Podcasts about early onset

Sara and Heather are exploring the nature of codependency and its impact on individuals pursuing an alcohol-free lifestyle. Through Heather's personal experiences and in-depth research, they discuss key aspects such as caretaking as control, the chameleon effect, chronic guilt, and the rescue complex. They highlight the roots of codependency in dysfunctional families and its manifestation in adult relationships and parenting. Practical advice is offered on recognizing and overcoming these behaviors through strategies like setting boundaries, embracing authenticity, practicing mindfulness, and seeking professional help. Additionally, the role of community support, creativity, and journaling is emphasized, along with the benefits of groups like Codependents Anonymous. The episode encourages listeners to reclaim their personal identity, enhance emotional well-being, and invites them to engage with supportive communities for continued growth.   00:00 Introduction to Codependency 00:51 Heather's Personal Journey with Codependency 02:33 Characteristics of Codependency 03:22 The Chameleon Effect and Personal Reflections 04:51 Chronic Guilt and Emotional Invisibility 08:25 Rescue Complex and Its Implications 12:42 Causes and Early Onset of Codependency 15:09 Understanding Codependency Beyond Alcohol 15:45 The Real Work Begins After Quitting Alcohol 17:55 Strategies to Break Free from Codependency 17:57 Embracing Authenticity and Self-Discovery 19:37 The Importance of Setting Boundaries 20:11 Reframing Self-Care as a Necessity 23:21 The Power of Community Support 26:04 Conclusion: Reclaiming Your Identity   Resources Mentioned: Join The Daymakers Community for personalized support and real-time interaction on alcohol-free topics. One-on-one coaching spots available with Heather. If you enjoy this episode, share it  with a friend who's navigating change or looking to stay alcohol-free. And please support the podcast by leaving a review.   Stay connected and tune in every Tuesday for more inspiring conversations on living alcohol-free! ************************************************   Looking for support on your alcohol free journey? Consider joining us in the Day Makers Community.  CLICK HERE for all the details. Want some 1-on-1 support on your alcohol free journey?  Work with Heather as your alcohol free coach.  CLICK HERE to start working with Heather today. ************************************************ Follow the podcast on Social Media: IG: @nomorewasteddays.pod   Follow Sara on Social Media: IG: @no_more_wasted_days TikTok: @no_more_wasted_days Facebook: https://www.facebook.com/NoMoreWastedDaysOfficial   Follow Heather on Social Media: IG: @theheatherleecollective TikTok: @thealcoholfreecoach

In this episode, we meet Bobby Krause, a former college athlete and sales executive who was diagnosed with early-onset Parkinson's disease at age 42. Bobby candidly discusses his struggle with debilitating tremors that impacted his ability to engage with his family and perform at work. After experiencing severe side effects from medications, Bobby turned to focused ultrasound treatment for help.   Bobby provides a vivid account of the focused ultrasound procedure, describing the immediate and profound results he experienced. Within hours, his tremors disappeared and muscle rigidity eased, allowing him to hike with his sons the very same day. Bobby remains tremor-free and has returned to coaching basketball and other activities he previously enjoyed.   Now a passionate advocate for focused ultrasound technology, Bobby has spoken to U.S. policymakers about his experience and founded the Be Still Foundation. The foundation aims to provide financial assistance for those seeking focused ultrasound treatment and raise awareness about this innovative technology. Be Still Foundation SHOW TRANSCRIPT ---------------------------- QUESTIONS? Email podcast@fusfoundation.org if you have a question or comment about the show, or if you would you like to connect about future guest appearances.  Email info@fusfoundation.org if you have questions about focused ultrasound or the Foundation.  FUSF SOCIAL MEDIA LinkedIn X Facebook Instagram TikTok YouTube FUSF WEBSITE https://www.fusfoundation.org SIGN UP FOR OUR FREE NEWSLETTER https://www.fusfoundation.org/newsletter-signup/ READ THE LATEST NEWSLETTER https://www.fusfoundation.org/the-foundation/news-media/newsletter/ DOWNLOAD "THE TUMOR" BY JOHN GRISHAM (FREE E-BOOK) https://www.fusfoundation.org/read-the-tumor-by-john-grisham/

