Podcasts about ICU

Rural nursing is anything but simple. They have limited resources, fewer specialists, and often have to send patients hours away from their families for a higher level of care. But all that is changing as new tech like Zeto brings monitoring right to the bedside and keeps more patients close to home.In this episode, ICU nurse leader Kristen RN shares how point-of-care EEG has empowered her team to catch subclinical seizures sooner and make faster, more informed clinical decisions. From buy-in to implementation, you'll hear how she advocated for her community and successfully integrated this technology into a small ICU. If you work in a rural or resource-limited facility, don't miss this one!Topics discussed in this episode:The unique challenges rural nurses and hospitals faceWhy keeping patients close to home mattersHow telemedicine and new tech are transforming rural healthcareWhy subclinical seizures are hard to recognizeHow Zeto's spot EEG helps nurses keep more patients close to homeThe positive impact on team confidence and patient careHow you can advocate for the tools your community needsLearn more about Zeto here:https://zeto-inc.com/Mentioned in this episode:CONNECT

You've probably been earning CEUs and studying way harder than you need to. In this episode, we walk through the Core Anesthesia app and show you how to turn your commute, dog walks, and dishwashing sessions into Class A credits, smarter studying, and less stress. If you're a CRNA, SRNA, or ICU nurse thinking about CRNA school, this walkthrough will show you how to make your studying and CEUs fit into your real life, not the other way around.Support the showTo access all of our content, download the CORE Anesthesia App available here on the App Store and here on Google Play. Want to connect? Check out our instagram or email us at info@coreanesthesia.com

Dr. Catherine Allan, Director of the Cardiac Care Unit and Inpatient Cardiology at the Cleveland Clinic joins us to talk about readiness for teams to perform pediatric ECMO, a high-risk, high-complexity therapy that staff might only see a third as often as they see patients on ventilators. ECMO can also be called for during CPR, which greatly increases the time pressure and complexity of the procedure. During ECPR, there is not only the ICU resuscitation microteam but also the surgical team and the perfusion team, leading to potentially having up to 20 people working in the room when running an ECPR case. We discuss how leaders can help connect seemingly imposed efforts like checklists and huddles to what it is that frontline workers are trying to achieve and are meaningful to them, and how simulation program designers must do the same in order to make sure that training is not a top-down checklist but rather a mutually owned process that gets teams where they believe they need to go. Host & Co-Producer: Chris Roussin, PhD, Senior Director, CMS-ALPS (https://harvardmedsim.org/chris-roussin/) Producer: James Lipshaw, MFA, EdM, Assistant Director, Media (https://harvardmedsim.org/james-lipshaw/) Consulting and readiness with CMS-ALPS: https://harvardmedsim.org/alps-applied-learning-for-performance-and-safety Dare to Be Ready on Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP Dare to Be Ready on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Jim's List: Top 10 Large Rockers, Gary Ho-Ho-Hoey joins the show, Flagrant podcast jumps the shark, Sydney Sweeney's new failure, Matthew Perry doctor sentenced, Thomas Markle in ICU, the Robocop statue arrives, and 30% of college kids are "disabled". Gary Hoey is in the building (aka on Zoom). Check out his new Christmas album, Ho Ho Hoey: Christmas Time Is Here! Also, make sure to check him out at The Magic Bag on December 14. Matthew Perry's doctor was sentenced. Quentin Tarantino's Top 20 Movies since 2000. Sydney Sweeney and her boobs have a new movie out soon that's going to bomb. Thomas Markle is in the ICU. Meghan must be so worried. Luke Nowacki brings you a new Bonerline. What is the actual definition of a three piece band? The new Flagrant Podcast is out. And Akaash AND the guys look to be taking a massive L. Sean Combs: The Reckoning is much watch Netflix. We catch Tom Mazawey before he gets his hair did. The Detroit Lions are on thin ice and BETTER win this week. College Football championship weekend talk...Michigan sucks...Drew is going to love James Franklin...Penn State is falling apart. Guess how many college kids are "disabled." Cindy Crawford's nepo-kid is having mental health issues. J Lo is trying to pump up sales for her new tour. Robocop is installed! Jim's Picks: Top 10 Fat Musicians. If you'd like to help support the show… consider subscribing to our YouTube Channel, Facebook, Instagram and Twitter (Drew Lane, Marc Fellhauer, Trudi Daniels, Jim Bentley and BranDon).

For Lisa Ferraro and Mary McCormick, leadership at Virtua Our Lady of Lourdes is personal. Lisa's journey was shaped by witnessing care in the ICU as a teen, and Mary's by her own experience with type 1 diabetes. Together, they've cultivated a culture where every team member has purpose and every patient feels supported. They share lessons from 17 years of leading side by side, offering insights and philosophies that guide how they inspire teams and make decisions. They also explore how living the mission of being "Here for Good" shapes their culture and the care they provide every day.

Send us a textWelcome back Rounds Table Listeners! In this solo episode, Dr. Mike Fralick discusses a recent trial examining whether noninvasive blood-pressure monitoring is noninferior to early insertion of an arterial catheter in patients with shock admitted to the ICU. Here we go! Deferring Arterial Catheterization in Critically Ill Patients with Shock (0:00 – 11:05).The Good Stuff (11:06 – 11:59):We've launched Critical Care Trial Files! https://criticalcaretrialfiles.substack.com/Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

durée : 00:59:46 - Le Wake-up mix - Le Wake-Up Mix, c'est tous les jours dès 07h sur Mouv' !!! Vous aimez ce podcast ? Pour écouter tous les autres épisodes sans limite, rendez-vous sur Radio France.

Send us a textIn this episode, Dr. Andrew Beverstock discusses his research on urinary sodium and its relationship with growth in preterm neonates. He shares insights into the importance of sodium for neonatal growth, the methodology of his study, and the unexpected results that challenge existing literature. The conversation also touches on his diverse medical training, mentorship experiences, and his involvement in medical education and point-of-care ultrasound (POCUS). Dr. Beverstock emphasizes the significance of careful population selection in research and outlines his future research directions. Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

In November 2022, hospitals across Australia began seeing patients with sudden rigidity, spasms, seizures—and in some cases cardiac arrest—after drinking homemade poppy seed tea. The source? Food-shelf poppy seeds contaminated with extraordinarily high levels of thebaine, an opioid alkaloid that acts nothing like morphine. In this Outbreak episode, host Ryan Feldman, clinical toxicologist and emergency medicine pharmacist, investigates how pharmaceutical-grade, thebaine-rich poppy seeds were mistakenly repackaged into the food supply—and how poison centers, clinicians, labs, and public health teams traced and contained the threat within days.You'll hear firsthand from the experts who responded:Dr. Katherine Isoardi, Emergency Physician, Clinical Toxicologist, Medical Director, Queensland Poisons Information CentreDr. Amanda Holford, Clinical Toxicology Fellow & Emergency Physician, Princess Alexandra HospitalDr. Darren Roberts, Medical Director, NSW Poisons Information Centre; Nephrologist; Clinical PharmacologistTogether, they walk us through the outbreak timeline—from the first ICU cases and puzzling “strych­nine-like” neuroexcitation to the multi-state investigation, product recall, and lessons for future foodborne poisonings.Looking for timestamps?A fully timestamped version—so you can jump to any topic—is available to our supporting members.

There are moments where the mission chooses you.Marine Corps Radio Operator SgtMaj Ted Painter was stationed in Okinawa when everything changed. A sudden illness left him paralyzed, intubated, and fighting his way out of an ICU with no windows and no clear answers.In this episode, Ted walks through how he went from that hospital bed to Iraq, then into Fortune 500 work, and finally into his role at CareSource Military and Veterans. He now focuses on improving how military families get care and support.We talk about Okinawa, Guillain-Barre, transition, mental health, TRICARE, military transition, and why Marines never really stop being Marines.Timestamps:00:00 Waking up paralyzed in the ICU00:38 How the crisis became a mission05:21 Okinawa, Guillain-Barre, and learning to walk again15:42 Fighting out of the hospital with Marine grit24:20 Finding purpose in healthcare29:39 What the TRICARE Prime demo actually is35:04 How this could change care for military families45:47 Open season, eligibility, and how to enrollHow veterans can use CareSource Military and Veterans:If you are in the Tampa or Atlanta areas and you are eligible for TRICARE Prime, you may be able to choose the TRICARE Prime demo with CareSource Military and Veterans. This is a Defense Health Agency program that gives families another option for how their care is supported. It does not replace TRICARE.What it offers:Simpler access to specialists within the networkHelp from real people when you need it (not chatbots)A focus on scheduling appointments faster and closer to homeFor eligible retirees and their family members who choose CareSource during the demo, the TRICARE Prime enrollment fee is waived for the first 12 months. Open season runs from Nov 11 to Dec 9. That is the window where you can choose CareSoure.To learn more or check your eligibility:CareSourceMilitary.comQuestions about the TRICARE Prime demo: 1-833-230-2080Ready to enroll during TRICARE Open Season: 1-877-996-9333

Anterior mediastinal masses make even seasoned anesthesiologists pause, and for good reason: a stable, upright patient can decompensate with a single change in position or a single dose of the wrong drug. We walk through a clear, stepwise approach that starts with anatomy and symptom red flags, then translates imaging, echocardiography, and pulmonary function testing into real-world decisions at the bedside. The focus stays practical: how to pick the safest setting, when to avoid general anesthesia, and what to prepare before anyone touches the airway.We break down adult and pediatric risk criteria, including mass-to-chest ratio, degree of tracheal compression, SVC obstruction, pericardial effusion, and standardized tumor volume in children. From there, we outline sedation-first strategies using ketamine, dexmedetomidine, and carefully titrated remifentanil to preserve spontaneous ventilation and avoid precipitous loss of tone. For patients who truly need general anesthesia, we share an OR playbook: lower-extremity access when SVC flow is threatened, semi-upright preoxygenation, slow induction while maintaining spontaneous ventilation, awake intubation options, and selective use of short-acting agents to test tolerance of positive pressure.Ventilation choices can make or break the case. We explain why long expiratory times and low respiratory rates reduce air trapping and auto-PEEP, and how fiberoptic bronchoscopy can guide tube position, predict extubation risk, and inform postoperative support. Rescue pathways are explicit: repositioning and CPAP, mechanical stenting with an endotracheal tube or rigid bronchoscope, rapid escalation to airway stents, and ECMO when distal collapse or cardiovascular compromise persists. We also spell out who needs ICU monitoring after surgery and why the safest path often means doing less.If this topic raises your heart rate, you're not alone. Tune in to sharpen your plan, align your team, and build a safer pathway from preop to postop for both adults and kids. Subscribe, share with your OR team, and leave a review with your best tip for managing high-risk mediastinal masses.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/283-how-to-plan-induce-and-recover-patients-with-anterior-mediastinal-mass-without-triggering-collapse/© 2025, The Anesthesia Patient Safety Foundation

