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As the world aims to eradicate Hepatitis C (HCV) by 2030, Carrielynn Lund and Dr. Alexandra King's team created Journeys to Wellness: Prairie Hepatitis C Roadmap — a step-by-step guide to tackling a spike of new infections across the prairies. Hepatitis C causes severe liver disease, and was notoriously difficult to treat until the introduction of direct-acting antivirals a decade ago — antivirals which boast a remarkable 95% success rate. Despite this advancement, Lund and Dr. King say Saskatchewan, Alberta and Manitoba need to know why HCV cases keep rising, particularly in jails, in remote communities, and in people who lack adequate housing and nutrition. Even so, the virus is not picky, as Carrielynn Lund learned when she was first diagnosed in the 1990s. Her doctor wrongly told her back then the blood-borne illness could be spread only through injection drug use. Shocked, Lund said “I went out of that room and drove home thinking, oh my God, I'm gonna die.” A single mother of two, she resumed her professional life and never disclosed that “dark, dirty secret” until nearly 20 years later, when she became friends with Dr. King. The Waniska team led by Saydi Harlton brought together researchers, health professionals, and people who've lived with hepatitis C in sharing circles, workshops and interviews. “The stigma around this needed to be addressed and I wanted to be a part of it,” said Lund. “People often feel really alone in this journey, and it's so important that we create spaces where they can share their stories and be heard,” Lund says As participants painted stones to represent their journey, many of them identified barriers to care, including confidentiality breaches, misinformation and inadequate access to testing. “My priority right now may or may not be my hepatitis C. It might be, where am I going to sleep today? Or, you know what? What food am I going to be getting?” said Dr. King. In the Roadmap she said the disproportionately high number of cases in Indigenous people shows a need for true elimination strategies, rather than pockets of “little pilot projects.” "There aren't necessarily a lot of resources, so you're dealing with fairly fragile systems," Dr. King noted. Recent provincial government decisions to axe needle exchanges, and cut public transportation routes to remote and northern communities have taken their toll, she added. Given the hurdles Indigenous and two-spirited people face, both Dr. King and Lund say prairie people need culturally informed care, and Indigenous-led hepatitis C elimination strategies with predictable funding and resources. “It really helps you to understand the importance of really good evidence-based policy that supports people and meet them where they're at,” Dr. King said. Lund and Dr. King believe making a fiscal case for early detection and treatment may also swing policy-makers back toward patient-centred care. Peer support also plays a part, Lund said. “When someone who has been through it helps a newly diagnosed person, it can truly change everything for them," she said.
Feb. 6, 2025 - We examine efforts to reduce the transmission of hepatitis C in New York with Sarah Cushman, senior manager for Hep C and community prevention services at Trillium Health, and Zaida Aguilar, a Hep C peer advocate at Housing Works.
Holmberg's Morning Sickness - Tuesday February 4, 2025 Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Holmberg's Morning Sickness - Tuesday February 4, 2025 Learn more about your ad choices. Visit podcastchoices.com/adchoices
Holmberg's Morning Sickness - Tuesday February 4, 2025 Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Holmberg's Morning Sickness - Tuesday February 4, 2025 Learn more about your ad choices. Visit podcastchoices.com/adchoices
This is a replay of an interview with El and Summer about recovery from compulsive addiction through Narcotics Anonymous recorded on 29 November 2019El didn't have an idyllic childhood as her parents separated when she was 12 years old, and her mum was unwell. She suffered physical and emotional abuse and turned to drinking and smoking marijuana in her early teens to cope with the anxiety, fear and shame. El's drug taking escalated quickly and she moved to amphetamines and heroin and contracted Hep C. Her mum and sister helped her to get into rehab and her first exposure to Narcotics Anonymous. However, El continued using for some years until; with two young children she had a moment of clarity and sought help again in NA. Now with over 18 months clean her life is better than ever thanks to the support from members of NA.Summer also had a difficult childhood as her parents separated when she was just 2 years old, and she lived with her mum. She was severely bullied at school and started drinking excessively and smoking weed in her early teens, progressing to ice and party drugs in her late teens. Summer eventually admitted she had a problem, and her mum helped her to get into rehab where she was introduced to NA. She finally found where she belonged and has been clean for over 16 months.If you would like to find out more about Narcotics Anonymous or need to talk to somebody, then please call 1300 652 820 at any time or go online at www.navic.net.au.Show your support to the Living Free show and keep us on air by:subscribing to 3CR https://www.3cr.org.au/subscribeand/or donating to 3CR https://www.3cr.org.au/donateMusic played in this episode was provided by the artists, via Australian Music Radio Airplay Project (https://amrap.org.au/):Ray Ramon - Move Your Body [https://amrap.org.au/release/ray-ramon-move-your-body] @16:47Madison Daniel - NIRVANA [https://amrap.org.au/release/madison-daniel-nirvana] @34:54Mark Howard – Scarlette [https://amrap.org.au/release/mark-howard-scarlette] @55:40
If you donate some of your money to charity, you're doing something good, right? Odds are, you could be doing better. Welcome to the conversation about effective giving. Aman is a financial advisor who has been doing more good for humanity through donating money than most people typically accomplish in their whole lives. That's because he, along with others in the effective giving community, hold their donation dollars to the highest standard they can find. Aman is a Canada-based financial advisor. I know him as a specialist in effective giving. Aman began his career in financial services in 2021 when he decided to pursue his lifelong passion for personal finance. He left a career in retail management, completed his securities license, and started as an independent advisor with Canada Life. Following exponential growth in his client base, he opened Village Financial in 2024 with the goal of reaching more people in his own way. Note: We recorded this ahead of EAGxToronto 2024, which occurred in August. Thanks to my amazing producer Chad Clarke for being essential in putting this show together. All mistakes are mine. Village Financial https://villagefinancialtoronto.ca/ Watch the full episode on YouTube: https://www.youtube.com/@-effectingouraltruism Listen to the full podcast: https://pod.link/1754081644 1Daysooner's Hep C campaign https://www.1daysooner.org/hepatitis-c/ Michael Lenczner's Firm https://wearedaro.com/about Kurzgesagt: This Disease is Deadlier Than The Plague https://www.youtube.com/watch?v=GFLb5h2O2Ww
Francis Collins is a veritable national treasure. He directed the National Institutes of Health from 2009 to 2021. Prior to that he led the National Human Genetics Research Institute (NHGRI) from 1997-2009, during which the human genome was first sequenced. As a physician-scientist, he has made multiple seminal discoveries on the genetic underpinnings of cystic fibrosis, Huntington's disease, neurofibromatosis, progeria, and others. This brief summary is barely scratching the surface oh his vast contributions to life science and medicine.A video clip from our conversation on hepatitis C. Full videos of all Ground Truths podcasts can be seen on YouTube here. The audios are also available on Apple and Spotify.Transcript with external inks and links to audioEric Topol (00:06):Well, I am really delighted to be able to have our conversation with Francis Collins. This is Eric Topol with Ground Truths and I had the chance to first meet Francis when he was on the faculty at the University of Michigan when I was a junior faculty. And he gave, still today, years later, we're talking about 40 years later, the most dazzling Grand Rounds during his discovery of cystic fibrosis. And Francis, welcome, you inspired me and so many others throughout your career.Francis Collins (00:40):Well, Eric, thank you and you've inspired me and a lot of other people as well, so it's nice to have this conversation with you in the Ground Truths format.Eric Topol (00:49):Well, thank you. We're at the occasion of an extraordinary book you put together. It's the fifth book, but it stands out quite different from the prior books as far as I can tell. It's called The Road to Wisdom: On Truth, Science, Faith and Trust, these four essential goods that build upon each other. And it's quite a book, Francis, I have to say, because you have these deep insights about these four critical domains and so we'll get into them. But I guess the first thing I thought I'd do is just say, how at some point along the way you said, “the goal of this book is to turn the focus away from hyperpartisan politics and bring it back to the most important sources of wisdom: truth, science, faith and trust, resting upon a foundation of humility, knowledge, morality, and good judgment.” So there's a lot there. Maybe you want to start off with what was in the background when you were putting this together? What were you really aiming at getting across?Reflections on CovidFrancis Collins (02:06):I'm glad to, and it's really a pleasure to have a chance to chat with you about this. I guess before Covid came along, I was probably a bit of a naive person when it came to how we make decisions. Yeah, I knew there were kind of wacky things that had gone out there from time to time, but I had a sort of Cartesian attitude that we were mostly rational actors and when presented with evidence that's been well defended and validated that most people will say, okay, I know what to do. Things really ran off the rails in the course of Covid. It was this remarkable paradox where, I don't know what you would say, but I would say the development of the vaccines that were safe and highly effective in 11 months using the mRNA platform was one of the most stunning achievements of science in all of history up until now.Francis Collins (03:02):And yet 50 million Americans decided they didn't want any part of it because of information that came to them that suggested this was not safe or there was conspiracies behind it, or maybe the syringes had chips that Bill Gates had put in there or all manner of other things that were being claimed. And good honorable people were distracted by that, lost their trust in other institutions like the CDC, maybe like the government in general like me, because I was out there a lot trying to explain what we knew and what we didn't know about Covid. And as a consequence of that, according to Kaiser Family Foundation, more than 230,000 people died between June of 2021 and April of 2022 because of a decision to reject the opportunity for vaccines that were at that time free and widely available. That is just an incredibly terribly tragic thing to say.Francis Collins (04:03):More than four times the number of people who died, Americans who died in the Vietnam War are in graveyards unnecessarily because we lost our anchor to truth, or at least the ability to discern it or we couldn't figure out who to trust while we decided science was maybe not that reliable. And people of faith for reasons that are equally tragic were among those most vulnerable to the misinformation and the least likely therefore, to take advantage of some of these lifesaving opportunities. It just completely stunned me, Eric, that this kind of thing could happen and that what should have been a shared sense of working against the real enemy, which was the SARS-CoV-2 virus became instead a polarized, divisive, vitriolic separation of people into separate camps that were many times driven more by politics than by any other real evidence. It made me begin to despair for where we're headed as a country if we can't figure out how to turn this around.Francis Collins (05:11):And I hadn't really considered it until Covid how serious this was and then I couldn't look away. And so, I felt if I have a little bit of credibility after having stepped down after 12 years as the NIH Director and maybe a chance to influence a few people. I just have to try to do something to point out the dangers here and then to offer some suggestions about what individuals can do to try to get us back on track. And that's what this book is all about. And yeah, it's called The Road to Wisdom because that's really how I want to think of all this in terms of truth and science and faith and trust. They all kind of give you the opportunities to acquire wisdom. Wisdom is of course knowledge, but it's not just knowledge, it's also understanding it has a moral character to it. It involves sophisticated judgment about difficult situations where there isn't an obvious answer. We need a lot more of that, it seems we're at short supply.Deconvoluting TruthEric Topol (06:13):Well, what I really loved about the book among many things was how you broke things down in just a remarkably thoughtful way. So truth, you have this great diagram like a target with the four different components.in the middle, necessary truth. And then as you go further out, firmly established facts, then uncertainty and then opinion, and truth is not a dichotomous by any means. And you really got that down and you explained each of these different facets of truth with great examples. And so, this among many other things that you broke down, it wasn't just something that you read somewhere, you really had to think this through and perhaps this experience that we all went through, but especially you. But because you bring so much of the book back to the pandemic at times with each of the four domains, so that and the spider web. The spider web of where your core beliefsare and then the ones further out on the web and you might be able to work on somebody out further periphery, but it's pretty hard if you're going to get to them in the middle where their main thing is science is untrustworthy or something like that.Eric Topol (07:36):So how did you synthesize these because the graphics are quite extraordinary?Francis Collins (07:44):Well, I will say the artist for the graphics is a remarkable graphic design student at the University of Michigan who happens to be my granddaughter. So it was nice having that ability to have my scratches turned into something actually looks like artwork. The concepts I got to say, Eric, I was feeling pretty unsure of myself. I never took a course in philosophy. I know there are people who've spent their entire careers going all the way back to Socrates and on up until now about what does truth mean and here's this scientist guy who's trying to say, well, let me tell you what I think about it. I'm glad to hear that you found these circles useful. They have been very useful for me and I hadn't thought about it much until I tried to put it in some sort of framework and a lot of the problems we have right now where somebody says, well, that might be true for you, but it's not true for me, that's fine if you're talking about an opinion, like whether that movie was really good or not.Francis Collins (08:43):But it's not fine if it's about an established fact, like the fact that climate change is real and that human activity is the main contributor to the fact that we've warmed up dramatically since 1950. I'm sorry, that's just true. It doesn't care how you feel about it, it's just true. So that zone of established facts is where I think we have to re-anchor ourselves again when something's in that place. I'm sorry, you can't just decide you don't like it, but in our current climate and maybe postmodernism has crept in all kinds of ways we're not aware of, the idea that there is such a thing as objective truth even seems to be questioned in some people's minds. And that is the path towards a terrible future if we can't actually decide that we have, as Jonathan Rauch calls it, a constitution of knowledge that we can depend on, then where are we?Eric Topol (09:37):Well, and I never heard of the term old facts until the pandemic began and you really dissect that issue and like you, I never had anticipated there would be, I knew there was an anti-science, anti-vaccine sector out there, but the fact that it would become so strong, organized, supported, funded, and vociferous, it's just looking back just amazing. I do agree with the statement you made earlier as we were talking and in the book, “the development of mRNA vaccines for Covid in record time as one of the greatest medical achievements in human history.” And you mentioned besides the Kaiser Family Foundation, but the Commonwealth Fund, a bipartisan entity saved three million lives in the US, eighteen million hospitalizations. I mean it's pretty extraordinary. So besides Covid, which we may come back to, but you bring in everything, you bring in AI. So for example, you quoted the fellow from Google who lost his job and you have a whole conversation with Blake Lemoine and maybe you can give us obviously, where is AI in the truth and science world? Where do you stand there and what were you thinking when you included his very interesting vignette?Perspective on A.I.Francis Collins (11:17):Well, I guess I was trying to talk about where are we actually at the point of AGI (artificial general intelligence) having been achieved? That is the big question. And here's Blake Lemoine who claimed based on this conversation that I quote in the book between him and the Google AI apparatus called LaMDA. Some pretty interesting comments where LaMDA is talking about having a soul and what its soul looks like and it's a portal to all sorts of other dimensions, and I can sort of see why Blake might've been taken in, but I can also see why a lot of people said, oh, come on, this is of course what an AI operation would say just by scanning the internet and picking out what it should say if it's being asked about a soul. So I was just being a little provocative there. My view of AI, Eric, is that it's applications to science and medicine are phenomenal and we should embrace them and figure out ways to speed them up in every way we can.Francis Collins (12:17):I mean here at NIH, we have