Podcasts about contraindicated

Glad to have Eddie back as he shares his story behind his book "Contraindicated" and breaks down its chapters for us. We go on to discuss the nuances of the Randall cycle, CICO and research! Follow him on his IG - @e.goeke_And his YouTube - (393) Edward A. Goeke - YouTubeHis book "Contraindicated" is available on Amazon - so order away!

TIME STAMPS:00:21 Catching up with Eddie Goeke!

Listen to 20 year young Eddie Goeke take us through his excruciating journey through Ehlers Danlos syndrome and how he is fighting it with Carnivore and his injections. He has managed to write a book though his struggles and done a lot of research into the biochemistry, anatomy, physiology and cellular biology behind nutrition and the species specific diet. Order his book "Contraindicated" from Amazon - a.co/d/3x4y5Gl Youtube - www.youtube.com/@e.goeke_ Patreon - patreon.com/EddieGoeke Help him move closer to his clinic in Florida - gofund.me/dec835e1 IG - @e.goeke_

Contributor: Taylor Lynch MD Educational Pearls: Anticholinergics are found in many medications, including over-the-counter remedies Medications include: Diphenhydramine Tricyclic antidepressants like amitriptyline Atropine Antipsychotics like olanzapine Antispasmodics - dicyclomine Jimsonweed Muscaria mushrooms Mechanism of action involves competitive antagonism of the muscarinic receptor Symptomatic presentation is easily remembered via the mnemonic: Dry as a bone - anhidrosis due to cholinergic antagonism at sweat glands Red as a beet - cutaneous vasodilation leads to skin flushing Hot as a hare - anhidrotic hyperthermia Blind as a bat - pupillary dilation and ineffective accommodation Mad as a hatter - anxiety, agitation, dysarthria, hallucinations, and others Clinical management ABCs Benzodiazepines for supportive care, agitation, and seizures Sodium bicarbonate for TCA toxicity due to widened QRS Activated charcoal if patient present < 1 hour after ingestion Temperature monitoring Contact poison control with questions Physostigmine controversy Acetylcholinesterase inhibitor Black box warning for asystole and seizure Contraindicated in TCA overdoses Crosses blood-brain barrier, so useful for TCA overdoses Indicated only in certain anticholinergic overdose with delirium Disposition Admission criteria include: symptoms >6 hours, CNS findings, QRS prolongation, hyperthermia, and rhabdomyolysis ICU admission criteria include: delirium, dysrhythmias, seizures, coma, or requirement for physostigmine drip References 1. Arens AM, Shah K, Al-Abri S, Olson KR, Kearney T. Safety and effectiveness of physostigmine: a 10-year retrospective review. Clin Toxicol (Phila). 2018;56(2):101-107. doi:10.1080/15563650.2017.1342828 2. Nguyen TT, Armengol C, Wilhoite G, Cumpston KL, Wills BK. Adverse events from physostigmine: An observational study. Am J Emerg Med. 2018;36(1):141-142. doi:10.1016/j.ajem.2017.07.006 3. Scharman E, Erdman A, Wax P, et al. Diphenhydramine and dimenhydrinate poisoning: An evidence-based consensus guideline for out-of-hospital management. Clin Toxicol. 2006;44(3):205-223. doi:10.1080/15563650600585920 4. Shervette RE 3rd, Schydlower M, Lampe RM, Fearnow RG. Jimson "loco" weed abuse in adolescents. Pediatrics. 1979;63(4):520-523. 5. Woolf AD, Erdman AR, Nelson LS, et al. Tricyclic antidepressant poisoning: An evidence-based consensus guideline for out-of-hospital management. Clin Toxicol. 2007;45(3):203-233. doi:10.1080/15563650701226192 Summarized by Jorge Chalit, OMSIII | Edited by Jorge Chalit  

Knowing what to ask and when will help you make key decisions about psoriasis and psoriatic arthritis. Listen as key terminology, questions to ask about the disease, and use of medications like "what prescriptions and over the counter medications may conflict with psoriatic disease" are discussed with NPF volunteer Dr. Kim Benner, a pharmacist at Children's of Alabama Hospital and Pharmacy Professor at Samford University in Birmingham, Alabama.

In this episode of The Performance Medicine Show, Dr. Rogers answers YOUR health and wellness questions! What did you think of this episode of the podcast? Let us know by leaving a review! Connect with Performance Medicine! Sign up for our weekly newsletter: https://performancemedicine.net/doctors-note-sign-up/ Facebook: @PMedicine Instagram: @PerformancemedicineTN YouTube: Performance Medicine

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Epoetin Trade Name Epogen Indication Anemia Action Stimulates erythropoiesis (production of RBCs) Therapeutic Class Antianemic Pharmacologic Class Hormones Nursing Considerations Assess dialysis shunts Contraindicated in albumin hypersensitivity May cause Seizures CHF MI CVA Hypertension Do not shake vial Initiate seizure precautions Monitor Bleeding times Signs of anemia

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Digoxin Trade Name Lanoxin Indication CHF, AFib, A-flutter Action Positive inotropic effect (increases force of myocardial contraction), prolongs refractory period, ↓ conduction through SA and AV nodes. Essentially digoxin is given to increase cardiac output and slow the rate. Therapeutic Class Antiarrhythmic, inotropics Pharmacologic Class Digitalis glycosides Nursing Considerations • Excreted by kidneys • Assess patient for hypersensitivity • Contraindicated with uncontrolled ventricular arrhythmias • Hypokalemia increase risk for toxicity • Hypercalcemia ↑ risk for toxicity • Use caution with diuretic use as they may cause electrolyte abnormalities that can lead to toxicity • Assess patient for cardiac arrhythmias including bradycardia • Signs of toxicity include vision changes (blurred vision, yellow, green vision disturbances) • Monitor pulse rate for 1 full minute prior to dosing patient (hold for pulse

