and doing everything that I could, but it got to be a lot. It got to be like, oh my gosh, so much work to prep for this birth. The whole time, you don't know if it's a given if you're going ot get that VBAC.Meagan: I know. Flannery: Sometimes, it can feel like, why am I doing this?Meagan: Yeah. Yeah. It is hard. It is hard because we don't know until it's done. Flannery: Exactly. Until it's 100% over. Yeah. Meagan: Yeah. Flannery: Yeah, so you know, 37 weeks came. 38 weeks, 39 weeks. I was feeling overdue basically since 35 weeks. Meagan: I'm sure. I bet you were like, “I don't know how much longer I can go.” Flannery: I mean, I was definitely hoping to make it to term this time and I was so happy that I did. It was a big, big moment when I hit that 37-week mark, but then I just kept going and going and going. I was like, “Am I ever going to go into labor? What am I doing wrong?” I was walking. It was the end of July and it was so hot out. It was hard to get out there and walk. I eventually hit my due date which was July 25th. I got a membrane sweep on that day which was not super fun. It made me lose my mucus plug and have a few cramps, but nothing else. I was very hopeful that it would kickstart labor, but it did not. Eventually, I thought, “I just have to let go. The baby will come. You might have to have an induction, but you just have to relax.” Finally, finally, 5 days after my due date, which I know is not that long, but it felt long. Meagan: It feels long. It feels long when you are almost 6 weeks after you had your first baby.Flannery: Yes, exactly. I woke up in the middle of the night and I had this period cramp feeling. I was like, “Oh my god. Is this it? Am I in labor?” I managed to calm down and go back to sleep. I put my hand on my belly and was like, “Am I going to get another cramp?” They came, and they came, and they started coming every 20 minutes. Eventually, I had to wake my husband up because it was pretty painful at that point. Maybe 2-3 hours in, I squeezed his hand. He was still sleeping, and he was like, “What's going on?” I was like, “I think I'm in labor.” He said, “I was having a dream that your water broke.”Meagan: Oh my gosh. You guys were both willing it in.Flannery: Yes, exactly. It was like we were on the same wavelength. The contractions kept coming, but they just felt like mild period cramps. I had a midwife appointment at 8:15. They said to go in to see if I was in early labor. She checked me and said I was 3 or 4 centimeters dilated and almost completely effaced. She said, “Your cervix feels labory.” I said, “I think that today is the day.” I was convinced it was prodromal labor or going to fizzle out or something. We went all the way back home. My plan was to labor at home for as long as possible and have my doula come over. I said goodbye to my little 2-year-old. My mom was taking him to hang out with her while we were in the hospital, and I remember she had him say to me, “Good luck, and be strong.”The sound of his little voice saying that to me literally just sustained me through the entire labor. It was replaying in my head in the hardest moments. I could just hear him saying that and it meant so much to me. Yeah. We just hung out at home. I was getting pretty irregular timed contractions. I was wondering why they weren't getting closer together because sometime they would be close together. Sometimes they would be spaced apart, but they were definitely getting stronger. I got in the bath or the shower. I was leaning over, and swaying and moaning, doing all of the things that you're supposed to do– the low-toned moaning and the breathing. I eventually had my doula come over after one really bad contraction. I was like, “What's going on? Why isn't it picking up? Why aren't they getting closer together? Should I go to the hospital? What's going on?” I was really afraid of the car ride because it was about 40 minutes in the car. She said, “I think what is happening is that you have this mental block about the car ride,” because this whole time, I was like, “What if I have the baby in the car? What if I have the baby in the car?” I heard a lot of stories about car babies, and I actually recently had a patient who had a car baby at work. She was like, “I think you have this mental block, and once you get to the hospital, your body is going to let you get fully into labor. So I do think you could go.” I was like, “Okay, okay. Let's go.” I called the midwives and let them know we were coming. My favorite, favorite midwife was on, the one I had hoped this whole time was going to deliver my baby.She was only on for a 12-hour shift, and it was already halfway through her shift. I was like, “Oh gosh. I'm glad she's going to be there.” We drove to the hospital. It was this very hot, very bright, and humid day. I was like, “I don't want to be here. I just want to be in a cold, dark room.”I remember as we turned onto the street that the hospital is in and pulled in the driveway, my contractions boom, boom, boom were ramping up. I was like, “Ashley (my doula), you are so right. This is exactly what happened.” I got into triage. I was making a lot of noise. It was very intense at that point. They checked me. I was 4 centimeters and 100% effaced. I wasn't too disappointed that I wasn't further along because I was like, “This feels pretty intense. I think things are really happening.” But they said, “You picked a very popular day to give birth. There are no rooms available on labor and delivery.” I was like, “No.”Meagan: What?Flannery: I was