Podcasts about ICU

In this episode of the NCS Podcast Perspectives series, Nicholas Morris, MD, speaks with Claude Hemphill, MD, MAS, FNCS, professor of neurology and neurological surgery at the University of California, San Francisco, and chief of neurology and director of neurocritical care at Zuckerberg San Francisco General Hospital. Hemphill reflects on the patient encounters that shaped his career, his longstanding focus on intracerebral hemorrhage and the clinical gaps that led to development of the ICH score. He discusses how the score was intended to support communication and risk stratification rather than precise prognostication, and shares insights on early care limitations, ICU culture and the importance of aligning teams around thoughtful, aggressive care when appropriate. The conversation also explores the origins and progress of the Curing Coma® Campaign, including its role in advancing research, driving culture change and fostering collaboration across the continuum of care. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

This episode explores how yoga therapy supports children aged 8–12 with anxiety and self-regulation, including the specific practices, and the effective approach behind Meg Vyas's course on the Breathing Deeply Wellness platform. In this conversation with certified yoga therapist Meg Voss, who has worked with children for 17 years, you'll discover: • Why ages 8–12 is a critical window for learning self-regulation skills • How yoga therapy differs from exercise for anxiety in children • The four pillars of how Meg helps kids self-regulate • A real case study: a 5-year-old in a paediatric ICU who shifted from distress to calm in one session Timestamps 00:00 - Intro 00:28 - Introducing Meg and her work as a yoga therapist 01:16 - What it's like working with children between the ages of 8-12 02:58 - The epidemic of childhood anxiety and how yoga can help 04:40 - The difference between yoga and exercise for self-regulation 06:12 - Meg's course: 4 ways to regulate children with yoga therapy 09:07 - Meg's story working with a child in ICU, how applying yoga therapy practices helped him ease anxiety in just 40 minutes 12:34 - The incredible knowledge Meg has after working with children for 17 years ——— Yoga therapy is a growing clinical field that helps people work with mental health challenges and chronic health conditions using evidence-informed yoga practices. Breathing Deeply Yoga Therapy School provides professional yoga therapy training programs designed to prepare you to work safely and effectively with real clients. Our graduates are trained to work with: • Mental health conditions such as anxiety, depression, and trauma • Chronic conditions, including autoimmune diseases • Chronic pain and musculoskeletal conditions • Fatigue, burnout, and complex long-term health challenges Learn about professional yoga therapy training: https://breathingdeeply.com If you're looking for yoga therapy for your own health, explore Breathing Deeply Wellness: Guided programs, practices, and support for mental health, chronic conditions, and long-term wellbeing. https://breathingdeeply.com/wellness

In today's VETgirl online veterinary continuing education podcast, we review new 2025 data on mechanical ventilation in dogs and explore whether outcomes for patients undergoing positive pressure ventilation are improving. Tune in for a practical look at survival data and what it means for everyday ICU decision-making and conversations with pet owners.

Send a textIn this episode, we sit down with Dr. Jessica Shui, attending neonatologist at Mass General for Children, to explore the game-changing potential of Electrical Impedance Tomography (EIT) in the NICU. We dive into her recent paper in the Journal of Perinatology on using non-invasive EIT to identify optimal PEEP in infants with severe bronchopulmonary dysplasia. Dr. Shui explains how this real-time, radiation-free technology allows clinicians to visualize lung mechanics, dynamically titrate ventilator settings, and confidently reduce PEEP without risking atelectasis. Join us as we discuss moving beyond blind adjustments and stepping into the future of personalized neonatal respiratory care. 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!

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

Can an ICU nurse or a college mascot land a high-six-figure job at Pfizer or Stryker? In this episode of Medical Sales U, I sit down with three successful alumni to deconstruct the exact "pivot" strategies they used to reinvent their careers and land roles at the world's top medical companies.Whether you're a clinician looking for better work-life balance or a recent grad navigating the post-COVID job market, this deep dive reveals the networking secrets and interview "hooks" that actually work in 2026.What You'll Learn in This Episode:The "Network Outer Ring" Strategy: Why the person who hires you is likely already in your phone (and how to reach out without being awkward).From the "Shoe" to Pharma: How Corey leveraged being the Ohio State Mascot to prove his "sales DNA" to Pfizer.The 30-60-90 Day Rule: The specific document Viti used to stand out during the Stryker interview process.OR vs. Diagnostics: Why Ru transitioned from the operating room to Exact Sciences for better consistency and balance.The "3-Minute" Pitch: The exact answer that got a recruiter to say "Be ready for an interview on Tuesday."Timestamps:0:00 – Introduction: Meet the Columbus Crew1:45 – Ru's Story: From Finance & Fitness to Stryker Trauma3:12 – Why Diagnostics? The shift to Exact Sciences4:30 – The Networking Myth: Your "Who" is already there6:50 – Advice for the First 90 Days in a new role8:15 – Corey's Pivot: Transitioning from ICU Nursing to Pfizer10:15 – How to use your "Unique Hook" in an interview11:30 – The Pfizer Interview Process: "Why should I hire you?"14:00 – Viti's Journey: Pivoting from Pre-Med to MedTech16:20 – Mastering the 30-60-90 Day Proposal18:45 – Closing: How to join the Medical Sales U Community Resources Mentioned: The Power of Who by Bob Beaudine.

Most people underestimate the power of resilience—until life forces them to rewire everything. Cameron's story of surviving life-altering brain injury and rediscovering strength behind invisible wounds will challenge what you think is possible.In this episode, Cameron shares his inspiring story of navigating life after a severe TBI caused by bacterial meningitis. Discover how resilience, community, and trusting medical professionals helped him rebuild his life from incredible odds.As You Listen:00:00 - Introduction: Meeting Cameron and his incredible story02:00 - Cameron's background before injury and pride in independence03:50 - The onset of bacterial meningitis and emergency brain surgery08:00 - Cameron's hospital stay, ICU delirium, and recovery journey10:15 - Recognizing the importance of trusting medical professionals11:45 - Navigating relationships and the invisible nature of brain injuries13:30 - Poignant ICU delirium stories15:00 - The significance of rest and patience in healing16:45 - Cameron's advice for new TBI survivors and families18:00 - Dealing with the unpredictability of brain injury recovery19:15 - Connecting with communities and sharing stories for mutual support21:00 - Final thoughts: Gratitude, humility, and the strength to ask for help    

In this special “PICU Doc On Call Shorts” episode, pediatric ICU physicians Dr. Monica Gray, Dr. Pradip Kamat, and Dr. Rahul Damania break down the concept of Mean Arterial Pressure (MAP). Using a case of a six-year-old in septic shock, they discuss how to calculate MAP, normal pediatric values, and the physiological determinants and clinical significance of MAP. The hosts highlight MAP's role in guiding management of critically ill children, review autonomic and endothelial regulation, and reinforce learning with a board-style question. This episode emphasizes practical bedside application for pediatric interns and ICU providers.Show Highlights:Overview of Mean Arterial Pressure (MAP) and its clinical significance in pediatric critical care.Introduction of a clinical case involving a 6-year-old child in septic shock.Explanation of the formula for calculating MAP and its application to the clinical case.Discussion of normal reference values for MAP in children and their clinical implications.Physiological determinants of MAP, including cardiac output and systemic vascular resistance.Role of the autonomic nervous system in regulating MAP through baroreceptor reflexes.Importance of maintaining adequate MAP for organ perfusion, particularly in critically ill patients.Clinical applications of MAP monitoring and management strategies in the PICU.Summary of key takeaways regarding MAP calculation, physiological determinants, and clinical relevance.Mention of related topics, such as invasive versus non-invasive blood pressure monitoring.References:DeMers D, Wachs D. Physiology, Mean Arterial Pressure. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.Pediatric Blood Pressure Metrics and Hypotension Thresholds (details the task force data used to derive the 5th and 50th percentile MAP estimation formulas for children)Berlin DA, Bakker J. Starling curves and central venous pressure. Crit Care. 2015 Feb 16;19(1):55.Magder S. Volume and its relationship to cardiac output and venous return. Crit Care. 2016 Sep 10;20(1):271

Send a textThe PDA debate has a new data point. TREOCAPA, a phase 3 multicenter European RCT, tested prophylactic acetaminophen in infants born at 23 to 28 weeks. The ductus closed more reliably. Whether that translated into better survival without severe morbidity at 36 weeks is where the conversation gets interesting.Also this week: a large multicenter cohort study puts real numbers on diazoxide use across US NICUs and the pulmonary hypertension risk that has driven so much practice variation. The NeoDry trial tests whether drying very preterm infants before plastic wrapping improves normothermia at admission, with results that are a good reminder of why we run trials. And a retrospective from NYU raises the question of whether standard caffeine dosing in the most premature infants is leaving something on the table.The episode closes with Ben and Eli on Florida's infant formula heavy metal report and why publishing findings without methods may be as much a public health problem as the data itself.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!

