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This Special Episode on Atrial Fibrillation covers: Cardiology this Week: A concise summary of recent studies Atrial fibrillation burden: clinical relevance of a new outcome Pulsed field ablation: game changer? Drug treatment following atrial fibrillation ablation Spotlight: Holiday Heart Syndrome Host: Rick Grobbee Guests: Rick Grobbee, Konstantinos Koskinas, Jason Andrade, Arian Sultan, Michiel Rienstra Want to watch that special episode? Go to: https://esc365.escardio.org/event/2549 Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Jason Andrade, Yasmina Bououdina, Rick Grobbee and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.  Michiel Rienstra has declared to have potential conflicts of interest to report: consultancy fees from Bayer (OCEANIC-AF national PI) , InCarda Therapeutics (RESTORE-SR national PI), Novartis to the institution. Speaker fee from Daiichi-Sankyo, Pfizer to the institution. Unrestricted research grant from the Dutch Heart Foundation and is conducted in collaboration with and supported by the Dutch CardioVascular Alliance, 01-002-2022-0118 EmbRACE. Unrestricted research grant from ZonMW and the Dutch Heart Foundation; DECISION project 848090001. Unrestricted research grants from the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation; RACE V (CVON 2014–9), RED-CVD (CVON2017-11). Unrestricted research grant from Top Sector Life Sciences & Health to the Dutch Heart Foundation (PPP Allowance; CVON-AI (2018B017). Unrestricted research grant from the European Union's Horizon 2020 research and innovation programme under grant agreement; EHRA-PATHS (945260). This research is funded by the Dutch Heart Foundation and is conducted in collaboration with and supported by the Dutch CardioVascular Alliance, 01 -002 -2022 -0118 EmbRACE.  Emma Svennberg has declared to have potential conflicts

