Podcasts about Account

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    Best podcasts about Account

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    Latest podcast episodes about Account

    The Opperman Report
    Dereliction of Duty: The Eyewitness Account of How President Bill Clinton Compromised America's Long-Term National Security

    The Opperman Report

    Play Episode Listen Later Jul 10, 2025 60:12


    Lt. Col. Robert Buzz” Patterson exposes the terrifying, behind-the-scenes story of the years when the most irresponsible President in our history had his finger on the nuclear trigger. Dereliction of Duty is the inside story of the damage Bill Clinton did to the U.S. military and how he compromised our national security. From his laughable salutes, to his arrogant, anti-military staffers, the message came through loud and clear: the Clinton Administration had nothing but contempt for America's men and women in uniform.For two years, Patterson was the White House military aide who carried the nuclear football,” which provides the President with remote nuclear strike capabilities. What he witnessed is shocking. In Dereliction of Duty, Patterson reveals:How Clinton missed a golden opportunity to take out Osama bin Laden long before September 11, 2001Why a minor family matter” caused the Clintons to scramble a military jetHow a young Clinton staffer tried to divert a full Navy carrier battle group just so the President could have a photo-opWhy female stewards on Air Force One had to keep their distance from the PresidentBut that's not all. Colonel Patterson reveals that Clinton treated our nation's most sensitive secrets and powerful weapons with cavalier disregard, while his aides regarded the military as just another tool for domestic politics.Dereliction of Duty is the book every American concerned about our national security has been waiting forwritten by a military man who was an eyewitness inside the Clinton White House, and who can no longer in good conscience keep silent.https://amzn.to/462zE9fBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-opperman-report--1198501/support.

    30 Minutes to President's Club | No-Nonsense Sales
    Sales Onboarding Strategy That Cut Time To First Sale by 49% | Bite-sized Tactics

    30 Minutes to President's Club | No-Nonsense Sales

    Play Episode Listen Later Jul 9, 2025 6:08


    Most orgs spend weeks training reps on the product… but months later, you're still stuck with an empty pipeline. What if the key to ramping AEs faster was skipping product training (at first)? Kyle Asay (VP Global Growth Sales @ LaunchDarkly) shares how his team cut time to first deal by 49% by rethinking onboarding. Instead of starting with feature dumps, they focused on: ✅ Account prioritization ✅ Customer problems & personas ✅ Story-based selling If you lead a team or are ramping yourself, don't miss this one. RESOURCES DISCUSSED: ⁠⁠Join our weekly newsletter⁠⁠ ⁠⁠Things you can steal⁠⁠ ⁠⁠Save $50 on any 30MPC course⁠⁠ with code “PODCAST” ⁠⁠Free Sales Templates, Scripts and Guides

    Empire Flippers Podcast
    Avoiding Account Shutdowns: Proactive Support Strategies for Amazon Sellers With John Cavendish [Ep.184]

    Empire Flippers Podcast

    Play Episode Listen Later Jul 8, 2025 40:45


    The rules of selling on Amazon have changed, and sellers who don't adapt are paying the price in time, revenue, and sometimes, their entire account. In this episode, we're joined by John Cavendish, the founder of Seller Candy, an agency that deals with Seller Support on behalf of Amazon sellers.We dive into what's really going wrong behind the scenes of Amazon businesses with someone who sees it all from the inside. From shifting product launch strategies to the overlooked support issues that sabotage sellers, we uncover the patterns that can quietly erode your success. We explore the most common launch mistakes Amazon sellers make, why account suspensions are on the rise, and what proactive steps you can take to protect your account's health before it's too late. If you want to launch smarter, avoid suspension triggers, and get ahead of account health issues before they escalate, this episode is packed with essential insights. Topics Discussed in this episode: How launching a product on Amazon has changed (03:47) Common product launch mistakes entrepreneurs make (10:17) The main support problems Amazon sellers experience (11:46) The most common reasons for account suspensions (17:19) Proactive steps you can take to avoid account health issues (19:59) How Seller Candy's clients are reacting to tariffs (25:14) John's advice to US-based Amazon sellers (29:42) Mentions:  Empire Flippers Podcasts Empire Flippers Marketplace Create an Empire Flippers account Subscribe to our weekly newsletter Seller Candy Seller Candy Academy Sit back, grab a coffee, and learn how to protect your Amazon seller account from unnecessary suspensions!  

    Dumb Dad Podcast
    Do I Stil Have A Myspace Account?

    Dumb Dad Podcast

    Play Episode Listen Later Jul 8, 2025 40:53


    We're back after a 2 week hiatus! Sorry for the unexpected time off. Evan took a fun adventure across the country with his family that ends in a Dumb Dad Moment. Meanwhile Kevin has started summer but hasn't yet ended the school year. If you want to send us your Dumb Parenting Submission, you can email us at DumbDadPod@gmail.com or send it by postal mail to The Dumb Dads, 17216 Saticoy St #678, Van Nuys, CA 91406. The Dumb Dad podcast is also on Youtube. Subscribe here! For more Dumb Dad Pod, follow us on social – https://bit.ly/3t6tE9M We've got DUMB DAD MERCH!  And we're on CAMEO! We'd love to send a message to a dad (or anybody) in your life who needs a Dumb Dad pick-me-up! CHEAT CODES – BETONLINE – Use our Promo Code: BLEAV to receive your 50% Welcome Bonus on your first deposit. Thanks to Chris Verdú for our show music! Check out Verdú on SoundCloud! And thanks to editor, Annie Laferriere. Check her out on instagram!

    The Wealthy Woman's Podcast | Save Money, Invest, Build Wealth, Manage Money, Overspending, Finances
    133. 3 Surprising Reasons You Overspend (Even If You're a High Earner)

    The Wealthy Woman's Podcast | Save Money, Invest, Build Wealth, Manage Money, Overspending, Finances

    Play Episode Listen Later Jul 8, 2025 25:12


    Click Here to book your complimentary Financial Clarity Consultation. Ready to finally Stop Overspending?Start The Stop Overspending Course today → Click here to enroll. Grab the Free Training:How to Build Wealth WITHOUT Going On A Strict Budget → Click here to watch now. Click Here to open an Account with Ally Bank Using My Referral Link. Follow Me on Instagram → @germainefoleycoaching

    The Opportunity Podcast
    Avoiding Account Shutdowns: Proactive Support Strategies for Amazon Sellers With John Cavendish [Ep.184]

    The Opportunity Podcast

    Play Episode Listen Later Jul 8, 2025 40:45


    The rules of selling on Amazon have changed, and sellers who don't adapt are paying the price in time, revenue, and sometimes, their entire account. In this episode, we're joined by John Cavendish, the founder of Seller Candy, an agency that deals with Seller Support on behalf of Amazon sellers.We dive into what's really going wrong behind the scenes of Amazon businesses with someone who sees it all from the inside. From shifting product launch strategies to the overlooked support issues that sabotage sellers, we uncover the patterns that can quietly erode your success. We explore the most common launch mistakes Amazon sellers make, why account suspensions are on the rise, and what proactive steps you can take to protect your account's health before it's too late. If you want to launch smarter, avoid suspension triggers, and get ahead of account health issues before they escalate, this episode is packed with essential insights. Topics Discussed in this episode: How launching a product on Amazon has changed (03:47) Common product launch mistakes entrepreneurs make (10:17) The main support problems Amazon sellers experience (11:46) The most common reasons for account suspensions (17:19) Proactive steps you can take to avoid account health issues (19:59) How Seller Candy's clients are reacting to tariffs (25:14) John's advice to US-based Amazon sellers (29:42) Mentions:  Empire Flippers Podcasts Empire Flippers Marketplace Create an Empire Flippers account Subscribe to our weekly newsletter Seller Candy Seller Candy Academy Sit back, grab a coffee, and learn how to protect your Amazon seller account from unnecessary suspensions!  

    Bad Hasbara - The World's Most Moral Podcast
    112: New Account Who Dis? with Michael Schirtzer [UNLOCKED]

    Bad Hasbara - The World's Most Moral Podcast

    Play Episode Listen Later Jul 7, 2025 73:19


    Unlocked this episode because Michael continues to be deplatformed for his Palestine advocacy. We have included all of his new social media links. Please sub![Recorded May 31st, 2025]Matt and Daniel are joined by comedian Michael Schirtzer to talk over his Instagram banishment, Piers Morgan's tête-à-tête with Israeli Ambassador to the U.K. Tzipi Hotovely, and several flagrant and lengthy violations of producer Adam's No Accents rule.Please donate to Mercy Corps: https://www.mercycorps.org/Follow Michael on everything!Tik Tok: https://www.tiktok.com/@mikeyb_onX: https://x.com/MicSchirtzerYoutube: https://www.youtube.com/channel/UCS3iwjdWG087EHzUUP8baggMy podcast: https://www.youtube.com/c/ThePalestinePodPlease support our project on Patreon! https://www.patreon.com/c/palestinepodSubstack: https://substack.com/@mikeybon-----Subscribe to the Patreon https://www.patreon.com/badhasbaraWhat's The Spin playlist: https://spoti.fi/4kjO9tLSubscribe/listen to Bad Hasbara wherever you get your podcasts.Spotify https://spoti.fi/3HgpxDmApple Podcasts https://apple.co/4kizajtSupport this podcast at — https://redcircle.com/bad-hasbara/donationsPrivacy & Opt-Out: https://redcircle.com/privacy

    Best of The Steve Harvey Morning Show
    Uplift: Top ten tips to grow your business and brand and how to avoid scams.