Welcome to Light ‘Em Up!At the conclusion of the editing and postproduction process for this episode in preparation for its upload and debut - DHS Secretary Kristi Noem was fired from her role as the Secretary of the Department of Homeland Security.Tonight, on this brand-new, intense episode we'll investigate and examine the more than 32 deaths that have happened at the hands of Immigration & Customs Enforcement (ICE).It may come as a surprise, but the killing of Renee Good (a mother of three) and Alex Pretti (an ICU nurse at the Minneapolis Veterans Affairs Health Care System Hospital in Minnesota) were not the first and they won't be the last.We'll drill down on the Department of Homeland Security — an organization led by individuals who lack both qualifications and integrity.This witch's brew often forces an organization — whether desired or not -- to eventually face severe consequences, ranging from operational inefficiencies to catastrophic, fatal incidents.Research indicates that when leadership prioritizes self-interest over competence and honesty, it creates a toxic culture that undermines safety and performance. ICE has made our streets unsafe with its tyrannical tactics, terrorizing our own people in the name of Trump.Since returning to office in 2025, President Trump has implemented a "hardline" and "maximalist" immigration policy focused on executing the largest domestic deportation operation in U.S. history.The administration doesn't care how the policy is carried out — ONLY that it is — so that Stephen Miller can satisfy his own sick, sadistic wishes.Miller is credited with shaping the racist and draconian immigration policies of President Trump, and Noem oversaw carrying those decisions out, which include:—   zero-tolerance policy, also known as family separation,—   the Muslim ban and—   ending the Deferred Action for Childhood Arrivals (DACA) program.As we go to air with this episode, a federal judge accuses the White House of ‘terror' against immigrants in the U.S.The administration has pursued a whole-of-government approach to identify, detain, and remove undocumented immigrants, aiming for a "1 million per year" deportation goal.But, in the process, there've been:—  tremendous oversights,—  poor procedural safeguards and protocols put in place,—  very little to no training for new hires,—  negligence and outright lies which have led to more than 32 people's death across the nation.We'll introduce you to those who have lost their lives at the hands of the governmental “political theater” that is unfolding right in front of our own eyes, daily.We will report that the (former) DHS Secretary, Kristi Noem is an outright liar — as is her boss.  That isn't opinion — that is fact and we have the receipts to prove it.Be sure to tune in for our reporting regarding a completely fabricated story — that Noem stated in one of her press briefings to the nation — about a man in deportation proceedings “cannibalizing” others, then, himself, like the fictitious character Hannibal Lecter, who Trump thinks is a real person.As we speak truth to power, we never cower — as we expose the fact that Secretary Noem has deported U.S. military veterans AND U.S. citizens and lied and covered up about that as well.As a painter paints and a singer sings, a liar lies.The streets of the U.S. are safer with Noem ousted at the top of DHS, but the man tapped to be her replacement isn't much of an improvement.Tune in for this episode and our sponsors Newsly & Feedspot!We want to hear from you!Support the show

Send a textIn this Neo News episode, Ben and Eli dive into the recent controversial announcement from the state of Florida regarding heavy metals and pesticides found in infant formulas. They discuss the implications of releasing testing data without transparent methodology or clinical context, especially for unregulated or recalled brands like ByHeart and Similac Soy Isomil. How should NICU clinicians counsel parents who want to bring their own formulas from home? Tune in as they unpack the regulatory loopholes, the evolving public health initiatives, and the ongoing challenge of navigating unverified reports in neonatal care!----https://www.miamiherald.com/news/politics-government/article314266407.htmlSupport 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!

Dr. Kwadwo Kyeremanteng is an ICU physician, health advocate, author, and wellness influencer who has spent his career on the front lines of critical care, supporting people and families in their most vulnerable moments. But his mission doesn't stop in the ICU—it starts long before anyone gets there.He is the author of Unapologetic Leadership and Prevention Over Prescription, two powerful books that challenge us to take ownership of our health, our mindset, and the way we lead our lives.Through his work in medicine, education, and community, Dr. Kwadwo helps people move from reaction to prevention, from burnout to strength, and from survival to intentional living. His message is clear: the daily choices we make determine whether we meet life thriving—or in crisis.More Info: Dr. KwadwoBook: Unapologetic Leadership: Finding The Moral Courage To Do The Right ThingBook: Prevention Over Prescription: Take Control of Your Health Through Nutrition, Movement, and CommunitySponsors: Become a Guest on Master Leadership Podcast: Book HereAgency Sponsorships: Book GuestsMaster Your Podcast Course: MasterYourSwagFree Coaching Session: Master Leadership 360 CoachingSupport this show http://supporter.acast.com/masterleadership. Hosted on Acast. See acast.com/privacy for more information.

Send a textIn this episode of Journal Club, Ben and Daphna review a retrospective cohort study exploring the effects of higher caffeine maintenance dosing on BPD and neurodevelopmental outcomes. They discuss the transition from the standard CAP trial doses to higher regimens for infants born at or before 28 weeks gestation. Does an average daily dose of over six milligrams per kilogram reduce severe BPD or improve Bayley cognitive scores at six months? Tune in as they debate the safety, clinical implications, and their own unit's practices regarding caffeine management in the NICU!----Effects of higher caffeine dosing on rates of bronchopulmonary dysplasia and neurodevelopmental outcomes. Fleishaker S, Kazmi SH, Mavrogiannis N, Street H, Ravuri H, Moinuddin T, Pierce K, Verma S.J Perinatol. 2026 Feb 23. doi: 10.1038/s41372-026-02593-1. Online ahead of print.PMID: 41731043Support 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!

Send a textIn this Journal Club episode, Ben and Daphna review the eye-opening results of the NeoDry Trial recently published in JAMA Network Open. They explore the clinical rationale of whether drying very preterm infants before applying a plastic wrap in the delivery room improves rates of normothermia upon NICU admission. While the intervention did not significantly improve temperatures, it unexpectedly revealed an alarming increased mortality risk for the smallest neonates. Tune in as they break down the study's design, discuss the potential causes for this stark safety signal, and highlight the ongoing challenge of maintaining thermoregulation for our most vulnerable preemies!----Drying Very Preterm Infants Before Plastic Wrapping at Birth: A Randomized Clinical Trial. Cavallin F, Doglioni N, Risso FM, Monari CB, Aversa S, Troiani S, Battajon N, Moschella S, Villani PE, Vedovato S, Maiorca D, Frezza S, Lista G, Laforgia N, Mondello I, Sibona I, Staffler A, Pratesi S, Paviotti G, De Bernardo G, Lama S, Miselli F, Bua J, Gitto E, Pesce S, Baraldi E, Trevisanuto D; NEODRY Trial Group.JAMA Netw Open. 2026 Mar 2;9(3):e2556902. doi: 10.1001/jamanetworkopen.2025.56902.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!

What changes when you realize time isn't guaranteed? On Healthy Mind, Healthy Life, hosted by Yusuf, comedian and speaker Mark DeCarlo shares the high-school accident that put him in the ICU—and flipped his life toward purpose, joy, and everyday wellness. This episode is for anyone feeling stuck in a draining job, a misaligned relationship, or a burnout loop. You'll leave with a grounded way to “take inventory,” spot what truly fuels you, and begin shifting your life—responsibly, steadily, and without overwhelming yourself. About the Guest: Mark DeCarlo is a writer, comedian, and speaker who teaches wellness, happiness, and team-building through keynotes and workshops. He also created travel content for the Travel Channel and shares his work online. Episode Chapters: 00:05:56 — “Are you actually well… or just getting by?” 00:07:14 — The ICU wake-up call after a track accident 00:09:02 — Time as your most valuable asset 00:13:28 — The “10 happy moments” inventory exercise 00:14:49 — Turning joy into work: comedy, creativity, purpose 00:20:48 — Burnout, stress, and choosing a calmer direction 00:26:10 — Where to find Mark + final message on workplace wellness Key Takeaways: Write 10 moments you felt truly happy; look for patterns. If your job/relationship never appears on that list, explore why. Don't quit impulsively—start a side-path toward what fuels you. Take daily quiet minutes: “What made me happy today?” Treat wellness like a practice—small steps, repeated, become your system. How to Connect With the Guest: Website: MarkDeCarlospeaker.com | Instagram: @MarkDeCarloTV   Want to be a guest on Healthy Mind, Healthy Life? DM on PM - Send me a message on PodMatch DM Me Here: https://www.podmatch.com/hostdetailpreview/avik Disclaimer: This video is for educational and informational purposes only. The views expressed are the personal opinions of the guest and do not reflect the views of the host or Healthy Mind By Avik™️. We do not intend to harm, defame, or discredit any person, organization, brand, product, country, or profession mentioned. All third-party media used remain the property of their respective owners and are used under fair use for informational purposes. By watching, you acknowledge and accept this disclaimer. Healthy Mind By Avik™️ is a global platform redefining mental health as a necessity, not a luxury. Born during the pandemic, it's become a sanctuary for healing, growth, and mindful living. Hosted by Avik Chakraborty, storyteller, survivor, and wellness advocate. With over 6000+ episodes and 200K+ global listeners, we unite voices, break stigma, and build a world where every story matters.

What if your anxiety about money didn't start in adulthood, but in your dysfunctional family during childhood?Growing up with financial instability doesn't just affect your bank account. It can train your nervous system to live in survival mode — forcing you to grow up too fast and quietly shaping how you date, marry, and handle responsibility.In this episode, pediatric cardiac ICU physician Liz shares her story of financial chaos, parentification, and how that hyper-responsibility followed her into adulthood and marriage.We cover:How money stress creates “parentified” kidsWhy responsibility can feel like survivalHow financial trauma affects relationshipsIf you grew up worrying about money, feel responsible for everyone, or struggle to rest — this episode is for you.Share Your StoryGet the Book or FREE chapters: It's Not Your FaultGet Dakota's FREE Guide, The Biggest Fitness Mistakes to AvoidWatch the Documentary: KennyWatch the Trailer: Kenny (3:31 min)Shownotes

Critical care physician and neurologist Dr. Adam Rizvi, author of Love Does Not Know Death, joins us. Drawing from years in the ICU and more than 500 deaths he has witnessed, Dr. Rizvi shares what he's learned about the moments surrounding death, the emotional reckoning families often face, and how forgiveness and compassion sometimes emerge in the most unexpected ways. We also explore remarkable experiences reported near the end of life, including deathbed visions and cases that challenge the idea that consciousness ends with the body. Along the way, Jim and Dr. Rizvi reflect on what these moments reveal about how we live our lives right now, and why confronting mortality can sometimes lead to deeper meaning and connection. Find LOVE DOES NOT KNOW DEATH at Amazon: https://amzn.to/3NfR0IE Thanks Dr. Rizvi! -- This post contains Amazon affiliate links that benefit Jim Harold Media when you make a qualifying purchase. Thank you for your support! -- VIRTUAL CAMPFIRE GROUPJoin our FREE online community at ⁠https://virtualcampfiregroup.com⁠ YOUTUBE CHANNELBe sure to subscribe to Jim's YouTube channel at: ⁠https://youtube.com/jimharold⁠ JOIN JIM'S SPOOKY STUDIO PLUS CLUBYou can get access to Jim's entire back catalog of Campfire and a TON of exclusive content with the Spooky Studio Plus Club. Go to https://⁠jimharold.com/plus⁠ and signup to support the show and get access to our MASSIVE library of content! MERCHGo to ⁠https://jimharold.com/merch⁠ to get your Jim Harold T's, sweatshirts, mugs, hats and more! BOOKSGet all SIX of Jim's Campfire books here: https://jimharold.com/campfirebooks/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Send a textIn this Journal Club episode, Ben and Daphna review a large cohort study from the Journal of Perinatology on the prevalence and safety of diazoxide in the NICU. With neonatal hypoglycemia seemingly on the rise, they discuss off-label use for transient hyperinsulinism and evaluate real-world data from over 340 Pediatrix units. They dive into the rates of concurrent diuretic therapy, respiratory support, and the dreaded risk of pulmonary hypertension. Tune in for a clinical breakdown of when and how this medication is being utilized across centers, plus Ben's echocardiography struggles with cranky term babies on diazoxide!----Prevalence and safety of diazoxide in the neonatal intensive care unit. Collins LC, Daniel KB, Tolia VN, Parikh P, Gray KD, Greenberg RG.J Perinatol. 2026 Feb 3. doi: 10.1038/s41372-026-02568-2. Online ahead of print.PMID: 41634357Support 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!

