Podcasts about Eustachian

The Life Group as a Human Form or Collective Person The human form is the Divine form, and is that which comes into being as the only possible expression of the Lord's life within those He is creating. This means that on the largest or smallest scale of creation all is organised or strives towards a more complete and thereby perfect, human form. In Heaven and Hell 73 it's explained that “Heaven in its whole complex resembles one man, as does any one society in heaven. From the sequence of reasons there set forth, it follows that this is equally true of each angel. As heaven is man in the greatest form, and a society of heaven in a less form, so is an angel in the least form. For, in the most perfect form such as that of heaven is, there is a likeness of the whole in the part and of the part in the whole”    Although we can relate to being supported by the Text at the level of our personal work, the idea that we are part of a collective human being that takes form as we meet together can be rather abstract, and difficult to grasp. The descriptions of heaven as a Grand Human composed of countless societies, with each society being a fully functioning human form composed of individual angels, provides an illustration of how the group can be, and of our function and use in it. This requires a perceptual shift where our sense of person expands from being limited to a single individual to incorporate many individuals functioning as one, in support of a common use. Expanding our sense of what actually constitutes a human being is important to contemplate and asks where our sense of self sits in relation to that. Logopraxis group life is concerned to provide an environment that leads us towards an ever-deepening sense of the Lord in our collective midst, as the Word. The more conscious we are of working - not only for ourselves, but for others in the group, and for the group as a whole - the deeper will become our sense of spiritual community; and the spiritual literacy skills and methods discussed throughout the Workbook are very much part of this shift in environment. The Lord is looking to be present in our midst, and He is present when the things of the Word are made the basis for our being together. The collective human that forms when a Life Group meets together is brought into being as we share our direct experience of the Word working in our lives; forming a sacred space where the Word can be known as the Lord.               “By the Lord's name is meant the Word, for the Lord is the Word” (Arcana Coelestia 5502; John 1:1) In the very act of meeting, what we bring from our experience of the Word's operation in our life becomes a live conjoining presence, creating connections: Between individuals in the group Between the group and the spiritual world Between the group and the Lord It is this lived experience of the Word, when shared with others, that serves as the soul or life of the group. It's what connects each to the other. Arcana Colestia 7359 Spirits from thence came to me, and applied themselves to my left temple, and there breathed on me with their speech, but I did not understand it. It was soft in its flow, nor do I remember ever to have perceived a softer, it being like the softest aura. It breathed first upon the left temple, and the left ear from above; and the breathing extended thence to the left eye, and by little and little to the right, and then flowed downward, especially from the left eye, to the lips; and when it was at the lips, it entered through the mouth, and by a way within the mouth, in fact by the Eustachian tube, into the brain. When the breathing came thither, I then understood their speech, and it was given me to talk with them. While they were talking with me I observed that my lips moved, and my tongue also a little, because of the correspondence of interior speech with exterior. Exterior speech is that of articulate sound falling toward the external...

Excerpt from the Logopraxis Workbook: Logopraxis Life Groups are an opportunity to practise spiritual literacy as we speak and listen when we meet. They are a hermetically sealed container within which the material gathered from each individual's practice can serve as the basis for creating a unique environment. It is where we may learn to be with others in a new way, and where the practise of the Word is what is central. To that end, participants are asked to be consciously present to what arises as they take part in group life through the practise of what are termed spiritual literacy ‘skills'. Each of the skills is designed to assist us in engaging in group life consciously, and be present so as to bear witness to what's arising within our minds as we speak and listen. It is the call to a different way of being with ourselves, with others, and with the Word as the Lord. So, in order to hear the Lord, which really is about hearing the spiritual principles that are being illustrated in each other's experience, we need to be able to divide our attention between what's going on externally in the group, and what is arising inwardly so far as our responses are concerned. It's not so much about listening to the words that a person is speaking, but listening to what arises within us in response to what's being shared. So, it's a state of divided attention, where we are working to be conscious of the fact that we are seeing our own states reflected back to us in what is being presented through our interactions with the Word and with others. Arcana Coelestia 7359 Spirits from thence came to me, and applied themselves to my left temple, and there breathed on me with their speech, but I did not understand it. It was soft in its flow, nor do I remember ever to have perceived a softer, it being like the softest aura. It breathed first upon the left temple, and the left ear from above; and the breathing extended thence to the left eye, and by little and little to the right, and then flowed downward, especially from the left eye, to the lips; and when it was at the lips, it entered through the mouth, and by a way within the mouth, in fact by the Eustachian tube, into the brain. When the breathing came thither, I then understood their speech, and it was given me to talk with them. While they were talking with me I observed that my lips moved, and my tongue also a little, because of the correspondence of interior speech with exterior. Exterior speech is that of articulate sound falling toward the external membrane of the ear, and thence by means of little organs, membranes, and fibers, which are within the ear, being conveyed to the brain. Third Round posts are short audio clips taken from Round 3 comments offered in the online Logopraxis Life Group meetings. The aim is to keep the focus on understanding the Text in terms of its application to the inner life along with reinforcing any key LP principles that have been highlighted in the exchanges.

In this episode I discuss the benefits of tiered pricing in you Salon Spa or Clinic. If you would like to attend my FREE webinar on Tuesday 8th of April 2025 where I will do a deep dive on this topic, just CLICK HEREMY OTHER FREE STUFFSalon Success Playbook https://salonsuccessplaybook.comFacebook https://www.facebook.com/lisaconwayzing/Instagram https://www.instagram.com/lisa.conway_/TikTok https://www.tiktok.com/@lisa_salonmentor MY PAID STUFFMy Healthy, Wealthy and Kind Retreats in Bali   https://healthywealthykindretreat.comLisa Conway's Reboot Your Salon 28-Day Challenge  https://salonreboot.com/ MY BOOKSThe Naked Salon, Your Salon Team, and Your Salon Retail Are essential reading for Salon owners are available in Paperback or Audio at Amazon, Audible, Kindle or from my store. https://www.thenakedsalon.com To contact Lisa, just reach out to jess@zingcoach.com.au

And seven days were fulfilled after that Jehovah had smitten the river. And Jehovah said unto Moses, Come unto Pharaoh, and say unto him, Thus saith Jehovah, Let My people go, that they may serve Me. And if thou refuse to let them go, behold I will smite all thy border with frogs; and the river shall make frogs to creep forth, and they shall go up and come into thy house, and into thy bed-chamber, and upon thy bed, and into the house of thy servants and of thy people, and into thine ovens, and into thy kneadingtroughs; and on thee, and on thy people, and on all thy servants, shall the frogs come up. Exodus 7: 25-29 Arcana Coelestia 7345: “And seven days were fulfilled after that Jehovah had smitten the river,” signifies the end of that state after truths had been falsified; “and Jehovah said unto Moses” signifies new instruction “Come unto Pharaoh, and say unto him,” signifies a command to those who infest; “Thus saith Jehovah, Let My people go, that they may serve Me,” signifies that they should leave those who are of the church to worship their God in freedom; “and if thou refuse to let them go,” signifies if they would not leave them; “behold I will smite all thy border with frogs,” signifies reasonings from mere falsities; “and the river shall make frogs to creep forth,” signifies that there will be reasonings from these falsities; “and they shall go up and come into thy house, and into thy bed-chamber,” signifies that they shall fill the mind even to its interiors; “and upon thy bed,” signifies to the inmosts; “and into the house of thy servants, and of thy people,” signifies all things that are in the natural; “and into thine ovens, and into thy kneadingtroughs,” signifies into the delights of cupidities; “and on thee, and on thy people, and on all thy servants, shall the frogs come up,” signifies that reasonings from falsities shall be in all things both in general and in particular. True Christian Religions 11(3). Faith in God enters into a man by an inner way, from the soul into the higher parts of the understanding. Knowledge concerning God, from which are formed conceptions of Him, enters by an outer way, because it is derived from the revealed Word by the understanding through the senses of the body. Both these forms of influx meet midway in the understanding. There natural faith, which is merely persuasion, becomes spiritual faith, which is real acknowledgment: the human understanding therefore, is, as it were, a place of exchange, or a refining vessel, in which the change takes place. AC 7359 Spirits from thence came to me, and applied themselves to my left temple, and there breathed on me with their speech, but I did not understand it. It was soft in its flow, nor do I remember ever to have perceived a softer, it being like the softest aura. It breathed first upon the left temple, and the left ear from above; and the breathing extended thence to the left eye, and by little and little to the right, and then flowed downward, especially from the left eye, to the lips; and when it was at the lips, it entered through the mouth, and by a way within the mouth, in fact by the Eustachian tube, into the brain. When the breathing came thither, I then understood their speech, and it was given me to talk with them. While they were talking with me I observed that my lips moved, and my tongue also a little, because of the correspondence of interior speech with exterior. Exterior speech is that of articulate sound falling toward the external membrane of the ear, and thence by means of little organs, membranes, and fibers, which are within the ear, being conveyed to the brain. Third Round posts are short audio clips taken from Round 3 comments offered in the online Logopraxis Life Group meetings. The aim is to keep the focus on understanding the Text in terms of its application to the inner life along with reinforcing any key LP principles that have been highlighted in the exchanges.

Each week I am going to read a chapter of my book The Naked Salon and talk about how I got there, and how you can put what you hear into action. This week - Chapter 20, the last chapter. On February 25, I am running a FREE Masterclass on how to Successfully transfer your client's to your team. To register click on this link, https://thesalonmentors.com/2025-masterclass MY OTHER FREE STUFFSalon Success Playbook https://salonsuccessplaybook.comFacebook https://www.facebook.com/lisaconwayzing/Instagram https://www.instagram.com/lisa.conway_/TikTok https://www.tiktok.com/@lisa_salonmentor MY PAID STUFFMy Healthy, Wealthy and Kind Retreats in Bali   https://healthywealthykindretreat.comLisa Conway's Reboot Your Salon 28-Day Challenge  https://salonreboot.com/ MY BOOKSThe Naked Salon, Your Salon Team, and Your Salon Retail Are essential reading for Salon owners are available in Paperback or Audio at Amazon, Audible, Kindle or from my store. https://www.thenakedsalon.comTo contact Lisa, just reach out to jess@zingcoach.com.au

Each week I am going to read a chapter of my book The Naked Salon and talk about how I got there, and how you can put what you hear into action. This week - Chapter 19. Tomorrow  I am running a FREE Masterclass on how to Successfully transfer your client's to your team. To register click on this link, https://thesalonmentors.com/2025-masterclass MY OTHER FREE STUFFSalon Success Playbook https://salonsuccessplaybook.comFacebook https://www.facebook.com/lisaconwayzing/Instagram https://www.instagram.com/lisa.conway_/TikTok https://www.tiktok.com/@lisa_salonmentor MY PAID STUFFMy Healthy, Wealthy and Kind Retreats in Bali   https://healthywealthykindretreat.comLisa Conway's Reboot Your Salon 28-Day Challenge  https://salonreboot.com/ MY BOOKSThe Naked Salon, Your Salon Team, and Your Salon Retail Are essential reading for Salon owners are available in Paperback or Audio at Amazon, Audible, Kindle or from my store. https://www.thenakedsalon.comTo contact Lisa, just reach out to jess@zingcoach.com.au 

In this episode I discuss how important it is for your  Salon, Spa or Clinic for you to be HEALTHY - it's just makes sense!  If you would like to checkout my Healthy Wealthy and Kind Retreat in Bali in August 2025 click on the link, there are only a few spots left so hurry as we always sell out.  https://healthywealthykindretreat.com MY OTHER FREE STUFFSalon Success Playbook https://salonsuccessplaybook.comFacebook https://www.facebook.com/lisaconwayzing/Instagram https://www.instagram.com/lisa.conway_/TikTok https://www.tiktok.com/@lisa_salonmentor MY PAID STUFFMy Healthy, Wealthy and Kind Retreats in Bali   https://healthywealthykindretreat.comLisa Conway's Reboot Your Salon 28-Day Challenge  https://salonreboot.com/ MY BOOKSThe Naked Salon, Your Salon Team, and Your Salon Retail Are essential reading for Salon owners are available in Paperback or Audio at Amazon, Audible, Kindle or from my store. https://www.thenakedsalon.comTo contact Lisa, just reach out to jess@zingcoach.com.au

Each week I am going to read a chapter of my book The Naked Salon and talk about how I got there, and how you can put what you hear into action. This week - Chapter 17. On February 25, I am running a FREE Masterclass on how to Successfully transfer your client's to your team. To register click on this link, https://thesalonmentors.com/2025-masterclass MY OTHER FREE STUFFSalon Success Playbook https://salonsuccessplaybook.comFacebook https://www.facebook.com/lisaconwayzing/Instagram https://www.instagram.com/lisa.conway_/TikTok https://www.tiktok.com/@lisa_salonmentor MY PAID STUFFMy Healthy, Wealthy and Kind Retreats in Bali   https://healthywealthykindretreat.comLisa Conway's Reboot Your Salon 28-Day Challenge  https://salonreboot.com/ MY BOOKSThe Naked Salon, Your Salon Team, and Your Salon Retail Are essential reading for Salon owners are available in Paperback or Audio at Amazon, Audible, Kindle or from my store. https://www.thenakedsalon.comTo contact Lisa, just reach out to jess@zingcoach.com.au 

Each week I am going to read a chapter of my book The Naked Salon and talk about how I got there, and how you can put what you hear into action. This week - Chapter 17. On February 25, I am running a FREE Masterclass on how to Successfully transfer your client's to your team. To register click on this link, https://thesalonmentors.com/2025-masterclass MY OTHER FREE STUFFSalon Success Playbook https://salonsuccessplaybook.comFacebook https://www.facebook.com/lisaconwayzing/Instagram https://www.instagram.com/lisa.conway_/TikTok https://www.tiktok.com/@lisa_salonmentor MY PAID STUFFMy Healthy, Wealthy and Kind Retreats in Bali   https://healthywealthykindretreat.comLisa Conway's Reboot Your Salon 28-Day Challenge  https://salonreboot.com/ MY BOOKSThe Naked Salon, Your Salon Team, and Your Salon Retail Are essential reading for Salon owners are available in Paperback or Audio at Amazon, Audible, Kindle or from my store. https://www.thenakedsalon.comTo contact Lisa, just reach out to jess@zingcoach.com.au 

MY FREE STUFFSalon Success Playbook  https://salonsuccessplaybook.comFacebook  https://www.facebook.com/lisaconwayzing/Instagram  https://www.instagram.com/lisa.conway_/Tik Tok  https://www.tiktok.com/@lisa_salonmentor MY PAID STUFFMy Healthy, Wealthy and Kind Retreats in Bali   https://healthywealthykindretreat.comLisa Conway's Reboot Your Salon 28-Day Challenge  https://salonreboot.com/ MY BOOKSThe Naked Salon, Your Salon Team, Your Salon Retail Are essential reading for Salon owners are available in Paperback or Audio at Amazon, Audible, Kindle or from my store. https://www.thenakedsalon.com To contact Lisa, just reach out to jess@zingcoach.com.au

MY FREE STUFFSalon Success Playbook https://salonsuccessplaybook.comFacebook https://www.facebook.com/lisaconwayzing/Instagram https://www.instagram.com/lisa.conway_/Tik Tok https://www.tiktok.com/@lisa_salonmentor MY PAID STUFFMy Healthy, Wealthy and Kind Retreats in Bali   https://healthywealthykindretreat.comLisa Conway's Reboot Your Salon 28-Day Challenge  https://salonreboot.com/ MY BOOKSThe Naked Salon, Your Salon Team, and Your Salon Retail Are essential reading for Salon owners are available in Paperback or Audio at Amazon, Audible, Kindle or from my store. https://www.thenakedsalon.comTo contact Lisa, just reach out to jess@zingcoach.com.au

MY FREE STUFFSalon Success Playbook https://salonsuccessplaybook.comFacebook https://www.facebook.com/lisaconwayzing/Instagram https://www.instagram.com/lisa.conway_/Tik Tok https://www.tiktok.com/@lisa_salonmentor MY PAID STUFFMy Healthy, Wealthy and Kind Retreats in Bali   https://healthywealthykindretreat.comLisa Conway's Reboot Your Salon 28-Day Challenge  https://salonreboot.com/ MY BOOKSThe Naked Salon, Your Salon Team, and Your Salon Retail Are essential reading for Salon owners are available in Paperback or Audio at Amazon, Audible, Kindle or from my store. https://www.thenakedsalon.comTo contact Lisa, just reach out to jess@zingcoach.com.au

I am running my January Jump Start Event on Monday the 13th of January 2025 for Salon owners. For more details of this half day live ZOOM event just go to https://thesalonmentors.com/2025-jan-jump-startMY OTHER STUFFTo get your FREE copy of The Naked Salon just go to www.thenakedsalon.comTo contact Lisa just reach out to jess@zingcoach.com.au

To contact Lisa just reach out to jess@zingcoach.com.auI found Alcoholics Anonymous to be a huge support, there is no judgement, and it costs nothing. There will be a meeting near you and I encourage you to take the first step. https://aa.org.au/

https://cmetracker.net/UTHSCSA/Publisher?page=pubOpen#/getCertificate/10098139 Join host Holly Wayment on Pediatrics Now as she discusses eustachian tube dysfunction with Dr. Marisa Earley from University Health and UT Health San Antonio. Discover why this condition is so prevalent in children and learn about common symptoms, diagnosis, and treatment options from a leading pediatric ENT specialist. Explore how eustachian tube dysfunction can affect a child's daily life, from hearing issues to sleeping and traveling difficulties. Dr. Earley offers advice on managing symptoms, and shares insights on when surgical interventions may be necessary. Additionally, delve into guidelines for tonsillectomy in children, learn about the innovative intracapsular tonsillectomy technique, and get practical tips on ear health management, such as the use of otoscopes, earplugs, and nasal sprays. This episode is a must-listen for pediatric practitioners seeking to improve their understanding of ENT disorders.

Is Long COVID wreaking havoc on your nervous system? In episode 110 of The One Thing Podcast, Dr. Adam Rinde interviews Dr. Robert Groysman, an anesthesiologist (MD), and pioneer in treating dysautonomia (autonomic nervous system dysfunction) and post-viral illness. Discover groundbreaking therapies, including: * **Vagal Nerve Stimulation (VNS):** Learn how affordable, transcutaneous VNS can help regulate inflammation and calm your nervous system , * **Stellate Ganglion Blocks:** Understand how this procedure, initially used for PTSD, is now offering relief from Long COVID symptoms., * **The EAT Procedure:** Discover a novel Japanese therapy (epipharyngeal abrasive therapy) targeting the root causes of inflammation, even stubborn conditions like tinnitus and Eustachian tube dysfunction. Dr. Groysman shares his unique approach to treating Long COVID, focusing on four primary causes: dysautonomia, mitochondrial dysfunction, gut dysbiosis, and mast cell activation (histamine issues). He also discusses the importance of the vagus nerve in inflammation management and why standard treatments for POTS might not be enough to address the full scope of dysautonomia. **If you're struggling with Long COVID, chronic fatigue, brain fog, or other post-viral symptoms, this episode is a must-watch!** 0:00 - Intro: Long COVID, Dysautonomia, and the Autonomic Nervous System 1:07 - Introducing Dr. Robert Groysman and His Journey 3:24 - Dr. Groysman's Medical Background and Interest in Long COVID 5:03 - Stellate Ganglion Blocks for PTSD and Connection to Long COVID 7:20 - How Dysautonomia Drives Long COVID Inflammation 9:19 - The Four Primary Causes of Long COVID11:18 - Inflammatory Mediators and Brain Fog 12:25 - Defining Dysautonomia and the Role of the Vagus Nerve 14:28 - The Vagus Nerve and Its Anti-Inflammatory Pathway 16:43 - Vagal Nerve Stimulation as a Treatment for Inflammation 17:55 - Transcutaneous Vagal Nerve Stimulation (tVNS) Devices 19:16 - Accessing the Vagus Nerve Through the Ear 21:55 - How VNS Works in the Brainstem 23:40 - Vagal Nerve Dysfunction in Long COVID 24:29 - Anesthesiology Background and VNS Therapy 26:30 - Research Supporting Vagal Nerve Stimulation 27:25 - Ear vs. Cervical Vagus Nerve Stimulation 29:30 - Choosing the TENS 7000 for tVNS 31:28 - Real-World Patient Response to tVNS 32:45 - Measuring Dysautonomia: Heart Rate Variability and Resting Heart Rate 34:15 - Orthostatic Readings and POTS 35:38 - Pre-Selecting Patients for Vagal Nerve Stimulation 36:50 - VNS as part of an Integrative Treatment Program 38:35 - Dr. Groysman's Four-Pillar Approach to Long COVID 41:10 - Long COVID Centers and Lack of Root Cause Treatments 42:48 - Introducing the EAT Procedure (Epipharyngeal Abrasive Therapy) 45:18 - How the EAT Procedure Cleans Inflamed Nasal Tissue 47:00 - Diagnosing the Need for the EAT Procedure 47:55 - EAT Procedure Success Stories: Voice Changes 49:10 - The Connection Between Vocal Cord Problems and the Vagus Nerve 50:15 - LPR (Laryngopharyngeal Reflux) and Potential Connection to Vagus Nerve 51:19 - Dr. Groysman's Practice, Telehealth and Treatment Approach 53:03 - Unique Combination of EAT and Stellate Ganglion Blocks 53:37 - Final Thoughts on Vagal Nerve Stimulation & Education 55:01 - Outro and Podcast Info Links: Show notes: https://onethingpod.com/110-vagal-stim Dr. Groysman's facebook page https://www.facebook.com/groups/longcovidsgb Dr. Groysman's clinic https://covidinstitute.org/about-dr-groysman/ **#LongCOVID #Dysautonomia #VagalNerveStimulation #VNS #StellateGanglionBlock #EATProcedure #PostViralSyndrome #ChronicFatigue #BrainFog #Inflammation #TENS7000 #AutonomicNervousSystem #RobertGryan #DrAdamRindy #FunctionalMedicine #RootCauseTreatment** --- Support this podcast: https://podcasters.spotify.com/pod/show/onethingpod/support

Do You See What I See?  Identifying and Treating Otitis Media, Otitis Externa and Eustachian Tube Dysfunction Link for CME Credit Coming Soon In this episode, host Holly Wayment talks to Dr. Marisa Earley, division chief and associate professor at UT Health San Antonio's division of pediatric Otolaryngology, and Pediatric ENT and University Health, as she shares valuable insights for pediatricians on the front lines helping children with ear infections. Dr. Earley draws on her rich background and experience to discuss the complex interplay between gastrointestinal and airway systems in children, and her pioneering efforts in establishing San Antonio's first aerodigestive clinic. This clinic offers comprehensive care for children with complex swallowing and breathing disorders. The conversation delves into ear infections and management strategies, particularly for pediatric practitioners. Dr. Earley offers practical advice on antibiotic stewardship, emphasizing watchful waiting over immediate prescriptions for children older than two, and the importance of managing eustachian tube dysfunction. Listeners will hear  tips on differentiating between Otitis Externa and Media, the significance of pneumatic otoscopy, and advice to give parents managing their child's symptoms.  This is part one in our two part ENT Update series.

