Podcasts about Lidocaine

A Knee Recovery Nightmare! Right Total Knee Replacement My Physical and Emotional Fight Against Pain Hypersensitivity and Protective Muscle Guarding – written by Cathy Banovac – interview by Lisa Pelley and Mary Elliott – Cathy was coached by Erin Rempher, PTA My name is Cathy and I reside in Arizona. I am 57 years old, a homemaker, and have had a genetic history of chronic osteoarthritis.  From a very young age, I have always had a very low pain threshold.  Prior to the commencement of pain in my knee, I considered myself a fairly fit and active person…loved gardening, entertaining family and friends, cooking, crafting, playing golf, traveling with my husband, walking our dogs, and playing with our grandchildren. Life was good! Early Summer In addition to the normal aches and pains that come with aging, I began to experience more than usual pain in my right knee.  I was experiencing daily occurrences of popping/clicking, giving out when walking at times, difficulty negotiating steps or stairs, and nightly interrupted sleep due to pain.  Over the counter medications, icing, heat, etc. was no longer managing my symptoms.  Upon visiting an orthopedic surgeon for examination and subsequent imaging, I learned I was over 70% bone on bone in my right knee joint.  I was told I was looking at a total knee replacement.  I was preparing to head to Michigan for a family vacation on the lake with my kiddos in August, so was not happy to hear this news.  I convinced my doctor to give me a steroid injection just to buy me the time I needed to take my vacation.  He was reluctant and told me that he predicted it would do nothing to help my condition at the very least or, at the very most, last for a brief time.  I made it through the trip, yet 3 weeks post-injection the symptoms had returned. No More Injections My surgeon declined my request for another injection, instead reiterating my need for the TKR.  Over previous years, I had witnessed my mother, father, husband and a few friends have knee replacement surgeries.  All came through their surgeries with what appeared to me to be a fairly pain controlled, timely recovery and successful return to their regular daily activities.  I was told I was on the younger side for this type of procedure, nevertheless, would greatly benefit from extended quality of life and return to desired activity, given my current quality of life and daily activity was becoming more diminished by the day. My Knee Replacement I underwent RTKR on September 25.  All went well and as expected with the surgery.  I was up and walking, began some light physical therapy exercises, and maintained post-op range and motion through use of a CPM while in hospital.  I was discharged to home on the third day post-op, with a couple of narcotic pain medications (initially Percocet/Oxycodone and Morphine) and directions to commence in-home physical therapy the following day.  My follow-up visit with the surgeon was scheduled for 6 weeks post-op.  Day one at home began my challenging journey of recovery, both physically and emotionally.  I experienced difficulty managing my pain even with narcotics and over the counter medications.  My swelling was as expected and able to be kept in check with anti-inflammatory meds and icing.  I experienced annoying side effects from the narcotics, i.e., headaches, nausea, constipation, and thus was bounced from one medication and dosage to another, none of which seemed to be the right combination or solution to my pain.  Out of complete desperation and in uncontrollable pain, I went to the emergency room after being home for four days post-op, hoping to get some relief. A Problem with the Surgery? I thought surely there must be something wrong.  A few hours later, together with a lecture from the hospital PT and some morphine, I was discharged back to home.  Back on more medication, I failed to again find relief from pain.  I was averaging about 2-3 hours of sleep per night and little sleep during the day.  My home physical therapist had her work cut out for her.  Over the next 4 weeks (twelve 45 min. sessions of in-home PT), I had yet to reach better than 85 degrees flexion and 10 degrees extension.  My in-home therapist said she spent most of those 4 weeks strengthening my calves, hamstrings, and quad muscles, all which were extremely weak.  Therefore, already I was approximately 4 weeks behind in range and motion advancement.  My pain was still very much out of control, all while I feared becoming more and more dependent on the narcotics prescribed. At the first follow-up appointment (six weeks post-op), my flexion was below 90 degrees and extension still not at the zero degree mark.  I was informed by my surgeon that I needed a Manipulation Under Anesthesia (MUA).  My knee felt very stiff, pain was still unmanageable, and I was stuck without advancement in physical therapy. Manipulation Under Anesthesia He took x-rays and made sure the appliance was not loose or slipping out of placement.  All was found to be in proper order and an examination found no infection that could be causing pain or other symptoms.  My surgeon had done his job.  I was told however, that he believed I was stuck due to scar tissue build-up and thus was in need of the MUA to break up the scar tissue.  This would also permit the ability to continue physical therapy, working towards achievement of the desirable degree of range and motion outcomes.  I underwent the MUA six weeks and one day post-op and immediately resumed PT the following day.  I was told not to worry about a reduction in my flexion and extension after having the MUA.  An MUA tends to put patients back about 3-4 weeks, so it is almost like starting all over again.  However, the idea is that advancement in range and motion should become easier now that the scar tissue has been broken up by the procedure.  I went to PT for 5 days in a row the first week following the MUA, did my home exercises faithfully on my own twice a day, then returned to PT three times a week for the next several weeks. After the MUA At the two week follow-up appointment post the MUA, I was still in unmanageable pain, still getting only 2-3 hours of uninterrupted sleep per night, and running every gamut of emotion and temperament.  