JCO PO author Dr. Alok A. Khorana, MD, FASCO, Professor of Medicine, Cleveland Clinic and Case Comprehensive Cancer Center, shares insights into the JCO PO article, “Molecular Differences With Therapeutic Implications in Early-Onset Compared With Average-Onset Biliary Tract Cancers.” Host Dr. Rafeh Naqash and Dr. Khorana discuss how multiomic analysis shows higher FGFR2 fusions and immunotherapy marker variations in early-onset biliary cancer. TRANSCRIPT Dr. Rafeh Naqash: Hello, and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO POarticles. I'm your host, Dr. Rafeh Naqash, Podcast Editor for JCO Precision Oncology and Assistant Professor at the OU Health Stephenson Cancer Center at the University of Oklahoma.  Today, we are joined by Dr. Alok A. Khorana, Professor of Medicine at the Cleveland Clinic and Case Comprehensive Cancer Center, and also the Senior Author of the JCO Precision Oncology article titled, “Molecular Differences With Therapeutic Implications in Early-Onset Compared With Average-Onset Biliary Tract Cancers.”  At the time of this recording, our guest disclosures will be linked in the transcript.  Dr. Khorana, it's an absolute pleasure to have you here today, and welcome to the podcast. Dr. Alok A. Khorana: Thank you. It's an absolute pleasure to be here and thank you for highlighting this article. Dr. Rafeh Naqash: Absolutely. We're going to talk about science, obviously, and a few other things. So to start off, for the sake of our audience, which comprises academicians and community oncologists as well as trainees, can you tell us a little bit about biliary tract cancers, what we have learned over the last decade or so, where the standard of treatment currently lies. And then we can dive into the article that you published. Dr. Alok A. Khorana: As many of you who treat GI cancers know, biliary tract cancers for a long period of time were sort of the orphan cancer in the GI cancer world. They're not nearly as common as, say, pancreatic cancer, and certainly not as common as colorectal cancer. They're sort of also, in this weird ‘no man's land' between well known sort of adjuvant therapy trials in pancreatic cancer or colorectal cancer, but because they're not as high in volume, there weren't really large trials done in this population. What's really changed in the past decade, especially, has been the slow but sure realization that biliary tract cancers are in fact a target rich cancer, almost similar to what you would see with lung cancer, and that's only a slight exaggeration. And in some studies, as many as up to 40% of patients with biliary tract cancers can have something that's targetable. And that's really revolutionized the way we think of biliary tract cancers. It also separated this field from pancreatic cancer where formerly the two used to be lumped together, and even within biliary tract cancers, we are now slowly realizing that there are differences between intrahepatic, extrahepatic and gallbladder cancers. Big change is really afoot in this field, particularly with the identification of mutation directed targets. Dr. Rafeh Naqash: Thank you for that explanation.  Now, another question I have is, although I don't see any GI cancers, but I have good colleagues of mine at our cancer center who see a lot of GI pancreatic/biliary cancers, and one of the things that comes up in our molecular tumor board often is how certain cancers of unknown primary end up being identified or categorized as biliary tract cancers based on NGS. And again, the uptake for these NGS is perhaps isn't optimal in the field yet, but in your practice, how do you approach situations like that? Do you use NGS in certain cases where the tissue of origin or the patterns of the mutations indicate that this might be biliary tract cancer and then treat the patient accordingly?  Dr. Alok A. Khorana: Yeah, that's true. And that's certainly how I approach things, and I would say even in my own personal practice, that has been a change. I was a little bit skeptical about the benefit of sort of tissue of origin type of testing in carcinoma of unknown, primarily, especially if you can sort of narrow it down to one or other area of the GI tract. But with the identification of sort of targeted subpopulations, especially of biliary tract cancer, I think it's become imperative. And I know we're going to get into the paper, but if you want to learn nothing else from this 20, 25 minute podcast, one lesson I just want to make sure everybody gets is that any patient with biliary tract cancer should have NGS done as soon as possible. Dr. Rafeh Naqash: Thank you for highlighting that important aspect.  Now, going to the topic at hand, what was the driving factor? I've heard a lot about colorectal cancers, early onset versus later onset. What was the reason that you looked at biliary tract cancers? Is that something that you've seen on a rise as far as early onset biliary tract cancers is concerned?  Dr. Alok A. Khorana: Yeah. So we got into this subject also from starting out at colorectal cancer. And as you know, and I'm sure most of your audience knows, there's been a lot of literature out there over the past five, six, seven years suggesting and then documenting and then sort of proving and reproving that colorectal cancer is on the rise, and especially in people younger than age 50. And even in that population, it's on the rise in two different subpopulations, people in their 20s and 30s and then people in their 40s that are close to the screening colonoscopy rates. That's been investigated heavily. We still don't fully understand why that's happening, but it's not restricted to the United States. It's a worldwide phenomenon. You can see it in the United States, in North America. You can see it in western Europe, but you can also see it in many Asian countries with specific sort of subpopulations. For instance, in some countries, men are more likely to have early onset cancers.   And then a newer finding that sort of emerged over the past couple of years is that this early onset increase in cancers is not just restricted to colorectal cancer, although that's the one that sticks out the most, but in fact, is widespread across a bunch of different types of cancers. In my own research program, we had gotten into a sort of better understanding of early onset colorectal cancer a couple of years ago, driven primarily by the sort of patients that I saw in my practice. And it's just, as you know, when you have a couple of those heartbreaking cases and they're just impossible to forget, and it sort of just drives your attention, and then you want to do something to help them. And if you can't help them personally, then you want to do something that can change the field so that more of these patients are not coming in your clinic next year or the year after.  So a couple years ago, at the Cleveland Clinic where I practice, we created a center for young onset cancers, and at the time it was primarily focused on colorectal cancer. But as we are getting into colorectal cancer, we realize that beyond colorectal cancer, we are also starting to see more younger people with other cancers, including pancreas cancer, including gastric cancer, and including bile duct cancers. And we realized that because so much attention was being focused on colorectal, that maybe we should also be paying a little bit of attention to what was happening in this space. I want to, for your listeners, point out that the problem in bile duct cancers is not to the same degree as you see in colorectal cancer. Just a couple numbers to sort of, to set this in perspective: about 5%, 7% of bile duct cancers are young onset - it's not a huge proportion - 90%+ percent of patients are not young onset. But the impact on society, the impacts on those providing care, is obviously substantial for younger patients. And it is true that even though the proportion of patients is not that high, the incidence is rising.   And there's a very nice study done a couple of years ago and published that looked at what the cancers are that are rising at the highest rates. And bile duct cancer and gallbladder cancers were listed amongst the two with the highest rate, so about an 8% rate per year of increase. And so that's really what drove our interest was, as we're seeing early onset bile duct cancers, it's rising year by year, and what is this disease? Is it the same as you see in sort of the average patient with bile duct cancer? Is it different? How do we characterize it? How do we understand it? What are some of the causes precipitating it? And so that's what led us to sort of one of the investigations that we've documented in this paper.  Dr. Rafeh Naqash: Excellent.   So, talking about this paper, again, can you describe the kind of data that you use to understand the molecular differences and also look at potential immune signatures, etc., differences between the groups? Dr. Alok A. Khorana: Yeah. So the objective in this paper was to look at genomic differences between early onset and usual onset, or average onset biliary tract cancers. And this sort of followed the paradigm that's already been established for early onset colorectal cancer, where you take a bunch of people with early onset disease, a bunch of patients with average onset or usual onset disease, and then look at the profiling of the tumors. And we've done this for genomics, we've done this for microbiomics, we've done it for metabolomics. And the lessons we've learned in colorectal cancer is that, in many ways, the profiles are actually quite substantially different. And you can almost think of them as diseases of the same organ, but caused by different processes, and therefore leading to different genotypes and phenotypes and microbiomes. We had absorbed that lesson from colorectal cancer, and we wanted to replicate it in this type of cancer.  But as we discussed earlier, this is a relatively rare cancer, not that many cases per year. For colorectal, we could do a single institution or two institution studies. But for this, we realized we needed to reach out to a source of data that would have access to large national data sets. We were happy to collaborate with Caris Life Sciences. Caris, many of you might know, is a provider of genomics data, like many other companies, and they house this data, and they had the age categorization of patients less than 50, more than 50. And so we collaborated with investigators at Caris to look at all the specimens that had come in of bile duct cancers, identified some that were young onset and some that were older onset. It was roughly about 450 patients with the early onset or young onset, and about 5000 patients with usual onset cases. And then we looked at the genomics profiling of these patients. We looked at NGS, whole exome sequencing, whole transcriptome sequencing, and some immunohistochemistry for usual, like PDL-1 and MSI High and things like that. And the purpose was to say, are there differences in molecular profiling of the younger patient versus the older patient? And the short answer is yes, we did find substantial differences, and very crucial for providers treating these patients is that we found a much higher prevalence of FGFR2 fusion. And that's important because, as I'm sure you've heard, there's a ton of new drugs coming out that are targeting specifically FGFR fusion in this and other populations. And hence my statement at the outset saying you've got to get NGS on everybody, because especially younger patients seem to have higher rates of some of these mutations.  Dr. Rafeh Naqash: Excellent. You also looked at the transcriptome, and from what I recollect, you identified that later onset tumors had perhaps more immune favorable tumor microenvironment than the early onset. But on the contrary, you did find that FGFR2 early onset had better survival. So how do you connect the two? Is there an FGFR link, or is there an immune signature link within the FGFR cohort for early onset that could explain the differences? Dr. Alok A. Khorana: Yeah, that's a great question. So, to kind of summarize a couple of these things you talked about. So, one is we looked at these genomic alterations, and, yes, FGFR2 fusion was much more prevalent. It's close to 16% of young onset patients, as opposed to roughly 6% of average onset patients. So almost a threefold increase in FGFR fusion. And because there's so many drugs that are targeting FGFR fusion, and because the population included a period of time when these drugs had already been approved, we think some of the benefit or the improvement in median survival associated with being younger is likely driven by having more FGFR fusion and therefore having more drugs available to treat FGFR fusion related tract cancer with corresponding increase and increase in survival. And that was part of it. There was one other alteration, NIPBL fusion, that's been sort of known to be associated with a certain subtype of cholangiocarcinoma, but it doesn't really have a drug that targets it, so it's not sort of very useful from a clinical perspective.   The other two things you talked about, so transcriptome and immuno oncology markers, we found a couple different results on this. So one is that we found in younger people, angiogenesis was enriched, and why this is so we don't quite have a good answer for that. The other was inflammatory responses. So there's a couple of gamma interferon pathways and a couple other types of pathways that you can sort of do pathway analysis, and we found that those were enriched in the older patients or the average onset patients. But the benefit for immunotherapy was similar across the two groups. So even though we saw these differences in signaling in terms of which pathways are upregulated or downregulated, it didn't seem to translate into the current generation of immune checkpoint inhibitors that we're using in terms of benefit for patients. But we did see those differences.  Dr. Rafeh Naqash: I completely agree, Doctor Khorana. As you mentioned, that one size fits all approach does not necessarily work towards a better, optimal, personalized treatment stratification. So, as we do more and more sequencing and testing for individuals, whether it's early onset cancers or later onset cancers, figuring out what is enriched and which subtype, I think, makes the most sense.   Now, going to the FGFR2 story, as you and most listeners probably already know, FGFR is an approved target, and there are a band of FGFR inhibitors, and there's some interest towards developing specific FGFR2, 3 fusion inhibitors. What has your experience with FGFR inhibitors in the clinic been so far? And what are you personally excited about from an FGFR standpoint, in the drug development space for GI cancers?  Dr. Alok A. Khorana: Yeah, I think the whole FGFR fusion story sort of actually deserves more excitement than it's gotten, and it may be because, as I mentioned earlier, biliary tract cancers are a relatively low volume type of cancer. But the results that we are seeing in the clinic are very impressive. And the results that we are anticipating, based on some ongoing phase two and phase three trials, appear to be even more impressive for the very specific inhibitors that are about to hopefully come out soon.   Also, the possibility of using successive lines of FGFR inhibitors - if one fails, you try a second one; if the second one fails, you try a third one because the mechanisms are subtly different - I think it will take a little while to figure out the exact sequencing and also the sort of the rates of response in people who might previously have been exposed to an FGFR inhibitor. So that data may not be readily available, because right now most patients are going in for longer trials. But having that type of possibility, I think, kind of reminds me of the excitement around CML back when imatinib suddenly became not the only drug and a bunch of other drugs came out, and it's kind of like that. I think again, it's not a very common cancer, but it's really wonderful to see so many options and more options along the way for our patients. Dr. Rafeh Naqash: Thank you. Now, going to your personal story, which is the second part of this conversation, which I think personally, for me, is always very exciting when I try to ask people about their personal journeys. For the sake of the listeners, I can say that when I was a trainee, I used to hear about Dr. Khorana's course, I always thought that Dr. Alok Khorana was a hematologist. My friends corrected me a few years back and said that you're a GI oncologist. Can you tell us about your love for GI oncology and the intersection with hematology thrombosis, which you have had a successful career in also? Can you explain how that came about a little bit? Dr. Alok A. Khorana: Yeah, sure. So it is a common, I guess I shouldn't say misperception, but it's certainly a common perception that I'm a hematologist. But I'll sort of state for the record that I never boarded in hematology. I did do a combined hem-onc fellowship, but only boarded in oncology. So I'm actually not even boarded in hematology. My interest in thrombosis came about- it's one of those things that sort of happen when you're starting out in your career, and things align together in ways that you don't sort of fully understand at the time. And then suddenly, 10 years later, you have sort of a career in this.   But it actually came about because of the intersection of, at the time, angiogenesis and coagulation. And this is the late ‘90s, early two ‘00s, there was a lot of buzz around the fact that many of the factors that are important for coagulation are also pro angiogenic and many factors that are coagulation inhibitors. These are naturally occurring molecules in your body, and can be anticoagulant and anti angiogenic. A great example of this is tissue factor, which is, as you'll remember from the coagulation pathways, the number one molecule that starts off the whole process. But less widely appreciated is the fact that nearly every malignancy expresses tissue factor on its cell surface. This includes breast cancer, it includes leukemia cells, it includes pancreatic cancer. In some cancers, like pancreatic cancer, we've even shown that you can detect it in the blood circulation. And so for me, as a GI oncologist who was seeing a lot of patients get blood clots, it was particularly fascinating to sort of see this intersection and try and understand what is this interaction between the coagulation and angiogenic cascades that's so vital for cancers. Why is coagulation always upregulated in cancer patients? Not all of them get blood clots, but subclinical activation of coagulation always exists. So I would say I was fascinated by it as an intellectual question and really approached it from an oncology perspective and not a hematology perspective.   But then as I got deeper into it, I realized not everybody's getting blood clots, and how can I better predict which patients will get blood clots. And so I had both a hematology mentor, Charlie Francis, and an oncology mentor, Gary Lyman. And using sort of both their expertise, I drafted a K23 career development award specifically to identify predictors of blood clots in cancer patients. And that's the multivariate model that later became known as the Khorana Score. So again, I approach it from an oncology perspective, not a hematology perspective, but really a fascinating and still, I would say an understudied subject is why are cancer patients having so many clotting problems? And what does it say about the way cancer develops biologically that requires activation of the coagulation system across all of these different cancers? And I think we still don't fully understand the breadth of that. Dr. Rafeh Naqash: Very intriguing how you connected two and two and made it a unique success story. And I completely agree with you on the tissue factor. Now there's ADCs antibody drug conjugates that target tissue factor, both a prude as well as upcoming.   Now, the second part of my question is on your personal journey, and I know you've talked about it on social media previously, at least I've seen it on social media, about your interactions with your uncle, Dr. Har Gobind Khorana, who was a Nobel Prize winner in medicine and physiology for his work on DNA. Could you tell us about how that perhaps shaped some of your personal journey and then how you continued, and then also some personal advice for junior faculty trainees as they proceed towards a successful career of their own? Dr. Alok A. Khorana: Yeah, thank you for bringing that up. So very briefly, this is about my uncle. He's actually my great uncle. So he's my grandfather's youngest brother. And I grew up in India in the ‘70s and ‘80s, and at the time, I ran away from this association as fast as I could, because growing up in India in the 70s and ‘80s, it was a socialist economy. There wasn't a lot going on. There was certainly none of the IT industry and all of everything that you see right now. And so there were very few icons, and my great uncle was definitely one of those few icons. As soon as you mentioned your last name, that would sort of be the first question people would ask. But he did serve as a role model, I think, both to my father, who was also a physician scientist and a professor of medicine, and then to myself in sort of making me realize, one, that you can't really separate medicine from science. I think those are really integrated, and we want to ask questions and answer questions in a scientific manner. He chose to do it in a basic science world. My father did it in a clinical science world, and I have done it in a clinical and a translational science world. Again, sort of using science as the underpinning for sort of understanding diseases, I think, is key. And so that was certainly a massive inspiration to me.  And then after I immigrated to the US in the late ‘90s, I met him on a regular basis. He was certainly very inspirational in his successes, and I realized the breadth of what he had done, which I did not realize in my youth growing up. But this is a person who came to the US. This was before Asian immigration was even legal. So he got here and they had to pass a special bill in Congress to let him be a citizen that was based on the sort of work that he had done in Canada and in the UK before he came here. And then he sets up shop in the University of Wisconsin in Madison and hires tons of these postdocs and essentially converted his lab into this massive factory, trying to figure out the genetic code. Really just the type of dedication that that needs and the amount of work that that needs and the ability to do that in a setting far removed from where he grew up, I think it's just really quite mind boggling.  And then he didn't stop there. He got the Nobel for that, but I have these letters that he wrote after he got the Nobel Prize, and he was just completely obsessed with the possibility that getting the Nobel would make him sort of lose his mojo and he wouldn't be as focused on the next aspects of science. And he was just really dedicated to synthesizing DNA in the lab, so creating artificial DNA, which he ended up doing. And the offshoot of that work, so not just the genetic code, but PCR essentially was developed by his lab before it became sort of what we now know as PCR. And then ditches all of that in the ‘80s and ‘90s and moves to understanding the retina and just focuses on retinal disorders. And then signal transduction, essentially trying to figure out when a single photon of light hits your eye, what happens biologically. It's a completely different field. And just took that on and spent the next 20,30 years of his life doing that. So the ability to sort of change fields, I thought that was very inspirational as well, that you don't have to just stick to one question. You can get into one question, answer it as much as possible, and then find something else that's really interesting to you and that really grabs your attention, and then stick with that for the next couple of decades. So lots to learn there. Dr. Rafeh Naqash: Thank you. Thank you. And then, based on some of your personal lessons, what's your advice for junior faculty and trainees as you've progressed in your career?  Dr. Alok A. Khorana: I think, number one, and I can't emphasize this enough, and sometimes it actually causes a little bit of anxiety, but it is finding the right mentor. And for me, certainly that was key, because my mentor, who was Charlie Francis, was not an oncologist who was a hematologist, but was like me, sort of supported this idea of trying to understand, hey, why does coagulation interact with cancer? And so he approached it from a hematology perspective, I approached it from a cancer perspective, but he sort of gave me the freedom to ask those questions in his lab and then later on in the clinical setting and clinical translational setting, and then got me access to other people who are experts in the field and introducing you and then getting you on committees and making sure you sort of get into clinical trials and so on. And so having a mentor who sort of supports you but doesn't stifle you, and that's really key because you don't want to just ask the question that the mentor is interested in. And as a mentor now, I don't want to have my mentee ask the question that I'm interested in, but also a question that the mentee is interested in. And so there's a little bit of a chemistry there that's not always replicable, and it can go wrong in sort of five different ways, but when it goes right, it's really vital. And I mentioned it causes anxiety because, of course, not every day is great with your mentor or with your mentee, but over a period of time, has this person done sort of their best to get your career off to a start? And have you served that mentor well by doing the things that are– there's responsibilities on both sides, on both on the mentor and on the mentee. And if you can find that relationship where there's a little bit of chemistry there and both of you are effectively discharging both your responsibilities and satisfying your intellectual curiosity, I think that can't be beat, honestly. To me, sort of number one is that and everything else follows from that. So, the networking, making sure your time is sort of allocated appropriately, fighting with sort of the higher ups to make sure that you're not having to do too much, things that are sort of away from your research interests, all of that sort of flows from having the right person. Dr. Rafeh Naqash: Couldn't agree with you more, Dr. Khorana, thank you so much. It was an absolute pleasure. Thank you for sharing with us the science, the personal as well as the professional journey that you had. And hopefully, when you have the next Khorana Score, Khorana score 2.0, JCO Precision Oncology will become the home for that paper and we'll try to have you again maybe in the near future.  Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcast. Thank you so much.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement.   Disclosures: Dr. Khorana  - Honoraria Company: Pfizer, Bayer,  Anthos, Sanofi, BMS, WebMD/MedscapeConsulting or Advisory Role Company: Janssen, Bayer, Anthos, Pfizer, Sanofi, BMS Research Funding Company: Anthos, Bristol-Myers,  Squibb Travel, Accommodations, Expenses Company: Janssen, Bayer, Bristol-Myers Squibb 