especially nervous because working in the field, I've seen how a busy unit can really affect the care that is given. It shouldn't be that way, but it totally is. Meagan: It's the reality sometimes. Flannery: Yep. My sister-in-law had recently given birth on a very busy day. She had a very difficult birth, and a very not attentive staff, so that was one of the things I was really afraid of is that I was going to give birth on a super busy day, but my care was excellent thankfully. We eventually waited in triage for a room to be ready, and it was a tub room that became available. There was one tub room in labor and delivery. I was so excited to get in that tub. I jumped right in as soon as we got there. Not jumped, waddled right in. It felt so good. The water felt amazing, but I did find it very hard to maneuver and get in the right position to work through a contraction in the tub because it was weirdly shaped. I didn't stay in there super long, but I was very surprised at how intense the contractions were which sounds silly, but they just really took over. I was hoping to use some coping techniques like music or my rebozo. I brought my massage gun. I brought this whole toolkit of stuff, but in the moment, all that was going through my head during a contraction was cursing and, “I need the epidural. I need the epidural.”I was squeezing my husband's hand so hard. My doula had this spiky, silver ball that you could use for counterpressure so I was squeezing that in my hand so hard breathing. I labored on the toilet for bit. I was in the bed. I was moving around. I could not be lying down. They were having to use continuous monitoring which I didn't really mind. The nurse was very good about not being intrusive about that. She would just follow me around with the monitor. The midwife, who I was hoping to have, was just there with me the whole time. She was holding the monitor onto my belly and speaking kind words to me. I remember going through this terrible contraction and looking over at her. She is just sitting serenely in her rocking chair just looking at me. In my head, I was like, “How can you be so calm? Help me. Do something.” Meagan: I can relate. Flannery: Being present. Meagan: Do something. Help me.Flannery: Help me. Help me. Meagan: Sometimes just being present is what you needed. Flannery: It is. It totally was. She was super hands-off, but in the moment, you're like, “Come on. Somebody do something to help me.” Eventually, I was just sitting on the toilet. The midwife had dimmed the lights. My husband was there speaking to me. I had been making these very loud moans through each contraction, and then during one of them, I started grunting, and I knew exactly what that meant. I was pushing involuntarily. I had been hoping to feel the fetal ejection reflex, and I think that's what this was because my body completely took over. There was no way that I could have not pushed during these contractions. The pain of the contraction was so intense, but it would go away when I pushed. Then I would just feel this really uncomfortable pressure, but at least the pain of the contraction was going away. I had been pushing for maybe 5 minutes, and my midwife was all excited. I was like, “Okay. Please, can you check me?” She was like, “No, just go with your intuition. Listen to your body.” I was like, “No. I need you to check me.” I did not want to be pushing on an incomplete cervix. She did, and I was a 9 and 100% effaced. She was like, “Okay, you can definitely push. That cervix is just going to melt away.” Yes. I tried the nitrous while I was pushing, but I really hated how it restricted my breathing. It also made me throw up everywhere. Meagan: Really? Flannery: Yes. Meagan: Interesting. Flannery: Yes. So much puke. It was so embarrassing. It was splashing on everyone's shoes. I was like, “Oh my god. I'm so sorry.” I pushed on the toilet for a little bit, and then I moved over to the bed. I went over to the bed because when I was on the toilet, I felt something coming out between my legs. I reached down, and it was the bubble of amniotic fluid. It hadn't popped yet. Meagan: Your bag of waters, yeah. Flannery: My bag of waters was coming out. I think I said to my husband, “Do you want to touch it?” He was like, “No.” Meagan: It just feels like a water balloon.Flannery: It felt exactly like a water balloon. I went over to the bed. I got on my side, and I was pushing so hard just totally going with my intuition, but it wasn't the type of peaceful breathing that people tell you to do like the J breathing or anything. There was no way I could breathe through these contractions and these pushes. I was totally holding my breath and bearing down, but that's just what was right for me in the moment. They were saying, “Can you feel the baby moving down?” I was like, “No. Not at all.” I think that's because the bag of waters was still intact. I couldn't feel anything except this really uncomfortable pressure. They said, “Put your fingers inside of yourself and see if you can feel a baby's head.” I put my fingers past the bag of waters, and I could feel the baby's head right there. I pushed, and I could feel the baby move down. It was the most incredible, coolest moment of the birth. I loved that. My midwife said, “Okay, baby's definitely feeling the squeeze.” Her heart rate was going down a little bit. She said, “Turn onto your left side, and with this next contraction, let's have the baby.” I pushed as hard as I possibly could, and just felt this release of pressure. I had no idea