My poor husband was beside himself and wondering whatever became of the woman he married 27 years ago.  My flexion was still only reaching in the low 90's and my extension was no better either.  I was still experiencing great sensitivity to the touch anywhere on or around my surgical knee.  I couldn't stand wearing pants or having any sheet or blanket covering my knee.  My pain was the worst at night, just when I was settling in for some restful moments on the couch watching TV with my husband.  I would suddenly be lifted off my seat with either pain that mimicked touching a lit match to my knee, or the stabbing of a knife, or the shock of a taser. Dealing with the Pain This pain varied and sometimes was relentless for several minutes.  I was in tears most evenings and headed to bed to ice or apply heat, which calmed the nerve pain somewhat.  I would take meds (Hydrocodone/Norco, Extra-Strength Tylenol, Ibuprofen,  Zofran (for nausea) Vitamins, a stool softener (due to Hydrocodone) and Gabapentin aka Neurontin.  I was soooo sick of taking medications.  I think my surgeon was beside himself as to how to control my pain and sensitivity, therefore, he recommended I seek help at a Pain Management Clinic for possible sympathetic blocks, as well as my medicinal pain management.  Both he and my physical therapist told me I was forecasting pain neurologically before any exerted physical effort on their part was made to cause any pain.  My intolerance for any amount of pain was prohibiting any measurable progress in my range and motion, thus scar tissue was building at a rapid pace.  Physical therapy continued to be a challenge as I protective muscle guarded any force applied by my therapist to get better R&M.  I cried through most of my sessions. Pain Management At my first appointment with the Pain Management Clinic, I met with the doctor.  Most people have sympathetic blocks in their back to relieve nerve pain, but the doctor I was referred to chose to recommend a Genicular Neurotomy, accomplished through a procedure called Coolief Cooled Radiofrequency Ablation.  I first underwent a test which involved Lidocaine injections in four areas surrounding my new knee.  The patient then logs their pain and activities over the following 72 hours.  A follow-up appointment with a Nurse Practitioner then reviews the log and determines eligibility for the ablation procedure.  At this appointment she chose to cut my medication cold-turkey for a couple of days as she deemed I was dependent on them, even though I was getting little pain control.  I experienced severe withdrawal symptoms for two days. A Change in Medication I thought I was going to go out of my mind.  A change in my medication increased the Gabapentin I was taking, and I was found to be eligible for the ablation.  I underwent that procedure approximately 6 weeks post my first MUA, just before the Thanksgiving holiday.  I was told that I would still be experiencing pain for approximately 4-6 weeks, due to the fact that the ablation was going to make my nerves “angry” as they fought their temporary death.  I was also informed that this procedure is temporary as nerve endings most often regenerate themselves over a 6 month to 2 year period.  Some patients must undergo two or three of these procedures to get lasting relief. Unhappy News This was not happy news to my ears, yet I was still desperate for relief and reaching out for anything, and I mean anything, that would control my pain.  I returned to the pain clinic for a follow-up to the ablation procedure only to report pain still very bad and that I was still taking a boatload of medication, icing, heat to quad muscles to relieve cramping, and poor results in physical therapy sessions.  I was told to give it more time and come back in a few more weeks.   At my next follow-up approximately 3 weeks later, I discharged myself from the Pain Management Clinic.  I felt that their treatment plan was not successful for me and they had no other plan to offer other than continued reliance on prescription medication and time. When recovery goes wrong – Read More A Desparate Time After barely getting through the Christmas holidays, persisting in physical therapy and weaning myself down on prescription medications (since they didn't seem to be having any great effect on my pain), I began to explore the possibility of medical marijuana as a solution to my pain control.  I have never tried marijuana and had little desire to smoke or vape it, but was interested in edibles they have out now.  I was desperate and finding myself sinking into anxiety, panic attacks and, at times, depression.  My family and my husband were becoming very concerned as I was changing into a person they did not know and they were at a loss as how to help me through my circumstances. Medical Marijuana Since medical marijuana is legal in the State of Arizona, I sought out a doctor with whom I met and applied for a patient card.  This process took approximately 3 weeks, including approval of my application through the Arizona Department of Health and Human Services.  Upon receiving my card, I met with a licensed nurse at a dispensary to become educated about the various products and my specific needs.  She was recommended by the doctor who signed off on my patient eligibility and works with a number of cancer patients to help control their symptoms.  We met for over an hour.  She was extremely patient with me, educating me about cannabis (which I knew little of) and gave me recommendations to try.  I purchased three of her recommendations.  I also decided to try getting a light massage once per week.  The massages lasted for approximately three weeks before I decided to suspend them, as I found them not helpful enough to warrant the expense. Little if Any Improvement Having done everything I was asked to do in my recovery and still making little if any gains, I found myself in a very dark place emotionally, desperate to end my pain, and I was done!!  One day, I was occupying my time, in between home therapy and out-patient therapy sessions, searching the Internet for anything that might literally save me.  