the BRAIN Initiative that's trying to figure out how your brain works with those 86 billion neurons and all their connections. We're never going to sort that out without having AI tools to help us. It's just too complicated of a problem. And look what AI is doing and things like imaging radiologists are going to be going out of business and the pathologists may not be too far behind because when it comes to image analysis, AI is really good at that, and we should celebrate that. It's going to improve the speed and accuracy of all kinds of medical applications. I think what we have to worry about, and I'm not unique in saying this, is that AI when applied to a lot of things kind of depends on what's known and goes and scrapes through the internet to pull that out. And there's a lot of stuff on the internet that's wrong and a lot of it that's biased and certainly when it comes to things like healthcare, the bias in our healthcare system, health disparities, inadequacies, racial inequities are all in there too, and if we're going to count on AI to fix the system, it's building on a cracked foundation.Francis Collins (13:18):So we have to watch out for that kind of outcome. But for the most part, generative AI it's taking really exciting difficult problems and turning them into solutions, I'm all for it, but let's just be very careful here as we watch how it might be incorporating information that's wrong and we won't realize it and we'll start depending on it more than we should.Breathtaking AdvancesEric Topol (13:42):Yeah, no, that's great. And you have some commentary on all the major fronts that we're seeing these days. Another one that is a particularly apropos is way back when you were at Michigan and the years before that when you were warming up to make some seminal gene discoveries and cystic fibrosis being perhaps the first major one. You circle back in the book to CRISPR genome editing and how the success story to talk about some extraordinary science to be able to have a remedy, a cure potentially for cystic fibrosis. So maybe you could just summarize that. I mean that's in your career to see that has to be quite remarkable.Francis Collins (14:32):It is breathtaking, Eric. I mean I sort of like to think of three major developments just in the last less than 20 years that I never dreamed would happen in my lifetime. One was the ability to make stem cells from people who are walking around from a skin biopsy or a blood sample that are pluripotent. My whole lab studies diabetes, our main approach is to take induced pluripotent stem cells from people whose phenotypes we know really well and differentiate them into beta cells that make insulin and see how we can figure out how the genetics and other aspects of this determine whether something is going to work properly or not. I mean that's just astounding. The second thing is the ability to do single cell biology.Francis Collins (15:16):Which really 15 years ago you just had to have a bunch of cells and studying diabetes, we would take a whole eyelid and grind it up and try to infer what was there, ridiculous. Now we can look at each cell, we even can look at each cell in terms of what's its neighbor, does the beta cell next to an alpha cell behave the same way as a beta cell next to a duct? We can answer those questions, and of course the third thing is CRISPR and gene editing and of course the first version of CRISPR, which is the knockout of a gene was exciting enough, but the ability to go in and edit without doing a double stranded break and actually do a search and replace operation is what I'm truly excited about when it comes to rare genetic diseases including one that we work on progeria, which is this dramatic form of premature aging that is caused almost invariably by a C to T mutation in exon 11 of the LMNA gene and for which we have a viable strategy towards a human clinical trial of in vivo gene editing for kids with this disease in the next two years.Eric Topol (16:24):Yeah, it's just the fact that we were looking at potential cures for hundreds and potentially even thousands of diseases where there was never a treatment. I mean that's astounding in itself, no less, the two other examples. The fact that you can in a single cell, you can not only get the sequence of DNA and RNA and methylation and who would've ever thought, and then as you mentioned, taking white cells from someone's blood and making pluripotent stem cells. I mean all these things are happening now at scale and you capture this in the book. On Humility and Trust Now the other thing that you do that I think is unique to you, I don't know if it's because of your background in growing up in Staunton, Virginia, a very different type of world, but you have a lot of humility in the book. You go over how you got snickered by Bill Maher, how you had a graduate student who was fabricating images and lots of things, how you might not have communicated about Covid perhaps as well as could. A lot of our colleagues are not able to do that. They don't ever have these sorts of things happening to them. And this humility which comes across especially in the chapter on trust where you break down who do you trust, humility is one of the four blocks as you outlined, competence, integrity, and aligned valueSo maybe can you give us a little brief lesson on humility?Eric Topol (18:06):Because it's checkered throughout the book and it makes it this personal story that you're willing to tell about yourself, which so few of us are willing to do.Francis Collins (18:17):Well, I don't want to sound proud about my humility. That would not be a good thing because I'm not, but thanks for raising it. I do think when we consider one of the reasons we decide to trust somebody, that it does have that humility built into it. Somebody who's willing to say, I don't know. Somebody's willing to say I'm an expert on this issue, but that other issue you just asked me about, I don't know any more than anybody else and you should speak to someone else. We don't do that very well. We tend to plunge right in and try to soak it up. I do feel when it comes to Covid, and I talk about this in the book a bit, that I was one of those trying to communicate to the public about what we think are going to be the ways to deal with this worst pandemic in more than a century.Francis Collins (19:06):And I wish Eric, I had said more often what I'm telling you today is the best that the assembled experts can come up with, but the data we have to look at is woefully inadequate. And so, it very well could be that what I'm telling you is wrong, when we get more data, I will come back to you as soon as we have something better and we'll let you know, but don't be surprised if it's different and that will not mean that we are jerking you around or we don't know what we're talking about. It's like this is how science works. You are watching science in real time, even though it's a terrible crisis, it's also an opportunity to see how it works. I didn't say that often enough and neither did a lot of the other folks who were doing the communicating. Of course, the media doesn't like to give you that much time to say those things as you well know, but we could have done a better job of preparing people for uncertainty and maybe there would've been less of a tendency for people to just decide, these jokers don't know what they're talking about.Francis Collins (20:10):I'm going to ignore them from now on. And that was part of what contributed to those 230,000 unnecessary deaths, it was just people losing their confidence in the information they were hearing. That's a source of grief from my part.His Diagnosis And Treatment for Prostate CancerEric Topol (20:24):Well, it's great and a lesson for all of us. And the other thing that along with that is remarkable transparency about your own health, and there's several things in there, but one that coincides. You mentioned in the book, of course, you wrote an op-ed in the Washington Post back in April 2024 about your diagnosis of prostate cancer. So you touched on it in the book and maybe you could just update us about this because again, you're willing to tell your story and trying to help others by the experiences that you've been through.Francis Collins (21:00):Well, I sure didn't want to have that diagnosis happen, but once it did, it certainly felt like an opportunity for some education. We men aren't that good about talking about issues like this, especially when it involves the reproductive system. So going out and being public and saying, yep, I had a five year course of watching to see if something was happening, and then the slow indolent cancer suddenly decided it wasn't slow and indolent anymore. And so, I'm now having my prostate removed and I think I'm a success story, a poster boy for the importance of screening. If I hadn't gone through that process of PSA followed by imaging by MRI followed by targeted biopsies, so you're actually sampling the right place to see if something's going on. I probably would know nothing about it right now, and yet incubating within me would be a Gleason category 9 prostate cancer, which has a very high likelihood if nothing was done to become metastatic.Francis Collins (22:03):So I wanted that story to be out there. I wanted men who were squeamish about this whole topic to say, maybe this is something to look into. And I've heard a bunch of follow-ups from individuals, but I don't know how much of it impact it hit. I'm glad to say I'm doing really well. I'm four months out now from the surgery, it is now the case I'm pretty much back to the same level of schedule and energy that I had beforehand, and I'm very happy to say that the post-op value of PSA, which is the best measure to see whether you in fact are now cancer free was zero, which is a really nice number.Eric Topol (22:45):Wow. Well, the prostate is the curse of men, and I wish we could all have an automated prostatectomy so we don't have to deal with this. It's just horrible.Francis Collins (22:58):It was done by a robot. It wasn't quite automated, I have stab wounds to prove that the robot was actually very actively doing what it needed to do, but they healed quickly.The Promise of Music As Therapy in MedicineEric Topol (23:11):Right. Well, this gets me to something else that you're well known for throughout your career as a musician, a guitarist, a singer, and recently you hooked up with Renée Fleming, the noted opera singer, and you've been into this music is therapy and maybe you can tell us about that. It wasn't necessarily built up much in the book because it's a little different than the main agenda, but I think it's fascinating because who doesn't like music? I mean, you have to be out there if you don't enjoy music, but can you tell us more about that?Francis Collins (23:53):Yeah, I grew up in a family where music was very much what one did after dinner, so I learned to play keyboard and then guitar, and that's always been a source of joy and also a source of comfort sometimes when you were feeling a bit down or going through a painful experience. I think we all know that experience where music can get into your heart and your soul in a way that a lot of other things can't. And the whole field of music therapy is all about that, but it's largely been anecdotal since about World War II when it got started. And music therapists will tell you sometimes you try things that work and sometimes they don't and it's really hard to know ahead of time what's going to succeed. But now we have that BRAIN Initiative, which is pushing us into whole new places as far as the neuroscience of the brain, and it's really clear that music has a special kind of music room in the brain that evolution has put there for an important reason.Francis Collins (24:47):If we understood that we could probably make music therapy even more scientifically successful and maybe even get third parties to pay for it. All of this became opportunity for building a lot more visibility because of making friends withRenée Fleming, who I hadn't really known until a famous dinner party in 2015 where we both ended up singing to a trio of Supreme Court justices trying to cheer them up after a bent week. And she has become such an incredible partner in this. She's trained herself pretty significantly in neuroscience, and she's a convener and an articulate spokesperson. So over the course of that, we built a whole program called Sound Health that now has invested an additional $35 million worth NIH research to try to see how we can bring together music therapy, musician performers and neuroscientists to learn from each other, speak each other's language and see what we could learn about this particularly interesting input to the human brain that has such power on us and maybe could be harnessed to do even more good for people with chronic pain or people with PTSD, people with dementia where music seems to bring people back to life who'd otherwise seem to have disappeared into the shadows.Francis Collins (26:09):It's phenomenal what is starting to happen here, but we're just scratching the surface.The Big Miss vs Hepatitis CEric Topol (26:14):Well, I share your enthusiasm for that. I mean, it's something that you could think of that doesn't have a whole lot of side effects, but could have a lot of good. Yeah. Well, now before I get back to the book, I did want to cover one other relatively recent op-ed late last year that you wrote about Hepatitis C. Hepatitis C, one of the most important medical advances in the 21st century that we're squandering. Can you tell us about that? Because I think a lot of people don't realize this is a big deal.Francis Collins (26:47):It's a really big deal, and I confess I'm a little obsessed about it. So yes, you may regret bringing it up because I'm really going to want to talk about what the opportunity is here, and I am still the lead for the White House in an initiative to try to find the 4 million Americans who are already infected with this virus and get access to them for treatment. The treatment is fantastic, as you just said, one of the most major achievements of medical research, one pill a day for 12 weeks, 95% cure in the real world, essentially no side effects, and yet the cost is quite high and the people who need it many times do not have great healthcare and maybe also in difficult circumstances because you get hepatitis C from infected blood. And the many ways that happens these days are from shared needles from people who are experimenting with intravenous drugs, but they are family too, and many of them now recovering from that, face the irony of getting over their opioid addiction and then looking down the barrel of a really awful final couple of years dying of liver failure. I watched my brother-in-law die of hepatitis C, and it was just absolutely gruesome and heartbreaking.Francis Collins (28:04):So this isn't right. And on top of that, Eric, the cost of all this for all those folks who are going to get into liver failure need a transplant or develop liver cancer, this is the most common cause now of liver cancer it is astronomical in the tens of billions of dollars. So you can make a very compelling case, and this is now in the form of legislation sponsored by Senators Cassidy and Van Hollen that in a five-year program we could find and cure most of those people saving tens of thousands of lives and we would save tens of billions of dollars in just 10 years in terms of healthcare that we will not have to pay for. What's not to love here? There's a lot of things that have to be worked out to make it happen. One thing we've already done is to develop, thanks to NIH and FDA, a point of care viral RNA finger stick test for Hep C. You get an answer in less than an hour.Francis Collins (29:00):FDA approved that the end of June. That was a big crash program so you can do test and treat in one visit, which is phenomenally helpful for marginalized populations. The other thing we need to do is to figure out how to pay for this and this subscription model, which was piloted in Louisiana, looks like it ought to work for the whole nation. Basically, you ask the companies Gilead and AbbVie to accept a lump sum, which is more than what they're currently making for Medicaid patients and people who are uninsured and people in the prison system and Native Americans and then make the pills available to those four groups for free. They do fine. The companies come out on this and the cost per patient plummets and it gives you the greatest motivation you can imagine to go and find the next person who's infected because it's not going to cost you another dime for their medicine, it's already paid for. That's the model, and I would say the path we're on right now waiting for the congressional budget office to give the final score, it's looking pretty promising we're going to get this done by the end of this year.The PledgeEric Topol (30:04):Yeah, that's fantastic. I mean, your work there alone is of monumental importance. Now I want to get back to the book the way you pulled it all together. By the way, if anybody's going to write a book about wisdom, it ought to be you, Francis. You've got a lot of it, but you had to think through how are we going to change because there's a lot of problems as you work through the earlier chapters and then the last chapter you come up with something that was surprising to me and that was a pledge for the Road to Wisdom. A pledge that we could all sign, which is just five paragraphs long and basically get on board about these four critical areas. Can you tell us more about the pledge and how this could be enacted and help the situation? Francis Collins (31:03):Well, I hope it can. The initial version of this book, I wrote a long piece about what governments should do and what institutions should do and what universities should do and what K through 12 education should do. And then I thought they're not reading this book and I'm not sure any of those folks are really that motivated to change the status quo. Certainly, politicians are not going to solve our current woes. It seems that politics is mostly performance these days and it's not really about governance. So if there's going to be a chance of recovering from our current malaise, I think it's got to come from the exhausted middle of the country, which is about two thirds of us. We're not out there in the shrill screaming edges of the left and the right we're maybe tempted to just check out because it just seems so discouraging, but we're the solution.Francis Collins (31:56):So the last chapter is basically a whole series of things that I think an individual could start to do to turn this around. Beginning with doing a little of their own house cleaning