Podcasts about Diagnosis

CardioNerds (Dr. Shazli Khan, Dr. Jenna Skowronski, and Dr. Shiva Patlolla) discuss the management of patients post‑heart transplantation with Dr. Shelley Hall from Baylor University Medical Center and Dr. MaryJane Farr from UTSW. In this comprehensive review, we cover the physiology of the transplanted heart, immunosuppression strategies, rejection surveillance, and long-term complications including cardiac allograft vasculopathy (CAV) and malignancy. Audio editing for this episode was performed by CardioNerds intern Dr. Bhavya Shah. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls The Denervated Heart: The donor heart is surgically severed from the autonomic nervous system, leading to a higher resting heart rate (90-110 bpm) due to loss of vagal tone. Because the heart relies on circulating catecholamines rather than neural input to increase heart rate, patients experience a delayed chronotropic response to exercise and stress. Importantly, because afferent pain fibers are severed, ischemia is often painless. Rejection Surveillance: Rejection is classified into Acute Cellular Rejection (ACR), which is T-cell mediated, and Antibody-Mediated Rejection (AMR), which is B-cell mediated. While endomyocardial biopsy remains the gold standard for diagnosis, non-invasive surveillance using gene-expression profiling (e.g., AlloMap) and donor-derived cell-free DNA (dd-cfDNA) is increasingly utilized to reduce the burden of invasive procedures. The Infection Timeline: The risk of infection follows a predictable timeline based on the intensity of immunosuppression. The first month is dominated by nosocomial infections. Months one through six are the peak for opportunistic infections (Cytomegalovirus, Pneumocystis, Toxoplasmosis) requiring prophylaxis. After six months, patients are primarily at risk for community-acquired pathogens, though late viral reactivation can occur. Cardiac Allograft Vasculopathy (CAV): Unlike native coronary artery disease, CAV presents as diffuse, concentric intimal thickening that affects the entire length of the vessel, including the microvasculature. Due to denervation, patients rarely present with angina; instead, CAV manifests as unexplained heart failure, fatigue, or sudden cardiac death. Malignancy Risk: Long-term immunosuppression significantly increases the risk of malignancy. Skin cancers (squamous and basal cell) are the most common, followed by Post-Transplant Lymphoproliferative Disorder (PTLD), which is often driven by Epstein-Barr Virus (EBV) reactivation. Notes Notes: Notes drafted by Dr. Patlolla 1. What are the unique physiological features of the transplanted heart? The hallmark of the transplanted heart is denervation. Because the autonomic nerve fibers are severed during harvest, the heart loses parasympathetic or vagal tone, resulting in a resting tachycardia (typically 90-110 bpm). The heart also loses the ability to mount a reflex tachycardia; thus, the heart rate response to exercise or hypovolemia relies on circulating catecholamines, which results in a slower “warm-up” and “cool-down” period during exertion. 2. What are the pillars of maintenance immunosuppression regimen? The triple drug maintenance regimen typically consists of: Calcineurin Inhibitor (CNI): Tacrolimus is preferred over cyclosporine. Key side effects include nephrotoxicity, hypertension, tremor, hyperkalemia, and hypomagnesemia. Antimetabolite: Mycophenolate mofetil (MMF) inhibits lymphocyte proliferation. Key side effects include leukopenia and GI distress. Corticosteroids: Prednisone is used for maintenance but is often weaned to low doses or discontinued after the first year to mitigate metabolic side effects (diabetes, osteoporosis, weight gain). 3. How is rejection classified and diagnosed? Rejection is the immune system’s response to the foreign graft and is categorized by the arm of the immune system involved: Acute Cellular Rejection (ACR): Mediated by T-lymphocytes infiltrating the myocardium. It is graded from 1R (mild) to 3R (severe) based on the extent of infiltration and myocyte damage. Antibody-Mediated Rejection (AMR): Mediated by B-cells producing donor-specific antibodies (DSAs) that attack the graft endothelium. It is diagnosed via histology (capillary swelling) and immunofluorescence (C4d staining). Diagnosis has historically relied on endomyocardial biopsy. However, non-invasive tools are gaining traction. Gene Expression Profiling (GEP) assesses the expression of genes associated with immune activation to rule out rejection in low-risk patients. Donor-Derived Cell-Free DNA (dd-cfDNA) measures the fraction of donor DNA in the recipient’s blood. Elevated levels suggest graft injury which can occur in both ACR and AMR. 4. What is the timeline of infectious risk and how does it guide prophylaxis? Infectious risk correlates with the net state of immunosuppression. < 1 Month (Nosocomial): Risks include surgical site infections, catheter-associated infections, and aspiration pneumonia. 1 – 6 Months (Opportunistic): This is the period of peak immunosuppression. Patients are at risk for PJP, CMV, Toxoplasma, and fungal infections. Prophylaxis typically includes Trimethoprim-Sulfamethoxazole (for PJP/Toxo) and Valganciclovir (for CMV, dependent on donor/recipient serostatus). > 6 Months (Community-Acquired): As immunosuppression is weaned, the risk profile shifts toward community-acquired respiratory viruses (Influenza, RSV) and pneumonias. However, patients with recurrent rejection requiring boosted immunosuppression remain at risk for opportunistic pathogens. 5. How does Cardiac Allograft Vasculopathy (CAV) differ from native CAD? CAV is the leading cause of late graft failure. Unlike the focal, eccentric plaques seen in native atherosclerosis, CAV is an immunologically driven process causing diffuse, concentric intimal hyperplasia. It affects both epicardial vessels and the microvasculature. Because of this diffuse nature, percutaneous coronary intervention (PCI) is often technically difficult and provides only temporary palliation. The only definitive treatment for severe CAV is re-transplantation. Surveillance is critical and is typically performed via annual coronary angiography, often using intravascular ultrasound (IVUS) to detect early intimal thickening before it is visible on the angiogram. References Costanzo MR, Dipchand A, Starling R, et al. The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients. J Heart Lung Transplant. 2010;29(8):914-956. doi:10.1016/j.healun.2010.05.034. https://www.jhltonline.org/article/S1053-2498(10)00358-X/fulltext Kittleson MM, Kobashigawa JA. Cardiac Allograft Vasculopathy: Current Understanding and Treatment. JACC Heart Fail. 2017;5(12):857-868. doi:10.1016/j.jchf.2017.07.003. https://www.jacc.org/doi/10.1016/j.jchf.2017.07.003 Velleca A, Shullo MA, Dhital K, et al. The International Society for Heart and Lung Transplantation (ISHLT) guidelines for the care of heart transplant recipients. J Heart Lung Transplant. 2023;42(5):e1-e141. doi:10.1016/j.healun.2022.10.015. https://www.jhltonline.org/article/S1053-2498(22)02187-5/fulltext

Text Dr. Lenz any feedback or questions Debunking Myths About Fibromyalgia Diagnosis: A Doctor's Reaction to Naturopathic ClaimsDr. Michael Lenz reacts to a naturopath's controversial statements about fibromyalgia diagnosis, emphasizing the importance of evidence-based medicine. He discusses the legitimacy of fibromyalgia as a real condition characterized by altered pain processing in the central nervous system. Dr. Lenz debunks myths about root causes like mold toxicity, food sensitivities, adrenal fatigue, and mitochondrial dysfunction, advocating for a holistic, science-based approach to managing these chronic invisible illnesses, also known as nociplastic pain syndromes, which fibromyalgia epitomizes.00:00 Introduction and Personal Story01:04 Controversy Around Fibromyalgia Diagnosis01:56 Understanding Fibromyalgia: Symptoms and Diagnosis03:12 Challenges with Fibromyalgia Diagnosis04:58 Functional Medicine Perspective13:39 Debunking Functional Medicine Claims15:07 Evidence-Based Solutions for Fibromyalgia18:50 Conclusion and Call to Action Support the showWhen I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That's why I created this space: to offer education, validation, and hope. If you've been told fibromyalgia “isn't real” or that it's “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you'll find trusted, evidence-based insights here, drawn from my 29+ years as an MD. Please remember to talk with your doctor about your symptoms and care. This content doesn't replace per...

Welcome back to the Restoring the Soul podcast with Michael John Cusick. In this episode, Michael sits down for a thoughtful and deeply personal conversation with his wife of nearly 35 years, Julianne Cusick. Together, they explore the emerging world of neurodiversity, focusing on neurodivergent individuals, neurodiverse couples, and the impact these differences can have on relationships.Drawing from Julianne Cusick's extensive work, research, and recent conference presentations, they break down commonly misunderstood terms like neurodiversity, neurodivergent, and Autism Spectrum Disorder (ASD). This conversation doesn't just dwell on diagnosis—instead, it offers a new framework for understanding ourselves and our partners, emphasizing how assessment and awareness can bring clarity, freedom, and healing to relationships.Support the showENGAGE THE RESTORING THE SOUL PODCAST:- Follow us on YouTube - Tweet us at @michaeljcusick and @PodcastRTS- Like us on Facebook- Follow us on Instagram & Twitter- Follow Michael on Twitter- Email us at info@restoringthesoul.com Thanks for listening!

This episode is going to be one of the most honest conversations I've ever had on Yo Quiero Dinero. It's a raw, unfiltered conversation about what happens when you mix family and business—and spoiler alert: it gets messy as hell. My sister Lianne is back after a year-long hiatus, and we're spilling ALL the tea. From her rapid social media growth that turned into a nightmare with death threats, to being diagnosed with MS at 37, to almost filing for bankruptcy—this episode holds nothing back.We talk about what it was really like when she worked for me while I was a brand new mom, how her personal struggles spilled into the business, and why we ultimately had to make the difficult decision to part ways professionally. This isn't some sanitized "family business success story", it is the real shit that nobody talks about.If you've ever worked with family, hired a family member, or wondered if you should mix business with blood, this episode is required listening.WE GET INTO: 00:00 - Intro: Family, Business & Messy Dynamics02:03 - From 0 to 100K Followers to Death Threats05:03 - MS Diagnosis, Hospitalization & Bankruptcy07:20 - "I Was a Horrible Employee": Taking Accountability10:58 - The Performance Improvement Plan & Final Warning30:38 - The Money Problem: 1099 Tax Chaos37:26 - Digging Out of the Spiral: The Brutal Reality41:36 - Landing the New Job & Finding Peace54:56 - The 2026 Comeback: What's Different This Time58:29 - Should You Work with Family? The Real AnswerKEY TAKAWAYS:​​The gift and curse of rapid social media growthWhy follower counts don't equal moneyHow to navigate difficult conversations with family in businessRecognizing when a business relationship has reached its expiration dateThe importance of boundaries in ALL relationshipsHow to rebuild after burning everything downRESOURCES MENTIONED:Listen: Episode 179: 2 Sisters, 2 Survivors | Lianne Torres | Watch Us Thrive PodcastErica KramerCONNECT WITH LIANNE:WebsiteInstagram: @watchusthrivepodcastTAKE THE NEXT STEP:Yo Quiero Dinero Private MembershipRead my book: Financially LitLeave me a voicemail*Content Warning: This episode contains discussions of mental health struggles, financial hardship, and online harassment.This episode of Yo Quiero Dinero was produced by Heart Centered Podcasting. Hosted on Acast. See acast.com/privacy for more information.

This week on the show I share a case study on a 2017 BMW X1 that has a large draw that's killing the battery (6amps!) I take my usual approach to a "network staying awake" problem, but don't get to the conclusion. The issue forced me to take a different approach to find the solution. Website- https://autodiagpodcast.com/Facebook Group- https://www.facebook.com/groups/223994012068320/YouTube- https://www.youtube.com/@automotivediagnosticpodcas8832Email- STmobilediag@gmail.comPlease make sure to check out our sponsors!SJ Auto Solutions- https://sjautosolutions.com/Automotive Seminars- https://automotiveseminars.com/L1 Automotive Training- https://www.l1training.com/Autorescue tools- https://autorescuetools.com/     

Welcome back to today's Friday Review where I'll be breaking down the best of the week!     I'll be sharing specifics on these topics:     Blue to Red Light Converter (product review) Inflammation Is a Signal, Not a Diagnosis (tip of the week) Zinc & Depression (research) Pancreatic Cancer & Baking Soda (research)   For all the details tune in to today's Cabral Concept 3647 – Enjoy the show and let me know what you thought! (edited)    - - - For Everything Mentioned In Today's Show: StephenCabral.com/3647 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

Behind the sterile veil of the modern asylum, a dark reality hides where clinical charts meet ancient malice. We descend into the darkness with Dr. Aaron Cowgill, author of Thou Art Mad, to expose the harrowing intersection of spiritual warfare and mental health. From the "lunatic" accusations leveled against Christ to the modern psychiatric ward, we explore whether the "voices" are fractured echoes or predatory guests who have overstayed their welcome. We cross the bleeding line between a medical emergency and a spiritual siege to uncover the jarring reality of ancient spirits masquerading as modern decay. Prepare yourself for a journey into the dark heart of the human soul, where the verdict is anything but clinical.Support the show

