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Bradenton Industrial Webinar-----------I'd like to invite you to learn more about an exciting opportunity located in Bradenton Florida. Bradenton is next to Sarasota for those of you who are familiar with Florida. This market has an industrial moratorium that is driving one asset class to new heights, specifically light industrial. This 35 are property, right in the middle of Bradenton has an existing Charter School on 11 of those acres and 24 acres of land that we are developing. We are hosting a webinar on Wednesday October 8 at 7PM Eastern time. This opportunity is only open to accredited investors residing in the US in compliance with SEC regulations. To learn more, click on the link in the show notes and we will see you on Wednesday evening at 7PM. --------------On today's show we are looking back in history for some of the narratives that surrounded the adoption of new technology. The year was 1999. At the time, it seemed like the internet was the answer, what's the question? Companies were spending hundreds of millions burying optical fibre anywhere they could. After all, the internet would need lots of fibre to carry all of that traffic. There was tons of investment in the core of the network to carry all of this traffic. I personally was an executive in the tech industry. I left Nortel in 1997. The next company I was at was Tundra Semiconductor. We were designing microprocessor core logic chips that were used in all kinds of applications. One of our customers was Motorola who was shipping 250,000 cellular base stations a year. These would eventually be upgraded from the GSM base station to the Edge base station and then eventually the 3G base station. Back in those days, the emphasis was on building out the core of the network.Later in my career I took progressively more senior positions in the tech industry. By 2004 I was VP of Engineering at AMCC that was headquartered in San Diego. I was also President of AMCC Canada. My company had raised about $1B in the public markets at the height of the Dotcom frenzy. As a result, we had all kinds of startup companies parading through our board room with the hopes of getting acquired by a company with a ton of cash. I learned to ask three very simple questions of every startup company. The answer to these questions revealed more than anything else. The technology, the features, the cool factor, none of it mattered. -------------**Real Estate Espresso Podcast:** Spotify: [The Real Estate Espresso Podcast](https://open.spotify.com/show/3GvtwRmTq4r3es8cbw8jW0?si=c75ea506a6694ef1) iTunes: [The Real Estate Espresso Podcast](https://podcasts.apple.com/ca/podcast/the-real-estate-espresso-podcast/id1340482613) Website: [www.victorjm.com](http://www.victorjm.com) LinkedIn: [Victor Menasce](http://www.linkedin.com/in/vmenasce) YouTube: [The Real Estate Espresso Podcast](http://www.youtube.com/@victorjmenasce6734) Facebook: [www.facebook.com/realestateespresso](http://www.facebook.com/realestateespresso) Email: [podcast@victorjm.com](mailto:podcast@victorjm.com) **Y Street Capital:** Website: [www.ystreetcapital.com](http://www.ystreetcapital.com) Facebook: [www.facebook.com/YStreetCapital](https://www.facebook.com/YStreetCapital) Instagram: [@ystreetcapital](http://www.instagram.com/ystreetcapital)
The Automotive Troublemaker w/ Paul J Daly and Kyle Mountsier
Shoot us a Text.Episode #1162: Tesla posts a surprise Q3 sales record, $1,000 car payments are becoming the new normal, Meta plans to use AI chats to make ad targeting more personal than ever.Show Notes with links:Tesla delivered a surprise Q3 record after a rocky first half of the year, beating Wall Street expectations with nearly half a million EVs sold. But with the federal EV tax credit now gone, the question is whether momentum can carry into Q4 and beyond.Tesla delivered 497,099 vehicles, topping estimates of 456,000 and reversing two quarters of declines.Model 3 and Y deliveries rose 9%, while other models dropped 30%.Tesla's energy business hit a record, nearly doubling storage deployments to 12.5 GWh.Rivian also posted a 32% bump, delivering 13,201 EVs in Q3.What used to be unthinkable is now routine: the $1,000-a-month car payment. Nearly one in six new-car buyers are signing up for four-figure notes, a trend driven by rising prices, interest rates, and longer terms — reshaping affordability conversations across the showroom floor.In 2015, only 2.4% of buyers paid $1,000+; that number hit 16.6% in JulySUVs (53%) and pickups (37%) dominate these deals; 5% of all $1,000+ buyers drove off in an F-150.Buyers today face average loans near $42K at 6.8% interest, compared to $28K at 3.9% a decade ago.Longer terms now stretch over 68 months on average, nearly a year longer than 2015.“There are some that are very shocked by the payment,” said Cody Anderson, GSM at Freedom Ford. “Their payment thought process is five years ago compared to now.”Meta is about to supercharge its ad business by tapping into conversations people have with its AI chatbot. Starting December 16, chats with Meta AI will help determine not just what ads users see, but what content fills their feeds across Facebook, Instagram, and WhatsApp.Meta AI chats will feed new ad-targeting signals, similar to posts, likes, and connections.Example: Talk about hiking → expect more hiking ads and related content.The company stresses sensitive topics (politics, religion, health, etc.) won't be used for targeting.Meta earned $46.5B in ad revenue last quarter, up 21% YoY.“Interactions with AIs will be another signal we use to improve people's experience,” Meta said.0:00 Intro with Paul J Daly and Kyle Mountsier1:35 The huge news out of More Than Cars2:48 Tesla Sets Delivery Record5:35 Nearly 17% of Car Payments are $10008:45 Meta Will Use AI Searches To Target Ads To UsersJoin Paul J Daly and Kyle Mountsier every morning for the Automotive State of the Union podcast as they connect the dots across car dealerships, retail trends, emerging tech like AI, and cultural shifts—bringing clarity, speed, and people-first insight to automotive leaders navigating a rapidly changing industry.Get the Daily Push Back email at https://www.asotu.com/ JOIN the conversation on LinkedIn at: https://www.linkedin.com/company/asotu/
Various kinds of topical vaginal hormonal medications used to treat genitourinary syndrome of menopause (GSM) and their differences Oestrogen versus prasterone for the treatment of GSM Use of topical vaginal hormonal medications in breast cancer patients Testosterone in women - when to use it and how to monitor its use Long term use of testosterone in women, and safety concerns The limitations of testosterone in women in terms of libido enhancement Host: Dr Terri Foran | Total Time:25 mins Expert: Dr M Talat Uppal, Obstetrician and Gynaecologist Register for our fortnightly FREE WEBCASTSEvery second Tuesday | 7:00pm-9:00pm AEST Click here to register for the next oneSee omnystudio.com/listener for privacy information.
Today, Grid Down Comms Up takes the microphone again for another great episode of the Prepping Academy. We do a short after-action report on the Eastern Tennessee Homestead Alliance festival, revisit a few items as we approach the one-year anniversary of the historic disaster caused by Hurricane Helene, and talk about radio and communications interference. We look at the common types of manmade interference and what you can do to ensure you aren't the cause, because making lots of people look for you isn't very gray man. We also discuss what you may want to consider adding to your plans if you experience intentional interference during an emergency. We also listened to an example of interference during my time in Eastern Tennessee with GSM and a much more entertaining example of some amateur operators trolling someone who is causing intentional interference to keep him talking until they locate him. I'll see you on the next episode.
Today, Grid Down Comms Up takes the microphone again for another great episode of the Prepping Academy. We do a short after-action report on the Eastern Tennessee Homestead Alliance festival, revisit a few items as we approach the one-year anniversary of the historic disaster caused by Hurricane Helene, and talk about radio and communications interference. We look at the common types of manmade interference and what you can do to ensure you aren't the cause, because making lots of people look for you isn't very gray man. We also discuss what you may want to consider adding to your plans if you experience intentional interference during an emergency. We also listened to an example of interference during my time in Eastern Tennessee with GSM and a much more entertaining example of some amateur operators trolling someone who is causing intentional interference to keep him talking until they locate him. I'll see you on the next episode. Support the showPlease give us 5 Stars! www.preppingacademy.com Daily deals for preppers, survivalists, off-gridders, homesteaders & everyday Americans. The best gear & supplies—posted in one place, every dayCheck out https://prepperfinds.com Contact us: https://preppingacademy.com/contact/ www.preppernet.net Amazon Store: https://amzn.to/3lheTRTwww.forrestgarvin.com
In this solo episode of the Not Your Mother's Menopause Podcast, Dr. Fiona Lovely provides a vital and compassionate guide to the Genitourinary Syndrome of Menopause (GSM). She begins by explaining that the GSM is a spectrum of symptoms affecting the genitourinary tract due to declining estrogen and androgenic hormones (like testosterone and DHEA) during the menopause transition. Dr. Lovely details the common yet often unspoken symptoms, which can include vaginal dryness, painful intercourse, urinary urgency, recurrent bladder infections, and changes in libido and sensation. She emphasizes that these changes are not something to suffer through in silence and offers clear, actionable solutions. We discuss treatment using low-dose vaginal estrogen, a safe and effective option for nearly everyone that directly addresses the root cause of tissue thinning and fragility. Dr. Lovely provides practical application advice and recommends specific formulations. Beyond treatment, she encourages open communication with our sex partners to navigate changing intimacy needs and suggests speaking with employers about necessary accommodations if symptoms affect work. This episode is an empowering call to seek compassionate care and prioritize quality of life, no matter where you are in the menopause landscape. Thank you to our sponsors for this episode:
Too many dealers still believe profit is made on the sale. The truth is profit is made the moment you acquire the car. If you buy wrong, you're already on a one-way road to margin destruction. While you're sitting at the desk hoping to “retail out of a bad buy,” CarMax and Carvana have been rewriting the sourcing playbook, eating away at your margins, and taking the future of retail automotive right out of your hands.In this episode of Follow The Money, host Frank J. Lopes (President of Strong30 Automotive) sits down with Kevin Kershner of Accu-Trade to break down exactly why profit is not made at the sale, why acquisition-first thinking is the only path forward, and how every dealership needs to start running like a used car powerhouse that also sells new.Kevin and Frank don't hold back. They expose how outdated appraisal strategies, slow processes, and poor sourcing decisions destroy gross before a vehicle even hits the lot. They also reveal how acquisition-first operators win by turning cars quickly, sourcing smart, and making it easy, transparent, and fast for customers to sell their vehicles.You'll learn in this episode:Why profit is won or lost at acquisition, not when the deal is inkedThe biggest mistakes draining dealership gross and how to stop themHow to source smarter and stop buying inventory wrongWhy transparency in appraisals wins both customer trust and long-term retentionHow CarMax and Carvana changed the rules while most local dealers looked the other wayWhy every new car store must be run like a used car operation in order to surviveKey Takeaways for Dealers, GMs, and Sales Leaders:Stop relying on “retail out of it” thinking — it no longer worksProtect your gross by making smart acquisitions up frontBuild staying power by turning inventory quickly and profitablyMeet customers where they are with simple, fast, transparent appraisal processesUse data the way big-box competitors do to identify demand and pay the right money for the right carFrank and Kevin also discuss the mindset shift that separates winners from losers in today's retail automotive world. Dealers who continue to think of themselves as “new car stores that also sell some used” will be left behind. Dealers who embrace acquisition-first thinking, who adopt used car strategies, and who build their culture around sourcing smart will thrive over the next decade.This conversation isn't just theory — it's practical advice from two leaders who live in the trenches of retail automotive. If you're a dealer principal, general manager, GSM, or sales manager, this episode is a wake-up call. The old playbook is dead. The new one starts with acquisition.Follow The Money is the podcast built for retail automotive leaders who are ready to grow, adapt, and dominate. Every Tuesday at 9AM, host Frank J. Lopes brings you straight talk and hard-hitting conversations about dealership growth, leadership, advertising, marketing, sales, and culture. No fluff, no filter, all facts.Retail Automotive, Car Dealership Growth, Automotive Leadership, Dealership Margins, Inventory Acquisition, Car Sales Training, Used Car Dealers, New Car Dealers, CarMax, Carvana, Accu-Trade, Strong30 Automotive, Frank J Lopes, Follow The Money Podcast, Dealership Culture, Sales Management, Automotive Sales Strategy, Gross Profit Protection.
Zaglądamy za kulisy działalności Pancernika, wspominamy (na szczęście minione) czasy komisów GSM, omawiamy targi IFA 2025 i podejmujemy wiele innych tematów. #BoCzemuNie ? POBIERZ ODCINEK Partnerzy technologiczni: > iDream – Apple Premium Reseller, Apple Premium Service Provider > Pancernik – Akcesoria do telefonów i nie tylko Linki: Bądźmy w kontakcie: X | Facebook | Instagram | kontakt@boczemunie.pl […] Artykuł #410 – Kulisy Pancernika pochodzi z serwisu Podcast „Bo czemu nie?”.
"An educated patient is the best patient." - Dr. Rachel Rubin In this episode, SHE+ President and Chairwoman Patty Brisben sits down with Dr. Rachel Rubin, a board-certified urologist and sexual medicine specialist. As a pioneer in the field, Dr. Rubin brings unmatched attention and expertise to conditions that impact so many women, and for too long, went without a name: Genitourinary Syndrome of Lactation (GSL) and Genitourinary Syndrome of Menopause (GSM). Dr. Rubin breaks down why naming these conditions matters, how symptoms manifest, and what patients and providers can do to move past dismissal and toward better care. For more information on GSL, GSM, and Dr. Rubin, check out the Resource Hub at www.sheplusfoundation.com/resourcehub
Gaza: offensiva via terra per prendere il controllo di Gaza City da parte dell'esercito israelianoGerusalemme: manifestanti israeliani davanti alla casa di Netanyahu contro l'incursione di terraUcraina: colpita la raffineria di Saratov, nella regione Russa. Possibile incontro tra Zelensky e Trump a margine dell'assemblea generale delle Nazioni Unite. Per il 76% degli ucraini, la guerra si potrebbe vincere se ci fosse più appoggio da parte dell'occidenteLondra: striscione al castello di Windsor raffigurante Epstein e TrumpBrasile: Bolsonaro ricoverato in ospedale dopo violenti episodi di singhiozzo durante gli arresti domiciliariPerù: 900 turisti bloccati vicino a Machu PicchuSud Sudan: la corruzione sta uccidendo la popolazioneZambia: due anni di prigione e lavori forzati a chi usa la stregoneria
In this episode of The Healers Café, Manon Bolliger, FCAH, RBHT (facilitator and retired naturopath with 30+ years of practice) speaks to Dr. Kelly Baron, a chiropractor and survivor of a violent assault, transformed her trauma into a journey of resilience and empowerment. She overcame her fear by participating in MMA fights and later shifted her focus to menopause and perimenopause, founding Tempesta to help women with genitourinary syndrome of menopause (GSM). Dr. Baron emphasizes the importance of mental resilience and self-care during menopause, advocating for a positive mindset and addressing the physical and emotional challenges. For the transcript and full story go to: https://www.drmanonbolliger.com/dr-kelly-baron Highlights from today's episode include: Transformation Through Adversity: Dr. Kelly shared how facing and overcoming trauma empowered her to reclaim her life, emphasizing that healing is an ongoing process and that women can adapt and grow stronger through challenges. Redefining Menopause: She highlighted the importance of viewing menopause as a positive transition and rebirth, encouraging women to embrace this phase with support, open conversation, and a shift in mindset from victimhood to empowerment. Challenging Cultural Stereotypes: Manon emphasized that cultural narratives and media shape negative perceptions of menopause, and advocated for self-acceptance, self-love, and viewing menopause as a natural, non-pathological life stage. ABOUT DR KELLY BARON: Dr. Kelly Barron, DC, is a dynamic chiropractor and survivor who transformed the scars of a violent assault into a powerful narrative of resilience and empowerment. A graduate of Life University with a Doctor of Chiropractic degree, she co-founded Tempesta and is a Certified Integrated Threat Response Instructor, equipping women with the tools to reclaim their strength and defy victimhood. As a mother of three, Dr. Barron balances family life with a fierce competitive spirit, shattering expectations with World Record titles in powerlifting, taking on the challenges of American Ninja Warrior, and boldly stepping into the MMA arena. Her relentless spirit dismantles stereotypes, inspiring others to rewrite their own stories of adversity with courage and determination. Dr. Barron's expertise extends to fostering mental and emotional resilience for women navigating all of life's transitions, embracing each stage with boldness and passion. With her fiery energy, Dr. Barron sparks transformation in every endeavor, empowering women to confront personal, physical, or societal challenges with unapologetic pride and resilience, leaving a lasting legacy of strength and defiance. Core purpose/passion: Dr. Kelly Barron is on a mission to shatter taboos and open up honest, raw discussions about the physical, emotional, and mental challenges women face during perimenopause and menopause. Here, no question is too personal or off-limits. Website | Facebook | LinkedIn | Instagram | YouTube 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!