    Best of The Steve Harvey Morning Show

    Play Episode Listen Later Jul 6, 2025 32:30 Transcription Available


    Two-time Emmy and Three-time NAACP Image Award-winning, television Executive Producer Rushion McDonald, interviewed Attorney Jalene Mack. Widely known as “America’s Favorite Entertainment Attorney.” The episode focuses on protecting creative and business assets, avoiding scams, and building a solid foundation for success in the entertainment industry and beyond.

    The Money Podcast
    Do You Really Know Who Owns Your Money?

    The Money Podcast

    Play Episode Listen Later Jul 6, 2025 30:28


    SPONSOR: Direct Bullion. Download your free Guide to Gold Pensions Now. (plus get a special bonus).CLICK HERE NOW: https://robmoore.directbullion.com Rob explains who really owns your money once it's in the bank. He covers seven ways banks can use, restrict, and take your deposits, from paying their bills to freezing accounts based on your political views. He shares real examples, including Andrew Tate's frozen £16 million and Nigel Farage's account closure. KEY TAKEAWAYS • Banks control your deposits, not you! They can lend out 90% of your money under fractional reserve rules and use the rest for their operating costs. • Deposit insurance has limits, the £85,000 protection applies per banking group, not per bank, and relies on the debt heavy government as guarantor. • Banks can block access to your money including setting withdrawal limits, restricting crypto purchases and they can demand explanations for large withdrawals. • Account closures happen for political reasons. Banks can close accounts based on your views or social media posts, as seen with Nigel Farage and Andrew Tate. • Banks can operate knowing they can't pay if just 11% of customers want their money back at once. The system allows legal insolvency. • Physical assets give real control, gold, silver, property, and other physical items can't be frozen or seized like bank deposits. BEST MOMENTS "If you borrow a million quid from the bank, you have the problem. If you borrow a hundred million from the bank, they have the problem." "Andrew Tate told me that the banking institutions froze 16 million pounds of his money... I wrote off the 16 million." "The banks can use your money for their operational costs... they can use it to buy elastic bands, paperclips, have their senior managers go and have dinners." "As soon as there's no cash, their ability to do this goes up by 10x and your freedom goes down by 10x." VALUABLE RESOURCES https://robmoore.com/ bit.ly/Robsupporter https://robmoore.com/podbooks rob.team ABOUT THE HOST Rob Moore is an author of 9 business books, 5 UK bestsellers, holds 3 world records for public speaking, entrepreneur, property investor, and property educator. Author of the global bestseller “Life Leverage” Host of UK's No.1 business podcast “The Disruptive Entrepreneur” “If you don't risk anything, you risk everything” CONTACT METHOD Rob's official website: https://robmoore.com/ Facebook: https://www.facebook.com/robmooreprogressive/?ref=br_rs LinkedIn: https://uk.linkedin.com/in/robmoore1979 See omnystudio.com/listener for privacy information. This Podcast has been brought to you by Disruptive Media. https://disruptivemedia.co.uk/

    money uk guide banks account owns andrew tate deposit nigel farage life leverage host disruptive entrepreneur if
    Selling With Social Sales Podcast
    Modern Buyer Journey Demands New Lead Generation Approaches with Zach Jones | Ep. 302

    Selling With Social Sales Podcast

    Play Episode Listen Later Jul 4, 2025 45:00


    In today's rapidly evolving sales landscape, lead generation remains a top priority for Chief Revenue Officers and sales leaders. But with the rise of AI, changing buyer behaviors, and an overwhelming array of tools and technologies, how can sales teams effectively navigate this complex terrain? In this episode of the Modern Selling Podcast, I sit down with Zach Jones, Chief Revenue Officer at TechnologyAdvice, to explore the cutting-edge strategies and tools that are reshaping the lead generation game. With over a decade of experience in scaling sales teams and driving revenue growth, Zach offers invaluable insights into the current state of B2B sales and marketing. Adapting to the New B2B Buyer Journey One of the most significant shifts we discuss is the changing nature of the B2B buyer journey. Zach highlights that: 75% of the buyer journey now happens before someone wants to talk to sales 86% of buyers start with a shortlist of vendors 92% of purchases come from that initial shortlist This means that awareness and early education are more critical than ever. Sales and marketing teams need to focus on getting on that shortlist through strategic content placement and engagement across various channels. The Rise of AI in Sales and Marketing Artificial Intelligence is not just a buzzword – it's reshaping how we approach lead generation and engagement. Zach shares eye-opening statistic: There's been a 240% increase in page views from ChatGPT to their websites since January This shift towards AI-driven content creation and research is changing how buyers find and evaluate vendors. Sales teams need to adapt their strategies to ensure they're visible and relevant in this new AI-powered landscape. From Funnel to Rooms: A New Perspective on Lead Nurturing Zach introduces an interesting concept of thinking about lead nurturing not as a funnel, but as two rooms: Prospects who are ready to talk to a vendor Prospects who are not ready The key is figuring out how to move prospects from the "not ready" room to the "ready" room. This approach requires a more dynamic and personalized marketing strategy, leveraging AI and intent data to create tailored experiences for each prospect. Actionable Takeaways for Sales Leaders Experiment with new technologies and strategies – don't be afraid to break things Focus on niching down and segmenting your audience for more personalized outreach Leverage AI tools to level the playing field and enhance your team's capabilities Align your sales and marketing strategies based on your target market and how they buy Consider implementing an Account-Based Experience (ABX) approach for enterprise sales As the B2B sales landscape continues to evolve, staying ahead of the curve is crucial. By embracing new technologies, focusing on personalization, and adapting to changing buyer behaviors, sales teams can position themselves for success in this dynamic environment. Timestamped Summary of this Episode: 00:00:00 The Rise of AI in Content Creation AI tools like ChatGPT are becoming increasingly popular for content creation and personalization. Marketers are focusing on delivering more relevant, timely messages to smaller, engaged audiences rather than high volume outreach. The shift towards AI-driven personalization is changing how companies approach lead generation and engagement. 00:01:07 Introducing Zach Jones: CRO of TechnologyAdvice Zach Jones, Chief Revenue Officer at TechnologyAdvice, shares his background and the company's role in connecting tech marketers with B2B buyers. TechnologyAdvice operates multiple digital media properties and offers services like content creation, digital advertising, lead generation, and buyer intent intelligence.  00:03:27 From Punk Pop to B2B Sales: Zach's Surprising Past Zach reveals his unexpected background as the frontman of a punk pop band in college. This experience, while not impressing his future wife, showcases Zach's diverse background before entering the B2B sales and marketing world. 00:05:19 Evolving Lead Generation Landscape The lead generation landscape is shifting due to economic changes and emerging technologies. Key trends include niching down to target smaller, engaged audiences, leveraging AI for personalization, and adapting to the changing demographics of B2B buyers, with millennials and Gen Z now dominating. 00:08:18 Adapting to Modern Buyer Journeys Marketing and sales teams are adapting to new buyer journeys by embracing diverse media channels like podcasts, YouTube, and newsletters. The focus is on meeting buyers where they are and providing relevant content throughout their decision-making process, rather than relying solely on traditional lead generation methods. 00:10:11 Effective Sales and Marketing Tools While some companies are cutting back on tools, certain platforms like Sixth Sense and ZoomInfo continue to deliver ROI. The trend is moving towards efficiency and proven value rather than accumulating multiple tools. New opportunities in forums, Reddit, and connected TV are emerging as ways to engage buyers. 00:12:50 Key Metrics for Evaluating Tools CROs should prioritize usage and adoption rates when evaluating tools. Pipeline generation and productivity improvements are also crucial metrics. The focus should be on how tools increase efficiency and drive tangible results rather than just adding more features. 00:17:37 Intent Data and Personalized Engagement Leveraging intent data and behavioral analytics is crucial for identifying and engaging high-potential leads early in the buyer's journey. TechnologyAdvice is developing an AI-driven "intent to lead" model that creates personalized, timely outreach based on prospect behavior across their ecosystem. 00:32:40 Rethinking the Sales Funnel The traditional sales funnel concept is evolving into a two-room model: prospects are either ready to talk to a vendor or they're not. The focus is on moving prospects from "not ready" to "ready" through personalized, dynamic marketing across various channels and touchpoints. 00:36:42 Tailoring Strategies to Audiences and Verticals There's no one-size-fits-all approach to sales and marketing strategies. Leaders must consider factors like product type, sales motion, and target market to determine the most effective channels and tactics. Account-based experience (ABX) is becoming increasingly important for enterprise sales. 00:40:18 Advice for CROs: Experiment and Personalize CROs should focus on testing new approaches, leveraging AI, and personalizing experiences for target accounts. The key is to be willing to experiment, niche down, and use available tools effectively to stand out in a competitive landscape. Follow Us on: ·         LinkedIn ·         Twitter ·         YouTube Channel ·         Instagram ·         Facebook You might also like: ·         FlyEngage - Social media AI engagement tool. ·         FlyPosts - Thought leadership AI post generator tool. ·         FlyMSG - Auto text expander (Try it out here for free). ·         FlyMSG Sales Pro for Individuals: On-demand sales training for individual sellers. ·         FlyMSG Sales Pro for Teams: On-demand sales training for sales teams for prospecting.  Install FlyMSG for free: ·         As a Chrome Extension. ·         As an Edge Extension.  