Preeclampsia is one of those pregnancy conditions that gets mentioned often, explained poorly, and frequently dismissed until it suddenly isn't. In this episode, HeHe sits down with Dr. Dallas Reed to pull back the curtain on what preeclampsia actually is, how it shows up, and what expectant parents deserve to understand long before things feel urgent. Together, they break down the basics in a way that's clear and human, including how common preeclampsia really is, what symptoms to take seriously, and how to make sense of blood pressure readings and pregnancy-related hypertension diagnoses. Dr. Reed explains the differences between severe and non-severe preeclampsia, what monitoring can look like before and after 37 weeks, and why postpartum preeclampsia deserves more attention than it often gets. The conversation also explores prevention and management, including lifestyle considerations, aspirin use, and how care plans may differ depending on risk level, gestational age, and whether someone is being monitored inpatient or outpatient. A major focus of the episode is the future of personalized maternal care, including a deep dive into the Encompass test. This new RNA-based blood test, available between 18 and 22 weeks, helps identify pregnancies at higher risk for preeclampsia and pairs that insight with an evidence-based action plan and virtual support. Dr. Reed shares how this type of testing may change the way providers and families approach monitoring, communication, and early intervention, including potential benefits for out-of-hospital birth settings. This episode is grounded, evidence-based, and empowering, offering expectant parents tools, language, and understanding so they can participate confidently in their care rather than feeling blindsided by it.   TIMESTAMPS 00:00 Introduction to Preeclampsia 00:56 Welcome to The Birth Lounge Podcast 01:39 Features of The Birth Lounge App 03:00 Pregnancy and Postpartum Articles 04:54 Introduction to Today's Episode 07:47 Discussion with Dr. Dallas Reed 08:35 Understanding Preeclampsia 10:46 Symptoms and Diagnosis 18:56 Managing Blood Pressure During Pregnancy 22:37 Risk Factors and Prevention 31:59 Strategies to Prevent Preeclampsia 32:29 Healthy Lifestyle Recommendations 33:37 Monitoring and Follow-Up 35:05 Risks and Complications of Preeclampsia 37:05 Postpartum Preeclampsia 39:20 Managing Preeclampsia Before 37 Weeks 41:20 Inpatient Care and Medications 46:22 Understanding the Encompass Test 53:06 Benefits of the Encompass Test for Home Births 58:19 Final Thoughts and Resources   Guest Bio: Dr. Dallas Reed, practicing OBGYN, medical geneticist and advisor to Mirvie, a company delivering data-driven solutions for predictive and preventive care in pregnancy. Mirvie recently launched Encompass, which is the first RNA-based blood test to predict preeclampsia risk, combined with an evidence-based preventive action plan and virtual assistant to guide individualized support and care.    SOCIAL MEDIA: Connect with HeHe on Instagram  Connect with Mirvie on IG    BIRTH EDUCATION: Join The Birth Lounge for judgment-free, evidence-based childbirth education that shows you exactly how to navigate hospital policies, avoid unnecessary interventions, and have a trauma-free labor experience, all while feeling wildly supported every step of the way Want prep delivered straight to your phone? Download The Birth Lounge App for bite-sized birth and postpartum tools you can use anytime, anywhere. And if you haven't grabbed it yet… Snag my free Pitocin Guide to understand the risks, benefits, and red flags your provider may not be telling you about, so you can make informed, powerful decisions in labor.  

CHOP and the Richard D Wood Jr. Center for Fetal Diagnosis and Treatment is at the forefront of new medicine doing wonderful work to stem the 1 in 3 birth defects of babies born in the US. Mark interviews Dr. Scott Adzick in this episode.

Mast Cell Activation Syndrome is one of the most misunderstood, and underrecognized, conditions in modern medicine. In this episode, Dr. Linda Bluestein is joined by Dr. Lawrence Afrin, one of the world's leading experts on mast cell disease, to unpack why MCAS is so often missed, why tryptase alone is not enough to diagnose it, and how this condition may be driving chronic inflammation, neurologic symptoms, psychiatric symptoms, and even hypermobile Ehlers-Danlos Syndrome (hEDS) in some patients. They talk about why MCAS can look completely different from one person to the next, how mast cells influence nearly every system in the body, and why so many patients are told “nothing is wrong” despite being profoundly unwell. We also explore emerging treatments, including GLP-1 medications, and what the future of MCAS research may hold. If you or your patients live with complex, multisystem symptoms that don't fit neatly into one diagnosis, this conversation may change how you see everything. Takeaways: MCAS rarely looks like classic allergy, which is why it's so often overlooked. Normal tryptase does not rule out mast cell disease, despite what many clinicians believe. Chronic multisystem inflammation is the biggest red flag for MCAS. MCAS may help explain hypermobile EDS in some patients, not as a genetic collagen defect but as an immune-driven process. New therapies are discussed, offering real hope for improved quality of life. Find the episode transcript here. Want more Dr. Lawrence Afrin? http://www.aimcenterpm.com Want more Dr. Linda Bluestein, MD? Website: https://www.hypermobilitymd.com/ YouTube: https://www.youtube.com/@bendybodiespodcast Instagram: ⁠⁠⁠⁠https://www.instagram.com/hypermobilitymd/⁠⁠⁠⁠ Facebook: ⁠⁠⁠⁠https://www.facebook.com/BendyBodiesPodcast⁠⁠⁠⁠ X: ⁠⁠⁠⁠https://twitter.com/BluesteinLinda⁠⁠⁠⁠ LinkedIn: ⁠⁠⁠⁠https://www.linkedin.com/in/hypermobilitymd/⁠⁠⁠⁠ Newsletter: ⁠⁠⁠⁠https://hypermobilitymd.substack.com/ Shop my Amazon store ⁠⁠⁠ https://www.amazon.com/shop/hypermobilitymd Dr. Bluestein's Recommended Herbs, Supplements and Care Necessities: https://us.fullscript.com/welcome/hypermobilitymd/store-start Thank YOU so much for tuning in. We hope you found this episode informative, inspiring, useful, validating, and enjoyable. Join us on the next episode for YOUR time to level up your knowledge about hypermobility disorders and the people who have them. Join YOUR Bendy Bodies community at ⁠⁠https://www.bendybodiespodcast.com/⁠⁠. YOUR bendy body is our highest priority!⁠⁠ Learn more about Human Content at ⁠⁠⁠http://www.human-content.com⁠⁠⁠ Podcast Advertising/Business Inquiries: ⁠⁠⁠sales@human-content.com⁠⁠⁠ Part of the Human Content Podcast Network FTC: This video is not sponsored. Links are commissionable, meaning I may earn commission from purchases made through links Learn more about your ad choices. Visit megaphone.fm/adchoices

In today's episode of the Cookbook Love Podcast, Maggie sits down with chef and cookbook author Emily Maxon, whose newest book Real Food, Every Day was born out of a life-changing health journey. Emily is a trained chef and lifelong food lover who, at age 28, was diagnosed with Crohn's disease. That diagnosis led her to the Specific Carbohydrate Diet — a rigorous way of eating designed to support gut health and healing. Drawing on her years of experience as a chef and caterer, Emily made it her mission to create recipes that not only met the diet's strict guidelines but also tasted wonderful and helped people feel better physically, mentally, and emotionally. How Emily's personal health challenges became the catalyst for creating her cookbook Real Food, Every Day • What it was like navigating the journey from cookbook idea to published book • Lessons Emily learned along the way about writing and publishing a cookbook rooted in real-life experience • Practical tips for aspiring cookbook authors on turning personal stories into strong cookbook concepts • How to stay motivated through the long (and rewarding) process of writing and publishing a cookbook If you've ever wondered how a personal challenge can become the foundation for a meaningful cookbook, or how chefs and food experts can turn their expertise into a published book, this episode is full of inspiration and insight. Things We Mention In This Episode: Emily's Fresh KitchenAgainst All Grain 