For decades, the retail automotive industry has promised change as if it were just around the corner. The reality is that many dealerships are still stuck in the past, operating with the same outdated playbook they used 20, 40, or even 60 years ago. These stores wonder why they cannot attract top talent, why they struggle to meet customer expectations, and why their leadership pipeline is weak. The truth is clear: dealerships that do not evolve are destined to fall behind.This episode of Follow The Money is a call to action for every dealer, general manager, GSM, sales manager, and automotive professional who wants to succeed in the next decade. Host Frank J. Lopes, President of Strong30 Automotive, sits down with Becca Jenkins, a proven leader who transformed rejection into resilience, built programs that empower leaders, and continues to drive culture shifts across the industry.Becca's story is raw and inspiring. At 19 she was told she would never be hired as a finance manager and would never make six figures. Years later she faxed her six-figure W-2 to the very person who doubted her. That moment proved that grit, resilience, and a leadership mindset can turn obstacles into rocket fuel.Now serving as a senior leader at Cars Commerce, Becca has been instrumental in launching and scaling transformative programs such as the Women in Leadership initiative and Iron Sharpens Iron mentorship groups. What began with 12 members in 2016 has grown into a network of more than 300 leaders, proving that mentorship and culture-building are not optional in today's automotive industry.In this powerful conversation you will learn:✅ How to build leadership in automotive that works: why waiting for permission is career suicide and why bold leadership drives dealership growth✅ How to implement mentorship that scales: why it does not have to be perfect, how to start small, and why mentorship boosts retention and performance✅ The skills every dealership leader must master: adaptability, curiosity about technology, resilience, and the ability to meet customers on their terms✅ How to create a culture that attracts and retains talent: why command-and-control leadership fails and how to build a culture where professionals and women thrive✅ Becca's real-world journey: from starting as a CSI manager in high school to climbing into leadership roles many said were off limitsFrank and Becca also tackle uncomfortable truths:Some “old school” leaders are obstacles to growth, and they must be challenged if the dealership is to move forwardEgo-driven leadership destroys culture, while self-awareness creates long-term profitabilityLeadership in 2025 is not about tenure or family connections, it is about adaptability, culture, and developing people for the futureThis episode delivers actionable takeaways for:Dealers and GMs who want to build strong teams and future-proof their storesSales Managers and GSMs who need to level up their leadership skillsSalespeople and future leaders who want to know the steps to rise in retail automotive todayWhether you operate a single store or oversee a multi-rooftop group, the lessons here are universal: leadership is not optional, mentorship is non-negotiable, and the dealerships that evolve will dominate.Follow The Money is the video podcast for retail automotive leaders, powered by Strong30 Automotive and presented by Cars Commerce. Every Tuesday at 9AM, host Frank J. Lopes brings you the conversations that matter: dealership growth, leadership development, sales strategy, and marketing execution that drives real results.Retail Automotive, Car Dealership Growth, Automotive Leadership, Women in Automotive, Dealership Mentorship, Car Sales Managers, Automotive Training, Grit and Resilience, Follow The Money Podcast, Frank J. Lopes, Becca Jenkins, Strong30 Automotive, Cars Commerce, Dealership Culture, General Managers, Sales Training, Car Sales Leadership, Building Leaders in Automotive.
The Skin Real app is officially LIVE! Download it now. Download my Free Guide 'In My Perimenopause Era' Download the Ultimate Affordable Skincare Guide When was the last time you thought about your vulvar health? If your answer is “never,” you're not alone. Most women avoid talking or even thinking about this part of their body, but during perimenopause and menopause, changes in vulvar and vaginal health can have a huge impact on your comfort, confidence, and quality of life. In this episode, I sit down with Dr. Diana Londoño, a urologist who is breaking the silence on intimate health. We talk about the changes estrogen loss brings—from dryness, itching, painful sex, and recurrent UTIs to the lesser-known issues like bladder urgency and vulvar atrophy. She also explains how simple solutions like vaginal estrogen cream, hormone therapy, and lifestyle tweaks can protect your vulvar health and prevent years of suffering. ✨ Key Takeaways: Why vulvar health is central to your bladder, vaginal, and sexual health during menopause. How to know if your symptoms are normal aging or a red flag that needs further evaluation. The connection between UTIs, GSM (genitourinary syndrome of menopause), and vulvar atrophy. Why vaginal estrogen is safe, preventative, and worth considering even if you're not sexually active. How stress and mindset affect bladder symptoms and overall well-being. If you've ever felt embarrassed, ignored, or confused about what's happening “down there,” this episode will give you clarity and confidence. Dr. Diana Londoño is a Board-Certified Urologist and one of the 10% of urologists in the US who are women and the 0.5% who are Latinx and women. She is originally from Mexico City and attended Claremont McKenna College for her undergraduate studies and then went on to attend UCLA for medical school. She completed a 6-year residency in Urology at Kaiser Permanente in Los Angeles. She has experienced burnout twice, which has led her to write and speak about it to raise awareness and help others. She has published multiple articles in prominent medical platforms, including Medscape, Doximity, Kevin MD, Men's Health, Giddy.com, and WebMD, among others. She is also a contributing author to the books “Thriving After Burnout” and “Medic S.O.S.” She has also been a guest on numerous podcasts, discussing various topics, including wellness, stress, spirituality, and energy. Her burnout journey led her to become a certified life coach and founder of Physician Coach Support.com, a peer support platform she ran for 3 years. In 2022, she received the Los Angeles County Medical Association Physician Leadership Award for her work. She is an international speaker and guest on multiple podcasts, discussing topics such as wellness, boundaries, ego, humanity in medicine, mindset, and mindfulness. She has also been featured on TV on Univision, Telemundo, Mundo Fox, CNN Latino, KCET, and ABC News as a health consultant discussing urological topics. She is also a Reiki Master, a Pranic Healer and the mother of two determined and joyful 7- —and 9-year-old girls, Daniela and Paloma. Follow Dr. Londoño here: Website -https://dianalondonomd.com/ LinkedIn - https://www.linkedin.com/in/dianalondonomd/ Instagram - https://www.instagram.com/dianalondonomd/ YouTube - https://www.youtube.com/@dianalondonomd Want more expert skin advice without the overwhelm? Subscribe to The Skin Real Podcast wherever you listen, and visit www.theskinreal.com for dermatologist-backed tips to help you feel confident in your skin—at every age. Follow Dr. Mina here:- https://instagram.com/drminaskin https://www.facebook.com/drminaskin https://www.youtube.com/@drminaskin https://www.linkedin.com/in/drminaskin/ Visit Dr. Mina at Baucom & Mina Derm Surgery Website: atlantadermsurgery.com Email: scheduling@atlantadermsurgery.com Call: (404) 844-0496 Instagram: @baucomminamd Thanks for tuning in. And remember—real skin care is real simple when you know who to trust. Disclaimer: This podcast is for entertainment, educational, and informational purposes only and does not constitute medical advice.
Wir reden über die Zeit vor dem Mobilfunk für alle und werfen einen Blick zurück auf den Standard, der ungewollt weltweit gültig wurde.
Founded in the year 2000, Wood Family Vineyards blossomed from a side hobby (Rhonda was initially a commercial airline pilot, while her husband, Michael Wood, was a regional CFO for Pacific Coast Trane) into a thriving winery. Wood Family Vineyards specializes mainly in Bordeaux varietals/blends, but produces other wines as well (such as Zinfandel, Chardonnay, GSM, etc.)Wood Family Vineyards has always been locally loyal to the Livermore soil; sourcing all their wines (whether from their own vineyards or from neighbors) from Livermore Valley.
De UFC komt volgend weekend erg dichtbij en met andere woorden kan ons panel niet anders dan bij elkaar komen voor een extra aflevering van OEP Z'N BAKKES. Nee, we kunnen nog niet met de tram naar Schijnpoort om te genieten van onze favoriete sport, maar zeg nu zelf: met de Eurostar naar Parijs is ook niet slecht. En het wordt nog beter, want met Bolaji Oki en Losene Keita staan twee landgenoten op de main card! Een fantastische prestatie voor ons land en met daarnaast nog Imavov - Borralho en Saint Denis - Ruffy op het menu wordt de avond alleen maar beter. Gsm's af dus - zeker jij, Andries - en volle aandacht op deze ideale voorbereiding op de fight night van zaterdagavond. Passeren daarbij de revue: een vadercomplex, vechten met een pitbull en een tripje met de FlixBus naar Dagestan.00:00 Intro02:23 Patricio Pitbull versus Losene Keita16:16 Bolaji Oki versus Mason Jones19:21 Nassourdine Imavov versus Caio Borralho wordt gekaapt door Dricus Du Plessis en Khamzat Chimaev 31:52 Nu echt Nassourdine Imavov versus Caio Borralho34:07 Benoît Saint Denis versus Mauricio Ruffy38:04 Rest van de card, met een uitstapje langs de zoon van Rampage Jackson47:50 Pronostiek52:57 Ander UFC-nieuws1:05:14 Outro
Liz is back answering your questions on vaginal atrophy, vitamin C, sugar cravings, and wellness retreats.For one anonymous listener, Liz looks at what be done to help vaginal atrophy (also known as genitourinary syndrome of menopause or GSM), and shares her favourite vitamin C supplements for Debra.Liz also answers a question from Eleanor on cravings, satiety and energy during perimenopause, and another on the best wellness retreats for Nicki.Links mentioned in the episode:YES Vaginal MoisturisersSylk natural intimate lubricantsTransform your sexual pleasure in midlife, with Sam EvansAltrient Lipsomal Vitamin C - save 10% with LIZLOVESThe Naked Pharmacy Immune Hero (vitamin C) - save 20% with LIZLOVESBuchinger Wilhelmi Clinic Yeotown Wellness retreatsPalazzo Fiuggi medical spaPelagoni Club PACE Wellness weeksSha Wellness CentresA Better Second Half by Liz EarleHave a question for Liz? Send a WhatsApp message or voicenote to 07518 471846, or email us at podcast@lizearlewellbeing.com for the chance to be featured on the showPlease note, on some occasions, we earn revenue if you click the links and buy the products, but we never allow this to bias our coverage and always honestly review. For more information please read our Affiliate Policy. Hosted on Acast. See acast.com/privacy for more information.
The guidelines are in and the myths are out. In this episode of the BackTable Podcast, Dr. Suzette Sutherland hosts Dr. Melissa Kaufman and Dr. Giulia Ippolito to discuss the new 2025 AUA/SUFU guidelines on genitourinary syndrome of menopause (GSM). ---SYNPOSISThe doctors delve into what GSM is, its symptoms, and the new evidence-based clinical guidelines for screening, diagnosing, and treating this condition. The episode emphasizes shared decision-making, safe use of local low-dose vaginal estrogen, and addresses concerns related to hormone therapy and cancer risks. Additionally, the doctors cover non-hormonal interventions, the role of vaginal moisturizers and lubricants, and the use of vaginal lasers. The importance of follow-up and ongoing patient education is also highlighted. The conversation aims to equip clinicians with the knowledge to better manage GSM and improve patient outcomes.---TIMESTAMPS00:00 - Introduction 01:35 - Overview of the 2025 AUA/SUFU Guidelines02:27 - Guideline Development Process05:48 - Categories of Guidelines07:03 - Understanding GSM: Symptoms and Diagnosis10:28 - Patient Education and Shared Decision Making15:22 - Hormonal Interventions and Safety Concerns17:17 - Local Vaginal Estrogen: Recommendations and Usage23:12 - Compounded Estrogens and Alternative Therapies25:48 - Understanding Estrogen Dosage Forms26:11 - Introduction to DHEA and Its Benefits27:15 - Exploring Ospemifene as an Alternative28:05 - Guidelines for Treating GSM Symptoms30:11 - The Role of Vaginal Estrogen in UTI Prevention33:01 - Non-Hormonal Interventions for GSM35:39 - Laser Treatments for GSM39:59 - Addressing Cancer Risks with Vaginal Estrogen44:48 - Endometrial Surveillance and Follow-Up49:14 - Advocating for Vaginal Estrogen Use51:13 - Conclusion and Final Thoughts
The guidelines are in and the myths are out. In this episode of the BackTable Podcast, Dr. Suzette Sutherland hosts Dr. Melissa Kaufman and Dr. Giulia Ippolito to discuss the new 2025 AUA/SUFU guidelines on genitourinary syndrome of menopause (GSM). ---SYNPOSISThe doctors delve into what GSM is, its symptoms, and the new evidence-based clinical guidelines for screening, diagnosing, and treating this condition. The episode emphasizes shared decision-making, safe use of local low-dose vaginal estrogen, and addresses concerns related to hormone therapy and cancer risks. Additionally, the doctors cover non-hormonal interventions, the role of vaginal moisturizers and lubricants, and the use of vaginal lasers. The importance of follow-up and ongoing patient education is also highlighted. The conversation aims to equip clinicians with the knowledge to better manage GSM and improve patient outcomes.---TIMESTAMPS00:00 - Introduction 01:35 - Overview of the 2025 AUA/SUFU Guidelines02:27 - Guideline Development Process05:48 - Categories of Guidelines07:03 - Understanding GSM: Symptoms and Diagnosis10:28 - Patient Education and Shared Decision Making15:22 - Hormonal Interventions and Safety Concerns17:17 - Local Vaginal Estrogen: Recommendations and Usage23:12 - Compounded Estrogens and Alternative Therapies25:48 - Understanding Estrogen Dosage Forms26:11 - Introduction to DHEA and Its Benefits27:15 - Exploring Ospemifene as an Alternative28:05 - Guidelines for Treating GSM Symptoms30:11 - The Role of Vaginal Estrogen in UTI Prevention33:01 - Non-Hormonal Interventions for GSM35:39 - Laser Treatments for GSM39:59 - Addressing Cancer Risks with Vaginal Estrogen44:48 - Endometrial Surveillance and Follow-Up49:14 - Advocating for Vaginal Estrogen Use51:13 - Conclusion and Final Thoughts
Selling 8–10 cars a month and wondering why the top performers at your dealership keep hitting 25, 30, even 35 units? In this episode of Ultimate Sales Pro LIVE, automotive sales expert Frank J Lopes, President of Strong30 Automotive, delivers the no-BS car sales training you need to change your career forever.You'll get automotive sales tips that work in the real world, not just in training rooms, and learn exactly how to sell more cars and close more deals without relying on luck.Here's what's inside this automotive sales podcast episode:The exact dealership sales process top automotive sales pros use to dominate their market.How to close more deals with follow-up strategies that make you unforgettable.Why most salespeople train less than their customers prepare to say “no.”The “Triple T” method to create opportunities instead of waiting for them.A blueprint to break free from weak habits and consistently hit 20–30 cars a month.Whether you're in car sales, a sales manager, GSM, or GM, this episode gives you automotive follow-up strategies, mindset shifts, and the car dealership marketing mindset to control the customer experience, increase gross profit, and build a high-income career.This is Ultimate Sales Pro LIVE — the show for pros who refuse to settle.