All About the Innovative Treatment Options for Ear Infections Looking for chronic ear infection relief? Join us on We Nose Noses as Dr. Reddy, Dr. Smith, and Dr. Undavia guide you through this revolutionary procedure for treating eustachian tube dysfunction through the use of balloon dilation. We'll cover everything from how the eustachian tubes work to the latest in treatment options, so you can find the relief you deserve. What you'll learn: Learn about eustachian tubes and why they're crucial for keeping your ears healthy and infection-free. Understand the symptoms and causes of eustachian tube dysfunction, and why traditional treatments may fall short. How a balloon eustachian tube dilation can be a less invasive, more effective alternative for long-term relief. If you are in need of ear, nose or throat support, schedule a consultation today at our Marlton, New Jersey location by visiting NJENT.com or call 609-710-NOSE (6673). https://njent.com/balloon-eustachian-tube-dilation-overview/    

I read from eustachian tube to EVA.     After a quick scan it SEEMS that Euthenics isn't racist (or other bad "ist" terms) but I'm sure it's more complicated than that.  It seems like a good idea, but what do I know?  https://en.wikipedia.org/wiki/Euthenics     The word of the episode is "euterpe".     Theme music from Tom Maslowski https://zestysol.com/     Merchandising! https://www.teepublic.com/user/spejampar     "The Dictionary - Letter A" on YouTube   "The Dictionary - Letter B" on YouTube   "The Dictionary - Letter C" on YouTube   "The Dictionary - Letter D" on YouTube   "The Dictionary - Letter E" on YouTube     Featured in a Top 10 Dictionary Podcasts list! https://blog.feedspot.com/dictionary_podcasts/     Backwards Talking on YouTube: https://www.youtube.com/playlist?list=PLmIujMwEDbgZUexyR90jaTEEVmAYcCzuq     https://linktr.ee/spejampar dictionarypod@gmail.com https://www.facebook.com/thedictionarypod/ https://www.threads.net/@dictionarypod https://twitter.com/dictionarypod https://www.instagram.com/dictionarypod/ https://www.patreon.com/spejampar https://www.tiktok.com/@spejampar 917-727-5757

We are joined by Erica Gilbert (Gilbert Aviation, Aerosafe), and her 9 year old son to talk about the things you need to think about when flying with children, the joy of making special memories with them while they are young. Patreon members also chime in with their tips, tricks, and questions. * Gilbert Aviation: https://www.gilbertaviation.com/ * Aerosafe on Youtube: https://www.youtube.com/@AeroSafe/videos * FAA's SAFETY passenger briefing (PDF): https://www.faasafety.gov/files/gslac/library/documents/2015/May/102764/05-18-15%20Passenger%20Safety%20Briefing%20JulAug2014.pdf * Eustachian tubes and valsalva maneuver: https://www.boldmethod.com/learn-to-fly/aeromedical-factors/in-flight-ear-block-sinuses-eustachain-tube/ * Earplanes: https://www.earplanes.com/ --- Send in a voice message: https://podcasters.spotify.com/pod/show/midlifepilotpodcast/message

In this episode of The Healers Café, Manon Bolliger, FCAH, RBHT (facilitator and retired naturopath with 30+ years of practice) speaks with Karese Laguerre about her children's sleep and health concerns and how they were treated through myofascial therapy and breathing. For the transcript and full story go to: https://www.drmanonbolliger.com/karese-laguerre     Highlights from today's episode include: Karese Laguerre  But when I came into this world and learning about myofunctional therapy, what I actually discovered is that ADHD, and all of the symptoms, because it's a symptom based diagnosis, all of the symptoms of it actually have a 70% overlap with the symptoms of sleep disorders in children. Karese Laguerre  23:59 Alleviated by doing a lot of work on breathing, establishing good nasal breathing, good tongue posturing, and ensuring that the pharyngeal muscles are nice and strong and able to help self sustain because they're still gonna relax when you sleep Karese Laguerre  So those ear infections, you know, our tongue is actually against the roof of the mouth whenever we're swallowing. It actually, when it presses up against the mouth in a peristaltic or normal swallow, it's actually helping to relieve or drain our Eustachian tube   ABOUT KARESE LAGUERRE:  Karese is a Registered Dental Hygienist and Myofunctional Therapist. She founded The Myo Spot, a practice aimed at amplifying oral wellness to whole body wellness. Through tele-therapy she helps clients of all ages overcome tongue ties, TMJ disorders, sleep apnea, grinding, anxiety, and various breathing and orofacial dysfunction. Passionate about education and self-help, she published Accomplished: How to Sleep Better, Eliminate Burnout and Execute Goals. When not working with clients globally she spends time with her husband and four kids. Core purpose / passion:  I am passionate about the oral systemic connection and building public awareness to ensure we can eliminate the deleterious impact of oral dysfunction. Website | Instagram | LinkedIn |    ABOUT MANON BOLLIGER, FCAH, RBHT  As a de-registered (2021) board-certified naturopathic physician & in practice since 1992, I've seen an average of 150 patients per week and have helped people ranging from rural farmers in Nova Scotia to stressed out CEOs in Toronto to tri-athletes here in Vancouver.  My resolve to educate, empower and engage people to take charge of their own health is evident in my best-selling books:  'What Patients Don't Say if Doctors Don't Ask: The Mindful Patient-Doctor Relationship' and 'A Healer in Every Household: Simple Solutions for Stress'.  I also teach BowenFirst™ Therapy through and hold transformational workshops to achieve these goals. So, when I share with you that LISTENING to Your body is a game changer in the healing process, I am speaking from expertise and direct experience". Manon's Mission: A Healer in Every Household!  For more great information to go to her weekly blog:  http://bowencollege.com/blog.  For tips on health & healing go to: https://www.drmanonbolliger.com/tips  Follow Manon on Social – Facebook | Instagram | LinkedIn | YouTube | Twitter | Linktr.ee | Rumble   ABOUT THE HEALERS CAFÉ:  Manon's show is the #1 show for medical practitioners and holistic healers to have heart to heart conversations about their day to day lives.  Subscribe and review on your favourite platform: iTunes | Google Play | Spotify | Libsyn | iHeartRadio | Gaana | The Healers Cafe | Radio.com | Medioq |   Follow The Healers Café on FB: https://www.facebook.com/thehealerscafe     Remember to subscribe if you like our videos. Click the bell if you want to be one of the first people notified of a new release.   * De-Registered, revoked & retired naturopathic physician after 30 years of practice in healthcare. Now resourceful & resolved to share with you all the tools to take care of your health & vitality!

In this episode, host Dr. Ashley Agan discusses eustachian tube (ET) dilation with Dr. Dennis Poe, neurotologist and Professor of Otolaryngology at Harvard Medical School. First, the surgeons describe clinically meaningful differences between adult and pediatric ETs. Then, Dr. Poe reviews workup of pediatric ET disorders. Since inflammation accounts for most ET dysfunction, controlling comorbid allergies and/or performing adenoidectomy provides relief to some patients. For patients with continued symptoms, balloon dilation – now approved for children as young as eight years of age– directly counteracts obstructive inflammation in the tube lumen. To conclude, Dr. Poe describes how to select patients for, perform, and avoid complications of balloon dilation. --- CHECK OUT OUR SPONSOR Acclarent AERA Eustachian Tube Balloon Dilation System https://www.jnjmedtech.com/en-US/product/Acclarent-aera-eustachian-tube-balloon-dilation-system --- SHOW NOTES 00:00 - Introduction 04:03 - Understanding Eustachian Tube Anatomy 07:22 - Causes of Eustachian Tube Dysfunction in Children 12:53 - Examination and Diagnosis of Eustachian Tube Dysfunction 19:10 - Treatment Options for Eustachian Tube Dysfunction 27:05 - Avoiding Unpredictable Injury and Scarring During Balloon Dilation 31:51 - Contraindications and Precautions for Balloon Dilation 37:49 - Understanding Risks & Complications of Balloon Dilation 48:34 - Closing Remarks & Future Prospects --- RESOURCES Dr. Dennis Poe's Harvard Profile: https://oto.hms.harvard.edu/people/dennis-poe BackTable ENT Ep. 40 – “Diagnosis & Management of Eustachian Tube Disorders with Dr. Dennis Poe:” https://www.backtable.com/shows/ent/podcasts/40/diagnosis-management-of-eustachian-tube-disorders American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guideline: Otitis Media with Effusion (Update): https://www.entnet.org/quality-practice/quality-products/clinical-practice-guidelines/ome/ “Complications of Eustachian Tube Balloon Dilation: Manufacturer and User Facility Device Experience (MAUDE) Database Analysis and Literature Review,” Chisolm, P.F. et al: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10731503/

Joining us for today's discussion is Holly Webster. Holly is a highly respected Osteopathic Manual Practitioner. She is a fellow member of the Ontario Osteopathic Association, the owner of Still Dynamics Osteopathy (Brantford and Oakville Locations) and colleague of Lauren's, and an associate professor at the Canadian Academy of Osteopathy.  Today we discuss where osteopathy fits into a patient's journey to health, our medical system, and the greatest gift our profession offers.    Together we sit down to reframe the definition of disease to highlight the impact of anatomical structure. We explain how using structural diagnosis as a process of elimination when searching for the root cause of disease can reduce tax on an already stressed body in lesion, decrease unnecessary stress on the liver for metabolizing drugs, and prevent avoidable side effects and dependency on pharmaceuticals for temporary symptom relief.  We invite listeners to think differently about pain and use it as information to guide our intervention decisions, seek osteopathy to prevent larger issues caused by compensations, and allow you to optimize performance in all areas of life!  This episode includes: 1:00 Osteopathy as a point of primary acute care, a spin on your typical Walk-In clinic   2:50 Manual Therapy as a means of healthcare (not just aches, pains and acute care)  3:30 Complimentary forms of care and how their approach treating the patient makes osteopathy more effective 5:25 Changing the narrative from musculoskeletal treatment to addressing an array of idiopathic and allopathic symptoms  7:25 The greatest gift of osteopathy is body awareness and the ability to advocate for yourself  9:30 Case Study: Osteopathy and Multiple Sclerosis (MS). Treating a viscero-somato lesion 15:30 Treatment goes beyond being symptom based to look at contributing factors 15:45 Treating the mental and emotional association with  disease; The mindset behind illness and injury   18:30 Osteopathic intervention over the lifespan— when is the best time seek care?  19:00 How does osteopathy play a role in fertility, conception, fetal and infant development?  21:30 Putting out the fire. Early intervention helps prevent larger issues due to compensations  21:45 The relationship with your practitioner   26:30 Osteopathy after birth for colic, Eustachian tube in newborns 28:15 No two patients or lesions are the same Still Dynamics Classical Osteopathy: https://stilldynamics.ca/services/osteopathy/ We're passionate about showcasing Osteopathy as an integral part of healthcare. As well as other alternative practices that share the common goal of staying proactive when it comes to health. Want to get inspired to take your health into your own hands? Discover how small, intentional changes have great effects on how we move through life. We are going to cover it all! Find us on Instagram & TikTok @WellAndBack Please consider Rating, Reviewing & Subscribing to our Podcast.  Music from #Uppbeat (free for Creators!): ⁠⁠https://uppbeat.io/t/richard-smithson/shacked-up⁠⁠ (https://uppbeat.io/t/richard-smithson/shacked-up) License code: CI8KXYV0EGUPVTAN

Jean Eustache is hard to pin down. A French auteur who combined the brevity of Bresson with the romantic rambling of Rohmer. Eustache often preferred telling to showing. Yet somehow these moments of gossip and reminiscence are powerfully cinematic. A spell is cast with judicious editing, subtle performances and gentle fades to black. After a short break the boys return to send new vibrations down your Eustachian tubes, prompted by a recent BFI Southbank retrospective.

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…   Darren: Good day Dr Cabral. What are your thoughts on recommendations for men to take low doses of Cialis daily? I'm seeing it recommended in the health and fitness sphere by different people in the know including Dr Andrew Huberman, Dr Rena Malek, Jay Ferruggia etc. There are claims of it helping with overall physical fitness/performance, heart health etc. Any drawbacks or is it something you definitely do not recommend.   Melissa: Hi Dr. Cabral - I wanted to ask if you can provide the correct technique to use for lymphatic drainage using a dry brush on your body and a gua sha tool on your face and neck. Many people on YouTube say different things regarding technique and I'm not sure what to follow. I know in the Rain Barrel Effect it says to lead the strokes for dry brushing to your heart but a video I found from a certified Lymphodema physical therapist said to direct strokes to your lymph nodes (such as toward your arm pits) as opposed to just the heart. What are your thoughts? I just want to be sure I'm doing it as effectively as possible. Any tips for gua sha for face and neck would be great as well. Also, is using the dry brush safe during pregnancy and breastfeeding? Thank you so much!   Elizabeth: Hi, Dr. Cabral! I have suffered from dry nose sores for years (literally years!). There have been a couple of times when I had staph infection so bad in my nose that it felt like somebody had punched me! The ONLY time that the sores went away was when I had covid (plus a few weeks after). Because they went away when I had covid, I thought it had something to do with immunity. HOWEVER, I am happy to report that ever since I have been fasting for at least 12 hours/day (and nearly immediately since I have started fasting), the nose sores are COMPLETELY gone. After YEARS of struggling day-in-and-day-out, they are now GONE! Can you please explain why fasting has had such a positive effect? I can't tell you how grateful I am to not have to deal with the discomfort anymore.   Dana: Hi Dr. Cabral, I asked in the Facebook group for resources on Patulous Eustachian tube dysfunction and it looks like you've never done a podcast on it before. I've been dealing with this most of my life and am curious if you have any information and insight on it. I know it can be triggered by exercise and weight loss, both of which I've experienced. I have learned to deal with it but it is inconvenient so I wanted to ask about it. Thanks!   Ashley: Hi Dr. Cabal, I first want to say thank you for sharing so much of your knowledge. It has really helped me on my health journey and I have gained valuable knowledge from your podcasts. My question is regrading estrogen, progesterone, and testosterone. What are the true healthy level ranges in females and males? I feel like you spoke about this before but for the life of me cannot find that podcast. I appreciate your help. Thank you, Ashley   Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes and Resources: StephenCabral.com/2844 - - - 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!  

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:    Cindy: I love Fatlossity PM for the best sleep, but I often get jittery with caffeine so I have only used the AM short term. I don't get the same effect with your Sleep Support supplement (melatonin tends to awaken me after only a few hours). I do benefit from the amino acid L-trypophine, on occasion. Since Fatlossity PM cannot be purchased separately, do you have any suggestions for improving sleep or which supplement is likely to help me? My sleep has improved over the last 6 years from learning from you, but I often still wake up after 5 or 6 hours of sleep to go to the bathroom. I am post-menopasusal, but I do take estrogen replacement- which has helped. But, Once my brain starts thinking, sadly sleep is usually over!   Anonymous: Hello Dr. Cabral. 39 year old male here. My issue is related to “Incomplete Bowel Movement” and I have been experiencing this issue for at least 10 years and I'm unsure what I should do about it. Basically, I have a normal bowel movement but it sometimes feels like not everything came out. So then I use an anal douche and every single time there is more poop coming out with the water. This happens with every single bowel movement. I'm a “fitness guy” with a healthy diet and lots of fiber. Thank you!   Joy: Thanks for all you do Dr Cabral! (Q #1 of higher importance) I'm a 30y/o F & would consider myself to be decently healthy & aware of my body. I however experience awful joint pain & weakness. It tends to hold me back from enjoying an active lifestyle. It's literally every joint from my neck to my ankles. My brother was born with a disease -Osteogenesis Imperfecta but has the more mild type 1. It affects the production of collagen. I don't think I have OI also. Curious what would you recommend me take/do to help my joint pain. Q#2 I recently read of the “earthing” concept, which is supposed to have a range of health benefits. It involves the natural electricity of the earth, here is a link for more info. I'm skeptical, but would like to know what u think! https://groundingofficial.com/   Jade: Hey there. I've been invested in my health for some time now and have been doing my best to encourage people around me to be healthier versions of themselves. However, I have one aunt in her late 50s whose diet isn't necessarily the best. She drinks Diet Coke mostly every day, eats out regularly and doesn't exercise. She also has an extremely stressful job which doesn't help. It‘s always been difficult to encourage her to change her eating habits, but she was just diagnosed with carpal tunnel. I told her I would do my best to get information on small changes she can make to better her condition and overall life. Is there anything she can do or take that may not be drastic? I would recommend your detox and less processed foods and drinks of course, but that's too extreme for her.   Erica: Hi Dr. Cabral! I wanted to ask you your thoughts on what could be the root of my symptoms. I've had dizziness for about 3-4 years now and it's very consistent almost every day. However, it hasn't gotten worse it's stayed very consistent over this time. It seems to be worse around the time of my period and also when under stress. In addition, I have a lot of popping in both of my ears and sometimes my ears feel itchy and almost like my eustachian tubes have to release pressure. I went to the ENT who said I might have Eustachian tube dysfunction but ruled out any fluid in my ears or other issues. I also tried the maneuver for crystals in my ears which didn't seem to have an effect either. Any thoughts on things I could try? Dizziness got worse when I took antibiotics 3/4 years ago. Thank you   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/2766 - - - 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!  

PODCAST HIGHLIGHTS: Eustachian tube dysfunction. Is there something you recommend for hormone replacement for males and females? Toe neuropathy - Signs, symptoms and causes. Please discuss glaucoma, cataracts and macular degeneration. How can we avoid stop cure them when diagnosed? best ways to boost immune system https://youtu.be/OEL2MMWbER4 PODCAST HIGHLIGHTS: 00:00 Introduction 01:11 Eustachian tube dysfunction...... Continue Reading →

A Discussion with NJENT Doctors on Equalizing Ear Pressure Do you experience ear pain or muffled hearing during takeoff or landing on flights? It's a common problem, but there are steps you can take to alleviate the discomfort. In this episode, Dr. Reddy, Dr. Smith, and Dr. Undavia discuss tips and medications you can use to manage ear pain and discomfort, especially if you frequently travel by plane. Whether you're seeking natural remedies, over-the-counter medications, or considering a visit to our New Jersey office for evaluation of your Eustachian tube function, we'll provide you with practical solutions to make your next flight a more comfortable experience. What you'll learn: Causes of eustachian tube dysfunction and related symptoms such as pressure and muffled hearing, particularly during flights. Medications that can be used to help alleviate symptoms of airplane ear, including decongestants and steroid nasal sprays. Various methods to relieve ear pain and discomfort during air travel and when to see a doctor or specialist about Eustachian tube dysfunction. If you're experiencing persistent ear pain or eustachian tube dysfunction, don't hesitate to contact NJENT to schedule an appointment with one of our experienced ENT specialists. We offer a range of diagnostic and treatment options to help you find relief. You can visit our New Jersey office or book a virtual consultation from the comfort of your own home. If you enjoyed this episode, be sure to like and subscribe to our channel for more informative content, and tune in next time for our next discussion. Thanks for listening! Resources and transcript: https://njent.com/how-to-manage-ear-pain-and-discomfort-during-flights/  

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…   Deborah: Hello, love you podcasts. I've been listening for years; you're a wealth of knowledge. I have fertility related questions. I have Hashimoto's and have had many early miscarriages. I do have have 4 children, with healthy and easy pregnancies, once established. 1. Is there any supp or Rx that would help with implantation in the case of autoimmune conditions? 2. Do you recommend to forgo coffee when TTC (I drink 1 cup organic in AM)? 3. This one is a little weird but just want your thought: Will taking my daily proteolytic enzymes effect sperm when TTC, and should I only do it early in cycle? Thanks so much for your insight!   Eric: I have a question re infrared sauna. I know it's very healing, but when TTC, should I refrain from it and also should my wife, or could she do it only the first half of her cycle before ovulation? Thanks so much for your dedication to all things wellness.   Cori: Hello! Love your podcast, so informative and I feel like I'm learning and growing so much just from listening! Life changing information here. I have been on birth control (nexplanon/arm implant) for 8 years now due to heavy periods and needing iron infusions because they are so heavy for 6-7 days. I went off of it for about a year and gained 30 pounds around stomach and thighs and upper arms :( I try hard to lose it but it doesn't budge, and I and ended up with extremely low ferritin levels, so my dr put me back on it. I want to come off birth control due to what I now know about it, but where do I start? Thank you for all you do!   Erica: Hi Dr. Cabral! I wanted to ask you your thoughts on what could be the root of my symptoms. I've had dizziness for about 3-4 years now and it's very consistent almost every day. However, it hasn't gotten worse it's stayed very consistent over this time. It seems to be worse around the time of my period and also when under stress. In addition, I have a lot of popping in both of my ears and sometimes my ears feel itchy and almost like my eustachian tubes have to release pressure. I went to the ENT who said I might have Eustachian tube dysfunction but ruled out any fluid in my ears or other issues. I also tried the maneuver for crystals in my ears which didn't seem to have an effect either. Any thoughts on things I could try? Dizziness got worse when I took antibiotics 3/4 years ago. Thank you   Jen: Hi Dr. Cabral, I recently had some blood tests on 11/29/22 and my AST was 126 and my ALT 218. They ran iron, Hepetitis, all negative. Ultrasound of my liver only showed small amount of fatty liver. I retested on 1/10/23 and now my AST is 149 and ALT is 244. I have taken Kratom for my Levoscoliosis but only sparingly 2-4 tablets once in a while when my back is really bad because I dont want to have to take pharma pills to manage my back pain. She had me stay off the Kratom before I retested. I don't drink much nor do any drugs. I do vape nicotine and in September I had a copper IUD implanted so I wonder if any of these might be the culprit or what could be causing my enzymes to be this high and what I can do to bring them back down. Thank you!   Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes and Resources: StephenCabral.com/2599 - - - 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!  