Psychogenic nonepileptic seizures (PNES) are common, often misunderstood, and increasingly encountered in pediatric emergency care. These events closely resemble epileptic seizures but arise from abnormal brain network functioning rather than epileptiform activity. In this episode of PEM Currents, we review the epidemiology, pathophysiology, and clinical features of PNES in children and adolescents, with a practical focus on Emergency Department recognition, diagnostic strategy, and management. Particular emphasis is placed on seizure semiology, avoiding iatrogenic harm, communicating the diagnosis compassionately, and understanding how early identification and referral to cognitive behavioral therapy can dramatically improve long-term outcomes. Learning Objectives Identify key epidemiologic trends, risk factors, and semiological features that help differentiate psychogenic nonepileptic seizures from epileptic seizures in pediatric patients presenting to the Emergency Department. Apply an evidence-based Emergency Department approach to the evaluation and initial management of suspected PNES, including strategies to avoid unnecessary escalation of care and medication exposure. Demonstrate effective, patient- and family-centered communication techniques for explaining the diagnosis of PNES and facilitating timely referral to appropriate outpatient therapy. References Sawchuk T, Buchhalter J, Senft B. Psychogenic Nonepileptic Seizures in Children-Prospective Validation of a Clinical Care Pathway & Risk Factors for Treatment Outcome. Epilepsy & Behavior. 2020;105:106971. (PMID: 32126506) Fredwall M, Terry D, Enciso L, et al. Outcomes of Children and Adolescents 1 Year After Being Seen in a Multidisciplinary Psychogenic Nonepileptic Seizures Clinic. Epilepsia. 2021;62(10):2528-2538. (PMID: 34339046) Sawchuk T, Buchhalter J. Psychogenic Nonepileptic Seizures in Children - Psychological Presentation, Treatment, and Short-Term Outcomes. Epilepsy & Behavior. 2015;52(Pt A):49-56. (PMID: 26409129) Labudda K, Frauenheim M, Miller I, et al. Outcome of CBT-based Multimodal Psychotherapy in Patients With Psychogenic Nonepileptic Seizures: A Prospective Naturalistic Study. Epilepsy & Behavior. 2020;106:107029. (PMID: 32213454) Transcript This transcript was generated using Descript automated transcription software and has been reviewed and edited for accuracy by the episode's author. Edits were limited to correcting names, titles, medical terminology, and transcription errors. The content reflects the original spoken audio and was not substantively altered. Welcome to PEM Currents: The Pediatric Emergency Medicine Podcast. As always, I'm your host, Brad Sobolewski, and today we are talking about psychogenic non-epileptic seizures, or PNES. Now, this is a diagnosis that often creates a lot of uncertainty in the Emergency Department. These episodes can be very scary for families and caregivers and schools. And if we mishandle the diagnosis, it can lead to unnecessary testing, medication exposure, ICU admissions, and long-term harm. This episode's gonna focus on how to recognize PNES in pediatric patients, how we make the diagnosis, what the evidence says about management and outcomes, and how what we do and what we say in the Emergency Department directly affects patients, families, and prognosis. Psychogenic non-epileptic seizures are paroxysmal events that resemble epileptic seizures but occur without epileptiform EEG activity. They're now best understood as a subtype of functional neurological symptom disorder, specifically functional or dissociative seizures. Historically, these events were commonly referred to as pseudo-seizures, and that term still comes up frequently in the ED, in documentation, and sometimes from families themselves. The problem is that pseudo implies false, fake, or voluntary, and that implication is incorrect and harmful. These episodes are real, involuntary, and distressing, even though they're not epileptic. Preferred terminology includes psychogenic non-epileptic seizures, or PNES, functional seizures, or dissociative seizures. And PNES is not a diagnosis of exclusion, and it does not require identification of psychological trauma or psychiatric disease. The diagnosis is based on positive clinical features, ideally supported by video-EEG, and management begins with clear, compassionate communication. The overall incidence of PNES shows a clear increase over time, particularly from the late 1990s through the mid-2010s. This probably reflects improved recognition and access to diagnostic services, though a true increase in occurrence can't be excluded. Comorbidity with epilepsy is really common and clinically important. Fourteen to forty-six percent of pediatric patients with PNES also have epilepsy, which frequently complicates diagnosis and contributes to diagnostic delay. Teenagers account for the highest proportion of patients with PNES, especially 15- to 19-year-olds. Surprisingly, kids under six are about one fourth of all cases, so it's not just teenagers. We often make the diagnosis of PNES in epilepsy monitoring units. So among children undergoing video-EEG, about 15 to 19 percent may ultimately be diagnosed with PNES. And paroxysmal non-epileptic events in tertiary epilepsy monitoring units account for about 15 percent of all monitored patients. Okay, but what is PNES? Well, it's best understood as a disorder of abnormal brain network functioning. It's not structural disease. The core mechanisms at play include altered attention and expectation, impaired integration of motor control and awareness, and dissociation during events. So the patients are not necessarily aware that this is happening. Psychological and psychosocial features are common but not required for diagnosis and may be less prevalent in pediatric populations as compared with adults. So PNES is a brain-based disorder. It's not conscious behavior, it's not malingering, and it's not under voluntary control. Children and adolescents with PNES have much higher rates of psychiatric comorbidities and psychosocial stressors compared to both healthy controls and children with epilepsy alone. Psychiatric disorders are present in about 40 percent of pediatric PNES patients, both before and after the diagnosis. Anxiety is seen in 58 percent, depression in 31 percent, and ADHD in 35 percent. Compared to kids with epilepsy, the risk of psychiatric disorders in PNES is nearly double. Compared to healthy controls, it is up to eight times higher. And there's a distinct somatopsychiatric profile that strongly predicts diagnosis of PNES. This includes multiple medical complaints, psychiatric symptoms, high anxiety sensitivity, and solitary emotional coping. This profile, if you've got all four of them, carries an odds ratio of 15 for PNES. Comorbid epilepsy occurs in 14 to 23 percent of pediatric PNES cases, and it's associated with intellectual disability and prolonged diagnostic delay. And finally, across all demographic strata, anxiety is the most consistent predictor of PNES. Making the diagnosis is really hard. It really depends on a careful history and detailed analysis of the events. There's no single feature that helps us make the diagnosis. So some of the features of the spells or events that have high specificity for PNES include long duration, so typically greater than three minutes, fluctuating or asynchronous limb movements, pelvic thrusting or side-to-side head movements, ictal eye closure, often with resisted eyelid opening, ictal crying or vocalization, recall of ictal events, and rare association with injury. Younger children often present with unresponsiveness. Adolescents more commonly demonstrate prominent motor symptoms. In pediatric cohorts, we most frequently see rhythmic motor activity in about 27 percent, and complex motor movements and dialeptic events in approximately 18 percent each. Features that argue against PNES include sustained cyanosis with hypoxia, true lateral tongue biting, stereotyped events that are identical each time, clear postictal confusion or lethargy, and obviously epileptic EEG changes during the events themselves. Now there are some additional historical and contextual clues that can help us make the diagnosis as well. If the events occur in the presence of others, if they occur during stressful situations, if there are psychosocial stressors or trauma history, a lack of response to antiepileptic drugs, or the absence of postictal confusion, this may suggest PNES. Lower socioeconomic status, Medicaid insurance, homelessness, and substance use are also associated with PNES risk. While some of these features increase suspicion, again, video-EEG remains the diagnostic gold standard. We do not have video-EEG in the ED. But during monitoring, typical events are ideally captured and epileptiform activity is not seen on the EEG recording. Video-EEG is not feasible for every single diagnosis. You can make a probable PNES diagnosis with a very accurate clinical history, a vivid description of the signs and appearance of the events, and reassuring interictal EEG findings. Normal labs and normal imaging do not make the diagnosis. Psychiatric comorbidities are not required. The diagnosis, again, rests on positive clinical features. If the patient can't be placed on video-EEG in a monitoring unit, and if they have an EEG in between events and it's normal, that can be supportive as well. So what if you have a patient with PNES in the Emergency Department? Step one, stabilize airway, breathing, circulation. Take care of the patient in front of you and keep them safe. Use seizure pads and precautions and keep them from falling off the bed or accidentally injuring themselves. A family member or another team member can help with this. Avoid reflexively escalating. If you are witnessing a PNES event in front of you, and if they're protecting their airway, oxygenating, and hemodynamically stable, avoid repeated benzodiazepines. Avoid intubating them unless clearly indicated, and avoid reflexively loading them with antiseizure medications such as levetiracetam or valproic acid. Take a focused history. You've gotta find out if they have a prior epilepsy diagnosis. Have they had EEGs before? What triggered today's event? Do they have a psychiatric history? Does the patient have school stressors or family conflict? And then is there any recent illness or injury? Only order labs and imaging when clinically indicated. EEG is not widely available in the Emergency Department. We definitely shouldn't say things like, “this isn't a real seizure,” or use outdated terms like pseudo-seizure. Don't say it's all psychological, and please do not imply that the patient is faking. If you see a patient and you think it's PNES, you're smart, you're probably right, but don't promise diagnostic certainty at first presentation. Remember, a sizable proportion of these patients actually do have epilepsy, and referring them to neurology and getting definitive testing can really help clarify the diagnosis. Communication errors, especially early on, worsen outcomes. One of the most difficult things is actually explaining what's going on to families and caregivers. So here's a suggestion. You could say something like: “What your child is experiencing looks like a seizure, but it's not caused by abnormal electrical activity in the brain. Instead, it's what we call a functional seizure, where the brain temporarily loses control of movement and awareness. These episodes are real and involuntary. The good news is that this condition is treatable, especially when we address it early.” The core treatment of PNES is CBT-based psychotherapy, or cognitive behavioral therapy. That's the standard of care. Typical treatment involves 12 to 14 sessions focused on identifying triggers, modifying maladaptive cognitions, and building coping strategies. Almost two thirds of patients achieve full remission with treatment. About a quarter achieve partial remission. Combined improvement rates reach up to 90 percent at 12 months. Additional issues that neurologists, psychologists, and psychiatrists often face include safe tapering of antiseizure medications when epilepsy has been excluded, treatment of comorbid anxiety or depression, coordinating care between neurology and mental health professionals, and providing education for schools on event management. Schools often witness these events and call prehospital professionals who want to keep patients safe. Benzodiazepines are sometimes given, exposing patients to additional risk. This requires health system-level and outpatient collaboration. Overall, early diagnosis and treatment of PNES is critical. Connection to counseling within one month of diagnosis is the strongest predictor of remission. PNES duration longer than 12 months before treatment significantly reduces the likelihood of remission. Video-EEG confirmation alone does not predict positive outcomes. Not every patient needs admission to a video-EEG unit. Quality of communication and speed of treatment, especially CBT-based therapy, matter the most. Overall, the prognosis for most patients with PNES is actually quite favorable. There are sustained reductions in events along with improvements in mental health comorbidities. Quality of life and psychosocial functioning improve, and patients use healthcare services less frequently. So here are some take-home points about psychogenic non-epileptic seizures, or PNES. Pseudo-seizure and similar terms are outdated and misleading. Do not use them. PNES are real, involuntary, brain-based events. Diagnosis relies on positive clinical features, what the events look like and when they happen, not normal lab tests or CT scans. Early recognition and diagnosis, and rapid referral to cognitive behavioral therapy, change patients' lives. If you suspect PNES, get neurology and mental health professionals involved as soon as possible. Alright, that's all I've got for this episode. I hope you found it educational. Having seen these events many times over the years, I recognize how scary they can be for families, schools, and our prehospital colleagues. It's up to us to think in advance about how we're going to talk to patients and families and develop strategies to help children who are suffering from PNES events. If you've got feedback about this episode, send it my way. Likewise, like, rate, and review, as my teenagers would say, and share this episode with a colleague if you think it would be beneficial. For PEM Currents: The Pediatric Emergency Medicine Podcast, this has been Brad Sobolewski. See you next time.