This episode of the Game Plan Podcast is sponsored by BetterHelp.If you're thinking of starting therapy, give BetterHelp a try. It's entirely online. Designed to be convenient, flexible, and suited to your schedule. Just fill out a brief questionnaire to get matched with a licensed therapist, and switch therapists any time for no additional charge.Visit https://www.betterhelp.com/Gameplan today to get 10% off your first month.Welcome back to another episode of the Game Plan Podcast!Today, we're sitting down with Louisa Nicola, neuroscientist and human performance expert, to unlock the secrets of optimizing your brain and body. Louisa has worked with top athletes and executives, helping them achieve peak performance through science-backed strategies.In this episode, Louisa dives into the essentials of human performance, breaking down the importance of exercise, sleep, and nutrition. We explore the benefits of cold exposure, ice baths, and saunas—why these techniques are more than just trends and how they can supercharge your brain and body.We also dig into the role of creatine for cognitive health, debunk myths around biohacking, and reveal the key to mastering your sleep for better mental clarity and productivity. Stay tuned till the end as Louisa offers insights into managing toxins like microplastics, the power of morning sunlight, and how a simple shift in your daily routine can drastically improve your life.Hit play now, and don't forget to like, comment, and subscribe for more high-performance insights!Louisa's Socials:Instagram: https://www.instagram.com/louisanicola_/YouTube: https://www.youtube.com/c/LouisaNicolaCheck out the best protein pancakes in the world at Fuel Cakes: https://fuelcakes.com/