of their worldview to be sure that we are re-anchoring to things like objective truths and to loving your neighbor instead of demonizing your neighbor. But yeah, it does go through a number of those things and then it does suggest as a way of making this not just a nice book to read, but something where you actually decide to make a commitment. Look at this pledge. I've tried the pledge out on various audiences so far and I haven't yet really encountered anybody who said, well, those are ridiculous things to ask of people. They're mostly things that make a lot of sense, but do require a commitment. That you are, for instance, you're not going to pass around information on social media in other ways unless you're sure it's true because an awful lot of what's going on right now is this quick tendency for things that are absolutely wrong and maybe anger inducing or fear inducing to go viral where something that's true almost lands with a thud.Francis Collins (33:07):Don't be part of that, that's part of this, but also to make an honest effort to reach out to people who have different views from you. Don't stay in your bubble and try to hear their concerns. Listen, not that you're listening in order to give a snappy response, but listen, so you're really trying to understand. We do far too little of that. So the pledge asks people to think about that, and there is a website now which will be as part of the book up on the Braver Angels website and Braver Angels is a group that has made its mission trying to bring together these divided parties across our country and I'm part of them, and you can then go and sign it there and make a public statement that this is who I am, and it will also give you a whole lot of other resources you could start to explore to get engaged in being part of the solution instead of just shaking your head. I think what we're trying to do is to get people to go beyond the point of saying, this isn't the way it should be to saying, this isn't the way I should be. I'm going to try to change myself as part of fixing our society.Eric Topol (34:14):Well, I'm on board for this and I hope it creates a movement. This is as you tell the stories in the book, like the fellow that you wrangled with about the pandemic and how you listened to him and it changed your views and you changed his views and this is the health of different opinions and perspectives and we got to get back there. It used to be that way more at least it wasn't always perfect, and as you said in the book, we all have some entrenched biases. We're never going to get rid of all of them, but your wisdom about the road, the pledge here is I think masterful. So I just want to pass on along and I hope listeners will go to the Brave for Angels website and sign up because if we got millions of people to help you on this, that would say a lot about a commitment to a renewed commitment to the way it should be, not the way it is right now. Well, I've covered a bunch of things, of course, Francis, but did I miss something that you're passionate about or in the book or anything that you want to touch on?Francis Collins (35:32):Oh my goodness, yeah. You did cover a lot of ground here, including things that I didn't pay much attention to in the book, but I was glad to talk to you about. No, I think we got a pretty good coverage. The one topic in the book that will maybe appeal particularly to believers is a whole chapter about faith because I am concerned that people of faith have been particularly vulnerable to misinformation and disinformation, and yet they stand on a foundation of principles that ought to be the best antidote to most of the meanness that's going on, and just trying to encourage them to recall that and then build upon the strength that they carry as a result of their faith traditions to try to be part of the solution as well.Eric Topol (36:12):I'm so glad you mentioned that. It's an important part of the book, and it is also I think something that you were able to do throughout your long tenure at NIH Director that you were able to connect to people across the aisle. You had senators and the Republicans that were so supportive of your efforts to lead NIH and get the proper funding, and it's a unique thing that you're able to connect with people of such different backgrounds, people of really deep commitment to religion and faith and everything else. And that's one of the other things that we talk about Francis here, and many times I gather is we don't have you at the helm anymore at NIH, and we're worried. We're worried because you're a unique diplomat with all this heavy wisdom and it's pretty hard to simulate your ability to keep the NIH whole and to build on it. Do you worry about it at all?Francis Collins (37:23):Well, I was privileged to have those 12 years, but I think it was time to get a new perspective in there, and I appreciate you saying those nice things about my abilities. Monica Bertagnolli is also a person of great skill, and I think on the hill she rapidly acquired a lot of fans by her approach, by some of her background. She's from Wyoming, she's a cancer surgeon. She's got a lot of stories to tell that are really quite inspiring. I think though it's just a very difficult time. She walked in at a point where the partisan attitudes about medical research, which we always hoped would kind of stay out of the conversation and become so prominent, a lot of it politically driven, nasty rhetoric on the heels of Covid, which spills over into lots of other areas of medical research and is truly unfortunate. So she's got a lot to deal with there, but I'm not sure I would be much better than she is in trying to continue stay on message, tell the stories about how medical research is saving lives and alleviating suffering, and we're just getting started, and she does that pretty well.Francis Collins (38:34):I just hope the people who need to listen are in a listening mood.Eric Topol (38:38):Yeah. Well, that's great to hear your perspective. Well, I can't thank you enough for our conversation and moreover for a friendship that's extended many decades now. We're going to be following not just your progeria research and all the other things that you're up to because juggling a bunch of things still, it isn't like you're slowed down at all. And thanks so much for this book. I think it's a gift. I think it's something that many people will find is a pretty extraordinary, thoughtful and easy read. I mean, it's something that I found that you didn't write it for in technical jargon. You wrote it for the public, you wrote it for non-scientists, non-medical people, and I think hopefully that's what's going to help it get legs in terms of what's needed, which is a sign the darn pledge. Thank you.Francis Collins (39:42):Eric, thank you. It has been a privilege being your friend for all these years, and this was a really nice interview and I appreciate that you already had carefully read the book and asked some great questions that were fun to try to answer. So thanks a lot.*******************************************************Thanks for listening, reading or watching!The Ground Truths newsletters and podcasts are all free, open-access, without ads.Please share this post/podcast with your friends and network if you found it informative!Voluntary paid subscriptions all go to support Scripps Research. Many thanks for that—they greatly helped fund our summer internship programs for 2023 and 2024.Thanks to my producer Jessica Nguyen and Sinjun Balabanoff for audio and video support at Scripps Research.Note: you can select preferences to receive emails about newsletters, podcasts, or all I don't want to bother you with an email for content that you're not interested in. Get full access to Ground Truths at erictopol.substack.com/subscribe
In 2023, the opioid crisis claimed over 81,000 lives -- a staggering number, yet many of these deaths could have been prevented. While prescription opioids can be essential for managing pain, they come with significant risks that are often overlooked. In this episode, we dive deep into the hidden dangers of opioid prescriptions and explore the crucial questions you should ask before accepting these medications. Ellen Eaton, MD, a leading expert in opioid treatment from the University of Alabama Birmingham, joins us to discuss the real risks of misuse, the warning signs to watch for, and the steps you can take to protect yourself and your loved ones. From understanding the potential side effects, to navigating the road to recovery, this conversation sheds light on the opioid epidemic and the urgent need for prevention and education. UAB Medicine Addiction Recovery Services Transcript Neha Pathak, MD, FACP, DipABLM: Welcome to the WebMD Health Discovered Podcast. I'm Dr Neha Pathak, WebMD's, Chief Physician Editor for Health and Lifestyle Medicine. Many of us have talked to our children and loved ones about how to respond if they're offered an opioid or some other unknown substance, even if it's candy at a party, fearing the dangers of opioids and overdose. But how many of us think about the risks in these situations? Our child is injured playing sports and we're given a 14-day prescription for an opioid containing medication. We're at the dentist's office and we're given a prescription for an opioid for a short course after a procedure. New data shows that there were over 81,000 opioid deaths in 2023. So, what can we do to keep our loved ones safe? Today we'll talk about the best strategies to prevent opioid misuse and abuse in the first place. Even if it starts with a prescription from our doctor's office. The journey to addiction and to recovery and what we need to know about preventing opioid deaths. But first, let me introduce my guest, Dr Ellen Eaton. Dr Eaton is an associate professor at the Department of Medicine at the University of Alabama at Birmingham. She's the director of the office based opioid treatment clinic at the UAB 1917 clinic, and a member of the leadership team of the UAB Center for Addiction and Pain Prevention and Intervention. Welcome to the WebMD Health Discovered podcast, Dr Eaton. Ellen Eaton, MD: Thank you so much for having me. Pathak: I'd love to just start by asking you about your own personal health discovery. So, what was your aha moment that led you to the work that you're doing with opioid treatment, management, and addiction and pain prevention interventions? Eaton: Yeah, I have an interesting story as an infectious diseases physician who is primarily working on substance use treatment and prevention. I had the honor of being a fellow with the National Academy of Medicine, really a health policy fellowship. And as an infectious disease physician, I was invited to a working group around infectious consequences of the opioid epidemic. And that was in 2017. It was a tremendous opportunity to go to D.C. and work with thought leaders in the field, other physician scientists, infectious diseases doctors, and those experiences and treatment models that I was hearing about in D.C. were not happening in my home institution at UAB. There were addiction medicine physicians, but we hadn't integrated care. We were not doing syndemic care where you're treating the infection, preventing Hep C, and you're treating their substance use disorder. So that opportunity in 2017 inspired me to come home to UAB, create a clinic here that is for our patients living with HIV who have opioid use disorder, and from there, we've really expanded services broadly for substance use and infectious diseases. So really grateful for the National Academy and that opportunity. That really was a launch pad for my career. Pathak: I would love to talk about what you've seen as the entry point for a lot of people when it comes to opioids and that progression to addiction, potentially overdose. What does that look like for many of the people that you see? Eaton: Because of the care I provide, I am seeing patients who are living with substance use disorder, but I always start when I meet them with really open-ended questions like tell me about your first exposure to opioids. Tell me when you began using them for medical reasons or recreationally. And what I hear over and over again is that many of our patients are starting to experiment or use from a prescriber for a medical condition in their teens or early twenties. And that is often a trusted medical provider. It may be an urgent care physician for a musculoskeletal injury, for a teenager on the athletic field who was injured. It may be a woman who just delivered a baby, a very healthy, common touch point, where there may have been a tear or maybe some residual pain. Another common touch point is a dentist treating you for a dental infection. And so, I hear these types of anecdotes over and over from my patients, and often it is a trusted physician, so they don't feel like this is a scary medication. They may be given a 14-day supply of opioids, not realizing that can lead to physical dependency and opioid misuse in the future. And often don't ask questions about what to look for, warning signs, and certainly as young people, I haven't ever heard that their caregiver expressed concerns. I think more often the patient has a prolonged course seeking opioids for various conditions, becomes dependent, is seeking them more and more, and often caregivers or family members don't get involved until they are pretty far down the continuum of opioid use disorder. So, those are the stories I hear when I meet patients and ask about their journey. Pathak: What are some of the questions we should ask before we even accept that prescription? Eaton: This is a really important question at that prevention touch point, that we often miss. I think asking your provider do you really need oxycodone. Could you start with something like an NSAID or a Tylenol. Asking your provider to be very explicit. When my pain hits a seven out of 10, when my pain hits an eight or nine out of 10, when do I need to take this opioid as opposed to some other opioids sparing pain modulators? And then number of days. So not just at what point today, but also tomorrow, the next day, what pain should I expect, and I think setting the expectation you will have some pain. This is a challenge that many of us that see patients in a primary care setting have to remind patients, you will have some pain. That is normal. That is healthy. That means your nerves are telling you they're giving you feedback on what's going on after your leg fracture. And I think unfortunately opioids have been normalized as safe, in many cases they can be, but in many cases they are not. I also see amongst families where an individual will tell me, “Oh, well, I got a Tramadol from grandma, or I had some opioids leftover from that time that I had a surgery and so I took that for some other condition,” comparing them to medications like chemotherapy, which also have risks. You would never hear a patient self-medicating, sharing with friends and loved ones. But I think because opioids became so ubiquitous, in past decades, entire families, kind of normalize them. They feel comfortable sharing them, taking others. And that type of culture leads to a culture where young people feel comfortable experimenting. They take pills at parties, they take pills from friends and, they purchase them off social media, like TikTok for example, because they do not appreciate the adverse outcomes that can be associated with these types of medications. Pathak: So, tell us about this slippery slope. What is it that happens to us when we take these medications unnecessarily? Eaton: Often one of the biggest teaching points that I make with trainees in my clinic, when is someone experimenting and when does it become a use disorder? And in my clinic, it's usually pretty clear and that includes negative consequences. So, taking opioids and falling asleep, nodding out, overdosing, right? Those patients have gone from opioid misuse to use disorder. So having negative consequences, becoming physically dependent. We do see that needing to take more and more to prevent withdrawals, which with opioids, unlike some other substances, you can pretty quickly become physically dependent. And then you need to continue to opioids just to not feel sick, to not have the flu-like symptoms. So, becoming physically dependent, having to take more and more, increasing your dose to get the same desired effect. Those are the things that I see most commonly in clinic. With opioids and certainly the very potent non-medical opioids we're seeing now, heroin, fentanyl, we don't see people who just dabble here and there at a party, at a wedding. Now the other substances that I see pretty routinely used in my clinic with or without opioid use disorder, stimulant use disorder, marijuana use disorder. Alcohol use. I do have to ask more questions and certainly there are validated screening tools out there that physicians and clinicians can use to determine very objectively. Did they just drink too much at that wedding two months ago and it was a problem because they got in a fight or had a DUI? Or is this a pattern of use that meets criteria for alcohol use disorder? So, it is important to ask those questions and know, but I would say really the negative consequences, the physical dependency, escalating use, those are things to look for in your patients. As a caregiver or a parent, those are things to look for as well because we are really in a position to identify these before our loved ones have escalated their use. Pathak: And then what do you do? So, you notice some of these types of red flags. What is the intervention that you should make as a parent or a loved one or a caregiver? Eaton: I think starting with a primary care provider is always the best step. And most of us do use these objective screening tools. There are several you can find. My clinic uses an assist. These are validated tools that have been tested on many patients, not physicians, not PhD scientists, that have been tested on patients to make sure that they are asking the right questions to get to the true use behaviors and patterns. And I would go from there with your primary care provider. I think if you as a parent or loved one are even asking yourself, is it time to go? It's time to go. I think too many of us wait until there are very obvious motor vehicle accidents, overdoses. And I think most parents that I encounter in a clinical setting knew there were issues much longer before they sought help. And this gets to your question around stigma, shame that a lot of families do not want associated with their loved one or their family. And so, they wait until there are really negative consequences. Ideally, we'd be intervening much sooner. Pathak: I'd