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Space Nuts Episode 516: Angular Momentum, Cosmic Inflation, and the Infinite UniverseIn this thought-provoking episode of Space Nuts, host Heidi Campo steps in for Andrew Dunkley, joined by the ever-knowledgeable Professor Fred Watson. Together, they tackle an array of fascinating listener questions that delve into the complexities of angular momentum, the nature of cosmic inflation, and the mysteries surrounding the universe's finiteness or infiniteness.Episode Highlights:- Angular Momentum Explained:Heidi and Fred kick off the episode by addressing a question from Buddy about angular momentum. They discuss how angular momentum affects spinning objects, the implications of expansion, and the intriguing concept of a potentially spinning universe.- Time Dilation and Cosmic Inflation: Scott from Sydney poses a compelling question regarding time dilation during the universe's hyperinflation period. Fred elaborates on how time behaves under extreme gravitational conditions and the significance of inflation in explaining the universe's homogeneity.- Is the Universe Finite or Infinite?The episode features a delightful audio question from young Enrique and his father Philip, exploring whether the universe is finite or infinite. Fred explains the concept of cosmic horizons and the challenges faced in determining the universe's boundaries.- Temperature Control on the ISS: Kevin from Melbourne asks about the temperature inside the International Space Station (ISS) and how it varies with sunlight exposure. Heidi and Fred discuss the engineering marvels that maintain a livable environment for astronauts, including the challenges of thermal regulation in space.For more Space Nuts, including our continually updating newsfeed and to listen to all our episodes, visit our website.Follow us on social media at SpaceNutsPod on Facebook, X, YouTube Music Music, Tumblr, Instagram, and TikTok. We love engaging with our community, so be sure to drop us a message or comment on your favorite platform.If you'd like to help support Space Nuts and join our growing family of insiders for commercial-free episodes and more, visit spacenutspodcast.com/aboutStay curious, keep looking up, and join us next time for more stellar insights and cosmic wonders. Until then, clear skies and happy stargazing.(00:00) Welcome to Space Nuts with Heidi Campo and Fred Watson(01:20) Discussion on angular momentum and its effects(15:00) Exploring time dilation and cosmic inflation(25:30) Is the universe finite or infinite?(35:00) Temperature control aboard the ISSFor the commercial-free versions of Space Nuts, join us on Patreon, Supercast, Apple Podcasts, or become a supporter here: https://www.spreaker.com/podcast/space-nuts-astronomy-insights-cosmic-discoveries--2631155/support.
Part of the BJUI/BURST podcast series In this BJUI/BURST podcast, Saad Masood, who is an SHO in urology department in York Hospital, discusses the BJUI Compass paper " Efficacy of direct visual internal urethrotomy versus balloon dilation to treat recurrent urethral stricture following failed urethroplasty" BJUI Compass is the fully open access sister title to BJU International. You can read the paper discussed in this podcast here https://bjui-journals.onlinelibrary.wiley.com/doi/10.1002/bco2.458
In this episode I answer frequently asked eye health questions, tackling topics like why your eyes hurt after removing contacts, whether it's possible to reverse pupil dilation with Rizumvi, and how UV light therapy for seasonal depression affects eye safety. Takeaways: Why Contact Lenses Should Never Hurt: If your eyes hurt after removing contacts, it's a sign of severe dryness, poor oxygen flow, or corneal irritation. Overwearing contacts can worsen long-term eye health, so taking breaks is essential. Reversing Eye Dilation with Rizumvi: A listener introduced Dr. Flanary to Rizumvi, an FDA-approved medication for reversing dilation. He explains why it's expensive, slow to act, and not widely used, meaning most people still have to wait it out. UV Light Therapy and Eye Safety: Seasonal affective disorder (SAD) lamps can help mood regulation, but they must have UV filters to prevent potential eye damage. Without proper filtering, they can increase the risk of photokeratitis (sunburn of the eye). Cataract Surgery and Timing: Not everyone needs cataract surgery at 60—it depends on how much the cataracts affect vision. Dr. Flanary explains how eye doctors determine when surgery is actually necessary. Watching Live Eye Surgery: A listener shared their experience of watching a live cataract surgery through a viewing window in a clinic. Dr. Flanary discusses why some clinics allow this and why most patients prefer NOT to see their own surgery up close. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact. For more information go to Anatomy Warehouse DOT com. Link: Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 Today's episode is brought to you by DAX Copilot from Microsoft. DAX Copilot is your AI assistant for automating clinical documentation and workflows helping you be more efficient and reduce the administrative burdens that cause us to feel overwhelmed and burnt out. A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit http://www.EyelidCheck.com for more information. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices
"They would feel the need to wait for higher blood pressure, wait for a higher fever - really got to justify this one - bleed a little bit more."On the evening of 18 August 2022, Amber Thurman was rushed to the Piedmont Henry Hospital in Stockbridge, Georgia. The 28-year-old single mother had been experiencing cramping and bleeding for days, and was beginning to vomit blood. After losing consciousness, her boyfriend had called 9-1-1 and requested an ambulance.After arriving at the hospital that evening, doctors would diagnose Amber with an infection that was quickly evolving into sepsis. They'd learn that Amber had recently undergone a medication abortion and needed a life-saving procedure known as a dilation and curettage (D&C). However, because of the recent repeal of Roe v. Wade, as well as Georgia's pre-existing abortion ban, doctors hesitated to perform the D&C. Meanwhile, Amber's condition worsened...Research, writing, hosting, and production by Micheal WhelanLearn more about this podcast at http://unresolved.meIf you would like to support this podcast, consider heading to https://www.patreon.com/unresolvedpod to become a Patron or ProducerBecome a supporter of this podcast: https://www.spreaker.com/podcast/unresolved--3266604/support.
BOO! I'm back just in time for Halloween and brought many treats. This is a Halloween music-focused episode from haunted independent musicians you may haven't heard of. So if you are decorating for that Halloween party or just driving to work and need that special dose of the season, I have you covered! Plus full coverage on two special haunts, Halloween Horror Nights 33 & Sir Henry's Haunted Trail. All this, pumpkin beer reviews, horror films, and comic recommendations. It's all here this October! Join me, won't you? MUSIC: -Pumpkin Man by Tim Heidecker -Love In Vein - Scary Lee Lewis by The Gastronomicon -Every Night Is Halloween - Alternates & Demos by Sam Haynes -Crypt Tide & Queen of Blood by Night Chill -Night Crawler - Delightfully Grim by Halloween at High Noon -Ride Of The Hallowmen - The Swindlemancers by The Gastronomicon -Dilation by Satan's Pilgrims Special thanks to Universal Orlando and Sir Henry's Haunted Trail for inviting me out! Back some great Halloween and horror comics! -Curse of the 31st -PUMPKIN #4 -Kolchak Meets the Classic Monsters Shoutouts: @thejulmarie , @dollihaze, @producewithjess, @abyssmalentertainment, @super.bonnie, @hypobifty, & @sassysledgehammer --- Support this podcast: https://podcasters.spotify.com/pod/show/hallowseve365/support
Interview with Alexander T. Hillel, MD, author of Oral Everolimus Following Dilation in Idiopathic Subglottic Stenosis: A Phase 1 Nonrandomized Clinical Trial. Hosted by Paul C. Bryson, MD, MBA. Related Content: Oral Everolimus Following Dilation in Idiopathic Subglottic Stenosis
Interview with Alexander T. Hillel, MD, author of Oral Everolimus Following Dilation in Idiopathic Subglottic Stenosis: A Phase 1 Nonrandomized Clinical Trial. Hosted by Paul C. Bryson, MD, MBA. Related Content: Oral Everolimus Following Dilation in Idiopathic Subglottic Stenosis
Welcome to another episode of the Entering Motherhood podcast hosted by Sarah Marie Bilger. In this episode, we dive into the fascinating and crucial aspects of labor: cervical dilation and effacement. Learn about the process, understand what to expect, and discover tips to help your body progress naturally. Sarah explains the significance of dilation and effacement, how they are measured, and the factors that can influence their progress. Whether you're a first-time mom or have given birth before, this episode provides valuable insights to help you feel more prepared and confident as you approach labor. Join us to learn about the natural progression of labor, the importance of trusting your body, and the various interventions that might be suggested if labor stalls. This episode is packed with information to empower you on your unique motherhood journey. Tune in and let's navigate this together! Click here to see full show notes.
Dr. Valentin Fuster evaluates a deep learning model designed to predict left and right ventricular dysfunction and dilation in congenital heart disease patients using ECG and CMR data. The research demonstrated that AI ECG can reliably identify significant cardiovascular issues, though future work should focus on refining thresholds and validating the model across diverse populations and healthcare settings.
This episode is brought to you with the support of Incogni...secure your information online with the help of Incogni. To check out our special deal visit www.incogni.com/spacenuts.Space Nuts Q&A: Gravitons, Dark Matter Twins, and Time Dilation MysteriesJoin Andrew Dunkley and Professor Fred Watson in this engaging Q&A episode of Space Nuts, where they tackle listener questions about some of the most intriguing concepts in the universe.Episode Highlights:- Gravitons and Gravity: Gus from Issaquah, Washington, poses a thought-provoking question about the relationship between energy, mass, and gravity. Fred delves into the hypothetical particles known as gravitons and discusses their potential mass and the implications for our understanding of the universe.- Dark Matter Twin: Rich from the UK suggests an intriguing idea: could our sun have a dark matter twin? Fred explores the plausibility of this concept and how it relates to the mysterious Planet Nine and the nature of dark matter.- Time Dilation and the Early Universe: Sean from British Columbia wonders if time dilation could explain the unexpectedly large and well-formed galaxies observed by the James Webb Space Telescope. Fred explains the role of time dilation in cosmology and why it might not be the answer to this particular puzzle.- Dead Stars: Jane asks how many stars in the observable universe are already dead. Fred discusses the lifespans of various types of stars and the vast number of stars that have already met their end.- Absolute High Temperature: Anthony from Kilkenny, Ireland, inquires about the concept of an absolute high temperature. Fred clarifies why there isn't an absolute maximum temperature, contrasting it with the well-defined absolute zero.Don't forget to send us your questions via our website... spacenuts.ioSupport Space Nuts and join us on this interstellar journey by visiting our website support page. Your contributions help us continue our mission to explore the wonders of the universe. Clear skies and boundless exploration await on Space Nuts, where we make the cosmos your backyard.Visit our websites:www.spacenuts.iowww.bitesz.com
Today we are excited to share Emma's beautiful birth stories, her first baby boy, Eric, born via caesarean after an induction, and her second baby girl, Chloe, born via a repeat caesarean after reaching full dilation during a spontaneous labour. Her first pregnancy resulted in a pre-eclampsia diagnosis which led to an induction. Emma beautifully describes this birth journey of labouring with a posterior baby with a deflexed head, her experience of having an epidural and then eventual decision to have a caesarean section at 7cm dilation. While Emma's caesarean section was done via general anaesthetic due to the spinal anaesthetic not working, she describes having a very positive experience of meeting her baby. She describes an initially difficult postpartum experience followed by months of positive breastfeeding with her son before falling pregnant with her next baby. Emma's next baby, Chloe, was conceived just 7 months after her son, Eric's, caesarean. Emma describes the discussions she had with the OBs, her decision to plan a VBAC for the easier, more positive recovery it would bring and this subsequent labour, birth and postpartum experience. Emma was an incredible advocate of the birth she wanted, including planning out what a future caesarean might look like so as to avoid the difficulties with epidural/spinal anaesthetic and having these difficult conversations before labour. She shares her labour with another posterior baby (but this time, no deflexed head!), what it was like receiving sterile water injections and also talks about getting to full dilation and pushing only to be told her pelvis was incorrectly shaped and not allowing her baby to descend. Emma describes her second caesarean, again via general anaesthetic, and the way that her empowered decisions during pregnancy and birth led to a much more positive recovery and easier breastfeeding journey too. The reflections shared in this episode are rich and vulnerable, and we believe will be so helpful for women processing their own experiences and journeys through a repeat caesarean after a planned VBAC. We hope you love listening to this episode and learning from Emma's journey as much as we have enjoyed sharing it with you. Please join us on our journey to bringing you all kinds of VBAC stories from across the country from here on in by subscribing and following us on social media, @australianvbacstories on Instagram and Australian VBAC Stories on Facebook. If you enjoyed this episode, we'd love to rate or review, and tell your friends! If you are feeling that you might benefit from mental health support after listening to our podcast, please reach out to one of the organisations below: PANDA https://panda.org.au/ Gidget Foundation https://www.gidgetfoundation.org.au/ COPE Australia https://www.cope.org.au/ If you've experienced mistreatment or disrespectful care in your pregnancy, birth or postpartum and are seeking advocacy support, please contact one of the following organisations: Maternity Choices Australia https://www.maternitychoices.org/ Maternity Consumer Network https://www.maternityconsumernetwork.org.au/ Thank you for tuning in to our podcast.
Get ahead with VETAHEAD and join Dr. Proença on 15 minutes of ZooMed (exotic animal medicine) content. Today, let's dive into the groundbreaking findings on radiological and laboratory prognostic parameters for gastric dilation in rabbits. This study is a must-hear for veterinary professionals, presenting vital insights and practical tools to evaluate gastric distention in rabbit radiography. Discover how to utilize the Vertebral Stomach Score and other key measurements to diagnose gastric dilation using radi9ography. Tune in to learn about the latest advancements and how they can revolutionize your approach to ZooMed (exotic animal medicine) Do you want to access more ZooMed (exotics) knowledge directly from specialists? Come with us and #jointhemovement #nospeciesleftbehind Head to VETAHEAD Website Join our VETAHEAD Community Follow @the_vetahead on Instagram Subscribe to @vetahead channel on YouTube Follow @vetahead on Facebook
Michael Rowe, CEO and Director Eyenovia joins me to talk about Mydcombi , the latest innovation in dilation as well as benefits of Optejet technology. Watch me as I demonstrate!
Today I am here to empower your sexual wellness journey. We are discussing a game-changer in the bedroom: lubricants. We'll explore the transformative impact lubes can have, not just for enhancing pleasure but also for those struggling with conditions like vaginismus or sexual pain. I'll guide you through choosing the right lube for different needs, such as using dilators or simply spicing things up. Remember, everything shared is for educational purposes to help you make informed decisions about your body. Let's get you comfortable and confident in your intimate experiences, without the medical jargon. Tune in as we get slippery with science!To work with a VRD pelvic floor physical therapist 1 on 1 to help you overcome vaginismus, sexual pain, and pelvic floor dysfunction then click here to schedule a free consult with me: https://calendly.com/d/cn6f-4vw-353/1-on-1-complimentary-vaginal-fitness-screening-session Or email me with any questions you have about our coaching program: janelle@vaginarehabdoctor.com Follow me on social media @vaginarehabdoctor Join my private email club: https://www.vaginarehabdoctor.com/join-my-private-pelvic-floor-email-club/ Produced by Light On Creative Productions
If you want to serve the head and neck cancer population or HOPE to one day…you do NOT want to miss this episode! Jennifer Larssen, an SLP at the University of South Florida, shares her experiences in developing innovative programs for head and neck surgery patients. She shares innovative programs and tools like… ✅A groundbreaking laryngeal speaking device for those who struggle with the traditional electrolarynx. ✅A self-dilation program for patients with laryngectomy and/or radiation to the neck. ✅A TEP clinic. ✅Support groups - include one for women who have undergone a laryngectomy. ✅Social events (like a trip to Busch Gardens and makeup lessons post-surgery and/or radiation) Prepare to feel inspired! Download the show notes: https://syppodcast.com/330 TIMESTAMPS: Introduction (00:00:00) Program Development at USF (00:00:42) Tracheoesophageal Prostheses and TEP Clinics (00:02:51) Larynx Demo Days (00:03:09) Competencies in TEP Changes (00:04:28) Self-Dilation Program (00:06:13) Advocating to Administration (00:07:56) Head and Neck Cancer Community Group (00:09:26) Funding and Resources (00:12:21) Women's Retreat (00:13:06) Clinical Pathway and Rehabilitation (00:16:38) Feeding Tube Removal (00:19:32) Collaboration with Dietitian (00:20:11) Patient Observation (00:20:54) Transitional Care Program (00:21:44) Fluoro MS Suite (00:23:33) Becoming an X-Ray Tech (00:25:09) Supportive Team at USF (00:28:11) Human Element in Healthcare (00:30:43) The post 330 – Makeup Lessons, TEP Clinics, Self-Dilation Programs, and More: Innovative Services for the Head and Neck Cancer Population appeared first on Swallow Your Pride Podcast.
Michael Ambron is a painter and paint maker who works through wildly experimental and meditative approaches to making in order to hone in on a kind of overwhelming simultaneity of lived experience. From an investigation of and curiosity about one's own perception, to the challenges and worries of living in uncertain and upsetting times, Ambron builds symbols, materials, and gestures into an expansive, floating, and timeless space. His paintings immerse the viewer in a loop of dreams, cartoon violence, lived experience, and world events, that create a vibrating sense of absurdity and urgency. Ambron received his BFA from Tyler School of Art and his MFA from The Ohio State University. He is currently based in Long Island City, NY where he is the owner and operator of Paint Makers Notes LLC, a small business that offers education, consulting, and paint making services to amateur and professional artists around the world. Boundaries, 2021, 63” x 66” x 2” - pigment, glass, stone chalk, acrylic, cellulose, marker, & pastel on canvas - photography for Ortega y Gasset Projects by Gidra Studios. Dilation, 2023, 50 x 52 x 3” - pigment, cork powder, glass, stone chalk, acrylic, cellulose, airbrush, marker, pastel and sand on canvas - photography for Ortega y Gasset Projects by Gidra Studios. No Time installation view Sell Your Dreams, 2024, 66 x 66 x 3" - pigment, marker, acrylic, cellulose, airbrush, & stone chalk on canvas (small painting: "Awake" 2024, acrylic, cellulose, pigment, marble sand, shellac & chalk on wood panel) - photography for Ortega y Gasset Projects by Gidra Studios.
All About the Innovative Treatment Options for Ear Infections Looking for chronic ear infection relief? Join us on We Nose Noses as Dr. Reddy, Dr. Smith, and Dr. Undavia guide you through this revolutionary procedure for treating eustachian tube dysfunction through the use of balloon dilation. We'll cover everything from how the eustachian tubes work to the latest in treatment options, so you can find the relief you deserve. What you'll learn: Learn about eustachian tubes and why they're crucial for keeping your ears healthy and infection-free. Understand the symptoms and causes of eustachian tube dysfunction, and why traditional treatments may fall short. How a balloon eustachian tube dilation can be a less invasive, more effective alternative for long-term relief. If you are in need of ear, nose or throat support, schedule a consultation today at our Marlton, New Jersey location by visiting NJENT.com or call 609-710-NOSE (6673). https://njent.com/balloon-eustachian-tube-dilation-overview/
In this episode, we break down the pros and cons of getting cervical exams. When they might be necessary and when they're not. How they can help, and how they could hinder!SummaryIn this episode, Ciarra and Samantha discuss the topic of cervical exams during pregnancy and labor. They explain what a cervical exam is and what providers are looking for during the exam. They discuss the reasons why providers offer cervical exams and the potential benefits and drawbacks of getting them. They emphasize that cervical exams are not a crystal ball and do not accurately predict when labor will start or progress. They also highlight the importance of informed consent and the right to decline cervical exams. The episode concludes with a reminder that the decision to have a cervical exam is ultimately up to the individual.TakeawaysCervical exams during pregnancy and labor are not a crystal ball and do not accurately predict when labor will start or progress.The decision to have a cervical exam is up to the individual, and informed consent is important.Cervical exams can provide information about the cervix's position, baby's position, and progress during labor.Cervical exams carry the risk of infection and accidental breaking of the water bag.Providers may offer cervical exams to gather information for potential inductions or to establish a baseline for labor progress.Chapters00:00 Introduction and Disclaimer00:32 Overview of the Podcast and Hosts01:04 Introduction to the Topic: Cervical Exams03:23 When and Why Providers Offer Cervical Exams06:36 The Potential Benefits and Drawbacks of Cervical Exams08:01 Personal Experiences and Emotional Impact of Cervical Exams09:55 The Controversial Nature of Cervical Exams10:53 Reasons to Decline Cervical Exams14:02 Considering the Benefits and Risks of Cervical Exams25:23 Informed Consent and the Right to Decline Cervical Exams29:30 The Complexity of Labor Progress and Generalizations33:45 Conclusion and Closing RemarksPlease feel free to reach out to us with any recommendations for show episode ideas. If you'd like to be a guest, email us with some information about yourself and what type of podcast you'd like to record together. Thank you for all of your support and don't forget to follow and review our podcast, Birth, Baby!Instagram: @BirthBabyPodcastEmail: BirthBabyPodcast@gmail.comWebsite: https://birthbabypodcast.transistor.fm/Intro and Outro music by Longing for Orpheus. You can find them on Spotify!