Dr. Deb Muth 0:03There’s a quiet shift happening in healthcare right now, and most doctors aren’t talking about it yet. People aren’t chasing diagnoses anymore. They’re exhausted by them. I see it every single day in my clinic. People who come in with stacks of paperwork, portals full of results, and a list of diagnoses longer than their grocery receipt, yet they’re still not living their lives. And they’ll say to me, Dr. Deb, I don’t want another label. Dr. Deb Muth 0:32 I just want my life back. If you’ve ever been told this is just how your body is, if you’ve been diagnosed, rediagnosed, and then dismissed, if you’ve been handed labels but never handed a roadmap, today’s episode is for you. Because we are officially entering what I call the post diagnosis era and it’s changing everything about how healing actually happens. So grab your cup of coffee or tea and let’s settle in to let’s talk wellness. Now, before we dive in, we need to take a quick pause to thank today’s sponsor. And when we come back, we’re going to talk about why diagnoses are no longer the most important thing about you. Dr. Deb Muth 1:17Did you know sweating can literally heal your cells? And infrared saunas don’t just relax you, they detox your body, balance hormones, and boost mitochondrial energy. I’m obsessed with my health tech sauna, and right now you can save $500 with my code at healthtechhealth.com Dr. Muth req 25 so here’s some truth for me. Dr. Deb Muth 0:47It was three years ago Christmas that I received my Ms. Diagnosis. And I remember it very clearly. It was the day before, two days before Christmas Eve, that I got the call and I heard the words, you have white matter brain disease. That’s consistent with Ms. And I immediately stopped in my tracks and thought, okay, well, this is just the way it is. We’re gonna fight this. We’re gonna figure this out. And it led me down a deeper path of healing and spirituality and emotional growth. And there were some really difficult days ahead for me because I remember thinking, what am I gonna do? How am I gonna practice what’s going to happen in my life? And every year at this time, I reflect back to that day that I got the call that really changed my life. And not for the worse, but for the better. It changed the way I was thinking about life. Dr. Deb Muth 3:01It changed the way I was complaining about things being ungrateful for all the amazing things that I have in my life. Not intentionally, but just living the American life. Right. Dr. Deb Muth 3:14And striving for more and wanting more and chasing more and doing more, and never really having the opportunity to just be present and just really think about life and enjoy what the Lord has given us and enjoy what’s around me, the people in my life, the family that I have, the amazing practice that I have, and the amazing people I get to work with and change lives with. And it really changed me for the better. And I’ve watched diagnoses like this change people for the worse and for them to sink deep into a depression and give up and. And live to their label instead of living to their potential. And that’s why I think this episode is so important for us, because we all have a choice in life. When we get dealt something kind of difficult, we can let it consume us and let it take every ounce of life from us, or we can allow it to become the fuel that makes us better, makes us contribute to life maybe differently, but in a better way. So, you know, I know that this idea of letting diagnoses lose their power can be really uncomfortable for some people, because there’s people that are waiting for that diagnosis. I’m in some. Some social media groups, and I’m listening and reading to people who are saying, I’m so angry I didn’t get the Ms. Diagnosis today. I’m so angry I didn’t get the Lyme diagnosis today. I’m so upset that they can’t find anything wrong with me. And I understand. Dr. Deb Muth 5:20I know the feeling of wanting to put a name to what you’re feeling so that you have validation and you have power around this diagnosis, and you can prove to people that what you’re feeling is not in your head. I get all of that. But for many people, the original diagnosis is meant to help guide treatment in the conventional sense. It’s a created, shared language that we have, and it brings clarity. But for many people, you give that label and that name so much power and so much control over your life and who you are and what you’re being. And that’s not what the label is meant for. Somewhere along the line, medicine started confusing naming with healing. And today, we have more diagnoses than ever. We have more testing than ever. We have so many thousands of specialists, and yet people are sicker. They’re more inflamed, they’re more exhausted, they’re more confused than ever. And that’s not just a coincidence. That is how the system is meant to work. It’s meant to confuse you. Dr. Deb Muth 6:44It’s meant to keep you dependent on it. It’s meant to. Meant to keep you on medical management for the rest of your life. And by doing that, we enrich the pharmaceutical companies to the point where their whole role is to continue to create drugs that you need to be on for the rest of your life. And the hard truth about all of this that I’ve seen in my practice is for many patients, the diagnosis really becomes their identity. They own it, they gravitate to it. It’s who they are. It also becomes their prison because they only live confined inside the diagnosis. I can’t do this because I can’t do that, because if I do this, this will happen, because I have. They’ve capped their ceiling of life based on a couple of words that somebody gave them at a point in their life when they were so low and potentially so desperate that they needed that name to identify themselves and what was going on. And instead of asking, why is this happening? Dr. Deb Muth 8:05Why are these symptoms happening? What’s causing these symptoms? They’re told, this is what you have, and this is what you’re going to have to live with. And instead of restoring function, these people become managed. Like I said, they’re managed with drugs. They’re managed inside the system. And instead of healing, they’re monitored with this blood test and that blood test and this MRI and that mri. Instead of providing hope, they’re handed a lifelong prescription with expectations that do nothing but decline. So you walk out of that room with this expectation that your life is never going to be the same, that your function is going to decline, your neurological disease is going to take over eventually, you’re going to be put in a home, you’re going to lose everything you have because you’re not going to be able to afford the care that you need. And that’s the expectations of our healthcare system today. When you’re labeled with a chronic illness diagnosis, and for a woman, especially women, this is magnified because their symptoms are told to them as. It’s stress, it’s hormones, it’s anxiety, it’s aging, it’s motherhood, and then, of course, it’s perimenopause. Like that is some major traumatic thing that should disrupt your entire life. Yet it shouldn’t, and it does, and it doesn’t have to. And of course, my favorite is always, but your labs are normal. We don’t know what’s wrong with you. It must just be in your head. Dr. Deb Muth 9:53And this is why women are done being dismissed, why this shift is happening now that we are empowering women to take back Their lives, take back who they are and take back how they’re being treated in the healthcare system. And it is one of the most important things that we can do right now is to give women their power back so that they can stand strong in who they are and in their intuition and fight and say, no, this is not happening to me right now. I am not accepting this label. I’m not accepting this diagnosis. I will fight, I will find answers, and I will do what I need to do to be the woman that I want to be. So why is this conversation exploding right now? Well, there’s actually three big reasons, and first and foremost, it’s over. Diagnosis, burnout. People are collecting diagnoses without solutions. Autoimmune labels, syndromes, vague neurological names, but no one’s connecting the dots. Dr. Deb Muth 11:02You see, when you start to stack these labels on top of each other, one after the next after the next, you know, it’s celiac disease, it’s Hashimoto’s, it’s fibromyalgia, it’s autoimmune. You know, rheumatoid arthritis. It’s. Whatever it is, it’s long haul Covid. These days, no one is putting these connections together to say, why are you developing so many diseases that are so similar in nature, ones that just kind of domino after each other? Nobody’s looking at your immune system. Nobody’s measuring it, Nobody’s telling you how well it’s working. No one’s supporting it. They’re just throwing these biological drugs at you. And if there’s an autoimmune disease and sending you on your way and saying, this is what you have to look forward to for the rest of your life. But don’t worry, these side effects are rare, including cancer. It does not make sense to me that we are not looking at the root cause for all of these crazy diagnoses that we are labeling people with today. And I am guilty of it myself, because within the system that we work, we have to label something in order for you to receive the care that you need, for your insurance, to pay for the treatment, for the tests, for the visits. There has to be a label. And that’s what we call an ICD10 code. And if we don’t have the appropriate label, none of what we’re recommending gets covered for you. And that’s the label game began. The second thing is long haul Covid. And post viral illnesses. Dr. Deb Muth 12:47Millions of people were told, we don’t know why, and then we sent them home to figure it out by themselves. We don’t know why your immune system is failing, we don’t know why you’re having these clotting issues that are happening. But don’t worry, these clotting issues really are not that severe. They’re mild in nature. You’ll never have to worry about it. And we’re not going to treat it even though it’s four times the level that’s normal, because we’re going to wait until it’s 10 times the level of normal to even worry about it at this point. Dr. Deb Muth 13:19And it will take us 25 to 30 years before we understand any of the risks and barriers that have happened from these post viral illnesses that have occurred in our environment and the ones that are in the future to come. Because it takes time for us to study things, it takes time for us to figure it out, takes time for us to train the practitioners, and it takes time for us to accept something different than we thought was reality. And that is the problem that we have today with these post viral illnesses that are long acting, that are retriggering new viruses, retriggering old illnesses like Lyme, reactivating things like Epstein Barr virus. It will take decades before this becomes mainstream. And right now it’s fringe medicine and it’s not realistic. And those of us that are speaking about it are chastised and gone after, but by our medical communities and we are told that we are the crazy ones. And that is how medicine has always been. Way in the beginning, and I forget the doctor’s name, who started just observing that when medical students worked on cadavers and then came into the labor and delivery ward and delivered babies, these women were getting sick with infections and they were dying. And he said, what if we just washed our hands between the cadaver and the delivery? Would we save lives? And he did a small study and he was right. And over time he was made fun of and he was put into insane asylums and he was locked away. And now today we would never think of entering a room and working on a patient without washing our hands beforehand. But that took 30 years for that one concept of washing hands to be adopted. And it destroyed one man’s life because he simply asked the question, what if it’s a crazy society that we live in, It’s a crazy outlook that we have on medicine and asking questions. And sometimes I wonder, is it truly science or is it politically driven? And I think the answer is it’s both. And the third thing that we have is technology. And technology is outpacing wisdom by far. Hands down, AI, advanced labs and imaging can identify everything. Now using AI, but without context, it creates a fear. Dr. Deb Muth 16:08And instead of clarity, without context, using AI to interpret labs makes absolutely no sense. Without context and understanding and us actually training this LLM model, the AI doesn’t really know what it, what it means. And someday it will, I’m sure, but right now it doesn’t. So as everyone is taking to AI to treat themselves and create a protocol and diagnose themselves and understand their labs and know that it is without context that you are doing this, and research is wonderful, but without having somebody truly understand you and the art of healing and the art of medicine, this is going to get lost and you will not have the information that you truly need simply by using chat GPT. Now I’ve created my own version called Venari and I hope that this will be much better because it will have context. It will have 15,000 protocols that I have used for the last 25 years. It will have lots of research. It has all of the research databases that we can connect to. It has training that I have given it using my brain and how I see a client every single day in practice. So when you’re using our Venari app, you will be able to have that context. You will be able to have that pushback and that voice. And not only that, you will have the option then to work alongside someone to help you identify that context that you’re looking for. Does this make sense? Dr. Deb Muth 17:53I’ve seen this a lot in the peptide world, where in these Facebook groups, people are talking about the peptide stacks that they’re using and they’re telling people that it’s okay to use any peptide you want because they’re just small chain branch amino acids. And that can’t be farther from the truth because there are some peptides you would not want to use because they can stimulate the growth of cells. And if you have cancer or if you have a history of this, there are some peptides that we need to avoid. And unfortunately, AI doesn’t understand that yet and doesn’t know that yet. And it’s just creating stacks. And people are creating stacks without understanding what they’re doing. And I watched my best friend do this as she was learning peptides and she had cancer and it created an aggressive sarcoma. And I believe the peptides had a lot to do with that because it stimulated the growth of the cells. And it wasn’t until after she had passed away that we found this journal of hers that she was studying peptides and recognized that this could have contributed to her advanced cancer. And if you don’t have that context and you’re using AI to create these stacks for you, you can put yourself in harm’s way. And so AI technology, I think, is going to be fantastic in a lot of ways. It’s going to have its downfalls. And you’re going to need an expert when you’re using AI. You’re not going to just be able to treat yourself with this. You know, understanding that more data doesn’t always equal healing, and more data can be helpful. But again, you have to understand how to put those pieces together, how to ask the right question questions. And for that, you need somebody who has seen thousands and thousands of cases to find the missing pieces for you. Because AI is not going to do that unless it’s been trained to do that. Vanari has been trained to do that. Dr. Deb Muth 20:01It’s been trained to push back and look at lime and mold and toxins and chemicals and metals and all of those things. But there is no other AI bot out there, LLM that has been trained to do that using clinical data that I use every single day in my practice. And people are finally realizing that, you know, they’re understanding that although this world of AI and technology is amazing, it has its limitations, just like practitioners have their limitations. We don’t know everything. We are not perfect. We are human. And humans make errors and we miss things. With or without technology, we miss things. And part of it is because we just don’t know what we don’t know yet. And sometimes it’s because we have our blinders on, and sometimes it’s just simply because we don’t have the information today that we’re going to have five years from now. And here’s what I teach instead. I teach the seenet last. And that’s what we built it on. Restore and root. Rise and restore. Sorry, that is my methodology. And it’s in the scene at last book. And it starts with healing. It starts with asking better questions. So instead of asking, what do you have? We want to ask, what has your body been exposed to? What symptoms are underperforming? What’s driving the inflammation for you? When you have joint pain and you have muscle pain and you have achiness, that is not normal. Dr. Deb Muth 21:38I don’t care if you’re 20 or you’re 80, it is not normal. And yes, I did say 80, because we are not supposed to have that kind of inflammation at 80. And why are we underperforming? Why is our Brain not working correctly? Why is our mood not working? Why can’t my body push up a hill? Why can’t I lift 10 pounds? What’s going on? Why can’t I recover from that activity? What’s interfering with my ability to repair and heal after I’ve done some things that I need to do? What’s keeping your nervous system stuck in this survival mode, in this fight or flight mode? Why can’t I get past that? Sometimes that answer is really simple and sometimes that answer, it is so hard and so complicated and it is so many things that are causing this body to be stuck. And sometimes it’s a six month fix, and sometimes it’s a six year fix and sometimes it’s decades long. And it is one of the most challenging things as a practitioner to get clients to understand and to be on the other side of the table and not get you that quick fix. It is extremely difficult for us as well when we are not seeing the results that we think we should see. We need to focus on function over diagnosis, root cause over labels. Dr. Deb Muth 23:09What is driving all this inflammation and certainly restoration over resignation. Do not resign to the fact that you have this life altering disease that is never going to change. Because if we find the root and we restore the body, you don’t have to live in that death sentence that you’ve been given of a diagnosis, whether it’s fibromyalgia, MS, Alzheimer’s disease, celiac disease, Hashimoto’s thyroiditis, it does not matter what that diagnosis is. We can change it, we can make it better, we can reduce the symptoms, we can improve your life. Maybe not in ways that you are absolutely looking for, maybe not in a perfect world, but we can change the trajectory of where your life is going. And it’s because you’re not an ICD9 code or an ICD10 code. You’re not a code, you’re not an MRI result, you’re not a lab result, you’re a human body asking support, not a name. And I say that with a little hesitation because so many people are looking for the name. So many people are angry that someone didn’t find the name. I have clients that come to me that are so angry that the conventional medicine system did not identify their Lyme disease, that they’re looking for someone to sue and there is no one to sue because they didn’t find it, because sometimes they just don’t know. You’re asking for conventional medicine, practitioner and system to provide for you a label that is not within their wheelhouse to do. Because the way they treat Lyme disease and the way an eyelads practitioner looks at Lyme disease and has. Has the ability to test differently are two very different things. Dr. Deb Muth 25:27You’re asking for a system to perform in a way that they are not trained and guided to do. Then you’re looking and asking for somebody to place blame for an illness that you have, that you have yet taken ownership for. And I know that sounds harsh, and I know there’s going to be a lot of people that are angry at me for saying that. But I sit in front of you as someone who had Lyme disease, who had mold mycotoxin illness, who had high viral titers, who had post Covid peripheral neuropathy, who had the diagnosis of ms, who has white matter brain disease, who treated all of it not in the conventional world, who has halted the white matter disease and regrew her brain by 1.5 standard deviations, which is unheard of in 18 months. So I can say this to you. There is no one to blame for your lack of diagnosis or your diagnosis. It is life. It is what happens to us. And you have a choice at the crossroad to either take the path of hatred and anger and bitterness and blame and never getting better a result of that, or you have the ability to take the path of curiosity and openness and willingness to change and willingness to walk down a path that is different than what the conventional medicine is telling you to do. And those are your choices and you get to make those choices. But what you don’t get to do is blame some someone else and try to destroy them for something that they are not able to do. That is not what we get to do in this life. Dr. Deb Muth 27:29It is not right and it is not fair. If someone has truly injured you, that’s different. That’s different. But this looking to blame somebody because they didn’t give you a label, Ridiculous in my opinion. And if you’re listening and thinking right now, I’ve been diagnosed, but I’m not better, I want you to hear this clearly. You are not broken. You are not crazy, and you are not done. Sometimes the most healing moment isn’t getting that diagnosis. It’s realizing that the diagnosis was never the whole story. And that’s where the real healing begins. When we look at the entire story, we look at your entire life from the beginning to where you are now and what has happened to get you there. And once we get that, then we can put you back together. Not in the old way, in a new way in an amazing way, in a way that you would cherish your life for every moment that you have of it. Good, bad and ugly. A diagnosis should not be the doorway. It’s not a dead end. It is just the beginning. Remember, you don’t need another diagnosis. You need your life back. And that’s what’s important. Dr. Deb Muth 29:19We are living in a moment where medicine is being forced to evolve not because systems want to, but because patients are demanding better. This post diagnosis era isn’t about rejecting science, it’s about using it wisely. It’s about restoring function, dignity and hope. And I hope that if this episode resonated with you, share it with someone who’s been labeled but not yet helped. Because sometimes the most powerful healing starts when someone finally feels seen. Thank you for being with me here today. If you haven’t already, make sure you subscribe and follow. Let’s talk Wellness now on YouTube, Spotify or wherever you’re listening and I’ll see you next time. Until then, keep asking better questions, trusting your body and remembering you are more than a diagnosis.The post Episode 254 – Beyond the Diagnosis: Healing in a Post-Diagnosis Era first appeared on Let's Talk Wellness Now.

A cancer diagnosis doesn't just affect the body — it touches every part of life.   In Episode 2 of My 15 Years, released during Mental Health Month, Melody opens up about the emotional reality of the months following her ocular melanoma diagnosis. She shares the fear, grief, and isolation she experienced, how her marriage began to fall apart, and the complex ways she related to her family during that time.   This episode is an honest conversation about mental health, relationships, and the invisible weight that often follows a life-altering diagnosis — especially when that diagnosis is rare.   Looking back 15 years later, Melody also reflects on what she wishes she had known then, offering thoughtful takeaways and perspective shaped by time, healing, and survivorship.   This episode is for anyone navigating the emotional aftermath of diagnosis — and for those supporting someone who is.   Rare Cancer. Resilient Hope. Revolutionary Research.  