love to talk a little bit and dig into what you just said about stigma and shame and some of the words we use when we talk about having a problem, quote unquote, with opioids, or becoming addicted or physically dependent. In that recovery phase, oftentimes we'll talk about someone becoming sober or sobriety from some of these medications. Can you talk a little bit about the terms that you use and what best helps uplift your patients? Eaton: This is a really nuanced area, and it does take some retraining of us as clinicians who have been in practice for a while. When I went through medical school, you were either 100 percent abstinent or not. We weren't taught that there was this whole middle ground of harm reduction, and I think as physicians, once we get some additional education on this, we realize that our words really matter. We can be much more supportive of our patients because this is a journey and much like diabetes or hypertension, your patient may have chapters where they aren't in care. Their chronic disease, substance use to chronic disease, is unmanaged. But unlike diabetes or hypertension, where we just counsel them and support them and bring them in maybe more frequently to check in, have them bring their spouse to help with the pill bottles and set their phone alarms so they don't forget. Unlike those medical conditions, this chronic brain disease of substance use, we treat patients unintentionally as if they have failed. They have failed our clinics. They have failed the treatment. We treat them with judgment and shame. And there are a lot of complex routes for that that I am not an expert in. But what I tell my colleagues and my trainees is that we need to know and our patients need to know that they have not failed us. They are not a failure. They are living with a chronic disease, just like diabetes or hypertension. And just like diabetes or hypertension, if they fall out of care, if they stop taking their medications, we allow them to come back when they're ready to reengage. Just like my patients with HIV, right? So, using words are often the first interaction that we have with our patients. I even say when I get to meet them, “tell me about your journey. Have you ever been in recovery before?” rather than tell me about your addiction. “Have you ever been abstinent?” Have you ever been sober? Did you fall off the wagon? These are all terms that have very negative connotations and really reinforce a lot of the stigma that our patients already feel. My patients come with a lot of stigma to clinic. I have to remind them not to use stigmatizing words to describe themselves. They'll say things like, “I've really been an addict for 20 years.” And I have to say, “you've been a survivor for 20 years. You've been a survivor.” Or, you know, I'm the black sheep of my family. And I remind them. Actually, you have a chronic disease, and didn't you tell me your uncle has the same brain disease it runs in your family? Just reminding them much like the diabetes example again, this is a chronic disease. Those are some of the strategies I use to be really person centered and inclusive. And I do use the survivor language a lot. If they're using opioids in 2024, they are a survivor because we know the substance is out there. I do try to use a lot of empowering language as well. Pathak: I come at a lot of this from the primary care lens. I'm a primary care physician and prevention is the key for what we're always trying to do before we get to treatment and management. If we're talking about red flags or the types of questions we should be asking before we even prescribe these the first time, is it asking about family history? Should our patients be thinking about that? Like, oh, you know, Uncle Jim has had a problem with opioids in the past. That's probably not a medication we want to start in our child. What are some of the other types of questions we can be asking before we even think about that very first prescription or letting your child know that this is something that you need to be thinking about if you're at a party and someone offers you something because this is our family history. What are some of the other things you ask about? Eaton: Family history is really important. Past experience with opioids. And if you have a patient who is in recovery, many of them will say, I know I have to have my hip replaced. Please do everything you can. Give me blocks. They want to avoid opioids. So, asking about any experience with opioids, how that went. I would also ask about social support. You know, remind me where you're living these days. Oh, you're in an apartment with your niece. Do you have a safe place to store your medications? Tell me about that. Where do you store your medications? This comes up a lot with our unhoused population, that they are frequently having to move. Their medications are often stolen. That doesn't mean that they don't meet criteria for opioids. It may just mean you need to be more thoughtful. Do you need to go to a boarding care or shelter while we get through this period where you're recovering from your injury and you need opioids to be kept in a locked box? I think those are most of them. And then just appreciating that things like a history of trauma and social determinants of health are really going to put our patients at risk. And a lot of the young people that I see are 30 and 40 year olds who started experimenting with substances in their teens and 20s were in these multi-generational households where mom had substance use. Grandma had substance use. There were always pills around. So, if you are seeing a patient who has a lack of social structure, living with other people with substance use, without a lot of accountability boundaries, without close follow up with a physician, that may be someone you want to consider alternatives or, you know, give them a three-day supply post op and bring them back. Right? Clinics are so full. We may not have that structure or care model in place, but that's ideal. Giving a short course. Reassess. Maybe it's time to transition something else. Pathak: Great. Can you help us understand what exactly an overdose is? What does it look like? And what are some of the strategies like naloxone that we should be aware of? Eaton: Yeah. So right now, we're seeing the vast majority of overdoses have opioids as a contributing substance. So many of our decedents who pass away and have toxicology results have multiple substances, including stimulants. But currently, fentanyl is contaminating so many types of street drugs, whether they're a counterfeit, benzodiazepine, or a counterfeit Vicodin, or cocaine. So, the vast majority of overdoses we're seeing right now, are opioid related, and that usually involves people looking sedated, stuporous, failure to respond to verbal stimuli, tactile stimuli. And in the current setting where we're seeing so many overdoses, I think you should always think opioids first when you're seeing someone like that. It is important to approach them, call their name, shake them if they don't respond. That's when you're going to call 9-1-1 and be looking for naloxone. I have some in my backpack. I travel on airplanes with naloxone. And my kids who are elementary age know about naloxone. I haven't gotten to the point of educating them. But because these events are more common than cardiac arrest in many, many communities, we're training our Boy Scouts how to do CPR, but we're not necessarily training our Boy Scouts how to do naloxone for overdose reversal. But we should. These are happening in schools. If you have a young person in your home, if you have a teenager in your home, you should have naloxone, and your teenager should as well and be trained to use. It doesn't mean your teenager is using or experimenting. It just means the people in places that young person is around have a higher likelihood of overdose than a cardiac arrest in many settings. Right? I know a lot of schools. My community schools are getting naloxone because they do appreciate that children are experiencing at school. They've had some adverse outcomes in my state on school property. I would encourage anyone who is living with young people or older people who have access to opioids, even prescription opioids, to have naloxone. And then obviously if you know your loved one has opioid use disorder, you and they and anyone who is a caregiver for them should have naloxone on their person. Truly. So that's pretty much all of us, right? And whenever I talk to the rotary, I've talked to schools, I talked to clinicians. There are very few people who don't need to know about naloxone in the current day and age. And think of compared to something like an AED or CPR. You know, we're really good about these less stigmatized acute medical events, right? We feel very comfortable training our Boy Scouts on how to do this, and we feel very comfortable putting an AED on our walking trails and at our gyms. Because of the stigma around substance use, we do not have naloxone in many of those community spaces, and we have not trained our community to respond to overdose in the same way we have cardiac events. Pathak: What would be part of your counseling in a Boy Scout troop or Girl Scout troop or at school to share that part of the information? How do you use something like a naloxone? What are the signs that you're looking for? Eaton: I think this is a great topic for Boy Scout and Girl Scout troops and for health education courses for middle school. By talking about it, we're normalizing it. And based on the prevalence of substance use, we should all be aware of the signs or symptoms. So that is very appropriate. There are developmentally appropriate ways to talk about this, even to elementary students. I think sharing the statistics on youth who start experimenting, the average age, the prevalence in communities, the types of places where they may be exposed to opioids that are non-medical, the signs or symptoms of overdose, which we discussed, and the fact that there is a safe, over-the-counter reversal. Naloxone that they can and should carry as a good community citizen and community helper. I know this will be stigmatized in some areas, and some parents will not feel comfortable with that. But I think the more that we have partnerships between pediatricians, public health officers, and schools and coaches, these types of individuals should really feel comfortable talking about this. It is nothing to stigmatize or shame or your kids aren't going to come to you. What we want is we want these kids looking out for their friends and their parents. We want this to be something we talk about, and we go to a trusted adult when we have concerns. And that's what it will take as we're speaking to prevention. It will take a village of informed adults, trusted individuals. Who our youth can go to early when someone is just starting to experiment. When your friend just brought pills to a party for the first time. Early intervention, right? So, I think the Boy Scout example is a perfect one, but thinking all the touch points for our young people, churches, the faith-based community. And we recently did a pop up with an AME church here in the deep South. Who wanted to have a pop up. It was myself and a community agency that I work with called the Addiction Prevention Coalition. They do great work. I'm delighted that they've included me, and we passed out naloxone and we talked to these church members, many of whom were elderly. They were grandparents. They're worried about their grandkids. They're worried about what they're seeing in the news. They're worried that these kids are going out partying and they know that there are substances involved. So, another great touch point, just thinking across the age continuum, all the people who are part of communities who can be on the prevention arm of substance use. Pathak: That's really helpful and really interesting. So, we've talked a little bit about prevention, overdose prevention. We've talked about substance misuse and what that can look like. What does the process of achieving and maintaining recovery look like? When someone comes to your clinic, because that's really the goal of their treatment, how do you get started? Eaton: So just thinking about the term recovery, we use to describe someone who has reached a point where they're not using any non-medical substances, but it's important that we have each patient define that for themselves. I have many patients who are in recovery from alcohol and opioids. They cannot give up cigarettes and they're not ready to, right? I would never tell them you're not there yet. But I congratulate them on every step, and I remind them you've been in recovery from opioid use for 10 years. You've been in recovery from alcohol use for five years. You don't want to talk about tobacco today. That's fine. Look how far you've come. And that is part of just supporting them in their journey and encouraging them. There are some people who are going to return to use. I never say fall off the wagon. I never say, you know, other stigmatizing terms. Return to use. There are some of my patients, specifically with opioid use disorder, common triggers, a breakup, a job loss, housing loss, death in the family. I do see patients return to use. It's less common when they have been on a stable medication for opioid use disorder like buprenorphine and they are engaged in medical care. They have some counseling or group that they can go to for support and accountability, but it still happens. And then once we get them back into our clinic and we initiate the treatment again, and we follow them very, very closely in that very fragile time, you're back in care. Let's start you back on buprenorphine, for example. Let's check in with you in a week. And I have a peer counselor in my clinic who has lived experience with substance use. She's the perfect person. She's been there. She sees them very frequently over that period until we can get them back into recovery. For opioid use disorder, it is pretty clear from their behaviors. It is so physically addictive. It is so disruptive to relationships that I have very few people who can dabble with opioids. Because usually once they return, they are back in active use, is the term we use. Pathak: And as we close out our episode, I'd love to invite you to share some bite sized action items to help create change in our lives if we are caring for a loved one, a child who may be experiencing some of the symptoms that you described. Eaton: Absolutely. I think thinking about their survival analogy can be very encouraging and not overwhelming. Just do the next step. I think many of us want to fix our loved one. We may want to fix our child, but what is the next step? The next step may just be getting your loved one to a doctor's appointment, and that's a win. They showed up, right? Then the next step may be getting them to commit to like goals. It's not accomplishing the goals. It's just having them identify what matters to them. You know, so do these baby steps make recovery seem much less overwhelming if recovery is the goal? But I think just viewing caregiving and living with substance use as survival. And being kind to yourself, being kind to your loved ones who's living with this chronic medical condition and taking things one step at a time. Pathak: Thank you so much for being with us today. Eaton: My pleasure. Thanks for having me. Pathak: We've talked with Dr Ellen Eaton today about prevention. How do you even prevent that first use of opioid if it's not necessary? And we've talked about the journey of addiction to recovery. To find out more information about Dr Eaton, we'll have information about her and her clinic in our show notes. But you can check out the Center for Addiction and Pain Prevention page. And again, we'll have that link in our show notes. Thank you so much for listening. Please take a moment to follow, rate, and review this podcast on your favorite listening platform. If you'd like to send me an email about topics you're interested in or questions for future guests, please send me a note at webmdpodcast@webmd.net. This is Dr Neha Pathak for the WebMD Health Discovered podcast.
Deception from the Haemophilia Foundation Australia as they deliberately mislabel the UK Infected Blood Inquiry as a UK Hepatitis C inquiry. https://www.haemophilia.org.au/news/uk-hepatitis-c-inquiry/Australian Red Cross letter to blood donor with HepC asking them to continue to donate their tainted blood for Haemophiliacs. https://static.wixstatic.com/media/ddd792_6c6046b9c92240f2b3df0c08d4e3db91~mv2.jpgSenator Coulter exposes foreign blood mixing https://static.wixstatic.com/media/ddd792_5834a23ea043499eb363abed49c45a41~mv2.jpgCriminal deception from Australia's health minister Mark Butler on mixing foreign blood in his reply to Senator Rennick https://static.wixstatic.com/media/ddd792_c792228d6d35403fa4ea7df963e73993~mv2.jpgNo mention of Australian Haemophiliacs being afflicted with tainted blood in the World Federation Haemophilia report on the annual global survey 2016:https://www1.wfh.org/publication/files/pdf-1690.pdfPlease help Charles MacKenzie keep surviving and fighting by donating to his GoFundMe here https://gofund.me/7963dd82Purchase a Make Accountability Happen Again cap here:https://www.joinhighadventure.com.au/patriotcap.php
Send us a Text Message.Grab your trainers, your dog lead or a cuppa and join us for some free CPD as we have another relaxed round up of recent Red Whale primary care Pearls of wisdom. June was another bumper month information, meaning that we can't possibly squeeze it all into one handy sized episode, so in the first of two episodes this month, Nik and Caroline discuss: Curable: hepatitis C and the NHS elimination programme.Acne: what's new?Listen as soon as you can to ensure you have full access to all the free resources. The rest of the Pearls from June will be covered next week along with a new best intentions story to put a smile on your face.Hep CHEP Drug Interactions (interaction checker for DAAs)If you're interested in becoming a GP champion for Hep C, email:connect.HepCULater@mpft.nhs or england.hepc-enquiries@nhs.netOrder Hep C home testing kit online at: hepctest.nhs.uk AcneThe British Association of Dermatology patient information leaflet for isotretinoinSend us your feedback podcast@redwhale.co.uk or send a voice message Sign up to receive Pearls here. Pearls are available for 3 months from publish date. After this, you can get access them plus 100s more articles when you buy a one-day online course from Red Whale OR sign up to Red Whale Unlimited. Find out more here. Follow us: X, Facebook, Instagram, LinkedInDisclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast....