Is Vitex Contraindicated in PCOS? You can probably tell from the episode title that, according to our current understanding, Vitex agnus-castus is not contraindicated for folks who have PCOS. In fact, there is reason to suspect that it may be quite helpful in this situation, at least in some cases. (Side note, Vitex can be a tricky herb to work with and isn't for everyone - if you are new to herbs, I highly recommend working with an herbalist before deciding whether Vitex is a good fit for you!) In this episode, Jillian reflects on hearing multiple practitioners suggest that folks with PCOS should not be using Vitex. When she went digging around looking for a reference, she was able to find where this information was coming from and also that the information was corrected/updated in a more recent source. We also get into a discussion of Vitex dosing and general strategies for incorporating this herb into protocols. Resources You can learn more about Jillian on her website Connect with Jillian via Facebook Learn more about Jillian's Herbal Observation Groups Subscribe to Jillian's newsletter Transcript --- Send in a voice message: https://podcasters.spotify.com/pod/show/intheclinic/message

Download the cheat: https://bit.ly/50-meds  View the lesson: https://bit.ly/EpoetinEpogenNursingConsiderations    Generic Name Epoetin Trade Name Epogen Indication Anemia Action Stimulates erythropoiesis (production of RBCs) Therapeutic Class Antianemic Pharmacologic Class Hormones Nursing Considerations Assess dialysis shunts Contraindicated in albumin hypersensitivity May cause Seizures CHF MI CVA Hypertension Do not shake vial Initiate seizure precautions Monitor Bleeding times Signs of anemia

What is health injustice? How do we recognize it? And what does law have to do with it? On this episode of Contraindicated, experts Liz Tobin-Tyler and Raquaijjah Yearby offer a primer on health injustice and inequity. Listeners can expect to learn about social determinants of health, the role of law in health inequity, interventions that can help, how people can protect themselves, as well as grassroots efforts to address health injustice. Further Reading: Elizabeth Tobin-Tyler and Joel Teitelbaum, https://www.jblearning.com/catalog/productdetails/9781284152074?utm_term=&utm_campaign=Strategic%20Products%20by%20ISBN%20%2F%20Media%20Format%20(LO)%20-%20NTV&utm_source=adwords&utm_medium=ppc&hsa_acc=6959852188&hsa_cam=12455877525&hsa_grp=116314127257&hsa_ad=502054202617&hsa_src=g&hsa_tgt=pla-293946777986&hsa_kw=&hsa_mt=&hsa_net=adwords&hsa_ver=3&gclid=Cj0KCQjwrJOMBhCZARIsAGEd4VHXeYqn_8F9nGD2KBZCy0-h5_c-enO2rSrzGfOUI9v1QjHYR_wMzN4aAr-WEALw_wcB (Essentials of Health Justice: A Primer), Jones and Bartlett, 2019.  Elizabeth Tobin-Tyler and Joel Teitelbaum, https://info.jblearning.com/en/essentials-of-health-justice-2e-tobin-tyler-email-mql?utm_campaign=PH_Tobin-Tyler_9781284248142&utm_medium=email&_hsmi=180254462&_hsenc=p2ANqtz-9rbQejqS1FrVcQGhHnPJulY4SrUhRWyGoZSwjpjYVvrd5NKIQ9riNW74hZ97ycodenky3YD0brJ0azx2u1Hpb9DsINTs8qHhMs_lBu86GTV-RO_no&utm_content=179364613&utm_source=hs_email (Essentials of Health Justice: Law, Policy and Structural Change), Jones and Bartlett, forthcoming 2022.  Elizabeth Tobin-Tyler, Ellen Lawton, Kathleen Conroy, et al., https://cap-press.com/pdf/2173.pdf (Poverty, Health and Law: Readings and Cases for Medical-Legal Partnership), Carolina Academic Press, 2011. http://medical-legalpartnership.org/ (National Center for Medical Legal Partnership)  Ruqaiijah Yearby, https://blog.petrieflom.law.harvard.edu/2020/09/22/structural-racism-social-determinant-of-health/ (Structural Racism: The Root Cause of the Social Determinants of Health), Bill of Health (September 22, 2020).  Ruqaiijah Yearby and Seema Mohapatra, https://academic.oup.com/jlb/article/7/1/lsaa036/5849058 (Law, Structural racism, and the COVID-19 Pandemic), Journal of Law and Biosciences (June 28, 2020). 

Introducing your hosts Areca Smit, and Sarah Hooper.

Download the cheat: https://bit.ly/50-meds  View the lesson: https://bit.ly/DigoxinLanoxinNursingConsiderations    Generic Name Digoxin Trade Name Lanoxin Indication CHF, AFib, A-flutter Action Positive inotropic effect (increases force of myocardial contraction), prolongs refractory period, ↓ conduction through SA and AV nodes. Essentially digoxin is given to increase cardiac output and slow the rate. Therapeutic Class Antiarrhythmic, inotropics Pharmacologic Class Digitalis glycosides Nursing Considerations • Excreted by kidneys • Assess patient for hypersensitivity • Contraindicated with uncontrolled ventricular arrhythmias • Hypokalemia increase risk for toxicity • Hypercalcemia ↑ risk for toxicity • Use caution with diuretic use as they may cause electrolyte abnormalities that can lead to toxicity • Assess patient for cardiac arrhythmias including bradycardia • Signs of toxicity include vision changes (blurred vision, yellow, green vision disturbances) • Monitor pulse rate for 1 full minute prior to dosing patient (hold for pulse

