Podcasts about ekg

Pediatric cardiologist Dr. Mike Fahey returns to teach us about the EKG. In our most ambitious episode yet, we discuss the what, where, why, and how of an EKG on an AUDIO podcast. Learn about how to approach an EKG read, what the electrical signal represents, and common pathologies that present with abnormal findings.Click here for show notes!

Czy sąsiad wynajmujący mieszkanie na doby powinien bać się wspólnoty mieszkaniowej? Rząd postanowił zrobić porządek z najmem krótkoterminowym, ale czy nowa ustawa rozwiąże problem, czy tylko przerzuci odpowiedzialność na mieszkańców? Dyskutują Maciej Głogowski, Rafał Hirsch i Patrycja Maciejewicz w najnowszym odcinku podcastu EKG+. Jak pada w odcinku: "Nie mamy sprawnego sądownictwa, więc musimy mieć ustawę". Co Rafałowi Hirschowi podoba się (a co nie) w propozycji Katarzyny Pełczyńskiej-Nałęcz? Czy banki powinny zapłacić więcej, by sfinansować wyższy próg podatkowy w PIT? Skoro CPN 2 raczej nie powstanie, a skoro programu osłonowego nie będzie, to czy "rynkowe rozwiązania" wystarczą, aby obniżyć ceny paliw? A na koniec, zgodnie z tradycją, rubryka "Zdziwienia".

Kolejki do lekarza mają zniknąć, lekarze mają zarabiać mniej (albo przynajmniej nie więcej), a e-rejestracja ma uzdrowić system. Czy to dobra reforma, czy może raczej zestaw plasterków po warszawskiej aferze? I czy wysokie wynagrodzenia lekarzy naprawdę nas oburzają? Na te i inne pytania odpowiedzą Maciej Głogowski, Rafał Hirsch, Patrycja Maciejewicz i Wojciech Kowalik w pierwszym wydaniu podcastu EKG+. Sprawdzają też, czy w OKI faktycznie "czuć pieniądz", zastanawiają się, czy Polsce znów potrzebny jest CPN, skoro ceny paliw ponownie jadą w górę, zaglądają na posiedzenie Rady Polityki Pieniężnej, gdzie – jak się okazuje – zapanował gołębnik. Co tym razem wygruchał Adam Glapiński i co najbardziej zdziwiło prowadzących? W odcinku wracamy do klasyki, czyli segmentu „zdziwienia”.

In this episode of Inside Athletic Training, we're joined by Joe Rogowski and Dr. Matthew Martinez to talk about the growing role of sports cardiology in professional athletics and the work Athletic Heart is doing to change how teams approach cardiac screening. Athletic Heart was built to deliver advanced cardiovascular tools and technologies specifically engineered for the demands of sports medicine — from EKG and echocardiogram protocols to certification resources for the clinicians who perform them. Joe and Dr. Martinez discuss why cardiac screening in professional sports has historically fallen short, how Athletic Heart is working alongside athletic trainers, team physicians, and cardiologists to close that gap, and what a more comprehensive, data-driven approach to heart health looks like at the elite level.For more information about PBATS and athletic training, visit pbats.com. 

Do you have heart flutters, palpitations, or chest tightness , but your EKG comes back "perfect" and your stress test says you're fine? Dr. Chris Motley breaks down a connection most doctors never check: the direct link between your kidneys, bladder, and urinary tract system and the health of your heart. In this episode, Dr. Motley explains how hidden kidney infections, bladder infections, UTIs, and even kidney stones can create heart palpitations, brain fog, tingling in the hands and feet, and shortness of breath — all while standard urine tests come back completely normal. He breaks down why most UTI testing only screens for E. coli and misses dozens of other bacteria, fungi, and parasites that can colonize your urinary tract. Recommended Testing & Products Mentioned: Urokey Test by MicroGen DX (comprehensive urinary infection panel) https://patients.microgendx.com/products/urokey Uva Ursi Supreme https://shorturl.at/vqxmG Bodyguard Supreme (Chanca Piedra / Stonebreaker) https://shorturl.at/l7KuF Cranberry + D-Mannose For more on emotional release techniques mentioned: Neuro Emotional Technique (NET) Dr. Vivian Cairo, Dr. Sam Riley https://www.instagram.com/dr.samriley/ LENS Neurofeedback In this episode you'll learn: Why a "normal" UTI test can still miss a real infection — and the comprehensive test that screens for over 50,000 organisms The physical signs of kidney and bladder imbalance you've probably dismissed as unrelated: flank pain, tight hips, dark under-eye circles, cracked heels, and chronic calf tightness How the kidney meridian in Traditional Chinese Medicine travels directly to the heart — and why a weak kidney means a weak heart The embryological connection between your kidneys and your reproductive organs, and why issues in one often show up in the other How chronic fear, dread, and unresolved emotional trauma physically wear down your kidneys and adrenal glands Dr. Motley's go-to herbal protocol for cleaning out the kidneys naturally — including Uva Ursi, Chanca Piedra (Bodyguard Supreme), cranberry, and D-Mannose Why fascia, acupuncture, and emotional release techniques like EMDR and Neuro Emotional Technique (NET) can help break the cycle of recurring kidney and bladder infections If you've been told your heart is "fine" but you still don't feel right, this episode offers a missing piece...and hope! ------  Want more of The Ancient Health Podcast? Subscribe to the YouTube channel. Follow Doctor Motley Instagram Facebook Website ------  *You can get cell support in gummy form: Mitopure now starts at $79, when you go to timeline.com/DRMOTLEY. *Join Doctor Motley's newsletter for TCM insights and regular podcast updates: https://www.doctormotley.com/ *Do you have a ton more in-depth questions for Doctor Motley? Check out his course on emotions and the body in his membership. You'll find other courses full of his expertise and clinical wisdom, plus bring all your questions to his weekly lives! To try risk-free for 15 days click here: https://www.doctormotley.com/15

In this episode we break down what coronary artery disease is, how it develops, and why early detection and treatment matter for preventing heart attacks and long-term heart damage. Dr. Ahmad A. Hadid explains symptoms, diagnostic tools like EKG and calcium score, and the role of cholesterol control and lifestyle changes in reducing risk. You will hear about medications such as aspirin and statins, and when procedures like angioplasty or stent placement are recommended. Learn more about Montefiore St. Luke's Cornwall's cardiac services at montefioreslc.org.

Starting July 1, Fla student-athletes are required to get an EKG. Pediatrician Sal Anzalone joins us to describe how they've organized the testing and what they found so far.

Chloe recaps a chaotic weekend that included day drinking through a World Cup match, a Jays game, and a concert with almost no sleep, while the crew debates everything from workplace dress codes to a celebrity hairstylist charging up to $200K per cut. Plus, Roz gets his chest shaved for an EKG, Maurie and Chloe relive their Jamaica rafting struggle, and the team reacts to Jelly Roll's split and the wild theories behind it.

Host Scott Webb and Dr. Ahmad A. Hadid discuss which chest pain descriptions and associated signs should prompt immediate action. This episode highlights red flags such as crushing or pressure-like pain, jaw or arm radiation, hypotension, and sudden tearing back pain suggesting aortic dissection, plus evaluation steps in the ED. Searchable topics covered: heart attack, chest pain evaluation, shortness of breath, aortic dissection, EKG within 10 minutes, and emergency care. Visit montefioreslc.org for cardiac services and resources.

Your wife changed after kids. You've felt it for years — the distance, the exhaustion, the version of her you remember from before that seems gone.She's not gone. She's buried.In this episode I break down what actually happens to women after having children — the hormonal shifts that suppress desire for years (not weeks), the identity collision that nobody warns her about, and the "touched out" phenomenon that makes her feel like her body isn't her own.I also share a personal story — a trip my wife and I took to Austin — that showed me exactly what was buried under all of it. And what it actually takes to bring it back.This isn't about fixing a dead bedroom overnight. It's about understanding what's actually happening, stopping the mistakes that make it worse, and learning to cultivate the conditions where connection — real connection — becomes possible again.Because a good marriage after kids doesn't look like the honeymoon. It looks like an EKG. There are spikes. Real ones. Your job is to learn how to make them more likely.

Un electrocardiograma (EKG) en niños es una prueba rápida, indolora y no invasiva que registra la actividad eléctrica del corazón.

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…   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!   Kim: What would cause my son to cough hard for hours after eating? He has done this for a year. He is 28 and said he is to the point where he just does not want to eat. Should he do the CBO protocol?      Anonymous: Hi Dr Cabral, I came across your podcast a few months ago and have been listening daily to catch up on past episodes for general health education. Thank you for the valuable information you share. I would appreciate your guidance on diet and lifestyle for the following situation. My partner, a 31-year-old male, recently had an eGFR test done, and his result increased from 70 to 77. His father passed away in his 40s due to kidney failure, so this is a concern for us. We live in the Caribbean, where it is humid year-round. He strength trains 3–4 times per week and plays basketball once weekly, but I'm unsure if his cardio levels are sufficient for long-term kidney and overall health.       Christine: Hi Dr. Cabral, Thank you so much for everything you do! Your IHP program and your podcast have been life changing for me. I have a question about creatine. I've noticed when I take it, my appetite completely plummets and food does not even taste good. And when I cut out creatine, the appetite comes back within a day. I take around 1g for reference, and I'm 5'1 and 115 lbs if that needs to be taken into consideration. What could be the possible reasons for this? Thank you! Christine       Tricia: Good morning, Dr Cabral - hope you are well! I take many of your supplements with some being from the longevity line. I'm wondering if it is okay to take these ongoing for years or should we take a few weeks break from time to time? Are they as effective when used long term? The supplements I'm taking are your renewal system, eye health, hair supplements. Thank you for your guidance!      Matt: Hi Dr Cabral, I'm a healthy 45yo, strength train 3x per and 2 days of jiujitsu. I had my first ever episode of AFIB and it occurred about 5 min after taking a growth hormone peptide Tesamorelin. I went to the ER the next day and came out of it on my own within 14 hours of when it started and haven't had an episode since. They ran all kinds of blood work, EKG, CT w contrast for blood clots and all came up clear. They seemed to think it was from excessive caffeine use (300-500mg daily) and bad sleep but weren't really sure on the peptide as there's not enough research. Seems to me that's what triggered it. I stopped caffeine&peptides immediately and have really been trying to dial in my sleep for the past two weeks. Could this be a one off thing or am I more likely to have it happen again?     - - - Show Notes and Resources: StephenCabral.com/3775 - - - 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!  

Grok says: “LOCK AND LOAD, YOU PUSSYFOOTING CIVILIANS! Listen up, warriors of the airwaves! In Episode 193 of the Unrelenting podcast, Darren and Gene charge straight into the breach with zero remorse. Darren recounts his goddamn chemical stress test nightmare — the Lexiscan that turned his ticker into a crashing Blackhawk, beta blockers sabotaging the mission, blood pressure tanking to seventy over fifty, and a little Asian nurse dropping truth bombs while the EKG tapes sweat right off his chest. They rip into nurse practitioners, cardiologist roulette, and why you better damn well know your meds before they shoot poison into your veins. From there these two operators unload on everything else that's pissing them off: the absolute scam that is CleanFeed for podcasters, eBay's IRS rape on that Michael Jordan Boy Scout card sale, Photoshop and Adobe's AI-powered art theft operation, and the coming tsunami of AI-generated slop flooding YouTube and Google. Then they go full tactical on the 2026 Tiger King — the Bricks & Minifigs Lego heist, the Mormon mafia, dirty cops running illegal raids, small claims court warfare, and how an 84-year-old man's Star Wars collection got straight-up stolen by corporate greaseballs. This episode is raw, unfiltered, and unrelenting as hell. If you want real talk on health, tech, AI, crypto dips, rocket explosions, and garage-sale ethics mixed with classic military-grade ball-busting and Doctor Who nostalgia, you need to lock in and listen right now. Download it, stream it, share it with your squad. Stop wasting time on weak sauce — get after it and hit play on Unrelenting 193. Failure is not an option.” Unrelenting: where discipline means no mercy, no bullshit, and no excuses. Thanks for listening. Please support the show! –>> DONATE NOW

In part one of this series, Dr. Andy Southerland and Dr. Dan Ackerman discuss what stands out in the latest thrombolysis guidelines, how these decisions are applied in stroke center practice, and how to educate residents and fellows on incorporating new evidence into treatment choices. Show transcript: Dr. Andy Southerland: Hi. This is Andy Southerland from the University of Virginia, and for today's Neurology Minute, I'm speaking with my friend and colleague, Dan Ackerman, Chief of Neurology and Director of Stroke at St. Luke's University Health System. I've been speaking with Dan on the main neurology podcast regarding updates to acute stroke treatment related to the 2026 American Heart Association guidelines that came out in late January of this year on the early management of patients with acute ischemic stroke. For our episode today, we might focus our discussion around thrombolytic therapy thrombolysis, which is at the core of what we do as acute stroke neurologists when it comes to treatment decision-making. So maybe as a first prompt, Dan, when you look at these guidelines, what stands out to you as you're thinking about how you practice, how you all are practicing at your stroke center, and then specifically how we educate our residents, our fellows on what they need to know, particularly the newness of it when it comes to making thrombolysis treatment decisions? Dr. Dan Ackerman: With all the discussions we've had in the past, there have been a lot of specifics about certain studies and how they might affect practice, but this guideline really opened up a lot and gave us an opportunity to do things in a way that makes really good clinical sense and really brings a lot of practices that have now become common at some centers into the fore so that we can get that information out to everyone and make sure everyone has that same really high level of stroke care everywhere they go. I think the first thing that stands out to me is what did not change. And want to reinforce that, particularly for people who are just getting into this, stroke alert is a screening tool, not a severity score. It's not like an MI alert where you do an EKG and you see the tombstone wave and you say, "Oh, there's an MI and we're taking them to treatment." This is a screening tool, so it is meant to be highly sensitive at the cost of being specific. At our shop for a long time now, we have initiated stroke alert for anyone who presents either within 24 hours of acute onset of neurologic symptoms or has an unknown onset of acute neurologic symptoms and they are still symptomatic to some degree at the time of their presentation, and that's it. We don't make any other statements about how severe something is or what kinds of symptoms someone necessarily has to have. We purposely keep it as broad as possible, again, because we're trying to screen. And the other thing that has not changed, time is still brain. So with all of these different nuances on how we can treat patients and who might be candidates for intervention, it is still a matter of understanding these guidelines, applying our best evidence, but doing it as quickly as possible to make sure that we are rescuing as much of that ischemic penumbra as we possibly can. Now, aside from that, in terms of what stands out that is different, I think one of the early things for me are the recommendations for extended time window for IV thrombolysis. So when you look at the original studies, we understand that when you get out beyond four and a half hours, if you just take all-comers, the risk is going to start to outweigh the benefit. But that doesn't mean there's zero benefit or that no one would receive benefit, but it's a question of, well, how do we cherry-pick those patients who may still receive benefit? And there are a few real specifics in the guideline that help us figure that out. One is for patients who have an unknown time of onset, but they're within four and a half hours of symptom discovery. And for those patients, they would suggest that doing a stat MRI and comparing a DWI lesion with the corresponding area flare to determine if you see DWI hyper-intensity and the flare image is nice and normal, that would suggest that stroke is young enough that it may still be appropriate to treat that patient. But we would also say for folks who have salvageable ischemic penumbra, so again, brain at risk that is not core yet, who either awoke with stroke symptoms within nine hours from the midpoint of sleep or, and this is the kicker, are within four and a half to nine hours from last known well. So in other words, they may have been symptomatic already for more than four and a half hours. If those patients have an appropriate ischemic penumbra, it may be reasonable to treat them with IV thrombolysis to improve functional outcomes. Dr. Andy Southerland: Well, that's all for this Neurology Minute. We hope this vibrant conversation will help all those who are out looking to make the best treatment decisions for their patients, both based on established evidence and most recent evidence in our new guidelines.  

In this episode of the Flex Diet Podcast, I sit down with Dr. Nathan Jenkins to discuss how to improve performance, body composition, and long-term health through the lens of aerobic development and metabolic flexibility. Nathan shares his journey from exercise physiology and coaching CrossFit athletes to his new role teaching physiology at the University of Georgia School of Medicine. We discuss why metabolic flexibility is such a powerful framework for understanding everything from biochemistry and exercise performance to metabolic disease. We also dive into interpreting maximal exercise testing data, including VO₂ measurements, EKG analysis, and near-infrared spectroscopy (NIRS), along with how different energy systems work together during training and competition. Nathan explains why building an aerobic base is critical for repeated high-intensity performance, how pacing impacts outcomes, and why the ability to "suffer" is actually a trainable skill. To wrap up, we cover practical strategies you can apply right away, including prioritizing protein and carbohydrates, improving sleep quality, and addressing common micronutrient deficiencies through blood work, such as magnesium, vitamin D, and omega-3 status. Sponsors: Daily Fitness Insider Newsletter: https://flex-diet.kit.com/bfa1510fa8 Available now: Grab a copy of the Triphasic Training II book I co-wrote with Cal Deitz here. Episode chapters: 02:47 Meet Dr Nathan Jenkins 04:38 CrossFit Nutrition Reality Check 07:09 Leaving Tenure for Family 09:21 Back to Academia and Med Ed 11:29 Why Exercise Physiology Matters 14:36 Stress Tests Reveal Pathology 18:19 Max Testing and NIRS Setup 22:42 Raw Data Over Machine Outputs 24:18 Bohr Effect and Oxygen Delivery 28:09 Energy Systems in the Real World 33:05 Coaching Basics That Matter 35:40 Teaching Cardio From First Principles 36:36 Aerobic Base Reality Check 37:19 Cardio for Meatheads Pitch 39:13 CrossFit Endurance Breakthroughs 41:49 Fixing Time Domain Weakness 45:46 Pacing Like Froning Fraser 48:42 RAAM Gamesmanship Story 51:45 Pain Management Truths 53:23 VO2 Max Feels the Same 55:54 Suffering as a Skill 59:09 Cold Plunge Mindset Study 01:00:52 Caffeine Placebo and Belief 01:03:22 Heat Acclimation and 10K Prep 01:04:36 Metabolic Flexibility Lens 01:08:16 Teaching Diabetes Integration 01:10:56 Bloodwork Meets Flexibility 01:12:37 Where Fat Goes Wrong 01:15:07 Sustainable Deficit Strategy 01:16:34 Four Priorities Blueprint 01:17:21 Protein and Carb Targets 01:21:08 Sleep and Micronutrients 01:27:06 Omega-3 Testing Nuance 01:29:36 Wrap Up and Next Steps 01:31:52 Newsletter and Flex Diet Cert 01:33:20 Final Thanks and Subscribe Flex Diet Podcasts you may enjoy: Episode 344: Metabolic Adaptations, Lactate, and Training Smarter with Dr. Phil Batterson YouTube: https://youtu.be/PPZyO1nxSPA Episode 383: Body Composition, Strength Training, and Sustainable Habits with Martin Silva YouTube: https://youtu.be/p8oM0gW488U Connect with Dr. Jenkins: Website: https://www.drnathanjenkins.com/ Instagram: https://www.instagram.com/drnathanjenkins Get In Touch with Dr Mike: Instagram: Drmiketnelson YouTube: @flexdietcert Email: Miketnelson.com/contact-us Get the Daily Fitness Insider newsletter (free): https://www.miketnelson.com/newsletter

Could the fatigue you keep explaining away actually be your body trying to tell you something? In this episode, I sit down with women's health expert and cardiovascular advocate Dr. Jayne Morgan to uncover the critical, often overlooked signs of heart disease in women. We dive deep into why atypical symptoms like constant fatigue and unexplained jaw pain are frequently normalized or misdiagnosed, potentially leaving women vulnerable to silent heart attacks. I want to empower you to take total control of your wellness by understanding how hormonal shifts during perimenopause impact your arteries, and which essential baseline tests you need to demand from your doctor. (00:00) Unusual fatigue can be one of the most overlooked heart symptoms in women. (01:39) How to tell the difference between normal tiredness and fatigue that deserves medical attention. (02:29) Getting winded during normal activities, like walking upstairs, can be a sign to pay attention. (03:14) Some women discover years later that they had a silent heart attack. (04:03) Unexplained jaw pain should not always be treated as a dental issue. (05:35) Women's smaller hearts, smaller vessels, and estrogen changes affect heart attack symptoms. (07:18) Blood pressure can rise as arteries become stiffer during hormonal shifts. (08:23) Dr. Morgan recommends women get a baseline EKG while they are healthy. Watch the whole episode: https://youtu.be/2ezqUWbo4ls Full show notes (including all links mentioned): https://jjvirgin.com/hearthealth Learn more about your ad choices. Visit megaphone.fm/adchoices

The Carver Carnival is the Carver College of Medicine's unofficial exhale — an end-of-year celebration where students who have been running on caffeine and anxiety for nine months can finally look up from their notes. In an unusual move, the Short Coat took its mic into the crowd and asked what these med students actually learned. The EKG crisis that resolved by Thursday, the anatomy confabulations that somehow pass, and the therapy dogs reveal a recurring theme: medical school is both harder and more fun than you might expect, the competition is a myth (at least, here), and the best thing you can do the hour before your next exam is probably go to the gym instead of studying. And the financial aid guy in the dunk tank sends memes at the end of bad-news emails.

It is getting hot in California, which has us thinking about the massive carbon footprint of healthcare. The emergency department is famously resource-heavy, but can we save lives and reduce waste? Dr. David Barnes joins us to explain how going green isn’t just about being a “tree hugger”—it's about saving money, cutting waste, and making our hospitals resilient against supply chain chaos. Defining Healthcare Sustainability Balancing Safety and Footprint: Sustainability in healthcare means delivering efficient, affordable care that minimizes resource waste while remaining clinically safe and meaningful. The Power of Resiliency: A sustainable healthcare system is inherently a resilient one. Reducing reliance on single-use items and utilizing local renewable energy sources (like microgrids) protects hospitals from supply chain disruptions caused by geopolitical conflicts or weather-driven power grid failures. The Three Scopes of Emissions Scope 1 (Direct): Emissions directly produced by hospital operations, such as idling fleet vehicles and leaking anesthetic gases. Scope 2 (Indirect): Purchased energy used to power and heat the facilities (e.g., local electricity and steam lines). Scope 3 (Supply Chain): The largest bucket, making up 60% to 80% of healthcare emissions. This includes employee commutes, medical waste incineration, manufacturing of disposable devices, and food production. Clinical Traps: Where We Waste the Most Pre-packaged Kits: Studies show 75% to 80% of items inside specialized kits (like central lines) go completely unused and are thrown away. Over-Preparation: Opening multiple single-use items (like various ET tube sizes) or donning full trauma PPE for minor injuries creates an immediate, unnecessary trash stream. Pharmaceutical Waste: Standard packaging size leads to heavy drug wasting (e.g., using 5 mL from a 100 mL propofol bottle). This regulated medical waste is costly and energy-intensive to incinerate. The Glove Epidemic: Glove overuse skyrocketed during COVID-19 and became a habit. Most routine encounters carry no contamination risk, making glove use clinically unnecessary. Shifting the Culture “Take What You Need, Leave What You Don’t”: Avoid opening supplies you may not need or bringing extra gauze or syringes into a room. Due to infection safety protocols, these often end up in the trash. Watch Where You Toss: Keep coffee cups and paper out of the red biohazard bins. Regulated medical waste costs six times more to process and must be incinerated, creating massive greenhouse gas emissions. Embrace Reprocessing & Reusables: Support partnerships with companies that safely clean and reuse devices historically labeled “single-use” (like EKG leads or waffle mattresses). Swap disposable plastic gowns for reusable cloth gowns that survive 90 washes. Model the Behavior: Culture change takes patience and persistence. Instead of finger-wagging or shaming colleagues, visibly adopt sustainable habits to drive grassroots practice changes. Key Takeaways for the ED Clinician Speak up on bad design: Clinicians are on the front lines of waste. Advocate for local sustainability initiatives to grab the attention of hospital executives who handle major purchasing contracts. Normalize virtual alternatives: Protect staff well-being and slash commuting emissions by offering Zoom or Teams options for short, solitary administrative meetings. Keep it in perspective: Healthcare sustainability is about finding the sweet spot where clinical safety, resource utilization, and environmental impact meet. Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest: Dr. David Barnes, Professor of Emergency Medicine, Director of ED Sustainability, and Member of the Sustainability Committee at UC Davis Health Resources: Practice Greenhealth Health Care Without Harm Green ED (Royal College of Emergency Medicine) *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Jay Gunkelman goes in BLIND on Case 8 — a 30-year-old whose eyes-open EEG looks like eyes-closed. Alpha at 150 microvolts. Widespread. Anteriorized. Not responding to eye opening. After half a million EEGs, Jay calls the phenotype on sight: vigilance regulation problem, not attention. Left-side mu disconnect. Right-parietal alpha persistence. Frontal alpha hyper-coherence climbing from 0.5 eyes-open to 0.6+ eyes-closed — affect regulation flag. Plus a treatment map more granular than the room expected: FC beta for salience activation, C3 for language, C4 for affect, C4-to-PZ for the parietal alpha that won't quit. And a history segment most listeners have never heard — the first transmitted EEG in 1974, phase-lock loops over voice-grade phone lines, Trudy and Eric Gibbs, Larry Wood's engineering. Stay for the inter-rater reliability number that should end the classical-EEG debate: 90% on phenotypes vs 30-40% on traditional reads.

In this episode, we explored KardiaMobile, a $79 personal EKG device that allows users to record a medical-grade, single-lead electrocardiogram in about 30 seconds using their smartphone. The FDA-cleared device detects atrial fibrillation, bradycardia, tachycardia, and normal sinus rhythm, with additional detection capabilities available through an optional KardiaCare membership. We also explored questions around who this device is really for, how it compares to EKG-enabled smartwatches, the role of the subscription membership, and whether at-home heart monitoring provides genuine peace of mind or creates unnecessary health anxiety for everyday users. Follow AndroidGuys(X) Twitter: https://www.twitter.com/androidguysInstagram: https://www.instagram.com/androidguysTikTok: https://www.tiktok.com/@androidguysofficialYouTube: https://www.youtube.com/@AndroidGuyscomOfficialWebsite: http://www.androidguys.comFollow Scott WebsterInstagram: https://www.instagram.com/scottwebsterFollow Luke GaulInstagram: https://www.instagram.com/lukegaul

On this episode of the Jared Williams Show, sales trainer Doug Wyatt of Synergy Learning Systems joins host Jared Williams to dismantle the sales stigma in trades like plumbing and HVAC, advocating ethical influence over high-pressure tactics through his 7 Foundations of Effective Communication—emphasizing mindset shifts, wordsmithing (e.g., "investment" vs. "fee"), RARE listening, and passionate EKG delivery to boost average tickets from $500 to $3,000+ without discounts. Drawing from his journey scaling companies from $1M to $7M amid recessions via communication mastery, Doug outlines three success pillars (technical, ops/marketing, influence), shares strategies for handling objections (bids, brands, stalls, price) to hit 60-90% close rates, managing "cancer" employees with 30-day plans, and scaling via direct mail frequency over blankets. Jared reveals implementing a fraction of Synergy's training added $1.2M revenue (net +$850K) with one fewer tech at his Alaska firm, concluding that focusing on value-driven communication transforms trades businesses and families ethically, with a free RARE Listening module offered at synergylearningsystems.net/rare.

In this episode, Larry and Uncle Joe are back for another live Wednesday Q&A with real men from the Dad Edge Alliance — and this one hits on two of the most common struggles we hear from men: a marriage in repair mode that's sending confusing signals, and a hot-tempered nine-year-old that nobody knows how to reach. The first question comes from Jimmy — a man whose wife gave him a 90-day ultimatum, who has been doing the work, and who is now completely confused by what's happening. She's been affectionate. Then she's not. Then she pulls back and says no more physical contact. Is it over? Should he give up? Joe and Larry speak into this with the kind of wisdom that only comes from having lived it — including Joe's own experience with physical contact happening and then the wall going right back up, and Larry's stock market analogy that every man in a marriage repair season needs to hear. The second question comes from Mark — a teacher and dad of three whose nine-year-old middle child has a hair-trigger temper that seems to come out of nowhere. Joe drops one of the most memorable pieces of wisdom this show has ever heard about what anger in a young boy actually means, what's running underneath it, and how to find the magma before it erupts. Larry adds his own raw, honest story about his ten-year-old Colton — a family meeting he called, the guilt he took full ownership of, and what it means when the softest voice in your family has to fight just to be heard. Joe closes with a Solomon quote that stops the whole room cold.   Timeline Summary [0:00] Introduction to the Dad Edge mission and the movement to raise leaders of families and communities [1:02] Larry and Joe open the Q&A — May is here, and the Alliance Bible study group gets a shoutout [5:28] Jimmy's question: my wife gave me a 90-day ultimatum, I've been doing the work, she's been affectionate — then suddenly pulled back and said no more physical contact. Is it over? [8:59] Joe's answer: she doesn't feel safe yet — the narrative justifying the divorce is still running, and physical contact is cracking it open in a way that terrifies her [11:47] The mistake Joe made — trying to use physical contact to manipulate the situation back to his side [13:18] It ain't over until you say you're done trying — Joe's message to Jimmy [16:23] Larry's answer: the EKG pattern — she softens, pulls back, softens, pulls back. This is not failure. This is repair. [18:00] The stock market analogy — marriage repair is not a straight line, and the only thing that crashes it is when the man stops doing the work [21:47] Have the clarifying conversation — if you initiate, what do you want from me? Get clear so the lines stop getting blurred [24:49] Do the work for you, not for her — and don't be needy. That standoffish groundedness is what actually draws her back. [27:45] Core values as a filter — Awesome's answer on staying congruent when everything feels chaotic [30:15] Mark's question: my nine-year-old middle child has an explosive temper and I don't know how to reach him [33:24] Joe's answer: middle kids often don't feel seen or heard — and a hot temper at nine means there is a river of rage running just under the surface. Find out what's feeding it. [35:47] What drove Joe's youngest son's anger — self-image struggles and the "am I good enough" question that lives in every boy [37:15] Larry's answer: go in soft, go in curious, and do it shoulder to shoulder — not nose to nose [39:10] The family meeting Larry called about Colton — taking full ownership and asking everyone to do better [42:04] Colton is the softest voice in the family and he's always fighting to be heard — and that has to change [45:07] Joe drops Solomon — the power of life and death is in the tongue. Speak the behavior you want to see. [47:33] The 45-second greeting rule — and why how you welcome your kid home sets the tone for everything that follows   Five Key Takeaways Marriage repair is not a straight line — it's the stock market. She will soften and pull back over and over. The only thing that crashes it is when you stop doing the work. If she says no physical contact, have the clarifying conversation. Honor her request — and ask what happens if she initiates. Getting clarity is not weakness. It's leadership. Do the work for you, not for her. The groundedness of a man who keeps growing regardless of her response is one of the most attractive things a woman can witness. A hot temper in a young boy is never just a temper. There is something running underneath it — usually tied to self-image, feeling unseen, or something happening at school that he doesn't have the words to explain yet. The power of life and death is in the tongue. If you want a certain behavior out of somebody — speak that behavior into them. Your words become self-fulfilling prophecies.   Links & Resources Dad Edge Alliance: https://thedadedge.com/alliance No More Mr. Nice Guy by Dr. Robert Glover: Available on Amazon Episode Link & Resources (Episode 1474): https://thedadedge.com/1474   Closing If there's one message from this episode that stands out, it's this: the softest voice in your family deserves to be heard — and the words you speak over your kids and your wife are either building something or tearing it down. Joe said it best. Solomon said it first. The power of life and death is in the tongue. Speak the behavior you want to see. Speak life into the people who need it most. And if you're Jimmy right now — don't give up. It ain't over until you say it is. Go out and live legendary.