Life, Wellness, and the "Marathon Mindset"In this raw and intimate "living room session," Ashley, Collin, and Brian sit down to pass a single mic and share a major life update. This isn't your typical clinical podcast; it's a deep dive into the "Not Alone" mission that defines The Making Of.From Brian's miraculous PET scan results to a surprise marathon challenge and the role of AI in personal wellness, this episode explores the grit required to navigate the "messy middle" of both dentistry and life.Key Discussion PointsThe Miraculous Update: Brian shares the incredible news that his tumor has responded to chemo and immunotherapy beyond expectations—showing no current evidence of existence on his latest PET scan.The Decision to Act: Despite the clear scan, the team discusses why surgery remains the necessary next step to ensure "dysplastic cells" don't create a monster down the road.The CIM Marathon Challenge: Brian officially puts the "nail in the coffin" by challenging Ashley and Collin to run the California International Marathon (CIM) this December. It's a 9-month journey from recovery to the finish line.Mindset & Control: Brian reflects on the struggle of losing his identity as an athlete during chemo and how this marathon represents taking back control of his body and health.AI in Wellness: Collin explains how she's been using Gemini AI as a digital personal trainer and nutritionist to bridge the gap between setting goals and executing them.Plant-Forward Living: The trio discusses the realities of a whole-food, plant-based diet, the struggle for protein, and Ashley's latest kitchen experiment: a sourdough starter made from macerated grapes.The Power of Prayer: Ashley shares her mindset heading into Brian's major surgery, leaning on faith and the strength of the community to get through the "rabbit hole" of anxiety.A Special Request for Our Tribe

Transfers don't have to feel like controlled chaos. We break down how to move a critically ill patient from the OR to the ICU with confidence by pairing structured handoffs with disciplined infection prevention—so information moves seamlessly while pathogens hit a dead end.We start by revisiting the ICU's influence on anesthesia practice through the story of ARDS and lung-protective ventilation. The shift to 6 ml/kg ideal body weight didn't just save lungs in the unit; it reshaped intraoperative strategy to reduce ventilator-induced injury for surgical patients. From there, we zoom into the human factors of handoffs: why complex, time-sensitive details—hemodynamics, antimicrobials, ventilator settings, imaging, and goals of care—so often fall through the cracks, and how IPASS, OR-to-ICU structured handoffs, and explicit role assignments align teams. Then we tackle pathogen transmission where it thrives: device-rich environments and high-touch surfaces. We unpack how environmental reservoirs and biofilms turn bed rails and anesthesia machine into unseen vectors, and why consistent, high-frequency hand hygiene is the most powerful countermeasure. Clear targets make habits stick: at least four sanitizer uses per hour in the ICU and eight per hour in the OR, coupled with strict isolation adherence and diligent decontamination. By the end, you'll have a tight, transferable playbook: adopt lung-protective settings across care areas, script handoffs with shared tools and timed calls, measure sanitizer touches, and treat the environment as a clinical variable. If this conversation helps your team cut errors or infections, share it with a colleague, subscribe for future episodes, and leave a review with one change you'll make this week.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/297-from-or-to-icu-how-checklists-and-clean-hands-save-lives/© 2026, The Anesthesia Patient Safety Foundation

If you've ever been told you look fine when you feel anything but, or found your people somewhere nobody expected, pull up a chair.More info, resources & ways to connect - https://www.tacosfallapart.com/podcast-live-show/podcast-guests/nicholas-ruchlewiczNicholas Ruchlewicz Survived a Traumatic Brain Injury. Then He Used Pathfinder TTRPG to Help Put Himself Back Together.On March 15, 2016 - the Ides of March, smack in the middle of Brain Injury Awareness Month - Nicholas Ruchlewicz was in a single-vehicle motorcycle crash that changed everything. He woke up not knowing where he was, seeing double, unable to control his own hands. Doctors had to tie them down because he kept pulling staples out of his own skull. He had a plate holding his pelvis together. He was living in his mom's basement with the handles taken off his wheelchair so he could fit down the hallway.That's where this story starts.In this episode, Nicholas walks us through what early recovery actually looked like... the speech therapy he fought tooth and nail because he "just hurt his legs," the 12 steps on a walker that were the hardest he'd ever taken, and the Pandora station full of Type O Negative and Opeth that his girlfriend played in the ICU and that you could literally watch lower his blood pressure on the monitors.The conversation gets really interesting when we get into how Nicholas found his way back through tabletop role-playing games. He'd already been playing Pathfinder before the crash. After it, rolling dice at a game store gave him a reason to get out of the house, a way to rebuild his cognitive function, and a community that showed up for him in ways he didn't expect... including visiting him in the hospital. He now runs organized play events up and down the East Coast, has run nearly 400 Pathfinder games, and uses the platform he's built to speak to political organizations and members of Congress about brain injury recovery and mental health.We also get into why TTRPGs specifically hit different from other hobbies when it comes to healing - the creative freedom, the social scaffolding, the way playing a confident character can quietly build confidence in real life. Nicholas has watched it help people work through social anxiety, find community, and feel seen in ways that are genuinely hard to manufacture anywhere else.He also shares a couple of practical life hacks from his recovery that honestly apply to everyone: the "1-2-3" pause technique and the Viktor Frankl principle about the space between stimulus and response being where your power lives.Nicholas's story is a good reminder that recovery is rarely linear and help shows up in unexpected places... sometimes in the form of math rocks and imaginary creatures, and a table full of people who are just glad you showed up.

Send a textIn this Journal Club episode, Ben and Daphna review the highly anticipated TREOCAPA trial results exploring the prophylactic use of acetaminophen for PDA closure in extremely preterm infants. They break down the study's tailored dosing regimens, safety outcomes like cholestasis, and discuss why achieving a higher rate of early ductal closure didn't necessarily translate to improved survival without severe morbidity. Plus, they share a nod to recent Neo Conference interviews and the realities of conducting clinical research in private practice. Tune in for a nuanced discussion on individualizing PDA management in the NICU!----Prophylactic Treatment of Patent Ductus Arteriosus With Acetaminophen: A Randomized Clinical Trial. Rozé JC, Cambonie G, Flamant C, Patkaï J, Mühlbacher T, Gascoin G, Rideau Batista Novais A, Tauzin M, Le Duc K, Beuchée A, Joye S, Babacheva E, Bouissou A, Ligi I, Tammela O, Plourde M, Dempsey E, Tosello B, Nguyen K, Vincent M, Andresson P, Binder C, Kruse C, Barcos Munoz F, Kuhn P, Proença E, Bartocci M, Kermorvant-Duchemin E, Nellis G, Lumia M, Giapros V, Rigo V, Sankilampi U, Mendes da Graça A, Rønnestad A, Soukka H, Mondì V, Aikio O, Torre-Monmany N, Rüegger C, Baud O, Zeitlin J, Morgan AS, Baruteau AE, Ancel PY, Carbajal R, Bouazza N, Diallo A, Levoyer L, Kemper R, Hallman M, Alberti C, Ursino M; TREOCAPA Study Group.JAMA Pediatr. 2026 Feb 16:e256150. doi: 10.1001/jamapediatrics.2025.6150. Online ahead of print.PMID: 41697673Support 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!

Most people hide their addiction until it destroys them — Kellan Fluckiger spent $3,000 a week on cocaine while testifying before Congress, then flatlined in an ICU and met God at the door. In this episode of The Root of All Success, Jason Duncan sits down with Kellan Fluckiger, a former energy executive turned coach, author of 30+ books, billboard-charting choir performer, and founder of The Ultimate Life Formula. After hiding cocaine addiction and depression for 30 years while working at the highest levels of government and industry, Kellan experienced a divine intervention in 2007, quit cold turkey, and walked away from millions in contracts. In 2018, he died in the ICU for 17 days — and what happened at that doorway changed everything. Kellan shares how severe childhood abuse created the “I'm not good enough” belief that fueled decades of overachievement and self-destruction, his 18-hour out-of-body life review of pain he caused and received, and the four truths God gave him about purpose and mission. This conversation dives into: • How childhood abuse created a lifelong “prove I'm good enough” addiction • Spending $3,000/week on cocaine while running energy operations and testifying before Congress • The 2007 divine intervention and 18-hour life review • Quitting cocaine cold turkey after hearing “it is enough” • Meeting his wife Joy at a Yo-Yo Ma concert when God said, “You need to marry this woman. Tonight.” • Walking away from millions in contracts without knowing what came next • The 2018 near-death experience: flatlining in the ICU for 17 days • Standing at the doorway with God and being asked, “Do you want to come home?” • A vision of infinite domains (like the movie Contact with Jodie Foster) • Four truths brought back from death: You're divine. You have a mission. You have gifts. Help is available. • Why God said “Because you don't believe,” when asked why people settle • The Book of Context framework for eliminating limiting beliefs • God's final question before returning: “Are you sure?” • How “context straitjackets” (BDEEP: Beliefs, Definitions, Experiences, Expectations, Perceptions) limit us • Why success isn't what you accumulate — it's what you make of yourself • His refusal to give up: “I friggin won't stop.” If you're battling hidden addiction, stuck in “not good enough” patterns, or wondering if transformation is possible after decades of pain — this episode will challenge everything you thought you knew about redemption and purpose.