Join Geraldine as she chats with David Casteleijn, PhD candidate, herbalist, naturopath and president of the Naturopaths & Herbalists Association of Australia (NHAA), Geraldine and David last chatted on episode 126 about raspberry leaf and its use in pregnancy. This leads onto the discussion on herbs that are avoided for all the wrong reasons! Today we're talking about herbs that have got a reputation - Slippery Elm, Senna and Cassia, Echinacea, Chamomile, Liquorice, Korean Ginseng to name a few! David recommends the book Essential Guide to Herbal Safety by Mills & Bone https://www.elsevierhealth.com.au/the-essential-guide-to-herbal-safety-9780443071713.html#tab-label-description 

iMessages, T-Mobile & iCloud, Apple Watch Apps iMessage is winning: teens dread the green text bubble After ruining Android messaging, Google says iMessage is too powerful Google exec says Apple is 'holding back' customers who text Apple to allow alternative payment system for 1st time in South Korea Developer exposes another multimillion-dollar scam app on the App Store T-Mobile says iOS 15.2 bug turning off iCloud private relay for some users Intel poaches Apple engineer responsible for arm transition and M1 chips Uber parks its Apple Watch app in the ever-growing junkyard Netflix cameras & image capture Spotify HiFi delayed indefinitely as the company says it has no 'timing details to share' LAPD cops hunted Pokémon instead of responding to a robbery Picks of the Week Rene's Pick: Cleo Abram Goes Indie Andy's Pick: Multiclock Screensaver Alex's Picks: Mixbus VBM Hosts: Leo Laporte, Alex Lindsay, Rene Ritchie, and Andy Ihnatko Download or subscribe to this show at https://twit.tv/shows/macbreak-weekly. Get episodes ad-free with Club TWiT at https://twit.tv/clubtwit Sponsors: newrelic.com/macbreak betterhelp.com/macbreak ourcrowd.com/mbw

iMessages, T-Mobile & iCloud, Apple Watch Apps iMessage is winning: teens dread the green text bubble After ruining Android messaging, Google says iMessage is too powerful Google exec says Apple is 'holding back' customers who text Apple to allow alternative payment system for 1st time in South Korea Developer exposes another multimillion-dollar scam app on the App Store T-Mobile says iOS 15.2 bug turning off iCloud private relay for some users Intel poaches Apple engineer responsible for arm transition and M1 chips Uber parks its Apple Watch app in the ever-growing junkyard Netflix cameras & image capture Spotify HiFi delayed indefinitely as the company says it has no 'timing details to share' LAPD cops hunted Pokémon instead of responding to a robbery Picks of the Week Rene's Pick: Cleo Abram Goes Indie Andy's Pick: Multiclock Screensaver Alex's Picks: Mixbus VBM Hosts: Leo Laporte, Alex Lindsay, Rene Ritchie, and Andy Ihnatko Download or subscribe to this show at https://twit.tv/shows/macbreak-weekly. Get episodes ad-free with Club TWiT at https://twit.tv/clubtwit Sponsors: newrelic.com/macbreak betterhelp.com/macbreak ourcrowd.com/mbw

iMessages, T-Mobile & iCloud, Apple Watch Apps iMessage is winning: teens dread the green text bubble After ruining Android messaging, Google says iMessage is too powerful Google exec says Apple is 'holding back' customers who text Apple to allow alternative payment system for 1st time in South Korea Developer exposes another multimillion-dollar scam app on the App Store T-Mobile says iOS 15.2 bug turning off iCloud private relay for some users Intel poaches Apple engineer responsible for arm transition and M1 chips Uber parks its Apple Watch app in the ever-growing junkyard Netflix cameras & image capture Spotify HiFi delayed indefinitely as the company says it has no 'timing details to share' LAPD cops hunted Pokémon instead of responding to a robbery Picks of the Week Rene's Pick: Cleo Abram Goes Indie Andy's Pick: Multiclock Screensaver Alex's Picks: Mixbus VBM Hosts: Leo Laporte, Alex Lindsay, Rene Ritchie, and Andy Ihnatko Download or subscribe to this show at https://twit.tv/shows/macbreak-weekly. Get episodes ad-free with Club TWiT at https://twit.tv/clubtwit Sponsors: newrelic.com/macbreak betterhelp.com/macbreak ourcrowd.com/mbw

iMessages, T-Mobile & iCloud, Apple Watch Apps iMessage is winning: teens dread the green text bubble After ruining Android messaging, Google says iMessage is too powerful Google exec says Apple is 'holding back' customers who text Apple to allow alternative payment system for 1st time in South Korea Developer exposes another multimillion-dollar scam app on the App Store T-Mobile says iOS 15.2 bug turning off iCloud private relay for some users Intel poaches Apple engineer responsible for arm transition and M1 chips Uber parks its Apple Watch app in the ever-growing junkyard Netflix cameras & image capture Spotify HiFi delayed indefinitely as the company says it has no 'timing details to share' LAPD cops hunted Pokémon instead of responding to a robbery Picks of the Week Rene's Pick: Cleo Abram Goes Indie Andy's Pick: Multiclock Screensaver Alex's Picks: Mixbus VBM Hosts: Leo Laporte, Alex Lindsay, Rene Ritchie, and Andy Ihnatko Download or subscribe to this show at https://twit.tv/shows/macbreak-weekly. Get episodes ad-free with Club TWiT at https://twit.tv/clubtwit Sponsors: newrelic.com/macbreak betterhelp.com/macbreak ourcrowd.com/mbw