    Consumer Tech Update
    Is your crypto account real?

    Consumer Tech Update

    Play Episode Listen Later Jul 4, 2025 8:15


    Crypto scammers promise fast cash. Only it's not. Here's how the con works. Learn more about your ad choices. Visit megaphone.fm/adchoices

    Only Friends
    212: caught on a burner account

    Only Friends

    Play Episode Listen Later Jul 2, 2025 68:22


    Only Friends is your weekly dose of girl talk where pop culture chaos meets historical moments in the zeitgeist. Only Friends dives into everything from celeb drama and viral trends to "This Day in History" moments you forgot you cared about. And of course, no episode is complete without  "Am I the Asshole?" — where we judge, debate, and sometimes...take sides. Shop SKIMS Ultimate Bra Collection and more at https://SKIMS.com. This episode is sponsored by BetterHelp. Give online therapy a try at https://betterhelp.com/ONLYFRIENDS and get on your way to being your best self Learn more about your ad choices. Visit podcastchoices.com/adchoices

    Daily Inspiration – The Steve Harvey Morning Show
    Uplift: Top ten tips to grow your business and brand and how to avoid scams.

    Daily Inspiration – The Steve Harvey Morning Show

    Play Episode Listen Later Jul 2, 2025 32:30 Transcription Available


    Two-time Emmy and Three-time NAACP Image Award-winning, television Executive Producer Rushion McDonald, interviewed Attorney Jalene Mack. Widely known as “America’s Favorite Entertainment Attorney.” The episode focuses on protecting creative and business assets, avoiding scams, and building a solid foundation for success in the entertainment industry and beyond.

    The Steve Harvey Morning Show
    Uplift: Top ten tips to grow your business and brand and how to avoid scams.

    The Steve Harvey Morning Show

    Play Episode Listen Later Jul 2, 2025 32:30 Transcription Available


    Two-time Emmy and Three-time NAACP Image Award-winning, television Executive Producer Rushion McDonald, interviewed Attorney Jalene Mack. Widely known as “America’s Favorite Entertainment Attorney.” The episode focuses on protecting creative and business assets, avoiding scams, and building a solid foundation for success in the entertainment industry and beyond.

    Strawberry Letter
    Uplift: Top ten tips to grow your business and brand and how to avoid scams.

    Strawberry Letter

    Play Episode Listen Later Jul 2, 2025 32:30 Transcription Available


    Two-time Emmy and Three-time NAACP Image Award-winning, television Executive Producer Rushion McDonald, interviewed Attorney Jalene Mack. Widely known as “America’s Favorite Entertainment Attorney.” The episode focuses on protecting creative and business assets, avoiding scams, and building a solid foundation for success in the entertainment industry and beyond.

    Account for Your Life
    Why, Why is so important

    Account for Your Life

    Play Episode Listen Later Jul 2, 2025 26:21


    What if asking “Why?”—and asking it seven times—could unlock the clarity, control, and purpose you've been craving? In this episode of Account for Your Life, Jay Moore dives deep into the power of discovering your core WHY. He shares his own journey from financial setbacks to renewed mission, explains why the next six months can be transformational, and shows how a rock-solid WHY equips you to push through fatigue, fear, and every “quit” moment. Tune in to learn the simple framework that turns big dreams into non-negotiable decisions—and sets you on fire to finish 2025 strong.Books and ResourcesNext Level Faith Book - https://a.co/d/9h2mU7RBeyond Tax Strategy - https://a.co/d/2zdDBmDLiving Life on the Next Level Book - https://a.co/d/ePjCOUzSubscribe on Itunes - https://podcasts.apple.com/.../account-for.../id1505029992Subscribe on Spotify - https://open.spotify.com/show/5iYSUx3ulmPMxs259MSyQLSubscribe on YouTube - https://www.youtube.com/channel/UC8jVgPs1GH2dF4Frm4kJ2N

    The Grimerica Show
    #716 - Gregory Dizzia and D.R. Foresi. Cosmos University - Enoch, An Antediluvian Account

    The Grimerica Show

    Play Episode Listen Later Jul 1, 2025 108:26


    Interview starts at 29:55   Gregory Dizzia of Cosmos University joins us for a great chat about Science and Spirit and the incomplete history of humans. We chat about myth, taking control of nature, rituals and magic books, the Apocrypha - Enoch, Jubilees, Giants, and Patagonia at 50'.   We also chat about Enoch's vault, City of the Caesars, map of ancient sites, the interactive map of the end of the last ice age, the bunker idea, archeology, the moon, venue electricity, wealth from the ancients and magic at a distance. “Cosmos University is a visionary publishing house and research collective committed to exploring the intersection of ancient wisdom, cutting-edge science, and the profound mysteries that lie beyond conventional understanding. With a dynamic blend of scholarly rigor, curiosity-driven inquiry, and innovative thinking, Cosmos University offers groundbreaking insights into spirituality, historical enigmas, and phenomena often overlooked by mainstream academia. https://cosmos.university/ Global Data Viewer (A tool we created to show the changing climate over the past ~22,000 years)  https://cosmos.university/research/global-data-viewer/   Become a Lord or Lady with 1k donations over time. And a Noble with any donation. Leave Serfdom behind and help Grimerica stick to 0 ads and sponsors and fully listener supported. Thanks for listening!! Help support the show, because we can't do it without ya.   Support the show directly: https://grimericacbd.com/ CBD / THC Gummies and Tinctures http://www.grimerica.ca/support https://www.patreon.com/grimerica http://www.grimericaoutlawed.ca/support www.Rokfin.com/Grimerica   https://www.eventbrite.com/e/experience-the-ultimate-hunting-adventure-in-alberta-canada-tickets-1077654175649?aff=ebdsshcopyurl&utm-campaign=social&utm-content=attendeeshare&utm-medium=discovery&utm-term=organizer-profile&utm-share-source=organizer-profile   The Eh- List site. Canadian Propaganda Deconstruction https://eh-list.ca/ The Eh-List YouTube Channel: https://youtube.com/@theeh-list?si=d_ThkEYAK6UG_hGX Adultbrain Audiobook YouTube Channel: https://www.youtube.com/@adultbrainaudiobookpublishing https://grimericaoutlawed.ca/The newer controversial Grimerica Outlawed Grimerica Show Check out our next trip/conference/meetup - Contact at the Cabin www.contactatthecabin.com Our audio book website: www.adultbrain.ca www.grimerica.ca/shrooms and Micro Dosing Darren's book www.acanadianshame.ca Grimerica on Rumble: https://rumble.com/c/c-2312992 Join the chat / hangout with a bunch of fellow Grimericans Https://t.me.grimerica https://www.guilded.gg/i/EvxJ44rk   Leave a review on iTunes and/or Stitcher: https://itunes.apple.com/ca/podcast/grimerica-outlawed http://www.stitcher.com/podcast/grimerica-outlawed Sign up for our newsletter https://grimerica.substack.com/ SPAM Graham = and send him your synchronicities, feedback, strange experiences and psychedelic trip reports!! graham@grimerica.com InstaGRAM https://www.instagram.com/the_grimerica_show_podcast/ Tweet Darren https://twitter.com/Grimerica Can't. Darren is still deleted. Purchase swag, with partial proceeds donated to the show: www.grimerica.ca/swag Send us a postcard or letter http://www.grimerica.ca/contact/ Episode ART - Napolean Duheme's site http://www.lostbreadcomic.com/ MUSIC https://brokeforfree.bandcamp.com/ - Something Galactic Felix's Site sirfelix.bandcamp.com - Space Cadet

    The Wealthy Woman's Podcast | Save Money, Invest, Build Wealth, Manage Money, Overspending, Finances
    132. Everything You Need to Know About Certified Financial Planners—With CFP and Author Jamie Bosse

    The Wealthy Woman's Podcast | Save Money, Invest, Build Wealth, Manage Money, Overspending, Finances

    Play Episode Listen Later Jul 1, 2025 29:57


    Jamie Bosse is a Certified Financial Planner®, author, and mother of four. She finds it extremely rewarding to help people organize their financial lives, maximize their human capital, and get closer to their life goals.She practices financial planning at CGN Advisors where she works with individuals and families to help them better understand, manage, and improve their financial situation. Jamie has a passion for mentoring and financial literacy and is the author of Money Boss Mom, HelpingYoung Parents Be the “Boss” of Their Financial Future as well as the Milton the Money Savvy Pup children's book series.To connect further with Jamie, use the following links:https://www.linkedin.com/in/jamiebosse/https://www.instagram.com/moneybossmom/www.miltonthemoneysavvypup.comwww.moneybossmom.comClick Here to book your complimentary Financial Clarity Consultation. Ready to finally Stop Overspending?Start The Stop Overspending Course today → Click here to enroll. Grab the Free Training:How to Build Wealth WITHOUT Going On A Strict Budget → Click here to watch now. Click Here to open an Account with Ally Bank Using My Referral Link. Follow Me on Instagram → @germainefoleycoaching

    Retire With Ryan
    Five Reasons a Brokerage Account Might Be Better Than an Annuity for Your Investments, #260