On a new TAGS LIVE aka Talk About Gay Sex the live edition, Host Steve V and Co-host Kodi Maurice Doggette are back with all new hot LGBTQ topics, sex and relationship advice and more in front of a live virtual audience:Daddyland Circuit event host hotel in Dallas tells guests they must leave due to complaints...Gay NewsElton John pees in bottle!Devil Wears Prada - are some gays not excited for the sequel???Troye Sivan says he's sexy because he feels sexy!Omar Apollo says he's had 'ugly boyfriends' and why he prefers them...Are you having a 'Brat Summer'?Gay dating standards - are they unattainable?Health: In addition to getting HIV tested experts are urging Syphilis and HEP C testing...Advice on when to say the words 'I love you'...Thirst Trap!Season 8 kickoff continues - Get our upcoming exclusive livestream! Patreon.com/tagspodcastGet 20% Off plus Free Shipping for the Sexual Performance Booster by JOYMODE. Go to usejoymode.com/tags and use code: TAGS Steve V's Link Tree: https://linktr.ee/tagspodcastFollow Steve V. on IG: @iam_stevevhttps://linktr.ee/kodimauricehttps://linktr.ee/kodimauriceFollow Kodi's Life Coaching on IG: @kmdcoachingFollow Kodi Maurice Doggette on IG: @mistahmauriceWanna drop a weekly or one time tip to TAGSPODCAST - Show your love for the show and support TAGS!Visit our website: tagspodcast.comNeeds some advice for a sex or relationship conundrum? Ask TAGS! DM US ON IG or https://www.talkaboutgaysex.com/contactFollow Of a Certain Age on IG: @ofacertainagepod
Eastwood Is Back The daughter of Clint Eastwood, Alison Eastwood is back for more fun! She's crowd-funding to raise money for Chimp Haven, the home of 110 research chimps purposely infected with HIV and Hep C. Listen Now Financial Help For Procedures Our Hero Person this week created the Brown Dog Foundation to help pet owners afford life-saving surgeries and procedures for their pets. Listen Now Bringing Pets Into The Classroom The 501c3 APPA (American Pet Products Association) is riding high on its viral Pets Add Life campaign. APPA President Bob Vetere says teaching compassion for animals in the classroom creates adults who respect and love pets and people. Listen Now Hawaiian Quarantine If you plan to take your pet to Hawaii, you might want to rethink your strategy. A dog that was put in the mandatory 120-day quarantine suffered heat stroke. Now, the owner is demanding an investigation of the quarantine center. Listen Now Would You Use A Shock Collar On Your Dog? That question is getting lots of interest lately. Researchers suggest that collars can cause physical and emotional harm to dogs. Listen Now Read more about this week's show.
Viral theory is the topic of today's discussion. I know today's episode has been long-awaited by some, including myself, as I'm joined by Dr. Sam Bailey. We'll discuss my mysterious case of Hep C and explore how the science, tests, and methods struggle to prove that such a virus even exists. Dr. Sam Bailey was a resident doctor working in all areas of medicine for many years, with a particular focus on Emergency Medicine and Cardiology. Following this, she worked in Clinical Trial Research for over a decade, working as the supervising doctor in phase I-IV clinical trials. Her journey eventually took her out of mainstream conventional medicine and into practicing holistic /functional medicine. As with many we've featured on this show, her decision was driven by an awakening to the flaws in the medical system as she grew to see the possibilities for true health and healing in holistic approaches. Dr. Bailey is not the only doctor to tell me (personally) that there is no proven isolated virus known as hepatitis C. In fact, she's about the fourth doctor I've come across who challenges the whole viral theory. Outside of being a medical doctor and health educator, Dr. Sam Bailey is also the co-author of the books ‘The Final Pandemic,' ‘Terrain Therapy,' and ‘Virus Mania.' In today's interview, bring an open mind and a fresh perspective to question the very nature of viruses, their history, and origins. We know and can prove toxins and poisons make us sick, but do we really have proof of viruses? Join us to explore!
Tulsa CARES helps to transform the lives of clients and serve as the leading voice of HIV and Hep C in the community.
Ian Cockburn is a survivor of one of the most harrowing health scandals in UK history. At just six years old Ian was battling childhood Leukemia, and during one of his final treatments was infected with Hepatitis C through a contaminated blood transfusion—a fallout from the UK's importation of unscreened blood products over two decades. His medical journey began with a dramatic evacuation to a UK airbase, then a fight against Hep-C, which threatened not only his life but his dream of serving his country. Ian opens up about the subsequent government and NHS cover-up that prolonged the crisis, the personal and professional hurdles he faced due to the infection, and how he overcame these challenges to live a fulfilling life with his family. Despite being barred from joining the British Army in his youth due to his medical history, Ian's unwavering determination, inspired by military podcasts, led him to reapply as a reservist and volunteer police officer, achieving success in both endeavors. The UK public inquiry's publication date is approaching, which Ian hopes will reveal the depths of the scandal's negligence which is still estimated to result in a death over four days. Ian shares his mission to raise awareness and ensure justice for the victims. https://www.infectedbloodinquiry.org.uk/ https://www.gov.uk/government/news/infected-blood-scandal-increased-financial-support-for-victims-confirmed https://www.hepctrust.org.uk/find-support/infected-blood-and-blood-products/infected-blood-inquiry/#:~:text=20%20May%202024.-,The%20history%20of%20the%20contaminated%20blood%20scandal,with%20on%2Dgoing%20health%20complications. Wolf 21- Check out what they have to offer for the best sleep of your life: https://www.thewolf21.com Use Code: "clearedhot" for 30% off of your 1st order The Speed of War Comic Series: https://www.thespeedofwar.com/ Check out the newest Cleared Hot Gear here: https://shop.clearedhotpodcast.com/
Is breastfeeding with Hepatitis C safe? The answer: Yes! But confusion persists today mainly surrounding the serum hepatitis C viral load. That's the topic and focus of the new publication released March 2024 in the Green journal, Obstetrics and Gynecology. We will highlight this new study in this episode. Yep, we have learned a lot about hepatitis C, and HIV, and breast-feeding. In this episode, we will review: the different hepatitis C genotypes and their implications, current breast-feeding guidelines for women with hepatitis C, the updated guidelines for breast-feeding with HIV, how some may be spontaneously “cured” of hep C postpartum, and why viral load matters for one of these conditions – but not the other!
In this edition, Charles MacKenzie speaks about the retirement last week of Ita Buttrose as chair of the tax payer funded Australian Broadcasting Corporation (ABC) and reveals why Australians never got to find out about their nations deadliest medical scandal HIV & HepC contaminated blood. Show linksPlease help Charles keep surviving and fighting for accountability by donating to his Go Fund Me here https://gofund.me/77abc074Ita print ad from 1985 where she lied about Haemophilia treatments being ‘purified' https://static.wixstatic.com/media/ddd792_d2874372777a4ef3a2c9342cce36349b~mv2.jpg Ita Buttrose's time as Chair of the National Advisory Committee on AIDShttps://www.youtube.com/watch?v=JDIO-AJN2_0The Australian Red Cross Lifeblood advertised for blood donors in sexually explicit gay publications such as the Sydney Star during the AIDS crisis https://www.infectedbloodaustralia.com/art51989 Haemophilia treatments not sterilised against deadly virus Hepatitis C. https://static.wixstatic.com/media/ddd792_cfb0cc665dbf4bf299aae943cf8ed6f4~mv2.jpegIta Buttrose + Bill Bowtell A friendship forged through crisishttps://www.abc.net.au/listen/programs/yours-queerly/ita-buttrose-bill-bowtell-a-friendship-forged-through-crisis/103490902Please sign the petition for a Royal Commission here https://www.infectedbloodaustralia.com/registration
Have you ever heard of Andrographis? Most people haven't, and it's time that changed! On this episode of Vitality Radio, Jared invites Cheryl Myers back to the show to dig deep on the clinically proven benefits of Andrographis - everything from helping with fatty liver, preventing and reducing the length of a cold, and its role with auto-immune disease. Next, they'll break down why CuraMed is the most powerful form of curcumin on the market and how it can help with inflammation, oxidative stress, and detoxification. You'll learn how and when to use these medicinal herbs and why they should be in your medicine cabinet.Cheryl Myers is Chief of Scientific Affairs for EuroPharma, Inc. She is an author and healthcare professional with certifications in cancer, pain control, and issues of aging. She is an expert in dietary supplements and natural medicines who has been a featured guest on hundreds of radio and television shows, as well as interviews with the New York Times, Prevention Magazine, the Wall Street Journal.Products:Terry Naturally AndrographisTerry Naturally CuramedAdditional Information:#325: Boswellia's Incredible Impact on Lung and Gut Inflammation, and the Powerhouse Antioxidant that is Grape Seed Extract, with Cheryl Myers#176 Natural Ways to Address Pain and Systemic Inflammation with Cheryl MyersVisit the podcast website here: VitalityRadio.comYou can follow @vitalityradio and @vitalitynutritionbountiful on Instagram, or Vitality Radio and Vitality Nutrition on Facebook. Join us also in the Vitality Radio Podcast Listener Community on Facebook. Shop the products that Jared mentions at vitalitynutrition.com. Let us know your thoughts about this episode using the hashtag #vitalityradio and please rate and review us on Apple Podcasts. Thank you!Please also join us on the Dearly Discarded Podcast with Jared St. Clair.Just a reminder that this podcast is for educational purposes only. The FDA has not evaluated the podcast. The information is not intended to diagnose, treat, cure, or prevent any disease. The advice given is not intended to replace the advice of your medical professional.
There has been an explosion in STIs in the UK in the last decade. But at the same time government funding for the services that treat potentially life threatening conditions has been dramatically cut in real terms. We speak to sexual heath expert Dr John White this week to discuss access to sexual health services and the ease of Hep C testing during the current NHS campaign. Also it turns out Hep C treatment is a lot easier than it was a few years ago. Dr John White has 25+ yrs of clinical experience in sexual health. He was an NHS consultant in Genitourinary Medicine for 13 yrs at Guy's and St Thomas' Hospitals, London. He currently works in Western and Northern Health & Social Care Trusts, Northern Ireland, while also working for Preventx. John was Editor-in-Chief of the International Journal of STD & AIDS from 2009 to 2020. He is an expert in bacterial STIs and novel diagnostic approaches and is passionate about educating and speaking on clinical sexual health and HIV medicine. Including Pride Daily update with Kev McGrath. --- Send in a voice message: https://podcasters.spotify.com/pod/show/outcastuk/message
On this episode, we review the 2023 Hepatitis C Guidance that was recently published by the Infectious Diseases Society of America (IDSA) and the American Association for the Study of Liver Diseases (AASLD). We discuss the pre-treatment work-up, various treatment options, and drug-drug interactions/clinical pearls for the most commonly used direct-acting antivirals. Cole and I are happy to share that our listeners can claim ACPE-accredited continuing education for listening to this podcast episode! We have continued to partner with freeCE.com to provide listeners with the opportunity to claim 1-hour of continuing education credit for select episodes. For existing Unlimited (Gold) freeCE members, this CE option is included in your membership benefits at no additional cost! A password, which will be given at some point during this episode, is required to access the post-activity test. To earn credit for this episode, visit the following link below to go to freeCE's website: https://www.freece.com/ If you're not currently a freeCE member, we definitely suggest you explore all the benefits of their Unlimited Membership on their website and earn CE for listening to this podcast. Thanks for listening! We want to give a big thanks to our sponsor, High-Powered Medicine. HPM is a book/website database of summaries for over 150 landmark clinical trials. You can get a copy of HPM, written by Dr. Alex Poppen, PharmD, at the links below: Purchase a subscription or PDF copy - https://highpoweredmedicine.com/ Purchase the paperback and hardcover - Barnes and Noble website We want to give a big thanks to our main sponsor Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. You can find our account at the website below: www.patreon.com/corconsultrx If you have any questions for Cole or me, reach out to us on any of the following: Text - 415-943-6116 Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com Instagram and other social media platforms - @corconsultrx This podcast reviews current evidence-based medicine and pharmacy treatment options. This podcast is intended to be used for educational purposes only and is intended for healthcare professionals and students. This podcast is not for patients and not intended as advice or treatment.
No Shame November kicks off with the most shameless bastards you've ever or never heard of. This episode, Matthew, DJ, and Justin talk turkey about mostly everything in entertainment. From Frasier to Frankenstein. From Gen V to Hep C...but that's because Valentine caught a little something from a striper. All that and more on this episode of the Simplistic Reviews Podcast.