EECP Therapy and Stroke Recovery: Can a Cardiac Treatment Help Grow New Blood Vessels? When I first heard about EECP therapy in the context of stroke recovery, I was skeptical. It’s a cardiac device approved in Australia for stable angina and congestive heart failure. Stroke is not on the label. So why are we talking about it on a stroke recovery podcast? Because the mechanism is fascinating. And the research, while still emerging, is pointing somewhere worth paying attention to. In this episode, I sat down with Jack Clifford, a heart disease patient who discovered EECP therapy and began exploring its potential beyond its approved indications. What started as a cardiac conversation quickly became one of the most scientifically interesting discussions I’ve had on the show. What Is EECP Therapy? EECP stands for Enhanced External Counterpulsation. The treatment involves a set of pneumatic cuffs fitted around the calves, thighs, and buttocks. These cuffs inflate and deflate in precise synchrony with the heartbeat, inflating during the heart’s resting phase (diastole) to push blood back toward the heart, and deflating just before the heart contracts. The result is an increase in blood flow and a specific type of fluid shear stress on blood vessel walls. It’s that shear stress that makes things interesting. The Biology: Arteriogenesis and Angiogenesis To understand why EECP therapy might be relevant to stroke survivors, you need to understand two terms: angiogenesis and arteriogenesis. Angiogenesis is the sprouting of entirely new capillary vessels — the body builds small blood channels where none existed before. Arteriogenesis is different: it’s the remodelling of pre-existing, dormant collateral vessels into functional bypass channels. Think of it like upgrading a dirt track into a highway. The track was always there; the body just wasn’t using it. When blood flow is obstructed, whether by a blocked coronary artery or a stroke, the body can, under the right conditions, activate these collateral pathways. The shear stress produced by EECP therapy appears to be one of the triggers that stimulate arteriogenesis. By generating repeated waves of increased blood flow, the treatment creates the mechanical signal that tells blood vessel walls to grow and remodel. This is why cardiac researchers originally developed EECP for heart patients. But it raises a legitimate scientific question: could the same mechanism support blood flow recovery in the brain after stroke? What Does the Research Say? A 2026 meta-analysis published in the QJM: An International Journal of Medicine examined 15 randomized controlled trials involving 506 participants, looking specifically at EECP’s effects on functional outcomes in stroke patients. The results showed statistically significant improvements, with EECP outperforming control conditions on standard functional recovery measures. This is preliminary evidence, not a settled clinical consensus. The studies are relatively small, the methodology varies across trials, and EECP remains off-label for stroke in Australia. But for a therapy with a well-understood safety profile and an existing approval framework, 15 studies and 506 participants is not nothing. It’s enough to warrant serious discussion. What I Discussed with Jack Clifford Jack came to EECP as a patient, not a researcher. His experience with heart disease led him to explore the therapy, and he’s spent considerable time understanding the evidence base and connecting with practitioners. He’s not a clinician, and neither am I, but what we can do together is examine what the research actually says, what the mechanism actually is, and what questions remain unanswered. In our conversation, we discussed: How Jack first encountered EECP therapy and what led him to investigate it further The difference between approved and off-label use, and why that distinction matters What the shear stress mechanism actually looks like in practice The existing network of EECP practitioners and how stroke survivors might access the therapy The questions both of us still have about where the research needs to go Important Disclaimers   EECP therapy is approved in Australia by the TGA for stable angina pectoris and congestive heart failure (ARTG Entry 376470). Stroke is NOT an approved indication. This article and podcast episode are not medical advice. Speak with your treating physician before pursuing any treatment. This episode is not medical advice. It is a conversation about an area of emerging research that I find scientifically credible and worth understanding. The goal is to help you ask better questions, not to tell you what treatment to pursue. Where to Learn More ecplocator.com a directory of EECP therapy providers eecpbook.com is a dedicated resource on the treatment and its evidence base recoveryafterstroke.com for stroke survivors looking for a broader community Research cited: Zhao et al. (2026). Enhanced external counterpulsation for ischaemic stroke: a systematic review and meta-analysis. QJM: An International Journal of Medicine. DOI: 10.1093/qjmed/hcag010. Therapy and Stroke Recovery: Can a Cardiac Treatment Help Grow New Blood Vessels? Bill Gasiamis sits down with Jack Clifford to explore EECP therapy, a TGA-approved cardiac treatment that may stimulate the growth of new blood vessels. Together, they examine the emerging research on angiogenesis, arteriogenesis, and whether this off-label approach holds promise for stroke survivors seeking to improve blood flow to the brain. Highlights: 00:00 Introduction – EECP Therapy06:06 Recognizing Health Issues and Seeking Help09:50 Hospital Experience and Heart Health12:12 Decisions Against Medical Advice16:28 Exploring Alternative Treatments18:06 Understanding Enhanced External Counter Pulsation (EECP)21:58 The Mechanism of EECP27:03 Personal Transformation Through EECP30:29 Lifestyle Changes and Holistic Health34:35 The Impact of Stress on Health38:30 The Journey of Writing a Book43:29 The Role of EECP in Heart Health48:21 Raising Awareness for EECP Therapy56:05 Exploring the Future of EECP Therapy Transcript: Introduction – EECP Therapy Jack Clifford (00:00)Mine was really severe. 100 % blocked in my widow maker, the left anterior descending. I’m 95 in my left coronary artery and in my right main, I am 80%. And I’m still that way today, but I can run a sub seven mile. Bill Gasiamis (00:16)Welcome to the Recovery After Stroke podcast. I am your host, Bill Gassiamus. Before we get into today’s interview, I need to share something important. The topic we’re exploring today involves a medical device called an EACP, Enhanced External Counterpulsation Machine. In Australia, EACP is registered with the Therapeutic Goods Administration for the treatment of stable angina and congestive heart failure. It is not approved for stroke. What we are discussing today is emerging off-label research, not a treatment recommendation. Everything in this episode is for informational purposes only. This is not medical advice. Please speak with your treating physician before pursuing any treatment, therapy or intervention discussed here. With that said, let’s talk about something that genuinely fascinated me when I started reading the research. Your body has the capacity to grow new blood vessels, not just small capillaries, but to remodel dormant pre-existing channels into functional bypass routes. Scientists call this arteriogenesis. There’s also angiogenesis, the sprouting of entirely new Both processes matter deeply for stroke because stroke is fundamentally a blood flow problem. Now here’s where it gets interesting. A cardiac therapy developed for heart patients, not stroke patients, trigger exactly this kind of vascular remodeling. And in 2026, a meta-analysis published in the QJM across 15 randomized controlled trials and 506 participants found that EECP produced statistically significant improvements in functional outcomes for ischemic stroke patients. Now, that’s not proof. That’s not a green light to go and get an EECP, but it is worth a serious conversation. My guest today is Jack Clifford. Jack is a heart disease patient who discovered EECP therapy while managing his own cardiac condition and who has since spent considerable time investigating its potential. beyond cardiac care. I should tell you, I was skeptical going into this conversation, but I’ve learned that skepticism without curiosity isn’t really skepticism. It’s just closed mindedness. So I read the research and then I sat down with Jack. So if you find this episode valuable, I’d love for you to grab a copy of my book, The unexpected way that a stroke became the best thing that happened at recoveryafterstroke.com/book. And if you want to support the show, you can join Patreon at patreon.com/recoveryafterstroke. And I want to thank everyone who is supporting me on Patreon, especially the people that have been around for a long time and the people who have just recently signed up. I very much appreciate it. And now here’s my conversation with Jack Clifford. Bill Gasiamis (03:19)Welcome to the podcast. Jack Clifford (03:22)Thanks, Bill. Great to be here. Bill Gasiamis (03:24)Let’s give the listeners a bit of a background understanding of why you’re on the podcast. You’re not a stroke survivor, but we have something in common as ⁓ somebody who has been unwell before myself and you in the past. Tell me a little bit about your journey to the podcast So we just kind of give people an understanding as to how it is that somebody who’s not a stroke survivor. Jack Clifford (03:34)We do. Bill Gasiamis (03:51)how we ended up chatting together? Jack Clifford (03:54)Yeah, absolutely. So the quick version here is ⁓ I was on the brink five years ago of having ⁓ unsentable emergency triple bypass surgery. And ⁓ I chose a different path, which we’ll get to. ⁓ But you you have some level of placking if you have a stroke, typically, depends on the stroke, but that’s typically the case. And in my case, I had placking in my coronary arteries. So it resulted in heart disease. Mine was really severe. 100 % blocked in my widow maker, the left anterior descending. ⁓ I’m 95 in my ⁓ left coronary artery and in my right main, I am 80%. And I’m still that way today, but I can run a sub seven mile. I can do some things that a guy that’s as blocked up as that should not theoretically be able to do. ⁓ Bill Gasiamis (04:49)All right. Tell me about life before the injury. What kind of work did you do? How did you go about life? What was generally a day like for you? Jack Clifford (04:59)Yeah. So I’m retired military guy. Um, so, you know, been in the military most of my life, um, retired about 10 years ago, a little over that. And, um, so I’ve always been a pretty fit guy. It wasn’t, you know, it wasn’t a fitness issue per se. Um, and, uh, I, I, I had kind of lost some of my self care because my wife had been going through some real significant medical issues that really required my full attention for quite a while. And because of that, really stopped taking care of myself in the ways I had in the past for about 10 years. And when we had just moved to Florida, I started trying to take care of myself again. And that’s when I discovered all these problems. Bill Gasiamis (05:44)So what does not taking care of yourself look like though? Jack Clifford (05:47)Gotta be in a couch potato and being on my computer way too much research and for ⁓ trying to help my wife get better and hold down a job at the same time and raise a family and all these other things that took the priority off of me in that sense that one should be taking care of themselves, meaning exercising, meaning eating the right foods, so on and Recognizing Health Issues and Seeking Help Bill Gasiamis (06:09)You know, caregivers tend to die before the person they’re caring for much more often. And it’s cause of that reason, right? Because time is really taken up by especially full-time caregiving with somebody’s in the house and they need caregiving. need care. The caregiver tends to neglect themselves in every way, shape and form and tends to ⁓ make it about the other person. And then the other person. Jack Clifford (06:14)I’ve seen that and heard about it. Yeah. Mm-hmm. Bill Gasiamis (06:39)seems to be doing okay, but the caregiver is struggling and doesn’t ask for help and doesn’t go and doesn’t go and get looked after. And then things tend to catch up with them and they become the ⁓ sickest person in that relationship. Jack Clifford (06:55)It’s like that whole put your oxygen mask on first on the airplane type thing, right? Like, you know, we can’t we can’t give what we don’t have to give Bill Gasiamis (07:01)Uh-huh. Yeah. So you, did you notice, did you notice the steady decline in your health? Did you kind of go, I’m not feeling right. I’m a feel a bit sluggish like 10 years down the track, or did it just creep up on you? then you got to this point. Jack Clifford (07:15)It really crept, it really crept. I, you know, like I had initially exercise induced angina, but it wasn’t much exercise that induced the angina. And then it very quickly progressed to trying to walk and getting out of breath and, know, at very basic walking speeds, just moderately paced, you know, anything anybody would do out in your neighborhood. ⁓ Bill Gasiamis (07:39)Did you know that you had an angina? Jack Clifford (07:41)I did, yeah. I didn’t have a big heart attack episode like some people have. I’m 100 % blocked. There’s no heart attack to happen, right? Because the stuff is, I’m so blocked that it’s just a pure blood flow issue. A lot of people don’t understand that that 50 % blockage is a huge risk for a heart attack because you’re gonna burst a plaque and then go from 50 % to 100 % like that. But you know about collaterals. And if you have collaterals in place, the blood’s not getting flowing this way, you’re gonna recruit some lead oval collaterals to be able to just get by with your activities of day living. But if you don’t push yourself, you don’t know that you don’t have enough blood flow to do these other things. Bill Gasiamis (08:22)Okay, so you got to the point where you were so unwell as far as the blood vessels around your heart were so unwell, they were so blocked that angina led to another escalation or something happened that got you to the point where you realized, okay, things are not good. Now, tell me what angina is exactly and what it’s like to have it. How do you experience it? Jack Clifford (08:39)Yeah. yeah, yeah. I’d love to talk about that. Bill. at its most basic, it’s a supply demand mismatch. So, you know, the blood flow that’s supplying your heart ⁓ is adequate for X, Y, or Z activities of daily living. You know, walking around the house, doing the dishes, you might have enough blood flow for that, but you don’t have enough blood flow to go run a mile or even walk potentially, you know, or Hospital Experience and Heart Health but it’s all about supply demand mismatch. And that’s about just the size of the pipes, you know, if they’re clogged up, how clogged up are they? And, know, ⁓ that’s, really it. So, and what it feels like is it’s scary because it feels like a heart attack. all like, what does a heart attack feel like? Well, there’s a thousand different sort of, ⁓ descriptions of it. ⁓ you know, radiating down your arm or nausea or something in your back, but. you know, if it’s right over your heart, it’s unmistakable. And that’s at least my presentation of angina. And I think it was a pretty typical one is, you know, I have this weird kind of deep pain. initially, when I, when I started, you know, run, trying to run and got it, I thought, ⁓ you know, I just pulled a chest muscle weirdly over my heart. You know, I’ll stop and let’s see if it goes away. I come back, you know, no, same thing. Okay. Still not better. Let’s do it again. Another couple of days later, so on and so forth. I was just kidding myself, but I didn’t know anything about the horror at that point. hadn’t had to research all this stuff and do all the deep dive. Bill Gasiamis (10:16)That’s the same crazy logic that stroke survivors put to, I’m feeling weird. I’m dizzy. I’m going to go and lie down. I’m going to rest. It’ll be better later. ⁓ I’m too busy. I’ve got to go to work. ⁓ I’ve even had stroke survivors where somebody’s telling them you maybe you’re having a stroke, you know, just tongue in cheek and they’re like, yeah, no, probably not. ⁓ it’s the same crazy logic that we say about things that are unfamiliar to us that we cannot potentially. Jack Clifford (10:25)Mm-hmm. Mm-hmm. Yeah. Yeah. Bill Gasiamis (10:46)link to something so serious because we have no knowledge, we’re ignorant, right? Jack Clifford (10:47)Yeah. Well, yeah, I think that’s really part of the key there is like most times with something as sudden as what you’re talking about or what I’m talking about in my instance, because it was pretty, pretty sudden, you know, weeks and months. ⁓ We went from being these, you know, healthy people that felt like we were on top of the world to all of a sudden not. you you didn’t have a frame for what not looked like. ⁓ Bill Gasiamis (11:14)Exactly. Yeah. That’s such an important comment. We don’t have the frame for what not healthy looks like and therefore you don’t know what you don’t know. So you don’t take any action. You just brush it off. Okay. I hear you. All right. We got to the bottom of the stupidity behind a lot of my decisions as well to avoid going to hospital for a week, et cetera, the first time. ⁓ So you end up Jack Clifford (11:24)Exactly. That’s it. Bill Gasiamis (11:43)being really unwell on this particular date. Kind of what is that day like? Explain us. Jack Clifford (11:46)Yeah. Yeah. Decisions Against Medical Advice So I got tight. I, I, I’ve been a biohacker for a while. So that’s probably the only reason I’m here talking to you because I went off the beaten path really far off the beaten path to get to the place where I know what I know and I have to share what I have to share. ⁓ because I’ve been trying to help my wife get better for some significant issues, including a really bad traumatic brain injury. And some other things and doctors didn’t have the answers for those so we had to we had to kind of biohack our way out of some things I was comfortable back. I’m saying that to say my wife got me a Chili pad for my bed because you know been trying to biohack sleep for a while and the colder environments to sleep are you know better to some degree at least in theory ⁓ and so Yeah, correct Bill Gasiamis (12:32)Chili meaning cold, not spicy. Jack Clifford (12:37)Yeah, correct. A chili pad as in the cold. So it’s a device that just, you know, cools your bed off. And so I crank that down to 55. She got it for me for Christmas. So Christmas day Eve, I’m like hopping into bed, like I’m going to sleep really well tonight, you know, and I woke up at four AM like, Oh, you know, I thought that was the big one because it felt that way. I a dead sleep woke me up with, with intense chest pain. And I knew something was going on, you but I was kidding myself. I hadn’t talked to family about it. You know, I hadn’t shared anything about what was going on with anybody. So at this point I’m like, oh my goodness, you know, and I could be dying and have not had, you know, just been an idiot the whole time. So I rushed to the hospital and I didn’t have a heart attack. I just made it so cold that I made my heart work and that supply demand mismatch was happening all night long in my sleep. Bill Gasiamis (13:15)Mm-hmm. Jack Clifford (13:31)And so it got to this, you know, a giant, creeps up, you know, it’s like, can feel it. And then if you push it, you’re like, can really feel it. Well, you know, I woke up out of a dead sleep going from not feeling it when I went to sleep to, to feeling it to the extreme when I woke up. Um, but that’s when they gave me the, uh, the, uh, nuclear stress test with a treadmill test, right in the hospital. And it was, it was really bad. They can’t quantify your blockages with that, but they can tell you that, you know, you’re You’re kind of screwed. And I was like really screwed. Like it was 47, but they said I was one of the worst I’d ever seen. ⁓ yeah. So I had all weekend to think about it, you know, cause I was a Friday, fortunately, and they could, they weren’t going to do the heart catheterization until Monday and the doc, you know, I was signing consent forms for them to do bypass surgery and it was pretty clear that the odds of it getting stented was not really good, but that’s what you hope for. Right. And most people are like, we’ll just get a step. once then in you’re fine. And ⁓ in my case, it wasn’t looking likely. And my mother had had bypass surgery five years before that. And I watched her cognition after the bypass surgery just declined to the point where she’s in memory care now. And she had gone from being this vibrant book author of multiple books and you know, she was a hypnotherapist and she’s helped a lot of people in her life, done a lot of amazing things, but ⁓ she never. she never really came out of the bypass surgery as her whole self and pretty quickly was just completely not herself at all. ⁓ So I wasn’t ready to come back. Now she’s 76. Bill Gasiamis (15:03)How old? How old’s your mom? Yeah. I know with people that are older, ⁓ heart surgery can lead to cognitive decline and there is a link there. There is a number of it’s well researched. It’s a risk. ⁓ not one that you’re probably aware of and that they talk about much, but it definitely is a thing. so, okay. You’re, you’re you go to the hospital. They realize, ⁓ the Jack Clifford (15:15)Mm-hmm. Bill Gasiamis (15:37)charts are not looking good. ⁓ They do the tests. They suggest that what they can offer you is bypass surgery. your, and you’ve got a weekend, think about it and you, and you go home, do they go, do you go home with medication and joining the medications to keep the blood flowing with anything? What do they do? Jack Clifford (15:51)Mm-hmm. Where’d you go? Yeah, such a blessing. No, no, because I was leaving against medical advice so they weren’t going to help me, right? And I actually said to the doc, said, you hey, I’m new here because I just moved a couple of months ago to Florida. And I said, can I come see you? And I didn’t have a cardiologist. I didn’t need one before this. And he says, if you live that long, just walks out. So I was on my own at that point. There was no resources of institutional medicine. I had to go find resources myself. Exploring Alternative Treatments Bill Gasiamis (16:28)Wow. Things are pretty wild in Florida. If you live that long and he walked out. Jack Clifford (16:30)Yeah. Yep. That’s exactly what we said. It’s a very sobering moment for me. Yeah. Bill Gasiamis (16:35)And you walked out. Yeah, and you walked out. Far out, man. So what’s the thinking behind walking out of that? Because I understand ⁓ that there are very few things that, like my situation was different, right? But I’ll give you kind of my thinking behind the, I’m gonna walk out routine. It’s like, there is a part of me that sort of says, I don’t need to subscribe to all that medical stuff, all the nonsense. I wanna try and avoid the medications. I wanna do all of that. Jack Clifford (16:41)Yeah. Yeah. Bill Gasiamis (17:07)That means I’ve got to do some work to get to that point, right? I’ve got to make sure that I’m eating well. I’m sleeping well. ⁓ I’m exercising. ⁓ I’m not overweight. I’m not smoking. I’m not drinking. Like there’s a responsibility that goes with, don’t want to take that medication. Right. And one of the other things is that, ⁓ if it wasn’t for the medical industry, I would not be here recording this, ⁓ podcast. Yeah. So there’s this big thing, which is. Jack Clifford (17:31)Yeah. Double-head sword, right? Yeah. Yeah. Bill Gasiamis (17:37)They’re not fixed. My brain is not getting fixed unless they go in and take out the faulty blood vessel and potentially risk all the complications that, that I got the ones I got, but also the ones I didn’t get, which many people get, which is far worse deficits than what I visible on me. So, ⁓ I’m, you know, I’ve never met anyone in my time who hasn’t Understanding Enhanced External Counter Pulsation (EECP) who has been through the medical ⁓ system, who hasn’t benefited from it in a way that’s sort of sustained their life, supported their life, lengthened their life. Like everyone that I’ve interviewed has always gone through the medical system and has saved them, supported them, helped them, right? And you’re going to, the first place to get help you’re going to is a hospital, right? You ring up and you go, I’ve got to go. Jack Clifford (18:22)Yeah. Bill Gasiamis (18:31)to the hospital because I’m feeling like I’m having heart attack. You get there, they confirm it, and then the place that you go to for help is the place you walk out of. What’s the thinking? Yeah, yeah. You have the angina, the blockages. Yeah, you got all of that. Jack Clifford (18:41)Well, I didn’t have a heart attack. That’s a really important nuance point. you know, I’m sitting in the hospital all weekend. there was nothing at risk in an emergent moment for me. My heart wasn’t, you know, I wasn’t going to lose heart muscle if they didn’t do something. Like my mother’s instance was different. She had a heart attack. She probably needed the bypass surgery. It was really hard on her, obviously, like we talked about, but in my case, I had time, but they didn’t treat it like I had time, right? Bill Gasiamis (18:54)Okay. Okay. Jack Clifford (19:10)They treated it like, we’re gonna go in and take care of this thing for you rather than you have time to explore other options when I knew in fact I did. So it might be that getting bypass surgery is the right move for some folks, but it also might be the right move for you and me. We’ve already discussed that you take care of yourself so you never get in that situation. And yeah. Bill Gasiamis (19:32)Yeah. And this is not a interview about do as I say, this is not that interview, right? What this interview is like one person’s experience and what they did. That’s it. We’re not giving medical advice here. We’re not telling you what decisions to make. We’re not telling you any of that stuff. This has got nothing to do with advising anyone to do anything, but what it has got to do with is what either you discovered Jack Clifford (19:45)Yeah. Right. Bill Gasiamis (19:58)or you knew before and put into action or what you discovered after you left the hospital that weekend. So take us through the next sort of phase of I’m taking responsibility for this and I’m going to take advantage of something that is documented scientifically and proven. Jack Clifford (20:03)Yeah. Okay. Yeah. Mm hmm. Yeah. Yep. Yeah. And you know, like, so I’ll go into that phase, but, but I just want to share this thing because, know, you, you pretty much already told me when you first heard EECP, you like EECP what? Right. And most doctors are EECP what? Basically every patient is EECP what? And it’s, it’s just, it’s really not going to lie. really bothers me because this, this, this therapy is, is so well-documented. It’s, it’s, it’s FDA approved. It’s not controversial. Bill Gasiamis (20:25)Mm-hmm. Jack Clifford (20:43)⁓ it just anyways, okay. So, so, so yeah, so I leave the hospital and the only reason I knew about a EECP was because when my mom had her heart attack, I listened to a podcast by Ben Greenfield. He’s a pretty, you know, pretty high-level guy, right? And that had been, that was like 2015. And I just heard mention of it. was like, it was maybe like two minutes of the, of a 60-minute podcast at most, but I was like noted. So I looked into it from my mom. The closest provider was two hours away and you got to go 35 times and my mom isn’t going to drive. 35 times, you four hours round trip. It wasn’t gonna happen, so we moved on, but I just sort of knew about it. And when I say knew about it, I didn’t know, Bill, like what it actually did or how it worked. I didn’t look into it at that level. just, you know, like assessed the situation. I was like, okay, there’s something out there. That’s it. Okay, yeah. It stands for enhanced external counter pulsation. And you want me to go into a little bit about how it works? Yeah, okay, so. Bill Gasiamis (21:27)Hmm. And what is a ⁓ CP stamp? What does it stand for? Yeah, yeah, let’s do that, yeah. Jack Clifford (21:42)So EECP involves lying on a bed. From the patient experience, you’re lying on a bed. You have ⁓ cuffs wrapped around your calves, your thighs, and your hips. And inside those cuffs, there are little air bladders. Bill Gasiamis (21:55)those cuffs, are they like blood pressure cuffs? The Mechanism of EECP Jack Clifford (21:58)Yeah, like big giant Velcro blood pressure cuffs. Yes. Bill Gasiamis (22:02)Okay, so like they’re much bigger than a regular cuff, which is just over the bicep. Okay. All right. Jack Clifford (22:04)Yes. Yes. Correct. yeah, just that’s the right way to think about it. you you cinch them up, you’re getting really snug in this thing, but it looks like a giant pantsuit, you know? ⁓ And you lie on the bed and then you get a three lead EKG on you. It’s here, here, in here. And then in between heartbeats, the machine… inflates compressed air into those bladders at 1.3 psi to start with, which feels like kind of a gentle massage. And then the pressure can be increased in increments of 0.1 psi all the way up to six, which feels like the exact opposite of a gentle massage. However, if you go slowly, your body accommodates to that pressure and that pressure feels different, both over one session and over multiple sessions, meaning you might not get to six your first session, that’s unlikely, but as you do repeated sessions, you’ll increasingly get closer to six earlier in the treatment and be cumulatively more hours at those higher pressures. And what’s happening is all the blood, not all the blood, a significant amount of blood from your lower body is being pushed up in between heartbeats and it’s causing this phenomenon called sheer stress in your vascular systemically. And wherever there’s pressure differentials in the body, it’s giving a stimulus to grow. It’s saying the pipes are not big enough, you gotta grow. We’re trying to put through more than is gonna fit. The body’s like, wait a second, it’s not big enough. But growing things in the body takes time. And so you need those repeated sessions. Like I mentioned, T.R., before we started recording, it works just like cardiovascular exercise, but at levels humans can’t do on their own. ⁓ And so, yeah. Bill Gasiamis (23:52)That’s important to talk about. so just for a moment, we’ll talk about that. Like it works like cardiovascular exercise. So the idea with cardiovascular exercise is that what, does cardiovascular exercise do that’s similar to EECP? Jack Clifford (24:04)Sure. If you’re out running, when you hit that stride on your feet, you’re doing that same thing, right? You’re ⁓ sending blood up, right? And then your circulation, your heart’s beating twice as fast maybe than it normally is, or substantially more than you’re just sitting here heartbeat is. And that’s because the heart is responding to the environment around it and saying, I gotta get… a lot more blood, a lot more places. So I gotta work a lot harder. you know, is maintenance. So collateral blood flow. have alternate routes that we can use that lie dormant throughout our body. And those collaterals, if they never get used, they honestly, they get weaker and they close off, but they also can be reopened, you know? And then you can grow more of them. And… Bill Gasiamis (24:38)And what’s the result of that? Uh-huh. Okay, so there’s blood vessels that get less ⁓ blood flow because people are sedentary or people aren’t doing the type of exercise that would activate those blood vessels, for example. And then what in theory, not in theory, and then what happens in cardiovascular exercise, the body goes, we need more blood flow, let’s open up. Jack Clifford (25:12)Exactly. Bill Gasiamis (25:26)other areas where normally blood flow wouldn’t be required or doesn’t go. And EECP kind of mimics that mechanism. Jack Clifford (25:27)Yeah. Exactly. Yeah, but not kind of, it’s really important just to note, cause I don’t want, I don’t want any of your listeners thinking, well I’m just going to go run more. Right? I mean, by all means do that safely. You know, the dose always makes the poison with everything, but, but don’t think that you can, you can just go do this. You can do it to a limited degree with exercise, but you’re not going to grow, you know. that I didn’t have that before. And I like it because it shows you like the world of the possibly or it might be a little unsightly, but it’s feeding my brain. EECP has changed my cognition in addition to my heart, you know, my pelvis and my kidneys and my liver. you know, like it’s, it’s optimized blood flow systemically. Um, yeah. Yeah. Bill Gasiamis (26:19)Okay, so let’s go back to the cuff, the cuff that we put on and then what happens. Jack Clifford (26:24)Yeah. Yeah. So, so you just lie on the machine. Typically you do 35 hours on a machine for a course of treatment and one hour a day is a typical, you know, five days a week. That’s just typically you’re going to the doctor. There’s lots of other variations of that, but that’s the typical course. And that’s the most well-researched course. And, ⁓ you know, over time, usually about halfway through those 35 sessions, if you had angina, you’re going to notice a difference, but Personal Transformation Through EECP you know, they use this to treat dementia. It’s a well studied in dementia. There’s a recent study in the US that was profound, a year-long study, a hundred demented patients, roughly a hundred non-demented or a hundred treated patients. Everybody had dementia and a hundred CHAM patients, placebo. The demented patients that got an EECP, they all got better when we know dementia, people get worse in a year, right? They all got better, all of them. And yeah, so that’s like, you know, similar phenomenon erectile dysfunction, similar phenomenon kidney disease, similar phenomenon stroke recovery. So, you know, these are studies. I’m not making it up. It’s just literally like really well documented. It’s not. Bill Gasiamis (27:33)studies that we can get a hold of and put in the show notes, link to the show notes. Jack Clifford (27:36)Yeah, go to to EECPLocator.com and all these studies are there. ⁓ Yeah. So what I did is in the U.S., I, you know, it’s really hard to find. so I couldn’t find it. I had to, I had to call around and like, I could find a few doctors, none of them near me, but a few of them that would had machines, but they would only use them after everyone had failed stints and failed bypass and they had nothing else to offer them, which makes no sense. But that’s how the insurance reimbursements work. Bill Gasiamis (27:41)Okay. Jack Clifford (28:04)That’s the only time they’ll actually pay for it. So that’s what they say it’s good for, but that’s not what it’s good for. That’s just what they can get money for, I guess. but, so I had to drive three hours and take a chance on a doctor and stay in a hotel to get my treatments. And it was really difficult. I mean, I ended up buying one of these machines and got it at my house and I’ve just been using it for the last five years. So, you know, 35 hours was great, but I was pretty bad off. Now I got about 700 hours and, uh, you know, more hours is just greater stimulus to the body to grow vasculature, right? And I mean, I… Bill Gasiamis (28:38)how do you know that you’ve grown? I know there’s this ⁓ feeling or this change that happens in the person. ⁓ Like you said, dementia, ⁓ people who experienced dementia have a better outcome later or a change in the way that they’re brain working, et cetera. can you see the, is there a way to see the difference between the blood vessels and Jack Clifford (29:02)You can’t, you can’t image, could image on a, on a cardiac pet would be like the only imaging or I guess, you know, if I went back and did a stress test again, you would, you would be able to see, cause it’s not quantifying specific arteries. It’s, quantifying the total volume, but I tried that they were, actually wouldn’t let me, they said it’s not safe because you have it at a stent or a bypass. So I went back to the same place that I got it, you know, and I was like, literally they put me through the imaging machine. gave me the dye and then they got Lifestyle Changes and Holistic Health I went to go on the stress test and the same doctor was there and he refused to tell me to go. So I like, wanted to say, hey doc, let’s go for a run. Cause like, you’re not going to keep up with me, but you know, so I, I didn’t bother with that, but I’ve got my own, you know, I did my own little stress, stress test with a treadmill, right? I started, I was getting chest pain. I found out where I can induce angina and I try and say just below it, you know, so I know where it is, right? I was 2.2 miles an hour. That’s not a fast walk. And then after the first 19 sessions where I was staying in the hotel, I got up to 2.7. That’s a really big difference even if it doesn’t sound like a lot. And then I got my machine and I kept going. And then within a couple of months, I was starting to do a running stride. And I could keep that up, no angina. I know where angina would come in. I had time calculations and everything. And then eventually, now I can run. comfortably 6.5 mile an hour pace for quite a while, know, push it up to 14 miles an hour for 30 second sprints and you know, like all kinds of stuff. So, ⁓ Bill Gasiamis (30:38)How long before you break the two hour barrier for the marathon? Like was recently done. Maybe, maybe the more blood vessels, the more blood flow. Maybe you can get there. Jack Clifford (30:42)⁓ I got zero interest in that. Yeah. I think so though, I think those Kenyans should be ⁓ hopping on these EECP machines and they’re I mean, they’re already amazing but. Bill Gasiamis (30:58)Well, you want the Kenyans to just completely own marathon running for the rest of eternity. It’s unbelievable what they did. Right. Like I imagine that there is something else going on there, but I imagine blood flow, oxygenation, more blood vessels. Like it’s got to potentially be a thing. reckon if you do a check between the last guy, me, who’s going to like 50 hours before you get to the other side and those dudes, there would Jack Clifford (31:03)Yeah, yeah, it’ll just be a Kenyan Yeah. ⁓ Bill Gasiamis (31:27)definitely be a difference because they’re exercising all the time, right? Jack Clifford (31:31)Sure, yeah, they’re pushing the collaterals as wide open as, know, whatever, whatever a human can do on their own, they’re doing it to the max to, know, the same phenomenon that EECP is doing for folks lying down. You know, they’re doing it to whatever the max you can without the machine, I would say. Bill Gasiamis (31:48)So this is a bog standard human body task. Like it just does that all the time. I have heard the blood vessels can reroute in the brain when somebody experiences a blockage and then, and it’s not useful at the time of the blockage, obviously, and it causes potential cell death when somebody has a stroke. But then later on. Jack Clifford (32:11)If there’s too much blood, the revascularization, yeah. Bill Gasiamis (32:14)Yeah, so EECP can kind of occur naturally and then it can support as much of the surrounding tissue as possible so that it doesn’t all die off. ⁓ So what you’re talking about is just encouraging EECP ⁓ to happen more than it would normally happen by ⁓ inducing it through this device where people ⁓ get sort of strapped in and then Jack Clifford (32:23)Yeah. Bill Gasiamis (32:43)the machine runs, what does it run like a program? Explain how that works. Jack Clifford (32:47)Literally, it’s just air pressure. got different pumps to pump the calves, the thighs and the hips up. And then it’s really just about the timing, right? It’s got to hit it at the right interval of your heartbeat. So it’s at the right place in diastole where your heart is at rest. that timing is very, crucial. And that’s really… Yeah, it’s not, it’s very old technology. The machine I have was built in 2009. You know, they have new machines that are portable now that I’m working with some of the manufacturers to actually, you know, make these available in the U S because there aren’t any in the U S but they do have portable machines that don’t require a bed. You could get treated on your couch. You could get treated, you know, on your own bed, uh, lying on the floor, I suppose. Um, so, you know, we’ve, we’ve really like technology hasn’t Bill Gasiamis (33:19)Wow. Jack Clifford (33:42)slowed down. just China’s like taking this thing and you know, have a basically every Chinese hospital has several of these machines and they treat patients in the, in the room with us. It’s, part of their standard of care for all kinds of different, different diseases that they’re treating. You know, and it’s adjunctive to just about everything. There’s nothing that you couldn’t do EECP with, right? ⁓ yeah. Bill Gasiamis (34:03)Okay, okay, so. How do you experience your body differently now? And actually, let’s go back actually, how long has it been since you came across this, decided to get the first treatment, implemented yourself ⁓ at home and then how do you feel different now? Jack Clifford (34:08)Oof. Yeah, it’s been five years and four months now. And every since like, this is this is a little hard part to quantify, because there’s been a lot of brain changes to from this, right? So so I don’t even like feel like my 47 year old self who was in the hospital, that feels really like somebody else to me. You know, it’s a version of me, I suppose, but I can’t really relate to that person. Because I like a small example. The Impact of Stress on Health I used to sleep eight to nine hours a night. That was my normal, my whole life. I was generally like the guy that would come in the latest. You could come to work. was the guy that came in the latest. You And now I get up at two 30 most mornings and I’m like, like rare to go with energy. I’m, you know, I’m working out doing resistance training. I’m reading, you know, I wrote a book, I’m writing another book. I’m writing a book on rectal dysfunction as it relates to this phenomenon, because that’s a whole other, you know, case study. and I work a full-time job and I just have an incredible amount of energy basically all the time. My mood is way better. My sense of touch is really different now. I give a lot more hugs because it feels really good. ⁓ My sense of smell and taste and… You know, hearing, you know, I used to like have to go to the bathroom at night sometimes, you know, wake me up to go to the bathroom. Long gone. Bill Gasiamis (35:47)So at the same time though, it sounds like also you might have changed other things as well though, right? So what else have you changed in the meantime? Jack Clifford (35:55)sure. Yeah. Yeah. Yeah. It hasn’t just been EECP. Absolutely. you know, really good supplement routine. ⁓ Pretty extensive, but, you know, managing my lipids, for example, I take a thousand milligrams of niacin twice a day. I’ve been able to bring my triglyceride to HDL ratio to kind of an optimal one-to-one, using fish oil and some other things. ⁓ And, you know, I… I really stay away from carbs for the most part. I like to eat keto, but I like it to be what I call clean keto. So I’m not like pounding keto ice cream or all these things that are, you know, they taste good and yeah, they’re keto, but they got all kinds of oils in them that aren’t really good for your body. ⁓ And, ⁓ you know, I’m big into moving and being active and, you know, having an engaged social life as much as possible as well. I mean, I think that’s a very underrated thing. That’s actually an area I struggle in because I’m working so much, but you even this helps just, you know, getting to know people even online. But, ⁓ Bill Gasiamis (37:04)It sounds like you haven’t re it doesn’t sound like you’ve reinvented the wheel. Like everything that you say is things that people take for granted that if they implemented would improve their life before EECP. We’re talking about EECP today, right? But just those things alone would make a massive difference to somebody’s experience. And that’s kind of the message that I’m trying to kind of get into the Jack Clifford (37:17)Totally agree. I thought it a good Sure. Bill Gasiamis (37:30)⁓ minds and hearts of the stroke survivors who I interview and who listened to the podcast. My book, I’m going to, we’re going to talk about your book in a sec, but I’m going to talk about my book. My book, when I wrote it, I thought I discovered all these things that people, should know about that no one knows about, but it’s not true in here is mindset. ⁓ there’s a chapter about emotional intelligence. There’s a chapter about nutrition. There’s a chapter about sleep. There’s a chapter about community. Jack Clifford (37:32)Yeah. Yeah. No, please. Bill Gasiamis (38:00)⁓ that’s just the five that I can just rattle off the top of my head right now. And you’ve already mentioned that in the last few minutes, that’s exactly the things that you mentioned. And people take it for granted how much that improves your overall health. Right. The Journey of Writing a Book Jack Clifford (38:13)That’s so true. And also what’s wrapped up in the wrapper of all of those things that are threaded together is stress, right? ⁓ If you do all of those things, right, you’re lowering stress. How did I get heart disease at 47 when it happened to my grandfather in his late 60s and my mom in her mid 60s and it happened to me at 47? And we know it didn’t happen at 47. It was years earlier and I realized it at 47. Stress, you know? Like I was the guy that took on a lot. Bill Gasiamis (38:38)Hiding earlier. Jack Clifford (38:44)and had some traumatic things happen in my life and whatever, and I don’t need to go into that. But I always felt like it was all rolling off my back. Like, you know, I’m fine. know, like I didn’t, and there are reasons why I felt that way. ⁓ However, at the end of the day, I know that I wasn’t processing. There was so much I did not process. And I didn’t learn how to like have really good boundaries and that, you know, begot more stress because of those lack of boundaries and, but stress, right? You know, like, but if you have good good social life and healthy people in your lives, that takes stress off. Eating the right food takes oxidative stress off your body. You could go on and on, but I think stress is gonna kill you before anything else. Bill Gasiamis (39:17)you Yeah. I love that you said that. I love what I love that. That was the answer that you gave when I said, what else did you do? Because it’s not just, you know, it’s like, I’m going to eat well, but smoke, you know, I’m going to eat well, but drink excessive amounts of alcohol. Like, no, it doesn’t work. You know, you can’t do that. Yeah. can’t do. Yeah. Small. Jack Clifford (39:42)No, you gotta do it all in concert. It’s the layers, right? Yeah. Bill Gasiamis (39:49)numbers, know, the percentages they add up, you know, 1 % here, 1 % there all adds up and you get a result at the end of it. Okay. So, so you’re you’ve gone, I’m going to see if I can grow new blood vessels to support my heart. And what you’re found between the time that you went to hospital around five years ago to now is that the angina has Jack Clifford (39:55)Yeah. Mm-hmm. Bill Gasiamis (40:17)⁓ improved, they’ve gone away. The heart has improved, I beg your pardon, the blood flow. And have you had a medical examination since then to do other comparison? Jack Clifford (40:28)Yeah, I have. Yeah, I’ve got a cardiologist. I haven’t seen him and I’ve talked to him the other day because I talked about the book, but I haven’t gone to see him because he’s a plane flight away. But I’ve been worked up for the crowded intermediate thickness. You might be familiar with that as it relates to stroke. okay, well, they just measure your crowded arteries and look at the placking in your crowded arteries as a proxy for your systemic plaque burden. And flow mediated deletation, is they totally occlude the… the arm with a blood pressure cuff and then see how quickly you can refill it after, you know, like, it’s like five minutes of this, your hand is completely numb. And those all, you know, workups were good and that was after a couple of years of treatment. You know, I tried to have that stress test, like I mentioned, but you know, now I just see my primary care, you know, he’s a good guy and he runs on my lipid panels and, ⁓ you know, so I’m definitely monitored, but. What I haven’t done is gotten re-imaged because I don’t want to put extra dye in my system. Sure, somebody wants the images because they don’t believe me, but I’m not trying to sell anybody anything here. I’m just trying to spread the word on something. If somebody doubts my honesty, they can, it’s fine. Bill Gasiamis (41:38)I know what you mean, Jack. I know what you mean. I and I asked you because yeah, I would love to see that before and after. would love to see the blood flow. What’s happening, watch change. would be amazing. story to tell, but I also went out of my way if I could to avoid having more dyes and all that kind of stuff injected into my body. I totally get it. It’s okay. Yeah. ⁓ Jack Clifford (41:49)Yeah. Yeah. Yeah. Bill Gasiamis (42:01)Okay. So you wrote a book about it. Like, what was the idea behind the book? What were you thinking? Show us the one that you got there with the old book cover. And then I’ll include the new book cover in this image as we chat. Jack Clifford (42:06)yeah. Yeah. Yeah. Yeah. Thanks. Yeah. So I started writing this book, in, know, ⁓ November timeframe, ⁓ after I mentioned to you, so my, my friend came down, ⁓ and stayed with me for 13 days and he had had some stroke damage five years before that was, you know, his whole right side, he just had like numbness and then pain. And then, you know, it this weird cascade of symptoms so bad, you know, sometimes he couldn’t sleep from it. And so All the time he took off work he could he came and he used the machine three times a day and then he left pain free and like nothing else had worked and then this worked and I didn’t per se expect that I but I was like, you I know it does stuff. It’s helpful. But anyways, when I saw that, you know, I really started digging even more because before that I was like, well, Jesus is amazing. But maybe it’s just me, you know, and and anyways, so, ⁓ so then I, you know, I just started writing the book one day and The Role of EECP in Heart Health You know, my mom was a book author and I always wanted to write a book. didn’t really have anything particular to write about and all of sudden I do. So I’m like, you know, let’s see what happens. And, uh, and you dig into the research more and more, and you’re just like, increasingly frustrated by how everyone has known about this. And yet, you know, they don’t promote it. They don’t talk about it because it’s inconvenient. You know, and I’m going to get a little, try not to get like soapboxy here, but Bill Gasiamis (43:36)Do it, do it, go for it man. Jack Clifford (43:37)Okay, okay, because, you know, cardiologists will say it, some of them, the ones that are honest, they’ll be like, like mine. He says, I was making obscene amounts of money, giving people bypass surgeries instance. And then I was given the same people bypass surgeries instance, a couple years later. And, you know, and then he stumbled upon some answers and EECP is one of them that helps his patients stay well. And, you know, he makes a lot less money. because of it, because he doesn’t go in and do these interventional approaches. And, you know, EECP, the most you could pay somebody is like $100 an hour, and you’re going to tie up a patient room for 35 hours with a tech, it doesn’t make any sense. I go pop a stint and you make 10 grand in two hours and never see you again. You know, like it just, I get it from, you know, I want to own a portion of Ferrari and have a lake house and a winter house, but You know, like, I don’t know how you live with yourself. You said go for it, man. I’m going to go for it. you know, and my son’s about to graduate. Okay. Yeah. Okay. Fair enough. I’m good with it. Yeah. Yeah. Bill Gasiamis (44:38)But come on, come on, Jack. Yeah, you go for it. I’m going to push back. I’m going to push back as well. You go for it. I’ll push back. There’s yeah. Which is cool. Right? That’s what I want. I want to have a conversation and I don’t want to control the narrative, but the guy that goes in needs a stint today has a blockage. Like that’s life saving. That does work. What I am afraid of that happens sometimes when people go in and they’ve got a blockage and then they get ⁓ even even a stroke blockage. Right. in carotid or a vertebral artery. What happens is sometimes people go in and they get told you need a stent. Fair enough. You’re about to have a heart attack. You’re about to have a major stroke. If we don’t put one in, you’ll have a, that’s necessary. The challenge is, that that person sometimes doesn’t learn the lesson of what got them into the situation where they need a stent. Jack Clifford (45:22)Good. Exactly. sure. Yeah, by all means. Like emergency medicine is great. And we’ll put that in the emergency medicine category of cardiology, right? Why aren’t they offering you, why aren’t they saying, Hey, you’re at risk for a whole lot of other things just by this happening. Why don’t you come 35 times to this EECP machine and you know, like, or why don’t we have centers Bill Gasiamis (45:36)Yeah. Yes, and then later… Jack Clifford (45:55)all over. I found exactly one place in Australia so far that I’m not focusing on Australia right now. I do plan to take EECP Locator International, but right now the access points in the US are abysmal. 70, 80 % of the people in the United States could not get to a center. There’s no access point that’s at all realistic for them to get to. And yet these machines are not that expensive. They’re the price of a Decent not that great car. ⁓ Bill Gasiamis (46:24)we’re starting to see them in, I don’t know, health spas or something like that, where people will go, they’ll get yoga, they’ll get this, they’ll get that, they’ll get infusions perhaps and all sorts of other things. And there’ll be a machine or there’ll be a suit that people can put on and they can go through one hour. Jack Clifford (46:29)Yeah, that’s good. That’s great. Yeah, although I do want to say that the Normatech, like the compression boots that they have and some of those things, when they don’t use the pressures that EECP uses up to 6 PSI and they’re not sinking it in between heartbeats, it’s helpful, but we’re not talking about things that can do the same thing in the body. It’s on the right path and I’m not digging it as being worthless because it’s not, but it’s just not the right thing. Bill Gasiamis (46:47)Yes. Yeah. Yeah. Yeah, that’s kind of what we’re seeing. And to go back to your point is because the medical profession does medical profession stuff. this is not, it’s not that it’s not medically kind of aligned. It definitely is. But when you’re told that the way you solve a problem is through putting a stent in and then never talking to that patient again, to tell them how to avoid to get a stent in that’s Jack Clifford (47:31)Yeah, that’s your job. Bill Gasiamis (47:34)what they do, like they’ve been trained to do that forever. And that’s what they do. And that works and it saves the life. But what it doesn’t do, which I also have a challenge with this, it doesn’t teach the lesson. What it reinforces is that if I have something wrong with me and I go to a doctor, they’ll fix it. So next time it goes wrong, I’ll just go to the doctor and they’ll fix it again. And I didn’t have to change my life. Like this even bloody advertisements that do that. They Jack Clifford (47:51)just I’ll go and he’ll fix it. Yeah. Yes. Yes. Bill Gasiamis (48:03)They hijack that part of the person’s brain and they say, you know, have you got reflux, heartburn, that kind of stuff? Don’t let reflux and heartburn get in the way of eating the foods that you love. Just take a tablet. You know, that’s the same kind of thing, right? And that’s why the medical profession doesn’t do that because they’re not trained to do anything other than sell their thing. And their thing is what they went to work, to school for. Raising Awareness for EECP Therapy Jack Clifford (48:17)Yes. Bill Gasiamis (48:30)20 years to be able to administer. But every so often you come across an amazing doctor, surgeon, et cetera, who says, I can’t do anything more for you, but maybe somebody else can. Those guys are better than the doctor who says, we can’t do anything else for you and then send you off their way. That next sentence, but maybe somebody else can, I don’t know who they are. That is. Jack Clifford (48:43)Mm-hmm. Bill Gasiamis (48:57)I think a great thing to say this is where I think EACP kind of fits in that now that I’m here and things are not good. Jack Clifford (49:05)I totally agree. I totally agree. And yeah. And you, so you, you mentioned like the wellness spas and whatnot. And here’s the thing in 2015. So, you know, somewhat recently the FDA approved EECP for a brand new indication, general circulation, right? In healthy people. Like it’s right on the FDA indication. And also in one case in increase in VO2 max, but rough, that’s roughly saying the same thing. ⁓ yeah. Bill Gasiamis (49:32)for healthy people, was that part of it? Jack Clifford (49:35)Yeah, it said unhealthy patients and healthy people didn’t call patients. So, so, ⁓ but, but, know, the litmus test for that is, is your doctor say you’re healthy enough to undergo circulation enhancement? If the answer is yes, you know, it doesn’t matter if you got all that other stuff or not, you know, we’re just not treating you for it. We’re not saying ECPs is fix for this, your erectile dysfunction. It might help it. You know, what’s not saying it’s, it’s the fix for your stroke, but it might really help your stroke, recovery, but. Bill Gasiamis (49:47)which Jack Clifford (50:03)Anyhow, so like you can, you know, I don’t know about in Australia, but in the United States, you could get an EECP machine and create a viable business model off of helping people as soon as people actually know about it and what it does, right? I’m trying to solve the access issue in the United States by aggregating demand, right, as one of the solutions. So I have a website, eecplocator.com. And if people… ⁓ tell me that they like EECP to be available in their area, when I get like five to 10 patients in one area, we’re gonna find a way to get it to them. ⁓ The how is, you there’s a bunch of different possible ways we can get EECP to them, but at the end of the day, you know, like people need this treatment. They really, really do. Bill Gasiamis (50:50)Yeah. We’re not talking about anything ⁓ out there. Like this is not an out there thing. This is definitely common. Now I, I don’t know how I haven’t come across it. I’ve all these years after all these years now I’ve just because of our conversation right now, I just did a Google search and I typed in EECP machine Australia. And the first thing that came up was an Australian government department of health, disability and aging. Jack Clifford (50:57)No, it’s that. Bill Gasiamis (51:20)document from the Therapeutic Goods Administration, which talks about a mid-trade Australia EECP system model, external counter pulsation system stationary. So it seems like they have a… Jack Clifford (51:36)Like they’ve approved it, sounds like they have some approved devices. Yeah. Bill Gasiamis (51:38)Something like they’re at least looking at it. Let me see what that says. The inclusion of the kind of device in the AI community is subject to compliance with conditions placed in post. Yeah, it sounds like it’s been through some regulated body in 2021. Jack Clifford (51:52)Yeah. Mm-hmm. Yep. There you go. Bill Gasiamis (51:57)This device is intended to provide external counter pulsation therapy and is indicated for use in the treatment of stable angina. Jack Clifford (52:06)Mm-hmm. Bill Gasiamis (52:08)pectoris and congestive heart failure. There you go, my friend. Jack Clifford (52:10)Yeah, it works great for people with art failure. It really does. Bill Gasiamis (52:14)Dude, father-in-law had heart failure. He passed away from heart failure just a few, about a year and a half ago. ⁓ Now, I don’t know, I’m not saying anything, but we’ve never heard of this before. Today’s my first time where I’m really going to deep dive about this thing with you. ⁓ So what are the challenges that you face? what are the, what is it? ⁓ The barriers that you face? Jack Clifford (52:20)Yeah. Bill Gasiamis (52:44)when you’re speaking to people about this or how people finding out about it, how do you help people like Jack Clifford (52:50)It’s just an awareness piece. It’s an EECP what? And then, you you get in with some physicians and then you got to duke it out a little bit. Not with all of them. There’s plenty of physicians, you know, I’ve talked to the physicians that have machines and are doing the right thing for society and still making plenty of money. ⁓ They’ll just tell you, you know, I’ve talked to some cardiologists and just they kno

