Podcasts about boster

Einige sagen, Charisma sei eine Gabe. Charisma hat man. Oder eben auch nicht. Auch die Psychologie hat sich lange Zeit schwer damit getan, diese ganz besondere Anziehungs-kraft bestimmter Menschen zu erklären. Inzwischen ist jedoch klar: in puncto „Ausstrahlung“ können sich Menschen durchaus einiges antrainieren. Wie? Darüber rede ich mit Ann-Kathrin Reuter. Sie ist Coach und Autorin des Buches „Tausche Grau gegen WOW!“. Als ‚Frau Propeller‘ zieht sie auf Instagram Tausende in ihren Bann. ACHTUNG! Diese Podcast-Episode ist ein Mitschnitt der Original-Redebeiträge meiner 'Sendung Sag mal Tanja?! Der antenne 1 Neckarburg Rock & Pop Talk'.

Margo Boster is a leadership coach and yoga teacher with over twenty- five years of diverse roles in information technology across private sector companies and governmental organizations. The book's title is Mindfully Successful, how do you describe what mindfully successful is and what it isn't? Can you share a real example of where a “successful” leader was hindering themselves or getting in their way – perhaps working harder than they had to or having an unintended impact on their team or organization - and how your techniques improved their performance, effectiveness, and health? Tell me a story of how you help your clients to move forward after a trauma. What can parents do to not have their children once leaders stop the negative talk to themselves? How do you help leaders become aware of why they want to be successful and why they are chasing it? Margo Boster Margo Boster is a leadership coach and yoga teacher with over twenty- five years of diverse roles in information technology across private sector companies and governmental organizations. She has spent the last fifteen years working with CEOs, US military generals, and other senior executives to reach their peak potential. Drawing on extensive studies of psychology, anatomy, philosophy, neuropsychology, and adult development, Boster has crafted a coaching philosophy that integrates the latest insights from these fields with her decades of leadership experience. She shares her insights in MINDFULLY SUCCESSFUL: Unlock the Power of Your BRAIN, BODY, and BREATH to Elevate Your Leadership (Amplify Publishing). Excellent Executive Coaching Podcast If you have enjoyed this episode, subscribe to our podcast on iTunes. We would love for you to leave a review. The EEC podcasts are sponsored by MKB Excellent Executive Coaching that helps you get from where you are to where you want to be with customized leadership and coaching development programs. MKB Excellent Executive Coaching offers leadership development programs to generate action, learning, and change that is aligned with your authentic self and values. Transform your dreams into reality and invest in yourself by scheduling a discovery session with Dr. Katrina Burrus, MCC to reach your goals. Your host is Dr. Katrina Burrus, MCC, founder and general manager of Excellent Executive Coaching a company that specializes in leadership development.

Join Scott "Shalom" Klein on his weekly radio show, Get Down To Business with guests: Anthony Degrado Margo Boster Ben Lamorte George Danis

Welcome to Living Well with MS, the podcast that empowers you to take control of your health and wellbeing. Today we're thrilled to welcome back Dr Aaron Boster as our guest! Dr Boster is a board-certified Neurologist specialising in Multiple Sclerosis. He is a frequent guest on Living Well with MS and in this episode he's here to talk about Medication, one of the pillars of the Overcoming MS Program. Specifically, Aaron goes into detail on a wide range of disease modifying therapies (DMTs) for MS, as well as discussing when people should start taking DMT's, and what they should consider before they do so. There's lots of useful information in this episode about many different DMT options – we hope you find it useful in making the right decisions for you. Let us know what you think! Watch this episode on YouTube here. Keep reading for the key episode takeaways. Topics and Timestamps: 01:21 What are the medication choices for people with MS and how have they improved? 02:39  When should I start a DMT? 04:30  What should I consider when choosing a drug? 07:08  Alemtuzumab (Lemtrada) 11:14  Cladribine (Mavenclad) 15:05  Fingolimod (Gilenya) 17:13  Mitoxantrone (Novantrone) 18:39  Natalizumab (Tysabri) 21:42  Ofatumumab (Kesimpta) 25:01  Ocrelizumab (Ocrevus) 28:58  Ozanimod (Zeposia) 30:35  Rituximab (Rituxan, MabThera, and Truxima) 32:34  Siponimod (Mayzent) 34:59  Avonex/ Betaferon/ Refib/ Extavia 37:49  Glatiramer Acetate (Copaxone) 40:07  Dimethyl Fumarate (Tecfidera) 42:38  Diroximel Fumarate (Vumerity) 43:46  Plegridy 44:45  Ponesimod (ponvory) 45:41  Teriflunomide (Aubagio) 50:14  Low-dose Naltrexone 52:07  BTK inhibitors   Want to learn more about living a full and happy life with multiple sclerosis?  Sign up to our newsletter to hear our latest tips. More info and links: Dr Boster was on six previous Living Well with MS episodes: S1E11: Making the Right Medication Choices S2E17: Lifestyle Choices and Their Impact on MS S3E43: Let's Talk About Sex (and MS) S5E5 Webinar highlights from Ask Aaron with Dr. Aaron Boster S5E36 Webinar Highlights: Ask a Neurologist with Dr Aaron Boster S6E19 Webinar Highlights: Ask a Neurologist with Dr Aaron Boster Check out Dr Boster's popular YouTube channel covering all aspects of MS New to Overcoming MS? Visit our introductory page Connect with others following Overcoming MS on the Live Well Hub Visit the Overcoming MS website Follow us on social media: Facebook Instagram YouTube Pinterest Don't miss out:  Subscribe to this podcast and never miss an episode. Listen to our archive of Living Well with MS episodes here. If you like Living Well with MS, please leave a 5-star review. Feel free to share your comments and suggestions for future guests and episode topics by emailing podcast@overcomingms.org. Make sure you sign up to our newsletter to hear our latest tips and news about living a full and happy life with MS. Support us:  If you enjoy this podcast and want to support the ongoing work of Overcoming MS, we would really appreciate it if you could leave a donation here. Every donation, however small, helps us to share the podcast with more people on how to live well with MS.

Welcome to Living Well with MS, the podcast that empowers you to take control of your health and wellbeing. Today we're sharing the highlights from our ‘Ask Aaron' webinar, recorded in front of a global audience, with the incredible Dr Aaron Boster. Dr Boster is a board-certified neurologist who specialises in MS, and we're delighted to have him answering a huge range of questions from our community! From medications to MRI's and pregnancy to cold showers, Dr Boster gave us so many brilliantly informative answers - we hope you find this episode really useful. Let us know what you think!     Watch this episode on YouTube here. Keep reading for the key episode takeaways.     Topics and Timestamps:    01:49 Defining benign MS  05:05 How to get the most out of your time with your neurologist  09:32 The DMTs that help with brain atrophy  09:46 MRI's as a way to show the rate of brain atrophy  18:20 Aubagio for secondary progressive MS  22:11 The future of Ocrevus dosing guidelines and becoming pregnant on ocrelizumab  26:31 Treating MS-relating dystonia  28:37 Treatments for MS-related bladder dysfunction   35:15 Low-dose Naltrexone for MS  39:00 The benefits of cold showers   39:38 Immune reconstitution therapies   43:22 Managing MS with diet and exercise   To join us live for the next webinar or watch the original presentation head to our website overcomingms.org    More info and links:   Dr Boster was on five previous Living Well with MS episodes: S1E11: Making the Right Medication Choices    S2E17: Lifestyle Choices and Their Impact on MS   S3E43: Let's Talk About Sex (and MS)  S5E5 Webinar highlights from Ask Aaron with Dr. Aaron Boster  S5E36 Webinar Highlights: Ask a Neurologist with Dr Aaron Boster  Check out Dr Boster's popular YouTube channel covering all aspects of MS  New to Overcoming MS? Visit our introductory page   Connect with others following Overcoming MS on the Live Well Hub   Visit the Overcoming MS website    Follow us on social media:  Facebook  Instagram  YouTube  Pinterest  Don't miss out:   Subscribe to this podcast and never miss an episode. Listen to our archive of Living Well with MS episodes here. If you like Living Well with MS, please leave a 5-star review.  Feel free to share your comments and suggestions for future guests and episode topics by emailing podcast@overcomingms.org.  Make sure you sign up to our newsletter to hear our latest tips and news about living a full and happy life with MS.  Support us:   If you enjoy this podcast and want to support the ongoing work of Overcoming MS, we would really appreciate it if you could leave a donation here. Every donation, however small, helps us to share the podcast with more people on how to live well with MS. 

Micah Boster, micah@nighthawkadvisors.comLinkedIn, https://www.linkedin.com/in/micahboster/..Feel free to contact us with any questionsBill Kenney, bill@meetroi.comMEET, http://meetroi.com/

Podcast, host Mark Jewell converses with Darrin Boster, President of Elevar Agri-Solutions, on the importance of being intentional in business and life. Darrin starts by drawing sports analogies to explain the power of commitment and how clarity in vision and adaptability play crucial roles in achieving success. They dive deep into the growth and unique business model of Elevar Agri-Solutions, highlighting transparency as a key differentiator in the fertilizer industry.This episode covers Darrin's experiences moving from a large organization like Koch Industries to running a startup. Key discussions include the dynamics of team building, managing decision rights, and creating a strong company culture through communication and transparency. Darrin shares his insights into lifelong learning, dealing with industry-specific challenges, and the significance of embracing new roles to drive personal and professional growth. Listeners are treated to anecdotes and practical advice on leadership, decision-making, and overcoming hurdles in the dynamic world of agribusiness.Key Takeaways:Commitment and Intentionality: Darrin emphasizes the importance of having a clear vision and committing fully to it while staying adaptable and aware of possible unknowns.Transparency in Business: Building trust and stickiness with clients through transparency, especially in sectors like fertilizer, can set a company apart.Effective Team Building: Attracting the right people involves offering flexibility, betting on their potential, and ensuring they understand the company's vision and their role within it.Growth through Challenges: Facing and overcoming challenges by stepping into unknown roles helps drive significant personal and professional growth.Creating Strong Culture: Communication, respect, and honesty are pivotal in building a cohesive and productive company culture.Notable Quotes:"To me, being intentional is having a clear vision where you want to go and committing to that while being aware of your lack of knowing and being willing to adjust your path.""Whether you want to call it transparency, honesty, or respect, sharing what's going on in your business with your team is crucial for building a strong culture.""I had a coach that always said, 'you got to commit to violence today'... if you don't commit, you're going to get hurt.""You just have to be a lifelong learner because whatever you thought you knew, it's always changing.""Comparison is the thief of joy, but you've got to check the scoreboard. It's about comparing yourself to your previous self, not others."For more insightful discussions and expert advice from industry leaders, tune into the full episode and stay connected with the Intentional Agribusiness Leader Podcast. Keep up with us for more valuable content and deep dives into the world of agribusiness.

Yarona Boster is an Advanced Certified Life Coach and International Speaker in the areas of Parenting, Loss, Infertility and Trauma. For over 17 years she has studied and worked in the fields of early childhood, psychology and coaching. How is loss connected to parenting? What is an emotional intelligent child? Is it a skill that we are born with or learn it? What vocabulary can we parents use to enhance our children's emotional intelligence? Are there any "best practice" strategies you'd recommend to executive, high profile parents? Yarona Boster Yarona Boster is an Advanced Certified Life Coach and International Speaker in the areas of Parenting, Loss, Infertility and Trauma. For over 17 years she has studied and worked in the fields of early childhood, psychology and coaching. Additionally, Yarona is an accomplished TEDx Speaker and Certified Speaker Coach who works with speakers the world over to hone and deliver their own TEDx talks, keynotes and more. In addition to her parenting podcast series "The Evolution of Parenting," her parenting book, “Unspoken Signals,” will revolutionize the way parents learn essential skills to raise emotionally secure children. As the daughter of a Holocaust survivor, having suffered acute losses and multiple traumas herself, Yarona believes we are all trying to live a life of purpose in the finite time we have left. Excellent Executive Coaching Podcast If you have enjoyed this episode, subscribe to our podcast on iTunes. We would love for you to leave a review. The EEC podcasts are sponsored by MKB Excellent Executive Coaching that helps you get from where you are to where you want to be with customized leadership and coaching development programs. MKB Excellent Executive Coaching offers leadership development programs to generate action, learning, and change that is aligned with your authentic self and values. Transform your dreams into reality and invest in yourself by scheduling a discovery session with Dr. Katrina Burrus, MCC to reach your goals. Your host is Dr. Katrina Burrus, MCC, founder and general manager of Excellent Executive Coaching a company specialized in leadership development.

We're all living longer and that includes people living with MS. And as they age, people with MS are asking new questions. Is there a need to stay on disease-modifying therapy after the age of 60?  How do we know whether a new symptom is a symptom of MS or a symptom of aging? Does an additional age-related health condition make treating MS more difficult? Does treating MS make treating that new health condition more difficult? How can we best offset the social isolation that's often associated with MS and with aging? This week, Dr. Aaron Boster joins me on a deep dive into aging with MS. Dr. Boster brings 19 years of experience as an MS clinician. He's participated in over 65 clinical trials. And, following its FDA approval, Dr. Boster administered the very first dose of Ocrevus in the world. Dr. Boster is well known throughout the MS community for the countless number of short videos and live Q&A sessions he regularly hosts and posts on YouTube. We have a lot to talk about! Are you ready for RealTalk MS??! This Week: Aging with MS :22 Dr. Aaron Boster tackles the multifaceted subject of aging with MS  1:59 Share this episode  38:09 Have you downloaded the free RealTalk MS app?  38:32 SHARE THIS EPISODE OF REALTALK MS Just copy this link & paste it into your text or email: https://realtalkms.com/337 ADD YOUR VOICE TO THE CONVERSATION I've always thought about the RealTalk MS podcast as a conversation. And this is your opportunity to join the conversation by sharing your feedback, questions, and suggestions for topics that we can discuss in future podcast episodes. Please shoot me an email or call the RealTalk MS Listener Hotline and share your thoughts! Email: jon@realtalkms.com Phone: (310) 526-2283 And don't forget to join us in the RealTalk MS Facebook group! LINKS If your podcast app doesn't allow you to click on these links, you'll find them in the show notes in the RealTalk MS app or at www.RealTalkMS.com Join the RealTalk MS Facebook Group https://facebook.com/groups/realtalkms Download the RealTalk MS App for iOS Devices https://itunes.apple.com/us/app/realtalk-ms/id1436917200 Download the RealTalk MS App for Android Deviceshttps://play.google.com/store/apps/details?id=tv.wizzard.android.realtalk Give RealTalk MS a rating and review http://www.realtalkms.com/review Follow RealTalk MS on Twitter, @RealTalkMS_jon, and subscribe to our newsletter at our website, RealTalkMS.com. RealTalk MS Episode 337 Guest: Dr. Aaron Boster Privacy Policy

Welcome to Living Well with MS. In this episode, we are sharing the highlights from one of our ‘Ask Aaron' webinars, where neurologist, Dr Aaron Boster, answers questions about MS from the community. In this episode, Dr Boster covers a range of topics, including heat intolerance, when to start a DMT and his tips for self-managing MS. You can watch the original webinar here. Keep reading for the key episode takeaways.   Topics and Timestamps: 02:13 Considerations for changing to a less stressful job and stronger DMTs. 05:09 Talking to clinicians about stress. 06:25 Hyperbaric oxygen therapy. 08:11 Stem cell transplants for PPMS. 10:35 Tysabri during pregnancy and breastfeeding. 12:23 MS and Stroke. 13:52 MRI showing brain cysts. 16:57 Betaferon and slow progression. 19:45 Changing from Tysabri to Ocrevus. 21:41 Vertigo. 23:05 Ampyra for walking, spasticity, and nerve pain. 25:50 Types of inflammation. 28:05 Anesthetic or epidural and MS. 30:15 B-cell depletion therapy and allergies. 31:17 Tips for self-managing MS. 37:42 Heat intolerance. 40:30 When to start on a DMT. 41:22 Ocrevus and low lymphocyte levels. 43:40 Diet and MS. 48:50 Nausea as an MS symptom. 51:30 CBD for MS. 52:45 Bursitis and MS. 53:36 Choosing a DMT and considering side effects. 55:16 Invisible illness in an ableist world. Selected Key Takeaways: Exercise as part of your daily lifestyle  34:42 “Exercising as part of a lifestyle means that if you do it, you're not rewarded. There's no reward for doing something as part of your lifestyle and if you don't do it, there's no punishment - you're not sent to the naughty corner. So, for example, I have a lifestyle of brushing my teeth. I don't tweet about it. I don't make YouTube videos about it. I don't even talk about it when I get to work. It's just something I do every morning and if I happen to forget to brush my teeth before I head off to the office, I'll run upstairs and do it. This is part of my lifestyle. So, I need people impacted by MS to exercise as part of their lifestyle.” Plan your day to minimise symptoms like heat intolerance 39:43 “We can conserve energy during those times when it's really hot out. Whereas I would normally encourage a patient to park at the back of the parking lot to get their steps in. If it's the middle of the day, [walking that far is] going to sap all your energy so that when you get to the grocery store you can't shop, that doesn't really work very well, does it? And so that's an example where we would have someone drop us off at the threshold of the grocery store so that you can be successful in your shopping.” Be brave in using mobility aids and seeking accommodations. 57:27 “I tell people who are embarrassed by their cane, ‘Don't you dare be embarrassed by your cane, a cane is a sign of intelligence.' A person with a cane would like to not fall. So, when a little boy is walking with [his] mum, and says, ‘Mummy, why is she using a cane?' That's an opportunity for the mother to say, ‘Well, she doesn't want to fall, she has a problem with her leg and the cane helps her.' It normalises it. So, one of the things that we need to do is to be brave. I'll remind you of the definition of bravery, ‘doing something despite being scared'. The second thing is, I want you to be very selfish. You need to be selfish; you live your life once. You're not living your life so some stranger, you don't know, thinks nice polite things about you.” Want to learn more about living a full and happy life with multiple sclerosis? Sign up to our newsletter to hear our latest tips. More info and links: Watch the original webinar here. Dr Boster was on three previous Living Well with MS episodes: S1E11: Making the Right Medication Choices   S2E17: Lifestyle Choices and Their Impact on MS  S3E43: Let's Talk About Sex (and MS) Check out Dr Boster's popular YouTube channel covering all aspects of MS. New to Overcoming MS? Visit our introductory page  Connect with others following Overcoming MS on the Live Well Hub Visit the Overcoming MS website Follow us on social media: Facebook Instagram YouTube Pinterest Don't miss out:  Subscribe to this podcast and never miss an episode. Listen to our archive of Living Well with MS episodes here. If you like Living Well with MS, please leave a 5-star review. Feel free to share your comments and suggestions for future guests and episode topics by emailing podcast@overcomingms.org. Make sure you sign up to our newsletter to hear our latest tips and news about living a full and happy life with MS. Support us: If you enjoy this podcast and want to support the ongoing work of Overcoming MS, we would really appreciate it if you could leave a donation here. Every donation, however small, helps us to share the podcast with more people on how to live well with MS.