In this episode, host Dr. Michael Barraza interviews Dr. Rehan Quadri, interventional radiologist, about the definition, indications and techniques for treating clot in transit.  We begin by defining and describing when to treat clot in transit. Traditionally, the definition is the washing machine mobile clot in the right atrium (RA) or right ventricle (RV). In these situations, the next place for the clot to travel is the pulmonary artery (PA). Mortality in these cases can reach as high as 30%, which is why these cases are considered emergencies. There is another category of clot in transit where a clot is partially adhered to a vessel wall, catheter, or heart valve. They are most commonly diagnosed via an echocardiogram, or found incidentally on a CT angiogram. They commonly present as catheter malfunction with symptoms resembling SVC syndrome. Dr. Quadri explains his usual method for retrieving clot in transit, though he notes each case is complex and different depending on the etiology and the overall status of the patient. In general, unless there is a massive PE, he treats the clot in transit before the PE. He always ensures with the preoperative echocardiogram that there is no interatrial shunt or patent foramen ovale (PFO). At the beginning of the case he checks PA and RA pressures.  He uses a 24 French Inari Flowtriever with FLEX technology, which helps with tough angles. He uses ICE guidance in all clot in transit cases. To help with orientation when using the ICE catheter, he recommends pointing it anteriorly while entering the RA, then using the Eustachian ridge, an echogenic line in the RA, to confirm you are in the RA and indicating that you should see the tricuspid valve as you advance. He uses the FlowSaver device, and always has 2 units of blood in the room just in case. At the end of the case, he remeasures the PA pressures, then injects through the Inari sheath to verify that there is no residual before finally doing a pulmonary arteriogram. He sends all the clots to pathology, and has seen that the morphology is usually mixed, with some organized fibrin in addition to acute thrombus.

Welcome to the Instant Trivia podcast episode 702, where we ask the best trivia on the Internet. Round 1. Category: Try "Star" 1: Overly awed and fascinated in the presence of celebrities. starstruck. 2: Structure from which the 3-year-olds fly forward at Churchill Downs. starting gate. 3: Banner carried by the attackers during Pickett's Charge. "Stars and Bars". 4: An asteroidean echinoderm found in tidepools. starfish. 5: It's composed mainly of amylose and amylopectin. starch. Round 2. Category: Smooching In Shakespeare 1: He claims that the sleeping Michael Cassio kissed him hard while dreaming of Desdemona. Iago. 2: He says, "Here hung those lips that I have kissed I know not how oft" while holding Yorick's skull. Hamlet. 3: "Love's Labour's Lost" and "Henry VI, Part III" both mention the kiss of this Biblical traitor. Judas Iscariot. 4: In this comedy Petruchio says, "Kiss me, Kate, we will be married o' Sunday". Taming of the Shrew. 5: "We have kiss'd away kingdoms and provinces" says Scarus in the play about this title couple. Antony and Cleopatra. Round 3. Category: Tubes 1: Submarines have fixed tubes in the bow to shoot these underwater weapons. torpedoes. 2: If a surfer rides the tube in London, he's on this. the subway. 3: Every little breeze seems to whisper the name of this first test tube baby. Louise (Brown). 4: The gas-filled Geissler tube of the late 1850s was adapted for use in these advertising signs. neon signs. 5: Like you, a frog has this tube connecting the middle ear and the throat. the Eustachian tube. Round 4. Category: Famous Franks 1: This "Wizard of Oz" author edited a trade magazine for store window decorators. L. Frank Baum. 2: Frank Fitzsimmons took control of this union when Jimmy Hoffa was imprisoned in 1967. Teamsters. 3: This musical satirist founded the Mothers of Invention in 1964. Frank Zappa. 4: In Gemini 7 he and Jim Lovell set a 14-day endurance record. Frank Borman. 5: This Idaho Democratic senator was active in investigating abuses by the CIA. Frank Church. Round 5. Category: Directors On Film 1: He not only was "The Outlaw Josey Wales", he was the director, too. Clint Eastwood. 2: When you watch his direction of himself and Jack Nicholson, he hopes you "Hoffa" good time. Danny DeVito. 3: He's seen in John Landis' "The Blues Brothers" and Landis is seen in his "1941". Steven Spielberg. 4: He was Mookie the delivery boy in "Do the Right Thing". Spike Lee. 5: 1 of the 2 directors who play the 2 main husbands in "Husbands and Wives". (1 of) Sydney Pollack (or Woody Allen). Thanks for listening! Come back tomorrow for more exciting trivia! Special thanks to https://blog.feedspot.com/trivia_podcasts/

Dr. Carole Keim discusses all the supportive care options available for your child's cold, beyond the over-the-counter medications. She details alternative medicines and things you can do to alleviate your child's cold symptoms.Most viruses don't have specific treatments in Western medicine. We have COVID and flu vaccines, but beyond that, there isn't much medically to be done for a cold. Dr. Keim not only explains what alternative options are available, she breaks down exactly what each virus does and what symptoms manifest in your child. This is a truly valuable resource episode.In this episode:Overview of colds Fever  Congestion and ear pain Runny noseCough Immune boosters Sample regimens Overview 00:51Viral infections - no specific treatment for most Many types and subtypes of virusesTypical course: illness lasts 7-10 days, peak on day 4, cough can linger for up to 2 weeks afterRed flags: respiratory distress, dehydration (dry lips/tongue, decreased urine output, lethargy), fever for 5 or more days in a row, fever that goes away for more than 24 hours and then comes back (can indicate a secondary infection such as UTI/AOM/pneumonia)Fever 04:40Acetaminophen / paracetamol IbuprofenThese will also help with systemic symptoms - pain, body aches, lack of energy, lack of appetite, trouble sleeping.These do NOT treat cough, congestion, or runny nose Magic socks - wet cotton socks, cover with wool socks before bed I don't recommend potatoes, garlic, or onions on feet - I've seen some burns Congestion and ear pain 09:01 Eustachian tubes drain at the back of the nasopharynx, so congestion leads to fluid buildup in ears, so decongestants treat bothMedications for adults and children over age 6: pseudoephedrine by mouth, oxymetazoline nose sprayChildren under age 6: nothing for congestion; ibuprofen for ear pain (x48h before abx)Saline nose spray or sinus wash - hypertonic salineGinger, spicy foods, steam, vick's Oils -  eucalyptus, peppermint, menthol, breathe blend Sinus drain/massage - OMT or chiropractic - tapping on sinuses and pressing along lymphatic channelsAcupuncture Onion earmuffs for ear pain Runny nose 18:43Antihistamines DO NOT work.  Use saline spray to keep the mucus cleared out.  Can use bulb sucker if boogers are stuck.Wash your hands every time you wipe their nose Color of mucus has to do with the amount of inflammation and not necessarily whether it's a bacterial or viral infection If mucus is very thick and seems to be stuck, can use guaifenesin (Mucinex) to help them clear it out.  Kids almost never need this and it works by causing them to cough, so many parents avoid it because it makes their child seem worse.Cough 21:45Mucinex causes more coughDextromethorphan, codeine, and similar anti-cough agents work by decreasing respiratory drive and can cause children under age 6 to stop breathing Antihistamines only work if it's allergies, not for infectionsThe only thing that has been shown to be both safe and effective in Western medicine trials is honey (and only for children older than 1 year because of the risk of botulism!) Teach children to cough in their elbow Immune boosters 23:45Vitamin D - 400 unitsVitamin C - 1000mg for adults; 100mg per 10 lbs Zinc - 30-60mg for adultsEchinacea - after exposure or at the onset of symptoms Elderberry - syrup or gummies GarlicLemon juice Fruits and veggies - 10 servings per day, or supplement The vitamins and supplements my family takes is in my link tree Sample regimens 29:10RSV and/or common cold 29:13Tylenol/ibuprofen, saline nose spray/drops before eating and sleeping, can bulb suck after each time (or not), bring them into the bathroom when you shower so they can breathe the steam, put vicks or essential oils on yourself or the shower floor before getting in, use a nighttime humidifier if you live in a dry climate, give vitamin C and D, zinc, echinacea, elderberry, consider chiropractic and acupuncture Keep baby hydrated - it's fine if they don't eat anything at all for days, but they need to be drinking water and have at least a little sugar and salt each day.  If they have breastmilk or formula that is plenty, they don't need food on top of that.  It's VERY hard to eat with RSV because of the congestion.If breastfeeding, take immune boosters and keep breastfeeding as much as possible.  If you're sick, wear a mask so you don't cough or sneeze onto your baby.  Do NOT allow children with “just a little runny  nose” around your baby - RSV causes very mild symptoms in children and adults, but can cause about 1% of babies to end up hospitalized Do NOT share bulb suckers or pacifiers between childrenCOVID 34:51As for RSV; there might be specific treatment in the future but right now only for adults.  Adults in the household should be vaccinated Flu 35:27Acetaminophen/ibuprofen for fever and body aches, can also help with sleep and appetiteSaline drops/spray for congestion, honey for cough (over 1 year), ginger for congestion and to settle the stomachFor vomiting and diarrhea, keep them hydrated with small sips of water, watered-down juice (50% water or more), oral rehydration solution, popsicles, jello, or commercial drinks like pedialyte/gatorade.  If they are unable to keep down fluids you need to bring them to the ER.  Tamiflu is sometimes helpful and sometimes causes GI upset.  It's approved for ages 6mos and up.  Adults and children over 6 months of age can be vaccinated Holistic Mama's Handbook 39:43I am in the midst of writing HMHCollaborating with pediatric acupuncturists, chiropractors, dietitians, naturopaths, etcFor parents of young children Release date Fall 2023 Dr. Keim has extensively researched the information presented in this episode. Her insight and knowledge on alternative and holistic treatments will come together in her new book, “The Holistic Mama's Handbook”, due out Fall of 2023. For additional tips and advice on babies and toddlers, follow Dr. Carole Keim on her TikTok and YouTube channels. Her book, “The Baby Manual”, covers the first year of baby life and is the subject of Season One of this podcast. And remember, it is always okay to call your doctor or emergency services if you have concerns about your child's health.   Resources discussed in this episode:The Baby Manual - Available on AmazonSubscribe to this podcast DrKeim LinkTree - for vitamins and supplement link--Dr. Carole Keim MD: linktree | tiktok | instagram

Have you been experiencing ear fullness, ear pressure, or clicking in the ears? There is a chance that you may have Eustachian Tube Dysfunction. Dr. Michelle is here to educate you on Eustachian Tube Dysfunction, including the causes, treatments, and other relevant information!

In this episode of BackTable ENT, Dr. Ashley Agan and Dr. Seilesh Babu discuss Eustachian tube dysfunction and balloon dilation as a therapeutic option. --- CHECK OUT OUR SPONSOR Acclarent https://www.jnjmedtech.com/en-US/companies/acclarent --- SHOW NOTES First, Dr. Babu provides background on Eustachian tube dysfunction. In kids and adults, Eustachian tube dysfunction can present as a sensation of “ear fullness”, recurrent fluid in the ear, or discomfort with pressure challenges, such as flying or scuba diving. Medical management involves nasal steroids, allergy medications, anti-reflux medications, avoidance of allergens, and doing a modified Valsalva maneuver at home. Additionally, ear tubes and balloon dilation are procedural options. Next, Dr. Babu explains his workup for Eustachian tube dysfunction patients. He takes a thorough patient history and examines the patient's tympanic membrane, nasopharynx, and serous outflow using a flexible scope. He orders an audiogram for all of his patients but notes that tympanograms are not as critical. For patients with discomfort during pressure challenges, he will consider doing a balloon dilation or placing an ear tube. For patients presenting with “ear fullness”, a more in-depth examination must be done through a trial tympanostomy tube or a myringotomy. He also looks for red flags, which indicate Eustachian tube dysfunction may not be the correct etiology for their ear symptoms. These red flags include: aggravation of symptoms upon tube insertion, symptoms of dizziness and vertigo, autophony, and pulsatile tinnitus. Although it is rare, a diagnosis of Patulous Eustachian tube dysfunction must be considered. If the patient does not have these red flags and has had multiple ear tubes without symptom relief, they may be a good candidate for balloon dilation. Dr. Babu then delineates his procedure for a Eustachian tube balloon dilation. He performs this procedure in the OR using the Acclarent AERA Eustachian tube dilation system. He inflates the balloon to achieve a pressure of 12 atm, keeps it dilated for 2 minutes, then removes the instrument. Some procedural pearls he shares are: putting the scope and balloon in at the same time to minimize bleeding in the nasopharynx and guiding the instruments in a lateral direction towards the external ear canal. He usually waits 2-3 weeks before reassessing the patient for recurrent symptoms. Upon discharge, he encourages patients to avoid nose blowing and Valsalva maneuvers, as these actions can cause a pneumothorax or pneumomediastinum. Common postoperative symptoms include minor nose bleeds and the sensation of a sore throat. Dr. Babu usually performs the balloon dilation in conjunction with other OR procedures, such as myringotomies and tympanoplasties, for efficacy. Finally, the doctors discuss the specifics of billing for the Eustachian tube dilation procedure. In recent years, a specific billing code has been assigned for balloon dilation, and insurance companies are beginning to authorize this procedure for a variety of patients. Devices discussed in this podcast are currently available in the US only. Acclarent, Inc. 223616-220810 --- RESOURCES Acclarent: https://www.jnjmedtech.com/en-US/companies/acclarent AERA® Esutachian Tube Balloon Dilation System: https://www.jnjmedtech.com/en-US/product/Acclarent-aera-eustachian-tube-balloon-dilation-system Howard, A., Babu, S., Haupert, M., & Thottam, P. J. (2021). Balloon Eustachian Tuboplasty in Pediatric Patients: Is it Safe?. The Laryngoscope, 131(7), 1657–1662. https://doi.org/10.1002/lary.29241

In this episode, host Dr. Doug Reh speaks with Dr. Rod Schlosser. They will discuss article: Eustachian tube dysfunction (ETD) in chronic rhinosinusitis with comparison to primary ETD: A systematic review and meta-analysis. Read the article in International Forum of Allergy and Rhinology. Listen and subscribe for free on Apple Podcasts , Google Podcasts and Subscribe on Android.

This episode covers Eustachian tube dysfunction.Written notes can be found at https://zerotofinals.com/surgery/ent/eustachiantubedysfunction/ or in the ear, nose and throat section of the Zero to Finals surgery book.The audio in the episode was expertly edited by Harry Watchman.

Dr. Ashley Agan sits down with the eustachian tube expert Dr. Dennis Poe to discuss his approach to management and treatment of eustachian tube dysfunction. --- CHECK OUT OUR SPONSOR Stryker ENT https://ent.stryker.com --- SHOW NOTES In this episode of BackTable ENT, Dr. Agan discusses eustachian tube disorders with Dr. Dennis Poe, professor of otolaryngology at Harvard Medical School. First, the doctors discuss the difference between the two main types of Eustachian tube disorders: obstructive dysfunctions and Patulous dysfunctions. Obstructive dysfunctions are a result of pathologies that cause inflamed or clogged Eustachian tubes, while Patulous dysfunctions are a result of the Eustachian tube remaining perpetually open. Obstructive and Patulous dysfunctions can be clinically differentiated. Patulous dysfunctions commonly experience extraordinary loud noises, variable pressure sensation, aural fullness, habitual sniffing, relief upon using the Valsalva maneuver, and autophony. Although autophony is not pathognomonic for Patulous dysfunction, it can give otolaryngologists a clue for a potential Patulous dysfunction diagnosis. Obstructive dysfunction patients commonly experience negative pressure in tympanic membrane, fluid in middle ear, scarring, and fixed retraction pockets. Otolaryngologists can also insert an endoscope through the nose to perform a physical examination on Eustachian tube disorder patients. Dr. Poe recommends that otolaryngologists obtain a longitudinal view of the Eustachian tube lumen to observe the cartilaginous and membranous walls and the quality of the valve. He recommends using the MEELO assessment (mucus production, erythema, edema, lymphoid hyperplasia, and opening quality) to grade Eustachian tube disorder patients on a scale of 1-4, with 4 being the most severe dysfunction. He cautions against using tympanograms for diagnoses because of their inaccuracy. Eustachian tube disorders can be treated with medication. Because the most common etiology of obstructive Eustachian tube disorder is allergic rhinitis, Dr. Poe starts with allergy testing to identify possible allergens. He notes that topical nasal steroids and nasal drops are effective, but may be difficult for patients to self-administer. For this reason, patient education is very important. If medications do not work after 6 weeks, Dr. Poe recommends performing a balloon dilation of the Eustachian tube. The length of balloon dilation depends on the MEELO grading scale. If obstructive Eustachian tube dysfunction patients are a grade 3 or 4 with moderate to severe inflammatory disease and a significantly compromised valve, he dilates for the full two minutes. If they are a grade 2 or low grade 3 with a lesser disease, he only dilates for one and a half minutes or even one minute. Because pediatric patients are very sensitive to balloons, he never goes above one and a half minutes in pediatric patients. Finally, he notes that Patulous Eustachian tube dysfunction patients can be surgically treated via a transtympanic tripod-shaped angiocatheter procedure. --- RESOURCES Eustachian Tube Disorder Questionnaire: https://earandsinusinstitute.com/online-questionnaires/etdq-7-questionnaire/ ​​ Xhance Nasal Spray: https://www.xhancehcp.com/

Good morning and welcome to your Monday dose of Your Daily Meds.Bonus Review: What is the difference between the blood-CSF barrier and the blood-brain barrier?Answer: Whereas in the blood-CSF barrier, the barrier is due to the tight junctions between the epithelial cells (ependyma) of the choroid plexus; the blood-brain barrier involves a barrier of tight junctions between the capillary endothelial cells.= BBB - tight junctions between capillary endothelial cells= BCSFB - tight junctions between choroid plexus epithelial cellsPsych Question:Marked fear or anxiety about which of the following is NOT consistent with a diagnosis of agoraphobia?Using public transportationBeing in open spacesBeing in enclosed spacesStanding in line or being in a crowdAllowing others into one’s homeHave a think.Scroll for the chat.Somewhat Anatomical:The Eustachian tube is an osseocartilaginous passage connecting the nasopharynx and middle ear. Which of the following cranial nerves supplies general sensory innervation to the Eustachian tube?CN VIICN VIIICN IXCN XCN XIHave a think.Remember some rude mnemonics.Scroll for the chat.The Phobia:Agoraphobia is essentially a disorder of excessive anxiety about being unable to escape a particular situation or place. Anxiety is a fearful response in the absence of a specific danger or threat, or in their anticipation. Anxiety is distinct from fear, which is a response to a realistic and immediate danger. Fear is adaptive in situations of stress or danger with priming of the physiological ‘fight or flight’ mechanism.Agoraphobia is characterised by more than six months of excessive anxiety about being unable to escape a particular situation or place, in the context of at least two of the following:Using public transportationBeing in open spacesBeing in enclosed spacesStanding in line or being in a crowdBeing outside of the home aloneThe management of agoraphobia includes education around the symptoms of the patient’s anxiety and on how avoidance behaviours may be self-perpetuating. Relaxation techniques and graded exposure to a hierarchy of the patient’s feared situations may also be employed. So marked fear or anxiety about allowing others into one’s home is not consistent with a diagnosis of agoraphobia.Tubes and Supply:The Eustachian tube receives general sensory innervation from cranial nerve IX, the glossopharyngeal nerve. The glossopharyngeal nerve exits the skull through the jugular foramen and has motor innervation to the stylopharyngeus muscle and sensory innervation for taste and general sensation to the posterior 1/3 of the tongue.Cranial nerve VII, the facial nerve, supplies taste sensation to the anterior 2/3 of the tongue; supplies motor innervation to the muscles of facial expression and the stapedius muscle; and supplies parasympathetic innervation to the salivary and lacrimal glands.Cranial nerve VIII, the vestibulocochlear nerve, supplies sensory innervation to the cochlea and vestibular apparatus.Cranial nerve X, the vagus nerve, supplies sensory innervation to many structures including the pharynx and larynx; supplies motor function to the soft palate, larynx, pharynx and upper oesophagus; and parasympathetic innervation to the cardiovascular, respiratory and gastrointestinal symptoms.Cranial nerve XI, the accessory nerve, supplies motor innervation to the sternocleidomastoid and trapezius muscles.Bonus: Tell me some functions of the Hypothalamus.Answer in tomorrow’s dose.Closing:Thank you for taking your Meds and we will see you tomorrow for your MANE dose. As always, please contact us with any questions, concerns, tips or suggestions. Have a great day!Luke.Remember, you are free to rip these questions and answers and use them for your own flashcards, study and question banks. Just credit us where credit is due. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit yourdailymeds.substack.com

This podcast episode features highlights of a media event held on November 2 2021 in Washington, DC, about vaccines safety and mandates. You will hear testimonies of real people, explaining their experience with vaccine injuries, either as a victim or as a parent of a victim. What you will hear is not easy to hear. It is dramatic, it is tragic, yet it is highly informative. And those people are not "rare" cases. There are thousands and thousands of such victims in the US and all over the world. You will hear:- Cody Flint, airline pilot from Cleveland, MS who accumulated 10,000 hours of flight time diagnosed with left and right perilymphatic fistula, Eustachian tube dysfunction, and elevated intracranial pressure following Pfizer vaccination.- Ernest Ramirez, father from Austin, TX whose only son collapsed playing basketball and passed away from myocarditis following Pfizer vaccination.- Kyle Werner, professional mountain bike racer from Boise, ID diagnosed with pericarditis following vaccination.- Doug Cameron, farm operations manager from Idaho, permanently paralyzed following vaccination.- Suzanna Newell, triathlete from Saint Paul, MN diagnosed with an autoimmune disease and reliant on a walker or cane to walk following vaccination - Kelly Ann Rodriguez, young mother from Tacoma, WA reliant on walker following vaccination.- Stephanie, the mother of Maddie de Garay, a 12-year old Pfizer clinical trial participant from Cincinnati, OH confined to wheelchair and feeding tube- Brianne Dressen, Astra Zeneca clinical trial participant from Utah, co-founded react19.org, a patient advocacy organization dedicated to increasing awareness of adverse events.- Dr. Joel Wallskog, orthopedic surgeon from Mequon, WI diagnosed with transverse myelitis following Moderna vaccination. - Shaun Barcavage, FNP-BC, a Research Nurse PractionnerOur next episode will feature other highlights from the same event, but this time focusing on expert testimonies.

Welcome back to TBOTA! (Good audio) Eustachian tube, Australian ballads, Mike Richards and cancel culture Support the show: Give us a rating & review Become a patron and help me make this show Like and follow us on Facebook or Instagram Rent the award-winning One Jewish Boy © Robert Neumark Jones

Burnout comes up a lot in the physician's space, and for a good reason. As women physicians, we are constantly exhausted from progressing our careers while doing everything society expects of women. The good news is that with a few mindset shifts and practices, you can get out of the box of burnout and start feeling like yourself again.   If You Want To Prevent Burnout, You Should: Get clear on what your passion is and create a plan to help you go after it Surround yourself with a supportive and inspiring community Ditch the all or nothing mentality and focus on taking small baby steps towards your goals   Preventing Burnout With Dr. Karen Hoffman Karen Hoffmann, MD, FAAOA, is board certified by the American Board of Otolaryngology-Head & Neck Surgery. Since joining Piedmont Ear, Nose, Throat, and Related Allergy in 2007, Dr. Hoffmann has specialized in the medical and surgical treatment of patients with Eustachian tube dysfunction, ear fullness, sinus, and allergy disorders, and hearing loss and chronic ear disease. She has successfully integrated compassionate and innovative care in private practice with clinical research and is passionate about helping others take care of themselves.   You Are In Control of Your Own Outcome Being a mother, wife, and physician, Dr. Hoffman got to a breaking point when she realized that her all-or-nothing mentality and internal dialogue were contributing to her burnout. By taking small baby steps to move away from this mentality and towards a long game strategy, she was able to change her thinking and change her life.  Now, Dr. Hoffman shows up to work every day excited, which reflects back onto her and onto her patients. By finding clients that push her out of her comfort zone and inspire her to approach medicine in a new way, she is pursuing her passion in an inspiring way.   Find Your Passion and Run With It One of the best ways to feel supported going forward in your journey is to find a community of other women and women physicians. If you don't have support, you will feel like you need to do it all. And while your imposter syndrome may be holding you back from finding a community, showing up authentically and making yourself a priority is the best way to overcome it.  The changes you will notice when you start to take care of yourself can be drastic. By getting clear and focusing on your passion, creating a plan to get there, and surrounding yourself with other women who continue to lift each other up, anything is possible.   Homework for Women Physicians Are you ready to prevent burnout by thinking outside of the box and prioritizing yourself? Share which ways you tackle burnout with me in the comments section of the episode page.   In This Episode  Why we experience burnout early on in our careers [3:30] How to use your thoughts and internal dialogue to determine your own outcome [6:49] Tips for creating a balance between family life and your career [13:30] Why being surrounded by a community of other women physicians is a gamechanger [15:28] Advice for women who believe they don't have the time to achieve their goals [19:20]   Quotes “You try to do everything, and I think it is almost like you are on a hamster wheel. You just keep going and going and going. It took me quite a while to figure out that wasn't really normal or sustainable.” [3:59] “I ultimately have the power to determine my outcome based on my thoughts. My internal dialogue and thoughts are much more important than my external circumstance and how I experience and interact with the world. So it ultimately gives me the power to determine my outcome.” [7:34] “There are really just so many hours in the day, and you can't be everything to everybody all at the same time.” [14:11] “Everyone has some imposter syndrome, I really think, unless they are a narcissist, and we just have to realize that everyone has that. And you just show up and do you, and you want to be your authentic self.” [18:25] “You have to figure out where you are going so that you can come up with a plan to actually get there.” [26:09]   Resources Mentioned Dr. Karen Hoffman Website Join G.O.A.L.S. Society Free for 30 Days  Join the Transform Waitlist Check out the full episode page here Find Life Coaching for Women Physicians Online Follow Dr. Ali Novitsky on Facebook | Instagram  Subscribe to Life Coaching for Women Physicians on Apple Podcasts Podcast production by the team at Counterweight Creative   Related Episodes Episode 64: Showing Up for Your Future Self Episode 59: Thinking Outside The Box with Dr. Tonya Caylor

This podcast highlights original research published in the June 2021 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation. The objective was to characterize the relationship between objective tympanogram values and patient-reported symptoms and associations with common comorbid conditions. In conclusion, patients with symptoms of ETD may have a TPP within a range typically considered normal per conventional standards. This suggests that the currently accepted interpretation of tympanometry findings may be insensitive for the diagnosis of less severe cases of ETD.   Click here to read the full article.

One of the reasons our ears pop when a plane is landing is because the air pressure is increasing. Therefore, the air pressure is literally pushing pressure unto the eardrum and the Eustachian tube can’t react fast enough! Something similar happens when swimmers or scuba divers are going underwater. The weight of the water above the swimmer increases upon them the deeper they go. They are not only experiencing the pressure of the water but the complete sum of the air and the water above them combined! In this episode, we’ll discuss how/why various seasons in our life will apply the most pressure. Especially those seasons spent near the bottom. In order to make it to the top of your game, you have to understand PRESSURE. Subscribe to Morning Motivation Messages: Text “Motivate Me” to 31996 Instagram: www.instagram.com/qualitysirvice Podcast: www.qualitysirvice.com/podcast LinkedIn: www.linkedin.com/in/qualitysirvice Facebook: www. facebook.com/QualitySIRvice Website: www.qualitysirvice.com

Guest: Laura J. Orvidas, M.D. Host: Darryl S. Chutka, M.D. (@ChutkaMD) Tonsils and eustachian tubes often get taken for granted until they cause problems. Eustachian tube dysfunction is quite common and usually resolves on its own, however some patients will develop recurrent eustachian tube dysfunction and it can result in recurrent episodes of otitis media, especially in children. Although recurrent tonsillitis used to be the most common indication for tonsillectomy, more children are having this procedure for disordered breathing conditions, such as obstructive sleep apnea. In this episode, we'll discuss disorders of the eustachian tube and tonsils with Laura J. Orvidas, M.D., an otolaryngologist at the Mayo Clinic. Specific topics discussed: Purpose of the eustachian tube Definition of eustachian tube dysfunction Physical exam findings of eustachian tube dysfunction Recurrent eustachian tube dysfunction in children and potential for recurrent episodes of otitis media When pressure equalization tubes are indicated Relationship between pharyngitis and tonsillitis Viral versus bacterial causes of tonsillitis How to suspect a peritonsillar abscess Indications for tonsillectomy Management of tonsil stones Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

We talk with Steven Goudy MD, MBA about his clinical practice and research emphasis on cleft palate care in children at Emory Healthcare, as well as some tips on trying projects/adventures outside of clinical medicine. --- CHECK OUT OUR SPONSOR Edward Jones https://www.backtable.com/401k --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/Z99Eai --- SHOW NOTES In this episode, pediatric otolaryngologist Dr. Steven Goudy joins Dr. Gopi Shah and Dr. Ashley Agan to discuss diagnosis, treatment, follow-up care, and family education for children with cleft lips and cleft palates. To start, we define cleft lip and cleft palate based on abnormalities in fetal developments. Then, we cover the timeline for identification and treatment of these conditions. Dr. Goudy emphasizes that cleft lip and cleft palate can have a large effect on basic needs such as feeding. While cleft lip repair can be performed early, it is best to wait until the 1-year mark for cleft palate repair. We discuss treatment of different variations of these conditions, including incomplete and bilateral cleft lips. As we move into post-surgical care, we cover Eustachian tube dysfunctions and post-surgical hearing screenings. Dr. Goudy also discusses co-morbid issues and the process of counseling families through genetic testing. Dr. Goudy highlights the importance of multidisciplinary care. Within his cleft clinic, the surgeons work with audiologists, speech pathologists, geneticists, dentists, and social workers. He discusses barriers to care for patients who live in rural areas and how his team works to overcome them. Finally, Dr. Goudy describes his own adventure in medicine, which extends beyond treating cleft lip and cleft palate. As he shares how he got started in translational research, he gives tips for assembling a research team and finding good mentors. He also explains how he addresses common parent concerns by starting a pediatric nasal suction device company, Dr. Noze Best. --- RESOURCES American Cleft Palate Association- https://acpa-cpf.org/ Babies Can't Wait- https://dph.georgia.gov/babies-cant-wait Georgia's early intervention program that offers a variety of coordinated services for infants and toddlers with special needs. Dr. Noze Best- https://www.drnozebest.com/

Dr. Brian McKinnon joins to chat about preventing erosion of patient benefits from overuse of novel surgical procedures in head and neck surgery.

If you mouth breathe, struggle sleeping, snore, or have eustachian tube issues, then check this out! Mouth breathing is linked to sleep disorders, tooth decay, eustachian tube issues, and so much more, what do you do about it? Could the answer be myofunctional therapy? That's what I sift through with Myofunctional therapist Melissa Mugno. In this podcast, you'll learn: Why Steph Curry chews on his mouthguard the way he does Why do we clench and grind our teeth? The importance of breastfeeding on orofacial development What myofunctional therapy is and where it belongs in the healthcare system The two causes of the mouth breathing epidemic and how to tackle this problem How behavior change plays a crucial role in a successful outcome The intersection of physical and myofunctional therapy Why belly breathing is totally overrated The myofunctional therapy intervention process The link between swallowing and eustachian tube dysfunction and TONS more If you are ready to make your upper airway healthy as can be, then definitely check this podcast out. Look here to watch the interview, listen to the podcast, get the show notes, and read the modified transcripts. Learn more about Melissa Since becoming an Orofacial Myofunctional Therapist in 2014, Melissa has improved the lives of hundreds of patients and lectured around the country. Melissa treats patients of all ages suffering from a wide range of conditions stemming from adverse myofunctional habits. Her background as a Dental Hygienist and experience in the fields of Orthodontics and Pedodontics contributes to her success. Melissa works in Las Vegas, NV, and is a Breathe Associate at The Breathe Institute in Los Angles, CA. Her website Show notes Here are links to things mentioned in the interview: Joy Moeller - One of the foundational people in the field of myofunctional therapy. Sandra Coulson - Another foundational person in myofunctional therapy. Myobrace - A possible way to improve teeth position. Dr. Tara Erson - A great dentist in Las Vegas Dr. Hockel - My dentist who is doing my palatal expansion. Dr. Kareen Landerville - She is my go-to optometrist in Las Vegas The Breathe Institute - Where I got my tongue-tie release done. Dr. Soroush Zaghi - The doctor who did my tongue-tie release. AOMT - That's who I took my myofunctional therapy course through. You can peep the review here.  Bill Hartman - Daddy-O Pops himself. My mentor. The Enduring Impact of What Clinicians Say to People With Low Back Pain - A great article that goes into how maladaptive beliefs can manifest.  Modified Transcripts Why Steph Curry chews on his mouthguard Zac Cupples: So, Steph Curry walks into your office, and he asks you, hey, Melissa, why is it that I like to chew on my mouth guard so much? Melissa Mugno: So, the chewing is because of his airway. Zac: Mm-hmm. Do tell. Tell me more. Melissa: So, in sleep dentistry or airway, we've really come full circle to understand that like chewing and clenching, has a lot more to do with a deficiency in the airway than it does anything else. So, there are habits that are created, that actually kind of stimulate the jaw to come forward, and there's a feeling that feels good. It gives us more air, more serotonin overall, and it actually will give you a lot more clarity. Get some good oxygen, you feel better. So that's actually what's happening. So, the chewing couple times you do it, you're like, it feels good, right? Most humans continue to do things that feel good, stop doing things that feel bad. So, please stop doing that. But the thing was, Steph Curry that's quite interesting is he doesn't just chew on it. He doesn't even - more interesting, he flips it out of his mouth and holds it. And what I was saying to you before was, again, I have not worked on Steph Curry so I do not know. This is just me looking at it, I was intrigued by it. My husband brought it up and said, ‘'Hey, this guy's really known for doing this'' and I was interested. I've always thought there was a big sports connection. I started looking at how thick his mouth guard was and I'm like, "oh, it's at least two millimeters, two and a half." One of the things we do, the dentist will do or to help patients that have sleep issues, is they'll actually open up their bite, open up the jaw, so they can't close all the way, which naturally will allow their jaw to come forward, and that does is it opens up the airway and allows for the air to flow easier. So, he's holding it, and he's protruding his own bite and you can see it's literally bringing his jaw forward. I started looking and then I watched some YouTube video and I saw that Forbes I think it was? It might be off one of the bigger publications that did an actual survey or did some type of research of how many free throws that he made when the mouthguard was out versus when it wasn't. He shot significantly better with it in! It was a no-brainer to me. he's breathing better. Oxygen will absolutely get you focused and therefore he is more comfortable. So why wouldn't you keep doing it? Yeah, so now it's become this whole thing. Now, I guess like, tons of athletes do it and I was like, yeah, of course, yes, it protects your teeth, but there's a lot more to it. Zac: But when you're clenching as well, how does that open up the airway then? Because I would think... Melissa: Clenching and grinding are not opening up the airway. It's a side effect of having a reduced airway. I love my analogies. So, I call it the body's fire alarm. And so, it triggers something and what's happening is the body knows it's getting a reduced amount of air, so it acts to check that. It's going to create some type of function, some type of habit to make sure everything's good down there. So, this, the grinding, and I have this little theory that we grind when we're kids because we're carefree and we clench when we're older because we're trying to control it. [caption id="attachment_13634" align="alignnone" width="810"] Grinding, but not like the Clipse :( (Photo credit: Free Dental Photos)[/caption] Zac: Gotcha. Melissa: It seems that way more adults clench than kids and I realized some of my, I mean, it's not absolutely proven, but my adults that grind are usually my cool cats. They just grind it out, let that jaw flow. The adults are like they're trying to control, they don't want that feeling. It's they're trying to control that bite. They don't know why their jaw wants to move. So, I believe the clenching has a lot to do with trying to contro Zac: Prevent it. Melissa: Exactly. It's also connected to the mind--anxiety and all like so much more mental health and stuff like that. I think it's a natural thing that happens as we become adults that we just want to control. Zac: Yeah. Melissa: That control leads to me building some type of subconscious behavior, to take it out on, and activating the buccinators and we're straining out all in here. No nasal breathing. Breastfeeding Melissa: That's one reason why breastfeeding is so important. Yes, it has a lot of cool nutrition value, but one of the coolest things is that happens is it actually teaches you how to breathe and eat at the same time. The tongues pushes the nipple up, and then be able to help extract the milk, and then the baby's actually letting the mom's body know, hey, you got to keep producing. When moms don't produce milk, they automatically assume it's their fault because they have mom guilt. So, then it's like, I just got to make my baby free to be able to eat and stuff. And they think that the formula is doing the trick but what's not happening is that then the bottle goes in, and now the tongue goes down. Zac: Then you can't control the rate at which the liquid is coming in when it's a bottle versus when you're breastfeeding. Melissa: Then nipple companies make it go quicker, the older you get, make it easier, it just flow it in there, no work needed. Then we don't learn how to breathe nasally really young, then problems ensue. Teeth clenching and grinding Zac: From my standpoint, when we see someone clenching or grinding on the PT side of things, usually that's done to restrict available movement. So, you almost make the system more rigid. And to your point when you're talking about who is this it's those type-A people and a lot of times, I forget what book it was where they talked about the chairs in the waiting room of a cardiologist. Melissa: Oh, yes in the armrests. Yeah, because like they're gripping way hard; fight or flight. Zac: Yeah, and maybe it's just to change the pressurization that's going on in the airway. The importance of breathing Melissa: I laugh a little bit, when people will be like, airway dentistry, PT, speech, what has that have to do with it? "I'm like, Oh, yeah. Who needs air?" Oh, we don't have enough research and I just want to be silly and be like, so we don't have enough research on how important oxygen is? Or seeing the interconnectivity of the body? We all heard that elbow bone is connected to the wrist bone song as a kid, right? Zac: Yeah. Melissa: I just paid you to tell me to breathe? I am breathing! Well, I mean, that's left to be decided, right? [caption id="attachment_12187" align="aligncenter" width="250"] Then you end up looking like this guy #gross[/caption] Myofunctional therapy Zac: Well, and I think most people don't even know that your specialty exists; myofunctional therapy. Melissa: I don't know if I'm the best representation of myofunctional therapists. Zac: You're just my favorite. Melissa: Because it's been more about connecting the dots for me and I think myofunctional therapy happened to be a vehicle that I could I drive that allowed me to go to all these places and I don't think that would maybe be the same for most. I think most love the skill and the passion of myofunctional therapy and what it is day in and day on and how to make the exercises better and that one on one with the patient. I love my patients, don't get me wrong but it's more of this bigger thing for me. I like looking at the teeth, tongue, and more. It opens the door to another place. It's probably my ADHD. The beginning of my journey was untraditional. I was an orthodontic assistant for a long time, hygiene, whatever but I ended up not really even practicing all. My real calling was running a business, selling dental stuff, and making sure the patient and being that liaison to connect everything but at the end of the day, what does that mean? It means making sure the numbers and production and collection were good and I was good at that. We had this really amazing pediatric dental program, but we had this hole in our practice. We would get these referrals for kids who we couldn't start because they didn't have all their molars in yet.  How do I make that work? So long story short, I'm from New Jersey, we don't have a very long summer there. And the doctor comes in and he's like hand me this thing and he's like, we're going to go to this course, I'm like, in August in New Jersey, no, thank you, and ended up being a Myobrace course. There was this patient with a class III bite (where maxilla is behind the mandible). These presentations can occur either genetically or because the tongue sits low, pushing the jaw forward instead of the maxilla. The only real way to fix it is to do surgery (or so I thought). Zac: Yeah, a lot of times they'll break the jaw and pull it back. Melissa: Yes. That's a whole other thing. Zac: I had a friend who did that and I didn't know him at the time. He was a coworker and I told him ahead of time, my buddy was like, don't do this. If anything, you got to bring the jaw forward. Melissa: Did you know that? This was before you started doing? Zac: Yeah. Melissa: so, you were already? Zac: Yeah. I knew like a little bit of airway stuff and like some of my earlier things, it was more about using splints to change occlusion. I started with a gelb splint. [caption id="attachment_13637" align="aligncenter" width="375"] Ah, the classic[/caption] Melissa: Really? Zac: Yeah, because my wisdom teeth were still in and I had no truce of movements in the jaw and so we use the gelb to try to get me a little bit extra just for moving perspective but then the fix was to get the wisdom teeth taken out. So, then we went that route. I wasn't really having sleep issues, then but as I got older, it was - Melissa: Well, you did your sleep study show sleep apnea? Zac: No, I got upper airway resistance syndrome. Melissa: I wonder because of your athleticism and all those things that because you – elongation in the sense you did, it would look like you might be more of a sleep apnea patient, but really, you're UARS?  Apparently, you and I are in the same club. Zac: I know right? Melissa: So we had this mom who all three of her boys had an underbite. She challenged us and asked if there was really nothing I can do besides surgery? We ended up implementing myobrace and started to notice some decent changes, but the execution was rough; we didn't know what to look for and how to progress. So, the journey then, long story short, kind of went in that I really started to crave the need of like, okay, who created these exercises? Where did they come from and that actually kind of brought me full circle to Sandra Colson and realizing she was a huge part of working with them. Her husband was an orthodontist, she was a speech therapist, and they were getting amazing results. Learning from her made sense to the cases we had that relapsed. And it was important. I didn't hear tonsils and adenoids so much like we weren't bringing like was sort of doctors doing an orthodontist is doing his you know console, he's usually rattling off stuff, that type of by you know, class one class two, upper post for your class or whatever, convex all the different profiles have any they might say, you know, within normal limits, but I noticed we started seeing WAY more enlarged tonsils. [caption id="attachment_12197" align="aligncenter" width="500"] Tonsils are the bottom read and white spot thingy. Looks like a solid "3" there, Bob. (Photo credit: Spider.Dog)[/caption] My real aha moment was working with this amazing orthodontist who produced incredible smiles. It was my first job assisting, so I didn't know any different, but he used removable appliances, nothing cemented. Zac: Really? Melissa: And we always were doing early expansion, twin blocks maras, we would use anything, everything was removable, prop that bite up, pull it forward, and expand the heck out of it. Zac: Wow. Melissa: Now he - how do I say this a nice way? He had, I guess back then I probably would have called an arrogance. He commanded the room. Right? Like you didn't question. He just carried himself in a way. There was no option but the one he gave. Like if Bobby didn't wear it. Like that's your problem, then you shouldn't make him wear like, so that level of expectation. So why that's important to understand. So, I go through and I remember one day we're in the office and I know nothing, right? Like, I'm just figuring out how to do this. He walks by, and the patients are humble, we do and he's like God, somebody should cut that kid's tongue out of his mouth. It's messing up my teeth. It sounds dramatic but now I totally understand but I didn't. I was like, wow, what a jerk. Right? Like, he doesn't care. So, come all the way full circle, I'm now inMyobrace class, I'm doing it, and it was like this light went off, I was like, oh my gosh, this is what he was talking about. The kid was tongue-thrusting. No matter what he did to that bite, he couldn't close it. Zac: Because the tongue kept pushing on the teeth. Melissa: Yes, that's what he meant. He's like God, that tongue is going to destroy everything. So, he knew it. But the crazy thing is if you go back into his story, he was originally an engineer. He was a mechanical engineer prior. Then after had gotten married, went back in dentistry and became an orthodontist. Essentially, orthodontics is engineering. It's all about force and movement and I think that's what makes most orthodontists very specialized is because they can see things in a different way. With Myobrace, we could take it to another level. Years go by and I go back to school and all those things. And I noticed, almost every orthodontist just cements everything in and they just, I didn't even know you cemented it. It allowed me to basically see all aspects of dentistry, and I needed this whole journey to see it. That myofunctional was the most powerful thing. Oh, that's why the teeth keep relapsing because we didn't address the tongue thrust or we didn't retrain the tongue, we would maybe tell the kid hey, Bobby, try to put your tongue up or we put a habit in there or something. Well, anyone that's ever had a real habit, thought was very easy to overcome, right? Especially if you don't even know why you're doing it. And mouth breathing and tongue posture, I mean, if you're drinking all the time, you kind of know what you're doing is wrong, right? Well, you know what the culprit might be, like this is what's causing this? But if you don't even know that it's wrong to mouth breathe and have a low tongue posture, now I tell you, oh, you have a breathing issue. It's because of your tongue. What? Like how do you do that? How do you fix that? Zac: Especially considering how common mouth breathing is. Melissa: Well look at how it's changed. So, you look in Disney movies, so if you go back to like Snow White, the older ones, all of the characters are lips closed. Zac: Really? Melissa: And now you go to Frozen, she's drooling with her mouth open. Zac: Wow. I never even noticed that but that totally make sense. Like sleeping beauty, was she snoring? Melissa: No, no, lips closed, breathing through. Zac: If you have this epidemic of mouth breathing, and maybe this is where you are realizing the limitations of myofunctional therapy. Just like I have limitations as a PT that's why I talk to you and work with a ton of other people who have skills that I don't. Where myofunctional therapy starts Melissa: In a perfect world, you'd start with breastfeeding. Every baby that's born would address whether or not the baby has a tongue-tie, and has a tongue tie to the new protocols and standards. Unfortunately, the system makes that hard. So now we go out longer and longer. Now, time starts dwindling. So that's in the perfect world, that becomes the standard and protocol. Zac: Interesting. Melissa: Just like, when you have a baby, they come and they check hearing and they've checked all the other stuff, like, we'd want to have the tongue checked as well. I also think we could put protocols in and say what we should all do but I think maybe just the real simple of somebody when they come in and they talk, the lactations will come and I know when I had my first daughter, and they talk about why it was important to breastfeed, they definitely talked about how important it was for connection and they talked about the nutrition value but they didn't tell me that hey, by the way, she might have some breathing issues, she might not be able to latch, she might not be able to really eat, could change the way her diet is, it could change her airway positioning. There is some research out there now that shows that unchecked could send somebody down the road of having sleep issues. Possibly, we know that there's a correlation in connection to ADHD with kids that snore. I wish I would've gotten that information because I did not breastfeed my first daughter. I mean, I have lots of my own reasons, but I don't know I had made my decision but I didn't feel like I was given all the information, right. So, don't we have the right to know everything? So, if we don't educate the parents, how can they make an educated decision? I don't know so I think education is probably the first thing that would make the biggest difference. [caption id="attachment_13638" align="aligncenter" width="600"] Get your knowledge up, yo! (Image by Sasin Tipchai from Pixabay)[/caption] It's all about building these programs, implementations, having standards and I mean, listen, when I first started and it's been like 11 years, 12 years now, and where we are today is leaps and bounds.  But as you grow new issues happening, like places like the breathe Institute, Dr. Zaghi, I mean, the whole industry change from Dr. Zaghi chose sleep, airway, tongue positioning to become his passion and his drive for research. It opened the door for so much. So, I mean, you have all these pioneers that are pushing limits and doing things all the time. Myofunctional therapy is what you guys do, in a way, but in the mouth. So, it's like physical therapy in the mouth. That's really all it is. And I feel like maybe we should also use maybe some of your standards, more to standardize what we do. So maybe I have a question for you and your fam is this. I was just like, I don't know, anyone that ever has had a rotator cuff surgery and then they go, yeah, maybe do PT, maybe not, like I don't know, like, it's not an option, right? Zac: Well, they're doing that for total hips now but sometimes you get a total hip replacement, and they will not recommend physical therapy. Melissa: And can I just be honest, like, is that because they have insurances? Like, where does it come from? Zac: I'm not sure. Yeah, I don't know. Melissa: I am sure if we went down that rabbit hole, we could find out. Zac: I have my suspicions. I think part of it is, you know, and in some cases, they're not showing physical therapy as having good outcomes. Melissa: Because it's not quick. You got to put work into it. Zac: Definitely. Melissa: We have to train the tongue just like we do any muscle. You must address the structure, function, and behavior. So, fixing the structure, and not addressing how the structure got there, to me is kind of stupid. like, I don't get it. You have to put in the work. Zac: Yeah, and that's the hard thing because really, any type of major lasting change has to do with a change in behavior of some kind. Melissa: Oh, absolutely. Zac: That is what makes our jobs that much harder as we really have to find ways to induce behavioral changes in the people, when, as humans, we inherently, if we can be lazy, we will and I don't think that's a fault, like a character flaw. It just, it takes work and work takes energy – Melissa: and let's give everybody a break. Be honest, is like what is expected of humans and for us to survive and add some kids in the mix and the house and a spouse and a dog and, you know, podcast and two jobs and or whatever it may be, to level up or do what you needed to get your hustle on or whatever, maybe there's just not a lot of extra time. And then you also are then to do to overcome these lifestyle changes, these behavioral changes that are going to have a Long Lasting structural and functional behavior change require self-assessment, looking in the mirror and taking time to evaluate and understand, oh, wow, I did not realize that was affecting this and connecting those dots. And when that doesn't, so you barely have time to do these basic little exercises that we're doing, and yet, you think you're going to have a behavior change? You worked with my mom. I'm going to use it as an example and my mom's good with this because she doesn't know what she doesn't know. So, she came out and she pretty much just wanted to have surgery. Yeah, that was her goal. I mean, she was excited. Now here's me, and I'm like, you even know why you're going to have the surgery? So, tell me exactly what's going to change after the surgery? And I was like, No, no, you're going to go see my buddy. And my mom is - she knows what I do for a living. She's seen me lecture. My mother's gotten some decent gifts of any little success I have. So, you would think she's like, of course, I'll go see your friend and she found out you're out of network. And she's like, Oh, he's not covered by my insurance and I was like, and that's exactly why you are going to see him. I was going to pay for it but think about that mentality, and I'm like, Oh, my God, it's touching nothing and then so now she comes back. She's like, wow, how amazing. I saw her really, you know, try and working and she started to feel better. She's like, it's so weird. I feel better. What do you mean, it's so weird? I get like, so here's somebody and I'm using this as an example. Like, it is my mother. How is she not getting and yet when something successful happens, it's like, I wonder without, what do you mean I wonder without? She knew but it was like, she almost had to be reminded. It's because, in her mind, the only thing that was going to fix her is if you did the surgery, or whatever it may be, right. So, if you can play on that, like not to go into her stuff, but I feel like isn't that across the board some of the stuff we're dealing with? Zac: Absolutely. Well, it's because it requires you to have some autonomy and you to have some ownership and almost intrinsic motivation to better yourself. It's within your control. Melissa: And most people don't want to believe anything they're doing or what they could do could better it because then it's on them. Zac: Or something that they're doing is causing it. [caption id="attachment_13639" align="alignnone" width="810"] But I'm not the problem. (Image by S. Hermann & F. Richter from Pixabay)[/caption] Melissa: I could easily change destructive habits, but it made me struggle having empathy for people that couldn't do that. Where does myofunctional therapy belong? Melissa: I think it belongs in lots of different areas: in speech therapy, dental offices, and physical therapy. I mean, it's everywhere. I mean, it should be bodyworkers, there are so many people because it affects - it's part of the whole thing if your mouth is weak, and your tongue is out, your mouth opened, you're going to be mouth breathing with the oxygen is going to change, you're not breathing through your nose, it's going to cause sinus issues, you're going to be more likely to have sinus stuff. It's going to affect your face; it's going to affect your cranial facial development, and then that can affect not that I don't know, but neck, the shoulders, your posture. Mom's will be like, if so if your teeth are off like this, I was like, so how's this constipation? And the dad's like, well, now you fix constipation. I was like, Oh, well, I mean, if you can't chew your swallowing whole, so hard for you know, go potty. And the mom was like "oh my god, he goes to the bathroom three times a week when that happens." It's really hard. I'm like, Oh, yeah, you can't? Yes. Yes. No contact back there. He's trying to so texture food is going to change the way he swallows the food. How quick he eats, how slow. I mean, it's like cutting scissors that don't line up. And he doesn't even know to tell you. Hey, Mom, I don't have any occlusion. I can't chew that meat. And we're like, eat your food, Johnny better eat your food, close your mouth. And literally, he's like, I can't breathe, I can't chew but I got to do it all so I'm just going to swallow it and real quick, get that down. It's going to make it a lot harder for us to digest food and then digesting now sleep, right? Now that's going to affect other things, I mean, long term and I can't imagine that. Me talking about this, that we can't go connect us that people that end up in your position with you are suffering from my stuff. And the people I see that are suffering from this need to be seeing you. Right? So, it's important to keep the connection going. Zac: Yeah, well, with that, the tongue is one component of the airway and, we've kind of talked about this a little bit where, you know, with you, you kind of specialize in the airway that's more upper whereas a lot of the PT stuff that I do is more airway lower. So, you really have to, I think, blend all of that in order to elicit or to maximize respiratory capabilities, which has wide-ranging effects. You know, we talked about vagus nerve, and you look at all the influences that I have across our physiology and - Melissa: anything when you say like your family or people I mean, that's, that's your place. You guys are all cool with that. So, the fact of like, your people and my people, while we haven't all sat down had dinner, like, you know, I mean until today. That's important because I think there's so much, I should learn from you and you should learn from me. And I hope one day that there is a course, that helps us all connect the dots and my stuffs included in your education and your stuffs vice versa, right? Like, the idea is to up the ante and build the specialties, and really help teach the students how to connect the dots. It shouldn't be something you have to learn once you get out of school. Zac: Yeah. 100%. Melissa: That should be taught in the beginning. Zac: Yeah, it's almost like you need a different profession that combines it all or you need a team and this is kind of where I think you are. You are realizing that you are one piece of a greater - Melissa: Oh, yeah, I mean, I've known that. That's always been but sometimes you got to do all the work to prove that you need help. Zac: Absolutely. Melissa: You got to show where you're falling weak and collaboration is everything. But with collaboration, also will bring some other hurdles. Patients, like we were saying before, don't like hard work. Well, they also don't like being told they have to go see nine people. Zac: Yeah, no, I and that's an issue that I've ran into with some people and I think I struggle with me, referring people into this space is, when I have that conversation of well, you might need a few different things, that's hard. I even just look at like myself, I've seen, I've been to Lincoln, Nebraska, and then that took me to getting wisdom teeth pulled in Phoenix, Arizona, and then that took me to getting the roto rooter done in Memphis, Tennessee. And then now I'm in San Francisco getting this and then working with you and it's just and then Zaghi cutting my tongue. Melissa: How do you build the ultimate practice? So, the question is, does that practice look like an airway-focused dentist? and you know, this airway focus dental thing has become like, who is this person? I mean, I hope that one day, it's just all dentists, because it's not about maybe others you know, they'll be Specialists of who does what technique, but the idea of, that's how you treatment plan. So, they actually, when you go get your six-month cleaning, it's discussed of what your airway looks like, or, hey, if you're mouth breathing, you can cause more decay, tell me how many of most people know that? When people are like, if you mouth breathe, your mouth is dry. If your mouth is dry, you have no saliva, you have no saliva, no antibodies, you have no antibodies, you have nothing to protect your teeth, you're going to get more decay. [caption id="attachment_13640" align="aligncenter" width="354"] But can you nasal breathe tho? (Image by Klaus Hausmann from Pixabay)[/caption] You can brush your teeth all day long. Yeah, like, where somebody else who has tons of saliva, and, you know, it goes like, so these are things like, we should always treatment plan to, hey, your tongue is not sitting where it's supposed to, have you noticed this? And not wait till it's to the point where now it's like, right now you mouth breathe, you snore, you this, you have to go and drop, you know, I've seen my money insurance doesn't cover. I mean, that's a shock to the system. So hopefully that will come to a point of that. But for now, seeing groups come together and it might have a PT, it has a myofunctional therapist, it has a dentist, a body worker, but now it's also a lactation consultant. We could go across the board. I hope that we'll be there and hopefully, we'll have these great little medical many places that can offer all of that, but you got to get your group, you got to get your crew. And I feel like also as a collaborative group, you got to talk finances with each other. What are your patients looking at? What's it going to cost for one patient to see everybody?  Already, how many people know that? Like, if you refer, what's the end of the day out of pocket? I don't know. I've always been curious. I always think of that, like, so if I'm going to send the nine people. I think it'd be like, thank you for the $50,000 journey. I don't know. Zac: Yeah, that's quite conservative. Melissa: Yes, and I've just seen because those are uncomfortable areas, right? You don't want to talk to your fellow colleague and be like, what you charge them. But what do you think about us working together? These are awkward conversations and I don't know if they're realistic. I don't know but I feel like no one ever says it, no one ever wants to talk about it. Zac: Yeah, but it can be a big barrier to, like, if you know so and so's going to charge 10k for an appliance and that's not in the cards for someone because they're on Medicaid or something. Melissa: It's just not in the cards. Zac: Yeah, you have to find a different avenue for that person to get better. Melissa: And I mean, like, again, going back to the things like what is wrong with you? What do you do? Well, you know, money. Zac: It's an unfortunate thing with our system. Melissa: Yeah, but let's be honest, I think even in other systems, do you think they're really addressing this? Zac: Probably not. Melissa: I have to say, I don't think there's any system that's looking at truly getting into what's really going on, which I'll tell you, in all systems do. I think I could sit here and tell you that if we were more aware of some of these breathing issues, we would see a decrease in multiple things like heart issues, Alzheimer's, I mean, we could go down the line. It's about more than fascia Zac: I think all of the tissues adapt and accommodate to ensure our survival and I think if you isolate it to one specific thing, then you're probably missing the boat. And not only that, it's like, say you do a fascia treatment, so you mean to tell me that nothing else changed you and you were able to isolate fascia, you were able to bypass the skin? Not create a ton of changes within the muscle. Melissa: Well, you literally had to go this whole journey to get there but nothing else was affected? Zac: Yeah, you can't isolate the tongue, because you're probably going to also have influences on the teeth, the nasal airway, it all works together. Melissa: And I think from your community and your family to ours, most people, and let's just get medical professionals out of here, let's just talk about our patients, the glaze people, right? You know, if you tell somebody like there's something that's connected to their toe all the way up to their tongue, they're like, no, and I'm like, No, really? Because we sometimes also forget, most people have no concept of what the body actually does, or how it actually is affected. Like, really, I find that to be - they have no understanding how if I walk one way with one shoe funny for a long period of time already, that's going to affect something. That helps us try to explain a little bit easier to patients, how come the tongue position can affect other things? Yeah. So, learning where other systems would only make it better for us to talk about it. Coaching breathing mechanics Melissa: Let's talk about breathing. We're always hands-on, like, when you breathe, you need diaphragmatic breathing, right, like you want to breathe in. And so the beginning, we kind of tried to keep it simple for kids, it was just like a very basic of, you know, put your hands on your stomach and chest, sit up straight and don't let your chest move. Because it's really hard to do if you slouch. So, it just became like, sit up straight, shoulders back, head up, because it felt like, at least opened it. But you would actually kind of had said, you know, it's not always about sitting like that. So, what would be that something to kind of show them that we can help each other? What would be a way that you would fix that? Zac: From my standpoint, when I look at that, you have to look at the actions that should happen at the rib cage. So, the rib cage should move as you breathe in and breathe out because if you think about it, when I take a breath of air in the tissues are filling our lungs, so the rib cage has to make room for the lungs and so it has to stand in all directions so we have these actions at the rib cage called the bucket handle, which would be lateral expansion, pump handle, which is anterior and superior expansion. And then you have posterior expansion. But I think what you were trying to do with the belly breath is trying to mitigate an accessory muscle breathing strategy, where I'm lifting the rib cage up as a unit with muscle such as the scalene, the sternocleidomastoid. We don't want that. I want the rib cage to stretch out. Melissa: Yes, but you would normally want to be more about explaining how it's rounded out and how you want to see it go like here and there. But we're keeping and trying to be simple because oftentimes, I most of all, say like take a deep breath and it looks awful. Zac: Well, when you demonstrated that you emphasize a lot of inhalation. Most people can't get an effective exhale. Melissa: Okay, yeah. Zac: So, you have to get as much air out as humanly possible and then guess what? So, if I am just doing a belly breath, I'm not getting any expansion of the rib cage. Well, you can think of it as like my mentor, Bill Hartman, he has a toothpaste analogy. So, if I take a toothpaste tube, and I squish the top of the toothpaste tube, I get all of the toothpaste going into the bottom. Well, the same thing happens with belly breathing, when I take a breath of air in and I do not allow expansion of the rib cage, I have greater downward pressure into the abdominal contents. So, the diaphragm will actually descend to the point where it's flat, which creates a negative pressure environment in the thorax, which causes compression, too much outflow into the abdominal contents, which is the same thing you see in sleep apnea. But now - because what is that? I have a negative pressure environment that I can't maintain the integrity of the upper airway, it collapses. When you're coaching belly breathing, you're creating the same environment, but now you're doing it in the lower part of the airway. Melissa: Wow. Zac: So then now I have a mismatch of intra-thoracic and intra-abdominal pressure. Melissa: So that is 100% correct. So, where we struggle with this is, most people I've noticed, I say breathe and they really do not know what the feeling is, like they really do not understand what it means to truly get a diaphragm out or like to really get that because that, like you see it in their eyes like to calm them down. So, they can't feel that difference. So sometimes, the way we kind of were like not saying, it's being picked from different kind of systems, and that we've been trained on, we got to get them to at least feel it before you can critique it. And that the more the deeper that professionals getting, is, how do we evolve it, to also get them to feel it, but do it properly to promote positive and like, also children versus adults is going to be very different. How we do that, how we teach it, how long that habits been into play. And I am hands down. If you can't get the breathing, right. I think miles doesn't have a chance to stand. So, to me, breathing has always been the biggest, has been a huge part and I have a lot of theories of like people, there are two ways that you end up with mouth breathing and one is like, there was something wrong with a structural situation with the nose early on and then that created low tongue posture because you had to breathe through your mouth. Or Yes, you had a tongue tie, right? And that tongue tie was tethered. You could have been breastfed, but it was further back. Tongue keeps pulling down and then eventually just slowly opens and then you start to mouth breathe anyway and then you stop breathing through the nose and then that changes the way the air comes in, and now the nose becomes a face ornament, and it's just hanging out and therefore, it's very hard for people. They think they're breathing through their nose, and they're not. And you know, the ones that are like [whoo] like, though, like, you put like one of the boom, boom sticks. You're trying to incentivize some type of nasal breathing. When you're stuffy, you should be doing nasal sinus rinses, 24/7 trying to force yourself to clean out your own sinus, but we go, Oh, no, I'm stuffy. Okay, you know, that's - Zac: It's not normal. Melissa: It's not normal. You need to breathe more. I'm sick. I'm taping my lips up even more, forcing myself to breathe and it's hard, don't get me wrong, but you got to push through it and you will absolutely always overcome something sinus-wise; a cold or something quicker if you force more nasal breathing. Treating adults with myofunctional therapy Zac: Yeah. So then with your treatment process, why don't you talk us through the - And I know it's going to be case-specific and I hate protocols. Like that was one of my - it was a little bit of a beef with I think when you're first learning some of this stuff is, they say, first, you do this, then you do this. You do this, do this and I think there are some case-by-case variants. Yeah. I mean, we're doing weird stuff with me. But say someone comes to you, and we'll say it's an adult, because most of the family - hopefully now that you know, we're talking about some of the stuff that. Melissa: you'll see with kids too Zac:  if an adult comes to you, and let's say they have these issues, they can't attain a palatal tongue posture, they have difficulty breathing through their nose, they have the gamut but it's not a surgical case and maybe it's someone that could just - they just need you. Melissa: They just need myofunctional therapy. Zac: They just need you. Where do you start? And maybe we could talk into your assessment and Melissa: So, I always have to be like, well, I do myofunctional therapy very different right off the bat than most. I only do it in conjunction with dentists. I mean, almost 5% of I mean, there's a couple of patients, I'm close with that end up knowing they're going to go into an appliance because they're going to somebody, but I very rarely not do that. If I could get tongue space, probably tattooed on me. I would. For me, that's my objective. If you don't have enough space, I mean, anyway, if you have a lion and the little cat cage, yeah, doesn't really matter what we do. Right. And so, I get really frustrated sometimes. I don't know, I guess also, I don't love to do things myself. I mean, you'll get changes and there's always benefit, like even myself, if I didn't do myofunctional therapy, I probably would have a way worse situation than I have. The therapies done quite well. I should use myself as an example and I struggle with space, but because at least I have tongue strength, I am able to hold at least what I have so I don't collapse so much and it's funny a CBCT scan, if you look, my tongue is like flat up, because I have like a little cocktail straw. I have like three, four millimeters in my airway. It's really tight. And so, I don't have an option. My tongue can't go back. I mean, game over, right? Zac: Yeah, low resting tongue posture. Melissa: Yeah. And so that's why I can nasal breathe because I had no choice. Right? It was like, this is what it was going to be because it felt so much in my throat. So, you can do myofunctional therapy, just to be able to abstain from what you have if you don't want to fix it, right and so, what would be the base? If someone is really good at nasal breathing, they can breathe, that's fine and keep their lips closed and you can do an easy test like, someone just puts a popsicle stick or they hold and just breathe through their nose for two, three minutes and they're able to do that, then yeah, I would definitely do some therapy and starting off with just doing tongue, just getting to understand where the tongue supposed to be sitting and then from there, you kind of go into being able to move the tongue and then compensation comes into play of can we separate the jaw from the tongue? Because that's when we really start to work the tongue muscles themselves because a lot of people think they can do things with their tongue but really, their jaws were doing it for them. And I mean, I'm no way in speech, but I always like, I asked parents all the time. I'm like, does he mumble and they're like - we'll say, well, do they have any speech issues? Or even adults? Oh, no, I go. Someone ever told you, you, you mumble Oh yeah, all the time. It's kind of a speech issue. Because the mumbling is if you do not have a lot of range, you'll notice someone will say like 123 their upper lip, like the inadequate movement of the upper lip because the lower jaw just kind of - well the tongue is down so you have to bring it up, right? So, they reduce tone. So, they'll talk quicker to get it out or they'll change the words because they're modifying. Humans are amazing. We're going to figure it out. So those are areas that we might work in just to help you build awareness and then body scanning right? What does that feel like? Does that affect your neck? Do you feel that down in your back? Does it feel weird? Like, where do you notice it? Because if I don't build awareness so that you feel the difference of where the tongue is? What's going to keep you in the long run? But I got frustrated with some cases that I wasn't getting better. In 2017 I was pregnant and watching everything Dr. Zaghi is putting out and what's this guy up to, whatever and I was like, oh, okay, I'm going to get this guy, I asked this guy, what about these patients? So, I actually started paying for consults for all my patients, just so I could get on this. So, I could introduce the patient, present it and ask him why they can't go any further. I know the joke is that eventually what I was like, sorry, on staff, like, Hi, like, I was just being me and I'm presenting patient and that and now I felt like oh, my God, someone was finally able to say like, oh, the tongue, he's tied, etc. And now I had somewhere to send them. And I was like, ah, and now listen, the tongue tie got released and we were able to overcome it but the ones we couldn't, which, unfortunately, were more I shouldn't say my patients were, I was lucky enough, I already had the tool in my arsenal. There was expansion going on, right? Like I was working with doctors so if it was a BWS, which I know - Zac: What's a BWS? Melissa: So BWS is a Bent Wire System, which comes from the company Myobrace and they use BWS, and then they have you wear the brace over it to kind of help do with [unsure word 1:06:10] The theory was to kind of do with the crows that did right, so. So whatever may be Crow's out all of these different things. I was lucky enough that I had somebody that we knew we needed to make t space like that's how we were showing that we were getting results. Or then if I would have somebody that would get good expansion, then they would relapse. That's how long I was keeping them so that they were relapsing with me. Because I was on this journey, I needed to know where is going. So then now, I was able to show Dr. Zaghi like, okay, we've done this, we've expanded, we've done, and now this has happened. And like everything happens for a reason. That's how I was able to really so grateful for that situation. So now I was able to see, then you had that tongue-tie release in there, huh? Zac: Because it really takes a team. Melissa: It does. Yeah, and I know I have a hard time being like I could do the therapy, but we don't have enough space so I don't know. But that's me, right? There are a lot of therapists do it. And then they only need tongue ties in there to expand and that's fine. This is just my vehicle and that's what I saw. And I really do think we now finally are like getting into a community. I mean, people are talking about tongue space more and we're more aware of the structure and that you need to be able to withhold all this, be able to have a place for the tongue, the tongue is able to be somewhere so that it can be in the right position. So, it is more and that's what's uneasy about it. And then you know, they're finally in a good place, they've had the release, they go home and now they have anxiety, they're depressed, I don't know, they get divorced, whatever their life comes into play. And we didn't really get into the fact of what the behaviors are, and then they come creeping back, or they get a little new doggie that they're highly allergic to, and they don't realize it and they're mouth breathing again. So, the body or they're doing you know, they have neck issues, or I don't know all these different things, I feel like you also have to bring that aspect into it, and you have to be able to address all of it. So, the treatment planning is complex so most of the time, when a patient comes, I feel confident, I'm able to quickly say to them, okay, this is what you present with, I know your low tongue posture, you have this, this is where I would go, I would start with probably looking to get some type of an appliance. Let's open up that bite work on that structure. While we're doing that, let's work on nasal breathing but while you're getting your structure fixed, let's work on nasal breathing. Let's see how you feel comfortable getting your lips closed. Seeing how that becomes comfortable and then once that structure is done the right thing, then kind of come in, let's bring that tongue up, start noticing where the tongue spot is, and then kind of prepare for the tongue release. Because if I'm setting a patient up, I don't want them to go get the tongue release done until they have tongue space. So then now, I'm going to focus on that, I'm going to keep it pretty structured, there was that tongue ties done. Now we go in and we do some swallowing techniques and we really kind of bring it all around, and hopefully now they're able to keep it and now they don't have their teeth moving and they're not functioning as much. And if they do move a little bit, they know why they have the tools in their toolbox to go back and do the therapy again and do things on those lines, Zac: Which again, gives them a locus of control. So then is it fair to say nasal breathing, space. Step one has to have that, range of motion, I'm assuming would be second and a little bit of awareness of the palatal tongue posture, because I would think if you don't have the range of motion available, it's going to be really tough to attain that position. Melissa: Well, so right if I go back, so I don't know for me range of motion. Okay, so it depends on so, like, we have four grades of tongue-tie, right? Then a two-step release might be the first thing to do. Zac: Interesting. Melissa: Yeah, just get up there. We got now we got to just do that. Then once we do that therapy, work on nasal breathing, work on the structure, then we go back and prepared for the functional frenuloplasty. Zac: Gotcha. Because I have a client who I'm working with right now, he's potentially a candidate for a second step. But so, they do anterior first, and then the posterior tongue tie second. Melissa: So, the concept of why the therapy is so crucial for a tongue tie release, specifically functional for any of us, is because they need to be able to do certain exercises, certain motions and movements, and hold it during the procedure. So, they're numb during the procedure so, they better have really good muscle memory, and know how to do these things, to hold it when you're numb, right. So, you better be able to do a cave suction really well and also, that's going to help build muscles. So now when the doctor goes in, and does that release, you're going to see the separation between fascia, you know, fascia fibers muscles, it makes it a lot easier for the surgeon to get in there and see that difference. Zac: Absolutely. Melissa: Now anyone that's ever worked for a doctor, anything we can do to make their jobs easier is always a win. A win for the patient, win for the doctors, win for everybody. So that's what's crucial for that beginning step. So, if you're so tied, right, anteriorly, which is a lot of people that are out there that will say, Oh, I had a -you know somebody that had a tongue tie release 20 or 30 years ago, I promise you, they still need another one. Because that was a snip. They saw that it was so tongue-tied, they couldn't move it. So, they were just doing what we do with the first step to prepare for the second one. I mean, that's how I look at it. Yeah, yeah. So, you know, look, I was like, Yeah, we got to give you enough rope so we can at least get you to move in, so we can get you to hit this, hit the tongue spot, and be able to then hold that cave, workup, get a little muscle tone, be able to, work there. So, we can get some identifying and be able then to get you ready for healing. And also, it's a lot easier to do therapy exercises for healing, when you already know them and you've gotten muscle memory when you're sore and in pain than it is to learn them when you're in pain. So, I'm like, Well, why would you not do it before the procedure? Because who wants to be learning something when they're also sore? and it's crucial afterward. Once the sutures off, you're doing therapy, I mean, every four hours, six hours. You know you've regimented; you don't want that stuff to reattach. You want to keep that moving. I mean, you want to use this amazing moment, and ability to - now your range of motion being so much wider, you want to continue and that's not going to happen. You can see it become worse, tethered up if they don't have a really great regimen and they didn't have good muscle tone to begin with. Zac: Yeah, and that's something that even in PT, like, if we have someone who's going into surgery, we try to see them - in a perfect world, you would see them pre-op for the exact same reason. Melissa: Yeah Zac: It makes it so much easier on the backend. Melissa: Of course. Zac: They have those concepts in place. Melissa: It's not new. And most of it all, it goes back to the implementation and trying to make sure people understand it. I think that's going to be a battle but I think more conversations like this, more people using their mind and opening up and finding unique places to educate patients. We talk about something earlier, but not to go into I but I believe people are a little bit - I'd like to give them more credit than we do. I think people are able to make decisions. I think we make a choice, unfortunately, to choose what information pertains to them and what they need. Because we don't think that they have the ability to always maybe make the right decision for themselves. I don't know. I feel like all people, this just should be spoken out. They should know, every option. Hey, if you choose not to do it once you've been given all the information. Okay, cool. It's your choice. I have an issue when you weren't presented with the side effects if you don't do it like I'm sure if I was going and having that hip. If no one came in and told me Hey, listen, okay, you don't you know, you couldn't do therapy. You could do PT prior, you know, pre and post. This is the benefits, whatever. If you don't, you know this can happen, this can happen, this can be a little bit more challenging, not everybody, but it does happen, and you truly set the expectations and limitations of both, let the patient choose. Once they're educated, they know, hey, do whatever you want. I have an issue that it's not. We don't do that. Educating patients on airway without inducing maladaptive beliefs Zac: Yeah, which makes sense, because then you're not making them an informed consumer. The thing that I struggle with, and I see this a lot, and I especially see this online is sometimes when you give someone a story, and you give them the doom and gloom of what could happen, a lot of times the maladaptive beliefs that they develop from that, become an issue. So, there was this article, this guy was named Darlow, and I forgot the name of the title is I'll link it in the show notes. And he had this thing that this patient says basically interviewed all these patients based on what doctors had told them. Okay. And I don't know what the doctor specifically said but the patient's interpretation of what he said was, he was so afraid of back pain. He was so afraid of the disalignment of his back that he thought that his spinal cord was going to sever and that led to tons of anger, fear, anxiety, lack of movement, and things like that. And I especially think in this domain, because it is a huge rabbit hole and there are some scary procedures that some people may have to go down like, sure. We're talking about appliances and myofunctional therapy and things of that nature but what if you got someone who needs the MMA surgery? How do you balance not instilling fear and maladaptive beliefs that this is, like, if I don't do this, my life is screwed versus informing them? Melissa: This is what I know, I'll just live with it. And I mean, I truly understand that. So, I said to you like I have a formula for an airway. I do this for a living. I'm aware of what I should do, right. Like, do I know that I should have surgery? It's scary and I know, from the best. So now the other side, right? It's human. Like, I'm going to try this first one, it's a scary thought. And let's be honest also I go into like, do I have it in me to do, you know, my own insecurity of will I follow through? Will, I get it done? Will it truly make a difference? And I think it's just like, I'm always high energy. I'm always like, appear, right? My fight or flight? That's become part of my identity. It's who I am. Is there something inside of me that also scares me from it? Because I'm scared of who I'd be without it. I mean, I'm going a little dark here and a little deeper, but it's, I mean, it's my truth. Zac: Oh, or sure. Melissa: And I play in my own head all the time. I'm like, I can't do it this because my kids like, you know, and I can make every excuse not to do it because at the end of the day, it's huge and it's a leap of faith. I think I respect that and I hope that nobody thinks that anyone's saying it's easy, and it's one shot and, and do it but the question is - then the other comes back to is, maybe I just don't think it's affecting my life that bad. Yeah. Yeah. Even though I statistically notice. Zac: You know what you don't know. Melissa: But the other thing is, you know, maybe I'm comfortable like this, I'm not ready to, I haven't hit my place of like, I can't do this anymore. This is no law. I can't live like this. Right. So, I'm willing to go do that. Where I think like, in some ways, like, those are extreme cases, right? But, you know, kind of just go away. Like, let's go to rotator cuff surgery, right, like, so that's not something, my arms like I can't move it, I don't want to have a choice. That's bottom. I got to fix it.  Well, I'm almost saying like, what are we doing? Why are doctors not - Of course, PT or - Like, why would that not be automatic? I mean, that's part of it. I feel like to say that if that's not the standard, that's scary. And I think things like you've had braces three times. Do you want to try something different. So, you've had braces three times and you also have sleep apnea and so there's a lot of things that have now are coming in your way that you'll pay for this, this, and this. Hey, do you want to also address these other issues? Then maybe we get through there? Just those kinds of conversations. Zac: Yeah. You have to give people options. It's funny you when you're mentioning the identity stuff because I totally run into some patients who will forever be a patient because that is who they are. That is their identity and that's who they become. Yeah, you do have to wonder like if I take that away from them, so your high energy. Well, if you – you get the chill pill and I think it was in Mark Manson's book, not the subtle art of not giving a Fuck but everything is, he talks about - I just read it the other day. Oh. In order to change who, we are, we have to mourn who we were. Yeah. It's such a profound quote and it's true. It's like some people just might not be ready to go through that grieving process of changing those things, those dark things that are about you. Melissa: Well, if you're anxious, you're living in the future. If you're depressed, you're living in the past and if you're content you're in the now. It's hard. Mental health is a big deal. Zac: In terms of like it being the X factor, or maybe the thing we're not addressing. Melissa: Actually, it's personal. So, that's like my connection to certain things. So, I had a patient, an office I was at and I walk into the room, they had the scan up. I mean, the kid has no airway. I mean, never mind, forget the cranial facial stuff and forget the teeth, who cares about the teeth? I like turned around and I was like, hey buddy, he was nervous. He's all these things anyway. So, I was like, great. I got the assistants taken out of the room and I said so any behavioral issues like the mom starts crying. I mean, anger issues, can't calm down,  bathroom issues, can't eat and I'm like, I want to like, just cry, right? Because I'm like, this is a kid in my mind, this young man and the mom is like, she thinks it's just who he is, right. Like, you know, we have one bad seed because I'm telling you, I'm telling her things and she's like, so that has to do with that and like with a little bit of disbelief, right? Like, yeah. Right lady. No joke, the father was in there, he had a mask on, new design and I brought up one thing, I said, so is he really good in like science? And then all of a sudden, like he's reading and comprehension seems to be lower and the mom's like, yeah, he gets stronger grades. Then I asked if he keeps rereading the same page and the dad like takes on his thing, he goes, why he gets that from me. Dad pulls down and he has this crazy deep bite. And I go, I know he gets it from you. I agree. You just have the same habits. And he's like, what? I go, yeah. I go, you both, like you live in fight or flight. Like you just, I just start reading out loud. It will change the game. His dad was like, no way. So the mom's like, I go watch it. So the kid came back and we gave him one little snippet of thing. We told him to read it to himself. I gave him three questions. and read it aloud. He was able to get it! Zac: Essentially recruited another sensory system. Melissa: Absolutely. Zac: Well, and then that goes into, and I don't know if you've ever checked this with those folks. Like if they have any visual issues along with that. Because a lot of times - Melissa: I got to fix it, I'm fixing bathroom issues. Now I got to fix my eyes. Zac: Absolutely. Yeah. Which Dr. Kareen, if you're tuning, I got you! Melissa: Okay. I'm sending it right. I mean, and I'm so sorry, not that I don't know how important the visual aspect is. Zac: Well, to me, I think this all relates to airway because if I have to assume a particular head posture, well, that's going to change where my eyes are looking in space. And so, you could potentially see some changes in the shape of the eyes potentially, or the focusing type stuff or eye teaming. Melissa: Well, we look at it when they, when they - Well, actually I always look like I can. They always like my little last, super what do you call it? Like my tarot card thing is I'll walk and I'll be like, Oh, so you only true on the left side of your face, where I looked in their mouth. And they're like, what? I'm like, well, one side of your face is stronger than the other. I can tell you only work those muscles, but also like the moment you bring somebody up and expand them out their eyes, all of a sudden open up. because they were squinting like this. And so, I guess, yeah, I knew the eyes were part. Everything's affected. Eustachian tube dysfunction So, let's just wrap on the one last thing. I mean, now we've done ears, we've done eyes and mouth. So, kids that have had tubes in theirs. Okay. Kids that have tubes in theirs can't swallow, that's why they can't clear their eustachian tubes. So they have a swallowing issue. That's why it keeps building up fluid. Zac: Yeah, so wait, you're going to have to unpack that a little bit because this is - so if someone has you stationed to dysfunction, how does that relate to the swallow? So are you saying that - Melissa: So, normally what happens? Right. So, swallowing and I am not a hundred percent, but like if the idea of the concept of the swallowing is what helps clear it. Like it helps the fluid run through. So, the concept of like, if you can't swallow, so if your tongue's low, so swallowing for anyone who doesn't know, right. So, the tongue should be up, you should be able to swallow with minimal facial movement. The tongue should just go up,

What's behind chronic ear infections in kidsWelcome to Cloverleaf Chiropractic Show. Today, we're going to talk about chronic infection in kids, what's behind this and what's the best way to handle it, how do you help the children that have ear infections. So I'm going to talk about how to manage this situation and how to help the kids.Welcome to the Cloverleaf Chiropractic Show, a podcast advocating wellness, life and healing from within. With 38 years in practice, 50,000 patients, and over 1 million chiropractic adjustments, here's your host, Dr. Daniel Abeckjerr.My name is Dr. Daniel Abeckjerr, I'm a Doctor of Chiropractic. Stay tuned. I'm doing this show to educate the public on health and wellness, in basically how are we going to help the kids today when they have chronic infection. And I know it's a common problem that a lot of kids have.Over 80% of the kids, the children, experience at least one ear infection by age 3 according to NIH. Ear infection is a very common problem. As parents, we should increase our knowledge on this condition.Chiropractic can help ear infection, and the situation, this condition can be fixed with chiropractic care. What are ear infections? Where do they call from? It is an inflammation that happens in the inner ear. The infection manifests as fluid builds up behind the eardrum.So this condition is called otitis media. It is very common in young children and toddlers and infants. This is the number one reason why parents take their kids to an ear infection specialist. When it comes to otitis media, everybody is vulnerable. Seniors can get it, young teenagers can get, pregnant women can get it, younger adults, middle aged people, young children. No one is immune to this condition.Children are more at risk with this, and it's much more common with young kids. So why the kids have a greater risk of getting otitis media or ear infection? Because the anatomy, the way the anatomy is, the Eustachian tube which is the tube in the ear, happens to be smaller in kids.And the tubes when they're developed, they're not really thick, they're kind of flat in children, and basically it allows less space for the ear to clear. And basically, the fluid doesn't drain out properly from the ear, and it's much more difficult for this to happen. So sometimes the Eustachian tube can swell and it can be blocked by mucus, especially when the child has a cold.

Today we take a deep dive . . . into the ear. We look at a client who had a sinus infection with lingering ear stuffiness. Magically, it resolved with massage! The MT naturally wants to know, “What happened? And can I make it happen again?”   Resources   Hayes, Kristin. “What Causes the Accumulation of Fluid in the Ear?” Verywell Health. Last modified November 2019. Accessed January 2021.   Hoffman, Matthew. “Picture of the Ear.” WebMD. Accessed January 2021.   Llewellyn, A. et al. (2014). “Interventions for Adult Eustachian Tube Dysfunction: A Dystematic Review.” Health Technology Assessment 18, no. 46. Accessed January 2021.   This podcast sponsored by:   Books of Discovery: www.booksofdiscovery.com   Anatomy Trains: www.anatomytrains.com   Host:   Ruth Werner: www.ruthwerner.com     Additional articles by Ruth Werner:   “COVID-19–Related Complications”

This podcast highlights original research published in the November 2020 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation. Eustachian tube dysfunction (ETD) is a common diagnosis among adults presenting for outpatient care. We sought to determine national utilization and the associated cost of invasive procedures for adult ETD. In conclusion, several nasal and otologic procedures are associated with a diagnosis of adult ETD at substantial cost. Development of therapeutic alternatives should be sought to mitigate the need for invasive procedures to treat this condition.   Click here to read the full article.

Dr. Ashley Agan and Dr. Gopi Shah talk with Dr. Joe Walter Kutz about the management of Eustachian Tube Disorders, including pearls and pitfalls on treating the "clogged ear". --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/CmPTBe --- SHOW NOTES In this episode, Dr. Walter Kutz joins Dr. Gopi Shah and Dr. Ashley Agan to discuss the essentials of caring for patients with chronic eustachian tube disorders. They emphasize that the diagnosis of patients with chronic eustachian tube disorders can be challenging. Patient history is often the driving factor in evaluation of these patients, but objective measures such as tympanograms can aid in the diagnostic process. They describe in detail the differentiating features of patulous eustachian tube, a commonly missed diagnosis with a similar presentation as eustachian tube dysfunction. The best practices for evaluation of patulous eustachian tube are outlined, including the ideal set up for otoscopic and endoscopic nasal exams. They also touch on the treatment options for patulous eustachian tube, giving insight into procedure details as well as complications. The discussion then evolves to focus on more complicated cases of eustachian tube dysfunction, including patients with atrophic tympanic membranes as well as those refractory to tympanostomy tube placement. The efficacy and challenges of eustachian tube targeted procedures such as balloon dilation are reviewed. The role of allergy evaluations in management and care of eustachian tube dysfunction patients are also considered. Finally, they touch briefly on some notes on the diagnosis of eosinophilic otitis media and superior canal dehiscence. --- RESOURCES Dr. Kutz's Website: https://utswmed.org/doctors/joe-kutz/ Dr. Kutz's Twitter Handle: @EarDoc1 Dr. Kutz's Instagram Handle: @walterkutzmd PatulEND - Patulend.com

Stop sleeping on planes If you're one of those people who goes to sleep once the jet reaches cruising altitude, you might want to rethink your air travel habits. There's a high price for not paying attention to what's going on. You could suffer from ear barotrauma. This happens when you don't take steps to clear the Eustachian tubes when the outside air pressure doesn't match the inner pressure. This mismatch usually occurs on takeoff and landing. If the tube stays blocked, fluids could build up behind the eardrum causing pain and hearing problems. Set your cell phone or other device to wake up and prepare. Flight attendants wake up sleeping people because they want everyone to be ready for landing, but they might overlook you if they're busy. Don't risk hearing damage. Take care of your own needs. You don't want to be distracted by ear pain and muffled hearing once you land. --- Send in a voice message: https://anchor.fm/drclaudia/message

Zsquare develops high performance, ultra-thin, single-use endoscopes for a broad range of indications. They have created a single-use endoscopic platform that completely eliminates the risk of cross-contamination which is caused by endoscopes that are reused. These endoscopes dramatically cut healthcare cost and improve diagnostics quality. Asaf Shahmoon, Founder and CEO of Zsquare, patented miniature fibers that allow for unprecedented access for doctors, serving indications that never been available before. "I think that we have started out very ambitiously by reconsidering endoscopy in general. Once we researched the market, we knew that rather than tackle a single barrier or a single trend, we were going to disrupt the way people approach endoscopy. We mapped out basically three components in the clinical, in the healthcare, as well as the market. We set out to create a sustainable technology that would significantly shift all of these elements," shared Asaf on the most recent episode of Inspiring Minds with Justin Starbird. For example, meeting the demands of the global pandemic has been at the forefront of their scope of work. The Zsquare tiny endoscope, can access the Eustachian in ENT, the Fallopian tube in gynecology and go deeper down the lungs in bronchoscopy. Asaf explained "I think that from the clinical aspect, we needed an endoscope that was from one side flexible enough but at the same time, very small in order to go inside areas that no other endoscope can go, but still provide high-resolution images. In terms of health care, we had to solve the cross-contamination problem that is actually affecting the entire environment of the multi-use. I think that specifically in these days when a pandemic is being spread around the globe, we're witnessing the magnitude of cross-contamination. Therefore, single-use endoscope can play a vital role in avoiding this."

In the episode of SpearFactor, I speak with ear, nose, and throat Doctor Cyrus Torchinsky. Dr. Torchinsky currently practices medicine and lives in San Diego, California.  He is original from Santa Cruz, California and attended UC San Diego Medical School, then traveled to Boston, Mass. for his speciality training as an ENT doctor. Dr Torchinsky shares his knowledge about various topics including common issues that both surfers and divers deal battle over the years. This episode has a ton of excellent information that will help a lot of us. It was an absolute pressure to have him on the show. I hope you will enjoy! 1. Coronavirus 0330-0927 2. Top issues and how to fix them 09:30-21:04 3. Infections and What happens when it rains 21:05-25:30 4. Swimmer’s Ear/Fungal Infections and treatment 25:35-29:10 5. When to seek out at Doctor for treatment 29:15-30:00 6. Do's and Don’ts 30:00-33:10 7. Craziest thing you’ve seen 33:10-37:10 8. Best conditions for beginner surfers 37:10-40:20 9. Eustachian tubes Issues and new treatment 40:20-47:12 10. Ringing in your ear. Reasons and treatment 47:12-53:05   Follow Spearfactor: Instagram @the_spearfactor Facebook Spearfactor Group, YouTube  @SpearFactor Reddit @SpearFactor  LEARN MORE SpearFactor is all about sharing information about spearfishing to enhance your experience in the ocean. If you are a new spearo, please checkout www.spearfactor.com for more information on targeted fish types and spearing.  SOCIAL MEDIA   → Podcast: https://www.Spearfactor.com/podcast  → Instagram: https://www.instagram.com/the_spearfa... → Facebook: http://www.facebook.com/SpearFactor   #spearfishing #spearfishingbaja #spearfactor #onedropspearfishing  

Today's podcast episode is up with some poetry and a short dark fiction by myself. I actually GREATLY disturbed myself writing today's feature because "oh, I'll write about a writer that's snowed in" went to "it's the end for me, it's at the window" very quickly.I am still dealing with minor ear, Eustachian tube, and throat issues, and thus also am not speaking at normal levels, as well as having to rebuild filter curves for audio processing. Due to a variety of issues this therefore does not sound as loud to me after bringing the RMS up, and I still sound a little muffled.Not intended for children. For those that need trigger warnings although the poems do not deal with death the feature story does.Gong sound courtesy of Cloudy Skies after a fortuitous accidental discovery.=Full Podcast content=www.FlashFictionFridays.com Podcasts.com: http://www.podcasts.com/mythical-minstrelsy-flash-fiction-fridays-and-ames-bookshelf-1a06920c4 iTunes: https://podcasts.apple.com/us/podcast/mythical-minstrelsy-and-flash-fiction-fridays/id1461538463 Google Play: https://playmusic.app.goo.gl/?ibi=com.google.PlayMusic&isi=691797987&ius=googleplaymusic&apn=com.google.android.music&link=https://play.google.com/music/m/Iregmi7sag7o3fg6p3e32k5ghwq?t%3DMythical_Minstrelsy_and_Flash_Fiction_Fridays%26pcampaignid%3DMKT-na-all-co-pr-mu-pod-16 Spotify: https://open.spotify.com/show/1vLsYYcHOkDdasTFvqe9Ph =Flash Fiction Only Pods=Soundcloud: https://soundcloud.com/teresa-garcia-34 =Financial assistance for the projects=Patreon: http://www.patreon.com/AmehanaKo-fi: http://www.ko-fi.com/amehanaPaypal: http://paypal.me/thgstardragonFiverr (if you'd like to hire my voice): https://www.fiverr.com/users/amehanaACX narration: https://www.acx.com/narrator?p=A2Y7PVT9DS7158 =Social and Communication=THG StarDragon Publishing, Mythical Minstrelsy & Arashiryuu Productions Discord: https://discord.gg/hvswe2A Instagram: https://www.instagram.com/amehanaarashi/ Twitter: https://www.twitter.com/amehanaarashi Facebook Artist/Author: https://www.facebook.com/Teresa.L.H.Garcia/ =Other places and ways to support=Amazon: https://www.amazon.com/Teresa-Garcia/e/B009Q938VE Commissions Info: https://www.deviantart.com/amehanarainstardrago/journal/Commissioning-Information-566657935 DeviantArt: http://amehanarainstardrago.deviantart.com Gumroad: http://www.gumroad.com/thgstardragonPublishing Blog: http://www.thgstardragonpublishingblog.com Publishing Website: http://www.thgstardragon.com Smashwords: https://www.smashwords.com/profile/view/TeresaGarcia Storenvy: http://thgstardragon.storenvy.com/ Check now and then for new things, some I can't list just yet.Threadless: https://thgstardragon.threadless.com Youtube: http://www.youtube.com/Amehana Livejournal: http://rainstardragon.livejournal.com Dreamwidth: http://rainstardragon.dreamwidth.org =Reviews, Readings, and Requests=Want to send me something to read on here or to review? Have a particular request? Need to send something the old-fashioned way?Maybe you've got a hard copy of a book you want reviewed, or a copy of some of your own work for me to look over?Perhaps you have some of your work you'd like me to record?THG StarDragon PublishingAttn: Teresa GarciaPO Box 249McCloud, CA 96057USAEmail necessary? Send me a note at TeresaAmehanaGarcia@gmail.com (freelance related) or THGStarDragonPublishing@gmail.com (publishing).

Today's podcast episode is up with some poetry and a short dark fiction by myself. I actually GREATLY disturbed myself writing today's feature because "oh, I'll write about a writer that's snowed in" went to "it's the end for me, it's at the window" very quickly.I am still dealing with minor ear, Eustachian tube, and throat issues, and thus also am not speaking at normal levels, as well as having to rebuild filter curves for audio processing. Due to a variety of issues this therefore does not sound as loud to me after bringing the RMS up, and I still sound a little muffled.Not intended for children. For those that need trigger warnings although the poems do not deal with death the feature story does.Gong sound courtesy of Cloudy Skies after a fortuitous accidental discovery.=Full Podcast content=www.FlashFictionFridays.com Podcasts.com: http://www.podcasts.com/mythical-minstrelsy-flash-fiction-fridays-and-ames-bookshelf-1a06920c4 iTunes: https://podcasts.apple.com/us/podcast/mythical-minstrelsy-and-flash-fiction-fridays/id1461538463 Google Play: https://playmusic.app.goo.gl/?ibi=com.google.PlayMusic&isi=691797987&ius=googleplaymusic&apn=com.google.android.music&link=https://play.google.com/music/m/Iregmi7sag7o3fg6p3e32k5ghwq?t%3DMythical_Minstrelsy_and_Flash_Fiction_Fridays%26pcampaignid%3DMKT-na-all-co-pr-mu-pod-16 Spotify: https://open.spotify.com/show/1vLsYYcHOkDdasTFvqe9Ph =Flash Fiction Only Pods=Soundcloud: https://soundcloud.com/teresa-garcia-34 =Financial assistance for the projects=Patreon: http://www.patreon.com/AmehanaKo-fi: http://www.ko-fi.com/amehanaPaypal: http://paypal.me/thgstardragonFiverr (if you'd like to hire my voice): https://www.fiverr.com/users/amehanaACX narration: https://www.acx.com/narrator?p=A2Y7PVT9DS7158 =Social and Communication=THG StarDragon Publishing, Mythical Minstrelsy & Arashiryuu Productions Discord: https://discord.gg/hvswe2A Instagram: https://www.instagram.com/amehanaarashi/ Twitter: https://www.twitter.com/amehanaarashi Facebook Artist/Author: https://www.facebook.com/Teresa.L.H.Garcia/ =Other places and ways to support=Amazon: https://www.amazon.com/Teresa-Garcia/e/B009Q938VE Commissions Info: https://www.deviantart.com/amehanarainstardrago/journal/Commissioning-Information-566657935 DeviantArt: http://amehanarainstardrago.deviantart.com Gumroad: http://www.gumroad.com/thgstardragonPublishing Blog: http://www.thgstardragonpublishingblog.com Publishing Website: http://www.thgstardragon.com Smashwords: https://www.smashwords.com/profile/view/TeresaGarcia Storenvy: http://thgstardragon.storenvy.com/ Check now and then for new things, some I can't list just yet.Threadless: https://thgstardragon.threadless.com Youtube: http://www.youtube.com/Amehana Livejournal: http://rainstardragon.livejournal.com Dreamwidth: http://rainstardragon.dreamwidth.org =Reviews, Readings, and Requests=Want to send me something to read on here or to review? Have a particular request? Need to send something the old-fashioned way?Maybe you've got a hard copy of a book you want reviewed, or a copy of some of your own work for me to look over?Perhaps you have some of your work you'd like me to record?THG StarDragon PublishingAttn: Teresa GarciaPO Box 249McCloud, CA 96057USAEmail necessary? Send me a note at TeresaAmehanaGarcia@gmail.com (freelance related) or THGStarDragonPublishing@gmail.com (publishing).

Hour 4 of A&G features the art of the re-direct, a way to avoid blowing out your eustachian tubes, coffee roaches and Jack apologizes to an entire retail store.

Hour 4 of A&G features the art of the re-direct, a way to avoid blowing out your eustachian tubes, coffee roaches and Jack apologizes to an entire retail store.

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… Let’s get started!    Anonymous: Hi, I was wondering whether there is any point in purchasing the DCD or candida & bacteria overgrowth protocol if you are not willing to follow the nutritional guidelines? I have been following a clean diet according to many of your recommendations since doing the DCD earlier this year. Unfortunately this has now slowly spiraled me back into former patterns of disordered eating. I previously had a clinically diagnosed eating disorder which I recovered from, but whenever I try to follow any sort of nutritional guidelines I end up back in that very negative place, even if my intentions were wellness based. I have therefore decided that this is not the path for me. I still want to do what I can for my health and therefore wonder if there are health benefits when only taking the supplements of the above protocols or whether it is not really worth the financial investment when not following the diet as well? Many thanks for all of the work that you do!! Krista: Hi Dr. Cabral, Quick question for you : how much protein do you recommend pre-teen and teenage boys get on a daily basis? Specifically I’m trying to figure out for my 11 & 14 year old boys (who are on the leaner end weighing 55 and 75 pounds respectively). Just wanting to make sure they are getting enough but also not too much…! Thanks so much for all you do! Larissa:Hi Dr. Cabral! What are your personal thoughts on the "healthier" alternatives to the standard "processed meats?" I know you've mentioned that the Mayo clinic found that Processed meats are definitely carcinogenic. What about Sausages and Hot Dogs made from organic / pasture-raised animal meat without the added Sodium Nitrate and those brands that say "no added sugar?" Thank you for all you do! :) Ari:hi I have depression and anxiety & am 21 years old. I am super low mood ( have been since I was 5 years old) and cannot get out of bed without adderal etc. I have been getting recurring sinus infections for at least the past 10 years, took birth control for 2 years, and have taken anti-biotics more times than I can count. I am going to do a DCD, and CBO protocol. Should i be doing anything else on the hormone front regarding the past birth control use? Nora: Hi, I get really bad periods and have depression & anxiety. Birth control pills are the only thing that have sucessfully gotten my period under control. I really want to take care of my gut as well as improve my liver function. Can I do the CBO protocol while on hormonal birth control pills? If I am taking hormonal birth control, how can I seal my leaky gut? Beth: Hello. I am an avid listener to your podcast and have been truly inspired by your knowledge. Thank you so much for all you give. I understand that this may not be answered for up to 12 weeks but I am desperate for an answer to some of my husband's health problems. I think I know that you're going to tell us to get him do all the tests, but being in England and having everything shipped over through you guys will cost. I will try to find a functional doctor near me over here but I don't feel like I can trust anyone but you! My other intuition tells me that he needs to see an Ayurveda Dr but Ayurveda is so unknown over here that it will be really difficult to find someone to help him. His problems are as follows: cold-induced urticaria, blocked sinuses; resulting in terrible headaches occasionally, blocked Eustachian tubes so he can hear constant clicking in his ears and now he has lost his sense of taste which came about after a recent tummy bug. We cut out meat and dairy (95%) from our diet last September and he has been to see a kinesiologist and so now he was told that his body doesn't like, pork, dairy, alcohol, sugar, chocolate, caffeine, prawns so he has cut out all of those. He used to drink a medium amount (probably about 2-3 beers and 2 glasses of red wine) every night and has cut back to almost zero since Christmas. It seems to have made no difference. On the odd occasion he has had a few beers (like twice since Christmas) he has ended up with such a bad headache the next day, accross the forehead, we presume linked to sinuses. He was told by his kinesiologist that all his organs are fine, liver is working well (which I was surprised about considering the amount he has drunk over the years!), strong digestion, no candida/sibo etc. He hasn't been to a regular Dr for about a year now because they told him it would 'probably just clear up'. Anitbiotics didn't work for him. I am worried that his sinusitis is never going to clear up (he has had it for 3-4 years) and now I am worried his sense of taste won't come back. Do you think they are blocked permanently (ie the damage has been done)? Lastly, he has taken your Sinus Support (3 per day for 2 months) and it hasn't done anything (yet?). We have completed Deepak Chopra's Ayurveda quiz and he is a Pitta (81) Vata (69) Kapha (50). He works really hard manually and usually 6 days per week, I know he needs to rest more ...but he is a Pitta!! Thank you in advance for any advice you can offer. I look forward to hearing any response.Kind regards, Beth   Thank you for tuning into this weekend’s Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes & Resources:  http://StephenCabral.com/1248 - - - Dr. Cabral's New Book, The Rain Barrel Effect https://amzn.to/2H0W7Ge - - - Join the Community & Get Your Questions Answered: http://CabralSupportGroup.com - - -   Dr. Cabral’s Most Popular Supplements: > “The Dr. Cabral Daily Protocol” (This is what Dr. Cabral does every day!) - - - > Dr. Cabral Detox  (The fastest way to get well, lose weight, and feel great!) - - - > Daily Nutritional Support Shake  (#1 “All-in-One recommendation in my practice) - - - > Daily Fruit & Vegetables Blend  (22 organic fruit & vegetables “greens powder”) - - - > CBD Oil  (Full-spectrum, 3rd part-tested & organically grown) - - - > Candida/Bacterial Overgrowth, Leaky Gut, Parasite & Speciality Supplement Packages - - - > See All Supplements: https://equilibriumnutrition.com/collections/supplements  - - -   Dr. Cabral’s Most Popular At-Home Lab Tests: > Hair Tissue Mineral Analysis (Test for mineral imbalances & heavy metal toxicity) - - - > Organic Acids Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Thyroid + Adrenal + Hormone Test  (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Adrenal + Hormone Test (Run your adrenal & hormone levels) - - - > Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Omega-3 Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - > Stool Test (Use this test to uncover any bacterial, h. Pylori, or parasite overgrowth) - - - > Genetic Test (Use the #1 lab test to unlocking your DNA and what it means in terms of wellness, weight loss & anti-aging) - - - > Dr. Cabral’s “Big 5” Lab Tests (This package includes the 5 labs Dr. Cabral recommends all people run in his private practice) - - - > View all Functional Medicine lab tests (View all Functional Medicine lab tests you can do right at home for you and your family)

"City on the Moon" by Murray LeinsterReviewed (but not read) by Khaki & K.  In which: Donald Atticus, an Earth journalist inspecting an absurdly-domed City On The Moon, becomes embroiled in inter-colonial conflict. But could hehave a secret agenda of his own? ...Yes. yes, he does have a secret agenda you got that, right? K quotes a Ukrainian colleague. Khaki warms up to Chewborka and invents the word 'hemitorus'. And a rival reviewer writes in! Bookmarked passages: Display prances, Fallopian and Eustachian tubes, methane-negative, Shackleton, Terry pratchett Stage Script, Potemkin Village, Pripyat and the Woodpecker, Señor Wellingcroft, every prepper's fantasy, Uranium Glass, Guy Noir, Bauhaus vs Rococo, Motorball from Alita, SCUBA regulator, buckminsterfullerine. "There's no holes in you yet.– Well, no more than usual." "And so Bugs Bunny is single-handedly responsible." "Yes, you can do it like that, if you want to do it stupid." "I shave, it's in canon." "He barely understands what’s going on; he’s just game – he doesn’t understand that he’s on Team Baddies" Find CoverMyAssCast on Twitter, Gmail and the good old-fashioned web.

This podcast highlights original research published in the April 2019 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation. Obstructive eustachian tube dysfunction (OETD) affects up to 5% of adults; however, available treatment strategies have limitations. It was previously reported that balloon dilation of the eustachian tube (BDET) with the eustachian tube balloon catheter + medical management (MM) results in a significantly higher proportion of subjects with normalized tympanograms versus MM alone at 6- and 24-week follow-up. The current analysis extends these initial findings by investigating the durability of BDET + MM treatment outcomes through 52 weeks. In conclusion, the present study suggests that the beneficial effects of BDET + MM on tympanogram normalization and symptoms of subjects with refractory OETD demonstrate significant durability that is clinically relevant through 52 weeks.   Click here to read the full article.

Session 11 Today, we discuss a more straightforward, neuro-anatomy question about the glossopharyngeal nerve. As always, we’re joined by Dr. Andrea Paul of Board Vitals. If you’re in the market for QBanks and practice tests for the USMLE/COMLEX, check out Board Vitals. Use the promo code BOARDROUNDS to save 15% on your purchase. [02:00] Question Which of the glands of the options below are innervated by the efferent autonomic fibers of the glossopharyngeal nerve? [02:14] Answer Choices You have to know what the glossopharyngeal nerve and what type of fibers are innervating the glands. Answer choices: (A) Nasal (B) Submandibular (C) Sublingual (D) Parotid (E) Lacrimal [02:45] Thought Process in Answering the Question Glosso refers to the tongue and pharyngeal refers to the pharynx area. So this is somewhere around the mouth. The interesting with glossopharyngeal is that it has a range of effects. Some of the places it touches would surprise you. But first, you can eliminate nasal. But the rest of the choices could be fair game. This specific nerve has a lot of sensory – parasympathetic and motor functions. It's tough to answer so this can be challenging to people. This nerve starts at the medulla and coming out of the jugular foramen. It's traveling through both anteriorly and posteriorly. So it has a branch that goes to the inner ear. Lacrimal refers to the tear ducts so you can get rid of this one too. Now, we're down with three choices. [06:55] Choosing Among the Three First, remember the motor functions. So it's innervating the muscle in the pharynx and then you think through the sensory functions. Glossopharyngeal is sensory to the posterior third of the tongue or the back half of the tongue. If you can remember that section of the tongue, it leads you closer to the location of the gland that may be in that area. It's also going up into the middle ear, the Eustachian tube for sensory function. Anatomically, you start to think more up anterior than sublingual. Think of it as more of in the ear area. So the correct answer here is the Parotid gland, which is the only gland that doesn't receive any autonomic innervations from the facial nerve. So it receives that from the glossopharyngeal nerve. This is the main differentiator. Hence, the exam likes to ask about it. The posterior third of the tongue and the middle ear are things they love to ask about glossopharyngeal. Also, know which muscles are innervated, which is the stylopharyngeus in the pharynx. Also, try to remember the path and the branches. It sends a branch up to the middle ear. There are five other branches. One goes to the stylopharyngeus muscle, one is the pharyngeal branch, one is tonsilar, one is sublingual, and then one goes to the parotid body and sinus. You can draw this to help give you a visualization. Afferent refers to the sensory nerves coming back towards the central nervous system and efferent refers to "going away" for motor function. In terms of understanding parasympathetic vs sympathetic, just remember that most glandular effects are parasympathetic just like most of your organs. [12:24] Board Vitals Check out the QBank and practice tests over at Board Vitals to help you be prepared for your exam. They have over 1,750 questions for USMLE and over 1,500 questions for COMLEX. Get a 1-month, 3-month, or 6-month plan. They all come with a free trial. No credit card required. Use the promo code BOARDROUNDS to save 15% on your purchase. Links: Board Vitals (promo code BOARDROUNDS)

Me-stachian or Eustachian? This week Mike and Chris bubble about ear infections. Giving you the low-down on one of the most common conditions, especially for children. Should you really jam a clove of garlic in your canal? It might not do anything, but we think it'd be fun to try. What role do antibiotics and antiinflammatories play? What are these "Naturopathic Drops" I've heard of? Y'ear in for a good one today.

Every year in the U.S., 20 per 100,000 people experience sudden hearing loss, a medical emergency commonly caused by upper respiratory tract infection. Dr. Selena Briggs discusses how early, specialized treatment can help restore hearing.   TRANSCRIPT Intro: MedStar Washington Hospital Center presents Medical Intel where our healthcare team shares health and wellness insights and gives you the inside story on advances in medicine. Host: Thanks for joining us today, we’re talking to Dr. Selena Briggs, a neurotologist skull base surgeon within the Department of Otolaryngology at MedStar Washington Hospital Center. Welcome Dr. Briggs. Dr. Selena Briggs: Thank you, thanks for having me. Host: Tell us a little about yourself, why did you go into medicine, and how did you come to practice at MedStar Washington Hospital Center? Dr. Briggs: I’ve had an interest in going into medicine, I think, from my youth. It actually stemmed from my pediatrician, Dr. Frank Newburger who practiced here in Silver Spring, and he was a great mentor, and a great pediatrician and that spurred my interest, and then later I developed an interest in music and dance, I was a ballerina, and I loved ballet.  And while I was younger, there was a miss America who was deaf and a ballerina, and that sparked my interest in understanding more about deaf culture and hearing loss. So, throughout my career it’s just kind of moved in that direction of hearing health and this direction. Host: Today we’re talking about upper respiratory infections that can lead to hearing loss. Dr. Briggs, how can an upper respiratory infection cause hearing loss? Dr. Briggs:  That is an excellent question.  Most people are unaware of the association between upper respiratory tract infections and hearing loss.  It’s not uncommon for an individual to wake up in the morning after experiencing an upper respiratory tract infection and state that they can’t hear out of one ear.  They’ll commonly call their primary care provider and try to get an appointment to be seen, and nothing gets seen on examination.  That is the main concern.  That is of pinnacle concern, in fact.  Those individuals may be suffering from something called sudden idiopathic sensorineural hearing loss or simply sudden hearing loss.  That’s most commonly associated with upper respiratory tract infections or the common cold. Host: So, I know when I have colds or even allergy problems and anything really affecting my sinuses I get that kind of clogged feeling in your ear—what are some symptoms patients tell you about when they get this hearing loss going on? Dr. Briggs: The clogged sensation in the ear and the sudden sensory no hearing loss actually are two separate entities.  Both cause hearing loss and both have similar symptoms of presentation, but the source of it is very different and the treatment for it is very different as well. So, when you have an ear infection or even pressure in your ear from a sinus infection, that’s usually caused by something called your Eustachian tube.  I don’t know if you’ve ever been on a plane and your ears popped and you feel that sensation?  It’s your Eustachian tube opening and closing that allows you to equalize your pressure while you’re on a plane.  But when you have a sinus infection, oftentimes that Eustachian tube becomes plugged, and doesn’t open and close normally. That causes pressure, muffled sensation, and sometimes can even cause fluid to develop in your ear.  That typically is a short-lived, self-limited process.  The sudden sensorineural hearing loss or sudden hearing loss is a completely different process, where it doesn’t cause a pressure problem, but it actually causes injury to your nerve. It may cause permanent damage to your ear. It’s not something that you should take lightly. It can be a long term even permanent issue for individuals. So, if one wakes up with sudden hearing loss, from the sudden sensorineural hearing loss, the nerve type of damage, about one out of three people it will resolve on its own, one out of three people it’ll improve but not go back to its normal, and one out of three people it won’t change at all.  There are interventions that we can do to make your likelihood of returning back to normal greater, but the key thing is that you have to get in and be seen within three days to three weeks.  Outside of that window, the likelihood of it becoming permanent loss is significantly greater. Host: How many people experience this? Dr. Briggs: So, on an annual basis, so every year within the United States, it’s speculated that approximately five to twenty out of 100,000 individuals experience sudden sensorineural hearing loss. Host: So, since this is suspected to be caused by viral problems or a virus, what can the doctor do either that primary care doctor, and then at what point do you need to be transitioned over to a specialist? Dr. Briggs: The key thing first is being evaluated by your primary care provider or even urgent care and having an ear examination.  Making sure your ear drum looks normal, there’s not wax that’s occluding or plugging up the ear canal, and make sure there’s not fluid behind the ear drum, as we talked about before associated with allergies or sinus problems.  It sounds strange, but a normal ear exam is an emergency. So, if you have a normal ear exam, and hearing loss, you need to be seen and have a hearing test right away Host: What about those individuals who do put it off? Is it damaged to the point where they can never get that back then if they wait too long? Dr. Briggs: There is a time window, and there is a time urgency.  A few days, ot so much out of the window of treatment. Typically, we state 21 days is when medical therapy is most effective, and those therapies tend to be steroids either taken orally or via an injection through the eardrum into the middle ear space. Host: Once the patient has had this hearing test, how quickly do they receive that treatment, and how long does that treatment take? Dr. Briggs: So once an individual has a hearing test that documents sudden sensorineural hearing loss, they should be seen by an otolaryngologist or a neurotologist within 24-48 hours.  The treatment is started rather urgently, because it gives them the best opportunity for the best outcome.  So the treatment, depending on the patient’s associated comorbidities such as diabetes or hypertension, may include oral steroids vs injection steroids in the middle ear space vs a combination of the two, and that’s started immediately.  There are other therapies that are recommended within the literature or can be used, such as hyperbaric oxygen therapy for restoration therapy as well. Host: What’s the hyperbaric oxygen therapy? Dr. Briggs: Essentially it simulates diving, scuba diving.  So, it puts you in a chamber where you have increased oxygenation or oxygen levels, to increase the oxygen to your nerve, in a hope that increasing its oxygenation it’ll help it to heal faster. Host: And what do the steroids do to help mend the hearing loss? Dr. Briggs: It decreases inflammation on the nerve similarly, helping to increase blood flow and hopefully improving the hearing Host: So, the more blood that’s flowing through the ear in a healthy way of course the better you’re able to hear. Dr. Briggs: Right, exactly. Host: So aside from that sudden sensation of not being able to hear, are there any other symptoms that an individual should be aware of or talk to their doctor about? Dr. Briggs: Oftentimes individuals who have this sudden hearing loss may experience other symptoms that can prompt them to know it is the sudden nerve type of loss vs the conductive type of hearing loss with the fluid and the sinuses.  Some of those symptoms include ringing in the ears, so if you have a high-pitched sound or even a sound of white noise like when you turn the radio between stations, that’s another indicator that you may have a nerve type of damage in your ear.  Vertigo or dizziness in association with the hearing loss is another indicator that it may be a nervous type of loss. Host: Are there other conditions aside from respiratory infections that might cause that sudden hearing loss? I know you think about construction workers and the loud noises and things, is that the same, or is that different? Dr. Briggs: That’s a different entity, that’s noise induced hearing loss, and that can cause a sudden we call it a sudden threshold shift, so sudden changes in your hearing. For example, if you’re exposed to a loud sound or a blast, that too can cause a sudden hearing loss. It’s similarly treated, interestingly, however. There is a host of disease processes that can cause hearing loss in addition to the viral ideology, and that’s why it’s even more important for you to come in and be seen and evaluated.  Individuals with diabetes can have it associated with neuropathy, it can be an early sign of strokes, it can be a sign of tumors of the skull base, thyroid disorders, autoimmune disorders, there’s a whole list. Host: So really since upper respiratory, obviously, probably one of the more common causes of hearing loss but since there are so many things that could cause it, it’s really about getting to the root of that issue.  Could you talk a little bit about how you do that and how your team works together to do that? Dr. Briggs: Yeah, definitely. So, the patients will come in and be evaluated with a physical examination and a history, and that largely directs which direction we’ll go in terms of diagnosis and treatment.  It’s very common for individuals who have a sudden hearing loss to have an MRI of their brain and their inner ear to evaluate for any changes of the hearing and balance nerve, or any lesions that might be compressing the hearing and balance nerve.  And then based upon the patient’s other history and family history and comorbidities, they may undergo various laboratory testing to assess for diabetes or other autoimmune disorders that might be contributing as well as Lyme disease and other infectious processes. Host: Could you talk about a compelling story that you’ve had come in with that upper respiratory problem and how that treatment looked for that patient Dr. Briggs: There is one individual who is a clinician as well, who presented with bilateral involvement so most often individuals come in and it’s involving one ear. In exceptionally rare cases it involves both ears.  This individual needed their hearing in order to perform their work, and so we were able—he got in almost immediately after onset of symptoms, started oral steroids, and inter-tympanic steroids, and hyperbaric oxygen therapy and remarkably had restoration of his hearing.  At his initial visit we had to communicate via typing on his computer and him speaking back, because he couldn’t hear at all. Host: He couldn’t hear at all?  It wasn’t just a decrease? Dr. Briggs: No, and that’s the other thing to understand with a sudden hearing loss, it’s not always just a sudden decline in hearing, some people actually wake up and be deaf in one ear. Host: What’s the emotional or the mental state of people when they come into the office? Dr. Briggs: Completely scared, definitely.  It’s life changing and life altering. I think we often take for granted our hearing, and then once we lose it, or lose some aspect of it, we realize how important it can be to your life. It can be jarring, and it can be life altering and scary for patients to experience, but as long as an individual’s gotten in early, the opportunity for treatment is significant. Without treatment, yes, one third may have no change, one third will have some change, and one third will improve somewhat.  But with treatment that can dramatically improve the odds of improving the hearing back to their baseline. Host: Is there anything an individual maybe that’s prone to those upper respiratory infections can do to reduce their risk? Dr. Briggs: Unfortunately, not. There’s no treatment, there’s no preventative therapy that’s been identified in the literature to reduce your risk of developing sudden sensorineural hearing loss from these upper respiratory tract infections. Host: Could you talk a little about the importance of an individual coming to an otolaryngologist Dr. Briggs: It’s critical for patients to come in and be seen by otolaryngologists or a neurotologist because of the specialized care and therapy that can be provided. We work as a team with primary care providers, with urgent care providers and with emergency department providers to get the patients in early and provide them with the treatment that’s necessary, but it is important that they are ultimately referred to an otolaryngologist who could provide them with that inter-tympanic steroid therapy injection which is a very specialized procedure, only performed mostly by neuro-otologists, but also by some otolaryngologists. In addition, it’s important that they be evaluated for those other disease processes that might be mimicking the sensorineural hearing loss, the idiopathic type. Host: Thank you for joining us today Dr. Briggs. Dr. Briggs: Thank you for having me Conclusion: Thanks for listening to Medical Intel with MedStar Washington Hospital Center. Find more podcasts from our healthcare team by visiting medstarwashington.org/podcast or subscribing in iTunes or iHeartRadio.

Do your kids get frequent ear infections? Is your baby constantly tugging on his or her ear? Want to know natural ways to support ear health before turning to antibiotics or tubes? Listen in as a father and chiropractor talks about how having a child has changed the he relates to parents facing a scary (and painful) situation with their children, and how chiropractic is a great way to prevent chronic ear infections. He also informs us about whether or not swimmers' ear is a traditional ear infection, and how we can deal with that type of issue. Dr. Tyler asked us to share these resources: Photos of "otitis media" (middle ear infection) and a visual of the child Eustachian tube vs. the adult Eustachian tube: https://medlineplus.gov/ency/article/000638.htm www.rebelchiropractic.com www.ICPA4kids.com www.gonstead.com http://icpa4kids.org/images/research/2016failedtympfinal.pdf This podcast is sponsored by Deep Root Wellness, A Holistic Approach to Mental Health Please visit our sponsor at www.MattHollo.com to learn more about holistic counseling and to book your appointment today. (Yes, he accepts insurance)! Music Credit: www.Bensound.com

On this episode of the Annual Meeting Expert Series, Benjamin D. Malkin, MD, and Dennis S. Poe, MD, discuss the surgical management of eustachian tube dysfunction. Methods of diagnosis, surgical indications, techniques, pitfalls, and results will be addressed.

After Simon Cowell paid for a Britain's Got talent contestant to have surgery in the US for her curved spine we examine the state of therapy for scoliosis here in the UK. Recent headlines claimed that 1 in 4 teenage girls are depressed but were they accurate? And pets in hospital: the Royal College of Nursing has called for patients to have better access to animals, including their own. Plus Eustachian tubes: tips for what to do if you have blocked ears after your summer holiday.

Come take a listen to the only movie-related podcast on the internet, Craft Disservices! Our mission: to review the films that critics rejected but audiences embraced; be they prime rib or pulp, genre or general, we give films a fighting chance to entertain us.On our first episode, we enlist with 2008's Punisher: War Zone, a movie that asks the question, "What would happen if you tried to recycle that guy from The Wire?" I don't know if we find the answer, but I do know it would be written in blood with a singed dreadlock.Jacob Gulliver of Hot Chocolate Media joins the show to discuss this misunderstood masterpiece, and we cover important topics like Doctor Strange's Hawaiian shirts, awkward political commentary, Eustachian tubes, rooting for the monster, and a startling confession about The Dark Knight!This show is more entertaining than a barrel of parkour gang members on meth! Listen today!Punisher: War Zone ScoresRotten Tomatoes: 27%Metacritic: 30IMDB: 6/10Follow the exploits of Hot Chocolate Media on their Facebook and Twitter or on their website at http://www.hotchocolatemedia.net!http://www.facebook.com/hotchocolatemediahttp://twitter.com/HotChocMediaCheck out the final weekend of HCM's Minnesota Fringe show, Waiting for Gygax!http://www.fringefestival.org/2017/show/?id=20171291Keep the party going with Craft Disservices on our Facebook and Twitter pages!http://www.facebook.com/craftdisserviceshttp://www.twitter.com/craftdisservice

Come take a listen to the only movie-related podcast on the internet, Craft Disservices! Our mission: to review the films that critics rejected but audiences embraced; be they prime rib or pulp, genre or general, we give films a fighting chance to entertain us.On our first episode, we enlist with 2008's Punisher: War Zone, a movie that asks the question, "What would happen if you tried to recycle that guy from The Wire?" I don't know if we find the answer, but I do know it would be written in blood with a singed dreadlock.Jacob Gulliver of Hot Chocolate Media joins the show to discuss this misunderstood masterpiece, and we cover important topics like Doctor Strange's Hawaiian shirts, awkward political commentary, Eustachian tubes, rooting for the monster, and a startling confession about The Dark Knight!This show is more entertaining than a barrel of parkour gang members on meth! Listen today!Punisher: War Zone ScoresRotten Tomatoes: 27%Metacritic: 30IMDB: 6/10Follow the exploits of Hot Chocolate Media on their Facebook and Twitter or on their website at http://www.hotchocolatemedia.net!http://www.facebook.com/hotchocolatemediahttp://twitter.com/HotChocMediaCheck out the final weekend of HCM's Minnesota Fringe show, Waiting for Gygax!http://www.fringefestival.org/2017/show/?id=20171291Keep the party going with Craft Disservices on our Facebook and Twitter pages!http://www.facebook.com/craftdisserviceshttp://www.twitter.com/craftdisservice

Ear Basics The auricle is the part of the ears you can see. It is made of cartilage (flexible tissue that doesn't have a large blood supply).  Everything else requires a tool for the doctor to see inside.  And the doctor can only see to the ear drum.  The stuff behind the ear drum isn't visible because of the membrane that blocks it.  The middle and inner ear are surrounded by your head bones. Science of Sound Sound is created when the air around us is compressed and then expands.  They move away from the source in circles (think radar or sonar or throwing a pebble in a pond). The ear canal directs the sound waves towards the ear drum. Sound gets translated in 2 main ways Identify the sound Identify if the sound has meaning Inside Your Ears The ear drum (tympanic membrane) vibrates according to the intensity of the sound and trigger the Hammer-Anvil-Stirrup cascade. The ear drum vibrates the handle of the Hammer (Malus bone - yes, it's a real bone). The Hammer bangs on the Anvil (Incus bone).   The Anvil has a tail that is connected to the Stirrup (Stapes bone). The Stirrup looks like the spurs on the back of boots.  It is connected to a membrane on the Cochlea and works like a plunger. All of these bones are surrounded by air and the pressure is controlled by the Eustachian tube.  This is the access point for ear infections or congestion due to allergies or a cold. The Cochlea is a bone full of fluid and lined with hairs and shaped like a spiraled sea shell.  The hairs pick up different frequencies of sound (sound wave frequency determines pitch).  If certain levels of hairs get damaged, then you will not be able to hear pitches in that range anymore.  If you unrolled the cochlea, it would be laid out low pitch to high pitch like a piano.  And these hairs are connected to the auditory nerves and turn sound signals into electrical signal to send it to your brain. Semicircular canals of the cochlea are little bone chambers full of fluid and they control balance.  This works like a leveling bubble to help you stay upright.  If it becomes dysfunctional, then it may trigger vertigo. The middle ear (the area behind the ear drum) is where most of the trouble happens - whether allergies causing stopped up ears, or colds leading to ear infections. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Introduction Doc Smo here, your pedcast host.  Thanks for joining me today for another edition of DocSmo.com, the pediatric podcast dedicated to children and their parents.  I am very fortunate to have as my returning guest, Dr. Sheila Kilbane, an integrative pediatrician and expert about much of life, to talk to us about a very common pediatric health problem, otitis media.  Anyone with children is very familiar with how frequently children are affected by otitis media or middle ear infections.  These infections are complications of bad colds and we all know that children get a lot of colds. So lets see how an integrative pediatrician approaches a child with recurrent ear infections.   Maybe Dr. Kilbane just might be able to help your children avoid that ear infection nastiness this winter.   Welcome Dr. Kilbane. Question 1:Why do children get ear infections? Question 2: For children with CHRONIC EAR INFECTIONS of CHRONIC EAR CONGESTION, how does the Integrative approach different than traditional pediatrics? (Decrease mucous/ enhance immune response/ decrease inflammation/avoid antibiotics) Question 3: How do you do these things? (Stop dairy, probiotics, vitamin D, immunocap, and correct structural problems) Question 4: Which children do you suspect have structural problems in their Eustachian tubes? Question 5: How do you reduce inflammation in a child's body? Question 6: Which children is the integrative approach most appropriate for? Let's summarize the integrative approach -Reduce mucous production from inhaled allergy and oral allergy to food, mostly milk -Correct structural problems -Enhance child's immune system -Reduce inflammation by changing diet Outro Well, Dr. Kilbane, as always, you bring a fresh approach and viewpoint to both parents and physicians and I really appreciate that. You and I are on the same page; we both want to inform parents and make things better for children. I can't thank you enough for sharing your time and expertise with us today. This is Dr. Paul Smolen, you know, Doc Smo, thanking you for joining us and hoping your little dears, always have nice clearears.  Until next time.  

This podcast highlights original research published in the July 2016 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation. Avoiding oral steroids for otitis media with effusion (OME) is endorsed as a performance measure by the National Quality Foundation, but data regarding current gaps and practice patterns are lacking. Our objectives were to evaluate oral steroid use for OME and the related diagnoses of eustachian tube dysfunction (ETD) and tympanic membrane retraction (TMR), to assess variations by visit setting, and to identify opportunities for measurable performance improvement. OME/ETD/TMR is infrequently treated with oral steroids, particularly in children. Opportunities for performance improvement are limited.   Click here to read the full article.

Join Dr. Scott Morehouse, M.D. and ‘She' as he shares the ClearPOP, Safety First and an invention that is for children, the ‘ear' and a public service. ClearPop was developed by Scott Morehouse, M.D. for use when his own children suffered earaches. He welcomes feedback, questions, and comments from you and your family. clEARpop ClearPop is the world's first over- the-counter earache treatment. Finally, rapid ear pain relief without side effects. ClearPop works by equalizing  pressure in the obstructed Eustachian tube of the infected ear. It relieves the pain of an ear infection within minutes for nine-out-of-ten kids tested. The results (Click Here) CONTACT Facebook Twitter Music by Jake Shimabukuro Over the Rainbow

It’s been more than a few weeks since I really listened to music. I mean it. First a long beach vacation kept me decompressing to the sound of ocean waves. Then, a nasty airline flu swept me off my feet and had me bed ridden with a fever. Even now, as I write this, my ears feel clogged due to expansion of the Eustachian tube, and my head feels like a clown balloon stuffed in a bag of cotton balls. So I wouldn’t even know where to begin with the next cycle of listening, let alone writing. Thankfully, I have this beautiful new mix by James Murray queued for publication just in time with his latest release on hibernate, titled Broken Homes. For full track listing and more information about this mix, please visit headphonecommute.com

Headaches. Root vs. branch of a problem. Stress-induced diarrhea. “Cock's crow diarrhea.” Toxicity as cause for numerous disorders. Leaky gut. IP-6. “Hallelujah symptoms.” Follow-up self-care. Iron levels. Cancer treatment support. Eustachian tube blockage. Traditional Chinese Medicine (TCM), Western Perspective, Integrative and Functional Medicine. Live streaming. The Balancing Point health radio talk show about Traditional Chinese [...]Read More »

Well, I bet you never thought podMaize would get the green light for a second harvest. The powers that be have decided we can have a second chance, so lube yer Eustachian tubes, it's MJ's podMaize - Chapter 2: The Reaping. Don't forget to check out www.facebook.com/podmaize for photos and videos and the like.