When in answer to my prayer, I came across several website postings about a therapy called X10.  I shared some of it with my husband, my parents and my kids.  They encouraged me to explore it more.  After reading some of the patient blogs and watching a few of the videos that I could access, I made my first contact with PJ Ewing by emailing him.  PJ responded very quickly telling me that the X10 Therapy and machine was not yet available in the State of Arizona, but he provided me with some other resources.  I was initially devastated by this news, but I almost immediately decided that I was not going to accept that response.  I instantly thought to myself, “Well, if it is not available in AZ, then maybe I can travel to wherever it is available. Not Taking ‘No’ for an Answer This time, I placed a phone call to PJ and we talked for over an hour.  As it so happened, in our conversation I discovered that the X10 headquarters is in Franklin, MI, and I had family who lived in Rochester, MI.  PJ was more than gracious in discussing all the parameters and specifics of the possibility of travel to Michigan to undergo the X10 program.  To say the least, after completion of my discussion with PJ, I heard God say “Not yet, Cathy, I still have a plan for you on this earth.”  I discussed the possibilities with my husband and shared them also with my son and daughter-in-law, exploring their permission to have me as a houseguest for 2-3 weeks.  Of course, they couldn't have been more gracious and welcoming. Pain Still a Big Problem My pain was still out of control, I continued out patient PT three times a week with slow or little advancement in my R&M, had my six week MUA follow-up with my surgeon only to be told I was facing a second MUA.  I told my surgeon and my physical therapist about the X10 Therapy website I had discovered, and PJ sent me the clinical data to share with them.  Each of them, I am grateful to say, told me they had looked at the data and were “intrigued” by the therapy plan.  Both encouraged me to pursue it as an option for me, yet both also strongly indicated that enough time had passed between my first MUA and the ablation, therefore, still recommended I have the second MUA before commencing X10 Therapy. Turning to X10 Therapy after a Second MUA Once my husband and I had made the decision to pursue this plan, the wheels began to roll quickly.  Initially, I scheduled the 2nd MUA and a flight out from Phoenix to Detroit by myself the next day following the MUA.  I notified PJ of my  plans and he began to put things in motion by placing me in contact with Mary Elliott, Melissa, Mike, a therapy Coach, Erin a Physical Therapist, and Marty, a technician for machine home delivery and set-up.  The X10 Therapy approach is really a “team” approach to wellness, in addition to the machine itself and the technological programs it delivers to the patient. The Second MUA Was Coming Up As the days approached the 2nd MUA, I became extremely anxious and experienced a couple of panic attacks.  I began to stress about the MUA pain, having gone through one already.  The thought of flying alone, even though my son would be there to meet me at the other end of my flight, and having to get through a 4 hour flight plus 1 hour car ride to his home in pain, had me scared beyond belief.  I was consumed with thinking about how I would manage my pain.  Should I just knock myself out to sleep on the plane?  What if that didn't work?  What meds could I then take if in pain?  What about my leg position – straightening and bending?  How would I get help from curb, through security, to gate, onto plane and the same again when arriving including a stop at baggage claim?  How am I going to sleep at night?  Is this therapy going to put me back in unmanageable pain again, even though the X10 Therapy information says I am in control?  What if it doesn't work?  Can this end my knee recovery nightmare? And on and on and on…! Making Plans After talking it over with my husband and doctor, it was decided that I would delay my trip to Michigan for one week following the 2nd MUA.  I would continue outpatient PT immediately following the MUA, but have some time to consult with a psychologist concerning my sleep depravation, fears, anxiety/depression and develop a plan to manage my pain, as well as talk to the airline for special assistance to help solve my transportation needs.  My husband decided to make the trip with me for a couple of days, just to get me settled and started with X10 Therapy.  Armed with a revised medication and travel plan, I notified the X10 Team of my change in start date and all were extremely understanding and accommodating.  I had the 2nd MUA  on January 18.  I continued outpatient PT for three more sessions, in addition to my own home exercises twice per day.  My daily sleep and pain control was managed better and I was counting the days until our departure date.  It simply could not arrive fast enough! Friday, January 19 This will remain a very important and pivotable day in my life.  My journey towards healing, life anew and well-being would begin that very day.  Having endured a comfortable flight and having managed all the transportation arrangements with ease (kudos to Delta Airlines), we arrived at my son's home ready to commence what I can now claim as my own personal miracle.  Within an hour, Marty arrived with a smile, this technological marvel known as the X10 machine, and a thorough first orientation/training session filled with words of encouragement and confidence.  I was on my way, although until I began to see results (which were really displayed within that first session), I Had Hope I was still cautiously optimistic about where I was headed.  Could I really achieve the flexion and extension goals I was unable to achieve thus far with any of my existing recovery methods?  Would this therapy really enable me to manage my pain comfortably with mild medications?  Could I trust my X10 therapist and her plan for me?  Would the X10 team really be there for me when I needed them?  Was the X10 therapy the answer to my prayers?  