Jaime Jump, DO, is a dual-trained physician specializing in pediatric critical care and palliative care. She currently serves as the Program Director of Palliative Care and is an Associate Professor in the Sections of Critical Care Medicine and Pediatric Palliative Care at Baylor College of Medicine and Texas Children's Hospital. Learning Objective: By the end of this podcast, listeners should be able to discuss an evidence-based and expert-guided approach to Withdrawal of Life Sustaining Therapy (WOLST) in children.References:TEXAS CHILDREN'S HOSPITAL DIVISION OF PALLIATIVE CARE Withdrawal of Life-Sustaining Therapies (WOLST) ProtocolKompanje EJ, van der Hoven B, Bakker J. Anticipation of distress after discontinuation of mechanical ventilation in the ICU at the end of life. Intensive Care Med. 2008 Sep;34(9):1593-9. doi: 10.1007/s00134-008-1172-y. Epub 2008 May 31.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

On May 20, 2016, ICU nurse Amber Kornhorst set out on a solo late-afternoon hike near Cane Beds, Arizona, and climbed a deceptively "sticky" sandstone wall she couldn't safely descend. With no cell service and no way out, she fell about 100 feet into a narrow rock "dungeon," suffering three spinal fractures, a crushed pelvis, head and facial injuries, severe dehydration, and hypothermia — and typed goodbye messages to her family on her phone. Refusing to give up, she crawled and climbed to a more visible ledge and blew her whistle three blasts every half hour until search-and-rescue teams and a helicopter located her nearly 24 hours later, executing a technical rope raise and hover-load evacuation to a Utah hospital. Her story drives home survival essentials: always tell someone your plan, never hike alone, start early, carry extra water and a whistle, consider a satellite communicator, and never climb anything you can't safely descend. 00:46 Show Intro And Setup 01:40 Amber Hits The Trail 03:02 Climbing The Sandstone Wave 04:10 No Way Down Desert Trap 05:32 The Hundred Foot Fall 06:20 Shock And Goodbye Texts 08:27 Painful Climb And Whistle 11:03 Search Effort Mobilizes 12:41 Helicopter Spots Her 14:16 Technical Rope Rescue 16:10 Hover Pickup Extraction 17:02 Helicopter Evacuation 17:43 Hospital Recovery Journey 19:06 Why She Survived 19:43 Whistle and Visibility 21:55 Search Mobilized Fast 22:50 Wilderness Safety Takeaways 25:03 Desert Hiking Mistakes 27:08 Survival Mindset Lessons 29:47 Final Wrap and Credits Listen AD FREE: Support our podcast at patreaon: http://patreon.com/TheCruxTrueSurvivalPodcast Email us! thecruxsurvival@gmail.com Instagram https://www.instagram.com/thecruxpodcast/ Get schooled by Julie in outdoor wilderness medicine! https://www.headwatersfieldmedicine.com/ Primary/First-Person Account Kohnhorst, Amber. "Surviving Alone After a 100-Foot Fall in the Arizona Wilderness." Backpacker Magazine, February 28, 2017. https://www.backpacker.com/survival/surviving-a-100-foot-fall-in-arizona/ News Coverage "Rochester Woman Survives 100-Foot Tumble On Hike In Arizona." WCCO/CBS Minnesota, May 24, 2016. https://minnesota.cbslocal.com/2016/05/24/rochester-woman-100-foot-fall-arizona "Hiker Recovering After Northwest Arizona Fall." KTNV, May 25, 2016. https://www.ktnv.com/news/hiker-rescued-in-rural-northwest-arizona "Hiker Who Fell Is Mending at Home." Post Bulletin, 2016. https://www.postbulletin.com/newsmd/hiker-who-fell-is-mending-at-home "The 100-Foot Fall. The Long Climb Back." Post Bulletin. https://www.postbulletin.com/news/the-100-foot-fall-the-long-climb-back Institutional Coverage "Nurse Becomes Patient After Surviving 100-Foot Fall While Hiking." Mayo Clinic In the Loop, June 9, 2016. https://intheloop.mayoclinic.org/2016/06/09/nurse-becomes-patient-after-surviving-100-foot-fall-while-hiking/ "Amber Kohnhorst's Trip to the Sanctuary." Best Friends Animal Society. https://bestfriends.org/stories/features/mayo-clinic-nurse-who-survived-100-foot-fall-returns-best-friends Background "Cane Beds, Arizona." Wikipedia. https://en.wikipedia.org/wiki/Cane_Beds,_Arizona Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this episode of the PFC podcast, Dennis and Doug discuss the critical importance of analog monitoring in intensive care settings. They explore how healthcare professionals can effectively assess patients without relying solely on digital tools, emphasizing the need for hands-on skills and clinical judgment. The conversation covers various aspects of patient assessment, including hemodynamic stability, the impact of pharmacological agents, and the value of traditional tools like the stethoscope. Doug shares insights from his experience in the ICU, highlighting the significance of recognizing trends and treating patients based on their clinical presentation rather than just numerical data. The episode serves as a reminder of the essential skills that healthcare providers must maintain, especially in challenging environments where technology may fail.TakeawaysAnalog assessment is crucial in critical care settings.Visual assessment often provides more insight than numbers.Mental status is the most important vital sign.Pharmacological effects can complicate patient assessments.Guiding therapy requires clinical judgment, not just numbers.Stethoscopes remain valuable despite advanced technology.Respiratory rate and work of breathing are key indicators of lung issues.Blood pressure measurements can vary; mean arterial pressure is critical.Trends in patient data are more important than isolated numbers.Practicing analog skills is essential for all healthcare providers.Chapters00:00 The Importance of Analog Monitoring in Critical Care04:12 Assessing Hemodynamic Stability10:25 Navigating Pharmacological Effects on Patient Assessment15:25 Guiding Therapy Without Digital Tools21:16 The Role of the Stethoscope in Modern Medicine27:10 Recognizing and Responding to Respiratory Distress34:09 Manual Blood Pressure Measurement and Its Relevance37:10 The Value of Analog Skills in Rugged EnvironmentsFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠⁠⁠

Three months after graduating from the U.S. Military Academy at West Point, Joe Oppold had a cerebral aneurysm. Instead of reporting to OBC, or Officer Basic Course, he wound up in the ICU. Just a year later though, he was able to go skiing with some fellow disabled veterans, which he still enjoys doing today as well as other activities. The Move United Warfighters Ambassador wrote a book,” That's a Great Haircut” about his experience.

Send a textThink space is fast? Try outrunning time. We kick off with a clear-eyed breakdown of Project Hail Mary's core science.Using the Parker Solar Probe as our real-world speed limit, we map the math of interstellar distances to compare to the ability for Ryan Gosling to get to Tau Ceti in Project Hail Mary.Then we turn to biology's unforgiving rules. Could a years-long medically induced coma carry a crew through deep space? We explain how coma differs from sleep, why weeks mark a dangerous threshold, and the cascade of complications ICU teams fight daily—muscle wasting, clots, pneumonia, pressure injuries, and dysregulated hormones. We sketch what a future-ready, autonomous critical-care system would actually need to stabilize a human body for years, and why today's medicine isn't there yet.Our pet science segment shifts from galaxies to living rooms, dissecting a viral claim about Sweden “banning” leaving cats home alone. We clarify the Swedish Animal Welfare Act, the twice-daily human check-in guideline for cats, and why cameras don't count. You'll hear how these rules protect animal welfare without criminalizing a normal workday, and why enforcement stories online deserve a healthy fact-check. It's the same habit we apply to sci-fi: verify the source, understand the standard, and do right by the beings who rely on us.If you enjoy smart science, grounded skepticism, and practical takeaways—from relativistic travel to responsible pet care—follow the show, share it with a friend, and leave a review. Your notes help more curious minds find us.Support the showFor Science, Empathy, and Cuteness!Being Kind is a Superpower. All our social links are here!

Send a textLive from the NEO Conference in Las Vegas, Ben and Daphna sit down with Dr. Tarek Nakhla to discuss his new book, Saving Babies Behind the Doors of the Neonatal Intensive Care Unit. Moving beyond standard medical textbooks, Dr. Nakhla shares how chronicling nearly 30 years of challenging patient encounters and complex family dynamics can serve as an essential guide for new trainees. The conversation highlights the therapeutic power of narrative medicine for clinicians and the profound impact of non-clinical staff on the family experience. Discover why capturing the human side of neonatology is just as critical as the clinical science.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!

Send a textHow can a database tracking 20% of all US NICU admissions change the way we practice neonatology? Live from the NEO Conference, Ben and Daphna sit down with Dr. Veeral Tolia to discuss his groundbreaking work with the Pediatrix Clinical Data Warehouse. Dr. Tolia dives into the power of leveraging decades of observational data to supplement randomized trials—from analyzing the 50-fold increase in Precedex usage to studying natural experiments like the vitamin A shortage. The group also looks ahead to the Newborn Express dataset, exploring how socioeconomic metrics like the Child Opportunity Index might help us understand the alarming rise in neonatal vitamin K refusals.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!