This week -- Basics of JOINTS!Our joints allow us to move! Learn how to move them…safer!-What are Joints?-How they Move-What are some common unsafe & contraindicated stretches and exercises?Need support on your wellness journey? Join us virtually on Zoom. Follow www.shalainefit.eventbrite.com for our next live discussion. Slideshow, articles and more at http://getfit.shalainefit.comHas life derailed your fitness goals? Health & Wellness is a journey of thousands of steps. It's a culmination of your time and effort! This channel is for beginners, seniors, group fitness professionals, and anyone interested in continued learning about their health, wellness, and fitness. I hope to inspire you to prioritize your health and live your best life by providing you with some whys & hows you might not have known. My goal is to provide interactive shows aimed to connect with your current journey with topics of interest and motivate you with knowledge, tips, and weekly challenges. I'm challenge you to be involved and present for the choices you make for your mind & body!A journey takes thousands of steps, congrats on taking one today!If you learned something from this video, please give it a like & follow my channel. Thank you!DISCLAIMER:The information, including but not limited to, text, graphics, video, images and other material provided ("Content") is for educational purposes only. Content is not intended in any way as a substitute for professional medical advice, diagnosis or treatment.Regardless of your current state of health, always seek the advice of your physician or other qualified health care provider with any questions you may have regarding your current health condition, a medical condition or treatment before undertaking a new health care regimen. Never disregard professional medical advice or delay in seeking it because of something you have read from Shalaine McLaughlin or Shalaine Fitness LLC ("FxS"). You agree that you are voluntarily participating in these activities and assume all risks of injury, illness, or death. FxS is not responsible for any loss of your personal property.

In this week's episode of the Aesthetics Mastery Show, we tackle autoimmunine diseases such as rheumatoid arthritis, Crohn's disease, myasthenia gravis and lupas, and ask if they are contraindications for dermal filler.Dr Tim dives into the circumstances in which it IS safe to treat people with autoimmunine diseases with filler, and explains how clinicians can make the clinical judgement whether or not to go ahead.After all, there are countless diseases and drugs your patients could present with a history of, meaning that it's almost impossible to rote learn all the permutations.The only answer is to apply a formula, and you can download Dr Tim's free 'Is It Safe To Treat? 5 Step Cheat Sheet' here: https://drtimpearce.com/is-it-safe-to-treat-2Facebook: https://www.facebook.com/drtimpearce1Instagram: https://www.instagram.com/drtimpearce/Linkedin: https://uk.linkedin.com/in/drtimpearce Website: https://drtimpearce.com/Podcast: https://www.buzzsprout.com/737156Signup: https://drtimcomplications.com/webinar#dermalfiller #medicalaesthetics #aesthetics

In this episode, Zack Shinar introduces a new physician to the podcast - Garrett Sterling.  Garrett and Zack discuss the sticky topic of ECMO for aortic dissection.  This traverses everything from VA ECMO in ECPR to VVECMO for pulmonary edema.  They go through the literature on the subject and make some conclusions based on this data. The ultimate question - "Is Aortic Dissection a Contraindication for ECMO?" The post 64: Contraindicated??? – Long Live the Aortic Dissection with Garrett Sterling appeared first on ED ECMO.

The Connected Yoga Teacher Podcast  Ep 135: How to Modify for the Prenatal Student with Rena Wren   Description: When teaching prenatal yoga, or pregnant students, what are the poses you should avoid? Can you teach twists, inversions or front extensions? What are some modifications I can cue, or props I can use to cater to the needs of my pregnant students? All your questions are going to be answered on this episode with Rena Wren.   Rena Wren is one of our MamaNurture lead trainers, and the founder of Empowered Yoga Teaching, where she provides continuing education and support for yoga teachers.  Apart from prenatal yoga teacher training through MamaNurture, she offers yin yoga training, and yoga teacher mentoring on a wide range of topics, as well as workshops, retreats, and online courses.    Contraindicated yoga during pregnancy covers eight main areas. Shannon and Rena dive into each of these, as well as modifications and variations that you can cue for your pregnant students and in your prenatal class. Be sure to check out the free PDF Download and Rena's videos where she shares variations you can use.   If you have ever taught prenatal yoga, or had a pregnant student come to your class, this episode is going to be a real treat. It is full of tips and modifications that you can immediately start applying to any of your prenatal classes or to work with pregnant students.   Key Takeaways: [5:38] Shannon introduces her guest for this episode - Rena Wren. [8:04] How did Rena get started in her yoga journey? [12:35] Rena juggles multiple roles and responsibilities. She shares how yoga has helped her find balance in what she does. [15:09] Check out the PDF download for the 8 contraindicated poses during pregnancy. [16:03] Shannon and Rena discuss the first contraindicated pose - Breath retention and/or strong, forced breathing. What are some of Rena's favorite modifications for this? [17:47] Advanced poses that challenge and build heat are second on the list. How can you tell when certain poses are advanced? [22:31] What are some modifications Rena recommends to avoid poses that engage and/or stretch the rectus abdominis muscles (e.g. boat, crow, leg lifts)? [27:18] Front extensions can overstretch the abdominal muscles. Rena walks us through a modification of camel pose for the pregnant body. [30:11] Inversions are contraindicated for pregnancy. How would Rena modify the headstand, handstand, shoulder stand and downward dog poses? [36:46] What are some of Rena's favorite variations for prone poses? [40:05] How can you identify closed twist poses and what are some modifications you can offer? [44:54] The last one is hot yoga. Shannon and Rena discuss why they would not teach hot yoga to pregnant people. [47:15] Check out the live video from September 16 to find out more about caution poses in the grey area. [47:48] Rena has some final insights on how teachers can approach having a pregnant student in their class. [49:39] Rena has a MamaNurture training coming up! [52:05] Shannon shares some details about upcoming teacher trainings that are available. [53:12] Shannon has an update about MamaNurture and all the work she is doing with niching down. Links: Rena Wren Empowered Yoga Teaching PDF Contraindicated Yoga The Connected Yoga Teacher Podcast Episode 089: Yoga for Stress Management with Courtney Butler-Robinson MamaNurture Facebook Page MamamNurture Mondays Videos Camel Variations Video with Rena Inversions Variations Video - Legs Up the Wall with Rena Closed Twists Variation Video Online Workshop with Shannon & Rena Work with Shannon 1:1 MamaNurture Prenatal Yoga Teacher Training in Conway, Arkansas   Gratitude to our Sponsors Schedulicity and MamaNurture.   Quotes from this episode:   "One of the main things I've learned from yoga is to know the things that I value, and to make sure that I have enough of those things in my life to help me have balance." "A lot of students who come to prenatal yoga are new to yoga."   "Challenging is dependent on the student."   "Getting people to slow down and feel nurtured in a space really helps them realize that they don't really care about their idea of yoga was anymore. They care that they feel good when they leave this room."   "One of the first things to do ...is [think about] what are the benefits, what are we trying to do?"   "Take baby with you in the twist."  