Would I really be returning home in as little as  just over 2 weeks time to see my surgeon's and physical therapist's jaws drop as they witnessed my flexion and extension reach what we all thought would be skeptical results, but instead blow them away with incredible success?  It would not be long before I could actually acknowledge to myself that the answers to each of those questions would be a resounding YES! 110º Flexion Once I was able to reach the 110 degree mark for flexion, it was decided that I would add 5 min a day on the stationery bike. As I felt comfortable, I was able to increase that time in small increments and add another bike session in the evening.  While my progress was measurable daily, I did experience some cramping in my right thigh and calf, dealt with some bursitis in my right hip for about two weeks, and waking with some right leg pain some nights. Taking Care of Myself I found icing and elevating regularly after each exercise session, icing my hip, heat on my upper thigh at night, Tramadol 50 mg. only twice a day with Ibuprofen and Acetaminophen alternated during the day, and Theraworx Relief foam massaged in the cramping areas once or twice a day helped keep my discomfort manageable.  In addition, I spent some resting time researching dietary recommendations for inflammation and pain.  I incorporated tumeric, magnesium, Osteo Bi-flex, 100% Cherry or Pineapple Juice, Vitamin B6 & B12, Vitamin C, Vitamin D3, Zinc, fresh berries and decaffeinated tea with ginger, lemon and honey in my daily diet.  I also decided to limit carbohydrates and sugar intake in an effort to keep my inflammatory response in check. One Week In After one week on the X10 and with constant reassurance and communication from all of my X10 team, I could actually begin to call this journey and the X10 Therapy my miracle.  I had breached the 100's for flexion after starting at 55 degrees, and reached 0 degrees at the end of the first session on my extension, previously at 8 degrees.  My fears, anxiety and uncertainty soon gave way to renewed love for life, joy at gaining confidence in doing daily activities again, sharing my daily success by telephone with family and friends, and hope for the future.  The almost daily contact from one or more of my X10 team members answered any questions that arose, provided authentic cheerleading for my cause, and motivated me to press on for better and better results. Working with My Coach Mary called often to check in with me and was my calm and steady encourager.  My conversations with her were uplifting and kind of like talking to an old friend, casual and comforting.  My PT, Erin, made a home visit to discuss my history and offered varied strategies for increasing my flexion degrees, as well as made adjustments in my therapy plan due to some bursitis that I had recently developed in my right hip.  She was careful to make the appropriate adjustments to my therapy plan.  She and Mike (my strengthening coach and with whom I also met in person to go over exercises), together modified my plan by delaying some of the exercises, while still permitting three sessions a day for range and motion growth. Conclusions As I approach my last day of sessions on the X10 Therapy machine and a return home to Arizona tomorrow, I write my story to encourage anyone who has experienced one or more of the circumstances that I experienced subsequent to a total knee replacement.  I am happy to report that I was successful in breaking through some of my scar tissue, reaching 0 degrees for my extension and 117 degrees flexion.  My gait is much improved and, as I have returned to walking without a limp or dragging my surgical leg, the pain in my hip and lower back has also improved greatly. My knee recovery nightmare has finally come to an end. Some Rehab Insurance I will continue outpatient therapy immediately upon my return home in order to solidify my current range and motion, and even further improve my flexion as I am able.  I write this also as a means of paying it forward to future patients of the X10 and in grateful appreciation to my X10 Team, my family and my friends who affirmed, guided, encouraged, and yes, celebrated, my X10 Therapy journey of success.  The proof, as they say, is in the pudding, which is said to mean that you can only judge the quality of something after you have tried, used, or experienced it.  I absolutely cannot wait to share my experience and demonstrate my range and motion achievement in person to my surgeon and PT Team back home in Arizona. Thanks be to my God, to all of my support team and to X10 Therapy… life is good once again! To read about total knee replacement for a younger population, click here. The X10 Meta-Blog We call it a “Meta-Blog” because we step back and give you a broad perspective on all aspects of knee health, surgery and recovery. In this one-of-a-kind blog we gather together great thinkers, doers, writers related to Knee Surgery, Recovery, Preparation, Care, Success and Failure. Meet physical therapists, coaches, surgeons, patients, and as many smart people as we can gather to create useful articles for you. Whether you have a surgery upcoming, in the rear-view mirror, or just want to take care of your knees to avoid surgery, you should find some value here. #mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; }/* Add your own MailChimp form style overrides in your site stylesheet or in this style block.We recommend moving this block and the preceding CSS link to the HEAD of your HTML file. */ Subscribe to the Blog Here * indicates required Email Address * First Name Last Name

In episode 616, Tina and James discuss the issue around the evidence for using topical anesthetics to reduce the pain associated with IUD insertion. To help with this discussion, we bring in Jessica Kirkwood and Caitlin Finley to provide practical information and insight. The evidence is really interesting and worth knowing. So have a listen […]