In this conversation, Dr. Ruchir Gupta shares his unconventional journey from established anesthesiologist to successful pain medicine entrepreneur. After 10 years of practicing anesthesia, he made the bold decision to return for a pain fellowship at Mayo Clinic, where he was older than most of his attendings.Dr. Gupta's story shows how strategic career reinvention can create competitive advantages in medicine. By combining his decade of anesthesia experience with pain medicine fellowship training, he identified a market opportunity that others overlooked: IV ketamine therapy for chronic pain patients. While other pain physicians were hesitant to offer ketamine infusions due to unfamiliarity with anesthetic protocols, Dr. Gupta's background made him uniquely qualified to bridge this gap.You'll hear about how his specialized fibromyalgia protocols achieves 80% success rates, his insights about monitoring standards including the "fifth vital sign" of proper patient follow up, and practical business advice about overcoming analysis paralysis.Dr. Gupta's journey from zero to building Mountain View Headache and Spine Institute offers valuable lessons for any medical professional considering practice ownership or career reinvention. His approach challenges common physician assumptions about entrepreneurship and shows how leveraging existing skills can lead to practice success.What You'll Learn in This Episode· Career reinvention strategy: how Dr. Gupta leveraged his anesthesia background to differentiate his pain practice and why returning to fellowship training became a competitive advantage rather than a setback· Physician entrepreneurship barriers: why medical professionals create mental obstacles around private practice that dentists, chiropractors, and other healthcare providers don't experience, and how to overcome this mindset· Clinical monitoring standards: detailed recommendations for ketamine infusion monitoring, including the importance of continuous EKG, pulse oximetry, and blood pressure monitoring for longer pain protocols· The "fifth vital sign" concept: why proper patient follow up and outcome measurement are essential for maintaining medical credibility and avoiding the "med spa" trap in ketamine therapy· Business development approach: practical strategies for practice growth including LinkedIn networking, physician education sessions, and building referral relationships with skeptical providers· Cross-disciplinary medicine benefits: why Dr. Gupta believes future physicians should combine multiple specialties or degrees to offer integrated approaches and differentiated services· Pain and mood disorder integration: clinical insights about treating patients with concurrent chronic pain and depression, including combination Spravato and ketamine protocols

I imagine it's been a little while since you've asked somebody, "How's your liver today?" I never thought about it until my wife got sick. She had hepatitis, and for many months I learned how vital the liver is; never thought about it before. It's the filtration plant of your body. We've got all kinds of toxic materials pumping into us every day in medicines that we take, and foods that we eat, and our liver keeps those poisons from getting into our blood stream. Now, liver disease like hepatitis or cirrhosis can cripple you or even kill you if the poison can't be filtered. See, it's deadly if the poisons don't get filtered and they get into your blood stream. And there is one toxin that is on the loose, and it has a long history of being a killer. I'm Ron Hutchcraft and I want to have A Word With You today about "Poison In the Blood Stream." Now, our word for today from the Word of God is going to come from Matthew 27. I'll begin reading from verse 18. And you are going to see the identification of perhaps one of life's most deadly toxins. We're in the middle of one of history's most ironic and most tragic episodes. Israel's Messiah has come in the person of Jesus Christ, and yet ironically it is the religious leaders who are clamoring to have Him executed. They bring Him to Pilate, because they don't have the authority to put Him to death. And there was a sobering footnote here as He is on trial before Pilate. You may have read past it many times. It's sort of a spiritual EKG that looks inside the human heart; what makes people so mean, so critical, so destructive. And it identifies that awful poison in the human blood stream. Here's what it says in a little footnote to the trial of Jesus. "For Pilate knew it was out of envy that they had handed Jesus over to him." In the words of the King James Bible, "Out of envy they had delivered Jesus up to him." Oh, they offered a lot of smoke screens; they gave other reasons. A lot of it was spiritual talk. There were religious reasons, and they sounded very, very spiritual about it. But the real issue - bottom line - was envy. Jesus was delivered up because of it, and people are still being delivered up because of envy. The dictionary says that envy is, "A feeling of discontent or jealousy, usually with ill will at seeing another's superiority, advantages or success." You see, envy is a denial of God's faithful provision for His children. It's saying, "You know what? He's got one and I don't. How come? How come I don't have any? It's not fair." And it often causes us to crucify people with religious words of course. But envy is a poison in the blood stream. It always starts with comparing. You can't envy unless you first compare homes, children, or beauty, or opportunities, or clothes, or positions with what somebody else has. Isn't it interesting that one of the Ten Commandments of God is "You shall not covet." And you know what? You'll never covet if you don't compare. It always starts with comparing. Think of someone you've been critical of lately - maybe negative toward them. When they come around you, you start getting some dark feelings. I wonder if you'd be honest enough to examine your motives today. Could it be envy at the root? You've seen what you perceive to be maybe their superiority, or their advantages, or their success. Ask yourself this, "If envy is in my life, Lord, who is the object of it? Envy gets all dressed up, starts to deliver someone up for destruction. It is an ugly poison in the blood stream. Pray for that person that you might be comparing yourself with and envying. Call envy by name, and trust your Shepherd to give you what's right for you. Filter out that poison of envy. It's a killer!