Emotional Anger After Stroke: Trisha Winski’s Story of a Carotid Web, Aphasia, and Learning to Slow Down Trisha Winski was 46 years old, working as a corporate finance director, with no high blood pressure, no diabetes, and no smoking history. By every conventional measure, she was not a stroke candidate. Then one morning, she stood up from the bathroom, collapsed, and couldn’t speak. Her ex-husband, sleeping on her couch by chance the night before, found her and called 911. The cause was a carotid web, a rare congenital condition she never knew she had. Three years and three months later, she’s living with aphasia, rebuilding her sense of self, and navigating something that doesn’t get nearly enough airtime in stroke conversations: emotional anger after stroke. What Is a Carotid Web — and Why Does It Matter? A carotid web is a rare shelf-like membrane in the internal carotid artery that disrupts blood flow, causing stagnation and clot formation. It is a form of intimal fibromuscular dysplasia and affects approximately 1.2% of the population. Most people never know they have it. Unlike the more commonly cited stroke risk factors, such as hypertension, diabetes, smoking, and obesity, a carotid web is congenital. You are born with it. There is no lifestyle adjustment that would have prevented Trisha’s stroke. That distinction matters enormously when you are trying to make sense of what happened to you. “I have nothing that could cause it,” Trisha says. “No blood pressure, no diabetes. It’s hard.” The treating hospital, MGH in Boston, caught the carotid web, something Trisha was later told many hospitals would have missed. It is a reminder of how much diagnosis still depends on the right clinician, the right technology, and a degree of luck.   Why Am I So Angry After My Stroke? One of the most underexplored dimensions of stroke recovery is emotional anger, not just grief, not just fear, but a specific kind of rage that has no clean target. “Why me? Why did I have to have it? It’s frustrating. It’s so frustrating,” Trisha says. “I’m just mad. I don’t know who I’m mad at.” This is a clinically recognized phenomenon. Emotional dysregulation after stroke can have both neurological and psychological origins. The brain regions that govern emotional control may be directly affected by the injury. At the same time, the psychological weight of sudden, unearned loss of function, of identity, of a future you thought you understood is enough to generate profound anger in anyone. For people like Trisha, who had no risk factors and no warning, the anger is compounded. There is no behaviour to regret, no choice to unwind. The stroke simply happened. That can make the anger feel even more directionless and, paradoxically, even more consuming. “Why me? Why did I have to have it? It’s frustrating. It’s so frustrating.” Bill’s gentle reframe in the conversation is worth noting here: “Why not me? Who are you to go through life completely unscathed?” It’s not a dismissal, it’s an invitation to move from the question that has no answer to the one that might.   Aphasia: The Deficit That Hurts the Most Trisha’s stroke affected her left hemisphere, producing aphasia, a language processing difficulty that affects word retrieval, word substitution, and speaking speed. Her numbers remained largely intact, which helped her return to her finance role. But the aphasia has been, in her own words, the hardest part. “If I didn’t have that, I wouldn’t be normal, but I could be normal,” she says. “The aphasia kills me.” One of the quieter consequences of aphasia that Trisha describes is self-censoring, stopping herself from communicating in public because she fears taking too long, disrupting the flow of conversation, or being misunderstood. She has developed a workaround: telling people upfront she has had a stroke, so they give her the time she needs to get her words out. The frustration-aphasia loop is well documented: the more stressed or frustrated a person becomes, the worse the aphasia tends to get. The therapeutic implication is significant. Managing emotional anger after a stroke is not just a well-being issue for someone with aphasia; it is directly tied to their ability to communicate. “Whenever I’m not stressed, I can get it out. When I get nervous, I can’t,” Trisha explains.   The Trauma Ripple: It’s Not Just About You One of the most striking moments in this episode is when Trisha reflects on her son Zach and ex-husband Jason, both of whom were visibly distraught in the days after her stroke. “I had a stroke. Why are they traumatized?” she says and then catches herself. “I forgot to look at it from their perspective. They watched me have a stroke.” This is something stroke survivors frequently underestimate. The people around them, partners, children, friends, even ex-partners like Jason, carry their own version of the trauma. They watched helplessly. They made decisions under panic. They grieved a version of the person they knew, even as that person survived. Acknowledging this doesn’t diminish the stroke survivor’s experience. It widens the frame of recovery to include the whole system and opens the door to conversations about collective healing.   Neuroplasticity Is Real — Give It Time Three years and three months after her stroke, Trisha’s message to people in the early stages of recovery is grounded and honest. “Neuroplasticity really does exist. My brain finds places to find the words I never had before. It takes longer, but it gets there. Just give yourself time.” She also reflects candidly on going back to work too early, returning before she was medically cleared, crying every day, and unable to follow her own cognitive processes. “I should have waited,” she says. “But I did it. It taught me that if I ever had it again, I won’t do that.” Recovery after stroke is non-linear, unglamorous, and deeply personal. But the brain is adapting, always. Trisha’s story is evidence of that and a reminder that emotional anger after a stroke, however consuming it feels, is not the end of the story.   Read Bill’s book on stroke recovery: recoveryafterstroke.com/book | Support the show: patreon.com/recoveryafterstroke  DisclaimerThis blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. Why Me? Navigating Emotional Anger After Stroke When You Did Nothing Wrong No risk factors. No warning. Just a carotid web she never knew about — and three years of emotional anger, aphasia, and finding her way back. Tiktok Instagram Facebook Highlights: 00:00 Introduction – Emotional anger after stroke 01:36 The Day of the Stroke 07:05 Post-Stroke Challenges and Rehabilitation 13:06 Ongoing Health Concerns and Medical Appointments 22:40 Navigating Health Challenges and Medical Support 30:20 Acceptance and Coping with Mortality 38:36 Communication Challenges and Aphasia 42:09 The Journey of Recovery and Self-Discovery 51:51 Facing the Aftermath of Stroke 59:22 Emotional Impact on Loved Ones 01:04:57 Navigating Life Changes 01:13:25 Finding Joy in New Passions 01:25:12 Trisha’s Journey: Emotional Anger After Stroke Transcript: Introduction – Emotional anger after stroke Trisha Lyn Winski (00:00) I don’t have anything that could cause it. I have nothing that, no blood pressure, no diabetes, It’s hard. It’s hard. don’t… It makes me mad. Really mad. Really, really mad that I to stroke. And like, everyone that has it… Bill Gasiamis (00:07) Yeah. Trisha Lyn Winski (00:21) or every dozen. I’m like, why me? Why did I have to have it? It’s frustrating. It’s so frustrating. Bill Gasiamis (00:28) Yeah, mad at who? Trisha Lyn Winski (00:30) I don’t know. I’m just mad. Like, I don’t know who I’m mad at. Bill Gasiamis (00:35) Before we get into Trisha’s story, and this is a raw, honest, and really important one, I wanna share a tool I’ve been using that I think can genuinely help stroke survivors get better answers faster. It’s called Turn2.ai. It’s an AI health sidekick that helps you deep dive into any burning question you have about your recovery. It searches across over 500,000 sources related to stroke, new research, expert discussions, patient stories and resources, and then keeps you updated on what matters each week. I use it myself and it’s my favorite tool of 2026 for staying current with what’s happening in stroke recovery. It’s low cost and completely patient first. Try it free and when you’re ready to subscribe, use my code, Bill10 at slash sidekick slash stroke to get a discount. I earn a small commission if you use that link at no extra cost to you. And that helps keep this podcast going. Also my book, The Unexpected Way That a Stroke Became the Best Thing That Happened is available at recoveryafterstroke.com/book. And if you’d like to support the show on Patreon and my goal of reaching a thousand episodes, you can do that by going to patreon.com/recoveryafterstroke. Links are in the show notes. Right, Trisha Winsky was 46 years old, healthy, had no risk factors and then a carotid web. She never knew she had changed everything. Let’s get into it. Bill Gasiamis (02:06) Trisha Winski, welcome to the podcast. Trisha Lyn Winski (02:09) Thank you. Bill Gasiamis (02:10) Also thank you for joining me so late. I really appreciate people hanging around till the late hours of the evening to join me on the podcast. I know it’s difficult for us to make the hours that suit us both. I’m in the daytime here in Australia and you’re in the nighttime there. Trisha Lyn Winski (02:27) Yeah. Yeah. It’s okay. I can come to you later. Yeah, it’s late. Bill Gasiamis (02:34) As a stroke survivor, is it too late? Trisha Lyn Winski (02:36) No, no, not at all. Bill Gasiamis (02:38) Okay, cool. Tell me a little bit about what you used to get up to. What was life like before the stroke? Trisha Lyn Winski (02:45) I just get up and get to work. deal with it all day, come home, I’d go to the restaurant, the bars, my friends, and then like I had a stroke and everything changed. Everything changed in an instant. Bill Gasiamis (03:00) How old were you in the district? Trisha Lyn Winski (03:02) I was 46. Bill Gasiamis (03:04) And before that, were you in a family, married, do you have kids, any of that stuff? Trisha Lyn Winski (03:08) I have a kid. Now he’s 28. He was 25 when I had it. I was married before, but like a long time ago. Actually, my ex found me when I had a serve. So he’s the one who found me. But so yeah, that’s all I have here. My mom passed away in November. So it’s been challenging. Yeah. Bill Gasiamis (03:30) Dramatic, ⁓ Sorry to hear that. how many years ago was a stroke? Trisha Lyn Winski (03:37) ⁓ It’s three years and three months. Bill Gasiamis (03:41) Yeah. What were you focused on back then? What were the main goals in your life? Was it just working hard? Was it getting to a certain time in your career? What was the main goal? Trisha Lyn Winski (03:50) I think I working hard, but I just wanted to get to a good place in my career. And I think I was in a good place. Now I second guess at all time because I’ve had strokes now, it doesn’t matter what happens. I’m always second guessing it. But I was in a good place. I just felt like I needed to make them better. And the stroke happened and I so didn’t. Bill Gasiamis (04:17) What kind of work did you do? Trisha Lyn Winski (04:18) I was the corporate finance director for an auto group. Bill Gasiamis (04:22) A lot of hours was it like crazy hours or was just regular hours. Trisha Lyn Winski (04:26) No, I worked a lot of hours, but in the end he wanted me work like 40, 50 hours a week. I couldn’t do that. 50 hours a week was killing me, but 40 was enough. Yeah. Bill Gasiamis (04:37) Yeah. Were, did you consider yourself healthy? Was there any signs that you were unwell, that there was a stroke kind of on the horizon? Trisha Lyn Winski (04:46) No, nothing, The day before this, had, my eye was like, I want to say it’s twitching, but it wasn’t twitching. It was doing something like odd. And I didn’t realize that until I had a TIA recently, but I realized it then. It’s, how can I explain it? It’s like a clear, a blonde shape in my eye. it, when I move, it goes with me. And I try to see around it, I can’t see around it. And I said to Gary, I worked with him, was like, I’m gonna have to go to hospital. This continues. can’t see.” And then it went away. And that’s the only symptom I had. Only symptom. And he said, no, I should told you that you might be having a stroke. like, even if you told me that, I never believed him. Never. Bill Gasiamis (05:23) Hello? Yeah. When you’re, and it went away and you didn’t have a chance to go see anyone about it. Trisha Lyn Winski (05:37) Yeah, it went away in like, honestly, like five minutes. So I didn’t see anybody, but I thought it was okay. I mean, I guess now that I’m looking back at it, it’s kind of odd. It’s one eye, but I felt like it was gone. I don’t know. yeah. No, you don’t. Bill Gasiamis (05:55) Yeah. How could you know? mean, no one knows these things. And, and then on the day of the stroke, what happened? Was there any kind of lead up? Did you notice not feeling well during that day? And then the stroke, what was it like? Trisha Lyn Winski (06:09) No, so I get up like every other day to go to work. I went in the bathroom and the night before that Jason said Jason’s ex-ad he stayed at my house because he needed need a place to stay because he couldn’t go out Zach again. I was like okay we’ll sleep in my couch I’m gonna go to work tomorrow but you can sleep here. So he was there and I think if he wasn’t there I would have died. Post-Stroke Challenges and Rehabilitation Makes me sad. Um, anyway, so when I woke up I went to bathroom and I stood up from the toilet and I like I fell over and I I didn’t even realize it. So I fresh my face in like five places when I fell and I didn’t even I didn’t even know it my whole side was numb. So I didn’t feel it. And Jason, you know, helped me to bed. I thought he helped me to bed. He didn’t he like drug me to bed. He got in the bed and then I… He came back in like five minutes later, are you okay? Like he knew something was wrong. And I couldn’t articulate to him. So I said, I’m fine, I’m fine. I’m gonna go to work. So he put the phone in my hand to call my boss. And he came back in like five minutes later and I… He put it in my right hand so I didn’t call anybody. And he said, my God, I’ll never forget this. He said, my God, you’re having a stroke. And I couldn’t talk. I couldn’t talk. I just… Yeah, I could hear him say that, but I couldn’t talk to him. It’s… It’s really scary. Like, even talking right now, like… It upsets me. Bill Gasiamis (07:37) but you can hear him say that. This is really raw for you, isn’t it? Yeah, understand. went through very similar things like trying to speak about it and getting it out of my self and trying to, you know, bring it into the world and get it off my shoulders. Like often brought me to tears and made it really difficult for me to have a meaningful conversation with anyone about it. Trisha Lyn Winski (08:07) It does. Bill Gasiamis (08:09) There’s small blessings there with you, okay? All happened when for whatever reason your ex was in the house and was able to attend you. It’s an amazing thing that that is even possible ⁓ considering how some breakups go and how possible. Yeah. Yeah. And so he called 911 and got you to hospital. Is that how you ended up in hospital? Trisha Lyn Winski (08:15) I know. We’re good friends, it was a challenge. Yes. So they ended up taking me to MGH, it’s a hospital right down the street from me. ⁓ But he’s not from here, he’s from Pennsylvania. he didn’t know where to me, like, just has to go to the hospital. So they knew when they came up. So MGH is like known for their strokes, they’re like really good at strokes. ⁓ And so that’s where they plan on taking me. Bill Gasiamis (09:01) Yeah. And do you get a sense of what happened when you were in the hospital? Do you have any kind of recollection of what was going on? Trisha Lyn Winski (09:11) I honestly, in the first week, no. I remember seeing, in the first day, I saw Zach, my son, and Zach, his brother Connor was in there too, and Jason, they all were there with me when I woke up. But I saw them, and I saw my friend Matt, and then that’s all I remember seeing. I remember seeing my mom on the third day. I’m in jail on this third day, but that’s about it. Bill Gasiamis (09:41) Yeah. And then did you have deficits? couldn’t feel one of your sides? Did that come back, whole problem, that whole challenge? Trisha Lyn Winski (09:50) So the right side, it came back, but it came back like sporadically. So I just kind of want to come back. So the first day I saw Matt and I put up my arm to talk to him and I couldn’t like put my arm out. So I just like tap my arm. ⁓ Now I can move my arm fully, but I can’t, I don’t have the dexterity in my arm. So I can’t like. I can’t flip an egg with this hand. it’s like this and then this is like that. I can’t do this. ⁓ And my right foot has spasticity in it. then the three toes on the side, I could curl them up all the time. Bill Gasiamis (10:36) Okay, next. Trisha Lyn Winski (10:37) and I did botox for it, nothing helps. Bill Gasiamis (10:40) huh. Okay. Have you heard of cryo-neuralysis? Trisha Lyn Winski (10:42) yeah, yeah, I got that back. Bill Gasiamis (10:45) You got cryo-neuralysis? Trisha Lyn Winski (10:47) No, what are you saying? Bill Gasiamis (10:49) That’s spasticity treatment. Cryo-neurolosis, it’s a real weird long word. There’s a dude in Canada that ⁓ started a procedure to help freeze a nerve and it expands the ⁓ tendons or something around that and it decreases spasticity and it lasts longer than Botox. Trisha Lyn Winski (10:50) ⁓ no. Okay. ⁓ yeah, you need to give me his name. We’re gonna talk. That’s I went twice to have it done. ⁓ it didn’t help at all. And I met, I met the guy, ⁓ the diarist, diarist ⁓ at the hospital. And he said, I didn’t think it was, it was going to work. I’m like, it’s the first I saw you. And he was like, I saw you and you had the shirt. I’m like, okay. I saw a million people that we can’t, I don’t remember who they are. Bill Gasiamis (11:20) Okay. Yeah. All right. So I’m going to put a link to the details for cryo-neuralysis in the show notes. ⁓ you and I will communicate after the podcast episode is done. And I’ll send you the details because there’s this amazing new procedure that people are raving about that seems to provide more relief than Botox in a lot of cases, and it lasts longer. And it’s basically done by freezing the nerve or doing something like that to the nerve. in an injection kind of format and then it releases the spasticity makes it improve. ⁓ well worth you looking into it, especially if you’re in the United States and it’s in Canada. ⁓ I know that doctor is training people in the United States and around the world. So there might be some people closer to you than Canada that you can go and chat about. Yeah. And how long did you spend in hospital in the end? Trisha Lyn Winski (12:28) Yeah. Yeah. Awesome. I love it. four weeks. Yeah. So the first, the first week I was at MGH, ⁓ they kept me for longer in the ICU because I had hemorrhagic conversion, transformation, whatever it’s called. I, you know what that is? Well, that went from the, I can’t think of what I was trying to say. Bill Gasiamis (12:40) for weeks. Ongoing Health Concerns and Medical Appointments Trisha Lyn Winski (13:05) It went from the aneurysm to the, not the aneurysm, the. Bill Gasiamis (13:09) The carotid artery. The clot, ⁓ Trisha Lyn Winski (13:11) ⁓ yes. Yeah, carotid artery and went to my brain. So I my brain bleed for a couple of days, but not like bleed, bleed, but it showed blood. So they kept me in it for longer. Bill Gasiamis (13:23) Okay. And then did you go straight home? Did you go to rehab? What was that like? Trisha Lyn Winski (13:29) I went to rehab for three weeks. And I sobbed my eyes out. So at that point I was like, I was good, but I wasn’t at all good, but I thought I was good. I said, I wanna go home, I wanna go home. My son can, he teach me all, do all this stuff, I gotta go home. Now that I’m past it, there’s no way he could tell me, no way. I couldn’t tie my shoes. Bill Gasiamis (13:34) three weeks. And when you came home, were people living with you? Trisha Lyn Winski (13:56) So he’s. No, nobody was living with but he had to come move in with me for three months. Bill Gasiamis (14:06) Yeah, your son, yeah. What was that like? Trisha Lyn Winski (14:07) Yeah. Here’s my proxid. I mean, honestly, at the time it was fine because I slept all the time. I slept like, God, I would go to bed like seven, 730 at night. And I was sleeping until like, at least, some sort of next day. I’d get up for a few hours, do what I had to do, and then fall back asleep. But just, I slept for a lot. So it was okay then. But come to the end of it, I’m like, okay, it’s time for you at your place. I need my space again, but yeah, he’s yeah, I need to have my own space. But at the time I know I need to rest. Yeah, I do. Yeah. ⁓ Bill Gasiamis (14:36) Yeah. and you need somebody around anyway. It’s important to have something near you if you’re unwell. Do they know what caused the stroke? Trisha Lyn Winski (14:53) ⁓ So I had a karate web. means that… ⁓ It’s really, it’s really rare. Only like 1.2 % of the whole population has it and I had it. It’s co-indentinob… co-ind… it’s… so I got it I was born. Bill Gasiamis (15:11) Yep, congenital. Trisha Lyn Winski (15:13) congenital, but they don’t know. I said that that would make it so much sense that they did a scan of your whole body at some point. I would have known that I had that years ago, but I didn’t know it. Bill Gasiamis (15:26) I don’t know what to look like, what to look for. The thing about scans, the whole body, my good friend of mine, the guy who helped me out when I was in hospital, he’s a radiographer and he does MRIs and all that kind of stuff. And he used to do my MRIs happened to be my friend happened to be working at the hospital that I was at. And he used to come and see me all the time. And I said to him, can we do a scan, you know, a preventative scan and check out, you know, my whole body? And he said, well, we can, but Trisha Lyn Winski (15:28) I know. Yeah. Bill Gasiamis (15:53) What are we looking for? I said, I don’t know anything. He said, well, we could, we could find a heap of things or we could find nothing. And if we don’t know what we’re looking for, we can’t set our scanners to the particular, settings to find the thing that you’re looking for. Because one scanner looks for hundreds of different things and the settings for to look for that thing has to be set into the scanner. And that’s only when people have a suspicion that you might have X thing. Trisha Lyn Winski (16:09) Yeah. Bill Gasiamis (16:23) then they set the scanner to find X thing and then they’ll look for it then they find it. He said, well, if we go in and do whole body scan, but we don’t even know what resolution to set it, how long to do the scan for. We don’t know what we’re looking for. So we don’t know what to do. And you have to be able to guide me and say, I want you to look for, in my case, a congenital arteriovenous malformation. In your case, carotid web. And in anyone else’s case is an aneurysm or whatever, but a general scan. Trisha Lyn Winski (16:38) Yeah. Bill Gasiamis (16:53) Like it’s such a hard thing to do for people. then, and then sometimes you said you find things that people do have unexpectedly because they go in for a different scan and then you discover something else. But now they’ve got more information about something that’s quite unquote wrong with them. And it’s like, what do you do with that information? Do I do a procedure to get rid of it? Do I, do I leave it there? Do I monitor it? Like, do I worry about it? Do I not worry about it? Trisha Lyn Winski (16:56) Yeah. Bill Gasiamis (17:21) is that it throws a big kind of curve ball out there and then no one knows how to react to it, how to respond. So it’s a big deal for somebody to say, can we have a whole body scan so we can work out what are all the things wrong with me? Trisha Lyn Winski (17:38) I it’s true, but I think that for me, most people have a carotid web. It’s obvious. know how old you are, it’s obvious. So then in that regard, like a carotid web, it looks a little indentured in the bloodstream. looks a little indentured in your artery. So I think that they would have seen it, but… ⁓ Bill Gasiamis (18:02) I love her. Trisha Lyn Winski (18:06) But then again, I don’t know. The hospital I went to, he said, you’re lucky you came here because most hospitals would have missed us. and I’m like, Bill Gasiamis (18:15) because they probably didn’t have the technology to find it. Trisha Lyn Winski (18:17) I don’t know. when I came to, it wasn’t months later, but I saw it on the scan. like, ⁓ it’s right there. ⁓ He said, yeah, but I thought it would be obvious, but it’s not so obvious. Bill Gasiamis (18:33) I just did a Google search for it and it says a carotid web is a rare shelf like membrane type narrowing in the internal carotid artery, specifically arising from the posterior wall of the carotid bulb. It is a form of intimal fibromuscular dysplasia that causes blood to stagnate forming clots that can lead to recurrent often severe ischemic strokes. Okay. So it causes blood to stay stagnant in that particular location causing clots. And you in the time we’ve been communicating, which is only in the last three or four weeks, you even sent me a message saying you just had an S you just had a TIA. ⁓ how come you’re still having clots? they not treating you or Trisha Lyn Winski (19:20) Yeah. No, I think they so they gave me um a scent in my re to kind of write that I don’t know why I had it cuz um, but my eye was like acting crazy again Just one eye and I I didn’t want to go to the hospital. I I don’t want the hospital at all for anything if I have if I don’t have to go I’m not going to hospital I Text Jason and Zach and they’re like no you have to go like I’ll wait a little while so Meanwhile, I was waiting a little while because I didn’t want to go and then I listened to ⁓ a red chat chat GBT He said no you have to go right now. Here’s why I’m like Now it’s like five hours later. I’m Sorry, so I went but and they said that I have ⁓ It’s likely I had a clot They don’t know where it came from though. So that’s that’s the thing is it’s confusing and by the way I think there’s something to be said about ⁓ I think if you have a stroke You can have one again easier than somebody who didn’t. I didn’t know that, but I learned it quickly. ⁓ So they said I had it, maybe went up in my eye, but it broke apart before it became an actual stroke. But I don’t know. Bill Gasiamis (20:41) thing. I love that you didn’t want to go and you ignored the male influences in your life, but you listen to chat. Trisha Lyn Winski (20:50) Thank you. I did, I did. They’re so smart. they say, I find on Google anyway. So that I listened to ChatGVT, it was like, I don’t know. And I know that like… Bill Gasiamis (21:05) You know that that’s kind of mental. Trisha Lyn Winski (21:08) It is actually, but I know that like my son is actually really smart and I think that they, but I didn’t listen him. I just listened to Chad Judy. Bill Gasiamis (21:18) Yeah. Anyhow, I love that you went in the end because, ⁓ and why don’t you want to go like, you just hate doctors and hospitals and that kind of thing? They saved you, didn’t they? Didn’t they save you? Didn’t they help you? Trisha Lyn Winski (21:29) There was? Yeah, but I don’t know. I think I spent so much time in there. ⁓ I don’t know. It’s in my head. I don’t like to sit in hospitals because of that. So after having the stroke, I stayed in hospital for month. I got out. I went back in like two weeks. I fell over twice. They thought that’s why. So when I was in hospital, something like they go Vegas something is pretty common. And I was like, okay, I did want to go then. I did want to go and then Zach made me. And then two months later, I went in to get the stint. And at that time I got a period. So it’s a long story. But I said to the doctor, I’m like, well, I’ll be okay. Does it do anything else because of this? He’s like, no, you should be fine. But if it gets bad, you have to go the hospital. he got bad. I almost died. I almost died from that. And that made me traumatized because I was awake and alive for all of it. I saw it all and passed out like six times in like three, I don’t know how many days, like five days. Yeah, but. Navigating Health Challenges and Medical Support Bill Gasiamis (22:46) Yeah. The challenge with something going wrong in hospital is that it’s less likely to be as dramatic as something going wrong at home. And that’s the thing, right? If you haven’t got help, then the chances that your stroke cause you way more deficits. That’s like so much worse. The best place for you to be is somewhere other than at home because you don’t want to risk being at home alone when something goes wrong and then you’re home alone. Trisha Lyn Winski (23:04) Yeah. Bill Gasiamis (23:15) when the blood flow has stopped to your head for a lot of hours. Like it could kill you, it make you more disabled and it could do all sorts of things. it’s like, but I get the whole, what is it like? It’s kind of like an anxiety about medical people and hospitals and stuff like that. Trisha Lyn Winski (23:20) Yeah. Yeah. I think that it’s mostly like I don’t like to stay there. I got a weird thing about this. I don’t like to stay there. I can stay anywhere I go, but the hospital really bothered me. I think that they were actually pretty good to me. So I’m not mad at them for that. ⁓ But I don’t want to see them now if I can possibly help it. Bill Gasiamis (23:54) Yeah, you’re done with them. Trisha Lyn Winski (23:56) I’m totally done. Bill Gasiamis (23:58) Yeah, I get it. I got, I got to that stage. My dramas were like three or four years worth of, you know, medical appointments, scans, surgery, rehab. Trisha Lyn Winski (24:07) Oh my god. Medical appointments. Medical appointments, forget it. They’re like, oh my god. I have so many of them, I can’t even say it. Bill Gasiamis (24:11) Yeah. I hear you. hear you. went through the same thing and then I got over it. now lately I’ve been going back to the hospital and seeing medical doctors for, um, not how I haven’t got heart issues, my, I’ve got high blood pressure and they don’t know what’s causing it. And, know, I’ve had my heart checked. I’ve had my arteries checked. I’ve had all these tests, blood tests, MRIs, the whole lot, and it’s getting a little bit old, you know, like I’m over it. But the truth is without them, I don’t. I don’t have a hope. Like if my blood pressure goes through the roof, you know, which had been, had been sitting at 170 over 120, 130. And I have a brain hemorrhage because of uh, high blood pressure. know what a brain hemorrhage is like, you know, I don’t want to have another one. So I’m like, I am going to, uh, I’m going to shut up, go through it and be grateful that I have medical support. Um, which, which Trisha Lyn Winski (24:55) Yeah. I know. Yeah. Bill Gasiamis (25:14) You know, a lot of people don’t get to have, it’s like, whatever, you know, I’ll cop it. I’ll cop it. I’ll go. And hopefully they can get ahead of it. So now they’re just changing my medication. I want to get to the bottom of it. Why have I got high blood pressure? The challenge with the medical system that I have is, is they just tell you, you have it and here’s something to stop it from being high. But I, they never say to you, we’re going to investigate why, like we’re going to try to get to the bottom of it. Trisha Lyn Winski (25:16) Yeah. Yeah. Bill Gasiamis (25:40) and I’ve been pushing them to investigate why do I have high blood pressure. Trisha Lyn Winski (25:44) sure. So I don’t have, I never had high blood pressure but speaking of I’ve, I don’t have a problem with my heart but they, so that when I had this for the first time they made me get out and have to, I had to wear a heart monitor for a month and I said like why am I wearing a heart monitor? There was something, they, I don’t know what it is. Bill Gasiamis (25:51) Yeah. Trisha Lyn Winski (26:13) Afib or something like that in there. And this time was the same thing. had heart bars over there right now. I had to send it back and they’re gonna send me new one. every time I’ve taken my heart test, and by the went for EKG just the other day. It was fine. But they found like something near my heart rate, it’s not like I need to be concerned about these. It’s nothing I need to be concerned about. So I was like, okay. They’re making you wear that for a month. Anyway. Bill Gasiamis (26:46) Yeah, just to go through things, just to check things, just to work some stuff out. Trisha Lyn Winski (26:47) Yeah. Yeah, yeah, this month I have ton, I have like seven appointments. Bill Gasiamis (26:56) Yeah, I used to forget my appointments all the time, even though I had him in my calendar, even though I had reminders, I just, even though I got reminded on the day, an hour before, two hours before, he meant nothing to me. I would just completely forget about him. Trisha Lyn Winski (26:59) me too. Me too. Same thing. I forgot all of it. And I had to share it with Zach and he could tell me, have an appointment. Like, okay. I forgot. He’s like, have an appointment. I’m like, fuck, I have to go. Bill Gasiamis (27:13) Yeah. How long did it take you to get back to work? Trisha Lyn Winski (27:28) I at least I went back to work. I went back to work before I was told I could go back to work. And I wrote them an email like, listen, I can’t sit at home and run one fucking freeze. I need to do something. So I went back to work. ⁓ And at first I went back to work part time. And honestly, like I cried. I left there crying every day. And not because I think that I. Not because of people. don’t think it was the people. I couldn’t understand. My head was like… I couldn’t focus and put all that work into my… I couldn’t put it into me. So I couldn’t understand what I was doing. And then you give them a month. Eventually I got it, but it was a struggle. I should have waited until October. And they said I should go back in October. Maybe I could go back in October. I should have waited until then. Bill Gasiamis (28:22) Yeah. Do you kind of like a nervous energy type of person? Do you can’t sit still or is it like, can’t spend a lot of time on your own with yourself? Like, is it? Trisha Lyn Winski (28:34) I can spend a lot of time by myself. don’t like to ⁓ here by myself. I can be by myself. I don’t like to be… I can’t think of… What did you say before? Bill Gasiamis (28:48) Is it just downtime? Is it the downtime? it too much? Did you have too much downtime? Trisha Lyn Winski (28:52) Yes, definitely too much downtime. But I couldn’t see I was sitting at home and Zach was there, whatever he was doing. was like, I can’t, I need to do something. So I went to work and in all reality, I should have walked around. should have, I didn’t do that. Bill Gasiamis (29:04) Yeah. Yeah. How did your colleagues find you when you went back? Did they kind of appreciate what you had been through? Was that easy to have those conversations? What was it like? Trisha Lyn Winski (29:21) Yeah, so I oversaw all the finances department. ⁓ They were actually like, honestly like rock stars. They were like really, really good to me. ⁓ That was helpful. because I love them anyway. it made me feel good to say that that’s what I’m doing. ⁓ But I still left there and cried. Not because like I think that I just couldn’t understand it. They were good to me. Everyone was good to me in theory, I couldn’t understand. Bill Gasiamis (29:56) you had trouble with the work, with doing your job because of your cognitive function. Trisha Lyn Winski (29:59) Yeah, yeah, yeah, there’s a other little things with that, it’s more or less the cognitive function is a problem to do the work. Bill Gasiamis (30:12) Yeah. Tiring. Like I mentioned, it’s really mentally draining and tiring. remember sitting in front of a computer trying to work out what was going on on the screen and it being completely just blank. Acceptance and Coping with Mortality Trisha Lyn Winski (30:22) And so that’s actually what probably got me the most was that what you’re saying. I’d be sitting there and look at my screen. I couldn’t remember what I was doing, but I remember like weird things. I remember how to do like Excel. I don’t know how I remember Excel, but I did. I was really good with numbers. And they said that I was going to have a problem with numbers and everything. So I have aphasia too. I don’t have a choice with that, but Bill Gasiamis (30:31) Yeah. Trisha Lyn Winski (30:49) That’s why I talk so weird. Bill Gasiamis (30:52) Okay, I didn’t notice. Trisha Lyn Winski (30:54) Oh, oh, I feel good. But yeah, I have aphasia. But I can do certain things. And the numbers was going to be, they said it going to, I couldn’t, that’s going to be a problem. And the numbers, I can do all day. But I can’t do other little things. Bill Gasiamis (31:11) I understand. So you went back to work. It was kind of helpful, probably too early to go back, but good to be out of the house. Good to be connecting with people again. And has that improved? Did you find that you’ve been able to kind of get better in front of a screen, better with the things that you struggled with, or is it still still a bit of a challenge? Trisha Lyn Winski (31:19) Yeah. Yeah. So two things, ⁓ I got fired eventually, and that’s another whole issue. Yeah, yeah, we’ll talk about that another time. but ⁓ so, but now that I’m here, I could look my computer and it’s fine. I can do it all day. But I really, it’s a long story. think that Warren, my boss, ⁓ Deb, but they definitely like hinder me. ⁓ Bill Gasiamis (31:39) Understand. another time. Yeah. Okay. I understand. Well, maybe we won’t talk about it, like, because of the complications with that, but that’s all good. I understand. So, ⁓ do you know, a lot of the times you hear about acceptance and you hear about, ⁓ like, Trisha Lyn Winski (32:07) Yeah. Yeah. Yeah. Bill Gasiamis (32:23) When some, well, something goes through something serious, something difficult, you know, there has to be kind of this acceptance of where they’re at. And that’s kind of the first stage of healing recovery, overcoming. Where are you with all of this? you like, totally get that at 46. It’s a shock to have a stroke. You look perfectly fine, perfectly healthy. This thing that you didn’t know about that you’ve had for 46 years suddenly causes an issue. How do you deal with your mortality and knowing that things can go wrong, even though you’re not aware of, you you’re not doing anything to really make your situation worse. You look fit and healthy. Were you drinking, smoking, doing any of that kind of stuff? Trisha Lyn Winski (33:06) I drank occasionally, I wasn’t a drunk, I don’t smoke. Bill Gasiamis (33:11) yeah social smoke social drinker but not smoker Trisha Lyn Winski (33:15) Yeah, I don’t smoke. I don’t have anything that could cause it. I have nothing that, no blood pressure, no diabetes, It’s hard. Jason talks about it all the time. It’s hard. don’t… It makes me mad. Really mad. Really, really mad that I to stroke. And like, everyone that has it… Bill Gasiamis (33:24) Yeah. Trisha Lyn Winski (33:41) or every dozen. I’m like, why me? Why did I have to have it? It’s frustrating. It’s so frustrating. Bill Gasiamis (33:48) Yeah, mad at who? Trisha Lyn Winski (33:50) I don’t know. I’m just mad. Like, I don’t know who I’m mad at. Bill Gasiamis (33:56) Yeah. The thing about the why me question, it’s a fair question. asked it too. I even ask it now sometimes, especially when, um, I’ve got to go back for more tests, more, uh, now I’ve got high blood pressure. Like, like I needed another thing to have, you know, like, and it’s like, the only thing that I come back with after why me is why not me? Like, who are you to go through life completely unscathed and get to 99 and then die from natural Bill Gasiamis (34:25) wanted to stop there for a second because that question, why me, is something I wrote about in my book. It’s one of the most common and most painful places stroke survivors get stuck. If you want to read about it and how I worked through it and what I found on the other side, the book is called The Unexpected Way That a Stroke Became the Best Thing That Happened and it’s available at You’ll find the link in the show notes. And now let’s get back to Tricia. Bill Gasiamis (34:54) like Trisha Lyn Winski (34:54) Yeah. Bill Gasiamis (34:55) You’re normal. being normal, ⁓ normal things happen to people. Some of those things that are shit are strokes and heart attacks and stuff that you didn’t know that you were born with. ⁓ what’s really interesting though, is to live the life after stroke and to kind of wrap my head around what that looks like. My left side feels numb all the time. ⁓ tighter, ⁓ has spasticity, but nothing is curled. Like my fingers on my toes are not curled, but it’s tighter. ⁓ it hurts. ⁓ It’s colder, it’s ⁓ sensitive, I’ve got a, and I always have a comparison of the quote unquote normal side, the other side, it’s always. And the comparison I think is worse because it makes me notice my affected side and that noticing it. Trisha Lyn Winski (35:31) Yeah. or yeah. Bill Gasiamis (35:46) makes the reality happen again every day. Like it’s a new, I wake up in the morning, I get out of bed, my left side still sleepy. I have to be careful. If I’m not careful, I’ll lose my balance. I don’t want to fall over. And it’s like, I get to experience a different version of myself. And sometimes I want to be grateful for that. want to say, wow, what a cool, different thing to experience in a body. But then I’m trying to work out like, what’s the benefit of it? don’t know if there’s a benefit. ⁓ Trisha Lyn Winski (36:14) I don’t know either. Bill Gasiamis (36:15) to me, but, Trisha Lyn Winski (36:15) I don’t either. Bill Gasiamis (36:18) but here I am talking to you and, and, and 390 people before you, ⁓ about strike all over the world and we’re putting something out and it’s making a difference. And maybe that’s the benefit. I don’t know, but do know what I mean? Like, why not us? I hate asking that question too. Trisha Lyn Winski (36:34) I don’t know. You had ⁓ the podcast on YouTube and I stumbled upon it on the wise. I watched YouTube and then you came out there and I’m like, so before that I was looking at different, I watched every video, every video on strokes, every video I could possibly type but I watched. I did. ⁓ And then I stumbled upon your stuff and I watched that stuff too. And that’s why I wouldn’t have thought to call you or reach out to you. Bill Gasiamis (37:11) Was it helpful? Was it helpful? Trisha Lyn Winski (37:13) Yeah, it is helpful. But it doesn’t change the fact that I had a stroke. All the people that had it, I feel bad for them. Honestly, like, so when I was at the hospital, they had me join a bunch of groups on Facebook and Instagram that are like, they’re people who’ve gone through a stroke. most, I don’t comment on them. I don’t say, because most of the time it’s people bitching. Bill Gasiamis (37:19) Yeah. Yeah. Trisha Lyn Winski (37:43) But I really like, times I, trust me, I’m like ready to kill somebody. But I don’t like say it there. I only ask them questions that are really serious. But sometimes I read what they say. And there was a guy the other day, I don’t know what he wrote, but he had like all kinds of words that they were way jumbled. was like, his message just didn’t make sense. I thought to myself, God, if I was like that, I’d be so sad. Somebody, I do think that he’s worse than I could be, but you don’t know. Bill Gasiamis (38:19) Yeah. Communication Challenges and Aphasia Yeah. He, his words are more jumbled than yours. And you, if you, you, you’re thinking, if you were like that, you would be probably feeling more sad than you currently are. And you’re assuming that maybe that person is feeling sad, but maybe they’re not, maybe they just got the challenge and they’re taking on the challenge and they’re trying to heal and recover. don’t know. And maybe, maybe they’re getting help and support through that therapy and also maybe psychological help and all that kind of stuff. Have you ever had any counseling or anything like that to sort of try and wrap your head around what the hell’s going on in your life? Trisha Lyn Winski (38:54) So I did it once and actually like I think she was okay. I felt like I was always having to talk. I know that I’m so stocked but she wasn’t asking me a lot of questions and I felt like she needs to me more questions. I’ll have more answers but like but she didn’t. She just wanted me to talk so I just talked. But I stopped seeing her because I… So two reasons. I stopped seeing her because they when they fire me I… I didn’t know what I had to do. I knew I insured that I didn’t know how long it was going to be for me to have that. So I talked to her for a little bit and then I stopped talking to her because I just couldn’t deal with it. I think now I’m getting to the point where I’m going to do it. Bill Gasiamis (39:37) It was a bit early. I like that. I like what you said there. Cause sometimes it’s early. It’s too early to go through that and unwrap it. Right. And now a little bit of times past, you probably have more conscious awareness of, do need to talk about this and I need to go through and see a certain person. And now I’m going to take that action. It’s been three years and now I can take that action. like it. ⁓ and I like what you said about, you have to feel like you’re connected to that person or you have rapport or Trisha Lyn Winski (39:46) It is. Yeah. Yeah. Yeah. Yeah. Bill Gasiamis (40:11) they get you and you’re not just, it’s not a one way conversation. That’s really important in choosing a counselor. I know my counselor, we, I didn’t do all the talking. was like you and me chatting now about stuff. had a conversation about things regularly. And therefore, ⁓ one of the good things that she was able to do was just ease my mind when I would go off on real negative tangents, you know, she would try to bring me back down just to calm and. Trisha Lyn Winski (40:35) Yeah. Bill Gasiamis (40:39) settle me down and offer me hope. Trisha Lyn Winski (40:42) I think my, honestly my biggest problem with this whole stroke and having it at all, I have aphasia and that 100 % kills me. Because I can’t like, I can talk like normal but I can’t talk like… I forget what I’m saying. So it’s in my brain, but I can’t spit it out. I get really frustrated at that point. people, I had a stroke, my left hemisphere and my right side went numb. My left hemisphere is all kinds of different, different things that I can’t do. The good news is my left means I can’t like, I can talk to people like this. But the other person and that guy I was talking about, he probably had the right side, his aphasia was. really bad, really bad. But I was a person who talked like really fast all the time, all the time. And now like, I think part of my brain goes so fast and I can’t spit it out. I get really, I get, it’s, yeah. Bill Gasiamis (41:38) Okay. as quickly as you can. Okay, so you know, I’ve spoken to a ton of people who have aphasia. And one of the things they say to me is when they have frustration, their aphasia is worse. So the skill is to learn to be less frustrated with oneself, which means that’s like a personal love thing. That’s self love, that’s supporting yourself, you know, and going. Trisha Lyn Winski (42:00) It is. The Journey of Recovery and Self-Discovery Yeah, that’s a point. That’s a good point. Bill Gasiamis (42:13) And it’s going like, well, you know, you’re trying your best. It’s all good. You know, don’t get frustrated with yourself. Don’t hate yourself. Don’t give yourself a hard time about it. ⁓ and try and decrease the frustration. Then the aphasia gets less impactful, but, ⁓ and then maybe, you know, this part of learning the new you is bring the old Trisha with you, but maybe the nutrition needs to be a little bit more slow, a little more measured, a little more calm. And it’s a skill because for 46 years, you were the regular. Trisha Lyn Winski (42:36) Yeah. Bill Gasiamis (42:42) Tricia, the one that you always knew, but now you’ve got to adjust things a little bit. It’s like people going into midlife, right? Like us, you know, in our fifties and then, um, or, know, sort of approaching 50 on and beyond and then go, I’m going to keep eating, uh, fast food that I ate when I was 21 and 20, know, McDonald’s or sodas or whatever. You can’t do it anymore. You have to make adjustments, even though that’s been your habit for the longest time, your body’s going, I can’t deal with this stuff anymore. Trisha Lyn Winski (43:03) Yeah. Bill Gasiamis (43:12) Take it out, you know, let’s simplify things. And it’s kind of like how to approach. I stroke recoveries things need to kind of get paid back and simplified. And it has to start with self love. And you have to acknowledge how much effort you’ve already put in for the last three years to get you to the position that you are now, which is far better than you were three years ago when the stroke happened. And you have to celebrate. how much your body is trying to support you heal your brain. Your body’s trying to get you over the line and your mindset is getting frustrated with itself, which is making things worse. Tweak that and things will get a bit better maybe. I don’t know. Trisha Lyn Winski (43:55) It does. You’re 100 % right. ⁓ So whenever I’m not stressed, so two things. I think when I talk to people I don’t know, I always get like nervous about that. ⁓ Bill Gasiamis (44:10) You think they’re thinking about things that you’re not they’re not really Trisha Lyn Winski (44:13) Yeah, but then who knows what they’re thinking of. that’s just how I get, whenever I get like, I went to a concert like a couple of years ago and I was like, I believe I couldn’t, I could hear that the music is so loud in my brain. Like I gotta get out of here. So I left. I’ve gotten better since then, but there’s something about, I have to do things slower. I have to do things over. I’ve realized that like recently, like in the last like maybe month, I have to do things very slow. I have to. And maybe this is God’s way of like, tell me like slow the f down, you’re going too fast. But that’s how I live my whole life. And then all of a sudden, now you’re not going to get up. Yeah, it’s a huge testament. So I can do it right. Not always right. Bill Gasiamis (45:01) Yeah, there’s an adjustment. Yeah, adjustment. Yeah. Trisha Lyn Winski (45:09) because again, it’s isophagia, it’s gonna be hair mess, if I go slower, much slower, I can get it all out. But, ugh. Bill Gasiamis (45:22) It’s a lot of work, man. It doesn’t end here. You know, the work just as just beginning, you know, this getting to understand yourself, to know yourself, to support yourself, to be your biggest advocate. ⁓ and then to fail and then to try and be the person that, ⁓ picks themselves up and goes again and tries again without getting frustrated. I know exactly what you mean. Like so many people listening will know what you mean. Trisha Lyn Winski (45:22) It’s a pain. It’s a pain! Bill Gasiamis (45:51) And with time, you’ll get better and better because I know that three years seems like a long time, but it’s early in the recovery phase. The recovery is still going to continue. Year four, five, six, seven will be better and better and better. I’m, I’m 12 years post brain surgery and 14 years post first incident. So it’s like, things are still improving and getting better for me. Trisha Lyn Winski (46:17) Yeah. Bill Gasiamis (46:18) And one of the things is the way that my body responds to physical exercise. went for a bike ride a little while ago, a couple of weeks ago. And when I used to go for a bike ride at the beginning, um, man, I would be wiped out for the entire day. Uh, and I used to do a morning bike ride about like 10, 30, 11 o’clock and I’d be wiped out for the rest of the day. Trisha Lyn Winski (46:32) Yeah. Bill Gasiamis (46:39) Whereas now I can go for a bike ride and just be wiped out like a regular person, you know, about an hour or two, and then I’m back on board with doing other tasks. So it takes so much time for the brain to heal. Nobody can give you a timeline and you’ve got heaps more healing to go. Trisha Lyn Winski (46:57) So I looked at my stuff on YouTube, how long it takes to recover from a stroke. I’ve looked at that everywhere. Everywhere I can find. I’ve looked at that. It’s so funny. Like everybody says that it’s, everybody’s story is different. Everybody. It doesn’t matter how long you were in hospital for, doesn’t how long. But that like, it’s crazy. have no like timetable of when I’m going to get better. None. I have to deal with it. Bill Gasiamis (47:27) Yeah. It’s such a hard thing. It’s not a broken bone, know, like six weeks, stay off it, do a little bit of rehab and then you’re back to normal. Trisha Lyn Winski (47:28) It sucks, but. I had two years before this or maybe a year before that, had a rotator cuff surgery. I look back at that and I’m like, that was so bad. And that was like night and day. The stroke definitely like, the stroke killed me. Not the stroke. I don’t want to say the stroke. I think having aphasia killed me. I do, the stroke is, get me wrong. I don’t like it either, but ⁓ the aphasia kills me. If I didn’t have that, I wouldn’t be normal, but I can be normal. But the aphasia. Bill Gasiamis (48:00) Okay. Yeah. But, but what, but that word killed me is a real heavy word, right? maybe you should consider changing that word, but also like, didn’t pick that you had aphasia and I, and I speak to stroke survivors all the time. Like I didn’t pick it. I, I just assumed that was the way you process your words and that’s how you get things out. Like it didn’t, I didn’t notice it at all. Trisha Lyn Winski (48:26) I know, I know, it’s funny that said Yeah, that’s actually good. That’s really good. But I know it’s it. I definitely know it’s it. I could talk like a mile a minute and now like. Bill Gasiamis (48:47) Yeah. Trisha Lyn Winski (48:52) I mean… Bill Gasiamis (48:52) Maybe it was maybe maybe now it’s more about ⁓ quality rather than quantity, Trisha. Trisha Lyn Winski (49:00) Apparently it is. Bill Gasiamis (49:01) I’m not saying that you didn’t have quality in that I didn’t know you so I’m not kind of yeah but you know what I mean like Trisha Lyn Winski (49:03) Yeah. No, it’s okay. Trust me, it’s okay. But yeah, it just frustrates me. I can’t get out what I want to get out. And so at that time, just give me a little time, I’ll get it out. But I can’t say that to people when I’m out. I can’t say this to So I just, I don’t say it at all. Bill Gasiamis (49:22) Yeah. so you stop yourself from communicating because you think you’re taking too long and it’s interrupting the flow of the conversation. Yeah. I think you’re doing that to yourself. I don’t think that’s true. We’ve had a fantastic conversation here and I’ve never picked it. Trisha Lyn Winski (49:34) Yeah. all day. But so you’re somebody who’s had a stroke before. It’s kind of different for me because you had. But if you didn’t have a stroke, will be… Well, I don’t know. Maybe not. Maybe one-on-one I’m okay. No, think I… No, it’s because you had a stroke. I think of all the people I’ve talked to and they’re one-on-one. I don’t do well with them. But I think that you’ve had a stroke so I just… I know how to communicate with you. Bill Gasiamis (49:54) I understand. And maybe you’re more at ease about it. Less feeling, judged. I understand. Yeah. Trisha Lyn Winski (50:20) Yes, all day. Even that guy I told you about that that said that on Facebook God like I Really like my heart goes out to him But then that there’s the people that are fishing a plane I’m like I want to say my heart goes out to them, it really, it goes to certain people. I think that. He’s like going through it. Bill Gasiamis (50:45) Yeah. One of the problems with going to Facebook to bitch and moan about it, especially when you’re going through it is that you get an abundance of people who also are there to bitch and moan about it. And, and that makes it worse. think you should do bitching and moaning on your own. Like when there’s no one watching or listening. Cause then that way there’s not a loop of bitching and moaning that happens. That makes it dramatically worse for everybody. Trisha Lyn Winski (51:01) Yeah, I do it myself. Bill Gasiamis (51:09) ⁓ and that’s why I don’t hang around on Facebook, Instagram, social media, or anything like that for those types of conversations. If I’m not sharing a little bit of wisdom or somebody’s story or, ⁓ asking a question, like a genuine question, one of the questions might be, did you struggle driving and did you have to pull over and go to sleep in the middle of the road? If you had a big trip ahead of you in the car, I’ve done that. Like if, if I’m not asking a question like that, I don’t want to be, ⁓ on social media saying. life sucks, this sucks, that sucks. Like forget about it. What’s the point of that? That’s why I started the podcast so I can have my own conversations about it that were positive based on what we’re overcoming rather than all the shit we’re dealing with. And that way ⁓ we take off that spiral, the negative downward spiral. trying to make it an upward spiral. You know, where things are. Trisha Lyn Winski (51:41) Yeah. Facing the Aftermath of Stroke Bill Gasiamis (52:05) I don’t know, we’re seeing the glass half full perhaps, or we’re seeing the positive that came out of it. If something like, I know there’s some positive stuff that came out of stroke for you. Day one, you definitely didn’t think that maybe three years down the track. Maybe if it wasn’t for this, well, then that wouldn’t have happened for me. Like I’ve been on TV. I’ve been at the stroke foundation. I’ve been on radio. I’ve been, I’ve presented. I’ve got a podcast. wrote a book. Like it’s taken years and years for all those good things to come, but they never would have happened if I didn’t have a stroke. So I wanted to have those types of conversations, you know, what are the positive things we can turn this into? Because dude, then there’s just enough shit to deal with that. We don’t have to deal with every other version of it, you know? ⁓ and I think it’s better to have your me personally, my negative moments alone, cause I don’t want to get into a competition with somebody. Trisha Lyn Winski (52:42) That’s good. Yeah. Bill Gasiamis (53:05) who I say, I didn’t sleep well, my left side hurts, it feels like pins and needles. And then they say to me, ⁓ you think that’s bad? Well, you know, forget about it. I don’t want to be that that guy on the other end of a conversation like that, you know. Trisha Lyn Winski (53:13) Yeah. ⁓ So you said your left side, ⁓ you see you have pin the needles, is always like that? So I’m sorry, had hemorrhagic stroke? Okay. I know the difference between two, ⁓ why did you have hemorrhagic stroke? Bill Gasiamis (53:27) Always, yeah, never goes away. Yeah, Brain blade. I was born with a blood vessel that was malformed. So it was like really weak one. I was really like, uh, was kind of like, uh, uh, it wasn’t created properly in my brain when I was born and it’s called an arteriovenous malformation. then they sit idle, they sit idle and they do nothing for a lot of people. And then sometimes they burst. Trisha Lyn Winski (53:58) Mm-hmm. ⁓ I heard it. Bill Gasiamis (54:08) And people sometimes have them all over their body. They don’t have to have them in their head. They can have them on the skin, ⁓ in, in an arm on a leg, wherever. And on an arm and a leg, they, they decrease the blood flow and they create real big lesions of skin damage on the surface in a brain. They leak into the brain and they cause a stroke. ⁓ so the challenge with it is like you, there was no signs and symptoms. for any of my life until it started bleeding. And when I took action, eventually, I was like, yo, I didn’t want to go to the doctor. I didn’t want to go to the hospital. I want to do any of that. It took seven days for me to go to the hospital. When I finally got there, they found the scan, found the blood in my head. And then they thought it would stop bleeding and it didn’t. And then it bled again and they wanted to monitor it to see if it stops bleeding. They wanted to try to avoid surgery. And then a bled a third time. And then after they bled the third time, they said, we have to have surgery. We’ve got to take it out because it’s too dangerous. And when it bled the second time, I didn’