Don't miss out — elevate your skills and save $100 on any online course with code START26! Join our library of live and on-demand veterinary dental courses here: https://internationalveterinarydentistryinstitute.org/veterinary-dental-online-webinars-courses-discount/?utm_source=podcast&utm_medium=podcastlink&utm_campaign=start26  —------------------------------------------------------------------- Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM In this episode of The Vet Dental Show, Dr. Victoria Lukasik, DVM, DACVAA, tackles the complexities of managing high-risk dental cases. Through detailed case studies, they discuss anesthetic protocols for patients with hepatic portal shunts and chronic heart failure. Learn how to navigate potential complications like hypoglycemia, hemorrhage, and ventricular tachycardia, while ensuring patient safety and optimizing recovery. What You'll Learn:  ✅ Understand anesthetic considerations for patients with hepatic portal shunts.  ✅ Discover strategies for managing hypoglycemia and electrolyte imbalances.  ✅ Simplify anesthetic protocols for patients with chronic heart failure.  ✅ Apply techniques for recognizing and treating ventricular tachycardia.  ✅ Master the use of short-acting and reversible drugs in high-risk patients.  ✅ Recognize and address delayed recovery in the post-anesthetic period. Key Takeaways:  ✅ Patients with hepatic portal shunts require short-acting, reversible drugs to minimize liver burden.  ✅ Intermittent hemorrhage in patients with hepatic dysfunction may lead to platelet consumption and anemia.  ✅ Bounding femoral pulses can indicate dehydration; adjust fluid therapy accordingly in cardiac patients.  ✅ Lidocaine has centrally depressing effects; anticipate mental dullness or sedation post-administration.  ✅ Early intervention with lidocaine is crucial for managing ventricular tachycardia and preventing further complications. Questions This Episode Answers: ❓ How should anesthetic protocols be adjusted for patients with hepatic portal shunts? ❓ Which anesthetic and analgesic drugs are safest for patients with true hepatic dysfunction? ❓ When should dextrose supplementation be considered in dental patients with liver disease? ❓ How do you manage intermittent hemorrhage, anemia, and low platelets during dental procedures? ❓ What causes delayed anesthetic recovery—and how do you systematically troubleshoot it? ❓ How should cardiac medications be handled on the morning of anesthesia for heart failure patients? ❓ What do bounding femoral pulses indicate, and how should fluid therapy be adjusted? ❓ Why can lidocaine cause deep sedation and delayed recovery after anesthesia? ❓ How do you recognize ventricular tachycardia intraoperatively—and when should you intervene? ❓ What recovery expectations should you have after treating ventricular tachycardia with lidocaine? —------------------------------------------------------------------- Explore Dr. Beckman's complete library of veterinary dentistry courses and CE resources! Save $100 on any online course with code START26! https://internationalveterinarydentistryinstitute.org/veterinary-dental-online-webinars-courses-discount/?utm_source=podcast&utm_medium=podcastlink&utm_campaign=start26  —------------------------------------------------------------------- Questions? Leave a comment below with your thoughts, experiences, or cases related to veterinary dentistry! —------------------------------------------------------------------- KEYWORDS: Veterinary Dentistry, IVDI, Brett Beckman, Dog Dental Care, Cat Dental Care, VetTech Tips, Animal Health, Veterinary Education, Veterinary Dental Practitioner Program, Vet Dental Show, Anesthesia, High-Risk Patients, Hepatic Portal Shunt, Chronic Heart Failure, Ventricular Tachycardia, Lidocaine, Hypoglycemia, Electrolyte Imbalance, Delayed Recovery

“There are hundreds, maybe thousands, of drug repurposing opportunities just waiting to be uncovered,” explains David Fajgenbaum, M.D.  David Fajgenbaum, M.D., physician-scientist, bestselling author of Chasing My Cure, co-founder of Every Cure, and leader in the global push for drug repurposing, joins us today to explain why the cures of tomorrow may already be on pharmacy shelves today—and how his team is racing to uncover them. - From college athlete to ICU (~3:15) - Finding a cure (~7:20) - Hope needs to drive action (~9:45) - Repurposing drugs (~11:10) - Use cases of generic drugs (~13:30) - Lithium for bipolar & Alzheimer's (~16:00) - Lidocaine & breast cancer (~17:25) - GLP-1 for longevity benefits (~19:20) - Increasing awareness in the healthcare system (~20:10) - The 3 main hurdles for repurposing drugs (~22:00) - Opportunities in the space (~23:10) - 14 advanced repurpose treatments (~28:00) - The power of AI (~32:50) - Using AI for personalized medicine (~34:30) - AI for treatment options (~37:45) - Common drugs with big potential (~41:00) - The future of healthcare & drug discovery (~44:50) - How you can help (~49:30) Referenced in the episode:  - Follow Fajgenbaum on Instagram (@dfajgenbaum)  - Check out his website (https://davidfajgenbaum.com/)  - Pick up his book, Chasing My Cure (https://www.amazon.com/Chasing-My-Cure-Doctors-Action/dp/1524799637/)  - Listen to his TED Talk (https://www.youtube.com/watch?v=sb34MfJjurc)   - Learn more about Every Cure (https://everycure.org/) We hope you enjoy this episode, and feel free to watch the full video on YouTube! Whether it's an article or podcast, we want to know what we can do to help here at mindbodygreen. Let us know at: podcast@mindbodygreen.com. Learn more about your ad choices. Visit megaphone.fm/adchoices

Cosmetic surgery must be pain free.  To have painless procedures, plastic surgeons often use general anesthesia, where a breathing tube is placed and your brain is basically anesthetized.  This type of anesthesia is important for liposuction, tummy tucks, and most  breast procedures.  But general anesthesia has risks, particularly cardiac problems and postoperative nausea.  So, when possible, intravenous sedation, using propofol and versed, is used.  Face and eyelid lifts are procedures that often are done under IV sedation.  And finally, some procedures can be done with you wide awake, using only lidocaine local anesthesia.  Mole and scar revisions can be done that way, and with the proper patients, eyelid lifts, small liposuctions, and procedures like chin impalnts can also be done under local anesthesia.  On this show, we discuss the various types of anesthesia used for cosmetic surgery. 