February 23, 2024Mark, Scott, and Ray discuss questions that came into the PRS Network: Regarding the most recent podcast episode on shard/split visits: Medicare's policy states that only one practitioner must have face-to-face time with the patient. In our practice the physician documents an addendum on the APP's note with the medical decision making portion of the visit. Per the episode, the physician must demonstrate involvement during the visit (not afterwards) in order to bill under the physician's NPI. Is there a guideline that states the physician must document their portion in real-time as the visit with the APP takes place? If they document the MDM portion of the visit in its entirety, isn't that enough to bill for the "substantive portion of MDM" as required by Medicare?For 52001, we commonly use this code for cysto and clot evacuation for gross hematuria under general anesthesia requiring rigid scope. Are physicians allowed to use this code for cystoscopy and irrigation of a clot with a syringe under local procedure or should they use 52000 + 57000?For 52281, does passage of the cystoscopy to dilate a narrowing in the urethra or meatus count? Or it is only meant to be used for cases where the meatus is cut or dilators or DVIU are used? Join the Documentation for Reimbursement Challenge - Starts 2/26/24Click Here for Information and to JoinPRS Billing and Other Services Click Here to Get More Information and Request a QuoteThe Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ Join the discussion:Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.Click Here to Start Your Free Trial of AUACodingToday.com
In this episode, host Dr. Ashley Agan discusses eustachian tube (ET) dilation with Dr. Dennis Poe, neurotologist and Professor of Otolaryngology at Harvard Medical School. First, the surgeons describe clinically meaningful differences between adult and pediatric ETs. Then, Dr. Poe reviews workup of pediatric ET disorders. Since inflammation accounts for most ET dysfunction, controlling comorbid allergies and/or performing adenoidectomy provides relief to some patients. For patients with continued symptoms, balloon dilation – now approved for children as young as eight years of age– directly counteracts obstructive inflammation in the tube lumen. To conclude, Dr. Poe describes how to select patients for, perform, and avoid complications of balloon dilation. --- CHECK OUT OUR SPONSOR Acclarent AERA Eustachian Tube Balloon Dilation System https://www.jnjmedtech.com/en-US/product/Acclarent-aera-eustachian-tube-balloon-dilation-system --- SHOW NOTES 00:00 - Introduction 04:03 - Understanding Eustachian Tube Anatomy 07:22 - Causes of Eustachian Tube Dysfunction in Children 12:53 - Examination and Diagnosis of Eustachian Tube Dysfunction 19:10 - Treatment Options for Eustachian Tube Dysfunction 27:05 - Avoiding Unpredictable Injury and Scarring During Balloon Dilation 31:51 - Contraindications and Precautions for Balloon Dilation 37:49 - Understanding Risks & Complications of Balloon Dilation 48:34 - Closing Remarks & Future Prospects --- RESOURCES Dr. Dennis Poe's Harvard Profile: https://oto.hms.harvard.edu/people/dennis-poe BackTable ENT Ep. 40 – “Diagnosis & Management of Eustachian Tube Disorders with Dr. Dennis Poe:” https://www.backtable.com/shows/ent/podcasts/40/diagnosis-management-of-eustachian-tube-disorders American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guideline: Otitis Media with Effusion (Update): https://www.entnet.org/quality-practice/quality-products/clinical-practice-guidelines/ome/ “Complications of Eustachian Tube Balloon Dilation: Manufacturer and User Facility Device Experience (MAUDE) Database Analysis and Literature Review,” Chisolm, P.F. et al: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10731503/
Description: Co-host Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and co-host Holly Knotowicz, a speech-language pathologist living with EoE, who serves on APFED's Health Sciences Advisory Council, speak with Dr. Amanda Muir, an Assistant Professor of Pediatrics at the Children's Hospital of Philadelphia. In this episode, Ryan and Holly interview Dr. Muir about tissue remodeling and eosinophilic esophagitis (EoE). Dr. Muir describes remodeling and stiffening, its effects, and how it relates to treatment and inflammation. Listen in for information on remodeling and a pediatric study Dr. Muir is planning. Disclaimer: The information provided in this podcast is designed to support, not replace the relationship that exists between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own. Key Takeaways: [:48] Co-host Ryan Piansky welcomes co-host Holly Knotowicz. Holly introduces Dr. Amanda Muir, an Assistant Professor of Pediatrics at the Children's Hospital of Philadelphia (CHOP). She has a translational lab that investigates esophageal remodeling in the setting of EoE. Holly thanks Dr. Muir for joining us today. [1:51] Dr. Muir became interested in eosinophilic disorders as a GI Fellow. There were so many patients with eosinophilic esophagitis and eosinophilic gastrointestinal diseases but there weren't many good therapies and little was known about the long-term results for children. [2:24] Dr. Muir's first eosinophilic interest was eosinophilic esophagitis. She joined a lab that was looking at how the esophagus changes over time in the setting of inflammation. After being in the lab, training, and learning all the skills and techniques, she was able to launch her career and lab. [2:46] Dr. Muir started her own EoE clinic at CHOP (Children's Hospital of Philadelphia) as part of their Center for Pediatric Eosinophilic Disorders. She sees patients at the clinic, then she can bring questions from the clinic to the lab and talk about them as a group. [3:28] Dr. Muir explains esophageal remodeling. There is remodeling that happens in the epithelial compartment of the esophagus. Then there's remodeling that happens underneath the surface in the lamina propria. For the most part, when people talk about remodeling in eosinophilic esophagitis, they refer to the remodeling happening below the surface. [3:50] There is a burgeoning field dedicated to studying the surface of the esophagus, and Dr. Muir is also very interested in that. For today's purposes, we are talking about the remodeling that happens under the surface. [4:03] Eosinophils that get to the esophagus secrete chemicals that excite the cells below the surface to secrete collagen. Collagen is the glue that holds the body together. They're secreting glue to help the esophagus hold together, and the esophagus gets stiffer and stiffer, over time. That is remodeling. It's the body trying to heal itself. [5:04] Are children and adults equally at risk for remodeling? Patients develop a stiffening of the esophagus more, later in life. It is thought that the more years you have this inflammation, the more stiff your esophagus gets. There are patients six to nine years old who already have signs of stiffening. [5:28] Dr. Calies Menard-Katcher from Colorado published a paper where she described all of the eosinophilic esophagitis patients at her institution who got dilated. Dilation is the process of a balloon stretching your esophagus open when it's too narrow. She had patients as young as six in her cohort that she described as having EoE strictures. [5:49] Remodeling happens with younger patients but we're not as good at finding it. [6:08] Any type of inflammation in the GI tract can lead to some stiffening. The typical gastrointestinal disease that we think of as remodeling is Crohn's Disease. An inflammatory process happens in the small bowel or colon that leads to narrowing and stiffness in the intestines. [6:28] Also GERD (reflux) can lead to stricture, over time. It is just much more rare to see a GERD-induced stricture as opposed to EoE. [7:13] We are not sure, but to some extent, we think of remodeling as not being reversible. Once there is a certain degree of stiffness, the esophagus does not seem to open up without these dilations. If you can control the inflammation, you can halt the stiffening. Maybe there is some degree of reversibility. [7:44] In the Phase 2 dupilumab trials, investigators found that patients on dupilumab were seen to gain two millimeters in diameter of the esophagus, compared to the patients on placebo. We may be able to prevent some remodeling if we catch it soon enough. More research is needed. [8:33] Dr. Muir tells of the work she is doing in her lab. They take biopsies from patients and grow collagen-secreting fibroblasts in a dish. The research is to find out what calms the fibroblasts down from actively secreting collagen. [9:22] It's tough to follow the symptoms of EoE when patients only have difficulty swallowing foods that are hard to swallow. If patients are not challenging their esophagus, they might not notice having daily trouble swallowing. It's hard to ask a young kid who is eating a lot of soft foods if they feel like anything's getting stuck. [10:06] Dr. Muir will ask teenage patients, “Do you ever want to eat chicken? Do you ever want to eat steak?” A lot of times they don't want to eat it, perhaps because it felt uncomfortable at some point in their life and they don't want to eat it, not based on taste but on repeated bad events. It's hard to tease out the symptoms, sometimes. [10:27] Dr. Muir says, based on our Functional Luminal Imaging Probe (FLIP) studies, patients who had feelings of food that felt stuck in the last 30 days did seem to have a more narrow caliber esophagus. There is not a 100% correlation between symptoms and remodeling, but there seems to be some correlation. [11:31] Ryan tells how patients have tendencies to get around their EoE symptoms, with a personal example of keeping food in his mouth and chewing it for a long time before swallowing. A scope would show he had bad inflammation of the esophagus. He had been diagnosed when young and was under treatment and on a restricted diet. [12:26] Biopsies don't always get a sample below the surface to check for fibrotic cells so it is hard to find remodeling with biopsies. There are some visual signs. Seeing rings or trachealization in the esophagus, or narrowing, can be signs that there is some remodeling under the surface. [13:38] For kids who have a lot of trouble swallowing, Dr. Muir performs an EndoFLIP test regularly. The test catches subtle narrowing that may not be visible to the endoscopist. Doing this test gives the doctor more information and a better sense of the patient's phenotype, such as inflammation, the esophagus being stretchy, or being stiff. [14:49] The EndoFLIP is a balloon with an imaging probe that includes a TV for the doctor to see how many millimeters the esophagus is in diameter as the balloon inflates along the whole body of the esophagus. It's not an imaging test that goes to radiology. It's a balloon that is blown up slowly with salt water and that gives this measurement. [15:18] The EndoFLIP is a helpful tool to help determine who may have some more stiffening or determine exactly what the diameter of the esophagus is before starting treatment. [15:33] One of the things that Dr. Menard-Katcher of Colorado, Dr. Ackerman of the University of Illinois, and Dr. Muir collaborated on was to look and see if they could find any markers in the esophagus that would relate to some of the things that are obtainable on biopsy or the esophageal string test. [15:57] What they found was that periostin — a protein made by the epithelium and by the fibroblasts, which is known to activate fibroblasts, and is very high in EoE — seemed to correlate with the EndoFLIP measurements. This makes Dr. Muir think that there might be some potential for biomarkers to detect remodeling. [16:16] The thing that everyone wants for this disease is to find a biomarker where we don't have to do a scope. As far as finding a non-invasive biomarker, we're not there, yet. There are some things going on at the tissue level that might clue us in on how distensible the esophagus is. [17:18] The thing Dr. Muir worries about the most with long-term inflammation is that the esophagus is going to get more narrow over time. That will make patients more susceptible to food impaction (although not all patients with food impaction have a stricture). [17:36] One worry is that the esophagus will get so narrow that an endoscope will not be able to pass a stricture. That will lead to more swallowing problems. That is what Dr. Muir hopes to be able to prevent as we get better at treating this. [18:09] Any of the treatments that stop the inflammation and help get you below that “magical” 15 eosinophil count that we all strive for, will help prevent remodeling. So, once you get everything calm, hopefully, the remodeling process will stop. However, with the stiffening, the fibroblasts get more excited and have a hard time turning off. [18:53] Simply turning off the inflammation will not turn off the fibroblasts. Many people within the GI space are looking at fibroblast-directed therapy, especially in Crohn's disease, there's a real need to prevent a lot of surgeries that are happening. Dr. Muir hopes to apply some of these to the esophagus, as well. [19:16] In the study by Dr. Menard-Katcher, Dr. Ackerman, and Dr. Muir, there were 80 patients. Some were on swallowed steroid treatment and others were on an elimination diet. There were not enough patients on each therapy to find a significant difference in remodeling between the therapies. Patients in remission had better distensibility. [19:44] Dr. Evan Dellon showed in a paper that patients who have sustained remission have fewer dilations, in the long term. While we don't have a way to reverse the fibrosis that's happened, we hope to prevent it from getting any worse. Dr. Muir's research goal is to find something to calm fibroblasts down and prevent fibrosis or even reverse it. [20:31] Dr. Muir explains that cells under the surface level are fibroblasts. When eosinophils and T cells come in and secrete antagonizing chemicals, the fibroblasts turn on and start secreting collagen. The fibroblasts also turn on when the epithelium is angry and inflamed. There is also evidence that surface cells can secrete collagen. [22:46] Dr. Muir says it's hard to know how far along in development some anti-fibrotic drugs are. We have many promising targets. Understanding how the remodeling happens is very important to be able eventually to treat this disease. Even though it seems like incremental progress, Dr. Muir believes research is moving the field forward. [24:16] Dr. Muir says her EoE patients at CHOP are generous with their blood and tissue. Getting consenting control patients for lab studies involves a lot of leaps of faith and trust that scientists will grow your cells ethically. Dr. Muir feels lucky she has a good research team that explains things in lay terms to control patients. [26:50] Dr. Muir's team has videotaped pediatric EoE patients and control patients' eating. The time EoE patients spent chewing and how long it took to swallow correlated to their esophageal distensibility measured by the EndoFLIP test. She believes that how we feed and the difficulty we have swallowing have to do with esophageal remodeling. [27:41] That's Dr. Muir's next area of study. It's being spearheaded by Dr. Kanak Kennedy, a fellow in Dr. Muir's lab, trying to figure out the relationship between pediatric feeding and remodeling. [28:08] As part of their research, they are videotaping as many kids eating as they can. This involves many control patients who don't have EoE. Another area of research is on the enzyme lysyl oxidase which organizes collagen into bundles and makes it stiff. She is looking into ways to decrease the organization of the collagen. [29:08] Ryan thanks Dr. Amanda Muir for coming on the podcast and giving a crash course on remodeling and EoE. [29:14] To learn more about eosinophilic esophagitis, visit apfed.org/eoe. To learn more about Dr. Muir's research, read her paper. [29:30] To find a specialist, visit apfed.org/specialists. To connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at apfed.org/connections. [29:47] Ryan and Holly thank Dr. Amanda Muir again for joining them. Holly thanks APFED's education partners, linked below, for supporting this episode. Mentioned in This Episode: Amanda Muir, MD. Children's Hospital of Philadelphia (CHOP) American Partnership for Eosinophilic Disorders (APFED) APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast Education Partners: This episode of APFED's podcast is brought to you thanks to the support of AstraZeneca, Bristol Myers Squibb, Sanofi, and Regeneron. Tweetables: “I was able to start my own EoE clinic at CHOP as part of their Center for Pediatric Eosinophilic Disorders. I see patients who have eosinophilic gastrointestinal diseases and then I can go back to the lab and bring those questions from my clinic to the lab.” — Dr. Amanda Muir “The thing that everyone wants for this disease is to find a biomarker where we don't have to do a scope.” — Dr. Amanda Muir “Any of the treatments that stop the inflammation and help get you below that ‘magical' 15 eosinophil count that we all strive for will help prevent remodeling. So, once you get everything calm, hopefully, the remodeling process will stop.” — Dr. Amanda Muir About Dr. Amanda Muir: Amanda B. Muir, MD, Attending Physician, Children's Hospital of Philadelphia, Research Institute. Dr. Muir investigates the mechanisms underlying esophageal fibrosis to improve therapeutic and diagnostic approaches.
I wondered if extreme time dilation was possible like in the movie Interstellar. So I talked to an astronomy educator to see how plausible it was. Join me as Athena Brensberger takes me on a deep dive into the science of fiction. At the end of the episode Astro Athens will rank the plausibility of time dilation portrayed in Interstellar on a 1-5 scale from pure fiction- science fact.#interstellar #timedialation #blackholesPlease support my new channel by subscribing, liking, sharing, and commenting if you want me to keep doing more episodes of your favorite sci-fi concepts with experts: https://www.youtube.com/@RealityCheck.PodcastComment and let me know what you think of this episode. Do you agree with Athena's score at the end? What would you have added to this conversation?SupportLet me know what episode you want to see in the future! You can also subscribe to my Patreon to help me get better equipment and bring you higher-quality episodes in the future. https://www.patreon.com/RealityCheck631ConnectReality Check is hosted by Heidi Campo @Mrs.Heidi.CampoProduced by Huw Drury @biteszhqInstagram @RealityCheckTSOFYouTube @RealityCheckTSOFwww.heidicampo.comLinkedIn https://www.linkedin.com/in/campocscs/OtherAstro AthensInstagram @AstroAthensYouTube www.youtube.com/astroathens
I wondered if extreme time dilation was possible like in the movie Interstellar. So I talked to an astronomy educator to see how plausible it was. Join me as Athena Brensberger takes me on a deep dive into the science of fiction. At the end of the episode Astro Athens will rank the plausibility of time dilation portrayed in Interstellar on a 1-5 scale from pure fiction- science fact.#interstellar #timedialation #blackholesPlease support my new channel by subscribing, liking, sharing, and commenting if you want me to keep doing more episodes of your favorite sci-fi concepts with experts: https://www.youtube.com/@RealityCheck.PodcastComment and let me know what you think of this episode. Do you agree with Athena's score at the end? What would you have added to this conversation?SupportLet me know what episode you want to see in the future! You can also subscribe to my Patreon to help me get better equipment and bring you higher-quality episodes in the future. https://www.patreon.com/RealityCheck631ConnectReality Check is hosted by Heidi Campo @Mrs.Heidi.CampoProduced by Huw Drury @biteszhqInstagram @RealityCheckTSOFYouTube @RealityCheckTSOFwww.heidicampo.comLinkedIn https://www.linkedin.com/in/campocscs/OtherAstro AthensInstagram @AstroAthensYouTube www.youtube.com/astroathens
ad free & all episodes @ patreon.com/samhurd the epic podcast is: instagram.com/nathanmitchellphotography instagram.com/iamthesam show notes: 00:00 Introduction and Cultural Event 03:32 Distorted Sense of Time 07:22 Impact of Sense of Time on Relationships 13:30 The Value of Photographers in Weddings 19:27 Importance of Blogging and SEO 27:05 Taking Photos Twice 36:43 Balancing Technology and Creativity 44:45 The Challenges of Technology 50:03 Establishing a Creative Process 52:28 Prince's Approach to Music 52:57 Retirement of F-Mount Lenses 53:27 Transition to Z Mount 56:25 Impact of Megapixel Cameras on Older Lenses 57:49 Creation of the Z Mount 58:20 Using Nikon and Canon Cameras 59:16 Upcoming Shoots and Year in Review 01:01:08 Returning to Podcasting
Case Discussion 103 Answer: Ascending Aorta Dilation
Petra joins us today from Modesto, California sharing her unmedicated, hospital VBA3C story! Petra learned and grew from each of her three C-section births which paved the way for her to manifest the birth of her dreams with her fourth. Though she had very little support around her, Petra stayed steady. She continued to prepare her heart, mind, and body for the physiological birth she knew she could have. She tuned out the negativity. She trusted the path she knew she was supposed to take. Petra was thrilled to experience labor when the time came. She knew what to do. Her education and preparation paid off. She labored hard at home and went to the hospital when it felt right. Two hours later, Petra was crying tears of joy with a sweet baby on her chest. Petra is forever changed by her empowering birth experience and has now dedicated her heart's work to helping other women do the same. Additional LinksPetra's WebsiteThe VBAC Link Blog: VBAC After 3 C-sectionsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello. I hope you guys had a wonderful Thanksgiving. We are back with another story for you. Today we have a VBAC-after-multiple-Cesareans story. In fact, it is a VBAC after three which is a little bit harder to find information on and to find support for. We have our friend, Petra– look, I almost did it. Petra. I asked her before the episode. Pay-tra? Petra? I had a neighbor, so in my head, it just went, “Pay-tra”. Anyway, hello, hello. Welcome. Petra: Thank you. I'm so happy to be here. Meagan: Yes, so happy. You are from California. Is that correct? Petra: I am, yes. Meagan: Was your VBAC after three C-sections in California? Petra: Yes. Meagan: I feel like especially when we have VBAMC, we have so many people writing in saying, “Where did this person go and where are they located? Because if they are in my area, I need to find that provider or I need to research.” It sucks, but we don't get the support after multiple Cesareans more often than not. Of course, through your episode, feel free to share and name-blast anyone in a positive way of course. Send those names out to the audience because I'm sure that they will want to research your provider. Review of the WeekOkay, so as always, we have a quick review. This is by cve18 and it was actually written in 2020. It says, “Gave me courage. This podcast is everything I needed to switch to a supportive instead of a tolerant provider at 28 weeks pregnant. The education and information I have learned is immeasurable. I have been researching and discussing with my husband to get a doula and all of the things to help me get a successful VBAC in December. Thank you for all of the things and I know I will have done everything I could for my future VBAC.” Thank you so much for your review and as always, you guys, we are always loving your reviews. You can go to Google. You can go to Apple Podcasts. Wherever you can, drop us a review because it may be read on the next podcast. Petra's StoriesI just want to tell people a little bit more about you. Guys, she is a birth doula and if you haven't noticed on this podcast, we love doulas. She is a birth doula, a birth educator, an advocate for VBAC, and a birth coach who had the most transformative vaginal birth after three C-sections. She now works with women who are ready to strengthen their authenticity and help them not only become healthier mentally, but have the pregnancy, birth, and postpartum experience they've dreamt of without feeling the fear and or inhibit– Oh my gosh. How do I say the word? How do I say the word? Petra: Oh my gosh. I think I need to change that word. Meagan: Inhibitions. Petra: So they don't feel—Meagan: So they don't feel– Petra: Inhibited. Meagan: Inhibited. Yeah. I couldn't spit it out. Okay, and hold them back. Okay. We're back on track. Okay. She wants to help women reclaim the power that they already possess. That right there, I just love that. Women of Strength, I want you to know this. You have the power. You already possess it. This is why I love this so much. You are reclaiming the power that you already possess so we can help break the cycle. Right? Let's break the cycle that is no longer serving us. The cycles are no longer serving us. That introduction– I'm sorry. You wrote that. I just read what you wrote and apparently couldn't even read what you wrote, but that is so powerful. So thank you. Thank you for writing that. Petra: Yeah, of course. I just feel like these are all barriers that I had. Going through each one of my pregnancies up until my VBAC and now in my support of clients that I have, it's huge. It's a huge barrier. So if it's okay, I'm going to start placing you in my story. Meagan: Yes. Yes. Petra: Okay, so it all started. I was a teen mom. I had my daughter a month before I turned 17. I was 16. Obviously, it wasn't planned but it happened and it was the best thing that ever happened to me. Even though I had zero support from family and a lot of people, I went on to– let's just go straight to the labor. I was in labor for a couple of hours. I went to the hospital. I rushed there because that's what I see in the movies. Meagan: Right. That's what we're taught. Even today, that's what we're told by our providers. You have contractions. Your water breaks. You come in. Petra: Yes. Exactly, so that's what we did. I took a shower and rushed to the hospital. I got there. They stuck me on monitors and told me to stay in bed so that they could see the baby on the monitors and make sure baby is doing okay. I didn't know any better. I didn't educate myself. I was a teenager. I was so scared and I had no idea what to expect other than what I had seen in media, movies, and all of the stuff. I never really talked about what could happen with my mom or anything like that. I was just like, “I know what I'm doing.” I was that person. “I've got this. My body was made to do this. It will just know what to do.” Well, yes it does, but when you are in a hospital setting and they have certain policies or expectations for how your labor should go, it's different. So yeah. I was hooked up to the monitors. I was there maybe 6 or 8 hours. I didn't progress past a 4 for a couple of hours and they told me, “Okay, the baby's heart is dipping. We've got to get to an emergency Cesarean.” Meagan: Whoa. Petra: I was like, “Whoa, what?” I was just so taken aback. I didn't understand because it was like all of a sudden, everyone was rushing. I'm like, “What is happening?” She's like, “Your baby is in distress. We have to take you to an emergency Cesarean.” I was like, “Okay,” because she said, “You don't want your baby to die, right?” I was like, “Of course, not.” I mean, who wants their baby to die? Come on. That's horrible language to give to somebody. Meagan: Yeah. Those words matter. Petra: Yes. Yes. Oh yeah. I mean, look. My daughter is 18 now and that's ingrained in my brain forever. Anyway, I went back for the Cesarean and once we got in there, nothing was an emergency. Everything was slow. I was like, “Wasn't this an emergency? Aren't you guys in a hurry?” I could hear the doctors talking to each other as they were opening me up and everything. They were talking about, “Oh, now I'll get to make my dinner, my dinner plans.” Meagan: They were saying that out loud? Petra: Yes. Meagan: Oh, I don't like that. Petra: Yes. They were talking to each other. I was just like, “Am I really hearing this right now?” I was like, “Oh gosh.” So anyway, I was so drugged up. I was in this fog. They were like, “Here's your baby.” I didn't even know what was happening. They brought this baby to me wrapped up in a million blankets. All you could see was literally the little circle of her face. You couldn't see any other body part of her. I was like, “Oh, okay.” They were like, “Oh, kiss your baby,” and brought her to my face. I was strapped down to the bed. It was horrible. I was like, “This sucks. This is weird. What? This is birth? I don't like it.” But after I had my daughter, I was so obsessed with her once all of the drugs wore off. It was blissful in the sense that I just loved her completely. It was a hard postpartum recovery because you had a major abdominal surgery. I didn't plan for any postpartum support. I was just flying by the seat of my pants. We had a nonexistent breastfeeding journey because I didn't know what to do. I didn't know who to call to get help but we just made it through. You know, you just get through it. I want to fast forward to my next birth. My daughter was about 8 years– no. Yeah. 8 years later– 10 years later. Oh my gosh, my brain. 10 years later, I was with my then-husband– well, now husband and we got pregnant. Then at my 20-week ultrasound, my doctor was like, “You have placenta previa. You have to have a C-section.”I wanted to have a VBAC, but once she said that she was like, “It's a non-negotiable. You cannot.” Meagan: At 20 weeks though?Petra: Yes. Yes. She was like, “It's fully covering your cervix. There's nothing we can do. It's not going to move.” I was like, “Well, okay.” In my head, I'm like, “Well, you know best. You're the doctor.” I didn't do my research. I didn't realize that it could move and at the 20-week mark, that's not really a good gauge for your placenta staying that way. So anyway, I did end up having her at 36 weeks. It was a planned Cesarean. Meagan: 36? Petra: Yes, because I had a little bit of spotting. It was literally a couple of drops of blood and the doctor was like, “Oh no. We need to have the C-section right now. This is an emergency.” It was crazy. I just felt like everything was a whirlwind and everything was telling me, “I had to. I had to.” There was no other choice given to me and no other option. I just believed in the medical system so much because I have a lot of family that is in the medical system. Anyway, we did it and then for my third baby, so going on to my next daughter, this was four years later. She was a planned Cesarean because my doctor said, “We don't support VBAC. We have a VBAC ban at this hospital. We won't. We'll turn you away.” I was just like, “What?” I just was so confused at all of this language being thrown at me. So she was like, “This is the safest route for you. Your uterus could rupture. Your baby could die.” All of the language is horrible to tell a mom who– of course, you don't want your baby to die or anything bad to happen to them. Meagan: You've been told now twice about emergencies and that your baby could die. Petra: Yes. Meagan: Ugh, I don't like that. Petra: Right. You know, talking to my husband, he was like, “Well, if the doctor says it's the safest route, I guess.” So we did have a planned Cesarean at 39 weeks. But you know, with that pregnancy, I felt like I was ready to give birth at the end. I was like, “Oh my gosh. I feel so good. I feel like I could really have her. We had already scheduled the C-section and my husband was like, “Well, let's just do it. We know what to expect.” I was like, “I guess.” Everybody in my family was like, “I think that is safest for you. That's probably the best option.” Nobody really even has C-sections in my family. Everybody gave birth vaginally so they hear C-section and they're like, “Well, you can't,” because they heard the “once a C-section, always a C-section.” We just had her. It's rough. Every C-section I had, I felt so disconnected from my babies. The breastfeeding journey was hard or nonexistent and I just felt broken. I was like, “What is wrong with my body? Why can't I do this?” It felt so heartbreaking because you're a woman and your body is made to give birth so when doctors say, “No, your body can't,” you're like, “Wait, what?” You feel like you should trust them because they see birth so often. After that birth experience, we decided we wanted to have one more baby. I told my husband, “Absolutely not do I want to have another C-section.” I said, “I don't care what it takes. I'm going to prepare my mind and body and I'm doing this.” Because we also were going to have the babies two years apart, so I was like, “I don't want to be running after a toddler and having a major abdominal surgery.” Meagan: Right. Petra: Once I started diving into the VBAC world, I found your podcast and was binging it like crazy. Meagan: Oh. Petra: It was so helpful hearing all of the positive stories of women succeeding in their VBAC goal. I hate to even put it that way because of course, we all want to have that VBAC if we are planning for it, but if you don't have it, it's not that you fail so I hate even putting that language towards it. It's just nice hearing those stories where they did it. I listened to all of those stories and I tried to find providers. This was before I was even pregnant. I couldn't. First off, obviously, I started with my OB who delivered my other two babies. She was like, “Absolutely not. This is dangerous. You could die. Your baby could die. Your uterus can rupture.” All the words. All the words. I was just like, “Oh my gosh. Here we go again,” but this time, I was educating myself. I was going full force into what I wanted to accomplish and that was my VBAC. Once we did get pregnant, I started calling midwives and doctors in the area. I called my local ICAN group and I got in touch with the ICAN leader. She referred me to all of the providers in my area and outside of my area that supported VBAC after three C-sections. After that, I found nobody supportive in my area. But I knew–Meagan: But they were on the list or they were just in your area? Petra: Yeah. After talking to my husband and discussing our options, we decided that it was not in our best interest to have to drive 4-6 hours outside of where we live because we have three other children. Meagan: Right, the logistics. Petra: Yes, work and at the time, we had just moved. We moved into this home where our rent was now three times what we were used to. It was a little tight and before this, I didn't know about Be Her Village. I am all up in Be Her Village's world now. Meagan: Oh my gosh. I love Be Her Village. Petra: Me too. Meagan: I love Kaitlin and her crew. Oh my gosh. Petra: Yes. I tell all of my clients and everybody. I shout it from the mountaintops, “Check out Be Her Village. If you want support, go to them. Go to them. Go to them.” Anyway, I wish I would have known about them back then. We are there now. We decided that we were just going to do what we could with what we had. I switched providers. I think I was about 30 weeks by the time I was able to switch insurances because I had to switch insurances and I wanted to switch to Kaiser. In my area, it's Kaiser Modesto. I knew they were supportive of vaginal birth after two C-sections so I was like, “Oh, okay. That's only one less than I had and maybe it will be supportive.” I went forward with that. I went to my first doctor's appointment and I told the lady, “I'm having a VBAC,” and she was like, “Absolutely not. That is ridiculous.” I was like, “Well, I'm doing this. I understand your concern. I already know what you're going to say because I've heard it all before. I'm planning to do this, so this is what I'm doing.” She was like, “We need to schedule your C-section. I have to do it.” I was like, “I'm not going to show up. You can schedule it all you want, but I'm not going to go.” Meagan: You have to do it. Petra: Yes. Meagan: Have to. Petra: All of the have-to's. After that, I had another appointment with her and she said the same thing, “Let's schedule your C-section,” right when I walked it. I was just like, “No. I already told you last time that I'm not going to show up. You can schedule it but I'm not going to go in.” She said, “Well, now I have to refer you to the maternal-fetal medicine doctor.” I was like, “Why?” She was like, “Because you're high risk and you're planning to do a high-risk thing, so I have to give you to them.” I was like, “Okay, that's fine.”So I went after that. I met with him and he told me all of the same things. I said, “I totally understand. I respect your opinion, but I'm still going to do what I'm going to do and nobody's going to sway my mind. I'm planning this and it's going to happen.” He was like, “Okay. It seems like you have your mind made up. I told you the risks and that's all I can do.” I was like, “Okay.” Literally after that, I saw a different doctor at every single appointment, and at every single appointment I went to, they all told me the same thing even though I told them what I was doing. It was the same and everything. It felt defeating in a sense. Meagan: I'm thinking too if you continue to hear it time after time after time after time, I feel like some self-doubt can start creeping in and being like, “Well, okay. Everyone is saying I shouldn't do this. Should I be doing this? Is this the right choice? Am I being selfish?” All of those questions, right? Petra: Oh yeah. That's exactly what crept into my mind after every appointment. My husband was working at the time. He wasn't able to come to appointments with me which was fine. But I would call him after every appointment and I would cry. I would tell him, “Am I making the right decision? I feel in my heart I am, but it's hard when somebody keeps telling you no, no, no, no, no.” He was like, “If you feel like it's right, I support you and you're doing the right thing. Who gives a crap what they say?” He's like, “They're nobody.” I was just like, “I know.” Once I started working on my mindset, I really dove into mindset work and started working on it literally daily. Meagan: You have to almost though. Petra: Yes. I was preparing my mind to be okay with the decision that I was making because those doubts crept in and I had to really sit with myself and ask myself, “Okay. What is the worst thing that could happen? What is the best thing that could happen?” I had to really sit with each of those and decide which one I could live with. In my mind, I couldn't sit with living with the, “What if?” Meagan: The what if? Petra: What if I did do it? What if I did succeed but I'll never know because I didn't try? I had to sit with my husband and talk to him about the risks and everything and make sure that we were both on board. I feel like if you're going forward with this type of decision that most people are going to say is dumb, is scary, is irresponsible, then you have to make sure that you have a support system that supports you 100%. I felt very confident in my husband's support. He was like, “If you feel confident in this decision, I trust your judgment.” That to me, was everything because we are a team. We created this baby together. I want to make decisions about this baby together. Of course, ultimately, I'm going to do what I'm going to do and he knows that. When I set my mind to something, it's going to happen. So yeah, we made the decision collectively and at first, I told a couple of people what I was doing like family and friends and then a couple of them were like, “You should just have a C-section. You've already had three. Don't you have a zipper that they can just zip and unzip?” Meagan: Okay, why do people think that? My husband said the same thing. He said, “Why can't we just go unzip you?” I'm like, “I am not a pair of jeans!”Petra: Yes. Yes. It was– oh my gosh. Meagan: I get it. Petra: It was so crazy. I was just like, “This is my body. It's not just a toy or a backpack that you can unzip. It's a major surgery.” Meagan: Exactly. Yep. Petra: It's a major surgery that affects you not only physically, your physical body, but your mentality, your spirituality, and everything. Everything. I stopped telling people what I was doing. I only told a handful of people that I knew would support me 100% and then I stopped telling anybody because I did not want to continue to hear all of the negative language that was feeding into my brain. If it did come in, that negative talk or whatever, I just blocked it out. I said, “Nope. I don't want to hear it. I don't want to hear it.” I feel like that really helped. That really helped. Meagan: It's actually really healthy. It's okay to do that. I did something very similar where I was like, “I love you and you're my people every day, but right now, you're not my person.” That's okay. I might have to accept that. I still love them, but they're not my people when it comes to talking about birth and having the support that I need. Petra: Yeah. Yeah, definitely. Meagan: That included some of my family members and that was really hard. Oh yeah. I felt that too because I wanted to share this journey with them, but since I knew that they were not going to be supportive, I was like, “You know what? I'm just going to do it and then afterward, I'll go, ‘Hey, look at what I did!'”I literally visualized my birth. This was one thing that I felt was pivotal. I would sit in quiet and calm and I would literally visualize every single part of my birth from start to finish. The labor, the pushing, and bringing my baby earthside. I would envision what it would smell like, what it would look like, who would be around me, and what it would feel like. The emotions I would experience once my baby came out and I was holding him on my chest. It makes me emotional thinking about it. Meagan: It's okay. We were crying on last week's episode too. Petra: It was so transformational for me because it wasn't just the fact that I gave birth vaginally. It was the fact that I believed in myself. I advocated for myself. I stood up for myself for what I believed in and as a recovering people-pleaser– I am a self-proclaimed recovering people-pleaser. I don't like to go against the grain. I don't like people to be upset with me. I don't like them to not like me. That was really, really hard but you know what?Meagan: Because you were doing all of those things– going against the grain, not pleasing people, not doing what they said, and maybe even shutting people out. Petra: Yeah. Yeah. It was really hard. I'm a very open and honest person, so like you said, shutting people out was hard because I wanted to share this beautiful journey with them. Fast forward to when I hired a doula because I researched all of the things and on one of your blog posts, it says, “How You Can Be Successful in Having a VBAC” and one of the things was to hire a doula. Yes. Get that support team. Meagan: Absolutely. Petra: Build your support team. So that's what I did. I hired a doula and she had never supported anybody with any VBACs but she was totally on board. She was like, “I'm totally with you. Let's do this.” I felt really confident in my support system that I had on board. Let's fast forward to labor. I had prodromal labor and it lasted from Friday night until I went to my next 40-week appointment which was on that Monday. I had prodromal labor for a couple of days.Meagan: That's exhausting. Petra: It is exhausting. I tried really hard to just get through it. I didn't want any interventions. That was my plan. I wanted to just go unmedicated and make sure nothing was introduced that didn't need to be introduced. So I went to my doctor's appointment. She was like, “Oh, are you okay if I check you?” I was like, “I guess so.” She was like, “Well, you're 2 centimeters. I can do a membrane sweep.” I was so tired. I originally didn't want that, but I was like, “Go ahead and do it.” Looking back, I wouldn't do it again, but at the time, plans can change. Meagan: Right. Plans can change. Yes. Petra: Yeah. So anyway, after that, oh my gosh. It was on. I was in full-blown labor after that. It was incredible. I was so excited and looking forward to my labor. I couldn't wait. I couldn't wait to be in labor because I knew I was going to do this amazing thing. I was in labor and I was like, “Oh my gosh. I'm excited.” My husband was like, “You're so weird.” It was painful. I had back labor which I wasn't expecting. That was intense. I even felt it through my thighs which I wasn't expecting either. I literally needed hip squeezes through every single contraction. But it felt manageable. I felt like I could handle it. I felt powerful through it. Between every contraction, I was smiling. I was laughing. I was having great conversations with everybody around me. I labored at my home and my family ended up coming. My mom, my brother, my sister. My nephew was there and my kids were there. Obviously, my husband was there too and it was beautiful. It wasn't planned that way. The plan was to labor at home, but all of my family coming that way was not planned and it was perfect. They were helping me. They were doing hip squeezes on me. They were talking to me between contractions and it just felt so blissful. It felt right. It felt perfect. I labored like that. 9 AM started the active labor and then by about 5-6:00 PM, it was mentioned, “Hey, should we go to the hospital?” We never talked about it beforehand when I wanted to go, but people kept asking, “Do you want to go?” It was pretty intense. I hit transition and I knew that because I was shaking when I was sitting on the toilet. Dilation station. Meagan: It's a real station. It does exist. Petra: Mhmm. I agree. Yes. Yes. After that, we headed to the hospital. I think it was 6:00 PM and then everything becomes a blur. We got to the hospital and immediately went up. They were like, “You can't be in active labor.” I was talking and laughing. They were like, “Okay, can we check you?” I was like, “Okay.” I can't remember what they said. I was either 9 or 10 centimeters. They were like, “Oh my gosh. How are you this far along?” Meagan: and chatting. Petra: Yeah. It was perfect. I was in the zone. Everything felt perfect. They got me into a room and we started doing different positions to try to help my back labor. At one point, they offered to break my water because I guess I had a bulging bag. At first, I didn't want that, but of course, in the moment, I was like, “I don't care, if you need to.” I was trying to focus on the task at hand. They did end up breaking my water and after that, everything was insanely intense. The contractions were more intense. They felt closer together and by 9:00 PM, I was like, “I need to push or I need to do something.” I just felt like I couldn't get comfortable anymore. I was like, “I'm going to start pushing.” I started pushing and they brought everybody in quickly. I was like, “Oh my gosh. Everybody is rushing in.” Then I pushed five times they said, and he flew out.Meagan: Oh, so everyone was seeing something and they were like, “Oh, this baby is coming.” Petra: Yes. Yes. I remember that they did bring the mirror in. They brought the mirror in real quick so I could see. I guess they were thinking it might take a little bit longer and I needed encouragement but anyway, no. It was really fast. I pulled him up out of me and onto my chest. It was like I literally manifested that birth because that's literally how I dreamt about it happening, literally. Meagan: Baby coming out, just flying out. Petra: Yeah. Yeah. No, it was perfect. After that, you have that oxytocin dump and I felt like I was in a dream. I was just so happy. I cried. I laughed. I was thanking God. I was like, “Oh my gosh.” It was so emotional and so beautiful. You know, the recovery is like night and day. I was up and walking, going to the bathroom and I didn't have an IV. I didn't have an epidural. I didn't have anything on board so I was able to just move and I was discharged less than 24 hours later. Meagan: That's the best. It's so nice when it can just be quick and you go home and can be in your space. Acclimate together. Petra: Mhmm. Meagan: So when they got there, I mean you were that progressed. You were really calm. Things were happening. Did anyone say, “Hey, we need to have the OB come in and talk to you,” or were they actually supportive? Because through this whole prenatal, you've been hounded as, “No, no, no. Why would you do such a thing?” I was just curious. Did they seem more supportive? Petra: Oh yeah. I didn't touch on that, but yeah. When I went in there and especially after they checked me, they were like, “Oh my gosh. Let's do this. Let's have a baby.” They were all excited. It was no doctor I had ever seen. It was a traveling OB so I don't even know where he was from but he was there on-call and then there was a student doctor. I don't know what he was but he was a student. He was actually the one who was there that helped bring my baby to my chest alongside my midwife. So yeah. There was a midwife there and then that training OB, they were together right there. Everybody was super supportive. My nurses were amazing. I will never forget her name. Her name was Brita. She was like, “I'm so proud of you. You're doing amazing.” She was so incredible. Of course, my doula was amazing too. She was helping me through everything and had all of the things with her that helped with lavender scents, keeping the lights dimmer, and just keeping that atmosphere calm and cool. My husband was there too. He's cool as a cucumber anyway. He's so go with the flow and afterward, we talked about it and he was like, “I was ready once those doctors were right there checking you. I was ready to jump in and be like, ‘She's having her VBAC!' but I didn't have to say anything. Everybody was so supportive and so sweet to you.” Meagan: Good. Petra: Then afterward, it was almost like I was a celebrity. Nurses were bringing other nurses in and they were like, “She was only here for two hours and she had her baby and she had three C-sections.” Yeah. It was amazing. Meagan: Do you know what you did? You changed their mental perspective. You changed a whole bunch of people's mental perspectives. Think about what you did for the student. VBAC after multiple C-sections, especially three, isn't widely studied because it's not happening. Petra: Right. Meagan: So for that provider to come and start right in the school world and training and be like, “Oh, actually I saw that happen and it happened really well and it was okay. Baby was okay. It is possible,” then maybe, just maybe– I don't know about that provider. Some providers that are in training don't even go to OB land, right? They are going to some other specialty and that is just their clinical, but hopefully, it will help some other future Woman of Strength who is going in and wanting that whether that be him or her or someone that they talked to, just changing the perspective. Look at what you have done. How amazing. You didn't just have a VBAC after three C-sections, right? Petra: No, it doesn't just feel like that. It feels like so much more. Honestly, I'm forever changed by this experience. Meagan: Absolutely. I understand that. Petra: It helped me. And honestly, I feel like even if I did have a C-section, I planned for it if I did end up having one. I had a plan set aside. I didn't put any energy towards it, but I had that plan just in case so I could have my preferences honored in that situation, but it helped educate me. I am so educated now. It threw me into the birth world. I had always been obsessed with birth, but I didn't know where I fit in. I went to school and was going to become a labor and delivery nurse, but once I got into the classes and everything, I was like, “This is not for me. This is not where I belong.” It just didn't feel right. I never knew about doulas. Once I had this experience, I was like, “I know where I belong.” This work sets such a fire off inside of me. Oh my gosh. I am supporting a couple of VBAC after two C-section clients right now. We are preparing for their birth and it's so exciting to me. I've never been so excited about work ever in my life until I hit this point. It's so amazing to see somebody switch mentally from being fearful to feeling empowered. It's not that I'm giving them that power. We all have that power inside of us. It's just somewhere along the way, it's been dimmed. I'm there to help them find that again. It feels so good when somebody is so confident in themselves and makes that transformation. No matter how their birth unfolds, they can feel good about it because they know that they are educated. They know what they plan for. It's not the fact that the plan goes exactly how you planned it. It's the fact that they educated themselves enough to be able to advocate for what they do or don't want. Meagan: Yes. Petra: That's huge. Meagan: Yes. I mean, I can relate on so many levels. It's crazy how the things you are saying, I'm like, “Oh my gosh. That was me. That was me.” I wanted to be a L&D nurse. I wanted to do that. I didn't even start the classes. I didn't even get to that. This is so bad to admit. I was like, “That's way too much math. Nope. I'm not doing that. No.” Then I had my second C-section and I wanted a VBAC. I was like, “Ugh.” I wasn't in a place where I was mad necessarily. I wasn't happy that I had a second C-section, but I wanted more. I wanted to support. I felt that desire. I felt that burning in my body that was like, “I want to help people.” Just hearing you talk, I'm like, “That was me.” That was me in 2014. I can just feel your energy so much and so will your clients. You're going to change your clients' lives. Like you said, no matter what the outcome is, they're going to feel supported and loved and educated along the way and that is powerful. Petra: Yes. Yes, exactly. That's what I'm here for. I feel like I'm here to just help be their cheerleader. You can do anything if you set your mind to it. I know that sounds so cliche. Meagan: I know, but it's true. Petra: Yeah. Yeah. It just makes me feel so good to know that I can help in any kind of way. I've always been this helper anyway. I've done in-home CNA work so my heart is in service. That's where I feel the best, so yeah. It's just amazing. I feel like also, the most important thing is just trusting yourself. Trust yourself to make the decision and not that it necessarily has to be the right decision to what everybody says is the right decision, but whatever feels right to you and staying true to yourself. We see all of these people on social media and it's easy to get caught up in what they're doing and it's staying authentic to ourselves and bringing that into your journey because not everybody's journey is going to be the same. I feel like that's so important to showcase, so yeah. Meagan: It is. Yes. I love that so, so, so much. I wanted to quickly talk a little bit about VBAC bans and multiple Cesareans, just what to do if you are in a situation like this. I feel like you touched on all of these things that you've done and I just love your journey. I love your journey so much. If you're running into a VBAC ban, and one of the things that you did too not necessarily for this purpose, get in contact with your local ICAN groups. See what information they have on local hospitals and their policies and see what they can do to help. Write a letter to the hospital. Write a letter to the state's medical board. I know that sounds crazy, but we are the ones who are going to be able to change this future.Doulas, we're loving. We're supporting. We're educating, but then also as VBAC parents ourselves, we have– I don't want to say a duty, but we have this power to start making a change by not letting every single provider bully you into something you know in your heart is not correct. To continue to reclaim that power and stop letting that light be dimmed as you were saying earlier, right? Petra: Exactly. Meagan: Let's light up the world. Let's light up the world. We have to light ourselves up first. We have to be fully lit before we can help others light. Petra: Yeah. I just want to touch on something real quick. The VBAC ban drives me insane. Meagan: Me too. Petra: They say they don't want to do it because they can't support an emergency situation for a VBAC, but what if a person goes in there in labor and she needs an emergency or if it's a true emergency situation and they can't give her a C-section? I'm sorry. That just doesn't sit well with me. I would go to a different hospital completely. Meagan: I know. I mean, ACOG recommends that VBAC is a great option for women and they can have it at any hospital location that is a level 1 facility or higher which is pretty much any hospital. Me too. I have such feelings about it. Such feelings. If you are a VBAC multiple Cesarean, check out our VBAC after multiple Cesareans blog. We'll make sure to attach it here in the show notes and it will go over some of the studies. What's hard is after two Cesareans, we don't really have a ton of really solid, hardcore evidence showing that your chances of rupture really do increase this much because it's not happening. It's not being offered. Look at how many providers shot you down. I'm a VBAC after two Cesareans and I went to 12 providers before I found the right provider for me. They didn't all necessarily say, “Absolutely not,” but they didn't necessarily say, “Yeah. Go for it,” either. They weren't cheering me on. It was, “Well, you can try,” or “Well, if you were my wife, I probably wouldn't suggest it, but I'm not their wife so sure. Go ahead.” It's so annoying that we don't have this information, but it is possible and you are living proof. Petra: Yes, definitely. Meagan: Oh, well thank you so much for being here and sharing your stories. Petra: Of course. Of course. I would be so happy if this touches just one person and it helps anybody. Meagan: It will. Petra: I would love to share my story with anybody. Anybody, feel free to connect with me. I just love talking about anything birth and VBAC. That is my heart's work. Meagan: Yes, well tell people where they can find you. Petra: Yes. I am on Instagram at Birthing Come True. The name comes from my birth coming true and also my website is birthingcometrue.com. If you basically type that in anywhere, you'll find me. Yeah. Meagan: Awesome. Thank you so much. Petra: Of course. Thank you for having me. I'm so happy to be there. Meagan: Absolutely. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
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Welcome to the Adams Archive, where we slice through the noise to bring you the unvarnished truth. In today's rollercoaster of an episode, we tackle a CIA whistleblower's shocking claim that analysts were financially incentivized to bury evidence supporting COVID's lab origin. Then, we dig into the dark cloud hovering over Russell Brand as allegations and YouTube demonetization tarnish his reputation. We also unveil the controversial denouncement of Tim Ballard by none other than the Mormon Church. And if you think that's where it stops, stick around. We dive into Mexican doctors' extraordinary findings on alleged alien corpses and explore the lingering mysteries surrounding the disappearance of Malaysia Air 370. Don't be another cog in the misinformation machine—hit subscribe and leave a five-star review to help us expose the truth that mainstream media often chooses to ignore. Head over to austinadams.substack.com for exclusive content and updates. Buckle up; it's time to challenge the status quo! All links: https://linktr.ee/theaustinjadams Substack: https://austinadams.substack.com ----more---- Full transcription Adams Archive. Hello, you beautiful people and welcome to the Adams Archive. My name is Austin Adams and thank you so much for listening today. On today's episode, we are going to dive deep into some wild situations. The first one being that the CIA has whistleblower come out and said that the CIA was actually paying off It's analysts to bury the findings that COVID was a lab leak, literally giving. Their own analysts, financial incentives to switch their opinions on whether or not that was the case. So we read about that, then we will discuss Russell Brand, who is in the news for some not so good things. Some reports coming out and accusations regarding some sexual assault allegations and potentially even worse, he was actually had his YouTube channel suspended or D demonetized today. So we'll discuss. That as a result. And then going a little bit deeper into that, we're going to look at the Mormon Church actually denouncing Tim Ballard. Tim Ballard being the once founder of Operation Underground Railroad. Also the person who is depicted in the movie, the Sound of Freedom, which we've talked about at length here before. So we'll look at what these allegations are, why they denounced him, and. Tim Ballard had a response to this that he did a video on this guy with his PRs is pretty, pretty wild stuff. So we'll look at that. After that, we'll look at a Texas church talking about churches Texas church, which is experimenting with AI generated services using chat GPT for worship sermon and original songs. That is one of the most dystopian things that I've ever heard. So, we'll discuss that. Now, again, as always, the longer you stay with me, the deeper we get. So, after that, we'll discuss the findings of the Mexican doctors who concluded after their tests were done on the alleged non human alien Corpses. So we have their findings on that. So if you don't know, we haven't talked about this yet here because we had a little bit of a layoff over the last couple of weeks for several reasons. But what happened was Mexico had a congressional hearing where there was two alleged alien bodies, which were shown at the congressional hearing. And they look every bit of ET that you could imagine. So what ended up happening is these Mexican doctors actually did a, some tests on these bodies and we'll see, I haven't read this yet, so we'll see what they actually found. And then, last but not least, this is a story that has been surfacing. Pretty consistently somewhat recently regarding, if you recall, Malaysia Air, I believe it was Malaysia Air 370. That was a airplane which had gotten lost, you know, we go all the way back to 2000 and, let's see. This was filmed in 2014, yeah, lost in 2014, I believe. Now there's some really big deep dives that some people did into this situation. And they came up with some pretty wild stuff. And we'll discuss it all. But first, I need you to head over to the substack Austin Adams dot substack calm, go ahead and get signed up. If there's any news, if there's any podcast companions, articles that I write, all of it is there for free, head over there right now, Austin Adams dot substack calm, then I need you to hit that subscribe button. All right, hit that subscribe button. If it's your first time here, if it is not your first time here, Or if it is, go ahead and leave a five star review. Just helps me get up in the rankings. It's really one of the only ways that you can show your appreciation for my hard work here. So go ahead, leave a five star review, hit the subscribe button, head over to austinadams. substack. com. And let's jump into it. The Adams archive. All right. The very first thing that we're going to discuss today is going to be that the CIA had a whistleblower come out and say that the CIA was paying off its own analysts to bury the findings that COVID was a lab leak from Wuhan. China. So let's read this article. It comes from the New York Post and it says, the Central Intelligence Agency offered to pay off analysts in order to bury their findings. That Covid most likely was from a lab in Wuhan China. A new whistleblower testimony to Congress alleges, and this goes on to say that a senior. Level CIA officer told house committee leaders that his agency tried to pay off six analysts who found that SARS COVID 2 likely originated in a Wuhan lab. And if they changed their position and said that this, the virus jumped from animals to humans, according to a letter sent Tuesday to CIA director, William Burns. Select committee on the coronavirus pandemic chairman, Brad one strap and. Permanent Select Committee on Intelligence Chairman Mike Turner requested all the documents, communications, and pay info from the CIA's COVID Discovery Team by September 26th. So they're actually going to be doing further investigation into this, thankfully, and that will be in just about a week's time. So we'll have to see what comes up from that. According to the whistleblower, at the end of its review, six of the seven members of the team believed the intelligence and science were sufficient to make a low confidence assessment that COVID 19 originated from a laboratory in Wuhan, China. The house. Panel chairman wrote. That's crazy. Six out of the seven people on this specific team believed that the virus came from a lab leak, and the CIA wanted to hush every one of them, and they tried to do so by incentivizing them, allegedly, With money. So now they're pulling all of those financial hearings. Now we actually have the document from Congress which says. Which is comes from the Honorable William J. Burns says to select to Director Burns to the Select Committee of the Coronavirus pandemic and the House Permanent Select Committee on Intelligence together. The committees have received new and concerning whistleblower testimony regarding the agency's investigation into the origins of COVID 19. A multi decade, senior level, current agency officer has come forward to provide information to the committees regarding the agency's analysis into the origins of COVID 19. According to the whistleblower, the agency assigned seven officers to a COVID discovery team. The team consisted of multidisciplinary and experienced officers with significant scientific expertise. According to the whistleblower, at the... End of its review, six of the seven members of the team believed that the intelligence and science were severe sufficient to make a low confidence assessment that COVID 19 originated from a laboratory in Wuhan, China. The seventh member of the team who also happened to be the most senior was the lone officer to believe that COVID 19 originated through zoonosis. The whistleblower further contends that to come to the eventual public contends that to come to the eventual public determination of uncertainty, the other six members were given a sufficient or significant monetary incentive to change their position. These allegations from a seemingly credible source requires the committees to conduct further oversight of how the CIA handled its internal investigations into the origins of COVID 19. To assist the committees, and again, this is What they actually wrote to Congress with their investigations. We request the following documents and information as soon as possible, but no later than September 26, 2023, all documents and communications regarding the establishment of all iterations of the COVID discovery teams. All documents and communications between or among the members of all iterations of the COVID discovery team regarding the origins of COVID 19 and all documents and communications between or among members of all iterations of the COVID discovery team and other employees or contractors of the agency regarding the origins of COVID 19all documents and communications between them or among members of all iterations. Including but not limited to the US Department of State, the Federal Bureau of Investigation, the US Department of Health and Human Services to include the National Institutes of Health and the National Institute of Allergy and Infectious Diseases and the US Department of Energy regarding the origins of Covid 19. And lastly, all documents and communications regarding the pay history to include the awarding of any type of financial or performance-based incentive financial bonuses to members of all iterations of the C Ovid 19 discovery team. The select subcommittee on the coronavirus pandemic is authorized to investigate the origins of the coronavirus pandemic, including but not limited to the federal government's funding of gain of function research and executive branch policies, deliberations, decisions, activities, and internal or external communications related to the COVID coronavirus pandemic. Whew, that's a mouthful. Further house rule. 11 Clause 2 and 1B grants committees of the House of Representatives with the authority to require by subpoena or otherwise the attendance and testimony of such witnesses in the production of such books, records, correspondence, memorandums, papers, and documents as it considers necessary should the required information not be produced in an expeditious or satisfactory manner. You should expect the committee or committees to use its additional tools and authorities to satisfy our legislative and oversight requirements. Thank you for your attention. And then signed by the chairman. Of the Permanent Select Committee on Intelligence, Mike Turner, and the Chairman of Select Subcommittee on Coronavirus Pandemic, Brad Wenstrup. Curious who this Brad Wenstrup is. Anyways. The Honorable Raul Ruiz Ranking Member. Alright, so there's your, there's your document on that. Alright so. This goes on to say that in a separate letter the House Committee leaders, and I'll go ahead and just pull this up on the screen for you guys so you can actually. Look with me here. There we go. All right. So this also goes on to say, In a separate letter, In a separate letter, the House committee leaders identified former CIA chief operating officer, Andrew McCready, Mac, Macridis, as having played a central role in the COVID investigation, and asked him to sit for a transcribed interview. At CIA, we are committed to the highest level of standards of analytic rigor, integrity, and objectivity. Of course you are, just not when it comes to assassinating Kennedys. We do not pay an analyst to reach specific conclusions. Of course we wouldn't do that. The post, in a statement, we take these allegations extremely serious and are looking into them. We will keep our congressional oversight committees appropriately informed. Hmm. Interesting, interesting to see if there's anything more from this article that we should be discussing now to the comment section, which is really what matters, which says that if they are actively covering up evidence that COVID came from gain of function research that was weaponizing a virus, then I wonder what other part they might have in all of this. It seems as if we would want to know the truth of origin if we truly want to prevent similar future. outbreaks. That's a good point, right? Why would you want to cover up the origins of this? Why would you not want to get to the bottom of what happened to prevent it from happening again in the future, unless you or somebody, you know, or somebody who's giving you money. Had any take or partook in any of it, right? Why, why, if you, if you don't have any skin in the game, if you're not somebody who's going to be held liable, if you're not concerned about anything coming back to you as an organization, or maybe as the person who ordered these things to happen, why would you be doing this? That's weird. Huh. The next person said, remember when it was the political left that challenged questions and were skeptical of the various three lettered agencies yet now the left is in unquestioning lockstep when with its former arch enemies, pretty remarkable change in the last. generation. It is pretty crazy to like you go back to the 70s, you go back to the 80s, you go back to the 90s, right? The Democratic Party, the left was primarily the hippies, not the the suit and tie wearing grandfathers that we used to think were Republicans back in the day, right? You always that's always how it was pictured for a very long time, right? That that Republicans were these stiff old white men, and The cool people, the, the artists, the this, the that, the, you know, the people who were free thinkers were the people who were on the left, right? Those were the liberals. Those were the the, the Democrats. And, and it seems like we have shifted pretty, pretty significantly to where the left just wants to be completely in line with anything and everything that daddy government says that they should be in line with. And the right questions literally everything, right? For how long were we saying that there's alien evidence, alien evidence, alien evidence? And all of a sudden, the government comes out with alien evidence, and all of a sudden, we're all questioning it, right? Just because the government actually told us that. There was no winning scenario there. But, now that that information's coming out, and it's coming from the mouth of the government, and not other institutions, which we actually trust, we're questioning that too. Because, Everything the government does has an agenda or else they wouldn't be doing it because the government is just about siphoning money from the pool of tax money that they extorted from its people, right? So once you realize that, you have to realize that there's an agenda behind everything, right? The only way for you to be successful in politics, the only way for you to get into the positions that you want to is, well, maybe a already have hundreds of billions of dollars in the bank and self fund yourself and not have to take money from lobbyists, but maybe there's only been. A handful of people like that in recent history and by handful, I mean, maybe two or three and by recent history, I mean, since 1776, but but it's, it's pretty wild to see that, you know, the left is just so in line with everything the government says, so in line with mask mandates, so in line with you know, what, what the CIA is doing with, with everything and anything that comes out from the government. They're just immediately fall in line with it, right? All of that. They are the propaganda Enforcers is the liberal far left, right and and we have to say far left Although I I tend to believe that the left is far more radical in this ideologies than the right is Even if you go to like the far right, right, the far right, being the proud boy type people the, the QAnon conspiracy theorists on, on all of the the deep channels of 4chan, right? It's like when, in order to get to that level, you're probably looking at when it, when it comes to the liberal left, right? We're talking about what, what are the extreme ideologies of the liberal left? The extreme ideologies of the liberal left is that, oh, Any single moment prior to birth, a child should be able to be killed within the womb, right? There's, there's no, there's no conversation more than until it's born, right? That's a pretty radical idea. And I would say, let's say 30 percent of Democrats agree with that idea. Okay, there's one. All right, the secondary idea being that, you know, let's let's say socialism, like true capital, not capitalism, but socialism, that, you know, everybody and anybody should have their fair share of everything, regardless of work ethic, right? Equality of outcome, right? And you might look at it, maybe not straight socialism, but equality of outcome, right? They want the top 1 percent of people to pay the top, you know, 75 percent of taxes, right? Okay, that seems like somewhat of a radical ideology. They don't want people to be able to have Guns that's a that's a pretty radical ideology. Let's just say again for argument's sake that that's 30 percent 30 percent of the radical left Believes that we shouldn't be able to own any weapons at all any weapons at all Well in 30 percent might be generous. It's probably closer like 35 40 and again, I'm just throwing shit out there, but 35% And then you go into what's another radical idea? Oh, well, maybe that your children at the age of two to three years old, four years old should be able to determine their gender, even though they were born with the chromosomes that they were born with. Okay, that's a pretty radical ideology that your child should be able to choose its own gender when it can't choose its own lunch. Because it would choose candy every day. And that's maybe closer to 60 percent of the, let's say, the radical left, or the left in general, believes that. Okay? We can probably even take that further and further and further, looking at the different ideologies. But let's say 30 60 percent of the far left ideologies Trickle into the majority almost of what the left believes right now. We, we can go to the other side of things and say, what are the radical ideologies of the radical? Right. Right. Okay. Trump's been in president for the last, or has been president during Biden's entire term, and we're just waiting on him to raise his hand and say, it was me the whole time, guys. And rip off his mask like it's Scooby-Doo You know, that's like the radical, radical, right. QAnon people. Right. And obviously, you know, QAnon's been, been has some, some merit to some of its belief systems when it comes to the the child sex trafficking rings and things like that. There's obvious merit to that. But, but when we're talking about the fact that there's going to be Trump's. In charge of the real military and he, and I think we haven't heard much whispers of that over the last year or so, but for about the first year or two for, for Joe Biden's presidency, there was a serious group of small group of extremist conservatives, extremist conservatives who were thinking that Trump was going to come back and take over and be like, ha, it was me, right? I'm still president. And, and, you know, that's, that's pretty radical, but I would say maybe Four, three, 3%, maybe less than 3% of of people right now. Another radical ideology on the right might be what? I can't, it's hard to even think of any. I dunno that you shouldn't have drag shows in front of children Like what is, what is the radical rights belief systems that the government shouldn't you know, we didn't even get the freedom of speech when it comes to the left, right? Censorship. The, the, the right might think that there should be No. No. No censorship of speech, right? That's not even radical. So it's just hard to see. It's hard to see what is the what? And I'm open to the conversation. So send me a message. Let me know what is the radical ideas of the right. And maybe maybe we can start to have the percentage conversations I just had with the left, but it's so much easier. Okay, let's just go with abortion. Right abortion. Let's say every single person believes that there should be no ability to have any abortion. And that let's call that a A radical ideology within the right. Let's just say that just for argument's sake. What percentage of people do you think That are conservatives that hold that belief that just zero abortions for any reason whatsoever, regardless of age, regardless of circumstance, regardless of medical situations, maybe, maybe 10%, maybe 5%, I would think like Uh, and primarily made up of people who are highly religious and for religious reasons, not just ideological reasons. So it's just a weird conversation, right? The far left is far more of the left than the far right being part of the right, right? The percentages of those people are just so much lower than what we see. So the craziness... That the entire left is pretty crazy in their ideology because you get thrown out of the group if you don't agree with all of it. Right? So, anyways, there's your tangent on that. Where were we? I don't think it matters. Last comment says there was no lab leak, virus developed in Georgia and released worldwide through various means with various intensities. Not natural, not an accident, U. S. military operation under the auspices of the deep state. Hmm. That's an interesting one. Now, if you go back, I did a whole episode on the what is it called? The water in the water. What was it? That guy, Peter or something did a documentary about how he believed that it was some form of snake venom that was being released to people through the water systems, right? That was a pretty, that was a crazy, crazy idea. But there's a whole documentary on it. Let's see if I can remember what it was called. Let's go. COVID, Snake, Venom, Water, Documentary. And I did a whole podcast breaking this down. So, you can go back and listen to that. Watch the water. Watch the water. That's what it was. Hmm. Yeah, I believe that was, and this guy is the guy who did it. That he interviewed. This, what's the guy's name? Here he is. Pretty sure the guy's like a chiropractor or some shit. But that's a pretty crazy one that the water, the drinking water was being poisoned with snake venom. That was a, that was a pretty wild one, but, but interesting. And I believe if you go back and actually listen to it, there was, there was some interesting arguments within that. But anyways, maybe that's what they were discussing within that comment there. But wrapping that topic up, the CIA was apparently and allegedly, according to this whistleblower, Paying people not to say that it was a lab leak. And again, you have to ask yourself why. All right? In other news, Russell Brand has been accused of sexual assault. And as a result, his YouTube channel has been immediately demonetized without any actual trial, any hearing. Right? And this is somebody's income. So... YouTube blocks Russell Brand from making money from videos on his channel over sexual assault and rape allegations. Right? Something, something that's embedded in our law is innocent until proven guilty. Right? The guy from That 70s Show that Ashton Kutcher and Mila Kunis was just basically sticking up for in a letter. Was convicted of rape by two women convicted, right? We can demonetize his YouTube. Not sure he would have access to it anyways. But do you just get to as a company? D demonetized the platform people kill their income for allegations. Now, are you playing judge and jury? And how does that play into when somebody goes to court for these things? Right? If you're if you're saying that you believe this person is guilty and also who's making these decisions at YouTube and that. Different companies like this. Anyways, let's go ahead and read this article, which says YouTube has suspended advertisements on Russell Brand's channel in light of a slew of sexual assault and rape allegations made against the comedian as clips of his former wife, Katy Perry, have resurfaced the platform suspensions for violating its policy will still allow brand to. Upload videos, of course it will, it just won't give him money, but he will not profit from advertising. Meanwhile, footage has re emerged of the moment Brand ended his relationship with US singer Perrie by text message in 2011 following their 14 month marriage. Presenter Vanessa Feltz has also shared deeply offensive footage of Brand. Asking to sleep with her and her daughters. When she appeared on his chat show in 2006 and the late comedian, Sean Locke disclosed the reason he hated brand and the clip from the panel show eight out of 10 cats in 2014, explaining he had a fear for his he had a fear his daughters would bring home a man like brand one day. I don't see how that has any merit. Brand has vehemently denied the very serious criminal allegations and said his relationships were absolutely always consensual. So let's see if we can get maybe some of these videos. No, they're just going to send us to a big page of random stuff. All right. So it goes on to say a timeline key points. YouTube suspends monetization. Big brother co creator describes brand allegations as. depressing and BBC confirms removal of brands, content, brand episodes removed from C4 website. No evidence to suggest channel four bosses knew of brands alleged assaults and review into the timeline at BBC led to by director of editorial complaints. This was three hours ago. It says that who cares? That's a silly one. It says the allegations against Russell Brand over the weekend have got people examining the age of consent. Rightly so, that a 30 year old man would embark on a sexual relationship with a schoolgirl feels instinctively wrong to many of us. The woman in question, Alice, who has said that she now feels she was groomed by Brand, though he also denied all of the allegations, has called for consent law to be reviewed in light of her experience. The law enabled it, she told reporters. For the times Saturday night, it shouldn't be legal for a 16 year old to have a relationship with a man in their thirties. Now, most of us are comfortable with the idea that a 16 year old can consent to have sex with another 16 year old, that two teenagers can have a sexual relationship, but we start to feel iffy when there's an adult in the sexual relationship with a minor, as the gap age gap increases, so does our discontent or disquiet. That's not mere hand wringing or moralizing, and it's not about. Trying to deny young people their sexuality, it's because we understand implicitly, even when we can't articulate it, that an imbalance of power can affect consent. Okay, agreed. 16 year olds and 30 year olds shouldn't be having sex. Let's see this clip. Can I have it off with either you or your daughters, the answer's no, and I'm, no. It's terribly awkward when you're a guest on somebody else's show, particularly in a theatre which is full of great fans of, of the presenter, Russell Brand, so they all loved him, they were cheering him and egging him on, and I was in this unbelievably awkward position where you don't quite know what to do. Are you meant to pretend you think it's funny and laugh along? Are you meant to stand up and walk out in high dutch and, and, and look as if you're a spoilsport and a party pooper? You know, what are you supposed to do? But I know I was deeply offended then as I remain deeply offended now. Now that woman looked about in her 40s and not very attractive at the time. And now that's not to take away the seriousness of this clip, but I don't see that there being any merit to that of people just trying to smear him. Now, now something that's come out as a revolt result of this, you know, and something that there seems to be a lot of attention on Russell Brand right now, right now, Russell Brand speaking out consistently, consistently, consistently against the deep state against George Soros against the world economic forum. So To me, it would be no surprise that there's things coming back. Now, from 20, 30, 20 years ago, 10, 15, 20 years ago, that obviously have not been litigated. There's no, nothing going through the court system. So again, I'm not saying that I don't think a 30 year old and a 16 year old should have a sexual relationship. That's creepy. It's weird. It's gross. I, I don't know if I, you know, we just had the one side of that, but he seems to say that he. didn't do any of that. Now telling a woman in her 40s during a talk show, let me have a go at you or your daughters and she's 40 and maybe your daughter's 2025 or something like, okay, it's still nothing there. You know, I would love to see, you know, and here's a, here's a good quote that came from Reddit. That's pretty popular right now. It says, All start caring whether or not Russell Brand had some questionable sex a decade or two ago when the media starts caring what Bill Gates or Prince Andrew was doing on Epstein Island. Or when it starts naming the customers Ghislaine Maxwell was convicted of supplying trafficked minors to. Right. There seems to be a lot of emphasis, right? I'll start caring about Russell brand. When you start to show that you actually care about the victims, right? That's what this is saying here. Not, not, let's not diminish if there was some allegations. Cause I haven't read enough into them to say they weren't true or they were true or whatever. Let's just say, sure. There's allegations here, but what we know 100 percent besides the fact that Russell brand had, what seems like a still. Something that has not been convicted against him. And he still hasn't even gone to court for this. That doesn't seem like there's any charges. But there has been somebody who was supplying and trafficking hundreds, if not thousands, of underage women to Prince Andrew, to Bill Clinton, to Hollywood executives, to Hollywood elites, to... Everybody in power, and everybody knew about it. Oh, and also, so did the news companies who silenced the articles to come out. Right? Everybody knew about this, but nobody said anything. And still... They're protecting the lists today, you're going to tell me you're going to tell me that they raided Epstein's Island and found nothing of merit that they're releasing to the public about who was a part of this, how they did it, about what we're doing as a result of that, you're going to tell me they raided an entire island that was used specifically for track picking and found nothing, not a Bit of evidence, not a single strand of evidence that led them to convict somebody who was on that island doing those things. Bill Gates, like I said, Prince Andrew, Bill Clinton just person after person after person. And the list, you know, we've gone into that and the whole breakdown of the black list that came out or black book that came out from Epstein. So you can go back and listen to that to see who was all a part of it. But. It's pretty crazy. And, and so this article or this, this person posted and goes on to say that I'll care what about what one former US president is or isn't guilty of. When the media starts caring about what other former US presidents are or are not guilty of. And I'll care about a more powerful country invading a less powerful country when the media reports the conflict and its context in exactly the same tone. And with the degree, same degree of neutrality versus moral outrage as it uses when there's a more powerful country in question is the U S A. Until that day, the mainstream media and everyone who repeats its talking points on social media is not, but idle gossip and the sound of one hand clapping. Until the day I could not give less fucks about what mainstream media says any person did or didn't do, so... Well, that's not what it said. It says about who the mainstream media says any fucker fucked or didn't fuck. And so fuck the mainstream media. Let anyone... It fucks with tell them to fuck the fuck off. With its farce ial fuckery. Now, the top comment on this, and I don't disagree with this, is you are allowed to care about all of those things simultaneously. Right. I don't disagree with that. It definitely seems like you should, you know, If you care about people who are the victims, you should just care about them regardless, but it doesn't seem like it's obviously not the same level of situation here. Now, in light of these things coming up here, I'm actually going to skip. We'll maybe push off the Tim Ballard one to a different episode here, because we have a little bit more to go. And I have a little bit limited amount of time here. So the next one that we're going to move to is a Texas church experiments with. AI generated service and uses chat GPT for worship sermon and original songs to praise the Lord says the church said the experiment would be a one time event. And this comes from Fox news. Now, if this isn't the most dystopian thing you've ever heard of when it comes to religion, I don't know what it is. This is just So sci fi, weird, and cult y. It says, with artificial intelligence seemingly infiltrating every facet of our lives, one church decided to experiment with the technology for one of its services last week. The Violet Crown City Church, located in Austin, held an AI generated service on Sunday, describing the experiment as uncharted territory. Yeah, because you're starting a cult with... a robot at the head of it. This, and you're, you're, you're actually the, so here's a philosophical issue with this is that you're, you're taking the person who is, let's say the, the coding behind the AI and turning that into a deity, right? You're, you're giving it infinite amounts of power over people. When somebody gives their life to a God or a deity or a religion and says, I believe in you. I trust in you. I give you my life. I give you my faith. You know, faith is a faith is a. a tricky thing, right? Faith is, is now not always blind faith, but, but faith with with a little bit of suspicion is, is healthy, right? But faith, faith is a tricky thing. And if you give that faith to something who's, who's being, can be at any single point manipulated by man. Right? You're, you're giving religious potential. You're giving deity like power to something that is man itself, right? We cannot have man worshiping man. That's the problem that we saw with science during COVID science, right? It turned into a cult, right? There's no man who should be a deity and there's no artificial intelligence that should be a deity because what does that become other than the manifestation of the programming, right? Right? So this says. This Sunday, they said, we're entering somewhat uncharted territory by letting Chachibiti create the order of worship, prayers, sermon, liturgy, and even an original song from our 10 a. m. service, the church wrote on its official Facebook page. The purpose, the purpose is to invite us to consider the nature of truth and challenge our assumptions about what, what God can make sacred and inspired. The Church acknowledged such an experiment would be easy to write off, but encouraged its members to keep an open mind. Why not attend instead of an experience for yourself, the Church said, clarifying that this would be a one time experiment and not something we'll likely do again. Yeah, I hope not. The Church assanjed any worries that Skynet, a reference to the fictional AI, I'm not sure an AI can actually express the emotions of love and kindness and empathy, Chambers said. I think that we must practice love and express that. Not only feel it, but we must. Express it. Interesting. Now the comment on this was pretty sure God was not impressed with the vanity of that service. They wanted the creator of the entire universe to interact with a machine? It's like man saying, here, listen to this thing we created. God made man so he could interact and connect with man. Not so that man could make a machine and use it as his proxy. Yes. Agreed. Right, this is, if you think there is layers to reality, one of those layers being the higher, the higher reality, right, which is, let's call it heaven or we're, we're, we're God lives, right? And the layer that we're on being a lower dimension of reality, right? You cannot create, and you cannot, when, when somebody is creating a sermon, when somebody is writing a song, when somebody is deciding on what they do or do not want to talk about, If you believe in, in the faith of, of Christian, Christianity and religion, you believe that God is speaking through that person, right? God's not going to speak through an AI chatbot that was created by some Silicon Valley, woke, purple haired, ear ringed, Weirdo, right? Earrings like there's something wrong with earrings but it's all, you know, I, I pictured like 22 earrings on their head and gate big gauges. Right? But God's not going to speak through that person or at least through the coding that they wrote. I'm sorry. Right? So, so if you believe that that is of this reality that is of this realm and it's not going to be the real thing and all that opens up is a weird it. Alien based cult. Let's get into the good stuff. Alright, so the doctors, if you go back, the doctors in Mexico actually have come out and done testing on the alien bodies that were found in Peru. Now they claim that these were almost over a thousand years old when they were found and they were found in the ruins of I believe it wasn't wreckage, but they were just found and dug up by like archaeologists. So it says Mexican doctors have found no evidence of any assembly or manipulation of the skulls of the so called non human being remains that were presented to Mexico's Congress last week. Seemingly proven the remains were not human made. The scientists conducted a number of tests on the two specimens at the Neuer Clinic on Monday and live streamed the entire procedure. Wow, that's pretty cool. In the end, Jose Zels Benitez, the director of Health Sciences Research Institute and the secretary of the Mexican Navy offices, said the studies proved the alleged aliens belonged to a single skeleton and were not assembled with human objects. He also said his team found that one was alive, was intact, Was biological and was in gestation, pointing to large lumps inside the alleged E. T. 's abdomen, which suggested could be eggs. Whoa. I can affirm that these bodies have no relation to human beings, he previously claimed. The pair, which were allegedly unearthed in Cusco, Peru in 2017, have elongated heads with three fingers on each hand. Creepy. Super creepy. Especially when you look at the pictures of this MRI. Whoa, how are these pictures not out? That's crazy. Also, I do just want to say that nobody seems to give a fuck about the fact that they just showed alien corpses on live TV and then just did an autopsy on them with MRI machines and cat scans and came out with the results. I haven't seen a single person. I found this literally randomly on the New York Post. It says, but otherwise they appear humanoid in shape with two arms and two legs. Each my son. Said that they had strong light bones and no teeth, and had implants of ca, ca, ca, ca, cadmium and osmium, which is one of the scary, scariest elements on Earth. Also, one third of their d n A is unknown. He testified claiming that beings are not part of our terrestrial evolution. These specimens are not part of our evolutionary history on earth. They're not beings recovered from a U F O crash site. Instead, they were found in diatom. Minds and subc subsequently became fossilized, which is an algae. This is the first time it is presented in such a form. And I think there is a clear demonstration that we are dealing with non human specimens. They're not related to any other species in our world, but many have expressed skepticism about the discovery. For years, academics, archaeologists and scientists said that mummified remains, that UFO enthusiasts claim or aliens are generally just modified human bodies. And there's people looking at these pictures. There's picture after picture of these skulls. Oh my gosh. Could you imagine being in this room? How wild is that? The very first comment on this said, I am partly convinced they are not human and could be extraterrestrial. However, the DNA results will tell the tale. It should be easy to send a small sample of DNA to a reputable company. In fact, why not send one of the eggs as well? If it was alive at one time, that should be. The final proof of origin. Somebody else commented back to that person and said, is anyone going to believe anything coming from Mexico? Says they performed the same tests on Biden and got the same results. Oh, pretty crazy. All right. And last but not least on today's episode, we're going to dive into the Malaysia air three 70 conspiracy. This was posted eight days ago on conspiracy Reddit by additional underscore add 3796. And I've dabbled in this a little bit. I haven't read the whole thing, but it's pretty crazy. So this says, Hello, this is Ashton from Twitter, and I have been writing about the MH370 videos for the past month. They are real, leaked, military videos. I don't want you to believe me, I want to convince you with the facts. This isn't all of the facts, just some of the most compelling. The videos... Oldest Archive is a satellite stereoscopic video from the Regenik Dianon with an archive upload date of May 19th, 2024. The description reads, Received March 12th, 2014. Source, protected. Alright, let's go ahead and see and make sure that he doesn't have any prior posts on this that give us a... T. L. D. R. A little bit on his post. So this was, well, he replies a lot. Let's go to his posts. We're looking at an overview. All right. So the one that we had looked at was from eight days ago. Let's just see if he has any the real story of MH three 70 all pertinent evidence and theories. That was 70 or seven days ago. Facts and theories to help the investigation. And okay. So this Reddit looks like started eight days ago or 10 days ago. And it says proof the Northern coordinates are correct and facts. Hey guys, this is Ashton from Twitter. I've noticed a lot of things have gotten destroyed here. Let's see if he gives us a quick synopsis here. And he does not. So let's jump first to the one that he says is all evidence and theories. Okay. So, so my J the general consensus. Well, not general consensus because I haven't done a census, but the idea here is that the original story was, was wrong, that this is a conspiracy and that it didn't just evaporate into thin air or fall into the ocean as everybody thinks. So this says Ashton Twitterson here, many people ask for a comprehensive list. Of the evidence of the M H 370 video. So I delivered most people's immediate reaction will be that the MH 370 videos are stupid or impossible, but they line up with all the facts to date. Don't believe me or trust me, verify the evidence. The U S government made a huge mistake recording this event. There's no excuse they can use to deny it. If you want to destroy all credibility and world governments here is. Your unique opportunity. Each piece of evidence can be verified either visually in the video from works of the community or my own investigation research. If it's not on the list, I either haven't verified it or don't find it to be credibly linked to the investigation. At this time, I'm limited in images that can be used or I would add more. I only put links and sources when it's a contentious point. When the time comes, all those who contributed will be giving credit. Quick disclaimer, they said This is not Q Anon. This is not to distract from Trump or Biden. This is not an alien invasion. This is not a hoax, misinformation, or disinformation. There are ufology elements, but that does not mean it is the explanation. This is the power of the community used to tell the story of the greatest conspiracy of all time. Is this the greatest conspiracy of all time? Note, I don't want to talk to any mainstream media. They'll never tell the truth. I'll talk to any alternative media or Tucker Carlson, Bill Maher, Joe Rogan. If these three can be convinced, I believe the world can be. Interesting. All right, so let's see if we can start with the theories, because I feel like he could have written this better to give us a brief synopsis first. But essentially. Oh, so that's what that video was. Okay, so this is showing that the Malaysia Air 370 was being circled by three unidentified objects in this crazy weird orbs all surrounding it and rotating. I did see this video. And then there's a zap, which is a cold event in the thermal because this was being picked up by thermal imaging. The zap accurately illuminates the clouds in the background and the foreground. All right. So. Let's go through this full. Let's go through this full deep dive. All right. So let's just go back to the top here because now it's starting to make a little bit more sense to me. There's a video that was circulating, which was showing and I'll pull it up here for you guys. So you can watch it if you're on YouTube with me here or on rumble or on the sub stack. This is the web archived video. Okay. Now, again, this comes from 2014 back when this airliner went missing. And here's a video. That they're saying is credible evidence of the Malaysia air showing, and here's my cursor showing there's the orb. There's three orbs that fly right around it in a crazy, crazy quick way that has no, wow. And they're, they're surrounding it like almost in a symmetrical triangle, rotating back and forth and in sync. Almost completely in sync and then rotating and turning back around and all surrounding this airliner, the same airliner that went missing suddenly back in 2014 and they go faster and faster and faster and faster, see if, and then disappears, what completely disappears. So we need to verify obviously the legitimacy of this video, but a lot of people seem to think it's legit. That was crazy. Okay. So one more time at the point where it disappears, the rotating, rotating, rotating, rotating, and it's gone big flash. And the airliner is just completely gone after being surrounded by these three orbs. Now there's a second video that comes from this, and we'll see what this shows us. That was the one that I saw, I believe. It says capture airliners and UFOs, UAV. And here's the thermal imagery. Alright, so here's the aircraft flying. Now why is a UAV this close to this airliner is a better question with thermal imaging. There's an orb, one orb, two orbs. Rotating, rotating, and leaving a thermal trail behind them, which is interesting. Oh, they're perfectly circling when you see the trail around them. Whoa, that's so weird. Super weird. And let's see if it shows it disappearing. Whoa, and it's Gone, dude, if this is real, and this if this is Malaysia air and the whole time I remember this, this was like, this was as big as the Titanic submarine situation. Like all those, you know, the three billionaires, this was an entire airliner just gone, gone. And I believe there was some high profile people on this airliner. But yeah, They we were looking for this for days and days and days went by and days went by and it should have been out of fuel and maybe they they landed here and maybe they didn't and maybe we just haven't their transponder went off whatever it was if this is the airliner and this is real this is one of the craziest conspiracies ever okay Now I'm in. Now I'm in. Alright. So, we got the background now. Filmed in 2014 with technology from 2014. Spy satellite videos, presumed from USA 229 is the earliest archived source. Received March 12, 2014. 3D stereoscopic video, technically a third video, which means we need two satellites in close proximity and on the same orbital trajectory. Satellite perspective changes eight times as do the coordinates, with coordinates visible in six of them showing us the location and direction of travel, south and east. A thermal layer of MQ 1C Grey Eagle posted by Rejiknion received, I don't know what the hell that's supposed to be a name or something received June 5th of 2014. And cameras on the equipment are made. For filming these events, it says this the thermal layer on a specialized electro infrared camera on the MQ one secret Eagle matches the mission purpose for this S I B R S and S I G I N T tracking boats and planes, electronic signals, monitoring intelligence and battlefield awareness, alternate sources and higher quality exists that point to none of these users being the original source. Maybe we can see if these are the same exact videos and higher resolution, but this is two minutes long. So I wonder maybe it's, it looks slowed down a little bit. That's probably why it's two minutes. I want to see it disappear like that. Slow motion. Gone. Whoa, that's wild. Okay it's a speculation. The original source may have come from a private forum or left on the dark web to be found. Videos show coordinates in them that change, but not when the mouse moves. Videos show satellite designations presumed to be N r o l 22 due to seeing 93 and thus ruling out threes. Not sure what that's supposed to mean. Satellite vis video explained by remote terminal access mouse drift. Explained by a JPEG wheel track ball that does not have the click activated screen capture of terminal running at some resolution. 30 frames per second. Citrix remote terminal running at default on 24 frames per second. Okay, very technical. So they're trying to figure out where did this video come from because you see on the screen a mouse going back and forth on top of it over top of the video. So I think that's what they're trying to do here. Remotely navigating around a very large resolution video playing at. Eight frames per second, or is that six? Six frames per second. Okay, so they're just trying to figure out where did this video come from? Plane is making a left hand turn and descending consistent with a circle formation consistent with capabilities of a 777 to 200. Plane's altitude is low based on how close they are to the cumulus cloud formations. Okay, true. There's a heat signature near the center bottom half of the plane. Yes, also true. There's an exhaust smoke coming from the plane, which is likely too low for contrails. Three orbs approach. The plane seemingly not affected by gravity. Yeah, that's that's what I said. It was just moving. It didn't seem to follow Newton's laws. Like it's just moving around in a way that our aircraft absolutely could not. Does the orbs have cold trails that are in front of the orb leading the orb? Yes. Saw that. Speculation. Orbs may be changing the pressure of the atmosphere or absorbing energy from it. Orbs entered a lock formation and begin a pattern and change patterns. Wow, they really broke down this pattern this way the way that they were rotating. Very interesting. And the two of them almost intersect and then change their formation and then go perfectly in sync. Perfectly in sync. It says the orb's pattern encircles the plane over time. The orbs may not be visible to the human eye. Both cameras are infrared. Huh, interesting. A zap occurs as the orbs bend and move towards the plane. The zap is a cold event in the thermal, and the zap accurately illuminates the clouds in the background and the foreground. Huh. So was this at night? The plane completely disappears after the zap, including the plane's visible trail. The MQ 1C is cropped out of the satellite video, just out of view. The user closes the window after the plane disappears, indicating this was not recorded in real time. It requires knowledge of classified military systems. Person who recorded or leaked these videos is likely in prison. How would a hoaxer know? They would never find a plane. Why this is M H three 70. Okay. Good question. How do we know that this is the plane, right? Is this says that it's the only missing seven 77. There was no debris field found official flight path. Has it running out of gas? Because there's nowhere else for it to go and the official search searched everywhere along the final ping art and along the flight path even the Nicobar Islands area, right? So the perfectly along this flight path perfectly around the time that it was flying and it's the exact aircraft type says the thermal matches the exact silhouette of a 777. Okay, yep, which is overlaid at the top of this image here. The color tone matches that of Malaysia Airlines. And satellite coordinates put it on the flight path of MH370 around... 640 Nicobar Islands, which is the smoking gun. Note, this is the suspected location of the turn into the South Indian Ocean. It has an imagery around that. It says NROL 22, released in 2006, is presumed to be a relay satellite due to its molnia. Orbit and clear view of the satellite that took the video, the smoking gun USA two 29 at the right location. Time apparent angle with a sister debris satellite capable of taking stereoscopic video at six 40 UTC. So it's just verifying that there was something in this location at that time that could have taken this video and says propose of. Signal intelligence and space based infrared systems is to track airplanes like this. Interesting, it shows a Lockheed Martin space based infrared system. And then it says the U. S. military had to have tracked MH370. We've proven they had the satellites in the area. US military confirmed the provided data to the intelligence community to help solve the mystery of MH370 and the freedom of information act about the DSP detection of the impact of 370 was ignored. Goes on to show the flight path. The pilot says good night. MH370 at 5 19 UTC at 17 21. 521 UTC MH370 disappears from all civilian radar due to both 8S, B and A cars being shut off. Captain Blelly suggests whoever was in command of the aircraft had intentionally achieved this by disconnecting all four electronic Electrical generators and APU. The radar says the plane makes impossible altitude changes from 5, 000 feet to 55, 000 feet. The radar loses the plane, but tracks an object they believed to be the plane as the satellite system resets three minutes and a log on request happens around 1724 plane changes directions. When the plane gets over Penang, the copilot cell phone pings, huh? The last Malaysian. Radar in between 1815 and 1822, 200 miles West by Northwest of Penang. Hmm. Very interesting. So it's showing basically the flight logs and the the pings of information that was being sent out from it. It says the witness interesting. So it's showing her blog post, Catherine T. It says the reported facts, their timing, and their identified geometrical relative position provided by Miss T are coherent, providing confidence in her reporting. So let's see this blog post while that's loading. She says, I thought it was coming to land. I felt it was traveling slowly. The aircraft was probably flying in L2 between 2000 and 100, 000 feet, held same tack for five minutes. The aircraft had considerably descended. from the first or from the first second of observation until the accidental change of tack. I saw that what looked like black smoke behind the orange glow, which resembled a contrail, but black, but I couldn't see any fire flames or anything like that. I just saw a plane glowing orange. Whoa. This comes from chat GPT, which has gases in the atmosphere, particularly oxygen. Nitrogen can glow orange under influence of electromagnetic effects, ionization, and other electron or energetic processes. The Aurors are a prime example of a phenomenon. Interesting. Says the glowing plane did not have any navigation lights. Alright, as it moved behind the boat, I could see the shape very clearly, which was a passenger plane. Here is the blog post. Which, quite lengthy. But maybe we'll have to send that out in the sub stack. Hmm. Interesting. So this woman says that she saw Malaysia Air right around the time that it disappeared. And wrote a blog post about it. It says other pertinent information. It says, my impression of the hall was that it was monocolor. I assume light matte gray. I doubted my sanity at the time. The plane circles around the boat counterclockwise from the Southeast. Hmm. The silence is sinister was the last tweet. It says other pertinent information to fake passengers using stolen passports that changed their appearance. What one possible passenger who bypassed security. And an SOS at 243 intercepted and reported only in Chinese news, which is a plane attempting emergency landing. Trump leaked a similar satellite photo in 2019 of USA 224, which launched in 2011, same year as USA 229. And then it says debunking the suicide myth. Everyone stands up for him, including officials and his wife. 18, 000 flight hours. Coworkers loved him. So it's talking about the pilot. No indication of suicide intent in the flight path. Had a huge custom simulator. Not standard model. Zahari's flight simulator had been used to pilot two data points in the southern Indian Ocean. Or to plot. And route found on the simulator closely matches MH 150 route to Jeddah with a diversion at the end of the South Pole. He was rostered to fly MH 150, impossible to disconnect all four electrical generators. Flying over his hometown is silly. It was an emergency and people would kick down the door before they would get knocked out. Depressurization is slow. In most emergency scenarios, the plane is not going to last until it runs out of fuel. Now it's going on to debunk the fact that the actual of the debris, no debris found by the official search or above or below water. It says the debris found years later was not consistent with barnacle growth. Only the Flay Perrin was matched with a non unique serial number. One person claims to have found 10 plus pieces, which was featured and contested on a Netflix documentary. Oh, excuse me. No one is allowed to inspect it. Okay. So it's trying to debunk it addressing debunks of the videos. Clouds do move just slowly. So it's just going over some of the things that people are saying about that. Hmm. Interesting. Plane disappears. So it says teleportation. Plane disappears from space time instantly. Intermediate black hole event. Which was it being cold? A witness sees a possible red shifted glow or orange glow Using a plane because it's in open space, huh? Teleportation may be to hide the plane Family's phones were proven ringing on Chinese TV for days Impossible if underwater or in another dimension, huh? Traveling forward in time doesn't break causality But traveling backward in time does See time Dilation says the science wormholes have been shown to be theoretically possible by at least three scientific papers They all show that exotic material is not necessary One paper argues a thin shell could be used to safely transport an object outside of space time Description of an intermediate black hole is consistent with the zap we see in the videos And one paper discusses needing to remove unwanted particles from the area The orbs may have been super conductive the orbs could be cleaning the area in Deucing the mouth of the wormhole and or acting as the barrier for passage. And there's a real patent for a magnetic vortex wormhole generator. What the fuck? No way. Let's pull that one up. Patents. google. com. A patent number is. U. S. 20030197093A1, and I will include this in the sub stack as well, because now we need a sub stack on this one. So this invention, which is called Magnetic Vortex Wormhole Generator. What? This invention relates to a magnetic vortex generator, which has the ability to generate negative mass and a negative spring constant, which, according to Einstein's general theory of relativity, is required in order to create a stable wormhole between R space and hyperspace. Whaaaaat? Very interesting, above my scientific pay grade. But I will definitely be reading through this another time. And maybe I'll highlight some stuff for you when I throw it in the sub stack. Here's the article that came from the last day of Malaysia airline passengers with stolen passports. Okay, interesting. Could these be the aliens? Alright let's wrap this up here. It says Diego Garcia, 1, 700 military and 1, 500 civilian personnel. Space Force has 86, 000 total servicemen and women. Okay. Sighting of a passenger plane 50 miles north of the base flying low in the early morning. I wish he would have put this together better. Pilot had Diego Garcia in his simulator. Not open to commercial aircraft. Enough space for a 7 77. So wait, what is this? Diego Garcia? Is this supposed to be like a a military base or something? What is Diego Garcia? Diego Garcia Base. It's gotta be a military base. Diego Garcia is a British atoll in the Indian Ocean. It is an island of the British Indian Ocean Territory, an overseas territory of the United States Kingdom or the United Kingdom. It is a militarized atoll just south of the equator in the central Indian Ocean and the largest of 60 small islands. Huh. Okay. Interesting. Interesting. Because there was a theory that it landed there, I guess. Okay. Alright, moving on here. Not open to commercial aircraft, has enough space for a 777, has underground facilities with a black vault Freedom of Information Act showing it may be a CIA black site. Message from Philip Wood saying he had held captive with a picture of EXIF data, placing it at Diego Garcia. Tens of millions. To black construction for dredging and other activities. Lockheed Martin contract for upgrading power and water photos of Diego Garcia, Facebook that look like the crew seems like the new area 51 Strava heat map and the small boat Harbor outside of the yacht club seems very active. Do D reassessed privacy's policies for the troops after Strava revelations in 2018. Hmm. Theories and speculation. The reason to do this must be large enough to warrant the risk unlikely to be about money. Shadow war for control of this technology, 20 semiconductor scientists on board. Whoa. So saying that basically the reason that they would have done this was that there was 20 semiconductor scientists on board Malaysia air and they wanted to either remove them, kill them, whatever. Or transport them to this base. Says video suppressed to hide hyper advanced technology not known to the public. Interesting. Video suppressed to hide non human intelligence. Filming had intent. UAV is too slow to catch a 777 and US 229 is only in position for minutes. So the only reason it got filmed, they're saying, is because they wanted to see this, and then somebody leaked it. Primary narratives. Ones with the most evidence, and we're getting towards the end of this. Set the satellite computer to stick to IOR 30 minutes prior to takeoff to make the plane difficult to trace. Three fake passengers possibly in on the hijack. Pilots and crew may be in on it. Flight changed to the last minute. Same data of Diego. 1721 UTC event is electromagnetic jamming plane is flown to Penang as a waypoint and for flies directly towards the coordinates. U. S. military equipment is waiting to teleport the plane to Diego Garcia. Deals are made with the crew and passengers, countries of the passengers. Maldives sighting just north of Diego Garcia in the early morning, Philip Wood resists, where is he now, witness protection. Who is Philip Wood? Debris later thrown in the ocean. Crew lookalikes found on Facebook at Diego Garcia. Motive is control of the very technology we see in the video. And the last portion of this says, UFO emergency event. All right, it says 1721 event disconnects all four electrical generators and APU transponders similar to what an EMP or electromagnetic interference may do damage to the plane will cause it to ground quickly depressurization may be slow fire could have started lithium batteries could be a source of fuel or interest in the UFO angle copilot cell phone pings over Penang. Indicating calling for help. Next logical place to land is in the water. Other narratives, USO, UFO teleports the plane to another dimension or location. Ooh. And motive of the cover up is to hide non human intelligence and technology from the world. Whoa. Decoy plate theory. Second 777 used to spoof the pings and track trick in Marsat. This event was to gain control of patents for some nanochips related to the Rothschilds. What? This event was to gain control of patents for some nanochips related to the Rothschilds. Huh. UFO is saving the passengers from their own doom. UFO is attracted to the lithium batteries, or the governments are working with the NHI for shadowy purposes. Interesting. That is a crazy one. Crazy one. He says, submission statement, the MH370 videos are the largest verifiable conspiracy of all time. This has been a cover up by multiple nations and multiple individuals. This conspiracy has the potential to break the minds of many, as well as destroy confidence in world governments. And this came from the same individual who said, Thank you for contributing, supporting, and getting the message out. Wow. That's a... Crazy one, crazy one. That's one of my most favorite conspiracies that we've gone over. All right. Wonderful. I hope you got something out of that. Code to the Substack, austinadams. substack. com, subscribe, leave a five star review. That'
Ever feel like you're stuck in a cycle of stagnation when it comes to teaching? Join us as we share an insightful conversation with Gary Miller, an Associate Vice President of Content and Implementation, known for his garden-variety ideas and captivating storytelling. Gary blows our minds with his unique perspectives on problems in education today, including stagnation, location, and dilation. Buckle up as we discuss the stagnation in education, ponder upon the profound impact of a student's location on their academic journey, and delve into the deepening academic gaps.We unpack Gary's thought-provoking theories, like how the repeated changes and initiatives in our educational system over the years haven't necessarily translated into improved student performance. Imagine that – decades worth of changes, yet progress remains a distant mirage! Gary also pulls back the curtain about how a student's zip code plays a monumental role in their educational trajectory. Wait, there's more! We explore the widening academic gaps post-pandemic and why we need to act pronto to address them. If you're eager to challenge the status quo and pioneer changes for a brighter educational future, this episode is your treasure trove. Listen in and get ready to be inspired!Visit the Blog: CurriculumAssociates.com/blogFollow us on Twitter: @CurriculumAssocFollow us on Instagram: @MyiReadyHave feedback, questions, or want to be a guest? Email ExtraordinaryEducators@cainc.com to connect with us!
It's time for the August Q&A episode with Cynthia & Trisha! We kick off today's episode with the crazy and unsupportive comments most often heard by our listeners. Grab a cup of coffee or tea, and get ready for some laughs. Next, we get into our questions, including:Is routine Pitocin postpartum necessary?What can you tell me about insufficient glandular tissue and breastfeeding?What to do about family members who use sweets as a way to get children's attention?Is aggressive fundal massage really necessary?Is too much fore-milk in breastfeeding causing problems for my baby?and more.And in the extended version of today's episode found on Apple subscriptions and Patreon we discuss: Experiencing nausea in labor and what can be done about it; manual dilation of the cervix and whether it's effective; how a nuchal hand at birth impacts tearing and whether a cesarean section necessary; and, what is normal weight gain in pregnancy, and what if I have already gained the recommended amount too soon?Finally, we have our quickie segment in which we answer another ten questions or so, including how period cramps influence labor experiences, heart rate in labor, boy versus girl pregnancies, and more!Thank you for all your great questions and please keep them coming at 802-438-3696 or 802-GET-DOWN. **********Down to Birth is sponsored by:Needed -- Optimal nutritional products to nourish yourself before, during, and after pregnancy DrinkLMNT -- Purchase LMNT today and receive a free sample kit. Stay salty.Love Majka Products -- Support your milk supply with nourishing protein powder, hydration boosters and lactation bites.Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort after vaginal birth. Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWNWork with Cynthia: 203-952-7299 HypnoBirthingCT.comWork with Trisha: 734-649-6294Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters. Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.
Commentary by Dr. Valentin Fuster
L.E.A.P: Listen, Engage, Allow and Process on Your Healing Journey
Welcome to Rock Your Shine: After you've been cracked wide open. On this show, I sit down with people from all over the world to hear their transformational stories on their deep grief and loss journeys. In this powerful and heartfelt episode of our podcast, we invite you to join us as we delve into the inspiring and transformative journey of Gabby Nobrega, who has faced immense loss and emerged stronger than ever. Gabby opens up about her deeply personal experiences with miscarriage, recounting the impact it had on her life. She shares the story of enduring not just one, but two miscarriages and the complex process of grieving these losses, revealing how she struggled to fully process her pain. She recounts her second miscarriage, which occurred during her second trimester while aboard a cruise ship. She vividly describes the harrowing experience of receiving a Dilation and Curettage (DNC) procedure while awake, creating a stark picture of the strength and resilience required to navigate such a challenging circumstance. Amidst the grief and turmoil, she shares her unexpected journey of discovering her pregnancy once again, only to receive a diagnosis of Down syndrome. With heartfelt honesty, she shares how her daughter, Hope, became a catalyst for transformation, reshaping her perspective on parenthood and life itself. As the episode unfolds, we explore the joys and struggles of raising a child with special needs, the importance of finding support systems, and the intricate planning required to provide the best care for Hope. Gabby passionately discusses her long-term plans and dreams for her daughter, highlighting the profound love and commitment that drives her every day. Beyond her personal journey, our guest sheds light on the broader challenges within the healthcare system and the need for transformative change. Drawing from her own experiences of grief and loss, Gabby candidly discusses her journey of mourning the passing of her mother and the significant role that grief support groups played in her healing process. She offers practical tips and heartfelt advice on navigating grief, emphasizing the importance of self-care and seeking support during difficult times. Gabby Nobrega is a mother of two to Matthew and Hope and a wife to her high-school sweetheart. She's the Principal of Breakthrough Communications, an integrated communications company she founded. Her unique expertise lies in her ability to see and assess the entire business continuum -- from strategy through sales deployment, internal communications, marketing and public relations and design programs which effectively leverage all parts of the business. She has won several awards for her publicity and marketing campaign as well as for her efforts to support women's leadership in business. Tune in to this emotionally gripping and inspiring episode as we delve into the depths of loss, resilience, and the enduring power of love. **TRIGGER WARNING** This episode covers sensitive subject matter and is not suitable for all listeners. If this topic could be a trigger for you, listen to this episode with a friend, a sibling, a loved one or a parent so you can talk about any emotions that come up for you. The contents of this episode are not intended to replace therapy and should not be taken as such. If you need immediate help, please call the crisis hotline listed below in our resources. Listen in as we talk about: [1:05] Experiencing her two miscarriages [2:45] Not fully grieving this loss and the impact these miscarriages had on her [5:50] Going through her second miscarriage in her second trimester, on a cruise ship [7:30] Receiving a DNC while awake on this cruise ship [11:10] Having emergency surgery in Italy, and navigating trying to get back to the cruise to go home [15:45] Getting pregnant again and receiving a diagnosis of down syndrome [25:55] How her daughter, Hope, changed them as parents [30:00] Finding help in caring for Hope over the years [34:00] Their long-term plans for Hope [37:35] Creating change to transform the healthcare system [38:50] Where to begin if you're in a similar situation [40:20] The planning it takes to care for a special needs child [46:10] Grieving the loss of her mom and participating in grief support groups [48:15] Tips to deal with your grief [49:20 What self love looks like for her today [50:30] Hope is… Resources mentioned in this episode: Book: https://www.amazon.com/Rock-Mining-River-Sibling-Grief/dp/1732888892/ref=sr_1_1?keywords=Rock+On%3A+Mining+for+joy&qid=1570199126&sr=8-1 L.E.A.P 6 week virtual course: https://rockyourshine.com/l-e-a-p-into-light-and-healing-6-week-virtual-course/ BetterHelp Go to https://betterhelp.com/rockyourshine for 10% off your first month of therapy with BetterHelp and get matched with a therapist who will listen and help. #sponsored Grief Hotline: https://www.griefresourcenetwork Connect with Gabby Instagram: www.instagram.com/gabbynobregapr Twitter: www.twitter.com/gabbynpr LinkedIn: https://www.linkedin.com/in/gabriella-gabby-nobrega-breakthrough/ Facebook: https://www.facebook.com/gabby.nobrega.PR/ https://breakthroughcommunications.ca/ Connect with Susan http://instagram.com/susan.casey/ https://www.facebook.com/Susan-E-Casey-101187148084982 https://www.youtube.com/channel/UCDcl58l8qUwO3dDYk83wOFA https://rockyourshine.com/ https://www.tiktok.com/@leapwithsusan?
St. Teresa explains how divine consolations dilate the heart and stresses how humility is key to receiving The Prayer of Quiet. Fr. Reid explains Teresa's analogy of the two water basins to compare and contrast the prayer of the 3rd mansions with that of the 4th mansions. Episode eight focuses on The 4th Mansions, Chapter 2.LEARN MORE - USE COUPON CODE COM25 FOR 25% OFF:The Interior Castle (Deluxe Edition): https://bit.ly/42oGlwWTAN Classics Deluxe Set: https://bit.ly/3MTGBOzThe Interior Castle (Paperback Edition): https://bit.ly/3CbAAbeThe Autobiography of St. Teresa of Ávila: https://bit.ly/43sanBoSt. Teresa of Ávila: Reformer of Carmel: https://bit.ly/3qpKVOaThe Commentaries is a podcast series from TAN in which you'll learn how to read and understand history's greatest Catholic works, from today's greatest Catholic scholars. In every series of The Commentaries, your expert host will be your personal guide to not just read the book, but to live the book, shining the light of its eternal truths into the darkness of our modern trials and tribulations.To download your FREE Classic Companion PDF and for updates about new seasons, expert scholars, and exclusive deals for The Commentaries listeners, sign up at TANcommentaries.com And for more great ways to deepen your faith, check out all the spiritual resources available at https://TANBooks.com and use Coupon Code COM25 for 25% off your next order.
Brittany's first C-section came after a long and exhausting pushing phase with no progress. Her second C-section came after providers gave her a 50/50 chance of VBAC success due to the VBAC calculator. Brittany chose a repeat Cesarean for the comfort of a controlled environment following multiple traumatic pregnancy losses beforehand. She did not expect another horrible recovery with an elective Cesarean, but it was even worse than the first. Brittany immediately began devouring all information about VBAC after two Cesareans even before her third pregnancy. When she became pregnant, she found an extremely supportive provider 2.5 hours away which proved to be the best decision she could have made. Her VBA2C was everything she hoped it would be– raw, difficult, beautiful, redemptive, and empowering. Right after that birth, she wanted to do it all again! Additional LinksBrittany's InstagramHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode Details Meagan: You are listening to The VBAC Link Podcast and this is your host, Meagan. I am always honored to be on this podcast with you. I love the listeners. I love the storytellers. I love the reviewers. We just love everything about this community and I am excited to bring a VBA2C– I'm not even going to be bringing it actually. Our friend Brittany is going to be bringing it. We are having a VBAC after two Cesareans story. Our most requested podcast topic is VBAC after multiple Cesareans, specifically two. We know how hard it is to find providers to support a VBAC after multiple Cesareans even though ACOG themselves says that VBAC after two Cesareans is totally acceptable and reasonable to go for. It's really hard and it's frustrating. I know as a VBA2C mom myself that it's so frustrating. It's so frustrating, right Brittany, to feel total defeat over and over again, being told that you cannot, you should not, and being filled with horror stories. I mean, all of the things. It's so frustrating and this is why we are here. We are sharing these stories. We are letting you know that you can. It is possible. It might not be easy along the way and you're going to hear today in Brittany's story that it's not easy but it is possible. So we have our friend Brittany like I mentioned. She is from southern Minnesota. She has been through quite the journey which she is going to share with you. If you want to know what some takeaways will be from this episode, one thing is finding that supportive provider just like we were talking about. It's so important. It's so key but we know that it can be challenging being rejected multiple times and being told no, and then not finding a supportive provider until the very end of pregnancy. You guys, this is something that I want you to know. If you are not feeling like you are being supported, if you are feeling or seeing the red flags, if something in your gut does not feel right, you are not stuck. You do not have to stay with any provider because they saw you for 34 weeks, 28 weeks, 40 weeks, 41 weeks, or even 42 weeks. You are not stuck. You can change. It's not always easy and we understand that, but you always have options to change. You can fire a provider at the very moment. We don't necessarily encourage you to fire your providers. I don't want to make it sound like, “Fire your provider!” but you can. If it's not feeling right, if it's not a good mix, you can say, “I would like to request a new provider at this time,” or you can start finding it through so many amazing resources like right here at The VBAC Link. Women of strength, if you are looking for a provider, write us. Go join our VBAC Link Community. We have a whole list of providers on there that have been known as supportive. I can't tell you. I'm just here in Utah. I've not met all of these providers. I've not talked to them. I've not interviewed them. These are providers that are being suggested by our other women of strength who have truly gone through this experience and believe them to be VBAC supportive. Their names are being compiled on this list for you all over the world not just here in the U.S. as guidance for you to help you find a supportive provider. So go to The VBAC Link Community on Facebook, answer the questions, and go check it out. And if you are listening today to this episode, please PM us on Instagram, Facebook, or info@thevbaclink.com. Tell us who your supportive providers are. If they are not on the list, we want to get them on. If you are a supportive provider listening, we want you on this list. It is so important and we as VBAC moms ourselves, and Brittany, I am sure you will attest to this. It is so important to have that provider on your side. It is so important. Review of the WeekOkay, I will jump off my soapbox and we will get to our Review of the Week so cute Brittany can share her stories. This is actually on our How to VBAC: The Ultimate Prep Course for Parents. Parents, if you didn't know, we actually have a VBAC prep course for you. It's filled with information on the history of Cesarean, the history of VBAC, the pros and cons, how to VBAC, and how to find these supportive providers. We will provide you with a lot of printables and things to take along with you on your journey to make sure that you've got the perfect team and that you feel confident in the birthing choice that you are choosing. This says, “This course was so helpful, especially with helping to educate my husband on the safety of VBACs. As he had previously been nervous about my choice, we watched all of the videos already and will also be reviewing the workbook again before birth. Highly recommended.” Thank you, Heather, for sharing that review. Yes, just like she said, this course is amazing. We have reading material and then we have a workbook that you can follow along. You can either download it or purchase a workbook to go along with it. We encourage your birthing partners to take this course with you because it is important for them to know this information. So check it out at thevbaclink.com if you haven't already and we will see you on the other side. Brittany's StoriesMeagan: Okay, Brittany. Brittany: Yes. Meagan: Thank you so much for taking the time today to share these stories. Like I said, we get emails and messages on Instagram and Facebook in our inbox saying, “Please share more VBAC after multiple Cesarean stories,” because there are times when we go in and we have an unplanned Cesarean and then sometimes we get coerced or we feel that it's best to choose another one, but then we start learning more and we want a different experience. We know how hard that is. I welcome you and let's turn the time over to you. Brittany: Absolutely. I am honored to be here. I am very excited to share my story. I know am a mama to three babies. I'm going to share a little bit about my C-sections before I move on to my vaginal birth. I found out I was pregnant with my first son in 2016. I'm sorry. I had him in 2016. I was actually newly sober. I'm a person in recovery so I was very new to a lot of things in life. I was going to be a single mom and I also was sober so a lot of big changes were going on at that time. I was very uneducated about birth, being a new mom, and everything at that time. I was going through so much at the time obviously and then I was nine days overdue which we know truly isn't overdue but that's what they say. At that point, I just wanted to have him. I was not educated about interventions or anything like that so I just went with the punches. Whatever the providers and team wanted, that's what I did. I also knew as much as possible, I didn't want as many pain meds as possible just because of my recovery from substances and I really liked narcotics so I knew that I didn't want to go down that slippery slope. I allowed them to induce me with two doses of Cytotec. It started working but then they wanted to break my water and I allowed them because I truly didn't know better or have any information on that. I got an epidural super early even though I think I panicked more than anything. I didn't want to have pain so I just got it not knowing that I was going to have a long labor and being stuck in bed wasn't going to do me any favors. After laying in bed basically for 24 hours, I pushed for two hours. He was not descending. At that point, I was truly done. I was exhausted. I had been up for two days being induced, so we decided on a C-section. He was sunny-side up so that's what made it more difficult for him to come down which made sense. So he was here. Recovery was rough. I'll talk about that a little bit more later. Fast forward to some time in 2017, I went into the ER. They couldn't really figure out what was going on with me. I really wasn't feeling well. Long story short, I actually had an ectopic pregnancy. I was on the IUD at the time so I had no idea that I was even pregnant. It was very traumatic. I went from not knowing I was pregnant then they had to take the baby out. I actually lost one of my tubes at the same time. I had to have lifesaving emergency surgery. I was in the hospital for five days and they couldn't do it laparoscopically. They did have to cut me all the way open and take everything out. So that was very traumatic and a very big loss. Then I met the man that I eventually married in 2018. We experienced an early miscarriage in 2018 as well so another loss. In 2019, we found in late 2018 going into 2019 that we were pregnant with our rainbow baby. At that point, I was very unsure of what I wanted for my birth. I knew how terrible my C-section experience was but I was also terrified of laboring for that long and then ending up with another C-section again. I trusted my doctors. I was listening to them. Of course, they did the VBAC calculator and at that time, they told me I had a 50/50 chance. Being that he never descended, they said, “It's up to you what you want to do” and I had lost two babies. I just wanted a baby here safe so I was like, “You know what? 50/50. Let's just go with the C-section.” I was hoping that not having that long labor beforehand would really help with my recovery. I just wanted my baby here safely too. With it being my rainbow baby, I just wanted my baby here. Meagan: Absolutely. Brittany: Yeah. My C-section, the surgery itself went fine with my second son but it was an even worse recovery. I had a severe reaction from the adhesive tape that was on my belly. I broke out completely all over my whole body. Meagan: Oh man. Brittany: I had shoulder pain and I have high blood pressure so it was very scary to have shoulder pain. It was very scary because I instantly thought of heart problems. It was just shoulder pain from the C-section.Meagan: It's usually air actually crazy enough. Air gets trapped. I had that too. I was like, “What is happening? Is this my milk?” They were like, “No, it's air.” Getting up and walking can really help but it can sometimes get trapped up in that shoulder or even the rib area. Brittany: Yeah, so strange. I was so sick and throwing up for 36 hours. Meagan: Oh, and with a new incision. Brittany: And then I was dehydrated and blacking out from that. It was just an absolute, awful mess. Basically immediately after he was born, I began researching vaginal birth after two C-sections because I knew I never wanted to do that again and I knew we were not done having babies. I binged every single episode that you guys have. I couldn't listen to them fast enough because I knew I wanted all of the information before we had another baby. Even before we were trying, I was doing all of this. I read many books and watched YouTube videos. I was practicing meditation and mindfulness because the mindset is such a big part. I learned about HypnoBirthing and I was also so much healthier. I gained way less weight. I was eating healthier. I was being active and trying to be as mobile as possible to let the baby descend when that time came. Like I mentioned, I do have chronic hypertension so I really wanted to keep that in check because I knew that would be a big red flag for everyone. So then eventually, we did get pregnant with our third baby. I was still doing all of my research and things like that. At that time, I actually did hire a doula as well. I wanted to do everything I possibly could. She was very supportive of a VBAC after two C-sections. So then we started the hunt of trying to advocate for myself. I really worked on relaxing myself just to get in that positive mindset. Initially, where I gave birth to my birth son, they now do some VBACs but they will absolutely not look at people who have more than one C-section and then it's case by case for just a single. They were like, “No, you either have to go to a C-section or go to the high-risk unit.” I said, “Okay, then send me to the high-risk unit. That's what I want.”At 32 weeks, they saw me at the high-risk and complex unit. This was basically to see. They would assess me and see if they believed that I had a fighting chance. My blood pressure at the time was in a great range and I was actually off medication because I was so healthy doing what I needed to do. Meagan: That's awesome. Brittany: Yeah, it was great. I advocated for myself with them saying, “I hired a doula. I have a supportive husband. I have done all of this research. I know what research truly says,” and of course, they pull out the calculator. Meagan: Oh boy. Brittany: It kind of depended. Sometimes it put me at 20%. Sometimes it put me at 40% depending on who did it because of the blood pressure and because of the two repeat C-sections with no vaginal birth before that. They said they would work with me. That was their wording yet they said that they wanted me to have a C-section no later than 38 weeks. Meagan: No later than 38 weeks? Brittany: Yep, yep. Knowing that my first son came at 38.5 weeks, I knew that was probably not likely. I was also in the mindset that if I went to 42 weeks, I was okay with it because I knew that as long as they continued to monitor things, then it was okay. I knew that if I didn't go into spontaneous labor myself, so say that my blood pressure spiked or anything like that, they would not do anything to help induce me. No low Pitocin, nothing like that, no breaking of water, nothing. I would have to do it all on my own. I knew that was a huge barrier too. Meagan: Yeah. They're putting restrictions on you already. Listeners, if you are getting, “Yeah, okay,” but then you are getting restriction, restriction, restriction, then it's probably not the right space. Brittany: Yeah, exactly. Those were my first thoughts. If I'm already knowing that these restrictions are being put up, I'm going to hold in more tension even when I come here and just wait for some kind of failure in the process for them to say, “Okay, we need a C-section.” So I truly wasn't even getting a chance to try. I literally left the office bawling with my husband. And of course, my husband is not as educated as I am because he's not going to be giving birth. He's very supportive and educated just not to our level but they fearmongered him. They made us, not me because I knew the statistic and things, but he was more worried like, “Are you sure this is safe?” and things like that. I was feeling so discouraged. I was 32 weeks pregnant and I was like, “What am I going to do because I know this isn't going to work?”I actually have a very good friend who had her first baby by a C-section and then she had two VBACs after that. She was one of my biggest supporters. She rooted for me so hard. Meagan: She was your motivator and in your space. Brittany: She had to be induced at 37 weeks with her babies due to being high risk with medical complications and she still did it. She just really gave me hope. We began researching together. She literally lives in a different state and she was researching with me. Meagan: That's amazing. Brittany: It is so amazing. That's what's great about this community. We found a provider that actually is 2.5 hours away from where I live. I knew it was crazy, but I was like, “You know what? What does it hurt for me to even go and see this guy once?”Meagan: Listen, it's not crazy. It's not. I know it sounds crazy and the world we live in makes it feel crazy to go so far. It's not crazy. It's not crazy. It's just you advocating for yourself and finding what you need for yourself. Brittany: I came on Facebook groups with you guys and other VBAC groups specific to our area. I just read testimony after testimony about how amazing and old-school he is. I called and even at this point, I was okay if insurance didn't cover things. I just wanted this. He's a different breed. He's a lone wolf, one of those very rare people that we find. I made an appointment. I believe it was for about 34 weeks so it was still a couple of weeks away. When the appointment came, I actually had influenza so I had to cancel it. I was like, “Oh my gosh. Everything that could work against me is working against me.” I said, “Nope. At his next appointment, I'll go.” I went and he had my medical records but he barely looked at me and he was like, “Yep. We're going to do this.” He was so positive. Meagan: Wow. Wow. Brittany: Not that we were going to try, but that we were going to do this. That was great. I continued to go to appointments weekly until post baby's due date. But also he was not naive. He told me the risks of both very realistically but not in a scary way. Just like, “This is what it can look like.”Meagan: These are the facts, yeah. Brittany: The clinic has just a small-town, homey feel. It's truly about the patient. It's not like we are just another number. Truly at the end of the day, he gave me the empowerment that not only was I going to do this but he was going to allow me to try. That's all I wanted was to be able to try this and to have hope in myself. At 38 weeks, we discovered that my blood pressure had skyrocketed. The next day, it continued to be so they monitored me for a little while. I'm also 2.5 hours away so they kept me for a little longer. The next day, it continued to be. Being that I was in a safe zone, the doctor said, “Would you be okay if we did a slow induction?” At that point, I trusted him even though I truly barely knew him. He gave such good vibes. My husband loved him. I said, “Absolutely.” I was completely closed so it did not seem like any baby was coming anytime soon from looking at it. At 7:00 PM that night, they inserted the Foley bulb to help me dilate. At 8:00 PM, my body actually took over and I had some major contractions. My job for the night was to rest, let the bulb do its work and just mentally get in the mindset that we were going to be in labor the next day. In the middle of the night, my COVID swab came back positive even though I had no symptoms. Meagan: Oh no and you had just gotten over influenza. Brittany: Yes. That was very interesting. My doula, this was the one weekend that she was unavailable of course, so she had her sub-doula available but she couldn't come in because of COVID. She was only available by phone which was a bummer but we made it through. 12 hours in the next morning at 7:00 AM, the Foley bulb was removed and I was 4 centimeters. That was great because with my first son, I had already gotten the epidural and I was panicking at that time. I was already in a great mindset. I was managing the discomfort so great. He started the Pitocin super slow and low. That's what he's known for, starting it super low and slow at the smallest amount possible. The baby's heart rate had some decels so they turned the PItocin off for a while, no panicking. They were just going to go with the flow. At 10:00 AM, they broke my water. We just hung out. I was feeling good. My contractions picked up on their own without that Pitocin ever being restarted. My body began doing it with that very little bit of intervention. At about 1:30, I began struggling pretty badly with pain and pressure. I stated, “I want an epidural.” Everyone knew that I didn't want that so I said that I would wait another 15 minutes and give it a minute. I still wanted it 15 minutes later and I knew in my mind that I was holding so much tension in. I just couldn't let it go so I was like, “You know what? At this point, let's do the epidural.” We did it. As soon as the anesthesiologist came in, I knew that I made the right choice. I was already feeling that relief that I was going to feel from just letting my body relax. I knew how important the mindset was that I just needed to let my body do it. Baby's heart again had a few decels but the team worked great to reposition me after the epidural was in. I could still feel the pressure of the contractions. I could tell we were progressing but at 2:45, I progressed far enough to be able to push. I progressed very quickly from being completely closed to being here very quickly within less than 24 hours. The team was so supportive. I could feel the baby moving down still, that pressure. I was ecstatic. Once we started the pushing phase, I was very nervous because that's how far I got with Benny, my oldest. I had pushed with two hours with him and he had never moved down. I was very scared that that was going to happen. With the first push, I knew it was different. I could feel him moving. I could feel the baby moving down. We were gender-neutral beforehand and at 3:44, our sweet baby girl was delivered vaginally. Meagan: Aww. Brittany: Yes. It was quite amazing to feel baby on my chest. It's still shocking now feeling the baby on my chest and having my husband look. He was crying and was like, “It's a girl.” After having two boys, it was the icing on the cake. It was absolutely amazing. Meagan: Yeah, and a different postpartum experience?Brittany: Absolutely. My provider had known how traumatic my C-sections were and then of course with my ectopic, completely being cut open with that too, it was totally different. It was stunning. Even with the epidural, I barely had the epidural so it's not like it was running for a long time. I was never able to eat right away after birth. I pretty much ate almost all labor until the epidural and then to be able to eat as soon as I wanted to right after without throwing up, that alone was huge. I could walk practically right after. No crazy abdominal pain because of the C-section. I could help the baby right away whereas I was stuck in bed for so long after the C-section. The doctor looked at me and he was like, “How is this?” I'm like, “Indescribable.” Meagan: Do you even need to ask? Brittany: It's insane how different C-section versus pure vaginal delivery was. I was ready to do it again. My husband was like, “Okay, we're done having babies because we got our girl.” I was like, “I'm ready to do it again.” Meagan: Yes. Oh, I was the same way. I was like, “No, I want to do this again. This was amazing. I got the birth that I wanted.” There is something special. I want to also point out that sometimes vaginal births can be traumatic too but there is something about that baby being placed on your chest after you've gone through some less ideal or traumatic experiences. Yeah. It's hard because you compare it and you're like, “This is a breeze.” It's still hard. Recovery is still hard but it's just magical. Oh, I love it. I love that you at the end of pregnancy were like, “No. We're going to do something differently.” It ended up being an induction so it was like, “Hey, come. Drive and come and it's planned.” But I would love to know or I'd love for you to share if you can any of your plans for listeners assuming that it was going spontaneously. I think a lot of people get nervous. It's a daunting feeling. They get nervous about, “When do I go? What do I do? It's a long drive.” Do you have any tips or suggestions of what your plan was to travel that distance assuming spontaneous labor went into play?Brittany: Absolutely. We talked about that. That was one of my husband's biggest worries because obviously, he would be driving me. We knew first of all that obviously every labor can be different but that my son's took forever. He was also induced. We were hoping for that but then also, we knew and had great backup for the other kids for daycare at a moment's notice. We had great people to be able to drop them off at. We had talked to the provider too. Basically, if my labor got at all semi-regular if it had happened at home, if my water broke, I was going to head right in because we knew we would be having a baby. We also knew with having two C-sections that we wanted to be near medical attention just in case. We knew that even if my contractions started coming semi-regularly that we would likely head in. I was ready to labor hard in the car if that's what it had to be. Also, say all of a sudden, I got pushy and that's how fast it was progressing, we were okay going to our hospital closer just because then, I'm in the thick of it. We don't want anything to happen to anybody but we knew that it could possibly be a barrier having to drive all the way 2.5 hours to this hospital. Meagan: Yeah. That is a really good point. Preparing to labor hard in the car is no joke for sure. Obviously, that's not what happened but preparing yourself mentally is so beneficial because if that does happen, it can take out some trauma because it could be traumatic in the car if you're not prepared for that and labor is progressing, and then of course, having that plan of, “Okay, if things shift and I'm pushing that baby out, we'll go to this nearest hospital.” Also, I would suggest, you were saying, “Oh, if things were getting active then we would go,” but you could also, when you get there, you don't have to go straight in but just be in the vicinity. Grab a hotel or go to a park and walk around. Just be close by. Preparing for that financially as well if you're getting a hotel or something like that is something that's important because you don't want to have anything crazy happen but also educate yourself on the signs of something going wrong so if you know that it's happening in the car and you still have 45 minutes, you can just go to the nearest hospital at the next exit or whatever. Brittany: Yeah, absolutely. Meagan: Great tips. I seriously love that. Prepare to labor hard in that car because it can happen. Congratulations to you and I am so proud of you on all of your journeys. It's hard because we've had these Cesareans, undesired, sometimes traumatic, or desired with unidentified outcomes where you wouldn't think that it would have been like that. These are the stories that make us who we are today. It's these stories that are changing others' lives and empowering them. Whatever your takeaway is from today, maybe it is recognizing a supportive versus non-supportive provider. Maybe it is figuring out what you need to do for yourself. Maybe it's traveling or whatever it may be. Maybe it's scheduling that repeat Cesarean. Whatever it may be, know that it is your birth. It's your birth. This is your body. This is your baby. This is your future and whatever decision you make that is best for you, we here at The VBAC Link support but do have all of these resources for you to turn to and learn so you can know what your options really are. Brittany: Yes. Information is key. That's one of the biggest things I took away. I am all for people making whatever decision they want in regard to anything including birth, but I just want people to have the information, the correct information, to be able to make those informed decisions. Meagan: Absolutely. Absolutely. One other quick thing I wanted to talk about is how you went in for a VBAC after two Cesareans with no progress. There wasn't any progress being made meaning that your body was not showing signs at that moment of labor beginning or progressing. They started with a Foley bulb or a Cook catheter depending on where you are or what your hospital uses. That can be something that a lot of providers will refuse to use if you're not dilated to a 1. Now, I want to preface. You'll have to tell us actually. It can be very uncomfortable getting a Foley in with no dilation because they're putting a tiny little tube in something that is closed. Brittany: Yes. Yes. Meagan: That is definitely a little bit of a disclaimer there. It can be very uncomfortable but just like Brittany and I want to say it was Shannon? I could be totally wrong. It was a VBAC after three Cesarean birth. She ended up doing a little bit of Pit to try and get her cervix to do something and then got a Foley in. It barely opened if I remember right. It just shows that it is possible. It is possible. They may say that it's not possible. I will say that it's not common for them to do it but it is possible. You can request it. Yes, prepare yourself mentally because I don't know Brittany if you want to describe it at all but it's possible. It's possible to do that. So if you're in a situation and they're like, “You are in no state to be induced,” but you're really not feeling like you want to do a scheduled C-section, try it. Brittany: Yes, totally. It was very uncomfortable. It was truly painful. I had been induced with my first son so I knew what labor was like, but I was like, “Oh, this is pretty rough.” But hands down, I would do it again. After that initial insertion which took a little bit because I was completely closed– Meagan: And probably posterior a little bit so they had to send the tube up and forward. Brittany: It was rough. I was worried that it wasn't going very well, but it just takes time because I was fully closed. I had pretty good contractions just from that for an hour. My body totally took over which was good. I mean, but then it was such good progress. I slept all night. By morning, I was 4 centimeters. I mean, can you honestly ask for more than that? Meagan: That's amazing. Brittany: That was the perfect start to an induction. Meagan: Yeah, absolutely. Absolutely. That's one of the things that the Foley can do is it can get your body to 4 centimeters, sometimes even to 5 centimeters. It's also important to note that sometimes when it falls out, the cervix relaxes. Do you like my sound effects? It's hard because we can see each other. She can get my emotion. It can relax and go backward. It doesn't really go backward, it just relaxes. So sometimes keep in mind that if a Foley comes out at 4 centimeters, you might be closer to 3.5 or 3 but it stretches to a 4 because it just stretched to a 4. If you get checked again and they're like, “Oh, you went backward. You're a 3.” No. Don't let that get in your head. And then they started low-dose Pit and things. That's something I wanted to point out. It's not something that is super common and oftentimes, providers say no but it is possible. Brittany: It was absolutely incredible. I mean, really the biggest thing is to educate yourself. I went to the chiropractor. I did all of the things. I was in so much pain at 37 weeks pregnant, 36 pregnant. I'm a firm advocate of the chiropractor anyway. I love it for everything. Helping my kids poop as weird as that is–Meagan: Oh no, I know. I've done that too and it's amazing. It works. Brittany: Yes. So I had been going very regularly anyway because I knew how much that can help get baby in place and help with pain, help with hips. I was in so much pain and I'm like, “Oh no. This is not good. I can't be in this much pain going into birth.” My chiropractor actually got COVID of course right around that time so I was like, “I can't even see her. Who knows if I'll get to see her again before I have his baby?” I was lucky enough to find a very nearby chiropractor the day before I went in to be induced. I swear that helped a lot too. Just incredible. It turned out beautifully. Meagan: Absolutely. Yeah and if sometimes you're having prodromal labor or if labor it just carrying on, carrying on, and carrying on, going and getting an adjustment can be a game changer. Yes. Awesome. Well, thank you so much for being here with us today and sharing these beautiful stories. Brittany: Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
Healthy // Toxic: Relationships with Narcissistic, Borderline, and other Personality Types
Healthy//Toxic Healthy versus Toxic is a podcast where licensed mental health professionals explore what makes a relationship healthy or unhealthy. Our hosts aim to provide a scientifically informed perspective on what factors go into making healthy relationships, how to build secure attachment, and how to be a better parent, child, partner, or friend. References: Burley, D. T., Gray, N. S., & Snowden, R. J. (2019). Emotional modulation of the pupil response in psychopathy. Personality Disorders: Theory, Research, and Treatment, 10(4), 365–375. https://www.ncbi.nlm.nih.gov/pmc/arti... Burley, D. T., Gray, N. S., & Snowden, R. J. (2017). As far as the eye can see: Relationship between psychopathic traits and pupil response to affective stimuli. PLoS ONE, 12, e0167436. Vinnars, B., & Barber, J. P. (2008). Supportive-expressive psychotherapy for comorbid personality disorders: A case study. Journal of Clinical Psychology, 64(2), 195–206. Want more mental health content? Check out our other Podcasts: Mental Health // Demystified with Dr. Tracey Marks True Crime Psychology and Personality Cluster B: A Look At Narcissism, Antisocial, Borderline, and Histrionic Disorders Here, Now, Together with Rou Reynolds Links for Dr. Grande Dr. Grande on YouTube Produced by Ars Longa Media Learn more at arslonga.media. Produced by: Erin McCue Executive Producer: Patrick C. Beeman, MD Legal Stuff The information presented in this podcast is intended for educational and entertainment purposes only and is not professional advice. Learn more about your ad choices. Visit megaphone.fm/adchoices
Mike B and Ty back at it without the captain. We talk all about the Cinco de Mayo holiday Mike B had to kick someone out Friday. Ty gets his eyes dilated. More to come next week. Thanks for listening. Watch us on Twitch. www.twitch.tv/onrslive Chat with us on Facebook. www.facebook.com/groups/ohnoradioshow Support us on Patreon. www.patreon.com/ONRS
Grab a cup of coffee and join the girl chat with DONA Certified Birth Doula, Shannon Bacus, to talk about the ins and outs of what it means to be a doula.Shannon shares her wealth of knowledge and experience as she explains what a doula is and what they do during the birth process. She also discusses the importance of setting boundaries and how doulas can help mothers-to-be advocate for their needs and desires during labor.In addition, Shannon dispels common myths surrounding dilation and discusses why it's not the only measure of progress during labor. Whether you're a first-time mom or just curious about the role of a doula, this episode is a must-listen.Tune in to Under the Sun Podcast on YouTube, Apple Podcasts, or Spotify to join the conversation with Aileeah, Irene and Shannon.Follow us on instagram: https://www.instagram.com/underthesun_podcast/Watch on YouTube: https://www.youtube.com/watch?v=2s_NDfG65_gWork with Shannon: https://www.google.com/search?client=safari&rls=en&q=shannon+Bacus&ie=UTF-8&oe=UTF-8Listen to more from Shannon! https://podcasts.apple.com/us/podcast/birthing-from-the-inside-out/id1667898109For more fun content you can also find us here: Instagram: https://www.instagram.com/underthesun...Aileeah: https://www.instagram.com/aileeahcolgan/Irene: https://www.instagram.com/ireneloveta/
Like the “Johnny Appleseed of the coast,” one woman is replanting oyster reefs across New York City's 520 miles of shoreline along New York Harbor, engaging communities and kids in restoration of their beloved waterways and ecosystems. In this episode of The Conch podcast, we chat with Tanasia Swift, marine educator and field station program manager for the Billion Oyster Project. Tanasia shares her journey— from fishing in Brooklyn as a young woman with her father to bridging the gap between urban communities and marine spaces through oyster restoration and connecting women to the water. Episode Transcript Episode Guide :00 Intro 00:58 Tanasia's journey—from a little girl in Brooklyn to attending the New York Harbor School to leading the Billion Oyster Project's oyster reef restoration in the New York Harbor 06:16 A recap of the historical and cultural importance of oysters in New York City, starting with the Lenape, the Indigenous people of the region 11:42 The process of restoration: Like a “mother of millions,” Tanasia recruits and trains an army of students and teachers in the classroom and in the field to help establish reefs and monitor and collect data on the growth of these incredible mollusks 16:52 Becoming part of the weaved community of the waterfront: How Tanasia engages stakeholders across the five boroughs of NYC 22:00 Bridging the gap between urban communities and the marine world 25:42 Introducing Water Women NYC - a community group aimed at getting women connected with water through mentorship 30:03 Who uses waterfronts and who has the most access to them? How do we ensure more diversity in these traditionally male-dominated spaces? 34:07 Tanasia passes on a piece of advice that once was shared with her for people who are breaking barriers 37:05 Uplifting fellow Water Women NYC founders and a young lady who doesn't see herself in marine spaces (Keep going and create the community you hope to see!) Resources: Support Tanasia's efforts to restore New York Harbor's oyster reefs at the Billion Oyster Project and her mission to connect women to the water with Water Women NYC. Recommend this episode to one person who is curious how to bridge the gap between urban communities and marine spaces! Credits: The Conch podcast is a program of Seafood and Gender Equality (SAGE). Audio production, engineering, editing, mixing, and sound design by Crystal Sanders-Alvarado and team at Seaworthy. Theme music: “Dilation” by Satan's Pilgrims Funding generously provided by: David and Lucile Packard Foundation and Builders Initiative
Pete Angelo is back along with Aaron Kaplan making his debut in the pod. We talk about crazy funerals, sex with the homeless, and apparently, I'm gayer than Pete. Subscribe, write a review, and tell other people to listen where/whenever you can. It is not, and we die, you can't come to our cool funerals. Follow these dudes @metalpetecomedy and @aaronkapcomedy
Immigrating from Russia, Harry Brownstein started delivering smoked fish in a horse-drawn wagon from smokers to shops around Brooklyn in 1906. Four generations later, Emily Caslow, Harry's great granddaughter, is an owner of Acme Smoked Fish and the President of the Acme Smoked Fish Foundation—every day, she gets to align her passion for the family business with philanthropy. On Season 3, Episode 8 of The Conch, Emily shares everything from how to start a sustainability journey in a company that's over a century old to fantastic tips on reintegrating into the workforce after having kids. Episode Transcript Episode Guide :00 Intro 01:18 Immigrating from Russia, Emily's great grandfather, Harry Brownstein, starts delivering smoked fish in a horse-drawn wagon from smokers to shops around Brooklyn, New York in 1906! 3:51 Out of school, Emily realized that she could work both in the family business and in philanthropy—the best of both worlds! 6:16 Be ready for anything: How Acme fared as essential workers in the food industry during the global pandemic and managed to continue their beloved Fish Friday program. 11:06 How do you start a sustainability journey in a company that's over a century old? By focusing on four key pillars of sustainability, Acme plans to leave the world a better place. 15:28 Acme launched the Acme Smoked Fish Foundation to honor Emily's late uncle, Eric Caslow. 17:38 In 2022, the foundation launched the Seafood Industry Climate Awards (SICA) to support innovations focused on lowering the carbon footprint within the seafood industry and/or increasing the leadership role of underrepresented groups in the industry. Get to know the winners! 21:41 Emily took time off from the family business to raise her children. She shares her tips for reintegrating into the workforce. 23:59 We need to keep up the momentum and continue having conversations to support each other in this industry. 26:25 Pass the passion: Emily's advice for people wanting to enter the seafood business. 28:02 A pandemic silver lining? Work/life balance! 30:07 From the source: what living in New York was like during the early stages of the global pandemic. 33:43 Emily uplifts the inaugural winners of the SICA awards: Cara O'Donnell at Mi'kmaq Nation, Linda Behnken, Alaska Longline Fishermen's Association, and Ben Conniff, Luke's Lobster. Resources: Learn more about Acme Smoked Fish at www.acmesmokedfish.com and read about the Seafood Industry Climate Awards and the winners here. Recommend this episode to one person who is curious about how a century-old company is leading the way in seafood sustainability and climate awareness. Credits: The Conch podcast is a program of Seafood and Gender Equality (SAGE). Audio production, engineering, editing, mixing, and sound design by Crystal Sanders-Alvarado and team at Seaworthy. Theme music: “Dilation” by Satan's Pilgrims Funding generously provided by: David and Lucile Packard Foundation and Builders Initiative
According to recent research, women make up only 4% of the CEOs of the world's largest seafood companies. That's why we're especially excited to bring you Kim Gorton's story and insights—Kim is the CEO and President of Slade Gorton, a third-generation, family-owned seafood importer, processor, and distributor in Boston that got its start way back in 1849. Tune into Season 3, Episode 7 of The Conch podcast to hear how Kim carries on her family's legacy and pushes for continuous improvement in reducing waste, regenerating resources, and providing sustainable seafood with a low carbon footprint. Episode Transcript Episode Guide: :00 Intro 01:10 As the President and CEO of Slade Gorton, Kim is carrying forth her family's incredible legacy in the seafood business that began in 1849! 3:58 How Slade Gorton is realizing their commitments to reducing waste, regenerating resources, and reshaping the consumer's experience with seafood. 12:18 Climate change: the 800 lb gorilla in the seafood industry. *Read more about the complexities and nuances of the carbon footprint of seafood and other protein sources. 18:10 The seafood industry showed great resilience and collaboration during the pandemic, however challenges still linger. 22:44 Don't let perfect be the enemy of good—advice on how nonprofits and the seafood industry must work together to achieve common goals. 26:24 A career in the family seafood business wasn't always a given. 33:40 The seafood industry—once highly dangerous, unpredictable, and rigorous—is evolving into an exciting career choice for more women and youth. 37:40 Advice to SAGE: highlight accomplishments of women in the sector who merit recognition. 39:03 Kim uplifts the dynamic Sylvia Wulf! Resources: Learn more about Slade Gorton and their mission to bring wholesome, nutritious and sustainable seafood from around the world to America's table. Recommend this episode to one person who is curious about America's original seafood family! Credits: The Conch podcast is a program of Seafood and Gender Equality (SAGE). Audio production, engineering, editing, mixing, and sound design by Crystal Sanders-Alvarado and team at Seaworthy. Theme music: “Dilation” by Satan's Pilgrims Funding generously provided by: David and Lucile Packard Foundation and Builders Initiative
February 24, 2023Mark, Ray, and Scott discuss questions that came into the PRS Community. I listened to the most recent podcast episode regarding the updated PCNL codes and I'm still confused on why we can't bill 50436 or 50437 with 50080/50081? Dilation was deleted from the code description and I attended an AUA webinar in Dec 2022 that said the dilation could be reported separately. What's changed?Good morning, Does 50548 include laparoscopic bladder cuff, or would the bladder cuff be separately billable with 51999? Bladder cuff is not mentioned in the code descriptor.It was discussed at New Orleans seminar that retrograde pyelogram (74420) was not appropriate to report with stent exchanges/ureteroscopic procedures (as it is considered included as part of the guidance for these procedures). Is this direction based on CPT guidance or is there another reference? Join The Urology Coding Compliance and Education Network and get started today!Pricing and More Information The Thriving Urology Practice Facebook Grouphttps://www.facebook.com/groups/ThrivingPractice Join the discussion:Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.Click Here to Start Your Free Trial of AUACodingToday.com
More than 85 percent of the top U.S., Canadian, and European retailers have commitments to sustainable seafood. Sourcing seafood for a retail grocer is especially difficult in terms of balancing the myriad of considerations about a seafood product, but it's also an extremely rewarding career if you have a thirst for knowledge. In this episode of The Conch podcast, we chat with Daisy Berg, the Program & Category Manager for Seafood at New Seasons Market. Daisy gives us the full scoop on what it's like to be a seafood buyer for a market, why opting for local seafood is a fantastic choice, and how important it is to try lesser-known species of fish. Episode Transcript Episode Guide: :00 Intro 01:23 Daisy's father started the family seafood business to support his cousin who recently returned from the war in Vietnam. 7:00 Sourcing seafood: A day in the life of a seafood retailer. 17:07 How a farmed salmon made Daisy “eat her words.” 22:24 Why “trash fish,” aka underappreciated species, deserve our attention. 25:36 How seafood sustainability nonprofit advisors work with retailers. 29:38 Because “seafood doesn't sell itself,” the best thing to do is educate your staff to guide them on a customer's seafood journey. 32:47 The uphill road of a woman in the seafood industry, but change is on the horizon. 38:30 Women are paid less than men in our industry. We need transparency in salaries. 40:54 Do you have an unending thirst for knowledge? The seafood industry might be right for you! 41:59 Daisy uplifts colleague Sarah Baker! 43:34 Putting the “new” in New Seasons—two of the hottest seafood items are hitting the shelves AND the produce section??? Resources: Learn more about New Seasons Market's journey to become the sustainability leader in one of the most climate-friendly communities in the U.S. Recommend this episode to one person who is curious about how retailers are driving responsible seafood through their commitments to sustainability. Credits: The Conch podcast is a program of Seafood and Gender Equality (SAGE). Audio production, engineering, editing, mixing, and sound design by Crystal Sanders-Alvarado and team at Seaworthy. Theme music: “Dilation” by Satan's Pilgrims Funding generously provided by: Davide and Lucile Packard Foundation and Builders Initiative
Seafood is critical in terms of feeding the world, providing valuable jobs, and addressing the climate crisis, but many don't know what to buy or how to prepare it. How do we build seafood literacy so that people are empowered with the knowledge and confidence they need to face the seafood counter? In this episode of The Conch podcast, we chat with Trish Whetstone, a Canadian-based food literacy educator, writer, and fishmonger on a mission to simplify the seafood experience. Trish translates the complexities of the seafood industry into real talk for fish curious folk through engaging hands-on workshops, events, and experiences. Episode Transcript Episode Guide :00 Intro 01:25 Trish's obsession with seafood led her down a winding career path to fish through the arts, music, folklore, and storytelling. 10:48 Living in a coastal community that feels disconnected from its local food sources, including seafood, sparked a new career. 12:17 First podcast shout out to the Fisher Poets Gathering, where people share art, poetry, and music to share their deep and intrinsic connection to fishing. 14:45 Filleting a fish is an empowering skill, and even YOU can do it! 19:11 Eliminating the mystery behind fish and seafood: what is seafood literacy and why is it important? 24:22 Ever heard of Newfoundland Screech? Trish shares one of her FAVORITE fish facts. 26:53 Why is tinned seafood a “rabbit hole?” Let's dive in! 31:14 The importance and value of collaborations and partnerships. 37:18 Trish uplifts Bretton Hills, an oyster and kelp farmer! 38:44 What's next for Trish and how to find her online. Resources: Head over to trishtalksfish.com to find more exciting fish knowledge and check out her upcoming events, workshops, and experiences. Explore the fascinating history of women's contributions to the fisheries of Newfoundland in this article. https://www.heritage.nf.ca/articles/economy/women-fishery.php Recommend this episode to one person who wants to become seafood literate! The Conch podcast is a program of Seafood and Gender Equality (SAGE). Audio production, engineering, editing, mixing, and sound design by Crystal Sanders-Alvarado and team at Seaworthy. Theme music: “Dilation” by Satan's Pilgrims
I read from dihydroxyacetone to dilation. As you know, "Dikes can be either magmatic or sedimentary in origin." https://en.wikipedia.org/wiki/Dike_(geology) "A dilatant is a non-Newtonian fluid where the shear viscosity increases with applied shear stress." https://en.wikipedia.org/wiki/Dilatant The word of the episode is "dilapidated". Theme music from Tom Maslowski https://zestysol.com/ Merchandising! https://www.teepublic.com/user/spejampar "The Dictionary - Letter A" on YouTube "The Dictionary - Letter B" on YouTube "The Dictionary - Letter C" on YouTube "The Dictionary - Letter D" on YouTube Featured in a Top 10 Dictionary Podcasts list! https://blog.feedspot.com/dictionary_podcasts/ Backwards Talking on YouTube: https://www.youtube.com/playlist?list=PLmIujMwEDbgZUexyR90jaTEEVmAYcCzuq dictionarypod@gmail.com https://www.facebook.com/thedictionarypod/ https://twitter.com/dictionarypod https://www.instagram.com/dictionarypod/ https://www.patreon.com/spejampar https://www.tiktok.com/@spejampar 917-727-5757
A deep dive into dilation during Seldinger techniques, such as central line placement: tips, pitfalls, and pearls.
In this episode of BackTable ENT, Dr. Ashley Agan and Dr. Seilesh Babu discuss Eustachian tube dysfunction and balloon dilation as a therapeutic option. --- CHECK OUT OUR SPONSOR Acclarent https://www.jnjmedtech.com/en-US/companies/acclarent --- SHOW NOTES First, Dr. Babu provides background on Eustachian tube dysfunction. In kids and adults, Eustachian tube dysfunction can present as a sensation of “ear fullness”, recurrent fluid in the ear, or discomfort with pressure challenges, such as flying or scuba diving. Medical management involves nasal steroids, allergy medications, anti-reflux medications, avoidance of allergens, and doing a modified Valsalva maneuver at home. Additionally, ear tubes and balloon dilation are procedural options. Next, Dr. Babu explains his workup for Eustachian tube dysfunction patients. He takes a thorough patient history and examines the patient's tympanic membrane, nasopharynx, and serous outflow using a flexible scope. He orders an audiogram for all of his patients but notes that tympanograms are not as critical. For patients with discomfort during pressure challenges, he will consider doing a balloon dilation or placing an ear tube. For patients presenting with “ear fullness”, a more in-depth examination must be done through a trial tympanostomy tube or a myringotomy. He also looks for red flags, which indicate Eustachian tube dysfunction may not be the correct etiology for their ear symptoms. These red flags include: aggravation of symptoms upon tube insertion, symptoms of dizziness and vertigo, autophony, and pulsatile tinnitus. Although it is rare, a diagnosis of Patulous Eustachian tube dysfunction must be considered. If the patient does not have these red flags and has had multiple ear tubes without symptom relief, they may be a good candidate for balloon dilation. Dr. Babu then delineates his procedure for a Eustachian tube balloon dilation. He performs this procedure in the OR using the Acclarent AERA Eustachian tube dilation system. He inflates the balloon to achieve a pressure of 12 atm, keeps it dilated for 2 minutes, then removes the instrument. Some procedural pearls he shares are: putting the scope and balloon in at the same time to minimize bleeding in the nasopharynx and guiding the instruments in a lateral direction towards the external ear canal. He usually waits 2-3 weeks before reassessing the patient for recurrent symptoms. Upon discharge, he encourages patients to avoid nose blowing and Valsalva maneuvers, as these actions can cause a pneumothorax or pneumomediastinum. Common postoperative symptoms include minor nose bleeds and the sensation of a sore throat. Dr. Babu usually performs the balloon dilation in conjunction with other OR procedures, such as myringotomies and tympanoplasties, for efficacy. Finally, the doctors discuss the specifics of billing for the Eustachian tube dilation procedure. In recent years, a specific billing code has been assigned for balloon dilation, and insurance companies are beginning to authorize this procedure for a variety of patients. Devices discussed in this podcast are currently available in the US only. Acclarent, Inc. 223616-220810 --- RESOURCES Acclarent: https://www.jnjmedtech.com/en-US/companies/acclarent AERA® Esutachian Tube Balloon Dilation System: https://www.jnjmedtech.com/en-US/product/Acclarent-aera-eustachian-tube-balloon-dilation-system Howard, A., Babu, S., Haupert, M., & Thottam, P. J. (2021). Balloon Eustachian Tuboplasty in Pediatric Patients: Is it Safe?. The Laryngoscope, 131(7), 1657–1662. https://doi.org/10.1002/lary.29241
I read from dairying to Dallis grass. Damselflies! https://en.wikipedia.org/wiki/Damselfly Danaë! https://en.wikipedia.org/wiki/Dana%C3%AB Dancing definition from WALL-E: "A series of movements involving two partners, where speed and rhythm match harmoniously with music." The word of the episode is "D&C" aka "dilation and curettage". https://en.wikipedia.org/wiki/Dilation_and_curettage Theme music from Jonah Kraut https://jonahkraut.bandcamp.com/ Merchandising! https://www.teepublic.com/user/spejampar "The Dictionary - Letter A" on YouTube "The Dictionary - Letter B" on YouTube "The Dictionary - Letter C" on YouTube Featured in a Top 10 Dictionary Podcasts list! https://blog.feedspot.com/dictionary_podcasts/ Backwards Talking on YouTube: https://www.youtube.com/playlist?list=PLmIujMwEDbgZUexyR90jaTEEVmAYcCzuq dictionarypod@gmail.com https://www.facebook.com/thedictionarypod/ https://twitter.com/dictionarypod https://www.instagram.com/dictionarypod/ https://www.patreon.com/spejampar https://www.tiktok.com/@spejampar 917-727-5757
Heidi talks about Station, Position, Effacement, and Dilation and why you need to ask for 5 markers in this 4 letter acronym every single time you consent to a vaginal exam. To join Birth Story Academy for your childbirth education, use code BIRTHSTORYFRIEND for $20 OFF. XOXO- Heidi Hope to see you in our private Facebook group when you join BSA!
On this week's episode e of Food, Freedom and Fertility we are joined by Karly Nuttall a Midwife and Educator. Karly is a certified Professional Midwife who has also launched on online school, Midwifery Finishing School. Today we have Karly here to discuss Midwifery Care for Pregnancy Health specifically focused on pregnancy loss. The Midwifery approach to pregnancy loss is very open and diverse. The thought process is that there is not one correct way to handle this but better yet you must do what is right for you and your family. Karly helps us understand the risk of infection for non-viable pregnancies and the details of a natural miscarriage and letting it pass on its own. Also, she discusses the benefits of this process and how you can truly make this experience something that will help you fell more at peace with the situation better. Karly walks us through how each miscarriage can be extremely different and especially based on how far along you are. One of those options is a D&C. She helps us understand what a D&C is… not to be confused as DNC. A D and C is Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. A lot of people assume D&C is specifically for the removal after a miscarriage but it can also be used for other uterine conditions. But she also explains that all medical procedures should have a discussion and informed consent with full explanation of all of a patient's options. Karly discusses that pregnancy loss early is commonly due to genetic abnormalities. Rarely are external causes the root of a miscarriage. Typically, women who are 35 and younger have a harder time requesting genetic testing until 3 miscarriages, however Karly suggests that if you feel the need for any testing you should speak up and find a provider that will support your decisions. Some of the testing to be done is to check for progesterone levels, MTHFR gene mutation and thyroid levels. Having a support team in place and a referral network will assist in your right as a patient to request these tests. The role of a midwife is discussed at length and what role your midwife will have in the scenario that you have a miscarriage at any time during your pregnancy. Traditionally we as a society feel it is expected to hand over our bodily functions to the hospital and doctors. However, Midwives' goals are to help people feel connected to the process. Take ownership of not only decisions but the process. Miscarriage is a difficult topic to navigate, but we want you to remember that you have options, you have support you don't have to do things a certain way. You get to regard the life of your baby however works for you and if your providers do not support that it is ok to find someone else who does. If you would like to learn more about Karly Nuttall please check her out at the links below. www.karlynuttall.com Midwifery Finishing School Podcast Instagram
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