I imagine it's been a little while since you've asked somebody, "How's your liver today?" I never thought about it until my wife got sick. She had hepatitis, and for many months I learned how vital the liver is; never thought about it before. It's the filtration plant of your body. We've got all kinds of toxic materials pumping into us every day in medicines that we take, and foods that we eat, and our liver keeps those poisons from getting into our blood stream. Now, liver disease like hepatitis or cirrhosis can cripple you or even kill you if the poison can't be filtered. See, it's deadly if the poisons don't get filtered and they get into your blood stream. And there is one toxin that is on the loose, and it has a long history of being a killer. I'm Ron Hutchcraft and I want to have A Word With You today about "Poison In the Blood Stream." Now, our word for today from the Word of God is going to come from Matthew 27. I'll begin reading from verse 18. And you are going to see the identification of perhaps one of life's most deadly toxins. We're in the middle of one of history's most ironic and most tragic episodes. Israel's Messiah has come in the person of Jesus Christ, and yet ironically it is the religious leaders who are clamoring to have Him executed. They bring Him to Pilate, because they don't have the authority to put Him to death. And there was a sobering footnote here as He is on trial before Pilate. You may have read past it many times. It's sort of a spiritual EKG that looks inside the human heart; what makes people so mean, so critical, so destructive. And it identifies that awful poison in the human blood stream. Here's what it says in a little footnote to the trial of Jesus. "For Pilate knew it was out of envy that they had handed Jesus over to him." In the words of the King James Bible, "Out of envy they had delivered Jesus up to him." Oh, they offered a lot of smoke screens; they gave other reasons. A lot of it was spiritual talk. There were religious reasons, and they sounded very, very spiritual about it. But the real issue - bottom line - was envy. Jesus was delivered up because of it, and people are still being delivered up because of envy. The dictionary says that envy is, "A feeling of discontent or jealousy, usually with ill will at seeing another's superiority, advantages or success." You see, envy is a denial of God's faithful provision for His children. It's saying, "You know what? He's got one and I don't. How come? How come I don't have any? It's not fair." And it often causes us to crucify people with religious words of course. But envy is a poison in the blood stream. It always starts with comparing. You can't envy unless you first compare homes, children, or beauty, or opportunities, or clothes, or positions with what somebody else has. Isn't it interesting that one of the Ten Commandments of God is "You shall not covet." And you know what? You'll never covet if you don't compare. It always starts with comparing. Think of someone you've been critical of lately - maybe negative toward them. When they come around you, you start getting some dark feelings. I wonder if you'd be honest enough to examine your motives today. Could it be envy at the root? You've seen what you perceive to be maybe their superiority, or their advantages, or their success. Ask yourself this, "If envy is in my life, Lord, who is the object of it? Envy gets all dressed up, starts to deliver someone up for destruction. It is an ugly poison in the blood stream. Pray for that person that you might be comparing yourself with and envying. Call envy by name, and trust your Shepherd to give you what's right for you. Filter out that poison of envy. It's a killer!

Sudden cardiac events in young athletes can occur without warning, raising urgent questions for families, coaches and anyone involved in youth sports. Pediatric cardiologist Dr. Kelvin Lau explains what sudden cardiac arrest is, why student athletes may be more vulnerable and what steps like monitoring symptoms and incorporating routine EKGs that can help protect kids competing at any level. To learn more about pediatric services at BayCare, go to BayCareKids.org.  To learn more about EKG screenings for student athletes, go to baycare.org/specialties-and-treatments/pediatric-services-at-baycare/pediatric-ekg-screenings.

The Clam Blaster. Gia facetimed Rover over an email. Did JLR get his EKG test results back? Duji made JLR lunch. Schoolboard member Keith Ervin was in trouble for making a lewd gesture in front of students. Gen Z are now carrying around anxiety bags. Charlie carries loose prescription pills in his pocket. The Predator of Seville. Duji had a talk with Gia and her friends about not leaving your friends behind. Who is the dumbest person on the show? Leaving drinks on electronic equipment. Rover says Duji is obsessed with someone. Does Duji listen to the show? Video of the quadruple amputee, accused of killing someone, snorting something and shooting a gun. A Canadian lawmaker is being ridiculed for casually dropping a new acronym ‘MMIWG2SLGBTQQIA+.' Charlie got a response from the BMV about his license plate. See omnystudio.com/listener for privacy information.

The Clam Blaster. Gia facetimed Rover over an email. Did JLR get his EKG test results back? Duji made JLR a lunch. Schoolboard member Keith Ervin was in trouble for making a lewd gesture in front of students. See omnystudio.com/listener for privacy information.

The Clam Blaster. Gia facetimed Rover over an email. Did JLR get his EKG test results back? Duji made JLR a lunch. Schoolboard member Keith Ervin was in trouble for making a lewd gesture in front of students. 

The Clam Blaster. Gia facetimed Rover over an email. Did JLR get his EKG test results back? Duji made JLR lunch. Schoolboard member Keith Ervin was in trouble for making a lewd gesture in front of students. Gen Z are now carrying around anxiety bags. Charlie carries loose prescription pills in his pocket. The Predator of Seville. Duji had a talk with Gia and her friends about not leaving your friends behind. Who is the dumbest person on the show? Leaving drinks on electronic equipment. Rover says Duji is obsessed with someone. Does Duji listen to the show? Video of the quadruple amputee, accused of killing someone, snorting something and shooting a gun. A Canadian lawmaker is being ridiculed for casually dropping a new acronym ‘MMIWG2SLGBTQQIA+.' Charlie got a response from the BMV about his license plate. 

Hosts: Don Stader, Nate Novotny, Travis Barlock, and Jeffrey Olson In this episode, we reminice about the first 1000 medical minutes presented by EMM and what the next 1000 might hold. Below are all of the episodes referenced in this episode. Please go back and give them all a listen. Segment 1- Recap and Facts 1st medical minute o   April 29, 2016. Almost exactly 10 years ago. o   Diverticulitis and Antibiotics by Dr. Chris Holmes 1000th Medical Minute o   March 30, 2026 o   Treatment of burns by Aaron Lessen o   Edited by Ashley Lyons and published by Jorge Chalit Favorite sub-topics have included: o   Cardiovascular topics- 150 episodes o   Pharmacology- 97 episodes o   Toxicology- 85 episodes o   Neurology- 75 episodes The "Hunting for…" cinematic universe. -Michael Hunt o   399: Hunting for Pancreatitis o   424: Hunting for Measles o   432: Hunting for UTIs o   445: Hunting for the Endotracheal Tube o   455: Hunting for PeeCP o   460: Hunting for PE in Syncope o   487: Hunting for Epiglottitis Obsession with 1966- Chris Holmes o   120: The State of Sepsis in 1966 o   125: Old School CPR - 1966 o   138: Bromide Toxicity - 1966 o   147: GI Bleed - 1966 o   675: CHF like it's 1966 Favorite drug: naloxone/narcan (9) o   7: Heroin Overdose and OTC Narcan o   464: Narcan't? o   516: Narcan and Pulmonary Edema o   931: Naloxone in Cardiac Arrest Favorite disease state: Sepsis (13) o   22: Sepsis Sofa o   219: History of Sepsis o   244: Fever in Sepsis o   263: Early Antibiotics in Sepsis o   272: More on Temperature in Sepsis o   287: Sepsis Bundles o   544: C is for Sepsis Unhinged title combinations o   84: Hypothermia and Lightning Strike: Code Blue o   203: Wine, Milk and… Vaccines!? o   216: Roller Coasters and Kidney Stones o   299: Black Death, Lice, Math, and Pottery o   427: Cookie Dough is Delicious o   670: Operation Tat-Type o   695: Einstein and Cellophane o   777: Grass, weed and ancient Rome o   781: Foxglove, dropsy, and Salvador Dali o   959: The KLM Flight Disaster and Lessons in Healthcare Communication Most frequent contributors -          Aaron Lessen- 192 -          Don Stader- 84 -          Jarod Scott- 83 -          Peter Bakes- 53 -          Samuel Killian- 45 -          Dylan Luyten- 41 -          Erik Verzemnieks- Dozens -          Michael Hunt- 34 -          Travis Barlock- 30 -          Ricky Dhaliwal- 25 Top female voices o   Rachael Duncan, PharmD o   Rachel Beham, PharmD o   Meghan Hurley o   Gretchen Hinson o   Suzanne Chilton o   Katie Sprinkle Most listened to -          8. Podcast 835: Syncope Review -          7. Podcast 766: Truth about Tramadol -          6. Podcast 839: Causes of Pancreatitis -          5. Podcast 760: Why Fentanyl is the Worst -          4. Podcast 844: Dental Infections -          3. Podcast 846: Early Repolarization vs. Anterior STEMI -          2. Podcast 845: Hyperkalemic Cardiac Arrest -          1. Podcast 847: ECMO CPR Mini-game: who has actually seen our most rare diagnoses? o   18: Lemierre's Syndrome – Septic thrombophlebitis of the internal jugular vein after oropharyngeal infection leading to septic emboli. o   139: Locked-in Syndrome – Ventral pontine lesion causing quadriplegia and inability to speak with preserved consciousness and eye movements. o   144: Moyamoya Disease – Progressive stenosis of intracranial carotids with development of fragile collateral vessels causing strokes. o   221: Cotard Delusion (Walking Corpse Syndrome) – Psychiatric disorder where patients believe they are dead or do not exist. o   240: Pott's Puffy Tumor – Frontal bone osteomyelitis with subperiosteal abscess from sinusitis causing forehead swelling. o   277: Mucormycosis (Rhizopus) – Angioinvasive fungal infection in immunocompromised patients causing rapid tissue necrosis. o   293: Transient Global Amnesia – Sudden, transient loss of ability to form new memories that resolves within 24 hours. o   329: Hypokalemic Periodic Paralysis – Episodic muscle weakness due to intracellular potassium shifts. o   374: Iliac Artery Endofibrosis – Exercise-induced fibrosis of the iliac artery causing claudication in athletes. o   466: Subacute Sclerosing Panencephalitis (SSPE) – Progressive, fatal neurodegenerative disease from persistent measles infection. o   477: Postpolypectomy Electrocoagulation Syndrome – Transmural burn of the colon after polypectomy causing localized peritonitis without perforation. o   578: Brown-Séquard Syndrome – Hemisection of the spinal cord causing ipsilateral motor/proprioception loss and contralateral pain/temperature loss. o   697: Kounis Syndrome – Acute coronary syndrome triggered by allergic reaction causing coronary vasospasm or plaque rupture. o   973: Meningitis Retention Syndrome – Acute urinary retention due to sacral nerve dysfunction during meningitis. Segment 2- Individual Interviews Segment 3- Looking forward Segment 4- Trivia Podcast 38, what is significant about diphtheria and March 18th? o   On March 18th, the Iditarod is run in Alaska to commemorate a sled dog team, led by Balto, that ran from Nome to Anchorage and back to provide children in Nome with the diphtheria anti-toxin serum. Podcast 52: Syphilis the Great Imitator. The study of Syphilis or "Syphilology" evolved into the field of what? o   Dermatology Podcast 121:  The Poor Man's Methadone. What is the poor man's methadone? o   Imodium Podcast 136:  James Lind, conducted the first clinical trial in 1747 and proved that what cure what? Hint: think vitamins. o   Citrus fruits cure scurvy. Podcast #213: --- and Potatoes. What food has been shown to lower LDL? o   Oats Podcast #216: Roller Coasters and Kidney Stones. A study used a model of a kidney and ureter with different sized stones and put it on ------ roller coaster in Disney World. o   Thunder Mountain Podcast #261. ---- was introduced to treat ACE-inhibitor induced angioendema. but later, better-powered studies showed that it had no benefit compared to standard treatment. o   Icatibant Podcast #304: ---. ---- was a formal medical diagnosis, and one that dates back to 17th century when soldiers had longing for home and melancholy with a constellation of symptoms including lethargy, sadness, disturbed sleep, heart palpitations, GI complaints, and/or skin findings for which the only cure was to return home. o   Nostalgia Podcast # 351: Steakhouse Syndrome. What is steakhouse syndrome? o   Impacted food bolus 2/2 esophageal stricture Podcast # 362: Giant Hogweed. What can Giant Hogweed cause. o   Photosensitivity, severe blisters, and burns Podcast #398:  Who is gonna fail your antibiotic plan? What vital sign abnormality at triage had the highest odds ratio for treatment failure for the treatment of cellulitis with antibiotics. o   Tachypnea Podcast # 458: A Tylenol a Day Keeps the ---- Away? A recent study investigated the effect of scheduled IV acetaminophen on the incidence of ---- in post-CABG patients in the ICU o   Delerium Podcast 554: Sleeping Away Alzheimer's. What is the difference between white noise and pink noise? o   White noise is all the surrounding sound frequencies mixed together that your brain tunes down so you don't get distracted while you're sleeping o   Pink noise, or deep soothing noises, is the accentuated bass sounds like falling rain or waves crashing your brain keys into while sleeping. o   Pink noise during sleep has been shown to increase stage 4, creating more CSF washout of beta amyloid. Podcast 580:  Origin of PPE. Why were rubber gloves invented? o   The invention of surgical gloves are credited to surgeon William Halsted. He developed gloves because one of his assistants (and later wife), Carol Hampton, was having severe irritation due to a caustic pre-op disinfecting process. They developed the rubber glove for Hampton which garnered popularity, and by the early 20th century, half of surgeons were using rubber gloves. Podcast 587:  Puppies Preventing Burnout? Puppies lower stress, what activity in that study increased stress? o   Coloring, because they were denied a chance to play with a puppy Podcast 596: Weather Can be a Headache. What are the three weather events that can increase the frequency of headaches? o   High temp o   Low humidity o   High air pollution Podcast 612: Origin of Vaccines. Guess both diseases. The potential of vaccinations was first observed in the late 1600s when Jenner observed people who had cowpox never contracted ----. Years later, Louis Pasteur inoculated chickens with ---- after his assistant accidently created the first live attenuated vaccine by creating a weakened bacteria when he left the bacteria out while he went on vacation o   Smallpox, cholera Podcast 670: Operation Tat-Type. In 1951, Operation Tat-Type began tattooing adults with their ---- in an effort to prepare for ---- in the time of the Cold War and the Korean War o   Blood type, rapid transfusions Podcast 695: Einstein and Cellophane. Albert Einstein had ----- as a middle-aged man. Dr. Rudolph Nissen, founder of the Nissen fundoplication, performed exploratory surgery for this pain and found a ---- -          The only treatment for an AAA at that time was to----, causing a fibrotic response to prevent rupture -          Einstein died 7 years after this surgery, likely from his leaking abdominal aortic aneurysm o   chronic abdominal pain o   AAA o   wrap the vessel in cellophane Podcast 748: -----. Whale blubber, honey, home fermented foods, homemade wine (especially the wine made in prison), and improperly stored canned food can all contain the toxin o   Botulism Podcast 777: Grass, Weed, and Ancient Rome. Wine and wormwood and white hellborn were used in ancient rome to treat ----. o   Nausea, sea sickness Podcast 821: EKGs in Syncope. Travis suggests a mnemonic for remembering additional EKG findings to look for in syncope o   WOBBLER §  Wolff-Parkinson-White (WPW) §  Obstructed AV node §  Brugada syndrome §  Bifascicular block §  Left Ventricular Hypertrophy (LVH) §  Epsilon waves §  Repolarization abnormalities Podcast 890: Outdoor Cold Air for Croup A 2023 study, published in the Journal of Pediatrics, investigated whether a 30-minute exposure to outdoor cold air could improve mild to moderate croup symptoms before the onset of steroid effects. In what country was this study conducted. o   Switzerland Podcast 925: Pediatric Tongue Entrapment. Case study of a peds patient with his/her tongue stuck in a drinking cap. What was the substance that finally set it free? o   Table sugar Podcast 960: Frank's Sign - A Marker for Coronary Artery Disease. What is Frank's Sign? o   Bilateral earlobe crease Thank you to all that make the EMM awesome! Hosted and editted by Jeffrey Olson MS4 | Additional editting by Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf

EKG 9:40 to najważniejsza, gospodarcza rozmowa dnia o Twoich sprawach. O Twoich podatkach, oszczędnościach, ratach kredytu, rachunkach za prąd, wydatkach na zakupy, emeryturze, o prowadzeniu własnego biznesu, rozwoju kariery zawodowej i bezpiecznych finansach w sieci będziemy rozmawiać z uznanymi ekspertami. Stałym punktem programu będą też wywiady z politykami i osobami, które kształtują rzeczywistość. W Twoim imieniu zapytamy ich o plany, pomysły i postulaty, które mają wpływ na nasze zwykłe, codzienne życie. EKG 12:40 to solidna dawka informacji ze świata gospodarki i gorące komentarze naszych ekspertów. Będziemy reagować na bieżąco na decyzje polityków, zapowiedzi urzędników, skomplikowane zmiany w przepisach czy nastroje inwestorów. Wspólnie poszukamy odpowiedzi na pytanie, jak ważne wydarzenia w Polsce i na świecie mogą się przełożyć nie tylko na kondycję całej gospodarki, ale przede wszystkim na nasze małe, domowe budżety. Trudny, ekonomiczny żargon będziemy zmieniać w prosty i przystępny przekaz dla każdego odbiorcy. EKG 14.40 Pieniądze, firma, podatki: popołudniowe EKG, to czas na rozmowę o naszych finansach. Przekładamy sytuację na światowych rynkach na nasze portfele: ile zapłacimy za paliwa, za ile kupimy euro na zagraniczny wyjazd, dlaczego drożeje masło, o ile drożeją mieszkania? Zaglądamy do koszyków zakupowych w sklepach, w raty kredytów, w procenty jakie banki wypłacają nam z lokat i w podatki. Pamiętamy o małych przedsiębiorcach, którym pomagamy w codziennych zmaganiach w prowadzeniu biznesu, a inwestorom objaśniamy sytuację na rynkach. Patrzymy też w dane: co cyfry ze statystyk mówią o naszej sytuacji finansowej? Udowadniamy, że ekonomia jest fascynująca!

Jay Gunkelman just shaved his beard for $5,000 — donated to student neurofeedback research — and showed up looking like Paul Giamatti. That's not even the most interesting thing that happened. Jay, Dr. Mari Swingle, and Pete dig deep into one of the most confused topics in clinical EEG: the difference between tonic theta, frontal midline theta, slowed alpha, and mu — and why mixing them up can lead practitioners completely astray.We also tackle the DSM head-on. Jay and Dr. Mari lay out exactly why psychiatric diagnosis without biomarkers is like a cardiologist treating chest pain without an EKG. Plus: The Brain Bar is officially born, Jay shares live EEG data on screen, and we announce a new NeuroNoodle album.

Step into The Other Side of Midnight with host Lionel for a wild St. Patrick's Day special that shatters everything you thought you knew about the holiday—starting with the fact that St. Patrick wasn't Irish and actually wore blue. After pouring one out for authentic New York Irish pubs, the show takes a sharp left turn into the ultimate mystery: the afterlife. From the quantum physics of brain "microtubules" proving consciousness survives death to bizarre medical anomalies like post-mortem EKG spikes and organ transplants causing sudden motorcycle cravings, Lionel blurs the line between life and death. Featuring raw caller stories of near-death experiences and a deep dive into the unsettling future of using AI to digitally resurrect the dead, this is a mind-bending late-night ride where the profound meets the absurd. Learn more about your ad choices. Visit megaphone.fm/adchoices

Ever wonder what really happens after you flatline? On this episode of The Other Side of Midnight, Lionel takes listeners on a hilarious, mind-bending deep dive into the great beyond. Blending cutting-edge medical research on post-mortem brain activity with wild caller stories, this episode explores the bizarre, blurry border between life and death. Tune in for bizarre tales of deceased patients throwing post-mortem EKG spikes, dead men waking up angry at their doctors, ghost dogs offering bedside cuddles, transplanted hearts causing sudden motorcycle cravings, and the strangely peaceful sensation of drowning at Coney Island. It's a profound, spooky, and unapologetically weird exploration of the final frontier. Learn more about your ad choices. Visit megaphone.fm/adchoices

EKG 9:40 to najważniejsza, gospodarcza rozmowa dnia o Twoich sprawach. O Twoich podatkach, oszczędnościach, ratach kredytu, rachunkach za prąd, wydatkach na zakupy, emeryturze, o prowadzeniu własnego biznesu, rozwoju kariery zawodowej i bezpiecznych finansach w sieci będziemy rozmawiać z uznanymi ekspertami. Stałym punktem programu będą też wywiady z politykami i osobami, które kształtują rzeczywistość. W Twoim imieniu zapytamy ich o plany, pomysły i postulaty, które mają wpływ na nasze zwykłe, codzienne życie. EKG 12:40 to solidna dawka informacji ze świata gospodarki i gorące komentarze naszych ekspertów. Będziemy reagować na bieżąco na decyzje polityków, zapowiedzi urzędników, skomplikowane zmiany w przepisach czy nastroje inwestorów. Wspólnie poszukamy odpowiedzi na pytanie, jak ważne wydarzenia w Polsce i na świecie mogą się przełożyć nie tylko na kondycję całej gospodarki, ale przede wszystkim na nasze małe, domowe budżety. Trudny, ekonomiczny żargon będziemy zmieniać w prosty i przystępny przekaz dla każdego odbiorcy. EKG 14.40 Pieniądze, firma, podatki: popołudniowe EKG, to czas na rozmowę o naszych finansach. Przekładamy sytuację na światowych rynkach na nasze portfele: ile zapłacimy za paliwa, za ile kupimy euro na zagraniczny wyjazd, dlaczego drożeje masło, o ile drożeją mieszkania? Zaglądamy do koszyków zakupowych w sklepach, w raty kredytów, w procenty jakie banki wypłacają nam z lokat i w podatki. Pamiętamy o małych przedsiębiorcach, którym pomagamy w codziennych zmaganiach w prowadzeniu biznesu, a inwestorom objaśniamy sytuację na rynkach. Patrzymy też w dane: co cyfry ze statystyk mówią o naszej sytuacji finansowej? Udowadniamy, że ekonomia jest fascynująca!

Emotional Anger After Stroke: Trisha Winski’s Story of a Carotid Web, Aphasia, and Learning to Slow Down Trisha Winski was 46 years old, working as a corporate finance director, with no high blood pressure, no diabetes, and no smoking history. By every conventional measure, she was not a stroke candidate. Then one morning, she stood up from the bathroom, collapsed, and couldn’t speak. Her ex-husband, sleeping on her couch by chance the night before, found her and called 911. The cause was a carotid web, a rare congenital condition she never knew she had. Three years and three months later, she’s living with aphasia, rebuilding her sense of self, and navigating something that doesn’t get nearly enough airtime in stroke conversations: emotional anger after stroke. What Is a Carotid Web — and Why Does It Matter? A carotid web is a rare shelf-like membrane in the internal carotid artery that disrupts blood flow, causing stagnation and clot formation. It is a form of intimal fibromuscular dysplasia and affects approximately 1.2% of the population. Most people never know they have it. Unlike the more commonly cited stroke risk factors, such as hypertension, diabetes, smoking, and obesity, a carotid web is congenital. You are born with it. There is no lifestyle adjustment that would have prevented Trisha’s stroke. That distinction matters enormously when you are trying to make sense of what happened to you. “I have nothing that could cause it,” Trisha says. “No blood pressure, no diabetes. It’s hard.” The treating hospital, MGH in Boston, caught the carotid web, something Trisha was later told many hospitals would have missed. It is a reminder of how much diagnosis still depends on the right clinician, the right technology, and a degree of luck.   Why Am I So Angry After My Stroke? One of the most underexplored dimensions of stroke recovery is emotional anger, not just grief, not just fear, but a specific kind of rage that has no clean target. “Why me? Why did I have to have it? It’s frustrating. It’s so frustrating,” Trisha says. “I’m just mad. I don’t know who I’m mad at.” This is a clinically recognized phenomenon. Emotional dysregulation after stroke can have both neurological and psychological origins. The brain regions that govern emotional control may be directly affected by the injury. At the same time, the psychological weight of sudden, unearned loss of function, of identity, of a future you thought you understood is enough to generate profound anger in anyone. For people like Trisha, who had no risk factors and no warning, the anger is compounded. There is no behaviour to regret, no choice to unwind. The stroke simply happened. That can make the anger feel even more directionless and, paradoxically, even more consuming. “Why me? Why did I have to have it? It’s frustrating. It’s so frustrating.” Bill’s gentle reframe in the conversation is worth noting here: “Why not me? Who are you to go through life completely unscathed?” It’s not a dismissal, it’s an invitation to move from the question that has no answer to the one that might.   Aphasia: The Deficit That Hurts the Most Trisha’s stroke affected her left hemisphere, producing aphasia, a language processing difficulty that affects word retrieval, word substitution, and speaking speed. Her numbers remained largely intact, which helped her return to her finance role. But the aphasia has been, in her own words, the hardest part. “If I didn’t have that, I wouldn’t be normal, but I could be normal,” she says. “The aphasia kills me.” One of the quieter consequences of aphasia that Trisha describes is self-censoring, stopping herself from communicating in public because she fears taking too long, disrupting the flow of conversation, or being misunderstood. She has developed a workaround: telling people upfront she has had a stroke, so they give her the time she needs to get her words out. The frustration-aphasia loop is well documented: the more stressed or frustrated a person becomes, the worse the aphasia tends to get. The therapeutic implication is significant. Managing emotional anger after a stroke is not just a well-being issue for someone with aphasia; it is directly tied to their ability to communicate. “Whenever I’m not stressed, I can get it out. When I get nervous, I can’t,” Trisha explains.   The Trauma Ripple: It’s Not Just About You One of the most striking moments in this episode is when Trisha reflects on her son Zach and ex-husband Jason, both of whom were visibly distraught in the days after her stroke. “I had a stroke. Why are they traumatized?” she says and then catches herself. “I forgot to look at it from their perspective. They watched me have a stroke.” This is something stroke survivors frequently underestimate. The people around them, partners, children, friends, even ex-partners like Jason, carry their own version of the trauma. They watched helplessly. They made decisions under panic. They grieved a version of the person they knew, even as that person survived. Acknowledging this doesn’t diminish the stroke survivor’s experience. It widens the frame of recovery to include the whole system and opens the door to conversations about collective healing.   Neuroplasticity Is Real — Give It Time Three years and three months after her stroke, Trisha’s message to people in the early stages of recovery is grounded and honest. “Neuroplasticity really does exist. My brain finds places to find the words I never had before. It takes longer, but it gets there. Just give yourself time.” She also reflects candidly on going back to work too early, returning before she was medically cleared, crying every day, and unable to follow her own cognitive processes. “I should have waited,” she says. “But I did it. It taught me that if I ever had it again, I won’t do that.” Recovery after stroke is non-linear, unglamorous, and deeply personal. But the brain is adapting, always. Trisha’s story is evidence of that and a reminder that emotional anger after a stroke, however consuming it feels, is not the end of the story.   Read Bill’s book on stroke recovery: recoveryafterstroke.com/book | Support the show: patreon.com/recoveryafterstroke  DisclaimerThis blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. Why Me? Navigating Emotional Anger After Stroke When You Did Nothing Wrong No risk factors. No warning. Just a carotid web she never knew about — and three years of emotional anger, aphasia, and finding her way back. Tiktok Instagram Facebook Highlights: 00:00 Introduction – Emotional anger after stroke 01:36 The Day of the Stroke 07:05 Post-Stroke Challenges and Rehabilitation 13:06 Ongoing Health Concerns and Medical Appointments 22:40 Navigating Health Challenges and Medical Support 30:20 Acceptance and Coping with Mortality 38:36 Communication Challenges and Aphasia 42:09 The Journey of Recovery and Self-Discovery 51:51 Facing the Aftermath of Stroke 59:22 Emotional Impact on Loved Ones 01:04:57 Navigating Life Changes 01:13:25 Finding Joy in New Passions 01:25:12 Trisha’s Journey: Emotional Anger After Stroke Transcript: Introduction – Emotional anger after stroke Trisha Lyn Winski (00:00) I don’t have anything that could cause it. I have nothing that, no blood pressure, no diabetes, It’s hard. It’s hard. don’t… It makes me mad. Really mad. Really, really mad that I to stroke. And like, everyone that has it… Bill Gasiamis (00:07) Yeah. Trisha Lyn Winski (00:21) or every dozen. I’m like, why me? Why did I have to have it? It’s frustrating. It’s so frustrating. Bill Gasiamis (00:28) Yeah, mad at who? Trisha Lyn Winski (00:30) I don’t know. I’m just mad. Like, I don’t know who I’m mad at. Bill Gasiamis (00:35) Before we get into Trisha’s story, and this is a raw, honest, and really important one, I wanna share a tool I’ve been using that I think can genuinely help stroke survivors get better answers faster. It’s called Turn2.ai. It’s an AI health sidekick that helps you deep dive into any burning question you have about your recovery. It searches across over 500,000 sources related to stroke, new research, expert discussions, patient stories and resources, and then keeps you updated on what matters each week. I use it myself and it’s my favorite tool of 2026 for staying current with what’s happening in stroke recovery. It’s low cost and completely patient first. Try it free and when you’re ready to subscribe, use my code, Bill10 at slash sidekick slash stroke to get a discount. I earn a small commission if you use that link at no extra cost to you. And that helps keep this podcast going. Also my book, The Unexpected Way That a Stroke Became the Best Thing That Happened is available at recoveryafterstroke.com/book. And if you’d like to support the show on Patreon and my goal of reaching a thousand episodes, you can do that by going to patreon.com/recoveryafterstroke. Links are in the show notes. Right, Trisha Winsky was 46 years old, healthy, had no risk factors and then a carotid web. She never knew she had changed everything. Let’s get into it. Bill Gasiamis (02:06) Trisha Winski, welcome to the podcast. Trisha Lyn Winski (02:09) Thank you. Bill Gasiamis (02:10) Also thank you for joining me so late. I really appreciate people hanging around till the late hours of the evening to join me on the podcast. I know it’s difficult for us to make the hours that suit us both. I’m in the daytime here in Australia and you’re in the nighttime there. Trisha Lyn Winski (02:27) Yeah. Yeah. It’s okay. I can come to you later. Yeah, it’s late. Bill Gasiamis (02:34) As a stroke survivor, is it too late? Trisha Lyn Winski (02:36) No, no, not at all. Bill Gasiamis (02:38) Okay, cool. Tell me a little bit about what you used to get up to. What was life like before the stroke? Trisha Lyn Winski (02:45) I just get up and get to work. deal with it all day, come home, I’d go to the restaurant, the bars, my friends, and then like I had a stroke and everything changed. Everything changed in an instant. Bill Gasiamis (03:00) How old were you in the district? Trisha Lyn Winski (03:02) I was 46. Bill Gasiamis (03:04) And before that, were you in a family, married, do you have kids, any of that stuff? Trisha Lyn Winski (03:08) I have a kid. Now he’s 28. He was 25 when I had it. I was married before, but like a long time ago. Actually, my ex found me when I had a serve. So he’s the one who found me. But so yeah, that’s all I have here. My mom passed away in November. So it’s been challenging. Yeah. Bill Gasiamis (03:30) Dramatic, ⁓ Sorry to hear that. how many years ago was a stroke? Trisha Lyn Winski (03:37) ⁓ It’s three years and three months. Bill Gasiamis (03:41) Yeah. What were you focused on back then? What were the main goals in your life? Was it just working hard? Was it getting to a certain time in your career? What was the main goal? Trisha Lyn Winski (03:50) I think I working hard, but I just wanted to get to a good place in my career. And I think I was in a good place. Now I second guess at all time because I’ve had strokes now, it doesn’t matter what happens. I’m always second guessing it. But I was in a good place. I just felt like I needed to make them better. And the stroke happened and I so didn’t. Bill Gasiamis (04:17) What kind of work did you do? Trisha Lyn Winski (04:18) I was the corporate finance director for an auto group. Bill Gasiamis (04:22) A lot of hours was it like crazy hours or was just regular hours. Trisha Lyn Winski (04:26) No, I worked a lot of hours, but in the end he wanted me work like 40, 50 hours a week. I couldn’t do that. 50 hours a week was killing me, but 40 was enough. Yeah. Bill Gasiamis (04:37) Yeah. Were, did you consider yourself healthy? Was there any signs that you were unwell, that there was a stroke kind of on the horizon? Trisha Lyn Winski (04:46) No, nothing, The day before this, had, my eye was like, I want to say it’s twitching, but it wasn’t twitching. It was doing something like odd. And I didn’t realize that until I had a TIA recently, but I realized it then. It’s, how can I explain it? It’s like a clear, a blonde shape in my eye. it, when I move, it goes with me. And I try to see around it, I can’t see around it. And I said to Gary, I worked with him, was like, I’m gonna have to go to hospital. This continues. can’t see.” And then it went away. And that’s the only symptom I had. Only symptom. And he said, no, I should told you that you might be having a stroke. like, even if you told me that, I never believed him. Never. Bill Gasiamis (05:23) Hello? Yeah. When you’re, and it went away and you didn’t have a chance to go see anyone about it. Trisha Lyn Winski (05:37) Yeah, it went away in like, honestly, like five minutes. So I didn’t see anybody, but I thought it was okay. I mean, I guess now that I’m looking back at it, it’s kind of odd. It’s one eye, but I felt like it was gone. I don’t know. yeah. No, you don’t. Bill Gasiamis (05:55) Yeah. How could you know? mean, no one knows these things. And, and then on the day of the stroke, what happened? Was there any kind of lead up? Did you notice not feeling well during that day? And then the stroke, what was it like? Trisha Lyn Winski (06:09) No, so I get up like every other day to go to work. I went in the bathroom and the night before that Jason said Jason’s ex-ad he stayed at my house because he needed need a place to stay because he couldn’t go out Zach again. I was like okay we’ll sleep in my couch I’m gonna go to work tomorrow but you can sleep here. So he was there and I think if he wasn’t there I would have died. Post-Stroke Challenges and Rehabilitation Makes me sad. Um, anyway, so when I woke up I went to bathroom and I stood up from the toilet and I like I fell over and I I didn’t even realize it. So I fresh my face in like five places when I fell and I didn’t even I didn’t even know it my whole side was numb. So I didn’t feel it. And Jason, you know, helped me to bed. I thought he helped me to bed. He didn’t he like drug me to bed. He got in the bed and then I… He came back in like five minutes later, are you okay? Like he knew something was wrong. And I couldn’t articulate to him. So I said, I’m fine, I’m fine. I’m gonna go to work. So he put the phone in my hand to call my boss. And he came back in like five minutes later and I… He put it in my right hand so I didn’t call anybody. And he said, my God, I’ll never forget this. He said, my God, you’re having a stroke. And I couldn’t talk. I couldn’t talk. I just… Yeah, I could hear him say that, but I couldn’t talk to him. It’s… It’s really scary. Like, even talking right now, like… It upsets me. Bill Gasiamis (07:37) but you can hear him say that. This is really raw for you, isn’t it? Yeah, understand. went through very similar things like trying to speak about it and getting it out of my self and trying to, you know, bring it into the world and get it off my shoulders. Like often brought me to tears and made it really difficult for me to have a meaningful conversation with anyone about it. Trisha Lyn Winski (08:07) It does. Bill Gasiamis (08:09) There’s small blessings there with you, okay? All happened when for whatever reason your ex was in the house and was able to attend you. It’s an amazing thing that that is even possible ⁓ considering how some breakups go and how possible. Yeah. Yeah. And so he called 911 and got you to hospital. Is that how you ended up in hospital? Trisha Lyn Winski (08:15) I know. We’re good friends, it was a challenge. Yes. So they ended up taking me to MGH, it’s a hospital right down the street from me. ⁓ But he’s not from here, he’s from Pennsylvania. he didn’t know where to me, like, just has to go to the hospital. So they knew when they came up. So MGH is like known for their strokes, they’re like really good at strokes. ⁓ And so that’s where they plan on taking me. Bill Gasiamis (09:01) Yeah. And do you get a sense of what happened when you were in the hospital? Do you have any kind of recollection of what was going on? Trisha Lyn Winski (09:11) I honestly, in the first week, no. I remember seeing, in the first day, I saw Zach, my son, and Zach, his brother Connor was in there too, and Jason, they all were there with me when I woke up. But I saw them, and I saw my friend Matt, and then that’s all I remember seeing. I remember seeing my mom on the third day. I’m in jail on this third day, but that’s about it. Bill Gasiamis (09:41) Yeah. And then did you have deficits? couldn’t feel one of your sides? Did that come back, whole problem, that whole challenge? Trisha Lyn Winski (09:50) So the right side, it came back, but it came back like sporadically. So I just kind of want to come back. So the first day I saw Matt and I put up my arm to talk to him and I couldn’t like put my arm out. So I just like tap my arm. ⁓ Now I can move my arm fully, but I can’t, I don’t have the dexterity in my arm. So I can’t like. I can’t flip an egg with this hand. it’s like this and then this is like that. I can’t do this. ⁓ And my right foot has spasticity in it. then the three toes on the side, I could curl them up all the time. Bill Gasiamis (10:36) Okay, next. Trisha Lyn Winski (10:37) and I did botox for it, nothing helps. Bill Gasiamis (10:40) huh. Okay. Have you heard of cryo-neuralysis? Trisha Lyn Winski (10:42) yeah, yeah, I got that back. Bill Gasiamis (10:45) You got cryo-neuralysis? Trisha Lyn Winski (10:47) No, what are you saying? Bill Gasiamis (10:49) That’s spasticity treatment. Cryo-neurolosis, it’s a real weird long word. There’s a dude in Canada that ⁓ started a procedure to help freeze a nerve and it expands the ⁓ tendons or something around that and it decreases spasticity and it lasts longer than Botox. Trisha Lyn Winski (10:50) ⁓ no. Okay. ⁓ yeah, you need to give me his name. We’re gonna talk. That’s I went twice to have it done. ⁓ it didn’t help at all. And I met, I met the guy, ⁓ the diarist, diarist ⁓ at the hospital. And he said, I didn’t think it was, it was going to work. I’m like, it’s the first I saw you. And he was like, I saw you and you had the shirt. I’m like, okay. I saw a million people that we can’t, I don’t remember who they are. Bill Gasiamis (11:20) Okay. Yeah. All right. So I’m going to put a link to the details for cryo-neuralysis in the show notes. ⁓ you and I will communicate after the podcast episode is done. And I’ll send you the details because there’s this amazing new procedure that people are raving about that seems to provide more relief than Botox in a lot of cases, and it lasts longer. And it’s basically done by freezing the nerve or doing something like that to the nerve. in an injection kind of format and then it releases the spasticity makes it improve. ⁓ well worth you looking into it, especially if you’re in the United States and it’s in Canada. ⁓ I know that doctor is training people in the United States and around the world. So there might be some people closer to you than Canada that you can go and chat about. Yeah. And how long did you spend in hospital in the end? Trisha Lyn Winski (12:28) Yeah. Yeah. Awesome. I love it. four weeks. Yeah. So the first, the first week I was at MGH, ⁓ they kept me for longer in the ICU because I had hemorrhagic conversion, transformation, whatever it’s called. I, you know what that is? Well, that went from the, I can’t think of what I was trying to say. Bill Gasiamis (12:40) for weeks. Ongoing Health Concerns and Medical Appointments Trisha Lyn Winski (13:05) It went from the aneurysm to the, not the aneurysm, the. Bill Gasiamis (13:09) The carotid artery. The clot, ⁓ Trisha Lyn Winski (13:11) ⁓ yes. Yeah, carotid artery and went to my brain. So I my brain bleed for a couple of days, but not like bleed, bleed, but it showed blood. So they kept me in it for longer. Bill Gasiamis (13:23) Okay. And then did you go straight home? Did you go to rehab? What was that like? Trisha Lyn Winski (13:29) I went to rehab for three weeks. And I sobbed my eyes out. So at that point I was like, I was good, but I wasn’t at all good, but I thought I was good. I said, I wanna go home, I wanna go home. My son can, he teach me all, do all this stuff, I gotta go home. Now that I’m past it, there’s no way he could tell me, no way. I couldn’t tie my shoes. Bill Gasiamis (13:34) three weeks. And when you came home, were people living with you? Trisha Lyn Winski (13:56) So he’s. No, nobody was living with but he had to come move in with me for three months. Bill Gasiamis (14:06) Yeah, your son, yeah. What was that like? Trisha Lyn Winski (14:07) Yeah. Here’s my proxid. I mean, honestly, at the time it was fine because I slept all the time. I slept like, God, I would go to bed like seven, 730 at night. And I was sleeping until like, at least, some sort of next day. I’d get up for a few hours, do what I had to do, and then fall back asleep. But just, I slept for a lot. So it was okay then. But come to the end of it, I’m like, okay, it’s time for you at your place. I need my space again, but yeah, he’s yeah, I need to have my own space. But at the time I know I need to rest. Yeah, I do. Yeah. ⁓ Bill Gasiamis (14:36) Yeah. and you need somebody around anyway. It’s important to have something near you if you’re unwell. Do they know what caused the stroke? Trisha Lyn Winski (14:53) ⁓ So I had a karate web. means that… ⁓ It’s really, it’s really rare. Only like 1.2 % of the whole population has it and I had it. It’s co-indentinob… co-ind… it’s… so I got it I was born. Bill Gasiamis (15:11) Yep, congenital. Trisha Lyn Winski (15:13) congenital, but they don’t know. I said that that would make it so much sense that they did a scan of your whole body at some point. I would have known that I had that years ago, but I didn’t know it. Bill Gasiamis (15:26) I don’t know what to look like, what to look for. The thing about scans, the whole body, my good friend of mine, the guy who helped me out when I was in hospital, he’s a radiographer and he does MRIs and all that kind of stuff. And he used to do my MRIs happened to be my friend happened to be working at the hospital that I was at. And he used to come and see me all the time. And I said to him, can we do a scan, you know, a preventative scan and check out, you know, my whole body? And he said, well, we can, but Trisha Lyn Winski (15:28) I know. Yeah. Bill Gasiamis (15:53) What are we looking for? I said, I don’t know anything. He said, well, we could, we could find a heap of things or we could find nothing. And if we don’t know what we’re looking for, we can’t set our scanners to the particular, settings to find the thing that you’re looking for. Because one scanner looks for hundreds of different things and the settings for to look for that thing has to be set into the scanner. And that’s only when people have a suspicion that you might have X thing. Trisha Lyn Winski (16:09) Yeah. Bill Gasiamis (16:23) then they set the scanner to find X thing and then they’ll look for it then they find it. He said, well, if we go in and do whole body scan, but we don’t even know what resolution to set it, how long to do the scan for. We don’t know what we’re looking for. So we don’t know what to do. And you have to be able to guide me and say, I want you to look for, in my case, a congenital arteriovenous malformation. In your case, carotid web. And in anyone else’s case is an aneurysm or whatever, but a general scan. Trisha Lyn Winski (16:38) Yeah. Bill Gasiamis (16:53) Like it’s such a hard thing to do for people. then, and then sometimes you said you find things that people do have unexpectedly because they go in for a different scan and then you discover something else. But now they’ve got more information about something that’s quite unquote wrong with them. And it’s like, what do you do with that information? Do I do a procedure to get rid of it? Do I, do I leave it there? Do I monitor it? Like, do I worry about it? Do I not worry about it? Trisha Lyn Winski (16:56) Yeah. Bill Gasiamis (17:21) is that it throws a big kind of curve ball out there and then no one knows how to react to it, how to respond. So it’s a big deal for somebody to say, can we have a whole body scan so we can work out what are all the things wrong with me? Trisha Lyn Winski (17:38) I it’s true, but I think that for me, most people have a carotid web. It’s obvious. know how old you are, it’s obvious. So then in that regard, like a carotid web, it looks a little indentured in the bloodstream. looks a little indentured in your artery. So I think that they would have seen it, but… ⁓ Bill Gasiamis (18:02) I love her. Trisha Lyn Winski (18:06) But then again, I don’t know. The hospital I went to, he said, you’re lucky you came here because most hospitals would have missed us. and I’m like, Bill Gasiamis (18:15) because they probably didn’t have the technology to find it. Trisha Lyn Winski (18:17) I don’t know. when I came to, it wasn’t months later, but I saw it on the scan. like, ⁓ it’s right there. ⁓ He said, yeah, but I thought it would be obvious, but it’s not so obvious. Bill Gasiamis (18:33) I just did a Google search for it and it says a carotid web is a rare shelf like membrane type narrowing in the internal carotid artery, specifically arising from the posterior wall of the carotid bulb. It is a form of intimal fibromuscular dysplasia that causes blood to stagnate forming clots that can lead to recurrent often severe ischemic strokes. Okay. So it causes blood to stay stagnant in that particular location causing clots. And you in the time we’ve been communicating, which is only in the last three or four weeks, you even sent me a message saying you just had an S you just had a TIA. ⁓ how come you’re still having clots? they not treating you or Trisha Lyn Winski (19:20) Yeah. No, I think they so they gave me um a scent in my re to kind of write that I don’t know why I had it cuz um, but my eye was like acting crazy again Just one eye and I I didn’t want to go to the hospital. I I don’t want the hospital at all for anything if I have if I don’t have to go I’m not going to hospital I Text Jason and Zach and they’re like no you have to go like I’ll wait a little while so Meanwhile, I was waiting a little while because I didn’t want to go and then I listened to ⁓ a red chat chat GBT He said no you have to go right now. Here’s why I’m like Now it’s like five hours later. I’m Sorry, so I went but and they said that I have ⁓ It’s likely I had a clot They don’t know where it came from though. So that’s that’s the thing is it’s confusing and by the way I think there’s something to be said about ⁓ I think if you have a stroke You can have one again easier than somebody who didn’t. I didn’t know that, but I learned it quickly. ⁓ So they said I had it, maybe went up in my eye, but it broke apart before it became an actual stroke. But I don’t know. Bill Gasiamis (20:41) thing. I love that you didn’t want to go and you ignored the male influences in your life, but you listen to chat. Trisha Lyn Winski (20:50) Thank you. I did, I did. They’re so smart. they say, I find on Google anyway. So that I listened to ChatGVT, it was like, I don’t know. And I know that like… Bill Gasiamis (21:05) You know that that’s kind of mental. Trisha Lyn Winski (21:08) It is actually, but I know that like my son is actually really smart and I think that they, but I didn’t listen him. I just listened to Chad Judy. Bill Gasiamis (21:18) Yeah. Anyhow, I love that you went in the end because, ⁓ and why don’t you want to go like, you just hate doctors and hospitals and that kind of thing? They saved you, didn’t they? Didn’t they save you? Didn’t they help you? Trisha Lyn Winski (21:29) There was? Yeah, but I don’t know. I think I spent so much time in there. ⁓ I don’t know. It’s in my head. I don’t like to sit in hospitals because of that. So after having the stroke, I stayed in hospital for month. I got out. I went back in like two weeks. I fell over twice. They thought that’s why. So when I was in hospital, something like they go Vegas something is pretty common. And I was like, okay, I did want to go then. I did want to go and then Zach made me. And then two months later, I went in to get the stint. And at that time I got a period. So it’s a long story. But I said to the doctor, I’m like, well, I’ll be okay. Does it do anything else because of this? He’s like, no, you should be fine. But if it gets bad, you have to go the hospital. he got bad. I almost died. I almost died from that. And that made me traumatized because I was awake and alive for all of it. I saw it all and passed out like six times in like three, I don’t know how many days, like five days. Yeah, but. Navigating Health Challenges and Medical Support Bill Gasiamis (22:46) Yeah. The challenge with something going wrong in hospital is that it’s less likely to be as dramatic as something going wrong at home. And that’s the thing, right? If you haven’t got help, then the chances that your stroke cause you way more deficits. That’s like so much worse. The best place for you to be is somewhere other than at home because you don’t want to risk being at home alone when something goes wrong and then you’re home alone. Trisha Lyn Winski (23:04) Yeah. Bill Gasiamis (23:15) when the blood flow has stopped to your head for a lot of hours. Like it could kill you, it make you more disabled and it could do all sorts of things. it’s like, but I get the whole, what is it like? It’s kind of like an anxiety about medical people and hospitals and stuff like that. Trisha Lyn Winski (23:20) Yeah. Yeah. I think that it’s mostly like I don’t like to stay there. I got a weird thing about this. I don’t like to stay there. I can stay anywhere I go, but the hospital really bothered me. I think that they were actually pretty good to me. So I’m not mad at them for that. ⁓ But I don’t want to see them now if I can possibly help it. Bill Gasiamis (23:54) Yeah, you’re done with them. Trisha Lyn Winski (23:56) I’m totally done. Bill Gasiamis (23:58) Yeah, I get it. I got, I got to that stage. My dramas were like three or four years worth of, you know, medical appointments, scans, surgery, rehab. Trisha Lyn Winski (24:07) Oh my god. Medical appointments. Medical appointments, forget it. They’re like, oh my god. I have so many of them, I can’t even say it. Bill Gasiamis (24:11) Yeah. I hear you. hear you. went through the same thing and then I got over it. now lately I’ve been going back to the hospital and seeing medical doctors for, um, not how I haven’t got heart issues, my, I’ve got high blood pressure and they don’t know what’s causing it. And, know, I’ve had my heart checked. I’ve had my arteries checked. I’ve had all these tests, blood tests, MRIs, the whole lot, and it’s getting a little bit old, you know, like I’m over it. But the truth is without them, I don’t. I don’t have a hope. Like if my blood pressure goes through the roof, you know, which had been, had been sitting at 170 over 120, 130. And I have a brain hemorrhage because of uh, high blood pressure. know what a brain hemorrhage is like, you know, I don’t want to have another one. So I’m like, I am going to, uh, I’m going to shut up, go through it and be grateful that I have medical support. Um, which, which Trisha Lyn Winski (24:55) Yeah. I know. Yeah. Bill Gasiamis (25:14) You know, a lot of people don’t get to have, it’s like, whatever, you know, I’ll cop it. I’ll cop it. I’ll go. And hopefully they can get ahead of it. So now they’re just changing my medication. I want to get to the bottom of it. Why have I got high blood pressure? The challenge with the medical system that I have is, is they just tell you, you have it and here’s something to stop it from being high. But I, they never say to you, we’re going to investigate why, like we’re going to try to get to the bottom of it. Trisha Lyn Winski (25:16) Yeah. Yeah. Bill Gasiamis (25:40) and I’ve been pushing them to investigate why do I have high blood pressure. Trisha Lyn Winski (25:44) sure. So I don’t have, I never had high blood pressure but speaking of I’ve, I don’t have a problem with my heart but they, so that when I had this for the first time they made me get out and have to, I had to wear a heart monitor for a month and I said like why am I wearing a heart monitor? There was something, they, I don’t know what it is. Bill Gasiamis (25:51) Yeah. Trisha Lyn Winski (26:13) Afib or something like that in there. And this time was the same thing. had heart bars over there right now. I had to send it back and they’re gonna send me new one. every time I’ve taken my heart test, and by the went for EKG just the other day. It was fine. But they found like something near my heart rate, it’s not like I need to be concerned about these. It’s nothing I need to be concerned about. So I was like, okay. They’re making you wear that for a month. Anyway. Bill Gasiamis (26:46) Yeah, just to go through things, just to check things, just to work some stuff out. Trisha Lyn Winski (26:47) Yeah. Yeah, yeah, this month I have ton, I have like seven appointments. Bill Gasiamis (26:56) Yeah, I used to forget my appointments all the time, even though I had him in my calendar, even though I had reminders, I just, even though I got reminded on the day, an hour before, two hours before, he meant nothing to me. I would just completely forget about him. Trisha Lyn Winski (26:59) me too. Me too. Same thing. I forgot all of it. And I had to share it with Zach and he could tell me, have an appointment. Like, okay. I forgot. He’s like, have an appointment. I’m like, fuck, I have to go. Bill Gasiamis (27:13) Yeah. How long did it take you to get back to work? Trisha Lyn Winski (27:28) I at least I went back to work. I went back to work before I was told I could go back to work. And I wrote them an email like, listen, I can’t sit at home and run one fucking freeze. I need to do something. So I went back to work. ⁓ And at first I went back to work part time. And honestly, like I cried. I left there crying every day. And not because I think that I. Not because of people. don’t think it was the people. I couldn’t understand. My head was like… I couldn’t focus and put all that work into my… I couldn’t put it into me. So I couldn’t understand what I was doing. And then you give them a month. Eventually I got it, but it was a struggle. I should have waited until October. And they said I should go back in October. Maybe I could go back in October. I should have waited until then. Bill Gasiamis (28:22) Yeah. Do you kind of like a nervous energy type of person? Do you can’t sit still or is it like, can’t spend a lot of time on your own with yourself? Like, is it? Trisha Lyn Winski (28:34) I can spend a lot of time by myself. don’t like to ⁓ here by myself. I can be by myself. I don’t like to be… I can’t think of… What did you say before? Bill Gasiamis (28:48) Is it just downtime? Is it the downtime? it too much? Did you have too much downtime? Trisha Lyn Winski (28:52) Yes, definitely too much downtime. But I couldn’t see I was sitting at home and Zach was there, whatever he was doing. was like, I can’t, I need to do something. So I went to work and in all reality, I should have walked around. should have, I didn’t do that. Bill Gasiamis (29:04) Yeah. Yeah. How did your colleagues find you when you went back? Did they kind of appreciate what you had been through? Was that easy to have those conversations? What was it like? Trisha Lyn Winski (29:21) Yeah, so I oversaw all the finances department. ⁓ They were actually like, honestly like rock stars. They were like really, really good to me. ⁓ That was helpful. because I love them anyway. it made me feel good to say that that’s what I’m doing. ⁓ But I still left there and cried. Not because like I think that I just couldn’t understand it. They were good to me. Everyone was good to me in theory, I couldn’t understand. Bill Gasiamis (29:56) you had trouble with the work, with doing your job because of your cognitive function. Trisha Lyn Winski (29:59) Yeah, yeah, yeah, there’s a other little things with that, it’s more or less the cognitive function is a problem to do the work. Bill Gasiamis (30:12) Yeah. Tiring. Like I mentioned, it’s really mentally draining and tiring. remember sitting in front of a computer trying to work out what was going on on the screen and it being completely just blank. Acceptance and Coping with Mortality Trisha Lyn Winski (30:22) And so that’s actually what probably got me the most was that what you’re saying. I’d be sitting there and look at my screen. I couldn’t remember what I was doing, but I remember like weird things. I remember how to do like Excel. I don’t know how I remember Excel, but I did. I was really good with numbers. And they said that I was going to have a problem with numbers and everything. So I have aphasia too. I don’t have a choice with that, but Bill Gasiamis (30:31) Yeah. Trisha Lyn Winski (30:49) That’s why I talk so weird. Bill Gasiamis (30:52) Okay, I didn’t notice. Trisha Lyn Winski (30:54) Oh, oh, I feel good. But yeah, I have aphasia. But I can do certain things. And the numbers was going to be, they said it going to, I couldn’t, that’s going to be a problem. And the numbers, I can do all day. But I can’t do other little things. Bill Gasiamis (31:11) I understand. So you went back to work. It was kind of helpful, probably too early to go back, but good to be out of the house. Good to be connecting with people again. And has that improved? Did you find that you’ve been able to kind of get better in front of a screen, better with the things that you struggled with, or is it still still a bit of a challenge? Trisha Lyn Winski (31:19) Yeah. Yeah. So two things, ⁓ I got fired eventually, and that’s another whole issue. Yeah, yeah, we’ll talk about that another time. but ⁓ so, but now that I’m here, I could look my computer and it’s fine. I can do it all day. But I really, it’s a long story. think that Warren, my boss, ⁓ Deb, but they definitely like hinder me. ⁓ Bill Gasiamis (31:39) Understand. another time. Yeah. Okay. I understand. Well, maybe we won’t talk about it, like, because of the complications with that, but that’s all good. I understand. So, ⁓ do you know, a lot of the times you hear about acceptance and you hear about, ⁓ like, Trisha Lyn Winski (32:07) Yeah. Yeah. Yeah. Bill Gasiamis (32:23) When some, well, something goes through something serious, something difficult, you know, there has to be kind of this acceptance of where they’re at. And that’s kind of the first stage of healing recovery, overcoming. Where are you with all of this? you like, totally get that at 46. It’s a shock to have a stroke. You look perfectly fine, perfectly healthy. This thing that you didn’t know about that you’ve had for 46 years suddenly causes an issue. How do you deal with your mortality and knowing that things can go wrong, even though you’re not aware of, you you’re not doing anything to really make your situation worse. You look fit and healthy. Were you drinking, smoking, doing any of that kind of stuff? Trisha Lyn Winski (33:06) I drank occasionally, I wasn’t a drunk, I don’t smoke. Bill Gasiamis (33:11) yeah social smoke social drinker but not smoker Trisha Lyn Winski (33:15) Yeah, I don’t smoke. I don’t have anything that could cause it. I have nothing that, no blood pressure, no diabetes, It’s hard. Jason talks about it all the time. It’s hard. don’t… It makes me mad. Really mad. Really, really mad that I to stroke. And like, everyone that has it… Bill Gasiamis (33:24) Yeah. Trisha Lyn Winski (33:41) or every dozen. I’m like, why me? Why did I have to have it? It’s frustrating. It’s so frustrating. Bill Gasiamis (33:48) Yeah, mad at who? Trisha Lyn Winski (33:50) I don’t know. I’m just mad. Like, I don’t know who I’m mad at. Bill Gasiamis (33:56) Yeah. The thing about the why me question, it’s a fair question. asked it too. I even ask it now sometimes, especially when, um, I’ve got to go back for more tests, more, uh, now I’ve got high blood pressure. Like, like I needed another thing to have, you know, like, and it’s like, the only thing that I come back with after why me is why not me? Like, who are you to go through life completely unscathed and get to 99 and then die from natural Bill Gasiamis (34:25) wanted to stop there for a second because that question, why me, is something I wrote about in my book. It’s one of the most common and most painful places stroke survivors get stuck. If you want to read about it and how I worked through it and what I found on the other side, the book is called The Unexpected Way That a Stroke Became the Best Thing That Happened and it’s available at You’ll find the link in the show notes. And now let’s get back to Tricia. Bill Gasiamis (34:54) like Trisha Lyn Winski (34:54) Yeah. Bill Gasiamis (34:55) You’re normal. being normal, ⁓ normal things happen to people. Some of those things that are shit are strokes and heart attacks and stuff that you didn’t know that you were born with. ⁓ what’s really interesting though, is to live the life after stroke and to kind of wrap my head around what that looks like. My left side feels numb all the time. ⁓ tighter, ⁓ has spasticity, but nothing is curled. Like my fingers on my toes are not curled, but it’s tighter. ⁓ it hurts. ⁓ It’s colder, it’s ⁓ sensitive, I’ve got a, and I always have a comparison of the quote unquote normal side, the other side, it’s always. And the comparison I think is worse because it makes me notice my affected side and that noticing it. Trisha Lyn Winski (35:31) Yeah. or yeah. Bill Gasiamis (35:46) makes the reality happen again every day. Like it’s a new, I wake up in the morning, I get out of bed, my left side still sleepy. I have to be careful. If I’m not careful, I’ll lose my balance. I don’t want to fall over. And it’s like, I get to experience a different version of myself. And sometimes I want to be grateful for that. want to say, wow, what a cool, different thing to experience in a body. But then I’m trying to work out like, what’s the benefit of it? don’t know if there’s a benefit. ⁓ Trisha Lyn Winski (36:14) I don’t know either. Bill Gasiamis (36:15) to me, but, Trisha Lyn Winski (36:15) I don’t either. Bill Gasiamis (36:18) but here I am talking to you and, and, and 390 people before you, ⁓ about strike all over the world and we’re putting something out and it’s making a difference. And maybe that’s the benefit. I don’t know, but do know what I mean? Like, why not us? I hate asking that question too. Trisha Lyn Winski (36:34) I don’t know. You had ⁓ the podcast on YouTube and I stumbled upon it on the wise. I watched YouTube and then you came out there and I’m like, so before that I was looking at different, I watched every video, every video on strokes, every video I could possibly type but I watched. I did. ⁓ And then I stumbled upon your stuff and I watched that stuff too. And that’s why I wouldn’t have thought to call you or reach out to you. Bill Gasiamis (37:11) Was it helpful? Was it helpful? Trisha Lyn Winski (37:13) Yeah, it is helpful. But it doesn’t change the fact that I had a stroke. All the people that had it, I feel bad for them. Honestly, like, so when I was at the hospital, they had me join a bunch of groups on Facebook and Instagram that are like, they’re people who’ve gone through a stroke. most, I don’t comment on them. I don’t say, because most of the time it’s people bitching. Bill Gasiamis (37:19) Yeah. Yeah. Trisha Lyn Winski (37:43) But I really like, times I, trust me, I’m like ready to kill somebody. But I don’t like say it there. I only ask them questions that are really serious. But sometimes I read what they say. And there was a guy the other day, I don’t know what he wrote, but he had like all kinds of words that they were way jumbled. was like, his message just didn’t make sense. I thought to myself, God, if I was like that, I’d be so sad. Somebody, I do think that he’s worse than I could be, but you don’t know. Bill Gasiamis (38:19) Yeah. Communication Challenges and Aphasia Yeah. He, his words are more jumbled than yours. And you, if you, you, you’re thinking, if you were like that, you would be probably feeling more sad than you currently are. And you’re assuming that maybe that person is feeling sad, but maybe they’re not, maybe they just got the challenge and they’re taking on the challenge and they’re trying to heal and recover. don’t know. And maybe, maybe they’re getting help and support through that therapy and also maybe psychological help and all that kind of stuff. Have you ever had any counseling or anything like that to sort of try and wrap your head around what the hell’s going on in your life? Trisha Lyn Winski (38:54) So I did it once and actually like I think she was okay. I felt like I was always having to talk. I know that I’m so stocked but she wasn’t asking me a lot of questions and I felt like she needs to me more questions. I’ll have more answers but like but she didn’t. She just wanted me to talk so I just talked. But I stopped seeing her because I… So two reasons. I stopped seeing her because they when they fire me I… I didn’t know what I had to do. I knew I insured that I didn’t know how long it was going to be for me to have that. So I talked to her for a little bit and then I stopped talking to her because I just couldn’t deal with it. I think now I’m getting to the point where I’m going to do it. Bill Gasiamis (39:37) It was a bit early. I like that. I like what you said there. Cause sometimes it’s early. It’s too early to go through that and unwrap it. Right. And now a little bit of times past, you probably have more conscious awareness of, do need to talk about this and I need to go through and see a certain person. And now I’m going to take that action. It’s been three years and now I can take that action. like it. ⁓ and I like what you said about, you have to feel like you’re connected to that person or you have rapport or Trisha Lyn Winski (39:46) It is. Yeah. Yeah. Yeah. Yeah. Bill Gasiamis (40:11) they get you and you’re not just, it’s not a one way conversation. That’s really important in choosing a counselor. I know my counselor, we, I didn’t do all the talking. was like you and me chatting now about stuff. had a conversation about things regularly. And therefore, ⁓ one of the good things that she was able to do was just ease my mind when I would go off on real negative tangents, you know, she would try to bring me back down just to calm and. Trisha Lyn Winski (40:35) Yeah. Bill Gasiamis (40:39) settle me down and offer me hope. Trisha Lyn Winski (40:42) I think my, honestly my biggest problem with this whole stroke and having it at all, I have aphasia and that 100 % kills me. Because I can’t like, I can talk like normal but I can’t talk like… I forget what I’m saying. So it’s in my brain, but I can’t spit it out. I get really frustrated at that point. people, I had a stroke, my left hemisphere and my right side went numb. My left hemisphere is all kinds of different, different things that I can’t do. The good news is my left means I can’t like, I can talk to people like this. But the other person and that guy I was talking about, he probably had the right side, his aphasia was. really bad, really bad. But I was a person who talked like really fast all the time, all the time. And now like, I think part of my brain goes so fast and I can’t spit it out. I get really, I get, it’s, yeah. Bill Gasiamis (41:38) Okay. as quickly as you can. Okay, so you know, I’ve spoken to a ton of people who have aphasia. And one of the things they say to me is when they have frustration, their aphasia is worse. So the skill is to learn to be less frustrated with oneself, which means that’s like a personal love thing. That’s self love, that’s supporting yourself, you know, and going. Trisha Lyn Winski (42:00) It is. The Journey of Recovery and Self-Discovery Yeah, that’s a point. That’s a good point. Bill Gasiamis (42:13) And it’s going like, well, you know, you’re trying your best. It’s all good. You know, don’t get frustrated with yourself. Don’t hate yourself. Don’t give yourself a hard time about it. ⁓ and try and decrease the frustration. Then the aphasia gets less impactful, but, ⁓ and then maybe, you know, this part of learning the new you is bring the old Trisha with you, but maybe the nutrition needs to be a little bit more slow, a little more measured, a little more calm. And it’s a skill because for 46 years, you were the regular. Trisha Lyn Winski (42:36) Yeah. Bill Gasiamis (42:42) Tricia, the one that you always knew, but now you’ve got to adjust things a little bit. It’s like people going into midlife, right? Like us, you know, in our fifties and then, um, or, know, sort of approaching 50 on and beyond and then go, I’m going to keep eating, uh, fast food that I ate when I was 21 and 20, know, McDonald’s or sodas or whatever. You can’t do it anymore. You have to make adjustments, even though that’s been your habit for the longest time, your body’s going, I can’t deal with this stuff anymore. Trisha Lyn Winski (43:03) Yeah. Bill Gasiamis (43:12) Take it out, you know, let’s simplify things. And it’s kind of like how to approach. I stroke recoveries things need to kind of get paid back and simplified. And it has to start with self love. And you have to acknowledge how much effort you’ve already put in for the last three years to get you to the position that you are now, which is far better than you were three years ago when the stroke happened. And you have to celebrate. how much your body is trying to support you heal your brain. Your body’s trying to get you over the line and your mindset is getting frustrated with itself, which is making things worse. Tweak that and things will get a bit better maybe. I don’t know. Trisha Lyn Winski (43:55) It does. You’re 100 % right. ⁓ So whenever I’m not stressed, so two things. I think when I talk to people I don’t know, I always get like nervous about that. ⁓ Bill Gasiamis (44:10) You think they’re thinking about things that you’re not they’re not really Trisha Lyn Winski (44:13) Yeah, but then who knows what they’re thinking of. that’s just how I get, whenever I get like, I went to a concert like a couple of years ago and I was like, I believe I couldn’t, I could hear that the music is so loud in my brain. Like I gotta get out of here. So I left. I’ve gotten better since then, but there’s something about, I have to do things slower. I have to do things over. I’ve realized that like recently, like in the last like maybe month, I have to do things very slow. I have to. And maybe this is God’s way of like, tell me like slow the f down, you’re going too fast. But that’s how I live my whole life. And then all of a sudden, now you’re not going to get up. Yeah, it’s a huge testament. So I can do it right. Not always right. Bill Gasiamis (45:01) Yeah, there’s an adjustment. Yeah, adjustment. Yeah. Trisha Lyn Winski (45:09) because again, it’s isophagia, it’s gonna be hair mess, if I go slower, much slower, I can get it all out. But, ugh. Bill Gasiamis (45:22) It’s a lot of work, man. It doesn’t end here. You know, the work just as just beginning, you know, this getting to understand yourself, to know yourself, to support yourself, to be your biggest advocate. ⁓ and then to fail and then to try and be the person that, ⁓ picks themselves up and goes again and tries again without getting frustrated. I know exactly what you mean. Like so many people listening will know what you mean. Trisha Lyn Winski (45:22) It’s a pain. It’s a pain! Bill Gasiamis (45:51) And with time, you’ll get better and better because I know that three years seems like a long time, but it’s early in the recovery phase. The recovery is still going to continue. Year four, five, six, seven will be better and better and better. I’m, I’m 12 years post brain surgery and 14 years post first incident. So it’s like, things are still improving and getting better for me. Trisha Lyn Winski (46:17) Yeah. Bill Gasiamis (46:18) And one of the things is the way that my body responds to physical exercise. went for a bike ride a little while ago, a couple of weeks ago. And when I used to go for a bike ride at the beginning, um, man, I would be wiped out for the entire day. Uh, and I used to do a morning bike ride about like 10, 30, 11 o’clock and I’d be wiped out for the rest of the day. Trisha Lyn Winski (46:32) Yeah. Bill Gasiamis (46:39) Whereas now I can go for a bike ride and just be wiped out like a regular person, you know, about an hour or two, and then I’m back on board with doing other tasks. So it takes so much time for the brain to heal. Nobody can give you a timeline and you’ve got heaps more healing to go. Trisha Lyn Winski (46:57) So I looked at my stuff on YouTube, how long it takes to recover from a stroke. I’ve looked at that everywhere. Everywhere I can find. I’ve looked at that. It’s so funny. Like everybody says that it’s, everybody’s story is different. Everybody. It doesn’t matter how long you were in hospital for, doesn’t how long. But that like, it’s crazy. have no like timetable of when I’m going to get better. None. I have to deal with it. Bill Gasiamis (47:27) Yeah. It’s such a hard thing. It’s not a broken bone, know, like six weeks, stay off it, do a little bit of rehab and then you’re back to normal. Trisha Lyn Winski (47:28) It sucks, but. I had two years before this or maybe a year before that, had a rotator cuff surgery. I look back at that and I’m like, that was so bad. And that was like night and day. The stroke definitely like, the stroke killed me. Not the stroke. I don’t want to say the stroke. I think having aphasia killed me. I do, the stroke is, get me wrong. I don’t like it either, but ⁓ the aphasia kills me. If I didn’t have that, I wouldn’t be normal, but I can be normal. But the aphasia. Bill Gasiamis (48:00) Okay. Yeah. But, but what, but that word killed me is a real heavy word, right? maybe you should consider changing that word, but also like, didn’t pick that you had aphasia and I, and I speak to stroke survivors all the time. Like I didn’t pick it. I, I just assumed that was the way you process your words and that’s how you get things out. Like it didn’t, I didn’t notice it at all. Trisha Lyn Winski (48:26) I know, I know, it’s funny that said Yeah, that’s actually good. That’s really good. But I know it’s it. I definitely know it’s it. I could talk like a mile a minute and now like. Bill Gasiamis (48:47) Yeah. Trisha Lyn Winski (48:52) I mean… Bill Gasiamis (48:52) Maybe it was maybe maybe now it’s more about ⁓ quality rather than quantity, Trisha. Trisha Lyn Winski (49:00) Apparently it is. Bill Gasiamis (49:01) I’m not saying that you didn’t have quality in that I didn’t know you so I’m not kind of yeah but you know what I mean like Trisha Lyn Winski (49:03) Yeah. No, it’s okay. Trust me, it’s okay. But yeah, it just frustrates me. I can’t get out what I want to get out. And so at that time, just give me a little time, I’ll get it out. But I can’t say that to people when I’m out. I can’t say this to So I just, I don’t say it at all. Bill Gasiamis (49:22) Yeah. so you stop yourself from communicating because you think you’re taking too long and it’s interrupting the flow of the conversation. Yeah. I think you’re doing that to yourself. I don’t think that’s true. We’ve had a fantastic conversation here and I’ve never picked it. Trisha Lyn Winski (49:34) Yeah. all day. But so you’re somebody who’s had a stroke before. It’s kind of different for me because you had. But if you didn’t have a stroke, will be… Well, I don’t know. Maybe not. Maybe one-on-one I’m okay. No, think I… No, it’s because you had a stroke. I think of all the people I’ve talked to and they’re one-on-one. I don’t do well with them. But I think that you’ve had a stroke so I just… I know how to communicate with you. Bill Gasiamis (49:54) I understand. And maybe you’re more at ease about it. Less feeling, judged. I understand. Yeah. Trisha Lyn Winski (50:20) Yes, all day. Even that guy I told you about that that said that on Facebook God like I Really like my heart goes out to him But then that there’s the people that are fishing a plane I’m like I want to say my heart goes out to them, it really, it goes to certain people. I think that. He’s like going through it. Bill Gasiamis (50:45) Yeah. One of the problems with going to Facebook to bitch and moan about it, especially when you’re going through it is that you get an abundance of people who also are there to bitch and moan about it. And, and that makes it worse. think you should do bitching and moaning on your own. Like when there’s no one watching or listening. Cause then that way there’s not a loop of bitching and moaning that happens. That makes it dramatically worse for everybody. Trisha Lyn Winski (51:01) Yeah, I do it myself. Bill Gasiamis (51:09) ⁓ and that’s why I don’t hang around on Facebook, Instagram, social media, or anything like that for those types of conversations. If I’m not sharing a little bit of wisdom or somebody’s story or, ⁓ asking a question, like a genuine question, one of the questions might be, did you struggle driving and did you have to pull over and go to sleep in the middle of the road? If you had a big trip ahead of you in the car, I’ve done that. Like if, if I’m not asking a question like that, I don’t want to be, ⁓ on social media saying. life sucks, this sucks, that sucks. Like forget about it. What’s the point of that? That’s why I started the podcast so I can have my own conversations about it that were positive based on what we’re overcoming rather than all the shit we’re dealing with. And that way ⁓ we take off that spiral, the negative downward spiral. trying to make it an upward spiral. You know, where things are. Trisha Lyn Winski (51:41) Yeah. Facing the Aftermath of Stroke Bill Gasiamis (52:05) I don’t know, we’re seeing the glass half full perhaps, or we’re seeing the positive that came out of it. If something like, I know there’s some positive stuff that came out of stroke for you. Day one, you definitely didn’t think that maybe three years down the track. Maybe if it wasn’t for this, well, then that wouldn’t have happened for me. Like I’ve been on TV. I’ve been at the stroke foundation. I’ve been on radio. I’ve been, I’ve presented. I’ve got a podcast. wrote a book. Like it’s taken years and years for all those good things to come, but they never would have happened if I didn’t have a stroke. So I wanted to have those types of conversations, you know, what are the positive things we can turn this into? Because dude, then there’s just enough shit to deal with that. We don’t have to deal with every other version of it, you know? ⁓ and I think it’s better to have your me personally, my negative moments alone, cause I don’t want to get into a competition with somebody. Trisha Lyn Winski (52:42) That’s good. Yeah. Bill Gasiamis (53:05) who I say, I didn’t sleep well, my left side hurts, it feels like pins and needles. And then they say to me, ⁓ you think that’s bad? Well, you know, forget about it. I don’t want to be that that guy on the other end of a conversation like that, you know. Trisha Lyn Winski (53:13) Yeah. ⁓ So you said your left side, ⁓ you see you have pin the needles, is always like that? So I’m sorry, had hemorrhagic stroke? Okay. I know the difference between two, ⁓ why did you have hemorrhagic stroke? Bill Gasiamis (53:27) Always, yeah, never goes away. Yeah, Brain blade. I was born with a blood vessel that was malformed. So it was like really weak one. I was really like, uh, was kind of like, uh, uh, it wasn’t created properly in my brain when I was born and it’s called an arteriovenous malformation. then they sit idle, they sit idle and they do nothing for a lot of people. And then sometimes they burst. Trisha Lyn Winski (53:58) Mm-hmm. ⁓ I heard it. Bill Gasiamis (54:08) And people sometimes have them all over their body. They don’t have to have them in their head. They can have them on the skin, ⁓ in, in an arm on a leg, wherever. And on an arm and a leg, they, they decrease the blood flow and they create real big lesions of skin damage on the surface in a brain. They leak into the brain and they cause a stroke. ⁓ so the challenge with it is like you, there was no signs and symptoms. for any of my life until it started bleeding. And when I took action, eventually, I was like, yo, I didn’t want to go to the doctor. I didn’t want to go to the hospital. I want to do any of that. It took seven days for me to go to the hospital. When I finally got there, they found the scan, found the blood in my head. And then they thought it would stop bleeding and it didn’t. And then it bled again and they wanted to monitor it to see if it stops bleeding. They wanted to try to avoid surgery. And then a bled a third time. And then after they bled the third time, they said, we have to have surgery. We’ve got to take it out because it’s too dangerous. And when it bled the second time, I didn’

Heart palpitations don't usually mean heart damage. In this video, I'll uncover the true underlying causes of heart palpitations and share simple heart health tips to address your heart rhythm problems. Download Dr. Berg's Free Daily Health Routine: https://drbrg.co/45qtO07Heart palpitations and heart rhythm problems are an electrolyte issue. Electrolytes are minerals that allow electricity to travel through the nervous system. Unfortunately, doctors rarely look at electrolytes as part of the problem.A magnesium deficiency is one of the most likely causes of heart palpitations. The majority of people with heart palpitations have normal EKG tests and echocardiogram results. If you have chest pains, fainting, or known heart disease, get these symptoms checked.A skipped or extra heartbeat is known as a heart palpitation. This may cause a strange sensation in your chest, cause you to take a breath, or even cause dizziness. This is caused by an unstable electrical rhythm. This does not mean your heart is failing or that you have any structural failure at all. Calcium causes contraction of the heart muscle. Too much calcium can also cause twitches, cramps, insomnia, and anxiety. Magnesium is the master controller of calcium, and the most important electrolyte for nerve stability. A magnesium deficiency rarely shows up in a blood test. When the demand for magnesium increases, you might experience palpitations. The most common trigger for heart palpitations is stress. Magnesium acts as a buffer to adrenaline and cortisol, so the demand increases when you're stressed. In addition to stress, there are many things that can increase the demand for magnesium, including the following:• Poor sleep• Unstable blood sugar• Hormonal shifts• ExerciseMagnesium excretion can also cause magnesium deficiency, leading to heart palpitations. Caffeine, a low-carb diet, heavy sweating, and alcohol can cause magnesium excretion.Simply not getting enough magnesium from your diet or water source can also contribute to heart palpitations. Salad, chocolate, avocado, and nuts are the best sources of magnesium. When you consume ultra-processed foods that are devoid of nutrition, you deplete magnesium. Magnesium glycinate is a highly absorbable form of magnesium that can help increase GABA and reduce cortisol levels. Start with 400 mg of magnesium daily and increase if necessary. When taking more than 400 mg, spread your doses throughout the day.Dr. Eric Berg DC Bio:Dr. Berg, age 60, is a chiropractor who specializes in Healthy Ketosis & Intermittent Fasting. He is the Director of Dr. Berg Nutritionals and author of the best-selling book The Healthy Keto Plan. He no longer practices, but focuses on health education through social media.Disclaimer: Dr. Eric Berg received his Doctor of Chiropractic degree from Palmer College of Chiropractic in 1988. His use of “doctor” or “Dr.” in relation to himself solely refers to that degree. Dr. Berg is a licensed chiropractor in Virginia, California, and Louisiana, but he no longer practices chiropractic in any state and does not see patients, so he can focus on educating people as a full-time activity, yet he maintains an active license. This video is for general informational purposes only. It should not be used to self-diagnose, and it is not a substitute for a medical exam, cure, treatment, diagnosis, prescription, or recommendation. It does not create a doctor-patient relationship between Dr. Berg and you. You should not make any change in your health regimen or diet before first consulting a physician and obtaining a medical exam, diagnosis, and recommendation. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.

We explore how to refine and optimize care in the vital minutes following ROSC. Hosts: Jonathan Elmer, MD, MS Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Post-ROSC_care.mp3 Download Leave a Comment Show Notes Core EM Modular CME Course Maximize your commute with the new Core EM Modular CME Course, featuring the most essential content distilled from our top-rated podcast episodes. This course offers 12 audio-based modules packed with pearls! Information and link below.  Course Highlights: Credit: 12.5 AMA PRA Category 1 Credits™ Curriculum: Comprehensive coverage of Core Emergency Medicine,  with 12 modules spanning from Critical Care to Pediatrics. Cost: Free for NYU Learners $250 for Non-NYU Learners Click Here to Register and Begin Module 1 I. Phase 1: Stabilization (Minutes 0–10) The “Rearrest” Window & Pathophysiology High-Risk Period: Rearrest rates reach 30% within the first minutes post-ROSC. Shock Incidence: Two-thirds of patients develop profound hypotension/shock as initial resuscitative efforts subside. Catecholamine Washout: Super-physiologic “code-dose” epinephrine (1mg IV) typically wears off within ~3 minutes post-ROSC, leading to predictable hemodynamic collapse. Secondary Injuries: Evaluate for “CPR-induced trauma” (blunt thoracic trauma, rib fractures, pneumothorax, liver/splenic lacerations). Immediate Resuscitative Actions Vascular Access: Transition rapidly from IO to reliable IV access within 1–2 minutes. Prioritize Intraosseous (IO) placement within 5 minutes if IV attempts fail; intra-arrest data suggests no significant difference in early outcomes. Vasoactive “Bridge”: Maintain a “bolus-dose” pressor at the bedside for immediate push-dose titration. Options: Phenylephrine, dilute Epinephrine, or dilute Norepinephrine (titrated to effect rather than rigid dosing). Physician-Specific Task: Arterial Line: Goal: Placement within 5 minutes of ROSC. Preferred Site: Femoral (by landmarks/blind if necessary) for speed; should be a 80 mmHg. The BOX Trial Nuance: While the BOX trial showed no difference between MAP 63 vs. 77, its cohort (Denmark) had exceptionally high survival rates (70% back to work) and short response times, which may not generalize to North American populations with lower shockable rhythm incidence. Permissive Hypertension: If the patient is “self-driving” to higher pressures, do not aggressively lower them, as this may be a physiologic demand for cerebral blood flow. Ventilation and Oxygenation PaCO2 Management: Target: High-normal to slightly hypercarbic (45–55 mmHg). Rationale: Avoid accidental hyperventilation (PaCO2

Broadcast from KSQD, Santa Cruz on 2-26-2026: Dr. Dawn opens with an urgent measles advisory, noting the virus has an R-value of 15 compared to COVID's peak of 5, with South Carolina reporting over 1,000 cases. She recommends those who received only one MMR shot—particularly people now in their 60s—get an immune titer blood test, as protection declines after 40-50 years. Measles can cause "immune amnesia" destroying immunity to other pathogens, and rarely leads to fatal subacute sclerosing panencephalitis years later. Dr. Dawn criticizes Quest Labs' cholesterol reporting, which flags average levels as "moderate risk" with alarming red H markers even when values fall within their own stated normal ranges. She explains this creates unnecessary panic and pushes patients toward statins based on outdated 2008-2012 guidelines, when cardiology has since recognized that cholesterol can be too low. An emailer asks how an EKG can detect a past heart attack from "jagged lines." Dr. Dawn explains that each spike represents electrical signals moving toward or away from electrode pads, and a 12-lead EKG views the heart from multiple angles—smaller-than-expected spikes in specific leads indicate dead or damaged heart muscle. She urges everyone to learn CPR and AED use, which more than doubles survival chances. An emailer reports that food tastes strong on the first bite but becomes tasteless thereafter. Dr. Dawn identifies numerous medications causing taste changes including calcium channel blockers, beta blockers, statins, diuretics, and even acetaminophen. She also highlights zinc—both deficiency and toxicity above 40mg daily can impair taste, noting a zinc nasal spray was pulled from market after causing smell loss. An emailer asks about Prenuvo full-body MRI scans costing $499-1,000. Dr. Dawn cautions that while Prenuvo found 22 cancers in 1,000 people scanned, 1 in 20 scans requires follow-up biopsy and more than half are false positives—leading to stress, expense, and potential complications from unnecessary procedures. An emailer asks about seed oils after reading a Johns Hopkins article defending them. Dr. Dawn distinguishes fruit oils (olive, avocado) from industrially-extracted seed oils requiring hexane solvent, a neurotoxin that may leave residues despite claims of evaporation. She cites a BMJ study showing coconut oil raised HDL (good cholesterol) while matching olive oil's LDL impact, and recommends cold-pressed oils while avoiding hexane-extracted products, especially for infants.

Perplexed by patients with normal exams but persistent symptoms like recurrent UTIs or palpitations? It could be menopause. In this insightful episode of Succeed In Medicine podcast, host Dr. Bradley Block interviews Dr. Lauren Streicher. They explore commonly overlooked menopause symptoms beyond hot flashes: recurrent urinary tract infections tied to genitourinary syndrome of menopause (GSM), palpitations as "hot flashes of the heart" (often sinus tachycardia without EKG changes), GI microbiome shifts causing nebulous digestive issues, xerostomia (dry mouth) linked to oral health risks, and skin/hair changes like alopecia. Dr. Streicher emphasizes reassuring patients early, validating symptoms as hormonal, and tailoring treatments, vaginal estrogen, safe even for breast cancer patients, systemic hormones, or new non-hormonal NK3 receptor antagonists like fezolinetant. They discuss the SWAN study's findings on long-term risks from untreated hot flashes (e.g., cardiovascular disease, bone loss), the need to differentiate perimenopausal (temporary) vs. lifelong postmenopausal effects, and avoiding arbitrary hormone therapy stops after 5 years. The conversation also touches on sexual health gaps in medicine, with tips for better history-taking and resources like Dr. Stryker's "Come Again" course. Listeners, clinicians and patients alike, will gain tools to address menopause holistically, improving quality of life and preventing complications. Three Actionable Takeaways: Recognize GSM in Recurrent UTIs: For postmenopausal women with new-onset recurrent UTIs, suspect genitourinary syndrome of menopause, prescribe local vaginal estrogen (cream, suppository, or ring) to restore microbiome and tissue health; it's safe for most, including breast cancer survivors on aromatase inhibitors. Reassure on Palpitations First: When midlife women present with palpitations, lead with "This is common in perimenopause (up to 50% affected) likely autonomic dysfunction like a 'heart hot flash'"; order a Holter monitor, but emphasize it's often benign and tied to vasomotor symptoms, treatable with hormones or NK3 antagonists. Integrate Sexual History Properly: Ditch "Are you sexually active?",  ask "Many women in menopause experience low libido, pain with sex, or orgasm difficulty; are any of these issues for you?"; refer to resources like Dr. Streicher's course for evaluation scripts, screeners, and solutions to address 50% of patients' unspoken concerns. About the Show: Succeed In Medicine covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school! About the Guest: Dr. Lauren Streicher is a clinical professor of OB-GYN at Northwestern University and founding director of its Center for Sexual Medicine and Menopause. A certified menopause practitioner, she serves on the Menopause journal's editorial board, is a Kinsey Institute fellow, and authors bestsellers like "Sex Rx" and "Hot Flash Hell." She hosts "Inside Information" podcast and created "Come Again" audio series on postmenopausal sexuality. Connect with Dr. Lauren Streicher: Website: https://www.drstreicher.com Email: info@drstreicher.com  About the Host: Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts Succeed In Medicine podcast, focusing on personal and professional development for physicians Want to be a guest? Email Brad at brad@physiciansguidetodoctoring.com  or visit www.physiciansguidetodoctoring.com to learn more! Socials: @physiciansguidetodoctoring on Facebook @physicianguidetodoctoring on YouTube @physiciansguide on Instagram and Twitter This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let's grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Artificial Intelligence in Medical Education: Opportunities, Risks, and GuardrailsIn this episode of The Pediatric Lounge, the hosts welcome back Dr. Rani Gareige, director of medical education and designated institutional official at Nicklaus Children's Hospital and a clinical professor at Florida International University, to discuss artificial intelligence in medical education now and in the future. They preview Nicklaus Children's Hospital's 61st annual postgraduate pediatrics CME conference in Fort Lauderdale (Hilton Marina Resort, March 20–22), highlighting sessions on IBD, short stature, dermatology, psychological screening, AI in practice management, social media communication, genetic testing/personalized medicine, and Florida's new requirement for EKG screening to clear athletes starting ninth grade. The conversation covers common AI tools learners use (ChatGPT, Claude, OpenEvidence) and institutional concerns about HIPAA/PHI, including blocking public tools and using a secure in-house system (“Ask Nick”) and closed or constrained approaches (e.g., tools that search only approved sources or documents provided, such as Google Notebook). They explore concerns about de-skilling and when to introduce AI in training, faculty development needs, and a precepting framework (DEFT-AI: Diagnosis, Evidence, Feedback, Teaching, and Recommendations for AI use) to assess clinical reasoning. The episode also discusses AI for simulated patient interactions (bad news delivery, motivational interviewing), ambient AI scribing pilots, clinician responsibility to review notes, and AI-driven coding that may reduce undercoding and administrative burden. The discussion concludes that AI will not replace physicians, but clinicians who use AI wisely may replace those who do not, stressing the importance of policies, ethics, transparency, and maintaining empathy and the art of medicine.00:00 Podcast Intro and Guest02:25 CME Conference Details03:13 Hot Topics and New Laws04:44 EKG Screening Program07:42 AI Tools in Training11:42 IRB and Data Privacy14:39 Meeting Minutes Automation16:48 Closed Models for Clinicians19:13 AI Hallucinations and References24:16 Deskilling and Timing AI30:11 Teaching Frameworks for AI32:46 Back to Evidence Basics33:40 Questioning the Evidence34:48 AI and Human Empathy37:45 AI as Clinical Assistant41:01 Recertification in the AI Era46:32 Ethics and Prompting50:40 AI Scribing and Guardrails54:35 Coding and Care Gaps57:15 Future of Medical Education01:01:13 Virtual Trials and Wrap-Up01:0Support the show