In this episode of Skin Anarchy, Dr. Ekta Yadav sits down with Jordan Harper, board-certified nurse practitioner and founder of Barefaced, to explore the movement toward simplicity, integrity, and long-term skin health. With nearly a decade in aesthetic medicine, Harper brings a refreshing, clinically grounded perspective to a beauty landscape overwhelmed by trends, noise, and overcomplicated routines.Harper shares how her early career in the ICU shaped her detail-oriented, problem-solving mindset — and how she carried that discipline into aesthetics. What she noticed immediately was a disconnect: patients would invest heavily in treatments but neglect the daily routine that actually sustains results. That realization became the foundation of Barefaced's “less but better” philosophy, anchored by her Core Four essentials: exfoliant, vitamin C, retinoid, and SPF.Throughout the conversation, Harper reframes skincare as prevention, not correction — a longevity-based approach that prioritizes the barrier, cellular health, and consistency over quick fixes. She also dives into the meaning of true “medical grade”: thoughtful formulations, meaningful concentrations, and uncompromising standards. It's the reason she once pulled a product at a $200,000 loss — integrity outweighs profit.From the cult-favorite Toning Pads that sparked the brand's cult following to Barefaced's commitment to education and honest guidance, Harper emphasizes serving the consumer, not selling to them.Tune in to hear how Jordan Harper is redefining modern skincare through clinical rigor, simplicity, and unwavering authenticity — and why the future of skin health is built on foundations, not fads.SHOP BAREFACED and learn more on social media!CHAPTERS:(0:02) - Introduction & Guest Welcome(0:40) - From ICU to Aesthetics: The Turning Point(2:34) - The 80/20 Rule: At-Home vs In-Office Results(4:39) - Common Routine Mistakes & Barrier Damage(7:16) - “Less, But Better” and The Core Four(9:28) - Longevity vs Anti-Aging(12:12) - What “Medical Grade” Really Means(17:28) - Scaling with Integrity & Brand Discipline(20:35) - Cult Favorites, Toning Pads & Community-Centered CarePlease fill out this survey to give us feedback on the show!Don't forget to subscribe to Skin Anarchy on Apple Podcasts, Spotify, or your preferred platform.Reach out to us through email with any questions.Sign up for our newsletter!Shop all our episodes and products mentioned through our ShopMy Shelf!*This is a paid collaboration Hosted on Acast. See acast.com/privacy for more information.

Bernie Mac's daughter tells the full story of her father's final days — from the ICU to the night he died.In this emotional episode of DEAD Talks, she shares what really happened during Bernie Mac's last hospitalization, the medical complications, and the moment she received the call that changed her life forever.Beyond the details of his death, she reflects on: • Growing up as Bernie Mac's only child • Watching a parent decline • The shock of sudden loss • Depression and grief • Becoming a parent without her father • How loss reshapes identity and familyThis is a deeply personal account of grief, legacy, and what it means to live after losing a parent the world loved.DEAD Talks with David Ferrugio explores death, grief, healing, and the human experience through real conversations.For Grief Support check out our new Grief Journey Appwww.studio.com/griefjourneySupport the Show Join the DEAD Talks Patreon for just $2 to support the mission—and get episodes early & ad-free!Sign Up For E-Mail Updates Here > Submit Your EmailHats, Shirts, Hoodies + More: Shop Here “Dead Dad Club” & “Dead Mom Club” – Wear your story, honor your people.Exclusive Discounts 10% off Neurogum – powered by natural caffeine, L-theanine, and vitamins B6 & B12 to boost focus and energy.About DEAD Talks DEAD Talks with David Ferrugio approaches death differently. Each guest shares raw stories of grief, loss, or unique perspectives that challenge the “don't talk about death” taboo. Grief doesn't end—it evolves. After losing his father on September 11th at just 12 years old, David discovered the power of conversation. Through laughter, tears, and honest dialogue, DEAD Talks helps make it a little easier to talk about death, mourning, trauma, and the life that continues beyond it.Connect with DEAD Talks YouTube | Facebook | Instagram | TikTok | www.deadtalks.net

The importance of leadership in the hospital setting is critically important yet often overlooked. It's even more important to have sound leaders and adhere to well-founded leadership practices when taking care of the critically ill. Join us as we sit down with Dr. Josh Hartzell - internist, infectious disease physician, author, veteran and physician-leader - as we discuss Leading in the ICU and Beyond!As always, please leave us feedback and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

December brings us to the final Papers of the Month for 2025 and we're finishing the year with three studies that challenge assumptions across critical care and resuscitation! This time questioning the role of arterial lines in shock, looking at the true prognostic value of end-tidal CO₂ in cardiac arrest and finally to airway management in neonates. We start in the ICU with the EVERDAC trial, a large multicentre RCT exploring whether early arterial catheterisation in shock truly changes outcomes. This challenges some of the papers we've recently looked at recently which champion the benefit of early arterial line insertion! The EVERDAC trial looks at the effect they have on mortality and the results are pretty striking. Next, we move into the world of cardiac arrest with a systematic review and meta-analysis examining end-tidal CO₂ as a prognostic tool for ROSC. ETCO₂ is firmly embedded in ALS practice, but its real predictive power isn't completely clear, as we've seen in the recent ERC guidelines. This review pulls together studies with more than 3,000 patients and helps us understand more how much weight we should give to ETCO₂ and the way in which it's best utilised. Finally, we finish with a neonatal focus: a systematic review and meta-analysis comparing video versus direct laryngoscopy for urgent neonatal intubation. Success rates in NICU and delivery room intubation are notoriously low. This paper looks at the impact of video laryngoscopy on first pass success with some dramatic results, which raises important questions around training and resource allocation. Three papers, three very different patient groups, and three opportunities to reflect on how evidence continues to challenge our practice. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon & Rob

Happy Mindful Monday Everyone!In this week's episode, our host, Allie Brooke, sits down with  amazing Brigette Panetta. Brigette has emerged as a powerful advocate for individuals facing social injustice and adversity. As the partner of James Mawhinney, founder of Media.com, Brigette has personally experienced the profound challenges of fighting against a government body. Over the past four years, she has witnessed the severe impact of Australia's corporate regulator, ASIC's, false allegations on her family's investment business, Mayfair 101. This ordeal has deeply affected Brigette, her young family, and the lives of nearly 600 Australians. Her journey began under extraordinary circumstances—two days after giving birth during the onset of the pandemic, Brigette found herself in the ICU, recovering from a traumatic birthing experience while simultaneously supporting James through 26 legal hearings. The struggle resulted in losing their family home and enduring significant personal and professional setbacks. Despite these hardships, Brigette's resilience has driven her to speak out and assist others in similar predicaments. Brigette is committed to creating a foundation to provide litigation funding and support for individuals battling injustices. She aims to offer a platform for people to share their stories and find solidarity in their experiences. In addition to her advocacy work, Brigette is passionate about holistic healing modalities. She has explored and benefited from practices such as breath work, meditation, kinesiology, and Reiki to overcome trauma and stress. Through her journey, she has discovered the power of internal healing and now wishes to educate others on these methods.Episode TopicsHow did you specifically cultivate mental resilience during such an intense social justice pursuit, when the stakes were so high?Can you share an experience where a mental barrier (like self-doubt, fear, or hopelessness) felt particularly overwhelming, and what immediate, in-the-moment strategies you used to overcome it?How did your experiences with adversity fundamentally shift your perspective on personal strength and the human capacity for endurance?You've leveraged meditation, Reiki, and other holistic healing modalities to transcend adversity. For listeners who might be new to these practices, where would you recommend they start to begin building their inner strength?Can you describe how integrating mind, body, and spirit through these practices creates a different kind of resilience compared to purely mental fortitude?Was there a specific holistic practice that felt most impactful for you during your most challenging times, and what made it so powerful?How do you continue to weave these holistic practices into your daily life now, beyond times of crisis, to maintain your well-being?How To Connect w| BrigetteWebsiteLinkedIn  The Growth METHOD. Membership◦ ⁠⁠⁠⁠⁠⁠⁠⁠Join Here!⁠⁠⁠⁠⁠⁠⁠⁠ (Both FREE and Premium)◦ Use Code:growthmindsetgal for 50% off your first month's subscription! THE GREAT 2025 LOCK-IN GIFTED 1HR COACHING CALL SIGN UPENDS 12/31/2025 1:1⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ GROWTH MINDSET COACHING PROGRAMS!◦ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Application Form ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ What are the coaching sessions like?⁠⁠• Tailored weekly discussion questions and activities to spark introspection and self-discovery.• Guided reflections to help you delve deeper into your thoughts and feelings.• Thoughtfully facilitated sessions to provide maximum support, accountability, and growth.• Please apply for a FREE discovery call with me!• Allie's Socials• Instagram:@thegrowthmindsetgal• TikTok: @growthmindsetgal• Email: thegrowthmindsetgal@gmail.comLinks from the episode• Growth Mindset Gang ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠ Broadcast Channel⁠⁠⁠⁠⁠⁠⁠⁠• Growth Mindset Gang ⁠⁠⁠⁠⁠⁠⁠⁠Newsletter ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠• Growth Mindset Gal ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Website⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠• Better Help Link: Save 10%SubstackDonate to GLOWIGloci 10% off Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Gina M. Piscitello, MD, and Katrina E. Hauschildt, PhD, BCPA, join CHEST® Journal Podcast Moderator Gretchen Winter, MD, to discuss their research into the ways that and extent to which hospital policies influence clinician approaches to decisions to withhold or withdraw life-sustaining treatment among patients admitted to an ICU.  DOI: 10.1016/j.chest.2025.06.036 Disclaimer: The purpose of this activity is to expand the reach of CHEST content through awareness, critique, and discussion. All articles have undergone peer review for methodologic rigor and audience relevance. Any views asserted are those of the speakers and are not endorsed by CHEST. Listeners should be aware that speakers' opinions may vary and are advised to read the full corresponding journal article(s) for complete context. This content should not be used as a basis for medical advice or treatment, nor should it substitute the judgment used by clinicians in the practice of evidence-based medicine. 