what was going on, but I had this cold cloth over my face so I couldn't see anybody, but I heard cheering. Then I felt this warm, wet baby come up onto my belly. I was laughing and crying, and everyone was saying, “Yay! You did it!” I was just like, “Oh my god, what happened?” Meagan: Just like that.Flannery: It was surreal. It was incredible. She started crying right away. We didn't know she was a girl. My husband looked down between her legs. We both looked at the same time and said, “It's a girl.” I said, “I knew you were a girl.” She just stayed with me the whole time right onto my chest. It was just the best feeling. I was so, so overjoyed. Meagan: That is so amazing. It's so amazing with VBAC how the whole room sometimes can just erupt with joy and, “You did it!” and screams and joyful laughs. Oh, man. Flannery: Yeah. It was beautiful. It was so, so intense in a way that I hadn't been expecting it to be. It was a calm, beautiful birth, but the intensity of the contractions and the way that my body completely took over, and I was just along for the ride. I was just riding the waves. It was crazy. Meagan: Truly riding that wave. We talk about it in HypnoBirthing and riding the wave, but that wave came over, and like you said, your body was just like, “Okay, I've got this. Let's go.” Here you went, and this baby came out pretty quickly it sounds like.Flannery: Yeah, she was born at 7:23 PM. I had felt my first contraction at 2:00 AM or something. It wasn't the shortest labor, but once I got to the hospital, it was 5 or 6 hours. It was pretty quick in the end there. She came out en caul. Her head did. Meagan: She did?Flannery: As her body came out, it popped, so she was almost en caul I guess which I thought was so cool. Meagan: Oh my goodness. That is so awesome. I love that. I've seen a couple in my doula career, and it is so cool-looking. A lot of people have said, “Oh, vaginal birth can't have encaul babies.” Oh, yes they can. Yes, they can. 100%. Flannery: Yes. Meagan: I love that you had mentioned, “Once I got to the hospital–”. Sometimes I've had this with doula clients where I'm noticing this pattern of inconsistency and a lot of the times, the client is saying things like, “Should I go? Should I go? Is it okay to be here still? How much longer should we stay?” They are saying these questions because inside, there's a lot going on. I had a client where I said, “You know what? I think we should go. I think you are going to feel safer there. It seems like you are going to feel safer there.” The second we got there, things ramped up. Doctor didn't even make it. The baby slipped out on the bed. Seriously, the second she got there, her body released. It was almost like her epidural. Sometimes, with an epidural, we get an epidural and our body is able to relax. If our mind is not confident or comfortable, we can't let our bodies sometimes. So I love that you pointed that out. I wanted to talk a little bit more really quickly on the types of uterine abnormalities or different types of uteruses. As she was saying, you have a bicornuate uterus which means it's a heart-shaped uterus. I'm probably going to butcher these names especially if you are a provider and you are listening. I don't really know how to say these words. There's an arcuate uterus which is similar to a bicornuate uterus, but with less of a dip in the heart shape. It's like an oddly shaped heart. It's asymmetrical in my mind. That's how I envision it. There's an arcuate uterus, which means there's a divide down the two parts of the membrane wall. Then there's a unicornuate uterus, which is when the fallopian tube has an irregular shape to it. Then I always butcher this one. It's didelphys. I don't even know how to say it. Flannery: Sorry. I can't help you on that one. Meagan: I'm going to stop trying. That is when you are born with two uteruses which does happen. One baby can be in one uterus, and we can have another uterus over here. Those are all abnormalities of the uteruses. Of course, we have different shapes, sizes, and all of the things. I wanted to just have a link in the show notes for that as well so you can read more on each of those types of uteruses. Then tell me if this is the right link. I found Jackson's Chance Foundation.Flannery: Yes. That's what it is. Meagan: Why parking matters. Flannery: Yes. Meagan: It looks like this is inspired. It's a foundation inspired by another person's story, another NICU baby's story. It said that–Flannery: Yeah. I believe that Jackson's parents set it up. Meagan: Yeah. Wow. This story is precious and inspiring. Wow. These parents are incredible. Then it does show that you can donate or sponsor a parking pass. They talk about the why and all of that. This is so awesome. I'm going to make sure that we have that in the show notes. If you know a NICU baby, or you know someone who is going to have a NICU baby, don't be like Flannery and find out later. This is how we all learn, and this is how. We find out when it's too late, then we have to go to show on. So, thank you for sharing that tip. I've actually never heard of it, but that's probably because I'm not a NICU mom.Flannery: Yeah. Yeah. I hope it helps someone. Meagan: Yes. Thank you again so much for sharing your story.Flannery: Oh my gosh, this is amazing. Thank you so much. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
In this episode, we review the high-yield topic of CNS Abnormalities from the Embryology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
Commentary by Dr. Ning-I Yang.