    Retire With Ryan

    Play Episode Listen Later Jul 1, 2025 23:50


    I'm exploring a common dilemma for anyone coming into a lump sum of money, whether from an inheritance, the sale of a business, or another windfall: Should you invest in a traditional brokerage account or opt for an annuity? On this week's episode, I discuss the key differences between annuities and brokerage accounts, highlighting the five major pitfalls of annuities that are often overlooked. You'll learn why transparency, flexibility, and tax efficiency make brokerage accounts a better fit for many investors, especially those seeking to beat inflation and maintain control of their funds. You will want to hear this episode if you are interested in... [06:12] Annuities have capped returns and may not keep up with inflation, making brokerage accounts a better investment for retirees. [07:59] Fixed annuities vs. inflation risks. [11:21] Brokerage accounts offer easy, penalty-free liquidity for investment withdrawal. [14:56] Brokerage accounts offer tax advantages, such as zero percent tax on long-term investments and flexibility to access funds at any age. [19:55] Traditional brokerage accounts offer transparency, ease of understanding, and no hidden fees, providing clear valuations and peace of mind. [20:54] Potential conflicts of interest associated with high commissions given to advisors who sell annuities. Understanding the Five Key Advantages of Brokerage Accounts for Lump Sum Investors Inflation Protection A primary concern for retirees is ensuring their income grows at least as fast as inflation. Fixed annuities, which guarantee a steady interest rate, sound appealing in their promise of stability, but these tend to pay rates (typically 4-6% as of now) that may barely keep pace with rising costs. If inflation spikes, the real value of your money could erode. Contrast this with long-term investing via a brokerage account. If you were to invest in a broad index fund tracking, say, the S&P 500, you'd historically average about a 10% annual return since 1957. Even accounting for average inflation (let's say 3%), you're left with a meaningful net gain. Over decades, this growth can make a significant difference, allowing your income and nest egg to grow, not just hold steady. Easy Access to Your Money Life is unpredictable. You might need to access your savings for a sudden expense, a home repair, a medical event, or a business opportunity. With annuities, most contracts enforce a “surrender period” during which you'll pay penalties (sometimes starting at 7% and declining over many years) for early withdrawals above a limited free amount (typically 10% per year). Paperwork and delays are another downside. Brokerage accounts, on the other hand, offer quick and penalty-free access. Whether you need all or just part of your funds, they're typically available within a couple of business days. You'll pay taxes on any gains, sure, but you'll sidestep surrender charges and bureaucratic hurdles.  Potentially Lower Taxes With Brokerage Accounts Tax treatment is often overlooked but can have a big impact on your bottom line. Annuitized payouts and withdrawals from annuities are taxed at ordinary income rates, with gains coming out first (LIFO: last in, first out). That can mean higher taxes for many, especially if you're in a modest or high tax bracket. With a brokerage account, long-term investment gains are generally taxed at lower capital gains rates (15% for most, and sometimes 0% for those in the lower brackets). Plus, if you inherit a brokerage account, most investments receive a “step up” in basis, the new tax cost becomes the value at the decedent's death, potentially eliminating decades of capital gains tax if sold immediately. Simplicity and Transparency Annuities come with layers of complexity, including various types (fixed, indexed, and variable), confusing rider add-ons, differing fees, and ever-changing product features. Even professionals can struggle to keep up! Brokerage accounts, by contrast, are simple and transparent. You get a clear statement showing exactly what you own, its value, and the associated fees, which are commonly lower than those inside annuity products. No hidden surrender charges or high ongoing costs. Avoiding Aggressive Sales Tactics and Conflicts of Interest Annuities are lucrative for the agents who sell them, with commissions sometimes soaring to 7%. This can create an inherent conflict of interest, particularly for seniors who might feel pressured into buying. Choosing a low-fee brokerage account, especially with the guidance of a fiduciary, fee-only financial advisor, can help you avoid these conflicts. You retain control, minimize costs, and benefit from unbiased advice. Annuities do have a place for certain ultra-conservative investors who value guarantees above all else. However, for most people, especially those seeking growth, flexibility, and transparency, a brokerage account is often the safer and smarter long-term choice. If you're unsure about your unique situation, consider consulting a fee-only advisor who will put your interests first and steer clear of high-commission sales pitches. Resources Mentioned Retirement Readiness Review Subscribe to the Retire with Ryan YouTube Channel Download my entire book for FREE  Connect With Morrissey Wealth Management  www.MorrisseyWealthManagement.com/contact   Subscribe to Retire With Ryan

    Go & Do — A youth Come, Follow Me podcast

    Have You Accounted for That?

    Dr Reality - Dave Champion
    Ep 1225 – U.S. Financial Institutions REQUIRE You to Commit PERJURY to Open An Account!

    Dr Reality - Dave Champion

    Play Episode Listen Later Jun 29, 2025 53:39


    Dr. Champion is interviewed on the John Dowling Show regarding the limited application of withholding US income tax, as well as revealing that every financial institution in America - including crypto platforms - requires a prospective customer to commit perjury as a condition of opening an account! Dave's books are at https://drreality.news/store/ To get FREE SHIPPING on any order containing "Income Tax: Shattering The Myths", use the code "tariffs" at checkout.

    Pastor Jimmy Macharia
    Episode 220: The Underground Church and Discipleship

    Pastor Jimmy Macharia

    Play Episode Listen Later Jun 29, 2025 61:21


     This sermon was preached by Pastor Jimmy Macharia at Harvest Family Church HQThis is part of The Underground Church series!You can give via the following methods: Buy goods and services Till No. 5178933. Paybill number 795194 Account number Purpose: tithe, offering,building Office number 0717062464 

    WAGMI Ventures Podcast
    Building Modular Smart Account Infrastructure, with Kurt Larsen (Rhinestone)

    WAGMI Ventures Podcast

    Play Episode Listen Later Jun 28, 2025 27:58


    Kurt Larsen is Co-Founder of Rhinestone (https://www.rhinestone.wtf), a platform revolutionizing Web3 by building modular smart account infrastructure to enhance interoperability, security, and developer accessibility. Kurt shares his journey from a banker to launching markets for Deliveroo and leading a machine learning product division, to co-founding Rhinestone, which recently raised $5 million in a seed round led by 1kx, with support from CoinFund, Lattice, Heartcore, Circle Ventures, among others. He discusses how his early fascination with crypto in 2017, coupled with insights from building Deliveroo's marketplace algorithms, exposed the flaws of centralized networks and fueled Rhinestone's mission to create user-friendly, self-sovereign tools that rival Web2 simplicity. Kurt dives into Rhinestone's platform for developers to build and monetize smart account modules, the challenges of improving Web3 UX, and his vision for smart accounts as the dominant interface for users, AI agents, and blockchain-integrated systems in the next three to five years.

    Guided Expressions Podcast
    Playbook Radio 156: Weekends Are for Planning, Weekdays Are for Execution

    Guided Expressions Podcast

    Play Episode Listen Later Jun 28, 2025 14:18


    In this episode of *Playbook Radio*, host Martin Williams breaks down a powerful strategy to boost productivity and avoid burnout: using your weekends to plan and your weekdays to execute. He discusses how most people juggle demanding 9-to-5 jobs, family obligations, and side projects—and how the key to managing it all lies in ruthless time management and written planning.Martin shares how he personally uses Sundays (or Saturdays) to map out his entire week using an AI-generated plan that covers work tasks, personal responsibilities, health goals, family obligations, and even fun. He stresses that your mind is for creativity, not storage—and that trying to keep everything in your head is a fast track to stress and failure.Listeners will learn how to:* Identify unfinished tasks from the previous week and roll them into the new week* Account for meetings and subtract that time from total work hours* Break the remaining time into 30-minute blocks to allocate and prioritize tasks* Protect their time from distractions and unnecessary meetings* Use a downloadable planning template to jumpstart their weekly game planMartin also explains how this structured approach leads not only to greater productivity but also to becoming more organized, creative, and ultimately more successful—both at work and in life.

    Beyond The Horizon
    Kohberger Was Interacting With Maddie's Instagram Account According To Kaylee's Parents

    Beyond The Horizon

    Play Episode Listen Later Jun 27, 2025 11:41


    In the initial hours after Bryan Kohberger's arrest, there was a frantic dash to try to find out as much information about him as possible. During that dash, those of us who were following along were able to get a glimpse of an instagram account that allegedly belonged to Bryan Kohberger. That same account was also following and interacting with Madison's account. A few hours later and that account was purged.In this episode, we hear from the Goncalves family who also saw that account and not only saw it, but they took screenshots as well. With many questions surrounding the motive in this case and the connection between the victims and the alleged murderer still in the air, could this be the glue that binds Bryan Kohberger? Let's dive in and give it a look. (commercial at 7:18)to contact me:bobycapucci@protonmail.comsource:Idaho student murders suspect Bryan Kohberger followed victims on Instagram, says family - CBS News

    Australian politics live podcast
    Greens leader Larissa Waters on holding the Labor government to account — Australian Politics podcast

    Australian politics live podcast

    Play Episode Listen Later Jun 27, 2025 22:39


    The new leader of the Australian Greens, Senator Larissa Waters from Queensland talks about her vision for the party, the challenges of a shifting political landscape, and why she believes this is a moment for bold reforms Labor must rewrite current environment laws which ‘facilitate development', says Larissa Waters

    Bright On Buddhism
    The Difference Between the Exoteric and Esoteric Teachings - Benkenmitsunikyōron - 偏顕密二教論