Is one outdated warning label standing between millions of women and safe, effective care? In this episode of BackTable Urology, Dr. Yahir Santiago-Lastra, a urologist specializing in female pelvic medicine and reconstructive surgery at UC San Diego, joins host Dr. Suzette Sutherland to discuss the black box warning on vaginal estrogen, its historical context, and the ongoing advocacy efforts to update outdated FDA guidelines. --- SYNPOSIS The conversation covers the importance of low-dose vaginal estrogen in treating genitourinary syndrome of menopause (GSM), the fear surrounding hormone therapy due to misinterpreted data from the Women's Health Initiative (WHI) study, and the inequities faced in women's health, particularly in the context of hormone replacement therapies. They discuss the legislative and advocacy strategies needed to enact change, emphasizing the role of professional societies, legislative efforts, patient advocacy, and industry support in overcoming the barriers to updating the black box warning. --- TIMESTAMPS 00:00 - Introduction03:43 - History Behind the Estradiol Black Box Warning13:44 - The FDA Citizen Petition18:18 - Gender Inequity in Medicine24:05 - The Role of Organizational Guidelines in Patient Advocacy28:51 - Vaginal Estrogen for Genitourinary Syndrome of Menopause (GSM)32:57 - Medicare Spending and Legislative Advocacy44:56 - Recap and Future Directions --- RESOURCES (TRAVERSE Trial) Cardiovascular Safety of Testosterone-Replacement Therapyhttps://www.nejm.org/doi/full/10.1056/NEJMoa2215025 Systemic or Vaginal Hormone Therapy After Early Breast Cancer: A Danish Observational Cohort Studyhttps://doi.org/10.1093/jnci/djac112 (ASCO Study) Use of local estrogen therapy among breast cancer patients in SEER-MHOS databasehttps://doi.org/10.1200/JCO.2025.43.16_suppl.578 Vaginal estrogen use in breast cancer survivors: a systematic review and meta-analysis of recurrence and mortality riskshttps://doi.org/10.1016/j.ajog.2024.10.054
In this episode of the Millionaire Car Salesman Podcast, Sean V. Bradley and LA Williams sit down with Rammy Joudeh and Dayne Thornicroft, co-founders of AutoBandit—a modern leasing marketplace transforming the automotive landscape. "Expand your horizons with all the different means of which you're selling." – Dayne Thornicroft The conversation opens with the success story of multimillionaire car salesman Cody Carter and highlights how his results stem from strategic use of auto brokers and marketplaces. Rammy and Dayne pull back the curtain on how AutoBandit sets itself apart from traditional brokers by offering a transparent, dealer-first platform backed by a rigorous vetting process to deliver high-quality, real leads. "He lives where the shoppers hang out." – Rammy Joudeh, on Cody Carter's strategy. This episode dives deep into the current leasing climate, explores how recent legislative changes like the “big beautiful bill” are impacting the market, and provides practical strategies for dealerships to diversify their prospecting channels and close more deals. "We produce a completely desked deal and qualified buyers.” – Rammy Joudeh Whether you're a GM, GSM, Internet Director, or top-performing sales professional, this episode is packed with insights that can help you scale smarter, sell faster, and take full advantage of what the marketplace model has to offer! Tune in to learn how AutoBandit is helping dealerships increase sales volume—and why now is the time to reach out and get started. Key Takeaways: ✅ Success Leaves Clues: Emulating the strategies of successful salespeople like Cody Carter can unlock new levels of achievement for sales professionals. ✅ Marketplace Versus Auto Broker: Understand the distinct benefits of using an online marketplace over traditional auto brokers to expand reach and streamline the car leasing process. ✅ Leasing Benefits: Discover why leasing is a thriving option in the automotive industry, particularly in light of recent economic and legislative changes. ✅ Transparent Transactions: Importance of maintaining transparency in vehicle pricing and the purchase process to promote customer trust and satisfaction. ✅ Risk-Free Opportunities: AutoBandit offers a risk-free way for dealers to list inventory, only charging fees upon the completion of a sale, providing a clear advantage over traditional sales models. About Dayne Thornicroft Dayne brings expertise in finance and insurance, combined with a robust knowledge of data analytics. His analytical skills played a key role in co-founding AutoBandit with Rammy. Dayne's ability to optimize automotive deals and his deep understanding of complex leasing strategies make him a pivotal force in providing digital automotive solutions designed to elevate customer experiences. About Rammy Joudeh Rammy is a serial technology entrepreneur with a rich background in SEO, search engine optimization, and online marketing. Driven by his passion for cars, Rammy co-founded AutoBandit, an online marketplace focused on transforming how vehicles are leased and financed. His experience includes founding successful startups and applying innovative marketing strategies to the automotive space. Mastering the Art of Car Sales: Insights from the Millionaire Car Salesman Podcast Key Takeaways Leverage Proven Strategies: Cody Carter's success stems from embracing diverse methods such as Facebook groups, leasing mastery, and auto brokers. Embrace Transparency in Marketplaces: Establish marketplaces, like AutoBandit, provide a risk-free, transparent platform for car dealerships. Future-Proofing with Leasing: Understanding emerging trends and new legislation can reshape dealership strategies and consumer interactions. In the world of automotive sales, achieving outstanding success demands both innovation and a keen understanding of market dynamics. The Millionaire Car Salesman Podcast provides a treasure trove of insights through candid discussions with industry insiders. The conversations with Sean V. Bradley and automotive experts Rammy Joudeh and Dayne Thornicroft underscore pivotal themes in today's automotive marketplace. By examining the strategies of top sellers, the role of innovative marketplaces, and the reshaping landscape due to new legislation, it becomes clear how these elements synergize to redefine success in car sales. Harnessing the Cody Carter Model: Strategic Success in Car Sales Cody Carter stands as a beacon of success in the automotive industry, consistently achieving remarkable sales numbers. His multifaceted strategy serves as a blueprint for other salespeople aiming to elevate their performance. As Sean V. Bradley notes, "Success leaves clues." Carter's approach is not just about exceptional interpersonal skills but about strategically positioning himself where the customers are: "He lives where the shoppers hang out," states Rammy Joudeh. Carter leverages several key tactics. His utilization of Facebook groups allows him to connect with potential buyers effectively. His expertise in leasing, specifically through self-service pricing platforms such as Least Genius, empowers customers with the information they crave, thus enhancing the buying experience. Moreover, Carter's strategic alliances with auto brokers create a pipeline for consistent, qualified leads. Understanding and implementing these elements can drive significant improvements in a salesperson's business model. Dealers and sales professionals need to adopt a mindset of continuous learning and adaptation, leveraging environments where customers are most active. Redefining Transparency in Car Dealerships with Marketplaces In an era where trust and transparency hold paramount importance, marketplaces like AutoBandit emerge as revolutionary platforms for dealerships. These marketplaces are transforming the car sales landscape by providing risk-free opportunities to connect buyers and dealerships. "We want to perform; if we don't perform, that's on us," says Rammy Joudeh, emphasizing the accountability and confidence embedded in their model. AutoBandit, as highlighted by Dayne Thornicroft, offers a unique approach by integrating transparency into the transaction process. With practices such as running soft credit apps, verifying IDs, and securing deposits upfront, the marketplace minimizes friction between buyer and dealership. This ensures that only qualified buyers engage, enhancing efficiency and customer satisfaction. By shifting focus to such platforms, dealerships can drive customer confidence and improve sales. They provide an avenue to bypass traditional lead generation pitfalls by creating seamless experiences that culminate in qualified, delivery-ready prospects. Navigating the Legislative Landscape: Impacts and Opportunities New legislation, particularly the recent "big beautiful bill," holds the potential to reshape the automotive industry. As Dayne Thornicroft outlines, significant aspects of these legislative changes include adjustments to EV rebates, impacting leasing's attractiveness. "Leasing a hybrid and an ev… their penetration rates… are much, much higher," he states, reflecting the growing importance of understanding these market shifts. The implications for car sales lie in adapting to these changes proactively. By capitalizing on current benefits, such as EV lease incentives before they phase out, dealerships can enhance their value proposition to customers. Such foresight ensures dealerships remain competitive amidst evolving legislative environments. Moreover, the conversation among the podcast's hosts touches on an evolving market ethos—consumers now expect pricing transparency. With the enforcement of initiatives like the Cars Act waning, responsibility falls on dealerships to maintain trust through integrity and openness, ultimately nurturing long-term customer relationships. Synthesizing Market Dynamics for Unparalleled Success The wisdom imparted through conversations on the Millionaire Car Salesman Podcast encapsulates key elements essential for domination in the car sales arena. From Cody Carter's strategic mastery to the disruptive innovations introduced by marketplaces like AutoBandit, and through the lens of crucial legislative shifts, a holistic understanding of these dynamics is vital. Dealers and sales professionals are encouraged to analyze and incorporate these insights, strategically aligning themselves with proven practices while remaining flexible to adapt to new challenges and opportunities. In doing so, they not only secure their success but redefine the standards of excellence in the automotive industry, paving the path for a future where knowledge, transparency, and strategic acumen drive unparalleled success. Resources: AutoBandit: Looking for a better way to move inventory and close more deals? AutoBandit is here to help. Autobandit partners with dealerships to deliver motivated, in-market buyers right to you — cutting down the time your sales team spends chasing cold leads. With AutoBandit, you stay in control: manage your pricing, track deals, and watch your close rates rise, all from one easy-to-use platform. Want to see how it works? Visit autobandit.com/for-dealers Dealer Synergy & Bradley On Demand: The automotive industry's #1 training, tracking, testing, and certification platform and consulting & accountability firm. The Millionaire Car Salesman Facebook Group: Join the #1 Mastermind Group in the Automotive Industry! With over 29,000 members, gain access to successful automotive mentors & managers, the best industry practices, & collaborate with automotive professionals from around the WORLD! Join The Millionaire Car Salesman Facebook Group today! Win the Game of Googleopoly: Unlocking the secret strategy of search engines. The Millionaire Car Salesman Podcast is Proudly Sponsored By: AutoBandit: Sign-up with the industry's leading leasing marketplace, connecting dealerships with high-quality, pre-qualified leads through a fully transparent and streamlined platform. Built by dealers for dealers, AutoBandit empowers automotive professionals to scale their leasing operations, close more deals, and increase profitability without the hassle of traditional broker models. Whether you're a seasoned veteran or looking to tap into the growing leasing market, AutoBandit is your go-to resource for sustainable, scalable growth! Dealer Synergy: The #1 Automotive Sales Training, Consulting, and Accountability Firm in the industry! With over two decades of experience in building Internet Departments and BDCs, we have developed the most effective automotive Internet Sales, BDC, and CRM solutions. Our expertise in creating phone scripts, rebuttals, CRM action plans, strategies, and templates ensures that your dealership's tools and personnel reach their full potential. Bradley On Demand: The automotive sales industry's top Interactive Training, Tracking, Testing, and Certification Platform. Featuring LIVE Classes and over 9,000 training modules, our platform equips your dealership with everything needed to sell more cars, more often, and more profitably!