Cullen and Mason chat with Emma Boster from Dying Wish. They chat about Dying Wish's history, their new album, Emma's most influential albums, and much more.Check out Dying Wish here: https://dyingwishofficial.comSubscribe to our YouTube channel: youtube.com/@theblacksheeppodcastFollow us on Instagram: https://www.instagram.com/theblacksheeppodcast

9/15//23 - Host Doug Stephan and Dr. Ken Kronhaus of Lake Cardiology (352-735-1400) cover a number of topics, Including; FDA approves new COVID booster vaccine but unlikely that many will get it, Dr. Ken recommends that all adults should get current flu vaccine, new study shows that obesity leading to deaths from heart disease, being fit leads to better mental health, staying up late can lead to Dementia and Diabetes, Cancer rates up 79% with young people and finally, FDA says that most disinfectants are ineffective.This show is part of the Spreaker Prime Network, if you are interested in advertising on this podcast, contact us at https://www.spreaker.com/show/3010085/advertisement

Dr. Boster is a board-certified neurologist specializing in MS at the Boster Center for MS in Columbus, Ohio. Dr. Boster made the decision to become an MS doctor at the age of 12, as he watched his uncle Mark suffer from the disease in an era before MS treatment was available. Join Jenn and Dr. Boster as they discuss the passion behind his practice, how he translates MS care through his YouTube and social media channels, and takeaways for living your best life with MS. Join the conversation on our MS forums: www.multiplesclerosisnewstoday.com/forums/ Follow us on social media: Instagram - www.instagram.com/msnewstoday/ Facebook - www.facebook.com/multiplesclerosisnewstoday Twitter - www.twitter.com/msnewstoday For more news on Multiple Sclerosis visit: www.multiplesclerosisnewstoday.com/

This special episode of RealTalk MS is sponsored by Sanofi. In this special episode of RealTalk MS, Dr. Aaron Boster walks us through everything you need to know about clinical trials.  If you've ever wondered what the difference is between a Phase 1 clinical trial, a Phase 2 clinical trial, or a Phase 3 clinical trial, you're about to find out. If you're curious about how a clinical trial participant's privacy is protected, how safety is ensured, and how you can learn about clinical trials that may be taking place near you, it's time to click that PLAY button! Dr. Aaron Boster is a board-certified neurologist specializing in MS and the founder of the Boster Center for Multiple Sclerosis in Columbus, Ohio, Dr. Boster has been a principal investigator in numerous clinical trials and has published extensively in medical journals. To learn more about Sanofi's clinical research studies, please visit https://www.sanofistudies.com/us/en

The Book of War - An Avatar Legends Real PlayThe Story of four teens seeking balance in a world without the AvatarChapter 8 - Disguises and Disagreements - Part 2The Teens square up against the Boster, Buster and Bester. Banji's looses balance, Tomo closes a part of himself off, Mihn Fang takes another risk, and Nuro has some more vision shennanigans. Starring Lucas Li as "The Razor" TOMOGeorgie Hazel as "The Destined" NUROTed Darling as "The Guardian" BANJIJesse Thomas as "The Foundling" MINH FANGand Ash Cooper as the GAME MASTERTheme song and outro ""The Book of War Remains" is by Matt HarrisonAdditional music and Sound effects from Zapsplat.comWebsite // Facebook // Instagram // Twitter // Tik TokUse our new afffiliate code 'thebookofwar' at Arkenforge to recieve $5 off!Please take the time to review us! We would be eternally thankful!

Female composer representation in music world has come a long way since our first chat with Jenny Boster three years ago. Jenny Boster, NCTM, is the owner of The Playful Piano, and author of the Shades of Sound Music History series. To celebrate Women's History Month, Jenny has returned to teach us about 10 more female composers we need to listen to in 2023....okay, there's a chance we talk about more than ten....but who's really counting? Topics include: *Updates in the world of female composers *How life experiences shape compositions *5 historic female composers to listen to in 2023 *5 female composers from this year's Female Composer Challenge *What is the Female Composer Club? *Suggestions for teachers to incorporate music history in lessons

In today's episode, we welcome an award-winning physician, researcher, and educator, Dr. Aaron Boster. He is a board-certified Neurologist and the founder and President of the Boster Center for Multiple Sclerosis in Columbus, Ohio.We had the pleasure of catching up with Dr. Boster to talk about harnessing the power of social media to provide 24-7 access to information reliable, understandable medical information. He also breaks down the importance of clinical trials and walks us through each phase of a study and what a participant can expect.ABOUT US:The Demystifying NMO and MOG podcast is a project of the Sumaira Foundation (TSF) and was made possible with the generous support of Genentech.STAY CONNECTED:Aaron Boster, M.D.Website - https://bosterms.comYoutube - https://www.youtube.com/c/AaronBosterMDTwitter - https://twitter.com/AaronBosterMDDemystifying NMO podcastInstagram - https://www.instagram.com/demystifying_nmomogTwitter - https://twitter.com/DemystifyingNMOThe Sumaira FoundationWebsite - https://www.sumairafoundation.orgFacebook - https://www.facebook.com/TheSumairaFoundationThe Connor B Judge FoundationWebsite - https://www.connorbjudgefoundation.orgFacebook - https://www.facebook.com/cbjvnmoTIMESTAMPS/TOPICS:00:00:21 Dr. Aaron Boster00:01:54 Social Media for Patient Education00:03:39 Being an Active Participant in Your Care00:04:05 Shared Clinical Decision Making00:05:21 Better Communication00:07:21 Permission To Be Selfish00:10:48 YouTube00:11:29 Clinical Trials00:12:25 The Importance of Being Part of Clinical Trials00:13:34 The Phases of a Clinical Trial00:21:00 Finding Clinical Trials00:26:39 A Paradigm Shift00:29:48Killing Old MythsLINKS:Dr. Noster's Multiple Sclerosis Clinical Research YouTube Playlisthttps://youtube.com/playlist?list=PL3a4GpjWLtCiSkGgtl4UlnFFnk1FhevktCREDITS:Host - Chelsey JudgeEditor - Brian DawsonMusic - Denys Kyshchuk from PixabayGuest Photo - Boster Center for Multiple Sclerosis

Welcome to Living Well with MS, the Overcoming MS podcast where we explore all topics relating to living well with multiple sclerosis (MS). In this episode, we are sharing the highlights from one of our ‘Ask Aaron' webinars, where neurologist, Dr. Aaron Boster, answers questions about MS from the community. Dr. Boster covers a range of fascinating topics such as fasting, menopause and gut health.  This webinar was recorded in March 2022 as part of our Finding Hope with Overcoming MS webinar series. You can watch the whole webinar here or the podcast highlights on YouTube here.  Keep reading for the key episode takeaways and Dr Boster's bio. Keep in touch: Make sure you sign up to our newsletter to hear our latest tips and news about living a full and happy life with MS. And if you're new to Overcoming MS, visit our introductory page to find out more about how we support people with MS.    Dr. Aaron Boster's Bio:   Dr. Aaron Boster is an award-winning, widely published, and board-certified neurologist specialising in multiple sclerosis (MS) and related CNS inflammatory disorders. He currently serves as the Director of the Neuroscience Infusion Center at OhioHealth.   Why Dr. Boster chose to become a specialist in MS  Witnessing his uncle's diagnosis with MS when he was 12, he and his family came to see a lack of coherence in the way MS was treated at the time. That experience informed Dr. Boster's drive to do things differently.   Dr. Boster's career   At OhioHealth, he spearheads a revolutionary model in MS treatment and patient care drawing on interdisciplinary resources and putting patients and families first. Dr. Boster is also an Adjunct Assistant Professor of Neurology at Ohio University Heritage College of Osteopathic Medicine, and a former Assistant Professor of Neurology at The Ohio State University, where he also formerly headed the Neuroimmunology division.   Dr. Boster has been intimately involved in the care of people impacted by MS; he has been a principal investigator in numerous clinical trials, trained multiple MS doctors and nurse practitioners, and has been published extensively in medical journals. He lectures to both patients and providers worldwide with a mission to educate, energise and empower people impacted by MS.   Dr. Boster's education and personal life  Dr. Boster grew up in Columbus, Ohio and attended undergraduate at Oberlin College. He earned his MD at the University of Cincinnati College of Medicine and completed an internship in Internal Medicine and Residency in Neurology at the University of Michigan, followed by a two-year fellowship in Clinical Neuroimmunology at Wayne State University.   He lives in Columbus, Ohio with his wife, Krissy, son Maxwell, and daughter Betty Mae.    Selected Key Takeaways: Embracing exercise is an important step to improve outcomes for MS “I would encourage the entire family to embrace exercise, when it's nice outside, you go for a walk and kayaking and canoeing and what have you. We have excellent data that people impacted by MS who exercise as part of their lifestyle end up less disabled at the end of their life as compared to they didn't. And so we want to help instil those important, very, very important behaviours in a young person as early as possible.”  Intermittent Fasting is recommended and is safe for MS  “Within the last year, I've become very interested in not just what PwMS eat, but when they eat. When they eat turns out to matter. It's my opinion that intermittent fasting specifically is a bio-hack, not just for people impacted by MS,but for [all] humans. And it's my opinion that intermittent fasting is very safe in the setting of MS.”   What to consider when thinking about alternative medicine  “When someone wants to consider alternative medicine, which I will define as something that I was not taught in medical school, it doesn't make it good or bad. It just means I wasn't taught about it. An example might be acupuncture. I was not trained in acupuncture, which doesn't mean it's not real. It just means I don't know much about it. So, when I'm presented with something that is alternative, then I'm okay with it as long as three rules are met. The first one is it can't be too expensive. ... The second thing is it can't be dangerous. ... And [the] third is it can't be instead of something that I know works.”   Related Links:  Dr. Boster was on three previous Living Well with MS episodes: S1E11: Making the Right Medication Choices   S2E17: Lifestyle Choices and their Impact on MS    S3E43: Let's Talk About Sex (and MS) Check out Dr. Boster's popular YouTube channel covering all aspects of MS.    Don't miss out:   Subscribe to this podcast and never miss an episode. You can catch any episode of Living Well with MS here or on your favourite podcast listening app. If you like Living Well with MS, please leave a 5-star review on Apple Podcasts or wherever you tune into the show. Feel free to share your comments and suggestions for future guests and episode topics by  emailing podcast@overcomingms.org. Make sure you sign up to our newsletter to hear our latest tips and news about living a full and happy life with MS.    Support us:  If you enjoy this podcast and want to support the ongoing work of Overcoming MS, you can leave a donation here. 

#LifeCoach #Infertility #ParentCoach CONVERSATIONS WITH CALVIN WE THE SPECIES NEW: YARONA BOSTER; #LifeCoach #TEDx #Infertility #ParentCoach 192 Interviews. GLOBAL Reach. Earth Life. Amazing People. PLEASE SUBSCRIBE (You can almost find any subject you want) https://www.youtube.com/c/ConversationswithCalvinWetheSpecIEs YARONA BOSTER; TEDx Speaker; Certified Life Coach; Certified Speaker Coach; Infertility Coach, Mentor & Advocate; Loss/Trauma & Parent Coaching; Thought Leader; Rutgers (Bloustein School of Public Policy & Planning), '99 YouTube: Contacts: LinkedIn: https://www.linkedin.com/in/yarona-boster-30b18543/ Website: footprintscoaching.org/ Facebook: https://www.facebook.com/profile.php?id=100086807306793 ** Yarona grew up in Passaic and Clifton, NJ, attended Rutgers University and graduated with a Bachelor of Science in Public Health from the Bloustein School of Planning & Public Policy. During her time at RU, Yarona became one of the founding members of SHADES Theater, Student Health Advocates Developing Educational Scenarios, run by the Rutgers Department of Health. She was also an active part of the Sexual Health Advocates program, as well as TA for the course during her upper classman years. Although Yarona's heart remained with the health and well being of others, after graduation she expanded her experiences into animal health and became a veterinary technician for a time. After a number of very tumultuous years of pain, loss, grief and betrayal, Yarona eventually moved back into the public health realm in the field of early childhood, running an Early Intervention program for children with developmental delays and disabilities. As the child of a Holocaust survivor, daughter of divorce, sexual assault survivor, aunt to 2 children who died from their disabilities, a divorcee herself, end of life caregiver to both parents lost to cancer and an infertility warrior, Yarona is a loss expert and believes firmly in the saying that we don't always have a choice in what happens to us, but we can choose how we respond to it. ** ALSO ON AUDIO: SPOTIFY http://spoti.fi/3bMYVYW GOOGLE PODCASTS http://bit.ly/38yH3yP edits by Claudine Smith- Email: casproductions01@gmail.com ** PLEASE SUBSCRIBE (You can almost get any subject you want ) #animalrescue #climatechange #womenshealth #ONEHEALTH #water #singersongwriter #branding #mindfullness #comedy #sport #infertility #racialequity #stuntwomen

Plant-based food is a hot market, but plant-based meat is not, and gas prices up for the third straight week.

On the fifth episode of “No Shade, All Tea's” Season 2, host Dr. Nancy DiTunnariello talks with Maddie Bradford and Francisco Lopez about how people communicate with and through music. Show Info: Host: Dr. Nancy DiTunnariello, ditunnan@stjohns.edu Production: The Bolt Productions Intro/Outro Arrangement & Audio Editor: Courtney Lemkin Chief Audio Editor: Elizabeth Petrillo Chief Content Creator: Nicole Sutherland Show Linktree: https://linktr.ee/_NoShadeAllTea_ Photo Media: Cactus Girl Media Logo: Toni Sanchez Pop Art Guest Info: Name: Madeline Bradford Title: Social Media Coordinator, Mach 9 Digital LinkedIn: https://www.linkedin.com/in/madeline-bradford-2a96a9155 Name: Francisco Lopez Title: Documentarian Chief Editor LinkedIn: https://www.linkedin.com/in/francisco-lopez-78540b199 Research Sources: Bensimone, M. (2022). Integration of trauma in music therapy: A qualitative study. Psychological Trauma: Theory, Research, Practice, and Policy, 14(3), 367-376. Boster, J. B., Spitzley, A. M., Castle, T. W., Jewell, A. R., Corso, C. L., & McCarthy, J. W. (2021). Music improves social and participation outcomes for individuals with communication disorders: A systematic review. Journal of Music Therapy, 58(1), 12–42. Doi: 10.1093/jmt/thaa015 Fu, V. X., Oomens, P., Merkus, N., & Jeekel, J. (2021). The perception and attitude toward noise and music in the operating room: A systematic review. Journal of Surgical Research, 263, 193-206. Doi: 10.1016/j.jss.2021.01.038 Raglio, A., Bellandi, D., Manzoni, L., & Grossi, E. (2021). Communication improvement reduces BPSD: A music therapy study based on artificial neural networks. Neurological Sciences, 42, 2103-2106. Doi: 10.1007/s10072-020-04986-2

It seems today as if everyone and everything is using Communication technology. From the broadcast studio to the control room, houses of worship, and theme parks, digital communications are one of the most vital pieces of technology for effective operations. Bob Boster, President at Clear-Com, understands the need all too well. Clear-Com is an industry leader in providing digital communication solutions, and as Booster tells it, they live and breathe communications every day.Theme parks stuck out in host Ben Thomas' mind because he recently visited a theme park and was surprised to find Clear-Com technology in operation at one of the park's new rides. And this example points to the convergence of opportunities for digital applications of regular communications solutions that are tried and true, migrating to other verticals due to the ease of installation and lower cost to scale. “You have both local and global IP connectivity coming into play,” Boster said. “And also, people expect wireless to be everywhere because they carry these devices around with them.”People expect and need real-time communication no matter the venue, arena, or service. It's no longer a nice to have; it's a must-provide. And the right communication solutions can help businesses do more with fewer people, which is imperative in today's worker-shortage climate. “And then things are pulling apart,” Boster said. “The distances of production teams. Some people are doing stuff from home, some people doing stuff from remote operations somewhere in the park, or the entity, or theater; all those people needing to interact together to produce stuff.”Clear-Com tries to bring in solutions that fit existing communication hardware so businesses don't have to replace what they have. “That building block mentality allows us to help somebody scale or design a solution is the way we tend to work,” Boster said.

Today I'm talking to Dr. Aaron Boster about the 10 red flags when you should talk to your neurologist or maybe even look for a new one. This episode exists in two language versions. The original one is this English inteview. But there is a transcripted and translated German version, where I speak both parts. We go a bit more into details, how a good relationship and care should look like in order to keep multiple sclerosis under control as best as possible. Summary of the ten red flags: Before we go into detail, please list once the ten red flags patients should be aware of when going to their neurologist [05:53] Dr. Aaron Boster: Yeah, sure. So, these are in the order that I presented them. And the context is if your neurologist does one of these things, you should be concerned and consider whether you stay with them. All right. Quote, unquote, number one is being seen only once a year. It's my opinion that that's not frequent enough. We'll come back to all of these. [06:15] Nele: Agreed. [06:15] Dr. Aaron Boster: Number two is not getting at least an annual MRI of your brain. So, if you're not getting an annual MRI, I'm concerned about that. Number three is not showing you your scans. So, just telling you, oh, it's okay. Or, oh, there's a new spot is inadequate. Number four is not checking laboratories because every drug except Copaxone requires monitoring. And so, if they're never ordering labs, then that's a red flag to me. Number five is not screening you for common, invisible symptoms. Invisible symptoms that plague MS such as the up there's thinking of memory, energy mood, you know, the down, there's bowel, bladder, bedroom, other things like pain, like those are invisible, but they're really important. And so, if your doctor's not asking you about them, I'm bothered by that. Number six is not discussing medication adherence because taking medicine is hard and adults aren't always good at it. And that's not a bad thing. That's just something that we must be discussing. So, if they're not asking you about that, that bothers me. Number seven is not watching you walk. So, if they're not going to do a full-blown exam, there's an argument to be made, not to do a full-blown exam, but they at least need to do some physical assessment. And that bare minimum watching you walk informs them significantly. So, if they're not, even if they're only seeing you seated in a chair with no testing, that's a red flag. [07:46] Number eight is offering a first-line injection new here in 2022. And I will put some caveats around that. There are some patients that I have that are super responders to first-line therapies, and I'm not going to take them off them. I'm talking about your newly diagnosed, and they say, okay, we're going to start you off in 2022 with the first line injection. Or if you have a breakthrough disease on a drug and the doctor's offering the first-line injection as a switch, I'm not okay with that. Number nine is if the doctor says, well, go home and pick up your medicine. Here are five pamphlets let me know what you think. And the last one, number 10 is the doctor not taking any efforts to learn about you as a human being. So, it's my contention that if those things are present, you should take pause and explore that relationship. You can find the full transcripted version of the interview at: https://ms-perspektive.de/interview-with-dr-boster-10-red-flags-when-to-change-your-neurologist ++++++++++++++++++++ Many thanks to Dr. Aaron Boster for providing a guideline, what are some main cornerstones in the relationship of neurologist and MS-patient. And please speak up, if you feel something is wrong, and just realized that there are to less checks or insights provided. You always have to bare in mind, that its your life and you deserve to live it in the best possible way and health! So stay informed and make conscious choices. Good luck and all the best, Nele For more information about MS, check out my free German MS-Letter. Here you can find an overview of all previous German podcast episodes.

Im MS Perspektive Podcast stelle ich dir meine Sichtweise die Multiple Sklerose vor und wie du das beste aus der Diagnose machen kannst. Denn ein schönes und erfülltes Leben ist auch mit einer chronischen Autoimmunerkrankung wie Multipler Sklerose möglich. Hier findest du Informationen und Strategien, wie du aktiv Einfluss nehmen kannst. Ich will dir Mut machen und zeigen, was du alles selbst in der Hand hast. Dazu veröffentliche ich Solobeiträge mit meinen Erfahrungen zur Basistherapie, zur Ernährung, zum Reisen, Arbeiten und der Familienplanung. Außerdem interviewe ich Experten zu verschiedensten Themen rund um ein Leben mit MS. Und einige Folgen dienen der puren Entspannung, die in jedem Leben einen wichtigen Platz einnehmen sollte.