Commentary by Dr. Jian'an Wang.
Featuring perspectives from Dr Komal Jhaveri and Dr Hope S Rugo, including the following topics: Introduction: PI3K/AKT/PTEN Pathway and Resistance to Endocrine Therapy (0:00) First-Line Therapy for HR-Positive Metastatic Breast Cancer (mBC) Harboring PI3K/AKT/PTEN Mutations (7:04) Treatment Options for Recurrent mBC with PI3K/AKT/PTEN Mutations (24:11) Beyond the Guidelines Survey (35:36) Faculty Case Presentations (51:27) CME information and select publications
Dr Komal Jhaveri from Memorial Sloan Kettering Cancer Center in New York, New York, and Dr Hope S Rugo from the UCSF Helen Diller Family Comprehensive Cancer Center discuss treatment decision-making for HR-positive metastatic breast cancer in patients who harbor PI3K/AKT/PTEN pathway mutations.
Dr Komal Jhaveri from Memorial Sloan Kettering Cancer Center in New York, New York, and Dr Hope S Rugo from the UCSF Helen Diller Family Comprehensive Cancer Center discuss treatment decision-making for HR-positive metastatic breast cancer in patients who harbor PI3K/AKT/PTEN pathway mutations, moderated by Dr Neil Love. Produced by Research To Practice. CME information and select publications here (https://www.researchtopractice.com/PI3KAKTPTENmBC24).
These People Might Not Be Able to Enjoy Some Things Due to an Abnormality; Who's This Famous Person With a Food Allergy?
Today we are gong to look at tone. Everyone has heard it… high tone, low tone, fluctuating tone, spasticity … what does all that even mean!? Spoiler alert it's can be a little complicated and depending on the diagnoses can look very different from participant to participant. Today we are going to do our best to simplify it and break down the basic differences between hyper- and hypo-tonia and how both impact our participants in the saddle. Register for the LIVE WEBINAR: Postural Corrections and Modifications for Adaptive Riding Participants, November 17th at 6:30 PM CT https://form.jotform.com/242204635686055 Get a more complex look at tone in Episode 53: Understanding Diagnoses in EAS: Cerebral Palsy https://spotifyanchor-web.app.link/e/9dNNl17b6Nb Register for the HETRA University Live Conference in Gretna, NE on March 13-15, 2025https://hetra.org/education/pre-conference-hetra-university-live.html This episode is proudly sponsored by Equiforce. https://www.equi-force.com/ Reference from today's episode: Ganguly J, Kulshreshtha D, Almotiri M, Jog M. Muscle Tone Physiology and Abnormalities. Toxins (Basel). 2021 Apr 16;13(4):282. doi: 10.3390/toxins13040282. PMID: 33923397; PMCID: PMC8071570.
Alternate Current Radio Presents: Boiler Room - Learn to protect yourself from predatory mass mediaOn this episode of Boiler Room the Social Rejects Club learns about hidden DICKS, not only in human anatomy but also in our media, government and all the other places globalist turds collude. As we come closer and closer to the 2024 election we're taking a critical look at what could LIE ahead for the United States and the global chess board. mRNA is back on the menu and a man eats too many magic mushrooms and chops his phallus off... all this and more on this episode of Boiler Room.Featured: Hesher, Spore, Infidel Pharaoh & RuckusSupport BOILER ROOM & ACRPatreonShop BOILER ROOM Merch Store
Drs. Lake D. Morrison and Joseph G. Mammarappallil conclude their discussion of ILAs as key precursors to ILDs, reviewing a patient case and addressing considerations when ordering imaging studies, focusing on HRCT scans, their optimal cut widths, views, and more, to help identify and differentiate ILAs from other lung abnormalities.