Erika Breivogel's journey through the ICU as a patient forever changed her as a person as well as transformed the care she now gives as an ICU nurse. In this episode she inspires up with her reflections of ICU culture vs. patient reality and what moves her to keep fighting the ICU revolution. www.DaytonICUConsulting.comGet CE credit for listening to this episode and unlimited other learning experiences here: SapienCE Reflecting Learning | Unleash Your Inner Sage

Bobbie supports Liz after her broken wedding, helps her sort through anger toward Lucky, and is caught in the middle when Lucky comes looking for her. At the same time, Scott pulls Bobbie into his awkward dating life, and Laura arrives in crisis over Luke.Bobbie and Scott grow closer just as Roy's investigation exposes Melissa's patient killings. Bobbie is shaken when Melissa breaks down and is arrested. She and Scott then try dating, but tensions rise over Carly—especially after Carly's apparent death and shocking return at her own funeral.As Bobbie helps Carly recover, she juggles Laura's spiraling anxiety, Scott's shady behavior, and Luke's mental decline. Scott's political stunt using Carly pushes Bobbie to cut ties with him publicly. Family trouble continues with Lucas acting out, Liz facing medical scares, and Alexis' baby in the ICU.Carly's search for her father forces Bobbie to confront painful parts of her past, especially once John Durant reappears. Heather Webber's return adds more chaos, poisoning Lesley and circling the Spencer family.Everything explodes when Skye learns Laura is alive. Bobbie admits she helped hide Laura to give Luke a chance at a new life, leaving the family reeling and showing the complicated lengths Bobbie will go to for those she loves.Listen at GeneralHospitalPodcast.com This podcast is not endorsed by, directly affiliated with, maintained, authorized, or sponsored by ABC Television Network, Prospect Studios, or any official General Hospital organizations. All product and company names are trademarks of their respective owners. Any use of trade names or trademarks is for identification and reference only and does not imply any association with the trademark holder. The views and opinions expressed on this podcast are solely those of the hosts and guests, and do not necessarily reflect those of any trademark or brand mentioned.Hosted by Ausha. See ausha.co/privacy-policy for more information.

Does discussing death actually help us live better? In this episode of the The Gritty Nurse Podcast, Host Amie Archibald-Varley sits down with Penny Hawkins Smith—better known to her millions of followers as Hospice Nurse Penny—to find out. Penny is a certified hospice and palliative care nurse and a "death influencer" who uses social media to combat death anxiety and misinformation. She joins us to share her incredible journey from the ICU to hospice care and to discuss her new memoir, Influencing Death: Reframing Dying for Better Living. Together, we break down the critical (and often misunderstood) differences between hospice and palliative care, debunk common myths about morphine and the dying process, and dive into the "gritty" reality of end-of-life advocacy. Penny also opens up about the mysterious side of dying—including "visioning" and the unexplainable phenomena nurses witness at the bedside. Whether you are a healthcare professional, a caregiver, or just someone looking to understand mortality better, this conversation is an honest, educational, and surprisingly uplifting look at the end of life. In This Episode, We Cover: Hospice vs. Palliative Care: What is the actual difference, and when should you ask for a consult? The "Death Influencer" Phenomenon: How Penny uses TikTok and Instagram to educate millions and fight death phobia. Controversial Topics in Death Care: We tackle the hard questions about withholding food/fluids, pain management, and the stigma surrounding hospice. Mysterious Experiences: Penny shares stories of "visioning" (seeing deceased loved ones) and terminal lucidity. Influencing Death: A look inside Penny's new memoir and how her personal struggles with addiction shaped her compassionate approach to nursing. Advocacy in Action: How nurses can lead the charge in normalizing conversations about death. Resources Mentioned: Book: Influencing Death: Reframing Dying for Better Living by Penny Hawkins Smith Follow Penny: @HospiceNursePenny on TikTok, Instagram, and YouTube. Website: https://www.hospicenursepenny.com/ Listen now to learn why talking about death is the key to a better life. Where to Listen / Watch to THE GRITTY NURSE * Listen on Apple Podcasts – : The Gritty Nurse Podcast on Apple Apple Podcasts  https://podcasts.apple.com/ca/podcast/the-gritty-nurse/id1493290782 * Watch on YouTube –  https://www.youtube.com/@thegrittynursepodcast Stay Connected: Website: grittynurse.com Instagram: @grittynursepod TikTok: @thegrittynursepodcast X (Twitter): @GrittyNurse Collaborations & Inquiries: For sponsorship opportunities or to book Amie for speaking engagements, visit: grittynurse.com/contact Thank you to Hospital News for being a collaborative partner with the Gritty Nurse! www.hospitalnews.com 

Host Jaclyn Zukerman Delory sits down with Eunice Weckesser a nurse, mom of two, and founder of Crown the Cool to explore her journey from the ICU to creating daring, soulful interiors. They discuss how design became an emotional escape during COVID, Eunice's signature use of black and bold patterns, and her mission to make clients feel crowned and seen. The episode also covers Eunice's path into the International Furnishings & Design Association, the realities of juggling two careers and parenting children on the autism spectrum, and practical confidence tips about visibility, kindness, and living authentically.

Another powerful episode is live here on IVPN-Voice!

In this special 200th episode of Reclaim Your Rise, I sit down with Risely coaching alum Layne—an ICU nurse practitioner who has lived with type 1 diabetes for over 30 years—to explore a struggle I know so many in our community quietly carry: the weight of comparison, perfectionism, and those triggering “perfect” flat-line graphs. Even with an A1C of 5.8, Layne shares how she felt mentally drained from micromanaging every detail of her diabetes and questioning whether true freedom and stable numbers could ever exist together. She opens up about the years when flat graphs came only from restriction, and how that left her wondering if peace was possible without losing herself again. In our conversation, Layne reflects on how she learned to redefine progress, shift her mindset, and rebuild trust with her body in a way that finally brought her steadier days and more ease. I'm so excited for you to hear this honest, raw, and deeply relatable story. And to celebrate episode 200, I'm hosting a special giveaway for the community—details are inside!

In this episode, Kelly welcomes Aly Johnston, FNP-BC, founder of Well by AM Nursing, who brings over 20 years of medical expertise in managing obesity and hormonal health. If you're doing "everything right" but still frustrated, Aly explains why your hormones are the crucial missing piece. Join us for the essential knowledge needed to finally nourish your body back into balance, leading to restored health, reclaimed time, and abundant energy. [4:02] Healing Takes Time "Patients really need time and attention to understand their bodies, and it's not just one appointment." [10:34] Education Gap in Our Healthcare System "We can't just dole out somebody a drug and tell them, good luck, hopefully you lose the weight that you want to lose, right? So, and that's another part of education missing in our country -  nutrition." [17:00] Real Formula for Sustainable Weight Loss "Nutrition and exercise and hydration and sleep hygiene, and all of these things, they all play a role in our ability to lose, and then maintain, that weight loss." [24:12] The Dark Side of Surgical Weight Loss "There are patients that have complications from weight loss surgery. I've seen it personally as a nurse at the bedside in the ICU. I've seen it in my primary care office when I worked as a nurse practitioner. You know, patients can die from these kinds of surgeries." [30:09] Identity Shift "The person that I was 5 years ago, the person I was 10 years ago, that person was not able to come with me to who I am today." [34:49] Hormones Matter Too "I'm doing all the things. I'm exercising, you know, maybe you're doing all of the things correctly, but your hormones, it's not just estrogen and testosterone that we have." [43:42] Hormone Management Support "Hormone management is the replacement for progesterone, testosterone, estrogen, and some other supplements that can affect your hormones." [52:27] Healthy Affirmations "It's just simple things. To tell yourself that you are whole and you are worthy and you are good; and then move forward with those thoughts that can change so much for a lot of people." [1:01:34] Finding Real Guidance "You don't need a coach that is a multi-bajillionaire. You need somebody that's one to two steps ahead of you that can tell you the steps in real time." Follow Aly Johnston on Instagram @alyjohnston - https://www.instagram.com/alyvjohnston?igsh=emZmeDcwazZzYTRm Follow Weight Loss + Health Care with Nurse Practitioner Aly Johnston on Instagram @wellbyam - https://www.instagram.com/wellbyam?igsh=eDV4dm9kMWM1N2Zu Visit the Well by AM Nursing, Inc. Website https://wellbyamnursing.com Connect with Kelly here: Follow Me on Instagram at @chaselifewithkelly - https://www.instagram.com/chaselifewithkelly/ Follow Me on TikTok at @iamkellychase - https://www.tiktok.com/@iamkellychase _t=8WCIP546ma6&_r=1 Subscribe to My YouTube Channel - https://www.youtube.com/channel/UCNqhN0CXWVATKfUjwrm65-g Work with Me: Private 1:1 Business & Mindset Coaching- More Details- https://www.chaselifewithkelly.com/private-coaching  Rejection to Redemption - More Details: https://www.chaselifewithkelly.com/rejection-to-redemption  Online Business Accelerator- More Details: https://www.chaselifewithkelly.com/online-business-accelerator  Money Magnet - More Details: https://www.chaselifewithkelly.com/money-magnet  Goddess Magic Course Bundle - More Details - https://www.chaselifewithkelly.com/goddess-magic Kelly's Favorites  https://linktr.ee/chaselifewithkelly Visit Our Website!  https://www.chaselifewithkelly.com

 The Big Unlock · Chris Gallagher, M.D., Founder and Chief Strategy Officer, Access TeleCare In this episode, Dr. Chris Gallagher, Founder and Chief Strategy Officer at Access TeleCare, shares valuable insights on the evolution of AI, how virtual care is reshaping access, staffing, and costs across health systems, and why making technology effortless is the key to driving a successful virtual-first care strategy. Chris recounts the pioneering achievement of building the first virtual ICU in Texas in 2013, which quickly proved life-saving and marked a turning point in virtual health adoption. He discusses how they are addressing physician distribution issues by augmenting in-person staff, shifting its focus from predominantly rural to 70% urban facilities by offering essential 24/7 virtual specialists to care teams. Chris stresses that solutions must be effortless for clinicians, “Fisher Price easy,” so adoption becomes self-perpetuating. Chris highlights AI's immense potential to improve efficiency, enhance physician experience, and expedite patient care, especially through automation and a future “virtual-first” healthcare strategy. Take a listen.

Nurse Renee became a TikTok hit taking the piss out of her mother, and filming her Yiayia. During COVID she changed careers from being a nurse in the ICU to being a carer for her father, and then developing her own range of skincare products. All of this has evolved while keeping the core essence of her Yiayia and her family at the front and centre of her products. Subscribe'a now! Tank'a you... https://linktr.ee/sooshimango Ptou you bastard!