Yarona discloses her strong advocacy for change and understands that "perspective" is everything in the events, traumas, highs, lows, and LOSSES that shape our lives. Her views of the overall human disconnect in society worry, frustrate, and pain her for the fate of our civilization. With more people overly connected to their personal devices instead of the other people around them, Yarona believes, that this is developing a society of indifference. LISTEN AND LEARN MORE:https://www.facebook.com/yarona.eyal.boster/footprintscoaching.orghttps://www.linkedin.com/in/yarona-boster-30b18543/YOUR HOST: Jeff Newmanjeff@rometraining.com908-906-4926Website… http://bit.ly/rome-trainingFacebook Group… http://bit.ly/30Hu8F9LinkedIn…. http://bit.ly/2kWKvgPRadical Acceptance Podcast.. https://bit.ly/3r9OFjD

Episode 009: Stefan Poster Today on The Get Up & Get Out Podcast we have Stefan Boster. He is a retired Respiratory Specialist from America (originally from Brooklyn). Stefan spends his time now between Bankok, Thailand and Ekaterinburg, Russia. Stefan shares his many stories with us, each one of them with a lesson to be learned.

Teacher and clinician Jenny Boster, NCTM, is back with more resources and information about female composers! In the year since Jenny's last visit, much has changed in the music world. From music publishers and symphony schedules to awards shows such as the Grammys and the Oscars, female composers are beginning to receive well-deserved attention. In this episode, Jenny and Christine talk about the progress being made, future goals, resources for teachers, and highlight some of their new favorite female composers.

Stanford Evans Boster is a South African who has made USA his home, and American Tennis is lucky to have him. He is the current coach to Junior World Number 4, Victor Lilov who made the final of the Boys Singles at Junior Wimbledon 2021. Stanford is no stranger to working with World Class Juniors. He coached Andy Roddick and Mardy Fish in their formative Junior days and was working for the USTA at the time when Taylor Fritz, Reily Opelka, Tommy Paul, Frances Tiafoe, Noah Rubin, Stefan Kozlov and co were coming through. So developing world class juniors into pros is in his blood. In today´s episode, Stanford tells his journey from the South African who entered America with $250 in his pocket, to the coach who was developing a future world number 1 and multiple Grand Slam winner. Episode highlights include:- His non-negotiables to be a top pro player. Why developing a top 100 ATP player ´ísn´t difficult´. Stories from Andy Roddick and Mardy Fish´s junior days. Why he was fired from the Evert Tennis Academy, and the player they told him to take with him! What one thing he sees parents getting wrong. An episode full of rich learnings and insightful, fun stories!

It can be uncomfortable to talk about bladder / urinary, and sexual dysfunction... but we're going there! In this week's episode, I'm joined by Dr. Aaron Boster. He is a board-certified Neurologist specializing in Multiple Sclerosis and related CNS inflammatory disorders. He decided to become an MS doctor at age 12, as he watched his uncle Mark suffer from the disease in an era before treatment was available. Since then, Dr. Boster has been intimately involved in the care of people impacted by Multiple Sclerosis; He has been a principal investigator in numerous Clinical Trials, trained multiple MS Doctors and Nurse Practitioners, published extensively in medical journals. He lectures to both patients and providers worldwide with a mission to EDUCATE, ENERGIZE and EMPOWER people impacted by MS. In this episode, we talked about bladder and sexual dysfunction. Take notes as you'll hear some of Dr. Boster's strategies he implements with his patients & tips on what type of conversation you should be having with your neurologist! Additional Resources: https://www.doctorgretchenhawley.com/insider Reach out to Dr. Boster... - Twitter: https://twitter.com/aaronbostermd- Youtube: https://www.youtube.com/c/AaronBosterMD- Facebook: https://www.facebook.com/AaronBosterMD/- Website: https://bosterms.com/ Reach out to Me... - Website: www.DoctorGretchenHawley.com- Youtube: https://www.youtube.com/c/DoctorGretchenHawley/featured- Facebook: https://www.facebook.com/groups/mswellness/- Instagram: http://www.instagram.com/Doctor.Gretchen ▶ For a behind the scenes look into my Online MS Wellness Program, The MSing Link, click: https://www.DoctorGretchenHawley.com/BehindTheScenes

In this week's episode, I'm joined by Dr. Aaron Boster. He is a board-certified Neurologist specializing in Multiple Sclerosis and related CNS inflammatory disorders. He decided to become an MS doctor at age 12, as he watched his uncle Mark suffer from the disease in an era before treatment was available. Since then, Dr. Boster has been intimately involved in the care of people impacted by Multiple Sclerosis; He has been a principal investigator in numerous Clinical Trials, trained multiple MS Doctors and Nurse Practitioners, published extensively in medical journals. He lectures to both patients and providers worldwide with a mission to EDUCATE, ENERGIZE and EMPOWER people impacted by MS. Additional Resources: https://www.doctorgretchenhawley.com/insider Reach out to Dr. Boster... - Twitter: https://twitter.com/aaronbostermd- Youtube: https://www.youtube.com/c/AaronBosterMD- Facebook: https://www.facebook.com/AaronBosterMD/- Website: https://bosterms.com/ Reach out to Me... - Website: www.DoctorGretchenHawley.com- Youtube: https://www.youtube.com/c/DoctorGretchenHawley/featured- Facebook: https://www.facebook.com/groups/mswellness/- Instagram: http://www.instagram.com/Doctor.Gretchen ▶ For a behind the scenes look into my Online MS Wellness Program, The MSing Link, click: https://www.DoctorGretchenHawley.com/BehindTheScenes