🧭 REBEL Rundown 🔑Key Points Try the coffee nap! Where you combine caffeine and a 30-minute nap to then have that boost energy and alertness by the time it kicks in.💤 Sleep isn’t optional—it’s crucial for memory, mood regulation, and physical recovery. It is fundamentally different from rest❌ Replacing sleep with caffeine isn’t effective and can have negative health impacts. Make getting enough sleep a priority🌞 Sunlight exposure is important for maintaining circadian rhythms and sleep quality. This applies even if you work as a nocturnist💡 Creating a personalized sleep system enhances quality and consistency. It gives you back control of a schedule that you may feel like is out of your hands.🧩 If you’ve tried these strategies and you’re still struggling, consider true sleep pathology (insomnia, shift work disorder, sleep apnea) and get help—this is not a “be tougher” problem.🩺 Better sleep isn’t just about feeling good; it’s directly tied to error reduction, patient safety, and longevity in EM/ICU careers. Click here for Direct Download of the Podcast. 👀Previously Covered and Related Content: REBEL Core Cast: Sleep HygieneREBEL MIND: Rest Is Not Sleep: The Seven Dimensions of True RecoveryRebellion in EM: Care For Yourself – Sleep HygieneFirst10EM: Some Evidence For Working Night ShiftsREBEL MIND: Dunning Kruger Effect 📝 Introduction Welcome to this episode of REBEL MIND, where MIND stands for Mastering Internal Negativity during Difficulty. Here we sharpen the person behind the practitioner by focusing on things that improve our performance, optimizing team dynamics and the human behavior that embodies the hidden curriculum of medicine. Today we are exploring the imperative topic of rest and why it’s not just about sleeping. The second of a two part series, hosted by Dr. Mark Ramzy with guests Dr. Maureen Aiad and Dr. Amil Badoolah, continue our discussion but this time on the multifaceted nature of sleep, how it serves as medicine and how we can use our tools deliberately to get more of it! Cognitive Question How would your clinical performance, patience with families, and long-term career sustainability change if you treated sleep as a non-negotiable clinical intervention rather than a flexible “nice-to-have”? 💤How is Sleep Different From Rest? 1. Rest reduces load; sleep repairs systemsWe previously talked about the 7 types of rest and you can check that out hereExamples of physical rest include: pausing tasks, stepping away from the monitor, taking a walk, stretching, breathing, journaling, connecting with a colleague. This lightens your cognitive/emotional burden.Sleep is fundamentally different in that it’s an active biologic process that helps:Consolidates memory and learning (yes, including the tough cases from last night).Regulates mood, impulse control, and emotional reactivity.Supports immunity, metabolic health, and cardiovascular function.Repairs tissue, replenishes neurotransmitters, and fine-tunes neural networks.You can have “rested but underslept” days (you took breaks but got 4 hours in bed), and “slept but unrested” days (you got hours, but all junk sleep). Both matter, but they are not interchangeable.2. Sleep architecture vs. “knocking out”True restorative sleep cycles through NREM and REM in predictable patterns.Alcohol, late caffeine, and fragmented nights may help you fall asleep faster but:Suppress REM.Shorten deep sleep.Increase awakenings and light sleep.The result: you technically slept, but your brain didn’t get the “software updates” it needed.Biology isn’t built for your scheduleCircadian rhythms were designed for light-day / dark-night cycles, not:10 pm–7 am ED shifts.24-hour calls.6 nights in a row followed by days.Your body can adapt partially, but not instantly and not perfectly. That’s why:You can feel “jet-lagged” even when you haven’t traveled.Sleep before and after nights feels odd and fragile.Recognizing that “this is biologically unnatural” is key: you’re not weak; you’re fighting physiology. 🏥How This Applies to the Emergency Department or ICU? Performance & safetySleep deprivation:Slows reaction time and increases error rate.Impairs risk assessment and complex decision-making.Drops your frustration tolerance with consultants, families, and staff.In both emergency medicine and critical care, that translates into:Anchoring on the wrong diagnosis.Missing subtle clinical changes.Snapping at a tech, nurse or resident and damaging team culture. Chronic health for chronic shift workLong-term sleep disruption is associated with:Hypertension, diabetes, obesity.Depression, anxiety, burnout.Arrhythmias (e.g., AFib) and increased stroke risk.Possibly increased all-cause mortality.You’re already in a high-stress, high-exposure specialty. Chronically poor sleep amplifies that risk profile and can end a career early—or make you miserable while you’re still in it.Culture of “heroics” vs. healthSkipping sleep to pick up extra shifts, late meetings, or “just one more note” is often praised.We rarely celebrate:The attending who says “no” to a 2 pm meeting post-nights.The resident who defends their blackout-curtains-and-earplugs routine. 🛏️Different Ways to Improve Your Sleep Clarify your “sleep non-negotiables”Decide how many hours you realistically need to function (e.g., 7–9 on off days, realistic blocks on nights).Treat those hours as you would a procedure time—blocked, protected, and respected.Use caffeine like a drug, not a reflexAim for ≤ 2 cups equivalent on most days.Avoid caffeine within 4–6 hours of your planned sleep time (remember: it can hang around up to 12 hours).Consider scheduling caffeine for:Early in the shift for alertness.Strategic “coffee naps” (see below), not late-night chugging.Respect alcohol’s impact on sleepRecognize that even small to moderate doses degrade sleep architecture.Avoid using alcohol as a “sleep aid”—you’ll fall asleep faster but sleep worse.If you do drink, separate it from bedtime and keep it modest.Optimize food and fluid timingHydrate consistently on shift, but taper fluids ~4 hours before bed to reduce nocturnal bathroom trips.Avoid heavy, spicy, or large meals within 2–3 hours of sleep to decrease reflux and discomfort.Plan a light, balanced “pre-sleep” snack if going to bed hungry keeps you awake.Move your body (but not right before bed)Regular exercise improves sleep depth and latency.Try to avoid intense workouts within 2 hours of bedtime.On shift: micro-movement (stairs, brisk walks between pods, quick stretch sessions) can help alertness without wrecking sleep later.Control light exposureMaximize sunlight or bright light after waking (even if that’s 3–4 pm after a night).Minimize bright light and screens before sleep:Dim lights.Use night mode/blue-light filters if you must scroll.For daytime sleep:Use blackout curtains, tinfoil, cardboard, or sleep masks.Yes seriously use tinfoil if you have to, we talk about it on the podcast episode!Aim for “I might be blind” darkness—so dark you can’t see your hand in front of your face.Dial in your sleep environmentCool room temperature (fan or AC if possible).White noise or sound machine to mask household/traffic noise.Earplugs and eye masks as needed.Bed used primarily for sleep (and sex)—not for charting, doom scrolling, or email.Strategic power napsKeep naps ≤ 20–30 minutes to avoid sleep inertia.Prefer early-afternoon or pre-night-shift naps.Coffee nap strategy:Drink a small coffee.Immediately lie down for a 20–30 min nap.Wake up as the caffeine kicks in, combining nap benefit + stimulant.Thoughtful melatonin useRemember melatonin is a hormone, not a vitamin gummy.Lower doses often work as well as (or better than) large OTC doses.Use it intentionally and intermittently, not as a crutch every night.Over-reliance may reduce your own natural production and its effectiveness over time.Build pre-sleep ritualsRepeated, calming habits signal your body it’s time to downshift:Warm shower, gentle stretching, or yoga.Guided breathing or body scan.Brief journaling or “brain dump” of tasks to get them out of your head and onto paper.Protect from pathologic patternsIf despite consistent effort you:Snore heavily, stop breathing, or gasp in sleep.Feel excessively sleepy driving home or at work.Cannot fall asleep or stay asleep for weeks to months.Consider evaluation for sleep apnea, insomnia, or shift-work sleep disorder with your physician or sleep specialist. ⏩Immediate Action Steps for Before/During/After Your Next Shift 1. **Before the Shift**: Plan a 20–90 minute nap before your first night shift (many clinicians find 3–5 hours earlier in the day is ideal).I treat ED and ICU shifts very differently. I always sleep 3-5 hours before my night shifts aiming for the full 5 (sometimes 6 or more) hours for my ED shifts because you always have to be “on”. Depending on the ICU I’m working in, I may have a bit more downtime so 3 to 5 hours is plenty.Set a caffeine plan: decide in advance when your last dose will be (e.g., none after 2–3 am if sleeping at 8–9 am).Tell your household, “This is my sleep block” and agree on a plan for kids, pets, deliveries, etc.On my calendar, I completely block off time called “Pre-call sleep” so no meetings can be scheduled and then put my phone in airplane mode2. **During the Shift** Hydrate early; taper fluids in the last 3–4 hours of your shift Eat something light but adequate; avoid “last-minute” heavy meals right before sign-out.Build in micro-breaks and movement: one or two short walks, a few stretches, even a quick stair run if safe.Get outside or near a window for a few minutes of light exposure if possible.3. **After the Shift**On the way home:Use sunglasses to reduce bright morning light if you’re aiming for sleep soon.Avoid “just checking” email or messages; shift into wind-down mode.At home:Do a brief, calming decompression (shower, light snack, 10–15 minutes of low-stimulation TV or reading).Make your room cold, quiet, and dark (blackout curtains, tinfoil/cardboard, white noise, fan).Put your phone on Do Not Disturb and physically place it away from the bed.On my calendar, I completely block off time called “Post-call sleep” so again no meetings can be scheduled and then I personally don’t just put my phone on Do Not Disturb but rather in airplane mode and WIFI OFF If you can’t sleep after ~20–30 minutes:Get out of bed, do something calming in dim light (breathing, gentle stretching, journaling).Return to bed when sleepy—this trains your brain to associate bed with sleep, not frustration. Conclusion Rest and sleep are both critical—but they’re not interchangeable. Rest helps you step out of the constant “on” of our jobs, while sleep is the biological intervention that restores your ability to show up safely and sustainably. Rest ≠ sleep. Rest reduces load; sleep repairs your brain and body. You need both, on purpose.As EM and ICU clinicians, we’re trying to perform formula-one-level medicine with engines that often only see half their maintenance. You won’t fix shift work. You can build a sleep system that respects your biology, your schedule, and your life at home.That system starts with valuing sleep, then prioritizing it, personalizing it, trusting the process when it’s imperfect, and actively protecting both your routine and your mindset. 🚨 Clinical Bottom Line Sleep is medicine. Shift work is biologically unnatural. Struggling does not mean you’re weak; it means you’re human fighting physiology. Use your tools deliberately. Caffeine, naps, light, food, movement, melatonin, and environment can be leveraged—or can quietly sabotage you. Build and defend a personalized sleep routine. Communicate it, normalize it, and protect it from casual encroachment. You can’t control every trauma, code, or admission—but you can control how seriously you take your own recovery. Your patients, your team, and your future self all benefit when you do. Further Reading Espie CA. The ‘5 principles’ of good sleep health. J Sleep Res. 2022 Jun; PMID: 34676592Solodar, J“Sleep hygiene: Simple practices for better rest.” Harvard Health, 31 January 2025 Link is HereSuni, E.“Mastering Sleep Hygiene: Your Path to Quality Sleep.” Sleep Foundation, 7 July 2025, Link is Here Meet the Authors Mark Ramzy, DO Co-Editor-in-Chief Cardiothoracic Intensivist and EM Attending RWJBH / Rutgers Health, Newark, NJ Maureen Aiad, DO Assistant Professor of Emergency Medicine NYU Grossman Long Island School of Medicine, New York Amil Badoolah, DO Assistant Professor of Emergency Medicine NYU Grossman Long Island School of Medicine, New York REBEL Core Cast 119.0 – Sleep Hygiene REBEL Core Cast 119.0 – Sleep Hygiene Click here for Direct Download of ... Read More The post REBEL MIND – How to Sleep When the World Says You Can't appeared first on REBEL EM - Emergency Medicine Blog.

New Jersey in the house. Octogenarian Calvin Schwartz shares life wisdom, the truth of marriage and support, being willing to make dramatic changes, his story from starting out his career as a pharmacist, moving into being a novelist and then running a podcast (with many other steps in between). And, throughout the show, he delivers awesome longevity nuggets.His "Just Be Practice" talks of Afib and Jesus.Connect with Calvin: Website: https://calvinschwartz.com  His Book - "There's a Tortoise in My Hair; A Journey to Spirit" on Amazon:  https://amzn.to/3tyNTBPodcast: Conversations with Calvin; WE the SpecIES (please subscribe):https://www.youtube.com/@conversationswithcalvinwethesp   LinkedIn: https://www.linkedin.com/in/calvin-schwartz-866a805 Email: calvinbarryschwartz@gmail.com*Host Eden Koz is a soul realignment specialist utilizing psychological empathy, intuition, psychic ability, mediumship, meditation, mindset shift, Reiki, dimensional and galactic healing, to name a few. She also performs spiritual Co#id Vac+ Healing as well as remote & face-to-face sessions with individuals and groups. **Additionally, in spreading the word... If you are questioning your Gold IRA because of potential scams (see EP188) or want to invest in a precious metals company with integrity...email: info@milesfranklin.com and put "Eden" in the subject line (they know me personally, so the best of attention and heart will come your way.)Miles Franklin website: https://milesfranklin.com Contact info for Eden Koz / Just Be®, LLC:Website: EdenJustBe.com Socials: TikTok, FB, FB (Just Be), X, Insta, LinkedInJust Be~Spiritual BOOM Podcast - Video Directories: BitChute, Rumble, ...