Roger Seheult, MD of MedCram examines a new study comparing ICU stay durations to IR exposure. See all Dr. Seheult's videos at: https://www.medcram.com/ (This video was recorded on November 15th, 2025) Roger Seheult, MD is the co-founder and lead professor at: www.medcram.com He is Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine and an Associate Professor at the University of California, Riverside School of Medicine. MEDCRAM WORKS WITH MEDICAL PROGRAMS AND HOSPITALS: MedCram offers group discounts for students and medical programs, hospitals, and other institutions. Contact us at customers@medcram.com if you are interested. MEDIA CONTACT:  Media Contact: customers@medcram.com Media contact info: https://www.medcram.com/pages/media-contact Video Produced by Kyle Allred Edited by Daphne Sprinkle of Sprinkle Media Consulting, LLC FOLLOW US ON SOCIAL MEDIA: Facebook:  www.facebook.com/MedCram Twitter/X: www.twitter.com/MedCramVideos Instagram: www.instagram.com/medcram DISCLAIMER: MedCram medical videos are for medical education and exam preparation, and NOT intended to replace recommendations from your doctor. #infrared #IR #light

Episode 179 of Limb Lengthening LIVE is an open mic discussion! Patients are invited to join the stream, share their stories, updates, and ask questions in real time._____________________Audio Podcast - will be available within 24-48hrs after stream endsTimestamps - Timestamps – LL LIVE 179 (Fat Embolism Episode)0:00 – Intro1:03 – Sam joins - Overdoing it after nail removal: tibia stress fracture & surgeon's plan8:43 – Comeback goal: training for the alumni soccer tournament in May10:07 – Vita joins: starting tibia lengthening11:18 – Fat Embolism #1 – Surgery day, sudden breathing issues & ICU rush13:38 – Fat Embolism #2 – CAT scans, oxygen, ICU stay & getting discharged18:19 – Fat Embolism #3 – What FES actually felt like, lingering high heart rate & recovery outlook21:19 – Early tibia recovery: brutal knee pain, swelling, dangling legs & calf-pump tips24:21 – Dorsiflexion, night splints, strong pre-hab & first PT session after tibias33:13 – Rare but real: honest talk on severe complications & why full-service centers matter37:04 – Q&A: nail strength in tibias vs femurs, falling on the nail & running again after LL51:01 – Q&A: bone healing, driving after surgery, painkillers & addiction concerns1:00:44 – Q&A: proportions, quad vs single-segment, length goals & athleticism trade-offs1:24:01 – Q&A: height dysphoria, “constant pain for life” myth, TSA/air travel & future tech1:41:10 – Closing: core-training priority, easy nutrition during LL, air-fryer hack1:42:00 - Outro______________________Find Links to Everything Here and Below: https://sleekbio.com/cyborg4life

Your pneumonia patient is hypotensive, tachycardic, and not responding to fluids… what did you miss? It could be sepsis-induced cardiomyopathy, a common under-recognized shock state you could see at the bedside.In this episode, Dr. Mahmoud Ibrahim MD and host Sarah Lorenzini use a case study to highlight how nurses, intensivists and the ICU team can work together to recognize the signs of sepsis-induced cardiomyopathy early and give patients a better chance at recovery. You'll learn the diagnostic clues that your patient's heart is in trouble, how to approach controversial treatments like sodium bicarb, and what has to happen before intubation in a dual shock state.Topics discussed in this episode:What the initial bedside assessment says about the patientTreatment priorities for the  intensivist and nurseSigns that point to more than just sepsisWhy fluids aren't always the answerBlood pressure management: vasopressors and inotropesPathophysiology of sepsis-induced cardiomyopathyHow a sepsis-induced cardiomyopathy diagnosis changes treatmentThe vasopressin debate for sepsis-induced cardiomyopathyClues your intervention isn't working and what to do nextHow to prepare the patient for high-risk intubationWhat you need to know about administering sodium bicarbWhy collaboration matters at every step for patient recoveryConnect with Dr. Ibrahim:Instagram: https://www.instagram.com/icuboy_meded/Facebook: https://www.facebook.com/share/1Dg1ZTyfsN/TikTok: https://www.tiktok.com/@icuboy_mededThreads: https://www.threads.com/@icuboy_mededX: https://x.com/icuboy_mededLearn more about the different phenotypes in sepsis induced cardiomyopathy:https://journal.chestnet.org/article/S0012-3692(25)05143-8/abstractMentioned in this episode:CONNECT

Marine Staff Sergeant Octavio was leading a convoy in Iraq when a daisy-chain IED of 80mm mortars blew his vehicle apart, killing Captain Maloney and Lance Corporal Help and leaving Octavio with third-degree burns over 70% of his body, a shattered arm, and a long road through ICU, skin grafts, and daily wound care.Today, Pastor Octavio leads Front Sight Military Outreach in Ontario, CA. A church and ministry for veterans and their families, a “city of refuge” for those still fighting battles in their minds and hearts.If you're a veteran, active duty, or a family member who's struggling, you're not alone. Reach out to Front Sight Military Outreach:Instagram: @FrontSightMilitaryOutreachFacebook: Front Sight Military Outreach

Jared Maynard (@jared.unbreakable) is a strength coach, physical therapist, and powerlifter whose story is one of the most powerful comebacks in the sport. In 2023, Jared was diagnosed with a rare and often fatal immune condition (HLH), spent weeks in the ICU, lost over 40 lbs of muscle, and had to relearn basic functions — walking, talking, breathing on his own. A year later, he returned to the platform and pulled a lifetime deadlift PR while navigating progressive vision loss.In this episode, Jared and Cam dive into resilience, rebuilding from rock bottom, the flaws in powerlifting rehab, and the mindset behind Jared's message: “You're not done yet.”

00:01:25 — China's First Cryogenic Wife Knight opens with the story of a man freezing his deceased wife, framing it as a warning about the growing obsession with technological immortality and the moral vacuum behind it. 00:52:28 — Hollywood Panics Over AI Actors Knight highlights how digital performers threaten the traditional film industry, exposing how fragile and artificial celebrity identity really is. 01:14:30 — Bitcoin Flash-Crash Exposes Crypto Fragility Bitcoin's sudden collapse with no clear trigger demonstrates how unstable and speculative the crypto ecosystem remains despite mainstream hype. 01:30:16 — Pompeo Joins Corrupt Ukraine Arms Firm Knight reveals Mike Pompeo's new advisory role in a scandal-plagued Ukrainian weapons company, illustrating how political insiders cash in on endless-war networks. 02:06:44 — Hospitals Paid to Kill Patients Zoe describes how federal COVID incentives rewarded deadly protocols — ventilators, remdesivir, and inflated diagnoses — turning hospitals into profit-driven death machines. 02:10:05 — COVID Diagnosed Without Tests or Exams Official coding rules allowed doctors to declare COVID based purely on opinion, bypassing examinations and PCR testing, guaranteeing inflated case numbers. 02:18:37 — COVID Protocols Created the Deaths Zoe explains that most fatalities were caused by hospital protocols — organ shutdown, sedation, remdesivir toxicity — not the virus itself. 02:21:01 — Vaccine Injuries Exploded Immediately She recounts severe neurological, cardiovascular, and clotting disorders occurring right after vaccination, all dismissed or unreported by medical staff. 02:34:38 — PCR Was a DNA Data-Mining Operation Zoe details how PCR samples were routed to global gene banks, turning COVID testing into a worldwide DNA-harvesting and sequencing program. 02:49:44 — Palantir & Tiberius Used to Track Vaccine Compliance Operation Warp Speed used Palantir's real-time data systems to monitor ICU beds, ventilators, demographics, and vaccination rates, creating a national surveillance infrastructure. Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silverFor 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHTFind out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-david-knight-show--2653468/support.

00:01:25 — China's First Cryogenic Wife Knight opens with the story of a man freezing his deceased wife, framing it as a warning about the growing obsession with technological immortality and the moral vacuum behind it. 00:52:28 — Hollywood Panics Over AI Actors Knight highlights how digital performers threaten the traditional film industry, exposing how fragile and artificial celebrity identity really is. 01:14:30 — Bitcoin Flash-Crash Exposes Crypto Fragility Bitcoin's sudden collapse with no clear trigger demonstrates how unstable and speculative the crypto ecosystem remains despite mainstream hype. 01:30:16 — Pompeo Joins Corrupt Ukraine Arms Firm Knight reveals Mike Pompeo's new advisory role in a scandal-plagued Ukrainian weapons company, illustrating how political insiders cash in on endless-war networks. 02:06:44 — Hospitals Paid to Kill Patients Zoe describes how federal COVID incentives rewarded deadly protocols — ventilators, remdesivir, and inflated diagnoses — turning hospitals into profit-driven death machines. 02:10:05 — COVID Diagnosed Without Tests or Exams Official coding rules allowed doctors to declare COVID based purely on opinion, bypassing examinations and PCR testing, guaranteeing inflated case numbers. 02:18:37 — COVID Protocols Created the Deaths Zoe explains that most fatalities were caused by hospital protocols — organ shutdown, sedation, remdesivir toxicity — not the virus itself. 02:21:01 — Vaccine Injuries Exploded Immediately She recounts severe neurological, cardiovascular, and clotting disorders occurring right after vaccination, all dismissed or unreported by medical staff. 02:34:38 — PCR Was a DNA Data-Mining Operation Zoe details how PCR samples were routed to global gene banks, turning COVID testing into a worldwide DNA-harvesting and sequencing program. 02:49:44 — Palantir & Tiberius Used to Track Vaccine Compliance Operation Warp Speed used Palantir's real-time data systems to monitor ICU beds, ventilators, demographics, and vaccination rates, creating a national surveillance infrastructure. Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silverFor 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHTFind out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-real-david-knight-show--5282736/support.