Living Well with MS is proud to welcome back Dr. Aaron Boster, an Ohio-based neurologist specializing in MS, who has featured on episodes that tackled exploring how to make the right medication choices and the impacts of lifestyle choices on MS. Now we tap his expertise to help us grapple with an important topic that isn't discussed as often as it should be – sex. Sex and sexuality are vital dimensions of a healthy life, but how are they impacted by MS? Our discussion with Dr. Boster digs into the science and practical implications behind this topic, so let's talk about sex and MS!   Dr. Aaron Boster's Bio:   Dr. Aaron Boster is an award-winning, widely published, and board-certified neurologist specializing in multiple sclerosis and related CNS inflammatory disorders. He currently serves as the Director of the Neuroscience Infusion Center at OhioHealth. Witnessing his uncle's diagnosis with MS when he was 12, he and his family came to see a lack of coherence in the way MS was treated at the time. That experienced informed Dr. Boster's drive to do things differently. At OhioHealth, he spearheads a revolutionary model in MS treatment and patient care drawing on interdisciplinary resources and putting patients and families first. Dr. Boster is also an Adjunct Assistant Professor of Neurology at Ohio University Heritage College of Osteopathic Medicine, and a former Assistant Professor of Neurology at The Ohio State University, where he also formerly headed the Neuroimmunology division. OMS has recently been pleased to welcome Dr. Boster as one of the newest additions to its Board of Trustees.   Dr Boster has been intimately involved in the care of people impacted by multiple sclerosis; he has been a principal investigator in numerous clinical trials, trained multiple MS doctors and nurse practitioners, and been published extensively in medical journals. He lectures to both patients and providers worldwide with a mission to educate, energize and empower people impacted by MS.    Dr Boster grew up in Columbus, Ohio and attended undergraduate at Oberlin College. He earned his MD at the University of Cincinnati College of medicine and completed an internship in Internal Medicine and Residency in Neurology at the University of Michigan, followed by a two-year fellowship in Clinical Neuroimmunology at Wayne State University.    He lives in Columbus, Ohio with his wife, Krissy, son Maxwell, and daughter Betty Mae.   Questions:   Aaron Boster, welcome back to Living Well with MS, and thanks for joining us again. Before we dig into this episode's main topic – sex and MS – there's a recent bit of news to mention. You've joined the Overcoming MS board of trustees. There is no doubt OMS is happy to have someone of your medical and clinical expertise on its board. How has the experience been so far and what compelled you to join in this capacity? Let's shift gear into our main topic – sex and MS. This is quite important and perhaps not discussed as often as it should be. First off, how would you define sexuality in the context of MS? Is it common for people with MS to experience sexual dysfunction or other challenges with having a normal sexual life? Do the types of sexual dysfunction differ depending on the types of MS you have? If a man is experiencing sexual dysfunction connected to his MS, what are his options for overcoming or managing it? What if you're a woman experiencing sexual dysfunction connected to your MS. What are your options for managing it? Some people with MS encounter some sort of physical impediments or disabilities. How might that affect your sexual life and what can you do about it? Is there any specific research currently going on that studies MS and its influence on a person's healthy sexual life? If there was one critical takeaway you could share with anyone in our audience experiencing sexual issues related to their MS, what would it be? Before we wrap up, and on a totally different note, I couldn't let someone of your expertise leave the guest chair without asking you a question of personal interest to me as well as many other members of our community – about supplements. There are many out there to choose from, from Co-enzyme Q10 and probiotics to things like Ginkgo Biloba, Echinacea, St. John's Wort, Valerian, Ginseng, and many more. Is there a general framework for deciding whether to try a supplement and are there any whose positive effects are supported by an evidence base?   Links:   Check out Dr. Boster's popular YouTube channel covering all aspects of MS. Boster is now a trustee of Overcoming MS.   Coming up on our next episode:   In just a few days, you can get another dose of our podcast with the premiere of the 24th installment of our Coffee Break series, as we travel (in the eco-friendly virtual sense) to Christchurch, New Zealand to meet another fascinating member of the OMS community, Lieza Vanden Broeke. Lieza has a remarkable personal backstory, and her experience with MS will provide insights and inspiration to our global community. Plus, she's also the ambassador of the OMS Circle in Christchurch. Thanks to Lieza for her candid interview, and to our listeners for being part of the OMS podcast family!   Don't miss out:   Subscribe to this podcast and never miss an episode. You can catch any episode of Living Well with MS here or on your favorite podcast listening app. Don't be shy – if you like the program, leave a review on Apple Podcasts or wherever you tune into the show.   S3E43 Transcript Let's Talk About Sex (and MS)   Geoff Allix (Intro) (2s): Welcome to Living Well with MS, the podcast for Overcoming MS for people with multiple sclerosis interested in making healthy lifestyle choices. I'm your host Geoff Allix. Thank you for joining us for this new episode. I hope it makes you feel more informed and inspired about living a full life with MS. Don't forget to check out our show notes for more information and useful links. You can find these on our website at www.overcomingms.org/podcast. If you enjoy the show, please spread the word about us on your social media channels. That's the kind of viral effect we can all smile about. Finally, don't forget to subscribe to the show on your favorite podcast platform so you never miss an episode.   Geoff Allix (Intro) (44s): Now without further ado, on with the show.   Geoff Allix (48s): Living Well with MS is proud to welcome back Dr. Aaron Boster, an Ohio-based award-winning, widely published, and board-certified neurologist, and the founder of the Boster Center for Multiple Sclerosis, who was featured on past episodes that tackled exploring how to make the right medication choices and the impacts of lifestyle choices on MS. Now we tap his expertise to help us grapple with an important topic that isn't discussed as often as it should be – sex. Sex and sexuality are vital dimensions of a healthy life, but how are they impacted by MS? Our discussion with Dr. Boster digs into the science and practical implications behind this topic. So, Dr. Aaron Boster, welcome back to Living Well with MS.   Geoff Allix (1m 28s): And let's talk about sex and MS.   Dr. Aaron Boster (1m 30s): Thank you so much for having me. I'm delighted to be back. And you're right, this is an underappreciated topic which needs to be discussed much more frequently. So, I'm glad that we're doing this today.   Geoff Allix (1m 41s): Before we dig into the main topic of sex and MS, there's two things I'd like to mention. Firstly, I just want to call out that your YouTube channel, which is very easy to find, if you just search for Aaron Boster on YouTube, you'll find it. In fact, if you search for MS on YouTube, I think it would come pretty high. It is personally, I think the single best resource for a person with MS.   Dr. Aaron Boster (2m 7s): Wow.   Geoff Allix (2m 8s): Hugely it is... I don't know how many videos you probably are much more aware than me, but I'd say hundreds. There are huge numbers.   Dr. Aaron Boster (2m 15s): Yes, 450 some.   Geoff Allix (2m 18s): Right. So, whatever topic there is an episode there, and I've found it incredibly useful, incredibly informative. So, I would –   Dr. Aaron Boster (2m 25s): So, nice of you to say thank you.   Geoff Allix (2m 27s): Well, yeah, I mean, I just think it's, I encourage everyone just going to have a look. It's just, you don't have to look at every topic. Recently, there's one on cannabis and MS. At which in the UK, the police would have different opinions. So, bits aren't going to be, you know, I mean appropriate for everyone. But yeah, there's such a wealth of resources there. So, the second thing, you've joined the Overcoming MS Board of Trustees.   Dr. Aaron Boster (2m 56s): Yes.   Geoff Allix (2m 56s): Yeah, I think everyone at OMS is happy to have you on board, and your medical and clinical expertise. So, what compelled you to join? And how has it been so far?   Dr. Aaron Boster (3m 9s): Thank you. Let me answer those in reverse order. Today, it's been awesome. There's a significant onboarding process, and I've had a great time meeting the other Board of Trustees members, getting to know the Chair, the CEO, and really starting to get to understand the organization. So far, I've participated in one formal board meeting. It's been pretty great so far. I am really excited for what's coming with Overcoming MS over the next couple years. So, the fact that I get to participate is really, really special to me. Now, what compelled me to do it? Really two things if I may. The first thing is, if you look at my style of MS, my brand of delivering MS care, and the tenets that I have developed and talk about and teach.   Dr. Aaron Boster (3m 58s): And you look at the tenets of Overcoming MS, they are remarkably convergent, like remarkably so. When I list out being five for five, when I talk about the importance of family, I mean, we just listed six of the seven. I mean, we're very, very converged. That was one thing that as I started to learn more about Overcoming MS, I said, “Wow, these folks are really thinking along the same lines as me.” The second thing is, getting an MS diagnosis is scary. And it's a moment in time when people aren't sure what to do. And in certain locations there's awesome resources to shepherd someone through an early diagnosis.   Dr. Aaron Boster (4m 41s): But in many locations, that's probably lacking, and access is a major issue. And so, if you're in a spot where you're recently diagnosed or you don't know what to do, reaching for something that is ready made and awesome is a beautiful thing. And I'll be transparent. In my religion, there are a set criteria of things that you're supposed to do when someone dies. Okay. So, if you don't know what to do when you're grieving the loss of a loved one, there's some set things you're supposed to do: You're supposed to grieve for a certain amount of time. The community helps you in a certain fashion. And really, in the absence of knowing how to cope in grief with a loss, that is an awesome structure to have.   Dr. Aaron Boster (5m 24s): And in many ways, I think for someone newly diagnosed with MS, this is a beautiful thing to say, “Sure do this.” So, for both of those reasons, I'm really, really excited to participate. It's been a great experience so far. So more to come.   Geoff Allix (5m 39s): And one thing I would say that you have that Overcoming MS doesn't, but should do, I think as an extra pillar would be drink more water. And that's not an Overcoming MS thing. So, we're on a podcast. You can't see me. I'm just picking up my glass this very moment.   Dr. Aaron Boster (5m 56s): Sure. And I've got water in my mug, yeah, yeah. So, I'm   Geoff Allix (5m 59s): And I think that's, I know we're going off-topic here, but I think that it should be. It's such a simple thing. And because a lot of us have bladder issues and things, and then you sort of say, “Okay, maybe drink less because that's a bladder buster.” I even know it. I know, if I didn't drink enough, then I feel worse. It's one of those instant things. So, some of the things with MS, slow burn as a summary instant. Stress is instant, dehydration is instant.   Dr. Aaron Boster (6m 27s): Absolutely spot on. And, you know, I like to challenge people sometimes because I'll say, you know, drink more water, and they'll say something to the effect of, "You sound like my mom." You know, or like, that's silly advice. I'll say, “Okay, but try it.”   Geoff Allix (6m 39s): Yeah.   Dr. Aaron Boster (6m 39s): Try drinking an adequate amount of water for like three days and see what happens. You know because people are shocked. They're like, “Oh, my gosh, I really do feel better.”   Geoff Allix (6m 45s): Yeah. And you've made it really simple as well. So, I just drink a pint or half liter with each meal, and then drink a pint or half liter between each meal.   Dr. Aaron Boster (6m 56s): Yeah, then you're done. You just did.   Geoff Allix (6m 59s): Yeah.   Dr. Aaron Boster (6m 59s): Spot on. Yeah. Then you're good for the day. And unfortunately, so many people, and you give a great example as to why they may shy away from water intake, and inadvertently make their situation so much worse.   Geoff Allix (7m 10s): Yeah, so I'd like to. Yeah, so on your next board meeting. So, can we add an extra? Drink more water.   Dr. Aaron Boster (7m 19s): Okay. I'll bring it up. As we talk about sex, this, we will come back to this whole bladder thing. It is very, very related.   Geoff Allix (7m 27s): I was going to think, yeah. I was thinking you can't say, drink water during sex, that wouldn't work. But anyway. So, let's get on to our main topic, sex and MS. So, it's a very important one. I mean, it's obviously very important for the survival of the species as much as anything, but it's an important topic. And probably not discussed often enough, often embarrassing. So, how would you define sexuality in the context of MS?   Dr. Aaron Boster (8m 2s): So, you know, sexuality arguably would be defined as humans' ability to experience sexual feelings. It's a really broad blanket term for a lot of things related to sex. So, my first comment is I don't think of sexuality in someone impacted by MS any different than I do in any other human. And I think that's actually a very, very important distinction because there's nothing unique about the sexuality of human being if they happen to have a chronic illness or not. Now, playing out sexual behaviors, intimacy, all these wonderful things, MS can risk interfering.   Dr. Aaron Boster (8m 46s): And that's where we get into a really important discussion. And that's where sometimes we really need to try to help educate and intervene.   Geoff Allix (9m 1s): So, is sexual dysfunction more common for people with MS? Does it increase the chances?   Dr. Aaron Boster (9m 7s): It certainly is. Now, you know, MS is a situation where the immune system can affect any part of the supercomputer that runs your body - the brain, and the superhighway - the spinal cord. And unfortunately, there's plenty of specific areas in the brain and spinal cord where if there's damage, it could interfere with sexual functioning. And so, the spinal cord is a really good example. Very commonly, when someone has a transverse myelitis, inflammation in their spinal cord, then they may find that their limbs are numb or kind of weak. But they also will very likely notice problems with the down theres – bowel, bladder, and sexual function. And this is, unfortunately, all too common in the setting of MS.   Dr. Aaron Boster (9m 48s): I would also say that it's oftentimes overlooked by the MS clinic, something that's kind of glossed over and not discussed. And given that it's somewhat of a taboo topic in casual conversation, I think patients are sometimes a little bit nervous to bring it up.   Geoff Allix (10m 8s): And does the type of MS you have whether it's relapsing or progressive, does that affect the types of sexual dysfunction you might have?   Dr. Aaron Boster (10m 16s): I would say no. I would rather think about the kinds of sexual dysfunction a little bit differently. Not so much related to the phenotype of MS. So, someone with relapsing MS, or Primary Progressive MS, Secondary Progressive MS, what have you, I don't see different kinds of sexual problems. I would run about it as follows: primary sexual dysfunction, secondary sexual dysfunction, and tertiary sexual dysfunction. So, just to share a couple quick definitions that helped me when I'm thinking about this. Primary sexual dysfunction is a problem with the circuitry and hormones of sex. So, when the down theres are stimulated, there's a lot of circuitry that goes on to assist in intercourse.   Dr. Aaron Boster (10m 58s): That message in the down there has to go all the way up to the brain, through the spinal cord, where the brain interprets the activities and says, “Ah, okay.” And then it sends messages from the brain back down to the down theres to do certain things. We're talking about arousal, orgasm… excuse me, arousal, either erection or lubrication depending on the gender, and then eventually orgasm. And so primary sexual dysfunction can result from MS damage in the brain and spinal cord. And what can happen is you can end up with problems in the circuitry. And so, you can have difficulties with any of those things - arousal, erection, maintaining an erection, ejaculating or arousal, lubrication orgasm.   Dr. Aaron Boster (11m 43s): The other piece to this when I think about primary sexual dysfunction is imbalances in hormones. And I have, for several years now started to routinely screen gentlemen, for example, looking at testosterone levels. Not just to help with sexual function, but there's also ramifications through other aspects of MS, believe it or not. So that's kind of primary sexual dysfunction. And we'll talk maybe a little bit later about how we overcome those things. Secondary sexual dysfunction is important and very often overlooked. And it's a situation where there's problems with sex, not because of the circuitry of sex, not because of hormones, but because of MS symptoms that make things not sexy.   Dr. Aaron Boster (12m 24s): For example, if you're having intercourse, and you lose your bladder, it may stop the activity. I mean, you know, that's like scary to a lot of people. They would think, “Oh my goodness, gracious.” And if you're having intercourse and your leg goes into an extensor spasm, it's extremely painful, you're not having sex anymore. Yet even things like motor fatigue can make it so that, you know the activity of intercourse can become challenging, and these are all secondary sexual dysfunction issues. This is where, to be honest, we can really gain a lot of ground. Now, tertiary sexual dysfunction, I would define as not so much the circuitry of sex or symptoms that interfere with sex, but it's more of a psychological phenomenon where the human being doesn't feel sexual.   Dr. Aaron Boster (13m 11s): They don't feel like a sexual being. They feel maybe like an they feel ill. They don't feel that they can be sexy. And so, when I think about sexual dysfunction, I find it most helpful to kind of try to bucket things into those categories. And oftentimes, we're dealing with all three.   Geoff Allix (13m 35s): And so, if we break it down into men and women, what options would a man have if he's experiencing sexual dysfunction connected with MS? Or how could that be managed or helped?   Dr. Aaron Boster (13m 50s): Absolutely. And so, if we first think about arousal, and this is actually true for both men and women. I'll make sure to give distinctions. When we think about arousal, the first thing I want to do is I want to look at their medicines. And I want to look and see if I have them on medicines that can impair arousal. And you'd be shocked at how many can. So, unfortunately, many of the SSRI and SNRI antidepressants, which are used very commonly in humans can impair libido. And so, you may have significant sexual dysfunction because of a high dose of Zoloft, for example. And so, we need to look at that. And there's a host of other medicines that could interfere with arousal.   Dr. Aaron Boster (14m 31s): Also in the setting of arousal, for gentlemen, we'll look at testosterone levels, and look and see if his testosterone, which I would like to be above 400 is down like in the 100s. And maybe that's a component as to why that's a problem. Another very, very, very common because of loss of arousal or interest in both men and women is depression. Now depression is twice as likely to be experienced by a person impacted by MS compared to the general population. And one of the hallmarks of depression is something called anhedonia. Where just stuff that you enjoy just isn't really that much fun anymore. Like if you do really like book club or watching TV, doesn't do it for you.   Dr. Aaron Boster (15m 10s): And so that can happen with sex, which is a major thing. And because depression is so common in MS, we would be foolish not to screen for that, or ask the question, could that be related to arousal? And so other things that we think about in both men and women, recent psychosocial stressors. You'll hear about a guy lose his job, and then he's not interested in intercourse, because he's really dealing with, he's kind of stressed out. So, I really require not just some laboratories, but also a careful history and some open honest communication when dealing with the gentleman's issues as it relates to arousal.   Dr. Aaron Boster (15m 56s): The women, I guess, if it's okay with you, let me answer the same question for women just really quick.   Geoff Allix (16m 2s): Yeah, it's okay.   Dr. Aaron Boster (16m 3s): So, with women, we will look at all the same things I just said. Right? Hormone levels included. And then in depression included in the like. With women, there's actually interestingly two FDA approved therapies to help women with low libido, which is really cool. And interestingly, not known by many, many people. So, there's a medicine which is approved in the United States of the trade name Addyi, A-D-D-Y-I. And I'm spelling it for you because I'm blanking as I talk to you about the generic name. So, I'm sorry. And that is a pill taken once a day, which in about half of our patients results in improving female libido quite substantially.   Dr. Aaron Boster (16m 46s): There's also an injection that's administered by urologist. And I don't, I've never prescribed it. It's called PT141. And this is also a therapy that can be very, very helpful in helping with female libido. So, there's actually more options to help with female libido than male. And so that's the first area. And I want to stress that you can't really skip over it. It is so terribly important. When we then talk about the second phase of things that would be erection for gentlemen. I like to divide my thoughts about erections into half. There is obtaining an erection and then maintaining an erection adequate for a penetration of vagina, anus, mouth, whatever it is that you're trying to accomplish that evening or day.   Dr. Aaron Boster (17m 28s): And so, with erections, we want to find out, are you able to -- do you have erections when you wake up ever? Like it is the physiology, the circuitry of erections, is that intact? Are you able to maintain an erection on your own, like through masturbation, for example? And during intercourse, what's going on? And this conversation is important because, again, we have to think about primary, secondary, tertiary options. Primary sexual dysfunction, most commonly occurs because of spinal cord involvement in MS. And what essentially happens is the down there are stimulated and as the message is going up the spinal cord it dies.   Dr. Aaron Boster (18m 9s): So, the message is never delivered to the brain. So, the brain is not informed of the dealio. So, in this situation, something that can be extremely helpful is a plug in the wall vibrator, right? So, I sometimes on podcasts and whatnot have talked about the vibrator trick, which I'll share now. In the vibrator trick is where you spend 60 bucks American and you purchase a plug in the wall vibrator. And my favorite brand is Hitachi Magic Wand. I don't have a contract. Though I would do a branding deal with them in a heartbeat until –   Geoff Allix (18m 43s): I believe, they're mentioned on the Sex in the City way back.   Dr. Aaron Boster (18m 47s): Yeah, certainly. Certainly. So, this is marketed as a back massager. And it's a plug in vibrator. And the reason it's so important is we need kind of like overdrive stimulation, right? A double D battery vibrator is not going to cut it for this purpose. And then what you do is you apply a water-based lubricant to the genitalia because that increases skin sensitivity. And then you apply the plug in the wall vibrator, you know, the hardcore power from the wall, and you apply it on the glands, penis, you apply to the head of the penis, you applied it under the testicles, you apply it somewhere where it feels good. And this is providing overdraft stimulation. Just to make the point clear, I'll use an example of us talking right now.   Dr. Aaron Boster (19m 29s): So, I'm talking using my indoor voice because there's no interference between essentially my mouth and your ear, even though we're across the continent, and there's microphones, and speakers and stuff involved. Now, let's say that we were having this exact same conversation during business hours. I'm in my lobby of my office. Today is Sunday. But if this was a busy business day, it would be super loud in here. And you wouldn't be able to hear me when I used my indoor voice. So, I would have to use overdrive stimulation. I would have to scream, and really project really loudly so that you could hear me. And that's what we're doing with a plug in the wall vibrator as it relates to intercourse. We're providing overdrive stimulation so down there can get the message to the brain and let the brain know what's up.   Dr. Aaron Boster (20m 13s): Now the advantage of a plug in the vibrator is there's no side effects. It's relatively inexpensive. And you can do it by yourself during masturbation. You can do it before intercourse as a form of foreplay. You can literally hold the device between you and your partner with continuous stimulation during intercourse. And it works well for both men and women. So, everything that I just said with regards to obtaining erection can be applied to maintaining an erection by using the vibrator. And we have taught some gentlemen, if they have difficulties they'll withdraw, and then they can apply the vibrator to the shaft of the penis, it will become adequately erect again, and they can continue having fun.   Dr. Aaron Boster (20m 55s): And so, this is a very helpful tool. Now, probably the most widely utilized tool is a little blue pill, right? So, Viagra, Cialis, and the like are very, very helpful medicines, in helping gentlemen obtain and maintain erection, pharmacologically, they're superb. And so, if there isn't a cardiovascular risk, why you can't handle the Viagra or Cialis, what have you, that's a very useful tool. Taken about an hour before intercourse works best on an empty stomach. You do have to worry about light-headedness, and there's some blood pressure concerns. And that can make a really big difference in a guy's life. You know, it's of note that if you want to make an adult miserable, mess up their ability to eat good food or have sex, and then we'll be miserable.   Dr. Aaron Boster (21m 41s): And MS risks interfering with sex for sure. And so, a little blue after dinner mint can really change a guy's outlook on life. Now, again, on the topic of obtaining and maintaining erection, testosterone level is very, very relevant. Now, there's a bunch of other things you can do. For example, intracavernous penile injections. So, before the era of pills, we had the shots on the side of the penis, and everyone listened going, “Ooh!” But in exchange for that route of administration, you have a fantastic erection. And sometimes when pills don't work, we still go back to those tried-and-true methods.   Dr. Aaron Boster (22m 24s): Other things that you can do if you're a gentleman, using a device, you can trap the erection. So, you can use a vacuum device, which can be very, very effective. And if you're really serious about an erection, and those things aren't working, urologists can actually do penile implants. I have some patients who have been very, very happy with penile implants because nothing else was really working for them. So, you know, you might say, how dedicated are you to your erection? Because if you're dedicated enough, we can guarantee that you'll be able to be erect.   