This week, Marianna sits down with two clinicians from the National Clinician Consultation Center (NCCC) - Astha Kanani, MD and Cristina Gruta, PharmD to talk about hepatitis c treatment and adherence when it comes to people with HIV. --Help us track the number of listeners our episode gets by filling out this brief form! (https://www.e2NECA.org/?r=UHL5555)-- Resources mentioned in this episode: https://www.hepatitisc.uw.edu/https://www.hcvguidelines.org/https://www.hep-druginteractions.org/checker https://www.cdc.gov/mmwr/volumes/71/wr/mm7132e1.htmFabbiani M, Lombardi A, Colaneri M, et al. High rates of sustained virological response despite premature discontinuation of directly acting antivirals in HCV-infected patients treated in a real-life setting. J Viral Hepat. 2021;28(3):558-568. Cunningham EB, Amin J, Feld JJ, et al. Adherence to sofosbuvir and velpatasvir among people with chronic HCV infection and recent injection drug use: the SIMPLIFY study. Int J Drug Policy. 2018;62:14-23.Kattakuzhy S, Mathur P, Gross C, et al. High SVR in PWID with HCV despite imperfect medication adherence: data from the anchor study. Hep
Mentors are instrumental in the professional and personal growth of healthcare professionals. However, mentoring relationships often fail to realize their full potential. Attendees will be encouraged and equipped to initiate mentoring relationships that provide both mentor and mentee with a rewarding experience.
NOTE: This was released several weeks ago early for Patreon members! If you can afford it and love what we do, please consider supporting our show by becoming a BTT Podcast Patreon Member! Dr. Blassie returns to BTT discussing some of his top deadly finishers if they were "real". Also, Dr. Blassie discusses the Hep C claims discussed on the recent DSOTR episode featuring Abdullah the Butcher! BTT Facebook Group! (WARNING: Join at your own risk) https://www.facebook.com/groups/281458405926389/ Pay Pal: https://www.paypal.me/BTTPod Follow us on Twitter @BTT_Podcast, @Mike504Saints, @CJHWhoDat and Like us on Facebook.
In this session, It will seek to help guide you on how to respond to God’s Command and Commission, The quest for discovering and following God’s will and purpose for one’s life is often an illusion to many children of the Living God, Many believers resorts to imitating others and or live a hypocritical phantom life as they are tied down to daily engagements and undertakings of everyday life, It is hoped that discovering the reason for living your life with purpose is made easier. You will discover the purpose for which God design you and gain the confidence to fruitfully be where you belong, through the power of the Holy Spirit. You will be guided through a biblical process and principles to seeing exactly God’s intent for your unique being and person, as Gods design, where you will discover that It all began with God before the foundations of the earth. Ever since, before the fall of humanity, God has you in mind, and he designed you for a purpose and through a process, but as a result of the departure of humans from God, through disbelief, you became blind and were kept ignorant of His plans for you. However, you will discover that His Deep love and Great Mercy, God called you to salvation, you became a new creature and adopted as His Child, hence He qualified you, by being a new creature in His image, He desires for you to return and rediscover His plan and purpose for your life As He God Intended. Responding to Gods Command and Commission, is a call to be ready, Dressed for service fully equipped and Lacking in nothing as you Respond through Obedience, based on a biblical Principles, These herculean task by helping you identify your uniqueness within the body of Christ, and to enable you walk confidently and victoriously where you belong in the program of God through the enabling power of the Holy Spirit. Finally, through the Scriptures and the Power of the Holy Spirit, You will be exposed and guided to God’s Command and Commission, That you begin to instantly manifest the reality of your purpose for living, Emblemed and empowered with full of Zeal, Passion and Fruitfulness, Genuinely ready for all the good works God has designed you to accomplish – Loving God with all your heart, soul and strength and loving others through your service of obedience to his Commission, Praying, Evangelizing, Discipling, Equipping and living a lasting fruit to the Glory of God. Our focus will be what it does take to be dressed, ready for service from your call to salvation to your call to service, Exploring your Meditational life, Family Life and a life of Obedience to His Command and Commission. AS YOU RESPONDING TO GOD’S COMMAND AND COMMISSION
One of the great things about podcasting is that I regularly get to meet and have in-depth conversations with fascinating people whose paths I would almost certainly never cross anywhere else. Today's guest, author, speaker and drum circle facilitator Andrew Ecker, is one such person. In this interview, Andrew weaves the rich tale of his life's story, how he found his authentic self, and how that brought him to help others through the tradition of drum circles and sound medicine. We think you'll find this a unique and fascinating journey. So let's get on the road!About Andrew EckerAndrew Ecker, author of the The Sacred 7, Apache “NDE”, Irish and German American. Born into an inheritance of trauma, both his parents were addicted to drugs and died very young. Mom, Kathy Lindsey, died from a cocaine overdose whereas Father, Dale Ecker, from HepC caused from intravenous drug use. Growing up in the height of the Reagan and Clinton “War on Drugs” policies led Andrew down a path of destruction that included cocaine and heroin abuse until he made a decision to change his life while serving 3.5 years in federal prison for drug charges. Andrew found healing in his life through the use of ancient technologies including drumming and a ceremonial introduction process of his Native American ancestry he outlines in his book The Sacred 7.Find out more:Andrew's book: The Sacred 7 (thesacredseven.com)Drumming Sounds (drummingsounds.com) Visit the Authenticity Road website: authenticityroad.onlineConnect with us here.© Authenticity Road, Inc. All rights reserved. Authenticity Road, its related marks, and "Adventures in men's work" are the exclusive property of Authenticity Road, Inc.
Episode 147: Routine Prenatal CareWritten by Elika Salimi, MSIV. Western University of Health Sciences, College of Osteopathic Medicine of the Pacific. Comments and editing by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice._____________________Elika: So, we're going to talk about some general principles of prenatal care and some of the most important diagnostic methods that we mainly use for taking care of pregnant women. I will forewarn you that there will be a ton of details in this talk, and I do recommend possibly taking notes as things can get easily confusing. This way you can have something to refer back to whenever you have a pregnant patient of your own.Arreaza: You can also download the episode notes from our website.Elika - So your patient is pregnant and she comes to you for care. How do we go about it? Well, this is assuming she had it at home urine pregnancy positive test and we got a blood hCG on her and everything's good and we know she's pregnant. Ok so now what happens next?Arreaza – We need to confirm the patient wants to keep the pregnancy.Elika - First, we're going to talk about the frequency of the check-ups. In this case, we are talking about a situation where the mother is coming to her appointments as she was supposed to but we all know that sometimes that doesn't happen if everything is going as it is supposed to then typically we get the initial examination at about 10 weeks of gestation and then until the 28th week there should be monthly visits, then from the 28th through the 36th there should be biweekly visits, and from the 36th week until birth, the visits are every week.Areaza – What´s next?Elika - Now I'd like to note that during the prenatal period, informed consent is very important and it should be obtained during this time because you want to prevent and manage any ethical conflicts that might exist between the mother and possibly the healthcare providers because we all know that any pregnancy can become high-risk at some point and pregnant individuals should be informed about the potential need for a c-section for example and be encouraged to discuss any concerns ahead of time. Elika - Now while we're talking about ethics, if the doctor finds him/ or herself in a situation where the patient is asking for something that the Dr does not feel comfortable with such as a certain type of treatment or a certain method of delivery or if they're, let's say, desiring an abortion and the doctor doesn't do abortions, then in this case you would refer the patient to a physician that is comfortable with the patient's desired outcome or treatment. And this is perfectly legal and fine just as long as you help the patient find somebody else. Arreaza – Abortion is legal in most states, but check your local regulations.Elika - So as mentioned earlier, the initial visit occurs at about 10 weeks of gestation. We start with checking their personal and family history and finding out about any previous pregnancies including at what GA baby born and weight if they know, any complications, gestational diabetes or preeclampsia, any history of postpartum hemorrhage requiring blood transfusion, any abortions (if present at what GA), and the method of deliveries, whether it was vaginal or a cesarean and what kind of C-section they had done. These are very important for you to obtain from your patient. You will also assess for depression and domestic partner violence.Arreaza – In California, we have a wonderful service called CPSP: Comprehensive Perinatal Services Program. What comes next? Elika - Upon receiving the history, we will do the gynecological examination and send in some samples. We will also send her to do some lab work. Now what do those labs entail? Well, we are going to get a CBC such as screening for anemia, we will also do TSH but only in people who have possible signs of thyroid disorder so not everybody needs to get this. And, we are going to send for a blood typing to find out about their ABO group and the Rhesus status. We will also obtain a urine analysis to screen for proteinuria and asymptomatic bacteriuria because in pregnancy, unlike outside of pregnancy, you do need to treat asymptomatic bacteriuria. We will also ensure that the mother is on prenatal vitamins, so folic acid, if not already, and iron, if indicated, and vitamin B6 if the patient has signs of nausea or hyperemesis gravidarum and this can be combined with doxylamine. Usually, pregnant women don't get a glucose screening test at the first visit unless let's say they have high risk of diabetes or they there was glucose in the urine. Arreaza – I like the topic of diabetes in pregnancy. So, in a high-risk population, we want to make sure a pregnant patient does not have diabetes, or pregestational diabetes.Elika - We will also screen for STI's including HIV, syphilis, hepatitis B, Hep C, and we also check for gonorrhea and chlamydia (pap) screening particularly in those under 25, or over 25 with high risk of infection. We will also test for rubella and varicella. Some places also order a QuantiFERON gold for tuberculosis. There are certain women that have indications for third-trimester screening for STI's on top of the ones that they already got in their first trimester. Those include chlamydia, gonorrhea, HIV, syphilis, and Hep B, and C but each of those have its own indications so for the purposes of time I will let you look that up on your own.Arreaza – Summary: Physical exam and labs to rule out preexisting conditions that may interfere with pregnancy, either infectious or metabolic, to mention some diseases. Elika - And finally, we will do an ultrasound assessment to get a more accurate reading of the fetus's gestational age.Arreaza – What comes after the first trimester?Elika- So like I mentioned they're going to need to be following up and some particular things need to be done at specific weeks. So we are going to discuss those. At every follow visit you need to obtain: the patient's weight, BP and other vitals, fetal heart sounds, the baby's measurement from the mother's pubic symphysis up until the fundus of the uterus, as well as a urine analysis to check for any glucose or protein in the urine because we are always concerned of possible preeclampsia or gestational diabetes. Another examination that I should mention is a Doppler ultrasound and this is usually indicated if there is suspected fetal growth restriction or if there's pregnancy-induced hypertension or if there's suspected fetal deformities or there is growth discordance in multiple pregnancies.Now we are going to discuss assessing for any abnormalities in the fetus. All pregnant women regardless of age should be offered noninvasive and aneuploidy screening test before 20 weeks of gestation. The 1st trimester combined screening occurs at about 10 to 13 weeks gestation, where we can order some blood tests for the mom such as the amount of hCG in maternal serum, as well as PAPP-A, on top of nuchal translucency that will see on the ultrasound. There is also the triple screen at 15-20 weeks which consists of ordering hCG, alpha-fetoprotein aka AFP, and estriol then there's also the quad screen test at 15-22 weeks gestation that consists of hCG, AFP, Estriol and Inhibin A. We also have the cell free fetal DNA testing that can occur after 10 weeks gestation at which the fetal DNA is isolated from the maternal blood specimen for genetic testing and this one actually happens to be the most sensitive and specific screening test for common fetal aneuploidies, and it is used for secondary screening after the ultrasound.Arreaza – Actually that test is done in all our patients on Medi-Call (cfDNA).Elika - If any of the screening tests are abnormal then we can provide counseling to mothers for more invasive diagnostic tests such as chorionic villus sampling, amniocentesis, and cordocentesis. At that point, you want to refer the patient to perinatology. Finally, in general an anatomical scan occurs ~18-22 weeks. Arreaza – Excellent, we have done the non-invasive genetic screening. What's next? Elika - Now we are going to talk about what happens in the third trimester specifically and what test you need to order. In the third trimester, you will order a CBC again, particularly at 24 weeks you want to do a repeat hemoglobin. We will also do the indicated repeat STI checks. We are also going to do gestational diabetes screening with the oral glucose test that I briefly mentioned earlier at around 24-28 weeks. This is usually done with a 50g 1 hr glucose tolerance test and if abnormal then a 100g 3 hour glucose test. You will also be repeating the Rh antibody just to make sure that the mother is still Rh negative because at 28 weeks, Rh negative mother should be administered RhoGAM 300 mcg intramuscularly and they need to get it again within 72 hours of delivery. Don't forget to give a TDAP vaccine at 27 weeks. And at 36 weeks you need to be obtaining a GBS culture (vaginal and rectal) for the patient just to make sure that there is no colonization because if there is then the patient is going to need GBS prophylaxis at admission because colonization by these bacteria can cause chorioamnionitis and neonatal infection such a sepsis. Overall when third trimester approaches you're going to make sure the plans for delivery have been properly scheduled or discussed with the patient and typically around 34 weeks you also want to check with your patient to see if they desire sterilization and obtain a consent if they will be having a C-section and they want to be sterilized after that. In those not requesting sterilization, it is a good idea to discuss what they want to do after this pregnancy for birth control since it is not safe to get pregnant again for another year. From 36 weeks' gestation, use Leopold maneuvers for assessment of fetal presentation but I'll let you look that up on your own. At this time, you may also use ultrasound as needed to confirm fetal lie and placental position.Patients with maternal conditions such as gestational diabetes or gestational hypertension/pre-eclampsia, or fetal condition such as heart defects or fetal growth restriction need to get biweekly NST/BPP tests at clinic in the third trimester because there is an increased risk of fetal hypoxic injury or death. An NST is basically a non-stress test that measures fetal heart rate reactivity to fetal movements. BPP /biophysical profile is a noninvasive test that evaluates the risk of antenatal fetal death usually after the 28th gestational week and what it consists of is the ultrasound assessment of fetal movement, fetal tone, fetal breathing, and amniotic fluid volume or we can also perform a contractions stress test that basically measures fetal heart rate reactivity in response to uterine contractions. Arreaza – I like talking about obesity. Weight gain is expected during pregnancy. Patients with normal weight are expected to gain 25-35 pounds. Patients with obesity are recommended to gain 11-20 only.Summary: Now I know that this was very extensive talk with a ton of details but if you took notes and refer back to it then I think things will somewhat make more sense and come together that way. The best thing we can do is try to adhere to guidelines to make sure that we don't miss anything. Sometimes it could be particularly difficult to manage patients that don't or can't come to their appointments regularly and you may sometimes have to give them bad news and what not so overall it is not always happy moments we face but the best we can do is try to give them the best care possible to avoid complications and have the patient deliver a healthy baby. Thank you for listening to me once again and hopefully I'll be back again soon on another talk on an OB/GYN related topic soon. Thank you very much. _____________________Conclusion: Now we conclude episode number 147, “Routine Prenatal Care.” Future Dr. Salimi gave an excellent summary of the care provided during the different trimesters of pregnancy. Remember to collect a detailed history, perform a comprehensive physical exam, and order the labs to rule out pre-existing conditions that could interfere with pregnancy or detect complications early to start timely interventions or refer to a higher level of care. This week we thank Hector Arreaza, Elika Salimi, and Verna Marquez. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:AAP, ACOG. Guidelines for Perinatal Care. American College of Obstetricians and Gynecologists Women's Health Care Physicians; 2017Zolotor AJ, Carlough MC. Update on prenatal care. Am Fam Physician. 2014; 89(3): p.199-208. pmid: 24506122.World Health Organization. WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. World Health Organization; 2016Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR. Recommendations and Reports. 2021; 70(4): p.1-187. doi: 10.15585/mmwr.rr7004a1Murray ML, Huelsmann G, Koperski N. Essentials of Fetal and Uterine Monitoring. Springer Publishing Company; 2018Royalty-free music used for this episode: Space Orbit by Scott Holmes, downloaded on July 20, 2022 from https://freemusicarchive.org/music/Scott_Holmes/.