    Bright On Buddhism

    Play Episode Listen Later Jun 27, 2025 34:29


    Bright on Buddhism - The Difference Between the Exoteric and Esoteric Teachings - Benkenmitsunikyōron - 偏顕密二教論Join us as we read and discuss Kūkai's "The Difference Between the Exoteric and Esoteric Teachings" - Benkenmitsunikyōron - 偏顕密二教論Resources: Davidson, Ronald M. (2002). Indian Esoteric Buddhism: A Social History of the Tantric Movement. Columbia University Press; Duckworth, Douglas (2015). "Tibetan Mahāyāna and Vajrayāna". In Emmanuel, Steven M. (ed.). A Companion to Buddhist Philosophy. Wiley. ISBN 978-1-119-14466-3.; Bowring, Richard (2008). The Religious Traditions of Japan: 500–1600. Cambridge, UK: Cambridge University Press.; BDK (2015), Esoteric Texts, Bukkyō Dendō Kyōkai America Incorporated.; Hakeda, Yoshito S., transl. (1972). Kukai: Major Works, Translated, With an Account of His Life and a Study of His Thought, New York: Columbia University Press, ISBN 0-231-03627-2.; Matsunaga, Daigan; and Matsunaga, Alicia (1974). Foundation of Japanese Buddhism, Vol. I and II: The Aristocratic Age. Buddhist Books International, Los Angeles und Tokio. ISBN 0-914910-25-6.; Kiyota, Minoru (1978). Shingon Buddhism: Theory and Practice. Los Angeles/Tokyo: Buddhist Books International; Orzech, Charles D; Sorensen, Henrik Hjort; Payne, Richard Karl (2011). Esoteric Buddhism and the tantras in East Asia. Leiden; Boston: Brill. doi:10.1163/ej.9789004184916.i-1200. ISBN 978-90-04-20401-0. OCLC 731667667.; Yamasaki, Taiko (1988). Shingon: Japanese Esoteric Buddhism, Boston/London: Shambala Publications.Do you have a question about Buddhism that you'd like us to discuss? Let us know by tweeting to us @BrightBuddhism, emailing us at Bright.On.Buddhism@gmail.com, or joining us on our discord server, Hidden Sangha https://discord.gg/tEwcVpu!Credits:Nick Bright: Script, Cover Art, Music, Voice of Hearer, Co-HostProven Paradox: Editing, mixing and mastering, social media, Voice of Hermit, Co-Host

    The Direct Care Derm
    Your Patients Have Scar Anxiety... Learn How to Help Them! | Lisa Massaad & Silagen

    The Direct Care Derm

    Play Episode Listen Later Jun 26, 2025 62:37


    Episode 054 | Today's episode is all about helping you empower your patients who want to be proactive about scar refinement and optimization. Most dermatologists perform procedures multiple times a day that will undoubtedly result in a scar. While we routinely inform our patients about this as part of the informed consent process, there tends to be far less routine discussion about how patients can optimize the appearance of those inevitable scars. We can and should do better. My guest is Lisa Massaad, Senior Director of Global Marketing & Business Development at Newmedical Technology, makers of the physician exclusive Silagen Scar Refinement System.   Ms. Massaad joined the Newmedical team in 2014 in anticipation of the launch of the Silagen professional line. She manages all aspects of global brand management for the Silagen and NewGel+ brands and serves as team lead for new product development projects. In addition to having extensive knowledge about the Silagen Scar Refinement System, she also has personal experience using it, which she shares in this episode.Ms. Massaad has 14 years of pharmaceutical industry sales experience, including six years as an award-winning Regional Sales Director. She joined Advanced Bio-Technologies, Inc. as the National Sales Manager and built its outside sales team. She has directed professional, consumer, and international marketing, including the launch of seven new products, while with ABT/enaltus/Sinclair IS Pharma.Lisa received a B.A. in Political Science from Allegheny College and an M.A. in Communications/PR from Kent State University.I'd like to extend a huge thank you to the whole team at Newmedical Technology for their generous support of this episode and their dedication to scar refinement and optimization. If you'd like to connect with them to learn more about how you can support your patients with Silagen products, you can contact them here.This episode was recorded at their headquarters in Northbrook, IL where I had the opportunity to meet with leadership and tour their remarkable manufacturing and packaging facility. Knowing that Silagen products are made in the USA makes me even more excited about sharing them with my patients.The Silagen Scar Refinement System is exclusively physician dispensed. If you're interested in purchasing it for yourself or someone you care about, you can contact me directly at 715-391-9774 or drlewellis@aboveandbeyondderm.com or head to silagen.biz if you'd like to order it online. My favorite Silagen products are the 100% Pure Silicone Gel (with and without SPF) and the Acne Scar + Spot Corrector. This will take you to a page that says "Login or Create an Account to Access the Website". Assuming you haven't previously made an account, click "Create Account" at the bottom. You'll be prompted to enter your Name, Email Address, Practice Code (1206240832P), and Password. You should then be able to learn about and purchase products.More from Dr. Lewellis and Above & Beyond DermatologyNeed a dermatologist? Fill out this short interest form, text or call me at 715-391-9774, or email me at drlewellis@aboveandbeyondderm.com if you'd like to have a no obligation discovery call. I offer in-office visits, house calls, and virtual care in Wisconsin and virtual care in Illinois, Nebraska, and Colorado.Have an idea for a guest or want to be on the show yourself? Send me a text or email, and we'll see if it's a good fit.Above & Beyond DermatologyNutrafol -- special pricing and physician exclusive productsNeoGenesis -- my favorite source of stem cell released molecules for skin/hairSilagen.biz -- physician dispensed scar refinement products delivered to your door (use practice code 1206240832P)NewsletterLinkedInFacebookDr. Lewellis on InstagramAbove & Beyond Dermatology on InstagramYouTubeTikTokTwitter/XChange Your Mind, Change Your LifeSoMeDocs (Doctors on Social Media)Pippa!

    Murder In The Black
    Code of Silence | Cabretti Wheeler + Kyle Ellis

    Murder In The Black

    Play Episode Listen Later Jun 26, 2025 38:31


    SummaryThis episode delves into the tragic case of Cabretti Wheeler and Kyle Ellis, two young men murdered in St. Petersburg, Florida, in 2008. The hosts explore the complexities of the investigation, including the cultural code of silence that hindered law enforcement's efforts to gather information. They discuss the backgrounds of the victims, the challenges faced by detectives, and the relentless pursuit of justice by the victims' families, particularly the mothers. The narrative unfolds with twists involving potential motives, love triangles, and the eventual arrest and conviction of Jerry Jones, one of the shooters. The episode concludes with reflections on the impact of violence on communities and the resilience of those left behind.Chapters00:00 Introduction to the Case00:48 The Crime Scene and Initial Investigation03:47 The Code of Silence in the Community05:36 Victims' Backgrounds and Personal Lives07:05 Survivor's Account and Key Details13:25 Lyrics and Leads from the Victims' Families14:49 Lisa's Determination and Grassroots Efforts17:09 Identifying Suspects and Love Triangle Theories19:11 The Case Goes Cold19:40 Detective Green and Renewed Investigation21:03 Identifying Jerry Jones23:27 X's Fear and Confirmation of the Shooter26:20 Jerry's Arrest and Confession30:23 Trial and Conviction34:18 Aftermath and Community Impact36:00 New Chapter38:00 trueCrime-outro-low.wavTakeawaysThe case highlights the devastating impact of gun violence on families.Cultural codes of silence can obstruct justice in communities.The pursuit of justice often falls on the shoulders of victims' families.Understanding the backgrounds of victims can provide insight into the case.The role of community activism in seeking justice is crucial.Survivors of violent crimes face long-lasting trauma.The investigation process can be hindered by fear and mistrust.Personal relationships can complicate motives in murder cases.The importance of eyewitness accounts in criminal investigations.Finding purpose in pain can lead to community change.

    The Moscow Murders and More
    Was Bryan Kohberger Interacting With Maddie's Instagram Account?

    The Moscow Murders and More

    Play Episode Listen Later Jun 25, 2025 11:41


    In the initial hours after Bryan Kohberger's arrest, there was a frantic dash to try to find out as much information about him as possible. During that dash, those of us who were following along were able to get a glimpse of an instagram account that allegedly belonged to Bryan Kohberger. That same account was also following and interacting with Madison's account. A few hours later and that account was purged.In this episode, we hear from the Goncalves family who also saw that account and not only saw it, but they took screenshots as well. With many questions surrounding the motive in this case and the connection between the victims and the alleged murderer still in the air, could this be the glue that binds Bryan Kohberger? Let's dive in and give it a look. (commercial at 7:18)to contact me:bobycapucci@protonmail.comsource:Idaho student murders suspect Bryan Kohberger followed victims on Instagram, says family - CBS NewsBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-moscow-murders-and-more--5852883/support.