Dr. Rod Passman, Director, Center for Arrhythmia Research, Northwestern Medicine, joins John Williams to talk about how many people in the U.S. are living with atrial fibrillation, the most common symptoms of AFib, how AFib is sometimes asymptomatic, who is at most risk of Afib, the role wearables have in detecting AFib, what you can […]

Dr. Rod Passman, Director, Center for Arrhythmia Research, Northwestern Medicine, joins John Williams to talk about how many people in the U.S. are living with atrial fibrillation, the most common symptoms of AFib, how AFib is sometimes asymptomatic, who is at most risk of Afib, the role wearables have in detecting AFib, what you can […]

Dr. Rod Passman, Director, Center for Arrhythmia Research, Northwestern Medicine, joins John Williams to talk about how many people in the U.S. are living with atrial fibrillation, the most common symptoms of AFib, how AFib is sometimes asymptomatic, who is at most risk of Afib, the role wearables have in detecting AFib, what you can […]

In the final episode of our three-part Heart Health Series, Dr. Michelle Plaster and Nurse Practitioner Amber Foster are once again joined by cardiologist Dr. Sims to discuss what happens when heart concerns go beyond prevention — and into procedures, rhythm disorders, and advanced cardiac care.When medications and lifestyle changes aren't enough, what comes next?In this episode, the team breaks down:What cardiac catheterization actually involvesHow and when stents are placedThe difference between blocked arteries and electrical rhythm issuesWhat atrial fibrillation (AFib) is and why it mattersWhen a pacemaker or ablation procedure may be necessaryHow cardiologists determine the right level of interventionDr. Sims explains complex procedures in a way that's clear and reassuring, helping listeners understand that advanced cardiac care isn't something to fear, it's often life-saving and highly effective.Throughout the series, we've explored: • Part 1: Preventing heart disease • Part 2: Recognizing the signs of a heart attack • Part 3: Understanding advanced treatment and cardiac proceduresAt Our Family Health, we believe true wellness includes education, prevention, and access to expert care when it matters most. Whether you're focused on lifestyle changes or navigating a cardiac diagnosis, this series equips you with knowledge to take control of your heart health. Hosted on Acast. See acast.com/privacy for more information.

In this standout episode of Next Steps 4 Seniors: Conversations on Aging, we’re bringing back an audience favorite: our eye-opening interview with Nurse Practitioner Liz Jackson from Henry Ford Hospital. Liz breaks down the B.E.F.A.S.T. method for spotting stroke symptoms early, dives into the different types of strokes, and explains why timing is everything when it comes to treatment. We also tackle the red flags of heart attacks, the sneaky signs of vascular disease (yes, even leg cramping!), and how managing conditions like high blood pressure and diabetes can be game-changers. Early detection = lives saved. This episode is packed with info that could protect you or someone you love. Every week brings two ways to grow: Tuesdays dive into the physical next steps with real-life guidance for seniors and families, and Fridays uplift the heart with spiritual and emotional next steps—encouragement, faith, and hope for the journey ahead. To learn more about Next Steps 4 Seniors, contact us at 248-651-5010 or visit us online at www.nextsteps4seniors.com Find us on YouTube at https://www.youtube.com/@nextsteps4seniorsLearn more : https://omny.fm/shows/next-steps-4-seniors-with-wendy-jonesSee omnystudio.com/listener for privacy information.

Join us as we review and appraise recent practice-changing articles on oral semaglutide for obesity, fish oil in ESRD, IV iron during infection, the new US Dietary Guidelines, & anticoagulation after ablation in AFib. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Josh Gilman, & Matt Watto (@doctorwatto).Claim CME for this episode at curbsiders.vcuhealth.org!Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CMECredits Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Joshua Gilman, MD, & Matthew Watto MD, FACP Cover Art: Rahul Ganatra, MD MPH Reviewer: Emi Okamoto, MD Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer Oral Semaglutide for obesity Fish Oil for CV risk reduction in hemodialysis patients IV Iron for iron deficiency anemia during infection New USA Dietary Guidelines Anticoagulation after catheter ablation for AF Outro Sponsor: FIGSCheck out the limited-edition Team USA collection, and get 15 percent off your first order at Wearfigs.com with code FIGSRX. Sponsor: Continuing Education CompanyVisit CMEmeeting.org/curbsiders and use promo code Curb30 for 30% off all online courses and webcasts.  Sponsor: GustoTry Gusto today at gusto.com/CURB, and get three months free when you run your first payroll.Sponsor: MDProgress For our listeners, enjoy your first month free at mdprogress.ca/promo/curbsiders

In this episode, we explore the powerful connection between mitochondrial dysfunction and heart rhythm disorders, including AFib. Often called the “powerhouses” of the cell, mitochondria play a critical role in cardiac energy production, electrical stability, and overall heart performance. When these cellular engines falter, the effects can ripple through the cardiovascular system.We'll break down the emerging science linking mitochondrial health to arrhythmias and structural heart disease — and more importantly, discuss the foundational role of nutrition in supporting lifelong cardiovascular resilience. From essential micronutrients and metabolic balance to strategies that optimize cellular energy, this conversation bridges cutting-edge research with practical, actionable insights.Whether you're a clinician, health professional, or someone seeking a deeper understanding of heart health, this episode will expand your view of cardiovascular care — from the heartbeat to the mitochondria that power it.https://www.georgebatista.com/  http://www.myvitaminresource.com/ - Wellness Resources

What should women look out for to know if they have AFib.

This week, Dr. Kahn breaks down a new paper examining the risks and reported side effects of statins—including the surprising finding that placebo alone is linked to many of the same symptoms. He also covers an oral PCSK9 inhibitor currently under study and what it could mean for cholesterol management. The episode then dives into the latest research on emerging therapies designed to lower lipoprotein(a), including a real-world case study that highlights where this rapidly evolving field is headed.  Shorter discussions include heart disease at a young age, why so many patients fail to reach blood pressure treatment goals, aspirin use one year after AFib ablation, skeletal muscle as an endothelial stabilizer, and why exercise variety may be one of the most powerful risk reducers we have.  Thanks to WellBean for sponsoring the show. Save on their delicious bean-based products at wellbean.life with code DrKahn15.  Dr. Kahn will also be leading a free online seminar on cholesterol on February 17, 2026 at 7 PM EST with Forks Over Knives. Register HERE.

Tune in each Tuesday to learn an interesting coffee fact, tip, tidbit, or amusing story told in 60ish (some stories are just too good to pack into a minute!) seconds. For more great coffee information, visit our blog, CoffeeWithTheQueen.com. 

Kid 'N Play's Christopher 'Kid' Reid nearly waited too late for his life-saving heart transplant, and T.K. Carter's fatal combination of diabetes, AFib, and pulmonary hypertension led to systolic heart failure at age 69. Plus, RHOP's Karen Huger got real with Andy Cohen on her Bravo TV interview about her DUI sentence, mixing alcohol with prescription meds.Did you know that prostate cancer will affect 1 in 8 men? It's a stat that hits home with Sanford and Son Star Demond Wilson's recent passing. This week, we're breaking down celebrity health news and the latest trending medical headlines with real lessons for all of us. Home Alone Star, Catherine O'Hara, lived with her heart on the wrong side for decades - these aren't just headlines - they're wake-up calls about symptoms you might be brushing off right now. Tune in for evidence-based medicine that could literally save your life. ❤️#HealthHappyLifePodcast #DrFrita #DrFritaLIVE! #CelebrityHealthNewsHere are a few helpful resources to help on your journey to wellness:▶️ Subscribe so you will never miss a YouTube video.

Welcome to another informative episode of the Legal Nurse Podcast, hosted by Pat Iyer. In this episode, Pat Iyer speaks with Kelley Curseaden, an experienced critical care nurse with extensive knowledge of cardiac device management. Their discussion focuses on atrial fibrillation (AFIB), how it affects the heart, and the medical technologies developed to manage this condition. They explain what happens when arrhythmias are left untreated and review current medical and procedural options, including medications, ablation procedures, and cardiac devices such as pacemakers and implantable cardioverter-defibrillators (ICDs). Drawing on her clinical background, Kelley Curseaden shares practical observations about changes in heart care technology, the role of remote monitoring, and legal matters related to device oversight. She explains how wearable tools and implanted devices support early detection of serious cardiac issues while also outlining the operational difficulties and legal risks that can arise when managing and responding to device-generated data. This episode offers meaningful insights for legal nurse consultants, attorneys, and anyone interested in how healthcare, medical technology, and legal accountability intersect. Listeners will gain a clearer understanding of cardiac device oversight, patient monitoring responsibilities, and how medical teams and legal professionals can better address complications linked to these technologies. What You'll Learn in This Episode on How Cardiac Devices Save Lives and When They Lead to Legal Cases - Kelley Curseaden Here are 5 discussion questions answered in the podcast: The episode highlights the importance of monitoring blood clots in AFIB patients. How does the risk of stroke from AFIB influence decisions about medication management? Kelley Curseaden explained several treatment options for AFIB, including medications, cardioversion, ablation, and implanted devices. How do healthcare providers determine which treatment path is best for individual patients? With today's technology, wearable devices and at-home monitors are capable of detecting arrhythmias like AFIB. What are the benefits and potential challenges of having patients send this data to clinicians, as discussed by Pat Iyer and Kelley Curseaden? Kelley Curseaden discussed remote monitoring for pacemakers and ICDs. What are the advantages and logistical hurdles associated with remote cardiac device monitoring? In the context of legal nurse consulting, what liabilities can arise from failures in device monitoring or timely response to alerts generated by implanted cardiac devices? Listen to our podcasts or watch them using our app, Expert.edu, available at legalnursebusiness.com/expertedu. Get the free transcripts and also learn about other ways to subscribe. Go to Legal Nurse Podcasts subscribe options by using this short link: http://LNC.tips/subscribepodcast. Grow Your LNC Business 13th LNC SUCCESS® ONLINE CONFERENCE April 23, 24, and 25, 2026 Skills, Strategy, Results Gain deposition mastery, marketing confidence, and clinical–legal insight from industry leaders you can apply to your next case and client call. Build a Practice Attorneys Remember Learn exactly how to showcase expertise, attract referrals, and turn complex medical records into clear, defensible stories that win trust. Learn From the Best—Then Ask Them Anything Get step-by-step training, live “hot seat” solutions, and exclusive VIP Q&A time with Pat Iyer to accelerate your LNC growth. Register now- Limited spots available https://youtu.be/gQzP8_-Q364 Your Presenters for How Cardiac Devices Save Lives and When They Lead to Legal Cases - Kelley Curseaden Pat Iyer Pat Iyer is a seasoned legal nurse consultant and business coach, renowned for her expertise in guiding new legal nurse consultants to successfully break into the field. As the host of the Legal Nurse Podcast, Pat addresses critical challenges that legal nurse consultants face, such as difficulty in landing clients and a lack of response from attorneys. Through her insightful episodes, she emphasizes the importance of effectively communicating one's value to potential clients. With a wealth of experience, Pat has empowered countless consultants to overcome these hurdles and thrive in their careers. Connect with Pat Iyer by email at patiyer@legalnusebusiness.com Kelley Curseaden Nurse, Explorer, Dog-lover. With over 25 years of nursing experience, including critical care, cardiac device management, and procedural sedation, she brings a deep understanding of patient care and system breakdowns to the legal field. Her background in high-acuity settings has sharpened her ability to interpret remote monitoring data, identify risks, and respond quickly to prevent harm. Today, she applies those same skills to help attorneys make sense of complex medical records through clear chronologies, focused merit reviews, and evidence-based insights. When she is not on this podcast, she is exploring the desert, traveling with her husband and dog, Ziggy, and reviewing files for merit review and creating road maps for legal strategy. Connect with Kelley Curseaden by email at kelley@sapphirelegalnurse.com

Today’s episode of Ask the Doctor was hosted by Dr. Michael Lange and Dr. Susan Summerton. Ask the Doctor is the longest-running live, syndicated medical talk show in the United States, broadcasting coast-to-coast for over 33 years. We opened the show discussing the massive global whey protein shortage. Whey protein is extremely difficult to obtain worldwide due to increased demand from patients using GLP-1 receptor drugs, who are being advised to consume higher protein intake to prevent muscle loss. In addition, major corporations such as Starbucks and Dunkin’ have purchased large quantities of whey protein for functional and sports drinks. Because of this shortage, Fortifeye Fit Pro is currently on backorder, though other Fortifeye whey protein products remain available, and we are actively working to secure supply. We then discussed black currant seed oil and GLA (gamma-linolenic acid) and why GLA may be a missing fatty acid in the modern diet. Fortifeye now offers Black Currant Seed Oil + GLA in a 90-count bottle. GLA helps support dry eye by stimulating Series-1 prostaglandins, which play an important role in controlling inflammation. Dr. Lange reviewed his clinical experience using Fortifeye Advanced Dry Eye Therapy, which combines: • Fortifeye Super Omega (RTG-form omega-3) • Fortifeye Focus • Fortifeye Black Currant Seed Oil + GLA This three-supplement combination has been very effective in helping reduce dry eye symptoms and improve overall ocular comfort. We also discussed the end of the BOGO on Fortifeye Vegan Super Protein. While the BOGO promotion has ended, this remains one of the top vegan proteins on the market, offering an amino acid profile comparable to whey protein, outstanding taste, and three delicious flavors. In addition, we covered exciting new research on carotenoids including lutein, zeaxanthin, and astaxanthin. These nutrients may help lower triglycerides and cholesterol, support brain health and mood, and may even help with depression. These carotenoids are beneficial for children and adults, supporting not only eye health but systemic and cognitive health as well. All three carotenoids are found together in Fortifeye Focus. We explained what photobiomodulation therapy (PBM) is and how it works. PBM uses specific wavelengths of low-level red and near-infrared light to stimulate mitochondrial function, increase cellular energy (ATP), improve circulation, and reduce inflammation. As more companies bring this technology to market, increased competition is expected to drive costs down, making this promising therapy more accessible to patients. Dr. Lange and Dr. Summerton shared their enthusiasm for photobiomodulation therapy as a supportive treatment option for macular degeneration, diabetic retinopathy, and dry eye disease. Dr. Kane has noted that when diet and supplementation are optimized, this technology may work even more effectively, reinforcing the importance of combining advanced technology with proper nutrition. Dr. Summerton also weighed in on chelation therapy, explaining how reducing toxic metal burden and oxidative stress may further support cellular health, circulation, and inflammation control. When used appropriately and combined with nutrition and lifestyle optimization, chelation therapy may enhance overall systemic and ocular health. An important discussion followed on the often-overlooked connection between dry eye disease and atrial fibrillation (AFib). Dr. Lange explained that many patients with both conditions commonly share deficiencies in: • Magnesium • Potassium • Sodium chloride • Omega-3 fatty acids • Hydration These deficiencies may contribute to inflammation, nerve dysfunction, poor tear quality, impaired circulation, and cardiac rhythm instability.

(For Entertainment Purposes only, always seek a qualified professional.) Support: PositiveSarcasm.com/Donate Segment 1: I'd like a Third Reichachino, Heil Barista. Segment 2: A plausible health situation I feel I need to discuss. FREE STOCKS, IRA, CASH MANAGEMENT: https://a.webull.com/S4xAPPzv9rXFMdF8Q4 Sign up via my referral link now! https://j.moomoo.com/00EoSC Trade Stocks and Crypto Reward when you sign up: https://etoro.tw/47OmXMl PositiveSarcasm.com - 2014 Therapy for yourself, for couples, for teens: https://www.betterhelp.com/

A study shows how effective the Apple Watch is at detecting AFib in adults over 65, and Tesla now has at least a couple of unsupervised autonomous robotaxis giving rides in Austin.Starring Jason Howell and Sarah Lane.Show notes can be found here. Hosted on Acast. See acast.com/privacy for more information.

In this episode of Better Edge, Baljash S. Cheema, MD, assistant professor of Cardiology at Northwestern Medicine, explores the integration of FDA-approved digital health technologies in cardiovascular care, focusing on a photoplethysmography-based algorithm for remote AFib detection and monitoring. Dr. Cheema discusses the clinical validation of this smartphone-enabled tool and its advantages over traditional wearables. He also highlights its implications for patient empowerment, stroke prevention and the evolving landscape of AI-driven diagnostics.

TALK TO ME, TEXT ITA routine surgery that spiraled into emergency reentry. A viral exchange where a doctor stumbled over a basic question. An ICE arrest that exposes years of enforcement gaps. A Disney stunt gone sideways and a veteran cast member who shielded a crowd from a 400‑pound runaway prop. Then, to end on a laugh, a baggage carousel spitting out socks and underwear before the suitcase finally limps into view.We pull the thread through all of it: when institutions wobble, people look for clear language, steady systems, and ordinary courage. The health update reminds us how non-linear recovery can be—ICU complications, AFib, and the long road back from anemia demand patience and honest timelines. The Capitol Hill clip sparks a frank talk about medical clarity: compassion and precision are not enemies, and patients deserve words they can trust. The immigration case highlights the difference between lawful entry and later violent convictions, and why transparency in removal timelines is key for public safety and confidence.On the ground, a 30‑year Disney cast member models duty in real time, stepping between danger and families. We unpack how safety culture, redundancy, and on‑stage authority prevent small failures from becoming tragedies. We also wrestle with parental risk at public events—when does protection turn into exposure—and give credit to early advocates who helped shape the debate over women's sports. Finally, that luggage fiasco is ridiculous and revealing: small process failures become viral when reliability slips, so we offer practical travel safeguards to keep your gear off the “carousel of shame.”Listen, share your take, and tell us your worst travel story. If this resonated, follow the show, leave a quick review, and send the episode to a friend who loves sharp takes and stranger‑than‑fiction moments. Your stories and shares help us keep the conversation honest and lively.Buzzsprout - Let's get your podcast launched!Start for FREE Thanks for listening! Liberty Line each week on Sunday, look for topics on my X file @americanistblog and submit your 1-3 audio opinions to anamericanistblog@gmail.com and you'll be featured on the podcast. Buzzsprout - Let's get your podcast launched!Start for FREESupport the showTip Jar for coffee $ - Thanks Music by Alehandro Vodnik from Pixabay Blog - AnAmericanist.comX - @americanistblog

Dr. Kanwar Singh, electrophysiologist at Cardiovascular Institute of the South in Houma and Thibodaux, Louisiana, explains atrial fibrillation (AFib), including its causes, symptoms, risk factors, and treatment options such as AFib ablation.Visit www.cardio.com for more information or to schedule an appointment with one of our providers.

Send us a textDr. Michael Koren joins Kevin Geddings to discuss atrial fibrillation. This heart condition is caused by rapid, irregular heartbeats originating in the upper chambers and is a critical risk factor for strokes. Dr. Koren talks about the current standard-of-care medicines for atrial fibrillation, blood thinners, and  their shortcomings. He finishes with an explanation of how clinical trials are looking for new ways to lower the risk of stroke in those with atrial fibrillation with a better side effect profile than current blood thinners.Be a part of advancing science by participating in clinical research.Have a question for Dr. Koren? Email him at askDrKoren@MedEvidence.comListen on SpotifyListen on Apple PodcastsWatch on YouTubeShare with a friend. Rate, Review, and Subscribe to the MedEvidence! podcast to be notified when new episodes are released.Follow us on Social Media:FacebookInstagramX (Formerly Twitter)LinkedInWant to learn more? Checkout our entire library of podcasts, videos, articles and presentations at www.MedEvidence.comMusic: Storyblocks - Corporate InspiredThank you for listening!

Doug Reynolds welcomes listeners back to the LowCarbUSA® Podcast with a guest who works in one of the most specialized—and most misunderstood—corners of cardiovascular medicine: the heart's electrical system.  Dr. David Nabert is an electrophysiologist ("EP" doctor), focused on heart rhythm disorders, and he's one of the featured speakers at the Boca Symposium for Metabolic Health (January 23–25)—including the event's full day-plus dedicated to cardiovascular conditions. What gives this episode its pull is the combination of clinical depth and lived experience. David isn't just talking about rhythm problems from a textbook perspective—he's explaining how his own curiosity about metabolic health evolved, what shifted when he started questioning conventional assumptions, and why those questions matter for real patients in the real world. David describes how his entry point into metabolic health didn't begin in a clinic—it began with a random Google search. In 2021, while looking up a cardiology formula, he accidentally landed on a Nina Teicholz talk at the Cato Institute. "I started to watch it, and all of a sudden, an hour and a half passed," he says—one of those moments where interest turns into momentum. He listened to Teicholz's book, The Big Fat Surprise, then began searching for more voices in the low-carb space and quickly reconnected with familiar names, including Dr. Robert Cywes and Dr. Eric Westman (both will also be presenting in Boca), whom he calls mentors. That exploration ultimately led him to the Society of Metabolic Health Practitioners (The SMHP) and, importantly, a willingness to test ideas on himself. David is candid about his own weight journey. He describes a time when a body mass index under 25 felt "skinny" to him, and he's open about losing weight, regaining some after a series of hip surgeries, and continuing to work on it. What ultimately shifted, though, wasn't just the number on the scale—it was how he began to rethink what "doing everything right" actually means. For years, he approached weight loss the way many clinicians were trained to: low-fat, high willpower, endure the hunger. He describes his old strategy bluntly: "The only way I had lost weight… was by doing protein sparing modified fast… I was just eating almost no fat." Predictably, it wasn't sustainable. When he later shifted to a lower-carb, higher-fat approach—"bacon, eggs, hamburger"—he was "amazed at how quickly I started to lose weight," and he began seeing changes in markers that traditional cardiology often de-emphasizes. After stopping long-term statin therapy (which he had been on for 25 years), he saw his LDL return to roughly where it had been earlier in life, but other changes caught his attention: triglycerides dropped to the lowest he'd ever seen, HDL improved, and fasting insulin improved as well. Just as meaningful were the changes he felt: "Every 10 or 20 pounds I lost, my hips got better," he says, attributing it not only to less load, but "also part of it was less inflammation." From there, the episode moves into the heart of why David is speaking during the cardiovascular-focused programming in Boca: rhythm, electricity, and the surprising overlap between conditions that seem unrelated—like seizures and arrhythmias. David explains that early ketogenic diet research in the 1920s focused on refractory seizures, and he argues the connection matters because many antiarrhythmic drugs and antiseizure drugs overlap mechanistically. In his view, these aren't separate worlds. "Treating seizures or treating cardiac arrhythmias is basically two faces of the same coin," he says—and that opens a practical question: if ketosis can help reduce seizures, might it also influence certain rhythm symptoms? He shares a striking clinical example that stuck with him: a former submariner with PTSD and episodes of fast heart rates who said, "I know when I'm… ketogenic… when I fall off the wagon… then I start having palpitations and fast heart rates." David later learned the patient was experiencing atrial fibrillation, and while he's careful not to overpromise, he describes a pattern he's observed: in earlier stages of rhythm problems, being in a ketogenic state may reduce symptoms and potentially slow progression for some people. "It doesn't cure atrial fibrillation," he emphasizes, but he's seen ketosis "improves symptoms," not only in AFib, but in other rhythm issues like SVT and PVCs—especially early on. From there, David widens the frame to what he's seeing in younger patients—particularly young women—showing up with palpitations, rapid heart rate, anxiety, and signs of metabolic dysfunction even when they don't "look" unhealthy by BMI alone. "Only 90% of them are metabolically unhealthy," he says, describing a familiar cluster: A1C not quite normal, resting heart rates high, daytime heart rates that shouldn't be running 100–120, and a nervous system dialed up in what he calls a "hyper adrenergic state." The mainstream response is often medication—beta blockers, for example—but David argues metabolic context matters, and he's exploring how nutritional strategies (including ketosis, sometimes even supplemental ketones) may reduce symptom burden in certain cases. He also discusses POTS (Postural Orthostatic Tachycardia Syndrome), noting it can be associated with viral infections and has become more common since "the bad virus we had five years ago." Again, he's measured in his claims: ketosis isn't a cure, but he's seen it help reduce symptoms in select patients who have tried many other standard approaches first. The second half of the conversation touches on medications and the tension between "lower the number" cardiology and whole-person outcomes. David brings up PCSK9 inhibitors and recalls being troubled by early data patterns: "You were less likely to die from that, but you're more likely to die from cancer or infection… And… the overall mortality was the same." That line of thinking captures what pushed him toward metabolic health: a concern that focusing on a single marker can obscure the bigger picture of risk, resilience, and long-term outcomes. He also discusses SGLT2 inhibitors (like Jardiance and Farxiga) as potentially useful tools—especially in heart failure and diabetes—while stressing the importance of monitoring and hydration. In a moment that captures both his clinical caution and his enthusiasm for empowered patients, he tells people who go low carb on these meds to "get a Keto Mojo to check your ketone levels," because the goal is to use tools intelligently, not blindly. As the episode closes, Doug returns to the bigger mission behind the upcoming Boca program: helping attendees develop a confident, educated response to the most common fear tactic people face when they change their diet—LDL, heart attacks, and the assumption that low carb automatically means danger. Doug notes there are still "so few that really do get it and support it and talk about it," which is exactly why the cardiovascular-focused day-plus at the Boca Symposium for Metabolic Health (January 23–25) matters. David, for his part, is grateful to be part of it—and to be healthy enough to show up differently than last time. He reminds Doug that at previous events he was "either walking with one or two canes," but now, "I'm actually not going to run up on the stage, but I'll be moving pretty quickly." That moment captures the heart of the episode: metabolic health isn't theoretical. It's lived. And in Boca, that lived experience meets serious clinical discussion—especially for anyone trying to better understand cardiovascular risk, rhythm disorders, and the metabolic foundations that too often go unaddressed. If this conversation sparks your curiosity, the next step is obvious: join the community in Boca January 23–25 and immerse yourself in a day and a half of cardiovascular-focused talks designed to help you think more clearly, speak more confidently, and act more effectively—whether you're a clinician, a patient, or someone trying to help the people you love. Learn more about the Boca Symposium and register here.