Setting your boundaries while still accepting love and help during this chapter.  All the links, tools & resources I personally share:https://linktr.ee/cfreecancerfree

The Athletic's Sabreena Merchant joins to discuss what is hopefully a blip season for the Fighting Irish women's team, including praise for Hannah Hidalgo, questions about roster construction, Niele Ivey's performance and whether women's basketball generally is in a bit of a rut. Then (42:30) Sam Werner (Three-Point Jesus podcast) and Joe Schueller (18 Stripes) discuss what has gone awry in Micah Shrewsberry's third season and where the men's program goes from here. Sign up for the newsletter and/or browse the merch here: https://linktr.ee/rakesreport

In this powerful and deeply human conversation, Dr. Michael Karlfeldt is joined by Bron Watson—registered nurse, educator, entrepreneur, and founder of The Serenity Project. With decades of experience in healthcare and two life-altering cancer diagnoses—breast cancer followed years later by incurable multiple myeloma—Bron brings a rare dual perspective: clinician and patient. Rather than being defined by diagnosis, she has transformed her lived experience into a framework for healing that integrates science, self-leadership, and soul.Bron shares her journey from passive patient to active participant, exploring what it truly means to become the CEO of your health. Together, she and Dr. Karlfeldt discuss navigating fear and uncertainty, asking empowered questions, and understanding what you can—and cannot—control. Bron introduces concepts such as the Serenity Project's “third space” (where science meets spirituality), the Serenity Prayer as a practical tool, capacity and the spoon theory, and strategies for managing fear without suppressing it. This episode also dives into integrative cancer care, functional medicine, mindset, and why healing is more than just physical outcomes.Whether you're facing cancer, supporting someone who is, or simply navigating uncertainty in life, this episode offers grounding wisdom and practical perspective. Bron's message is clear and compassionate: healing is personal, empowerment matters, and you can live fully—right where your feet are—no matter the diagnosis. This conversation is an invitation to step out of fear, reclaim agency, and find serenity even in life's hardest moments.Key Topics CoveredBecoming the CEO of your health as a cancer patientBron Watson's journey through breast cancer and multiple myelomaThe Serenity Project and the concept of the “third space” (science + soul)Managing fear, grief, and uncertainty without denialCapacity, energy management, and the spoon theoryIntegrative and holistic approaches alongside conventional oncologyAsking empowered questions and moving from passive to active careMindset, presence, and “being where your feet are”Why healing is not the same as longevityBuilding the right healthcare “team” beyond siloed medicine -----------------------------------------------A Better Way to Treat Cancer: A Comprehensive Guide to Understanding, Preventing and Most Effectively Treating Our Biggest Health ThreatGrab my book here: https://www.amazon.com/dp/B0CM1KKD9X?ref_=pe_3052080_397514860 Unleashing 10X Power: A Revolutionary Approach to Conquering CancerGet it here: https://store.thekarlfeldtcenter.com/products/unleashing-10x-powerPrice: $24.99100% Off Discount Code: CANCERPODCAST1 Healing Within: Unraveling the Emotional Roots of CancerGet it here: https://store.thekarlfeldtcenter.com/products/healing-withinPrice: $24.99100% Off Discount Code: CANCERPODCAST2-----------------------------------------------Integrative Cancer Solutions was created to instill hope and empowerment. Other people have been where you are right now and have already done the research for you. Listen to their stories and journeys and apply what they learned to achieve similar outcomes as they have, cancer remission and an even more fullness of life than before the diagnosis. Guests will discuss what therapies, supplements, and practitioners they relied on to beat cancer. Once diagnosed, time is of the essence. This podcast will dramatically reduce your learning curve as you search for your own solution to cancer. To learn more about the cutting-edge integrative cancer therapies Dr. Karlfeldt offer at his center, please visit www.TheKarlfeldtCenter.com

On this episode of NP Pulse, we discuss the common causes of misdiagnosis and the red flags NPs can encounter on the road to diagnosing and treating rare diseases. Today's guests are Stephanie Hosley and Deena Rodney, two NP experts who approach the topic of rare diseases with consideration and care. This podcast is made possible by Alexion.

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Send us a textThis week, my guest is Tracy Hicks, a doctorally-prepared and dual-certified family and psychiatric mental health nurse practitioner. She also holds an MBA, which is particularly useful in her role as a CEO.Tracy is the founder of C-Trilogy Comprehensive Clinical Care and C-Trilogy Outreach, a certified community behavioral health clinic that provides mental health services, substance use support, primary care, and 24-hour crisis help.I was excited to talk with Tracy, who is an expert in the care and treatment of individuals with schizophrenia, because in my 36 years as a nurse, I have encountered only two patients with this diagnosis, both of whom were teenagers. I knew very little about the condition and was eager to learn from Tracy, and she did not disappoint.We discussed long-acting injectables as a successful treatment option, the challenges of compliance, and the management of a long-term chronic disease. We also emphasized the crucial importance of a strong support system to help patients lead meaningful lives.A recurring theme in our conversation was Tracy's passion when discussing these complex cases. This emotion stems from her lived experience, as two of her beloved family members—her father and her daughter—both have the disease. Growing up with the stigma of having a father with schizophrenia has shaped her perspective, and even though her daughter is now grown, Tracy's concerns for her never waver.Tracy's days are incredibly busy. Between practicing in the clinic, serving on multiple boards that advocate for marginalized populations, and shaping the next generation of nurses as an Associate Professor, people often ask her how she manages it all. Her answer? When you align with your purpose from God, He will guide your steps. She truly is a blessing to her community.In the five-minute snippet: Be prepared to jump! For Tracy's bio, visit my website (link below).Dr. Tracy Hicks Puts Her Mind to Improving Access to Mental Care, Frontier Nursing Empowering Care Partners Through Psychoeducation in Schizophrenia Care, Psychiatric TimesContact The Conversing Nurse podcastInstagram: https://www.instagram.com/theconversingnursepodcast/Website: https://theconversingnursepodcast.comYour review is so important to this Indie podcaster! You can leave one here! https://theconversingnursepodcast.com/leave-me-a-reviewWould you like to be a guest on my podcast? Pitch me! https://theconversingnursepodcast.com/intake-formCheck out my guests' book recommendations! https://bookshop.org/shop/theconversingnursepodcast I've partnered with RNegade.pro! You can earn CE's just by listening to my podcast episodes! Check out my CE library here: https://rnegade.thinkific.com/collections/conversing-nurse-podcast Thanks for listening!

In Conversation with Dr. Wolfgang Weyers: The Complexities of Dermatopathology DiagnosisIn this episode of The Girl Doc Survival Guide, Christine welcomes Dr. Wolfgang Weyers, a highly respected dermatopathologist and author, to discuss his experience and perspectives on medical diagnosis. Dr. Weyers shares a personal anecdote about his influential mentor, Dr. Bernie Ackerman, and dives into a critical discussion on overdiagnosis, the importance of specific diagnosis in dermatopathology, problems caused by partial samples, and the criteria for diagnosing melanoma. He emphasizes the importance of experience, proper training, and the need to biopsy adequately developed lesions. The conversation also touches on the complexity of biological classification and the role of behavior and molecular studies in understanding diseases. 00:00 Introduction to Dr. Wolfgang Weyers00:46 Personal Anecdotes and Influences02:05 Discussion on Overdiagnosis05:04 Criteria for Melanoma Diagnosis08:34 Challenges in Diagnosis and Solutions16:48 Final Thoughts and Conclusion

We walk through a practical approach to evaluating cognitive change with Dr. Seth Gale, from fast domain-based questions and high-yield screening to when, and how, to utilized imaging and biomarkers meaningfully. We also cover reversible factors, older medications used in dementia management, lifestyle changes that can benefit, and how new Alzheimer's treatments shift urgency in making a definitive diagnosis.Send us a textUnderstanding Hypophosphatemia: Recognition, Diagnosis, and TreatmentEndocrine experts distinguish Hypophosphatemia from osteoporosis & osteomalaciaListen on: Apple Podcasts SpotifySupport the show Check out our website at www.theneurotransmitters.com to sign up for emails, classes, and quizzes! Would you like to be a guest or suggest a topic? Email us at contact@theneurotransmitters.com Follow our podcast channel on

Gil Alderete of Catholic Men's Fellowship (CMF) serves as host of Men of Faith; in this episode he speaks with businessman Mark Prather about Gil's embrace of the Catholic faith after experiencing turmoil in life.Listen live to Gil's show Men of Faith at https://www.spiritfilledevents.com/radio-podcast Monday -Friday at and 12:30pm Pacific Time. Podcast is available https://www.spiritfilledevents.com/men-of-faith and other podcast outlets. Support the show

Join Elevated GP: www.theelevatedgp.com Register for the live meeting: https://www.theelevatedgp.com/ElevationSummit Download the Injection Molding Guide: https://www.theelevatedgp.com/IMpdf  Episode Description In part one of this two-part conversation, Dr. Brian Vence shares a deeply thoughtful and experience-driven perspective on what it actually takes to build a successful fee-for-service practice—one rooted not in persuasion or sales tactics, but in trust, diagnosis, and meaningful human connection. With more than three decades of clinical experience and a career dedicated to interdisciplinary, comprehensive care, Dr. Vence reframes treatment planning as a behavioral and relational process, not a transactional one. He challenges the idea that comprehensive dentistry is something that must be "sold," and instead positions it as a process of helping patients clarify their own values, goals, and tolerance for risk—at their pace, not ours. This episode explores how dentists can meet patients where they are without abandoning ideal diagnosis. Dr. Vence explains why patients often fixate on a single tooth or isolated concern, and how honoring that starting point—when done thoughtfully—can open the door to deeper, more comprehensive care over time. Rather than overwhelming patients with full-mouth solutions on day one, he advocates for sequencing conversations, building psychological safety, and creating space for patients to envision what's possible. A major theme of the discussion is the concept of "Pathways to Essential and Meaningful Treatment." Dr. Vence walks through how environment, language, and timing directly influence patient decision-making—and why treatment planning conversations are often better held outside the operatory, away from the fight-or-flight associations many patients carry with dentistry. In this episode, you'll hear: Why fee-for-service dentistry begins with mindset and culture—not insurance policies How to stop "convincing" patients and instead become a clear, unbiased sounding board Why comprehensive treatment planning is fundamentally about behavior, not procedures How environment and language influence whether patients feel safe enough to future-focus The importance of honoring patient autonomy while still holding space for ideal diagnosis Dr. Vence also shares practical insights into new patient workflows, from the first phone call to in-office consultations, emphasizing the value of curiosity, listening, and slowing down. He highlights why efficiency often crowds out effectiveness—and why the most productive clinical days are rarely about volume, but about depth of connection. This conversation is especially relevant for dentists who feel tension between practicing the dentistry they know is right and navigating patient hesitancy, financial concerns, or insurance-driven expectations. If you've ever felt frustrated trying to align comprehensive care with patient readiness, this episode offers a grounded, humane, and sustainable way forward. Part one sets the philosophical and relational foundation. In part two, the conversation continues into diagnosis, case presentation, and how to guide patients through complex decisions without coercion. This is not an episode about selling dentistry. It's about helping patients—and clinicians—make clearer, more meaningful choices.  

On this week’s episode, we’re continuing our Guidelines Series exploring the 2022 ESC/ERS Guidelines for the diagnosis and treatment of Pulmonary Hypertension. If you missed our first episode in the series, give it a listen to hear about the most recent recommendations regarding Pulmonary Hypertension definitions, screening, and diagnostics. Today, we’re talking about the next steps after diagnosis. Specifically, we’ll be discussing risk stratification, establishing treatment goals, and metrics for re-evaluation. We’ll additionally introduce the mainstays of pharmacologic therapy for Pulmonary Hypertension. Meet Our Co-Hosts Rupali Sood  grew up in Las Vegas, Nevada and made her way over to Baltimore for medical school at Johns Hopkins. She then completed her internal medicine residency training at Massachusetts General Hospital before returning back to Johns Hopkins, where she is currently a pulmonary and critical care medicine fellow. Rupali’s interests include interstitial lung disease, particularly as related to oncologic drugs, and bedside medical education. Tom Di Vitantonio  is originally from New Jersey and attended medical school at Rutgers, New Jersey Medical School in Newark. He then completed his internal medicine residency at Weill Cornell, where he also served as a chief resident. He currently is a pulmonary and critical care medicine fellow at Johns Hopkins, and he’s passionate about caring for critically ill patients, how we approach the management of pulmonary embolism, and also about medical education of trainees to help them be more confident and patient centered. Key Learning Points 1) Episode Roadmap How to set treatment goals, assess symptom burden, and risk-stratify patients with suspected/confirmed pulmonary arterial hypertension (PAH). What tools to use to re-evaluate patients on treatment Intro to major PAH medication classes and how they map to pathways. 2) Case-based diagnostic reasoning Patient: 37-year-old woman with exertional dyspnea, mild edema, abnormal echo, telangiectasias + epistaxis → raises suspicion for HHT (hereditary hemorrhagic telangiectasia) and/or early connective tissue disease. Key reasoning move: start broad (Groups 2–5) and narrow using history/exam/testing. In a young patient without obvious left heart or lung disease, think more about Group 1 PAH (idiopathic/heritable/associated). HHT teaching point: HHT can cause PH in more than one way: More common: high-output PH from AVMs (often hepatic/pulmonary) Rare (1–2% mentioned): true PAH phenotype (vascular remodeling; associated with ALK1 in some patients), behaving like Group 1 PAH. 3) Functional class assessment WHO Functional Class: Class I: no symptoms with ordinary activity, only with exertion Class II: symptoms with ordinary activity Class III: symptoms with less-than-ordinary activity (can't do usual chores/shopping without dyspnea) Class IV: symptoms at rest Practical bedside tip they give: Ask if the patient can walk at their own pace or keep up with a similar-age peer/partner. If not, think Class II (or worse). 4) Risk stratification at diagnosis: why, how, and which tools Big principle: treatment choices are driven by risk, and the goal is to move patients to low-risk quickly. ESC/ERS approach at diagnosis (as described): Use a 3-strata model predicting 1-year mortality: Low: 20% ESC/ERS risk assessment variables (10 domains discussed): Clinical progression, signs of right heart failure, syncope WHO FC Biomarkers (NT-proBNP) Exercise capacity (6MWD) Hemodynamics Imaging (echo; sometimes cardiac MRI) CPET (peak VO₂; VE/VCO₂ slope) They note: even if you don't have everything, the calculator can still be useful with ≥3 variables. REVEAL 2.0: Builds on similar core variables but adds further patient context (demographics, renal function, BP, DLCO, etc.) Case result: both tools put her in intermediate risk (ESC/ERS ~1.6; REVEAL 2.0 score 8), underscoring that mild symptoms can still equal meaningful mortality risk. 5) Treatment goals and follow-up philosophy What they explicitly prioritize: Help patients feel better, live longer, and stay out of the hospital Use risk tools to communicate prognosis and to track improvement Reassess frequently (they mention ~every 3 months early on) until low risk is achieved “Time-to-low-risk” is an important treatment goal Also emphasized: The diagnosis is psychologically heavy; patients need clear counseling, reassurance about the plan, and connection to support groups. 6) Medication classes for the treatment of PAH Nitric oxide–cGMP pathway PDE5 inhibitors: sildenafil, tadalafil Soluble guanylate cyclase stimulator: riociguat Important safety point: don't combine PDE5 inhibitors with riociguat (risk of significant hypotension/hemodynamic effects) Endothelin receptor antagonists (ERAs) “-sentan” drugs: bosentan (less used due to side effects/interactions), ambrisentan, macitentan Teratogenicity emphasized Hepatotoxicity that requires LFT monitoring Can cause fluid retention and peripheral edema Prostacyclin pathway Prostacyclin analogs/agonists: Epoprostenol (potent; short half-life; IV administration) Treprostinil (IV/SubQ/oral/inhaled options) Selexipag (oral prostacyclin receptor agonist) 7) Sotatercept (post-guidelines) They note sotatercept wasn't in 2022 ESC/ERS but is now “a game changer” in practice: Mechanism: ligand trap affecting TGF-β signaling / remodeling biology Positioned as potentially more disease-modifying than pure vasodilators Still evolving: where to place it earlier vs later in regimens is an active question in the field 8) How risk category maps to initial treatment intensity General approach they outline: High risk at diagnosis: parenteral prostacyclin (IV/SubQ) strongly favored, often aggressive early Intermediate risk: at least dual oral therapy (typically PDE5i + ERA); escalate if not achieving low risk Low risk: at least one oral agent; many still use dual oral depending on etiology/trajectory For the case: intermediate-risk → start dual oral therapy (they mention tadalafil + ambrisentan as a typical choice), reassess in ~3 months; add a third agent (e.g., selexipag/prostacyclin pathway) if not low risk.  References and Further Reading Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, Carlsen J, Coats AJS, Escribano-Subias P, Ferrari P, Ferreira DS, Ghofrani HA, Giannakoulas G, Kiely DG, Mayer E, Meszaros G, Nagavci B, Olsson KM, Pepke-Zaba J, Quint JK, Rådegran G, Simonneau G, Sitbon O, Tonia T, Toshner M, Vachiery JL, Vonk Noordegraaf A, Delcroix M, Rosenkranz S; ESC/ERS Scientific Document Group. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022 Oct 11;43(38):3618-3731. doi: 10.1093/eurheartj/ehac237. Erratum in: Eur Heart J. 2023 Apr 17;44(15):1312. doi: 10.1093/eurheartj/ehad005. PMID: 36017548. Condon DF, Nickel NP, Anderson R, Mirza S, de Jesus Perez VA. The 6th World Symposium on Pulmonary Hypertension: what’s old is new. F1000Res. 2019 Jun 19;8:F1000 Faculty Rev-888. doi: 10.12688/f1000research.18811.1. PMID: 31249672; PMCID: PMC6584967. Maron BA. Revised Definition of Pulmonary Hypertension and Approach to Management: A Clinical Primer. J Am Heart Assoc. 2023 Apr 18;12(8):e029024. doi: 10.1161/JAHA.122.029024. Epub 2023 Apr 7. PMID: 37026538; PMCID: PMC10227272. Hoeper MM, Badesch DB, Ghofrani HA, Gibbs JSR, Gomberg-Maitland M, McLaughlin VV, Preston IR, Souza R, Waxman AB, Grünig E, Kopeć G, Meyer G, Olsson KM, Rosenkranz S, Xu Y, Miller B, Fowler M, Butler J, Koglin J, de Oliveira Pena J, Humbert M; STELLAR Trial Investigators. Phase 3 Trial of Sotatercept for Treatment of Pulmonary Arterial Hypertension. N Engl J Med. 2023 Apr 20;388(16):1478-1490. doi: 10.1056/NEJMoa2213558. Epub 2023 Mar 6. PMID: 36877098. Ruopp NF, Cockrill BA. Diagnosis and Treatment of Pulmonary Arterial Hypertension: A Review. JAMA. 2022 Apr 12;327(14):1379-1391. doi: 10.1001/jama.2022.4402. Erratum in: JAMA. 2022 Sep 6;328(9):892. doi: 10.1001/jama.2022.13696. PMID: 35412560.

In episode #418 of The Hormone Puzzle Podcast, our host, Dr. Kela Smith, talks about Why Infertility Is a Puzzle Not a Single Diagnosis - Inside the Fertility Puzzle with Dr. Kela. At the end of every month on The Hormone Puzzle Podcast, Dr. Kela takes you Inside the Fertility Puzzle with a special solo episode dedicated to key fertility topics. From optimizing hormones and decoding lab results to fostering emotional resilience, these episodes deliver actionable advice and expert insights to support your journey to conception. Designed to equip you with the tools and knowledge needed to navigate your unique fertility challenges, this series is your guide to empowerment and clarity. Tune in and let's work together to solve your fertility puzzle with confidence! More about Dr. Kela: Dr. Kela Smith is a leading Holistic Integrative Fertility & Hormone Doctor, dedicated to supporting women and couples facing fertility challenges. After overcoming her own fertility struggles using the Hormone P.U.Z.Z.L.E Method, it has been her mission to help others solve their infertility puzzles so they can get and stay pregnant, have a healthy happy pregnancy, and easy postpartum. An accomplished author, she also hosts Solving-Infertility Summit, and Healthy Happy Pregnancy Summit. Dr. Kela's expertise also extends to guiding and inspiring future fertility experts as the lead educator at the Hormone Puzzle Society Educational Institute. Thank you for listening! This episode is brought to you in partnership with Puzzle Brew Fertility tea - https://hormonepuzzlesociety.com/fertility-tea Follow Dr. Kela on Instagram: @‌kela_healthcoach Get your FREE Fertility Meal Plan: https://hormonepuzzlesociety.com/ FTC Affiliate Disclaimer: The disclosure that follows is intended to fully comply with the Federal Trade Commission's policy of the United States that requires to be transparent about any and all affiliate relations the Company may have on this show. You should assume that some of the product mentions and discount codes given are "affiliate links", a link with a special tracking code This means that if you use one of these codes and purchase the item, the Company may receive an affiliate commission. This is a legitimate way to monetize and pay for the operation of the Website, podcast, and operations and the Company gladly reveals its affiliate relationships to you. The price of the item is the same whether it is an affiliate link or not. Regardless, the Company only recommends products or services the Company believes will add value to its users. The Hormone Puzzle Society and Dr. Kela will receive up to 30% affiliate commission depending on the product that is sponsored on the show. For sponsorship opportunities, email HPS Media at media@hormonepuzzlesociety.com

In this episode of Our Forever Smiles, Laura sits down with Natalie, a mom of two whose son was prenatally diagnosed with a cleft lip. Natalie shares the emotional journey from receiving the diagnosis at 16 weeks to preparing for surgery and finding peace in the unknown. She opens up about anxiety, faith, choosing the right cleft team, and what helped her feel grounded during pregnancy. This conversation offers reassurance and hope for families navigating a prenatal cleft diagnosis. Links: Buy Us a Coffee FB Support Group  

Send us a textWhat if the words you needed were waiting inside the moments you try to rush past? We sit down with Australian poet and radiographer Nadine Ellis to explore late autism diagnosis, the quiet injuries of daily life, and the craft of turning hard feelings into language that heals. Nadine was diagnosed at 58, alongside her daughters and husband, and that clarity reframed decades of masking, missed cues, and misplaced shame. Instead of pathologizing sensitivity, she treats it as guidance—and her poems channel that signal into lines that land with precision.Across our conversation, we map the practical tools that helped her build resilience: journaling as a pressure valve and memory archive, compact poetry that cuts through noise for a dyslexic mind, and the steady discipline of noticing. We talk about creating a home where each person's decompression needs are honored, and how shared understanding replaces friction with ease. Nadine's perspective is generous and grounded: you don't need to be a “writer” to express yourself. If words aren't your medium, paint, stitch, cook, garden, sing, or use voice-to-text. The point is contact, not perfection.You'll also hear two live readings from her collection The Gray Between: Caustic Comments, a searing piece about the long echo of a teacher's cruelty and the alchemy of reclaiming it, and Solitary Confinement, a tender meditation on laundry, motherhood, and the sweetness packed into small domestic rituals. Each poem shows how everyday micro-traumas and quiet joys shape identity—and how art can metabolize both into strength.If you're navigating neurodivergence, seeking healthier boundaries, or just craving a way to make sense of what you feel, this conversation offers language, validation, and tangible next steps. Check out Nadine's work on Amazon, visit nadineellis.com for poems and interviews, and follow @nadineellispoetry on Instagram for new pieces. If this resonated, share it with a friend, subscribe for more thoughtful conversations, and leave a review so others can find the show.Support the showSJ CHILDS - SOCIALS & WEBSITE MASTER LIST WEBSITES - Stream-Able Live — https://www.streamable.live-COMING SOON - The SJ Childs Global Network — https://www.sjchilds.org - The SJ Childs Show Podcast Page — https://www.sjchildsshow.com YOUTUBE - The SJ Childs Show — https://www.youtube.com/@sjchildsshow - Louie Lou (Cats Channel) — https://www.youtube.com/@2catslouielou FACEBOOK - Personal Profile — https://www.facebook.com/sara.gullihur.bradford - Business Page — https://www.facebook.com/sjchildsllc - The SJ Childs Global Network — https://www.facebook.com/sjchildsglobalnetwork - The SJ Childs Show — https://www.facebook.com/SJChildsShow INSTAGRAM - https://www.instagram.com/sjchildsllc/ TIKTOK - https://www.tiktok.com/@sjchildsllc LINKEDIN - https://www.linkedin.com/in/sjchilds/ PODCAST PLATFORMS - Spotify — https://open.spotify.com/show/4qgD3ZMOB2unfPxqacu3cC - Apple Podcasts — https://podcasts.apple.com/us/podcast/the-sj-childs-show/id1548143291 CONTACT EMAIL - sjchildsllc@gmail.com

Episode 1: My Diagnosis Fifteen years ago, Melody heard the words that would change her life forever: you have ocular melanoma. In the first episode of My 15 Years, Melody — founder and president of A Cure in Sight — shares an overview of her diagnosis and the moments surrounding it. From the initial symptoms and medical appointments to the shock, fear, and uncertainty that followed, this episode begins the story at its starting point. This conversation lays the foundation for the series, offering an honest look at what it's like to receive a rare cancer diagnosis and begin navigating a future filled with unknowns. This episode is for patients, survivors, caregivers, and anyone facing a diagnosis they never expected. Thank you for being here — and for walking this journey with us. Rare Cancer. Resilient Hope. Revolutionary Research.

This interview was brought to you in partnership with Eisai and is part of the Journey to Diagnosis series.Eisai: https://www.eisai.com/index.htmlJourney to Diagnosis: https://beingpatient.com/journey-to-diagnosis/Luke Davis spent four decades as a Dallas attorney — and an active husband, father, youth sports coach and school board member — before subtle memory changes raised concerns. In this Being Patient Perspectives interview, Luke and his wife, Paula Davis, share the early signs of Alzheimer's they noticed first, how they pursued answers, and what helped them move forward.After a primary care visit, Luke underwent cognitive testing, an MRI and an amyloid PET scan that confirmed plaque. In April 2023, just before his 69th birthday, he was diagnosed with early-stage Alzheimer's disease. Luke later learned he carries two copies of the APOE4 gene, a major genetic risk factor for Alzheimer's.Luke and Paula also discuss treatment and support — including Luke's experience with Leqembi (lecanemab) infusions — and how they've leaned on the Alzheimer's Association, community, and practical day-to-day strategies. Their message for newly diagnosed individuals and couples: Alzheimer's is a detour, not a dead end — and Luke is focused on “living with Alzheimer's, not dying from it.”Topics covered: early Alzheimer's symptoms, diagnosis journey, amyloid PET scan, APOE4, Leqembi/lecanemab, caregiving as a spouse, coping after diagnosis, living well with Alzheimer's, advocacy and support.#Alzheimers #EarlyAlzheimers #Leqembi #Lecanemab #APOE4 #Dementia #BrainHealth #BeingPatient---- If you loved watching this Live Talk, visit our website to find more of our Alzheimer's coverage and subscribe to our newsletter: https://www.beingpatient.com/Follow Being Patient: Twitter: https://twitter.com/Being_Patient_Instagram: https://www.instagram.com/beingpatientvoices/Facebook: https://www.facebook.com/beingpatientalzheimersLinkedIn: https://www.linkedin.com/company/being-patientBeing Patient is an editorially independent journalism outlet for news and reporting about brain health, cognitive science, and neurodegenerative diseases. In our Live Talk series on Facebook, former Wall Street Journal Editor and founder of Being Patient, Deborah Kan, interviews brain health experts and people living with dementia. Check out our latest Live Talks: https://beingpatient.com/live-talks/

Send us a textIf you're a video production owner doing six figures but feeling stuck, it's because you're caught in the Technician Trap. You are selling "tasks," such as the lighting, the focus, and the edit, which puts you in a direct race to the bottom against a machine that doesn't sleep and doesn't charge.In this episode, Den reveals why AI is actually the best news for your pricing in a decade, provided you know how to pivot. We break down the Certainty Framework, which is the exact strategy used to help 178+ production companies move from the "Commodity Bucket" to the "Consultancy Bucket" and scale past the $250k glass ceiling.Here's what you'll discover:The Commodity Trap: Learn why your "human camera" mindset is currently your biggest liability.The Certainty Framework: Explore the three pillars, Diagnosis, Strategic Alignment, and Accountability, that justify $10,000 to $20,000 fees.Brand Safety: Understand why high-level CEOs are terrified of "AI slop" and why they view your high fee as an insurance policy.The AI Objection Script: Get the exact words to say when a prospect asks why they shouldn't just use Sora or Runway to save $15k.The 2026 Filter: Discover why the next 12 months will replace technicians but allow strategic partners to scale. Stop being the "video guy" and start being the CEO of a strategic consultancy. Ready to scale? Take the free Video Business Scale Quiz at denlennie.com. Mentoring options : www.denlennie.com Connect with Den on Instagram: https://www.instagram.com/den_lennie

Platelet-Rich Plasma (PRP) is everywhere—but why does it help some patients and completely fail for others?In this episode, Dr. Greg Jones sits down with Dr. Joe Albano, a nationally recognized expert in regenerative orthopedics, to break down why not all PRP is created equal. They explore the real reasons PRP fails, including missed diagnoses, incorrect platelet dosing, poor patient preparation, and inadequate after-care protocols.Dr. Albano explains the true order of regenerative treatments, from PRP to bone marrow–based therapies, and why age alone should never disqualify someone from regenerative care. The conversation also dives into overlooked but critical factors like hormone balance, peptides, nutrition, sleep, body weight, and why common interventions—such as steroid injections and statins—can quietly sabotage joint and tendon healing.This is a direct, science-based discussion for patients considering PRP, stem cell therapies, or regenerative injections—and for anyone who wants to avoid costly mistakes and understand what actually helps the body heal.

Welcome to another episode of the Sustainable Clinical Medicine Podcast! In this episode, Sarah invites Dr. Elizabeth Beg Hall, an expert in adult ADHD and psychiatrist, to discuss executive function challenges faced by physicians, particularly those with ADHD. Dr. Hall shares her professional journey from family medicine to psychiatry, highlighting the importance of psychoeducation and executive function skills development. They explore common struggles such as time management, charting, and the impact of life transitions like menopause and parenthood. Dr. Hall offers practical advice on enhancing productivity, using tools like time tracking and setting realistic goals. She also emphasizes the importance of self-awareness, kindness, and understanding one's strengths to manage executive function effectively. Tune in to gain valuable insights into managing ADHD and improving executive function skills in the demanding field of medicine. Here are 3 key takeaways from this episode: ADHD in High-Achieving Physicians is Real—and Often Missed: Intelligence, creativity, and strong relationships help many physicians compensate for ADHD symptoms through medical school. Diagnosis often comes later when scaffolding disappears—starting practice, having children, menopause, or taking on leadership roles. The myth that "you can't have ADHD if you're a doctor" keeps many from getting help. Executive Function Skills Matter for Everyone, Not Just ADHD: Supporting your executive function—through proper sleep, regular meals, movement, and brief breathing breaks—benefits all physicians. These aren't just "ADHD strategies"; they're fundamental tools for managing cognitive fatigue and the overwhelming administrative burden of modern medicine. Start Small: Track, Reflect, and Be Kind to Yourself Instead of trying to fix everything at once, try tracking your time for just one hour or one morning. Then reflect: What were your expectations? Were they realistic? This awareness helps you adjust without shame. Multiply your time estimates by three, control your environment (headphones, closed doors, no wifi), and remember—you're not going to do groceries in a 20-minute break. Meet Dr. Elisabeth Baerg Hall: Elisabeth Baerg Hall MD, CCFP, FRCPC As a respected speaker, educator, and therapist specializing in adult ADHD, Dr. Baerg Hall is known for her leadership in building capacity to care for and improve services for adults with ADHD. She is passionate about advancing physician wellness, particularly in supporting medical professionals who have ADHD, through her targeted physician program, Build a Better Core and other Executive Function Workshops. She directs the ADHD Centre for Education and Training. She led development of ADHD Skills Builder, an online modular ADHD psychoeducational program funded by the James Family Foundation. Connect with Dr. Elisabeth Baerg Hall:

What happens when you finally get the diagnosis that explains your whole life… and what doesn't it change at all?In this powerful episode of ListenABLE, Angus sits down with disability advocate and podcaster Kelly Berger, who shares her journey living with an ultra-rare form of congenital muscular dystrophy, Collagen 6. After years of misdiagnosis, Kelly received her genetic confirmation as an adult, a moment that brought clarity, community and a new sense of direction, without changing who she fundamentally is.Kelly speaks candidly about the emotional weight of diagnosis, navigating healthcare systems, building community, and what real accessibility actually looks like in daily life. From the realities of infrastructure in the US to the gaps between performative inclusion and genuine integration, this conversation goes well beyond awareness and into what meaningful change requires.We also dive into Kelly's podcast 'Wheel Talk', her advocacy work, and how she's helping reshape how disability, rare disease and identity are spoken about in public spaces.This is a conversation about resilience, identity, leadership and how visibility changes everything.Living with Collagen 6 congenital muscular dystrophyThe emotional impact of finally receiving a genetic diagnosisRare disease advocacy and disability representationAccessibility in infrastructure and public spacesNavigating healthcare systems and misdiagnosisDisability identity and prideBuilding community with and without disabilityLanguage, inclusion and allyshipPerformative vs meaningful disability representationCreating podcasts within the disability communityWhy visibility mattersKelly Berger is a disability advocate, podcaster and rare disease community leader living with Collagen 6 congenital muscular dystrophy. She is the co-host of Wheel Talk, a podcast exploring disability, identity and lived experience through honest, accessible conversations. Kelly works actively in advocacy, accessibility awareness and rare disease representation.ListenABLE is a podcast created to amplify disability voices, challenge stereotypes and explore what inclusion actually looks like in practice. Hosted by Angus O'Loughlin alongside Dylan Alcott, the show brings real stories, lived experience and meaningful conversations into the mainstream.Podcast: Wheel Talk with Kelly and Averyhttps://www.instagram.com/thewheeltalkpodcast/

Love the episode? Send us a text!What does it really mean to be diagnosed with DCIS (ductal carcinoma in situ)—often called “stage zero” breast cancer?In this in-depth episode of Breast Cancer Conversations, host Laura Carfang is joined by a breast surgical oncologist, a radiation oncologist, and a patient advocate to unpack why DCIS can be both reassuring and deeply complex. While survival rates are excellent, treatment decisions often involve difficult trade-offs between reducing recurrence risk and preserving long-term quality of life.The panel explores how advances in tumor biology, radiation techniques, and genomic testing—particularly the DecisionRT test—are helping clinicians and patients personalize care. Together, they discuss when radiation may meaningfully reduce recurrence risk, when it may be safely avoided, and how shared decision-making empowers patients to choose treatment paths based on information rather than fear.Guests:Dr. Erica Giblin, a breast surgical oncologist in Indianapolis and Director of Breast Surgical Oncology at Ascension, who brings a surgeon's perspective on balancing effective treatment with long-term survivorship.Dr. Fleure Gallant, a nationally recognized leader in breast radiation oncology and Radiation Medicine Lead for the Breast Disease Management Team at Northwell Health Cancer Institute, whose work focuses on delivering highly personalized, quality-of-life-centered care.And Dr. Leona Hamrick, Vice President of Global Medical Affairs at PreludeDx, a board-certified physician associate with decades of experience in internal medicine and oncology diagnostics—and an 11-year stage III breast cancer survivor who brings the patient voice into every scientific conversation.Topics Discussed:What DCIS is—and why it's considered non-invasive breast cancerWhy DCIS is classified as stage zero, regardless of sizeHow DCIS differs from invasive breast cancer and LCISWhy a DCIS diagnosis can still be emotionally traumaticStandard treatment approaches: lumpectomy, mastectomy, radiation, and hormone therapyWhen and why radiation therapy is recommended after DCISHow radiation schedules have evolved (5 days vs. 3–6 weeks)What DecisionRT measures and how it helps predict recurrence riskWhy tumor biology matters more than age aloneShared decision-making vs. fear-based decision-makingQuality-of-life considerations, especially for younger patientsWhy more options can sometimes feel more overwheUnderstanding Hypophosphatemia: Recognition, Diagnosis, and TreatmentEndocrine experts distinguish Hypophosphatemia from osteoporosis & osteomalaciaListen on: Apple Podcasts SpotifySupport the showLatest News: Become a Breast Cancer Conversations+ Member! Sign Up Now. Join our Mailing List - New content drops every Monday! Discover FREE programs, support groups, and resources! Enjoying our content? Please consider supporting our work.

In this episode of "PICU Doc On Call," Drs. Pradip Kamat and Rahul Damania discuss the acute management of a 14-year-old boy with severe rectal bleeding and hypertension, ultimately diagnosed with inflammatory bowel disease (IBD). They review the approach to pediatric lower GI bleeding, diagnostic workup, and imaging, emphasizing early recognition and resuscitation. They outline IBD management, including steroids, biologics such as infliximab, and nutritional support, while highlighting the importance of screening for infections before immunosuppression. The episode provides practical insights for PICU physicians on handling acute GI emergencies in children.Show Nighlights: Clinical case of a 14-year-old male with hypertension and rectal bleeding.Diagnosis of inflammatory bowel disease (IBD) following significant blood loss.Approach to pediatric rectal bleeding and its implications.Diagnostic workup including laboratory tests and imaging modalities.Management strategies for IBD in acute pediatric care.Importance of early recognition and resuscitation in cases of shock.Physiological principles related to blood loss and shock in children.Differential diagnoses for lower gastrointestinal bleeding in pediatrics.Initial evaluation and stabilization protocols for pediatric patients.Nutritional support and multidisciplinary care in managing IBD. References:Romano C, Oliva S, Martellossi S, et al. Pediatric gastrointestinal bleeding: Perspectives from the Italian Society of Pediatric Gastroenterology. World J Gastroenterol. 2017;23(8):1326-1337.Pai AK, Fox VL. Gastrointestinal bleeding and management. Pediatr Clin North Am. 2017;64(3):543-561.Padilla BE, Moses W. Lower gastrointestinal bleeding and intussusception. Surg Clin North Am. 2017;97(1):63-80.Kaur M, Dalal RL, Shaffer S, Schwartz DA, Rubin DT. Inpatient management of inflammatory bowel disease-related complications. Clin Gastroenterol Hepatol. 2020;18(11):2417-2428.Ashton JJ, Ennis S, Beattie RM. Early-onset paediatric inflammatory bowel disease. Lancet Child Adolesc Health. 2017;1(2):147-158.Bouhuys M, Lexmond WS, van Rheenen PF. Pediatric inflammatory bowel disease. Pediatrics. 2022;150(6):e2022059341.Rosen MJ, Dhawan A, Saeed SA. Inflammatory bowel disease in children and adolescents. JAMA Pediatr. 2015;169(11):1053-1060.Conrad MA, Rosh JR. Pediatric Inflammatory Bowel Disease. Pediatr Clin North Am. 2017 Jun;64(3):577-591.

1.26.25 | Pastor Heath Hardesty

Pastor Daniel kicks our first home edition of 2026 with the conclusion of his MORE diagnosis

The Tenpenny Files – Animals decline long before a crisis is named, yet early warning signs are often ignored. This piece reveals how predictable changes in behavior, movement, and vitality appear well before diagnosis. It challenges modern care systems that dismiss observation, normalize regression, and intervene too late, urging owners to recognize decline early and act with informed responsibility...

In this episode of the NeuroVeda podcast, we sit down with Sujatha Reddy, LPC, BC-TAM, BAMS, a deeply experienced mental health clinician and Ayurvedic practitioner whose work bridges ancient wisdom and modern therapeutic practice. Sujatha is a Licensed Professional Counselor in Colorado and Ohio, a Licensed Natural Medicine Facilitator in Colorado, a Board-Certified Traditional Ayurvedic Medicine practitioner, certified psychedelic-assisted psychotherapist, holosomatic breathwork therapist, and yoga therapist. With over 35 years of Ayurvedic practice in the U.S. and 25 years in the mental health field, she brings a rare depth of perspective to the conversation. She is the founder and executive director of Ayumind LLC and Heartland Wellness PLLC, and also owns a Humanly mental health franchise in Lakewood, Colorado.Together, we explore the Ayurvedic understanding of mental health as a metabolic and systemic process rather than a standalone diagnosis. Sujatha explains the concept of the koshas, the layers of self, and how disconnection across these layers contributes to anxiety, depression, and emotional dysregulation. She shares how the gunas shape our mental and emotional states, and how practices like breathwork, meditation, mantra, yoga therapy, and personalized Ayurvedic protocols can release stored trauma and restore balance. This episode offers a powerful look at truly integrative mental health care, blending Ayurveda, Western psychology, and psychedelic-assisted psychotherapy to address root causes rather than symptoms, while emphasizing the importance of resilience, community, and reconnection to self in healing.TakeawaysAyurveda views mental health as a metabolic disorder.The mind is interconnected with the body and spirit.Understanding the koshas helps in addressing mental health.Disconnection from self leads to anxiety and depression.Breathwork can release trauma stored in the body.The gunas influence our mental and emotional states.Personalized programs are essential for mental health.Holistic approaches integrate body, mind, and spirit.Ayurvedic practices can enhance resilience and well-being.Community and social engagement are vital for mental health.