    The Wealthy Woman's Podcast | Save Money, Invest, Build Wealth, Manage Money, Overspending, Finances
    MASTERCLASS REPLAY- Get Out of Debt Without Giving Up Your Summer Vacation

    The Wealthy Woman's Podcast | Save Money, Invest, Build Wealth, Manage Money, Overspending, Finances

    Play Episode Listen Later Jun 24, 2025 64:36


    Click Here to Sign up for the Get Out of Debt Without Giving Up Your Summer Vacation Masterclass. Click Here to book your complimentary Financial Clarity Consultation. Ready to finally Stop Overspending?Start The Stop Overspending Course today → Click here to enroll. Grab the Free Training:How to Build Wealth WITHOUT Going On A Strict Budget → Click here to watch now. Click Here to open an Account with Ally Bank Using My Referral Link. Follow Me on Instagram → @germainefoleycoaching

    Kincaid & Dallas
    Extra MONEY got into YOUR ACCOUNT

    Kincaid & Dallas

    Play Episode Listen Later Jun 24, 2025 10:40


    See omnystudio.com/listener for privacy information.

    The PainExam podcast
    Herpes Zoster & Post Herpetic Neuralgia- For the Pain Boards & your Patients!

    The PainExam podcast

    Play Episode Listen Later Jun 24, 2025 27:40


    Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

    AnesthesiaExam Podcast
    Post Herpetic Neuralgias: Epidurals, Paravertebral Blocks and more!

    AnesthesiaExam Podcast

    Play Episode Listen Later Jun 24, 2025 27:40


    Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

    Retirement Rescue Radio
    Episode 194 - Beyond Work Retirement Plans: Exploring Investment Account Options

    Retirement Rescue Radio

    Play Episode Listen Later Jun 23, 2025 26:23


    Nate discusses some of the investment accounts that you can open and investing for retirement other than someone's retirement plan at work.

    Investing for Americans Abroad & U.S. Expats | Gimme Some Truth for Expats
    Navigating Brokerage Options as an Expat in 2025

    Investing for Americans Abroad & U.S. Expats | Gimme Some Truth for Expats

    Play Episode Listen Later Jun 23, 2025 30:06


    This episode of Gimme Some Truth International features a detailed discussion on the considerations involved in selecting a custodian or brokerage for U.S. expats and international investors. Hosts Syl Michelin, Stan Farmer, and Keith Poniewaz explore the regulatory, logistical, and practical factors that may affect investment accounts when living abroad.Topics include the implications of changing residency, limitations on certain investment products, multi-currency account features, estate planning issues, and questions related to Transfer on Death (TOD) arrangements. The conversation is intended to highlight the range of potential variables expats may encounter and to provide a framework for evaluating available options.This content is provided for informational purposes only and is not intended as investment, legal, or tax advice.⏱️ Timestamps:00:00 – Introduction01:40 – Defining expat-friendly custodians03:20 – Residency and account eligibility05:10 – Account status after moving abroad07:45 – Fund access limitations for expats10:25 – Currency holding and transfer features13:10 – Currency conversion fees and structures15:55 – Mixed-nationality household considerations18:35 – Estate planning for expats21:50 – Transfer on Death accounts and jurisdiction25:05 – Assessing custodial flexibility27:30 – Closing thoughtsFor more on this topic and others check out the blog on our website: https://usexpatinvesting.com/blog/ Visit our website for more financial planning resources and educational information: https://www.usexpatinvesting.com ————————————————ADD US ON:LinkedIn: https://linkedin.com/company/walkner-condon-financial-advisors-llc Facebook:https://facebook.com/usexpatinvesting#ExpatFinance #InternationalInvesting #CustodianOptions #TransferOnDeath #MultiCurrencyAccounts #InvestmentLogistics #CrossBorderPlanning #GimmeSomeTruthPodcast

    Books & Writers · The Creative Process
    THE DREAM HOTEL with LAILA LALAMI

    Books & Writers · The Creative Process

    Play Episode Listen Later Jun 22, 2025 41:38


    What happens when the state, with the pretext of protecting public safety, can detain indefinitely certain individuals whose dreams seem to indicate they may be capable of committing a crime? Set in a precarious world where sleep-enhancing devices and algorithms provide the tools and formulae for making one's unconscious a witness to one's possible waking life, this novel touches on a myriad of political, philosophical, and moral concerns as they particularly connect to issues of gender, race, ethnicity, privacy, and the security state.In this episode of Speaking Out of Place podcast Professor David Palumbo-Liu talks with award-winning novelist Laila Lalami about her new novel, The Dream Hotel. Laila Lalami is the author of five books, including The Moor's Account, which won the American Book Award, the Arab-American Book Award, and the Hurston / Wright Legacy Award. It was on the longlist for the Booker Prize and was a finalist for the Pulitzer Prize in Fiction. Her most recent novel, The Other Americans, was a national bestseller, won the Joyce Carol Oates Prize, and was a finalist for the National Book Award in Fiction. Her books have been translated into twenty languages. Her essays have appeared in the Los Angeles Times, the Washington Post, The Nation, Harper's, the Guardian, and the New York Times. She has been awarded fellowships from the British Council, the Fulbright Program, the Guggenheim Foundation, and the Radcliffe Institute at Harvard University. She lives in Los Angeles.www.palumbo-liu.comhttps://speakingoutofplace.comBluesky @palumboliu.bsky.socialInstagram @speaking_out_of_placeEpisode WebsitePhoto credit: Beowulf Sheehan

    Social Justice & Activism · The Creative Process
    THE DREAM HOTEL with LAILA LALAMI

    Social Justice & Activism · The Creative Process

    Play Episode Listen Later Jun 22, 2025 41:38


    What happens when the state, with the pretext of protecting public safety, can detain indefinitely certain individuals whose dreams seem to indicate they may be capable of committing a crime? Set in a precarious world where sleep-enhancing devices and algorithms provide the tools and formulae for making one's unconscious a witness to one's possible waking life, this novel touches on a myriad of political, philosophical, and moral concerns as they particularly connect to issues of gender, race, ethnicity, privacy, and the security state.In this episode of Speaking Out of Place podcast Professor David Palumbo-Liu talks with award-winning novelist Laila Lalami about her new novel, The Dream Hotel. Laila Lalami is the author of five books, including The Moor's Account, which won the American Book Award, the Arab-American Book Award, and the Hurston / Wright Legacy Award. It was on the longlist for the Booker Prize and was a finalist for the Pulitzer Prize in Fiction. Her most recent novel, The Other Americans, was a national bestseller, won the Joyce Carol Oates Prize, and was a finalist for the National Book Award in Fiction. Her books have been translated into twenty languages. Her essays have appeared in the Los Angeles Times, the Washington Post, The Nation, Harper's, the Guardian, and the New York Times. She has been awarded fellowships from the British Council, the Fulbright Program, the Guggenheim Foundation, and the Radcliffe Institute at Harvard University. She lives in Los Angeles.www.palumbo-liu.comhttps://speakingoutofplace.comBluesky @palumboliu.bsky.socialInstagram @speaking_out_of_placeEpisode WebsitePhoto credit: Beowulf Sheehan

    Education · The Creative Process
    THE DREAM HOTEL with LAILA LALAMI

    Education · The Creative Process

    Play Episode Listen Later Jun 22, 2025 41:38


    What happens when the state, with the pretext of protecting public safety, can detain indefinitely certain individuals whose dreams seem to indicate they may be capable of committing a crime? Set in a precarious world where sleep-enhancing devices and algorithms provide the tools and formulae for making one's unconscious a witness to one's possible waking life, this novel touches on a myriad of political, philosophical, and moral concerns as they particularly connect to issues of gender, race, ethnicity, privacy, and the security state.In this episode of Speaking Out of Place podcast Professor David Palumbo-Liu talks with award-winning novelist Laila Lalami about her new novel, The Dream Hotel. Laila Lalami is the author of five books, including The Moor's Account, which won the American Book Award, the Arab-American Book Award, and the Hurston / Wright Legacy Award. It was on the longlist for the Booker Prize and was a finalist for the Pulitzer Prize in Fiction. Her most recent novel, The Other Americans, was a national bestseller, won the Joyce Carol Oates Prize, and was a finalist for the National Book Award in Fiction. Her books have been translated into twenty languages. Her essays have appeared in the Los Angeles Times, the Washington Post, The Nation, Harper's, the Guardian, and the New York Times. She has been awarded fellowships from the British Council, the Fulbright Program, the Guggenheim Foundation, and the Radcliffe Institute at Harvard University. She lives in Los Angeles.www.palumbo-liu.comhttps://speakingoutofplace.comBluesky @palumboliu.bsky.socialInstagram @speaking_out_of_placeEpisode WebsitePhoto credit: Beowulf Sheehan

    Feminism · Women’s Stories · The Creative Process
    THE DREAM HOTEL with LAILA LALAMI

    Feminism · Women’s Stories · The Creative Process

    Play Episode Listen Later Jun 22, 2025 41:38


    What happens when the state, with the pretext of protecting public safety, can detain indefinitely certain individuals whose dreams seem to indicate they may be capable of committing a crime? Set in a precarious world where sleep-enhancing devices and algorithms provide the tools and formulae for making one's unconscious a witness to one's possible waking life, this novel touches on a myriad of political, philosophical, and moral concerns as they particularly connect to issues of gender, race, ethnicity, privacy, and the security state.In this episode of Speaking Out of Place podcast Professor David Palumbo-Liu talks with award-winning novelist Laila Lalami about her new novel, The Dream Hotel. Laila Lalami is the author of five books, including The Moor's Account, which won the American Book Award, the Arab-American Book Award, and the Hurston / Wright Legacy Award. It was on the longlist for the Booker Prize and was a finalist for the Pulitzer Prize in Fiction. Her most recent novel, The Other Americans, was a national bestseller, won the Joyce Carol Oates Prize, and was a finalist for the National Book Award in Fiction. Her books have been translated into twenty languages. Her essays have appeared in the Los Angeles Times, the Washington Post, The Nation, Harper's, the Guardian, and the New York Times. She has been awarded fellowships from the British Council, the Fulbright Program, the Guggenheim Foundation, and the Radcliffe Institute at Harvard University. She lives in Los Angeles.www.palumbo-liu.comhttps://speakingoutofplace.comBluesky @palumboliu.bsky.socialInstagram @speaking_out_of_placeEpisode WebsitePhoto credit: Beowulf Sheehan