Drs. Lake D. Morrison and Joseph G. Mammarappallil discuss ILAs as key precursors to ILDs, including defining what ILAs are, their identification by imaging specialists, as well as the clinical implications of ILAs for HCPs caring for these patients.
On this episode of the Healthy, Wealthy, and Smart podcast, Dr. Karen Litzy discusses chronic pain with Dr. David Clark, president of the Psychophysiologic Disorders Association. Dr. Clark sheds light on stress-related brain-generated medical conditions and the mission of his organization to end the chronic pain epidemic. They emphasize the importance of looking beyond structural damage in addressing chronic pain. Tune in to learn more about this important topic! Time Stamps: [00:02:41] Psychophysiologic disorders definition. [00:06:26] Abnormalities in spine and pelvis. [00:09:26] Vacation and stress relief. [00:14:30] Adverse childhood experiences. [00:17:03] Stress-related triggers for symptoms. [00:22:18] Deep stress. [00:25:36] Brain-generated symptoms. [00:31:27] The brain generating physical symptoms. [00:34:00] Transforming healthcare education. More About Dr Clark: Dr. David Clarke is the President of the Psychophysiologic Disorders Association (PPDA), a 501(c)(3) nonprofit dedicated to ending the chronic pain epidemic. Dr. Clarke holds an MD from the University of Connecticut School of Medicine, and is Board-certified in Internal Medicine and Gastroenterology. His organization's mission is to advance the awareness, diagnosis, and treatment of stress-related, brain-generated medical conditions. Learn more at EndChronicPain.org. Resources from this Episode: Psychophysiologic Disorders Association Past Media Coverage of Dr. Clark PPDA Facebook Dr. Clark on LinkedIn PPDA on YouTube Jane Sponsorship Information: Book a one-on-one demo here Mention the code LITZY1MO for a free month Follow Dr. Karen Litzy on Social Media: Karen's Twitter Karen's Instagram Karen's LinkedIn Subscribe to Healthy, Wealthy & Smart: YouTube Website Apple Podcast Spotify SoundCloud Stitcher iHeart Radio
In this episode of the It's A Mimic! podcast, the panel of Dungeon Masters visits potentially the last Campaign Setting published in 5th Edition before OneD&D is released. Cold Open 0:00 Opening Theme 2:59 Intro 3:20 Info Break 6:57 Planescape 8:08 Sigil 32:46 The Outlands 1:08:44 Info Break 1:33:36 Outro 1:34:05 Closing Theme 1:38:01 Post-Credits 1:38:28 DON'T FORGET TO LIKE & SUBSCRIBE! Find Us On: Patreon at https://www.patreon.com/user?u=84724626 Website at https://www.itsamimic.com iTunes at https://itunes.apple.com/ca/podcast/its-a-mimic/id1450770037 Spotify at https://open.spotify.com/show/3Y19VxSxLKyfg0gY0yUeU1 Podbean at https://itsamimic.podbean.com/ YouTube at https://www.youtube.com/channel/UCzQmvEufzxPHWrFSZbB8uuw Social: Facebook at https://www.facebook.com/itsamimic/ Instagram at https://www.instagram.com/itsamimic/?hl=en Reddit at https://www.reddit.com/r/ItsaMimic/ Email at info@itsamimic.com Dungeon Master: Adam Nason Host 2: Kasi Just Kasi Host 3: Miaca Nason Narrator: Pepperina Sparklegem Written by: Adam Nason Director: Adam Nason Editor: Adam Nason Executive Producers: Adam Nason Intro/Outro Music by: Cory Wiebe Logo by: Katie Skidmore at https://www.instagram.com/clementineartportraits/ This episode is meant to be used as an inspirational supplement for Dungeons & Dragons 5th Edition and tabletop roleplaying games in general. It's A Mimic! does not own the rights to any Wizards of the Coasts products. Artwork included in this episode's visualizations is published and/or owned by Wizards of the Coast.