This episode of The Manchester Living Podcast is a personal and insightful discussion about early-onset Alzheimer's, featuring Brian Levy in conversation with Jeff and Kim Kort along with Brenda Shuttlesworth. Jeff's diagnosis at just 56 years old offers a personal perspective on the disease, while the family shares their strategies for coping and the crucial role of support systems. This episode emphasizes both the emotional difficulties and the hope that can be found in facing such challenges together. It would be a valuable listen for anyone impacted by Alzheimer's or interested in learning more about the realities of living with this diagnosis.http://www.ManchesterLivingPodcast.com

In this episode of the Brain and Body Things podcast, host Dr. Natasha Mehta is joined by Dr. Veda Giri and Dr. Nancy Borstelmann from Yale Cancer Center to discuss early onset cancer. Dr. Giri, a medical oncologist specializing in clinical cancer genetics, and Dr. Borstelmann, an expert in chronic disease epidemiology and social work, both co-lead Yale's Early Onset Cancer Program. They delve into the unique needs and challenges faced by young cancer patients, insights into genetic testing, the importance of tailored cancer screening, and the multifactorial nature of rising cancer rates in younger populations. The episode also highlights novel approaches in patient care, support systems, and the roles of lifestyle and mental health in managing cancer.00:00 Introduction to the Brain and Body Things Podcast00:41 Season Four Kickoff: Early Onset Cancer01:18 Meet the Experts: Dr. Giri and Dr. Borstmann02:51 Understanding Early Onset Cancer09:07 Genetic Testing and Cancer Screening18:27 Rising Rates of Early Onset Cancer22:16 Holistic Care for Cancer Patients29:18 Yale's Early Onset Cancer Program33:26 Patient Engagement and Awareness34:14 Personalized Patient Navigation35:48 Addressing Clinical Trials and Support Needs37:29 Psychosocial Focus in Healthcare38:50 Cancer Screening and Risk Assessment41:15 Healthy Lifestyle and Mental Health47:49 Rising Cancer Rates and Prevention49:13 Self-Care Practices of Healthcare Professionals58:18 Conclusion and Final ThoughtsThe podcast episodes drop weekly on Monday's in seasonal chunks. Subscribe to stay up to date, and tune in when you can! Be sure to rate, review, and follow on your favorite podcast app and let me know what other brain & body things you'd like to hear about. For more information about me, check out my website.Follow me on Instagram or Tik Tok @drnatashamehta.This episode is not sponsored.

When TFMR is for YOUR health, also called Termination for Maternal Health or Termination for the Pregnant Person's Health, it can bring an extra layer of survivor's guilt. Marie-Laure shares how she lost her baby Juliette to early onset preeclampsia with severe features and IUGR (intrauterine growth restriction). Her symptoms became more pronounced around 22 to 24 weeks pregnant. She shares the roller coaster of her illness and diagnosis and end of the pregnancy with Juliette. TFMR for maternal health can feel less represented in the ending a wanted pregnancy space - let's talk about it! You can also find out more about Marie-Laure and follow along with her story and get support at She Isn't a Taboo instagram page https://www.instagram.com/she_isnt_a_taboo/ Resources mentioned:1. The TFMR Support Circle, our free Facebook group for termination for medical reasons (TFMR) parents. Apply to join here: https://www.thetfmrdoula.com/facebookgroup 2.The TFMR Doula instagram page www.instagram.com/thetfmrdoula Grief circle info: If you are a bereaved TFMR parent looking for group grief support, I invite you to check out our upcoming grief circles starting in August 2024 https://www.theTFMRdoula.com/ascend-apply And if you would like to share your TFMR Story on "Our TFMR Stories," email me here to find out more: sabrina at theTFMRdoula dot com Music clip:Pamgaea by Kevin MacLeodLink: https://incompetech.filmmusic.io/song/4193-pamgaeaLicense: https://creativecommons.org/licenses/by/4.0/

Send us a Text Message.Trends in C-Reactive Protein Use in Early-Onset Sepsis Evaluations and Associated Antibiotic Use.Barboza AZ, Flannery DD, Shu D, Galloway M, Dhudasia MB, Bonafide CP, Benitz WE, Gerber JS, Mukhopadhyay S.J Pediatr. 2024 Jun 18:114153. doi: 10.1016/j.jpeds.2024.114153. Online ahead of print.PMID: 38901777As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

In a recent American Cancer Society publication, there are increasing data that rates of colorectal cancer are rising rapidly among people in their 20s, 30s and 40s. This has certainly caught the attention of the lay press, most recently in a widely circulated New York Times article published in March 2024. Today, we welcome Dr. Chris Cann, who is an Assistant Professor of Hematology/Oncology at the Fox Chase Cancer Center in Philadelphia where he focuses on GI oncology and has a particular area of interest in early onset colorectal cancer. In his short career thus far, Dr. Cann is already making a name for himself in this space on a national level and so we are so glad he was able to join us for this special discussion. Dr. Cann sheds light on what we know and what we don't know about this phenomenon. Definitely an episode to check out!** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodesLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

Our next two guests are two single Sydney mothers who both have early-onset Parkinson's disease. Paula and Emma's shared medical status has helped them find a new lease on life. The self-proclaimed "Soul Sisters" refuse to let Parkinson's dampen their sparkle. For more, Emma and Paula join. See omnystudio.com/listener for privacy information.

This is the first half of our conversation. The full episode and the complete archive of Subversive episodes, including exclusive episodes and my writing, are available on Substack. You can also subscribe to the podcast sans writing on Patreon for a bit less. This is how the show is financed and grows, so I appreciate every contribution! Please subscribe at: https://www.alexkaschuta.com/ https://www.patreon.com/aksubversive Our conversation explores the genealogy and evolution of the alt-right movement, discussing its origins, key figures, and the reasons behind its rise and subsequent implosion. We also talk about the demographic makeup of the alt-right, the influence of events like the Ron Paul movement and the Trayvon Martin case, and the role of race and IQ in shaping the movement's ideology. The conversation also touches on the leadership vacuum within the alt-right and the challenges of navigating the online space, different styles of communication between men and women, the challenges women face in leadership roles, the changing dynamics of sexuality, and the impact of technology on society and much more. Walt Bismarck is a writer with a rapidly growing Substack presence and you can find him on Twitter as well. Chapters for the full chat 00:00 Introduction to the alt-right movement 06:04 Demographics and influences of the alt-right 13:09 The leadership vacuum and challenges of the online space 25:01 The emergence of the dissident right 34:47 Introduction and the Importance of Women in Leadership 38:02 The Changing Dynamics of Sexuality and Early Onset of Puberty 47:31 Navigating the Complexities of the Modern World 01:00:38 The Fragmentation of Political Movements 01:01:27 Engaging with Different Worldviews 01:02:35 Finding Fulfillment and Meaning in a Complex World 01:03:29 Ethical Implications of Emerging Technologies 01:10:05 The Historical and Cultural Dynamics of Eastern Europe The Walt Right We also mentioned a previous guest's Substack on the show, Regan Arntz-Gray. https://www.allcatsarefemale.com/ --- Send in a voice message: https://podcasters.spotify.com/pod/show/aksubversive/message

The number of colorectal cancer cases is declining for people 50 and older, but going up for younger people, and doctors don't know why. News 8's Brittany Noble explains a new study that is identifying younger people who may need to be screened before they turn 45.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

There are more calls to further lower the bowel cancer screening age.  An Otago University study shows rates of early onset colorectal cancer have risen by 26% each decade over the past 20 years.  Rates for Māori aged under 50 years rose 36%.  Professor Frank Frizelle told Kerre Woodham that the screening age needs to be lowered from the current age of 60 to at least 45.  He said that a lot of the issue is that young people having bowel cancer is unexpected, so symptoms are often ignored.  LISTEN ABOVE See omnystudio.com/listener for privacy information.

On this episode, we will hear from naturopathic oncologist Tina Kaczor who will share some important cancer risk reduction strategies for young adults, a demographic which is experiencing an alarming increase in the incidence of cancer. We will explore the unique aspects of reducing the risk of cancer in younger adults.Five To Thrive Live is broadcast live Tuesdays at 7PM ET and Music on W4CS Radio – The Cancer Support Network (www.w4cy.com) part of Talk 4 Radio (www.talk4radio.com) on the Talk 4 Media Network (www.talk4media.com). Five To Thrive Live Podcast is also available on Talk 4 Media (www.talk4media.com), Talk 4 Podcasting (www.talk4podcasting.com), iHeartRadio, Amazon Music, Pandora, Spotify, Audible, and over 100 other podcast outlets.