    Tech, Innovation & Society - The Creative Process
    THE DREAM HOTEL with LAILA LALAMI

    Tech, Innovation & Society - The Creative Process

    Play Episode Listen Later Jun 22, 2025 41:38


    What happens when the state, with the pretext of protecting public safety, can detain indefinitely certain individuals whose dreams seem to indicate they may be capable of committing a crime? Set in a precarious world where sleep-enhancing devices and algorithms provide the tools and formulae for making one's unconscious a witness to one's possible waking life, this novel touches on a myriad of political, philosophical, and moral concerns as they particularly connect to issues of gender, race, ethnicity, privacy, and the security state.In this episode of Speaking Out of Place podcast Professor David Palumbo-Liu talks with award-winning novelist Laila Lalami about her new novel, The Dream Hotel. Laila Lalami is the author of five books, including The Moor's Account, which won the American Book Award, the Arab-American Book Award, and the Hurston / Wright Legacy Award. It was on the longlist for the Booker Prize and was a finalist for the Pulitzer Prize in Fiction. Her most recent novel, The Other Americans, was a national bestseller, won the Joyce Carol Oates Prize, and was a finalist for the National Book Award in Fiction. Her books have been translated into twenty languages. Her essays have appeared in the Los Angeles Times, the Washington Post, The Nation, Harper's, the Guardian, and the New York Times. She has been awarded fellowships from the British Council, the Fulbright Program, the Guggenheim Foundation, and the Radcliffe Institute at Harvard University. She lives in Los Angeles.www.palumbo-liu.comhttps://speakingoutofplace.comBluesky @palumboliu.bsky.socialInstagram @speaking_out_of_placeEpisode WebsitePhoto credit: Beowulf Sheehan

    Radiant Church Visalia
    Proverbs: Words

    Radiant Church Visalia

    Play Episode Listen Later Jun 22, 2025 41:49 Transcription Available


    Good morning, Radiant! Mike Young is teaching today. Continuing "Summer of Wisdom" in Proverbs: wisdom is rooted in fear of the Lord, fueled by a teachable spirit, and avoiding foolishness. Today: the incredible power of our words.Scripture References: Proverbs 18:21, Proverbs (various), Matthew 12:33-37, James 3, Romans 8:9-11, Romans 10:9-10, Proverbs 6:16-19, Proverbs 11:13, Proverbs 16:28, Proverbs 12:18, Proverbs 15:1, Proverbs 28:23, Proverbs 16:24, Proverbs 25:11, Proverbs 15:4, Proverbs 10:19, Proverbs 17:28Key Points:Words: Weapon & Divine Reflection:Proverbs 18:21: "Death and life are in the power of the tongue."Our words, unique to humans, reflect God's image. He spoke creation; we wield similar power.Every word carries spiritual weight: fostering flourishing or destruction. Reckless speech yields bad "fruit"; Spirit-led words bring peace.Words' Source (Matthew 12):Jesus: "Out of the abundance of the heart the mouth speaks." (Matt 12:34). Words perfectly mirror our heart.Bitter hearts speak cutting words; Spirit-filled hearts speak grace.Jesus warns: "Account for every careless word" (Matt 12:36).Jesus' "harsh" words (e.g., "brood of vipers") were perfectly aimed to expose hypocrisy, unlike our own. He perfectly tamed His tongue.Proverbs on Speech: Death-Bringing:Lying (Prov 12:22): Erodes trust.Gossip/Slander (Prov 11:13): Destroys relationships.Hasty (Prov 29:20): Causes irreversible damage.Contentious (Prov 15:1): Escalates conflict.Flattery (Prov 28:23): Insincere praise entraps.Proverbs on Speech: Life-Giving:Truthful (Prov 12:19): Established forever.Gracious (Prov 16:24): "Like honeycomb, sweetness to the soul."Well-timed (Prov 25:11): Precious, beautiful.Comforting/Gentle (Prov 15:4): Bring healing; "a gentle tongue is a tree of life."Restraint (Prov 17:28): "Even a fool who keeps silent is considered wise." Silence can be powerful.Words Shape Eternity:We can't perfectly tame our tongues; only Jesus did. He lives in us!Rom 10:9-10: mouth confession saves. Rom 8:9-11: Spirit in us gives life.God gives us words to proclaim the Gospel, bringing others from death to life. More than avoiding negative speech, actively bringing God's Kingdom.Conclusion:Our words hold incredible power. We're imperfect, but Jesus, the living Word, perfectly tamed His tongue to bring life, even through death. We now partake in His "fruit."Call to Action:At the table, confess foolishness/death-bringing words. Ask God for His ways. Then, stop talking and listen for His voice. Let the Holy Spirit transform your mouth to proclaim good news and bring life. Support the show*Summaries and transcripts are generated using AI. Please notify us if you find any errors.

    Sox In The Basement
    A Unique Account Of The 2005 White Sox

    Sox In The Basement

    Play Episode Listen Later Jun 21, 2025 32:53


    Left alone for an episode, host Chris Lanuti recounts the 2005 White Sox Championship Season from a unique perspective. From answered prayers at the expense of another fanbase to conversations with Lou Piniella to celebrating the pennant with a guy holding a mop it is a trip down a weird memory lane in "30 Minutes of Sox!" Brought to you by Cork & Kerry At The Park. Chris Lanuti and Ed Siebert sit at his 9-foot homemade oak bar in a basement on the South Side of Chicago to discuss their favorite team - The Chicago White Sox in a podcast "For Fans, By Fans!" Listen. Subscribe. Share. Video version now available on YouTube! Call 708-459-8406 and leave your comments and questions for the next episode! SUBSCRIBE NOW​ on Apple Podcasts, Spotify, everywhere podcasts can be found and always at SoxInTheBasement.com!

    MoneyWise on Oneplace.com
    What If I Haven't Filed Taxes in Years? with Kevin Cross

    MoneyWise on Oneplace.com

    Play Episode Listen Later Jun 20, 2025 24:57


    Did you hear about the guy who tried to pay his taxes with a smile? Unfortunately for him, the IRS still prefers cash.All jokes aside, failing to file your taxes for several years is no small matter—but it's not the end of the road, either. Kevin Cross joins us today with practical steps to help you get back on track.Kevin Cross is a Certified Public Accountant (CPA) who has headed CPA firms in Florida and now Georgia. He has studied the tax code extensively and specializes in representing taxpayers before the Internal Revenue Service (IRS).Start With the Present, Not the PastThe further you fall behind, the more difficult it is to catch up. But rather than beginning with the year you first missed, he recommends filing your most recent return first—say, 2024—and working backward as needed. This shows the IRS that you're attempting to come into compliance, not ignoring your obligations.Falling behind on taxes is more common than most people think. Life events like divorce, disability, job loss, or even the rise of gig work can trigger tax complications. For example, many gig workers receive a 1099 for the first time, try to file using online software, and are shocked to discover they owe thousands. Rather than seek help, they freeze—and the following year's return also goes unfiled.Of course, COVID didn't help as many people have been struggling since then to get back on track.Do You Always Have to File?A common misunderstanding is that you must always file. If you're not going to owe anything, you don't have to file. That includes many senior citizens who live solely on Social Security.However, if you're due a refund, you have up to three years to file and claim it. Miss that window, and the refund is forfeited.Importantly, there's a difference between not filing and not paying. Sometimes you don't know what you owe—or if you owe—until you file.Even if you don't owe taxes on the sale of a primary residence, for example, the IRS won't know that unless you file. If you don't, you might receive a letter saying you owe thousands in capital gains tax—money you could've avoided paying.How to Begin the ProcessIf you're unsure how many years you've missed, a good first step is to request a Wage and Income Transcript from the IRS. This document shows all your reported income—W-2s, 1099s, Social Security, retirement distributions, and more. You can request it through the IRS website by searching for “IRS wage and income transcript.”Even with transcripts in hand, deciphering them can be complicated. That's why we strongly recommend seeking help from a CPA or tax professional familiar with IRS representation. You may not know what to do with what you find. You can find a Certified Kingdom Advisor (CKA) in your area who specializes in tax planning and preparation by going to FaithFi.com and clicking “Find a Professional”. Also, it's helpful to know that the IRS's own handbook, the Internal Revenue Manual, usually requires only the last six years of returns to be filed. That's a helpful limit for those unsure where to begin.The IRS Will Work With YouDon't let fear keep you stuck. The IRS can work with you. Options include payment plans or even an offer in compromise, which may reduce your total tax liability.Filing late taxes doesn't have to be terrifying. With the right help and a step-by-step plan, you can get back on track—and even experience peace of mind. The IRS just wants to see you trying. Start with today, and take it one step at a time.On Today's Program, Rob Answers Listener Questions:I have a TIAA retirement account from my husband's time as an adjunct professor at a local community college. It's a small amount. As I'm 76, I'm required to set aside a certain amount each year. I would like to give this to my son now so that those amounts can stay in the account and start accruing interest. Can I do that?We have a credit card balance of $15,000 with an interest rate of 11%. We try to pay $2,000 a month, but the balance keeps increasing. Part of the reason is that our 29-year-old daughter, who lives and works in London, has a card on our account. We initially gave her the card for emergencies and plane tickets home, but she's using it for other expenses, such as occasional Ubers and travel. We want to pay off this card, but we're making no progress. What can we do?Resources Mentioned:Faithful Steward: FaithFi's New Quarterly Magazine (Become a FaithFi Partner)Kevin Cross (CPA)Internal Revenue Service (IRS.gov)Wisdom Over Wealth: 12 Lessons from Ecclesiastes on Money (Pre-Order)Look At The Sparrows: A 21-Day Devotional on Financial Fear and AnxietyRich Toward God: A Study on the Parable of the Rich FoolFind a Certified Kingdom Advisor (CKA) or Certified Christian Financial Counselor (CertCFC)FaithFi App Remember, you can call in to ask your questions most days at (800) 525-7000. Faith & Finance is also available on the Moody Radio Network and American Family Radio. Visit our website at FaithFi.com where you can join the FaithFi Community and give as we expand our outreach.