In this episode of The Worst Girl Gang Ever, Bex and Laura sit down with community member Anita. She shares her story of trying to start a family, navigating the challenges of IVF, experiencing the joy of pregnancy, and then facing the difficult news of a severe brain condition in her unborn baby, ultimately leading to a heart-wrenching decision. Listen in to hear about: Anita's experience with bereavement midwives, highlighting the support and care she received Her reflection on our ability to compartmentalise and the resilience and strength we are capable of How she navigated pregnancy after loss with caution, fearing another miscarriage The Warriorship is a membership to help you navigate life after baby loss. It covers every stage of the recovery pathway, and provides support, advice, and a range of emotional tools to help you through this difficult time. This is more than a support group. For more information and to join The Warriorship go to: https://theworstgirlgangever.co.uk/warriorship/ The Worst Girl Gang Ever is a real, honest emotive podcast that covers the heartbreaking subject of miscarriage, infertility and baby loss, expect honest conversations about unspoken experiences. Hosted by TWGGE founders Bex Gunn and Laura Buckingham, this show is a chance to break the silence and really open up the dialogue around the topic of miscarriage and pregnancy loss. No more shame, no more taboo - let's ditch that for our children; the ones that will come, the ones that are and the ones that never came to be. Learn more about your ad choices. Visit megaphone.fm/adchoices
Dr. Zaghi graduated from Harvard Medical School, completed residency in ENT (Otolaryngology- Head and Neck Surgery) at UCLA, and Sleep Surgery Fellowship at Stanford University. The focus of his sub-specialty training is on the comprehensive treatment of tongue-tie, nasal obstruction, mouth breathing, snoring, and obstructive sleep apnea. He is very active in clinical research relating to sleep disordered breathing with over 80+ peer-reviewed research publications in the fields of neuroscience, head and neck surgery, and sleep-disordered breathing.Dr. Zaghi is particularly interested in studying the impact of tethered-oral tissues (such as tongue-tie) and oral myofascial dysfunction on maxillofacial development, upper airway resistance syndrome, and obstructive sleep apnea. He is an invited lecturer, author, and journal reviewer for topics relating to the diagnosis and management of sleep-disordered breathing and tongue-tie disorders.Research interests include: Study design, literature review, and statistical analysis. Special interest in collaborative and multidisciplinary research projects relating to airway and breathing disorders, obstructive sleep apnea, nasal obstruction, upper airway resistance syndrome, pediatric sleep disorders, myofunctional therapy, frenuloplasty, facial and airway development, and maxillofacial reconstructive surgery.Clinical interests: Sleep and Breathing Disorders, Tongue-tie, Snoring, Obstructive Sleep Apnea, Nasal Obstruction, Upper Airway Resistance Syndrome, Inspiratory Flow Limitation, Sleep Endoscopy, Deviated Septum, Tonsil Hypertrophy, TMJ Pain, Teeth-grinding, Mouth Breathing, Frenuloplasty, Tonsillectomy, Septoplasty, Turbinate Reduction, Vivaer Nasal Valve Remodeling, Maxillary Skeletal Expansion, MMA Jaw Surgery. SHOWNOTES:
This week we are joined by Dr. Bronson Strickland of the Mississippi State Deer Lab and he explains deer anomalies. Occasionally at the skinning rack we notice things about our deer that make us wonder everything from what is that, to, is the meat good to eat? Luckily, Bronson knows all and explains it all without getting too gross. You'll hear about arterial worms, nasal bots, cutaneous fibroma, brain abscess, Bullwinkle syndrome, liver flukes, louse flies and more. It's an interesting discussion and information that will make you appreciate the white-tailed deer a little bit more. Bronson also brings his own trivia question and attempts to stump us. Listen, Learn and Enjoy. Show Notes:(1) MSU Deer Lab: https://www.msudeer.msstate.edu/index.php (2) MSU Deer Lab Instagram: https://www.instagram.com/msudeerlab/ (3) MSU Deer Lab Facebook: https://www.facebook.com/msu.deerlab/ (4) MSU Deer Lab X: https://twitter.com/MSUDeerLab Support the showStay connected with GameKeepers: Instagram: @mossyoakgamekeepers Facebook: @GameKeepers Twitter: @MOGameKeepers YouTube: @MossyOakGameKeepers Website: https://mossyoakgamekeeper.com/ Subscribe to Gamekeepers Magazine: https://bit.ly/GK_Magazine Buy a Single Issue of Gamekeepers Magazine: https://bit.ly/GK_Single_Issue Join our Newsletters: Field Notes - https://bit.ly/GKField_Notes | The Branch - https://bit.ly/the_branch Have a question for us or a podcast idea? Email us at gamekeepers@mossyoak.com