Contributor: Aaron Lessen, MD Educational Pearls: How do amiodarone and lidocaine work on the heart? Amiodarone Blocks potassium channels (Class III effect). Also blocks sodium and calcium channels. Additional noncompetitive beta-blocker effects. Stabilizes cardiac tissue, slows heart rate, and suppresses both atrial and ventricular arrhythmias. Lidocaine Blocks fast sodium channels in ventricular tissue (Class Ib). Shortens the action potential in ventricular myocardium, especially in ischemic tissue. Suppresses abnormal automaticity in damaged/irritable myocardium. Which one should you pick for a patient in vtach/vfib cardiac arrest? The current guidelines recommend amiodarone for shock-refractory cases but this is based on randomized trials showing better arrhythmia termination and short-term outcomes, but not long-term survival benefits. Two recent studies suggest that lidocaine might actually be preferable. A 2023 paper published in Chest Performed a large retrospective cohort study for treating in-hospital VT/VF cardiac arrest. Among more than 14,000 patients, lidocaine was associated with higher rates of ROSC, 24-hour survival, survival to discharge, and favorable neurologic outcomes. These results held after adjusting for covariates and using propensity score methods. Overall, lidocaine outperformed amiodarone across all major clinical outcomes in this population. A 2025 paper published in Resuscitation Performed a target trial emulation in adults with out-of-hospital shockable cardiac arrest. After propensity score matching in more than 23,000 eligible cases, lidocaine was associated with higher odds of prehospital ROSC, fewer post-drug defibrillations, and greater survival to hospital discharge. These advantages were consistent across matched patient pairs. Dose for lidocaine is an initial 1-1.5 mg/kg IV bolus, followed by additional boluses of 0.5-0.75 mg/kg every 5-10 minutes up to a total of 3 mg/kg if needed. Dose for amiodarone is a 300 mg bolus followed by an additional 150 mg bolus if needed. References Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, Deal BJ, Dickfeld T, Field ME, Fonarow GC, Gillis AM, Granger CB, Hammill SC, Hlatky MA, Joglar JA, Kay GN, Matlock DD, Myerburg RJ, Page RL. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: Executive summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm. 2018 Oct;15(10):e190-e252. doi: 10.1016/j.hrthm.2017.10.035. Epub 2017 Oct 30. Erratum in: Heart Rhythm. 2018 Nov;15(11):e278-e281. doi: 10.1016/j.hrthm.2018.09.026. PMID: 29097320. Smida T, Crowe R, Price BS, Scheidler J, Martin PS, Shukis M, Bardes J. A retrospective 'target trial emulation' comparing amiodarone and lidocaine for adult out-of-hospital cardiac arrest resuscitation. Resuscitation. 2025 Mar;208:110515. doi: 10.1016/j.resuscitation.2025.110515. Epub 2025 Jan 23. PMID: 39863130; PMCID: PMC11908894. Wagner D, Kronick SL, Nawer H, Cranford JA, Bradley SM, Neumar RW. Comparative Effectiveness of Amiodarone and Lidocaine for the Treatment of In-Hospital Cardiac Arrest. Chest. 2023 May;163(5):1109-1119. doi: 10.1016/j.chest.2022.10.024. Epub 2022 Nov 2. PMID: 36332663. Summarized by Jeffrey Olson, MS4 | Edited by Jeffrey Olson and Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/

The US has no shortage of lidocaine patch television commercials. Topical lidocaine has a role for local, topical, minor aches and pains. What about lidocaine patches for post-op cesarean section pain? Is there data for that? A brand-new meta-analysis in AJOG-MFM (Nov 13, 2025) looks at this option. However, there has been 3 prior reviews on the same topic from 2019, 2022, and 2023. Do they all arrive at the same result? Listen in for details!1.     Smoker J, Cohen A, Rasouli MR, Schwenk ES. TransdermalLidocaine for Perioperative Pain: A Systematic Review of the Literature. Current Pain and Headache Reports.2019;23(12):89. doi:10.1007/s11916-019-0830-9.2.     Koo CH, Kim J, Na HS, Ryu JH, Shin HJ. TheEffect of Lidocaine Patch for Postoperative Pain: A Meta-Analysis of Randomized Controlled Trials. Journal of Clinical Anesthesia. 2022;81:110918.doi:10.1016/j.jclinane.2022.110918.3.     Wu X, Wei X, Jiang L, et al. Is Lidocaine PatchBeneficial for Postoperative Pain?: A Meta-Analysis of Randomized Clinical Trials. The Clinical Journal of Pain. 2023;39(9):484-490. doi:10.1097/AJP.00000000000011354.     Parisi, Nadia et al.Lidocaine patches aftercesarean delivery: a meta-analysis of randomized controlled trials. American Journal of Obstetrics & Gynecology MFM, Volume 0, Issue 0, 101832

Indications & use of an antiarrhythmic infusion of Amiodarone or Lidocaine for cardiac arrest patients that have return of spontaneous circulation (ROSC).Our primary focus immediately following return of spontaneous circulation (ROSC).Post-arrest goals for O2 saturation, ETCO2, and BP/MAP.Indications for use of an antiarrhythmic after ROSC.Determining which antiarrhythmic to use post cardiac arrest.Administration of Amiodarone or Lidocaine after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC.Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Five articles from the November 2025 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles this month are, "Metformin Reduces the Incidence of Shoulder Stiffness After Arthroscopic Rotator Cuff Repair: A Randomized, Double-Blinded, Placebo-Controlled Trial," "Delayed Surgery and Adenosine, Lidocaine, and Mg2+ Immunomodulatory Therapy Improve Joint Recovery in a Sex-Specific Manner After Anterior Cruciate Ligament Reconstruction in a Rat Model," "Comparison of Anchor Hole Enlargement Between Biodegradable and All-Soft Suture Anchors After Arthroscopic Bankart Repair: Longitudinal 2-Year Follow-up Study," "Sports Participation 25 Years After Anterior Cruciate Ligament Reconstruction: A Prospective Longitudinal Study Comparing Patients With Patellar Tendon and Hamstring Tendon Grafting to Uninjured Controls," and "Risk Profile for Cyclops Syndrome Necessitating Reoperation After Anterior Cruciate Ligament Reconstruction." Click here to read the articles.