To have Dr. Morse answer a question, visit: https://drmorses.tv/ask/   00:00:00 - Intro - New Teas! 00:15:48 - Weight - Hormones  00:32:34 - Diverticulitis 00:40:55 - Hyperthyroidism 00:47:50 - Bladder Cancer 00:54:58 - Lungs - Mucous - Breathlessness 01:13:43 - Myasthenia Gravis (MG) - Psoriasis - Afib (Atrial Fibrillation) 00:15:48 - Weight - Hormones  Is the extra weight holding back the flow of things? 00:32:34 - Diverticulitis I was told to have colorectal surgery to remove my entire large colon due to the bleeding. 00:40:55 - Hyperthyroidism The day after a vaccine, I started shedding my hair. 00:47:50 - Bladder Cancer Please tell me how I can rid my bladder of the chemo and restore the cells? 00:54:58 - Lungs - Mucous - Breathlessness Could you please talk about fasting one's way into a breatharian lifestyle? 01:13:43 - Myasthenia Gravis (MG) - Psoriasis - Afib (Atrial Fibrillation) I'm a MD from Mexico, living for a long time in the United States.

Nutritionist Leyla Muedin discusses the crucial importance of Omega-3 fats, particularly emphasizing their role in mental and heart health. She highlights a recent UK Biobank study demonstrating that higher Omega-3 levels are linked to a significantly lower risk of self-harm and suicidal ideation. Additionally, another study in the Journal of the American Heart Association reveals that elevated Omega-3 levels correlate with a reduced risk of atrial fibrillation (AFib). Leyla underscores the necessity of a balanced diet rich in Omega-3 sources like fatty fish and grass-fed meats, arguing that these nutrients are crucial for optimal mental and heart health.

Think you know the Health app? Think again. This episode unpacks Apple's quiet rollout of powerful and important features, from crash detection to real-time medication reminders, that are quietly transforming the way you can track your wellbeing. • Dive into emergency SOS, medical ID, and safety alerts • Apple Watch-exclusive notifications: heart rate, crash, fall, and walking steadiness • Hypertension and blood pressure notifications arrive for Apple Watch users • Cardio fitness, ECG, and irregular rhythm alerts explained • Court drama and a workaround for Apple's blood oxygen feature • Monitoring vitals, hearing safety, and sleep apnea detection • AFib history versus irregular rhythm notifications • Health data trends and fresh health records notifications • Sleep tracking, wind down routines, and schedule-based alerts • Medication reminders with smart time zone adjustments • Mental wellbeing tracking with state-of-mind check-ins and depression/anxiety quizzes • Walking steadiness notifications and quick access to the checklist Host: Mikah Sargent Download or subscribe to Hands-On Apple at https://twit.tv/shows/hands-on-apple Want access to the ad-free audio and video and exclusive features? Become a member of Club TWiT today! https://twit.tv/clubtwit Club TWiT members can discuss this episode and leave feedback in the Club TWiT Discord.

Think you know the Health app? Think again. This episode unpacks Apple's quiet rollout of powerful and important features, from crash detection to real-time medication reminders, that are quietly transforming the way you can track your wellbeing. Dive into emergency SOS, medical ID, and safety alerts Apple Watch-exclusive notifications: heart rate, crash, fall, and walking steadiness Hypertension and blood pressure notifications arrive for Apple Watch users Cardio fitness, ECG, and irregular rhythm alerts explained Court drama and a workaround for Apple's blood oxygen feature Monitoring vitals, hearing safety, and sleep apnea detection AFib history versus irregular rhythm notifications Health data trends and fresh health records notifications Sleep tracking, wind down routines, and schedule-based alerts Medication reminders with smart time zone adjustments Mental wellbeing tracking with state-of-mind check-ins and depression/anxiety quizzes Walking steadiness notifications and quick access to the checklist Host: Mikah Sargent Download or subscribe to Hands-On Apple at https://twit.tv/shows/hands-on-apple Want access to the ad-free audio and video and exclusive features? Become a member of Club TWiT today! https://twit.tv/clubtwit Club TWiT members can discuss this episode and leave feedback in the Club TWiT Discord.

Think you know the Health app? Think again. This episode unpacks Apple's quiet rollout of powerful and important features, from crash detection to real-time medication reminders, that are quietly transforming the way you can track your wellbeing. Dive into emergency SOS, medical ID, and safety alerts Apple Watch-exclusive notifications: heart rate, crash, fall, and walking steadiness Hypertension and blood pressure notifications arrive for Apple Watch users Cardio fitness, ECG, and irregular rhythm alerts explained Court drama and a workaround for Apple's blood oxygen feature Monitoring vitals, hearing safety, and sleep apnea detection AFib history versus irregular rhythm notifications Health data trends and fresh health records notifications Sleep tracking, wind down routines, and schedule-based alerts Medication reminders with smart time zone adjustments Mental wellbeing tracking with state-of-mind check-ins and depression/anxiety quizzes Walking steadiness notifications and quick access to the checklist Host: Mikah Sargent Download or subscribe to Hands-On Apple at https://twit.tv/shows/hands-on-apple Want access to the ad-free audio and video and exclusive features? Become a member of Club TWiT today! https://twit.tv/clubtwit Club TWiT members can discuss this episode and leave feedback in the Club TWiT Discord.

Think you know the Health app? Think again. This episode unpacks Apple's quiet rollout of powerful and important features, from crash detection to real-time medication reminders, that are quietly transforming the way you can track your wellbeing. Dive into emergency SOS, medical ID, and safety alerts Apple Watch-exclusive notifications: heart rate, crash, fall, and walking steadiness Hypertension and blood pressure notifications arrive for Apple Watch users Cardio fitness, ECG, and irregular rhythm alerts explained Court drama and a workaround for Apple's blood oxygen feature Monitoring vitals, hearing safety, and sleep apnea detection AFib history versus irregular rhythm notifications Health data trends and fresh health records notifications Sleep tracking, wind down routines, and schedule-based alerts Medication reminders with smart time zone adjustments Mental wellbeing tracking with state-of-mind check-ins and depression/anxiety quizzes Walking steadiness notifications and quick access to the checklist Host: Mikah Sargent Download or subscribe to Hands-On Apple at https://twit.tv/shows/hands-on-apple Want access to the ad-free audio and video and exclusive features? Become a member of Club TWiT today! https://twit.tv/clubtwit Club TWiT members can discuss this episode and leave feedback in the Club TWiT Discord.

Think you know the Health app? Think again. This episode unpacks Apple's quiet rollout of powerful and important features, from crash detection to real-time medication reminders, that are quietly transforming the way you can track your wellbeing. Dive into emergency SOS, medical ID, and safety alerts Apple Watch-exclusive notifications: heart rate, crash, fall, and walking steadiness Hypertension and blood pressure notifications arrive for Apple Watch users Cardio fitness, ECG, and irregular rhythm alerts explained Court drama and a workaround for Apple's blood oxygen feature Monitoring vitals, hearing safety, and sleep apnea detection AFib history versus irregular rhythm notifications Health data trends and fresh health records notifications Sleep tracking, wind down routines, and schedule-based alerts Medication reminders with smart time zone adjustments Mental wellbeing tracking with state-of-mind check-ins and depression/anxiety quizzes Walking steadiness notifications and quick access to the checklist Host: Mikah Sargent Download or subscribe to Hands-On Apple at https://twit.tv/shows/hands-on-apple Want access to the ad-free audio and video and exclusive features? Become a member of Club TWiT today! https://twit.tv/clubtwit Club TWiT members can discuss this episode and leave feedback in the Club TWiT Discord.