Are you comfortable asking people for money? Do you understand the critical areas you must address if you are going to ask people to invest in you? This session will give you an understanding of the basics in fundraising that is fundamental to anyone in ministry. You will learn 5 critical things you must do in order to raise your own support. There is a solution to the obstacle of educational loans which often prevent many from going due to the amount of money that must be raised – MedSend. Additionally, you will understand how to qualify for a MedSend grant and what the Board is looking for in those who apply. Finally, you will gain and understanding of what you need to be doing right now if you are hoping to go to the field soon, next steps.
This session will consider case studies of biomedical research in mission contexts, derive best practices in biomedical research that enhance the work of mission institutions, and describe how to get involved in biomedical research in faith-based settings. Presentation Slides: https://bit.ly/gmhc2022_marktopazian_biomedicalresearchandfaith
On this West Virginia Morning, a Higher Education Policy Commission vote has put Alderson Broaddus University one step closer to closing its doors. Emily Rice has more. The post An Elusive Songbird And HEPC Votes To Close Alderson Broaddus This West Virginia Morning appeared first on West Virginia Public Broadcasting.
When people were dying from AIDS in the 1980s and 90s, Congress found a way to expedite the drug approval process and saved countless lives. Established in 1992, the Accelerated Approval Program allows the FDA to speed approval of drugs for patients with serious and life-threatening conditions. In this episode we talk with the father of children with a rare disease, a company CEO working to treat rare diseases and two policy experts on Accelerated Approval.
Surfing NASH delivers a session on-site in Vienna to offer a real-time review as EASL Congress 2023 unfolds. This first of two on-site recordings features Ian Rowe, Michael Betel, Jörn Schattenberg and Roger Green as the group digests takeaways from an energized meeting. Some topics they touch on include Madrigal's MAESTRO-NASH clinical trial of resmetirom, notes around interesting emerging liver science, the potential role of AI assistance, the NASH therapeutic landscape and many more milestones witnessed by the field since the days of Hep-C. Listen on to learn more and stay tuned for a Part 2 of this exclusive coverage. If you have any question or interests around the event, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!
We're so f@#king back baby!! And just like that "And Just Like That" is back. We couldn't be happier. All the things we hated about the first season were dialed up to a 10 in these first two episodes and we have no choice but to applaud the audacity of the writers! They gave us strap-ons, unnecessary racial tensions, budding designers failing to make a simple garment for the MET gala, gay bashing, Hep C, top hats and latex corsets and of course, Tony Danza. Truly, we are right where we belong. Back with our gals as they wear $80,000 outfits to go to lunch in the park. Thank you MAX for bringing us back to our gals. We can't wait to see what this season has in store for us! And remember, season one recap episodes are all available on our Patreon!Support the show
Neka Pasquale L.Ac M.S. is a California state-licensed Acupuncturist, herbalist, author and founder of Urban Remedy a company specializing in certified organic, non-GMO, gluten free, vegan offerings. In her practice she combines acupuncture and Chinese medicine with cutting-edge nutrition and lifestyle modification, to heal, balance and create optimal health. Neka has studied with specialty experts in the fields of nutrition, metabolic syndrome, Hep C, gynecological disorders including infertility, NAET Allergy Elimination, addiction, pain management, digestive disorders, and HIV/AIDS treatment. Use this link for 15% off at Paleovalley.com You can find her at:IGUrban RemedyLinkedin Subscribe or keep tuning in at: IGTikTokYouTubeThelukecook.comNewsletterSee omny.fm/listener for privacy information.
Robyn McTague joins us to discuss the importance of understanding relationships, psychology and communication styles in entrepreneurship. She emphasizes how tools like the Enneagram can improve decision-making, team functioning and business growth. Highlights From This Episode: The biggest communication issue is looking at things from different perspectives and understanding other people's points of view can help. Having a deeper understanding of relationships in business can lead to exponential growth and business impact. Building relationships and communication systems for better team functioning. Conflict resolution through curiosity and understanding. How Enneagram helps in understanding leadership styles, communication issues and different ways of dealing with pain and loss. Links & Resources From This Episode: Learn more: A Life of Choice Robyn McTague Resources: ‘The Road Back To You' An Enneagram Journey. Ian Morgan Cron Quote: ‘We can't have a business that's really heart-centred if we don't build relationships' More About Robyn McTague Robyn McTague is a published author, writer and speaker, and the creator of A Life of Choice coaching and consulting. Robyn helps entrepreneurs and small business owners build a deeper understanding of relationships and what drives behaviours so they can increase engagement, energy and enthusiasm, resulting in performance, productivity, and profits. Her areas of expertise include psychology, motivation, conflict resolution, and the enneagram. Robyn has overcome many challenges including breast cancer and Hep C. Awesome FREE Resources for YOU! Entrepreneur Toolbox Special access to reports, books and resources provided to you as gifts from our podcast expert guests. This valuable information covers various business and life topics. Power of 3 Daily Planner A one-page daily planner to keep you on track to reaching your goals and taking action on the important things in your business and life. Thanks for listening! Thanks so much for listening to our podcast! If you enjoyed this episode and think that others could benefit from listening, please Share It, Subscribe to the Podcast and Leave Us An iTunes Review. Val Low is a MAP IT Master & Brand Strategist and takes entrepreneurs to their next level of growth and impact. Through visual business mapping, Val works with entrepreneurs to take their dreams and business ideas out of their head and bring them to life. Val provides strategy on creating a message and brand to stand out in a noisy marketplace that people love to talk about. Visit Val's Website: https://vallow.me/ Connect with Val on Linked In: https://www.linkedin.com/in/val-low #entrepreneur #business #team functioning #conflict resolution #leadership #building relationships #self care #enneagram #communication
This week, we're sharing a recent chat with Devi Machete, an anarchist involved in the Tijuana mutual aid project known as Contra Viento y Marea Comedor which distributes clothing, medical supplies, meals and packaged food throughout the week near the border with the USA. The project, known for short as El Comedor is launching a free school and art laboratory in May. For the hour, we talk about the migrant caravan in 2018 that gave rise to El Comedor, the self-organized work around the project and resisting the dehumanization of the border through solidarity and community. Since the US allowed the Trump-Era Title 42 Covid-based restriction on immigrants entering the country to expire and has moved back to Title 8, so in a post-script Devi talks about concerns of a surge at the border and the further difficulties this change creates for migrants and refugees seeking asylum in the north. Facebook: @ContraVientoYMareaComedor Instagram: @ContraVientoYMarea_ElComedor Venmo: @TJRefugee-support Youtube Channel: https://m.youtube.com/channel/UCFY2Pmih9n1hN1b5-6JVq9A/videos Email: contravientoymareacomedor@gmail.com GoFundMe: https://www.gofundme.com/f/migrant-organizers-of-tijuana-need-covid-support soon-to-be-relaunched website: http://www.contravientoymareatj.com/ You can also check out our prior interview with Elements of Mutual Aid directors Leah & Payton to get some visuals of El Comedor, which is a featured project in that docu-series. Announcement Phone In For Shine White All power to the people, As I've pointed out in my previous writings, Hepatitis C kills more Amerikans each day than HIV and sixty other infectious diseases combined, making it the deadliest infectious disease in the United States. It is a viral infection, caused by the Hepatitis C virus (“HCV”) that affects the liver and can result in serious, life-threatening complications. On February 15 of this year blood tests revealed that I had Hepatitis C. In contrast to NCDAC's Clinical Practice Guidelines (CPG) for the treatment of Hepatitis C, I was sent back to my cell, instead of having further blood testing done to determine my fibro-scores. I was provided no further information, other than that I had Hepatitis C and that I would be seen by the facility's healthcare provider at a later date. The following days were mentally exhausting. Only after consulting with a prisoner who was receiving treatment for HCV at the time, did I become aware of the procedures that are in place for evaluating and treating prisoners who have the Hep-C virus. Before treatment can be started, additional blood testing is required to determine one's level of fibrosis. After becoming aware of the aforementioned, I immediately began to submit sick calls requesting the required blood testing be done to determine my Fib-4 index score. My sick calls went unanswered, only after those of you on the outside made calls to the prison on my behalf was I taken to medical to have the Fib-4 test done. The test results revealed that my Fib-4 score was 5.7, which indicates that I am at risk of cirrhosis, liver disease and/or liver cancer. However, the health care provider has yet to begin my treatment. These scores were revealed to me on March 3, subsequently I've not been assessed by medical personnel since, despite submitting multiple sick-calls due to the complications I am experiencing caused by the hepatitis-c virus. Since early March I have lost approximately 30 pounds, I have various pock-like scores on my lower legs, rashes cover my elbows and knees, and the sharp pains in my lower back and side make it difficult to sleep at night. When I inquire about my treatment, the response I receive is that it is out of their hands. I am firmly convinced that they have no intentions of treating me. Combined with the recent continuation of my term on supermax, it's evident that their intentions are to hold me incommunicado and hope that the hepatitis-c will do what they have been unable to do - silence me! Having to openly admit that I am at the mercy of my overseers infuriates me. I feel helpless and I am scared. I'm witnessing what is being done to Komrade Rashid, I witnessed the late elder Maroon Shoatz languish with cancer for years, Mumia Abu-Jamal continues to suffer from complications caused by hepatitis-c, the names go on and on. I feel as if my twenty-year prison sentence has become a death sentence. I entreat that calls be made and emails be sent on my behalf, demanding that I be treated immediately. Only if pressured by those of you on the outside will these miscreants act with professionalism. I am deeply grateful for the support. I conclude this as I began, Daring to struggle, daring to win All power to the people, Joseph “Shine White” Stewart Below is the contact information for those who should be contacted: NCDAC's Deputy Secretary - Comprehensive Health Services Gary Junker 919-838-4000 gary.junker@dac.nc.gov Chief Deputy Secretary - Rehabilitative and Correctional Services Maggie Brewer 919-733-9313 maggie.brewer@dac.nc.gov Facility's lead nurse J Rowe jacqueline.rowe@dac.nc.gov . ... . . Featured Tracks: One by J Dilla from Welcome 2 Detroit Instrumental En Caravana by Chiky Rasta Es Épico by Canserbero from Can Vive
The mounting death toll from the opioid crisis in the United States continues to wreak havoc in cities, towns, and rural communities across the nation. Over the past two decades, the number of people dying from opioid overdoses in New York, and across the United States, are rising each year. But there is something that some public health experts say could help. Narcan, the brand name for the drug naloxone, is an overdose prevention tool that anyone can use. It's a simple nasal spray, it's legal, it's pretty quick and easy to learn how to use, and it can reverse the effects of opioid overdose, and potentially save a life. In March, the Food and Drug Administration authorized over the counter sales of Narcan, making a potentially live-saving drug even more widely available. A CDC study from 2020 found that nearly 40 percent of overdose deaths occurred while another person was nearby — which means the more people carrying Narcan, the better chance there is of saving a life. Takeaway producer Katerina Barton reports, and spoke with Joanna Kaufman, a nursing student, full spectrum doula and priestess in training, living in Santa Fe, New Mexico, whose brother, Benjamin, died in 2019 from a fatal opioid overdose. Katerina also received a Narcan training from Elena Rotov, an overdose prevention coordinator, Hep C/HIV tester, and Hep C coordinator at the Brooklyn-based harm reduction center After Hours Project. Narcan is currently accessible and mostly distributed outside of the traditional health care system from nonprofits and harm reduction organizations. It is also available in some states at participating pharmacies. Most cities offer free community Narcan trainings, where you will receive a free dose of Narcan, and you can also find trainings at nonprofits and harm reduction organizations near you, and online.New York City Public Overdose Prevention Programs
The mounting death toll from the opioid crisis in the United States continues to wreak havoc in cities, towns, and rural communities across the nation. Over the past two decades, the number of people dying from opioid overdoses in New York, and across the United States, are rising each year. But there is something that some public health experts say could help. Narcan, the brand name for the drug naloxone, is an overdose prevention tool that anyone can use. It's a simple nasal spray, it's legal, it's pretty quick and easy to learn how to use, and it can reverse the effects of opioid overdose, and potentially save a life. In March, the Food and Drug Administration authorized over the counter sales of Narcan, making a potentially live-saving drug even more widely available. A CDC study from 2020 found that nearly 40 percent of overdose deaths occurred while another person was nearby — which means the more people carrying Narcan, the better chance there is of saving a life. Takeaway producer Katerina Barton reports, and spoke with Joanna Kaufman, a nursing student, full spectrum doula and priestess in training, living in Santa Fe, New Mexico, whose brother, Benjamin, died in 2019 from a fatal opioid overdose. Katerina also received a Narcan training from Elena Rotov, an overdose prevention coordinator, Hep C/HIV tester, and Hep C coordinator at the Brooklyn-based harm reduction center After Hours Project. Narcan is currently accessible and mostly distributed outside of the traditional health care system from nonprofits and harm reduction organizations. It is also available in some states at participating pharmacies. Most cities offer free community Narcan trainings, where you will receive a free dose of Narcan, and you can also find trainings at nonprofits and harm reduction organizations near you, and online.New York City Public Overdose Prevention Programs
God painted His heart for the Nations throughout the pages of His Word, from Genesis to Revelation... If we live our lives, spend our money, eat/drink, exercise, pray, and practice medicine without catching this vision, we're missing out on the greatest masterpiece ever created! We create a false dichotomy of domestic healthcare and that which is international. God doesn't see it this way and neither should we.