Linda Brubaker, M.D. emphasizes the urgent need to advance women's health research beyond its traditional focus on reproduction, pregnancy, menopause, and breast cancer. She highlights the biological, social, and lifestyle factors that affect women across the lifespan and calls for greater inclusion of women in clinical research. Brubaker announces her leadership of a new JAMA initiative to centralize women's health content and promote rigorous scientific studies. She stresses that conditions like menopause and aging impact all areas of medicine and should be understood by all clinicians. Brubaker encourages collaboration, innovation, and resilience in pursuing high-quality science to support personalized care, healthy aging, and improved outcomes for all women. Series: "Motherhood Channel" [Health and Medicine] [Show ID: 40677]
Linda Brubaker, M.D. emphasizes the urgent need to advance women's health research beyond its traditional focus on reproduction, pregnancy, menopause, and breast cancer. She highlights the biological, social, and lifestyle factors that affect women across the lifespan and calls for greater inclusion of women in clinical research. Brubaker announces her leadership of a new JAMA initiative to centralize women's health content and promote rigorous scientific studies. She stresses that conditions like menopause and aging impact all areas of medicine and should be understood by all clinicians. Brubaker encourages collaboration, innovation, and resilience in pursuing high-quality science to support personalized care, healthy aging, and improved outcomes for all women. Series: "Motherhood Channel" [Health and Medicine] [Show ID: 40677]
Linda Brubaker, M.D. emphasizes the urgent need to advance women's health research beyond its traditional focus on reproduction, pregnancy, menopause, and breast cancer. She highlights the biological, social, and lifestyle factors that affect women across the lifespan and calls for greater inclusion of women in clinical research. Brubaker announces her leadership of a new JAMA initiative to centralize women's health content and promote rigorous scientific studies. She stresses that conditions like menopause and aging impact all areas of medicine and should be understood by all clinicians. Brubaker encourages collaboration, innovation, and resilience in pursuing high-quality science to support personalized care, healthy aging, and improved outcomes for all women. Series: "Motherhood Channel" [Health and Medicine] [Show ID: 40677]
Linda Brubaker, M.D. emphasizes the urgent need to advance women's health research beyond its traditional focus on reproduction, pregnancy, menopause, and breast cancer. She highlights the biological, social, and lifestyle factors that affect women across the lifespan and calls for greater inclusion of women in clinical research. Brubaker announces her leadership of a new JAMA initiative to centralize women's health content and promote rigorous scientific studies. She stresses that conditions like menopause and aging impact all areas of medicine and should be understood by all clinicians. Brubaker encourages collaboration, innovation, and resilience in pursuing high-quality science to support personalized care, healthy aging, and improved outcomes for all women. Series: "Motherhood Channel" [Health and Medicine] [Show ID: 40677]
Linda Brubaker, M.D. emphasizes the urgent need to advance women's health research beyond its traditional focus on reproduction, pregnancy, menopause, and breast cancer. She highlights the biological, social, and lifestyle factors that affect women across the lifespan and calls for greater inclusion of women in clinical research. Brubaker announces her leadership of a new JAMA initiative to centralize women's health content and promote rigorous scientific studies. She stresses that conditions like menopause and aging impact all areas of medicine and should be understood by all clinicians. Brubaker encourages collaboration, innovation, and resilience in pursuing high-quality science to support personalized care, healthy aging, and improved outcomes for all women. Series: "Motherhood Channel" [Health and Medicine] [Show ID: 40677]
Linda Brubaker, M.D. emphasizes the urgent need to advance women's health research beyond its traditional focus on reproduction, pregnancy, menopause, and breast cancer. She highlights the biological, social, and lifestyle factors that affect women across the lifespan and calls for greater inclusion of women in clinical research. Brubaker announces her leadership of a new JAMA initiative to centralize women's health content and promote rigorous scientific studies. She stresses that conditions like menopause and aging impact all areas of medicine and should be understood by all clinicians. Brubaker encourages collaboration, innovation, and resilience in pursuing high-quality science to support personalized care, healthy aging, and improved outcomes for all women. Series: "Motherhood Channel" [Health and Medicine] [Show ID: 40677]
Talking tournament history, GSM ownership, NEW Dobyns Fishing Rods, New Releases, Baits, BFS, Frenzy Series Rods, Xtasy Swimbait rods & reels & anything else Bass Fishing with the MAN Gary Dobyns! West Coast Legend! Check out Dobyns selection at Omnia - https://omnia.direct/DobynsLearn about Supreme Lending Dream Team - https://bit.ly/DreamBigHBHellaBass LIVE now BOOSTED by Power House Lithium - https://bit.ly/HB-PHL—————————————————————————▼ SAVE MONEY & SUPPORT HELLABASS ▼Get 15% off at ARSENAL Fishing w/ code: HELLABASS15 - http://bit.ly/ArsenalShopGet 15% off at OMNIA Fishing w/ code: OMHB8XTN7 - https://omnia.direct/HBOmnia
Coming off one of the most eventful weekends of wrestling all year, Graham "GSM" Matthews and RJ Marceau waste no time on WrestleRant Radio delving into every single topic, starting with Goldberg retiring following his loss to Gunther at Saturday Night's Main Event... and then complaining about it on The Ariel Helwani Show! Was he justified or should he be more appreciative of being afforded one last match? Plus, Jon Moxley is no longer AEW World Champion! GSM and RJ discuss the big title change, what it means for Darby Allin, Adam Cole potentially having to retire due to injury, other thoughts from All In 2025 and Evolution 2025, Becky Lynch and Lyra Valkyria's feud over the Women's Intercontinental Championship being WWE's best of the year so far, Naomi cashing in Money in the Bank to become Women's World Champion, if it was the right call and a rant on IYO SKY's abysmally-booked reign, Roman Reigns returning on Raw, if Seth Rollins' injury is legitimate, Jelly Roll set to wrestle at SummerSlam, and more!
The Automotive Troublemaker w/ Paul J Daly and Kyle Mountsier
Shoot us a Text.Episode #1091: Today we're covering how dealers are adapting to the end of EV tax credits, Tesla's push to bring robotaxis to the Bay Area, and the TSA's surprising move to let travelers keep their shoes on.Show Notes with links:With the federal EV tax credits ending September 30, dealers are shifting strategies to keep momentum in a market suddenly missing key incentives.Liza Borches of Carter Myers Automotive says, “We're planning marketing campaigns to help [customers] take advantage while they still can.”Joe Jackson, GSM at Bowman Chevrolet in Clarkston, Mich., said they are learning into leasing, “EVs are a lease-heavy vehicle; I expect the leasing to weather this a little bit better than the purchases,”EV Auto's Alex Lawrence thinks that “adoption [will] increase, but it's going to be a lumpy line.”Liza and CMA are confident about the future,, saying “We're committed to educating customers about all the other benefits. Our job is to be proactive, transparent and ready to help customers navigate this shift.”Tesla is aiming to bring its experimental robotaxi service to the San Francisco Bay Area within the next two months—pending regulatory approval.Elon Musk confirmed expansion plans on X, following a limited pilot in Austin, Texas.The Austin test fleet, with safety monitors onboard, is set to grow its service area this weekend, with an ultimate goal of 1,000 Robotaxis in several months.Tesla faces tight regulation in California, unlike the light-touch environment in Texas.Approval from the California DMV and CPUC is still needed to charge passengers for rides, although initial approvals were given in MarchA major travel headache is officially over: U.S. travelers no longer need to remove their shoes at airport security, thanks to new TSA technology and a successful pilot program.The change is effective immediately nationwide, per Homeland Security Secretary Kristi Noem.Passengers ages 12 to 75 were previously required to remove shoes—a post-9/11 rule spurred by the 2001 “shoe bomber,” but a pilot program showed TSA's equipment could maintain safety standards without requiring shoe removal.“Most Americans will be very excited... it will be a much more streamlined process,” said Noem.TSA PreCheck still offers added perks like skipping laptop and toiletry removal.TSA is exploring more changes, including special lanes for families and service members, to simplify screenings further.0:00 Intro with Paul J Daly and Kyle Mountsier0:45 Paul saw Halloween decor at Costco yesterday2:08 Announcements2:50 Dealers React To The End of the EV Tax Credit6:42 A look at Paul and Kyle's bookshelf7:30 Tesla Eyeing Robotaxi In San Fran9:43 TSA No Longer Join Paul J Daly and Kyle Mountsier every morning for the Automotive State of the Union podcast as they connect the dots across car dealerships, retail trends, emerging tech like AI, and cultural shifts—bringing clarity, speed, and people-first insight to automotive leaders navigating a rapidly changing industry.Get the Daily Push Back email at https://www.asotu.com/ JOIN the conversation on LinkedIn at: https://www.linkedin.com/company/asotu/
A massive weekend of wrestling awaits, arguably the biggest all year, and Graham "GSM" Matthews and RJ Marceau are providing their complete previews and predictions for each event on the latest WrestleRant Radio! After giving their quick picks for NXT's The Great American Bash, the duo delve into AEW All In on Saturday afternoon and discuss whether Adam Cole and The Hurt Syndicate are leaving with their titles intact, who will win the men's and women's Casino Gauntlet matches, if The Young Bucks will finally lose the EVP titles, Kenny Omega and Kazuchika Okada renewing their rivalry to determine the inaugural AEW Unified Champion, if Mercedes Mone will claim yet another title by beating Toni Storm, and the unpredictable Texas Death match between Jon Moxley and Adam Page. Will Hangman reclaim the AEW World Championship or will Moxley's reign of terror continue so Darby Allin can be the one to ultimately dethrone him? GSM and RJ are also talking the upcoming installment of Saturday Night's Main Event featuring Solo Sikoa vs. Jimmy Uso for the United States Championship, Randy Orton vs. Drew McIntyre, Seth Rollins vs. LA Knight, and Goldberg's retirement match against Gunther for the World Heavyweight Championship. Is there actually a chance of Gunther holding gold again before he calls it a career? Plus, hear who they have winning at Evolution, including the Women's Intercontinental Championship Triple Threat match, the Battle Royal for a title opportunity at Clash in Paris, IYO SKY vs. Rhea Ripley for the Women's World Championship, and more!
In today's FittBite, I'm breaking down the key to quality activewear: GSM (grams per square meter). You'll discover exactly what GSM means, why it directly affects your product's feel and durability, and specific GSM ranges recommended for leggings, performance tees, shorts, and hoodies. I'll also provide crucial tips on selecting and testing fabrics to avoid costly production mistakes. Tune in to confidently choose the perfect fabric GSM for your activewear every single time.Book a 1 on 1 with our host, Shadi for personalized advice on how to create and grow your fashion business: https://www.fittdesign.com/services/consultation Design your own collection with our instantly downloadable factory ready tech pack templates: FittDesign Tech Pack Templates Follow our host on instagram: https://www.instagram.com/shadiadada/ https://www.instagram.com/fittdesign/ Got any other questions, email us for an instant response at: studio@fittdesign.com Subscribe to our weekly fashion design podcast (New episodes every Thursday at 4pm CST): https://podcasts.apple.com/gb/podcast/the-fittdesign-podcast/id1454410683 Visit our website:https://www.fittdesign.com/ Follow us on:https://www.linkedin.com/company/fittdesign/ https://www.facebook.com/fittdesign https://www.pinterest.com/fittdesign/ https://www.behance....
Humans have long been exposed to three main types of smoke: from early domestic fires, modern wildfires, and more recently, tobacco and fossil fuel pollution. All release tiny particles from partly burned plants, containing harmful chemicals like nitrogen oxides and carcinogens. These particles raise risks for lung cancer, dementia, and even childhood obesity. Studies show that air pollution can disrupt brain chemistry, increase Alzheimer's-related proteins, and activate stress-related genes (NFkB, Nrf2). A new drug (GSM-15606) shows promise in reducing brain damage from pollution in mice. People with the ApoE4 gene may be more vulnerable, while the ApoE3 gene, possibly evolved 200,000 years ago, may offer some protection. Series: "CARTA - Center for Academic Research and Training in Anthropogeny" [Humanities] [Science] [Show ID: 40700]
Humans have long been exposed to three main types of smoke: from early domestic fires, modern wildfires, and more recently, tobacco and fossil fuel pollution. All release tiny particles from partly burned plants, containing harmful chemicals like nitrogen oxides and carcinogens. These particles raise risks for lung cancer, dementia, and even childhood obesity. Studies show that air pollution can disrupt brain chemistry, increase Alzheimer's-related proteins, and activate stress-related genes (NFkB, Nrf2). A new drug (GSM-15606) shows promise in reducing brain damage from pollution in mice. People with the ApoE4 gene may be more vulnerable, while the ApoE3 gene, possibly evolved 200,000 years ago, may offer some protection. Series: "CARTA - Center for Academic Research and Training in Anthropogeny" [Humanities] [Science] [Show ID: 40700]
CARTA - Center for Academic Research and Training in Anthropogeny (Video)
Humans have long been exposed to three main types of smoke: from early domestic fires, modern wildfires, and more recently, tobacco and fossil fuel pollution. All release tiny particles from partly burned plants, containing harmful chemicals like nitrogen oxides and carcinogens. These particles raise risks for lung cancer, dementia, and even childhood obesity. Studies show that air pollution can disrupt brain chemistry, increase Alzheimer's-related proteins, and activate stress-related genes (NFkB, Nrf2). A new drug (GSM-15606) shows promise in reducing brain damage from pollution in mice. People with the ApoE4 gene may be more vulnerable, while the ApoE3 gene, possibly evolved 200,000 years ago, may offer some protection. Series: "CARTA - Center for Academic Research and Training in Anthropogeny" [Humanities] [Science] [Show ID: 40700]
Humans have long been exposed to three main types of smoke: from early domestic fires, modern wildfires, and more recently, tobacco and fossil fuel pollution. All release tiny particles from partly burned plants, containing harmful chemicals like nitrogen oxides and carcinogens. These particles raise risks for lung cancer, dementia, and even childhood obesity. Studies show that air pollution can disrupt brain chemistry, increase Alzheimer's-related proteins, and activate stress-related genes (NFkB, Nrf2). A new drug (GSM-15606) shows promise in reducing brain damage from pollution in mice. People with the ApoE4 gene may be more vulnerable, while the ApoE3 gene, possibly evolved 200,000 years ago, may offer some protection. Series: "CARTA - Center for Academic Research and Training in Anthropogeny" [Humanities] [Science] [Show ID: 40700]
Humans have long been exposed to three main types of smoke: from early domestic fires, modern wildfires, and more recently, tobacco and fossil fuel pollution. All release tiny particles from partly burned plants, containing harmful chemicals like nitrogen oxides and carcinogens. These particles raise risks for lung cancer, dementia, and even childhood obesity. Studies show that air pollution can disrupt brain chemistry, increase Alzheimer's-related proteins, and activate stress-related genes (NFkB, Nrf2). A new drug (GSM-15606) shows promise in reducing brain damage from pollution in mice. People with the ApoE4 gene may be more vulnerable, while the ApoE3 gene, possibly evolved 200,000 years ago, may offer some protection. Series: "CARTA - Center for Academic Research and Training in Anthropogeny" [Humanities] [Science] [Show ID: 40700]
Send us a textThe streets of Staten Island harbor a deadly contradiction - two sets under the same gang banner locked in a bitter rivalry that's destroying lives from within. This raw, unfiltered conversation with returning guest Chyna Brim exposes the troubling reality of what happens when brothers turn against brothers.At the center of this Staten Island drama is Zeuss, a Bugatti member with a documented history of cooperation with authorities dating back to his teenage years. Now he's romantically involved with Method Man's daughter while allegedly providing information that's sent rival GSM member Trag away on potential double life sentences. The web of betrayal, violence, and broken loyalties unfolds through shocking details and even video evidence of confrontations between these warring factions.The most disturbing question emerges as we peel back layers of this street conflict: What's the purpose of joining a gang family if you can't trust your own brothers? "What's the reason for being a part of something if I don't feel protected?" our host asks, highlighting the fundamental breakdown of the system. The conversation reveals an alleged pattern of cooperation with authorities throughout the Bugatti hierarchy, challenging the very code these street organizations claim to uphold.Whether you're familiar with New York's complex gang landscape or simply interested in understanding the psychology behind these deadly rivalries, this episode offers rare insight into a world where loyalty and betrayal exist in constant tension. Subscribe now and join the conversation about how these street dynamics impact communities and the young men caught in their grip.Support the showFollow our IG & YouTube for live updates @LFTGRadio
In this episode, I'm talking about something I see all the time in my practice but that too many women still suffer through in silence: Genitourinary Syndrome of Menopause (GSM). This condition shows up in women as estrogen levels decline, most commonly during and after menopause.If you've been dealing with vaginal dryness, itching, pain with intercourse, or repeated urinary tract infections, you're not alone, and it may be GSM.I walk you through the updated guidelines from the American Urologic Association (AUA) and the American Urogynecologic Society (AUGS) for diagnosing and treating GSM. We talk about what symptoms to look for and the full range of treatment options, including hormonal and non-hormonal therapies, so you can make informed decisions that work for you.In this episode, I also cover:Why follow-up care is just as important as starting treatmentHow shared decision-making with your provider changes outcomesWhat research still needs to catch up when it comes to cost and accessIf you've ever wondered if your symptoms are "just aging" or felt unsure about what's normal after menopause, this episode is for you. My goal is to empower you with information and make sure you know you're not alone.For more information on this study: https://www.auanet.org/guidelines-and-quality/guidelines/genitourinary-syndrome-of-menopauseTimeline:00:30 Introduction to Genital Urinary Syndrome of Menopause 01:25 Understanding the Symptoms and Diagnosis 03:15 Guidelines for Treatment 06:09 Hormonal Treatments and Recommendations 07:43 Non-Hormonal Treatments and Considerations 08:49 Energy-Based Treatments and Their Efficacy 10:36 Cancer Concerns and Hormonal Treatments 13:14 Follow-Up and Long-Term Management 14:04 Conclusion and Future Research
Everyone thinks hormone therapy is finally getting attention but no one's really talking about the fact that estrogen can be life-saving. The data is right there: lower mortality, fewer hospitalizations, less sepsis. So why is it still being overlooked?In my practice, I see patients every day who are silently suffering dealing with UTIs, vaginal dryness, painful sex, and bladder issues they think are just part of aging. But these symptoms often point to something much bigger: Genitourinary Syndrome of Menopause. And what's worse, it's still widely misunderstood or ignored.A recent study with new data stopped me in my tracks. Over 11 million patient records showed that vaginal estrogen doesn't just improve quality of life it dramatically reduces serious outcomes like sepsis and even death. That kind of impact should be front-page news in every medical journal, yet here we are… still debating whether it's “necessary.”We also talked about the brand new AUA guidelines, which now make it clear: local estrogen is first-line therapy. It's safe, even for many patients who were once told they couldn't use hormones. These guidelines finally reflect what we've known clinically for years that low-dose vaginal estrogen isn't just symptom relief. It's prevention.There's still a lot of confusion about systemic absorption, cancer risk, and when to refer out. So in this episode, I'm breaking down what's new, what's misunderstood, and what every patient and provider needs to know. I'm also sharing how I approach treatment options from estrogen and DHEA to pelvic floor therapy and even energy-based devices (yes, we go there).If you've ever been told this is just part of aging, or you're not sure what your options are, I hope this gives you clarity—and maybe a little validation, too. Highlights:Why vaginal estrogen can lower mortality, sepsis, and hospital stays.What the AUA's 2025 GSM guidelines say—and why they matter.Clearing up myths about hormone absorption and cancer risk.When to consider DHEA, Ospemifene, or non-hormonal options.The role of pelvic floor therapy in managing GSM.Resources:AUA's GuidelinesGyno Girl-GSM VideoGet in Touch with Dr. Rahman:WebsiteInstagramYoutube
Graham "GSM" Matthews is eating his hat (okay, not literally) to kick off WrestleRant Radio this week after admitting RJ Marceau was right: Mariah May has officially arrived in WWE! They get into her departure from AEW and quick debut on NXT this past Tuesday, why it's smart for her to head there first ahead of a main roster run, her successful AEW run and if Tony Khan could be hesitant to push certain people in the future in fear they'll jump to WWE, and more! The duo are also discussing R-Truth, Carlito and Valhalla (a.k.a. Sarah Lorgan) not having their contracts renewed by WWE, why releases are the nature of the beast but Truth being an exception, loyalty not meaning a damn thing to the TKO regime, and if fans are overreacting to the news. Plus, GSM and RJ give their complete preview and predictions for this weekend's Worlds Collide and Money in the Bank premium live events!
In this episode of the You Are Not Broken podcast, I'm diving into the brand-new clinical guidelines for Genitourinary Syndrome of Menopause (GSM)—because you deserve facts, not fear. We're breaking down what GSM actually is, why it's so often overlooked, and how these updated recommendations can help you and your clinician make informed, collaborative decisions about your care. I walk you through the full range of treatment options—yes, including hormones—and explain why vaginal estrogen remains a safe, effective choice, even for breast cancer survivors. We also talk about: Why education around hormonal changes in midlife isn't optional The role of pelvic exams (and how to make them less intimidating) Non-hormonal treatments that actually work Why this all matters: GSM impacts your quality of life, intimacy, and overall health This episode is your call to action. Use these new guidelines as a springboard for conversations with your healthcare provider—especially if they're not up to speed. Your body. Your voice. Your choice. AUA 2025 GSM Guidelines Order my book "You Are Not Broken: Stop "Should-ing" All Over You Sex Life" and "Menopause Moment: Science, Hormones and Mindset for Optimal Longevity" Listen to my Tedx Talk: Why we need adult sex ed Take my Adult Sex Ed Master Class: My Website Interested in my sexual health and hormone clinic? Waitlist is open To learn more about GennaMD by Solv Wellness, visit gennaMD.com for 20% off your first order. For an additional $5 off, use coupon code DRKELLY5. Providers can request patient education materials or samples at gennaMDHCP.com. Thanks to our sponsor Midi Women's Health. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care.https://www.joinmidi.com Learn more about your ad choices. Visit podcastchoices.com/adchoices
Our guest is Dr. Irene Crescenze, an Associate Professor of Urology at Ohio State Univeristy. She talks with us about Genitourinary Syndrome of Menopause, or GSM. Learn what you should know about symptoms, treatment and improving your quality of life. For more podcasts, follow The Urology Care Podcast on Spotify, SoundCloud, and/or iTunes. Don't forget to subscribe to our free digital magazine, UrologyHealth extra® at www.urologyhealth.org/uhe. **** May 30, 2025
In this episode, Dr. Carolyn Moyers dives into one of the most overlooked yet impactful topics in women's health: low sexual desire. Despite growing recognition of sexual wellbeing as a key part of overall quality of life, sexual concerns are still rarely addressed in clinical settings. Drawing from the ISSWSH Process of Care for Hypoactive Sexual Desire Disorder (HSDD) and a new 2025 study published in Menopause, Dr. Moyers explores the barriers women face in getting support—and what healthcare providers can do to change that.Nearly 50% of postmenopausal women experience GSM symptoms — yet many suffer in silence. From vaginal dryness to recurrent UTIs and painful sex, these symptoms are chronic, progressive, and treatable.In this episode you will learn:Why sexual health conversations are often missing from routine careHow to use the Decreased Sexual Desire Screener (DSDS) to identify HSDDWhat a targeted physical exam can reveal—think clitoral adhesions, vulvodynia, high-tone pelvic floor dysfunction, and moreMedical and psychological conditions that contribute to low desireHow medications may be sabotaging sexual functionEvidence-based treatment strategies that go beyond “just relax and try wine”Why giving women permission to talk about sex is a clinical skill we all need to practiceISSWSH Process of Care for the Management of Hypoactive Sexual Desire Disorder in Women, published in Mayo Clinic Proceedings, April 2016New study in Menopause (May 2025) exploring physician barriers to addressing sexual concerns in clinical care
JUST DROPPED! The 2025 Genitourinary Syndrome of Menopause (GSM) guidelines are here — and trust us, they're a game-changer for pelvic health pros. Pelvic pain, dryness, urgency, and more — GSM is so much more than just hot flashes.The 2025 Genitourinary Syndrome of Menopause guidelines just dropped — and they're packed with clinical pearls pelvic health OTs can't afford to miss. What's new? What's outdated? What's YOUR role as an OT?We're breaking it all down in this week's episode of the OTS in Pelvic Health Podcast — and let's just say…you'll never look at menopause the same way again. Listen now. Learn more. Lead better. Link in bio.#PelvicHealthOT #GSM2025 #MenopauseMatters #OccupationalTherapy #WomensHealthOT #PelvicFloorTherapy #GSMguidelines #TraumaInformedOT #OTpodcast_______________________________________________________________Podcast: OTs in Pelvic HealthOT Pelvic Health HeadQuarters____________________________________________________________________________________________Pelvic OTPs United - Lindsey's off-line interactive community for $39 a month! Inside Pelvic OTPs United you'll find: Weekly group mentoring calls with Lindsey. She's doing this exclusively inside this community. These aren't your boring old Zoom calls where she is a talking head. We interact, we coach, we learn from each other. Highly curated forums. The worst is when you post a question on FB just to have it drowned out with 10 other questions that follow it. So, she's got dedicated forums on different populations, different diagnosis, different topics (including business). Hop it, post your specific question, and get the expert advice you need. More info here. Lindsey would love support you in this quiet corner off social media!
In this episode of the Sky Women's Health Podcast, Dr. Carolyn Moyers, board-certified OB/GYN and Menopause Society Certified Provider, breaks down the newly released 2024 American Urological Association (AUA) Clinical Guideline on Genitourinary Syndrome of Menopause (GSM).
Join Sean V. Bradley and L.A. Williams as they feature the incredible Toni Cornell, a true trailblazer in automotive sales who's making waves with her innovative use of social media. From being a young mom to becoming a six-figure earner, Toni's journey is nothing short of inspiring! "I went from a 15-year-old mom to making over six figures. You know, I haven't needed state assistance." – Toni Cornell In this episode, she opens up about how she's leveraged her personal and business Facebook pages to generate leads, sell cars, and grow her network organically, creating lasting relationships along the way! "I've been using social media for, I would say 10 years... and it's my main source of business." – Toni Cornell Toni shares the secrets behind her content strategy, designed to foster personal connections and community trust. With the support of her manager, she dives into her transition from BDC to full-time sales, emphasizing the power of adaptability and a human-first approach, especially in an era dominated by AI. Plus, discover how AI technologies like Podium's conversational AI are helping salespeople engage with customers continuously, enhancing their sales efforts. This episode is packed with game-changing insights you don't want to miss! Key Takeaways: ✅ Toni Cornell achieved an impressive feat in automotive sales, selling up to 51 cars in one month, primarily through social media strategies. ✅ By using her Facebook pages, Toni reaches nearly 300,000 people, with over 90,000 direct engagements, which translates to daily leads and consistent sales. ✅ Social media is not only about direct sales; Toni emphasizes the importance of community engagement, authentic content sharing, and building trust with followers. ✅ Integrating AI into sales processes can facilitate continuous customer interaction, allowing professionals like Toni to manage increased leads without compromising personal touch. ✅ Managers like Harry play a pivotal role in recognizing and nurturing talent, encouraging the use of innovative platforms like the Millionaire Car Salesman Network to drive success. About Toni Cornell Toni Cornell is a distinguished automotive sales professional who has mastered the art of selling vehicles through social media! Starting as a BDC representative, Toni has built an impressive career, selling up to 51 cars in a month and leveraging platforms like Facebook to expand her clientele. With over 17,500 organic followers and an engagement reach of 90,000 on her personal Facebook page, Toni has become a social media influencer in the automotive industry. Aside from her sales achievements, she is also recognized for her commitment to community service and advocacy! Unlocking Success in Car Sales: Leveraging Social Media, Mentorship, and Innovation Key Takeaways: Social Media Mastery: Harnessing Facebook to generate leads and influencer-level engagement can significantly boost car sales. Mentorship and Empowerment: A supportive management team can elevate salespeople, transforming potential into performance. Innovation in a Changing Landscape: Staying ahead in the auto industry requires thinking outside the traditional dealership model. Harnessing the Power of Social Media for Car Sales In today's digital age, social media has emerged as an invaluable tool for car sales professionals looking to maximize their reach and influence. Leveraging platforms like Facebook not only enhances personal branding but also serves as a powerful lead generation tool. Toni Cornell, a standout figure in automotive sales, exemplifies this transformation with her impressive use of social media to drive business outcomes. Toni's journey from a beginner to a leading salesperson showcases the monumental power of social media in sales. By cultivating a staggering 17,500 followers on her organic page, she managed to achieve an engagement level that reaches up to 300,000 people, with 90,000 directly engaging with her content. As she shares, "I have videos with up to 1.4 million views, and it's my main source of business." What sets Toni apart is not just her ability to attract followers but also her strategic use of Facebook as a revenue-generating tool, earning $1,000 to $2,000 a month from ad revenue. This showcases the potential of social media to supplement income while bolstering sales efforts. Her story is a testament to the impact of integrating social media into a sales strategy, emphasizing how platforms like Facebook can become indispensable allies in a competitive market. The Role of Mentorship and Empowerment in Sales Success Behind every high-achieving professional is often a supportive mentor who recognized and nurtured their potential. For Toni Cornell, that mentor was her general sales manager, Harry, who not only identified her potential but also directed her towards invaluable resources to foster her growth. "I've been following it for a while. Someone just suggested it for me, and I really like the content, what you guys were about," Harry explains. Harry's approach highlights a critical element of success: empowerment. By encouraging Toni to join the "Millionaire Car Salesman Facebook Group," he provided her with tools that propelled her knowledge and operations beyond traditional dealership expectations. Harry describes Toni as someone who "took off with it" and transformed her online presence into a consistent source of leads, thereby enhancing dealership sales without any direct dealership expenditure. The essence of Harry's mentorship style lies in allowing salespeople to explore creative methods of growing their business while offering unwavering support. This strategy has propelled Toni to achieve remarkable feats, such as selling 51 cars in a single month. Her experience shows how encouragement and autonomy can unlock previously untapped potential within sales professionals. Innovation: Leading the Auto Sales Industry into a New Era In a rapidly evolving automotive landscape, innovative thinking has become non-negotiable. The traditional dealership model's limitations are becoming increasingly apparent, especially when contrasted with the fresh approaches of individuals like Toni Cornell. Her story is a blueprint for those looking to thrive amidst industry changes. The proactive pursuit of alternative avenues, such as strategic social media utilization, not only fills the gaps left by traditional methods but also opens new doors for customer engagement. Harry, the GSM at her dealership, recognized this dynamic early on: "I didn't do anything with it. I didn't prospect it, I didn't work or lead. I wasn't in the CRM, didn't pay for it. It's all extra." Such forward-thinking approaches are critical, especially in an industry where to remain stagnant is to fall behind. As dealerships face tighter competition and evolving consumer expectations, integrating innovative tools like AI chatbots and personalized social media campaigns can enhance customer experience and loyalty. Gaining Traction: Elevating Car Sales through Creativity and Community The journey depicted in this conversation serves as a powerful example of how combining social media prowess with effective mentorship can lead to unprecedented success in car sales. Toni Cornell's achievements underscore the profound impact that social media and community engagement can have on business outcomes. Her story is a reminder that in an ever-changing industry, innovation and adaptability remain the cornerstones of sustained success. Supporting team members and equipping them with the tools to thrive is not just beneficial for individual professionals; it contributes to a dealership's overall growth and resilience. As Toni continues to forge ahead, her journey inspires others to explore how they can reinvent their practices and embrace the digital age's opportunities. The account from the millionaire car sales podcast offers crucial insights into the changing automotive sales landscape. It shows that by embracing technology, mentoring talented professionals, and fostering a culture of innovation, dealerships can not only survive but thrive in a rapidly evolving marketplace. Resources: Podium: Discover how Podium's innovative AI technology can unlock unparalleled efficiency and drive your dealership's sales to new heights. Visit www.podium.com/mcs to learn more! ProMax: Complete CRM: Complete CRM is a streamlined, all-in-one system that simplifies your dealership software and processes so you can manage every aspect of your operation with ease; from tracking and following up on leads, desking deals, managing inventory, marketing to your customers, and more. Visit www.nccdirect.com/dealer-synergy to learn more! Dealer Synergy & Bradley On Demand: The automotive industry's #1 training, tracking, testing, and certification platform and consulting & accountability firm. The Millionaire Car Salesman Facebook Group: Join the #1 Mastermind Group in the Automotive Industry! With over 29,000 members, gain access to successful automotive mentors & managers, the best industry practices, & collaborate with automotive professionals from around the WORLD! Join The Millionaire Car Salesman Facebook Group today! Win the Game of Googleopoly: Unlocking the secret strategy of search engines. The Millionaire Car Salesman Podcast is Proudly Sponsored By: Podium: Elevating Dealership Excellence with Intelligent Customer Engagement Solutions. Unlock unparalleled efficiency and drive sales with Podium's innovative AI technology, featured proudly on the Millionaire Car Salesman Podcast. Visit www.podium.com/mcs to learn more! ProMax: Complete CRM: As an innovative leader in the industry for the last 30 years, Complete CRM is designed to give your dealership the competitive edge in a demanding marketplace. Powered by Complete Credit™ and award-winning desking, Complete CRM™ is the industry's only credit and compliance-enabled CRM that lets dealers achieve maximum profitability on every deal. Built on modern technology, Complete CRM seamlessly integrates credit, compliance, inventory, data mining, lead generation, enterprise functionality, and customized reporting in one tool with a single login. Visit www.nccdirect.com/dealer-synergy to learn more! Dealer Synergy: The #1 Automotive Sales Training, Consulting, and Accountability Firm in the industry! With over two decades of experience in building Internet Departments and BDCs, we have developed the most effective automotive Internet Sales, BDC, and CRM solutions. Our expertise in creating phone scripts, rebuttals, CRM action plans, strategies, and templates ensures that your dealership's tools and personnel reach their full potential. Bradley On Demand: The automotive sales industry's top Interactive Training, Tracking, Testing, and Certification Platform. Featuring LIVE Classes and over 9,000 training modules, our platform equips your dealership with everything needed to sell more cars, more often, and more profitably!