What if the toughest moments in your life were preparing you to lead better, serve deeper, and live with more purpose? In this episode of Unstoppable Mindset, I sit down with Greg Hess, known to many as Coach Hess, for a wide-ranging conversation about leadership, resilience, trust, and what it really means to help others grow. Greg shares lessons shaped by a lifetime of coaching athletes, leading business teams, surviving pancreatic cancer, and building companies rooted in service and inclusion. We talk about why humor matters, how trust is built in real life, and why great leaders stop focusing on control and start focusing on growth. Along the way, Greg reflects on teamwork, diversity, vision, and the mindset shifts that turn adversity into opportunity. I believe you will find this conversation practical, honest, and deeply encouraging. Highlights: 00:10 – Hear how Greg Hess's early life and love of sports shaped his leadership values. 04:04 – Learn why humor and laughter are essential tools for reducing stress and building connection. 11:59 – Discover how chasing the right learning curve redirected Greg's career path. 18:27 – Understand how a pancreatic cancer diagnosis reshaped Greg's purpose and priorities. 31:32 – Hear how reframing adversity builds lasting resilience. 56:22 – Learn the mindset shift leaders need to grow people and strengthen teams. About the Guest: Amazon Best-Selling Author | Award-Winning Business Coach | Voted Best Coach in Katy, TX Greg Hess—widely known as Coach Hess—is a celebrated mentor, author, and leader whose journey from athletic excellence to business mastery spans decades and continents. A graduate of the University of Calgary (1978), he captained the basketball team, earned All-Conference honors, and later competed against legends like John Stockton and Dennis Rodman. His coaching career began in the high school ranks and evolved to the collegiate level, where he led programs with distinction and managed high-profile events like Magic Johnson's basketball camps. During this time, he also earned his MBA from California Lutheran University in just 18 months. Transitioning from sports to business in the early '90s, Coach Hess embarked on a solo bicycle tour from Jasper, Alberta to Thousand Oaks, California—symbolizing a personal and professional reinvention. He went on to lead teams and divisions across multiple industries, ultimately becoming Chief Advisor for Cloud Services at Halliburton. Despite his corporate success, he was always “Coach” at heart—known for inspiring teams, shaping strategy, and unlocking human potential. In 2015, a diagnosis of pancreatic cancer became a pivotal moment. Surviving and recovering from the disease renewed his commitment to purpose. He left the corporate world to build the Coach Hess brand—dedicated to transforming lives through coaching. Today, Coach Hess is recognized as a Best Coach in Katy, TX and an Amazon Best-Selling Author, known for helping entrepreneurs, professionals, and teams achieve breakthrough results. Coach Hess is the author of: Peak Experiences Breaking the Business Code Achieving Peak Performance: The Entrepreneur's Journey He resides in Houston, Texas with his wife Karen and continues to empower clients across the globe through one-on-one coaching, strategic planning workshops, and his Empower Your Team program. Ways to connect with Greg**:** Email:  coach@coachhess.comWebsite: www.CoachHess.com LinkedIn: https://www.linkedin.com/in/coachhess Facebook: https://www.facebook.com/CoachHessSuccess Instagram: https://www.instagram.com/coachhess_official/ About the Host: Michael Hingson is a New York Times best-selling author, international lecturer, and Chief Vision Officer for accessiBe. Michael, blind since birth, survived the 9/11 attacks with the help of his guide dog Roselle. This story is the subject of his best-selling book, Thunder Dog. Michael gives over 100 presentations around the world each year speaking to influential groups such as Exxon Mobile, AT&T, Federal Express, Scripps College, Rutgers University, Children's Hospital, and the American Red Cross just to name a few. He is Ambassador for the National Braille Literacy Campaign for the National Federation of the Blind and also serves as Ambassador for the American Humane Association's 2012 Hero Dog Awards. https://michaelhingson.com https://www.facebook.com/michael.hingson.author.speaker/ https://twitter.com/mhingson https://www.youtube.com/user/mhingson https://www.linkedin.com/in/michaelhingson/ accessiBe Links https://accessibe.com/ https://www.youtube.com/c/accessiBe https://www.linkedin.com/company/accessibe/mycompany/ https://www.facebook.com/accessibe/ Thanks for listening! Thanks so much for listening to our podcast! If you enjoyed this episode and think that others could benefit from listening, please share it using the social media buttons on this page. Do you have some feedback or questions about this episode? Leave a comment in the section below! Subscribe to the podcast If you would like to get automatic updates of new podcast episodes, you can subscribe to the podcast on Apple Podcasts or Stitcher. You can subscribe in your favorite podcast app. You can also support our podcast through our tip jar https://tips.pinecast.com/jar/unstoppable-mindset . Leave us an Apple Podcasts review Ratings and reviews from our listeners are extremely valuable to us and greatly appreciated. They help our podcast rank higher on Apple Podcasts, which exposes our show to more awesome listeners like you. If you have a minute, please leave an honest review on Apple Podcasts. Transcription Notes: Michael Hingson  00:00 Access Cast and accessiBe Initiative presents Unstoppable Mindset. The podcast where inclusion, diversity and the unexpected meet. Hi, I'm Michael Hingson, Chief Vision Officer for accessiBe and the author of the number one New York Times bestselling book, Thunder dog, the story of a blind man, his guide dog and the triumph of trust. Thanks for joining me on my podcast as we explore our own blinding fears of inclusion unacceptance and our resistance to change. We will discover the idea that no matter the situation, or the people we encounter, our own fears, and prejudices often are our strongest barriers to moving forward. The unstoppable mindset podcast is sponsored by accessiBe, that's a c c e s s i capital B e. Visit www.accessibe.com to learn how you can make your website accessible for persons with disabilities. And to help make the internet fully inclusive by the year 2025. Glad you dropped by we're happy to meet you and to have you here with us. Michael Hingson  01:21 Well, hi everyone. I am Michael Hinkson. Your host for unstoppable mindset. And today we get to enter, well, I won't say interview, because it's really more of a conversation. We get to have a conversation with Greg. Hess better known as coach Hess and we'll have to learn more about that, but he has accomplished a lot in the world over the past 70 or so years. He's a best selling author. He's a business coach. He's done a number of things. He's managed magic Johnson's basketball camps, and, my gosh, I don't know what all, but he does, and he's going to tell us. So Coach, welcome to unstoppable mindset. We're really glad that we have a chance to be with you today. Greg Hess  02:07 I'm honored to be here. Michael, thank you very much, and it's just a pleasure to be a part of your program and the unstoppable mindset. Thank you for having me. Michael Hingson  02:17 Well, we're glad you're here and looking forward to having a lot of fun. Why don't we start? I love to start with tell us about kind of the early Greg growing up and all that stuff. Greg Hess  02:30 Oh boy, yeah, I was awfully fortunate, I think, to have a couple of parents that were paying attention to me, I guess. You know, as I grew up, at the same time they were growing up my my father was a Marine returned from the Korean War, and I was born shortly after that, and he worked for Westinghouse Electric as a nuclear engineer. We lived in Southern California for a while, but I was pretty much raised in Idaho, small town called Pocatello, Idaho, and Idaho State Universities there and I, I found a love for sports. I was, you know, again, I was very fortunate to be able to be kind of coordinated and do well with baseball, football, basketball, of course, with the sports that we tend to do. But yeah, I had a lot of fun doing that and growing up, you know, under a, you know, the son of a Marine is kind of like being the son of a Marine. I guess, in a way, there was certain ways you had to function and, you know, and morals and values that you carried forward and pride and doing good work that I learned through, through my youth. And so, you know, right, being raised in Idaho was a real great experience. How so well, a very open space. I mean, in those days, you know, we see kids today and kids being brought up. I think one of the things that often is missing, that was not missing for me as a youth, is that we would get together as a group in the neighborhood, and we'd figure out the rules of the game. We'd figure out whatever we were playing, whether it was basketball or, you know, kick the can or you name it, but we would organize ourselves and have a great time doing that as a community in our neighborhood, and as kids, we learn to be leaders and kind of organize ourselves. Today, that is not the case. And so I think so many kids are built into, you know, the parents are helicopter, and all the kids to all the events and non stop going, going, going. And I think we're losing that leadership potential of just organizing and planning a little bit which I was fortunate to have that experience, and I think it had a big influence on how I grew up and built built into the leader that I believe I am today. Michael Hingson  04:52 I had a conversation with someone earlier today on another podcast episode, and one of the observations. Sense that he made is that we don't laugh at ourselves today. We don't have humor today. Everything is taken so seriously we don't laugh, and the result of that is that we become very stressed out. Greg Hess  05:15 Yeah, well, if you can't laugh at yourself, you know, but as far as I know, you've got a large background in your sales world and so on. But I found that in working with people, to to get them to be clients or to be a part of my world, is that if they can laugh with me, or I can laugh with them, or we can get them laughing, there's a high tendency of conversion and them wanting to work with you. There's just something about relationships and be able to laugh with people. I think that draw us closer in a different way, and I agree it's missing. How do we make that happen more often? Tell more jokes or what? Michael Hingson  05:51 Well, one of the things that he suggests, and he's a coach, a business coach, also he he tells people, turn off the TV, unplug your phone, go read a book. And he said, especially, go buy a joke book. Just find some ways to make yourself laugh. And he spends a lot of time talking to people about humor and laughter. And the whole idea is to deal with getting rid of stress, and if you can laugh, you're going to be a whole lot less stressful. Greg Hess  06:23 There's something that you just feel so good after a good laugh, you know, I mean, guy, I feel that way sometimes after a good cry. You know, when I'm I tend to, you know, like Bambi comes on, and I know what happens to that little fawn, or whatever, the mother and I can't, you know, but cry during the credits. What's up with that? Michael Hingson  06:45 Well, and my wife was a teacher. My late wife was a teacher for 10 years, and she read Old Yeller. And eventually it got to the point where she had to have somebody else read the part of the book where, where yeller gets killed. Oh, yeah. Remember that book? Well, I do too. I like it was a great it's a great book and a great movie. Well, you know, talk about humor, and I think it's really important that we laugh at ourselves, too. And you mentioned Westinghouse, I have a Westinghouse story, so I'll tell it. I sold a lot of products to Westinghouse, and one day I was getting ready to travel back there, the first time I went back to meet the folks in Pittsburgh, and I had also received an order, and they said this order has to be here. It's got to get it's urgent, so we did all the right things. And I even went out to the loading dock the day before I left for Westinghouse, because that was the day it was supposed to ship. And I even touched the boxes, and the shipping guy said, these are them. They're labeled. They're ready to go. So I left the next morning, went to Westinghouse, and the following day, I met the people who I had worked with over the years, and I had even told them I saw the I saw the pack, the packages on the dock, and when they didn't come in, and I was on an airplane, so I didn't Know this. They called and they spoke to somebody else at at the company, and they said the boxes aren't here, and they're supposed to be here, and and she's in, the lady said, I'll check on it. And they said, Well, Mike said he saw him on the dock, and she burst out laughing because she knew. And they said, What are you laughing at? And he said, he saw him on the dock. You know, he's blind, don't you? And so when I got there, when I got there, they had and it wasn't fun, but, well, not totally, because what happened was that the President decided to intercept the boxes and send it to somebody else who he thought was more important, more important than Westinghouse. I have a problem with that. But anyway, so they shipped out, and they got there the day I arrived, so they had arrived a day late. Well, that was okay, but of course, they lectured me, you didn't see him on the dock. I said, No, no, no, you don't understand, and this is what you have to think about. Yeah, I didn't tell you I was blind. Why should I the definition of to see in the dictionary is to perceive you don't have to use your eyes to see things. You know, that's the problem with you. Light dependent people. You got to see everything with your eyes. Well, I don't have to, and they were on the dock, and anyway, we had a lot of fun with it, but I have, but you got to have humor, and we've got to not take things so seriously. I agree with what we talked about earlier, with with this other guest. It's it really is important to to not take life so seriously that you can't have some fun. And I agree that. There are serious times, but still, you got to have fun. Greg Hess  10:02 Yeah, no kidding. Well, I've got a short story for you. Maybe it fits in with that. That one of the things I did when I I'll give a little background on this. I, I was a basketball coach and school teacher for 14 years, and had an opportunity to take over an assistant coach job at California Lutheran University. And I was able to choose whatever I wanted to in terms of doing graduate work. And so I said, you know, and I'd always been a bike rider. So I decided to ride my bike from up from Jasper, Alberta, all the way down to 1000 Oaks California on a solo bike ride, which was going to be a big event, but I wanted to think about what I really wanted to do. And, you know, I loved riding, and I thought was a good time to do that tour, so I did it. And so I'm riding down the coast, and once I got into California, there's a bunch of big redwoods there and so on, yeah, and I had, I set up my camp. You know, every night I camped out. I was totally solo. I didn't have any support, and so I put up my tent and everything. And here a guy came in, big, tall guy, a German guy, and he had ski poles sticking out of the back of his backpack, you know, he set up camp, and we're talking that evening. And I had, you know, sitting around the fire. I said, Look, his name was Axel. I said, Hey, Axel, what's up with the ski poles? And he says, Well, I was up in Alaska and, you know, and I was climbing around in glaciers or whatever, and when I started to ride here, they're pretty light. I just take them with me. And I'm thinking, that's crazy. I mean, you're thinking every ounce, every ounce matters when you're riding those long distances. Anyway, the story goes on. Next morning, I get on my bike, and I head down the road, and, you know, I go for a day, I don't see sea axle or anything, but the next morning, I'm can't stop at a place around Modesto California, something, whether a cafe, and I'm sitting in the cafe, and there's, probably, it's a place where a lot of cyclists hang out. So there was, like, 20 or 30 cycles leaning against the building, and I showed up with, you know, kind of a bit of an anomaly. I'd ridden a long time, probably 1500 miles or so at that point in 15 days, and these people were all kind of talking to me and so on. Well, then all sudden, I look up why I'm eating breakfast, and here goes the ski poles down the road. And I went, Oh my gosh, that's got to be him. So I jump up out of my chair, and I run out, and I yell, hey Axel. Hey Axel, loud as I could. And he stops and starts coming back. And then I look back at the cafe, and all these people have their faces up on the windows, kind of looking like, oh, what's going to happen? And they thought that I was saying, mistakenly, Hey, asshole, oh gosh, Michael Hingson  12:46 well, hopefully you straighten that out somehow. Immediately. Greg Hess  12:50 We had a great time and a nice breakfast and moved on. But what an experience. Yeah, sometimes we cross up on our communications. People don't quite get what's going on, they're taking things too seriously, maybe, huh? Michael Hingson  13:03 Oh, yeah, we always, sometimes hear what we want to hear. Well, so what did you get your college degree in? Greg Hess  13:10 Originally? My first Yeah, well, I'd love the question my first degree. I had a bachelor of education for years, but then I went on, and then I had my choice here of graduate work, right? And, you know, I looked at education, I thought, gosh, you know, if I answered committee on every test, I'll probably pass. I said, I need something more than this. So I in the bike ride, what I what I came to a conclusion was that the command line being DOS command line was the way we were computing. Yeah, that time in the 90s, we were moving into something we call graphical user interface, of course, now it's the way we live in so many ways. And I thought, you know, that's the curve. I'm going to chase that. And so I did an MBA in business process re engineering at Cal Lu, and knocked that off in 18 months, where I had a lot of great experiences learning, you know, being an assistant coach, and got to do some of magic Johnson's camps for him while I was there, California. Lutheran University's campus is where the Cowboys used to do their training camp, right? So they had very nice facilities, and so putting on camps like that and stuff were a good thing. And fairly close to the LA scene, of course, 1000 Oaks, right? You know that area? Michael Hingson  14:25 Oh, I do, yeah, I do. I do pretty well, yeah. So, so you, you, you're always involved in doing coaching. That was just one of the things. When you started to get involved in sports, in addition to playing them, you found that coaching was a useful thing for you to do. Absolutely. Greg Hess  14:45 I loved it. I loved the game. I love to see people grow. And yeah, it was just a thrill to be a part of it. I got published a few times, and some of the things that I did within it, but it was mostly. Right, being able to change a community. Let me share this with you. When I went to West Lake Village High School, this was a very, very wealthy area, I had, like Frankie avalon's kid in my class and stuff. And, you know, I'm riding bike every day, so these kids are driving up in Mercedes and BMW parking lot. And as I looked around the school and saw and we build a basketball and I needed to build more pride, I think in the in the community, I felt was important part of me as the head coach, they kind of think that the head coach of their basketball program, I think, is more important than the mayor. I never could figure that one out, but that was where I was Michael Hingson  15:37 spend some time in North Carolina, around Raleigh, Durham, you'll understand, Greg Hess  15:41 yeah, yeah, I get that. So Kentucky, yeah, yeah, yeah, big basketball places, yeah. So what I concluded, and I'd worked before in building, working with Special Olympics, and I thought, You know what we can do with this school, is we can have a special olympics tournament, because I got to know the people in LA County that were running, especially in Ventura County, and we brought them together, and we ran a tournament, and we had a tournament of, I don't know, maybe 24 teams in total. It was a big deal, and it was really great to get the community together, because part of my program was that I kind of expected everybody, you know, pretty strong expectation, so to say, of 20 hours of community service. If you're in our basketball program, you got to have some way, whether it's with your church or whatever, I want to recognize that you're you're out there doing something for the community. And of course, I set this Special Olympics event up so that everybody had the opportunity to do that. And what a change it made on the community. What a change it made on the school. Yeah, it was great for the Special Olympians, and then they had a blast. But it was the kids that now were part of our program, the athletes that had special skills, so to say, in their world, all of a sudden realized that the world was a different place, and it made a big difference in the community. People supported us in a different way. I was just really proud to have that as kind of a feather in my calf for being there and recognizing that and doing it was great. Michael Hingson  17:08 So cool. And now, where are you now? I'm in West Houston. That's right, you're in Houston now. So yeah, Katie, Texas area. Yeah, you've moved around well, so you, you started coaching. And how long did you? Did you do that? Greg Hess  17:30 Well, I coached for 14 years in basketball, right? And then I went into business after I graduated my MBA, and I chased the learning curve. Michael, of that learning curve I talked about a few minutes ago. You know, it was the graphical user interface and the compute and how all that was going to affect us going forward. And I continued to chase that learning curve, and had all kinds of roles and positions in the process, and they paid me a little more money as I went along. It was great. Ended up being the chief advisor for cloud services at Halliburton. Yeah, so I was an upstream guy, if you know that, I mean seismic data, and where we're storing seismic data now, the transition was going, I'm not putting that in the cloud. You kidding me? That proprietary data? Of course, today we know how we exist, but in those days, we had to, you know, build little separate silos to carry the data and deliver it accordingly for the geophysicists and people to make the decision on the drill bit. So we did really well at that in that role. Or I did really well and the team that I had just what did fantastic. You know, I was real proud I just got when I was having my 70th birthday party, I invited one of the individuals on that team, guy named Will Rivera. And will ended up going to Google after he'd worked us in there. I talked him into, or kind of convinced him so to say, or pushed him, however you do that in coaching. Coached him into getting an MBA, and then he's gone on and he tells me, You better be sitting down, coach. When he talked to him a couple days ago, I just got my PhD from George Washington University in AI technology, and I just turned inside out with happiness. It was so thrilling to hear that you know somebody you'd worked with. But while I was at Halliburton, I got diagnosed with pancreatic cancer, Michael, and so that's what changed me into where I am today, as a transition and transformation. Michael Hingson  19:21 Well, how did that happen? Because I know usually people say pancreatic cancer is pretty undetectable. How did it happen that you were fortunate enough to get it diagnosed? It obviously, what might have been a somewhat early age or early early Greg Hess  19:35 time, kind of a miracle, I guess. You know. I mean, I was traveling to my niece's high school graduation in Helena, Montana. And when we were returning back to Houston, we flew through Denver, and I was suffering from some very serious a fib. Was going up 200 beats a minute, and, you know, down to 100 and it was, it was all. Over the place. And I got the plane. I wasn't feeling well, of course, and they put me on a gurney. And next thing you know, I'm on the way the hospital. And, you know, they were getting ready for an embolotic, nimbalism potential, those type of things. And, and I went to the hospital, they're testing everything out, getting, you know, saying, Well, before we put your put the shock paddles on your on your heart to get back, we better do a CAT scan. And so they CAT scan me, and came back from the CAT scan and said, Well, you know what, there's no blood clot issues, but this mass in your pancreas is a concern. And so that was the discovery of that. And 14 days from that point, I had had surgery. And you know, there was no guarantees even at that point, even though we, you know, we knew we were early that, you know, I had to get things in order. And I was told to put things in order, a little bit going into it. But miracles upon miracles, they got it all. I came away with a drainage situation where they drained my pancreas for almost six months. It was a terrible pancreatic fluids, not good stuff. It really eats up your skin, and it was bad news. But here I am, you know, and when I came away from that, a lot of people thought I was going to die because I heard pancreatic cancer, and I got messages from people that were absolutely powerful in the difference I'd made in their life by being a coach and a mentor and helping them along in their life, and I realized that the big guy upstairs saved me for a reason, and I made my put my stake in the ground, and said, You know what? I'm going to do this the best I can, and that's what I've been doing for the last eight years. Michael Hingson  21:32 So what caused the afib? Greg Hess  21:35 Yeah, not sure. Okay, so when they came, I became the clipboard kid a little bit, you know. Because what the assumption was is that as soon as I came out of surgery, and they took this tumor out of me, because I was in a fib, throughout all of surgery, AFib went away. And they're thinking now, the stress of a tumor could be based on the, you know, it's a stress disease, or so on the a fib, there could be high correlation. And so they started looking into that, and I think they still are. But you know, if you got a fib, maybe we should look for tumors somewhere else is the potential they were thinking. And, yeah, that, Michael Hingson  22:14 but removing the tumor, when you tumor was removed, the AFib went away. Yeah, wow, Greg Hess  22:22 yeah, disappeared. Wow, yeah. Michael Hingson  22:26 I had someone who came on the podcast some time ago, and he had a an interesting story. He was at a bar one night. Everything was fine, and suddenly he had this incredible pain down in his his testicles. Actually went to the hospital to discover that he had very serious prostate cancer, and had no clue that that was even in the system until the pain and and so. But even so, they got it early enough that, or was in such a place where they got it and he's fine. Greg Hess  23:07 Wow, whoa. Well, stuff they do with medicine these days, the heart and everything else. I mean, it's just fantastic. I I recently got a new hip put in, and it's been like a new lease on life for me. Michael, I am, I'm golfing like I did 10 years ago, and I'm, you know, able to ride my bike and not limp around, you know, and with just pain every time I stepped and it's just so fantastic. I'm so grateful for that technology and what they can do with that. Michael Hingson  23:36 Well, I went through heart valve replacement earlier this year, and I had had a physical 20 years ago or or more, and they, they said, as part of it, we did an EKG or an echo cardiogram. And he said, You got a slightly leaky heart valve. It may never amount to anything, but it might well. It finally did, apparently. And so we went in and they, they orthoscopically went in and they replaced the valve. So it was really cool. It took an hour, and we were all done, no open heart surgery or anything, which was great. And, yeah, I know exactly what you mean. I feel a whole lot better Greg Hess  24:13 that you do does a lot. Yeah, it's fantastic. Well, making that commitment to coaching was a big deal for me, but, you know, it, it's brought me more joy and happiness. And, you know, I just, I'll share with you in terms of the why situation for me. When I came away from that, I started thinking about, why am I, kind of, you know, a lot of what's behind what you're what you're doing, and what brings you joy? And I went back to when I was eight years old. I remember dribbling the ball down the basketball court, making a fake, threw a pass over to one of my buddies. They scored the layup, and we won the game. That moment, at that time, passing and being a part of sharing with someone else, and growing as a group, and kind of feeling a joy, is what I continued to probably for. To all my life. You know, you think about success, and it's how much money you make and how much this and whatever else we were in certain points of our life. I look back on all this and go, you know, when I had real happiness, and what mattered to me is when I was bringing joy to others by giving assist in whatever. And so I'm at home now, and it's a shame I didn't understand that at 60 until I was 62 years old, but I'm very focused, and I know that's what brings me joy, so that's what I like to do, and that's what I do. Michael Hingson  25:30 I know for me, I have the honor and the joy of being a speaker and traveling to so many places and speaking and so on. And one of the things that I tell people, and I'm sure they don't believe it until they experience it for themselves, is this isn't about me. I'm not in it for me. I am in it to help you to do what I can to make your event better. When I travel somewhere to speak, I'm a guest, and my job is to make your life as easy as possible and not complicated. And I'm I know that there are a lot of people who don't necessarily buy that, until it actually happens. And I go there and and it all goes very successfully, but people, you know today, were so cynical about so many things, it's just hard to convince people. Greg Hess  26:18 Yeah, yeah. Well, I know you're speaking over 100 times a year these days. I think that's that's a lot of work, a lot of getting around Michael Hingson  26:27 it's fun to speak, so I enjoy it. Well, how did you get involved in doing things like managing the Magic Johnson camps? Greg Hess  26:37 Well, because I was doing my MBA and I was part of the basketball program at Cal Lu, you know, working under Mike Dunlap. It just he needed a little bit of organization on how to do the business management side of it. And I got involved with that. I had a lunch with magic, and then it was, well, gee, why don't you help us coordinate all our camps or all our station work? And so I was fortunate enough to be able to do that for him. I'll just share a couple things from that that I remember really well. One of the things that magic just kind of, I don't know, patted me on the back, like I'm a superstar in a way. And you remember that from a guy like magic, I put everybody's name on the side of their shoe when they register. Have 100 kids in the camp, but everybody's name is on the right side of their shoe. And magic saw that, and he realized being a leader, that he is, that he could use his name and working, you know, their name by looking there, how powerful that was for him to be more connected in which he wants to be. That's the kind of guy he was. So that was one thing, just the idea of name. Now, obviously, as a teacher, I've always kind of done the name thing, and I know that's important, but, you know, I second thing that's really cool with the magic camp is that the idea of camaraderie and kind of tradition and bringing things together every morning we'd be sitting in the gym, magic could do a little story, you know, kind of tell everybody something that would inspire him, you know, from his past and so on. But each group had their own sound off. Michael, so if he pointed at your group, it would be like, or whatever it was. Each group had a different type of sound, and every once in a while we'd use it and point it kind of be a motivator. And I never really put two and two together until the last day of the camp on Friday. Magic says, When I point to your group, make your sound. And so he starts pointing to all the different groups. And it turns out to be Michigan State Spartans fight song to the tee. Figured that out. It was just fantastic. It gives me chills just telling you about it now, remembering how powerful was when everybody kind of came together. Now, you being a speaker, I'm sure you felt those things when you bring everybody together, and it all hits hard, but that was, that was one I remember. Michael Hingson  28:50 Well, wow, that's pretty funny, cute, yeah, yeah. Well, I mean, he has always been a leader, and it's very clear that he was, and I remember the days it was Magic Johnson versus Larry Bird. Greg Hess  29:10 Yeah, yeah. Well, when he came to LA you know, they had Kareem and Byron Scott, a whole bunch of senior players, and he came in as a 19 year old rookie, and by the end of that year, he was leading that team. Yeah, he was the guy driving the ship all the time, and he loved to give those assists. He was a great guy for that. Michael Hingson  29:30 And that's really the issue, is that as a as a real leader, it wasn't all about him at all. It was about how he could enhance the team. And I've always felt that way. And I you know, when I hire people, I always told them, I figure you convince me that you can do the job that I hired you to do. I'm not going to be your boss and boss you around. What I want to do is to work with you and figure out how the talents that I have can complement the talents that you have so that we can. Enhance and make you more successful than you otherwise would be. Some people got it, and unfortunately, all too many people didn't, and they ended up not being nearly as successful. But the people who got it and who I had the joy to work with and really enhance what they did, and obviously they helped me as well, but we they were more successful, and that was what was really important. Greg Hess  30:24 Yeah, yeah, I appreciate that. It's not about controlling, about growing. I mean, people grow, grow, grow, and, you know, helping them certainly. There's a reason. There's no I in team, right? And we've heard that in many times before. It's all about the group, group, pulling together. And what a lot of fun to have working in all throughout my life, in pulling teams together and seeing that happen. You know, one plus one equals three. I guess we call it synergy, that type of thinking, Michael Hingson  30:56 Yeah, well, you've faced a lot of adversity. Is, is the pancreatic cancer, maybe the answer to this, but what? What's a situation where you've really faced a lot of adversity and how it changed your life? You know you had to overcome major adversity, and you know what you learned from it? Greg Hess  31:16 Sure, I think being 100% honest and transparent. I'd say I went through a divorce in my life, and I think that was the most difficult thing I've gone through, you know, times where I'm talking to myself and being crazy and thinking stupid things and whatever. And I think the adversity that you learn and the resilience that you learn as you go, hey, I can move forward. I can go forward. And when you you see the light on the other side, and you start to create what's what's new and different for you, and be able to kind of leave the pain, but keep the happiness that connects from behind and go forward. I think that was a big part of that. But having resilience and transforming from whatever the event might be, obviously, pancreatic cancer, I talked about a transformation there. Anytime we kind of change things that I think the unstoppable mindset is really, you know what's within this program is about understanding that opportunities come from challenges. When we've got problems, we can turn them into opportunities. And so the adversity and the resilience that I think I'd like to try to learn and build and be a part of and helping people is taking what you see as a problem and changing your mindset into making it an opportunity. Michael Hingson  32:40 Yeah, yeah. Well, you've obviously had things that guided you. You had a good sense of vision and so on. And I talked a lot about, don't let your sight get in the way of your vision. But how's a good sense of vision guided you when necessarily the path wasn't totally obvious to you, have you had situations like that? Absolutely. Greg Hess  33:03 And I think the whole whole I write about it in my book in peak experiences, about having vision in terms of your future self, your future, think where you're going, visualize how that's going to happen. Certainly, as a basketball player, I would play the whole game before the game ever happened by visualizing it and getting it in my mind as to how it was going to happen. I do that with golf today. I'll look at every hole and I'll visualize what that vision is that I want to have in terms of getting it done. Now, when I have a vision where things kind of don't match up and I have to change that on the fly. Well, that's okay, you know that that's just part of life. And I think having resilience, because things don't always go your way, that's for sure. But the mindset you have around what happens when they don't go your way, you know, is big. My as a coach, as a business coach today, every one of my clients write a three, three month or 90 day plan every quarter that gets down to what their personal goal is, their must have goal. And then another kind of which is all about getting vision in place to start putting in actual tactical strategies to make all of that happen for the 90 day period. And that's a big part, I think, of kind of establishing the vision in you got to look in front of us what's going to happen, and we can control it if we have a good feel of it, you know, for ourselves, and get the lives and fulfillment we want out of life. I think, yeah, Michael Hingson  34:39 you've clearly been pretty resilient in a lot of ways, and you continue to exhibit it. What kinds of practices and processes have you developed that help you keep resilience personally and professionally? Greg Hess  34:54 I think one of them for sure is that I've I've lived a life where I've spent you. I'm going to say five out of seven days where I will do a serious type of workout. And right now bike riding. I'll ride several days a week, and, you know, get in 10 to 15 miles, not a lot, but, I mean, I've done but keeping the physical, physical being in the time, just to come down the time to think about what you're doing, and at the same time, for me, it's having a physical activity while I'm doing that, but it's a wind down time. I also do meditation. Every morning. I spend 15 minutes more or less doing affirmations associated to meditation, and that's really helped me get focused in my day. Basically, I look at my calendar and I have a little talk with every one of the things that are on my calendar about how I'm setting my day, you know? And that's my affirmation time. But yeah, those time things, I think report having habits that keep you resilient, and I think physical health has been important for me, and it's really helped me in a lot of ways at the same time, bringing my mind to, I think, accepting, in a transition of learning a little bit accepting the platinum rule, rather than the golden rule, I got to do unto others as they'd like to be treated by me. I don't need to treat people like they'd like to like I'd like to be treated. I need to treat them how they'd like to be treated by me, because they're not me, and I've had to learn that over time, better and better as I've got older. And how important that is? Michael Hingson  36:33 Well, yeah, undoubtedly, undoubtedly so. And I think that we, we don't put enough effort into thinking about, how does the other person really want to be treated? We again, it gets back, maybe in to a degree, in to our discussion about humor earlier we are we're so much into what is it all about for me, and we don't look at the other person, and the excuse is, well, they're not looking out for me. Why should I look out for them? Greg Hess  37:07 You know, one of the biggest breakthroughs I've had is working with a couple that own a business and Insurance Agency, and the they were doing okay when I started, when they've done much better. And you know, it's besides the story. The big part of the story is how they adjusted and adapted, and that she I think you're probably familiar with disc and I think most people that will be listening on the podcast are but D is a high D, dominant kind of person that likes to win and probably doesn't have a lot of time for the other people's feelings. Let's just put it that way to somebody that's a very high seed is very interested in the technology and everything else. And the two of them were having some challenges, you know, and and once we got the understanding of each other through looking at their disc profiles, all of a sudden things cleared up, a whole, whole bunch. And since then, they've just been a pinnacle of growth between the two of them. And it was just as simple as getting an understanding of going, you know, I got to look at it through your eyes, rather than my eyes. When it comes to being a leader in this company and how sure I'm still going to be demanding, still I'm going to be the I'm not going to apologize about it, but what I got him to do is carry a Q tip in his pocket, and so every time she got on him, kind of in the Bossy way. He just took out, pulled out the Q tip, and I said, that stands for quit taking it personal. Don't you love it? Michael Hingson  38:29 Yeah, well, and it's so important that we learn to communicate better. And I'm sure that had a lot to do with what happened with them. They started communicating better, yeah, yeah. Do you ever watch Do you ever watch a TV show on the Food Network channel? I haven't watched it for a while. Restaurant impossible. Greg Hess  38:51 Oh, restaurant impossible. Yeah, I think is that guy? Michael Hingson  38:55 No, that's not guy. It's my Michael. I'm blanking out Greg Hess  39:00 whatever. He goes in and fixes up a restaurant. Michael Hingson  39:03 He fixes up restaurants, yeah, and there was one show where that exact sort of thing was going on that people were not communicating, and some of the people relatives were about to leave, and so on. And he got them to really talk and be honest with each other, and it just cleared the whole thing up. Greg Hess  39:25 Yeah, yeah. It's amazing how that works. Michael Hingson  39:28 He's He's just so good at at analyzing situations like that. And I think that's one of the things that mostly we don't learn to do individually, much less collectively, is we don't work at being very introspective. So we don't analyze what we do and why what we do works or doesn't work, or how we could improve it. We don't take the time every day to do that, which is so unfortunate. Greg Hess  39:54 Oh boy, yeah, that continuous improvement Kaizen, all of that type of world. Critical to getting better, you know. And again, that comes back, I think, a little bit to mindset and saying, Hey, I'm gonna but also systems. I mean, I've always got systems in place that go, let's go back and look at that, and how, what can we do better? And if you keep doing it every time, you know, in a certain period, things get a lot better, and you have very fine tuning, and that's how you get distinguished businesses. I think, yeah, Michael Hingson  40:27 yeah, it's all about it's all about working together. So go ahead, I Greg Hess  40:31 was working with a guy at Disney, or guy had been at Disney, and he was talking about how they do touch point analysis for every every place that a customer could possibly touch anything in whatever happens in their environment, and how they analyze that on a, I think it was a monthly, or even at least a quarterly basis, where they go through the whole park and do an analysis on that. How can we make it better? Michael Hingson  40:55 Yeah, and I'm sure a lot of that goes back to Walt having a great influence. I wonder if they're doing as much of that as they used to. Greg Hess  41:04 Yeah, I don't know. I don't know, yeah, because it's getting pretty big and times change. Hopefully, culture Go ahead. I was gonna say a cultural perspective. I just thought of something I'd share with you that when I went into West Lake Village High School as a basketball coach, I walked into the gym and there was a lot of very tall I mean, it's a very competitive team and a competitive school, 611, six, nine kids, you know, that are only 16 years old. And I looked around and I realized that I'm kid from Canada here, you know, I gotta figure out how to make this all work in a quick, fast, in a hurry way. And I thought these kids were a little more interested in looking good than rather being good. And I think I'd been around enough basketball to see that and know that. And so I just developed a whole philosophy called psycho D right on the spot almost, which meant that we were going to build a culture around trying to hold teams under a common goal of 50 points, common goal, goal for successful teams. And so we had this. I started to lay that out as this is the way this program is going to work, guys and son of a gun, if we didn't send five of those guys onto division one full rides. And I don't think they would have got that if they you know, every college coach loves a kid who can play defense. Yeah, that's what we prided ourselves in. And, of course, the band got into it, the cheerleaders got into it, the whole thing. Of course, they bring in that special olympics thing, and that's part of that whole culture. Guess what? I mean, we exploded for the really powerful culture of of a good thing going on. I think you got to find that rallying point for all companies and groups that you work with. Don't you to kind of have that strong culture? Obviously, you have a very huge culture around your your world. Michael Hingson  42:54 Well, try and it's all about again, enhancing other people, and I want to do what I can do, but it's all about enhancing and helping others as well. Yeah. How about trust? I mean, that's very important in leadership. I'm sure you would, you would agree with that, whereas trust been a major part of things that you do, and what's an example of a place where trust really made all the difference in leadership and in endeavor that you were involved with? Greg Hess  43:29 Yeah, so often, clients that I've had probably don't have the they don't have the same knowledge and background in certain areas of you know, we all have to help each other and growing and having them to trust in terms of knowing their numbers and sharing with me what their previous six month P and L, or year to date, P and L, that kind of thing, so that I can take that profit and loss and build out a pro forma and build where we're going with the business. There's an element of trust that you have to have to give somebody all your numbers like that, and I'm asking for it on my first coaching session. And so how do I get that trust that quickly? I'm not sure exactly. It seems to work well for me. One of the things that I focus on in understanding people when I first meet and start to work with them is that by asking a simple question, I'll ask them something like, how was your weekend? And by their response, I can get a good bit of an idea whether I need to get to get them to trust me before they like me, or whether they get to get them to like me before they trust me. And if the response is, had a great weekend without any social response at all connected to it, then I know that I've got to get those people to trust me, and so I've got to present myself in a way that's very much under trust, where another the response might be. Had a great weekend, went out golfing with my buddies. Soon as I hear with the now I know I need to get that person to like. Me before they trust me. And so that's a skill set that I've developed, I think, and just recognizing who I'm trying and building trust. But it's critical. And once, once you trust somebody, and you'd show and they, you don't give them reason to not trust you, you know, you show up on time, you do all the right things. It gets pretty strong. Yeah, it doesn't take but, you know, five or six positive, that's what the guy said he's going to do. He's done it, and he's on top of it to start trusting people. I think, Well, Michael Hingson  45:31 I think that that trust is all around us. And, you know, we we keep hearing about people don't trust each other, and there's no trust anymore in the world. I think there's a lot of trust in the world. The issue isn't really a lack of trust totally. It's more we're not open to trust because we think everyone is out to get us. And unfortunately, there are all too many ways and times that that's been proven that people haven't earned our trust, and maybe we trusted someone, and we got burned for it, and so we we shut down, which we shouldn't do, but, but the reality is that trust is all around us. I mean, we trust that the internet is going to keep this conversation going for a while. I shouldn't say that, because now we're going to disappear, right? But, but, trust is really all around us, and one of the things that I tell people regularly is, look, I want to trust and I want people to trust me. If I find that I am giving my trust to someone and they don't reciprocate or they take advantage of it. That tells me something, and I won't deal with that person anymore, but I'm not going to give up on the idea of trust, because trust is so important, and I think most people really want to trust and I think that they do want to have trusting relationships. Greg Hess  47:02 Yeah, totally agree with you on that, you know. And when it's one of those things, when you know you have it, you don't have to talk about it, you just have it, you know, it's there, right? Michael Hingson  47:16 Yeah, and then, well, it's, it's like, I talk about, well, in the book that I wrote last year, live, it was published last year, live like a guide dog. Guide Dogs do love unconditionally, I'm absolutely certain about that, but they don't trust unconditionally. But the difference between them and us, unless there's something that is just completely traumatized them, which isn't usually the case, they're open to trust, and they want to trust and they want to develop trusting relationships. They want us to be the pack leaders. They know we're supposed to be able to do that. They want to know what we expect of them. But they're open to trust, and even so, when I'm working with like a new guide dog. I think it takes close to a year to really develop a full, complete, two way trusting relationship, so that we really essentially know what each other's thinking. But when you get that relationship, it's second to none. Greg Hess  48:15 Yeah, isn't that interesting? How long were you with Rosella? Before the event, Michael Hingson  48:21 Rosella and I were together. Let's see we Oh, what was it? It was February or May. No, it was the November of 1999 so it was good two year. Good two years. Yeah, wow, yeah. So, you know, we we knew each other. And you know, even so, I know that in that in any kind of a stressful situation, and even not in a stressful situation, my job is to make sure that I'm transmitting competence and trust to Roselle, or now to Alamo. And the idea is that on September 11, I all the way down the stairs just continue to praise her, what a good job. You're doing a great job. And it was important, because I needed her to know first of all that I was okay, because she had to sense all of the concern that people had. None of us knew what was going on on the stairwell, but we knew that something was going on, and we figured out an airplane hit the building because we smelled jet fuel, but we didn't know the details, but clearly something was going on, so I needed to send her the message, I'm okay, and I'm with you and trust you and all that. And the result of that was that she continued to be okay, and if suddenly she were to suddenly behave in a manner that I didn't expect, then that would tell me that there's something different and something unusual that's going on that I have to look for. But we didn't have to have that, fortunately, which was great. It's. About trust, and it's all about developing a two way trust, yeah, Greg Hess  50:05 yeah, amazing. Well, and it's funny how, when you say trust, when in a situation where trust is lost, it's not so easily repaired, no, Michael Hingson  50:16 you know, yeah. And if it's really lost, it's because somebody's done something to betray the trust, unless somebody misinterprets, in which case you've got to communicate and get that, that that confidence level back, which can be done too. Greg Hess  50:33 Yeah, yeah. Important to be tuned and tuned into that, Michael Hingson  50:40 but it is important to really work to develop trust. And as I said, I think most people want to, but they're more often than not, they're just gun shy, so you have to really work at developing the trust. But if you can do it, what a relationship you get with people. Greg Hess  50:57 Circumstances, you know, and situational analysis change the level of trust, of course, in so many ways. And some people are trusting people where they shouldn't, you know, and in the right in the wrong environment. Sometimes you know, you have to be aware. I think people are fearful of that. I mean, just even in our electronic world, the scammers and those people you gotta, we get, we get one or two of those, you know, messages every day, probably people trying to get you to open a bank account or something on them. Better be aware. Don't want to be losing all your money. Yeah, but it's not to have trust, right? Michael Hingson  51:41 Yeah, it's one we got to work on well, so you you support the whole concept of diversity, and how has embracing diversity of people, perspectives or ideas unlocked new opportunities for you and the people you work with. Greg Hess  52:00 I got a great story for you on that. Michael A when I got into this coaching business, one of the one of the clients I was lucky enough to secure was a group called shredding on the go. And so the mother was kind of running the show, but her son was the president, and kind of the one that was in charge of the company. Now he's wheelchair, 100% wheelchair bound, nonverbal, very, very, I don't remember the exact name, but I mean very, very restrictive. And so what she figured out in time was his young is that he could actually take paper and like putting paper into a shredder. So she grew the idea of saying, Gosh, something James can do, we can build a business. This, this kid's, you know, gonna, I'm gonna get behind this and start to develop it. And so she did, and we created, she had created a company. She only had two employees when she hired me, but we went out and recruited and ended up growing it up to about 20 employees, and we had all the shredders set up so that the paper and all of our delivery and so on. And we promoted that company and supporting these people and making real money for real jobs that you know they were doing. So it was all, you know, basically all disabled autism to, you name it. And it was just a great experience. And so we took that show to the road. And so when we had Earth Day, I'd go out and we'd have a big event, and then everybody would come in and contribute to that and be a part of growing that company. Eventually, we got to the company to the point where the mother was worried about the the owner, the son's health was getting, you know, his life expectancy is beyond it, and she didn't want to have this company and still be running and when he wasn't there. And so we worked out a way to sell the company to a shredding company, of course, and they loved the the client. We had over 50 clients going, and they ended up making quite a bit of money that they put back into helping people with disabilities. So it was just a great cycle and a great opportunity to do that and give people an opportunity. I got to be their business coach, and what a lot of fun I included myself in the shredding I was involved with all parts of the company, and at one point, what a lot of fun I had with everybody. Michael Hingson  54:22 Yeah, yeah. There's something to be said for really learning what other people do in a company and learning the jobs. I think that's important. It's not that you're going to do it every day, but you need to develop that level of understanding. Greg Hess  54:37 Michael, you'll love this. Our best Shredder was blind. She did more than anybody, and she was blind. People go, you can't be doing that when you're What do you mean? She had it figured out. Yeah. Michael Hingson  54:48 What's the deal? Yeah, no, Shredder doesn't overheat, you know? But that's another step, yeah. So what's an example you've worked with a lot of teams. And so on. What's an example where a collaborative effort really created something and caused something to be able to be done that otherwise wouldn't have happened? Right? Greg Hess  55:10 Well, I referred back real quickly to the psycho D thing, where he had a common goal, common pride in taking it, and we just were on it. And I think that was a really, really transformational kind of thing to make everybody better as one whole area in a team. Now that's probably the first thing that comes to mind. I think the the idea of bringing the team together, you know, and really getting them to all work as one is that everybody has to understand everybody else's action plan. What's their plan? What is their vision? Where are they going in terms of, you know, playing basketball, to whether you're on the sales team, whether you're on the marketing team, or whatever part of the business you're in, do you have an action plan? And you can openly show that, and you feel like you're 100% participating in the group's common goal. I can't over emphasize an element of a common goal. I think, in team building, whatever that may be, you know, typically, the companies I'm working with now, we try to change it up every quarter, and we shoot quarter by quarter to a common goal that we all and then we build our plans to reach and achieve that for each individual within a company. And it works really well in building teams. And it's a lot of fun when everything comes together. You know, example of how a team, once you built that, and the team's there, and then you run into adversity, we have a team of five people that are selling insurance, basically, and one of them lost her father unexpectedly and very hard, Hispanic, Hispanic background, and just devastating to her and to her mother and everything. Well, we've got a machine going in terms of work. And so what happened is everybody else picked up her piece, and all did the parts and got behind her and supported her. And it took her about five months to go through her morning phase, and she's come back, and now she's going to be our top employee. Now going forward, it's just amazing how everybody rallied around her. We were worried about her. She comes back, and she's stronger than ever, and she'd had her time, and it was just nice to see the team of a group of company kind of treat somebody like family. That's a good thing. Michael Hingson  57:30 That's cool. What a great story. What mindset shift Do you think entrepreneurs and leaders really need to undergo in order to be successful. Greg Hess  57:45 Boy, you know, we talked a little bit earlier about the idea of looking through it, through other people's eyes, right? And then as a leader, you know, the same thing you were mentioning earlier, Michael, was that you draw the strength out of the people, rather than demand kind of what you want them to do in order to get things done, it's build them up as people. And I think that that's a critical piece in in growing people and getting that whole element of leadership in place. Yeah, what was the other part of that question? Again, let me give you another piece of that, because I think of some Go ahead. Yeah. I was just remember, what did you ask me again, I want to make sure I'm right Michael Hingson  58:28 from your books and coaching work. The question was, what kind of mindset shift Do you think that entrepreneurs and leaders have to adopt? Greg Hess  58:39 Yeah, yeah. So that's one part of the mindset, but the big one is recognizing that it's a growth world that we need to look at how we can grow our company, how we can grow individuals, how we can all get better and continuous improvement. And I think that is an example of taking a problem and recognizing as an opportunity. And that's part of the mindset right there that you got to have. I got a big problem here. How are we going to make that so that we're we're way better from that problem each time it happens and keep improving? Michael Hingson  59:10 Yeah, that makes sense. Well, if you could leave everyone who's listening and watching this today with one key principle that would help them live and lead with an unstoppable mindset. What would that be? What, what? What advice do you have? Greg Hess  59:30 Yeah, my advice is make sure you understand your passion and what, what your purpose is, and have a strong, strong desire to make that happen. Otherwise, it's not really a purpose, is it? And then be true to yourself. Be true to yourself in terms of what you spend your time on, what you do, in terms of reaching that purpose. It's to be the best grandparent there you can be in the world. Go get it done, but make sure you're spending time to grandkids. Don't just talk it so talks cheap and action matters. You know, and I think, figure out where you're spending your time and make sure that fits in with what you really want to gather happen in your life and fulfilling it. Michael Hingson  1:00:09 Well, I like that talks cheap and action matters. That's it. Yeah, I tell that. I tell that to my cat all the time when she doesn't care. But cats are like that? Well, we all know that dogs have Masters, but cats have staff, so she's a great kitty. That's good. It's a wonderful kitty. And I'm glad that she's in my life, and we get to visit with her every day too. So it works out well, and she and the Dog get along. So, you know, you can't do better than that. That's a good thing. Well, I want to thank you for being here. This has been absolutely super. I we've I think we've talked a lot, and I've learned a lot, and I hope other people have too, and I think you've had a lot of good insights. If people would like to reach out to you and maybe use your services as a coach or whatever, how do they do that? Greg Hess  1:01:00 Well, my website is coach, hess.com Michael Hingson  1:01:06 H, E, S, S, Greg Hess  1:01:07 yeah, C, O, A, C, H, H, E, S, s.com, that's my website. You can get a hold of me at coach. At coach, hess.com that's my email. Love to hear from you, and certainly I'm all over LinkedIn. My YouTube channel is desk of coach s. Got a bunch of YouTubes up there and on and on. You know, all through the social media, you can look me up and find me under Coach. Coach S, is my brand Cool? Michael Hingson  1:01:38 Well, that it's a well worth it brand for people to go interact with, and I hope people will so Oh, I appreciate that. Well, I want to thank you all for listening and watching us today. Reach out to coach Hess, I'd love to hear from you. Love to hear what you think of today's episode. So please give us an email at Michael H i, at accessibe, A, C, C, E, S, S, i, b, e.com, wherever you're monitoring our podcast, please give us a five star rating. We value it. And if you know anyone who might be a good guest to come on and tell their story, please introduce us. We're always looking for more people to come on and and chat with us. Coach you as well. If you know anyone, I'm sure you must love to to get more people. Now, if you could get Magic Johnson, that'd be super but that's probably a little tougher, but it'd be, it'd be fun. Any, anyone t