On this episode of NOON Max, an ER nurse working at a Level 1 trauma center, shares his journey from starting his career during the pandemic to overseeing trauma and critical care today. He discusses the challenges of resource limitations, managing high-acuity cases, and how the pandemic reshaped resilience in healthcare. He also reflects on his future goals in pediatric ICU and transport medicine, the value of nurse-driven recommendations, and the unique stories that have shaped his path in emergency care.Today's Sponsor is: JumpMedicAre you looking for top-notch first aid kits? Look no further than JumpMedic! Owned by a seasoned paramedic with over a decade of EMS experience, their kits are user-friendly and packed with essential supplies. From the most popular Pro Gen 2 to the compact Hard Shell Kit, they've got you covered. You can even Customize your own kit with their Build A Bag option! Enter the code NOON10 and enjoy 10% off your order! Free US shipping, and everything is HSA/FSA approved. Visit JumpMedic.com and follow @JumpMedicUSA on Instagram. Stay prepared with JumpMedic!Podcast: ⁠https://open.spotify.com/show/1vAokfqG5aifoRBKk9MAUh?si=T8DipSBCQzWfOeiBW3h-Vw⁠FB Page: https://m.facebook.com/groups/nineoneonenonsense/?ref=shareInstagram: ⁠https://www.instagram.com/911nonsense/⁠X: ⁠https://twitter.com/911Nonsense⁠Bonfire Merch: https://www.bonfire.com/store/nine-one-one-nonsense/?utm_source=copy_link&utm_medium=store_page_share&utm_campaign=nine-one-one-nonsense&utm_content=defaultContent Warning: This episode contains discussions about death, including graphic and potentially triggering details. Listener discretion is advised. The episode also covers sensitive topics and may not be suitable for all audiences. If you or someone you know is struggling with suicidal thoughts or mental health issues, please seek help immediately. You can contact the Suicide & Crisis Lifeline by dialing 988 from anywhere in the U.S. #911Podcast #ParamedicLife #FirstResponderStories #EMSFamily #EmergencyCalls #SavingLives #BehindTheSiren #FirstResponderLife #911nonsense #ParamedicPodcast #PodcastLaunch #PodcastLife #PodcastCommunity #TrueStoryPodcast #NewPodcastAlert #PodcastAddict #PodcastEpisode #PodcastPromotion #PodcastHost #PodcastRecommendations #RealLifeHeroes #EmergencyServices #TrueStories #BehindTheScenes #LifeOnTheLine #AdrenalineRush #HumanStories #OnTheJob #EverydayHeroes #TrueLife