The term "genitourinary syndrome of menopause" (GSM) was introduced in 2014 by the International Society for the Study of Women's Sexual Health and the North American Menopause Society (now the Menopause Society). This new term was created to replace older terms like vulvovaginal atrophy, urogenital atrophy, and atrophic vaginitis, and it encompasses the range of symptoms related to hormonal changes in the vulvovaginal and urinary tract areas that can occur during menopause. Recurrent UTIs are more likely in postmenopausal women not on vaginal estrogen therapy. IN this episode, we will highlight new data from the recent AUA meeting which looked at surprising benefits on postmenopausal vaginal estrogen in women with recurrent UTIs. Nonetheless, questions on the data remain. Listen in for details.
*DISCLAIMER* This episode covers adult topics that are not intended for young ears. 260. Sex After Cancer with Dr. Kris Christiansen James 1:19 (NIV) My dear brothers and sisters, take note of this: Everyone should be quick to listen, slow to speak and slow to become angry, **Transcription Below** Questions We Discuss: What is common mis-information that you want to set straight as it relates to cancer and sex? If someone is walking their own cancer journey right now, what would you advise them to both do and avoid doing so that they can still enjoy the healthiest sex life possible with their spouse? What hope do you have to share with people who have battled cancer and still desire to connect intimately with their spouse? Dr. Kris Christiansen is a board-certified family physician who specializes in sexual medicine. She attended medical school and completed her residency in family medicine at the University of Minnesota. She practiced full spectrum family medicine for 10 years and then pursued additional training to specialize in sexual medicine. She works as a sexual medicine specialist at two different clinics in the twin cities. Her clinical interests include both male and female sexual dysfunction, and she loves working with individuals and couples to restore an important part of life. Dr. Christiansen is involved with teaching medical students and residents at the University of Minnesota Medical School, and she has presented at multiple local, national, and international medical conferences. She is involved with the International Society for the Study of Women's Sexual Health (ISSWSH) and serves on committees, collaborates with other experts to publish articles for medical journals, and edits informational articles for the society's new patient facing website. She is passionate about teaching patients, students, and colleagues about the importance of sexual health and well-being. In her free time, she started her own business called Intimate Focus which provides information and quality products to enhance and restore sexual health and wellness. She also enjoys shopping, hiking, and spending time with her family. Dr. Kris Christiansen's Website Previous Episodes featuring Dr. Kris Christiansen on The Savvy Sauce: 215 Enriching Women's Sexual Function, Part One with Dr. Kris Christiansen 216 Enriching Women's Sexual Function, Part Two with Dr. Kris Christiansen Additional Place to Find More Episodes from The Savvy Sauce Related to This Topic: One-Stop Shop for Marriage and Intimacy Resources Dr. Kris Christiansen's Recommended Websites for Sexual Health: The Menopause Society Mayo Clinic National Institutes of Health International Society for the Study of Women's Sexual Health American Urological Association International Society of Sexual Medicine Sexual Medicine Society of North America American Cancer Society ISSWSH International Society for the Study of Women's Sexual Health SMSNA Sexual Medicine Society of North America ISSM International Society of Sexual Medicine The Menopause Society Find a provider: For a women's sexual health provider, pelvic floor physical therapist, (non-Christian) sex therapist ABCST American Board of Christian Sex Therapists (for a Christian sex therapist) Thank You to Our Sponsor: Leman Property Management Company Connect with The Savvy Sauce on Facebook or Instagram or Our Website Please help us out by sharing this episode with a friend, leaving a 5-star rating and review on Apple Podcasts, and subscribing to this podcast! Gospel Scripture: (all NIV) Romans 3:23 “for all have sinned and fall short of the glory of God,” Romans 3:24 “and are justified freely by his grace through the redemption that came by Christ Jesus.” Romans 3:25 (a) “God presented him as a sacrifice of atonement, through faith in his blood.” Hebrews 9:22 (b) “without the shedding of blood there is no forgiveness.” Romans 5:8 “But God demonstrates his own love for us in this: While we were still sinners, Christ died for us.” Romans 5:11 “Not only is this so, but we also rejoice in God through our Lord Jesus Christ, through whom we have now received reconciliation.” John 3:16 “For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life.” Romans 10:9 “That if you confess with your mouth, “Jesus is Lord,” and believe in your heart that God raised him from the dead, you will be saved.” Luke 15:10 says “In the same way, I tell you, there is rejoicing in the presence of the angels of God over one sinner who repents.” Romans 8:1 “Therefore, there is now no condemnation for those who are in Christ Jesus” Ephesians 1:13–14 “And you also were included in Christ when you heard the word of truth, the gospel of your salvation. Having believed, you were marked in him with a seal, the promised Holy Spirit, who is a deposit guaranteeing our inheritance until the redemption of those who are God's possession- to the praise of his glory.” Ephesians 1:15–23 “For this reason, ever since I heard about your faith in the Lord Jesus and your love for all the saints, I have not stopped giving thanks for you, remembering you in my prayers. I keep asking that the God of our Lord Jesus Christ, the glorious Father, may give you the spirit of wisdom and revelation, so that you may know him better. I pray also that the eyes of your heart may be enlightened in order that you may know the hope to which he has called you, the riches of his glorious inheritance in the saints, and his incomparably great power for us who believe. That power is like the working of his mighty strength, which he exerted in Christ when he raised him from the dead and seated him at his right hand in the heavenly realms, far above all rule and authority, power and dominion, and every title that can be given, not only in the present age but also in the one to come. And God placed all things under his feet and appointed him to be head over everything for the church, which is his body, the fullness of him who fills everything in every way.” Ephesians 2:8–10 “For it is by grace you have been saved, through faith – and this not from yourselves, it is the gift of God – not by works, so that no one can boast. For we are God‘s workmanship, created in Christ Jesus to do good works, which God prepared in advance for us to do.“ Ephesians 2:13 “But now in Christ Jesus you who once were far away have been brought near through the blood of Christ.“ Philippians 1:6 “being confident of this, that he who began a good work in you will carry it on to completion until the day of Christ Jesus.” **Transcription** Music: (0:00 – 0:09) Laura Dugger: (0:10 - 1:22) Welcome to The Savvy Sauce, where we have practical chats for intentional living. I'm your host, Laura Dugger, and I'm so glad you're here. Leman Property Management Co. has the apartment you will be able to call home, with over 1,700 apartment units available in Central Illinois. Visit them today at lemanproperties.com or connect with them on Facebook. Today's message is not intended for little ears. We'll be discussing some adult themes, and I want you to be aware before you listen to this message. Not many people specialize in the same thing as our returning guest for today, Dr. Kris Christiansen. She specializes in sexual medicine, and today she's going to provide clarity, information, and direction for how to maximize sexual pleasure with our spouse after one receives a cancer diagnosis. Here's our chat. Welcome back to The Savvy Sauce, Dr. Christiansen. Dr. Kris Christiansen: (1:23 - 1:30) Well, thank you so much, Laura. We had so much fun last time, and I'm looking forward to this conversation again today. Laura Dugger: (1:31 - 1:57) Likewise. I feel the same way. And it really wasn't that long ago that you were on The Savvy Sauce two times, so I'll make sure and link to both of those episodes in the show notes for today. But hopefully everybody's already well acquainted with you, and that's why we're just kind of diving right into our topic today. So, for starters, how did this topic of sex after cancer become an interest of yours to study? Dr. Kris Christiansen: (2:00 - 2:32) Well, so Laura, my job as a sexual medicine physician is that I work with both men and women and helping them with their sexual lives when they have problems or whatever. So, cancer is often a big part of that. So, through my journey with work, I've just developed a significant interest in learning how to really care for people to help restore this important part of life. Laura Dugger: (2:33 - 2:52) Absolutely, because a lot is taken away when somebody gets that awful diagnosis, and so I'm very grateful for people like you who are experts. But is there any common misinformation that you would like to set straight as it relates to cancer and sex? Dr. Kris Christiansen: (2:55 - 6:42) Well, interesting you say that, because there is so much misinformation out there just about sex in general. And then when we throw cancer in on top of that, it just makes it even more complicated. So, I think a common fear that people experience when they get that diagnosis that they hope they never hear, the C word, is that it's going to have a significant impact on their sexual intimacy. And you know what, it can, but that doesn't mean that that chapter in life is closed. We just have to remember that sexual intimacy is much, much broader than just intercourse. So, if we can refer to this as PIV sex, penis in vagina sex, many people view it as kind of an all or none thing. If they can't have vaginal intercourse or that PIV sex, then they don't want anything at all. Unfortunately, that just rules out or shuts out so much of sexual intimacy that God has intended for us. We may not be able to engage in the same activities for a time or even long term, but that doesn't mean that we can't connect. So, if we try to remember that intimacy, sexual intimacy is all about giving and receiving pleasure, then there are so many more opportunities. So, we have to get beyond the fact that sexual intimacy, sexual intercourse is just vaginal intercourse because it's not. It's giving and receiving pleasure. And however people want to connect or comfortable connecting, that they can still enjoy a very fruitful sex life. The other thing that is misunderstood and misconceptions is estrogen, vaginal estrogen, especially. Because, well, all women who enter menopause and you're in menopause for the rest of your life do experience some changes. And it's so common that women experience the genital urinary syndrome of menopause. That's vaginal atrophy, or when the tissues get drier and thinner and there can be tearing and pain as well as bleeding and decreased sensation, decreased sensitivity. These things are common with aging, but oftentimes cancer treatments emphasize that or accelerate it or make it even worse. And vaginal estrogen is really, really safe. It does not cause cancer. And most of the studies show that even in women who have breast cancer, that it doesn't cause recurrence. So vaginal estrogen, being so safe, can really save our vaginas. And we're talking about vaginal health and bladder health. It's not just about sex, but it helps keep our bodies functioning properly and minimizing pain and discomfort. So, if a woman is diagnosed with breast cancer and she's on treatment, then obviously we have to talk to the oncologist, make sure they're okay with that. But we get more and more studies showing it's safety and it's definitely effective and can help keep our tissues young. Laura Dugger: (6:42 - 7:25) This is really helpful and brand new information to me. So someone, like you used that example, if they have breast cancer diagnosis and there's different types, but if they're doing the treatment where perhaps they go into early menopause or they have a hysterectomy or remove their ovaries and they even have an estrogen blocker so that they're not producing estrogen, for that type, you're still saying as long as you're working with the oncologist for that personal client, even in those situations, vaginal estrogen, which would be, I'm assuming, more of a cream or something you insert to the vagina, is that right? That that would be safe? Dr. Kris Christiansen: (7:25 - 10:55) So, where it gets a little gray is if the woman is taking an aromatase inhibitor, which is the estrogen blocker. So, it pretty much wipes all estrogen out of her system. There's a little more risk there. So most definitely we need to double check with the oncologist. But it often comes down to quality of life. I have a patient who, she was diagnosed with breast cancer, I believe, in her early 60s. And she came to me at the sexual medicine clinic and she was just miserable. I mean, when we think of vaginal dryness, you think of, okay, it's annoying. You use a lubricant, right, and it's going to be just fine. In the beginning, yes, that's the case. But this genital urinary syndrome of menopause, GSM, gets worse with time, especially with those anti-estrogen treatments. And for this poor woman, she couldn't exercise. She loved to go hiking. She loved to go skiing. And just any kind of movement was painful. And we don't think of that. We kind of take it for granted. But for some women who really experience severe side effects of the breast cancer treatments and causing dryness and irritation, it affects everything. And for her, we tried all the non-hormonal things first. They didn't work. And her oncologist gave us the blessing saying, you know, we tried it. This is really important to you. Let's give it a try. And so, we've monitored her, and the vaginal estrogen hasn't caused any problems. So, a couple points on that. With the vaginal estrogen, yes, it comes as a cream. There's a tablet, which is like a little pill with an applicator that you insert in the vagina. There are vaginal inserts. They look like little caplets that you just insert with the finger. There's a vaginal ring. But with the localized treatment, it's meant to just act locally, meaning just on the vaginal tissues. And, oh, package insert. So, you know, here we tell patients, vaginal estrogen is safe. Don't worry. It's not going to cause cancer, heart attack, strokes, or blood clots. But then they go home. They get their prescription. They open up the patient insert, package insert, and it talks about risks and bad things that can happen and side effects. Unfortunately, the FDA says we have to use the class labeling or the side effects that are associated with systemic estrogen. And it automatically gets applied to the localized or vaginal estrogen treatments. So, patients go home, they read that, and they think we're lying to them. But, unfortunately, it's just very misleading because we have plenty of studies to show that vaginal estrogen doesn't cause those terrible things. And it's very safe. So, they just have to trust us. And there are groups and people out there trying to work with the FDA to get that class labeling effect removed because it just scares everybody away from using estrogen, which can be so helpful. Laura Dugger: (10:57 - 11:04) Wow, that is helpful. Is there any other common misinformation you want to make sure we don't overlook before we continue on? Dr. Kris Christiansen: (11:05 - 11:29) Well, I made a few notes here. No, I don't think so. Except that media, television, and all that other stuff that we see out there is so misleading when it comes to sexual intimacy. Because sex in real life doesn't look like what you see in the movies. Yeah. Laura Dugger: (11:30 - 11:45) Great, great point. And so, when somebody does get, like you said, that dreaded C-word diagnosis, what's a common path that they may experience as it affects them sexually? Dr. Kris Christiansen: (11:48 - 14:00) Well, so, the different cancers are so different and treatments are so different that it's hard to generalize for everybody. But, you know, first thing most people experience is fear. What's this mean for me? What's this mean for my life, my family? Am I going to be around in five years? So, it's that fear. And the initial part of that journey is often involved with meeting with lots of doctors, having all the tests, trying to figure out what's going on, what we're going to do. And sexual intimacy often isn't part of that first steps that they take. So, but when things kind of finally settle down, then those questions start popping up. What does this mean? It's important to talk with your cancer journey, your cancer team, the oncology team to find out what's going on. And it's important to ask all