Join primary care physicians Kate, Gary, Henry and Mark as they discuss 4 new POEM (Patient Oriented Evidence that Matters), chosen for their potential to change practice and improve patient outcomes: Mediterranean diet to prevent diabetes, an update to the community-acquired pneumonia guideline, coffee or decaf for afib, and safety of meds for acute agitation in the elderly. North Dakota Academy of Family Physicians Conference in Big Sky: https://www.ndafp.org/cme/big-sky-conference/ Essential Evidence Plus and all the POEMs: www.essentialevidenceplus.comMed diet to prevent diabetes: https://pubmed.ncbi.nlm.nih.gov/40854218/ Safety of meds for agitation in elderly: https://pubmed.ncbi.nlm.nih.gov/40275439/Updated pneumonia guidelines from ATS/IDSA: https://pubmed.ncbi.nlm.nih.gov/40679934/ Coffee or decaf with afib:  https://pubmed.ncbi.nlm.nih.gov/41206802/

In this Podcast, I sit down with a great mate called Rich. He talks very frankly about his experience of getting AFib, all the tests he went through to make sure he could continue to ride his bike safely, and some of the ups and downs. He shares how he emotionally dealt with it, and how he's come out the other side understanding AFib a lot better, not worried, but very aware of what he should and shouldn't do to remain healthy and keep riding.Because he's mindful, eats well, trains consistently, listens to his body, and uses tools like WHOOP, he's learned how his body deals with fatigue, sleep, hydration, and nutrition. Afib has not stopped him from racing at a high level on Zwift or tackling big solo challenges like riding through France on his gravel bike. So hopefully Rich's story inspires others who might be going through the same thing.Keep on keeping on, Simon 

In this interview with an experienced cardiac nurse, we break down the heart health risks cyclists should understand, especially as we get older. You'll learn the clear difference between AFib (often manageable) and VFib (a medical emergency), why endurance athletes can be more prone to AFib, and how to reduce risk with smart, consistent training and better habits around hydration, sleep, stress, alcohol, and caffeine. We also cover what to do if you feel palpitations on a ride, including when to stop, when to get checked, and when to call 999. This is education, not medical advice, so always speak to your GP if symptoms are recurring or worrying.

Send us a textCoffee and heart rhythm don't have to be enemies. We dig into a new randomized trial across the US, Canada, and Australia suggesting that caffeinated coffee may lower the risk of recurrent atrial fibrillation compared with abstaining, then connect the dots with real-world monitoring, ablation strategy, and day-to-day choices that influence heart health.We start by grounding AFib in plain terms: what it is, why so many people never feel it, and how stroke risk rises when the atria stop driving a steady beat. From there, we step into the electrophysiology lab to explain why trouble often starts near the pulmonary veins and how clinicians map and ablate rogue electrical tissue. Along the way, we highlight the role of wearables like Apple Watch in catching silent arrhythmias and guiding decisions, a shift that is rapidly improving detection and management outside the clinic.Then we unpack the DECAF trial's headline: coffee drinkers showed meaningfully lower recurrence of AFib or flutter over six months versus those who abstained. We explore possible reasons, from caffeine's adenosine receptor antagonism and calcium signaling effects to the antioxidant and mitochondrial support offered by coffee's polyphenols. We also compare with NEJM data in the general population showing no significant increase in ectopy, putting fears into perspective. Finally, we get practical: dosing and timing to protect sleep, what brewing methods change, how dairy proteins can blunt polyphenol absorption, and when unfiltered versus filtered makes sense if you're balancing lipids and antioxidants.If you enjoy coffee and live with AFib, these insights can help you personalize your cup without losing sight of the fundamentals: anticoagulation when indicated, smart rate or rhythm control, and balanced training that avoids chronic overload. If this conversation helps you think differently about caffeine, subscribe, share with someone who cares about heart health, and leave a review so others can find it.For powerpoint slide deck, video recording and reference open-source articles go to: www.thehealthedgepodcast.com

Thanks to our Partner, NAPA Autotech Training and Pico TechnologyWatch Full Video EpisodeIn this episode, Matt shares a personal Thanksgiving story that turned into a real medical emergency. A long-time family friend suddenly becomes unresponsive at the dinner table, and Matt walks through the moment he had to decide whether to act, despite not being “formally” current on CPR.He talks candidly about what it felt like to drag her to the floor, check for breathing, make the call to start chest compressions, hear ribs crack—and then watch her come back. From there, he connects the experience to life in an automotive shop: CPR and first-aid readiness, AEDs, fire extinguishers, panic, freezing, and why “somebody will know what to do” is not a plan.It's a conversation about preparedness, stress, and how our greatest weapon really is the thought we choose when everything suddenly goes sideways.Episode HighlightsOpening with the quote: “Our greatest weapon against stress is our ability to choose one thought over another.”Matt fighting a cold and joking about his “Nat King Cole” voice.Thanksgiving at his parents' house: Family and close friends gathered, including a 75-year-old family friend (“Jane”) who's been part of the family's holidays for years.Jane says she's really dizzy; Matt gets up to escort her to the living room.Her chin suddenly drops to her chest, she becomes unresponsive, cold, and clammy.The decision point:Matt checks for airway, tries to feel for a pulse, listens for breathing—only hears gurgling.Admits he doesn't fully trust his own ability to feel a pulse with his heart pounding.The mental calculus: If you can't be sure, what else is there to do but chest compressions?Starting chest compressions:Dragging her to the floor and focusing completely on her while the rest of the room “disappears.”Locking his elbows, using the beat of “Stayin' Alive” as a guide.First compression: feeling and hearing the sternum/ribs crack—and taking that as feedback that he's at the right depth.Before the second compression, her eyes fly open and she lets out a sound.The immediate emotional whiplash:First feeling isn't relief, but anger and self-doubt: “Did I just overreact?” “Did I crack her ribs for nothing?” “Was this some dramatic hero move I didn't need to make?”Reorienting to the reality that she was unresponsive and now is awake, talking, and oriented.EMS arrives:Very low blood pressure at the house (around 70/40).Hooked up to a 4-lead, showing atrial fibrillation with PVCs.Matt nerds out on the waveforms and explains AFib and PVCs in plain terms.EMTs jokingly ask if he's a doctor because of how well he reads the traces.Later imaging reveals:A cracked or stress-fractured sternum from compressions.Multiple blood clots in her lungs.The doctor tells her that sternum fractures are common with CPR and adds:Don't be mad at him — he saved your life.For Matt, the key relief is not the “hero” label, but confirmation that he did the right thing by acting.Connecting it back to shops and real life:Afterward, Matt starts calling around trying to set up CPR and first-aid training.Hard question: if he drops at the shop, who's going to act?Extending the concern beyond employees: what about customers?Preparedness checklist for shops:Is there an AED on-site, and does anyone actually know how to use it?Has anyone at the shop had recent CPR and first-aid training?Do...