We're closing out February with Dr. Aisha Harris of Flint, Michigan, a board-certified family physician, community advocate, and the founder of Harris Family Health, the first Direct Primary Care clinic in her hometown. In this episode of My DPC Story, Dr. Harris shares how returning to Flint to open a DPC practice allowed her to practice medicine with purpose - addressing trust, environment, and health literacy upstream while creating real opportunities for prevention, especially around heart and metabolic health. Her journey weaves together entrepreneurship, advocacy, and deep community commitment, showing how Direct Primary Care offers physicians autonomy while strengthening the communities that raised them. We chose Dr. Harris for February because she embodies what it means to practice medicine rooted in service, ownership, and accountability, proving that sustainable, relationship-based care can thrive even in communities shaped by systemic barriers.Get a SmartHeart 12-lead EKG for your DPC with board-certified cardiologists available to help you at the press of a button.Learn more about Zion HealthShare and REGISTER for the LIVE WEBINAR on Feb 13th at 2pm PST. Earn money WHILE running your DPC! Join SERMO for FREE today! Brought to you by SmartHeart: get your copy of the 5-Day Mini Metabolic Health Reset to use with your patients during Heart Health month!Support the showGET your FREE MONTHLY BUSINESS TOOL DOWNLOAD Become A My DPC Story PATREON MEMBER! SPONSOR THE PODMy DPC Story VOICEMAIL! DPC SWAG!FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

Melissa Lavasani & Jay Kopelman join our podcast to discuss how psychedelic policy is actually moving in Washington, DC. Lavasani leads Psychedelic Medicine Coalition, a DC-based advocacy organization focused on educating federal officials and advancing legislation around psychedelic medicine. Kopelman is CEO of Mission Within Foundation, which provides scholarships for veterans and first responders seeking psychedelic-assisted therapy retreats, often outside the United States. The conversation centers on veterans, the VA, and why that system may be the first realistic federal pathway for psychedelic care. Early Themes Lavasani describes PMC's work on Capitol Hill, including hosting events that bring lawmakers, staffers, and advocates into the same room. Her focus is steady engagement. In DC, progress often happens through repeated conversations, not headlines. Kopelman shares his background as a Marine and how his own psychedelic-assisted therapy experience led him to Mission Within. The foundation has funded more than 250 scholarships for veterans and first responders seeking treatment for PTSD, mild traumatic brain injury, depression, and addiction. They connect this work to pending veteran-focused legislation and explain why the VA matters. As a closed health system, the VA can pilot programs, gather data, and refine protocols without the pressures of private healthcare markets. Core Insights A recent Capitol Hill gathering, For Veteran Society, brought together members of Congress and leaders from the psychedelic caucus. Lavasani describes candid feedback from lawmakers. The message was clear: coordinate messaging, avoid fragmentation, and move while bipartisan interest remains. Veteran healthcare is not framed as the final goal. It is a starting point. If psychedelic therapies can demonstrate safety and effectiveness within the VA, broader adoption becomes more plausible. Kopelman raises operational realities that must be addressed: Standardized safety protocols across providers Integration support, not medication alone Clear training pathways for clinicians Real-world data beyond tightly screened clinical trials They also address recent negative headlines involving ibogaine treatment abroad. Kopelman emphasizes the need for shared learning across providers, especially when adverse events occur. Lavasani argues that inconsistency within the ecosystem can slow federal confidence. Later Discussion and Takeaways The discussion widens to federal momentum around addiction and mental health. Lavasani notes that new funding initiatives signal growing openness to innovative treatment models, even if psychedelics are not named explicitly in every announcement. Both guests stress that policy moves slowly by design. Meetings, follow-ups, and relationship building often matter more than public statements. For clinicians, researchers, operators, and advocates, the takeaways are direct: Veterans are likely the first federal pathway Public education remains essential Safety standards must be shared and transparent Integration and workforce development need attention now If psychedelic medicine enters federal systems, infrastructure will determine success. Frequently Asked Questions What do Melissa Lavasani & Jay Kopelman say about VA psychedelic policy? They argue that veteran-focused legislation offers a realistic first federal pathway for psychedelic-assisted care. Is ibogaine currently available through the VA? No. They discuss ibogaine in the context of private retreats and future possibilities, not an existing VA program. Why do Melissa Lavasani & Jay Kopelman emphasize coordination? Lawmakers respond more positively when advocates present aligned messaging and clear priorities. What safety issues are discussed by Melissa Lavasani & Jay Kopelman? They highlight the need for standardized screening, monitoring, integration support, and transparent review of adverse events. Closing Melissa Lavasani & Jay Kopelman provide a grounded look at how psychedelic policy develops inside federal systems. Their message is practical: veterans may be the first lane, but long-term success depends on coordination, safety standards, and sustained engagement. Closing This episode captures a real-time view of how federal policy could shape the next phase of the psychedelic resurgence, especially through veteran-facing legislation and VA infrastructure. Melissa Lavasani & Jay Kopelman argue that coordination, public education, and shared safety standards will shape whether access expands with credibility and care. Transcript Joe Moore: [00:00:00] Hello everybody. Welcome back to Psychedelics Today. Today we have two guests, um, got Melissa Sani from Psychedelic Medicine Coalition. We got Jake Pelman from Mission Within Foundation. We're gonna talk about I bga I became policy on a recent, uh, set of meetings in Washington, DC and, uh, all sorts of other things I'm sure. Joe Moore: But thank you both for joining me. Melissa Lavasani: Thanks for having us. Jay Kopelman: Yeah, it's a pleasure. Thanks. Joe Moore: Yeah. Um, Melissa, I wanna have you, uh, jump in. First. Can you tell us a little bit about, uh, your work and what you do at PMC? Melissa Lavasani: Yeah, so Psychedelic Medicine Coalition is, um, the only DC based Washington DC based advocacy organization dedicated to the advancing the issue of psychedelics, um, and making sure the federal government has the education they need, um, and understands the issue inside out so that they can generate good policy around, around psychedelic medicines. Melissa Lavasani: [00:01:00] Uh, we. Host Hill events. We host other convenings. Our big event every year is the Federal Summit on psychedelic medicine. Um, that's going to be May 14th this year. Um, where we talk about kinda the pressing issues that need to be talked about, uh, with government officials in the room, um, so that we can incrementally move this forward. Melissa Lavasani: Um, our presence here in Washington DC is, is really critical for this issue's success because, um, when we're talking about psychedelic medicines, um, from the federal government pers perspective, you know, they are, they are the ones that are going to initiate the policies that create a healthcare system that can properly facilitate these medicines and make sure, um, patient safety is a priority. Melissa Lavasani: And there's guardrails on this. And, um, you know, there, it's, it's really important that we have. A home base for this issue in Washington DC just [00:02:00] because, uh, this is very complicated as a lot of your viewers probably understand, and, you know, this can get lost in the mix of all the other issues that, um, lawmakers in DC are focused on right now. Melissa Lavasani: And we need to keep that consistent presence here so that this continues to be a priority for members of Congress. Joe Moore: Mm. I love this. And Jay, can you tell us a bit about yourself and mission within Foundation? Jay Kopelman: Yeah, sure. Joe, thanks. Uh, I, I am the CEO of Mission within Foundation. Prior to this, most of my adult life was spent in the military as a Marine. Jay Kopelman: And I came to this. Role after having, uh, a psychedelic assisted therapy experience myself at the mission within down in Mexico, which is where pretty much we all go. Um, we are here to help [00:03:00] provide, uh, access for veterans and first responders to be able to attend psychedelic assisted therapy retreats to treat issues like mild TBI, post-traumatic stress disorder, uh, depression, sometimes addiction at, at a very low level. Jay Kopelman: Um, and, and so we've, we've been doing this for a little more than a year now and have provided 250 plus scholarships to veterans and first responders to be able to access. These retreats and these, these lifesaving medicines. Um, we're also partnered, uh, you may or may not know with Melissa at Psychedelic Medicine Coalition to help advance education and policy, specifically the innovative, uh, therapy Centers of Excellence Act [00:04:00] that Melissa has worked for a number of years on now to bring to both Houses of Congress. Joe Moore: Thank you for that. Um, so let's chat a little bit about what this event was that just, uh, went down, uh, what, what was it two weeks ago at this point? Melissa Lavasani: Yeah. Yeah. It's called For Veteran Society and it's all, um, there's a lot of dialogue on Capitol Hill about veterans healthcare and psychedelics, but where I've been frustrated is that, you know, it was just a lot of. Melissa Lavasani: Talk about what the problems are and not a lot of talk about like how we actually propel things forward. Um, so it, at that event, I thought it was really important and we had three members of Congress there, um, Morgan Latrell, who has been a champion from day one and his time in Congress, um, having gone through the experience himself, um, [00:05:00] at Mission within, um, and then the two chairs of the psychedelic caucus, uh, Lou Correa and Jack Bergman. Melissa Lavasani: And we really got down to the nitty gritty of like w like why this has taken so long and you know, what is actually happening right now? What are the possibilities and what the roadblocks are. And it was, I thought it was a great conversation. Um, we had an interesting kind of dynamic with Latres is like a very passionate about this issue in particular. Melissa Lavasani: Um, I think it was, I think it was really. A great event. And, you know, two days later, Jack Bergman introduced his new bill for the va. Um, so it was kind of like the precursor to that bill getting introduced. And we're just excited for more and more conversations about how the government can gently guide this issue to success. Joe Moore: Hmm. Yeah. [00:06:00] That's fantastic. Um, yeah, I was a little bummed I couldn't make it, but next time, I hope. But I've heard a lot of good things and, um, it's, it sounded like there was some really important messages in, in terms of like feedback from legislators. Yeah. Yeah. Could you speak to that? Melissa Lavasani: Yeah, I mean, I think when, uh, representative Latrell was speaking, he really impressed on us a couple things. Melissa Lavasani: Um, first is that, you know, they really kind of need the advocates to. Coordinate, collaborate and come up with like a, a strategic plan, you know, without public education. Um, talking to members of Congress about this issue is, is really difficult. You know, like PMC is just one organization. We're very little mission within, very little, um, you know, we're all like, kind of new in navigating, um, this not so new issue, but new to Washington DC [00:07:00] issue. Melissa Lavasani: Um, without that public education as a baseline, uh, it's, it's, you have to spend a lot of time educating members of Congress. You know, that's like one of our things is, you know, we have to, we don't wanna tell Congress what direction to go to. We wanna provide them the information so they understand it very intimately and know how to navigate through things. Melissa Lavasani: Um, and secondly. Um, he got pretty frank with us and said, you know, we've got one cha one chance at this issue. And it's like, that's, that's kind of been like my talking point since I started. PMC is like, you have a very limited window, um, when these kind of issues pop up and they're new and they're fresh and you have a lot of the veteran community coming out and talking about it. Melissa Lavasani: And there's a lot of energy there. But now is the time to really move forward, um, with some real legislation that can be impactful. Um, but, you know, we've gotta [00:08:00] be careful. We, we forget, I think sometimes those of us who are in the ecosystem forget that our level of knowledge about these medicines and a lot of us have firsthand experience, um, with these drugs and, and our own healing journeys is, um, we forget that there is a public out there that doesn't have the level of knowledge that we all have. Melissa Lavasani: And, um. We gotta make sure that we're sticking to the right elements of, of, of what needs to happen. We need to be sure that our talking points are on track and we're not getting sideways about anything and going down roads that we don't need to talk about. It's why, um, you know, PMC is very focused on, um, moving forward veteran legislation right now. Melissa Lavasani: Not because we're a veteran organization, but because we're, we see this long-term policy track here. Um, we know where we want to get [00:09:00] to, um. Um, and watching other healthcare issues kind of come up and then go through the VA healthcare system, I think it's a really unique opportunity, um, to utilize the VA as this closed system, the biggest healthcare system in the country to evaluate, uh, how psychedelics operate within systems like that. Melissa Lavasani: And, you know, before they get into, um, other healthcare systems. What do we need to fix? What do we need to pay attention to? What's something that we're paying too much attention to that doesn't necessarily need that much attention? So it's, um, it's a real opportunity to look at psychedelic medicines within a healthcare system and obviously continue to gather the data. Melissa Lavasani: Um, Bergman's Bill emerging, uh, expanding veteran access to emerging treatments. Um, not only mandates the research, it gives the VA authority for this, uh, for running trials and, and creating programs around psychedelic medicines. But also, [00:10:00] one of the great things about it, I think, is it provides an on-ramp for veterans that don't necessarily qualify for clinical trials. Melissa Lavasani: You know, I think that's one of the biggest criticisms of clinical trials is like you're cre you're creating a vacuum for people and people don't live in a vacuum. So we don't necessarily know what psychedelics are gonna look like in real life. Um, but with this expanding veteran access bill that Bergman introduced, it provides the VA an opportunity to provide this access under. Melissa Lavasani: Um, in a, in a safe container with medical supervision while collecting data, um, while ensuring that the veteran that is going through this process has the support systems that it needs. So, um, you know, I think that there's a really unique opportunity here, and like Latrell said, like, we've got one shot at this. Melissa Lavasani: We have people's attention in Congress. Um, now's the time to start acting, and let's be really considerate and thoughtful about what we're doing with it. Joe Moore: Thanks for that, Melissa and Jay, how, [00:11:00] anything to add there on kind of your takeaways from the this, uh, last visit in dc? Jay Kopelman: Yeah, I, I think that Melissa highlighted it really well and there, there were a couple other things that I, I think, you know, you could kind of tie it all together with some other issues that we face in this country, uh, and that. Jay Kopelman: Uh, representative Correa brought up as well, but one of the things I wanted to go back and say is that veterans have kind of led this movement already, right? So, so it's a, it's a good jumping off point, right? That it's something people from both sides of the aisle, from any community in America can get behind. Jay Kopelman: You know, if you think about it, uh, in World War ii, you know, we had a million people serving our population was like, not even 200 million, but now [00:12:00] we have a population of 330 million, and at any given time there might be a million people in uniform, including the Reserve and the National Guard. So it's, it, it's an easy thing to get behind this small part of the population that is willing to sign that contract. Jay Kopelman: Where you are saying, yeah, I'm going to defend my country, possibly at the risk of my l my own life. So that's the first thing. The other thing is that the VA being a closed health system, and they don't have shareholders to answer to, they can take some risks, they can be innovative and be forward thinking in the ways that some other healthcare systems can't. Jay Kopelman: And so they have a perfect opportunity to show that they truly care for their veterans, which don't, I'm not saying they don't, but this would be an [00:13:00] opportunity to show that carrot at a whole different level. Uh, it would allow them to innovate and be a leader in something as, uh, as our friend Jim Hancock will say, you know. Jay Kopelman: When he went to the Naval Academy, they had the world's best shipbuilding program. Why doesn't the VA have the world's best care program for things like TBI and PTSD, which affects, you know, 40 something percent of all veterans, right? So, so there's, there's an opportunity here for the VA to lead from the front. Jay Kopelman: Um, the, these medicines provide, you know, reasonably lasting care where it's kind of a one and done. Whereas with the current systems, the, you know, and, and [00:14:00] again, not to denigrate the VA in any way, they're doing the best job they can with the tools in their toolbox, right? But maybe it's time for a trip to Home Depot. Jay Kopelman: Let's get some new tools. And have some new ways of fixing what's broken, which is really the way of doing things. It's not, veterans aren't broken, we are who we are. Um, but it's a, it's a way to fix what isn't working. So I, I think that, you know, given there's tremendous veteran homelessness still, you know, addiction issues, all these things that do translate to the population at large are things that can be worked on in this one system, the va that can then be shown to have efficacy, have good data, have [00:15:00] good outcomes, and, and take it to the population at large. Joe Moore: Mm-hmm. Brilliant. Thanks for that. And so there was another thing I wanted to pivot to, which is some of the recent press. So we've, um, seen a little bit of press around some, um, in one instance, some bad behavior in Mexico that a FI put out Americans thrive again, put out. And then another case there was a, a recent fatality. Joe Moore: And I think, um, both are tragic. Like we shouldn't be having to deal with this at this point. Um, but there's a lot of things that got us here. Um, it's not necessarily the operator's fault entirely, um, or even at all, honestly, like some medical interventions just carry a lot of risk. Like think, think about like, uh, how risky bypass surgery was in the nineties, right? Joe Moore: Like people were dying a lot from medical interventions and um, you know, this is a major intervention, uh, ibogaine [00:16:00] and also a lot of promise. To help people quite a bit. Um, but as of right now, there's, there's risk. And part of that risk, in my opinion, comes from the inability of organizations to necessarily collaborate. Joe Moore: Like there's no kind of convening body, sitting in the middle, allowing, um, for, and facilitating really good data sharing and learnings. Um, and I don't, I don't necessarily see an organization stepping up and being the, um, the convener for that kind of work. I've heard rumors that something's gonna happen there, and I'm, I'm hopeful I'll always wanna share my opinion on that. Joe Moore: But yeah. I don't know. Jay, from your perspective, is there anything you want to kind of speak to about, uh, these two recent incidents that Americans for Iboga kind of publicized recently? Jay Kopelman: Yeah, so I, I'll echo your sentiment, of course, that these are tragic incidents. Um, and I, [00:17:00] I think that at least in the case of the death at Ambio, AMBIO has done a very good job of talking about it, right? Jay Kopelman: They've been very honest with the information that they have. And like you said, there are risks inherent to these medicines, and it's like anything else in medicine, there are going to be risks. You know, when I went through, uh, when I, when I went through chemo, you know, there were, there are risks. You know, you don't feel well, you get sick. Jay Kopelman: Um, and, and it. There are processes in place to counter that when it happens. And there are processes and, and procedures and safety protocols in place when caring for somebody going through an ibogaine [00:18:00] journey. Uh, when I did it, we had EKG echocardiogram. You're on a heart monitor the entire time they push magnesium via iv. Jay Kopelman: You have to provide a urinalysis sample to make sure that there is nothing in your system that is going to potentially harm you. During the ibogaine, they have, uh, a cardiologist who is monitoring the heart monitors throughout the ibogaine experience. So the, the safety protocols are there. I think it's, I think it's just a matter of. Jay Kopelman: Standardizing them across all, all providers, right? Like, that would be a good thing if people would talk to one another. Um, as, as in any system, right? You've gotta have [00:19:00] some collaboration. You've gotta have standardization, you know, so, you know, they're not called standard operating procedures for nothing. Jay Kopelman: That means that in a, you know, in a given environment, everybody does things the same way. It's true in Navy and Marine Corps, air Force, army Aviation, they have standard operating procedures for every single aircraft. So if you fly, let's say the F 35 now, right? Because it's flown by the Navy, the Marine Corps, and the Air Force. Jay Kopelman: The, the emergency procedures in that airplane are standardized across all three services, so you should have the same, or, you know, with within a couple of different words, the same procedures and processes [00:20:00] across all the providers, right? Like maybe in one document you're gonna change, happy to glad and small dog to puppy, but it's still pretty much the, the same thing. Jay Kopelman: And as a service that provides scholarships to people to go access these medicines and go to these retreats, you know, my criteria is that the, this provider has to be safe. Number one, safety's paramount. It's always gotta be very safe. It should, it has to be effective. And you know, once you have those two things in place, then I have a comfort level saying, okay, yeah, we'll work with this provider. Jay Kopelman: But until those standardized processes are in place, you'll probably see these one-off things. I mean, some providers have been doing this longer than others and have [00:21:00] really figured out, you know, they've, they've cracked the code and, you know, sharing that across the spectrum would be good. Um, but just when these things happen, having a clearing house, right, where everybody can come together and talk about it, you know, like once the facts are known because. Jay Kopelman: To my knowledge, we still don't know all the facts. Like as, you know, as horrible as this is, you still have to talk about like an, has an autopsy been performed? What was found in the patient's system? You know, there, there are things there that we don't know. So we need to, we need to know that before we can start saying, okay, well this is how we can fix that, because we just don't know. Jay Kopelman: And, you know, to their credit, you know, Amio has always been safe to, to the, to the best of my knowledge. You know, I, [00:22:00] I haven't been to Ambio myself, but people that I have worked with have been there. They have observed, they have seen the process. They believe it's safe, and I trust their opinion because they've seen it elsewhere as well. Jay Kopelman: So yeah, having, having that one place where we can all come together when this happens, it, it's almost like it should be mandatory. In the military when there's a training accident, we, you know, we would have to have what's called a safety standout. And you don't do that again for a little while until you figure out, okay, how are we going to mitigate that happening again? Jay Kopelman: Believe me, you can go overboard and we don't want to do that. Like, we don't wanna just stop all care, but maybe stop detox for a week and then come back to it. [00:23:00] Joe Moore: Yeah. A dream would be, let's get like the, I don't know, 10, 20 most popular, uh, or well-known operators together somewhere and just do like a three day debrief. Joe Moore: Hey, everybody, like, here's what we see. Let's work on this together. You know how normal medicine works. And this is, it's hard because this is not necessarily, um, something people feel safe about in America talking about 'cause it's illicit here. Um, I don't understand necessarily how the operations, uh, relate to each other in Mexico, but I think that's something to like the public should dig into. Joe Moore: Like, what, what is this? And I, I'll start digging into that. Um, I, I asked a question recently of somebody like, is there some sort of like back channel signal everybody's using and there's no clear Yes. You know? Um, I think it would be good. That's just a [00:24:00] start, you know, that's like, okay, we can actually kind of say hi and watch out for this to each other. Jay Kopelman: It's not like we don't all know one another, right? Joe Moore: Yes. Jay Kopelman: Like at least three operators we're represented. At the Aspen Ibogaine meeting. So like that could be, and I think there was a panel kind of loosely related to this during Aspen Ibogaine meeting, but Joe Moore: mm-hmm. Jay Kopelman: It, you know, have a breakout where the operators can go sit down and kind of compare notes. Joe Moore: Right. Yeah. Melissa, do you have any, uh, comments on this thread here? And I, I put you on mute if you didn't see that. Um, Melissa Lavasani: all right, I'm off mute. Um, yeah, I think that Jay's hits the nail on the head with the collaboration thing. Um, I think that it's just a [00:25:00] problem across the entire ecosystem, and I think that's just a product of us being relatively new and upcoming field. Melissa Lavasani: Um, uh, it's a product of, you know. Our fundraising community is really small, so organizations feel like they are competing for the same dollars, even though their, their goals are all the same, they have different functions. Um, I think with time, I mean, let's be honest, like if we don't start collaborating and, and the federal government's moving forward, the federal government's gonna coordinate for us. Melissa Lavasani: And not, that might not necessarily be a bad thing, but, you know, we understand this issue to a whole other level that the federal government doesn't, and they're not required to understand it deeply. They just need to know how to really move forward with it the proper way. Um, but I think that it. It's really essential [00:26:00] that we all have this come together moment here so we can avoid things. Melissa Lavasani: Uh, I mean, no one's gonna die from bad advocacy. So like I've, I have a bit of an easier job. Um, but it can a, a absolutely stall efforts, um, to move things forward in Washington DC when, um, one group is saying one thing, another group is saying another thing, like, we're not quite at a point yet where we can have multiple lines of conversation and multiple things moving forward. Melissa Lavasani: Um, you know, for PMC, it's like, just let's get the first thing across the finish line. And we think that is, um, veteran healthcare. And, um, I know there's plenty of other groups out there that, that want the same thing. So, you know, I always, the reason why I put on the Federal Summit last year was I kind of hit my breaking point with a lack of collaboration and I wanted to just bring everyone in the same room and say like, all right, here are the things that we need to talk about. Melissa Lavasani: And I think the goal for this year is, um. To bring people in the same room and say, we talked about [00:27:00] we scratched the surface last year and this is where we need to really put our efforts into. And this is where the opportunities are. Um, I think that is going to, that's going to show the federal government if we can organize ourselves, that they need to take this issue really seriously. Melissa Lavasani: Um, I don't think we've done a great job at that thus far, but I think there's still plenty of time for us to get it together. Um, and I'm hoping with these two, uh, VA bills that are in the house right now and Senate is, is putting together their version of these two bills, um, so that they can move in tandem with each other. Melissa Lavasani: I think that, you know, there's an opportunity here for. Us to show the federal government as an ecosystem, Hey, we, we are so much further ahead and you know, this is what we've organized and here's how we can help you, um, that would make them buy into this issue a bit more and potentially move things forward faster. Melissa Lavasani: Uh, at this point in time, it's, I think that, [00:28:00] you know, psychedelics aren't necessarily the taboo thing that they, they used to be, but there's certainly places that need attention. Um, there's certainly conversations that need to be had, and like I said, like PMC is just one organization that can do this. Um, we can certainly organize and drive forward collaboration, but I, like we alone, cannot cover all this ground and we need the subject matter experts to collaborate with us so we can, you know, once we get in the door, we wanna bring the experts in to talk to these officials about it. Melissa Lavasani: So I. I, I really want listeners to really think about us as a convener of sorts when it comes to federal policy. Um, and you know, I think when, like for example, in the early eighties, a lot of people have made comparisons to the issue of psychedelics to the issue of AIDS research and how you have in a subject matter that's like extremely taboo and a patient population that the government [00:29:00] quite honestly didn't really care about in the early eighties. Melissa Lavasani: But what they did as an ecosystem is really organized themselves, get very clear on what they wanted the federal government to do. And within a matter of a couple years, uh, AIDS research funding was a thing that was happening. And what that, what that did was that ripple effect turned that into basically finding new therapies for something that we thought was a death, death sentence before. Melissa Lavasani: So I think. We just need to look at things in the past that have been really successful, um, and, and try to take the lessons from all of these issues and, and move forward with psychedelics. Joe Moore: Love that. And yes, we always need to be figuring out efficient approaches and where it has been successful in the past is often, um, an opportunity to mimic and, and potentially improve on that. Melissa Lavasani: Yeah. Jay Kopelman: One, one thing I think it's important to add to this part of the conversation is that, [00:30:00] you know, Melissa pointed out there are a number of organizations that are essentially doing the same thing. Jay Kopelman: Um, you know, I like to think we do things a little bit differently at Mission within Foundation in that we don't target any one specific type of service member. We, we work with all veterans. We work with first responders, but. What that leads to is that there are, as far as I've seen, nothing but good intentioned people in this space. Jay Kopelman: You know, people who really care about their patient population, they care about healing, they are trying to do a good job, and more importantly, they're trying to do good. Right? It, it, I think they all see the benefit down the road that this has, [00:31:00] pardon me, not just for veterans, but for society as a whole. Jay Kopelman: And, and ultimately that's where I would like to see this go. You know, I, I would love to see the VA take this. Take up this mantle and, and run with it and provide great data, great outcomes. You know, we are doing some data collection ourselves at Mission within foundation, albeit anecdotal based on surveys given before and after retreats. Jay Kopelman: But we're also working with, uh, Greg Fonzo down at UT Austin on a brain study he's doing that will have 40 patients in it when it's all said and done. And I think we have two more guys to put through that. Uh, and then we'll hit the 40. So there, there's a lot of good here that's being done by some really, really good people who've been doing this for a long time [00:32:00] and want to want nothing more than to, to see this. Jay Kopelman: Come to, come full circle so that we can take care of many, many, many people. Um, you know, like I say, I, I wanna work myself out of a job here. I, I just, I would love to see this happen and then I, you know, I don't have to send guys to Mexico to do this. They can go to their local VA and get the care that they need. Jay Kopelman: Um, but one thing that I don't think we've touched on yet, or regarding that is that the VA isn't designed for that. So it's gonna be a pretty big lift to get the right types of providers into the va with the knowledge, right, with the institutional knowledge of how this should be done, what is safe, what is effective, um, and then it, it's not just providing these medicines to [00:33:00] people and sending them home. Jay Kopelman: You don't just do that, you've gotta have the right therapists on the backend who can provide the integration coaching to the folks who are receiving these medicines. And I'm not just talking, I bga, even with MDMA and psilocybin, you should have a proper period of integration. It helps you to understand how this is going to affect you, what it, what the experience really meant, you know, because it's very difficult sometimes to just interpret it on your own. Jay Kopelman: And so what the experience was and what it meant to you. And, and so it will take some time to spin all that up. But once it's, once it's in place, you know, the sky's the limit. I think. Joe Moore: Kinda curious Jay, about what's, what's going on with Ibogaine at the federal level. Is there anything at VA right now? [00:34:00] Jay Kopelman: At the va? No, not with ibogaine. And, you know, uh, we, we send people specifically for IBOGAINE and five MEO, right? And, and so that, that doesn't preclude my interest in seeing this legislation passed, right? Jay Kopelman: Because it, it will start with something like MDMA or psilocybin, but ultimately it could grow to iboga, right? It the think about the cost savings at, at the va, even with psilocybin, right? Where you could potentially treat somebody with a very inexpensive dose of psilocybin or, or iboga one time, and then you, you don't have to treat them again. Jay Kopelman: Now, if I were, uh, you know, a VA therapist who's not trained in psychedelic trauma therapy. I might be worried [00:35:00] about job security, but it's like with anything, right? Like ultimately it will open pathways for new people to get that training or the existing people to get that training and, and stay on and do that work. Jay Kopelman: Um, which only adds another arrow to their quiver as far as I'm concerned, because this is coming and we're gonna need the people. It's just like ai, right? Like ai, yeah. Some people are gonna lose some jobs initially, and that's unfortunate. But productivity ultimately across all industries will increase and new jobs will be created as a result of that. Jay Kopelman: I mean, I was watching Squawk Box one morning. They were talking about the AI revolution and how there's gonna be a need for 500,000 electricians to. Build these systems that are going to work with the AI [00:36:00] supercomputers and, and so, Joe Moore: mm-hmm. Jay Kopelman: Where, where an opportunity may be lost. I think several more can be gained going forward. Melissa Lavasani: And just to add on what Jay just said there, there's nothing specific going on with Ibogaine at, at the va, but I think this administration is, is taking a real look at addiction in particular. Uh, they just launched, uh, a new initiative, uh, that's really centered on addiction treatments called the Great American Recovery. Melissa Lavasani: And, um, they're dedicating a hundred million dollars towards treating addiction as like a chronic treatable disease and not necessarily a law enforcement issue. So, um, in that initiative there will be federal grant programs for prevention and treatment and recovery. And, um, while this isn't just for psychedelic medicines, uh, I think it's a really great opportunity for the discussion of psychedelics to get elevated to the White House. Melissa Lavasani: Um, [00:37:00] there's also, previous to this announcement last week from the White House, there's been a hundred million dollars that was dedicated at, um, at ARPA h, which is. The advanced research projects, uh, agency for healthcare, um, and that is kind of an agency that's really focused on forward looking, um, treatments and technologies, uh, for, um, a, a whole slew of. Melissa Lavasani: Of issues, but this a hundred million dollars is dedicated to mental health and addiction. So there's a lot of opportunity there as well. So we, while I think, you know, some people are talking about, oh, we need a executive order on Iboga, it's like, well, you know, the, the president is thinking, um, about, you know, what issues can land with his, uh, voting block. Melissa Lavasani: And I think it's, I don't think we necessarily need a specific executive order on Iboga to call this a success. It's like, let's look at what, [00:38:00] um, what's just been announced from the White House. They're, they're all in on. Thinking creatively and finding, uh, new solutions for this. And this is kind of, this aligns with, um, HHS secretaries, uh, Robert F. Melissa Lavasani: Kennedy Junior's goals when he took on this, this role of Health Secretary. Um, addiction has been a discussion that, you know, he has personal, um, a personal tie to from his own experience. And, um, I think when this administration started, there was so much like fervor around the, the dialogue of like, everyone's talking about psychedelics. Melissa Lavasani: It was Secretary Kennedy, it was, uh, secretary Collins at the va. It was FDA Commissioner Marty Macari. And I think that there's like a lot of undue frustration within folks 'cause um, you don't necessarily snap your fingers and change happens in Washington dc This is not the city for that. And it's intentionally designed to move slow so that we can avoid really big mistakes. Melissa Lavasani: Um. [00:39:00] I think we're a year into this administration and these two announcements are, are pretty huge considering, um, you know, the, we, there are known people within domestic policy council that don't, aren't necessarily supportive of psychedelic medicine. So there's a really amazing progress here, and frustrating as it might be to, um, just be waiting for this administration to make some major move. Melissa Lavasani: I think they are making major moves like for Washington, DC These, these are major moves and we just gotta figure out how we can, um, take these initiatives and apply them to the issue of psychedelic medicines. Joe Moore: Thanks, Melissa. Um, yeah, it is, it is interesting like the amount of fervor there was at the beginning. You know, we had, uh. Kind of one of my old lawyers, Matt Zorn, jumped in with the administration. Right. And, um, you know, it was, uh, really cool to [00:40:00] see and hopeful how much energy was going on. It's been a little quiet, kind of feels like a black box a little bit, but I, you know, there was, Melissa Lavasani: that's on me. Melissa Lavasani: Maybe I, we need to be more out in public about like, what's actually happening, because I feel like, like day in and day out, it's just been, you gotta just mm-hmm. Like have that constant beat with the government. Mm-hmm. And, um, it's, it's, it's not the photo ops on the hill, it's the conversations that you have. Melissa Lavasani: It's the dinner parties you go to, it's the fundraisers you attend, you know? Mm-hmm. That's why I, I kind of have to like toot my own horn with PCs. Like, we need to be present here at, at not only on the Hill, not only at the White House, but kind of in the ecosystem of Washington DC itself. There's, it's, there are like power players here. Melissa Lavasani: There are people that are connected that can get things done, like. I mean, the other last week we had a big snow storm. I walked over to my friend's house, um, to have like a little fire sesh with them and our kids, and his next door neighbor came over. He was a member of Congress. I talked about the VA bills, like [00:41:00] we're reaching out to his office now, um, to get them, um, up to speed and hopefully get their co-sponsorship for, uh, the two VA bills. Melissa Lavasani: So, I mean, it, the little conversations you have here are just as important as the big ones with the photo ops. So, um, it, it's, it's really like, you know, building up that momentum and, and finding that time where you can really strike and make something happen. Joe Moore: Mm-hmm. Yeah. Jay, anything to add there? Jay Kopelman: Yeah, I was just gonna say that, you know, I, I, I think the fervor is still there, right? Jay Kopelman: But real life happens. Melissa Lavasani: Yes, Jay Kopelman: yes. And gets in the way, right? So, Melissa Lavasani: yeah, Jay Kopelman: I, I can't imagine how many issues. Secretary Kennedy has every day much less the president. Like there's so many things that they are dealing with on a daily basis, right? It, we, we just have to work to be the squeaky wheel in, in the right way, right. Jay Kopelman: [00:42:00] With the, with the right information at the right time. Like just inundating one of these organizations with noise, it's then it be with Informa, it just becomes noise, right? It it, it doesn't help. So when we have things to say that are meaningful and impactful, we do, and Melissa does an amazing job of that. Jay Kopelman: But, you know, it, it takes time. You know, it's, you know, we're not, this is, this is like turning an aircraft carrier, not a ski boat. Melissa Lavasani: Yeah, Joe Moore: yeah, absolutely. Um, and. It's, it's understandably frustrating, I think for the public and the psychedelic public in particular because we see all this hope, you know, we continue to get frustrated at politics. It's nothing new, right? Um, and we, we wanna see more people get well immediately. [00:43:00] And I, I kind of, Jay from the veteran perspective, I do love the kind of loud voices like, you're making me go to Mexico for this. Joe Moore: I did that and you're making me leave the country for the thing that's gonna fix me. Like, no way. And barely a recognition that this is a valid treatment. You know, like, you know, that is complicated given how medicine is structured here domestically. But it's also, let's face the facts, like the drug war kind of prevented us from being able to do this research in the first place. Joe Moore: You know? Thanks Nixon. And like, how do we actually kind of correct course and say like, we need to spend appropriately on science here so we can heal our own people, including veterans and everybody really. It's a, it's a dire situation out there. Jay Kopelman: Yeah. It, it really is. Um, you know, we were talking briefly about addicts, right? Jay Kopelman: And you know, it's not sexy. People think of addicts as people who are weak-minded, [00:44:00] right? They don't have any self-control. Um, but, but look at, look at the opioid crisis, right? That Brian Hubbard was fighting against in Kentucky for all those years. That that was something that was given to the patient by a doctor that they then became dependent on, and a lot of people died from that. Jay Kopelman: And, and so you, you know, it's, I I don't think it's fair to just put all addicts in a box. Just like it's not fair to put all veterans in a box. Just like it's not fair for doctors, put all their patients in a box. We're individuals. We, we have individual needs. Our, our health is very individual. Like, I, I don't think I should be put in the same box as every other 66-year-old that my doctor sees. Jay Kopelman: It's not fair. [00:45:00] You know, if you, if you took my high school classmates and put us all in a photo, we're all gonna have different needs, right? Like, some look like they're 76, not 66. Some look like they're 56. Not like they're, we, we do things differently. We live our lives differently. And the same is true of addicts. Jay Kopelman: They come to addiction from different places. Not everybody decides they want to just try heroin at a party, and all of a sudden they're addicted. It happens in, in different ways, you know, and the whole fentanyl thing has been so daggum nefarious, right? You know, pushing fentanyl into marijuana. Jay Kopelman: Somebody's smoking a joint and all of a sudden they're addicted to fentanyl or they die. Melissa Lavasani: I think we're having a, Jay Kopelman: it's, it's just not fair to, to say everybody in this pot is the same, or everybody in this one is the same. We have [00:46:00] to look at it differently. Joe Moore: Yeah. I like to zoom one level out and kind of talk about, um, just how hurt we are as a country, as a world really, but as a country specifically, and how many people are out of work for so many. Joe Moore: Difficult reasons and away from their families for so many kind of tragic reasons. And if we can get people back to their families and back to work, a lot of these things start to self-correct, but we have to like have those interventions where we can heal folks and, and get them back. Um, yeah. And you know, everything from trauma, uh, in childhood, you know, adulthood, combat, whatever it is. Joe Moore: Like these things can put people on the sidelines. And Jay, to your point, like you get knee surgery and all of a sudden you're, you know, two years later you're on the hunt for Fentanyl daily. You know, that's tough. It's really tough. Carl Hart does a good job talking about this kind of addiction pipeline and [00:47:00] a few others do as well. Joe Moore: But it's just, you know, kind of putting it in a moral failure bucket. It's not great. I was chatting with somebody about, um, veterans, it's like you come back and you're like, what's gonna make me feel okay right now? And it's not always alcohol. Um, like this is the first thing that made me feel okay, because there's not great treatments and there's, there's a lot of improvements in this kind of like bringing people back from the field that needs to happen. Joe Moore: In my opinion. I, it seems to be shared by a lot of people, but yeah, there's, it's, it's, IGA is gonna be great. It's gonna be really important. I really can't wait for it to be at scale appropriately, but there's a lot of other things we need to fix too, um, so that we can just, you know, not have so many people we need to, you know, spend so much money healing. Joe Moore: Mm-hmm. Jay Kopelman: Yeah. You ahead with that. We don't need the president to sign an executive order to automatically legalize Ibogaine. Right. But it would be nice if he would reschedule it so that [00:48:00] then then researchers could do this research on a larger scale. You know, we could, we could now get some real data that would show the efficacy. Jay Kopelman: And it could be done in a safe environment, you know? And, and so that would be, do Joe Moore: you have any kind of figures, like, like, I've been talking about this for a while, Jay. Like, does it drop the cost a lot of doing research when we deschedule things? Jay Kopelman: I, I would imagine so, because it'll drop the cost of accessing the medicines that are being researched. Jay Kopelman: Right? You, you would have buy-in from more organizations. You know, you might even have a pharma company that comes into this, you know, look at j and j with the ketamine, right? They have, they have a nasal spray version of ketamine that's doing very well. I mean, it's probably their, their biggest revenue [00:49:00] provider for them right now. Jay Kopelman: And, and so. You know, you, it would certainly help and I think, I think it would lower costs of research to have something rescheduled rather than being schedule one. You know it, people are afraid to take chances when you're talking about Schedule one Melissa Lavasani: labs or they just don't have the money to research things that are on Schedule one. Melissa Lavasani: 'cause there's so much in an incredible amount of red tape that you have to go through and, and your facility has to be a certain way and how you contain those, uh, medicines. Oh, researching has to be in a specific container and it's just very cumbersome to research schedule one drugs. So absolutely the cost would go down. Melissa Lavasani: Um, but Joe Moore: yeah, absolutely. Less safes. Melissa Lavasani: Yeah. Joe Moore: Yes. Less uh, Melissa Lavasani: right. Joe Moore: Locked. Yeah. Um, it'll be really interesting when that happens. I'm gonna hold out faith. That we can see some [00:50:00] movement here. Um, because yeah, like why make healing more expensive than it needs to be? I think like that's potentially a protectionist move. Joe Moore: Like, I'm not, I'm not here yet, but, um, look at AbbVie's, uh, acquisition of the Gilgamesh ip. Mm-hmm. Like that's a really interesting move. I think it was $1.2 billion. Mm-hmm. So they're gonna wanna protect that investment. Um, and it's likely going to be an approved medication. Like, I don't, I don't see a world in which it's not an approved medication. Joe Moore: Um, you know, I don't know a timeline, I would say Jay Kopelman: yeah. Joe Moore: Less than six years, just given how much cash they've got. But who knows, like, I haven't followed it too closely. So, and that's an I bga derivative to be clear, everybody, um mm-hmm. If you're not, um, in, in the loop on that, which is hopeful, you know? Joe Moore: Mm-hmm. But I don't know what the efficacy is gonna be with that compared to Ibogaine and then we have to talk about the kind of proprietary molecule stuff. Um, there's like a whole bunch of things that are gonna go on here, and this is one of the reasons why I'm excited about. Federal involvement [00:51:00] because we might actually be able to have some sort of centralized manufacturer, um, or at least the VA could license three or four generic manufacturers per for instance, and that way prices aren't gonna be, you know, eight grand a dose or whatever. Joe Moore: You know, it's, Jay Kopelman: well, I think it's a very exciting time in the space. You know, I, I think that there's the opportunity for innovation. There is the opportunity for collaboration. There's the opportunity for, you know, long-term healing at a very low cost. You know, that we, we have the highest healthcare cost per capita in the world right here in the us. Jay Kopelman: And, and yet we are not the number one health system in the world. So to me, that doesn't add up. So we need to figure out a way to start. Bringing costs down for a lot of people and [00:52:00] at the same time increasing, increasing outcomes. Joe Moore: Absolutely. Yeah. There's a lot of possible outcome improvements here and, and you know, everything from relapse rates, like we hear often about people leaving a clinic and they go and overdose when they get home. Tragically, too common. I think there's everything from, you know, I'm Jay, I'm involved in an organization called the Psychedelics and Pain Association. Joe Moore: We look at chronic pain very seriously, and IGA is something we are really interested in. And if. We could have better, you know, research, there better outcome measures there. Um, you know, perhaps we can have less people on opioids to begin with from chronic pain conditions. Um, Jay Kopelman: yeah, I, I might be due for another Ibogaine journey then, because I deal with chronic pain from Jiujitsu, but, Joe Moore: oh gosh, let's Jay Kopelman: talk Joe Moore: later. Jay Kopelman: That's self inflicted. Some people would say take a month off, but Melissa Lavasani: yeah, Jay Kopelman: I'm [00:53:00] not, I'm not that smart. Joe Moore: Yeah. Um, but you know, this, uh, yeah, this whole thing is gonna be really interesting to see how it plays out. I'm endlessly hopeful pull because I'm still here. Right. I, I've been at this for almost 10 years now, very publicly, and I think we are seeing a lot of movement. Joe Moore: It's not always what we actually wanna see, but it is movement nonetheless. You know, how many people are writing on this now than there were before? Right. You know, we, we have people in New York Times writing somewhat regularly about psychedelics and. Even international media is covering it. What do we have legalization in Australia somewhat recently for psilocybin and MDMA, Czech Republic. Joe Moore: I think Germany made some moves recently. Mm-hmm. Um, really interesting to see how this is gonna just keep shifting. Um Jay Kopelman: mm-hmm. Joe Moore: And I think there's no way that we're not gonna have prescription psychedelics in three years in the United States. It pro probably more like a [00:54:00] year and a half. I don't know. Do you, are you all taking odds? Melissa Lavasani: Yeah. I mean, I think Jay Kopelman: I, I gotta check Cal sheet, see what they're saying. Melissa Lavasani: I think it's safe to say, I mean, this could even come potentially the end of this year, I think, but definitely by the end of 2027, there's gonna be at least one psychedelic that's FDA approved. Joe Moore: Yeah. Yeah. Melissa Lavasani: If you're not counting Ketamine. Joe Moore: Right. Jay Kopelman: I, I mean, I mean it mm-hmm. It, it doesn't make sense that it. Shouldn't be or wouldn't be. Right. The, we've seen the benefits. Mm-hmm. We know what they are. It's at a very low cost, but you have to keep in mind that these things, they need to be done with the right set setting and container. Right. And, and gotta be able to provide that environment. Jay Kopelman: So, but I would, I would love, like I said, I'd love to work myself out of a job here and see this happen, not just for our veterans, [00:55:00] but for everybody. Joe Moore: Mm-hmm. Um, so Melissa, is there a way people can get involved or follow PMC or how can they support your work at PMC? Melissa Lavasani: Yeah, I mean, follow us in social media. Melissa Lavasani: Um, our two biggest platforms are LinkedIn and Instagram. Um, I'm bringing my newsletter back because I'm realizing, um, you know, there is a big gap in, in kind of like the knowledge of Washington DC just in general. What's happening here, and I think, you know, part of PC's value is that we're, we are plugged into conversations that are being had, um, here in the city. Melissa Lavasani: And, you know, we do get a little insight. Um, and I think that that would really quiet a lot of, you know, the, a lot of noise that, um, exists in the, our ecosystem. If, if people just had some clarity on like, what's actually happening or happening here and what are the opportunities and, [00:56:00] um, where do we need more reinforcement? Melissa Lavasani: Um, and, and also, you know, as we're putting together public education campaign, you know. My, like, if I could get everything I wanted like that, that campaign would be this like multi-stakeholder collaborative effort, right? Where we're covering all the ground that we need to cover. We're talking to the patient groups, we're talking to traditional mental health organizations, we're talking to the medical community, we're talking to the general population. Melissa Lavasani: I think that's like another area that we, we just seem to be, um, lacking some effort in. And, you know, ultimately the veteran story's always super compelling. It pulls on your heartstrings. These are our heroes, um, of our country. Like that, that is, that is meaningful. But a lot of the veteran population is small and we need the, like a, the just.[00:57:00] Melissa Lavasani: Basic American living in middle America, um, understanding what psychedelics are so that in, in, in presenting to them the stories that they can relate to, um, because that's how you activate the public and you activate the public and you get them to see what's happening in these clinical trials, what the data's been saying, what the opportunities are with psychedelics, and then they start calling their members of Congress and saying, Hey, there is this. Melissa Lavasani: Bill sitting in Congress and why haven't you signed onto it? And that political pressure, uh, when used the right way can be really powerful. So, um, I think, you know, now we're at this really amazing moment where we have a good amount of congressional offices that are familiar enough with psychedelics that they're willing to move on it. Melissa Lavasani: Um, there's another larger group, uh, that is familiar with psychedelics and will assist and co-sponsor legislation, but there's still so many offices that we haven't been able to get to just 'cause like we don't have all the time in the world and all the manpower in the world to [00:58:00] do it. But, you know, that is one avenue is like the advocates can speak to the, the lawmakers, the experts speak to the lawmakers, and we not, we want the public engaged in this, you know, ultimately, like that's. Melissa Lavasani: Like the best form of harm reduction is having an informed public. So we are not, they're not seeing these media headlines of like, oh, this miracle cure that, um, saved my family. It's like, yes, that can happen psychedelics. I mean, person speaking personally, psychedelics did save my family. But what you miss out of that story is the incredible amount of work I put into myself and put into my mental health to this day to maintain, um, like myself, my, my own agency and like be the parent that I wanna be and be the spouse that I wanna be. Melissa Lavasani: So, um, we, we need to continue to share these stories and we need to continue to collaborate to get this message out because we're all, we're all in the same boat right now. We all want the same things. We want patients to have safe and [00:59:00] affordable access to psychedelic assisted care. Um, and, uh. We're just in the beginning here, so, um, sign up for our newsletter and we can sign up on our website and then follow us on social media. Melissa Lavasani: And, um, I anticipate more and more events, um, happening with PMC and hopefully we can scale up some of these events to be much more public facing, um, as this issue grows. So, um, I'm really excited about the future and I'm, I've been enjoying this partnership with Mission Within. Jay is such a professional and, and it really shows up when he needs to show up and, um, I look forward to more of that in the future. Joe Moore: Fantastic. And Jay, how can people follow along and support mission within Foundation? Jay Kopelman: Yeah, again, social media is gonna be a good way to do that. So we, we are also pretty heavily engaged on LinkedIn and on Instagram. Um, I do [01:00:00] share, uh, a bit of my own stuff as well. On social media. So we have social media pages for Mission within Foundation, and we have a LinkedIn page for mission within foundation. Jay Kopelman: I have my own profiles on both of those as well where people can follow along. Um, one of the other things you know that would probably help get more attention for this is if the general public was more aware of the numbers of professional athletes who are also now pursuing. I began specifically to help treat their traumatic brain injuries and the chronic traumatic encephalopathy that they've, uh, suffered as a result of their time in professional sports or even college sports. Jay Kopelman: And, you know. I people worship these athletes, and I [01:01:00] think that if more of them, like Robert Gall, were more outspoken about these treatments and the healing properties that they've provided them, that it would get even more attention. Um, I think though what Melissa said, you know, I don't wanna parrot anything she just said because she said it perfectly Right. Jay Kopelman: And I'd just be speaking to hear myself talk. Um, but being collaborative the way that we are with PMC and with Melissa is I think, the way to move the needle on this overall. And like she said, if she could get more groups involved in, in these discussions, it would, it would do wonders for us. Joe Moore: Well, thank you both so much for your hard work out there. I always appreciate it when people are showing up and doing this important, [01:02:00] sometimes boring and tedious, but nevertheless sometimes, sometimes exciting work. And um, so yeah, just thank you both and thank you both for showing up here to psychedelics today to join us and I hope we can continue to support you all in the future. Jay Kopelman: Thank you, Joe. Thank you, Joe. It's a pleasure being with you today and with Melissa, of course, always Melissa Lavasani: appreciate the time and space. Joe Moore: Thanks.  