    Trump's Trials
    A former DOGE employee gives his account of working for the operation

    Trump's Trials

    Play Episode Listen Later Jun 20, 2025 4:39


    What did the Department of Government Efficiency actually accomplish under Elon Musk? And what might change now that Musk is out? One former DOGE worker is going public and sharing what he learned.Support NPR and hear every episode of Trump's Terms sponsor-free with NPR+. Sign up at plus.npr.org.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

    Tech Path Podcast
    Coinbase Loans Skyrocketing

    Tech Path Podcast

    Play Episode Listen Later Jun 20, 2025 38:50


    On this episode, we discuss the latest products coming to Coinbase as well as top user questions about coinbase. Coinbase allows borrowing against Bitcoin for USDC loans, with rates as low as 5%, no monthly payments, and up to $1,000,000 USDC available. ~This episode is sponsored by iTrust Capital~iTrustCapital | Get $100 Funding Reward + No Monthly Fees when you sign up using our custom link! ➜ https://bit.ly/iTrustPaulGuest: Max Branzburg, Head of Consumer Product, CoinbaseBuy $50 & Get $50 for getting started on Coinbase➜ https://bit.ly/CBARRON00:00 Intro00:18 Sponsor: iTrust Capital01:20 Bitcoin backed loans03:30 Borrowed USDC can't be used for trading crypto?04:50 Coinbase One Card: Why only Bitcoin?06:45 How do you get on the list?07:53 Coinbase basic vs Regular Coinbase One09:20 Coinbase favoring Bitcoin over ETH?14:40 New customers18:30 Wen DEX trading?21:30 Coinbase prioritizing Aerodrome vs Uniswap?23:50 Will Coinbase take an added fees on DEX buys?24:06 Coinbase Fees27:30 Is Coinbase ONE Membership vs Robinhood Gold29:45 When Wallet Beta release?31:10 Account lockouts still a thing?34:40 Coinbase AI?36:00 Ready for bullrun?38:06 Outro#Coinbase #Crypto #Bitcoin~Coinbase Loans Skyrocketing

    The Wealthy Woman's Podcast | Save Money, Invest, Build Wealth, Manage Money, Overspending, Finances
    132. {NEW CLASS} Get Out of Debt Without Giving Up Your Summer Vacation

    The Wealthy Woman's Podcast | Save Money, Invest, Build Wealth, Manage Money, Overspending, Finances

    Play Episode Listen Later Jun 19, 2025 13:49


    Click Here to Sign up for the Get Out of Debt Without Giving Up Your Summer Vacation Masterclass. Click Here to book your complimentary Financial Clarity Consultation. Ready to finally Stop Overspending?Start The Stop Overspending Course today → Click here to enroll. Grab the Free Training:How to Build Wealth WITHOUT Going On A Strict Budget → Click here to watch now. Click Here to open an Account with Ally Bank Using My Referral Link. Follow Me on Instagram → @germainefoleycoaching

    Build Your Digital Community
    Should I Start A New Social Media Account? Building Brands That Grow With You.

    Build Your Digital Community

    Play Episode Listen Later Jun 19, 2025 9:26


    In today's solo episode of Community Kristina is diving into one of the most common questions entrepreneurs ask us when they make a pivot in business: Should I start a new account?Whether you're navigating a niche change, starting something fresh in your life, or wondering if your engagement is low because your audience just isn't aligned anymore, this episode is for you. Kristina unpacks the two biggest account-related decisions: do I have a personal and business brand, and when it might be time to build something new on social media?Key takeaways in this episode:Why personal and business brands both matter—and how to balance them.When a new account is a smart move (and when it's not).How to leverage collaborative posts to expand your reach.The secret to fixing low engagement without starting over.It is important to build a brand that grows with you so that you don't find yourself starting over down the line!If you've ever asked yourself “should I just start a new social account?” — Make sure you don't miss this one!Mentioned In Episode:Join the Social Business Club: use the code PODCAST for your first month for $1.The Wellness LabSend me a text!Support the showFor Your Information: • Host your podcast on Buzzsprout! •Use Code ‘PODCAST' For Your First Month For $1 Inside The Social Business Club • Join our favourite scheduling platform Later • FLODESK Affiliate Code | 50% off your first year! Don't forget to come say hi to us on Instagram @thesocialsnippet, join the Weekly Snippet or follow us on any social media platform! Website . Instagram . Facebook . Linkedin

    The Clark Howard Podcast
    06.09.25 Vanguard's New Cash Management Account / Debt Collections

    The Clark Howard Podcast

    Play Episode Listen Later Jun 9, 2025 31:55


    In today's episode, an ongoing concern - where should you store your cash? One of Clark's favorite children (discount brokers) has just launched a new offering worthy of your attention. Also today, dealing with debt collectors. Some are legit, some not so much. Know what to do if the debt is indeed yours, or if it is a mistake. Clark has key information for handling collectors in a way that protects your rights and your credit.  Vanguard Cash Plus: Segment 1 Ask Clark: Segment 2 Debt Collectors: Segment 3 Ask Clark: Segment 4 Mentioned on the show: Vanguard Cash Plus Account | Vanguard Uni - One Toll Pass. 19 States. Car Insurance Archives - Clark Howard Association for Independent Agents | IIABA How To Send a 'Drop Dead' Letter to a Collection Agency What to Do When You're Being Harassed About an Old "Zombie Debt" We've still got some protections against medical debt collectors National Association of Estate Planners & Councils - NAEPC What Is a Fiduciary Financial Advisor and Do I Need One? What's the Best Way To Exchange Dollars for Foreign Currency? What Is a Backdoor Roth IRA? Clark.com resources Episode transcripts Community.Clark.com  /  Ask Clark Clark.com daily money newsletter Consumer Action Center Free Helpline: 636-492-5275 Learn more about your ad choices: megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices

    BibleProject
    Pentecost and the Expected Unexpected Spirit (Re-Release)

    BibleProject

    Play Episode Listen Later Jun 4, 2025 35:37


    The story of Pentecost in Acts 2 is brimming with rich imagery and hyperlinks from the Hebrew Bible. God's Spirit dramatically fills a house of Jesus' followers like a wind, and fire burns over the disciples' heads as they begin speaking languages from across the known world! What is happening here, and how is it a fulfillment of God's promises? In this re-released episode from our 2018 Luke-Acts series, Jon and Tim trace the significance of Pentecost, revealing how God's presence now dwells within his people and empowers them to advance his Kingdom mission.CHAPTERSFire at Pentecost and the Place Where Heaven and Earth Meet (0:00–2:15)The Fiery Arrival of the Promised Helper (2:15–11:27)Overlaying Ancient Stories of God's Presence (11:27–24:12)Peter's Speech to the Crowd (24:12–31:13)Recovering the Exiles (31:13–35:37)OFFICIAL EPISODE TRANSCRIPTView this episode's official transcript.REFERENCED RESOURCES“Pentecost: Acts 1-7” from our Luke-Acts video seriesActs (Zondervan Exegetical Commentary on the New Testament) by Eckhard J. SchnabelThe Acts of the Risen Lord Jesus: Luke's Account of God's Unfolding Plan by Alan J. ThompsonYou can view annotations for this episode—plus our entire library of videos, podcasts, articles, and classes—in the BibleProject app, available for Android and iOS.Check out Tim's extensive collection of recommended books here.SHOW MUSIC“Color Pallette 90” by Dan Koch“Do it Right” by Dan Koch“Fall Back” by Dan KochBibleProject theme song by TENTSSHOW CREDITSThis episode was originally produced in 2018 by Jon Collins, Dan Gummel, and Matthew Halbert-Howen. Production of today's re-release is by Lindsey Ponder, producer, and Cooper Peltz, managing producer. Tyler Bailey is our supervising engineer. JB Witty does our show notes, and Hannah Woo provides the annotations for our app. Our host and creative director is Jon Collins, and our lead scholar is Tim Mackie. Powered and distributed by Simplecast.