In this episode of BioHackingVille, Rob Rene hosts Dr. Clinton Demaris from Well Within Chiropractic to discuss the intricate connections between emotional and physical health. The conversation highlights the role of stress, subconscious emotions, and trauma in chronic health issues. Dr. Deme explains the Neuro Emotional Technique (NET) and its effectiveness in treating psychological and physical ailments by addressing underlying emotional traumas. The episode also touches on various holistic health strategies, including nutritional supplements, chiropractic adjustments, and the importance of close personal relationships in overall health. The significance of dental health and its impact on systemic health is also discussed.00:00 Introduction and Disclaimer00:26 Welcome to Biohack01:22 Meet Dr. Clinton Deme03:05 Dr. Deme's Journey and Philosophy05:37 Understanding the Root Causes of Health Issues07:13 The Role of Emotional Stress in Health21:22 Exploring Muscle Testing25:36 Using Acupuncture for Diagnosis and Correction26:08 Understanding Conditioned Responses28:16 Identifying Root Causes of Emotional Triggers34:36 The Impact of Close Relationships on Health40:38 The Connection Between Dental Health and Overall Well-being47:25 The Importance of Addressing Emotional Health48:33 Conclusion and Final Though

In this episode, we review the clinical presentation, diagnosis, and treatment of uncomplicated urinary tract infections. Key Concepts Uncomplicated urinary tract infections (UTI) are defined as an infection localized to the bladder without any systemic signs or symptoms of infection in someone who is not immunocompromised, pregnant, catheterized, and has normal urologic anatomy. UTIs are most commonly seen in younger women. E. coli is by far the most common urinary pathogen. Symptoms alone drive most of the diagnosis of UTI; however, urinalysis and urine culture can be helpful in some circumstances. Nitrofurantoin (Macrobid) is recommended for men and women for first-line therapy in most patients. Fosfomycin, Bactrim, pivmecillinam, and certain B-lactams can be considered in certain circumstances. Women are usually treated for 3-5 days and men 5-7 days. Some evidence suggests inferior clinical outcomes for B-lactam; however, the amount of data in general is lacking for B-lactams. Recommended B-lactams (aside from pivmecillinam) include amoxicillin/clavulanate, cephalexin, cefadroxil, cefpodoxime, and cefdinir. References Nelson Z, Aslan AT, Beahm NP, et al. Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults: A WikiGuidelines Group Consensus Statement. JAMA Netw Open. 2024;7(11):e2444495. Published 2024 Nov 4. doi:10.1001/jamanetworkopen.2024.44495 Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103-e120. doi:10.1093/cid/ciq257 Kurotschka PK, Gágyor I, Ebell MH. Acute Uncomplicated UTIs in Adults: Rapid Evidence Review. Am Fam Physician. 2024;109(2):167-174. https://www.wikiguidelines.org/

What is up, Theology Nerds! This week I'm joined by my buddy Matthew Segall from the Footnotes to Plato Substack to announce something exciting: we're doing a joint reading group on Hartmut Rosa's new book Time and World. Rosa's a German sociologist who does big-picture thinking—like old school "let me tell you about modernity" stuff—and his work resonates deeply with process philosophy. His diagnosis? We're stuck in what he calls a frenetic standstill—exhausted, burnt out, running faster just to stay in place. I gave Matt my above-ground pool whirlpool metaphor: we're all running in circles, and if you stop, you get pulled under. Modernity promises us the good life through control—making everything available, accessible, attainable—but the cost is a mute world and the birth of monsters. Rosa's antidote isn't slowing down; it's resonance—a mode of relationship where we're genuinely touched, we respond, we're transformed, and we accept it's all gloriously uncontrollable. Process folks will eat this up: it's Whitehead's prehension, creativity, and divine persuasion in sociological clothing. The invitation? Stop. Listen. Let the world address you again. If you want to join us for the Zoom sessions this February, become a member of either Process This or Footnotes to Plato—preferably both. See you soon. You can WATCH the conversation on YouTube⁠⁠ ⁠⁠⁠Join us at Theology Beer Camp, October 8-10, in Kansas City! Dr. Segall is a transdisciplinary researcher and teacher who applies process philosophy to various natural and social sciences, including consciousness. He is also an Assistant Professor in the Philosophy, Cosmology, and Consciousness Program at the California Institute of Integral Studies in San Francisco, CA. Make sure you check out SubStack Footnotes to Plato, his YouTube channel, and his recent book. Previous Podcasts with Matt The Meaning Crisis in Process Processing the Political Cosmology, Consciousness, and Whitehead's God. Science, Religion, Eco-Philosophy, Etheric Imagination, Psychedelic Eucharist, Ecological Crisis and more…⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠ UPCOMING ONLINE LENT CLASS: Jesus in Galilee w/ John Dominic Crossan⁠ What can we actually know about Jesus of Nazareth? And, what difference does it make? ⁠This Lenten class ⁠begins where all of Dr. John Dominic Crossan's has work begins: with history. What was actually happening in Galilee in the 20s CE? What did Herod Antipas' transformation of the "Sea of Galilee" into the commercial "Sea of Tiberias" mean for peasant fishing communities? Why did Jesus emerge from John's baptism movement proclaiming God's Rule through parables—and what made that medium so perfectly suited to that message? Only by understanding what Jesus' parables meant then can we wrestle with what they might demand of us now. ⁠The class is donation-based, including 0, so join, get info, and join up here. This podcast is a ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Homebrewed Christianity ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠production. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠the Homebrewed Christianity⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Theology Nerd Throwdown⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, & ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠The Rise of Bonhoeffer⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ podcasts for more theological goodness for your earbuds. Join over 75,000 other people by joining our ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Substack - Process This!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Get instant access to over 50 classes at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.TheologyClass.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Follow the podcast, drop a review⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, send ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠feedback/questions⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or become a ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠member of the HBC Community⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠.⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

The doctor asked a simple question of Christin and her husband. "Are you sure you won't consider a reduction?" Hear the story of an expectant mother of twins who was told she should terminate the pregnancy of one of her children. How do you respond to a devastating prenatal diagnosis? And what happened to that baby who was given little chance at life? Don’t miss the story on Chris Fabry Live. Featured resource:Saving Nate: Choosing Life after a Devastating Prenatal Diagnosis by Christin Rosa January thank you gift:How Should Christians Think About Israel? by Michael Rydelnik Chris Fabry Live is listener-supported. To support the program, click here.Become a Back Fence Partner: https://moodyradio.org/donateto/chrisfabrylive/partnersSee omnystudio.com/listener for privacy information.

We all want quality leads in our pipeline. But these days, a lot of experts tell me they're having trouble getting leads. The thing is, I don't think that's actually their problem. All the visibility in the world won't help you if your real issue lies somewhere else. In this episode, I break down one of the biggest (and most expensive) mistakes I see smart, talented experts making: chasing more leads when the real issue is that their message, offer, or positioning just isn't clear enough to convert the people they're already talking to.Tune into this episode to hear:How lack of specificity about your audience, your process, and your pricing is actually losing you clientsWhy “what's your budget?” is one of the worst questions you can askHow fear budgets actually workAnd how a simple, clear lead product can flip the entire dynamic with clientsResources:Get on the Early Readers List of my new bookNo BS Clients LabNo BS Agencies MasteryThe Price to Freedom Calculator™No BS Agency Owners Free Facebook GroupStart reading the first chapter of my bookPiasilva.com

This is The Briefing, a daily analysis of news and events from a Christian worldview.Part I (00:14 – 15:51)China's Demographic Catastrophe: The Fall Off of China's BirthrateChina's Birthrate Plunges to Lowest Level Since 1949 by The New York Times (Alexandra Stevenson)China's Birthrate Sinks to Record Low by The Wall Street Journal (Hannah Miao)China’s birth rate fell to a record low last year despite attempts to boost it by NPR (Anthony Kuhn)Part II (15:51 – 19:28)China's Attacks on Condoms: The CCP is Attempting to Increase the Birthrate by Totalitarian CoercionPart III (19:28 – 21:32)Secularism and the Decline of the Birthrate: When Belief in God Goes Away, So Do the BabiesPart IV (21:32 – 26:45)Will the DSM Add Postpartum Depression as a Diagnosis? There are Big Issues (and Money) Behind This ConsiderationWill ‘Psychiatry's Bible' Add a Postpartum Psychosis Diagnosis? by The New York Times (Ellen Barry and Pam Belluck)Sign up to receive The Briefing in your inbox every weekday morning.Follow Dr. Mohler:X | Instagram | Facebook | YouTubeFor more information on The Southern Baptist Theological Seminary, go to sbts.edu.For more information on Boyce College, just go to BoyceCollege.com.To write Dr. Mohler or submit a question for The Mailbox, go here.

The doctor asked a simple question of Christin and her husband. "Are you sure you won't consider a reduction?" Hear the story of an expectant mother of twins who was told she should terminate the pregnancy of one of her children. How do you respond to a devastating prenatal diagnosis? And what happened to that baby who was given little chance at life? Don’t miss the story on Chris Fabry Live. Featured resource:Saving Nate: Choosing Life after a Devastating Prenatal Diagnosis by Christin Rosa January thank you gift:How Should Christians Think About Israel? by Michael Rydelnik Chris Fabry Live is listener-supported. To support the program, click here.Become a Back Fence Partner: https://moodyradio.org/donateto/chrisfabrylive/partnersSee omnystudio.com/listener for privacy information.

Sponsor: Learn more about Zenith Health's Pregnancy Evidence Navigator -Penny- tool and their Pregnancy Evidence Project at www.zenithhealth.io or in the app store The Birth Hour Links: Know Your Options Online Childbirth Course (code 100OFF for $100 OFF!) Beyond the First Latch Course (comes free with KYO course) Access archived episodes and a private Facebook group via Patreon! 

On this week's transformative episode of A Voice and Beyond, Marisa sits down with Renee Zukin, author, educator, writing coach, mental health advocate, and the courageous voice behind the book Every Day, I'm Brave, which is part memoir, part manifesto, and entirely a call for radical bravery.Renee's story blends personal struggle with psychological insight. She lived for decades with crippling anxiety, masking her internal chaos with achievement, productivity, and perfectionism, until she was diagnosed with obsessive-compulsive disorder (OCD) in adulthood.In this deeply compassionate and raw conversation, Renee opens up about:Growing up with undiagnosed OCD and high-functioning anxietyThe cost of pretending to be okay — and what happens when we stopHow procrastination and self-sabotage are often fear in disguiseHealing after a late-in-life diagnosisHow to take courageous action even when fear doesn't disappearWhy honesty is the most powerful mental health tool we haveWhy “trust your gut” is dangerous advice for anxious mindsThe hidden ways fear shapes our relationships, identity, and choicesIf you've ever lived with anxiety, masked your needs, or felt afraid to take up space, this episode will touch your heart, speak to your story, and remind you that you are not alone.Book:Every Day, I'm Brave: https://www.reneezukin.com/brave-bookFind Renee Here:Website: www.everydayimbrave.comWebsite: www.reneezukin.comEmail: info@reneezukin.comLinkedIn: https://www.linkedin.com/in/rzukin/Instagram: https://www.instagram.com/reneezukin/Facebook: https://www.facebook.com/zukin1Facebook: https://www.facebook.com/groups/everydayimbraveFacebook: https://www.facebook.com/ZPSCoachingTikTok: https://www.tiktok.cFind Marisa online: Website: https://drmarisaleenaismith.com/ LinkedIn: https://www.linkedin.com/in/drmarisaleenaismith/ Instagram: https://www.instagram.com/drmarisaleenaismith/ Facebook: https://www.facebook.com/marisa.lee.12 YouTube: https://www.youtube.com/@avoiceandbeyond3519/videos Resources: MLN Coaching Program: https://drmarisaleenaismith.com/mentoring/ Schedule a Free Clarity Call: https://calendly.com/info-56015/discovery Gratitude Journal: https://drmarisaleenaismith.com/product/in-gratitude-my-daily-self-journal/ Download your eBook: Thriving in a Creative Industry: https://drmarisaleenaismith.com/product/ebook-thriving-in-a-creative-industry-dr-marisa-lee-naismith/ Like this episode? Please leave a review here - even ...

It regulates 20 percent of the U.S. economy, and its commissioner has an aggressive agenda — faster drug approvals, healthier food, cures for diabetes and cancer. How much can he deliver? (Part two of “The Freakonomics Radio Guide to Getting Better.”) SOURCES:Marty Makary, commissioner of the Food and Drug Administration. RESOURCES:"Clinical Trials Affected by Research Grant Terminations at the National Institutes of Health," by Vishal Patel, Michael Liu, and Anupam Jena (JAMA Internal Medicine, 2025)."What the evidence tells us about Tylenol, leucovorin, and autism," by Matthew Herper (STAT, 2025)."I Run the F.D.A. Pharma Ads Are Hurting Americans." by Marty Makary (New York Times, 2025).Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health, by Marty Makary (2024). EXTRAS:"Are You Really Allergic to Penicillin?" by Freakonomics Radio (2025)."How to Fix the Hot Mess of U.S. Healthcare," by Freakonomics Radio (2021)."Bad Medicine, Part 3: Death by Diagnosis," by Freakonomics Radio (2016). Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.