Dr. Linda Duska and Dr. Kathleen Moore discuss key studies in the evolving controversy over radical upfront surgery versus neoadjuvant chemotherapy in advanced ovarian cancer. TRANSCRIPT Dr. Linda Duska: Hello, and welcome to the ASCO Daily News Podcast. I am your guest host, Dr. Linda Duska. I am a professor of obstetrics and gynecology at the University of Virginia School of Medicine.  On today's episode, we will explore the management of advanced ovarian cancer, specifically with respect to a question that has really stirred some controversy over time, going all the way back more than 20 years: Should we be doing radical upfront surgery in advanced ovarian cancer, or should we be doing neoadjuvant chemotherapy? So, there was a lot of hype about the TRUST study, also called ENGOT ov33/AGO-OVAR OP7, a Phase 3 randomized study that compares upfront surgery with neoadjuvant chemotherapy followed by interval surgery. So, I want to talk about that study today. And joining me for the discussion is Dr. Kathleen Moore, a professor also of obstetrics and gynecology at the University of Oklahoma and the deputy director of the Stephenson Cancer Center, also at the University of Oklahoma Health Sciences.  Dr. Moore, it is so great to be speaking with you today. Thanks for doing this. Dr. Kathleen Moore: Yeah, it's fun to be here. This is going to be fun. Dr. Linda Duska: FYI for our listeners, both of our full disclosures are available in the transcript of this episode.  So let's just jump right in. We already alluded to the fact that the TRUST study addresses a question we have been grappling with in our field. Here's the thing, we have four prior randomized trials on this exact same topic. So, share with me why we needed another one and what maybe was different about this one? Dr. Kathleen Moore: That is, I think, the key question. So we have to level-set kind of our history. Let's start with, why is this even a question? Like, why are we even talking about this today? When we are taking care of a patient with newly diagnosed ovarian cancer, the aim of surgery in advanced ovarian cancer ideally is to prolong a patient's likelihood of disease-free survival, or if you want to use the term "remission," you can use the term "remission." And I think we can all agree that our objective is to improve overall survival in a way that also does not compromise her quality of life through surgical complications, which can have a big effect. The standard for many decades, certainly my entire career, which is now over 20 years, has been to pursue what we call primary cytoreductive surgery, meaning you get a diagnosis and we go right to the operating room with a goal of achieving what we call "no gross residual." That is very different – in the olden days, you would say "optimal" and get down to some predefined small amount of tumor. Now, the goal is you remove everything you can see.  The alternative strategy to that is neoadjuvant chemotherapy followed by interval cytoreductive surgery, and that has been the, quote-unquote, "safer" route because you chemically cytoreduce the cancer, and so, the resulting surgery, I will tell you, is not necessarily easy at all. It can still be very radical surgeries, but they tend to be less radical, less need for bowel resections, splenectomy, radical procedures, and in a short-term look, would be considered safer from a postoperative consideration. Dr. Linda Duska: Well, and also maybe more likely to be successful, right? Because there's less disease, maybe, theoretically. Dr. Kathleen Moore: More likely to be successful in getting to no gross residual. Dr. Linda Duska: Right. Yeah, exactly. Dr. Kathleen Moore: I agree with that. And so, so if the end game, regardless of timing, is you get to no gross residual and you help a patient and there's no difference in overall survival, then it's a no-brainer. We would not be having this conversation. But there remains a question around, while it may be more likely to get to no gross residual, it may be, and I think we can all agree, a less radical, safer surgery, do you lose survival in the long term by this approach? This has become an increasing concern because of the increase in rates of use of neoadjuvant, not only in this country, but abroad. And so, you mentioned the four prior studies. We will not be able to go through them completely. Dr. Linda Duska: Let's talk about the two modern ones, the two from 2020 because neither one of them showed a difference in overall survival, which I think we can agree is, at the end of the day, yes, PFS would be great, but OS is what we're looking for. Dr. Kathleen Moore: OS is definitely what we're looking for. I do think a marked improvement in PFS, like a real prolongation in disease-free survival, for me would be also enough. A modest improvement does not really cut it, but if you are really, really prolonging PFS, you should see that-  Dr. Linda Duska: -manifest in OS. Dr. Kathleen Moore: Yeah, yeah. Okay. So let's talk about the two modern ones. The older ones are EORTC and CHORUS, which I think we've talked about. The two more modern ones are SCORPION and JCOG0602. So, SCORPION was interesting. SCORPION was a very small study, though. So one could say it's underpowered. 170 patients. And they looked at only patients that were incredibly high risk. So, they had to have a Fagotti score, I believe, of over 9, but they were not looking at just low volume disease. Like, those patients were not enrolled in SCORPION. It was patients where you really were questioning, "Should I go to the OR or should I do neoadjuvant? Like, what's the better thing?" It is easy when it's low volume. You're like, "We're going." These were the patients who were like, "Hm, you know, what should I do?" High volume. Patients were young, about 55. The criticism of the older studies, there are many criticisms, but one of them is that, the criticism that is lobbied is that they did not really try. Whatever surgery you got, they did not really try with median operative times of 180 minutes for primary cytoreduction, 120 for neoadjuvant. Like, you and I both know, if you're in a big primary debulking, you're there all day. It's 6 hours. Dr. Linda Duska: Right, and there was no quality control for those studies, either. Dr. Kathleen Moore: No quality control. So, SCORPION, they went 451-minute median for surgery. Like, they really went for it versus four hours and then 253 for the interval, 4 hours. They really went for it on both arms. Complete gross resection was achieved in 50% of the primary cytoreduced. So even though they went for it with these very long surgeries, they only got to the goal half the time. It was almost 80% in the interval group. So they were more successful there. And there was absolutely no difference in PFS or OS. They were right about 15 months PFS, right about 40 months OS.  JCOG0602, of course, done in Japan, a big study, 300 patients, a little bit older population. Surprisingly more stage IV disease in this study than were in SCORPION. SCORPION did not have a lot of stage IV, despite being very bulky tumors. So a third of patients were stage IV. They also had relatively shorter operative times, I would say, 240 minutes for primary, 302 for interval. So still kind of short. Complete gross resection was not achieved very often. 30% of primary cytoreduction. That is not acceptable. Dr. Linda Duska: Well, so let's talk about TRUST. What was different about TRUST? Why was this an important study for us to see? Dr. Kathleen Moore: So the criticism of all of these, and I am not trying to throw shade at anyone, but the criticism of all of these is if you are putting surgery to the test, you are putting the surgeon to the test. And you are assuming that all surgeons are trained equally and are willing to do what it takes to get someone to no gross residual. Dr. Linda Duska: And are in a center that can support the post-op care for those patients. Dr. Kathleen Moore: Which can be ICU care, prolonged time. Absolutely. So when you just open these broadly, you're assuming everyone has the surgical skills and is comfortable doing that and has backup. Everybody has an ICU. Everyone has a blood bank, and you are willing to do that. And that assumption could be wrong. And so what TRUST said is, "Okay, we are only going to open this at centers that have shown they can achieve a certain level of primary cytoreduction to no gross residual disease." And so there was quality criteria. It was based on – it was mostly a European study – so ESGO criteria were used to only allow certified centers to participate. They had to have a surgical volume of over 36 cytoreductive surgeries per year. So you could not be a low volume surgeon. Your complete resection rates that were reported had to be greater than 50% in the upfront setting. I told you on the JCOG, it was 30%. Dr. Linda Duska: Right. So these were the best of the best. This was the best possible surgical situation you could put these patients in, right? Dr. Kathleen Moore: Absolutely. And you support all the things so you could mitigate postoperative complications as well. Dr. Linda Duska: So we are asking the question now again in the ideal situation, right? Dr. Kathleen Moore: Right. Dr. Linda Duska: Which, we can talk about, may or may not be generalizable to real life, but that's a separate issue because we certainly don't have those conditions everywhere where people get cared for with ovarian cancer. But how would you interpret the results of this study? Did it show us anything different? Dr. Kathleen Moore: I am going to say how we should interpret it and then what I am thinking about. It is a negative study. It was designed to show improvement in overall survival in these ideal settings in patients with FIGO stage IIIB and C, they excluded A, these low volume tumors that should absolutely be getting surgery. So FIGO stage IIIB and C and IVA and B that were fit enough to undergo radical surgery randomized to primary cytoreduction or neoadjuvant with interval, and were all given the correct chemo. Dr. Linda Duska: And they were allowed bevacizumab and PARP, also. They could have bevacizumab and PARP. Dr. Kathleen Moore: They were allowed bevacizumab and PARP. Not many of them got PARP, but it was distributed equally, so that would not be a confounder. And so that was important. Overall survival is the endpoint. It was a big study. You know, it was almost 600 patients. So appropriately powered. So let's look at what they reported. When they looked at the patients who were enrolled, this is a large study, almost 600 patients, 345 in the primary cytoreductive arm and 343 in the neoadjuvant arm. Complete resection in these patients was 70% in the primary cytoreductive arm and 85% in the neoadjuvant arm. So in both arms, it was very high. So your selection of site and surgeon worked. You got people to their optimal outcome. So that is very different than any other study that has been reported to date. But what we saw when we looked at overall survival was no statistical difference. The median was, and I know we do not like to talk about medians, but the median in the primary cytoreductive arm was 54 months versus 48 months in the neoadjuvant arm with a hazard ratio of 0.89 and, of course, the confidence interval crossed one. So this is not statistically significant. And that was the primary endpoint. Dr. Linda Duska: I know you are getting to this. They did look at PFS, and that was statistically significant, but to your point about what are we looking for for a reasonable PFS difference? It was about two months difference. When I think about this study, and I know you are coming to this, what I thought was most interesting about this trial, besides the fact that the OS, the primary endpoint was negative, was the subgroup analyses that they did. And, of course, these are hypothesis-generating only. But if you look at, for example, specifically only the stage III group, that group did seem to potentially, again, hypothesis generating, but they did seem to benefit from upfront surgery.  And then one other thing that I want to touch on before we run out of time is, do we think it matters if the patient is BRCA germline positive? Do we think it matters if there is something in particular about that patient from a biomarker standpoint that is different? I am hopeful that more data will be coming out of this study that will help inform this. Of course, unpowered, hypothesis-generating only, but it's just really interesting. What do you think of their subset analysis? Dr. Kathleen Moore: Yeah, I think the subsets are what we are going to be talking about, but we have to emphasize that this was a negative trial as designed. Dr. Linda Duska: Absolutely. Yes. Dr. Kathleen Moore: So we cannot be apologists and be like, "But this or that." It was a negative trial as designed. Now, I am a human and a clinician, and I want what is best for my patients. So I am going to, like, go down the path of subset analyses. So if you look at the stage III tumors that got complete cytoreduction, which was 70% of the cases, your PFS was almost 28 months versus 21.8 months. Dr. Linda Duska: Yes, it becomes more significant. Dr. Kathleen Moore: Yeah, that hazard ratio is 0.69. Again, it is a subset. So even though the P value here is statistically significant, it actually should not have a P value because it is an exploratory analysis. So we have to be very careful. But the hazard ratio is 0.69. So the hypothesis is in this setting, if you're stage III and you go for it and you get someone to no gross residual versus an interval cytoreduction, you could potentially have a 31% reduction in the rate of progression for that patient who got primary cytoreduction. And you see a similar trend in the stage III patients, if you look at overall survival, although the post-progression survival is so long, it's a little bit narrow of a margin.  But I do think there are some nuggets here that, one of our colleagues who is really one of the experts in surgical studies, Dr. Mario Leitao, posted this on X, and I think it really resonated after this because we were all saying, "But what about the subsets?" He is like, "It's a negative study." But at the end of the day, you are going to sit with your patient. The patient should be seen by a GYN oncologist or surgical oncologist with specialty in cytoreduction and a medical oncologist, you know, if that person does not give chemo, and the decision should be made about what to do for that individual patient in that setting. Dr. Linda Duska: Agreed. And along those lines, if you look carefully at their data, the patients who had an upfront cytoreduction had almost twice the risk of having a stoma than the patients who had an interval cytoreduction. And they also had a higher risk of needing to have a bowel resection. The numbers were small, but still, when you look at the surgical complications, as you've already said, they're higher in the upfront group than they are in the interval group. That needs to be taken into account as well when counseling a patient, right? When you have a patient in front of you who says to you, "Dr. Moore, you can take out whatever you want, but whatever you do, don't make me a bag." As long as the patient understands what that means and what they're asking us to do, I think that we need to think about that. Dr. Kathleen Moore: I think that is a great point. And I have definitely seen in our practice, patients who say, "I absolutely would not want an ostomy. It's a nonstarter for me." And we do make different decisions. And you have to just say, "That's the decision we've made," and you kind of move on, and you can't look back and say, "Well, I wish I would have, could have, should have done something else." That is what the patient wants. Ultimately, that patient, her family, autonomous beings, they need to be fully counseled, and you need to counsel that patient as to the site that you are in, her volume of disease, and what you think you can achieve. In my opinion, a patient with stage III cancer who you have the site and the capabilities to get to no gross residual should go to the OR first. That is what I believe. I do not anymore think that for stage IV. I think that this is pretty convincing to me that that is probably a harmful thing. However, I want you to react to this. I think I am going to be a little unpopular in saying this, but for me, one of the biggest take-homes from TRUST was that whether or not, and we can talk about the subsets and the stage III looked better, and I think it did, but both groups did really well. Like, really well. And these were patients with large volume disease. This was not cherry-picked small volume stage IIIs that you could have done an optimal just by doing a hysterectomy. You know, these were patients that needed radical surgery. And both did well. And so what it speaks to me is that anytime you are going to operate on someone with ovary, whether it be frontline, whether it be a primary or interval, you need a high-volume surgeon. That is what I think this means to me. Like, I would want high volume surgeon at a center that could do these surgeries, getting that patient, my family member, me, to no gross residual. That is important. And you and I are both in training centers. I think we ought to take a really strong look at, are we preparing people to do the surgeries that are necessary to get someone to no gross residual 70% and 85% of the time? Dr. Linda Duska: We are going to run out of time, but I want to address that and ask you a provocative question. So, I completely agree with what you said, that surgery is important. But I also think one of the reasons these patients in this study did so well is because all of the incredible new therapies that we have for patients. Because OS is not just about surgery. It is about surgery, but it is also about all of the amazing new therapies we have that you and others have helped us to get through clinical research. And so, how much of that do you think, like, for example, if you look at the PFS and OS rates from CHORUS and EORTC, I get it that they're, that they're not the same. It's different patients, different populations, can't do cross-trial comparisons. But the OS, as you said, in this study was 54 months and 48 months, which is, compared to 2010, we're doing much, much better. It is not just the surgery, it is also all the amazing treatment options we have for these patients, including PARP, including MIRV, including lots of other new therapies. How do you fit that into thinking about all of this? Dr. Kathleen Moore: I do think we are seeing, and we know this just from epidemiologic data that the prevalence of ovarian cancer in many of the countries where the study was done is increasing, despite a decrease in incidence. And why is that? Because people are living longer. Dr. Linda Duska: People are living longer, yeah. Dr. Kathleen Moore: Which is phenomenal. That is what we want. And we do have, I think, better supportive care now. PARP inhibitors in the frontline, which not many of these patients had. Now some of them, this is mainly in Europe, will have gotten them in the first maintenance setting, and I do think that impacts outcome. We do not have that data yet, you know, to kind of see what, I would be really interested to see. We do not do this well because in ovarian cancer, post-progression survival can be so long, we do not do well of tracking what people get when they come off a clinical trial to see how that could impact – you know, how many of them got another surgery? How many of them got a PARP? I think this group probably missed the ADC wave for the most part, because this, mirvetuximab is just very recently available in Europe. Dr. Linda Duska: Unless they were on trial. Dr. Kathleen Moore: Unless they were on trial. But I mean, I think we will have to see. 600 patients, I would bet a lot of them missed the ADC wave. So, I do not know that we can say we know what drove these phenomenal – these are some of the best curves we've seen outside of BRCA. And then coming back to your point about the BRCA population here, that is a really critical question that I do not know that we're ever going to answer. There have been hypotheses around a tumor that is driven by BRCA, if you surgically cytoreduced it, and then chemically cytoreduced it with chemo, and so you're starting PARP with nothing visible and likely still homogeneous clones. Is that the group we cured? And then if you give chemo first before surgery, it allows more rapid development of heterogeneity and more clonal evolution that those are patients who are less likely to be cured, even if they do get cytoreduced to nothing at interval with use of PARP inhibitor in the front line. That is a question that many have brought up as something we would like to understand better. Like, if you are BRCA, should you always just go for it or not? I do not know that we're ever going to really get to that. We are trying to look at some of the other studies and just see if you got neoadjuvant and you had BRCA, was anyone cured? I think that is a question on SOLO1 I would like to know the answer to, and I don't yet, that may help us get to that. But that's sort of something we do think about. You should have a fair number of them in TRUST. It wasn't a stratification factor, as I remember. Dr. Linda Duska: No, it wasn't. They stratified by center, age, and ECOG status Dr. Kathleen Moore: So you would hope with randomization that you would have an equal number in each arm. And they may be able to pull that out and do a very exploratory look. But I would be interested to see just completely hypothesis-generating what this looks like for the patients with BRCA, and I hope that they will present that. I know they're busy at work. They have translational work. They have a lot pending with TRUST. It's an incredibly rich resource that I think is going to teach us a lot, and I am excited to see what they do next. Dr. Linda Duska: So, outside of TRUST, we are out of time. I just want to give you a moment if there were any other messages that you want to share with our listeners before we wrap up. Dr. Kathleen Moore: It's an exciting time to be in GYN oncology. For so long, it was just chemo, and then the PARP inhibitors nudged us along quite a bit. We did move more patients, I believe, to the cure fraction. When we ultimately see OS, I think we'll be able to say that definitively, and that is exciting. But, you know, that is the minority of our patients. And while HRD positive benefits tremendously from PARP, I am not as sure we've moved as many to the cure fraction. Time will tell. But 50% of our patients have these tumors that are less HRD. They have a worse prognosis. I think we can say that and recur more quickly. And so the advent of these antibody-drug conjugates, and we could name 20 of them in development in GYN right now, targeting tumor-associated antigens because we're not really driven by mutations other than BRCA. We do not have a lot of things to come after. We're not lung cancer. We are not breast cancer. But we do have a lot of proteins on the surface of our cancers, and we are finally able to leverage that with some very active regimens. And we're in the early phases, I would say, of really understanding how best to use those, how best to position them, and which one to select for whom in a setting where there is going to be obvious overlap of the targets. So we're going to be really working this problem. It is a good problem. A lot of drugs that work pretty well. How do you individualize for a patient, the patient in front of you with three different markers? How do you optimize it? Where do you put them to really prolong survival? And then we finally have cell surface. We saw at ASCO, CDK2 come into play here for the first time, we've got a cell cycle inhibitor. We've been working on WEE1 and ATR for a long time. CDK2s may hit. Response rates were respectable in a resistant population that was cyclin E overexpressing. We've been working on that biomarker for a long time with a toxicity profile that was surprisingly clean, which I like to see for our patients. So that is a different platform. I think we have got bispecifics on the rise. So there is a pipeline of things behind the ADCs, which is important because we need more than one thing, that makes me feel like in the future, I am probably not going to be using doxil ever for platinum-resistant disease. So, I am going to be excited to retire some of those things. We will say, "Remember when we used to use doxil for platinum-resistant disease?" Dr. Linda Duska: I will be retired by then, but thanks for that thought. Dr. Kathleen Moore: I will remind you. Dr. Linda Duska: You are right. It is such an incredibly exciting time to be taking care of ovarian cancer patients with all the opportunities.  And I want to thank you for sharing your valuable insights with us on this podcast today and for your great work to advance care for patients with GYN cancers. Dr. Kathleen Moore: Likewise. Thanks for having me. Dr. Linda Duska: And thank you to our listeners for your time today. You will find links to the TRUST study and other studies discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. More on today's speakers:   Dr. Linda Duska  @Lduska Dr. Kathleen Moore Follow ASCO on social media:     @ASCO on X (formerly Twitter) ASCO on Bluesky   ASCO on Facebook     ASCO on LinkedIn     Disclosures of Potential Conflicts of Interest:    Dr. Linda Duska:   Consulting or Advisory Role: Regeneron, Inovio Pharmaceuticals, Merck, Ellipses Pharma  Research Funding (Inst.): GlaxoSmithKline, Millenium, Bristol-Myers Squibb, Aeterna Zentaris, Novartis, Abbvie, Tesaro, Cerulean Pharma, Aduro Biotech, Advaxis, Ludwig Institute for Cancer Research, Leap Therapeutics  Patents, Royalties, Other Intellectual Property: UptToDate, Editor, British Journal of Ob/Gyn  Dr. Kathleen Moore: Leadership: GOG Partners, NRG Ovarian Committee Chair Honoraria: Astellas Medivation, Clearity Foundation, IDEOlogy Health, Medscape, Great Debates and Updates, OncLive/MJH Life Sciences, MD Outlook, Curio Science, Plexus, University of Florida, University of Arkansas for Medical Sciences, Congress Chanel, BIOPHARM, CEA/CCO, Physician Education Resource (PER), Research to Practice, Med Learning Group, Peerview, Peerview, PeerVoice, CME Outfitters, Virtual Incision Consulting/Advisory Role: Genentech/Roche, Immunogen, AstraZeneca, Merck, Eisai, Verastem/Pharmacyclics, AADi, Caris Life Sciences, Iovance Biotherapeutics, Janssen Oncology, Regeneron, zentalis, Daiichi Sankyo Europe GmbH, BioNTech SE, Immunocore, Seagen, Takeda Science Foundation, Zymeworks, Profound Bio, ADC Therapeutics, Third Arc, Loxo/Lilly, Bristol Myers Squibb Foundation, Tango Therapeutics, Abbvie, T Knife, F Hoffman La Roche, Tubulis GmbH, Clovis Oncology, Kivu, Genmab/Seagen, Kivu, Genmab/Seagen, Whitehawk, OnCusp Therapeutics, Natera, BeiGene, Karyopharm Therapeutics, Day One Biopharmaceuticals, Debiopharm Group, Foundation Medicine, Novocure Research Funding (Inst.): Mersana, GSK/Tesaro, Duality Biologics, Mersana, GSK/Tesaro, Duality Biologics, Merck, Regeneron, Verasatem, AstraZeneca, Immunogen, Daiichi Sankyo/Lilly, Immunocore, Torl Biotherapeutics, Allarity Therapeutics, IDEAYA Biosciences, Zymeworks, Schrodinger Other Relationship (Inst.): GOG Partners