In this episode of Parallax, Dr Ankur Kalra welcomes Dr Rakesh Shah, a former interventional cardiologist, Oxford MBA graduate, and founder of DRS.LINQ. Dr Shah brings a unique perspective on addressing critical delays in heart attack diagnosis through the intersection of clinical medicine, engineering, and business strategy. The conversation explores a pressing challenge in cardiovascular care: the majority of cardiac damage occurs within the first hour of symptom onset, yet treatment activation often takes several hours. Dr Shah introduces mHeart, a mobile EKG platform designed to create a "virtual cardiology office." Unlike consumer wearables that lack critical chest leads, this technology enables patients to initiate comprehensive cardiac evaluation anywhere—at home, at work, or while traveling—transmitting diagnostic-quality data directly to cardiologists. The episode delves into Dr Shah's diverse career path and offers candid advice for physician-entrepreneurs, emphasizing the importance of collaboration with professional business leaders to achieve scalability. Looking ahead, Dr Shah discusses the integration of AI and machine learning into mobile diagnostic platforms as essential tools for an aging workforce and overstretched healthcare system. Questions and comments can be sent to "podcast@radcliffe-group.com" and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

In this previously aired episode of My DPC Story, host Maryal Concepcion sits down with Dr. Jalan Burton, a Washington, DC/DMV–based pediatrician practicing at the intersection of healthcare policy and deeply relational care. As the founder of Healthy Home Pediatrics, Dr. Burton shares how Direct Primary Care allows her to deliver unrushed, home-based pediatric care in a policy-dense environment while protecting both physician autonomy and patient trust. Her story highlights values-driven medicine, proactive cardiovascular and metabolic health conversations for children, and the power of designing a practice that supports families and physician wellbeing. We chose Dr. Burton for February because her journey reflects intentional, equity-centered care at the crossroads of policy and practice and later this season, we'll be bringing you an update as her DPC story continues to evolve!Get a SmartHeart 12-lead EKG for your DPC with board-certified cardiologists available to help you at the press of a button.Learn more about Zion HealthShare and REGISTER for the LIVE WEBINAR on Feb 13th at 2pm PST. Earn money WHILE running your DPC! Join SERMO for FREE today! Brought to you by SmartHeart: get your copy of the 5-Day Mini Metabolic Health Reset to use with your patients during Heart Health month!Support the showGET your FREE MONTHLY BUSINESS TOOL DOWNLOAD Become A My DPC Story PATREON MEMBER! SPONSOR THE PODMy DPC Story VOICEMAIL! DPC SWAG!FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

In this episode of My DPC Story, we're highlighting Dr. Adelola "Lola" Ashaye, a board-certified family and lifestyle medicine physician and the founder of InTouch Primary Care in the Sugar Land area of Texas. Practicing in one of the most complex healthcare markets in the country, Dr. Ashaye shares how Direct Primary Care protects physician autonomy while expanding access for patients, creating space for meaningful conversations around prevention, metabolic health, and long-term outcomes. Her journey, shaped by experiences with fragmented care, immigration barriers, and burnout in fee-for-service medicine, is a powerful reminder that physicians of color don't have to conform to broken systems to build sustainable, patient-centered practices. As part of our Heart Health Month focus, be sure to download your free copy of the 5-Day Metabolic Health Mini Reset brought to you by SmartHeart, a DPC-aligned tool designed to support preventive, relationship-based care and help patients engage with metabolic and cardiovascular health in a practical, non-overwhelming way.Get a SmartHeart 12-lead EKG for your DPC with board-certified cardiologists available to help you at the press of a button.Learn more about Zion HealthShare and REGISTER for the LIVE WEBINAR on Feb 13th at 2pm PST. Brought to you by SmartHeart: get your copy of the 5-Day Mini Metabolic Health Reset to use with your patients during Heart Health month! REGISTER for the upcoming LIVE WEBINAR Feb 13th 2pm PST about Zion HealthShare.Support the showGET your FREE MONTHLY BUSINESS TOOL DOWNLOAD Become A My DPC Story PATREON MEMBER! SPONSOR THE PODMy DPC Story VOICEMAIL! DPC SWAG!FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

Emergency medicine has an interruption-based workflow. There's no getting around some of that, but recurrent interruptions erode quality of care, accuracy of documentation, concentration, and ultimately the ability to leave work on time. While some interruptions are unavoidable, most are predictable and preventable. Reclaiming control over interruptions is more than a way to improve efficiency; it's about patient safety, reducing medical errors, and safeguarding your mental health. Constant task switching creates cognitive load, contributing to emergency physician burnout and compromising clinical decision-making.In this episode, we explore tactical and mindset shifts that emergency clinicians can use to reduce interruptions, enhance documentation efficiency, and avoid the hidden costs of task switching. We'll cover practical strategies for managing EKG interruptions, skillful ways to manage nursing questions, and setting boundaries all while maintaining team dynamics and patient care quality. Whether you're an emergency physician, PA, NP, or resident, these evidence-based strategies will help you work smarter, reduce stress, and reclaim control of your clinical day.Finishing emergency department shifts with a stack of charts to complete gets old fast. This chart debt also contributes to burnout.We will help you break bad habits and equip you with the skills to walk out the door unencumbered.Out-On-Time is a course for emergency physicians and clinicians that teaches shift efficiency and real-time documentation, enabling you to write fast, focused charts that bill well and are medicolegally sound.Learn More About The Out-On-Time Course We Discuss:The Cost of Interruptions in Emergency MedicineNot All Interruptions Are UrgentThe Cognitive Cost of Task SwitchingBecoming a Non-Interruptible ClinicianDeferring Without Alienating Your TeamProtecting Focus at the End of the ShiftFixing the EKG Interruption ProblemAsynchronous Communication That Actually Works

Welcome back to our weekend Cabral HouseCall shows!   This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track!   Check out today's questions:    Will: Hi Dr Cabral, Thank you for giving us the opportunity to ask you questions. I've learned so much from other people's questions! I have two of my own. 1. Regarding your past podcast on the importance of broccoli and garlic. I travel a lot for work. When I travel and can't get broccoli or garlic, would it be ok to take a broccoli and garlic supplement. ? 2. I recently purchased the equililife mushroom supplement. Do you recommend taking it all year round or just in the winter. Thanks so much! Will   Carol: Dr Cabral, I would like to start by thanking you for all the information you freely give. I've been listening to your podcast almost since it started and I have been able to make positive changes in my life and my family's. I am a healthy, active 62 year old woman. I walk 5 to 10 miles most days. I do strength training 3 to 5 times a week plus cardio a couple days a week. Through diet and exercise I have been able to maintain my weight most of my adult life. If my weight started to go up I would make adjustments in my diet (which was usually from getting sloppy with my diet). Since 2017 I've done your detox at least 3 times a year (I just haven't been able to swing 4), and they usually help me lose the few pounds I gained and put me back on track with my eating. For the last few years, however, my weight has been creeping up higher and nothing (not even the detoxes) have helped me lose the added weight. I've tried everything I could think of, but my weight continues to go up instead of down. I went through menopause 10 years ago. I'm at a loss at what to do, but I definitely don't want to continue to gain weight. Do you have any thoughts or suggestions? Thank you, Carol                                                                                                                                                                                  Mohamed: Good morning to you Doctor Cabral and all the listeners. Grateful for all that you do. My question is regarding a sort of pinch like feeling on my left side (near heart). On and off randomly.. did blood work and EKG (normal findings). Ran minerals and Metals.. on the higher side for K & N.. Mg green and Calcium (leaning towards high). Other minerals were low, except phosphorus (slightly high) Noticing bloating after meals.. could leaky gut be related to the occasional pinch feeling I get… it's either that or cortisol.. Which lab should I run (can only do 1).. Taking Omega3 support, DNS, Magnesium and exercising twice a week.. I'm a 27 year old man. Noticing new onset fatigue, bloating.. A bit worried about my heart.. thanks.. What can help, proteolytic enzymes, Apple cider Vinegar before meals. Or B vitamins. Thoughts?    Cheryl: Morning, My 73 year old dad has type 2 diabetes. He is otherwise in good health, an active golfer, is about 165lbs and walks daily. My parents are old school and believe everything the dr says. Recently, his dr just uped his metformin to 2x a day from 1x and put him on a pill for his A1C. I am annoyed that the meds are just increased instead of looking at the root cause. They recently saw a dietician who said it is not reversable which I know is not at all true. My mom cooks healthy meals but my dad does have a sweet tooth. When he wants something sweet it is often sugar/free which is terrible and full of chemicals. I do not agree with all of the sugar free stuff/sweetners and try go get them to choose different things-monkfruit/coconut sugar but the dietician recommended the splenda type stuff. would love to help my dad reverse this. Any suggestions where to start would be appreciated. Thank you:)    Elizabeth: Hi Dr Cabral! Thank you for the amazing work that you do! My 80 year old mother has been experiencing consistent burning mouth syndrome for the past 12 years. She had tried all the conventional methods, gabapentin, CT scan etc and nothing has helped. I recently read that the drop in estrogen during menopause could be the cause. What do you think and any recommendations? Thanks again!    Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!    - - - Show Notes and Resources: StephenCabral.com/3648 - - - 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!