JCO Editor-in-Chief Dr. Jonathan Friedberg is joined by colleagues Dr. Jennifer Woyach, Dr. Wojciech Jurczak, and Dr. Matthew Davids to discuss simultaneous publications presented at ASH 2025 on pertibrutinib, a new upfront treatment option for patients with chronic lymphocytic leukemia. TRANSCRIPT The disclosures for guests on this podcast can be found in the show notes. Dr. Jonathan Friedberg: I'm Jonathan Friedberg, editor of Journal of Clinical Oncology, and welcome to JCO After Hours, where we are covering two manuscripts that were presented at the American Society of Hematology meeting 2025 in Orlando, Florida. I am delighted to be joined by colleagues on this call to discuss these pivotal manuscripts which cover the topic of pirtobrutinib, a new upfront treatment option for patients with chronic lymphocytic leukemia. I will first just introduce our guests, Dr. Woyach. Dr. Jennifer Woyach: Hi, my name is Jennifer Woyach. I am from the Ohio State University. Dr. Wojciech Jurczak: Hello, I am Wojciech Jurczak, working at the National Research Institute of Oncology in Krakow, Poland. Dr. Matthew Davids: Hi, I am Matthew Davids from Dana-Farber Cancer Institute in Boston. Dr. Jonathan Friedberg: We are going to start by just learning a little bit about these two trials that were both large, randomized phase 3 studies that I think answered some definitive questions. We will start with your study, Jennifer. If you could just describe the design of your study and the patient population. Dr. Jennifer Woyach: Absolutely. So this is the BRUIN CLL-314 study, and this is a phase 3 randomized trial of pirtobrutinib versus ibrutinib in patients with CLL or SLL who had not previously been treated with a covalent BTK inhibitor. The patients were both treatment-naive and relapsed/refractory, about one-third of the patients treatment-naive, the rest relapsed/refractory, and they were stratified based upon 17p deletion and the number of prior lines of therapy. The primary objective was looking at non-inferiority of overall response rate over the entire treated population as well as the relapsed/refractory patient population. Key secondary objectives included progression-free survival in the intention-to-treat and the smaller relapsed/refractory and treatment-naive populations. Dr. Jonathan Friedberg: And just comment a little bit on the risk of the patients. Dr. Jennifer Woyach: This study was fairly typical of this cohort of patients. Within the relapsed/refractory patient population, there was a median of one prior line of therapy in each of the groups, up to nine prior lines of therapy in the patients included on the study. For the overall cohort, about two-thirds of the patients were IGHV unmutated, about 15% had 17p deletion, 30% had TP53 mutations, and about 35% to 40% had a complex karyotype, which is three or more abnormalities. Dr. Jonathan Friedberg: And what were your findings? Dr. Jennifer Woyach: Regarding the primary outcome, which is the focus of the publication, we did find that pirtobrutinib was indeed non-inferior and actually superior to ibrutinib for overall response rate throughout the entire patient population and in both the relapsed/refractory and treatment-naive cohorts. PFS is a little bit immature at this time but is trending towards also being significantly better in pirtobrutinib-treated patients compared with ibrutinib-treated patients. Probably most significantly, we found this to be the case in the treatment-naive cohort where there was a striking trend to an advantage of pirtobrutinib versus ibrutinib. Dr. Jonathan Friedberg: And the follow-up that you have on that progression-free survival? Dr. Jennifer Woyach: So we have about 18 months follow-up on progression-free survival. Dr. Jonathan Friedberg: The second study, Wojciech, can you just go through the design and patient population that you treated? Dr. Wojciech Jurczak: Thank you, Dr. Friedberg, for this question. So the BRUIN CLL-313 study was, in fact, the first phase 3 study with pirtobrutinib in exclusively untreated CLL patients. It was a randomized study where we challenged pirtobrutinib versus bendamustine-rituximab. At the time we designed the protocol, bendamustine-rituximab was an option as a standard of care, and Bruton tyrosine kinase monotherapy was used far more commonly than nowadays. The primary target of the study was progression-free survival. We took all untreated patients except for those with 17p deletions. Therefore, it is a good representation for intermediate risk. We had about 60% of the population, 56 to be precise, which was unmutated, evenly distributed into two treatment arms. 17p deleted cases were excluded, but we had about 7% and 8% of TP53 mutated patients as well as about 11% and 7%, respectively, in the pirtobrutinib and bendamustine-rituximab arm of patients with complex karyotype. The progression-free survival was in favor of pirtobrutinib and was assessed by an independent review committee. What is important is that the progression-free survival of the bendamustine-rituximab arm was actually similar to the other studies addressing the same questions, like the comparison with ibrutinib in the ALLIANCE study or zanubrutinib in the SEQUOIA study. What was different was the hazard ratio. In our study, it was 0.20. It was one of the longest effect sizes noted in the frontline BTK study. It represented an 80% reduction in progression-free survival or death. If we compare it to ibrutinib or zanubrutinib, it was 0.39 and 0.42 respectively. Presumably, this great effect contributed towards a trend of overall survival difference. Although survival data are not mature enough, there is a clear trend represented by three patients we lost in the pirtobrutinib arm versus 10 patients lost in the bendamustine-rituximab arm. This trend in overall survival is becoming statistically significant despite the fact that there was a possibility of crossover, and effectively 52.9 patients, which means 18 out of 34 patients relapsing in the bendamustine-rituximab arm, were treated by pirtobrutinib. Dr. Jonathan Friedberg: I am going to turn it over to Matt. The question is: why study pirtobrutinib in this patient population? And then with these two studies, how do you find the patients that were treated, are they representative of people who you see? And do you see this maybe being approved and more widely available? Dr. Matthew Davids: I think in terms of the first question, why study this in a frontline population, we have seen very impressive data with pirtobrutinib in a very difficult-to-treat population of CLL patients. This was from the original BRUIN phase 1/2 study where most of the patients had at least two or three lines of therapy, often both a covalent BTK inhibitor and the BCL2 inhibitor venetoclax, and yet they were still responding to pirtobrutinib. The drug was also very well tolerated in that early phase experience. And actually, we have seen phase 3 data from the BRUIN 321 study comparing pirtobrutinib to bendamustine and rituximab in a relapse population as well. So I think that really motivated these studies to look at pirtobrutinib as a first therapy. You know, often in other cancers of course, we want to use our best therapy first, and I think these studies are an initial step at looking at that. In terms of the second question around the patient population, these are pretty representative patient populations, I would say, for most frontline CLL studies. We see patients who are a bit younger and fitter than sort of the general population of CLL patients who are treated in clinical practice, and I think that is true here as well. Median age in the sort of mid-60s here is a bit younger than the typical patients we are treating in practice. But that is not different from other CLL frontline studies that we have seen recently, so I think it makes it a little bit easier as we kind of think across studies to feel comfortable that these are relatively similar populations. Dr. Jonathan Friedberg: How do you see this either getting regulatory approval or potentially being used compared to current standard of care options? Dr. Matthew Davids: So my understanding is that both of these trials were designed with registrational intent in the frontline setting, and they are both positive studies. That is certainly very encouraging in terms of the potential for an approval here. We have seen in terms of the FDA recently some concerns around the proportion of patients who are coming from North America, and my understanding is that is relatively low on these two studies. But nonetheless, the datasets are very impressive, and so I think it is certainly supportive of regulatory approval for frontline pirtobrutinib. Dr. Jonathan Friedberg: I will ask Jennifer a question. The control arm in your study was ibrutinib, and I think many in the audience may recognize that newer, second-generation BTK inhibitors like acalabrutinib and zanubrutinib are more frequently used now if monotherapy is decided. How do you respond to that, and how would you put your results in your pirtobrutinib arm in context with what has been observed with those agents? Dr. Jennifer Woyach: Yeah, that is a great question. Even though in the United States we are predominantly using acalabrutinib or zanubrutinib when choosing a monotherapy BTK inhibitor, this is actually not the case throughout the entire world where ibrutinib is still used very frequently. The head-to-head studies of both acalabrutinib and zanubrutinib compared to ibrutinib have shown us pretty well what the safety profile and efficacy profile of the second-generation BTK inhibitors is. So even though we do not have a head-to-head study of acalabrutinib or zanubrutinib versus pirtobrutinib, I think, given the entirety of data that we have with all of the covalent BTK inhibitors, I think we can safely look at the pirtobrutinib arm here, how the ibrutinib arm compares or performs in context with those other clinical trials. And though we really can not say anything about pirtobrutinib versus acalabrutinib or zanubrutinib, I think we can still get a good idea of what might be the clinical scenarios in which you might want to choose pirtobrutinib. Dr. Jonathan Friedberg: And Wojciech, do you agree with that? Obviously, I think you have acknowledged that chemoimmunotherapy is rarely used anymore as part of upfront treatment for CLL. So, I guess a similar question. If you were to put the pirtobrutinib result in your study in context with, I guess, more contemporary type controls, would you agree that it is competitive? Dr. Wojciech Jurczak: Well, I think that that was the last study ever where bendamustine-rituximab was used as a comparator arm. So we should notice that smashing difference. Because if we look at the progression-free survival at two years, we have 93.4% in pirtobrutinib arm versus 70.7% in bendamustine-rituximab arm. Bendamustine-rituximab arm did the same as in the other trials, like ALLIANCE or SEQUOIA. Pirtobrutinib did exceptionally well, as pirto is not just the very best BTK inhibitor overcoming the resistance, but perhaps even more important for the first line, it is very well tolerated and is a very selective drug. Now, if we look at treatment-related adverse events, the discontinuation rate, they were hardly ever seen. If we compared the adverse events in exposure-adjusted incidence, literally all adverse events were two or three times higher in bendamustine-rituximab arm except for the bleeding tendency, which however was predominantly in CTCAE grade 1 and 2 with just 0.7% of grade 3 hemorrhage. Therefore, I think that we should actually put the best and the safest drugs upfront if we may, and pirtobrutinib is, or should be, the first choice if we choose monotherapy. Now, I understand that we are not presenting you the data of pirtobrutinib in combination with anti-CD20 or with BCL2 inhibitors, but that is to come. Dr. Jonathan Friedberg: Matt, how would you envision, were regulatory approval granted and this were an option, using this in the upfront patient population? Is there anybody who you would preferentially use this or start on this treatment? Or would this be something that you would tend to reserve for second line? Dr. Matthew Davids: So I would say that in general for most of my patients who would want to start with a continuous BTK inhibitor, I would still use a covalent BTK inhibitor, and I say that for a couple of reasons despite the very promising data from these studies. The first is that the follow-up for both of these phase 3 trials is still quite short, in the range of a median 18 to 24 months. And we know that CLL is a marathon, not a sprint, and these patients are going to probably be living for a very long time. And we do have much longer follow-up from the covalent BTK inhibitors, median of 10-year follow-up with ibrutinib and five to six years with zanubrutinib and acalabrutinib respectively. And you know, I do not think that the pirtobrutinib is going to fall off a cliff after two years, but on the other hand, I think there is a lot of value to long-term data in this disease, and that is why I think for most of my patients I would stick with covalent BTK inhibitors. But the other important factor that we need to consider is patients who are younger and may have many different CLL treatments over the years. We have to be very careful, I think, about how we sequence these drugs. We know right now that we can start with covalent BTK inhibitors and then subsequently patients will respond well to the non-covalent inhibitor pirtobrutinib in later lines of therapy. But right now we do not have prospective data the other way around. So how will the patients on these studies who progress on pirtobrutinib respond to covalent BTK inhibitors? We do not know yet. There have not been a lot of progression events, which is great, but we would like to see some data in that respect to feel more comfortable with that sequence. Now, I do think that particularly for older patients and those who have significant cardiovascular comorbidities, if they wanted to go on a continuous BTK inhibitor, I do think these data really strongly support using pirtobrutinib as the BTK inhibitor of choice in that population. In particular, the cardiovascular risks with pirtobrutinib seem to be quite low. I was very struck in the comparison with BR that the rate of AFib was equivalent between the two arms of the study. And that is really the first time we have seen that with any of these BTK inhibitors, no elevated risk of AFib in a randomized study. I think that is the population where it will get the most traction first, is the upfront, sort of older patient with significant cardiovascular comorbidities. And as the data from these studies mature, I think that we will start to see more widespread use of pirtobrutinib in the frontline setting. Dr. Jonathan Friedberg: Jennifer, I am just curious if you have any personal experience or heard anecdotally about after progression on pirtobrutinib the use of other BTK inhibitors and whether there is a growing experience there. Dr. Jennifer Woyach: I do not think that there is much clinical experience, you know, as Matt alluded to, it certainly has not been tested yet. There has been some data in relapsed CLL suggesting that in people who have resistance mutations to covalent BTK inhibitors after treatment with pirtobrutinib, sometimes those mutations go away. I think most of us are concerned that they are probably not actually gone but maybe in compartments that we just have not sampled, suggesting that sort of approach where you might sequence a covalent inhibitor after a non-covalent in somebody who had already been resistant probably would not work that well. But, you know, in this setting where people had never been exposed to a covalent BTK inhibitor before, we really have no idea what the resistance patterns are going to be like. We assume they will be the same as what we have seen in relapsed CLL, but I think we just need some longer follow-up to know for sure. Dr. Wojciech Jurczak: If I may confront Dr. Davids about the use of covalent BTK inhibitors upfront, well, I think that we should abandon the idea of using the first and the second and the third generation, at least if we don't have medical lines. If we endlessly block the same pathway, it is not going to be effective. So if pirtobrutinib gets approval in first, second line, we do not necessarily have to use it in the first line. I am not here in a position to defend that we should treat patients with pirtobrutinib upfront and not BCL2 time-limited regimen. However, the way I look at CLL patients when choosing therapy is not just how should I treat them now, but what would be the best regimen in 5, 10 years if I have to re-treat them. And in some instances, the idea may be that in this setting we would like to have a BTK inhibitor upfront to have a BCL2 inhibitor later to make it time-limited. Although I understand and I agree with Matthew that if we have an elderly, fragile population, then the charm of having a drug taken once a day in a tablet with literally few cardiovascular adverse events might be an option. Dr. Jonathan Friedberg: And I will give Matt the last word whether he wants to respond to that, and also just as a forward-looking issue, I know both investigators have implied that there will be future studies looking at combinations with pirtobrutinib, and if you have any sense as to what you would be looking for there. Dr. Matthew Davids: The field really is heading toward time-limited therapy for most patients, I would say. There is a bit of a discrepancy right now in the field between sort of what we are doing in academic practice and what is done sort of more widely in community practice. And so right now we are going to see evolving datasets comparing these approaches. We are already seeing data now from the CLL17 study with ibrutinib comparing continuous to time-limited venetoclax-based therapy, and we are seeing similar efficacy benefits from these time-limited therapies without the need for continuous treatment. And so that is where I think some of the future studies with pirtobrutinib combining it with venetoclax and other partners are so important. Fortunately, several of these studies are already ongoing, including a phase 3 trial called CLL18, which is looking at pirtobrutinib with venetoclax, comparing that to venetoclax and obinutuzumab. So I am optimistic that we are going to be developing these very robust datasets where we can actually use pirtobrutinib in the frontline setting as a time-limited therapy as a component of a multi-drug regimen. So far, those early data are very promising. Dr. Wojciech Jurczak: Perhaps last but not least, in a single center we have treated over 300 patients with pirtobrutinib. So eventually some of them relapsed. And I must say that our experience on BCL2 inhibitors, not just venetoclax but including sonrotoclax, are appealingly good. Therefore, by using pirtobrutinib even earlier, we do not block the efficacy of other compounds. Dr. Jonathan Friedberg: All right. Well, I want to thank all of our speakers. I also want to congratulate our two guests who presented these very influential papers at the ASH Annual Meeting, and chose to publish them in JCO, so we thank you for that, and Dr. Davids for your commentary - really appreciated. That is this episode of JCO After Hours. Thank you for your attention. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.   Disclosures Dr. Wojciech Jurczak Consulting or Advisory Role: BeiGene, Lilly, Abbvie/Genentech, Takeda, Roche, AstraZeneca Research Funding: Roche, Takeda, Janssen-Cilag, BeiGene, AstraZeneca, Lilly, Abbvie/Genentech Dr. Jennifer Woyach Consulting or Advisory Role: Pharmacyclics, Janssen, AstraZeneca, Beigene, Loxo, Newave Pharmaceutical, Genentech, Abbvie, Merck Research Funding: Company name: Janssen, Schrodinger, beone, Abbvie, Merck, Loxo/Lilly Dr. Matthew Davids Honoraria: Curio Science, Aptitude Health, Bio Ascend, PlatformQ Health, Plexus Consulting or Advisory Role: Genentech, Janssen, Abbvie, AstraZeneca, Adaptive Biotechnologies, Ascentage Pharma, BeiGene, Lilly, Bristol-Myers Squibb, Genmab, Merck, MEI Pharma, Nuvalent, Inc., Galapagos NV, Schroedinger Research Funding: Ascentage Pharma, Novartis, MEI Pharma, AstraZeneca  

What if the only thing standing between you and your breakthrough year… is your comfort zone? In this powerful solo episode, Dr. Lauryn gets radically honest about the habits, mindset shifts, and uncomfortable changes required to create a life, business, and level of health that don't just look good on a vision board — but actually happen in real life. If you're tired of feeling stagnant, overwhelmed, or stuck in the same patterns, this episode will wake you up in the best way.Lauryn dives into the truths most high achievers avoid: why comfort quietly kills momentum, how ceilings form inside us long before they show up in our numbers, and why the body always keeps the score when ambition goes unchecked. She shares her 2026 plan with total transparency — from tightening her health habits after an unexpected AFib diagnosis, to leveling up her business strategy, to grounding her goals in faith and intention. If you're ready for a year that asks more of you (and rewards you for it), this is your roadmap.Key TakeawaysGrowth requires discomfort — every time. Lauryn breaks down why comfort zones create stagnation, how to identify the real ceilings in your life and business, and what it takes to push through them with intention and clarity.Your health is part of your success strategy. After facing a surprising AFib diagnosis, Lauryn shares how stress, ambition, and ignored habits catch up — and why your body will always force changes you don't willingly make.Big goals demand real systems. Learn how to reverse-engineer revenue, plan launches, delegate effectively, and treat your business like a business rather than “fun money.”Your relationships and faith must evolve with your ambitions. Lauryn explores how marriage, spirituality, and emotional grounding become non-negotiable when you're scaling your life in any direction.Resources:Join The Uncharted CEO: An 8-week immersive experience for clinic owners designed to increase revenue, maximize profits, and build cash flow systems that create freedom NOW, not at 65.Follow Dr. Lauryn: Instagram | X | LinkedIn | FacebookFollow She Slays on YouTubeSign up for the Weekly Slay newsletter!Mentioned in this episode:Go from surviving to thriving with Genesis Chiropractic Software. Learn more and get your special discount using the link below!Genesis Chiropractic SoftwareHolistic Marketing HubHolistic Marketing HubTo learn more about CLA and the INSiGHT scanner go to the link below and enter code SHESLAYS when prompted.CLADo you need help in your practice with the busy work that you or your staff don't like doing? If you said yes, then you've got to check out the virtual chiropractic assistants offered by Chiro Matchmakers.Chiro MatchmakersLearn more about Sunlighten Saunas and get your She Slays discount by clicking the link...

Updates on coffee and AFib, a polypill approach for HFrEF, the first oral PCSK9 inhibitor, vitamin D supplementation for secondary prevention, and more: Joanna Chikwe, MD, chair of the American Heart Association's Scientific Sessions conference and of the Department of Cardiac Surgery in the Smidt Heart Institute at Cedars-Sinai Medical Center, shares clinical research highlights from the recent meeting. Related Content: Coffee and AFib, Oral PCSK9 Drugs, an HFrEF Polypill, and Vitamin D Post-MI—Highlights From AHA 2025

In this episode of The Healthspan Podcast, Dr. Robert Todd Hurst, MD, FACC, FASE, explores the powerful intersection between sleep, heart health, and medical innovation.   Joining him is Dr. Ruchir Sehra, a physician, cardiologist, and medical device entrepreneur whose career spans electrophysiology, venture capital, and health technology. Together, they discuss how better sleep can prevent heart disease, why modern healthcare must evolve beyond reactive care, and how technology and AI are reshaping medicine for the age of longevity.   They discuss the connection between sleep apnea and atrial fibrillation (AFib), the importance of lifestyle medicine, and how future healthcare models can extend both lifespan and healthspan.   About the Guest:   Dr. Ruchir Sehra is a cardiologist, electrophysiologist, and healthcare innovator with decades of experience at the intersection of medicine, business, and technology. He has led and advised multiple medical device startups and continues to champion innovation that advances preventive and personalized healthcare. His work spans arrhythmia treatment, sleep health, and AI-driven patient solutions.

Welcome back to this week's Friday Review where I can't wait to share with you the best of the week!     I'm looking forward to reviewing:     Beacon40 (product review) Artificial Sweeteners & AFib Risk (research) Blood Markers & Depression Link     For all the details tune into this week's Cabral Concept 3584 – Enjoy the show and let me know what you thought!   - - - For Everything Mentioned In Today's Show: StephenCabral.com/3584 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

Weird Thanksgiving Side Dishes...Thanksgiving Trending...Ask The Morning Crew -- PLUS -- we want Friday off, coffee & Afib, Titanic watch vs. Superman, and much more

In this episode of The Healthspan Podcast, Dr. Robert Todd Hurst, MD, FACC, FASE, sits down with electrophysiologist Dr. Varma to break down everything you need to know about AFib, from stroke prevention and rhythm control to lifestyle modification and quality of life strategies. You'll learn about the four core pillars of AFib management, how modern ablation techniques have evolved, and why understanding your triggers is key to getting your life back. Meet Our Guest Dr. Varma is a board-certified cardiologist and electrophysiologist who specializes in heart rhythm disorders. With a passion for personalized, whole-person care, she brings a modern, patient-centered approach to treating AFib and helping people regain control over their health and quality of life. ⏱️ Timestamps 00:00 – Introduction from Dr. Robert Todd Hurst, MD, FACC, FASE 00:50 – The four pillars of atrial fibrillation treatment 02:30 – What “contemporary rhythm control” really means 03:15 – Why early ablation is now a top recommendation 04:00 – Lifestyle and risk factor modification explained 05:30 – Treating sleep apnea, obesity, alcohol use, and more 06:45 – How much do genetics actually matter? 07:40 – The surprising mental and emotional toll of AFib 08:15 – Dr. Varma's approach to quality of life in AFib patients 09:30 – Final advice: take charge, see a specialist, reclaim your life 10:30 – How HealthspanMD can help with personalized heart longevity care   This information is for educational purposes only and is not medical advice. Don't make any decisions about your medical treatment without first talking to your doctor. *Connect* *with* *HealthspanMD* :

Send us a textAccording to the American Heart Association, Afib affects an estimated 5 million Americans today, and 12 million are projected to have it by 2030. Returning to the podcast to discuss Atrial Fibrillation is Dr. Talha Farid, cardiologist with St. Luke's Heart Care Clinic. To learn more about heart care services at St. Luke's Hospital, visit unitypoint.org/cr-heart.Do you have a question about a trending medical topic? Ask Dr. Arnold! Submit your question and it may be answered by Dr. Arnold on the podcast! Submit your questions at: https://www.unitypoint.org/cedarrapids/submit-a-question-for-the-mailbag.aspxIf you have a topic you'd like Dr. Arnold to discuss with a guest on the podcast, shoot us an email at stlukescr@unitypoint.org.

Program notes:0:50 Fish oil supplements and hemodialysis1:50 1200 individuals to fish oil or not2:50 Needs another study3:11 PCSK9 inhibitor in people without MI or stroke4:13 3- or 4-point MACE5:11 Getting LDL down helps6:11 Addition of more than one oral agent6:50 Right therapy for afib and a stent7:50 Noninferiority trial8:50 After 12 months single agent works9:27 Anticoagulation after afib tx10:30 Low primary safety outcomes11:25 96% won't have a stroke12:16 End

Family nurse practitioner Karen re-airs a timely episode on “holiday heart syndrome,” the spike in alcohol-triggered arrhythmias (often AFib) that can strike otherwise healthy people during festive gatherings. She explains what binge drinking looks like, key symptoms to watch for (from palpitations and chest pressure to shortness of breath), why it raises stroke risk, and simple prevention steps.Visit our website itchyandbitchy.com to read blog posts on the many topics we have covered on the show.

In this Faces of Digital Health episode Dr. David Dodick, Chief Science and Medical Officer at the Atria Health Institute and Co-Chair of the Atria Research Institute talks about brain health, dementia prevention, the rapidly evolving science of Alzheimer's, and how digital tools and AI are transforming care. We also cover why women face higher Alzheimer's risk, the microvasculature's role in cognition, and the biggest leap in migraine treatment: CGRP-targeting therapies. A must-watch if you're curious about prevention, personalized risk, and which consumer tech is actually useful today. Dr. David Dodick trained at the Mayo Clinic and served on the faculty there for more than three decades. At the Mayo Clinic, he founded the Neurology Residency Program, the Headache Fellowship Program, the Sports Neurology and Concussion Program, the Migraine and Headache Program, and co-founded the Vascular Neurology/Stroke Program. What you'll learn: 1. How much dementia is realistically preventable—and how to lower your risk 2. Why amyloid ≠ destiny, and what “biological vs. clinical” Alzheimer's means 3. The role of sleep, hearing, blood pressure, metabolic health, and social connection 4. Smart wearables that matter (AFib, BP, CGM) and what's just hype 5. How AI “diagnostic orchestrators” could supercharge clinicians and empower patients 6. Migraine red flags (when to go to the ER) and the CGRP revolution in treatment

Back on the Free Outside podcast, I'm catching up with Will Murray after a wild eight months. Since Black Canyon he's gone all-in: new coach (CTS's John Fitzgerald), smarter long runs, and a rock-solid mindset that turned Javelina into a masterclass in steady, no surges. We talk about why he wore a pack while the front pack rocked belts (spoiler: seven bottles a lap and an ice pocket), how he practices mantras on long runs, and the simple crew rule that keeps big races from falling apart: do simple better. Will opens up about the detour through AFib, an ankle injury, a bout of giardia, and how cycling + hiking rebuilt fitness and trust. We also wander into big ideas—Western States, training camps, and what a Grand Tour of trail running could look like. It's process over hype, and it's really, really good.Chapters00:00 Intro & catching up05:30 All-in since Black Canyon08:30 Why get a coach (CTS/John)11:00 Race plan: steady, no surges13:30 Lap themes & mindset15:30 Pack choice & hydration (7 bottles/lap)18:00 Mantras in training20:30 Crew: “Do simple better”23:00 AFib, ankle, giardia detour26:00 Rebuilding with cycling & hiking29:00 Western States lessons32:00 Future goals & balance34:00 Shoes talk (Catamount, super shoes?)36:00 Stage-race / team ideas38:00 Wrap & outroSubscribe to Substack: http://freeoutside.substack.comSupport this content on patreon: HTTP://patreon.com/freeoutsideBuy my book "Free Outside" on Amazon: https://amzn.to/39LpoSFEmail me to buy a signed copy of my book, "Free Outside" at jeff@freeoutside.comWatch the movie about setting the record on the Colorado Trail: https://tubitv.com/movies/100019916/free-outsideWebsite: www.Freeoutside.comInstagram: thefreeoutsidefacebook: www.facebook.com/freeoutside

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