these questions because doctors really aren't very good about asking about sexual health and what that means to you. Oncologists, generally speaking, they want to treat the cancer and their job is done when the cancer is treated, under control, gone, whatever. And they've done a good job. However, so many of us are just left afterwards saying, okay, thanks, cancer's gone, but now what? And so, it's a matter of really trying to figure out what's important over time, learning what's going to work and what's not. And know that there are people out there to help you and that want to help you if it's not going as planned. You know, I just want to reiterate that people really need to advocate for themselves and they need to ask questions. And if they're not getting the answers that they want, don't give up because there are people, organizations, information out there that can be helpful. So rather than just worrying about what's next, seek help. Laura Dugger: (14:02 - 14:18) That's really great advice. And I think this may be an appropriate place to pause and just get some of those recommended places. Because if somebody, this is new to them and they don't know where to turn, do you have any places or websites off the top of your mind that you would recommend? Dr. Kris Christiansen: (14:20 - 15:41) Well, so cancer.org, the American Cancer Society has a lot of resources on there. When it comes to menopause-type symptoms and such, menopause.org is the Menopause Society, which has a lot of information. And a website called PROSAYLA, it's P-R-O-S-A-Y-L-A.com, is a website that's managed by ISHWISH. We've got all these acronyms. The International Society for the Study of Women's Sexual Health. So that is my go-to. Okay, so that's the organization where there's so much research and science and such happening. And the PROSAYLA.org or prosayla.com, either one works, is a website where there are several articles written by experts in the field. So, these are articles backed by science. It's not just somebody's opinion or somebody's blog. And I know there's an article on there about sex or cancer and sexuality. So, some generalities and some other references on that site too. Laura Dugger: (15:42 - 15:51) Okay, that is super helpful information. We'll make sure and add links to those places as well. Anything else that you want to make sure we don't miss? Dr. Kris Christiansen: (15:52 - 17:36) Well, when we talk about sexual concerns or sexual problems, we always try to approach it from a biopsychosocial aspect. Because those three different entities all play a big role in what works well and what doesn't. So, from the biological section, that's pain, medications, nerve problems, chronic medical problems. So obviously cancer plays a big role in that. And with cancer treatments and such, pain may be part of that, nausea, fatigue. And so, we just don't feel the same going through these treatments because it's really hard. As far as the psych bubble, I'm usually referencing a Venn diagram here. Psychological, so when we experience anxiety or depression or performance anxiety, that plays a big role. So, we need to take a step back and realize that what happens up here in our brain has a huge impact on how our bodies function physically. And then as far as the social aspect, that's our relationships, our interpersonal relationships with our partner, our spouse, with our family and how things are going on at work. A cancer diagnosis and treatment can affect all of those. And so, it's not just a magic pill to improve your libido because if we don't treat all these other things, people continue to struggle with their sexual function. Laura Dugger: (18:01 - 19:46) Duplexes, studios and garden style options located in many areas throughout Pekin. In Peoria, a historic downtown location and apartments adjacent to the OSF Medical Center provide excellent choices. Check out their brand-new luxury property in Peoria Heights overlooking the boutique shops and fine dining on Prospect. And in Morton, they offer a variety of apartment homes with garages, a hot downtown location and now a brand-new high-end complex near Idlewood Park. Their beautiful, spacious apartments with private garages in a quiet but convenient location await you in Washington. And if you're looking in Canton, don't miss Village Square Apartments. Renters may be excited to learn about their flexible leases, pet-friendly locations and even mini storage units available in some locations. Leman Property Management Co. has a knowledgeable and helpful staff, including several employees with over 30 years working with this reputable company. If you want to become a part of their team, contact them about open office positions. They're also hiring in their maintenance department, so we invite you to find out why so many people have chosen to make a career with them. Check them out on Facebook today or email their friendly staff at Leasing@LemanProps.com. You can also stop by their website at lemanproperties.com. That's LEMANproperties.com. Check them out and find your place to call home today. Also, Dr. Kris, are there any certain cancers or treatments that have the most detrimental impact on a person's sex life? Dr. Kris Christiansen: (19:48 - 23:15) We know that cancers that affect the breast, for women, but men too get breast cancer, and also the genital area have the biggest impact. We've talked a fair amount about breast cancer. Many of the treatments for breast cancer result in early menopause. If a woman is premenopausal when this happens, menopause can have a definite impact. The treatments can cause the pain and dryness and decrease sensitivity. Also, if surgery is involved in a mastectomy, it can affect our own body self-image. From a more physical standpoint too, when we have the mastectomy and those nerves are cut, it decreases the sensitivity. For a lot of women, breast stimulation is really important as part of their sexual play. If now her breasts are gone and she can't feel anything when her husband is touching her breasts, that can be a really hard adjustment. Any cancers that affect the genital area, uterine cancer, ovarian cancer, or anal rectal cancer for both men and women, and prostate cancer for men, those all have a huge impact. In addition to working with a lot of women who have breast cancer and overcoming and improving those areas, I work with a lot of men who have prostate cancer. Those treatments usually result in erection problems and urinary incontinence, which can be hard to deal with. Men who have a prostatectomy, so if they have their prostate removed, then 100% of them are going to have erectile dysfunction in the beginning. It's going to take time for those nerves to recover, and it may take up to two years to see that full recovery. In those first few months when I'm working with men, I'm trying to be their cheerleader, saying, don't lose hope, don't give up, because this is going to get better. It just takes time for those nerves to regrow. In the process, though, it is important to do whatever we can to make sure that that tissue stays healthy. Remember that the penis is actually muscle, muscle tissue, smooth muscle. If we don't use a muscle for several months, atrophy sets in, which is a bad thing. With atrophy, the penis can shrink in size, and scar tissue potentially can set in, and it just makes that recovery less optimal than what it would have been. Trying to maintain the blood flow during those first few months or first year is really helpful. Just to help maintain the blood flow and the oxygen to help keep the tissues healthy, so when the tenders do recover as best as they're going to, we get the best outcome. Laura Dugger: (23:16 - 23:36) This may be an ignorant question, but then if erectile issues are present during that first time period, but it's crucial to have the blood flow to that area, what can men do to increase blood flow there, even if erection is difficult or impossible? Dr. Kris Christiansen: (23:36 - 25:01) That's a great question. Taking a medication like Viagra or Cialis. Cialis is my favorite because it stays in the system for a good 36 to 48 hours every time you take it. If you're just taking a low dose every day, it just encourages a little bit of that blood flow every day. Using a vacuum device, which I just happen to have one right here, looks like this. A penis goes inside the cylinder, we create a vacuum or suction, and it pulls the blood flow in. It's not the most sexy thing, but using it and using the vacuum device several times a week just to get that blood flow going is a very helpful way to keep the tissues healthy. Getting an erection with the vacuum doesn't get those arousal-type feelings, so it looks a little weird, but it does work. For men who want to use this for sexual activity, you can get the erection within the tube, and then it comes with these tight rings that are stretched over the edge of the cylinder. Once you get the full erection within the tube, you slide that ring off to maintain the erection. Laura Dugger: (25:04 - 25:14) That's incredible just to pause and think of God's grace and these inventions and how incredible that there are solutions. Please continue, but I find that encouraging. Dr. Kris Christiansen: (25:16 - 27:39) There are all kinds of encouraging things, but if you're in the middle of this journey, it can be sometimes hard to keep going when you're not getting the results that you want to. But we believe in a big God, and he created sexual intimacy, and it's a gift. Other ways to help manage erectile dysfunction and a couple other show-and-tell things here. This medication is called Muse. The actual medication is a pellet that comes preloaded in this applicator. You insert it in the tip of the penis, the medication gets absorbed, and 10 minutes later, magic happens. I don't prescribe this very often because it's really, really expensive, a little harder to find. But the advantage to this medication is that it doesn't need the nerves to work, whereas the medications like Viagra and Cialis, they need the nerves. Guys usually kind of turn white when I pull this out. For our listeners, I'm holding an insulin syringe and needle. There is such a treatment where you can actually inject a tiny amount of medicine directly into the penis, and it will give you an erection. I tell men that with the pills like Viagra and Cialis, just in general with ED, it works in about 60% of men. We can get this to work, the injections to work, in 90-95%. It's such a tiny needle that men say it feels like a poke or a pinch once they get past that initial shock that they think is going to hurt. The usual response is, oh, that wasn't so bad, and it's very effective. This can work within four to six weeks, so whenever your surgeon says it's okay to engage in sexual activity again, this will work. Then last but not least is a penile implant. That's surgery, and that you have to wait at least a year, if not two, after the prostate surgery. That works in 99.99%. Wow. Laura Dugger: (27:40 - 27:56) We were focusing a lot on men for that one. Is there any medication or any other injections or anything like that for women, other than the vaginal cream or different ways to get estrogen in the vagina? Dr. Kris Christiansen: (27:58 - 31:15) Yes, we've got all kinds of treatments. If a woman has breast cancer, or for whatever reason we want to avoid hormones as much as possible, then generally we're starting with a vaginal moisturizer, which is different than a lubricant. A lubricant is just for sexual activity and just to make things slipperier and feel better. That often helps in the beginning, but as the GSM or the atrophy continues, the lubricant isn't enough. A moisturizer, think of like a facial moisturizer or a moisturizer for your hand, in order for it to work, you have to use it regularly, which is probably at least three times a week. These moisturizers can come in forms of a liquid that gets injected. They're little capsules that you can insert. Reveri is a hyaluronic acid suppository, which you insert in the vagina and over time that can be really helpful. One of my favorites is this Rosebud Everyday Balm. It's a really nice balm that you can put on the tissues inside the lips and inside the vagina. It's just really, really soothing. Again, you've got to use these things regularly. It will take a good two months at least to see the full effect, so it doesn't work right away. Just like with the guys where they've got to be patient with the nerves, we have to be persistent and patient with things that can work. A vaginal moisturizer is really helpful. A lubricant for sexual activity. There are over-the-counter and prescription medications that can help with arousal and orgasm. There are two approved medications for the treatment of low libido in premenopausal women. One is Addi, which is a pill that you take every day, also known as the pink pill. Another treatment is Vilece, which is an injection. It comes in a pen, so you never see the needle and really don't feel the needle. You give it to yourself about 45 minutes to an hour before sexual activity. Both of these medications are working on the brain chemistry because the brain is the biggest sex organ in the body. It's the most important sex organ. It works on the brain chemistry and improving the dopamine and norepinephrine and the good sex positive hormones. Like I said, it's only approved for premenopausal women, but many of us do prescribe it for postmenopausal women. We have studies to show that it's safe and it's effective. The drug companies didn't go through with all the rigmarole they had to do to get the FDA-approved indication for that. We've got all kinds of tricks up our sleeve. Laura Dugger: (31:16 - 31:26) Absolutely. Just piggybacking on that, they wouldn't oftentimes follow through on all those studies, would you say primarily because of financial restraints? Dr. Kris Christiansen: (31:27 - 31:41) Totally. To get a medication approved for female sexual function, it's multi-million, if not a billion dollars. Studies and everything that needs to be done, it's crazy. That's why these meds are so expensive. Laura Dugger: (31:42 - 32:14) Then you also mentioned earlier bringing in the quality of life. There are so many options to consider, but such a personal basis. I had another question that arose. You kind of were answering that because this one works with the brain chemistry. I'm thinking the body parts may be functioning and you can do different things to have an erection or be aroused with your genitalia, but how is desire affected with cancer? Dr. Kris Christiansen: (32:16 - 35:03) It's huge, unfortunately. Again, if we go back to that biopsychosocial model and for everything to work well, everything's got to be working well. If we have pain, of course that drives down desire. We use the analogy of putting your hand on a hot stove. Pain with sex can hurt just as badly as that. I have women tell me it's 10 out of 10 pain feels like shards of glass. Obviously, that's not pleasant. If we compare that to putting your hand on a hot stove, why in the world would you want to do that? We've got to take care of the pain. When it comes to pain, it becomes imprinted in the brain and the body responds by just amplifying that pain. You've got more pain and you have less desire. Part of GSM or surgery or chemotherapy and other treatments, radiation, can affect the nerves. We don't get those positive sensations and the arousal anymore. There's arousal in the brain as well as arousal in the genital area. If we're not getting that positive feedback that this just isn't fun anymore, it's hard to get enthused about engaging in that. Sex therapy can be really helpful. Sex therapy isn't going to fix thin tissues, but a sex therapist is very skilled and trained at working with people and working with couples on trying to process this, working through the process and the changes that are happening. Sometimes it is a permanent change in sexual function, so there's grief involved. Helping to process through some of that is really important. But again, if we take a step back and remember that sexual intimacy is more than just PIV sex, that there are all kinds of ways to be able to give and receive pleasure, as long as each person is comfortable with this. And moving beyond the thinking that, well, if I can't have intercourse, I'm not going to have anything at all, then that may mean you might not have anything at all for the rest of your life. That makes me sad. We just have to take a step back, work through some of this, because it's a journey, it's a cancer journey, it's an aging journey, and try to make the most of it. Laura Dugger: (35:04 - 36:32) I want to make sure that you're up to date with our latest news. We have a new website. You can visit thesavvysauce.com and see all of the latest updates. You may remember Francie Hinrichsen from episode 132, where we talked about pursuing our God-given dreams. She is the amazing businesswoman who has carefully designed a brand-new website for Savvy Sauce Charities, and we are thrilled with the final product. So, I hope you check it out. There you're going to find all of our podcasts, now with show notes and transcriptions listed, a scrapbook of