A look at the opioid epidemic and what ED providers can do to combat this formidable foe. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Opioid_Epidemic.mp3 Download Leave a Comment Tags: Opioid Dependence, Opioid Free ED Show Notes Consider alternatives to opiates for acute pain NSAIDs Subdissociative ketamine Nerve blocks Curb misuse and diversion through prescribing a short supply and perform I-STOP checks Narcan is not just for acute overdose treatment by EMS or within the ED anymore We can equip patients, family members and friends with Narcan kits prior to discharge In New York state, can prescribe Narcan to patients with near fatal overdoses or who screen positive for an opioid use disorder Intranasal formulation is cheaper and more commonly prescribed than IM Buprenorphine induction can be done in the ED for patients in active withdrawal, as calculated by the COWS score. MDcalc calculator: https://www.mdcalc.com/cows-score-opiate-withdrawal Providers do not need an X-waiver to give a dose of Buprenorphine in the ED for 3 days Home induction can be considered for patients not actively withdrawing but would like to enter medication assisted treatment Some considerations: Contraindicated in patients with severe liver dysfunction and with hypersensitivity reaction to drug Oversedation can occur with concurrent use of benzodiazepines and alcohol Will precipitate withdrawal if concurrently using full opioid agonists Longitudinal care has to be established for patients started on Buprenorphine

A look at the opioid epidemic and what ED providers can do to combat this formidable foe. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Opioid_Epidemic.mp3 Download Leave a Comment Tags: Opioid Dependence, Opioid Free ED Show Notes Consider alternatives to opiates for acute pain NSAIDs Subdissociative ketamine Nerve blocks Curb misuse and diversion through prescribing a short supply and perform I-STOP checks Narcan is not just for acute overdose treatment by EMS or within the ED anymore We can equip patients, family members and friends with Narcan kits prior to discharge In New York state, can prescribe Narcan to patients with near fatal overdoses or who screen positive for an opioid use disorder Intranasal formulation is cheaper and more commonly prescribed than IM Buprenorphine induction can be done in the ED for patients in active withdrawal, as calculated by the COWS score. MDcalc calculator: https://www.mdcalc.com/cows-score-opiate-withdrawal Providers do not need an X-waiver to give a dose of Buprenorphine in the ED for 3 days Home induction can be considered for patients not actively withdrawing but would like to enter medication assisted treatment Some considerations: Contraindicated in patients with severe liver dysfunction and with hypersensitivity reaction to drug Oversedation can occur with concurrent use of benzodiazepines and alcohol Will precipitate withdrawal if concurrently using full opioid agonists Longitudinal care has to be established for patients started on Buprenorphine

Introduction to Jojo and Slow Postpartum 3:29 Slow Postpartum is the time after the birth of the baby and the women in taken care of by her community. Time  is 30-40 days of complete rest and care: support, nourishment, and time to heal and bond with the baby. Quite common in several cultures around the world. When a women has a baby, the brain recalibrates and parts of the brain start interacting for the first time as the women becomes a mother. This transformation needs time, care, nourishment, healing, and making connection with the baby. Matriescence = moving from being a woman to being a mother. 8:00 Jojo teaches yoga classes to pregnant women. Yoga is helpful during the birth, and postpartum can also be helped by yoga but in a different form. 9:30 Pregnant and postpartum body are very different. Many new pregnant students coming to a yoga class are beginners. They have relaxin hormone in their bodies which loosens muscles, tendons, ligaments. Have to be careful not to push into the joints, hyperextension. Postpartum body is different: will still have relaxin for weeks or months. Body is very open from giving birth; the pelvic floor muscles have been greatly stretched. Body is open: physically, mentally and spiritually. Can’t do poses that they did before pregnancy for weeks or months. Need a teacher that understands the postpartum body. 13:49 Postpartum mums and bubs classes: very common for someone to be crying either babies or mums. Jojo recommends that they don’t come for at least 6 weeks. Mums are very sleep deprived, hormonal, anxious. The class is for the women; body needs caring, nourishing and yoga can be beneficial. They are told to make the class what they need it to be. Social interaction with other new mums is very important. 17:30 Helpful poses and contraindicated poses during this period. Women may have C-section scars, and/or separation of the rectus abdominus. So very slowly, methodically strengthen the abdominal muscles and pelvic floor. Contraindicated poses include twists, especially deep seated twists and plank  because they destabilise the core. Remain careful about pushing into the joints. Poses should close the pelvic area, not stretch it. Shoulder stretches are very helpful because of always holding the baby. Babies naturally do yoga as they stretch and move their bodies. 21:00 Jojo does offer her postpartum doula clients training in meditation. Women in the postpartum class are told to do savasana in any position that they want. They are to come into the present and just be with their baby. 23:08 Body in postpartum needs care, nourishing and support. Find a teacher that is familiar with the postpartum body’s needs. Shouldn’t return to pregnancy, gym or regular yoga classes  as they are not suitable for the postpartum body. Your baby is your yoga at this time. Motherhood is a deeply spiritual practice, you learn patience, accept how things are instead of how you want them to be, unlimited and unconditional lovee. 26:15 Returning to regular classes is very individualised. High impact classes not before 6 months, regular classes not for 12 weeks. Listen to your body. Contact: Website: www.slowpostpartum.com FB: slowpostpartum Insta: #slowpostpartum.  