Just the facts, mam --- Send in a voice message: https://podcasters.spotify.com/pod/show/paulina2020/message Support this podcast: https://podcasters.spotify.com/pod/show/paulina2020/support
When people were dying from AIDS in the 1980s and 90s, Congress found a way to expedite the drug approval process and saved countless lives. Established in 1992, the Accelerated Approval Program allows the FDA to speed approval of drugs for patients with serious and life-threatening conditions. In this episode we talk with the father of children with a rare disease, a company CEO working to treat rare diseases and two policy experts on Accelerated Approval.
We live in the most amazing days since Jesus walked the earth. The global church is sprinting toward the finish line of the 2000-year Great Commission race, and by God’s grace, our generation may be the one to finish it. In this session, Douglas Cobb of The Finishing Fund will explain the global effort to get the gospel for the first time to the world’s last few unengaged people groups and will present the amazing promise of Matthew 24:14 that the completion of the Great Commission will open the door to the return of Christ.
The missional landscape has changed. The recent global events, the shifting distribution of Christians, and the realities of what God is allowing; are presenting a whole new missional landscape. What then are the new structures, approaches, and strategies that are proving effective for missions in our days? This will be shared with a special emphasis on the emerging role of medical missions and the strategy for partnerships. https://bit.ly/gmhc2022_florencemuindi_ourcurrentmission
Please note that this interview was done before Dr. Hamilton had completed her PhD. Her update about her MS and the work she is doing now airs 01/20/2023 in episode HM259 “Quantum Biology and Healing with Dr. Skyler Hamilton.” Dr. Skyler Hamilton is interviewed by Dr. Liz about how she healed her Multiple Sclerosis (MS) and how her husband used hypnosis to reduce side-effects of chemotherapy to the point where he was able to run 3 miles a day during his treatments and not miss a day of work. Please note that hypnosis is not a cure for medical conditions but is discussed in this episode as a way to reduce side-effects and reframe treatment as healing and strength-giving. We'll Learn: Skyler's first experiences with hypnosis through free diving and a 46 minute birth of her second child. How Skyler used hypnosis to go from being in a wheelchair with home health aides to heal her own MS. How her husband used hypnosis to reduce side-effects of chemotherapy treatment and live years past his original estimate of 18 months. How her husband uses hypnosis to maintain his progress. How hypnosis works on a cellular level. Skyler's work with Opioid addiction and Opioid recovery and the transformation she begin to see with hypnosis. Skyler's research on hypnosis for healing on the cellular level. **Correction: Skyler mentions Hep B when discussing addiction when she meant to say Hep C. About Dr. Skyler Hamilton Dr. Skyler Hamilton Ph.D., is a Mind Body Psychologist, specializing in brain-gut disorders and the somatization of stress, anxiety, and trauma. Dr. Hamilton's methods include cutting-edge, evidenced-based techniques including neurolinguistic re-programming, psychoneuroimmunology, hypnosis, meditation, family systems and attachment theories. Her approach is evidenced based but is built upon a genuine, empathic bond. Dr. Hamilton has developed a unique evidence based neuroscience approach for treating inflammatory diseases. Her approach incorporates the power of the mind and Hypnosis for successful management of these extraordinarily difficult cases. See more about her at https://www.drsky.net About Dr. Liz Winner of numerous awards including Top 100 Moms in Business, Dr. Liz provides psychotherapy, hypnotherapy, and hypnosis to people wanting a fast, easy way to transform all around the world. She has a PhD in Clinical Psychology, is a Licensed Mental Health Counselor (LMHC) and has special certification in Hypnosis and Hypnotherapy. Specialty areas include Anxiety, Insomnia, and Deeper Emotional Healing. See more about Dr. Liz and get Free hypnosis files at http://bit.ly/drlizhypnosis -------------- Do you have Chronic Insomnia? Find out more about Dr. Liz's Better Sleep Program at https://bit.ly/sleepbetterfeelbetter Search episodes at the Podcast Page http://bit.ly/HM-podcast Help yourself with Hypnosis Downloads by Dr. Liz! http://bit.ly/HypnosisMP3Downloads --------- A problem shared is a problem halved. In person and Online hypnosis and CBT for healing and transformation. Schedule your free consultation at https://www.drlizhypnosis.com. Listened to in over 140 countries, Hypnotize Me is the podcast about hypnosis, transformation, and healing. Certified hypnotherapist and Licensed Mental Health Counselor, Dr. Liz Bonet, discusses hypnosis and interviews professionals doing transformational work Thank you for tuning in! Please subscribe to auto-download new episodes to your listening device.
All my 5 Podcasts / Video Channels / Donations https://bio.link/podcaster About Haleem Biography My name is Haleem Abdul-Rahman. I am a coach for sensual health. I watch my sensual expressions decline as my health challenges emerged. I had to overcome HIV. HEP C, DIABETES and Hypertension. With these factors managed, I am now able to experience the sensual expression I desire. Many of us are wanting sensual expression but have not addressed the mental, emotional and physical challenges needed for that expression to manifest. I have been coaching mostly men but also women about their sensual health needs for seven years. What we Discussed: - Helping with Erectile Dysfunction - Toxins that are effecting us - Prostate advice - Testosterone Levels - Male Frogs turning into Female frogs - Ways to Detox - His 6 week course and more How to Contact Haleem https://www.facebook.com/haleem.abdulrahman https://www.youtube.com/channel/UCTYFiXHxwApSb-6rIp2alKQ email tarahman16 (at) gmail.com ======================================= More about Roy: All Podcasts + Coaching and Social Media https://bio.link/podcaster https://awakeningpodcast.org/ Video https://www.bitchute.com/channel/y2XWI0VCPVqX/
Importance of Designated Spaces ie. LGBTQ, BIPOC, Women's, Trans, HIV and or Hep C, etc.Join Anthony, Bonnie Violet, & Lou Lou every Tuesday at 4pm for our new podcast, broadcast live from The Castro Country Club in San Francisco.We strive to create a brave space where we engage in topics of recovery, where there are no outside issues. To send us a voice message or ask a question: https://www.speakpipe.com/attheccc Email: podcast@castrocountryclub.org Youtube: http://bit.ly/attheccc Facebook: https://www.facebook.com/CastroCountryClubFind us on all podcast channels: At The CCCFor more information go to www.castrocountryclub.org#designatedspaces #recovery #podcast #vulnerability #resentment #amends
THE THESIS: There is going to be a battle between President Trump and Governor DeSantis. THE SCRIPTURE & SCRIPTURAL RESOURCES: Matthew 20:2828 just as the Son of Man did not come to be served, but to serve, and to give his life as a ransom for many.”THE NEWS & COMMENT:We need to have a President who seeks to serve and not be served. That same President must understand the real and verified attack on America by globalists who want technocrat rule over our lives[AUDIO] - WHO - Global Health central control. Energy, transport, agriculture, water and food. All globally controlled by the WHO, the UN & their stakeholders. A Health Climate Emergency anyone?America needs a President who understands that the Mockingbird Media are actively destroying the Country. Look at this example, while the CCP purchasing massive amounts of American farm land and water rights, settings up police stations in East Coast cities, their role in the release--accidental or not--of the virus we probably paid them to make via Tony Fauci, with their money invested in the Biden Crime Family--a reporter's national security question for the FigureHead is about Elon Musk . . .[AUDIO] - Joe Biden just said @elonmusk "is worth being looked at" as a national security threat. A reporter calls him out by asking "HOW?!" A clueless Joe Biden panics, mumbles, and says, "there's a lot of ways" ELONGATE?!President Trump seems to want that fight with DeSantis. I that helping Trump? Is it helping conservatives win?These are Twitter polls and, as Rush Limbaugh (God rest him) said, “Twitter is not the real world.”THE LISTENERS:Marty, Stockton, CA:We need to face reality. The Mockingbird Media's 6 years of attacking Trump has worked. Beyond his base, he's toxic. I don't want that to be the case, but it is. I would like to think DJT would understand but his strongest asset and his biggest weakness are the same thing: his ego. That ego gave him the eggs to fight The Left or The Party as you call it. It also stops him from realizing what the Covid shots were and are and that the political tides have changed. I wish he would back DeSantis, but DJT is already attacking him. Maybe that's for the best, so DeSantis can show himself to be the one that can take him on and win. Love your show and I will leave California in a box. It's my three generation home.MartyStockton, CA. --- --- ---Breanna, Charleston, S.C.Dearest Todd,Please don't turn on President Trump. He needs to fire his advisers and just run on his own ideas and wit and grit. I will vote for DeSantis if he wins, but please don't turn on our President Trump. God bless you and your family,Breanna W. Charleston, S.C. --- --- ----BrianI am so angry about the political climate after the midterms. I live in Edmonds, WA and am surrounded by left wing ideology. I feel like I'm being slowly murdered by vicious people who want to shove their ideology down my throat, making me angry, sick, and exhausted. My dad died in January. My mother is still in deep grief. I am keeping my father's rental property business afloat while raising two kids under 5. As a landlord, I and my father are to be hated under current mob rules. I feel I have no support here. Can you offer any advice? Should I move out of Washington? I'd have to leave my mother. I'm not very religious. Should I seek help from a religious organization? Every one of them here seems to support lgbtq+Etc “rights” and black lives matter. Should I just bury my head in the sand? It would mean the world to me to just have a prayer for strength and a sign that that it's not me that has everything all wrong in my mind.--- --- ---Cindy, Harvest AlabamaDear Todd,I want to thank you for revealing so many areas where the Cabal/Deep State has been destroying America from within.The talk for months has been about a “Red Wave” sweeping the country and it did not turn out as expected and from experience I can understand why it did not happen.My parents worked on the 1964 Goldwater Campaign and observed what is still happening today. Republicans attacking other republicans. They belittle and ridicule their own voters and expect them to continue voting for republicans. Who wants to vote for someone who detests their own voters?After all my years working in Republican Party Politics I have had enough of the lies and promises of those who seek power over preserving America and the Constitution.When we had the House, Senate, and White House the Republicans would not work with President Trump on America First policies and that was the end of the line for me.As far as I'm concerned, Liz Cheney is the face of the Republican Party and there is no difference between her and the McC's (McConnell and McCarthy). The McC's are following in the steps of another McC, McCain who was the quintessential “reach across the aisle” po-liar-tician! Reaching across the aisle is nothing but accepting the other side's policies, which I detest.The Left and the traitors on the Right destroyed President Trump because he was a threat to their power. Now President Trump is attacking Governor DeSantis. The enemy of the world is Satan and he has taken the minds of millions. We don't need republicans using the tactics of the devil. I would urge President Trump to be above the petty party politics and focus on his accomplishments.As Edmund Burke said “The only thing necessary for the triumph of evil is for good men to do nothing. There are few republicans doing anything that matters for the Constitution and the Rule of Law. I would contend that they are not good men and need to be removed from the privilege of serving in government office.Thank you for keeping the focus of God's Word first in your political analysis. I appreciate someone who will take a stand for righteousness in this fallen world.May God bless you and keep you safe from the enemy.Cindy --- --- --- ---SusanGood Morning, Todd!I am sitting here listening to the Jennifer Margulis episode. As she was talking about speaking with the pediatricians regarding the vaccination schedule, it made me want to share my journey as a 54 year old woman.I went to my MD in May for a small medical issue I wanted looked at. The first thing she said to me was that my age is group is the fastest age group experiencing asymptomatic spread of Hep C. She advised a simple blood test to find out if I has asymptomatic Hep C. Then when I refused, she said “But there is a drug that practically cures it.” I told her that if I had no symptoms, I was not interested in getting a blood test to determine if I had something that was not symptomatic. She could not believe what I said and told me she was ordering the blood test and I had up to a year to go get it. I told I would not be getting the blood test and she still put the order on my chart.Then, she goes on to tell me that I am coming up on the age of getting vaccines. I inquired what vaccines. She said Shingles. I asked her why I would need to get that injection. Her response was “so you don't have to go through the pain of Shingles.” I asked if anyone died from getting the Shingles. And she was astounded that I even asked that question. I told her I was not interested. I have survived a couple of natural births with large babies and feel that I can handle the pain of Shingles. Plus, I added, that we don't even know if I will get Shingles.She was in such disbelief that I was not complying. I told her that since COVID came around, I really started reading and looking up more and more information on what was best for me. She honestly said “you cannot believe everything you read” and I responded back “yeah, you cannot believe everything you read.”She still had not asked me about the reason I was there, by the way.She went on to tell me about the pneumonia vaccine at 60. I asked that if I was in peak health if it would be necessary. She said that it would be because you just never know. Again, I told her I was not interested.I have been a relatively healthy human not requiring the advice of a doctor until I really need it. Nowhere in the conversation did she ask about my diet regime or exercise routine. I had actually just started SOTA Weight Loss and was excited to tell her about it, but it wasn't important for her.With that being said, I lost 35 pounds, am back to regular exercise, and wearing clothes in a size I never thought I would be in. In fact, I am smaller than I was in high school as a top swimmer. Thank you for introducing me to SOTA (okay it was more your wife's success that led me to make the call).Thank you for all that you do for the listeners. I appreciate the research you do as well as bringing back around to a biblical view.Sincerely,Susan
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