Critical illness impacts not only the patient in the bed but also their entire family during and after the ICU. Eli and Cathy Garrison join us to share their young family's course of twists and turns of an amniotic fluid embolism to long-term disability.Check out Cathy's podcast at: Birth Trauma Storieswww.DaytonICUConsulting.com

Let us know what you think of the show and what we can do better! A 24-year Army veteran races 28 hours to his soldier son's bedside and steps into a maze of tests, policies, and a life-or-death decision he never agreed to. Eddie Peoples recounts the night an apnea test was called “inconclusive,” the promised blood-flow study was dropped, and a brain death declaration arrived anyway—followed by a “family advocate” carrying a donor registry printout the family says does not reflect Keone's wishes.We walk through the ICU timeline in detail: early assurances that injuries looked survivable, abrupt scheduling and cancellations of critical exams, and the moment consent became the central battle. Eddie lays out why the family opposes organ donation on religious grounds, how two government IDs showed no donor designation, and why a no-signature, shifting-date registry record raised alarms. Along the way, we unpack how hospitals coordinate with organ procurement organizations, where state rules mandate notification, and why families so often feel the process becomes unstoppable once “donor” appears on a chart.This conversation goes beyond one case to surface the bigger issues: the ethics of brain death determinations under time pressure, the reliability of online donor registries, and the need for clear, verifiable consent. We share practical steps to protect your choices—advance directives, named proxies, consistent updates across DMV, military, and VA systems, and a dated video statement your family can present if records conflict. Whether you support organ donation or question its current safeguards, this story asks for transparency, accountability, and respect for patient autonomy when it matters most.If this moved you, subscribe, share with someone who needs it, and leave a review with your takeaways. Your voice can help more families document their wishes and avoid preventable turmoil.Support the showVisit my website: https://thehello.llc/THERESACARPENTERRead my writings on my blog: https://www.theresatapestries.com/Listen to other episodes on my podcast: https://storiesofservice.buzzsprout.comWatch episodes of my podcast:https://www.youtube.com/c/TheresaCarpenter76

Send a textHow will artificial intelligence fundamentally change the way we chart, teach, and monitor patients in the NICU? Live from the NEO Conference, Ben and Daphna sit down with Dr. James Barry to explore the critical need for "AI literacy" among bedside clinicians. Dr. Barry draws parallels between driver's education and safe AI use, highlighting the hidden dangers of automation complacency with AI scribes. They also discuss the exciting potential of computer vision in respiratory monitoring and how the CONCERN early warning system is quantifying nursing intuition. Join us as we navigate the guardrails of neonatology's technological future.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!

Send a textCan groundbreaking neonatal research thrive outside of academic medicine? Live from the NEO Conference, Ben and Daphna sit down with Dr. Kaashif Ahmad, Vice President of Research at Pediatrix. Dr. Ahmad shatters the myth that community NICUs can't drive clinical science, discussing how everyday documentation in systems like Baby Steps quietly fuels hundreds of publications. He also unveils "The Parent Network," a revolutionary initiative designed to partner with family-led organizations from day one to establish comparative effectiveness trial priorities. Tune in to discover how private practice clinicians are successfully balancing bedside care with robust, meaningful research.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!

Howie and Harlan are joined by Yale School of Medicine neurologist Kevin Sheth to discuss how collaboration helps drive breakthroughs in brain health, including advances in detecting stroke and other neurological diseases earlier and more precisely. Harlan reflects on lessons from his family's recent experience navigating the healthcare system; Howie examines the expanding marketplace for GLP-1 weight-loss drugs and the challenges of ensuring safe and appropriate use. Show notes: The Family Perspective Cleveland Clinic: Percutaneous Coronary Intervention "What's the Difference Between a CCU and an ICU?" Kevin Sheth Alva Health Mayo Clinic: Stroke Video: Kevin Sheth at the Yale Innovation Summit Sandra Saldana, PhD, MBA "Buddy System"  NIH: Multiple Principal Investigators "Assessing the Decade of the Brain" "Cerebrospinal fluid and plasma biomarkers in Alzheimer disease" Kevin Sheth: "Burden of Ischemic and Hemorrhagic Stroke Across the US From 1990 to 2019"  Endovascular Thrombectomy (EVT) Ischemic vs Hemorrhagic Stroke "What is cognitive reserve?"  Cheaper Obesity Drugs "Will Novo Nordisk's slashing of obesity drug prices save patients' money? It depends"  "Novo Nordisk to halve US list price of Wegovy from 2027"  "Walgreens Virtual Healthcare Adds Weight Management Services to Support Patients on Their Weight Loss Journey"  In the Yale School of Management's MBA for Executives program, you'll get a full MBA education in 22 months while applying new skills to your organization in real time. Yale's Executive Master of Public Health offers a rigorous public health education for working professionals, with the flexibility of evening online classes alongside three on-campus trainings. Email Howie and Harlan comments or questions.

🧭 REBEL Rundown 🔑Key Points Try the coffee nap! Where you combine caffeine and a 30-minute nap to then have that boost energy and alertness by the time it kicks in.💤 Sleep isn’t optional—it’s crucial for memory, mood regulation, and physical recovery. It is fundamentally different from rest❌ Replacing sleep with caffeine isn’t effective and can have negative health impacts. Make getting enough sleep a priority🌞 Sunlight exposure is important for maintaining circadian rhythms and sleep quality. This applies even if you work as a nocturnist💡 Creating a personalized sleep system enhances quality and consistency. It gives you back control of a schedule that you may feel like is out of your hands.🧩 If you’ve tried these strategies and you’re still struggling, consider true sleep pathology (insomnia, shift work disorder, sleep apnea) and get help—this is not a “be tougher” problem.🩺 Better sleep isn’t just about feeling good; it’s directly tied to error reduction, patient safety, and longevity in EM/ICU careers. Click here for Direct Download of the Podcast. 👀Previously Covered and Related Content: REBEL Core Cast: Sleep HygieneREBEL MIND: Rest Is Not Sleep: The Seven Dimensions of True RecoveryRebellion in EM: Care For Yourself – Sleep HygieneFirst10EM: Some Evidence For Working Night ShiftsREBEL MIND: Dunning Kruger Effect 📝 Introduction Welcome to this episode of REBEL MIND, where MIND stands for Mastering Internal Negativity during Difficulty. Here we sharpen the person behind the practitioner by focusing on things that improve our performance, optimizing team dynamics and the human behavior that embodies the hidden curriculum of medicine. Today we are exploring the imperative topic of rest and why it’s not just about sleeping. The second of a two part series, hosted by Dr. Mark Ramzy with guests Dr. Maureen Aiad and Dr. Amil Badoolah, continue our discussion but this time on the multifaceted nature of sleep, how it serves as medicine and how we can use our tools deliberately to get more of it! Cognitive Question How would your clinical performance, patience with families, and long-term career sustainability change if you treated sleep as a non-negotiable clinical intervention rather than a flexible “nice-to-have”? 💤How is Sleep Different From Rest? 1. Rest reduces load; sleep repairs systemsWe previously talked about the 7 types of rest and you can check that out hereExamples of physical rest include: pausing tasks, stepping away from the monitor, taking a walk, stretching, breathing, journaling, connecting with a colleague. This lightens your cognitive/emotional burden.Sleep is fundamentally different in that it’s an active biologic process that helps:Consolidates memory and learning (yes, including the tough cases from last night).Regulates mood, impulse control, and emotional reactivity.Supports immunity, metabolic health, and cardiovascular function.Repairs tissue, replenishes neurotransmitters, and fine-tunes neural networks.You can have “rested but underslept” days (you took breaks but got 4 hours in bed), and “slept but unrested” days (you got hours, but all junk sleep). Both matter, but they are not interchangeable.2. Sleep architecture vs. “knocking out”True restorative sleep cycles through NREM and REM in predictable patterns.Alcohol, late caffeine, and fragmented nights may help you fall asleep faster but:Suppress REM.Shorten deep sleep.Increase awakenings and light sleep.The result: you technically slept, but your brain didn’t get the “software updates” it needed.Biology isn’t built for your scheduleCircadian rhythms were designed for light-day / dark-night cycles, not:10 pm–7 am ED shifts.24-hour calls.6 nights in a row followed by days.Your body can adapt partially, but not instantly and not perfectly. That’s why:You can feel “jet-lagged” even when you haven’t traveled.Sleep before and after nights feels odd and fragile.Recognizing that “this is biologically unnatural” is key: you’re not weak; you’re fighting physiology. 🏥How This Applies to the Emergency Department or ICU? Performance & safetySleep deprivation:Slows reaction time and increases error rate.Impairs risk assessment and complex decision-making.Drops your frustration tolerance with consultants, families, and staff.In both emergency medicine and critical care, that translates into:Anchoring on the wrong diagnosis.Missing subtle clinical changes.Snapping at a tech, nurse or resident and damaging team culture. Chronic health for chronic shift workLong-term sleep disruption is associated with:Hypertension, diabetes, obesity.Depression, anxiety, burnout.Arrhythmias (e.g., AFib) and increased stroke risk.Possibly increased all-cause mortality.You’re already in a high-stress, high-exposure specialty. Chronically poor sleep amplifies that risk profile and can end a career early—or make you miserable while you’re still in it.Culture of “heroics” vs. healthSkipping sleep to pick up extra shifts, late meetings, or “just one more note” is often praised.We rarely celebrate:The attending who says “no” to a 2 pm meeting post-nights.The resident who defends their blackout-curtains-and-earplugs routine. 🛏️Different Ways to Improve Your Sleep Clarify your “sleep non-negotiables”Decide how many hours you realistically need to function (e.g., 7–9 on off days, realistic blocks on nights).Treat those hours as you would a procedure time—blocked, protected, and respected.Use caffeine like a drug, not a reflexAim for ≤ 2 cups equivalent on most days.Avoid caffeine within 4–6 hours of your planned sleep time (remember: it can hang around up to 12 hours).Consider scheduling caffeine for:Early in the shift for alertness.Strategic “coffee naps” (see below), not late-night chugging.Respect alcohol’s impact on sleepRecognize that even small to moderate doses degrade sleep architecture.Avoid using alcohol as a “sleep aid”—you’ll fall asleep faster but sleep worse.If you do drink, separate it from bedtime and keep it modest.Optimize food and fluid timingHydrate consistently on shift, but taper fluids ~4 hours before bed to reduce nocturnal bathroom trips.Avoid heavy, spicy, or large meals within 2–3 hours of sleep to decrease reflux and discomfort.Plan a light, balanced “pre-sleep” snack if going to bed hungry keeps you awake.Move your body (but not right before bed)Regular exercise improves sleep depth and latency.Try to avoid intense workouts within 2 hours of bedtime.On shift: micro-movement (stairs, brisk walks between pods, quick stretch sessions) can help alertness without wrecking sleep later.Control light exposureMaximize sunlight or bright light after waking (even if that’s 3–4 pm after a night).Minimize bright light and screens before sleep:Dim lights.Use night mode/blue-light filters if you must scroll.For daytime sleep:Use blackout curtains, tinfoil, cardboard, or sleep masks.Yes seriously use tinfoil if you have to, we talk about it on the podcast episode!Aim for “I might be blind” darkness—so dark you can’t see your hand in front of your face.Dial in your sleep environmentCool room temperature (fan or AC if possible).White noise or sound machine to mask household/traffic noise.Earplugs and eye masks as needed.Bed used primarily for sleep (and sex)—not for charting, doom scrolling, or email.Strategic power napsKeep naps ≤ 20–30 minutes to avoid sleep inertia.Prefer early-afternoon or pre-night-shift naps.Coffee nap strategy:Drink a small coffee.Immediately lie down for a 20–30 min nap.Wake up as the caffeine kicks in, combining nap benefit + stimulant.Thoughtful melatonin useRemember melatonin is a hormone, not a vitamin gummy.Lower doses often work as well as (or better than) large OTC doses.Use it intentionally and intermittently, not as a crutch every night.Over-reliance may reduce your own natural production and its effectiveness over time.Build pre-sleep ritualsRepeated, calming habits signal your body it’s time to downshift:Warm shower, gentle stretching, or yoga.Guided breathing or body scan.Brief journaling or “brain dump” of tasks to get them out of your head and onto paper.Protect from pathologic patternsIf despite consistent effort you:Snore heavily, stop breathing, or gasp in sleep.Feel excessively sleepy driving home or at work.Cannot fall asleep or stay asleep for weeks to months.Consider evaluation for sleep apnea, insomnia, or shift-work sleep disorder with your physician or sleep specialist. ⏩Immediate Action Steps for Before/During/After Your Next Shift 1. **Before the Shift**: Plan a 20–90 minute nap before your first night shift (many clinicians find 3–5 hours earlier in the day is ideal).I treat ED and ICU shifts very differently. I always sleep 3-5 hours before my night shifts aiming for the full 5 (sometimes 6 or more) hours for my ED shifts because you always have to be “on”. Depending on the ICU I’m working in, I may have a bit more downtime so 3 to 5 hours is plenty.Set a caffeine plan: decide in advance when your last dose will be (e.g., none after 2–3 am if sleeping at 8–9 am).Tell your household, “This is my sleep block” and agree on a plan for kids, pets, deliveries, etc.On my calendar, I completely block off time called “Pre-call sleep” so no meetings can be scheduled and then put my phone in airplane mode2. **During the Shift** Hydrate early; taper fluids in the last 3–4 hours of your shift Eat something light but adequate; avoid “last-minute” heavy meals right before sign-out.Build in micro-breaks and movement: one or two short walks, a few stretches, even a quick stair run if safe.Get outside or near a window for a few minutes of light exposure if possible.3. **After the Shift**On the way home:Use sunglasses to reduce bright morning light if you’re aiming for sleep soon.Avoid “just checking” email or messages; shift into wind-down mode.At home:Do a brief, calming decompression (shower, light snack, 10–15 minutes of low-stimulation TV or reading).Make your room cold, quiet, and dark (blackout curtains, tinfoil/cardboard, white noise, fan).Put your phone on Do Not Disturb and physically place it away from the bed.On my calendar, I completely block off time called “Post-call sleep” so again no meetings can be scheduled and then I personally don’t just put my phone on Do Not Disturb but rather in airplane mode and WIFI OFF If you can’t sleep after ~20–30 minutes:Get out of bed, do something calming in dim light (breathing, gentle stretching, journaling).Return to bed when sleepy—this trains your brain to associate bed with sleep, not frustration. Conclusion Rest and sleep are both critical—but they’re not interchangeable. Rest helps you step out of the constant “on” of our jobs, while sleep is the biological intervention that restores your ability to show up safely and sustainably. Rest ≠ sleep. Rest reduces load; sleep repairs your brain and body. You need both, on purpose.As EM and ICU clinicians, we’re trying to perform formula-one-level medicine with engines that often only see half their maintenance. You won’t fix shift work. You can build a sleep system that respects your biology, your schedule, and your life at home.That system starts with valuing sleep, then prioritizing it, personalizing it, trusting the process when it’s imperfect, and actively protecting both your routine and your mindset. 🚨 Clinical Bottom Line Sleep is medicine. Shift work is biologically unnatural. Struggling does not mean you’re weak; it means you’re human fighting physiology. Use your tools deliberately. Caffeine, naps, light, food, movement, melatonin, and environment can be leveraged—or can quietly sabotage you. Build and defend a personalized sleep routine. Communicate it, normalize it, and protect it from casual encroachment. You can’t control every trauma, code, or admission—but you can control how seriously you take your own recovery. Your patients, your team, and your future self all benefit when you do. Further Reading Espie CA. The ‘5 principles’ of good sleep health. J Sleep Res. 2022 Jun; PMID: 34676592Solodar, J“Sleep hygiene: Simple practices for better rest.” Harvard Health, 31 January 2025 Link is HereSuni, E.“Mastering Sleep Hygiene: Your Path to Quality Sleep.” Sleep Foundation, 7 July 2025, Link is Here Meet the Authors Mark Ramzy, DO Co-Editor-in-Chief Cardiothoracic Intensivist and EM Attending RWJBH / Rutgers Health, Newark, NJ Maureen Aiad, DO Assistant Professor of Emergency Medicine NYU Grossman Long Island School of Medicine, New York Amil Badoolah, DO Assistant Professor of Emergency Medicine NYU Grossman Long Island School of Medicine, New York REBEL Core Cast 119.0 – Sleep Hygiene REBEL Core Cast 119.0 – Sleep Hygiene Click here for Direct Download of ... Read More The post REBEL MIND – How to Sleep When the World Says You Can't appeared first on REBEL EM - Emergency Medicine Blog.

Send a textWhen parents fundamentally disagree on life-saving interventions in the delivery room, how do clinical teams decide the next step? Live from the NEO Conference, Ben and Daphna sit down with Dr. Mark Mercurio, Executive Director of the new Center for Pediatric Bioethics at Boston Children's Hospital. Dr. Mercurio dissects a highly complex ethical case regarding parental disagreement over resuscitation at the border of viability. Emphasizing the distinction between parental "preference" and parental "judgment," he explores the necessity of clinical humility, the hidden margins of error in gestational age dating, and how admitting our own medical uncertainty is the first step toward honest family counseling.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!

Send a textHow does individualized medicine shape both patient trust and neonatal careers? Live from the NEO Conference, Ben and Daphna catch up with Dr. Zubin Shah, Clinical Ambassador for Pediatrix. The team explores the power of tailoring bedside conversations to individual babies—whether discussing targeted hemodynamics or framing RSV prevention with nirsevimab—rather than relying solely on generalized trial data. Dr. Shah also sheds light on the evolving landscape of neonatal recruitment, emphasizing how peer mentorship and direct networking can help new physicians find practices that balance rigorous clinical care with research and quality improvement.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!

Send a textDr. Kwadwo Kyeremanteng is a returning guest on our show! Be sure to check out his first appearances on episode 471 and 585 of Boundless Body Radio!Dr. Kwadwo Kyeremanteng is an ICU physician, health advocate, and wellness influencer dedicated to transforming lives. With a deep understanding of critical care medicine and a passion for prevention, he helps individuals like you take charge of your health through education and community. His holistic approach empowers you to live healthier and more fulfilling lives—and ensures he meets you thriving, not in the ICU.Dr. Kwadwo is here to guide you toward the health transformation you deserve. By addressing the core aspects of your well-being, he equips you with practical strategies to create lasting change. With every article, podcast, and resource he shares, Dr. Kwadwo's focus remains on helping you prevent health setbacks, avoid the ICU, and live a life rooted in wellness.He is the author of two books, including Unapologetic Leadership: Finding The Moral Courage To Do The Right Thing, and his latest book Prevention Over Prescription: Take Control of Your Health through Nutrition, Movement and Community.He is also the host of the amazing Prevention over Prescription Podcast, AKA the KWADCAST!!Find Dr. Kwadwo at-https://drkwadwo.ca/TW- @kwadcastIG- @kwadcastFind Boundless Body at- myboundlessbody.com Book a session with us here!

Dr. Kelly Pruden shares her innovative "Build Your Dream Unit – Nurse Recruitment Challenge," where students design an innovative clinical unit and then compete to recruit peers to work there. In this activity, small groups design a specialty unit (eg, ICU, Labor & Delivery, Medical-Surgical) incorporating evidence-based principles of healthy work environments, nurse well-being, and recruitment strategies. Dr. Pruden believes nursing students deserve to practice leadership long before they inherit it on the job.

There is enormous heterogeneity in clinical outcomes and severity of septic shock, with some patients needing only supportive care in the ICU and others progressing to multiorgan system failure and death. How can clinicians identify patients at higher risk of death? In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn Bulloch, PharmD, BCPS, FCCM, is joined by John A. Kellum, MD, FCCM, to discuss high endotoxin activity as a possible endotype for septic shock. Dr. Kellum's article, “Organ Failure, Endotoxin Activity, and Mortality in Septic Shock,” was published in the September 2025 compendium of Critical Care Explorations. Dr. Kellum is a professor and director of the Center for Critical Care Nephrology, as well as vice chair for the Department of Critical Care Medicine, at the University of Pittsburgh in Pittsburgh, Pennsylvania, USA. The study used a novel biomarker called the endotoxin activity assay (EAA) to detect endotoxin in the blood. While the EAA is not good at identifying patients who are at risk for sepsis, Dr. Kellum said that, when combined with organ failure, it identifies patients at high risk for endotoxic septic shock. In the study, these patients had a mortality rate of 60%. Neither the EAA nor the anti-endotoxin therapy is readily available. And, although endotoxic septic shock is rare, occurring in only a quarter of patients with septic shock, Dr. Kellum hopes that, through precision medicine, segmenting this population into treatable subgroups may allow better diagnostics and opportunities to develop or repurpose therapies in the future. This episode is sponsored by Prenosis. Resources referenced in this episode: Organ Failure, Endotoxin Activity, and Mortality in Septic Shock (Molinari  L, et al. Crit Care Explor. 2025;7:e1308) Derivation, Validation, and Potential Treatment Implications of Novel Clinical Phenotypes for Sepsis (Seymour CW, et al. JAMA. 2019;321:2003-2017) Safety and Efficacy of Polymyxin B Hemoperfusion (PMX) for Endotoxemic Septic Shock in a Randomized, Open-Label Study (TIGRIS) (ClinicalTrials.gov. ID NCT03901807. Last update posted January 9, 2026)

Welcome to Classic Skeptic Metaphysicians! We're re-releasing some of our back catalog so that these gems can be re-discovered!This week: Should We Fear Death? An Honest Conversation with Hospice Nurse Julie McFaddenDeath. It's the one certainty we all share...and the one topic most of us avoid like the plague. For years, Will openly admits his biggest fear was dying. Not just the process… but the terrifying possibility of nothingness afterward. And even after years of exploring consciousness, spirituality, and Near-Death Experiences on this show, that old panic still sneaks in from time to time. So this week, we go straight to the source. We sit down with Hospice Nurse Julie McFadden, a former ICU nurse turned hospice advocate who has witnessed hundreds of deaths, and calls the experience not tragic… but beautiful. Yes. Beautiful. Julie pulls back the curtain on what really happens as the body shuts down, what families often misunderstand about the dying process, and why so many people report seeing deceased loved ones in the final weeks of life. We cover:What actually happens to the body in the final months, weeks, and hoursWhy dying does not automatically mean sufferingThe science behind decreased appetite, increased sleep, and metabolic shiftsWhat “visioning” is, and why it happens to so many peopleWhether atheists experience end-of-life visions tooThe truth behind the “6 ounces of the soul” mythWhat it feels like to be in the room when someone takes their final breathWhy education about death reduces fearAnd the ultimate question: Is there life after death?Julie speaks candidly about the mysterious, metaphysical phenomena she's witnessed, and the sacred stillness that seems to fill a room when someone transitions. This conversation may not give you absolute certainty about what lies beyond… But it may radically change how you think about the journey getting there. If you've ever feared the process of dying… If you've ever sat beside a loved one and wondered if they were suffering… Or if you're simply curious about what really happens when we take our last breath… This episode might bring you more peace than you expect.Why This Episode Matters We spend so much time preparing for life. Almost none preparing for death. And yet, according to someone who sees it daily, the body knows exactly what to do. The real fear may not be death itself…But our misunderstanding of it. Listen in. You may walk away feeling lighter.The Skeptic Metaphysicians is a spiritual awakening podcast for open-minded thinkers who refuse to check their critical thinking at the door. Each episode explores consciousness expansion, enlightenment, soul purpose, and soul growth through honest, grounded conversation with leading voices in metaphysics, psychic phenomenon, quantum healing, and beyond. We dive deep into spiritual awakening, ascension, alignment, and the awakening process without the dogma. From mediumship and spirit guides to Arcturian contact, astrology, and the subconscious mind, we explore it all with curiosity, humor, and zero guru worship. Whether you're in the middle of your own awakening, questioning reality, or just spiritually curious, this is the podcast for seekers and skeptics alike.Subscribe, Rate & Review!If you found this episode enlightening, mind-expanding, or even just thought-provoking (see what we did there?), please take a moment to rate and review us. Your feedback helps us bring more transformative guests and topics your way!Connect with Us: 

Send a textJoin Ben and Daphna live from the NEO Conference as they welcome the 2026 Legends in Neonatology Award recipient, Dr. Waldemar "Wally" Carlo. In this inspiring conversation, Dr. Carlo discusses the driving forces behind his enduring passion for clinical care and the critical need for robust bedside research. They explore how full-time clinicians can actively shape the research agenda by turning everyday diagnostic uncertainties into innovative trials. Dr. Carlo also offers a preview of his highly anticipated lecture on neonatal oxygen targets, revealing why it remains one of the most rigorously studied—yet complex—areas in modern medicine.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!

Send a textDoes our fear of necrotizing enterocolitis do more harm than good? In this live episode from the Neo conference, Ben and Daphna sit down with Dr. Ariel Salas to challenge the "culture of fear" surrounding neonatal nutrition. Dr. Salas argues that while we obsess over ill-defined NEC risks, we may be sacrificing the proven benefits of early feeding on sepsis reduction. From the emotional weight of "wasted" breast milk to the "illusion of control" provided by strict protocols, this conversation urges neonatologists to move toward a family-centered, evidence-based approach that prioritizes human milk over clinical hesitation.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!

Bryce Savoy lost his father unexpectedly on New Year's Day. Ten months later, he became a father himself.In this episode of DEAD Talks, we explore grief, masculinity, faith, and transformation. Bryce shares what it was like walking into the ICU, watching his father's health decline suddenly, and starting a new year in shock.Months later, he and his partner received devastating news at their 20-week ultrasound — including a rare one-in-a-million condition affecting their unborn son.We discuss:Losing a parent unexpectedlyGrieving as a manBlack men and emotional suppressionFaith during crisisBecoming a father after lossFacing fear and the illusion of controlGrowing through griefThis is a conversation about death, resilience, and stepping into adulthood through pain.Check out Bryce Savoy on IG: ⁠@brycesavoy510⁠Check out his music and here: ⁠Bryce Savoy⁠Sign Up For E-Mail Updates Here > ⁠Submit Your Email⁠If you're looking 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!Hats, Shirts, Hoodies + More: ⁠Shop Here⁠ ⁠“Dead Dad Club” & “Dead Mom Club”⁠ – Wear your story, honor your people.Exclusive Discounts⁠10% 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 Talks⁠YouTube⁠ | ⁠Facebook⁠ | ⁠Instagram⁠ | ⁠TikTok⁠ | ⁠www.deadtalks.net⁠

Send a textLive from the Neo Conference in Las Vegas, Ben and Daphna sit down with Dr. Zach Anderson from Winnie Palmer Hospital to demystify the integration of Point of Care Ultrasound (POCUS) in the NICU. Moving beyond the intimidation of complex cardiac scans, Zach explains why starting with "pinch points" like vascular access or bladder volume can revolutionize bedside decision-making. From the SAFER protocol to managing the agitated infant on ECMO, this episode explores how POCUS serves as a powerful problem-solving tool that bridges the gap between clinical mystery and immediate intervention.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!

Send a textIn this live episode from the Neo Conference in Las Vegas, we welcome back Dr. Souvik Mitra to unpack the evolving landscape of PDA management in extremely preterm infants. We dive into the recent AAP guidelines recommending against early medical treatment and explore potential unintended consequences, including rising transcatheter closure rates and delayed intervention. Dr. Mitra shares his institution's approach using the SMART-PDA criteria, highlighting the importance of treatment timing and proper patient selection. Join us for a nuanced discussion balancing large pragmatic trial data with bedside clinical judgment for our most vulnerable babies.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!

Send a textIn this live episode from the Neo Conference in Las Vegas, we welcome back Dr. Souvik Mitra to unpack the evolving landscape of PDA management in extremely preterm infants. We dive into the recent AAP guidelines recommending against early medical treatment and explore potential unintended consequences, including rising transcatheter closure rates and delayed intervention. Dr. Mitra shares his institution's approach using the SMART-PDA criteria, highlighting the importance of treatment timing and proper patient selection. Join us for a nuanced discussion balancing large pragmatic trial data with bedside clinical judgment for our most vulnerable babies.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!

Send a textWhat are we actually compressing during neonatal CPR? This week on The Incubator Podcast, Ben and Daphna dive into a provocative echocardiography study out of Edmonton showing that standard chest compressions in newborns likely target the right heart and great vessels — not the left ventricle. A small sample size, but a finding that anyone who ultrasounds hearts all day will instantly recognize.Daphna presents a retrospective multicenter study from Nationwide Children's on antibiotic duration for Gram-negative bloodstream infections in the NICU. Short course (≤8 days) showed no treatment failures — while 14% of infants in the long duration group developed a multi-drug resistant organism infection. Eight days versus ten: does the difference matter? The data says yes.Ben reviews a randomized controlled trial from UAB on early vitamin D supplementation in extremely preterm infants fed human milk. Eight hundred units daily for the first two weeks appears safe and effective at achieving vitamin D sufficiency — but did it move the needle on BPD? And is that even the right question to ask?Daphna brings a QI paper from Levine Children's on universal social determinants of health screening across nine pediatric divisions, achieving 92% compliance and connecting thousands of families to resources through findhelp.org. A reminder that the tools are already there — we just have to use them.The episode wraps with Ben, Daphna, and Eli discussing Colorado's landmark paid NICU leave law — the first in the nation to require employers to provide up to 12 weeks of paid leave for parents with a baby in the NICU. What does the evidence say, and how do we advocate for this in our own states?Science, equity, and advocacy — all in one episode.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!

CardioNerds (Dr. Jenna Skowronski [Heart Failure Council Chair], Dr. Shazli Khan, and Dr. Josh Longinow) are joined by renowned leaders in the field of AHFTC (Advanced Heart Failure and Transplant Cardiology) and mechanical circulatory support, Dr. Jeff Teuteberg and Dr. Mani Daneshmand to continue the discussion of advanced heart failure therapies by taking a deep dive into the world of durable LVADs (Left Ventricular Assist Devices). In this episode, we will review the history of ventricular assist devices, the basics of LVAD function, selection criteria for LVAD therapy, and surgical nuances of LVAD implantation. Audio Editing by CardioNerds intern, Joshua Khorsandi. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls There have been significant advances in the field of MCS/LVAD therapy since the first implanted LVAD in the 1960s, to the first FDA approved device in the early 2000's, to now the HM3 LVAD, with the most important change being a centrifugal flow/magnetically levitated design that led to minimized hemocompatibility-related adverse events (HRAE's) (MOMENTUM 3 trial comparing HM2 and HM3).  The REMATCH trial in 2001 was a pivotal trial for LVAD therapy, demonstrating that in a population of patients with advanced HF (70% IV inotrope dependent), LVAD therapy significantly improved survival at both 1 and 2 years as compared to medical therapy alone.    MOMENTUM 3 trial was a landmark trial for the HM3 device, showing that in a population of end stage HF patients (86% inotrope dependent, 32% INTERMACS 1-2, and 60% DT strategy), 5-year survival with HM3 was 58% and HM3 had lower HRAE's compared with HM2.  There are both patient-specific factors and surgical considerations when it comes to candidacy for LVAD therapy.  RV function prior to LVAD is a key determinant for success post-LVAD  Many patients being considered for LVAD may not have robust RV function, however, predicting RV failure after LVAD is exceedingly difficult.   In general, it doesn’t matter how bad the RV may look on imaging; we care more about the pre-LVAD hemodynamics (look at the PAPi and RA/wedge ratio).   What happens in the OR may be the most important determinant of how the RV will do with the LVAD!  Notes Notes drafted by Dr. Josh Longinow.  1. Historical background of heart pumps and LVADs  LVAD Evolution   FDA approval year  2001  2008  2012  2017  Pump  HeartMate XVE   HeartMate II  Heartware HVAD  HeartMate III  Flow/Design Features  Pulsatile Technology   Continuous flow Axial design  Continuous flow  Centrifugal design  Continuous flow   Full MagLev + Centrifugal design  The 1960's ushered in the first ‘LVADs', when the first air-powered ‘LVAD' was implanted. It kept the patient alive for four days before the patient expired.   The first generation of LVADs were pulsatile pumps   The first nationally recognized, FDA approved LVAD was the HeartMate XVE (late 1990s to early 2000s, REMATCH trial). The XVE pump used compressed air (pneumatically driven) to power the pump.   Prior to the XVE, OHT was the standard of care for patients with advanced, end-stage heart failure.   The second and third generations of LVADs were non-pulsatile, continuous flow devices and included the HVAD, HM2, and HM3 devices.   MOMENTUM 3 was a landmark trial for the HM3 device, showing that in a population of sick patients with end stage HF (86% inotrope dependent, 32% INTERMACS 1-2, and 60% DT strategy), 5-year survival with HM3 was 58% and HM3 had lower HRAE's compared with HM2.   The only pump that is currently FDA approved for implant is the HM3, although other pumps are in clinical trials (BrioVAD system, INNOVATE Trial).  2. What are LVADs, and how do they work?   In simplest terms, the LVAD is a heart pump comprised of several key mechanistic components:   Inflow cannula  Mechanical pump   Outflow cannula  Driveline  Controller/Power source  The HM3 differs from its predecessors (HM2 and HVAD) in several key ways;   HM3 is placed intrapericardial whereas the HM2 was placed pre-peritoneal.   Perhaps most importantly, the HM3 is a fully magnetically levitated, centrifugal flow pump, whereas the HM2 is an axial flow device.  Axial flow pumps are not magnetically levitated, leading to more friction produced between the ruby bearing's contact with the pump rotors, and higher rates of hemocompatibility related adverse events (HRAEs, i.e. pump thrombosis) and the HM2 was ultimately discontinued in favor of the HM3 (MOMENTUM 3 trial).  3. What do the terms ‘Destination Therapy' (DT) or ‘Bridge to Transplant' (BTT) mean when it comes to LVADs?   When LVADs first came on the stage, EVERYONE was a BTT; these early pumps weren't designed for long term use (I.e. REMATCH Trial, Heartmate XVE)  Destination therapy means the LVAD was placed in leu of transplant because there are contraindications to transplant   REMATCH trial brought about the concept of “Destination therapy”, comparing outcomes in patients (with contraindications for transplant) who received an LVAD vs optimal medical therapy  Bridge to transplant means we are placing the LVAD in a patient who may not be a transplant candidate at this moment in time (is too sick, or conversely, not sick enough), but may be down the line   Bridge to recovery is another term used when the LVAD is being placed for a patient we think may have a recoverable cardiomyopathy  4. What are some factors we should consider when assessing a patient’s candidacy for LVAD, in general, and from a surgical perspective?   Patient factors   Older age might push us towards thinking LVAD rather than transplant  In general, age > 70 is the cutoff for transplant, but this is not a hard cut off and varies institution to institution    In general, think about things that help predict recovery after a major surgery; Frailty and Nutritional status are important, we try to optimize these prior to LVAD implant   Right ventricular function remains the Achilles heel of LV support  We know that needing temporary RV support post LVAD puts you on a different survival curve than patients who don’t need RVAD support  Studies have not been able to successfully predict who will develop RV failure after LVAD implantation  What happens in the time between when the patient goes to the OR and when they get back to the ICU is an important determinant who might develop RV failure post LVAD   Surgical techniques such as implanting the HM3 in the intra-thoracic cavity, rather than intra-pericardial may help maintain LV/RV geometry to help optimize the RV post LVAD   Surgical considerations for LVAD candidacy  Small, hypertrophied LV: HM3 inflow cannula is small, but small hypertrophied ventricles tend towards chamber collapse during systole causing suction, needing to run slower with lower flow rates  Chest size/diameter: pumps have gotten so small now, that for adults, these have become less of a consideration  BMI: low BMI used to be more of a concern with the older pumps due to where they were placed, and the relative size of the pump itself, not so much now with the smaller HM 3 pumps  Calcified LV apex: would increase risk of stroke, bleeding   Driveline tunneling becomes a concern in the super obese population, higher risk for driveline infections (might tunnel these driveline's shorter, and to a less fatty region of the abdomen, could even tunnel out the thoracic cavity in the super obese to limit skin motion)    5. Is there a role for MCS (i.e. temporary LVAD such as Impella) in pre-habilitation of patients prior to LVAD surgery?   The theory of being able to improve systemic perfusion, decongest the organs, and make the patient feel better prior to surgery makes sense, but becomes problematic due to the lack of a hard end point/time for prehabilitation which might risk delays in surgery   More likely that it can lead to delay in the surgery, with less-than-optimal benefit; you don't want to prolong the wait for surgery and increase the risk for complications prior to surgery    An Impella 5.5 is currently FDA approved for 2 weeks of support, not 2 months so timing is important to keep in mind  It’s unlikely that you will take a patient and convert them from a malnourished, cachectic person in 2 weeks’ time   6. Is there a role for LVAD therapy in the younger patient population? Should we be thinking of LVAD up front for these patients, with the goal of transplanting down the line?   Recovery may be more likely in certain populations, particularly younger females with smaller LV's; in those populations, perhaps bridge to recovery should be the focus, optimizing them on GDMT etc.   The replacement of transplant, with MCS (LVAD) in young patients has become a topic of discussion, because these pumps have become better and better, with the thinking that an LVAD could bridge a patient for 10 years or so, and they could get a transplant later   It is still a big unknown, but several concerns exist  Patients who get LVADs might end up with complications that become contraindication to transplant down the line (stroke, sensitization etc)   Patients and providers are more hesitant because of the more recent iteration for the UNOS criteria for OHT listing which no longer gives patients with an uncomplicated LVAD higher priority, and therefore they could end up waiting a longer time for a heart after undergoing LVAD  References Rose EA, Gelijns AC, Moskowitz AJ, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001;345(20):1435-1443. doi:10.1056/NEJMoa012175  Mehra MR, Uriel N, Naka Y, et al. A Fully Magnetically Levitated Left Ventricular Assist Device – Final Report. N Engl J Med. 2019;380(17):1618-1627. doi:10.1056/NEJMoa1900486  Mancini D, Colombo PC. Left Ventricular Assist Devices: A Rapidly Evolving Alternative to Transplant. J Am Coll Cardiol. 2015;65(23):2542-2555. doi:10.1016/j.jacc.2015.04.039  Mehra MR, Goldstein DJ, Cleveland JC, et al. Five-Year Outcomes in Patients With Fully Magnetically Levitated vs Axial-Flow Left Ventricular Assist Devices in the MOMENTUM 3 Randomized Trial. JAMA. 2022;328(12):1233-1242. doi:10.1001/jama.2022.16197  Rose EA, Moskowitz AJ, Packer M, et al. The REMATCH trial: rationale, design, and end points. Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure. Ann Thorac Surg. 1999;67(3):723-730. doi:10.1016/s0003-4975(99)00042-9  Kittleson MM, Shah P, Lala A, et al. INTERMACS profiles and outcomes of ambulatory advanced heart failure patients: A report from the REVIVAL Registry. J Heart Lung Transplant. 2020;39(1):16-26. doi:10.1016/j.healun.2019.08.017  Mehra MR, Netuka I, Uriel N, et al. Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure: The ARIES-HM3 Randomized Clinical Trial. JAMA. 2023;330(22):2171-2181. doi:10.1001/jama.2023.23204  Mehra MR, Nayak A, Morris AA, et al. Prediction of Survival After Implantation of a Fully Magnetically Levitated Left Ventricular Assist Device. JACC Heart Fail. 2022;10(12):948-959. doi:10.1016/j.jchf.2022.08.002  Bhardwaj A, Salas de Armas IA, Bergeron A, et al. Prehabilitation Maximizing Functional Mobility in Patients With Cardiogenic Shock Supported on Axillary Impella. ASAIO J. 2024;70(8):661-666. doi:10.1097/MAT.0000000000002170