Linda Schatz, Director of AKASA, explains the role of Clinical Documentation Integrity (CDI) specialists in ensuring accurate coding and bridging the gap between clinical documentation and specific, accurate codes to ensure proper reimbursement. The complexity of medical coding often leads to errors, which can be nearly eliminated by using AI to review 100% of patient encounters to identify inconsistencies and help CDI and coding professionals process more accurate claims quickly. Accurate documentation is important for hospital revenue, patient care quality, and perception of the hospital's performance. Linda explains, "Well, the old adage, if it isn't documented, it wasn't done. If the doctor uses incorrect or perfectly acceptable medical terminology, it doesn't translate into an appropriate code. You've heard the term UIs, this is years ago, right? Grandma had UTIs and died. In the coding world, that used to code for a simple UTI. So the hospitals are getting paid for a patient that took care of a UTI, when in reality that patient was septic. To the outside world, it looks like Grandma came to the hospital, something that could have been treated outpatient, and she died. So the public perception of quality is less. So not only is it revenue, it's quality, but ultimately it's delivering patient care."   "I'm an old nurse. I've been in this field for over 40 years. I've worked across the NICU, PICU, and adult ICU. I've worked in access hospitals to large academics and all the way through hospice. That's pretty unique as a nurse to have that big of a background. Then I became a CDS, or clinical documentation specialist, or integrity specialist, and learned the documentation and coding aspect." "Then I moved into the consulting role and worked with organizations and physicians all across this nation, helping them learn how to do this. And so you've got the clinical background, the coding background, and now I understand how generative AI works. And so while you're a new nurse, you're a horse, right? When we hear a heartbeat, we think of a horse, and after years, you earn your stripes and you become a zebra, and then you add all of these multiple areas of expertise, you become uniquely valuable as a pink zebra."  #AKASA #GenAI #CDI #RevenueCycleManagement akasa.com Listen to the podcast here

Linda Schatz, Director of AKASA, explains the role of Clinical Documentation Integrity (CDI) specialists in ensuring accurate coding and bridging the gap between clinical documentation and specific, accurate codes to ensure proper reimbursement. The complexity of medical coding often leads to errors, which can be nearly eliminated by using AI to review 100% of patient encounters to identify inconsistencies and help CDI and coding professionals process more accurate claims quickly. Accurate documentation is important for hospital revenue, patient care quality, and perception of the hospital's performance. Linda explains, "Well, the old adage, if it isn't documented, it wasn't done. If the doctor uses incorrect or perfectly acceptable medical terminology, it doesn't translate into an appropriate code. You've heard the term UIs, this is years ago, right? Grandma had UTIs and died. In the coding world, that used to code for a simple UTI. So the hospitals are getting paid for a patient that took care of a UTI, when in reality that patient was septic. To the outside world, it looks like Grandma came to the hospital, something that could have been treated outpatient, and she died. So the public perception of quality is less. So not only is it revenue, it's quality, but ultimately it's delivering patient care."   "I'm an old nurse. I've been in this field for over 40 years. I've worked across the NICU, PICU, and adult ICU. I've worked in access hospitals to large academics and all the way through hospice. That's pretty unique as a nurse to have that big of a background. Then I became a CDS, or clinical documentation specialist, or integrity specialist, and learned the documentation and coding aspect." "Then I moved into the consulting role and worked with organizations and physicians all across this nation, helping them learn how to do this. And so you've got the clinical background, the coding background, and now I understand how generative AI works. And so while you're a new nurse, you're a horse, right? When we hear a heartbeat, we think of a horse, and after years, you earn your stripes and you become a zebra, and then you add all of these multiple areas of expertise, you become uniquely valuable as a pink zebra."  #AKASA #GenAI #CDI #RevenueCycleManagement akasa.com Download the transcript here

A man goes into a coma, wakes up totally paralyzed, gets fired from his job in the hospital… and somehow his investments are doing better than before.In this episode, AJ Osborne walks us through the day his body shut down from Guillain-Barré syndrome, what it felt like to wake up trapped in his own head, and the moment he realized his real estate investments were quietly keeping his family afloat while he fought to stay alive. He talks about the guilt, the pain, the look on his kids' faces the first time they saw him in the ICU—and the pride of knowing he'd built something that took care of them when he couldn't.From there, we dig into how that experience reshaped his entire mission: why he doubled down on self-storage, how he built a business that works without him, and why most people are stuck on the “earn a paycheck, hope it works out” treadmill. AJ breaks down supply and demand in housing and storage in plain English, what investors get wrong about cycles, and why owning assets (not just having a job) is the real line between security and chaos.We also get into working with family (without blowing it up), why the education system trains employees instead of owners, and how younger investors can still win in a world of high prices, high rates, and wild inequality—if they're willing to change the playbook.If this conversation punches you in the gut a little, don't just nod and move on. Share this episode with someone who's depending 100% on their job, then take one concrete step toward owning an asset this week—no matter how small. To learn more or connect with AJ, visit cedarcreekcapital.com or find him on Instagram and YouTube by searching “AJ Osborne Self Storage” or “Cedar Creek Capital.” And make sure you're subscribed to REIA Radio and plugged into your local REIA so you're not trying to figure this game out alone.You can Join the Omaha REIA - https://omahareia.com/join-todayOmaha REIA on Facebook - https://www.facebook.com/groups/OmahaREIACheck out the National REIA - https://nationalreia.org/ Find Ted Kaasch at www.tedkaasch.com Owen Dashner on Facebook https://www.facebook.com/owen.dashner Instagram - https://www.instagram.com/odawg2424/ Red Ladder Property Solutions - www.sellmyhouseinomahafast.com Liquid Lending Solutions - www.liquidlendingsolutions.com Owen's Blogs - www.otowninvestor.com www.reiquicktips.com Propstream - https://trial.propstreampro.com/reianebraska/Timber Creek Virtual - https://timbercreekvirtual.com/services/MagicDoor - https://magicdoor.com/reia/...

What do you do when life suddenly takes an unwanted turn? In Season 12, Episode 2 of the Candace Cameron Bure Podcast, Candace and co-host Ruth Chou Simons talk about crisis, grief, and depending on God when life feels out of control. Ruth shares the story of her son Judah's mountain biking accident and how God met her in the ICU. Candace opens up about her 10-year break from acting, the fear she'd never work again, and how God used that season to deepen her understanding of the gospel. They also discuss motherhood, grief, identity, and freedom from anxiety through Christ. Listener questions include how to keep faith during a cancer diagnosis and how to find motivation to live when life is falling apart.   00:00 – Tour announcement 03:10 – Season 12 intro 05:00 – How Candace and Ruth met 10:30 – Motherhood is sanctifying 14:30 – Judah's accident 21:30 – Preparing your heart for crisis 24:30 – Candace's 10-year hiatus 28:30 – When the gospel “clicked” 33:00 – Grief & eternal hope 37:00 – Listener Q: cancer diagnosis 41:00 – Listener Q: no motivation to live 45:00 – Advent guide + Together Community • Download the free Advent guide at Candace.com  • Submit questions at Candace.com  • Join The Together Community at Candace.com/together  • Subscribe, like, and comment on YouTube  Connect with Candace and Ruth Candace on Instagram @candacecbure  Follow the Podcast on Instagram @candacecameronburepodcast  Follow the Podcast on TikTok @ccbpodcast Follow Ruth Chou Simons on Instagram: @ruthchousimons Website: https://ruthchousimons.com/ YouTube: https://www.youtube.com/c/RuthChouSimons Sponsors For This Episode  -Grand Canyon University: https://www.gcu.edu/ -WeShare weshare.org/candace -Harper Collins nivapplicationbible.com -IFCJ ifcj.org-A'Del Natural Cosmetics https://adelnaturalcosmetics.com/ Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Joe Moore sits down with Dr. Jason Konner, a longtime oncologist who recently left his full-time clinical role at Memorial Sloan Kettering to devote himself to the emerging intersection of cancer care and psychedelics. Dr Konner shares how, after more than two decades treating people, he hit a wall. The accumulated grief, constant exposure to death, and intensity of oncology left him deeply burned out, though he didn't have that language for it at the time. A chance moment in a yoga class, overhearing someone say "ayahuasca retreat" just before he was scheduled for hernia surgery, became the turning point. Within a week, he was in the jungle. That first week with ayahuasca, followed later by work with mushrooms, "absolutely transformed" his life. His fear of death lifted. The burnout he hadn't even recognized in himself was both revealed and relieved. When he returned to his practice, Konner describes feeling like he suddenly had a "superpower": he could stay present, connected, and compassionate with patients facing advanced disease without collapsing under the emotional weight. He and Joe explore what this third path looks like: not the classic binary between either hardening and distancing as self-protection, or staying open-hearted and getting shattered. Instead, psychedelics helped him hold deep relationship with patients and families while maintaining inner stability and meaning. This opened space for authentic conversations about spirituality, fear, grief, and what it means to live with (or die from) cancer. From there, Dr Konner zooms out to critique the broader oncology system: The lack of training and support for oncologists around their own emotional and existential load, How little space there is for relational work even though it's central to healing, Why many support groups and standard psychiatric approaches (like reflexively prescribing SSRIs) often miss the mark for people dealing with cancer, How caregivers, partners, family members, and others are deeply affected but rarely truly supported. Joe and Jason then dig into psychedelics and oncology as a frontier: easing existential distress in patients with terminal cancer, the neglected suffering of caregivers, the potential role of psychedelics in helping people relate differently to death, and what it might mean for ICU use, aggressive end-of-life interventions, and overall healthcare costs if more people could make decisions from a place of peace rather than terror. Dr Konner also shares a striking ovarian cancer case that hinted at powerful immune changes after shamanic work, and why he believes we need new research paradigms that can honor the integrity of retreat and ceremonial settings while still learning from them. Finally, he talks about his early-stage project, Psychedelic Oncology, and his hope that the first wave of change starts with clinicians themselves becoming more psychedelic-literate—and, where appropriate, doing their own inner work—so better options can eventually reach the people who need them most. Learn more - https://psychedeliconcology.com/