.yogalightness.com.au/Osteoporosis SN   Introduction to Osteoporosis: bones become fragile which leads to increased risk of fractures. May be due to bone mineral decreases or the failure of the microarchitecture.   2:54 Causes: At menopause, the cells that destroy bone become more active than the cells that build bone. These are both natural processes but the balance is disturbed as the sex hormones decrease In the later years of life 80+ the muscles and the bones become more fragile. Without the muscles pulling on the bones (and as they lose strength, this happens naturally), the bones also become weaker Illness and drugs can also affect the bone density. 5:30  No symptoms there is a test called the DEXA test that measures bone density (but not bone microarchitecture) It tests three sites on the body: hip, vertebrae and wrist. Each site receives it’s own score. Normal Score; men and women naturally lose bone density in their fifties but the loss is not enough to increase the risk of fracture Osteopenia: there is bone loss in excess of normal bone loss and the risk of fracture is increased Osteoporosis: there is significant bone loss and the risk of fracture is high. Vertebral fractures can also lead to kyphosis which is 1) a risk factor for more vertebral fractures, it impacts breathing and balance. 9:59 Exercise, especially weight-bearing exercise, is recommended to move the muscles that then pull on the bones to signal the need for increased density. Axial Skeleton – skull, vertebrae, ribs. Protects the core organs and gives structure to the trunk. Women lose more bone (as a percentage) from the axial skeleton than men do so they have an increased risk of vertebral fractures. Need strong core muscles to protect the bones and to help with holding up the trunk. 11:35 Dr. Mersheed Sinaki, has done several studies on osteoporosis at the Mayo Clinic in the US. She recommends more than just weight-bearing exercise but also need to improve a) flexibility, b) core strength, c) cardiovascular fitness, d) axial strength, and e) gait steadiness (to prevent falls from loss of balance). 13:00 Yoga poses to strengthen the axial skeleton (primarily the vertebrae). Laying down: Gentle locust; laying on the stomach, lift the head (in line with the spine) and then release. After building strength with the previous pose, can then transition to clasping the hands behind the back, lifting the head and chest and pulling with the hands towards the feet. Another gentle pose would be to lay on back and lift head and then release,   Standing: With one arm on a chair if needed, lift one arm above the head with the inhale and let it come down with the exhale. Do the other arm. With sufficient strength, can use weights or lift both arms up at the same time (with or without weights).   Sitting: Bring arms to shoulder height; bend elbows so hand are pointing towards the ceiling and try to press the elbows together and then release. If the student cannot bring the arms to shoulder height, then place the arms along the side and bend the elbows and then press the elbows and release.   16:45 Appendicular Skeleton: limbs, hip and shoulder girdles. Breaks in hip are often at the neck of the femur which causes a fall. Hip fractures are highly correlated with death in older individuals so a hip fracture is quite dangerous. Wrist fractures often occur when trying to stop a fall. And falls increase fracture risk.             Yoga poses: most standing poses (not Warrior I), Downward dog (can be modified with chair or wall), and balance poses. 19:34 Contraindicated poses Inversions seated twists, forward bends, bridge Warrior I 24:30 With kyphosis, yoga can provide tools to help breathing. Need more space in the chest to allow the lungs to fully inflate. 25:25 New study correlates disturbed sleep with osteoporosis. Yoga Nidra is good for showing students how to relax and can be a tool to help them sleep at night. Or any relaxation tool used in savasana. Research: Yoga Vetebral Fractures & Osteoporosis: Research and Recommendations, Norlyk, E., Boses, A., International Journal of Yoga Therapy, No. 23 (1) 2013 Musculoskeletal Rehabilitation in Patients with Osteoporosis: Rehabilitation of Osteoporosis Program (ROPE), Sinaki, M., Journal für Mineralstoffwechsel & Muskuloskelettale Erkrankungen 2010 Yoga Spinal Flexion Positions an Vertebral Compression Fracture in Ostepenia and Osteoporosis of the Spine: Case Series Sinaki, M., MD, MS Clinical Report https://www.ncbi.nim.nih.gov/pubmed 22449949 Impact of Sleep on Osteoporosis: Sleep quality is associated with bone stiffness index, Sasaki, N., Fujiwara, S., Yamashita, H., Ozono, R., Teramen, K., Kihara, Y. Sleep Medicine 2016 Sept: 25: 73-77 Comments: www.yogalightness.com.au/podcasts/

When competitive fitness icon Marcus Filly says recovery is essential for health and longevity, I heed his message. As Creator of the Functional Bodybuilding program, he has changed the game by redefining what constitutes a healthy fitness routine. During this conversation, he shares his tips for achieving success in physical competitions and in business and how he maintains focus. Find the show notes here — DecodingSuperhuman.com/Marcus   “When people experience burnout, whether it’s in the corporate world or whether it’s in training and sport, it's the culmination of too much stress in their life and basically their systems can't keep up. They can't adapt or recover fast enough in order to feel normal, or in homeostasis..."   Who is Marcus Filly?   Marcus Filly grew up in the San Francisco Bay Area. He played multiple sports as a child including soccer, baseball, and golf, which eventually led to a collegiate career in soccer at the University of California, Berkeley. There he earned his degree in Molecular and Cell Biology with an emphasis in Nutrition and Physiology. After Berkeley, he completed a year of graduate work at the Ohio State University School of Medicine.   His interest in both athletics and human health and performance eventually led him to CrossFit in 2007. He has gone on to compete at the CrossFit Games 6 times, three times as an individual (2016 12th fittest) and three times as a team member (2012 6th fittest team). Marcus is also the captain and member of the Phoenix Rise in the NPGL. For two years he has been voted to the all-GRID league team, in 2016 earning 1st team honors, and in 2015 earning the award for leadership excellence.   Marcus has been a Health & Fitness Coach for eight years since leaving Medical School in 2009. He was formerly a CrossFit facility owner for five years, has completed all five of the OPEX CCP courses and has coached clients remotely from all over the world. He has coached athletes at the CrossFit Games as well as several Regionals athletes.   Marcus lives with wife Megan and his daughter. He lists his parents, Barbara and Roy, as role models.   Key Highlights of the discussion with Marcus Filly: Competitive fitness can wade into unhealthy territory [5:02] Functional Bodybuilding [9:55] Recommendations for Training, Recovery, Nutrition, and Supplements [18:49] SARMs & Performance Enhancing Drugs in competitive fitness [30:56] How Marcus mentally prepares for competition and business [39:43] Marcus’ Pet Peeve about Medical Industry [46:02]: Contraindicated people. Marcus’ Tip for Enhancing Focus [47:51]: Have a healthy dose of pessimism — prepare for the worst. Marcus Filly’s Favorite Book on Peak Performance[52:14]: The 4-Hour Workweek: Escape 9-5, Live Anywhere, and Join the New Rich, by Timothy Ferriss Continue Your Performance Journey: Revival Strength @MarcusFilly on Instagram @Functional.Bodybuilding on Instagram The Awaken Training Series   Our sponsor today is Neurohacker Collective. Chairman, Jordan Greenhall has been on the show discussing Sovereignty and Medical Director, Dr. Daniel Stickler joined me to discuss Unleashing your Human Potential Through Epigenetics. I enjoy the products so much that I use them 5 out of 7 days. Whether it’s Qualia or Qualia Mind, which is a new formula that you should all try, I do find them to be completely revolutionary in the supplement world. I do think it upgrades me as a person. If you wanna try either Qualia or Qualia Mind, go over to neurohacker.com, plug in the discount code ‘BOOMER’ and you’ll get 10% off your first order or 15% off any order if you subscribe. Get their free Foundational Guide to Neurohacking.   This information is being provided to you for educational and informational purposes only. This is being provided as a self-help tool to help you understand your genetics, biodata and other information to enhance your performance. It is not medical or psychological advice. Virtuosity LLC is not a doctor. Virtuosity LLC is not treating, preventing, healing, or diagnosing disease. This information is to be used at your own risk based on your own judgment. For the full Disclaimer, please go to (Decodingsuperhuman.com/disclaimer).   See acast.com/privacy for privacy and opt-out information.

Valproate is now contraindicated in pregnancy and women of child-bearing potential. The new stipulations from the Coordination Group for Mutual Recognition and Decentralised Procedures-Human (CMDh), a regulatory body representing European Union member states, about the use of valproate in women of child-bearing potential states that “Valproate should never be started unless alternative treatments are not suitable”. However, people taking this drug used to treat epilepsy should not stop valproate use abruptly, without consulting their doctor. The new regulations are discussed in this podcast by Professor Sanjay Sisodiya (UCL Institute of Neurology, London), who’s the author of a Practical Neurology editorial on this subject (http://pn.bmj.com/content/early/2018/04/19/practneurol-2018-001955). Other related articles in the Practical Neurology website: ►http://pn.bmj.com/content/early/2018/04/19/practneurol-2018-001932 ► http://pn.bmj.com/content/early/2018/04/19/practneurol-2018-001931

Downward Dog in Prenatal Yoga with Kim MacDonald-Heildant and Shannon Crow Shannon met Kim MacDonald-Heildant at a prenatal yoga teacher training and they bonded over their enthusiasm for this area of expertise. Leaving the training with even more questions, Shannon and Kim decided to join forces. They felt that while every teacher and training brought them valuable experience, they wanted to expand on what they learned to incorporate the research and experience they've gained since.   Shannon and Kim co-founded Mama Nurture to provide a 100-hour prenatal yoga teacher training (PYTT) that spends more time on all the wonderful aspects of prenatal that are often only touched on in PYTT (e.g. postnatal and fertility) while expanding on anatomy. Their website also provides great resources such as articles, breath practices and yoga sequences.   Kim was drawn to yoga as a self-care practice and became even more enthusiastic about the practice when she became pregnant. She enjoyed her pregnancies and the way yoga enhanced her experience. This positive relationship led her to enrol in a 200-hour YTT followed by a PYTT and is now a certified children's and prenatal yoga teacher.  She is also a mother of 2, a teacher, co-owner and director of Gibbons Park Montessori School as well as the founder of Live Laugh Breathe Yoga.   Shannon and Kim found that one of the most common questions from yoga teachers in prenatal training is: “Can I teach downward dog to pregnant yoga students?” There are many opinions about this. Shannon and Kim are going to share their opinions which they emphasize are not meant to be a definitive answer. In fact, through listening to each other they've switched positions!   As Shannon and Kim say: “No one yoga pose is good for everyone. No one yoga pose is bad for everyone.” They explore reasons why downward dog is on their caution list and offer alternative poses that can provide some of the same benefits. 7:20 Kim's yoga journey   9:00 What inspired Kim and Shannon to create their own prenatal yoga teacher training   10:45 Kim's thoughts on prenatal and downward dog   12:25 How Shannon and Kim ended up switching their positions on downward dog in prenatal yoga   13:35 Article written by Kim and Shannon   Can I Teach Downward Dog to Prenatal Yoga Students   14:10 Reasons Kim and Shannon caution, take out, or only offer downward dog as an option in their classes:   14:25  1) Unnecessary strain on the low back   15:45 2) Can cause or exacerbate heartburn and nausea   16:45 3) Most prenatal students are beginners and downward dog is not a beginner pose   18:30 4) Can irritate carpal tunnel which is common in pregnant women   19:20 5) It can cause baby to turn   20:40 6) Can increase round ligament pain   21:15 7) Can affect very low or high blood pressure   23:35 Kim and Shannon's favourite pose for prenatal students- Puppy Pose   25:10 Kim and Shannon's cueing for downward dog for a prenatal student that wants to attempt the pose   26:25 To stretch out the calf muscles- Modified Big Toe Pose   27:55 Bird Dog Pose   28:45 Legs Up the Wall   29:20 Half Forward Fold   30:50 Kim's words of wisdom when it comes to incorporating Downward Dog- “Try to let go with what's expected of you.” Observe your class, don't be afraid to ask how it feels for your students, your students may do it because they feel like they should, not because it works for them   31:55 Kim and Shannon want to share their information and experience to help others make a more informed opinion about downward dog in prenatal- no absolute answer   33:15 Shannon's closing thoughts- ask yourself what benefit do you want to gain from a pose?   Links   Gibbons Park Montessori School MamaNurture Article: Can I Teach Downward Dog to Prenatal Yoga Students PDF: 8 Contraindications for pregnant yoga students (to get the list sign up on the homepage) Mama Nurture Teacher Training (RPYT) TCYT Podcast 033: A New Perspective with Diastasis Recti with Sinead Dufour Spinning Babies Website The Connected Teacher Facebook Group Free Images Discussion on TCYT Facebook Group-A special thanks to Lindsey Larson for starting the discussion Follow The Connected Teacher on Youtube Book a Consultation Call with Shannon Gratitude to our Sponsor Schedulicity

Author: Dylan Luyten, M.D. Educational Pearls Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). Exsanguination is a major cause of mortality in trauma One temporizing technique to buy time to definitive hemorrhage control is to occlude the aorta thereby shunting blood away from pelvis and lower extremities, increasing cardiac afterload to increase myocardial and brain perfusion. Rather than perform a thoracotomy to cross clamp aorta, a REBOA catheter may be introduced into the aorta via the common femoral artery and a balloon inflated in the descending aorta to occlude it. The indications for REBOA include PEA arrest of brief duration attributable to exsanguination for sub-diaphragmatic source in a young, healthy patient, or severe hypovolemic shock or those in an agonal state due to non-compressible hemorrhage not responding to volume and in whom obstructive cause of shock has been ruled out. Contraindicated in prolonged arrest, suspected proximal aortic injury, advanced age/comorbidities. Controversies and evidence:   High quality evidence is lacking - as it is for much of what we do and even consider standard of care in trauma. It has not been shown to improve survival, which is hard to demonstrate. Role in remote settings vs trauma centers unclear. Further refinements of indication for use are likely to occur with time and experience. Summarize - REBOA is a promising relatively new technology that may have potential to improve outcomes in the sickest of trauma patients. Reference: https://lifeinthefastlane.com/ccc/resuscitative-endovascular-balloon-occlusion-aorta-reboa/

Why are some points contraindicated during pregnancy?This is a very common question and concern. There is no absolute, 100% agreed upon list of these points in modern times. However, knowing the reasons for traditionally contraindicated points has guided my work. Based on what was taught to me, I arrange contraindicated points into 3 categories:1. Points that bring the Qi down2. Points on the abdomen3. Points based on empirical evidence Read the whole article here Acupuncture Points Contraindicated during Pregnancy

The use of steroids in head trauma is a hot topic in both human and veterinary medicine. Theoretically, steroids can reduce inflammation; however, there are many adverse effects which can lead to significant morbidity and mortality. While the use of steroids with trauma is debated, the use of steroids with head trauma is currently considered contraindicated. Why? In this veterinary podcast, VetGirl discusses why steroids are bad following head trauma in veterinary medicine.

The use of steroids in head trauma is a hot topic in both human and veterinary medicine. Theoretically, steroids can reduce inflammation; however, there are many adverse effects which can lead to significant morbidity and mortality. While the use of steroids with trauma is debated, the use of steroids with head trauma is currently considered contraindicated. Why? In this veterinary podcast, VetGirl discusses why steroids are bad following head trauma in veterinary medicine.