Dr. Aaron Boster (23m 6s): Getting into the same questions with women, we're really dealing with lubrication, alright? And engagement of the tissue to allow adequate arousal. And so, that's kind of the equivalent for women as erections are to men. And there's several ways of addressing difficulties that a woman may have with lubrication. So, one thing you can do is apply a water-based lubricant. Very straightforward, very, very effective. Another option is to apply an estrogen cream to the vulva. If you're not taking systemic hormones, and there are reasons why some women may not be appropriate for taking systemic hormones, because of cancer risks. Applying a hormone cream topically is really great because it's just absorbed locally.   Dr. Aaron Boster (23m 51s): So, there's no systemic risks. But applying an estrogen cream can really help with engagement and with lubrication. We very commonly prescribe a compounded cream which is called scream cream. And it is what it sounds like. It's a compounded mix, which includes Viagra and theophylline and several other agents which help in increase blood flow and encouragement and help with lubrication. And so, someone may have a can of scream cream that they use in preparation for intercourse. And so those things can be very, very helpful. Obviously, adequate clitoral stimulation, or vaginal stimulation through the same plug in the wall vibrator is a really smart tool.   Dr. Aaron Boster (24m 32s): And that can help with lubrication. Now, the tips for orgasm, for achieving orgasm are all along the same lines. Really we have to bring, for both men and women - primary, secondary, and tertiary measures to the table to achieve orgasm. And sometimes we have to take extra measures depending on the specifics of the individual. But the point that I hope I'm conveying is, is that: number one, there are a lot of options to make this better if you're a boy or girl. And number two, it's worth it. Right? It's worth it to have an excellent sexual experience. Sorry, that was a little bit of a long-winded answer.   Dr. Aaron Boster (25m 14s): I got a little carried away there but talk about that.   Geoff Allix (25m 15s): No, no its good. And so, what you've talked to us about was very medical. But you mentioned especially the tertiary side of it.   Dr. Aaron Boster (25m 25s): Yes.   Geoff Allix (25m 25s): I love the thinking as well.   Dr. Aaron Boster (25m 26s): Yes.   Geoff Allix (25m 26s): So, is it worth getting counseling, maybe couples counseling? Because still, it's difficult to -- and this happens, whether you have MS or not. It's to convince the other person it's useful.   Dr. Aaron Boster (25m 34s): Super, super important. In fact, if you said, “Aaron, what's the number one tip?” The number one tip is none of the stuff I just mentioned. The number one tip is talking to your partner. So, let's discuss that. Very commonly, independent from having a chronic condition like MS. Very commonly, we have hang-ups about sex, and we have areas of concern or embarrassment, or topics that we're shy about. For example, many people are reluctant to flatulate in front of their spouse. Right? So, that's the thing. Like, you know, we don't want to do that. And so, talking about sex is not something that most of us are just completely at ease doing.   Dr. Aaron Boster (26m 20s): Even with our spouse, even with a monogamous partner of 30 years. And when you have a chronic condition, like multiple sclerosis, which can, as we've talked about interfere with the circuitry and the success of intercourse, it adds complexity. It doesn't make it easier, it makes it harder. What I have found in talking to families for over a decade and a half now. And I'm very, very open about this topic in that oftentimes, the two members of the couple would love to talk to the other person. They are dying to talk the other person about this, and they are nervous.   Dr. Aaron Boster (27m 4s): And when they broach a conversation, it's almost cathartic because together, they can game out an earth shattering, toe-curling, blood-curdling orgasm that would set land speed records and make the neighbors call to make sure everyone's still safe. And it's accomplished because of communication with the partner. Say, and let me be a little bit granular. One partner may really enjoy a particular position in sex because it's really fun for them, which might cause the other partner with MS to go into spasms. Or it may make the other partner develop truncal ataxia, or maybe it overheats that partner. And the person with MS might not be sharing that.   Dr. Aaron Boster (27m 46s): They may not be telling the spouse or the partner, “Hey, listen, when you lay on top of me like that, you're a heavy dude, my body gets heated up and I can't feel anything. Get off me!” You know, simply talking about changing something as simple as a sexual position might be the answer to really meaningful intercourse. So, you are very spot on in bringing this up. And if you are uncomfortable talking about the topic, let's game out several things that you can do to broach the situation. Okay. So you could, for example, do couples counseling. Couples counselors are very wonderful because they can help be sounding boards.   Dr. Aaron Boster (28m 27s): “Did you hear what he just said? Let me repeat it for you.” I mean, you know, they're fantastic kind of notes. I really like couples counseling myself. There are sex counsellors, alright? I mean, maybe another thing to do is just to have the person listen to our podcast that we're doing right now and say, “Hey, the little balding, hyper neurologist in Columbus, Ohio was saying we should talk about sex. I mean, what do you think?” And maybe that broaches a conversation. But if you can sit down and talk about sex, and really what I would want you to bring to the table is the following: What are your goals? Seriously. Is your goal to help your partner achieve orgasm? If that's a goal, state it. State that's a goal.   Dr. Aaron Boster (29m 6s): Is your goal to simply be intimate and touch one another? I mean, these are things that you should talk about. Are you going to orgasm? State the goals. If there are certain things that you really like, and really don't like sexually, particularly the don't like part. “You know, I know that you're really like doing blankety blank to me, and that's very sweet. Except I can't feel it. I can't feel it.” So, you doing that is awesome. I just want to let you know that like I don't even notice that you're doing. So, FYI. I mean that kind of communication is really valuable. Because then the partner will say “Well, geez, Louise, let me not do that. Let me do something different.” And I think what you'd find is if you have this conversation, it will improve your sex life.   Dr. Aaron Boster (29m 55s): The conversation will lead to a better experience. It really will.   Geoff Allix (30m 1s): And so, we've talked a lot about that there could be nerve damage between brain and sexual organs and that's affecting your ability to have an erection, lubrication, orgasms. But what if a person with MS has physical impediments or a disability? You know, apart from their sexual organs don't work properly.   Dr. Aaron Boster (30m 22s): Yes.   Geoff Allix (30m 22s): How could that affect their sexual life? What could they do about that side of things?   Dr. Aaron Boster (30m 30s): So that involves playing smarter, not harder. Let me give you an example. If we think about a traditional Western missionary position of sex, the guy on top in this like, misogynist example, I apologize. It's kind of doing push-ups, right? Which is a tremendous amount of physical activity, keeping the core body strong and the arms, it's a lot. So that might not be feasible for someone. Right? Now, instead, install in your bedroom an eye hook in the ceiling beam, and install a sex sling. The whole world changes now. You place a partner on a sex sling, you can move them around, spin them, pivot them, push them, thrust, move, up, down, left, right, and it takes almost no effort, right.   Dr. Aaron Boster (31m 20s): And so, by changing from good old-fashioned force of will to using something like leveraging a sex sling, or using a wedge, they make these awesome wedges, which is kind of like bringing a gymnastics room into your bedroom. Where you can position a partner on a wedge. If you have problems in certain positions, again, this goes back to the talking about planning, don't do those things. And if other positions are more successful, do those things. Let's use another example of bowel and bladder issues. Very common. Someone has such fear of incontinence of urine or stool, they will not have sex, which is a travesty.   Dr. Aaron Boster (32m 3s): So, what can you do instead? You can, if necessary, do an inner in self cath, and empty your bladder completely, 100% guaranteed prior to intercourse. If you are prone to urinary tract infections, have your neurologist give you antibiotics that you take before or after sex, alright? If you are having trouble with constipation, you can spend a day or two pre-sex emptying out and getting completely evacuated. Even if that involves an or you know, digital rectal stimuli, or whatever is necessary, you can prepare for that. Do you see what I mean? There's a bunch of things that we can do. You have dyspareunia, which is a terrible word.   Dr. Aaron Boster (32m 47s): It means pain with sexual sensation. So, the act of sex hurts. We have to look into, why you have dyspareunia? If it's because of spasms of the vaginal canal, we might use a rectal suppository of valium before intercourse. If it's because of neuropathic pain and burning sensation, we might use a numbing cream. Right? My point here, is if we can identify -- because in my mind what you're saying those are all secondary sexual dysfunctions. If we identify what the problem is, we can game out how to make it better. Then if you remember nothing from my answer, I simply want you to remember sex swing.   Dr. Aaron Boster (33m 28s): Sex swing. Okay.   Geoff Allix (33m 29s): And in the last few years, the amount of research in MS medication has just leapt forward. I mean, it's gone from -- so my father had MS. There are no real treatments. When I first was diagnosed. Not really, like what? Five years ago? There were treatments then but there must be 4, 5, 6, 10 times that many now. That seems to be it's really escalating. So, are there any treatments going on or studies going on for people with MS, and their ability to have a healthy sexual life?   Dr. Aaron Boster (34m 5s): So, in preparation for our discussion, I actually looked this up because I wanted to be able to answer this question if asked. So, yay. And I went, the way I look up information like that is at the clinicaltrials.gov, which is a site for any clinical trial that's registered by the United States government. And there were 125 hits for when I searched for multiple sclerosis sexuality. And I looked through the first 10 or 20. All over the world, France, Turkey, Louisiana, Cleveland. So, there were trials throughout. Now, almost all of these are investigator-initiated trials. You know, so a clinic running a small study.   Dr. Aaron Boster (34m 46s): But my point here is yes, there's a lot going on. Looking at testosterone levels, looking at various pharmacotherapies, looking at behavioral therapies, a lot of stuff. And so, I hope if you're listening to this, it's reassuring to know that clinic doctors and researchers alike recognize this is such a critically important aspect to life that we're investing resources to try to help you make it better.   Geoff Allix (35m 9s): And you mentioned about testosterone. So, getting testosterone checked is that part of blood test?   Dr. Aaron Boster (35m 13s): Yes. So, the way that I do it in clinic is I draw a morning level of testosterone. And the reason it needs to be morning, a gentleman's testosterone is highest in the morning, and it goes down throughout the day. So, if you tested in the evening and have a low value, you don't really know if it's just because of the diurnal, you know, the fact that it drops down. So, you want to get the best most accurate reading. You do that in the morning. You know testosterone level in the morning. I get it on two separate occasions. And if it's low, the total testosterone is low, that's a blood test, then that opens up the opportunity to treat with testosterone. Which in MS helps gentlemen not just with intercourse, not just with erectile function and ejaculation in the bedroom, but it also helps improve cognition, and slow disability progression, and improve fatigue with gentlemen with MS.   Geoff Allix (36m 9s): And is there an equivalent for women with estrogen?   Dr. Aaron Boster (36m 12s): It's not the same rules, interestingly. It's not the same set of variables. And now looking at hormone levels in women is important. And particularly surrounding times of menopause, when we can see an uptick of MS symptoms, and specifically related to intercourse, as I was mentioning with lubrication. So that is relevant, but for a different set of reasons.   Geoff Allix (36m 38s): So, men definitely worth getting checked out on testosterone, but women…?   Dr. Aaron Boster (36m 43s): Not as much. No, I don't routinely check women's testosterone levels in my clinic.   Geoff Allix (36m 49s): Okay, and if, so, if there's one takeaway you could share with the audience, if people are having sexual issues related to MS, what would that be?   Dr. Aaron Boster (36m 57s): That the one takeaway would be to have open communication with your partners and with your clinicians, because there are ways to make it better. We don't have to just accept this is now the new state of affairs. On the contrary, there are plenty of things that we can do. And you're worth it. It's worth exploring and improving because it is such an important aspect of life, that it's not okay, you just to say, "Well, too bad."   Geoff Allix (37m 27s): And there's no reason, I mean, the two of us, I think, are probably beyond wanting to have more children at our age.   Dr. Aaron Boster (37m 35s): Correct.   Geoff Allix (37m 36s): There's no reason that a person can't be fertile as well as…   Dr. Aaron Boster (37m 43s): Oh, absolutely. So, there's a whole separate conversation. But I actually love to come back and talk to you about this. But there's a whole separate conversation about fertility, and pregnancy, and gestation and delivery related to MS. The quick skinny is MS has no bearing on fertility whatsoever. None. And as it relates to our conversation, if you're having intercourse, we need to be thinking about the appropriate use of contraception to avoid unplanned events such as unplanned pregnancies and things like that.   Geoff Allix (38m 17s): And before we wrap up, there's something I wanted to ask you on a completely different tack.   Dr. Aaron Boster (38m 26s): Absolutely.   Geoff Allix (38m 27s): So, just as someone who's got a lot of expertise in this area, and something that is of personal interest. Because of the podcast, I get asked lots about different supplements. So, people say, “Have you tried Coenzyme Q10? Have you tried lion's mane mushroom, St. John's Wort, ginseng, ginkgo biloba?” There's countless things. And some of them, I'm fairly sure, yeah, if your magnesium is low that's, you know, if anything's not off the normal levels, then yeah, absolutely.   Geoff Allix (39m 7s): But there's always someone championing a supplement or other. So firstly, is there a framework that you would use to decide whether to try a supplement?   Dr. Aaron Boster (39m 18s): That's an awesome question. Thank you for asking me that question. And it's a multi layered answer. So, I have two criteria, if you will. So, the first criteria, there are three things that must be met, if I'm going to greenlight a supplement. The first one is it can't be too expensive. So, each individual family has to decide if the cost of something is too expensive or not for them. And I bring that up because sometimes you may find supplements where it's actually a big chunk of their weekly check, and that's not okay with me. Particularly, if I don't have hardcore science suggesting that I can guarantee it works. So, it can't be too expensive. The second thing is it can't be dangerous.   Dr. Aaron Boster (39m 59s): And sometimes supplements are dangerous. Now, oftentimes, they're not. But let me give you an example. If an immune booster actually boosted your immune system, it would be dangerous to take when you have MS. And, you know, just because it's natural doesn't mean it's safe. I mean, cyanide is natural. So, the second criterion is it can't be dangerous. And sometimes I have to do some investigations, digging through various ingredients to try to answer that question. The third is that it can't be instead of something I know works. So, if you tell me that you want to take CoQ10. CoQ10 is not dangerous. CoQ10 is not generally expensive.   Dr. Aaron Boster (40m 41s): And if you're going to take CoQ10, along with your disease modifying therapy, I have no issues with that. But if you have to take your CoQ10 instead of your disease modifying therapy, where I have good solid scientific evidence that it helps you, now I have an issue. So that's my first criterion. The second criterion is more rigorous in that scientific evidence, you know, properly studied science to prove or disprove that something's helpful. And that second one, you know, we don't have a lot of info. There is some info for some supplements, and I'm going to go over a couple with you right now. But that would be the second one. And you know, it's worthwhile sharing, at least here in United States where I practice.   Dr. Aaron Boster (41m 24s): The supplements and vitamins are not monitored by the American FDA. So, if there's a bottle of a prescription medicine, and it says it does something, they can prove that. It's been proven, it does something or they can't say it. You know, if there's a side effect on the bottle, or a dosage on the bottle, it has to be proven. Like that's not a suggestion, it's a proof. If you bottle a supplement that you get at a health food store, let's say. What they say on it isn't proven. It doesn't have to be proven. So, they could say, for example, it will make you grow 10 feet tall. And they're allowed to say that even if it's not true.   Dr. Aaron Boster (42m 6s): And as a result, it calls into question, and it creates challenges and knowing whether something's okay, but which is kind of I think your point. So, when you look at the evidence, to me, this is a conversation about nutrition, right? And I start with, as we talked about, maybe a little bit earlier, I start with increasing water intake, believe it or not. I think if you're going to change one thing, increasing water is actually more relevant than any other vitamin or mineral or something that we're going to talk about. But that's my first one, honestly. After that, I really would rather spend time talking about healthy eating than I would about supplements. And I would like to engage in a conversation about eating real food, whole food, and avoiding heavy processed foods and the like.   Dr. Aaron Boster (42m 54s): But let's move into some recommendations about vitamins. The first vitamin that I think is actually the most studied with the most evidence for benefit of MS is vitamin D3. And so low levels of vitamin D correlate with increased risk of developing MS. And if you have MS, low levels of vitamin D are correlated with worse outcomes. And so, I routinely check a blood level for vitamin D, and if it's below 50, I supplement. And I use D3, because I feel like it's better absorbed in the human body. And I want to push that level above 40 below 100, or excuse me, above 50 and below 100.   Geoff Allix (43m 32s): So, can I just interject that. Because we measured it in a different way in the UK, and I think Europe. So, it's actually four times the number you're talking about. So, when you say 50, we say 200.   Dr. Aaron Boster (43m 40s): Oh, okay.   Geoff Allix (43m 40s): I don't know why that is just, it's not even an imperial metric thing. It's just because it is exactly –   Dr. Aaron Boster (43m 46s): Thank you for bringing that up. That's a really, really important point. And you know, another important point is you and I, even though we don't live in the same continent, both live in areas where there's not a lot of sun for a good portion of the year. And so, taking a vitamin D supplement is important because we can't get it, you know, the good old-fashioned way. Now, I have through my involvement with Overcoming MS become turned on to the idea that it doesn't take a lot of sun to soak up vitamin D. So, if you go out and let's say shirtless, or, you know, wearing a halter top, or what have you with some exposed skin, for 15 minutes, you'll absorb 5,000 international units of D3.   Dr. Aaron Boster (44m 30s): And now in the winter, Ohio with a foot of snow on the ground very few Ohioans are going to do that. But it is good to know that. Yeah. You know, and during the summer months you certainly do consider that. So, vitamin D3, I think, is very relevant. Past vitamin D3, my next recommendation. And I have to tell you, it's becoming increasingly something that I recommend. I'm on the cusp of recommending it for all people with MS. That's probiotics. So, taking a probiotic is really interesting. And there's an entire fascinating discussion surrounding dysbiosis and the impact of abnormal gut bacteria on the immune system.   Dr. Aaron Boster (45m 16s): Although that's not why I'm recommending it. That's a discussion which is ongoing and still a work in progress. But the reason I'm recommending it is for gut health. People impacted by MS very commonly have significant constipation. And sometimes people with MS have significant diarrhea or incontinence. And so, probiotics pull someone who has constipation more towards the center. And probiotics pull similar diarrhea more towards the center. And so, I really think probiotics are a very, very helpful tool. The next supplement that I would recommend beyond that is added fiber. Because particularly where I practice in the United States, the very low fiber diets, which is a major problem for multiple things, and actually has an impact on MS, in my opinion. And so supplementing fiber, I think is important.   Dr. Aaron Boster (45m 57s): Now, I would like you to do that with pears, plums, apples, and green vegetables but if you can't or aren't able, or don't want to do it that way, you can purchase a supplement like a FiberCon or Metamucil, or what have you, and then you can do it that way. Now, after that, it really depends on the situation. I think it's very reasonable for humans to take a multivitamin because, you know, we're not eating enough salads and vegetables with different colors. But the American diet is normally not devoid of things. It's not typically a problem with excess.   Dr. Aaron Boster (46m 39s): And so, if you just add a multivitamin that kind of covers your bases. Now, I don't recommend mega doses of say, vitamin B12 routinely, or vitamin C routinely, unless there's deficiencies that I'm discovering. So, I'm not a physician that recommends as a priority that you take a B12 complex. Many people do, because it helps with energy in some cases. But I really find that if I'm not, if I can get you to eat a healthy diet, I'm going to take care of that through eggs and other things. Now, there's specifics that are recurrent low dose naltrexone.   Dr. Aaron Boster (47m 21s): You mentioned L-carnitine, things like that. And there's varying levels of evidence for them. Some of maybe the best evidence would be some of, I think L-carnitine has some good evidence for energy. I believe that. I think that helps a lot. I think that's one that I look at. Then when you get into some of the other things, you can find small trials. Turmeric, for example. Low dose naltrexone, for example. And really, I deal those in a one-off fashion where someone's coming to me saying, “Aaron, what about this?” And then together, we kind of look through it. We look at the data if it's in existence, or if it's not, we discuss that. We go through my three criteria and then someone may try it. And here's the important part. If they try it, I want them to tell me what they found.   Dr. Aaron Boster (48m 7s): You know, did it seem to help? Do they notice a difference? When they stopped it, did it get changed in any fashion? And that's anecdotally one of the ways that we have to kind of assess things.   Geoff Allix (48m 20s): Because on the turmeric there are basically no risks, cost is very low, and there's anecdotal evidence, because it's been taken --   Dr. Aaron Boster (48m 36s): Yeah.   Geoff Allix (48m 36s): And it's been used on the Indian subcontinent for centuries or millennia.   Dr. Aaron Boster (48m 39s): And it's delicious.   Geoff Allix (48m 43s): Yeah, that's right.   Dr. Aaron Boster (48m 43s): You know, if someone wants to take turmeric, how about it? That doesn't violate any of the discussions we've had, and it may help.   Geoff Allix (48m 56s): Yeah. And if it doesn't help, you still like the food and carry on.   Dr. Aaron Boster (49m 4s): You know, its still and its still delicious.   Geoff Allix (49m 4s): Yeah. I'll just add, just on a personal level. Because I'm fairly similar to what you're saying. So, I take vitamin D3 every day. I take a probiotic every day. And the other thing I take is - so probiotic gut health. But also, to reduce UTI, so there's something I came across that in Germany, they're routinely prescribed called D-mannose?   Dr. Aaron Boster (49m 25s): Yes.   Geoff Allix (49m 26s): And I found that I, and this may be -- because I think some of these things work in some people and some don't. And it's not expensive. It doesn't have a lot of risks. And so, I thought I'll give it a try. And literally within a week, I didn't have a UTI problem at all. Literally, I don't have UTI problems at all from having D-mannose.   Dr. Aaron Boster (49m 50s): That's fantastic. I think that's a really, really great tip to share with people. And it's what I'm going to think about when I start my clinic tomorrow - about whether or not I'm not recommending D-mannose enough to folks with recurrent urinary tract infections. That's a pro tip. Thank you for sharing that one today.   Geoff Allix (50m 12s): Well, yeah, I mean, but it may just be that worked for me. So, yeah. But then that's the same.   Dr. Aaron Boster (50m 16s): Well, again, it's nice to have a toolbox where we can consider different things. And that's a very good supplement to keep in mind.   Geoff Allix (50m 30s): So, with that, I'd like to thank you very, very much for joining us, and welcome you to the Overcoming MS Board and it's fantastic news. Giving some of your expertise towards the head of the organization. And I thank you for joining us, Aaron Boster.   Dr. Aaron Boster (50m 48s): It's my absolute pleasure. Again, I love talking with you. And I hope that we get to do it again soon.   Geoff Allix (50m 35s): Thank you.   Geoff Allix (Outro) (50m 36s): Thank you for listening to this episode of Living Well with MS. Please check out this episode's show notes at www.overcomingms.org/podcast. You'll find all sorts of useful links and bonus information there. Do you have questions about this episode or ideas about future ones? Email us at podcast@overcomingms.org. We'd love to hear from you. You can also subscribe to the show on your favorite podcast platform, so you never miss an episode. Living Well with MS is kindly supported by a grant from the Happy Charitable Trust. If you'd like to support the Overcoming MS Charity and help to keep our podcast advertising free, you can donate online at www.overcomingms.org/donate.   Geoff Allix (Outro) (51m 22s): Thank you for your support. Living Well with MS is produced by Overcoming MS, the world's leading multiple sclerosis healthy lifestyle charity. We are here to help inform, support, and empower everyone affected by MS. To find out more and subscribe to our e-newsletter, please visit our website at www.overcomingms.org. Thanks again for tuning in, and see you next time.    

10/15/21 - Host Doug Stephan and Dr. Ken Kronhaus of Lake Cardiology (352-735-1400) begin with a truly in-depth discussion of recently released studies that warn against daily use of low dose Aspirin. Dr. Ken offers his recommendation, and as usual, one size does not fit all. Then, Doug asks Dr. Ken if it's possible to take too much fish oil and speculation that too much could lead to Atrial fibrillation (A-fib), an irregular and often very rapid heart rhythm (arrhythmia) that can lead to blood clots in the heart. Finally, the who, what, when and why of getting a COVID booster shot.

Welcome to Living Well with MS Coffee Break #23, where we are pleased to welcome Katy Glenie as our guest!   Our Coffee Break series is your chance to get to know members of our diverse OMS community. In each episode, you'll join Geoff Allix for an intimate chat with a different member of our global community. Our guests will share their personal stories and talk about their challenges and victories, large and small. We hope you find common cause and a source of inspiration from the stories of these very special people.   As always, your comments and suggestions are always welcome by emailing podcast@overcomingms.org. We hope you enjoy this episode's conversation with Katy, coming to you straight from Taupō, New Zealand.   Bio:   Katy is an outdoor loving adventurer who lives on the shores of Lake Taupō in New Zealand. She is mom to 4-year-old Rosie, wife to Mike and runs a communications consultancy that supports businesses who are making a positive impact in the community and on the environment.    Katy is currently training to climb a 3,000-meter peak in the Southern Alps of New Zealand. It will be the first mountain she has climbed since her MS diagnosis in 2019. She keeps her mind and body strong through a daily program of exercise, meditation and OMS-friendly diet. She wants to use her journey to show others that having MS doesn't mean the end of adventure. In Katy's own words: "The training might look a little different, the journey might be a little slower, and the goal might change, but the joy of a life filled with adventure is still out there waiting for you."   Questions:   Katy, welcome to Living Well with MS Coffee Break. We're so pleased to have you on our program. The purpose of this series is to better get to know some of the diverse members of our community from around the world, and today you're in the hot seat. You live in what sounds like an idyllic place. Can you tell us about Lake Taupō in New Zealand? When were you diagnosed with MS? Can you provide some context on that? When were you diagnosed and how did you initially deal with it? You live in a remote place. What are some of the challenges of having MS and living in a beautiful yet distant paradise? At which point did you come across the OMS program? How was that experience for you? Why did you decide to start following it? What are some of the challenges you've faced at first in adopting the OMS program? How did you overcome them? When did you first start to see any kind of positive indicators in following OMS guidelines? What were these? One of your core philosophies is that nature if the best medicine. Seems that's led you to take up mountain climbing. Can you share the backstory about how you got into climbing, and how your balance your own health needs with what seems like a rigorous physical activity? And how, if at all, has OMS helped with this? You're training to climb a 3,000-meter mountain in NZ's southern alps. Wow! Tell us more. Shifting gears slightly, one of your other passions is caring for the environment and reducing consumption. How do you put that into practice in your daily life and can you share some perspectives or ideas that may enlighten our listeners? If you tap into your experience with MS generally and OMS specifically for a nugget of wisdom that would help people ease into and better adopt the OMS program, what would that advice be?   Katy's Mountain Climbing Adventures:   Katy completed her first alpine climb since her MS diagnosis in August 2021, climbing Single Cone in the Remarkables, near Queenstown, NZ. This was part of her training program for the big 3,000m climb, which is due to happen in November 2021.   According to Katy: “The climb was incredible, and although I was a bit slower than before my diagnosis, and was very tired afterwards, my body was able to keep going. Hooray!”   Katy's Links:   Check out Katy's Instagram Learn more about climbing mountains in New Zealand from Katy's climbing website   Katy's Glossary of Māori Phrases   I'd love to share some of our local Māori phrases that are commonly used here in Aotearoa (New Zealand in Māori). Our indigenous language is unique to our country and is seen locally as a treasure (or taonga) and an important connection to our land and people:   Kia ora = hello  Mōrena = good morning Ka kite anō = see you again / later Ngā mihi = greetings (commonly used as a sign-off on emails / letters) Kaitiakitanga = guardianship / care and protection of our land and native species   A macron over a vowel indicates a longer vowel sound, and Māori vowel sounds are:   a (‘a' as in ‘car') e (‘e' as in ‘egg') i (‘i' like the ‘ee' in ‘tee') (‘o' as in ‘four') u (‘u' like an ‘o' in ‘to')   Coming up on our next episode:   Starting October 20, Living Well with MS welcomes back Dr. Aaron Boster, an Ohio-based neurologist specializing in MS. This time we tap his expertise to grapple with an important topic that isn't discussed as often as it should be – sex. Sex and sexuality are vital dimensions of a healthy life, but how are they impacted by MS? Our discussion with Dr. Boster digs into the science and practical implications behind this topic, so let's talk about sex and MS! Also, the final installment of Ask Jack for 2021 premieres on November 10, and it's our special holiday cooking edition. Remember, you can submit your questions early for the next and all future Ask Jack episodes by emailing them to podcast@overcomingms.org.   Don't miss out:   Subscribe to this podcast and never miss an episode. You can catch any episode of Living Well with MS here or on your favorite podcast listening app. Don't be shy – if you like the program, leave a review on Apple Podcasts or wherever you tune into the show. And feel free to share your comments and suggestions by emailing podcast@overcomingms.org.   S3E42b Transcript Coffee Break #23 with Katy Glenie   Geoff Allix (1s): Welcome to Living Well with MS Coffee Break, a part of the Overcoming MS podcast family, made for people with multiple sclerosis interested in making healthy lifestyle choices. Today, you'll meet someone living with MS from or our global Overcoming MS community. Our guest will share their personal perspective on the positive and practical lifestyle changes they have made, which have helped them lead a fuller life. You can check out our show notes for more information and useful links. You can find these on our website at www.overcomingms.org/podcast. If you enjoy the show, please spread the word about us on your social media channels.   Geoff Allix (45s): Finally, don't forget to subscribe to the show on your favorite podcast platform so you never miss an episode. So, get your favorite drink ready and let's meet our guest. Welcome to Living Well with MS Coffee Break #23, where we are pleased to welcome Katy Glenie as our guest. As always, your comments and suggestions are welcome by emailing podcast@overcomingms.org. We hope you enjoy this episode's conversation with Katy coming to you straight from Taupo, New Zealand. So, Katie, welcome to Living Well with MS Coffee Break. We're very pleased to have you on our program and just to explain the purpose of this series is to better get to know some of the diverse members of our community from around the world. And today you're in the hot seat.   Geoff Allix (1m 26s): You live in what sounds like an idyllic place. So, could you tell us a little bit about Lake Taupo in New Zealand?   Katy Glenie (1m 34s): [unintelligible], Geoff. Thank you for having me on the program. It's lovely to chat with you. Yes, I live in the most beautiful place in the world, Taupo out there in New Zealand. So, we're on the edge of New Zealand's biggest lake and in the distance, some beautiful mountains on the edge of the lake. And that's one of the reasons that we moved to Taupo three years ago actually was to start doing a bit more mountain climbing, rock climbing, and I also love to swim and it's a freshwater lake and one of the cleanest lakes in New Zealand. So, it's beautiful swimming as well in the summertime. So, we were very lucky to live here.   Geoff Allix (2m 16s): And when were you diagnosed with MS. And could you provide a bit of a backstory of that?   Katy Glenie (2m 23s): Yeah, sure. So, I was diagnosed with MS around two and a half years ago. It was actually soon after we moved to Taupo, came as quite a shock as it will do for most people diagnosed. I have no family history of MS. We came to Taupo and we're really excited to start enjoying this wonderful outdoor lifestyle. We have a young daughter, so she would have been two at the time. And I had a, what I now know is a relapse. So progressively more and more pins and needles, numbness, loss of sensation on my right side.   Katy Glenie (3m 3s): And eventually that turned into what I now know as the classic MS hug, so I was really struggling to breath doing anything more than very basic sort of day-to-day things. It took a really long time for me to get diagnosed through our public health system. So it was, it came eventually as a bit of a relief to have a name against what was happening to me, but it was also a huge shock. I imagined that I, within weeks might be in a wheelchair, which I now know is not the case, but I guess that's where my brain went and I thought, wow, how am I going to be a parent? How am I going to be a wife and a contributing part of a relationship?   Katy Glenie (3m 50s): And how am I going to be able to engage in this beautiful outdoor lifestyle that we had come to Taupo to experience? So, it was a rough time.   Geoff Allix (4m 1s): So, you've, you said you live in a beautiful but remote place. So, what are some of the challenges of having MS and living somewhere that's quite distant and remote?   Katy Glenie (4m 13s): Yeah, thanks for asking that question, it is really challenging. And I hadn't realized that until I started to try and engage with the health system from a regional community. So, there's a lot of driving to appointments quite far away because our local hospital is really just very basic. The neurologist I see is just a visiting neurologist, he comes to the hospital at a town that's over an hour's drive from where we live and all of the services like MRIs and specialized testing and my infusions that I get are all done in another town.   Katy Glenie (5m 1s): So, there's a lot of driving and there's a lot of sort of, I guess, stress around trying to find out if you're getting the right treatment, because there's no MS specialists anywhere near where I live or the specialists that we have around the main centers. So that's, I guess another complication.   Geoff Allix (5m 19s): But you managed it well, do you get over those problems?   Katy Glenie (5m 25s): Yeah. Yeah. I mean, everything's surmountable in the end, but it's just, you just kind of have to navigate your way through and try and find support where you can get it. So, for example, I found an excellent neurophysio who's based in Auckland and I've seen her through online sessions. And initially I thought, how do you see a physio online? Like, don't they have to see you doing exercises. But actually, most of the time we just talking about where I'm at, where I could go to next, what some of the challenges I'm facing might be.   Katy Glenie (6m 6s): And then I just fly up and see her every sort of three or four months in person. And that actually worked really well. So, you sort of be a bit creative in that way. And the other thing that's, to be honest has been absolutely excellent are Overcoming MS tools and support that's available online, because that has been a huge source of inspiration and support for me on this journey.   Geoff Allix (6m 32s): That's good. And one thing actually has been a good side of COVID is that actually the online ability to do things has gotten much better. I'm the same my-- I just spoke to my neurophysio last week, but although I can normally see her, that's very restricted because of coronavirus. But actually they, everyone has made real efforts to be able to do things virtually and you're right. Actually, I didn't need to physically see her. And it was easier just to do this, do it over Zoom, and we could have a conversation and actually get some things resolved and it was a good meeting. And I think things hopefully will stay like that because we've got this ability to communicate that's been improved because we had to.   Katy Glenie (7m 19s): Yeah, yeah. I did notice that the, you know, like the webinars series that are in this, going through the different parts of the protocol and some sort of ideas and inspiration, you know, I feel like that might not have happened unless COVID sort of, or maybe sped things up a little bit and it, you know, I would have gone on a retreat if I could have, but that was all kind of closed down and with all the institutes not operating, so that option isn't there for me and being able to see all that stuff and engage with the little message boards and that, that's been really cool.   Geoff Allix (7m 60s): And when did you come across OMS and why did you start, when do you decide to start to follow it?   Katy Glenie (8m 8s): So, Dr. Google found me OMS, Dr. Google is an amazing resource. And I mean, I sort of had a look about, but it wasn't long until I found that. And then I know you've mentioned before on previous podcasts that you, you know, you like the idea that it's not selling you on a thing. And that appealed to me as well about really the research and that's quite genuine. So yeah, I came across it really quickly. And then I soon, you know, I started to see that people were having good results and I know, you know, the results on an individual level will be hugely variable depending on your situation and those sorts of things, but just having inspiration there, listening to people that I'm going to doing really well and that I encouraged them moving forward.   Katy Glenie (9m 1s): That's been, yeah, it's been really good.   Geoff Allix (9m 4s): And what are some of the challenges you've faced in implementing the OMS protocols?   Katy Glenie (9m 12s): So first thinking about this before this conversation started, you know the hardest thing was I was not even vegetarian. I was a full meat eater; I had a lots of meat at every meal pretty much. And we, you know, I think we eat veggies here maybe once every three months and we had lots of cheese. So, it's kind of like, how do you cook without meat and cheese, is that even a thing? So that's been a real learning curve for us. We're kind of on a good record now, but that took a long time.   Katy Glenie (9m 52s): And my husband was a very much a meat eater and he was like, well, when do I get to eat the steak? And I'm like, just put it on top. I just won't have those fats.   Geoff Allix (10m 2s): I came from a very similar-- I say, in some many ways actually with your hobbies as well. So, I was into rock climbing and outdoor sports and might have by the case of surfing and very, very, very active, but my diet was terrible. It was very processed as well, as well as being mostly meat. There's a lot of pies. Yeah. There was a lot of fried food, a lot of cheese. And you wonder whether that contributed, I don't know, but I thought I was okay because I was so active. I was slim. And I thought, well, if I'm slim, then eating all that food is not doing me any harm, I'm burning it off.   Geoff Allix (10m 43s): And you don't realize that there are other side effects to what you eat and, you know, heavily processed food is never going to be good. And yeah. Food with high fat.   Katy Glenie (10m 54s): You know, [inaudible]. We're quite lucky in New Zealand, I mean, you know, everyone's a bit different, but our diet generally isn't that processed, but definitely a lot of meat. And, you know, fat, you know, I used to say to friends, fat's back, don't worry fat's back. You can eat as much as you like it's safe and you know, it keeps you [inaudible] So definitely, it was a big challenge. And the other thing that was initially a bit of a challenge, but it's now something I've come to love was the meditation. I mean, I own my own business. I have a young daughter and I'm very active in the community, and then the outdoors.   Katy Glenie (11m 39s): And I was like, when do you fit this in? This is ridiculous. They're asking you to meditate every day, who does that? And then actually my physio said to me, as part of fatigue management, she said, you need to do something that rests your brain every day and you need to do it not right at the end of the day, when you're trying to go to sleep, you need to do it at a time when you really going to benefit from having your brain rested, which is the middle of the day. She said, you need to sit down, and you need to stop everything that's going on. All the stimulation, no reading, no listening to what's going on in the news. You need to just quiet your brain down.   Katy Glenie (12m 20s): And I was like, jeepers even the physio is telling me to do this, all right, I'll give it a go. And so, you know, put your Air Pods on and listen to this woman telling me to chill out. And after a while, I was like, this is amazing. This is, it's been a really, really beneficial change to my life adding meditation to the bag, and now I do it religiously every day.   Geoff Allix (12m 43s): That was like my physio as well. And she said, my first neurophysio said, don't forget your mind, which I found really strange because I thought they would be, it's all about exercise and they would ignore all the other elements. And that would be their thing. But yeah, he said, no, you must think about your mind as well. And he was sort of talking about, you know, think about yoga and think about different things, but basically try and not get stressed out, calm your mind. And it was really interesting to get that from someone who's actually from a different field saying that they see benefits from people who practice mindfulness, stress relief, yoga, those sort of things.   Geoff Allix (13m 25s): So, when did you start to see positive benefits from following OMS and what were these?   Katy Glenie (13m 32s): Well, it's taken longer than I had thought, but it's been a slow progression of less symptoms. So, my symptoms have been mainly pins and needles and sort of lack of sensation. And then also I would get, I get problems around fatigue and heat tolerance. So, when I get too hot, I get really, really tired and all my symptoms, my pins and needles go a bit crazy. So, what I've noticed at the start, I didn't really notice anything, but over time I noticed that all the symptoms were getting less and less.   Katy Glenie (14m 21s): So, I was still getting them, but I was getting them less frequently and they were lasting for a much shorter amount of time. But the thing that it really gave me, so that's obviously a benefit, but the thing that it really gave me was a sense of hope and a sense of focus. So, I knew I just needed to keep following the steps and keep working through it and it gave me some autonomy over my own health. I wasn't sitting and waiting to see if there was a new medication that was going to save me. I wasn't, you know, waiting to see if some amazing new neurologist was going to come into our town. I felt that I had that autonomy over my own health, and that has been probably the biggest benefit to the program.   Katy Glenie (15m 4s): So, I have definitely seen improvements in my symptoms, but in terms of my outlook and my approach to life, that's where I've really benefited. And I feel that I've got much more confidence to continue to live a full life.   Geoff Allix (15m 20s): And I think that the book talks about that. Having faith in there is actually, medically If people believe they're doing something and they know they're empowering themselves, and they're doing something to get better, that actually has a point of positive benefit. And there's an element of that in placebo effect. So, if you give someone a sugar tablet, but tell them it's the latest, greatest medicine, then the proportion of those people get better because they think they're doing something. And then your mind is so powerful that actually it can have an effect. And so, it's actually part of the program that you need to believe in the program, you need to read into it and understand it because that belief in itself is in itself a positive benefit.   Katy Glenie (16m 6s): Yeah. And I've really experienced that. So, I mean, we'll come on to talk about it soon, but I guess taking on physical challenges and taking on things that initially I thought might not be possible for someone with MS, they just come through following the program. So, I just have belief that what I'm doing is helping my body for the long term and that I can go on to do challenging and exciting things that I might've thought were not possible.   Geoff Allix (16m 40s): Well, talking about that then. So could you tell us a bit about climbing and how you got into climbing and how you balance your health needs with rigorous physical activity and dangerous physical activities.   Katy Glenie (16m 56s): Manage danger, Geoff.   Geoff Allix (16m 59s): Well, I don't know if I mentioned this on previous podcasts, but I've actually had a compound fractured tibia and femur of my right leg when I was 17 years old in a rock climbing incident and I couldn't walk for six months. There are some, sort of man-- it was managed because I'm still alive, so.   Katy Glenie (17m 24s): Oh, all right. Yeah. So maybe there is an element of doubt. Yeah. So, and I guess in my sort of personal time, I love doing lots of things in the outdoors. And two of those things are rock climbing and alpine climbing and what I've sort of been working on it. So, I was recently the lucky recipient of a grant that will -- it's called the Mastering Mountains grant that's hoping to pay for a major go and take on a peak in southern New Zealand. So, I'm going to plan a 3000m peak at the end of the year.   Katy Glenie (18m 6s): And that grant has, was started by someone with MS who went from a wheelchair to climbing a mountain, doing lots of, you know, focused work on diet and exercise and mindfulness. And that really inspired me reading that and I thought, okay, well if he can do it, I'm sure I can. And so, once I got the grant, I guess I've kind of publicly said to the world I'm going to do this peak. And then I bought, I don't know how I just write it down on the application form. So, then I thought, okay, I need to work out how to do this. And my, so I got in touch with the neurophysio that I mentioned before, and she's helping me on the program, on my sort of fitness program.   Katy Glenie (18m 56s): And what I've done is I've just started out sort of with something that I think is achievable. And I've just, I've always done a lot of tramping that I think to the rest of the world is hiking. In New Zealand, we call it tramping, I don't know why. And so, I went on an overnight tramp, and I took a friend and I said, hey, can you carry most of my stuff? I just want to see if I can physically walk this far, but I want to be able to do it more than just a bush walk, like the neighborhood. And that worked, and then I thought, okay, well next time maybe I'll carry a bit more gear, that worked. And then the next time I thought, maybe I'll walk a bit further.   Katy Glenie (19m 38s): And so, I've sort of taken it in stages like that without pushing too far, but each time pushing a bit further. And I just make sure I'm really listening to my body. So, I've got some great tips on what to do if my symptoms are a bit [inaudible], so, you know, take a rest, take some water, get something to eat, get yourself a decent rest, you know, 20, 30 minutes and then start again. Don't think I've just got to push through this you know, if your body's saying to stop that's okay, but that doesn't mean you have to turn around and go home. And then I've also recruited, I guess, some great friends who are helping me, so they know what's going on for me, they understand that sometimes I might want to walk slower or that I might want to rest a bit longer than they would normally rest.   Katy Glenie (20m 29s): And they've all been really supportive with that. So, I guess it's about recruiting people to help you along the way, getting good knowledge and information about how to manage your symptoms when you're going through them. And also, just to not be afraid to push yourself a little bit further, you don't need to push yourself to the point of getting a relapse, but you do need to push yourself beyond just walking down to the litter box and back every day.   Geoff Allix (20m 55s): You've mentioned Alpinism and climbing mountains, but for those people who don't know what alpinism is, and because it's a bit more than what you're saying is tramping and what mountain are you climbing? Because it's not, it's not a sort of like, yeah, it's not small hill.   Katy Glenie (21m 17s): Yeah. Fair enough, yeah. So, I guess we aren't tramping because at the moment the snow hasn't come on yet. So, I'm waiting for the snow to come before I can start going on the mountain. And tramping is really good training for mountain climbing, but alpinism is when you are on the mountain and you have an ice ax in your hand, you have crampons on your feet. You have lots of warm gear on, and you've probably got a harness around your belly, and you're attached with the rope to someone else. So, entry level mountain climbing, you might not get ropes, but as you get better and on to the more technical climb then you're often roped to your climbing partner, and you would be off to climb something that might involve quite a steep slope, that might involve a bit of ice and snow and rock and a [inaudible] ideally you top out on some sort of summit.   Katy Glenie (22m 11s): And that's what my objective is at the end of the year is to climb a peak called the Minarets, which is on the spine of the Southern Alps and the south of the South Island of New Zealand. And I'll be doing all those things, ropes and ice axes taking on some steeper slopes on a snowy peak.   Geoff Allix (22m 39s): And on another subject, one of your other passions is caring for the environment and reducing consumption. So how do you put that into practice in daily life? And is there anything that could enlighten our listeners about this?   Katy Glenie (22m 55s): Oh, I love that question. Awesome. So, I'm really, really passionate about looking after the land that we are so deeply connected to. And I guess for me how that works in daily life is I think a lot about reducing my consumption. So that's probably one of the easiest ways to summarize sustainability is that less is best. So, if you can buy less, if you can grow more of your own food, if you can buy things without packaging, if you can reduce your food waste, if you can drive less or drive-- we have an electric car, so we'd drive that, if you can share your ride with someone else that is less of you and different cars.   Katy Glenie (23m 44s): If you can think about flying less, or if you can think about buying less things for your home, you don't need two TVs, you might need one. You don't need five sofas, you might need one, and it could be a sofa that's been used by someone else before it came to your house. All that sort of way of living is something that I really enjoy. And I liked the idea that through my actions, I can make an impact. And also, if I'm sharing those stories with other people, they can start to learn how they can also have a positive impact.   Geoff Allix (24m 21s): Yeah. I noticed, I mean, we're very good at recycling, but we're now at a phase where someone said, you start off you need to recycle more and then you need to recycle less because actually there's an awful lot of stuff going to recycling and that's not necessarily a good thing. There's a huge amount, I mean, certainly in the UK, the amount of plastics in everything you buy and if you buy anything from Amazon, sorry, and other retailers are probably the same. I shouldn't just call them out, but if it comes in a box, in packaging, in another box. And it's like, sometimes you end up with three or four boxes to actually get inside the thing that's in the middle and yeah.   Geoff Allix (25m 3s): The packaging and plastics and just buying food stuff, everything is covered in plastic.   Katy Glenie (25m 10s): Yeah. And don't underestimate the power of one person because I think, you know, we're getting more and more understanding right now around the world on the issue and all those voices are getting louder and louder, you know? So, I would like to think that one day when you go to a UK supermarket, not every item, not every vegetable is single wrapped in plastic. Cause when I lived in the UK, hopefully it's different now, but when I lived over there, everything was individually wrapped because it comes from Ecuador or Argentina or something, that's like-- you know, limes aren't in season right now.   Katy Glenie (25m 51s): So why are limes in the supermarket? [crosstalk]   Geoff Allix (25m 56s): I would say there's less plastic now, but it still comes around the world and you can't explain it to your children, that you can't have an avocado this time of year because they don't grow. They're going to go, I want avocado, or I want strawberries, but it's December and they can get strawberries and that's the problem. Yes, they're from Peru or Kenya or, you know, they've flown them in an airplane. That's insane to do, but that's not-- I mean, I think it's a generational thing because when I was growing up, you ate what you could eat in season. And that was that.   Katy Glenie (26m 33s): We did try to eat in season here. And I guess the other flip side of it, as, you know, the UK is kind of much more attached to a global economy. In New Zealand if the strawberries come from Argentina, they will be way too expensive for anyone to buy. So, no one will buy them. So we only buy strawberries when they come from New Zealand, because they're affordable and so I guess there's a bit of just that understanding that if you think every time you're wanting to buy something, just because it's something that you really need and if it is, try and buy second hand or try and buy it from a local supplier who might've made it locally or might be quite thoughtful about how much sort of [inaudible] and carbon dioxide has been involved in producing that item because it's, yeah.   Katy Glenie (27m 26s): It's just being sort of a bit more thoughtful about your life.   Geoff Allix (27m 32s): Okay, interesting perspective. So, if you tap into your-- back to MS. If you tap into your experience with MS generally and OMS specifically for a nugget of wisdom, what will help people adopt the OMS program?   Katy Glenie (27m 50s): I guess for me, it's about that sense of community, that you're surrounded by others that are following the program and want you to do well and want to support you on that journey. And it's also understanding that even if you're not getting amazing results straight away, and you're not, you know, suddenly feeling better, it's a journey. And part of that journey is the belief that you're doing something that's positive for your health. And if you can kind of keep on that hopefulness and positivity, that will help you so much and your health and in your general wellbeing and outlook.   Geoff Allix (28m 36s): And with that, I'd like to thank you very much for joining us, Katy Glenie.   Katy Glenie (28m 42s): Thanks, Geoff.   Geoff Allix (28m 42s): Thank you for listening to this episode of Living Well with MS Coffee Break. Please check out this episode's show notes at www.overcomingms.org/podcast. You'll find all sorts of useful links and bonus information there. If you'd like to be featured on a future Coffee Break episode, or have any suggestions, please email us at podcast@overcomingms.org. You can also subscribe to the show on your favorite podcast platform, so you never miss an episode. Living Well with MS Coffee Break is kindly supported by grant from the Happy Charitable Trust. If you'd like to support the Overcoming MS charity and help keep our podcast advertising free, you can donate online at www.overcomingms.org/donate.   Geoff Allix (29m 23s): Thank you for your support. Living Well with MS Coffee Break is produced by Overcoming MS, the world's leading multiple sclerosis healthy lifestyle charity. We are here to help inform, support, and empower everyone affected by MS. To find out more and subscribe to our email newsletter please visit our website at www.overcomingms.org. Thanks again for tuning in and see you next time.

A podcast series on how people in Macau are coping with Covid-19.

Have you ever thought: Is it possible to live your life to the fullest with MS? How can this diagnosis affect me and my loved ones? In this week's episode, I will be joined by Dr. Aaron Boster. He is a board-certified Neurologist specializing in Multiple Sclerosis and related CNS inflammatory disorders. He decided to become an MS doctor at age 12, as he watched his uncle Mark suffer from the disease in an era before treatment was available. Since then, Dr. Boster has been intimately involved in the care of people impacted by Multiple Sclerosis; He has been a principal investigator in numerous Clinical Trials, trained multiple MS Doctors and Nurse Practitioners, published extensively in medical journals. He lectures to both patients and providers worldwide with a mission to EDUCATE, ENERGIZE and EMPOWER people impacted by MS. In this episode, we talked about MS DMTs. The strategies he implemented with his patients. What DMTs he'd never recommend for certain MS patients? What type of conversation you should be having with your neurologist? What study shows how mindfulness can be valuable in improving the well-being of people living with MS? Live your best life -- in spite of MS.Additional Information: Additional Resources: https://www.doctorgretchenhawley.com/insider Reach out to Dr. Boster: Social: Twitter: https://twitter.com/aaronbostermd Youtube: https://www.youtube.com/c/AaronBosterMD Facebook: https://www.facebook.com/AaronBosterMD/ https://www.facebook.com/alb.ohiohealthms Website: https://bosterms.com/ Reach out to Me: Social: msinglink.com https://www.facebook.com/Doctor.Gretchen/ https://www.instagram.com/doctor.gretchen https://www.youtube.com/c/DoctorGretchenHawley/featured

Questa è una puntata speciale, realizzata sul campo, anzi, nel bosco! In un bosco di pini silvestri dell'Alta Val Susa, dove da diversi anni va in scena "BOSTER Nord-Ovest", una Fiera dedicata a ogni aspetto della gestione sostenibile delle foreste che è diventata un riferimento, un appuntamento fisso per gli addetti ai lavori del settore. Ogni fiera è un crocevia di volti, di storie, di sensibilità, di innovazioni, di punti di vista, un "luogo di relazioni" essenziale per una comunità come quella forestale, che è piccola, ma che gestisce quasi il 40% d'Italia.Per questo abbiamo accolto con grande entusiasmo la proposta di Gianluigi Pirrera, l'organizzatore di BOSTER Nord-Ovest, di realizzare una puntata di Ecotoni in Fiera: volevamo raccogliere le voci di questa comunità e farle vibrare insieme alle nostre per raccontarvi le mille sfaccettature di questo settore tanto interessante quanto sconosciuto.Il nostro "inviato speciale" nel bosco è stato Luigi, mentre Ferdinando, dalla redazione, ha fatto da "tessitore" delle tante interviste raccolte in diretta insieme ai protagonisti della Fiera.Ci auguriamo che questa puntata, ricca di voci e storie, faccia sentire anche voi, ascoltatori di Ecotoni, parte di questa comunità caratterizzata dalla passione per il proprio lavoro, per l'ambiente forestale e da un simbolo inconfondibile: le camicie a quadri!Buon ascolto!Ferdinando & Luigi

Bob Boster runs a large manufacturer of live and broadcast communications and combines this with a side passion and profession as a sound artist. We discuss how this came about and how he manages to juggle these two threads of his life. We dive into sound art, how a niche artist from USA can economically plan a 20-30 date European tour and much more.

Join us for a retrospective of some gems that Dr. Aaron Boster, MD has shared with us over the years. We are so honored to have been gifted his time and insight on the podcast over the past four seasons. We hope you enjoy this compilation of some of our favorite Dr. B. moments. You'll hear excerpts from Episodes 73 & 135 (from Seasons 3 & 4). We encourage you to listen to each episode in its entirety. They're brilliant. Dr. Aaron Boster, MD is President of The Boster Center for Multiple Sclerosis (bosterms.com). He is a board-certified Neurologist specializing in Multiple Sclerosis and related CNS inflammatory disorders. Find Dr. Boster on Twitter @aaronbostermd and YouTube. You can find us on the web at http://myelinandmelanin.com, Facebook, Instagram, and Twitter @myelinmelanin. You can also subscribe to us on YouTube. Consider supporting us through our Patreon -- http://patreon.com/myelinmelanin. Patrons can gain access to exclusive content, Myelin & Melanin swag & more. Your support helps us offset the cost of maintaining our website, paying for our remote recording technology, music, podcast & merchandise production, and more. As we do not get paid to produce the podcast, these are costs that come out of our pockets. This can often be a struggle. If you enjoy the podcast, please take a minute to leave us a 5-Star rating on Apple Podcasts. Stream the podcast on Apple Podcasts, Spotify, Google Play, and everywhere you listen to podcasts. Peace!

Join us for a retrospective of some gems that Dr. Aaron Boster, MD has shared with us over the years. We are so honored to have been gifted his time and insight on the podcast over the past four seasons. We hope you enjoy this compilation of some of our favorite Dr. B. moments. You'll hear excerpts from Episodes 17, 40 & 51 (from Seasons 1-3). We encourage you to listen to each episode in its entirety. They're brilliant. Dr. Aaron Boster, MD is President of The Boster Center for Multiple Sclerosis (bosterms.com). He is a board-certified Neurologist specializing in Multiple Sclerosis and related CNS inflammatory disorders. Find Dr. Boster on Twitter @aaronbostermd and YouTube. You can find us on the web at http://myelinandmelanin.com, Facebook, Instagram, and Twitter @myelinmelanin. You can also subscribe to us on YouTube. Consider supporting us through our Patreon -- http://patreon.com/myelinmelanin. Patrons can gain access to exclusive content, Myelin & Melanin swag & more. Your support helps us offset the cost of maintaining our website, paying for our remote recording technology, music, podcast & merchandise production, and more. As we do not get paid to produce the podcast, these are costs that come out of our pockets. This can often be a struggle. If you enjoy the podcast, please take a minute to leave us a 5-Star rating on Apple Podcasts. Stream the podcast on Apple Podcasts, Spotify, Google Play, and everywhere you listen to podcasts. Peace!

Intimacy extends beyond romantic relationships. Today we're joined by Dr. Aaron Boster, MD, and we chat about one of the most intimate relationships an MSer will ever have -- with their MS specialist.  Dr. Aaron Boster, MD is President of The Boster Center for Multiple Sclerosis (bosterms.com). He is a board-certified Neurologist specializing in Multiple Sclerosis and related CNS inflammatory disorders. Find Dr. Boster on Twitter @aaronbostermd and YouTube. You can find us on the web at http://myelinandmelanin.com, Facebook, Instagram, and Twitter @myelinmelanin. You can also subscribe to us on YouTube. Consider supporting us through our Patreon -- http://patreon.com/myelinmelanin. Patrons can gain access to exclusive content, Myelin & Melanin swag & more. Your support helps us offset the cost of maintaining our website, paying for our remote recording technology, music, podcast & merchandise production, and more. As we do not get paid to produce the podcast, these are costs that come out of our pockets. This can often be a struggle. If you enjoy the podcast, please take a minute to leave us a 5-Star rating on Apple Podcasts. Stream the podcast on Apple Podcasts, Spotify, Google Play, and everywhere you listen to podcasts. Peace!

Go online to PeerView.com/PPP860 to view the entire program with slides. In this activity, an expert in multiple sclerosis discusses available disease-modifying therapies and strategies for shared decision-making for patients with multiple sclerosis. Upon completion of this activity, participants should be better able to: Recognize the mechanisms of action of disease-modifying therapeutic options for patients with multiple sclerosis, Apply available data on disease-modifying therapies when managing patients with multiple sclerosis, Employ evidence-based strategies designed to facilitate shared decision-making and maintain a therapeutic alliance with patients with multiple sclerosis.

Go online to PeerView.com/PPP860 to view the entire program with slides. In this activity, an expert in multiple sclerosis discusses available disease-modifying therapies and strategies for shared decision-making for patients with multiple sclerosis. Upon completion of this activity, participants should be better able to: Recognize the mechanisms of action of disease-modifying therapeutic options for patients with multiple sclerosis, Apply available data on disease-modifying therapies when managing patients with multiple sclerosis, Employ evidence-based strategies designed to facilitate shared decision-making and maintain a therapeutic alliance with patients with multiple sclerosis.

Go online to PeerView.com/PPP860 to view the entire program with slides. In this activity, an expert in multiple sclerosis discusses available disease-modifying therapies and strategies for shared decision-making for patients with multiple sclerosis. Upon completion of this activity, participants should be better able to: Recognize the mechanisms of action of disease-modifying therapeutic options for patients with multiple sclerosis, Apply available data on disease-modifying therapies when managing patients with multiple sclerosis, Employ evidence-based strategies designed to facilitate shared decision-making and maintain a therapeutic alliance with patients with multiple sclerosis.

Go online to PeerView.com/PPP860 to view the entire program with slides. In this activity, an expert in multiple sclerosis discusses available disease-modifying therapies and strategies for shared decision-making for patients with multiple sclerosis. Upon completion of this activity, participants should be better able to: Recognize the mechanisms of action of disease-modifying therapeutic options for patients with multiple sclerosis, Apply available data on disease-modifying therapies when managing patients with multiple sclerosis, Employ evidence-based strategies designed to facilitate shared decision-making and maintain a therapeutic alliance with patients with multiple sclerosis.

Go online to PeerView.com/PPP860 to view the entire program with slides. In this activity, an expert in multiple sclerosis discusses available disease-modifying therapies and strategies for shared decision-making for patients with multiple sclerosis. Upon completion of this activity, participants should be better able to: Recognize the mechanisms of action of disease-modifying therapeutic options for patients with multiple sclerosis, Apply available data on disease-modifying therapies when managing patients with multiple sclerosis, Employ evidence-based strategies designed to facilitate shared decision-making and maintain a therapeutic alliance with patients with multiple sclerosis.

Go online to PeerView.com/PPP860 to view the entire program with slides. In this activity, an expert in multiple sclerosis discusses available disease-modifying therapies and strategies for shared decision-making for patients with multiple sclerosis. Upon completion of this activity, participants should be better able to: Recognize the mechanisms of action of disease-modifying therapeutic options for patients with multiple sclerosis, Apply available data on disease-modifying therapies when managing patients with multiple sclerosis, Employ evidence-based strategies designed to facilitate shared decision-making and maintain a therapeutic alliance with patients with multiple sclerosis.

Is faking it until you make it a bad thing?  Can it snowball into positive energy or is just a "Florida Snowball"? Eric Readinger and Law Smith go over this and provide pragmatic, business development advice about Bark.com and Drift, conversational marketing. Please Support Our Sponsors That Support Our Girthy Show!  This episode's girthy sponsor is FreshBooks, the best cloud accounting software for hustlers, entrepreneurs or anyone with a side piece business.     Sweat Equity listeners get a free 30 day trial of FreshBooks. TO HELP THE SHOW, PLEASE USE OR SHARE OUR UNIQUE LINK GoFreshBooks.com/Sweat   Like any young, plucky business or passion project, any revenue from our sponsors will be reinvested right into the podcast and streaming show.      Subscribe, 5 ⭐ And Please Write A Review! The funniest or biggest hater reviews are likely to get a shout out on the show.   Where To Listen, Watch, Review, and Share With A Friend! Spotify http://bit.ly/swequity iTunes http://bit.ly/se-it Laughable http://bit.ly/2k7y6Ff YouTube: http://bit.ly/se-yt Facebook: http://bit.ly/se-fbp   Yeah yeah now are going now are going to tech difficulties have been her issue lately Erickson's register just relax I'm getting down mad I and to functioning so dad mad sitting still Newport is up to me the Apple Watch don't tell you to freeze yeah it's college full of useless reminders of all been forget to breathe I'll be I'll be sitting there just thinking about an argument that I just had but I'm sitting still and it's like in a box up that the worst one is the one that says you haven't done anything in your heart rate at 120 yeah will that's not good at sudsy that's me if you don't think it's reef you may go to the doctor know that now I mean that's me getting picked by heart rate is higher normally just nothing but I'm saying life does not come to be proud that's weird it's still not proud of its it's scary is on St. John the hypochondriac so I've architected by Dr. it's that's what I do I bring a list of questions every time ago and 1/2 shout out to Dr. to Onyx and the evil he loves his podcast and so these numbers soar knows what five gases here but I bring a list of questions and I'm not proud of you understand that's that's crazy psychosomatic, so your brain can get you so mad but physically my doing anything internally physically and yet will wait when you met at other than the technical difficulties that we now know I guess I start transition between thoughts little bit but I am bad how much time we spend on tech issues and that's the good kind segue into apologizing to the audience about last two weeks we've read some good news bad news we've had we have some good things in the hopper coming up unfortunately have to do that they were super vague because we can't that's the bad news you can really talk about it yet just no trust me we will talk to shoot out of it once we can but yeah and maybe more frequency to Yahoo I can wear those that yeah so so good news is stuff in the future near future to look good no matter what happens if we get this thing going we have a backup plan anyway bad news is we we didn't thank you enough episodes were schedule our time together to do episodes with gas Regis got her a self the last one Eric you did a great job on your ear I went good news bad news right now I started that way and then cheers and jeers and knowing what's your notes on how they did know this stuff so not Celica report card or anything I thought you did a really good job you had a yen of Jacqueline Jack yeah my funky face between my wife and my best friend who they have about zero respect for my opinions and whatnot he wrangled them as much as you could know why I thought it was good idea I don't know what I was thinking but career what it is not as bad as you say you have a listener back right now though I was in the first five seconds and it was me maxing out and I was liking the audit in the audio is a little bad debts on the deal I think a lot of people were we only three of the audio file, listeners I think a lot of people put up with that you were not a music podcast so it's like yeah or were not like audio tech people, podcasts so voiceover podcasts I'm sure made some people mad and I hope they don't unsubscribe but we tried it removed figure get something out is better than not get it out all can we want to make sure we get one this week on Thursdays like we've been doing it will even know it has been that bad it's been maybe one week this appears that one of the last three weeks right yeah but it is interesting about being consistent first podcast is so huge to someone who absorbed a lot of them I get perturbed if I don't know there's not the episode coming up sometimes when you're really bored are you really a monotony you can rely on like right will Rogan podcast three or four and when he goes hunting doesn't tell you you're like dude that's I mean just the volume used with notes so hours a week so on-air I thought you good opinions and it made me reflect a little bit that get some good angles weaved in their bike route the data about I do know how I forgot how libertarian you can be a way okay before we start breaking me down the house you want this is a good thing do you want to what about Facebook's William sponsorship I probably another weave and it that's part of this that I was just like I don't even surface books now I know you and appalled, I found you to get to that those villagers I had you know I know but it maybe reflect I gotta stop steamrolling the is there stuff that you got on your mind probably and I probably talk over that's that was the jeers to begin you can help it but everybody's over talking yeah the amino I don't really feel that way from you but you Bruckner also hosts it will close ally single leg, most but yeah so someone's gotta come to guide the boat a little bit and someone no it's it it's as if there's more fluidity I'd say going forward it's gotta be like I never watch out ice hockey players discount they get in their and there they get enough first second third fourth line right altogether and they're just fluid they don't talk to each other yet but they know what to do they come to get in there and cut fluidity a little bit yeah I'm not coming in for podcast practice that I'm talking about why that's why there is no atonement sexual fluidity we have to bang I'm saying like I just got pickup basketball like you play because you never met you you somehow have to buy kind no everybody kind of roof falls into line so sometimes you're cheap sometimes you're Indian I thought John Paul did a good job asking questions is the everyman I thought I thought Nikki actually was really great your life as a Leica sometimes you're the sharpshooter you're kind of the assassin when you're on a podcast a lot of Mike's right so she would just kinda like to do I throw in something every now and again you lease the beginning half that happens a lot love of focus but I think yeah I think she was singer for O choose audio I think you know you try going from dome about how was going as you do it and it was fun for which no good story with the most important things we got that story on hand and maybe actually help someone else yeah okay you know the subject matter itself to me is what they are doing psychedelics you know that's my love else it wasn't anybody's silly story so there is that you know I feel like there's a lot of stuff that can help you come out of it so if you can manage not hearing quality audio there will be a good thing who knows this this episode with the tech issues could we have three things recording audio just in case and they might not might work who knows yet is be patient with us please our equipment is elsewhere that's all we can say and them even Cameron is no action on it so I hope they they face fulfill their end of the bargain were there to replace it yeah because really thought a lot of love and then we don't get a lot back from me calling you about Meebo so the other digit temperatures is just no describing a product there's audit you remember the audio listeners and he tried a little bit but it was deftly like you said y'all were describing a mustache and I was like yeah looks like this and then you open this up and it's like the unusual words that yeah I couldn't tell if Dave wanted to really and I think I asked him get into the pit side of it in terms of like him doing it you know him describing it you know you said you said also that I do wrong that you this isn't this is it like a report card and this is all this is good the fact that we got it up and out and I was like I was the guy running around outside of the park and studio I lost my wallet I was frantically doing a lot of like I do want to work it was just a bad like I should I want to be in here so it's even weirder for y'all that I'm in the office while you are recording the podcast yeah I was in a really related will give a little subtle hi Todd you get this show started ready to take that sweat equity which I tell you to do that but that's that's okay it's not your design work on I would say fresh books we will from Oco that was the only real jeers at no no no wheat we have an affiliate link sorry it's go fresh books.com/select okay not promo code sweat this I don't know we don't get that we should plan to make my mortgage payment is really ticked that up the whole thing's going under now or go belly up because that promo code air yet were not from the goat but we do have an affiliate link and all the others are promo code it'll be in the description which you just have it statically on our site since we don't really change the sponsors to too much we can have all three of them her main sponsors up I'll make a note of that three display sponsors website your notetaking voice although you have sounds like Mr. Peabody I'll end up doing that shooting look I'm crushing out my taxes right now for the business of total body consulting the officer sitting in us refer this and it QuickBooks is terrible I gotta get off that I got delivered fresh books I don't I administratively I can't I get that Florida snowball where I can't get that move over yet but I'm going to the circus flock for QuickBooks freshwater life you will explain floors noble I don't remember what was it's when you have it you have a task or project you have to do and it keeps need you to come to delaying it whether you procrastinate whether it's a legit reason or not and then it just becomes this huge thing that you never get to in this case it's no it's Artie melted now after sucking cramped it's literally the opposite it's a snow globe KYLE never keeps growing and then it just melts eventually I think of a better name that you get will go to their source I know I'm still pushing Florida's no-fault wide yeah itself it will figure out a better term Outlook I'm elastic with it I'm flexible and I'm to say go fresh books.com/sweat baggage that 30 day free trial that hook up holler fear me all are I I've got you do you have anything you want to talk about I think the lead will talk about is it is kind inside Yukon outside of you yeah so where does it for doesn't lie just if you're not big management rose talk I want to fast for the next at least five minutes probably I hope it's a whole pocket honestly it were a public service I've got a hemorrhoid right now that it's life-changing and it's been a learning experience I've got all sorts of new issues so first of all you can get hemorrhoids from sitting on the toilet to figure that out I knew that before I got there wife but what I figured out I was doing was sitting on the toilet to avoid my kids asked me to do stuff they will bother anyone proven my guess so to sit on the toilet take my sweet time and one day that it just happened all was going far did you feel it yeah like his older son yeah was the first time that it was like late late came out I was like oh no really I had on the music as it does normally it kind of Pulitzer for slowly but this left for trip felt so it was good it's legit it was a big one is big one still will deal with it but I do it it's like really painful and I got buddy whose physician's assistant and it was of the pointer is like you're have to come over and looking somewhat BH and he was all for if it is a beautiful everybody wedding, he would totally do it will be weird about it you got have a friend like that yeah and menus Marine's budget but so in anticipation of my body looking in my but I trimmed down there and now I'm dealing with the worst chafing possible and I don't know what to do minutes just everything just it's a Florida snowball man no it also describe it is so sarcastic it just keeps frontages one thing after another keeps Avenue I wish to adjust them right at this point now every time I get you notice how you can best be to get up at go to the cross of all of them like yeah we'll get to it preshow we are trying to figure out tech issues are our friends across the hall to eight monkeys and dimming out bizarre frequent guest of the program I like to discover their office I didn't even put that together I was in the zone working on executive summary farm is his plan hydrocortisone can you pick can you get some with talking music mind that that's up from a bath I know I noticed it is asserted yeah I think you're going have to find my my blanket on the dude's name I love what can you log and you have yeah yeah yeah why don't we start every show can you log is a little bit it does any log now I love arcade fire but they're not really bringing the birth like Kenny Loggins so how many days we had this this is like two weeks now well yeah and it's it it slowly gets better no matter, what you do always what I've done flipping the Lincoln high school gets better right will no remember that campaign several of I'm just I was okay of the hemorrhoidal way yeah it'll go away I guess because I'm not really paying attention to it are the ones worried about last crack tree thinking to death so a little grumpy you won't talk more about it doesn't mean does it affect your energy yeah in the crazy did the tell anybody know when characters write no will to hear that get off your lazy ass through the thing I care because it's funny right and that's what you know about is I know is brighten your day the funny thing to me is when your friends drink too much and barf like I don't know why I think it's because there's a punitive a little bit and when you bar I hate barfing so much that I think it's so funny because you can't breathe it is kind like this you know this pain is temporary sits up some real yeah and you brought it on yourself really really injured before you really start about life you know what my friends at right right even minor injuries will be funny if you're not injured wasn't next yeah what is it comity equals pain plus time overall over a little bit sometimes it's immediate and beautiful man should ever that I have what made you name it yeah Alfonso, you name it like like the name the hurricanes next will be be the name is you plan on another incoming the back of the last one out that Manuel was as I have learned a lesson here is a site trusting like busting your first night and you like I from now on you will be doing more that you know like or is it just a one time the I am asking the question I don't know if my blood snow sure like it it's about more prone to it now if it is one all out I don't know yes when I is like a baby I anticipate at least 25 more Chris Kelly letters are in the alphabet 26 yeah spells you anyway so many others that going on in life my life do the work part was that like I didn't know about a pooper not because the nerve endings down there you don't realize that that's what's filling out the poop the pressure on the nerve endings so when those get messed up I'm some consul revealing my fiction I don't what is that it is okay in an it's this constant confusion I get that a lot think you have mud but it's your sweat yeah it is what it gathers long avoidance that I've got an asset doesn't quit is this done take any days off notification personal days and that he had quit so when it's hot out in Florida and I walked around Mike, I do probably 99% of the time it's never issue but I have to check so good I feel you yeah upcoming I might just get going a little bit embarrassing on justice, get down this level with you wow to sweaty butt holes is definitely that's not right you live in Florida yeah everybody every man is that I believe were thinking of the frequency of which I have to do this I Smith I know most of you know I run hot to yes so there's that part is well I'm sitting on your saddle which I'm sure would hurt all overly say Erica saddle share in which I highlight because it actually makes me sit up half the time my postures that I'm going like scoliosis most of the time I know so I've got I got kind of a topic that I did run by you before and I meant to we are Stu too many things anything else you got no no other things grown out of me or anything that's it so are we trying to shoot for with these episodes were given this one normal retraction for that 33 Mark we might have to do in the future or we might do my computer optimal what you got to talk about labels will keep sure the guy was upside so I listen to y'all's episode one of the few without me in it and dad I like the shout outs talk about what I was doing pretty funny and I was walking the dogs understand think about it about faking it you make it kind of thing and not Ruth not really related to performance of urologist just how many people I talked to in the startup game or you know how many business owners who talk to about how the fake it till you take it kindly it's like everybody I write that social media to me is kind of that personal scale yeah because it's it would follow Israel I like I don't like that I don't like it scope coin F what is if you're missing out right I deftly have it for sure I deftly got a check is a might why do I give a shape I should be happy for people that doing all these things I'm the person I want to do a bunch of different things right entrepreneurial different things I like the variety is the spice of life but II deftly was like I need to not you know when things are good and our own don't don't get jealous or envious of what you see a histogram of your friends doing direction I want to do that yes the other side me though I know I got your being included battle of the hall and you know what you want your kids you will be letting her know that you got your kids young if you're taking them controllers of diverticulitis was a huge pain in the ass like it's working a little over so that's nice but yeah only I told Shlomo to start my just to leave have anywhere and unpack so what I'm saying is I get that social media life on a personal scale. It was nonbusiness he know a lot of people don't show the bad stuff and when they do it usually like I don't have health insurance I got a car wreck here's a go funny right you know that's the bad stuff I used to take miserable pics yeah I'm a joke but kind of like we go on spring break look like we've not had a good time at all in college yeah and just have that would those be the only photos out there my wife and I do that sometimes reasons do like to be at a show behind stage like really exciting which is fake like the word out about time I visited that's good nobody does that I think it's real life yeah I think the regular basis to do that we take the ugliest pictures of himself yeah. January does that yes I think like I think there's a over sharing thing were you know I was trying to do the accountable wake up take a picture of the watch deal how many days did you make it I did about three weeks and you know it becomes unraveled just for a lot of stuff at home as far as time management you were still moving in God thing that cut that throws in a variable that I can't really control yeah and that means not sleeping you should be posing a weeklong snapshot yeah I just googled one's week will soak my whole thing was like New York I agree with you because I don't turn off anybody else or not more people I had more people talk to me about this 430 wake-up thing little bit like anything iconic consistently post online the idea was to be consistent to I've ever an issue with routine consistency I thought this would give me accountable to Connie did my wife thought I was become a dish bag with it sounds like okay but can't bum me out so I was like just I don't need to do that I just I'll do it on my own I don't need a posted but it didn't two people did reach out to help them yet the accountability is what it's about now it's if you know you're having to pose that thing that that feeling of not doing it that's what that's what it's for so there's that weird I don't know there's a duality to me doing something to Matt for some kind of campaign like that personal but self-improvement thing but II will get back to kind of fake it till you make it in my big thing I heard Chris Sacca in areas thinks Chris Sacca look this up okay he is one of the main investors of Uber he's one of Phil land shark tank guys always wears a cowboy shirt I don't trestle of that shirt I do because I wear rodeo shirt that was my state shirts I like it because it's like as Zuckerberg with it.just total gray shirts every day you just don't have to think about it is that with this guy does he does these Servicemaster you every day yes now it's up I think your pearl snaps I'm not sure but it's deftly nestled Western he kind of textile but if you feel it feels like an old glove, thank based on lies to wear every day what he lives in Idaho Silicon Valley got now there's Idaho I think her Montana because you can tell that's how good he is yeah so I heard him on upon a podcast I want to sit with Bill Simmons is like three years ago he talked about how he started up and he literally said he just faked everything until he made he failed already wants with an idea that he got so ingrained in that he was like $-800,000 in like of his own not even not even like investor something it was like he was making money doing something on the sideline trend is one part and it backfired and then he had to start all over and he had like law school payments 2% like that and so I'm butchering probably a story but the main the main part was the way she got through was praying he said he thought this like they could to make it attitudes it's an entrepreneurial kind of philosophy a little bit so a lot of startups want to immature businesses three years or younger I said you kinda have to say yes to a lot of stuff get your foot in the door that you might not do yeah video tell me there's got to be Sony video thank you… Yeah I mean it's your like the fake it till you make it think it's like almost like the negative connotations were you know because it's your right everybody there is an aspect to it for everything don't be a phony it's just like you're being adaptable when you're being your wanting to learn about it you know it's really you just can't tell somebody don't know what it is that you're trying to do what I was like hey an like there's a really I we have a project that pays a lot I need you to do Adobe After Effects on video that's a situation like okay I know little bit practical rest I'd say okay yeah probably got a problem and then take a couple hours and you scramble uniting my fellowship yeah and I mean there's the thing about it is like we say it's for immature visit but you know any sort of new anything any sort of new aspect of the business is going to have you know it's like you don't know where it's going you don't know what you're trying to do with it so a lot of us do in real life a nonbusiness you discover your life so you know how to do this right at home your late dads do this a lot yeah I'm mounted on a nonexistent TV before I got it yet and it's like I got it I'm done it before yeah it's a it's a weird ego attachment thing you know like why only our generation has it as much but like her dad's generation stuff like I'd much rather just look like a jackass trying to figure it out in the front yard and look it up on the Internet and then actually learn how to do something correctly you know both have extreme the sale points right to life our generation just feels like on the Percy got a knife and I like I do like the older generations they go Amanda figured out phenomenally talking from a man's perspective really meet or dad perspectives like yet you just figured out that's what you do that's that's how you do it you just say yes you do it they were really asking you if you know how a lot of time a lot of people to go can you do this not you know how true this with our generation it's the other way to the extremities are either your snowflake and don't how to do it in your very honest yeah but you're articulating in a way that says I don't know anything about anything or your expert because you watch YouTube videos yeah I mean I've seen deftly both sides of it but it's like is the desire to learn it they are or not you know like we've had people that sleep I don't know how to do this and yet the holder through trust that you did you try did you Google it first drive as I frowned and I knew quite what were really good one of top five skills we have to just be patient to Google stuff yeah like for real like you can find out almost any how to do almost at its all out there you just need to be patient and figure out what exactly you need to search for the search term keyword that's important you know you don't necessarily know what you're looking for the best lesson I got when I worked at dimensional fund advisors mutual fund company in Santa Monica was was it right and I know I do Excel but I didn't know advanced stuff and I would ask a lot of questions because I was told no asked questions will don't don't sit on stuff and so it's better to ask questions and not but that I that shorthand right just saying ask questions after you've worked it out for a minute yeah after you've exhausted all of your mental capacities so I asked I would ask when I do this if you look at formula on Excel and I think Rochon John Shannon shout out to my buddy nobody but he was technically by Boster over me or whatever and it hears all to implement missionary this anywhere in my computer type is funky for all like that for him no is addressing the that is I'm so glad that everyone is 2122 that's the best legend we live in an era where we can do that right like how fortunate are we 10 years before you could yeah 20 it was like my parents and stuff like I really have to resist not doing that you can just type everything here the so far. Phil tells the yeah that do not know your audience but like what what I really want to get to his energies, contagious rights will so you're having a bad day and you don't bring that to the office rights I I vent to you but I think that's more cathartic when were talking about stuff going on personally a all energies already happened and it's all it correlates so heavily with what we do here to because worklife balance is used for an agency or firm or whatever we are this office so phenotyping of you can bring positive energy and you can go home and bring that guy around right now yet maybe a pessimistic parts is your personality test yeah but you bring positive energy yes you don't love anybody out yet as you say people is way to observe eight people I does the will think not expecting the good that happened that they have a questions and not going to be overly optimistic to that that was extreme example to give a figment to make it were you can have delusions of grandeur right things are going well room the right direction yeah I definitely have been guilty of that yeah it's doubly contagious all that stuff Alicia a little meter so to settle her energies were doing today it's on Apple watch Tony agrees here is a quick energy so I want to say is you know you might not want to do the job you're doing and I was there right I wanted to stand up for as I got older and my professional career wanted to do some entrepreneurial things like this and the deal was like decent good that day job bring positive energy because if you find people out it comes back to you yet twice as heavy. The fact that negativity but that's that I heard that almost blows my mind for every email you send out you get 2.3 DAC really like work emails that's why like people to stop emails, died but for something to be reformatted with that but my thing is like it has like almost an exponential effect on slaves yeah for sure like Evernote that she is person you know for the worst attitude you ever notice how much should they have going on in their life bad right this is right it's you kick that dog to what it can also that psychosomatic way to become a star of the show like it can have an effect on you physically hello they can safari you can create this echo chamber neither way talk about that with the online world were you can create an echo chamber of opinions you can do that with like positive or negative, enthusiasm definitely socially online please let something pop off my best friends Lincoln song used to tell me he inmate he makes himself self smile more when he talks because it puts in a better mood yet that we had to do when you're talking Brian Aguiar yeah you make sure he likes if you sing in a single little smile will demoralize doing you know that the jammin out the car listen to George Strait yeah it's like when I I accidentally do bad traffic move that somebody offer something and they try to get up next to me big cheesy smile every time given notice like that's yeah hello that was truly exactly Laura hold the bottom teeth like a if you tie on you loosen it yet the group here is more tension for do you mean but I think it's a big thing that and if you're by yourself a lot we do a lot of work that's like Connor isolated it's like I'm in a jam out this website for this ad campaign it's a lot of work we are just sitting the computer by yourself what short-term memory don't talk to the document running his own, thank and sometimes you know if you bring negative energy into that they chose it yet chose to consciously work if it does that with or in general is going to be like that that way or your art so abstract no marriage pretty records of the like that that leak you have the removal of the art is the closest thing to your your whatever you call your energy you know at that time that your your paintings on their telling is just clearly creative but if you're doing work it might not show up as obviously but it's in a business sense to if you were totally transparent we we we promote that we are as transparent as we can, be but if you show everything how the sausage is made every business has a weak point rocketing like hey you find my books, the law does like to do in his mind is not we can't find a bookkeeper we want to use up like that's an example right there like a known asked to hear about the hat and then be like note why would we short while we tell people that everything right they don't need to know it's not that were hiding anything right yeah does effective run post social it is something about now anything is is is all family background Amanda Reuters else's think my hemorrhoid is the badness coming out who you know I didn't think about that but maybe were the good I don't know it's got to go back in okay second not like a baby to so click the I think I got Lance to the no I cannot cancel my buddies chickened out that will not get better this is getting better slowly the you bring positive energy to that situation right my and really this I thought of this because I've I've always heard on the parenting tip and this is kind number one in my book I'm not a parent to rule by any means we'll wrap up with two kids are under two but before we had kids before you thought about it I would sure like sponge off a lot of energy right will so whatever you like my parents didn't want to talk about finances a lot were did want to talk about what, like a cold Norwegian family lifetime very right and I don't talk about feelings a lot yeah you your family by talk about feelings yeah healthy yeah we try to it's really just like they kids alone while being human yet so there watching the humans they see the most often and if you're going to be however you are there and want to be like daddy or mommy and so that's if you end up turning what happens know right now I'd like I handle situations people think I'm impatient I think I'm actually pretty patient I just like to vocalize a lot it impatient whites bother me immediately like little stuff yeah but people thought cut me a line all the time I don't know why they don't notice they do it it's my superpower. It's so weird it's so weird by why superpower is getting the shootings customer service person anywhere like you'll be by physically at a target or whatever right of the three people Joel somehow picked the wrong one every time Orville get the most should get them a ship for nothing manager what kind of like you don't think it's a contagious energy to do but note it online I never kid now I just think like a lot of people think I'm a hothead I think a lot of friends and I like now I do for comedic effect but like you know if you if you have 12 items and you go in that in the express line at the grocery store I get perturbed talk I'll say something about out loud but it's 10 items or less just the fact that you counted on 12 is okay 20 why the real Nozick speed limit in no speed limit 60 with real speed limit 70 okay how about this if you do it I'm cool but you gotta be quick but you gotta have some potato combines the lighting right X like me can't be like how I do this you can't especially slick self checkout should find someone that only leadership that a baseline I'm saying like there is there is a subconscious energy to bring night I caught myself like I get frustrated and mumble myself up my son my dad was like no under pass it on my kid I don't do that and apply have that going off work I don't realize it well I think the you know young men are like so fall tool delicately really aggressive and stuff I think Dr. Firefox up it's just a young yet why me like early 20s ago I told the older you get in the older your kids are going to get your tires are going to become and the less energy you're going to have to get this off about 12 items nowhere in other fungus for dad to come to take HGH or some clinic that it humongous well enough whatever whatever does what if I don't if I am what hell if I feel a lot better have big no not to get Jack to cite have more testosterone at a later age can this up that this would be good for your wellness area yeah I don't know if it's the best you know so I know you're like 30 units like 50s 60s you want to start HGH very I'm talking really small really small doses doses of small penis really forgot that no why I think were good on that note oh I got a couple little things with the practical pragmatic stuff I'll probably do little tutorial videos and will maybe I'll throw in a Leica compilation is a makeup episode or notice the little one minute guys Gary V style will laugh this podcast lab interview ones are maybe longer and will have like 12 minute tutorial deals who knows but I do have to do a lifelike content like that for other stuff and I realize you know as much as we can give this advice out in the podcast sometimes some things are best but I was asked how to get on LinkedIn's provider someone brought up on heritable professional directory sometimes you gotta have like Justin's own little isolated video if we did that during the podcast episode become boring to be born here and I have to like, do it live on tape kind of thing right were loyal to your left yeah I rather just do something for a minute have that posted yet online to help people out position was supposed to be primary device bring anything you got to the table I told but so did you have something other than just you know you can so there's a site called fark.com that I forward you a bunch of potential work so if you're in a professional service I was on the roof your website clipart handoff will move that's that's alas stupid dumb choices with my kids but part.com we it's it's interesting thing I would say try to catch these these potential sites that can bring in revenue before a lot of other people if you dominate there you might have his niche so our listeners should know about that it was a it it's a website development like this people logging all for website developers write a bunch of stuff I was in the web development so if you wanted to do those kind of bid on it as as the company like us we have a certain amount of credits that you buy to bid on jobs that it's a marketplace I put around the United States I'll take any bids look at them and will give up like 124 credits this 116 credits and then you bid on those to get it going get the talks are pretty interesting up work is a similar thing but they don't do the credits back and forth system and so the reason this once good to get on now is because it is a UK thing first I feel like there only marketing it to the demand-side not the supply side which is so that that's why get so many Latinos, dad I literally cleared out 500 Boston you must love anybody on there so we we pulled in our criminal defense attorney client Brett Metcalf from Hillsboro to fenced off last Friday and I said let's do a dummy test like I've done other sites for Sega DUI to lipids, there's only one so so as the I did dummy test is the user trying to find professional services in the ZIP Code were in or the like city and only one other attorney and also that tells me my hypothesis prion one point that this is it there's not a lot of business the other thing I have if you want to website Toca works.com TOC of W Arkansas.com our business website not our part aren't brand-new sweat equity podcasts website all sweat equity conduct you if you go to our business I told her works.com you can check out this little chat option so you not succumb to gullies after software sites   Check box pops up talk to you. We've embedded that drift the Company really interesting to see a lot more spots that look like a real persons have a conversation with you yeah but it's just the decision tree yeah so you had to set that up so I set up the basic if you are going to cite China set up a basic the most basic it took me 15 minutes to bed the widget but it the more you use it the more we might be able I looked at our traffic we don't get a lot of people that contact us as we should if you go down to to commit it pops up site is up as my picture Jeff it's I like these things that create engagement online that work in the background for school and then I integrated it with R/channel the general oh we again that I got a little will want to write sildenafil and Cameron for coverage if you are I able to see that you get on it we could have life conversations and then you can set it up to only pop up certain hours really interesting stuff go drift check out our website Seo Seo WR RPS.com and I'll be on the bottom right corner will take about they do like a three second pause before it really pops up so you see a little chat option on the bottom right desktop if possible hello but Sue, so those are two of the pragmatic kind of advice things that this is what the shows about general discourse about business philosophy figure to make it but also want to make sure were getting into the site these little things that we we know about that were going out all the time revitalize the chat chat window show up on mobile yeah but now you know you tested on non-Wi-Fi it goes to trial so you good yes builds of the people change life we are make sure to share this podcast of love one friend family member Wells people trying to start their own business at around the job they're doing that's really the audience that we think we can help with new email by way no Eric and in law sweat equity product goes through so it is up there that you got some ideas you want to send questions I want more of a mailbag from from listeners yeah I like answering questions plus that does all the preproduction for us basically be great work for us were run spot file iTunes Apple podcast Run video YouTube Facebook Facebook page LinkedIn Instagram we got a group we got to pay attention to and toss questions and big things around the corner excited and were excited that you made it this far just like Shawshank redemption if you made it this far larger, further and it really knew the show was over room the classic reason when Nick snapped his the ops guy productivity on produce podcasts and eco-so you can check the waves on their so you can see breakout in the sections