various previous guests, and an easy place to join our email list to receive monthly encouragement and questions to ask your loved ones so that you can have your own practical chats for intentional living. You will also be able to access our donation button or our mailing address for sending checks that are tax deductible so that you can support the work of Savvy Sauce Charities and help us continue to reach the nations with the good news of Jesus Christ. So, make sure you visit thesavvysauce.com. What are some of those examples for someone if they can't have PIV sex anymore? What are ways that you encourage continuing to build intimacy and a knowing of one another and offering and receiving pleasure? Dr. Kris Christiansen: (36:34 - 41:17) Well, starting with making sure each person is on the same page as far as what they're comfortable with. Okay? Communication is key. To be able to talk about what you want, what you desire, what your needs are, and listening to your partner say that same thing, trying to make no judgments and not forcing anybody into anything, but just so that we can help understand each other. And when it comes to actual giving and receiving pleasure, whether that's with manual stimulation, with your hands, with your fingers, or if you have a massager, oral stimulation, using a vibrator. And a vibrator can be really helpful for women in menopause, women dealing with cancer treatments, and also for men if they need a little extra help with the stimulation because their nerves aren't working so well. A vibrator, using it together in the context of giving and receiving pleasure can help, just help with the response, help with the enjoyment, and make it a little more fun, as long as everybody's okay with that. Using a lubricant is really important. And a good lubricant, you want to use a good lubricant because some of the more common ones, unfortunately, have ingredients in them that can actually hurt or irritate. And like KY and Astroglide, sorry to name names here, but they're basic water-based lubricants, have either glycerin, parabens, or propylene glycol in them, and those can irritate, so we want to try to avoid those. A silicone-based lubricant doesn't have those preservatives, and it stays slippery longer. Where we have to be careful with that is that if you're using a silicone tool, otherwise known as a vibrator, you don't want to use those together because it can ruin the tool. And if the man is struggling with ED, using too much, especially of a silicone lubricant, can make it too slippery. And too slippery is not so good for him. Oil-based lubricants, they're very nice, except if you're using condoms, it will degrade the condom and create other problems, potentially. Other ways to stimulate, manually, orally, and when women have pain with intercourse, I'm going to bring in another show-and-tell here, the pain is often coming from the vulva, not so much in the vagina. We talk about vaginal dryness and vaginal atrophy, but the part that's most sensitive is often just right inside the little lips here. And so, if we have terrible pain with penetration, we want to avoid that. However, the whole surrounding vulvar area is very rich in nerves, can be very much stimulated, and it can feel really good, however each person is comfortable stimulating that area. And another fun fact is that this entire structure is the clitoris. You know, when we think of the clitoris, we think of the glands, this tiny little magic button right here, which, by the way, has 10,000 nerve endings in it. It's incredible. But the legs, the legs are the cruise of the clitoris, as well as the bulbs. They come down on either side of the vagina. So, the vagina is here. However, this part of the clitoris can easily be stimulated, so the legs of the clitoris can be easily stimulated, just inside the labia majora, or the outer lips. So, using a vibrator here can be really pleasurable, and you're avoiding the part that hurts. So, stimulating externally the clitoris, the labia, and wherever else feels good can be very fun. And so, if you try to approach it may be like a game, making it fun and exploring each other's bodies so that you can really figure out ways to make the other person feel good or experience pleasure without causing pain. Laura Dugger: (41:18 - 41:43) That's so great. And like you had mentioned, if they go see a Christian sex therapist, they would say the same thing as you to stop when there is pain, because it just makes it worse over time. And so, I love that you've given us other options, if that is the case. Is there ever a time where orgasm is no longer possible after cancer? Dr. Kris Christiansen: (41:46 - 43:14) It's possible. Yes. Depending on the cancer and the treatment, that it can make it really difficult or even impossible to get there. But that's where we want to not focus on orgasm as the ultimate goal, because if we engage in sexual activity with orgasm as the ultimate goal, your brain's not going to let you go there, whether it's the male or the female, either one, the brain is the biggest sex organ in the body. Just trying to go for the gold just won't let you get there. So, you have to relax and enjoy the journey regardless. So even if the cancer or the treatment didn't necessarily affect orgasm or if it's just our brains, my encouragement is to approach a sexual encounter as an experience. Enjoy the experience. It's not a performance. We don't want to perform because then we get in our head, and we get nervous and our muscles all tighten up. So, we don't want to perform. We want to enjoy the experience, and it can be very pleasurable. Even if orgasm isn't part of the picture anymore, it doesn't mean you can't have fun and can't connect because you can. Laura Dugger: (43:15 - 43:25) But then I guess also to offer the hope, if I ask it a different way, are there times that orgasm is still possible after a cancer diagnosis? Dr. Kris Christiansen: (43:27 - 44:01) Absolutely. We always have hope. We always have hope. Just because you're diagnosed with cancer doesn't mean you're not going to be able to engage in PIV sex or be able to experience an orgasm because that's always a possibility. Don't focus on just getting to the big orgasm. You want to slow down, enjoy the journey, and oftentimes it will come. There are medications that help with blood flow, that help with arousal and orgasm, and sometimes they can be helpful. Sometimes they're not, but usually it doesn't hurt to try them. Laura Dugger: (44:02 - 44:26) There you go. That's a very helpful reminder. It's a piece of the puzzle, not the whole thing. But if someone right now is walking through their own cancer journey, what else would you advise them both to do and to avoid doing so that they can still enjoy the healthiest sex life possible with their spouse? Dr. Kris Christiansen: (44:29 - 47:19) That's going to involve several pieces. One, first and foremost, maintain the communication about wants and desires, what hurts, what doesn't, what can we do, what do you want to try tonight? Maintaining the communication. It's much better to prevent problems like the vaginal dryness and pain than to try to treat it after you've been dealing with it for years sometimes, or even months. If you have, say, breast cancer, just getting in the habit of using one of those vaginal moisturizers from the get-go even before the dryness starts can help prevent problems. Seeing a pelvic floor physical therapist can be really, really helpful. A pelvic floor physical therapist is a physical therapist who specializes in these pelvic floor muscles that help support everything on the inside. And so if these muscles are too tight, causes pain, and if they're already too tight, doing tangles is the last thing that you want to do, because sometimes it means being able to relax them. Or women who have, who need pelvic radiation, say for uterine cancer, the gynecologic oncologist is usually really good about giving you a vaginal dilator and to use it, but they're not always really good at telling you exactly how to use it, how frequently and how long, so be sure and ask. Because again, we want to maintain the integrity of the tissues, because it's better to maintain them than try to get it back. That's often quite hard. For guys, especially with prostate cancer, it means participating in that, we call it penile rehabilitation. So, it's basically physical therapy for the penis. You know, its muscle, so we want to keep that muscle healthy and to help maintain healthy tissues. And just trying to be as good to ourselves as we can, giving ourselves and our partners grace when we need it, because it's a journey and it's not an easy one. But we believe in a big God and he's there to help us through this and he delights when husband and wife can unite as one, whatever that looks like. And it makes him happy and he's there to try to keep this going for us. Laura Dugger: (47:21 - 47:40) And you may have already answered this question with that, but I love how you're always encouraging and gentle and full of hope. So, any other hope that you want to share with anyone who's battled cancer or is in the midst of their journey, but they're still desiring to connect intimately with their spouse? Dr. Kris Christiansen: (47:47 - 48:33) Sometimes it means asking for help. So, for finding a provider, whether that's a therapist, a gynecologist, a sexual medicine provider, or even your pastor counselor to help you through this. In the show notes, we'll put in websites where you can find a provider because not everybody is educated. Hardly anybody's educated on this, unfortunately. But there are people out there throughout the country, throughout the world, where you can find to help guide you on this journey. Don't suffer in silence. We're here to help. So be sure to reach out so we can help you. Laura Dugger: (48:33 - 48:50) That's so good, Dr. Christiansen. And are there any other proactive measures that all of us can take to set us up for a healthy sex life into aging or any diagnoses that we may get in the future? Dr. Kris Christiansen: (48:53 - 50:38) Well, treating our body like a temple, like God says. We have to take good care of ourselves. And just in general, going for your preventative visits and checking your cholesterol and your blood sugar and your blood pressure and screening for cancer so we can prevent them or catch them really early. And it's so much easier to treat. But things like smoking and diabetes and being overweight and high blood pressure, high cholesterol, they impact sexual function very negatively, especially smoking. Guys are still surprised when I tell them, or I show them a picture of a cigarette with ashes that are kind of wilting off the end. This is your penis. This is what happens with smoking. Okay. So quitting smoking. And in women, we have those same little blood vessels and nerves that men do. And so not taking care of ourselves as far as weight, exercise and diabetes and all that stuff, that affects our sexual function, too. So just making sure that we take a proactive stance on just taking really good care of our medical and our mental health because that's so important. And our spiritual health. Can't forget that, too. Yeah. Just, you know, taking care of ourselves because aging does impact sexual function. As we get older, our endurance isn't quite what it used to be. Certainly not as flexible as we used to be. Things kind of hurt. Achy joints and whatever. So, the more we can take care of ourselves, the more we can enjoy that sexual intimacy, which does involve a little bit of physical exertion. Laura Dugger: (50:39 - 51:03) Absolutely. Well, you've shared a lot of places where we can go to seek help. But I would love to know where we can continue to learn from you or a website where people can find out more of your offerings because you mentioned not many people are educated in this field or on this topic, but you are a great resource. So where would you direct all of us after this chat? Dr. Kris Christiansen: (51:05 - 52:23) Well, I started my own business called Intimate Focus, Intimate-Focus.com. Where my goal is to offer education and quality products that people can use to help equip them and enhance sexual intimacy. As part of my clinical career where I see patients, we'd often talk about using a good lubricant or getting a vibrator to help with those nerves that just aren't quite as effective anymore. And so many times they told me they were just not comfortable going to an adult store or they didn't want to purchase them on Amazon because it could be a shared account and kids or whatever may see what they're ordering. So, this is a private and secure site and I don't even know how to sell your email so don't worry, that's not going to happen. Where you can purchase good quality products, I vet them out myself to make sure that they don't contain the ingredients that I encourage women to avoid and no pictures with nudity or anything like that because I want it to be a comfortable space or at least as comfortable as we can make it for everybody. Laura Dugger: (52:24 - 52:43) Wonderful. Well, I'll certainly link that in the show notes as well. And Dr. Christiansen, you are already a friend of The Savvy Sauce, so you know that we're called The Savvy Sauce because savvy is synonymous with practical knowledge. And so, as my final question for you today, what is your Savvy Sauce? Dr. Kris Christiansen: (52:46 - 53:15) Well, you know, James in the Bible is a very practical kind of guy and I love his advice that we should all be quick to listen, slow to speak and slow to become angry. And if we were all able to do that or at least just a little more of that, I think our world would be a much better place to live. Laura Dugger: (53:16 - 53:42) This is so good. I cannot hear that verse enough and I just truly look so forward to the times that I get to spend with you. You are such a calming presence full of wisdom. That's what we prayed for before we had the recording begin for today. And I am just overflowing with gratitude. So, thank you, Dr. Christiansen, for all that you've shared. Thank you so much for being my returning guest. Dr. Kris Christiansen: (53:43 - 53:48) Well, thank you, Laura. This has been great. It's an honor to be on your show. Laura Dugger: (53:50 - 57:32) One more thing before you go. Have you heard the term gospel before? It simply means good news. And I want to share the best news with you. But it starts with the bad news. Every single one of us were born sinners, but Christ desires to rescue us from our sin, which is something we cannot do for ourselves. This means there is absolutely no chance we can make it to heaven on our own. So, for you and for me, it means we deserve death and we can never pay back the sacrifice we owe to be saved. We need a savior. But God loved us so much, he made a way for his only son to willingly die in our place as the perfect substitute. This gives us hope of life forever in right relationship with him. That is good news. Jesus lived the perfect life we could never live and died in our place for our sin. This was God's plan to make a way to reconcile with us so that God can look at us and see Jesus. We can be covered and justified through the work Jesus finished if we choose to receive what He has done for us. Romans 10:9 says, “That if you confess with your mouth Jesus is Lord and believe in your heart that God raised him from the dead, you will be saved.” So, would you pray with me now? Heavenly Father, thank you for sending Jesus to take our place. I pray someone today right now is touched and chooses to turn their life over to you. Will you clearly guide them and help them take their next step in faith to declare you as Lord of their life? We trust you to work and change lives now for eternity. In Jesus' name we pray. Amen. If you prayed that prayer, you are declaring him for me, so me for him. You get the opportunity to live your life for him. And at this podcast, we're called The Savvy Sauce for a reason. We want to give you practical tools to implement the knowledge you have learned. So, you ready to get started? First, tell someone. Say it out loud. Get a Bible. The first day I made this decision, my parents took me to Barnes & Noble and let me choose my own Bible. I selected the Quest NIV Bible and I love it. You can start by reading the book of John. Also, get connected locally, which just means tell someone who's a part of a church in your community that you made a decision to follow Christ. I'm assuming they will be thrilled to talk with you about further steps, such as going to church and getting connected to other believers to encourage you. We want to celebrate with you too, so feel free to leave a comment for us here if you did make a decision to follow Christ. We also have show notes included where you can read scripture that describes this process. And finally, be encouraged. Luke 15:10 says, “In the same way I tell you, there is rejoicing in the presence of the angels of God over one sinner who repents.” The heavens are praising with you for your decision today. And if you've already received this good news, I pray you have someone to share it with. You are loved and I look forward to meeting you here next time.