“OMM helps us look beyond the place where pain shows up and understand what may be contributing to it.” —Dr. Drew RoseIn this episode of the Real Health Podcast, Ron Hunninghake, MD, sits down with Drew Rose, DO, to explore how Osteopathic Manipulative Medicine (OMM) offers a hands-on way of understanding the body's structure and movement patterns. Dr. Drew explains how structure and function are interconnected, why touch can offer insight that standard testing may not provide, and how OMM can be used as part of an individualized approach for people navigating chronic pain, headaches, fatigue, inflammatory conditions, COPD, fibromyalgia, and other complex concerns.He also shares lessons from his years practicing hospital and ICU medicine, including why one-size-fits-all care often falls short—and how osteopathic principles offer a deeper perspective on what the body may be signaling.Highlights include:→ What OMM is and how it differs from chiropractic care→ Why osteopathic medicine focuses on structure and function→ How foot and gait mechanics can influence low back pain→ What NASA research revealed about cranial motion→ How hands-on assessment can offer a different perspective than imaging alone→ Using OMM within individualized care for chronic and complex concerns→ The role of lymphatic flow, fascia, and subtle motion→ How OMM complements the Riordan Clinic approach to whole-person careAbout Drew Rose, DODrew Rose, DO, is an internal medicine physician with advanced training in Osteopathic Manipulative Medicine. Before joining Riordan Clinic, he spent six years practicing hospital and ICU medicine in Kansas. He brings a whole-person, hands-on approach to patient care, integrating structural evaluation, osteopathic principles, and nutritional insights to support alignment, mobility, and overall well-being. Learn more about Dr. Drew or schedule a new patient appointment.Episode Links & ResourcesLearn more about the Riordan ClinicListen to more episodes of the Real Health PodcastEpisode Chapters00:00 Welcome + introducing OMM01:10 MD vs DO vs chiropractic training02:46 Structure, function, and whole-body evaluation04:18 Low back pain and the kinetic chain06:01 Foot mechanics and alignment07:34 Cranial motion, NASA research, and headaches10:14 OMM and migraines12:19 Foundational osteopathic principles14:11 OMM in chronic and complex experience17:22 Nervous system sensitization and subtle motion20:05 Individualized care in hospital medicine22:12 How OMM complements whole-person careDisclaimerThe information contained on the Real Health Podcast and the resources mentioned are for educational purposes only. They are not intended as and shall not be understood or construed as medical or health advice. The information contained on this podcast is not a substitute for medical or health advice from a professional who is aware of the facts and circumstances of your individual situation. Information provided by hosts and guests on the Real Health Podcast or the use of any products or services mentioned does not create a practitioner-patient relationship between you and any persons affiliated with this podcast.Topics we explore in this episode:osteopathic medicine, OMM, osteopathic manipulative medicine, cranial motion, cranial rhythmic impulse, chronic pain, migraines, headaches, low back pain, gait mechanics, kinetic chain, lymphatic flow, fascia, COPD, fibromyalgia, chronic fatigue, integrative medicine, functional medicine, hands-on medicine, individualized care, whole-person health, Riordan Clinic providers, structural alignment, root-cause perspective

Thomas Crooks may have identified as non-binary. Ted Cruz sets stage for 2028. Paul Finebaum maybe closer to Senate Run. Operation Charlotte Web. Rev. Jesse Jackson moved out of ICU. Could Alabama Public Television cut ties with PBS.See omnystudio.com/listener for privacy information.

Thomas Crooks may have identified as non-binary. Ted Cruz sets stage for 2028. Paul Finebaum maybe closer to Senate Run. Operation Charlotte Web. Rev. Jesse Jackson moved out of ICU. Could Alabama Public Television cut ties with PBS.See omnystudio.com/listener for privacy information.

Thomas Crooks may have identified as non-binary. Ted Cruz sets stage for 2028. Paul Finebaum maybe closer to Senate Run. Operation Charlotte Web. Rev. Jesse Jackson moved out of ICU. Could Alabama Public Television cut ties with PBS.See omnystudio.com/listener for privacy information.

Thomas Crooks may have identified as non-binary. Ted Cruz sets stage for 2028. Paul Finebaum maybe closer to Senate Run. Operation Charlotte Web. Rev. Jesse Jackson moved out of ICU. Could Alabama Public Television cut ties with PBS.See omnystudio.com/listener for privacy information.

If you've ever felt trapped by stress or grief, episode 388 of Grief and Happiness offers a science-backed way out. Stanford physician Dr. Greg Hammer shares the four-step practice that helped him find peace after losing his son—and that can rewire your brain for calm and gratitude. Blending neuroscience, mindfulness, and lived experience, he proves that happiness isn't luck—it's something you can train.In This Episode, You Will Learn:(01:01) Dr. Greg Hammer's path from ICU medicine to mindfulness and wellness(03:37) Why A Mindful Teen was written for parents, not teens(04:32) The modern pressures today's teens face—and how to help(07:21) The GAIN method: Gratitude, Acceptance, Intention, Non-Judgment(10:40) How acceptance helped Dr. Hammer heal after losing his son(15:51) The science behind mindful breathing and calm(19:47) How listing “three good things” boosts happiness and sleep(22:50) Facing grief vs. suppressing it—how to tell the difference(27:40) Healing through writing letters to lost loved ones(29:44) Why parents must model gratitude and openness(37:51) Forgiving yourself and letting go of judgment(43:20) Why most of what we stress about doesn't matterDr. Greg Hammer is a Stanford physician, wellness expert, and bestselling author devoted to helping people build happiness and resilience through mindfulness and science. After 35 years as a professor and pediatric intensive-care specialist at Stanford, he shifted his focus to stress reduction and well-being. His book Gain Without Pain introduced the GAIN method—Gratitude, Acceptance, Intention, and Non-Judgment—as a practical path to balance and fulfillment, followed by A Mindful Teen, guiding parents and educators to better support today's youth.In this episode, Dr. Hammer shares how his GAIN practice turns grief, stress, and self-criticism into calm and connection. Drawing on personal loss and decades of experience, he shows how gratitude and acceptance can rewire the brain toward positivity, and how mindful breathing resets the body by activating the vagus nerve. Addressing modern teen pressures—from social media to anxiety about the future—he urges adults to lead by example through compassion, presence, and forgiveness.Connect with Dr. Greg Hammer:WebsiteA Mindful Teen WebsiteLinkedInInstagramYouTubeLet's Connect: WebsiteLinkedInFacebookInstagramTwitterThe Grief and Happiness AllianceBook: Loving and Living Your Way Through Grief Hosted on Acast. See acast.com/privacy for more information.

For those who work in an ICU - or with any patients for that matter -the concepts of burnout and moral injury are no stranger. In order to mitigate the effects of these forces, it's important to understand them. Join Nick and Cyrus, as they sit down with an incredible guest, Dr. Venktesh Ramnath, with the hopes of doing just that. On this episode we step away from the pressors and central lines and focus on the contributors to burn out and moral injury in the medical field while developing some strategies to combat them. Listen, watch, learn and let us know what you think! Hosted on Acast. See acast.com/privacy for more information.

John Stewart Hill, founder of The Good Contractors List, who, in 2011, was broke, hopeless, and praying for death during a deep personal crisis. That moment of despair culminated in a massive heart attack. As he was wheeled into the ICU, he heard a clear, life-altering voice: “Well, John, do you want to stay or go?”John shares the three simple requests he made upon surrendering his life, requests that led him—despite having no money or business experience—to found a company that has since backed over $5 billion in projects. Learn how he built a "Kingdom-minded" business model focused on integrity, proving that faith can restore trust in the darkest of industries.The story doesn't end there. In 2022, John received a heart transplant, only to discover his donor was named Christian Wachal (Wachal means "Watchman"). John literally carries the heart of a Christian Watchman.In this powerful interview, you will hear:How to turn tragedy into purpose and business into ministry.The profound power of surrender—and how it unlocks success even when you feel unqualified.The meaning behind building for God's glory, not your own.This conversation offers hope to anyone who feels disqualified or forgotten. Hit subscribe and let John Stewart Hill inspire you to start living your true purpose. Available on all podcast streaming services:spotify: https://open.spotify.com/show/71jAuFEpE62eXOJQsQmx74apple podcast: https://podcasts.apple.com/us/podcast/the-highest-point-podcast/id1573678608pandora: https://pandora.com/podcast/the-highest-point-podcast/PC:1000637890iHeart: https://www.iheart.com/podcast/269-the-highest-point-podcast-83744185/ Support the show:https://www.cash.app/$highestpointenthttps://www.paypal.com/paypalme/highestpointpodcast

Biden's Afghanistan blunder allows the GOP to pivot away from their election insanity and escape culpability from the real story. Mass death is coming to MAGA country. ICU's are full and health care systems on verge of collapse. Kurt Eichenwald joins Mea Culpa to discuss it all. To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices