Podcasts about international society

Join hosts Shaiey Hoogendoorn and Dr. Andrea Vassilev in an enlightening discussion focusing on the often misunderstood concept of mixed features. With personal anecdotes and professional insights, they unpack what it means to experience mixed episodes and how these can present in daily life. This episode sheds light on diagnostic challenges, common misconceptions, and the importance of accurate treatment. Additionally, the episode touches on the risks associated with mixed features, including heightened impulsivity and agitation. Listen in as they explore how living through these experiences can feel like being on two roller coasters at once, and the vital need for advocacy and self-awareness in managing mood disorders. This episode is a testament to the power of shared knowledge and community healing. this is bipolar... (00:10:08) The Complexity of Diagnosis (00:12:28) Dr Andrea's upcomig workbook book on Self Stigma (00:16:43) Personal Experience with Mixed Features (00:21:35) Navigating Mixed Features (00:27:09) Agitation & Despair (00:30:52) Urgency of Treatment (0035:46) Encouragement & Resistance (00:39:32) Closing Thoughts & Community Call to Action Connect with us: IG @this.is.bipolar Youtube: this is bipolar channel TT @this.is.bipolar thisisbipolar.com   Thank you from the bottom of my heart for listening. If this episode or podcast means something to you, I would be forever grateful if you would follow/subscribe the ‘this is bipolar' podcast wherever you listen to your podcasts so you stay up to date. It would also mean the world to me if you gave a 5 ⭐️ star review- this helps the podcast reach those who need to hear it most.  Much love, Shaley xo  More about your Host: Shaley Hoogendoorn is a speaker, content creator and currently hosts the popular “this is bipolar” vlog and podcast. She lives with bipolar 2 disorder and shares her story and the stories of others to dismantle the stigma around mental illness.  Shaley is passionate about educating and empowering others about bipolar disorder. She has contributed to publications for Sanctuary Ministries, Psych Central and BP Hope magazine. She hosted a series interviewing women living with mental illnesses at SheLoves Magazine in a series named "Sisters in Mental Illness."  Shaley's greatest hope is that creating safe spaces to connect will give hope and comfort those that struggle. Meet our Guest Co-Host: Dr. Andrea Vassilev holds a doctorate in psychology, is a therapist in California, and has lived with bipolar disorder for over 25 years. Andrea is the creator of the program Overcoming Self-Stigma in Bipolar Disorder and serves on the Board of Directors of the International Society for Bipolar Disorders. As a clinician and academic with lived experience, Andrea brings a special perspective to both her professional and advocacy work. Andrea hopes that by telling her own story of life with bipolar disorder through the lenses of clinical causes, treatments, and outcomes that she can provide education, hope, and comfort to others. You can connect with her on Instagram @best.life.bipolar or at www.andreavassilev.com. IG @this.is.bipolar Youtube: this is bipolar channel TT @this.is.bipolar thisisbipolar.com Thank you from the bottom of my heart for listening. If this episode or podcast means something to you, I would be forever grateful if you would follow/subscribe the ‘this is bipolar' podcast wherever you listen to your podcasts so you stay up to date. It would also mean the world to me if you gave a 5 ⭐️ star review- this helps the podcast reach those who need to hear it most.  Much love, Shaley xo  More about your Host: Shaley Hoogendoorn is a speaker, content creator and currently hosts the popular “this is bipolar” vlog and podcast. She lives with bipolar 2 disorder and shares her story and the stories of others to dismantle the stigma around mental illness.  Shaley is passionate about educating and empowering others about bipolar disorder. She has contributed to publications for Sanctuary Ministries, Psych Central and BP Hope magazine. She hosted a series interviewing women living with mental illnesses at SheLoves Magazine in a series named "Sisters in Mental Illness."  Shaley's greatest hope is that creating safe spaces to connect will give hope and comfort those that struggle. Meet our Guest Co-Host: Dr. Andrea Vassilev holds a doctorate in psychology, is a therapist in California, and has lived with bipolar disorder for over 25 years. Andrea is the creator of the program Overcoming Self-Stigma in Bipolar Disorder and serves on the Board of Directors of the International Society for Bipolar Disorders. As a clinician and academic with lived experience, Andrea brings a special perspective to both her professional and advocacy work. Andrea hopes that by telling her own story of life with bipolar disorder through the lenses of clinical causes, treatments, and outcomes that she can provide education, hope, and comfort to others. You can connect with her on Instagram @best.life.bipolar or at www.andreavassilev.com.

In June 2025, we attended ISSCR 2025, the annual meeting of the International Society for Stem Cell Research, in Hong Kong. We spoke with delegates about their research, their impressions of the meeting, and the most memorable research presented. They also discussed their experiences exploring Hong Kong.

Véronique Altglas holds a PhD from the Ecole Pratique des Hautes Etudes in Paris and has served as a as a lecturer in sociology at Queen's University Belfast since 2009. Dr. Altglas' publications include two monographs: Le nouvel hindouisme occidental (CNRS, 2005); and From Yoga to Kabbalah: Religious Exoticism and the Logics of Bricolage (Oxford University Press, 2014), for which she won the book award of the International Society for the Sociology of Religion in 2017. She is also the editor of a four-volume reader, Religion and Globalization: Critical Concepts in Social Studies (Routledge, 2010). Her In this interview, she discusses her new book, Judaizing Christianity and Christian Zionism in Northern Ireland, recently published with Routledge. This book explores the contemporary Judaization of evangelical Christianity through the ethnography of a Messianic congregation in Northern Ireland. A constellation of Messianic "congregations" have expanded worldwide over recent years, combining Jewish liturgy, symbols, and artifacts with prophecies about the End Times and the return of Jesus. Increasingly recognized as a legitimate subdivision within evangelicalism, the Messianic movement has facilitated a popularization of Jewish practices and symbolism beyond its own congregations. The author considers: What insights do these congregations offer about the deregulation of religions? Is there any logic to the combinations of Christian and Jewish sources in Messianic beliefs and practices? How can we understand this fascination with Jews and Judaism? Finally, what is the political significance of Messianic relationship with Jewish people, the state of Israel, and Christian Zionism? The book will be of particular interest to scholars of the sociology and anthropology of religion, religion and politics, and Jewish-Christian relations. Judaizing Christianity and Christian Zionism in Northern Ireland. For God, Israel and Ulster is published with Routledge Aidan Beatty is a lecturer in the history department at Carnegie Mellon University Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network

Véronique Altglas holds a PhD from the Ecole Pratique des Hautes Etudes in Paris and has served as a as a lecturer in sociology at Queen's University Belfast since 2009. Dr. Altglas' publications include two monographs: Le nouvel hindouisme occidental (CNRS, 2005); and From Yoga to Kabbalah: Religious Exoticism and the Logics of Bricolage (Oxford University Press, 2014), for which she won the book award of the International Society for the Sociology of Religion in 2017. She is also the editor of a four-volume reader, Religion and Globalization: Critical Concepts in Social Studies (Routledge, 2010). Her In this interview, she discusses her new book, Judaizing Christianity and Christian Zionism in Northern Ireland, recently published with Routledge. This book explores the contemporary Judaization of evangelical Christianity through the ethnography of a Messianic congregation in Northern Ireland. A constellation of Messianic "congregations" have expanded worldwide over recent years, combining Jewish liturgy, symbols, and artifacts with prophecies about the End Times and the return of Jesus. Increasingly recognized as a legitimate subdivision within evangelicalism, the Messianic movement has facilitated a popularization of Jewish practices and symbolism beyond its own congregations. The author considers: What insights do these congregations offer about the deregulation of religions? Is there any logic to the combinations of Christian and Jewish sources in Messianic beliefs and practices? How can we understand this fascination with Jews and Judaism? Finally, what is the political significance of Messianic relationship with Jewish people, the state of Israel, and Christian Zionism? The book will be of particular interest to scholars of the sociology and anthropology of religion, religion and politics, and Jewish-Christian relations. Judaizing Christianity and Christian Zionism in Northern Ireland. For God, Israel and Ulster is published with Routledge Aidan Beatty is a lecturer in the history department at Carnegie Mellon University Learn more about your ad choices. Visit megaphone.fm/adchoices

Véronique Altglas holds a PhD from the Ecole Pratique des Hautes Etudes in Paris and has served as a as a lecturer in sociology at Queen's University Belfast since 2009. Dr. Altglas' publications include two monographs: Le nouvel hindouisme occidental (CNRS, 2005); and From Yoga to Kabbalah: Religious Exoticism and the Logics of Bricolage (Oxford University Press, 2014), for which she won the book award of the International Society for the Sociology of Religion in 2017. She is also the editor of a four-volume reader, Religion and Globalization: Critical Concepts in Social Studies (Routledge, 2010). Her In this interview, she discusses her new book, Judaizing Christianity and Christian Zionism in Northern Ireland, recently published with Routledge. This book explores the contemporary Judaization of evangelical Christianity through the ethnography of a Messianic congregation in Northern Ireland. A constellation of Messianic "congregations" have expanded worldwide over recent years, combining Jewish liturgy, symbols, and artifacts with prophecies about the End Times and the return of Jesus. Increasingly recognized as a legitimate subdivision within evangelicalism, the Messianic movement has facilitated a popularization of Jewish practices and symbolism beyond its own congregations. The author considers: What insights do these congregations offer about the deregulation of religions? Is there any logic to the combinations of Christian and Jewish sources in Messianic beliefs and practices? How can we understand this fascination with Jews and Judaism? Finally, what is the political significance of Messianic relationship with Jewish people, the state of Israel, and Christian Zionism? The book will be of particular interest to scholars of the sociology and anthropology of religion, religion and politics, and Jewish-Christian relations. Judaizing Christianity and Christian Zionism in Northern Ireland. For God, Israel and Ulster is published with Routledge Aidan Beatty is a lecturer in the history department at Carnegie Mellon University Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/sociology

Mary welcomes back Don Veinot to talk about taming Jesus to fit a progressive worldview, false representations of Christian and Christianity, and what fills that void every human has. For the last few decades especially, the progressive left has not only sought to dominate the American political landscape, but has infiltrated the church - purposefully and methodically. From Red Letter Christians to Social Justice warriors, the church has been leaning left on a large scale. The church has been duped into rethinking gay rights, social causes and immigration; Israel is no longer the apple of God's eye and that piece of land is now home to apartheid and genocidal Jews. How did we get here, and what are the dangers of such an unbiblical worldview? Does it impact our eternity? Yes, and people are making eternal choices over temporal issues, misrepresenting Jesus and His ministry. A thoughtful hour on the Jesus of the Left.  Don Veinot and his wife Joy are co-founder and president of Midwest Christian Outreach, Inc. (MCOI), a mission to cults and non-Christian religions based in Wonder Lake, IL. They have studied numerous cults and new religious movements impacting the church since 1987. Don is a frequent guest on numerous radio and television broadcasts including The John Ankerberg Show as well as being a staff researcher and writer for the Midwest Christian Outreach Journal. Additionally, Don is co-author of the book A Matter of Basic Principles: Bill Gothard and His Cultish Teachings, as well as various research articles in the CRI Journal, PFO Quarterly Journal, Campus Life Magazine, Journal of the International Society of Christian Apologetics, Midwestern Journal of Theology, and other periodicals.   Stand Up For The Truth Videos: https://rumble.com/user/CTRNOnline & https://www.youtube.com/channel/UCgQQSvKiMcglId7oGc5c46A

On this episode of JHLT: The Podcast, the Digital Media Editors invite first author Nikil Prasad, MD, a cardiology fellow in the Columbia University Medical Center in New York, to discuss the paper, “Can the grading of mild cardiac allograft vasculopathy be further refined? An angiographic and physiologic assessment of heart transplant recipients with ISHLT CAV 1.” The discussion explores: The study's subdivisions of CAV grade 1 into CAV 1a and CAV 1b, based on the degree of coronary stenosis Differing clinical information provided by different methods of CAV screening: reduced myocardial blood flow reserve vs angiographic grading Limitations in implementing PET-based CAV assessments at various centers, and how transplant programs can use combined testing data For the latest studies from JHLT, visit www.jhltonline.org/current, or, if you're an ISHLT member, access your Journal membership at www.ishlt.org/jhlt. Don't already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.

Creatine for Alzheimer's — let's separate the hype from the hope. A new study has caused a stir in June 2025, but lead researcher Matthew K. Taylor told us: “ I don't think I can recommend it to a patient that this is going to ultimately have some sort of cognitive influence.” We speak to Dr. Taylor and Dr. Russell Swerdlow in this episode, discussing: • Role of creatine in your brain, and why it matters for energy metabolism • What the 2025 study found (and why it wasn't designed to prove effectiveness) • How scientific nuance gets lost in supplement hype • Why even promising early data must be handled with care • The vital difference between hype and hope Dr. Russell Swerdlow, MD is Director of the University of Kansas Alzheimer's Disease Research Center. Dr. Matthew Taylor, PhD, RD is Associate Professor of Dietetics & Nutrition at the University of Kansas Medical Center. This is... Your Brain On Creatine. SUPPORTED BY: NEURO World. Help your brain thrive, now and into the future: https://neuro.world/  ‘Your Brain On' is hosted by neurologists, scientists, and public health advocates Ayesha and Dean Sherzai.  ‘Your Brain On... Creatine' • SEASON 5 • EPISODE 8 LINKS  Dr. Taylor at the University of Kansas: https://www.kumc.edu/mtaylor3.html Dr. Swerdlow at the University of Kansas: https://www.kumc.edu/rswerdlow.html REFERENCES 1. Smith AN, Choi IY, Lee P, Sullivan DK, Burns JM, Swerdlow RH, Kelly E, Taylor MK. Creatine monohydrate pilot in Alzheimer's: Feasibility, brain creatine, and cognition. Alzheimer's & Dementia: Translational Research & Clinical Interventions. 2025 Apr;11(2):e70101. 2. Taylor MK, Burns JM, Choi IY, et al. Protocol for a single-arm, pilot trial of creatine monohydrate supplementation in patients with Alzheimer's disease. Pilot Feasibility Study. 2024;10(1):42.  3. Habeck C, Risacher S, Lee GJ, et al. Relationship between baseline brain metabolism measured using [18 F]FDG PET and memory and executive function in prodromal and early Alzheimer's disease. Brain Imaging Behav. 2012;6(4):568-83.  4. Kreider RB, Kalman DS, Antonio J, et al. International Society of Sports. Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18.

This week on The Profitable Photographer, I had a fun and inspiring conversation with Angela Lawson, an international award-winning pet photographer with 28 years of experience. For the past 15 years, she's focused exclusively on animals of all shapes and sizes—from dogs and cats to reptiles and pocket pets.She has also earned her Accredited Professional of Animal Imagery from the International Society of Animal Photographers and has taken the PPA judges' training Angela shares how understanding animal behavior and breed traits has been essential to her success, and how she brings compassion and purpose to every session.One of her most meaningful offerings is her Legacy Sessions, created for senior or terminally ill pets. These sessions capture the deep bond between pets and their people and result in lasting keepsakes like albums and wall portraits.Her sadness that she doesn't have nice portraits of a beloved pet that passed over the rainbow bridge motivated her to start, and teach, this specialty.She breaks down some of the things to know before one of these special sessions.How to gently navigate emotional sessions and support grieving clientsWhy it's important to research each animal before photographing themHow Angela uses local groups and The Tilly Project to market Legacy SessionsTips for intentional business building and meaningful client relationshipsWhether you're already photographing pets or thinking about it, Angela's insights will help you connect more deeply with clients and create work that truly matters.To get in touch with Angela:angela@aglphotography.net www.aglphotography.net www.facebook.com/aglphotoWant support with your business goals? Let's chat at www.lucidumascoaching.comConnect with Photography Business Coach Luci Dumas: Website Email: luci@lucidumas.comInstagram FacebookYouTubeNew episodes drop every week — make sure to subscribe so you never miss an inspiring guest or a powerful solo episode designed to help you grow your photography business.

In this episode, we welcome Dr. Jewel Kling, an expert in women's health and menopause. Dr. Kling is a professor of medicine, chair of the Division of Women's Health at the Mayo Clinic in Scottsdale, Arizona. She is also the director of the Women's Health Center and dean of the Mayo Clinic Arizona Campus. With a background in public health and internal medicine, Dr. Kling has become a recognized leader in the fields of menopause, sexual health, and LGBT care education. She speaks nationally on menopause and hormone therapy and has published extensively on the subject.Dr. Kling joins us to dive into the topic of perimenopause, shedding light on common misconceptions and discussing the best approaches to treatment. In particular, she offers her insights on the pros and cons of starting hormone therapy during perimenopause and how to address contraception during this transitional period.Key discussion points: Perimenopause and Hormone Therapy Managing Symptoms Contraception Considerations Individualized CareThroughout the episode, Dr. Kling provides evidence-based insights and reassures women that effective treatments are available, especially for those suffering from persistent symptoms beyond the typical transition period.As an advocate for women's health, Dr. Kling is also involved in advanced hormone therapy training through the International Society for the Study of Women's Sexual Health (ISWHISH), where she and Dr. Sarah Cigna offer a comprehensive course for healthcare professionals. See below!Resources Mentioned: Advanced Hormone Therapy Course - A year-long virtual course for healthcare professionals, covering a range of topics, including hormone therapy and its effects on sexual functioning throughout different life stages, including pregnancy, lactation, and menopause. The Menopause Society - A resource for menopausal health and guidance on finding certified menopause practitioners.If you're experiencing perimenopausal symptoms or seeking guidance on hormone therapy, this episode offers invaluable knowledge and practical advice for navigating this stage of life with confidence.For more information on the Advanced Hormone Therapy Course and other resources, visit ISWHISH.

In June 2025, Daylon and Arun attended the International Society for Stem Cell Research's (ISSCR) annual meeting in Hong Kong, and recorded daily episodes discussing highlights of the previous 24 hours. Here is the final of four episodes from the meeting. Sessions focused on cell therapy for spinal cord injury, immunocompatible pig organs, and community engagement.

In June 2025, Daylon and Arun attended the International Society for Stem Cell Research's (ISSCR) annual meeting in Hong Kong, and recorded daily episodes discussing highlights of the previous 24 hours. Here is the third of four episodes, where Daylon and Arun discuss research on cell therapy for inflammatory bowel disease and hearing loss. They also talk about Dr. Jacob Hanna's work on ex utero embryo culture, Dr. Paola Arlotta's research on long-term brain organoids, and Di Pan's insights into sponge regeneration.

In June 2025, Daylon and Arun attended the International Society for Stem Cell Research's (ISSCR) annual meeting in Hong Kong, and recorded daily episodes discussing highlights of the previous 24 hours. Here is the second of four episodes, where Daylon and Arun cover talks on animal models of regeneration and the public perception of in vitro gametogenesis. They also discuss work on CiPSCs for Type 1 diabetes therapy and growing pig-human chimeric embryos.

In June 2025, Daylon and Arun attended the International Society for Stem Cell Research's (ISSCR) annual meeting in Hong Kong, and recorded daily episodes discussing highlights of the previous 24 hours. Here is the first of four episodes, where Daylon and Arun discuss updates from clinical trials for ALS, congenital heart disease, and Parkinson's disease. They also talk about the Presidential Plenary session, chaired by Dr. Valentina Greco.

Support us on Patreon!Thanks to Skratch Labs for sponsoring the podcast! Get a free sample pack on us!This week on Your Diet Sucks, we're digging into one of the most misunderstood—and over-marketed—topics in endurance sports: nutrition for female athletes.You've probably heard the myths: women should eat for their body type, avoid carbs during their cycle, or that we're not just small men when it comes to fueling. But most of that advice isn't based on solid science; it's based on outdated research, rigid stereotypes, and a whole lot of pseudoscience.In this episode, Kylee and Zoë unpack:​Why most sports science has ignored female athletes for decades​How hormonal fluctuations, birth control, and life stage transitions affect fueling​What's actually different about female endurance physiology​The truth about somatotypes (ectomorph, mesomorph, endomorph) and why they're BS​Evidence-backed nutrition strategies for training, recovery, and long-term health​Why research gaps are still being filled by grifters, and how to stay skepticalWhether you're menstruating, on birth control, pregnant, postpartum, or in perimenopause—or you coach or care about someone who is—this episode is your myth-busting guide to what women really need to fuel their performance.Thanks to Janji for supporting the podcast! Use code YDS for 10% off your purchase. REFERENCESCowley, E. S., Olenick, A. A., McNulty, K. L., & Ross, E. Z. (2021).“Invisible sportswomen”: The sex data gap in sport and exercise science research. Women in Sport and Physical Activity Journal, 29(2), 146–151. https://doi.org/10.1123/wspaj.2020-0051Elliott-Sale, K. J., Minahan, C. L., de Jonge, X. A. K. J., Ackerman, K. E., Sipilä, S., Constantini, N. W., Lebrun, C. M., Hackney, A. C., & Nindl, B. C. (2021).Methodological considerations for studies in sport and exercise science with women as participants: A working guide for standards of practice for research on women. Sports Medicine, 51(5), 843–861. https://doi.org/10.1007/s40279-021-01435-2International Society of Sports Nutrition (Sims, S. T., Kerksick, C. M., Smith-Ryan, A. E., de Jonge, X. A. K. J., Hirsch, K. R., Arent, S. M., & Antonio, J.). (2023).International Society of Sports Nutrition Position Stand: Nutritional concerns of the female athlete. Journal of the International Society of Sports Nutrition, 20(1), 15. https://doi.org/10.1186/s12970-023-00541-wMountjoy, M., Sundgot-Borgen, J., Burke, L., Ackerman, K. E., Blauwet, C., Constantini, N., Lebrun, C., Lundy, B., Melin, A., Meyer, N., Sherman, R., Tenforde, A., Torstveit, M. K., & Budgett, R. (2018).IOC consensus statement: Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine, 52(11), 687–697. https://doi.org/10.1136/bjsports-2018-099193Sims, S. T. (2016).ROAR: How to match your food and fitness to your unique female physiology for optimum performance, great health, and a strong, lean body for life. Rodale Books.

Hersch Lauterpacht Memorial Lectures 2025: Diversity and Self-Determination in International Law: Continuing Conversations with Karen KnopWe will come together to celebrate the life and scholarship of our colleague and friend, Professor Karen Knop (1960-2022). Karen, until her untimely passing, was the Cecil A Wright Chair at the University of Toronto's Faculty of Law. A long-time friend of the Lauterpacht Centre, Karen was to have delivered the Centre's 2025 Hersch Lauterpacht Memorial Lectures.Session I - History and TheoryProfessor Martti Koskenniemi in conversation with Dr Megan DonaldsonChair: Professor Surabhi RanganathanProfessor Koskenniemi' s talk, 'Narrating International Society: Management of Pluralism according to Marcel Gauchet & Karen Knop', will first address the emergence of the theme of a “law of an international society” in the 19th century, its use in the 20th century to support a managerial view of international institutions. It will then focus on the challenges that cultural and ideological pluralism poses to received ideas about the role of law in the government of domestic and international society. Dr Donaldson's talk, ‘Gaze, Agency and International Society', reads Karen Knop's early work on self-determination as a repertoire of techniques for thinking collectivities and affiliations against and across states. The multiple and mobile perspectives she brought to bear, and the agency she glimpsed in disparate individuals and communities, pervaded much of her later work too, and remains open to, even generative of, renewed understandings of international society.Martti Koskenniemi is Professor Emeritus of International law at the University of Helsinki. Megan Donaldson is Associate Professor of International Law at University College London.

Hersch Lauterpacht Memorial Lectures 2025: Diversity and Self-Determination in International Law: Continuing Conversations with Karen KnopWe will come together to celebrate the life and scholarship of our colleague and friend, Professor Karen Knop (1960-2022). Karen, until her untimely passing, was the Cecil A Wright Chair at the University of Toronto's Faculty of Law. A long-time friend of the Lauterpacht Centre, Karen was to have delivered the Centre's 2025 Hersch Lauterpacht Memorial Lectures.Session I - History and TheoryProfessor Martti Koskenniemi in conversation with Dr Megan DonaldsonChair: Professor Surabhi RanganathanProfessor Koskenniemi' s talk, 'Narrating International Society: Management of Pluralism according to Marcel Gauchet & Karen Knop', will first address the emergence of the theme of a “law of an international society” in the 19th century, its use in the 20th century to support a managerial view of international institutions. It will then focus on the challenges that cultural and ideological pluralism poses to received ideas about the role of law in the government of domestic and international society. Dr Donaldson's talk, ‘Gaze, Agency and International Society', reads Karen Knop's early work on self-determination as a repertoire of techniques for thinking collectivities and affiliations against and across states. The multiple and mobile perspectives she brought to bear, and the agency she glimpsed in disparate individuals and communities, pervaded much of her later work too, and remains open to, even generative of, renewed understandings of international society.Martti Koskenniemi is Professor Emeritus of International law at the University of Helsinki. Megan Donaldson is Associate Professor of International Law at University College London.

Timeline: Get 10% off Mitopure, clinically proven to boost mitophagy. Go to timeline.com/vanessa. In this eye-opening episode of the Optimal Protein Podcast, I'm joined by Dr. Chris Lockwood, PhD—a renowned sports nutrition scientist, industry expert, and former Editor-in-Chief of the International Society of Sports Nutrition Journal—to break down why not all protein is created equal. We dive deep into the Survive vs. Thrive paradigm, uncover how amino acids act as powerful metabolic signals, and explain the critical role of protein quality in fat loss, muscle gain, and long-term health. Whether you're trying to optimize body composition, preserve lean mass as you age, or understand why your plant-based protein isn't delivering results, this episode delivers actionable science you need to hear. What We Cover in This Episode:

The white-coat effect is a measure of blood pressure change from before to during the visit in office/clinic when the blood pressure is recorded by a physician or nurse; this was first described in 1983 by Mancia et al, and was initially thought to represent a benign process. But it was unclear what this actually meant for pregnancy. Ambulatory blood pressure monitoring (ABPM) has been used in pregnancy for about 20 years now. Use of this monitoring option has revealed a subgroup of patients who have persistently high blood pressure (BP) in the presence of health care providers, but a normal ambulatory or self-measured BP. This phenomenon has been termed “White Coat Hypertension” (WCH). In 2013, The International Society for the Study of Hypertension in Pregnancy (ISSHP) published the revised classification for hypertensive disorders in pregnancy, that included WCH, not previously included. The ISSHP guidelines also emphasize that a diagnosis of white coat hypertension in pregnancy should only be considered before 20 weeks of gestation. We now know that WCH, outside of pregnancy, is not an entirely benign process. The role of metabolic risk factors in patients with white-coat hypertension was first outlined in 2000 by Kario and Pickering. When metabolic risk factors are present in association with white-coat hypertension, the increased risk of target organ damage is determined not only by the blood pressure characteristics but also by the metabolic abnormalities. Recognizing the potential risks of white coat hypertension was also published in a commentary in 2016 out of the European Society of Cardiology. That article's title was, “White-coat hypertension: not so innocent”. But what is the latest data on WCH in pregnancy? Is WCH linked to poor obstetrical outcomes? Does WHC need medication therapy? We have data from 2024 to help us. Listen in for details.

In this episode we're talking to Chelsea Ryckis, President of Ethos Benefits on what it means to view your health plan through the eyes of a fiduciary and how that perspective could lead to savings and improved benefits for your employees. Chelsea presented on this topic at the 2024 International Society of Certified Employee Benefit Specialists Symposium. Hear many other great presentations like hers at this year's Symposium! https://www.iscebs.org/symposium Check out Chelsea's own podcast from Ethos Benefits: https://businessofbenefitspodcast.com/ Don't forget - if you manage an ERISA plan, you're legally required to think (and act!) like a fiduciary. The International Foundation has your back with everything you need to know about your fiduciary duties in one easy-to-understand e-learning course. It's a great option to learn about your duties for the first time or brush up on them: https://www.ifebp.org/education---events/virtual-education-and-webcasts/e-learning-course/e-learning-courses/fiduciary-responsibility-for-erisa-plans

Tune in to the latest episode of the AAOHN podcast for an overview of travel medicine. Hear from Anne Terry, ARNP, as she discusses global disease and the vaccines employees travelling abroad need to consider. Depending on where an individual travels, whether it is for personal or professional business, and patients' existing conditions, they may need to take additional protective measures in addition to vaccines. Terry shares her unique experience as the head of the Travel Clinic at the University of Washington, the plethora of environmental exposures travelers may encounter, and how her interactions with her patients influence her practice in real time. Further Reading: Travel Medicine Update CDC Yellow Book - https://www.cdc.gov/yellow-book/index.html International Society of Travel Medicine (ISTM) - https://www.istm.org/ American Society of Tropical Medicine & Hygiene - https://www.astmh.org/ UW CME – Travel Medicine and Global Health Conference June 2025 - https://uw.cloud-cme.com/course/courseoverview?P=5&EID=11210 The Travel and Tropical Medicine Manual - https://shop.elsevier.com/books/the-travel-and-tropical-medicine-manual/sanford/978-0-323-37506-1 Germ and Worm Podcast - https://podcasts.apple.com/us/podcast/germ-worm/id1744408724

In this episode, Peter O'Toole is joined by Virginia Litwin, the President-Elect of the International Society For Advancement of Cytometry (ISAC).They discuss Virginia's journey from academia to industry and her pivotal role in the creation and development of CYTO Women, a committee that's having a genuine positive impact on the opportunities available for women in cytometry.She also shares her experiences in translational science, working closely with clinical trials, and her passion for standardization in flow cytometry. Watch or listen to all episodes of Flow Stars: flowstars.bitesizebio.com

In this episode, we discuss the diagnosis and treatment of resistant hypertension, including a newer endothelin receptor antagonist (ERA) called aprocitentan (Tryvio®). Key Concepts The diagnosis of true resistant hypertension is based on requiring more than 3 antihypertensives (ACE inhibitor or ARB + calcium channel blocker + diuretic) to achieve goal BP, ruling out inaccurate BP readings, and ensuring patient adherence to their antihypertensive therapy. Non-pharmacologic therapy (especially dietary sodium restriction), medication adherence, and lifestyle changes are critical to the treatment of resistant hypertension. The preferred 4th line option for most patients with resistant hypertension is spironolactone. After adding spironolactone, additional therapies are based on expert opinion and patient-specific factors. These additional therapies may include beta blockers, alpha-2 agonists, alpha-1 blockers, hydralazine, minoxidil, and aprocitentan. References Carey RM, Calhoun DA, Bakris GL, et al. Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association. Hypertension. 2018;72(5):e53-e90. doi:10.1161/HYP.0000000000000084 Mancia G, Kreutz R, Brunström M, et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens. 2023;41(12):1874-2071. doi:10.1097/HJH.0000000000003480

Is whey protein safe? How much protein is actually effective and how much is too much? In this episode of Sweat Success, Dr. Jose Antonio, PhD, founder of the International Society of Sports Nutrition (ISSN), sits down with host Michael Benso to break down the science behind protein intake, whey protein side effects, supplement myths, and the future of sports nutrition.We explore what the research actually says about whey protein and whether it's the best option for muscle growth and recovery. Dr. Antonio shares his insight on how many grams of protein per kilo of body weight you should be consuming and revealing why serious athletes and even everyday lifters should consider going far beyond that number.For anyone wondering about whey protein shakes, this episode answers the question: is whey protein good for you, or are you just flushing expensive supplements down the drain? Dr. Antonio also dives into the science of hyperplasia, the process of growing new muscle fibers (not just enlarging existing ones), and why it may be more possible in humans than many think.This conversation is loaded with value for gym owners, fitness professionals, and anyone serious about performance. It's science-backed, no-BS, and packed with insights that can elevate how you train, eat, and grow.

Dr. Jacqueline Barry is the Chief Clinical Officer at Cell and Gene Therapy Catapult, Dr. Kapil Bharti is a Senior Investigator at the National Eye Institute at the National Institutes of Health, and Dr. Jack Mosher is the Scientific Director at the International Society for Stem Cell Research (ISSCR). They discuss their work on the ISSCR's Best Practices for the Development of Pluripotent Stem Cell-Derived Cellular Therapies. They talk about the need for consistency and rigor in cell therapy development, and how the document can be navigated and applied across jurisdictions.

Hey friends! In this episode, I'm joined by the amazing Dr. Heather Quaile, DNP, as we dive into all things ISSWSH — that's short for the International Society for the Study of Women's Sexual Health (try saying that five times fast). We talk about how this incredible organization has exploded in size and why that matters for women everywhere. We get into the power of staying curious in sexual medicine, why funding research is still such a grind, and how hormones — yes, especially testosterone — play a huge role in sexual function. Heather and I also share some of our favorite takeaways from recent ISSWSH conferences, like new ways of looking at orgasm and sexual dysfunction that actually make sense. We don't shy away from the hard stuff either — off-label meds, outdated guidelines, and the frustrating lack of clarity around hormone therapy. But more than anything, this convo is about how we, as healthcare professionals, need to collaborate and push for change that reflects real women's needs. If you're curious about the future of female sexual medicine or just want to hear two clinicians geek out over the latest research, this episode is for you. Let's get into it! www.isswsh.org https://theshowcenter.com/ Sedona in October - ONE slot left: ⁠⁠⁠https://www.ascendretreats.com/menopause-and-sexual-health-2025⁠⁠⁠ ⁠⁠⁠Order my book⁠⁠⁠ "You Are Not Broken: Stop "Should-ing" All Over You Sex Life" and ⁠⁠"Menopause Moment: Science, Hormones and Mindset for Optimal Longevity"⁠⁠ Listen to my Tedx Talk: ⁠⁠⁠Why we need adult sex ed⁠⁠⁠ ⁠⁠⁠Take my Adult Sex Ed Master Class:⁠⁠⁠ ⁠⁠⁠My Website⁠⁠⁠ Interested in my sexual health and hormone clinic? ⁠⁠⁠Waitlist is open⁠⁠ To learn more about GennaMD by Solv Wellness, visit ⁠⁠⁠gennaMD.com ⁠⁠⁠for 20% off your first order. For an additional $5 off, use coupon code DRKELLY5. Providers can request patient education materials or samples at ⁠⁠⁠gennaMDHCP.com⁠⁠⁠.   Thanks to our sponsor ⁠⁠⁠Midi Women's Health⁠⁠⁠. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care.⁠⁠⁠https://www.joinmidi.com Learn more about your ad choices. Visit podcastchoices.com/adchoices

This spring, are you bombarded by wellness trends promising miraculous results? From detox juices to the surprising popularity of beef tallow, it's easy to get swept up in the hype. But what if some of these "healthy" habits are doing more harm than good? Join us as we dive into the science behind spring's most talked-about health fads. To explain these trends, journalist, health entrepreneur and bestselling author Liz Earle, joins us to share insights from her 40 year career in the wellness industry. Alongside Liz is Dr. Federica Amati, a scientist from Imperial College London, ZOE's Head Nutritionist, and author of the bestseller "Every Body Should Know This." Together, we'll put five popular trends under the microscope: detox drinks, red light therapy, beef tallow for skin, creatine, and high-cost probiotics. Discover what's fact and what's fiction, empowering you to make evidence-based choices. Finally, we'll share practical ZOE-approved tips for embracing spring with genuine, science-backed wellness strategies, helping you navigate the season of renewal with confidence.

Dr. Cynthia Bulik is a clinical psychologist and one of the world's leading experts on eating disorders. She is the Founding Director of the University of North Carolina Center of Excellence for Eating Disorders and also the founder director of the Centre for Eating Disorders Innovation at Karolinska Institutet in Stockholm, Sweden. Dr. Bulik is Distinguished Professor of Eating Disorders in the Department of Psychiatry at UNC, Professor of Nutrition in the Gillings School of Global Public Health, and Professor of Medical Epidemiology and Biostatistics at Karolinska Institute.  Dr Bulik has received numerous awards for her pioneering work, including Lifetime Achievement Awards from the National Eating Disorders Association, the Academy for Eating Disorders, and the International Society of Psychiatric Genetics. She has written over 750 scientific papers, and several books aimed at educating the public about eating disorders.  Currently, Dr. Bulik's focus  is in the reconceptualization of eating disorders as being a metabo-psychiatric diseases. Food Junkies is keen to explore this interest in how metabolic disease plays a role in disordered eating: can this construct be the  common ground to start to understand the muddy waters  between eating disorders and food addiction?  In This Episode, You'll Learn:

On this special episode of JHLT: The Podcast, the Digital Media Editors take a look back at the exciting science that was on display at ISHLT2025, the ISHLT 45th Annual Meeting & Scientific Sessions. Topics include: Telomere biology disorders and lung transplantation The meeting's special focus on cardiogenic shock The apixiVAD trial exploring low dose apixaban in HeartMate 3 LVADs Myocardial recovery on durable LVADs For the latest studies from JHLT, visit jhltonline.org/current, or, if you're an ISHLT member, access your Journal membership at ishlt.org/jhlt. Full-text abstracts of the meeting can also be found at the JHLT website. Don't already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.  

This week, we interviewed Scott Laster. Scott is an award-winning entrepreneur with 20+ years of global medical device and digital health leadership. His time spent within an FTSE 100 and Top 4 Global Medical Device Manufacturer was focused on high-growth markets and transformational commercial business models. His roles drove deep knowledge of business structure, process excellence, and commercial execution – honed by leading teams for product launches (4 platform systems), acquisitions and corporate integrations (>$300M USD), and consistent commercial execution (10x market growth). Scott holds 5 patents and 4 provisional applications. He has also co-authored 4 peer-reviewed scientific posters and 3 peer-reviewed publications and has lectured globally at key industry events such as the International Society for Technology in Arthroplasty (ISTA) and International Congress for Joint Replacement (ICJR) , among others. As MiCare Path's Chief Executive Officer, he oversees all functions across all aspects of the company.

Kiera is joined by Fred Heppner of Arizona Transitions to talk through dental practice transitions. Their conversation includes when you should start thinking about your transition, what the economic outcomes will be any way you go, what a private indemnity group is (and how it can help), and more. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcrpt Kiera Dent (00:01) Hello, Dental A Team listeners. This is Kiera. And today I am so excited to welcome an incredible guest to our podcast, Fred Heppner. He's with Arizona Transitions. And honestly, I feel like right now in today's world, dentists need more than ever guidance and direction of like, what do we do? How do I transition my practice? What am I looking at for retirement? Do I go the DSO route? Do I do the legacy practice route? I just feel like there's so much confusion. And so trying to cut through that noise,   Fred is incredible. We met him and I just said, you know what? He's incredible. And so he said for him, it's whether a person is buying a dental practice or putting a dental practice up for sale, Fred truly can help you successfully navigate through that transition. He deals with complete transitions of dental offices and also practices securing a partner or an associate, which that is such a hard thing. Like, how do we do this? There's a million ways to slice and dice that pie because he's worked with so many different aspects of the dental industry. His experience allows him   to ensure that all parties are satisfied with the transition. So I'm super jazzed. Fred, welcome to the show today. How are you?   Fred Heppner (01:02) I'm   doing great. Thank you, Kiera. I gotta meet this guy. Who is this guy, Fred?   Kiera Dent (01:06) Well,   here he is, if I'm not mistaken. But truly, I'm so honored to have you on the podcast. When our team met you, they were like, Kiera, he's got to get on the podcast. And so just truly excited because like I said, this is a zone that I get excited to geek out on because we deal with it in consulting all the time. Our clients are constantly asking us like, what should we do? They want to bring on partners, they want to bring on associates, they want a retention model. ⁓ They want to know like,   I feel like your dental practice can be your greatest asset or your greatest burden, depending upon how you set it up. And so really being able to just dive in with you. And like I said, I think there's so much noise right now. The dentists are like, it's almost like ostrich in the sand. Like, I just don't want to even think about it. I'm going to put my head in the sand. I'm not going to pay attention. But the reality is like, let's educate, let's learn. Let's bring experts in like yourself. So that way dentists can feel more confident making the decision. I don't think it has to be scary. I don't think it's be daunting. We just need to be educated and.   Fred Heppner (01:41) Yeah, I agree.   No.   Kiera Dent (02:05) and hear wisdom and then do what feels right. So Fred, that was my intro, but anything else you want to add of how you got here or, mean, I'm just excited to riff with you today.   Fred Heppner (02:14) I appreciate the opportunity and I can tell you even from what you just said back in, back in 1983, when I started in the business of dentistry, the interesting thing was I didn't hear very often, Hey, what's your transition plan? Because oftentimes dentists were really just going to build a practice and then that was going to be their retirement and they would sell their practice and retire. Financial planners were, were non-existent to a large degree. And it was early on that I heard somebody and it really resonated with me.   They asked a young dentist who had just taken ownership or started a practice, when are you going to hang up your hand piece? And the dentist kind of, I just got started. What do mean? When am going to hang it up? I got, you know, I got 20, 30 years here. No, no, no. The moment you take ownership of a business, you want to consider what your transition plan out would be early on so that it doesn't spring it on.   Kiera Dent (02:51) Mm-hmm.   Mm-hmm.   Fred Heppner (03:09) We may   talk here later on about, what happens if you're not there? What happens if there's an injury or disability or illness and you can't practice dentistry? Now what? And let's consider talking about that maybe later on. So early in the game, it's appropriate to have some kind of idea of some kind of transition plan. Transition plan doesn't mean I have to value my business. I have to procure a buyer act to make sure that financially qualified. I have to get a contract. I have to get a lease. That's not a transition plan. In simple, think.   Kiera Dent (03:21) Yeah.   Fred Heppner (03:38) The transition plan is what do you want to do when you sell your practice, when you move on from dentistry? And you know, as well as I do, you have clients who have been in dentistry and practice for 25, 30, 35, 40 years. And if they stopped doing something that they've been doing for three decades, what are they going to do with their time? And that's, that's really high on the scale of importance in a transition plan, because ultimately they're going to sit back and say,   Kiera Dent (03:53) Mm hmm. Yeah.   Fred Heppner (04:08) I don't know that I want to be home. I don't know that my spouse wants me to be home all day. And you have to think about these things. So it's much more than I have a practice to sell. I've got a purchase price. I have to figure out how I'm going to sell everything and my staff and my patients and so on. It's more than that. So I think in the initial phases of somebody considering what's my transition plan that can pull their head out of the sand and look at a spot and say, what do I really want to do if I   Kiera Dent (04:12) Totally.   Fred Heppner (04:37) If I don't do this, what will I do? And then feels a whole bunch of other questions into the play. Number one, how much am I going to make from selling my practice? What are the economic outcomes? How much in proceeds will I have after all the fees associated with selling the business and the taxes associated with paying for the proceeds? Now, what have I got left? What is that? What does that number look like? Well, I have no idea. Well, I need to find out. That's why I have a business.   Kiera Dent (05:05) Mm-hmm.   Gosh, Fred, I am so grateful you brought this up because honestly, feel like so I don't know my financial advisor teases me all the time. He's incredible. And he's like, Kiera, you are the person that has every exit strategy. You're like, all right, so what's going to happen if this happens or what happens? And I love to play this game with my husband. I'm like, okay, so if there was a fire in our house in this location, how are we going to get out? Or if we had this, because I feel like when you have almost that North star, especially in your life of   Okay, this is how much I want when I wanna retire. This is when I wanna retire. This is like you said, if I want to, what am I gonna do when this doesn't, like when I'm no longer doing dentistry? Because you're right, I actually, ⁓ working at Midwestern ⁓ University in Arizona, I know a lot of dental students and I know a lot of dentists now. And ⁓ I've been gone from Midwestern for about now, about nine years. And ⁓ in those nine years, which does not seem that long, it's not even been a decade, ⁓   Fred Heppner (05:50) Mm-hmm.   Kiera Dent (06:05) There have been students who have gotten a disability. There have been students who have gotten cancer and can no longer practice dentistry. There are students that have already sold to DSOs. And I'm like, their life looks so different. The student I'm thinking about who ended up getting pretty sick and had to leave, thank goodness he had his ⁓ insurance on him, his disability insurance. But like when I met him,   there was no way that we ever would have thought like four or five years into practice. I went and saw him in his practice and now like he's not doing dentistry anymore. And so I think Fred, it's one of those things where I help him pray every dentist who's listening gets to work until they're 80, 90, however long they want to go that they get to practice their craft. but I think what you're talking about of let's think of what would I do if I couldn't do this anymore, whether by choice or whether by life, ⁓ and then be able to make decisions because I feel like   When you stair step it back, you're able to actually navigate today way more confidently than if you don't have a plan. And I think that gives you more security than anything else. ⁓   Fred Heppner (07:08) Amen. And if your practice   is stable, strong, producing a good profit and you are able to not only retire debt, but start to put away for your own retirement, you are much more in a direction of control also. So retirement may not be a year or a number. It sometimes is an event because injury, disability, illness, sudden death have no discrimination. It can happen to anybody.   And if there isn't a plan in place for that, which I would recommend dentists look into, ⁓ if they don't have them in their community, forming private indemnity groups, disability coverage groups, where if a group of 16, 17 dentists that per oculi are in the same community and know each other and respect each other would agree that if anything were to happen, the group would get activated and it would cover the practice a day at a time on rotation for all the membership.   until the practitioner returns from the injury or disability or the practice is sold because the dentist is incapacitated and can't come back. As a side note, I want to mention to you that I do this for six different groups here in the Valley in Phoenix where I live. And there are anywhere from about 12 to 22 dentists in each of those groups.   So if you're listeners or if anybody in the A team wants to know more about forming groups, I'm happy to pay it forward, provide it for you. It's important. It's really something that dentists, we're invincible. Nothing's going to happen to us, especially when they're 30 years old and they just graduated from Midwestern and they bought their first practice and they're fired up. And it's like, they are looking at nothing other than growth, development, coaching. They're not even thinking if something were to happen to them. So.   Kiera Dent (08:38) Mm-hmm.   hope. Right?   Mm-hmm.   Fred Heppner (08:57) Just as an aside,   let's you and I make sure that we talk more. And for any dentists who want to develop those kinds of groups, it is invaluable. And there are tons of stories that I could impart to you and impart to anybody who's willing to listen about dentists that have a mishap. ⁓ Jim Jorgensen here in Phoenix ⁓ owns Squaw Peak Dental for years. He was in Vegas with his wife, Terry, midnight. They were up in the hotel room and he flatlined. He had a massive heart attack.   Kiera Dent (09:15) Mm-hmm. Yep. Mm-hmm.   Fred Heppner (09:28) She kept him going until the paramedics arrived. He survived. We activated the group. We covered his practice for three months. He came back, continued to practice. A year later, he sold it. So he couldn't have done that. He would have lost that asset and lost the value that that asset has on the open market if that group hadn't been in place. So.   Kiera Dent (09:39) incredible.   Thank   I will. love that. And thank you for sharing that. And that's something I didn't even know existed. And I, I don't, I'm just very pro. Like, I remember when I was filling out our trust and I had to write my will and I was not very old, still like in my thirties, it was really weird. And it made me feel icky. And when you said the phrase earlier of like death, disability, illness, that has no discrimination. It hit me in my core of you're right. Like we do feel like we're invincible, but the reality is those three are hanging   out at any moment and we have no idea when they're going to strike us or our family or someone that we know. As icky as that is. And so I feel like it's like, let's just get, let's get prepared. Like when I had to figure out what's going to happen to me, if I ever am incapacitated and I called my brother, who's my power of attorney. I said, okay, this is what I want. Are you willing to do it? But now I don't like if it happens great. Like he knows, I know there's a plan in place and as much as I would hate for it to happen, there is a plan that's like, and I feel   Gosh, maybe I'm just a selfish egotistical human over here. It does give me a lot of empowerment to know that I know if something were to happen to me, things are good. And I will also say my whole team hates it, but I have an entire death plan of if Kiera Dent dies, I haven't made it so sweet that they want to kill me off. So like, that's my, that's my caveat. Like, let's not make it that good. But there's an entire plan because I realized...   If I don't have this plan in place, if things aren't able to be transferred quickly to people that I trust and that people need to execute on, this company would die and we would not be able to serve all the people that we have. And so as, as weird and as eerie as it is, I feel like Fred, there's so much empowerment that can happen because it's no longer scary. Just like getting an operations manual, just like getting all your systems in your practice in case someone leaves. I feel like it's the same thing for your business in your life. So Fred, like that's a great tip. And I think people should reach out and definitely connect with you.   Fred Heppner (11:42) maybe   for another future podcast. Coming to an A-Team podcast near you,   Kiera Dent (11:44) Like,   I mean, hey, I'm here for it.   Fred Heppner (11:50) I don't know.   It's really important. People take it for granted. And it's interesting because the people that are in the groups that I have and sponsor just sitting back and say to themselves, why wouldn't anybody not be involved in this type of group? So good for future.   Kiera Dent (12:05) That's helpful. Okay. All right. And Fred, just like, mean,   we'll, share it at the end too, but if people are interested, how do they connect with you? We'll just put it in the middle too. So people have the info and then of course we're going to continue on.   Fred Heppner (12:16) ArizonaTransitions.com is my website. ArizonaTransitions@gmail.com is my email. Best way to reach you.   Kiera Dent (12:23) And I'm sure people are   questioning, you work only in Arizona or do you work outside of Arizona just to clear that up for our listeners? Okay.   Fred Heppner (12:29) Good. Time for a little backstory. So   back in 1983, when I started in dentistry, I was a, I was a business coach, similar to how you operate and develop business systems and coaching and training for dentists and their teams to grow and essentially develop profitable and enjoyable practices. I did that for about 20 years. And then about 22 years ago, I really saw a void in Phoenix where I live. moved here in 1995.   of the transition space. just didn't see dental practice transitions being done with integrity, in my opinion. They could have been, but I saw some of the aftermath because dentists would call me and say, hey, I just bought this practice. Can you help me? It's a mess. So I would go in and assist them. Well, slowly but surely, I saw an opportunity to be able to jump into the transitions realm. So I jumped deep into ⁓ classroom study and book work on how to do business evaluations correctly.   Kiera Dent (13:04) Mm-hmm.   Fred Heppner (13:26) the International Society of Business Analysts was my education forum. ⁓ Casey Conrad, who is brilliant, he taught me how to do business valuations correctly. And by the way, he writes the curriculum for the organizations that provide accreditation to people who want to be a business analyst. So I'm learning from the guy who teaches everybody. And then I started studying large contract negotiations.   Kiera Dent (13:45) Mm-hmm. Amazing.   Fred Heppner (13:52) As I developed that understanding and saw that there were things that I could contribute to, I jumped into that realm and became more of ⁓ a transition specialist here in the greater Phoenix area. Well, along the way, I came upon a group called American Dental Sales, which is a large cooperative of 40 dental practice transition specialists, 23 different companies. They cover all 50 states and they had a void in Arizona that they needed to fill. So they approached me and said, we'd like you to come on board.   ⁓ I then met a guy named Hi Smith, who really was one of the preeminent dental practice brokers in the country. ⁓ He was in Naples, Florida. He had a place in Oregon, so he kind of commuted periodically. But Hi was very, very well regarded and still is. He's retired now. Hi was the transition specialist for the Pride Institute, a very well regarded practice management company out of California. And for 35 years.   Kiera Dent (14:44) Mm-hmm.   Fred Heppner (14:50) They referred all the business nationwide to High to develop any kind of transition plan or valuation or partnership or associate ship or practice sale. Well, he was a member of ADS and he actually, I want to say he took me under his wing to some degree because we just became very good friends and he became a really significant mentor of mine.   I fell ill and said, I'm not gonna be able to do this any longer, so you're gonna take over my book of business. and by the way, you're also gonna start doing seminars for the Pride Institute. And I'm gonna introduce you to the people over there so that when they need help, like I've been giving them for the last 30 years, you'll take over. So as a result, we were doing seminars all around the country. So four to five times a year, we'd be in Denver, Boston, Seattle, Orlando, Dallas, Chicago, Philadelphia, you name it.   Kiera Dent (15:30) Mm-hmm.   Fred Heppner (15:43) So people that would come to those meetings were Pride disciples, clients, and they would ask me to help them with their transition. So that became more of a establishing services for dentists that are outside of Arizona, not necessarily creating a footprint in each of those territories. The Pride Institute was purchased by Spear Practice Solutions about 10 or 12 years ago.   Kiera Dent (16:08) Mm-hmm.   Fred Heppner (16:09) So I got dragged kicking and screaming over to Spear and developed a really good relationship with the track practice growth partners at Spear and also Amy Morgan, who was the CEO at Pride out still with Spear. So that's the backstory to tell you that I've done transitions in 26 different States. And it's very easy for me to help provide consultation and guidance for transitions really anywhere.   Kiera Dent (16:12) Thank   Mm-hmm. Mm-hmm.   Awesome.   Fred Heppner (16:39) Florida, as an example, Florida requires a person to be a commercial real estate broker to broker business assets. So I have colleagues in Florida that I refer to. And with my affiliation with ADS, I have boots on the ground in pretty much every territory that if I don't think I can provide value to the client, I simply connect it with the people in my group and everything gets worked right.   Kiera Dent (17:04) That's awesome.   That's amazing. And it's such a fun story.   mean, I think our our paths have crossed on probably several levels. One of my business coaches is former pride. And as soon as you said that, I was like, Oh, my gosh, I bet we both know Liz. I'm sure we and all the different pieces. But I love that because I figured Arizona transitions might some of the listeners might feel like you can't help them and assist them. So I really wanted to clear that up that it's all across the nation in different areas. So all right, Fred, let's dive into like walk us through I know you've got some   Fred Heppner (17:11) Yeah, chances are.   yeah, ⁓ yeah, absolutely.   Kiera Dent (17:36) points.   I know you've got some things of like, what is the transition plan? Like how do doctors get to that level? What do they need to do if they're transitioning? Now again, this doesn't mean you're selling. Right now, I think there's a lot of options to sell, but also like prepping in case life, one of those three mysterious, hopefully never coming to you, like orbs is how feel. I feel like they're like floating around and hopefully they never strike. But what do we do? What are kind of the steps? What are some of the things you have for that?   Fred Heppner (17:56) Yeah, yeah.   Well,   I think the first step in any kind of relationship that I build with a client, it would be a true consultation. And in that sense, it's tell me what your ideal retirement plan or transition plan would look like. You've worked your practice for a number of years. At some point in time, you're going to decide that you will retire from the practice of dentistry. What do you want to do? What does that look like?   What would you be involved with? I'll give you a quick example. Jerry Cox, who's a dentist in Old Scottsdale here in Phoenix, called me and said, I'd like you to help me sell my practice. And I said, I'd be honored, thank you. So I went and saw him and we put together the plan and I asked him the question, what do you want to do? What do you want to do after you retire from practice? says, well, I like to do sculpture. And I said, really, Fred?   Kiera Dent (18:56) you   Fred Heppner (18:57) What have you done? kind of work have you done? He says, well, let me show you. He showed me pictures of the statue of Heather Farr. Heather Farr was an amateur golfer 25, 30 years ago or so, who played at ASU, who was an enormous success, played on the LPGA tour, and ultimately ⁓ developed breast cancer and died. Heather's statue ⁓ was sitting at Karsten Golf Course down near ASU, which they've now plowed.   Kiera Dent (19:20) Wow.   Fred Heppner (19:27) and also at Greyhawk Golf Club. And Jerry sculpted that statue. And I got goosebumps right now. Anyway, so as an example, Jerry has a studio at his house. He said, as soon as I sell, I'm doing that. So the point is in the transition planning phase, know what you want to do. Know what you will occupy your time. If it's turn.   Kiera Dent (19:33) Wow. Yeah.   So Fred, I'm gonna just like ask questions right here because, and   I'm gonna talk for myself. So guys, like this is my own therapy session. So thank you for being a part and a fly on the wall. Like sometimes we don't know. ⁓ So like I feel I'm very much, I know I wanna retire. I know I want more free time, ⁓ but I literally sit here and this, it's like, know how you think about like how time truly never ends. And if you think about like too hard, it actually creeps you out. Like that's kinda how I feel about like retiring of like,   Well, I know I don't want to keep working this hard. Like I don't want to be putting in as many hours, but I still love the impact. I still love the legacy, but I don't quite know what that looks like. And I feel like a lot of times people in their thirties, in their twenties, in their forties, I think as you get later on in life, you probably have more of that clear picture. But what about for those that are very fresh, like that truly maybe some people do, maybe I'm, maybe I'm the only one on my own planet. I don't think I am, but like, what do you do if you don't know what you want to do?   Fred Heppner (20:46) You're not alone. So good. part of the time, what did Chelsea, what did Kelsey Grammer say? I'm listening. So the, the, the idea is that there are portions of people that don't know. There are some that are very clear on what they want to do and there's some that are kind of, well, I'm not sure. My, my recommendation would be, think about it. Then don't answer right now, but think about it because I want you to know what you will be doing when.   Kiera Dent (20:48) Thank you. Thanks for my therapy today, Fred. I appreciate it. Thank you.   Hahaha ⁓   Fred Heppner (21:16) you stop doing this and it may change over time. It may kind of morph into, my God, I didn't know that I really enjoyed painting. Okay. Then, then that's maybe what you might do because as you retire from the proceeds of your sale of your business, you'll, you'll build out a studio in your home or in the Casita or wherever it is. So it, it's okay that you may not know. It's okay that a person may not know what they want to do, but it's important to start thinking about it.   Kiera Dent (21:26) Mm-hmm.   Fred Heppner (21:47) And then we can kind of move into the rest of the, ⁓ the rest of the questions, which I would say, is it a year that you'd like to finish working? Some dentists may want to finish when they're 55. Some may want to work until they're 65. Some may want to finish working when they're 50 or it might be a number. My investment portfolio has to be at $10 million liquid, not including asset hard assets like home.   vacation home, cars, anything like that, boats, whatever, ⁓ but that the liquid assets have a certain number because then I know through my financial planner, because he did a wealth timeline, another side note, right, Kiera? ⁓ He said that if you keep doing what you're doing and you retire at this age and you pull in social security and you have this mandatory required distributions from your portfolio,   Kiera Dent (22:16) Mm-hmm.   Right? Exactly.   Fred Heppner (22:41) you'll be able to have this much money when you're 99. So, and that's just a mathematical spreadsheet that most good financial planners have. And I highly recommend it for anybody who's in business, who's developing a portfolio for retirement. So it may not be, I don't know yet. Okay, good. Well think about it and know that I may circle back during our relationship and ask you, have you given much thought? Do know what you're going to do?   Kiera Dent (22:45) Mm-hmm.   Fred Heppner (23:09) Early on, is it important? Not as much as when it's a three to five year window. When it's a three to five year window from retirement, then we want to talk more significantly about it. Because that will be a good...   Kiera Dent (23:23) got it because that's what I was curious I was like should people be talking   when they're in their 20s 30s or is it something we're like start to think about it I know Ryan and I from Dentist advisors we we talk shop about this quite often of like there I mean there are studies that show that when you retire you actually start to atrophy in life and ⁓ there isn't as much of a purpose and so we talk often of like how can we continue that   mental stamina, the things that are going to fulfill us, whether it's working or something else of philanthropy, like whatever is going to keep you going as a human, whether you're working in the chair or you're not, I think is important. So that's I was curious of like, really probably connecting with you three to five years before we think we might retire, but with the caveat of, hey, if something were to happen to me, what would kind of be my exit strategy? your like death list like I do, like if I die, this is what's going to happen. It's creepy, but it's awesome.   Fred Heppner (24:15) No, it's, it's creepy and it is awesome. And at the same time, it's a really good conversation to have because if we're three to five years out, then one of the first things to do is say, okay, so what's going to happen if you're not here? And that carries on to the discussion we had earlier.   Kiera Dent (24:28) Mm-hmm.   The Dental A Team (24:31) Awesome. Thank you. And thank you, Fred. Thank you, all of you. And for all of you listening, thanks for listening. And I'll catch you next time on the Dental A Team Podcast.  

In 2014, the International Society for the Study of Women's Sexual Health together with the North American Menopause Society introduced the term “Genitourinary syndrome of menopause” to replace the prior term vulvovaginal atrophy. Ten years after that, in 2024, a related term “Genitourinary Syndrome of LACTATION, was introduced to better capture the genitourinary issues lactating women may experience. A new systematic review, soon to be released in the journal obstetrics and gynecology, provides new data on GSL prevalence and characteristics. This is a good reminder for any clinician who evaluates postpartum/lactating women to ask about GSL. How does sexual dysfunction fit into this question? Listen in to the next episode of Dr. Chapa's Clinical Pearls Podcast for more details.

Jehane Samaha is the National Urban Nursery Specialist with the US Forest Service. She develops trainings and networking for both urban foresters and nursery growers to improve tree stock quality, enhance connectivity in the urban nursery pipeline, and promotes climate-adaptive genetics for urban trees. Jehane is based in Philadelphia, serves on the board of UC (University City) Green, and previously worked at PHS (Pennsylvania Horticultural Society) and the Morris Arboretum.She is an ISA Certified Municipal Arborist® through the International Society of Arboriculture, and completed a master's thesis at UBS (University of British Columbia) on street tree species selection.

The potential of pluripotent stem cells and the ability to scale and differentiate them to generate large numbers of enriched cell populations has created new opportunities and approaches to treat human disease. Preclinical proof-of-principle data demonstrates that stem cell-derived neural grafts can be used to reverse symptoms of multiple neurological conditions, including Parkinson's Disease. Cell grafts enriched with dopaminergic neurons, can structurally and functionally integrate in the brain of Parkinson's Disease models to reverse motor deficits, a finding which has launched several clinical trials. While the results in animal models is essential proof-of-concept, the survival and integration of these cells is suboptimal compared to treatments from fetal-derived ventral midbrain grafts.  An area of preclinical and clinical research showing promise in influencing neuronal survival and plasticity is exercise. The benefits of exercise on neural function and disease progression have been widely reported and they have also been shown to enhance the survival and integration of transplanted cells in models of some neurological diseases. However, there is limited data on the benefit of exercise on the functional outcomes of neural grafts in Parkinson's Disease models. The guests on today's program will discuss their recent study looking at the effect of exercise on cellular engraftment and functional recovery in animal models of Parkinson's Disease and the implications for clinical outcomes. GuestsClare Parish, PhD, The Florey Institute of Neuroscience and Mental Health and University of Melbourne, Australia Niamh Moriarty, PhD, The Florey Institute of Neuroscience and Mental Health and University of Melbourne, AustraliaSupporting ContentPaper link: Exercise promotes the functional integration of human stem cell-derived neural grafts in a rodent model of Parkinson's disease HostJanet Rossant, Editor-in-Chief, Stem Cell Reports and The Gairdner FoundationAbout Stem Cell ReportsStem Cell Reports is the open access, peer-reviewed journal of the International Society for Stem Cell Research (ISSCR) for communicating basic discoveries in stem cell research, in addition to translational and clinical studies. Stem Cell Reports focuses on original research with conceptual or practical advances that are of broad interest to stem cell biologists and clinicians.X: @StemCellReportsAbout ISSCRWith nearly 5,000 members from more than 80 countries, the International Society for Stem Cell Research (@ISSCR) is the preeminent global, cross-disciplinary, science-based organization dedicated to stem cell research and its translation to the clinic. The ISSCR mission is to promote excellence in stem cell science and applications to human health.ISSCR StaffKeith Alm, Chief Executive OfficerYvonne Fisher, Managing Editor, Stem Cell ReportsKym Kilbourne, Director of Media and Strategic CommunicationsMegan Koch, Senior Marketing ManagerJack Mosher, Scientific AdvisorHunter Reed, Senior Marketing Coordinator

Collagen is everywhere—but not all collagen is created equal. In this episode, we're diving into the science-backed benefits of collagen, from skin elasticity and joint support to gut and bone health. We'll explore how patented peptides make a difference in absorption and efficacy, plus break down the latest research on how to get the most out of your collagen routine. Plus we're celebrating the fresh new look of our Pure Collagen!  Tune in as we answer your top collagen questions, including Can I put collagen in my coffee? Do I need vitamin C for absorption? And what's the deal with the social media rumors linking collagen to cancer? Whether you're a longtime collagen user or just curious about its benefits, this episode will give you the facts you need to support your body from the inside out! Also in this episode:  Get Pure Collagen for 15% off with code NEWLOOK What is collagen and why do we need it? What accelerates collagen loss? How can we support collagen production?  What sets Pure Collagen apart? Fortigel Current Medical Research and Opinion Osteoarthritis and Cartilage Journal of the International Society of Sports Nutrition Verisol Skin Pharmacology and Physiology Journal of Medicinal Food Nutrients Fortibone Nutrients Journal of Clinical Densitometry Journal of the American College of Nutrition Do I need to worry about heavy metals in collagen? Consumer Beware: These Popular Collagen Supplements Contain Heavy Metals Collagen is not a complete protein, do I need to supplement with something else? What's the difference between collagen and gelatin? What about collagen and cancer? Do I need vitamin C to absorb collagen?  Bio-C Plus Can I still put collagen in my coffee? Bone Broth Hot Cocoa | A Nutrient Dense Indulgence for Kids Smoothies and Shakes Ebook Is vegan collagen a thing?  Dosage and considerations For preventative health/wellness: 1 scoop/day Pregnancy/postpartum: 2 scoops/day Symptomatic (joint pain, etc): 2-3 scoops/day Perimenopause: 2 scoops/day Osteoporosis/osteopenia: 3 scoops/day Bone Builder Bundle Post-surgical: 4 scoops/day for 2 weeks   Sponsors for this episode:  Pure Collagen: The Ultimate Collagen Support for Skin, Joints, and Bones Shop now with code NEWLOOK   Pure Collagen is sourced from pasture-raised cows and we lab test every batch to ensure there are no heavy metals including mercury, lead, cadmium, and arsenic. But our purity isn't the only thing that sets our product apart from competitors, it is all about the extraction!    Pure Collagen is not just a protein powder or even just collagen peptides! Our product is made through a proprietary extraction method that produces bioactive peptides shown in research to stimulate new bone, joint cartilage tissue, and skin, hair, and nails via regenerative anti-aging effects. Our formula contains research supported patented peptides FORTIGEL, FORTIBONE, and VERISOL, 3 compounds that promote synthesis of collagen and stimulate focused cells to prevent breakdown while supporting new growth.   Fortigel supports chondrocytes for cartilage health to promote joint function and reduce joint pain. Verisol stimulates fibroblasts to support the production of collagen for improved structure and appearance of the skin, reduction of cellulite, healthy hair growth, and anti-aging effects. Fortibone stimulates osteoblasts to improve bone density and the body's mineralization processes while supporting bone strength.

What if creatine isn’t just for bodybuilders—but a potent, research-backed tool for women’s health, performance, and longevity? In this powerhouse episode, Angela sits down with Darren Candow, a leading expert on creatine and Professor and Director of the Aging Muscle and Bone Health Laboratory at the University of Regina, Canada. Darren is also the Director of Research for the Athlete Health and Performance Initiative and past Associate Dean of Graduate Studies and Research in the Faculty of Kinesiology and Health Studies. Together, they unpack the groundbreaking science behind one of the most misunderstood supplements. From brain energetics and mood stability to bone density, fat loss, and anti-aging, this is your comprehensive guide to creatine beyond the gym. Angela and Darren explore the myths, the mechanisms, and the real-world applications of creatine—especially for women navigating perimenopause, high stress, and cognitive load. Whether you’re looking to train smarter, improve memory and sleep, or simply age with more energy and resilience, this masterclass will change the way you think about creatine forever. KEY TAKEAWAYS: Creatine for Cognitive Health: It crosses the blood-brain barrier slowly but significantly, especially under stress or sleep deprivation. Dosage Evolution: 10g/day may be optimal for full muscle, brain, and bone saturation—especially in women. Bone Health & Aging: Combined with resistance training, creatine may help preserve bone density, especially post-menopause. Body Composition Benefits: Contrary to myth, creatine reduces body fat over time and improves lean mass, even in women. Mental Health & Resilience: Early evidence shows potential benefits for depression, anxiety, and sleep quality. Safer Than You Think: Creatine does not cause kidney issues or hair loss—these myths are finally being debunked with new data. Emerging Synergies: Stacks with protein, collagen, or taurine may enhance its effects—especially for brain and recovery support. TIMESTAMPS AND KEY TOPICS: 0:00 – Introduction 3:33 – Creatine’s impact on fat loss, strength, and performance in women 7:31 – Recovery, overtraining & HRV: how creatine supports your nervous system 13:31 – Creatine for mood, mental health, and inflammation 18:36 – Bone health benefits in postmenopausal women 22:03 – Muscle breakdown: why women respond differently than men 31:25 – GAA, taurine & stacks that supercharge brain performance 36:28 – Brain fog, stress & cognition: creatine’s impact on energy and focus 47:43 – Creatine and sleep: timing, dosage, and recovery benefits 52:07 – The perimenopause trifecta: mood, metabolism, and muscle 55:13 – Final verdict: What dose actually works—and is it safe? VALUABLE RESOURCES Click here for discounts on all the products I personally use and recommend Check out my blog to learn How Spermidine Can Reset Your Sleep and Hormonal Balance During Perimenopause A BIG thank you to our sponsors who make the show possible: Get 20% off the Creatine I love at trycreate.co/ANGELA20, and use code ANGELA20 to save 20% on your firsts order. LVLUP HEALTH: Slow aging, repair gut health boost collagen and recovery and more with LVLUP Health’s amazing products. Save 15% with code ANGELA at https://lvluphealth.com/angela For 10% off at Timeline visit www.timelinenutrition.com and use code ANGELA10 ABOUT THE GUEST Darren G. Candow, Ph.D., CSEP-CEP, FISSN is a Professor and Director of the Aging Muscle and Bone Health Laboratory, Director of Research for the Athlete Health and Performance Initiative and past Associate Dean-Graduate Studies and Research in the Faculty of Kinesiology and Health Studies at the University of Regina, Canada. The overall objectives of Dr. Candow’s research program are to develop effective lifestyle interventions involving nutrition (primarily creatine monohydrate) and physical activity (resistance training) which have practical and clinical relevance for improving properties of muscle, bone and brain health/function. Dr. Candow has published > 150 peer-refereed journal manuscripts (h-index: 49, i10-index: 107), received > $2 million in research support, and supervised over 20 MSc and PhD students. In addition, Dr. Candow serves on the editorial review boards for the Journal of the International Society of Sports Nutrition; Nutrients; Frontiers; Advanced Exercise and Health Sciences; Scientific Reports; and Longevity and as a Scientific Advisor for AlzChem and Create. Dr. Candow is also a fellow of the International Society of Sports Nutrition and a Canadian Society for Exercise Physiology-Clinical Exercise Physiologist. Darren G. Candow, PhD | CSEP-CEP | FISSN Professor Director-Aging Muscle and Bone Health Laboratory Director of Research-Athlete Health and Performance Initiative Faculty of Kinesiology & Health Studies University of Regina Google Scholar: https://scholar.google.ca/citations?hl=en&user=iUYFaeoAAAAJ&view_op=list_works&sortby=pubdate Instagram: https://www.instagram.com/dr.darrencandow/?hl=en ABOUT THE HOST Angela Foster is an award winning Nutritionist, Health & Performance Coach, Speaker and Host of the High Performance Health podcast. A former Corporate lawyer turned industry leader in biohacking and health optimisation for women, Angela has been featured in various media including Huff Post, Runners world, The Health Optimisation Summit, BrainTap, The Women’s Biohacking Conference, Livestrong & Natural Health Magazine. Angela is the creator of BioSyncing®️ a blueprint for ambitious entrepreneurial women to biohack their health so they can 10X how they show up in their business and their family without burning out. The High Performance Health Podcast is a top rated global podcast. Each week, Angela brings you a new insight, biohack or high performance habit to help you unlock optimal health, longevity and higher performance. Hit the follow button to make sure you get notified each time Angela releases a new episode.Anne Laure’s book: Tiny Experiments CONTACT DETAILS Instagram Facebook LinkedIn Affiliate Disclaimer: Note this description contains affiliate links that allow you to find the items mentioned in this video and support the channel at no cost to you. While this channel may earn minimal sums when the viewer uses the links, the viewer is under no obligation to use these links. Thank you for supporting the show! Disclaimer: The High Performance Health Podcast is for general information purposes only and do not constitute the practice of professional or coaching advice and no client relationship is formed. The use of information on this podcast, or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for medical or other professional advice, diagnosis, or treatment. Users should seek the assistance of their medical doctor or other health care professional for before taking any steps to implement any of the items discussed in this podcast. This Podcast has been brought to you by Disruptive Media. https://disruptivemedia.co.uk/

This year's International Society of Autism Research Meeting was filled with great presentations about causes, diagnosis, interventions, mechanisms, supports, understanding sex differences and different populations of those with autism. But not everyone could fly to Seattle to attend. This week's podcast provides a short summary of just some of the science presented. Michael Lombardo provided … Continue reading "News from the International Society for Autism Research Meeting, 2025"

What if the pain isn't just physical—and what if fixing the body is only half the battle?Sexual pain is one of the most misunderstood issues in medicine. I invited my friend and colleague Dr. Corey Babb to dive into why so many women still struggle with pain, even after their doctors tell them everything looks “normal.” Corey just released his new book A Practical Guide for Female Sexual Medicine, which aims to help clinicians actually treat sexual dysfunction—not just study it.We unpack the deeper reasons patients experience conditions like vaginismus, vestibulodynia, and hypertonic pelvic floor, including trauma, religious shame, and outdated medical training. Corey and I also explore the groundbreaking Pacik method for treating vaginismus, including why Botox and dilators can truly change lives (and minds).But as we both know, treatment is never just about the body. We talk about the psychological side of healing—including why some patients avoid intimacy even after their pain resolves. Corey shares his insights on retraining the brain, rebuilding trust, and supporting patients beyond the exam room.We also discuss why pelvic pain is so often dismissed, how to empower women to advocate for themselves, and why our field still has so much work to do when it comes to teaching clinicians about sexual health.If you've ever been told to “just relax” or “drink some wine” to fix your pain—you'll want to hear this.Highlights:Why sexual pain can persist even after physical treatmentHow trauma and religious shame impact vaginismusThe Pacik method: Botox and dilator therapy explainedWhy desire and intimacy often lag behind pain reliefThe critical need for better sexual health education in medicineIf this episode helped you feel seen or gave you new insights, please leave a review on Apple Podcasts and share the episode with someone who might need it. Your reviews help more people find this important information and advocate for their health!Dr. Babb's Bio:Dr. Corey Babb is a Tulsa native who has dedicated his life to bringing awareness and acceptance to female sexual health. Through education, activism, and empathy, he helps people feel heard and validated, empowering them to find answers in a complicated medical environment. In addition to being a board-certified gynecologist, he is a Fellow of the International Society for the Study of Women's Sexual Health, a Menopause Society Certified Menopause Practitioner and a member in the International Society for the Study of Vulvovaginal Disorders. Currently, Dr. Babb serves on the board of directors for ISSWSH, is a reviewer for multiple sexual medicine journals, is a respected lecturer and educator, and has been featured in numerous national and international publications, as well as the author of A Practical Guide to Female Sexual Medicine (CRC Press).Get in Touch with Dr. Corey Babb :WebsiteFacebookInstagramTikTokGet in Touch with Dr. Rahman:WebsiteInstagramYoutube

Today we are joined by Dr. Denis Alexander, who will soon teach a class on Current Issues in Science and Theology (May 26-30). Denis is known for his research as a molecular biologist, so we start this conversation by discussing theistic evolution, genetics, DNA, and the difference between mind and brain. He also probes the implications of emerging issues and fields such as neuroscience, transhumanism, and AI. We are grateful to engage with someone who thoughtfully and insightfully participates in the scientific world, bringing Christian faith and reflection to bear on emerging knowledge and realities. If you are unsure whether his class is for you, Dr. Alexander assures us that this course suits those with no science background! BioDr. Denis Alexander is a prominent molecular biologist and Christian thinker known for his extensive work in the dialogue between science and religion. In 2006, Dr. Alexander co-founded The Faraday Institute for Science and Religion with Professor Bob White to conduct research and promote dialogue between the scientific and religious communities. He was the journal Science & Christian Belief editor from 1992 to 2013. He has been an active member of organizations such as Christians in Science and the International Society for Science and Religion. Throughout his career, Dr. Alexander has been a vocal proponent of the compatibility between scientific inquiry and religious faith, contributing significantly to discussions on how these fields intersect and inform each other. He'll join us from May 26-30 to teach on Current Issues in Science and Theology. He will also give an Evening Public Lecture in the Regent College Chapel on Monday, May 26, 2025.Previous Podcast AppearancesEvolution, Neanderthals and Original Sin (March 2021)Regent College Podcast Thanks for listening. Please like, rate and review us on your podcast platform of choice and share this episode with a friend. Follow Us on Social Media Facebook Instagram Youtube Keep in Touch Regent College Summer Programs Regent College Newsletter

On this episode of JHLT: The Podcast, the Digital Media Editors invite first author Peter Cho and senior author Abbas Ardehali, MD, to discuss the paper, “Severe primary graft dysfunction in heart transplant recipients using donor hearts after circulatory death: a United States Experience.” Peter is a third year medical student at Drexel University, and Dr. Ardehali is professor of surgery and medicine and the Director of the Heart, Lung, and Heart-Lung Transplant programs at UCLA. The episode explores: The study's findings regarding an increased incidence of severe PGD at 24 hours post-transplant in DCD over DBD recipients What risks weren't changed in DCD recipients—suggesting that DCD PGD is likely to be transient, and may have a different phenotype How NRP may impact the outcomes Mitigating the risk of PGD For the latest studies from JHLT, visit www.jhltonline.org/current, or, if you're an ISHLT member, access your Journal membership at www.ishlt.org/jhlt. Tune in again later this month for the Digital Media Editors' findings and observations from the ISHLT2025 Annual Meeting in Boston. Don't already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.

The term "genitourinary syndrome of menopause" (GSM) was introduced in 2014 by the International Society for the Study of Women's Sexual Health and the North American Menopause Society (now the Menopause Society). This new term was created to replace older terms like vulvovaginal atrophy, urogenital atrophy, and atrophic vaginitis, and it encompasses the range of symptoms related to hormonal changes in the vulvovaginal and urinary tract areas that can occur during menopause. Recurrent UTIs are more likely in postmenopausal women not on vaginal estrogen therapy. IN this episode, we will highlight new data from the recent AUA meeting which looked at surprising benefits on postmenopausal vaginal estrogen in women with recurrent UTIs. Nonetheless, questions on the data remain. Listen in for details.

In this episode, I'm sharing my Boston Marathon experience from Hopkinton to Boston. Then we're diving into the science of fueling and hydration — specifically, electrolyte depletion: what it is, why it matters for performance, and how you can stay ahead of it. Whether you're training for your first marathon or refining your race-day strategy, this episode is packed with practical tips to help you feel strong, stay balanced, and go the distance.www.trainmk.com@melissa_kendterBurke, L. M., et al. (2011). Carbohydrates for training and competition. Journal of Sports Sciences.Stellingwerff, T. (2012). Contemporary nutrition approaches to optimize elite marathon performance. International Journal of Sports Physiology and Performance.Hew-Butler, T., et al. (2015). Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference.Noakes, T. D. (2007). The central governor model of exercise regulation applied to the marathon. Sports Medicine.Rothschild, J. A., et al. (2020). Blood biomarker profiling and monitoring for endurance athletes. Journal of the International Society of Sports Nutrition.Precision Hydration. (n.d.). www.precisionhydration.com

If you've ever been curious about twins, nature vs. nurture, or how our closest relationships shape who we are, you'll want to dive straight into our latest conversation with Dr. Nancy Segal. From nature versus nurture debates to the unique bonds that connect twins, Dr. Segal shares her groundbreaking research and personal stories that reveal just how much twins can teach us about human behavior, relationships, and even ourselves. You'll hear incredible insights into the genetics of twinning, the emotional intensity of twin loss, and the surprising science behind topics like IVF, surrogacy, and even doppelgängers. Get ready for heartwarming stories, real-life drama including a remarkable court case about citizenship and twin brothers born through surrogacy to gay fathers—and plenty of wisdom from both Dr. Segal and Grandpa Wayne. Whether you're a parent of twins, know a set of twins, or have ever wondered what life would be like with a carbon copy of yourself, this episode is packed with unforgettable tales, expert advice, and thought-provoking discussions you won't want to miss. Stay tuned—these are stories you truly have to hear to believe! Nancy L. Segal is a distinguished researcher whose work explores the unique bonds between twins. In her studies, she discovered that twins whether identical or fraternal tend to grieve the loss of their twin sibling even more deeply than the loss of a parent. This remarkable finding highlights the profound kinship twins share. Segal's curiosity extends to the complex web of genetics and relationships, noting that identical twins share all their genes, which might, in theory, make their grief even more intense compared to losing a child, with whom they share only half their genes. While she has yet to study how the loss of a child compares to the loss of a twin, Segal continues to ask thought-provoking questions about family, genetics, and the human experience of loss. Dr. Nancy Segal is a distinguished professor of psychology, developmental psychologist, director of the Twin Studies Center, and published author. Dr. Nancy Segal is an American evolutionary psychologist and behavioral geneticist, specializing in the study of twins. She is the Professor of Developmental Psychology and Director of the Twin Studies Center, at California State University, Fullerton. Dr. Segal has studdied twin relationships for her entire career and continues to the is day, whe has developed facsinating takes on the topic of twin relationships. Dr. nancy Segal was a recipient of the 2005 James Shields Award for Lifetime Contributions to Twin Research from the Behavior Genetics Association and International Society for Twin Studies. Dr. Nancy Segal has published nine books on twins, with the latest book detailing a high-profile lawsuit against the US State Department that almost reached the US Supreme Court, appeared on the Oprah Winfrey Show and countless others, and is a twin herself. Dr. Nancy Segal is a board certified expert in her field. Studying the unique twinship helps shape our understanding of genetics, our own relationships with ourselves and others, and the nature of genetic predisposition. Join us as we dive into the inner thoughts of Dr. Nancy Segal and the attributes she has given on this subject.   (00:00) Twin Grief vs. Parental Grief (07:45) Twins in Schools: Separation Myth (11:43) Girls Mature Faster Than Boys (18:08) Immigration Lawsuit Victory (25:21) "Record-Breaking Twin Separation Surgery" (30:54) Twin Studies: Genes vs. Environment (36:35) Twins' Cheating Case Victory (37:25) Public Policy and Genetic Testing (42:52) Holocaust Twins Reunion Journey (50:26) "Influences in Partner Attractions" (53:54) Oldest Holocaust Twin Survivor's Memoir (58:33) Exploring Doppelganger Similarities (01:07:38) Twin Cloning and Family Bonds (01:10:01) Family Dynamics and Shared Traits (01:14:34) Subscribe and Follow Our Channels Connect with Nancy drnancysegaltwins.org Connect with Reena Friedman Watts: - Website: bettercalldaddy.com - LinkedIn: Reena Friedman Watts - Twitter: @reenareena - Instagram: @Reena Friedman Watts - YouTube: Better Call Daddy Don't forget to like, subscribe, and share this episode with someone who needs to hear a story of resilience and hope!    

SUMMARY In this episode of Whistlekick Martial Arts Radio, Sensei Neil Prime shares his journey in martial arts, starting from his early days in the late 1970s. He discusses his introduction to Wado karate, the influence of his instructor Sensei Shintani, and the evolution of his training from traditional karate to full contact. Sensei Prime reflects on the challenges of balancing martial arts with school and other sports, the importance of discipline, and the strategies he learned from renowned martial artists.   He emphasizes the significance of enjoyment in martial arts and the community aspect of training. He also discusses the importance of good people, diversity in training, and the influence of legendary figures like Joe Lewis, Bill Wallace and Sensei Shintani. He shares insights on cross-training, the need for international recognition in martial arts, and his current training practices, highlighting the significance of community and personal growth in the martial arts journey. TAKEAWAYS Neil Prime's martial arts journey began at a flea market in 1978. Sensei Shintani's unique approach focused on individual growth without harsh training methods. Sensei Shintani's background influenced his teaching style and philosophy. Neil has remained a part of the Shintani Wado-Kai Karate Federation since his training began. The mental discipline learned in martial arts translates well to other sports like golf and baseball. Neil's training evolved from traditional karate to include full contact sparring. The importance of strategy in martial arts was emphasized by mentors like Joe Lewis. Enjoyment and fun are crucial elements in martial arts training. Diversity in training is essential for growth. Cross-training helps students develop their own style. It's important to keep an open mind in martial arts. Training with legends offers unique perspectives on the sport. Community and collaboration are vital in martial arts. The journey in martial arts is about personal growth, not just rank. Teaching others helps reinforce your own knowledge.   This episode is sponsored by Kataaro. Please check out their site at www.kataaro.com and use the code WK10 to save 10% off your first order. And be sure to ask them about a wholesale account for school owners! All orders for Autism Awareness belts in March and April will see 50% of the PROFITS donated to the International Society for Autism Research!

Nina Bernat is a double bass performer and educator based in New York City. In 2023, Nina was honored as a recipient of the Avery Fisher Career Grant and winner of the CAG Elmaleh Competition. Her recent first-prize awards include the Barbash J.S. Bach String Competition, the Minnesota Orchestra Young Artist Competition, the Juilliard Double Bass Competition, and the 2019 International Society of Bassists Solo Competition. In this episode, recorded live in San Francisco in 2025, Nina shares her background and discusses the program she performed at the 2025 San Francisco Winter Bass Bash. Enjoy! Recital program: Nina Bernat, double bass Keisuke Nakagoshi, piano Bach Suite No. 5 in C Minor, BV 1011 Prelude, Allemande, Courante Pantomime by Sofia Gubaidulina Prayer by Enrst Bloch Sonata for Violin by Aaron Copland photo credit: Titilayo Ayangade Subscribe to the podcast to get these interviews delivered to you automatically! Connect with us: all things double bass double bass merch double bass sheet music Thank you to our sponsor! Upton Bass - From Grammy Award winners and Philharmonic players like ME Max Zeugner of the New York Philharmonic, each Upton Bass is crafted with precision in Connecticut, USA, and built to last for generations.  Discover your perfect bass with Upton Bass today! theme music by Eric Hochberg

It's Wednesday, April 23rd, A.D. 2025. This is The Worldview in 5 Minutes heard on 125 radio stations and at www.TheWorldview.com.  I'm Adam McManus. (Adam@TheWorldview.com) By Jonathan Clark Nigerian Muslims have killed 20,000 Christians since 2015 Nigerian Muslims have killed over 20,000 Christians since 2015, according to a report by the International Society for Civil Liberties and Rule of Law. The report accuses various jihadist groups of targeting Christian communities in the southeast part of the African nation. The group also blames local government leaders for doing nothing about the violence. The report called on the United States to reinstate Nigeria on its list of Countries of Particular Concern and to classify Fulani Muslim jihadist herdsmen as an Entity of Particular Concern.  Nigeria is ranked seventh on the Open Doors' World Watch List of nations where it is most difficult to be a Christian.     Psalm 144:4-5 asks, “Have all the workers of iniquity no knowledge, who eat up My people as they eat bread, and do not call on the LORD? They are in great fear, for God is with the generation of the righteous.” Worldwide economic outlook looks more dim The International Monetary Fund released its latest World Economic Outlook yesterday. The report projects the world economy will grow 2.8% this year, down from a previous forecast of 3.3%.  Large economies like the U.S. and China are expected to weaken. U.S. economic growth is forecast to be 1.8% this year, down from a previous expectation of 2.7%.  The declining economic outlook comes during the uncertainty of what U.S. tariffs will look like.  Supreme Court likely to support parental opt-out right The U.S. Supreme Court heard arguments in a religious freedom case yesterday. Public schools in Montgomery County, Maryland don't let children opt out of classes that include sexually perverted lifestyles in storybooks. Parents are challenging this. They come from various backgrounds including Muslim, Christian, Roman Catholic, and Ukrainian Orthodox.  The conservative majority on the Supreme Court appeared likely to support parents in the case during the hearings yesterday.  Eric Baxtor, Senior Counsel at the Becket Fund for Religious Liberty, commented on the case, reports The Hill. BAXTOR: “Around 300 parents in Montgomery County, [Maryland] are just looking for the right to opt their children out of instruction that is highly controversial, tells kids that doctors guessed at their sex when they were born, and that they can choose for themselves who they are. “The board allowed opt-outs for an entire year and then overnight kind of withdrew them with no explanation. We're simply asking for that opt-out right to be returned.” Ephesians 6:4 says, “And you, fathers, do not provoke your children to wrath, but bring them up in the training and admonition of the Lord.” Maryland's physician-assisted suicide bills killed Speaking of Maryland, the state did not enact physician-assisted suicide bills during its most recent legislative session. This is the eighth time such deadly legislation has been introduced and the eighth time it has failed. Americans United for Life celebrated the defeat of the bills, crediting “numerous grassroots testimonies and thousands of letters speaking out.” Sadly, physician-assisted suicide is legal in 10 states and the District of Columbia. Secretary of State Rubio cuts staff by 15% U.S. Secretary of State Marco Rubio announced plans to overhaul the State Department yesterday. The changes will cut staff in the U.S. by 15% and close or consolidate over 100 bureaus around the world. It's part of President Donald Trump's “America First” foreign policy. In a press statement, Rubio said, “The sprawling bureaucracy created a system more beholden to radical political ideology than advancing America's core national interests. That is why today I am announcing a comprehensive reorganization plan that will bring the Department into the 21st Century.” Tammy Bruce, a State Department spokeswoman, added this in a press conference yesterday. BRUCE: “This is a whole of government, every department looking at how they can make their department more efficient, less burdensome, less bureaucratic. This is the State Department's version of that.” Alabama schools to display Ten Commandments, ban drag shows Lawmakers in Alabama passed several conservative bills last Thursday. One bill would require public schools to display the Ten Commandments. Republican State Rep. Phillip Rigsby, the sponsor of the bill, shared his mindset. RIGSBY: “In no way is this establishing a religion in the schools.  I think it gives us a good, at a minimum, moral compass.” Another bill would ban schools from promoting sexually perverted lifestyles through instruction or homosexual pride flags. And a third bill would prohibit schools and libraries from hosting drag performances.  Appearing on WDHN, Republican State Rep. Mack Butler explained why he believes children should be protected from drag shows in schools and libraries. BUTLER: “I'm a dad, you know, and if you look at all these sponsors of the bill, same thing: just dads trying to protect children. I'm just trying to take a stand for our children. Let them have their innocence. Just protect them.” The measures have passed in the state's House of Representatives and are awaiting approval by the Alabama State Senate.  Louisville Univ. pays $1.6 million to fired Christian psychiatrist And finally, University of Louisville officials agreed to a nearly $1.6 million settlement in a free speech case recently. Dr. Allan Josephson worked for the university's Division of Child and Adolescent Psychiatry and Psychology. The Christian psychiatrist spoke out against transgender drugs and surgeries. In response, the university demoted him, harassed him, and fired him. Travis Barham with Alliance Defending Freedom commented on the recent court victory for Josephson. He said, “After several years, free speech and common sense have scored a major victory on college campuses.” Close And that's The Worldview on this Wednesday, April 23rd, in the year of our Lord 2025. Subscribe for free by Amazon Music or by iTunes or email to our unique Christian newscast at www.TheWorldview.com. Or get the Generations app through Google Play or The App Store. I'm Adam McManus (Adam@TheWorldview.com). Seize the day for Jesus Christ.

SUMMARY In this episode, host Jeremy Lesniak engages in a deep conversation with Michael Calandra, a seasoned martial artist with a rich background in various styles including Ishinryu, Judo, and Taijiquan. They explore Michael's journey through martial arts, the importance of cross-training, and the principles that guide effective teaching.   The discussion also delves into the significance of self-defense training, the differences in teaching kids versus adults, and the complexities surrounding rank in martial arts. Michael emphasizes the need for a more holistic approach to martial arts training, focusing on principles rather than personalities, and the importance of adapting teaching methods to suit different age groups and skill levels.   In this conversation, Michael Calandra and Jeremy Lesniak explore the evolving standards in martial arts training, emphasizing the importance of adapting practices for longevity and health. They discuss the role of instructors in fostering student engagement and the necessity of injury prevention through proper body mechanics. The dialogue also touches on the impact of the Martial Truth podcast in sharing knowledge and experiences within the martial arts community.   TAKEAWAYS Michael Calandra has been training in Isshin-Ryu since 1979. Cross-training in various martial arts can enhance overall skills. Principles should take precedence over personalities in martial arts. Teaching methods should differ for kids and adults. Rank in martial arts should reflect individual progress, not just time served. Rank should reflect individual journeys and capabilities. Proper training can prevent injuries and promote longevity. Martial arts should adapt to the practitioner's body and age. Health benefits are integral to martial arts training. The martial arts community needs to be open to evolution. Injury prevention requires understanding body mechanics. Training should be enjoyable and sustainable for all ages. The podcast serves as a platform for sharing diverse martial arts perspectives. Martial arts can provide significant health benefits when practiced correctly. This episode is sponsored by Kataaro. Please check out their site at www.kataaro.com and use the code WK10 to save 10% off your first order. And be sure to ask them about a wholesale account for school owners! All orders for Autism Awareness belts in March and April will see 50% of the PROFITS donated to the International Society for Autism Research!

*DISCLAIMER* This episode covers adult topics that are not intended for young ears.   260. Sex After Cancer with Dr. Kris Christiansen   James 1:19 (NIV) My dear brothers and sisters, take note of this: Everyone should be quick to listen, slow to speak and slow to become angry,   **Transcription Below**   Questions We Discuss: What is common mis-information that you want to set straight as it relates to cancer and sex? If someone is walking their own cancer journey right now, what would you advise them to both do and avoid doing so that they can still enjoy the healthiest sex life possible with their spouse? What hope do you have to share with people who have battled cancer and still desire to connect intimately with their spouse?   Dr. Kris Christiansen is a board-certified family physician who specializes in sexual medicine. She attended medical school and completed her residency in family medicine at the University of Minnesota. She practiced full spectrum family medicine for 10 years and then pursued additional training to specialize in sexual medicine. She works as a sexual medicine specialist at two different clinics in the twin cities.   Her clinical interests include both male and female sexual dysfunction, and she loves working with individuals and couples to restore an important part of life. Dr. Christiansen is involved with teaching medical students and residents at the University of Minnesota Medical School, and she has presented at multiple local, national, and international medical conferences. She is involved with the International Society for the Study of Women's Sexual Health (ISSWSH) and serves on committees, collaborates with other experts to publish articles for medical journals, and edits informational articles for the society's new patient facing website. She is passionate about teaching patients, students, and colleagues about the importance of sexual health and well-being. In her free time, she started her own business called Intimate Focus which provides information and quality products to enhance and restore sexual health and wellness. She also enjoys shopping, hiking, and spending time with her family.   Dr. Kris Christiansen's Website   Previous Episodes featuring Dr. Kris Christiansen on The Savvy Sauce: 215 Enriching Women's Sexual Function, Part One with Dr. Kris Christiansen 216 Enriching Women's Sexual Function, Part Two with Dr. Kris Christiansen   Additional Place to Find More Episodes from The Savvy Sauce Related to This Topic: One-Stop Shop for Marriage and Intimacy Resources   Dr. Kris Christiansen's Recommended Websites for Sexual Health: The Menopause Society Mayo Clinic National Institutes of Health International Society for the Study of Women's Sexual Health American Urological Association International Society of Sexual Medicine Sexual Medicine Society of North America American Cancer Society ISSWSH International Society for the Study of Women's Sexual Health SMSNA Sexual Medicine Society of North America  ISSM International Society of Sexual Medicine The Menopause Society   Find a provider: For a women's sexual health provider, pelvic floor physical therapist, (non-Christian) sex therapist ABCST American Board of Christian Sex Therapists (for a Christian sex therapist)   Thank You to Our Sponsor: Leman Property Management Company   Connect with The Savvy Sauce on Facebook or Instagram or Our Website   Please help us out by sharing this episode with a friend, leaving a 5-star rating and review on Apple Podcasts, and subscribing to this podcast!   Gospel Scripture: (all NIV)   Romans 3:23 “for all have sinned and fall short of the glory of God,”   Romans 3:24 “and are justified freely by his grace through the redemption that came by Christ Jesus.”   Romans 3:25 (a) “God presented him as a sacrifice of atonement, through faith in his blood.”    Hebrews 9:22 (b) “without the shedding of blood there is no forgiveness.”    Romans 5:8 “But God demonstrates his own love for us in this: While we were still sinners, Christ died for us.”    Romans 5:11 “Not only is this so, but we also rejoice in God through our Lord Jesus Christ, through whom we have now received reconciliation.”    John 3:16 “For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life.”   Romans 10:9 “That if you confess with your mouth, “Jesus is Lord,” and believe in your heart that God raised him from the dead, you will be saved.”    Luke 15:10 says “In the same way, I tell you, there is rejoicing in the presence of the angels of God over one sinner who repents.”   Romans 8:1 “Therefore, there is now no condemnation for those who are in Christ Jesus”   Ephesians 1:13–14 “And you also were included in Christ when you heard the word of truth, the gospel of your salvation. Having believed, you were marked in him with a seal, the promised Holy Spirit, who is a deposit guaranteeing our inheritance until the redemption of those who are God's possession- to the praise of his glory.”   Ephesians 1:15–23 “For this reason, ever since I heard about your faith in the Lord Jesus and your love for all the saints, I have not stopped giving thanks for you, remembering you in my prayers. I keep asking that the God of our Lord Jesus Christ, the glorious Father, may give you the spirit of wisdom and revelation, so that you may know him better. I pray also that the eyes of your heart may be enlightened in order that you may know the hope to which he has called you, the riches of his glorious inheritance in the saints, and his incomparably great power for us who believe. That power is like the working of his mighty strength, which he exerted in Christ when he raised him from the dead and seated him at his right hand in the heavenly realms, far above all rule and authority, power and dominion, and every title that can be given, not only in the present age but also in the one to come. And God placed all things under his feet and appointed him to be head over everything for the church, which is his body, the fullness of him who fills everything in every way.”   Ephesians 2:8–10 “For it is by grace you have been saved, through faith – and this not from yourselves, it is the gift of God – not by works, so that no one can boast. For we are God‘s workmanship, created in Christ Jesus to do good works, which God prepared in advance for us to do.“   Ephesians 2:13 “But now in Christ Jesus you who once were far away have been brought near through the blood of Christ.“   Philippians 1:6 “being confident of this, that he who began a good work in you will carry it on to completion until the day of Christ Jesus.”   **Transcription**   Music: (0:00 – 0:09)   Laura Dugger: (0:10 - 1:22) Welcome to The Savvy Sauce, where we have practical chats for intentional living. I'm your host, Laura Dugger, and I'm so glad you're here.    Leman Property Management Co. has the apartment you will be able to call home, with over 1,700 apartment units available in Central Illinois.   Visit them today at lemanproperties.com or connect with them on Facebook.    Today's message is not intended for little ears. We'll be discussing some adult themes, and I want you to be aware before you listen to this message.   Not many people specialize in the same thing as our returning guest for today, Dr. Kris Christiansen. She specializes in sexual medicine, and today she's going to provide clarity, information, and direction for how to maximize sexual pleasure with our spouse after one receives a cancer diagnosis. Here's our chat.   Welcome back to The Savvy Sauce, Dr. Christiansen.   Dr. Kris Christiansen: (1:23 - 1:30) Well, thank you so much, Laura. We had so much fun last time, and I'm looking forward to this conversation again today.   Laura Dugger: (1:31 - 1:57) Likewise. I feel the same way. And it really wasn't that long ago that you were on The Savvy Sauce two times, so I'll make sure and link to both of those episodes in the show notes for today.   But hopefully everybody's already well acquainted with you, and that's why we're just kind of diving right into our topic today. So, for starters, how did this topic of sex after cancer become an interest of yours to study?   Dr. Kris Christiansen: (2:00 - 2:32) Well, so Laura, my job as a sexual medicine physician is that I work with both men and women and helping them with their sexual lives when they have problems or whatever. So, cancer is often a big part of that. So, through my journey with work, I've just developed a significant interest in learning how to really care for people to help restore this important part of life.   Laura Dugger: (2:33 - 2:52) Absolutely, because a lot is taken away when somebody gets that awful diagnosis, and so I'm very grateful for people like you who are experts. But is there any common misinformation that you would like to set straight as it relates to cancer and sex?   Dr. Kris Christiansen: (2:55 - 6:42) Well, interesting you say that, because there is so much misinformation out there just about sex in general. And then when we throw cancer in on top of that, it just makes it even more complicated. So, I think a common fear that people experience when they get that diagnosis that they hope they never hear, the C word, is that it's going to have a significant impact on their sexual intimacy.   And you know what, it can, but that doesn't mean that that chapter in life is closed. We just have to remember that sexual intimacy is much, much broader than just intercourse. So, if we can refer to this as PIV sex, penis in vagina sex, many people view it as kind of an all or none thing.   If they can't have vaginal intercourse or that PIV sex, then they don't want anything at all. Unfortunately, that just rules out or shuts out so much of sexual intimacy that God has intended for us. We may not be able to engage in the same activities for a time or even long term, but that doesn't mean that we can't connect.   So, if we try to remember that intimacy, sexual intimacy is all about giving and receiving pleasure, then there are so many more opportunities. So, we have to get beyond the fact that sexual intimacy, sexual intercourse is just vaginal intercourse because it's not. It's giving and receiving pleasure.   And however people want to connect or comfortable connecting, that they can still enjoy a very fruitful sex life. The other thing that is misunderstood and misconceptions is estrogen, vaginal estrogen, especially. Because, well, all women who enter menopause and you're in menopause for the rest of your life do experience some changes.   And it's so common that women experience the genital urinary syndrome of menopause. That's vaginal atrophy, or when the tissues get drier and thinner and there can be tearing and pain as well as bleeding and decreased sensation, decreased sensitivity. These things are common with aging, but oftentimes cancer treatments emphasize that or accelerate it or make it even worse.   And vaginal estrogen is really, really safe. It does not cause cancer. And most of the studies show that even in women who have breast cancer, that it doesn't cause recurrence.   So vaginal estrogen, being so safe, can really save our vaginas. And we're talking about vaginal health and bladder health. It's not just about sex, but it helps keep our bodies functioning properly and minimizing pain and discomfort.   So, if a woman is diagnosed with breast cancer and she's on treatment, then obviously we have to talk to the oncologist, make sure they're okay with that. But we get more and more studies showing it's safety and it's definitely effective and can help keep our tissues young.   Laura Dugger: (6:42 - 7:25) This is really helpful and brand new information to me. So someone, like you used that example, if they have breast cancer diagnosis and there's different types, but if they're doing the treatment where perhaps they go into early menopause or they have a hysterectomy or remove their ovaries and they even have an estrogen blocker so that they're not producing estrogen, for that type, you're still saying as long as you're working with the oncologist for that personal client, even in those situations, vaginal estrogen, which would be, I'm assuming, more of a cream or something you insert to the vagina, is that right? That that would be safe?   Dr. Kris Christiansen: (7:25 - 10:55) So, where it gets a little gray is if the woman is taking an aromatase inhibitor, which is the estrogen blocker. So, it pretty much wipes all estrogen out of her system. There's a little more risk there.   So most definitely we need to double check with the oncologist. But it often comes down to quality of life. I have a patient who, she was diagnosed with breast cancer, I believe, in her early 60s.   And she came to me at the sexual medicine clinic and she was just miserable. I mean, when we think of vaginal dryness, you think of, okay, it's annoying. You use a lubricant, right, and it's going to be just fine.   In the beginning, yes, that's the case. But this genital urinary syndrome of menopause, GSM, gets worse with time, especially with those anti-estrogen treatments. And for this poor woman, she couldn't exercise.   She loved to go hiking. She loved to go skiing. And just any kind of movement was painful.   And we don't think of that. We kind of take it for granted. But for some women who really experience severe side effects of the breast cancer treatments and causing dryness and irritation, it affects everything.   And for her, we tried all the non-hormonal things first. They didn't work. And her oncologist gave us the blessing saying, you know, we tried it.   This is really important to you. Let's give it a try. And so, we've monitored her, and the vaginal estrogen hasn't caused any problems.   So, a couple points on that. With the vaginal estrogen, yes, it comes as a cream. There's a tablet, which is like a little pill with an applicator that you insert in the vagina.   There are vaginal inserts. They look like little caplets that you just insert with the finger. There's a vaginal ring.   But with the localized treatment, it's meant to just act locally, meaning just on the vaginal tissues. And, oh, package insert. So, you know, here we tell patients, vaginal estrogen is safe.   Don't worry. It's not going to cause cancer, heart attack, strokes, or blood clots. But then they go home.   They get their prescription. They open up the patient insert, package insert, and it talks about risks and bad things that can happen and side effects. Unfortunately, the FDA says we have to use the class labeling or the side effects that are associated with systemic estrogen.   And it automatically gets applied to the localized or vaginal estrogen treatments. So, patients go home, they read that, and they think we're lying to them. But, unfortunately, it's just very misleading because we have plenty of studies to show that vaginal estrogen doesn't cause those terrible things.   And it's very safe. So, they just have to trust us. And there are groups and people out there trying to work with the FDA to get that class labeling effect removed because it just scares everybody away from using estrogen, which can be so helpful.   Laura Dugger: (10:57 - 11:04) Wow, that is helpful. Is there any other common misinformation you want to make sure we don't overlook before we continue on?   Dr. Kris Christiansen: (11:05 - 11:29) Well, I made a few notes here. No, I don't think so. Except that media, television, and all that other stuff that we see out there is so misleading when it comes to sexual intimacy.   Because sex in real life doesn't look like what you see in the movies. Yeah.   Laura Dugger: (11:30 - 11:45) Great, great point. And so, when somebody does get, like you said, that dreaded C-word diagnosis, what's a common path that they may experience as it affects them sexually?   Dr. Kris Christiansen: (11:48 - 14:00) Well, so, the different cancers are so different and treatments are so different that it's hard to generalize for everybody. But, you know, first thing most people experience is fear. What's this mean for me?   What's this mean for my life, my family? Am I going to be around in five years? So, it's that fear.   And the initial part of that journey is often involved with meeting with lots of doctors, having all the tests, trying to figure out what's going on, what we're going to do. And sexual intimacy often isn't part of that first steps that they take. So, but when things kind of finally settle down, then those questions start popping up.   What does this mean? It's important to talk with your cancer journey, your cancer team, the oncology team to find out what's going on. And it's important to ask all these questions because doctors really aren't very good about asking about sexual health and what that means to you.   Oncologists, generally speaking, they want to treat the cancer and their job is done when the cancer is treated, under control, gone, whatever. And they've done a good job. However, so many of us are just left afterwards saying, okay, thanks, cancer's gone, but now what?   And so, it's a matter of really trying to figure out what's important over time, learning what's going to work and what's not. And know that there are people out there to help you and that want to help you if it's not going as planned. You know, I just want to reiterate that people really need to advocate for themselves and they need to ask questions.   And if they're not getting the answers that they want, don't give up because there are people, organizations, information out there that can be helpful. So rather than just worrying about what's next, seek help.   Laura Dugger: (14:02 - 14:18) That's really great advice. And I think this may be an appropriate place to pause and just get some of those recommended places. Because if somebody, this is new to them and they don't know where to turn, do you have any places or websites off the top of your mind that you would recommend?   Dr. Kris Christiansen: (14:20 - 15:41) Well, so cancer.org, the American Cancer Society has a lot of resources on there. When it comes to menopause-type symptoms and such, menopause.org is the Menopause Society, which has a lot of information. And a website called PROSAYLA, it's P-R-O-S-A-Y-L-A.com, is a website that's managed by ISHWISH.   We've got all these acronyms. The International Society for the Study of Women's Sexual Health. So that is my go-to.   Okay, so that's the organization where there's so much research and science and such happening. And the PROSAYLA.org or prosayla.com, either one works, is a website where there are several articles written by experts in the field. So, these are articles backed by science.   It's not just somebody's opinion or somebody's blog. And I know there's an article on there about sex or cancer and sexuality. So, some generalities and some other references on that site too.   Laura Dugger: (15:42 - 15:51) Okay, that is super helpful information. We'll make sure and add links to those places as well. Anything else that you want to make sure we don't miss?   Dr. Kris Christiansen: (15:52 - 17:36) Well, when we talk about sexual concerns or sexual problems, we always try to approach it from a biopsychosocial aspect. Because those three different entities all play a big role in what works well and what doesn't. So, from the biological section, that's pain, medications, nerve problems, chronic medical problems.   So obviously cancer plays a big role in that. And with cancer treatments and such, pain may be part of that, nausea, fatigue. And so, we just don't feel the same going through these treatments because it's really hard.   As far as the psych bubble, I'm usually referencing a Venn diagram here. Psychological, so when we experience anxiety or depression or performance anxiety, that plays a big role. So, we need to take a step back and realize that what happens up here in our brain has a huge impact on how our bodies function physically.   And then as far as the social aspect, that's our relationships, our interpersonal relationships with our partner, our spouse, with our family and how things are going on at work. A cancer diagnosis and treatment can affect all of those. And so, it's not just a magic pill to improve your libido because if we don't treat all these other things, people continue to struggle with their sexual function.   Laura Dugger: (18:01 - 19:46) Duplexes, studios and garden style options located in many areas throughout Pekin. In Peoria, a historic downtown location and apartments adjacent to the OSF Medical Center provide excellent choices. 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Check them out on Facebook today or email their friendly staff at Leasing@LemanProps.com. You can also stop by their website at lemanproperties.com.   That's LEMANproperties.com. Check them out and find your place to call home today.    Also, Dr. Kris, are there any certain cancers or treatments that have the most detrimental impact on a person's sex life?   Dr. Kris Christiansen: (19:48 - 23:15) We know that cancers that affect the breast, for women, but men too get breast cancer, and also the genital area have the biggest impact. We've talked a fair amount about breast cancer. Many of the treatments for breast cancer result in early menopause.   If a woman is premenopausal when this happens, menopause can have a definite impact. The treatments can cause the pain and dryness and decrease sensitivity. Also, if surgery is involved in a mastectomy, it can affect our own body self-image.   From a more physical standpoint too, when we have the mastectomy and those nerves are cut, it decreases the sensitivity. For a lot of women, breast stimulation is really important as part of their sexual play. If now her breasts are gone and she can't feel anything when her husband is touching her breasts, that can be a really hard adjustment.   Any cancers that affect the genital area, uterine cancer, ovarian cancer, or anal rectal cancer for both men and women, and prostate cancer for men, those all have a huge impact. In addition to working with a lot of women who have breast cancer and overcoming and improving those areas, I work with a lot of men who have prostate cancer. Those treatments usually result in erection problems and urinary incontinence, which can be hard to deal with.   Men who have a prostatectomy, so if they have their prostate removed, then 100% of them are going to have erectile dysfunction in the beginning. It's going to take time for those nerves to recover, and it may take up to two years to see that full recovery. In those first few months when I'm working with men, I'm trying to be their cheerleader, saying, don't lose hope, don't give up, because this is going to get better.   It just takes time for those nerves to regrow. In the process, though, it is important to do whatever we can to make sure that that tissue stays healthy. Remember that the penis is actually muscle, muscle tissue, smooth muscle.   If we don't use a muscle for several months, atrophy sets in, which is a bad thing. With atrophy, the penis can shrink in size, and scar tissue potentially can set in, and it just makes that recovery less optimal than what it would have been. Trying to maintain the blood flow during those first few months or first year is really helpful.   Just to help maintain the blood flow and the oxygen to help keep the tissues healthy, so when the tenders do recover as best as they're going to, we get the best outcome.   Laura Dugger: (23:16 - 23:36) This may be an ignorant question, but then if erectile issues are present during that first time period, but it's crucial to have the blood flow to that area, what can men do to increase blood flow there, even if erection is difficult or impossible?   Dr. Kris Christiansen: (23:36 - 25:01) That's a great question. Taking a medication like Viagra or Cialis. Cialis is my favorite because it stays in the system for a good 36 to 48 hours every time you take it.   If you're just taking a low dose every day, it just encourages a little bit of that blood flow every day. Using a vacuum device, which I just happen to have one right here, looks like this. A penis goes inside the cylinder, we create a vacuum or suction, and it pulls the blood flow in.   It's not the most sexy thing, but using it and using the vacuum device several times a week just to get that blood flow going is a very helpful way to keep the tissues healthy. Getting an erection with the vacuum doesn't get those arousal-type feelings, so it looks a little weird, but it does work. For men who want to use this for sexual activity, you can get the erection within the tube, and then it comes with these tight rings that are stretched over the edge of the cylinder.   Once you get the full erection within the tube, you slide that ring off to maintain the erection.   Laura Dugger: (25:04 - 25:14) That's incredible just to pause and think of God's grace and these inventions and how incredible that there are solutions. Please continue, but I find that encouraging.   Dr. Kris Christiansen: (25:16 - 27:39) There are all kinds of encouraging things, but if you're in the middle of this journey, it can be sometimes hard to keep going when you're not getting the results that you want to. But we believe in a big God, and he created sexual intimacy, and it's a gift. Other ways to help manage erectile dysfunction and a couple other show-and-tell things here.   This medication is called Muse. The actual medication is a pellet that comes preloaded in this applicator. You insert it in the tip of the penis, the medication gets absorbed, and 10 minutes later, magic happens.   I don't prescribe this very often because it's really, really expensive, a little harder to find. But the advantage to this medication is that it doesn't need the nerves to work, whereas the medications like Viagra and Cialis, they need the nerves. Guys usually kind of turn white when I pull this out.   For our listeners, I'm holding an insulin syringe and needle. There is such a treatment where you can actually inject a tiny amount of medicine directly into the penis, and it will give you an erection. I tell men that with the pills like Viagra and Cialis, just in general with ED, it works in about 60% of men.   We can get this to work, the injections to work, in 90-95%. It's such a tiny needle that men say it feels like a poke or a pinch once they get past that initial shock that they think is going to hurt. The usual response is, oh, that wasn't so bad, and it's very effective.   This can work within four to six weeks, so whenever your surgeon says it's okay to engage in sexual activity again, this will work. Then last but not least is a penile implant. That's surgery, and that you have to wait at least a year, if not two, after the prostate surgery.   That works in 99.99%. Wow.   Laura Dugger: (27:40 - 27:56) We were focusing a lot on men for that one. Is there any medication or any other injections or anything like that for women, other than the vaginal cream or different ways to get estrogen in the vagina?   Dr. Kris Christiansen: (27:58 - 31:15) Yes, we've got all kinds of treatments. If a woman has breast cancer, or for whatever reason we want to avoid hormones as much as possible, then generally we're starting with a vaginal moisturizer, which is different than a lubricant. A lubricant is just for sexual activity and just to make things slipperier and feel better.   That often helps in the beginning, but as the GSM or the atrophy continues, the lubricant isn't enough. A moisturizer, think of like a facial moisturizer or a moisturizer for your hand, in order for it to work, you have to use it regularly, which is probably at least three times a week. These moisturizers can come in forms of a liquid that gets injected.   They're little capsules that you can insert. Reveri is a hyaluronic acid suppository, which you insert in the vagina and over time that can be really helpful. One of my favorites is this Rosebud Everyday Balm.   It's a really nice balm that you can put on the tissues inside the lips and inside the vagina. It's just really, really soothing. Again, you've got to use these things regularly.   It will take a good two months at least to see the full effect, so it doesn't work right away. Just like with the guys where they've got to be patient with the nerves, we have to be persistent and patient with things that can work. A vaginal moisturizer is really helpful.   A lubricant for sexual activity. There are over-the-counter and prescription medications that can help with arousal and orgasm. There are two approved medications for the treatment of low libido in premenopausal women.   One is Addi, which is a pill that you take every day, also known as the pink pill. Another treatment is Vilece, which is an injection. It comes in a pen, so you never see the needle and really don't feel the needle.   You give it to yourself about 45 minutes to an hour before sexual activity. Both of these medications are working on the brain chemistry because the brain is the biggest sex organ in the body. It's the most important sex organ.   It works on the brain chemistry and improving the dopamine and norepinephrine and the good sex positive hormones. Like I said, it's only approved for premenopausal women, but many of us do prescribe it for postmenopausal women. We have studies to show that it's safe and it's effective.   The drug companies didn't go through with all the rigmarole they had to do to get the FDA-approved indication for that. We've got all kinds of tricks up our sleeve.   Laura Dugger: (31:16 - 31:26) Absolutely. Just piggybacking on that, they wouldn't oftentimes follow through on all those studies, would you say primarily because of financial restraints?   Dr. Kris Christiansen: (31:27 - 31:41) Totally. To get a medication approved for female sexual function, it's multi-million, if not a billion dollars. Studies and everything that needs to be done, it's crazy.   That's why these meds are so expensive.   Laura Dugger: (31:42 - 32:14) Then you also mentioned earlier bringing in the quality of life. There are so many options to consider, but such a personal basis. I had another question that arose.   You kind of were answering that because this one works with the brain chemistry. I'm thinking the body parts may be functioning and you can do different things to have an erection or be aroused with your genitalia, but how is desire affected with cancer?   Dr. Kris Christiansen: (32:16 - 35:03) It's huge, unfortunately. Again, if we go back to that biopsychosocial model and for everything to work well, everything's got to be working well. If we have pain, of course that drives down desire.   We use the analogy of putting your hand on a hot stove. Pain with sex can hurt just as badly as that. I have women tell me it's 10 out of 10 pain feels like shards of glass.   Obviously, that's not pleasant. If we compare that to putting your hand on a hot stove, why in the world would you want to do that? We've got to take care of the pain.   When it comes to pain, it becomes imprinted in the brain and the body responds by just amplifying that pain. You've got more pain and you have less desire. Part of GSM or surgery or chemotherapy and other treatments, radiation, can affect the nerves.   We don't get those positive sensations and the arousal anymore. There's arousal in the brain as well as arousal in the genital area. If we're not getting that positive feedback that this just isn't fun anymore, it's hard to get enthused about engaging in that.   Sex therapy can be really helpful. Sex therapy isn't going to fix thin tissues, but a sex therapist is very skilled and trained at working with people and working with couples on trying to process this, working through the process and the changes that are happening. Sometimes it is a permanent change in sexual function, so there's grief involved.   Helping to process through some of that is really important. But again, if we take a step back and remember that sexual intimacy is more than just PIV sex, that there are all kinds of ways to be able to give and receive pleasure, as long as each person is comfortable with this. And moving beyond the thinking that, well, if I can't have intercourse, I'm not going to have anything at all, then that may mean you might not have anything at all for the rest of your life.   That makes me sad. We just have to take a step back, work through some of this, because it's a journey, it's a cancer journey, it's an aging journey, and try to make the most of it.   Laura Dugger: (35:04 - 36:32) I want to make sure that you're up to date with our latest news. We have a new website. You can visit thesavvysauce.com and see all of the latest updates. You may remember Francie Hinrichsen from episode 132, where we talked about pursuing our God-given dreams. She is the amazing businesswoman who has carefully designed a brand-new website for Savvy Sauce Charities, and we are thrilled with the final product. So, I hope you check it out.   There you're going to find all of our podcasts, now with show notes and transcriptions listed, a scrapbook of various previous guests, and an easy place to join our email list to receive monthly encouragement and questions to ask your loved ones so that you can have your own practical chats for intentional living. You will also be able to access our donation button or our mailing address for sending checks that are tax deductible so that you can support the work of Savvy Sauce Charities and help us continue to reach the nations with the good news of Jesus Christ. So, make sure you visit thesavvysauce.com.   What are some of those examples for someone if they can't have PIV sex anymore? What are ways that you encourage continuing to build intimacy and a knowing of one another and offering and receiving pleasure?   Dr. Kris Christiansen: (36:34 - 41:17) Well, starting with making sure each person is on the same page as far as what they're comfortable with. Okay? Communication is key.   To be able to talk about what you want, what you desire, what your needs are, and listening to your partner say that same thing, trying to make no judgments and not forcing anybody into anything, but just so that we can help understand each other. And when it comes to actual giving and receiving pleasure, whether that's with manual stimulation, with your hands, with your fingers, or if you have a massager, oral stimulation, using a vibrator. And a vibrator can be really helpful for women in menopause, women dealing with cancer treatments, and also for men if they need a little extra help with the stimulation because their nerves aren't working so well.   A vibrator, using it together in the context of giving and receiving pleasure can help, just help with the response, help with the enjoyment, and make it a little more fun, as long as everybody's okay with that. Using a lubricant is really important. And a good lubricant, you want to use a good lubricant because some of the more common ones, unfortunately, have ingredients in them that can actually hurt or irritate.   And like KY and Astroglide, sorry to name names here, but they're basic water-based lubricants, have either glycerin, parabens, or propylene glycol in them, and those can irritate, so we want to try to avoid those. A silicone-based lubricant doesn't have those preservatives, and it stays slippery longer. Where we have to be careful with that is that if you're using a silicone tool, otherwise known as a vibrator, you don't want to use those together because it can ruin the tool.   And if the man is struggling with ED, using too much, especially of a silicone lubricant, can make it too slippery. And too slippery is not so good for him. Oil-based lubricants, they're very nice, except if you're using condoms, it will degrade the condom and create other problems, potentially.   Other ways to stimulate, manually, orally, and when women have pain with intercourse, I'm going to bring in another show-and-tell here, the pain is often coming from the vulva, not so much in the vagina. We talk about vaginal dryness and vaginal atrophy, but the part that's most sensitive is often just right inside the little lips here. And so, if we have terrible pain with penetration, we want to avoid that.   However, the whole surrounding vulvar area is very rich in nerves, can be very much stimulated, and it can feel really good, however each person is comfortable stimulating that area. And another fun fact is that this entire structure is the clitoris. You know, when we think of the clitoris, we think of the glands, this tiny little magic button right here, which, by the way, has 10,000 nerve endings in it.   It's incredible. But the legs, the legs are the cruise of the clitoris, as well as the bulbs. They come down on either side of the vagina.   So, the vagina is here. However, this part of the clitoris can easily be stimulated, so the legs of the clitoris can be easily stimulated, just inside the labia majora, or the outer lips. So, using a vibrator here can be really pleasurable, and you're avoiding the part that hurts.   So, stimulating externally the clitoris, the labia, and wherever else feels good can be very fun. And so, if you try to approach it may be like a game, making it fun and exploring each other's bodies so that you can really figure out ways to make the other person feel good or experience pleasure without causing pain.   Laura Dugger: (41:18 - 41:43) That's so great. And like you had mentioned, if they go see a Christian sex therapist, they would say the same thing as you to stop when there is pain, because it just makes it worse over time. And so, I love that you've given us other options, if that is the case.   Is there ever a time where orgasm is no longer possible after cancer?   Dr. Kris Christiansen: (41:46 - 43:14) It's possible. Yes. Depending on the cancer and the treatment, that it can make it really difficult or even impossible to get there.   But that's where we want to not focus on orgasm as the ultimate goal, because if we engage in sexual activity with orgasm as the ultimate goal, your brain's not going to let you go there, whether it's the male or the female, either one, the brain is the biggest sex organ in the body. Just trying to go for the gold just won't let you get there. So, you have to relax and enjoy the journey regardless.   So even if the cancer or the treatment didn't necessarily affect orgasm or if it's just our brains, my encouragement is to approach a sexual encounter as an experience. Enjoy the experience. It's not a performance.   We don't want to perform because then we get in our head, and we get nervous and our muscles all tighten up. So, we don't want to perform. We want to enjoy the experience, and it can be very pleasurable.   Even if orgasm isn't part of the picture anymore, it doesn't mean you can't have fun and can't connect because you can.   Laura Dugger: (43:15 - 43:25) But then I guess also to offer the hope, if I ask it a different way, are there times that orgasm is still possible after a cancer diagnosis?   Dr. Kris Christiansen: (43:27 - 44:01) Absolutely. We always have hope. We always have hope.   Just because you're diagnosed with cancer doesn't mean you're not going to be able to engage in PIV sex or be able to experience an orgasm because that's always a possibility. Don't focus on just getting to the big orgasm. You want to slow down, enjoy the journey, and oftentimes it will come.   There are medications that help with blood flow, that help with arousal and orgasm, and sometimes they can be helpful. Sometimes they're not, but usually it doesn't hurt to try them.   Laura Dugger: (44:02 - 44:26) There you go. That's a very helpful reminder. It's a piece of the puzzle, not the whole thing.   But if someone right now is walking through their own cancer journey, what else would you advise them both to do and to avoid doing so that they can still enjoy the healthiest sex life possible with their spouse?   Dr. Kris Christiansen: (44:29 - 47:19) That's going to involve several pieces. One, first and foremost, maintain the communication about wants and desires, what hurts, what doesn't, what can we do, what do you want to try tonight? Maintaining the communication.   It's much better to prevent problems like the vaginal dryness and pain than to try to treat it after you've been dealing with it for years sometimes, or even months. If you have, say, breast cancer, just getting in the habit of using one of those vaginal moisturizers from the get-go even before the dryness starts can help prevent problems. Seeing a pelvic floor physical therapist can be really, really helpful.   A pelvic floor physical therapist is a physical therapist who specializes in these pelvic floor muscles that help support everything on the inside. And so if these muscles are too tight, causes pain, and if they're already too tight, doing tangles is the last thing that you want to do, because sometimes it means being able to relax them. Or women who have, who need pelvic radiation, say for uterine cancer, the gynecologic oncologist is usually really good about giving you a vaginal dilator and to use it, but they're not always really good at telling you exactly how to use it, how frequently and how long, so be sure and ask.   Because again, we want to maintain the integrity of the tissues, because it's better to maintain them than try to get it back. That's often quite hard. For guys, especially with prostate cancer, it means participating in that, we call it penile rehabilitation.   So, it's basically physical therapy for the penis. You know, its muscle, so we want to keep that muscle healthy and to help maintain healthy tissues. And just trying to be as good to ourselves as we can, giving ourselves and our partners grace when we need it, because it's a journey and it's not an easy one.   But we believe in a big God and he's there to help us through this and he delights when husband and wife can unite as one, whatever that looks like. And it makes him happy and he's there to try to keep this going for us.   Laura Dugger: (47:21 - 47:40) And you may have already answered this question with that, but I love how you're always encouraging and gentle and full of hope. So, any other hope that you want to share with anyone who's battled cancer or is in the midst of their journey, but they're still desiring to connect intimately with their spouse?   Dr. Kris Christiansen: (47:47 - 48:33) Sometimes it means asking for help. So, for finding a provider, whether that's a therapist, a gynecologist, a sexual medicine provider, or even your pastor counselor to help you through this. In the show notes, we'll put in websites where you can find a provider because not everybody is educated.   Hardly anybody's educated on this, unfortunately. But there are people out there throughout the country, throughout the world, where you can find to help guide you on this journey. Don't suffer in silence.   We're here to help. So be sure to reach out so we can help you.   Laura Dugger: (48:33 - 48:50) That's so good, Dr. Christiansen. And are there any other proactive measures that all of us can take to set us up for a healthy sex life into aging or any diagnoses that we may get in the future?   Dr. Kris Christiansen: (48:53 - 50:38) Well, treating our body like a temple, like God says. We have to take good care of ourselves. And just in general, going for your preventative visits and checking your cholesterol and your blood sugar and your blood pressure and screening for cancer so we can prevent them or catch them really early.   And it's so much easier to treat. But things like smoking and diabetes and being overweight and high blood pressure, high cholesterol, they impact sexual function very negatively, especially smoking. Guys are still surprised when I tell them, or I show them a picture of a cigarette with ashes that are kind of wilting off the end.   This is your penis. This is what happens with smoking. Okay.   So quitting smoking. And in women, we have those same little blood vessels and nerves that men do. And so not taking care of ourselves as far as weight, exercise and diabetes and all that stuff, that affects our sexual function, too.   So just making sure that we take a proactive stance on just taking really good care of our medical and our mental health because that's so important. And our spiritual health. Can't forget that, too.   Yeah. Just, you know, taking care of ourselves because aging does impact sexual function. As we get older, our endurance isn't quite what it used to be.   Certainly not as flexible as we used to be. Things kind of hurt. Achy joints and whatever.   So, the more we can take care of ourselves, the more we can enjoy that sexual intimacy, which does involve a little bit of physical exertion.   Laura Dugger: (50:39 - 51:03) Absolutely. Well, you've shared a lot of places where we can go to seek help. But I would love to know where we can continue to learn from you or a website where people can find out more of your offerings because you mentioned not many people are educated in this field or on this topic, but you are a great resource.   So where would you direct all of us after this chat?   Dr. Kris Christiansen: (51:05 - 52:23) Well, I started my own business called Intimate Focus, Intimate-Focus.com. Where my goal is to offer education and quality products that people can use to help equip them and enhance sexual intimacy. As part of my clinical career where I see patients, we'd often talk about using a good lubricant or getting a vibrator to help with those nerves that just aren't quite as effective anymore.   And so many times they told me they were just not comfortable going to an adult store or they didn't want to purchase them on Amazon because it could be a shared account and kids or whatever may see what they're ordering. So, this is a private and secure site and I don't even know how to sell your email so don't worry, that's not going to happen. Where you can purchase good quality products, I vet them out myself to make sure that they don't contain the ingredients that I encourage women to avoid and no pictures with nudity or anything like that because I want it to be a comfortable space or at least as comfortable as we can make it for everybody.   Laura Dugger: (52:24 - 52:43) Wonderful. Well, I'll certainly link that in the show notes as well. And Dr. Christiansen, you are already a friend of The Savvy Sauce, so you know that we're called The Savvy Sauce because savvy is synonymous with practical knowledge. And so, as my final question for you today, what is your Savvy Sauce?   Dr. Kris Christiansen: (52:46 - 53:15) Well, you know, James in the Bible is a very practical kind of guy and I love his advice that we should all be quick to listen, slow to speak and slow to become angry. And if we were all able to do that or at least just a little more of that, I think our world would be a much better place to live.   Laura Dugger: (53:16 - 53:42) This is so good. I cannot hear that verse enough and I just truly look so forward to the times that I get to spend with you. You are such a calming presence full of wisdom.   That's what we prayed for before we had the recording begin for today. And I am just overflowing with gratitude. So, thank you, Dr. Christiansen, for all that you've shared. Thank you so much for being my returning guest.   Dr. Kris Christiansen: (53:43 - 53:48) Well, thank you, Laura. This has been great. It's an honor to be on your show.   Laura Dugger: (53:50 - 57:32) One more thing before you go. Have you heard the term gospel before?   It simply means good news. And I want to share the best news with you. But it starts with the bad news.   Every single one of us were born sinners, but Christ desires to rescue us from our sin, which is something we cannot do for ourselves. This means there is absolutely no chance we can make it to heaven on our own. So, for you and for me, it means we deserve death and we can never pay back the sacrifice we owe to be saved.   We need a savior. But God loved us so much, he made a way for his only son to willingly die in our place as the perfect substitute. This gives us hope of life forever in right relationship with him.   That is good news. Jesus lived the perfect life we could never live and died in our place for our sin. This was God's plan to make a way to reconcile with us so that God can look at us and see Jesus.   We can be covered and justified through the work Jesus finished if we choose to receive what He has done for us. Romans 10:9 says, “That if you confess with your mouth Jesus is Lord and believe in your heart that God raised him from the dead, you will be saved.” So, would you pray with me now?   Heavenly Father, thank you for sending Jesus to take our place. I pray someone today right now is touched and chooses to turn their life over to you. Will you clearly guide them and help them take their next step in faith to declare you as Lord of their life?   We trust you to work and change lives now for eternity. In Jesus' name we pray. Amen.   If you prayed that prayer, you are declaring him for me, so me for him. You get the opportunity to live your life for him. And at this podcast, we're called The Savvy Sauce for a reason.   We want to give you practical tools to implement the knowledge you have learned. So, you ready to get started? First, tell someone.   Say it out loud. Get a Bible. The first day I made this decision, my parents took me to Barnes & Noble and let me choose my own Bible.   I selected the Quest NIV Bible and I love it. You can start by reading the book of John. Also, get connected locally, which just means tell someone who's a part of a church in your community that you made a decision to follow Christ.   I'm assuming they will be thrilled to talk with you about further steps, such as going to church and getting connected to other believers to encourage you. We want to celebrate with you too, so feel free to leave a comment for us here if you did make a decision to follow Christ. We also have show notes included where you can read scripture that describes this process.   And finally, be encouraged. Luke 15:10 says, “In the same way I tell you, there is rejoicing in the presence of the angels of God over one sinner who repents.” The heavens are praising with you for your decision today.   And if you've already received this good news, I pray you have someone to share it with. You are loved and I look forward to meeting you here next time.

Patreon/Supercast Special Release - Disarming the Narcissist: Myths, Truths, & Strategies for Healing with Wendy Behary (264) This is a sneak peek of our episode with Wendy Behary - available only on our Premium Supercast and Patreon platforms. For as little as $5/month you can have access to special releases like this one, first-to-know about upcoming events and discounts and an ad-free feed. Click here to join & finish the episode!! Dr. Ann Kelley and narcissism expert, Wendy Behary, explore the complexities of narcissistic behavior, its development, and the challenges faced by those experiencing relationships with narcissists. Follow along as they dive into the myths, the spectrum of narcissistic traits, and the importance of understanding the underlying insecurities that drive behavior. Behary touches on the cultural implications and how it manifests in society today, as well as practical strategies for individuals to navigate relationships, highlighting the significance of maintaining one's own mental health and well-being. “Narcissism occurs along a spectrum within the human condition. Embodied in human nature itself is a tendency for narcissistic expression... and that isn't all bad.” - Wendy Behary About our Guest - Wendy Behary With 25+ years of professional experience and advanced level certifications, Wendy Behary is the founder and director of The Cognitive Therapy Center of New Jersey and The Schema Therapy Institutes of NJ-NYC-DC. She has been treating clients, training professionals and supervising psychotherapists for more than 25 years. Wendy was on the faculty of the Cognitive Therapy Center and Schema Therapy Institute of New York (until the Institutes merged in 2012), where she trained and worked with Dr. Jeffrey Young since 1989. She is a founding fellow and consulting supervisor for The Academy of Cognitive Therapy (Aaron T. Beck's Institute). Wendy served as the President of the Executive Board of the International Society of Schema Therapy (ISST) from 2010-2014 and served as the Training and Certification Coordinator for the ISST Executive Board from 2008-2010. She is currently the chair of the Schema Therapy Development Programs Sub-Committee for the ISST. Wendy Behary has co-authored several chapters and articles on Schema Therapy and Cognitive Therapy. She is the author of an international bestselling book, "Disarming the Narcissist...” translated in 16 languages. The Third Edition was recently released and was selected by Oprah Daily as one of the top books on the subject of Narcissism. Wendy has a specialty in treating narcissists and the people who live with and deal with them. As an author and subject matter expert on narcissism, she is a contributing chapter author of several chapters on schema therapy for narcissism for professional readers. She lectures both nationally and internationally to professional and general audiences on schema therapy, narcissism, interpersonal relationships, anger, and dealing with difficult people. Find Upcoming Events here!! Our Beyond Attachment Styles course is available NOW! Learn how your nervous system, your mind, and your relationships work together in a fascinating dance, shaping who you are and how you connect with others. Earn 6 Continuing Education Credits – Available at Checkout Online, Self-Paced, Asynchronous Learning with Quarterly Live Q&A's Integrative Attachment Therapy Course Information Therapists: THIS is our recommended course experience for the most comprehensive training on attachment out there. Use our link for a discount! Thanks for stopping by & for being on this journey with us!