Episode 165: Early-Onset Sepsis Part 2Dr. Lovedip Kooner explains how to use the Kaiser Permanente early-onset sepsis calculator and explains other useful tools to assist in the diagnosis of EOS. Dr. Arreaza adds comments about the usefulness of this calculatorWritten by Lovedip Kooner, MD. Comments and editing by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction: As a recap, Early-onset sepsis is diagnosed within 72 hours (or within 7 days, according to some experts) after birth. We talked about GBS as the main culprit of EOS. 28% of EOS by GBS are babies born 2 hours to maintain oxygen saturations > 90% (outside of the delivery room)After all that information is entered into the Kaiser Permanente calculator, the options for management are clinical monitoring, laboratory evaluation, or antibiotic administration. Example: -Incidence: 0.5/1,000 live births -Gestational age: 36 6/7 weeks-Highest maternal antepartum temperature: 102 F-ROM: 5 hours-Maternal GBS: Positive-Intrapartum antibiotics: Broad spectrum 3 hours prior to birth-RESULT: EOS risk at birth 2.34.Recommendations based on physical exam:1. Well-appearing baby, risk 0.96, RECOMMENDATIONS: No culture, no antibiotics, vitals every 4 hours for 24 hours.2. Equivocal, risk 11.61, RECOMMENDATIONS: Start empiric antibiotics and vitals per NICU.3. Clinical Illness, risk 47.46, RECOMMENDATIONS: Start empiric antibiotics and vitals per NICU.The Kaiser Permanente neonatal early-onset sepsis calculator was analyzed in a meta-analysis, as published in the American Family Physician in 2021. Six high-quality, non-randomized controlled trials were evaluated, including more than 170,000 neonates. The calculator was compared to the standard approach recommended by the CDC guidelines. The analysis showed there was a statistically significant reduction in antibiotic use, a reduction in the number of laboratory tests, and a reduction in NICU admission in neonates who were managed following the sepsis calculator compared with the standard approach. There was no difference in readmission rates to NICU and no difference in culture-positive sepsis between neonates treated using the sepsis calculator and those treated with the standard approach. In summary, I recommend using the Kaiser Permanente calculator as part of your evaluation. BTW, I received no money from KP. It is important to know that depending on resources and institutional policies, your management may change.Use of CBC and CRP.CBC interpretation in neonates: Remember that CBC in newborns needs to be evaluated following the normal parameters for neonates. For example, WBC up to 30,000 per mm3, and hemoglobin up to 19.9 gm/dL can be normal in neonates. Serial white blood cell counts and immature–to–total neutrophil ratio (I/T ratio) generally greater than or equal to 0.2 by some experts is considered positive for sepsis. Complete blood cell counts taken 12-24 hours after birth are associated with increased sensitivity and negative predictive value compared to a sample taken 1-7 hours after birth. C-reactive protein (CRP) is also often used and it rises within 6 hours of infection and peaks at 24 hours. Two normal CRP levels, one taken between 8-24 hours of age and the second 24 hours later, have an over 99% negative predictive value. Single values of CRP or procalcitonin obtained after birth to assess the risk of EOS are neither sensitive nor specific to guide EOS care decisions.Procalcitonin: Procalcitonin may be difficult to interpret within the first 3 days after birth due to elevations caused by noninfectious etiologies and the physiologic rise after birth. It is important to note that neither single values of CRP nor procalcitonin after birth should be used to guide the management plan of infants undergoing evaluation for EOS>.Extreme values in CBC: Extreme values (total WBC count 0.3; ANC

What hobby or personality trait do you have that makes you feel like an old person? A 2nd Date Update in a Cat Cafe, and Jon and Jake hold a Confession Wednesday!Jon & Chantel's Radio Podcast is your daily dose of fun and entertainment. Your podcast shouldn't give you anxiety! Let Jon and Chantel make you laugh, share their life stories, and give you the trending topics of the day.

It's not unusual to have difficulty finding the right word or remembering where you put things. But persistent problems with memory or the ability to perform everyday tasks might be signs of something more serious. An "Early Onset of Dementia" or "Mild Cognitive Impairment" diagnosis can be a sudden blow to any family. In this case and on this episode, gospel musician, Josh Singletary, shares about his Mom with a recent diagnosis of dementia. His honesty of the unknown road ahead makes this a vulnerable story of a family trying to pull together for their loved one.  Josh's love for his Mom, his knowledge of music and faith in the Lord and his family's desire to walk this unknown territory with their eyes wide open, is encouraging for any family walking this dementia journey.   www.verandaministries.org www.joshsingletary.com

Episode 162: Early-Onset Sepsis      Dr. Kooner explains how to diagnose early-onset sepsis by using clinical evaluation and clinical tools. Dr. Schlaerths describes the signs and symptoms of sepsis in neonates, and Dr. Arreaza adds comments about GBS bacteriuria.  Written by Lovedip Kooner, MD, editing Hector Arreaza, MD, and comments by Katherine Schlaerth, MD. Rio Bravo Family Medicine Residency Program.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction:Neonatal sepsis is defined as pathogenic bacterial growth from blood or cerebral spinal fluid culture within the first 28 days of life. Neonatal sepsis can be divided into two categories: early-onset sepsis (EOS) and late-onset.  EOS is neonatal sepsis within 72 hours or 7 days after birth, depending on the specialist. How common is early-onset sepsis (EOS)?According to the CDC, the infant mortality rate rose for the first time in 20 years in the USA. In the U.S., the incidence of EOS is 0.5 in 1,000 live births and carries a mortality rate of about 3%. What causes EOS?Most infections are due to ascending lower vaginal tract flora. Other causes include intra-amniotic infections and maternal hematogenous spread of systemic infections. Group B streptococcus (S. agalactiae) accounts for about 1/3 of the infectious organisms, followed by E. coli which accounts for about 1/4, and Viridans streptococci account for about 1/5 of infections. Cases of E. coli are seen more often with prolonged rupture of membranes and intrapartum antibiotic exposure. Other notable infections are Listeria monocytogenes, coagulase-negative staphylococci (CoNS), herpes simplex virus, and enteroviruses. The role of GBS.Approximately 30% of women have vaginal and rectal GBS colonization and 50% will transmit it to the newborn. Without maternal antibiotic treatment, 1-2% of those infants will develop EOS. The American College of Obstetricians and Gynecologists (ACOG) recommends universal culture-based screening for GBS at 36-37 weeks and 6 days regardless of mode of delivery. GBS bacteriuria: Treat it (symptomatic and asymptomatic) if >105 CFU/mL. Do not treat it in asymptomatic patients if GBS 18 hours, intrapartum fever, or GBS positive in previous pregnancy.Nucleic acid amplification test: NAAT in pregnancy is not recommended to determine colonization status. However, if NAAT is obtained in the intrapartum period, give IAP if positive. But, you must also give IAP if negative + mentioned risk factors (18h, Maternal fever >100.4F)What is considered adequate intrapartum antibiotic prophylaxis? Penicillin and ampicillin are the recommended antibiotics for prophylaxis. Cefazolin can be given if there is a penicillin-allergy with a low risk for anaphylaxis. Clindamycin and vancomycin are reserved for cases of maternal penicillin allergy. Specifically, clindamycin can be used only if GBS is known to be sensitive to clindamycin. Vancomycin must be used if GBS is resistant to clindamycin. Do not use erythromycin. You will Administered at least 4 hours before delivery.IAP is believed to reduce neonatal GBS disease by: (1) temporarily reducing maternal vaginal GBS colonization; (2) preventing colonization of the fetus or newborn's surfaces and mucous membranes; and (3) achieving antibiotic levels in the newborn's bloodstream sufficient to surpass the minimum inhibitory concentration (MIC) for eliminating group B streptococci.Diagnosis of EOS:Clinical presentation: Tachycardia, tachypnea, temperature instability, supplemental oxygen requirement, and lethargy. Hypoglycemia should not be considered a sign of EOS.Diagnosing early-onset sepsis is achieved through blood or cerebrospinal fluid (CSF) cultures. Not effective methods for diagnosing EOS include laboratory tests, such as a complete blood cell count or C-reactive protein (CRP), as well as surface cultures, gastric aspirate analysis, or urine culture.Most infants will generally show signs of EOS GBS infection within the initial 24 hours of birth, with approximately 85% exhibiting symptoms during this timeframe.Waiting for cultures and/or signs can delay lifesaving treatment.Management:According to the American Academy of Pediatrics (AAP), the management of term and late-term infants is undertaken via the clinical condition assessment, the categorical risk factor assessment, and the multivariate risk assessment. As a part of the 2015 AAP guidelines, the Categorical Risk Factor Assessment is more of an algorithmic approach based on the presence or absence of specific risk factor threshold values such as:Ill-appearing infant. Mother diagnosed with chorioamnionitis.Mother GBS positive with inadequate intrapartum prophylaxis.ROM >18 hours.Birth before 37 weeks of gestation.Antibiotics are not always needed, and they can even cause damage. Information taken from the American Academy of Pediatrics, “Management of Neonates Born at ≥35 0/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis,” published on December 1, 2018:(1) Any newborn infant who is ill-appearing or (2) when the mother has a clinical diagnosis of chorioamnionitis -> laboratory testing must be ordered, and empirical antibiotic therapy should be started.(3) A mother who is colonized with GBS and who received inadequate intrapartum antibiotic prophylaxis, with a duration of ROM being >18 hours or birth before 37 weeks' gestation -> laboratory testing should be ordered.(4) A mother who is colonized with GBS who received inadequate IAP but with no additional risk factors -> observation in the hospital for ≥48 hours.______________________________Conclusion: Now we conclude episode number 162, “Early-onset Sepsis Introduction.” Dr Kooner explained the role of GBS in the pathophysiology of EOS, Dr. Schlaerth discussed the importance of clinical evaluation and Dr. Arreaza explained that GBS screening in the third trimester is not needed when there is a GBS positive urine culture early in pregnancy. Don't miss part 2 of this discussion. By the way, we do not recommend using feces to prevent or treat sepsis, we just shared anecdotal information to end with a funny note.This week we thank Hector Arreaza, Lovedip Kooner, and Katherine Schlaerth. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Neonatal Early-Onset Sepsis Calculator by Kaiser Permanente, available at: https://neonatalsepsiscalculator.kaiserpermanente.org/.Espinosa K, Brown SR. Neonatal Early-Onset Sepsis Calculator. Am Fam Physician. 2021;104(6):636-637.https://www.aafp.org/pubs/afp/issues/2021/1200/p636.html.Puopolo KM, Benitz WE, Zaoutis TE; COMMITTEE ON FETUS AND NEWBORN; COMMITTEE ON INFECTIOUS DISEASES. Management of Neonates Born at ≥35 0/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics. 2018 Dec;142(6):e20182894. doi: 10.1542/peds.2018-2894. PMID: 30455342. https://pubmed.ncbi.nlm.nih.gov/30455342/.Briggs-Steinberg C, Roth P. Early-Onset Sepsis in Newborns. Pediatr Rev. 2023 Jan 1;44(1):14-22. doi: 10.1542/pir.2020-001164. PMID: 36587021. https://pubmed.ncbi.nlm.nih.gov/36587021/.Flannery DD, Puopolo KM. Neonatal Early-Onset Sepsis. Neoreviews. 2022 Nov 1;23(11):756-770. doi: 10.1542/neo.23-10-e756. PMID: 36316253. https://pubmed.ncbi.nlm.nih.gov/36316253/.Polin RA; Committee on Fetus and Newborn. Management of neonates with suspected or proven early-onset bacterial sepsis. Pediatrics. 2012 May;129(5):1006-15. doi: 10.1542/peds.2012-0541. Epub 2012 Apr 30. PMID: 22547779. https://pubmed.ncbi.nlm.nih.gov/22547779/.Royalty-free music used for this episode: Good Vibes_Adventure Time by Simon Pettersson, downloaded on July 20, 2023, from https://www.videvo.net/  

Ann Moyer, M.D., Ph.D., explains how Mayo Clinic Laboratories' test panel provides comprehensive evaluation of patients with suspected monogenic early onset inflammatory bowel disease, or IBD. Accurate diagnosis is key to guiding therapy for patients, who might be as young as age 2.(00:32) Could you please tell us a little bit about your background? (01:17) Could you please do a brief overview of our EOIBD test? (03:24) Which patients should have this testing and when should it be performed? (05:31) How are results used in patient care? (07:02) What alternative test options are available and how do these compare to our test?

Today we delve into an important topic that many of us may not yet have on our radar. Did you know that up to 8% of women have their final period by age 45? I'll break down the terminology surrounding menopause, including premature, early menopause, perimenopause, and menopause itself. We explore the symptoms that might catch you by surprise if you're under 44 and experiencing fatigue, insomnia, night sweats, weight gain, and more. We also discuss the challenges of diagnosing menopause in younger women, the nuances of conditions like premature ovarian insufficiency (POI), and the various factors that can influence whether you'll experience menopause earlier than expected. For those navigating POI or early menopause and hoping to start a family, we touch on options such as hormone therapies and alternative pathways to parenthood, such as IVF and surrogacy. We also highlight the importance of mental and emotional health during this transition and offer practical advice for self-care and seeking support. Discover how menopause can be both a challenging journey and an empowering new chapter in your life. Let's rewrite the narrative on menopause!

In this episode, Dr. Catherine Lumenello explores the different treatment approaches for late-onset and early-onset PTSD, emphasizing the importance of understanding the cause of trauma to effectively address the symptoms. She also highlights herbal formulas and acupuncture techniques for both types of PTSD. You can access the written article here.  Select your favorite podcast provider to subscribe and get notified of new recordings!To visit Dr. Lumenello's website, click here. See our Monthly Practitioner Discounts https://www.mayway.com/monthly-specialsSign up for the Mayway Newsletterhttps://www.mayway.com/newsletter-signupFollow ushttps://www.facebook.com/MaywayHerbs/https://www.instagram.com/maywayherbs/

Eric Courchesne, Ph.D., explores autism, highlighting its complexity beyond the brain and its connection to genetics and brain development. He focuses on the "temporal cortex," a crucial area in autism research associated with gene regulation and social processing. Courchesne also shares how his personal journey with polio has informed his thinking on neurodiversity, research, and beating the odds. Series: "Autism Tree Project Annual Neuroscience Conference" [Health and Medicine] [Science] [Show ID: 39171]

Eric Courchesne, Ph.D., explores autism, highlighting its complexity beyond the brain and its connection to genetics and brain development. He focuses on the "temporal cortex," a crucial area in autism research associated with gene regulation and social processing. Courchesne also shares how his personal journey with polio has informed his thinking on neurodiversity, research, and beating the odds. Series: "Autism Tree Project Annual Neuroscience Conference" [Health and Medicine] [Science] [Show ID: 39171]

Eric Courchesne, Ph.D., explores autism, highlighting its complexity beyond the brain and its connection to genetics and brain development. He focuses on the "temporal cortex," a crucial area in autism research associated with gene regulation and social processing. Courchesne also shares how his personal journey with polio has informed his thinking on neurodiversity, research, and beating the odds. Series: "Autism Tree Project Annual Neuroscience Conference" [Health and Medicine] [Science] [Show ID: 39171]

Eric Courchesne, Ph.D., explores autism, highlighting its complexity beyond the brain and its connection to genetics and brain development. He focuses on the "temporal cortex," a crucial area in autism research associated with gene regulation and social processing. Courchesne also shares how his personal journey with polio has informed his thinking on neurodiversity, research, and beating the odds. Series: "Autism Tree Project Annual Neuroscience Conference" [Health and Medicine] [Science] [Show ID: 39171]

Eric Courchesne, Ph.D., explores autism, highlighting its complexity beyond the brain and its connection to genetics and brain development. He focuses on the "temporal cortex," a crucial area in autism research associated with gene regulation and social processing. Courchesne also shares how his personal journey with polio has informed his thinking on neurodiversity, research, and beating the odds. Series: "Autism Tree Project Annual Neuroscience Conference" [Health and Medicine] [Science] [Show ID: 39171]

Eric Courchesne, Ph.D., explores autism, highlighting its complexity beyond the brain and its connection to genetics and brain development. He focuses on the "temporal cortex," a crucial area in autism research associated with gene regulation and social processing. Courchesne also shares how his personal journey with polio has informed his thinking on neurodiversity, research, and beating the odds. Series: "Autism Tree Project Annual Neuroscience Conference" [Health and Medicine] [Science] [Show ID: 39171]

Eric Courchesne, Ph.D., explores autism, highlighting its complexity beyond the brain and its connection to genetics and brain development. He focuses on the "temporal cortex," a crucial area in autism research associated with gene regulation and social processing. Courchesne also shares how his personal journey with polio has informed his thinking on neurodiversity, research, and beating the odds. Series: "Autism Tree Project Annual Neuroscience Conference" [Health and Medicine] [Science] [Show ID: 39171]

Experiencing Life The Way You Want To: My Early Onset Midlife CrisisExperiencing life the way you want to is about being intentional with your time and giving yourself permission to do the things that matter most to you. It's about making choices that align with your vision, values, and priorities and not letting external factors or other people's opinions and expectations dictate how you live your life. When we're conscious and intentional with our time, we're more likely to make choices that lead to a fulfilling and meaningful life. So, give yourself the permission to experience life the way you want to, get clear on what you want out of life, let go of the inner conflict, expectations, and judgment, and align with your vision to maximize your outcome and achieve what you desire in life. In this episode, your host, Paul Lyngso, shares tips and strategies from his coaching experience and book reading metaphor story on transformation, intentional living, and time consciousness to help you overcome inner conflict, get clear on your vision, invest your time currency wisely and align your behavior with your vision. Tune in!Key Highlights from the Show[00:01] Introduction to the show[00:23] The genesis of Paul's passion for helping people get clear and align with their vision [04:01] Paul's story that he uses as a metaphor with his clients [08:27] How reading books has helped Paul cultivate intentionality in his life [10:11] Time Vs. money: How to minimize time expenses and invest it wisely [12:19] Intentionality and prioritization in shifting your perspective and outcome[14:47] Being careful of who you let into your brain [16:36] Giving yourself permission to choose the way you want to consume a book[18:08] Time-conscious can be a life changer in your life [18:46] Wrap-up and end of the showNotable Quotes Reading books is a metaphor for how you are going to do everything, how you are going to spend your time, and what you want to accomplish with your life. - (08:39).Money is cool; it can do valuable stuff for you, but the most viable currency is time, and you should invest it wisely. - (10:11)Time is a currency; get smart on how you budget, spend, and invest in it. - (12:03)If you don't prioritize something, it might not happen. - (13:05)There are many ways to read a book and gain value and insights from it without starting from page one to the end. - (16:58)Give yourself permission to change your mind, put the book down, not be linear, or skim for the high-level view to experience the book the way you want to experience it. - (17:11)Don't just take blind recommendations; if something sucks, you don't have to read the whole thing, experience life and book exactly the way you want. - (19:48)Let's ConnectWebsite: https://thegoodshit.info/LinkedIn: https://www.linkedin.com/in/paul-lyngso-b3963120b/Facebook: https://web.facebook.com/profile.php?id=1923456&Instagram: https://www.instagram.com/paul.lyngso/Mixed and Edited by Next Day Podcast

Dave's wife, Cheryl, was diagnosed with alzheimer's at the age of 47.  We talk about the disease itself, prevention, and Dave's experience caring for Cheryl. Dave Myers

Learn more about Parkinson's disease from Senior Health Care Hub's latest guide covering symptoms, treatments, and coping strategies that help patients and caregivers detect early symptoms and make life after PD diagnosis a bit easier.Find out more at https://seniorhealthcarehub.com/parkinsons-disease-symptoms-treatments-and-coping-strategies/#Physical_Therapy_and_Rehabilitation_for_Improved_Mobility Senior Health Care Hub City: New York Address: 60 W 23rd St Website https://seniorhealthcarehub.com/ Phone +1 877 675 4340 Email scott.hall@betteronlineinfo.com

What everyone should know: why intervene early, how to do it, and does it work? Credit available for this activity expires: 9/1/24 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/993439?ecd=bdc_podcast_libsyn_mscpedu

The federal government puts cannabis in the same category as the world's most dangerous drugs. That could change under a new recommendation. What it might mean in Colorado. Then, a young Denver woman loses her battle with colon cancer. She and her husband were both diagnosed with the disease. Doctors say younger people are increasingly vulnerable. And later, one-time Denverite Ethel Merman... does disco?

The federal government puts cannabis in the same category as the world's most dangerous drugs. That could change under a new recommendation. What it might mean in Colorado. Then, a young Denver woman loses her battle with colon cancer. She and her husband were both diagnosed with the disease. Doctors say younger people are increasingly vulnerable. And later, one-time Denverite Ethel Merman... does disco?

Our medical roundtable examines the latest health care headlines, including a new drug for postpartum depression, stroke care, a gas station expanding into health care and full body MRI's.

Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks…   Summer: Hi doc! I would love your thoughts on calcium hydroxide or pickling lime, mainly for preserving eggs. Hens naturally slow way down in egg production in the winter so I'm looking for ways to preserve our excess farm eggs during the summer to have in the winter. Preserving the raw eggs in pickling lime is one option and I'm just not sure whether it's a good idea or not! Basically you submerge clean, raw, unwashed, day old eggs or freshly layed eggs in a solution of 1 oz lime to 1 quart water in jars or buckets. They are supposed to be good for up to a year and can be used just like a fresh egg. Just a bit skeptical of calcium hydroxide. Thanks for everything!   Patti: Hi, hope all is well. Any connection with calcium supplements & breast cancer? Thank you   Lacey: Diagnosed with early onset osteoporosis. Was only told I need to go on a pill and that still wouldn't fix it. What are lifestyle tips and steps to take to change this diagnosis??   Noreen: Hello Dr Cabral! Thank you for your commitment to health and well being, and for being such a great educator and practitioner. Have enjoyed your podcast for many years. Question - I have not seen you address or review the Terahertz Healing Wand or Blower. I heard about it earlier this year via the Budwig Center, which I follow, and then recently from a distributor. Gather it has been in the states for a few years and coming into use in alternative health care practices. Should your interest and time permit, would love to hear what you think in a future podcast. God's best to you and yours!   Anonymous: Good Morning Dr. Cabral! I recently had a small leak in my waterline (underground in my front yard) that was going one for around 3 months. During this time, I also noticed that the water coming out of my faucets was slightly cloudy and sometimes had a very subtle bad smell (like rotten eggs). I just had the leak identified and repaired, and the water is much clearer and odorless now. I always filter all drinking/cooking water through my Berkey filter, but while the leak was ongoing I was still exposed to certain unfiltered water (i.e. dishwasher, shower, sink, brushing teeth). My main question: is it possible that something leached into the water supply that could have affected my metabolism? During this time, my metabolism slowed a crazy amount (even though same exercise/diet)    Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes and Resources: StephenCabral.com/2753 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

Dr Emma Farrell, Chartered Psychologist and researcher in UCD. She is author of Making Sense of Mental Health: A Practical through Lived Experience

Listen to our episode on Early Onset Scoliosis as Dr. Matthew Landrum gives us an excellent overview!  Show notes at: www.naileditortho.com/eos Video at: https://www.youtube.com/watch?v=CxRG01QiIVQ  Dr. Landrum is an Orthopaedic Surgeon who specializes in Pediatric Orthopaedics. He provides both non-operative and operative treatment to improve function, prevent disability, and reduce pain. He has special interests in complex spine deformity and scoliosis, hip dysplasia, lower extremity complaints, and trauma. Dr. Landrum was born and raised in Lafayette, Louisiana. He attended Louisiana State University in Baton Rouge and completed medical school at LSU in New Orleans. He then moved to Dallas, Texas where he completed his residency at Parkland Memorial Hospital and the University of Texas Southwestern Medical Center. While training at Parkland gave him significant experience in adult orthopaedic trauma, he did his pediatric orthopaedic training at Texas Scottish Rite Hospital for Children (TSRH) and Children's Medical Center. At the end of residency, he attained further pediatric orthopaedic experience at Starship Hospital in Auckland, New Zealand. After residency, Dr. Landrum performed a pediatric orthopaedic fellowship at the Children's Hospital of Philadelphia. Goal of episode: To develop a baseline knowledge on early onset scoliosis. We cover: -Congenital scoliosis – Juvenile scoliosis – Clinical presentation – Pertinent imaging findings – Bar v hemivertebrae – curves at high risk of progression + more

At a mere 22 years old, Rachel takes the fellas on an exhilarating rollercoaster ride through her jaw-dropping journey with Multiple Sclerosis (MS). Picture this: a young, vibrant soul released from St. Michael's Hospital with a diagnosis that would make even the bravest tremble. Rachel defies the odds as she reflects on her transformation from scared rookie to seasoned warrior, sprinkling gratitude and renewed passion along the way. On top of it all this experience leaves Rachel reconsidering her dreams of being a lawyer and she discovers her true calling as a personal trainer and spin instructor. Join the post-episode conversation over on Discord! https://discord.gg/expeUDN

At a mere 22 years old, Rachel takes the fellas on an exhilarating rollercoaster ride through her jaw-dropping journey with Multiple Sclerosis (MS). Picture this: a young, vibrant soul released from St. Michael's Hospital with a diagnosis that would make even the bravest tremble. Rachel defies the odds as she reflects on her transformation from scared rookie to seasoned warrior, sprinkling gratitude and renewed passion along the way. On top of it all this experience leaves Rachel reconsidering her dreams of being a lawyer and she discovers her true calling as a personal trainer and spin instructor. Join the post-episode conversation over on Discord! https://discord.gg/expeUDN

6.1.23 Kevin opens the show reacting to all the tweets sent to him loving the action they've seen on social media from Commanders OTAs.

Join me in my conversation with Dr. Rebecca Miller who has extensive experience in the healthcare arena, both as a highly trained psychiatrist and as a patient. We touch on a trip to the Pyrenees, parenthood, and cogntive bias as pertaining to the misdiagnosis of early onset Parkinson's disease. Dr. Rebecca Miller, PhD attended Barnard College-Columbia University as an undergraduate, received an MA and PhD at Long Island University in Clinical Psychology, and completed pre- and post-doctoral training at Yale University School of Medicine. She has received the Goldberg Leadership in Education from the American Psychological Association in 2019, and she is currently an Associate Professor Psychiatry as well as the Director of Peer Support and Family Initiatives at the Connecticut Mental Health Center. She is a strong believe in the power of the patient voice and has written on the lived experience with Parkinson's disease as well as the lived experience of safe disclosure for mental health professionals. She was diagnosed with Parkinson's at age 39 although first identified symptoms as early as age 26. For more information, visit https://www.rebeccamillerphd.com/. Links to articles on better care in the hospital, parenting with Parkinson's, and the body as public property for commentary.

On this week's show: Spotting volcanic activity on Venus in 30-year-old data, and giving context to increases in early onset colon cancer   First up this week, a researcher notices an active volcano on Venus in data from the Magellan mission—which ended in 1994. News Staff Writer Paul Voosen joins host Sarah Crespi to discuss how to find a “fresh” lava flow in 30-year-old readings.   Next up, a concerning increase in early onset colon cancer. Kimmie Ng, director of the Young-Onset Colorectal Cancer Center at the Dana-Farber Cancer Institute and associate professor of medicine at Harvard Medical School, is here to talk about how these early colon cancers—those diagnosed before age 50—are different from those diagnosed later in life. We also talk about what needs to be learned about diet, environment, and genetics to better understand this condition.   This week's episode was produced with help from Podigy.   About the Science Podcast   [Image: NASA; Music: Jeffrey Cook]   [alt: Maat Mons volcano on Venus with podcast symbol overlay]   Authors: Sarah Crespi; Paul Voosen   Episode page: https://www.science.org/doi/10.1126/science.adh8158   See omnystudio.com/listener for privacy information.

Mary Leigh speaks about her family history with the early onset of menopause, going through divorce and infertility, and ultimately the IVF transfer that stuck. To learn more about Mary Leigh follow her on IG: @maryleighspencer

Please Subscribe and Review: Apple Podcasts | RSS Submit your questions for the podcast here News Topic: Mike Rowe The Way I Heard It, episode 294: The Ballad of Tom Odom   Show Notes: Muscular exercise can cause highly pathological liver function tests in healthy men Muscle Protein Synthesis Laura says: Hi Robby and Nicki I'm a 45 year old female and have been listening to lots of things protein related recently. It seems like "experts" from many backgrounds seem to agree on the importance of protein, especially as one ages. Meeting a leucine threshold in a meal seems to be a common consensus as well. I love meat and hit that target with no issue 3x per day. However, what I've never heard any of these protein experts talk about is a "stimulus" threshold for MPS. They all talk about weight lifting being a MPS signal but I've never heard of a minimum required dose. I was wondering if in your reading/learning you've heard anyone talk about the minimum "strength workout" needed to initiate MPS. Or is it relative? Like my doing 2 sets of max rep pull ups gets a little MPS going but an hour long leg workout with leg press, deadlifts, RDLs, split squats triggers more? Any insights here would be appreciated! Thanks :)   Early onset Parkinsons and a different approach Amy says: First I want to say I love you guys. I'm always trying to obtain more knowledge in the health and wellness field as a Firefighter/Paramedic and Fitness Coach as a part time. Your show is easy and fast knowledge. Plus I love LMNT. The chocolate medley is my favorite. Now my question. Recently my husband had a hand tremor experience. Early in the morning in bed where it woke me up. He didn't mention it for a couple days but when he did I realized it concerned him as well. He is your typical male that doesn't want to seek medical advice and had to be dragged to the doctor years ago when I suspected a DVT. We found out he had the largest his physician had seen from his ankle to his hip and 3 PEs. ( Pre covid, no he is not vaccinated) we found out it was a genetic disorder. Since the tremor, in my own research I feel like he has a lot of early signs for Parkinsons which I may be me jumping ( but so was the DVT at the time) but this is so concerning. We take a more functional approach to our health and I was wondering your thoughts on that for Parkinsons. I have a previous client where we found weight training really helped his tremors but also any emotional response could make it worse. My husband is healthy, 45, weight trains multiple times a week and does a lot of zone 2 training. Only medical history is the clotting disorder for which he takes Eliquis. Sorry for the long question. Thanks in advance.   Kidney function and protein with age Dawn says: Hello Robb and Nicki, A friend of mine in her late 40's is following a mostly paleo diet and has been increasing animal proteins and working on resistance training to increase muscle mass the last few years to help with healthy aging, glucose control, maintaining function etc. She has recently started including creatine supplementation to help with brain and muscle function as per all sorts of recommendations from various ppl in the healthy aging and menopause space. She has relatively low body fat (visible abs and shoulder muscles) and has only a couple drinks a week. She uses LMNT daily. She just received blood work results showing higher than normal creatinine and ALT levels and is wondering whether to stop creatine supplements. Also, she will be booking in to see a renal doc to discuss further but is worried because all conventional advise for kidney disease Appears to be: go on a low protein diet, eat vegetable oils, “healthy” whole grains etc….which completely flies in the face of her experience of better health and body comp for years on a more ancestral style diet with increasing protein over time. She has experienced several UTIs in the last year which could be due to estrogen dropping post hysterectomy (therefore she is menopausal) and recently had covid…so there is a history now of urinary infection AND it seems that some people experience renal issues post virus. Any suggestions on protein and creatine? Resources we can research so she can make informed choices? It's scary that the conventional dietary changes are totally opposite what someone needs to do to retain good muscle mass as one ages, and they seem to promote higher glucose levels over time which we know will lead to diabetes. Thanks so much for any light you can shed. It can be difficult when you are trying to buck the normal trend of decline with middle age by doing seemingly the opposite of what the doctors tell us to do. Sponsor: The Healthy Rebellion Radio is sponsored by our electrolyte company, LMNT. Proper hydration is more than just drinking water. You need electrolytes too! Check out The Healthy Rebellion Radio sponsor LMNT for grab-and-go electrolyte packets to keep you at your peak! They give you all the electrolytes want, none of the stuff you don't. Click here to get your LMNT electrolytes

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!_____________________________________________________________________________________Show notes, articles, and CME form can be found on our website: http://www.the-incubator.org/107/

Puberty is an important part of human growth and development, but what happens when it occurs too soon? Early onset puberty is defined as a child undergoing the developmental changes of puberty earlier than normal. While this was once a rare occurrence, rates of early-onset puberty more than doubled during the pandemic. On this episode of The Model Health Show, we're diving into one of the epidemics plaguing our youth: early-onset puberty. You're going to learn some of the contributing factors of early puberty, the long-term ramifications of undergoing puberty at a young age, plus action steps you can take to protect your children from this condition. Poor statistics relating to our health isn't something we just have to accept, especially when it comes to our children. My hope is that this episode will arm you with the information and empowerment you need to implement changes in your own home. As always, change starts with us. In this episode you'll discover: How rates of early onset puberty in girls surged during the pandemic. The relationship between our circadian timing and puberty. How early onset puberty increases rates of breast cancer and heart disease. The connection between early puberty and disordered eating. What puberty actually is, and why it's starting earlier. Why side effect is a misnomer. Symptoms of early onset puberty in boys and girls. The link between obesity and early onset puberty. How obesity rates in children have risen over recent years. The connection between the microbiome and likelihood of obesity. What percentage of the average American's diet is comprised of ultra-processed foods. How much sugar the average American consumes every year. What insulin resistance is, and how it can occur over time. The definition of xenoestrogens. How to choose healthier personal care products for your family. The connection between toxic stress and early onset puberty. Which demographic is most impacted by early puberty. How to create healthier relationships with our devices. The relationship between screen time, circadian disruptions, and puberty. Simple ways to protect your children against obesity and early onset puberty. The importance of building movement into your family culture. Items mentioned in this episode include: Beekeepersnaturals.com/model -- Save 30% sitewide through 11/29! Organifi.com/Model -- Use the coupon code MODEL for 20% off! The History of Sugar – Episode 222 Estrogen Dominance – Episode 148 Join TMHS Facebook community - Model Nation  Be sure you are subscribed to this podcast to automatically receive your episodes:  Apple Podcasts Stitcher Spotify Soundcloud *Download Transcript   

Sponsors: BetterHelp: As a listener, you'll get 10% off your first month by visiting our sponsor at BetterHelp.com/birthhour. Reel Paper: Go to reelpaper.com/birthhour and sign up for a subscription using code BIRTHHOUR at checkout, you'll automatically get 30% off your first order and FREE SHIPPING! Other Links: Know Your Options Online Childbirth Course Beyond the First Latch Course (comes free with KYO course) Support The Birth Hour via Patreon!