BLS & ACLS's Adult Cardiac Arrest algorithm makes it easier to act as team leader during a code by following an If/Then methodology.Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest.If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm.If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm.An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered.We will follow the algorithm until the patient has ROSC or we call the code.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

As little as 3000 steps per day can slow progression to Alzheimer's Disease; Self-reports of memory impairment soaring among young people; New study vindicates unprocessed red meat—and even often-vilified processed red meat—for cancer and overall health. Prostate artery embolization (PAE) offers new non-invasive option for men's age-related urinary problems; Targeting the mitochondria and the microbiome for Parkinson's Disease; Popular prostate and hair loss prevention drugs linked to depression and suicide—while Cialis for urinary symptoms may stave off cardiovascular disease; Discovery that a safe, cheap medication may increase survival after breast cancer surgery. 

Reach out and touch us: shiftlesslive@gmail.comThe Unconventional Justin Carey Pushes the Limits: Insights and Future EndeavorsIn this episode, Justin Carey shares his latest experiences, including his remarkable FKT (Fastest Known Time) on the 'Rat 1000'—a grueling 1000-mile bikepacking race. The conversation delves into his preparation strategies, nutrition intake, and lessons learned about managing sleep and dealing with extreme conditions. He discusses his plans for future ultra-distance races like the Tour Divide and strategies for potentially cutting down his time on races like the Rat 1000. The episode also touches on his approach to bike maintenance, upcoming race goals, and ambitions to inspire others through coaching and his nutritional products. Throughout the discussion, there's a blend of humor, personal anecdotes, and valuable insights that make for a compelling listen.00:00 Audio Sync and Episode Introduction00:26 Welcome to Shiftless: Bicycles and Power Tools01:02 Introducing the Guests01:41 Reflecting on Past Podcasts03:24 Race Across Texas: The Journey Begins06:42 Chasing the Pack: Strategy and Challenges10:26 Nutrition and Hydration Strategies19:41 Technical Issues and Sleep Deprivation34:57 Post-Race Reflections and Recovery36:48 Saddle and Arrow Bars Adjustments37:07 Training for Big Sugar37:20 Comfort and Acclimation Challenges38:17 Hand and Foot Issues40:09 Shammy Cream and Saddle Sores40:32 Lidocaine and Pain Management43:39 Recovery and Physical Issues45:33 Age and Recovery Discussion49:43 Mountain Lion Encounter53:39 Nutrition and Hydration Strategies01:09:21 Bike Setup and Mechanical Issues01:13:34 Future Bikepacking Goals01:15:08 The Benefits of a Dynamo Hub01:16:54 Preparing for the Tour Divide01:18:20 Strategies for Long-Distance Races01:19:32 Dealing with Wildlife on the Route01:21:16 Bike Choices and Equipment01:24:48 Training and Local Races01:34:35 Future Race Plans and Goals01:46:44 Nutrition and Coaching Services01:49:47 Concluding Thoughts and Upcoming Events

Review of antiarrhythmic medications Amiodarone & Lidocaine for use in ACLS's Adult Cardiac Arrest, Post Arrest, and Tachycardia algorithms.The two first-line ACLS antiarrhythmics that are generally used.Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Use of antiarrhythmic infusions post-cardiac arrest to suppress ventricular ectopy.Amiodarone use & dosing for stable patients in V-Tach with a pulse.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

My guest is Dr. David Fajgenbaum, MD, professor of translational medicine and human genetics at the University of Pennsylvania. He explains how, unbeknownst to most doctors, many approved medications can successfully treat or even cure diseases other than the ones they are typically used to treat. He shares his story of escaping death from Castleman's disease by discovering a life-saving treatment using repurposed drugs that were approved for other purposes. Our conversation explores how researchers, physicians, and you—the general public—can explore novel treatments and cures to conditions the medical profession has deemed untreatable, including cancers. We also discuss the crucial role of mindset in battling diseases and the lesser-known use of compounds to promote health and longevity. Read the episode show notes at hubermanlab.com. Thank you to our sponsors AGZ by AG1: https://drinkagz.com/huberman Eight Sleep: https://eightsleep.com/huberman Rorra: https://rorra.com/huberman David: https://davidprotein.com/huberman Function: https://functionhealth.com/huberman Timestamps (0:00) David Fajgenbaum (4:06) Self-Agency in Healthcare; New Uses for Old Medicines (6:44) Other Uses of Aspirin & Viagra; Drug Development & Approved Use (8:53) Lidocaine & Breast Cancer; Pharmaceutical Companies & Incentives (11:36) Sponsors: Eight Sleep & Rorra (14:16) Pharmaceutical Companies, Patents & New Uses; Lithium (18:40) Tools: Finding Reliable Health Sources, Asking Questions & Disease Organizations; DADA2 Treatment (21:53) Medical Community & Connections; Integrated Medical Databases (24:36) Drug Repurposing, Thalidomide, Pembrolizumab (28:45) Medical Research Databases, Mapping Disease Connections (33:51) Every Cure Database & Programs, Bachmann-Bupp Syndrome; Colchicine & Heart Disease (37:57) Sponsors: AGZ by AG1 & David (40:41) David's Medical & Career Journey, Glioblastoma, Castleman Disease (49:10) Autoimmune Disease, Driven Personality, Stress & Immune System (52:52) Castleman Disease, Treatment, Chemotherapy (55:54) Physician Continuing Education, Santa Claus Theory of Civilization; Science Collaboration (1:03:32) Medical School, Relapse & “Overtime”, Finding a New Treatment, Rapamycin (1:12:46) Sport, Football & Resilience; Challenge & Personal Growth, Family (1:18:41) Sponsor: Function (1:20:29) Social Support; “Overtime”, Gratitude (1:23:19) Business School, Castleman Disease Treatment; Repurposing Drugs & AI (1:28:29) Drug Repurposing, POEMS Syndrome; Mitigating Risk (1:35:32) Nicotine, Compounds for Preventive Health; GLP-1 Agonists (1:40:51) Bioprospecting, Drug Development; AI, Prioritization & Novel Connections (1:46:18) Healthcare & Children; Hope, Action & Impact Circuit; Challenge & Super-Agers (1:52:50) Get Involved with Every Cure (1:56:20) Zero-Cost Support, YouTube, Spotify & Apple Follow, Reviews & Feedback, Sponsors, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures Learn more about your ad choices. Visit megaphone.fm/adchoices

From dealing with a shortage of lidocaine across the country to answering questions about supplements for skin, hair, and nails, dermatology NP/PAs find themselves continually adapting. Jayme M. Heim, MSN, FNP-BC and Sandri Johnson, MSN, FNP-BC respond to questions from colleagues. Plus, updates on biologic treatment selection from Jennifer Soung, MD, and insights from David E. Cohen, MD, MPH on a new treatment for chronic hand eczema.Like what you're hearing? Want to learn more about the Dermatology Education Foundation? Explore assets and resources on our website.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog If you ever doubted your doctor because she wrote a script that you later “Googled” and found was not FDA approved, I hope you trusted your doctor enough to realize that she wouldn't recommend any medication that would hurt you…. What is an unapproved use of a drug, also called “off-label”? Unapproved use of an approved drug is often called “off-label” use. This term can mean that the drug is: Used for a disease or medical condition that it is not approved to treat, such as when a chemotherapy is approved to treat one type of cancer, but healthcare providers use it to treat a different type of cancer. The drugs that are not approved by the FDA, yet are commonly used, have been used for decades before the 1964 law that required new drugs to go through extensive and very expensive testing before their release to the public. The operative word is NEW DRUGS AFTER 1964. Today I will talk about the safety of non-FDA approved drugs because they are: Older cheaper drugs used for many diseases and conditions before 1964 and are still used Drugs that are approved for one use, or one condition, but not for other conditions that it is effective and safe for. Drugs made by compounding pharmacies for diseases that the FDA has not approved a drug for, but there is research backing the drug and years of safe use. First, before we discuss the non-FDA approved drugs, I will discuss the safety/risks of FDA approved drugs, and why FDA approval doesn't mean a drug will do no harm or even that it is effective for the use it is approved for. A little background will help you understand the problem and the reason an FDA approval does not necessarily mean a drug is safe.  Since 1964, a law was passed that established testing prior to a drug being approved by the FDA became mandatory.   Since that time several drugs that survive FDA approval and are released but are later removed or banned after their FDA release when the public finds side effects that the FDA didn't discover in their trials. One such drug is Fen-Phen, Fenfluramine/Phentermine. This drug was released during my time practicing medicine and was withdrawn after one study claimed it caused heart valve disease…In the end the “one post approval study” that claimed that heart valves were affected by this drug that caused its bann was found to be false. The withdrawal of the drug followed one study by a single cardiologist from Kansas City had reviewed all of the cardiac valve echo tests and falsified the results to make Fen-Phen appear dangerous to heart valves, when in reality it wasn't.  She lost her license, but the FDA never put Fen-Phen back on the market!  The FDA hates to be wrong twice, so they never allowed this drug back on the market after its removal. Other mistakes made by the FDA include not allowing women in the studies to approve a drug before 2014 which ignores or misses all of the side effects or lack of effectiveness for a drug when taken by women.  Despite all the expensive testing before the release of a drug by the FDA, many drugs not tested on women were later often found to have severe side effects only on women. A few examples follow: You might have heard of the FDA approved drug Ambien that causes many women to experience “night eating”, sleepwalking, and night terrors, while their male counterparts were not affected, so because they only tested men the drug was approved. In retrospect it should have been tested on women as well, and then either not passed through the FDA or should have had a black box warning for women. It takes years get action from the FDA, notifying doctors of these side effects. Women were not included in testing for any drugs except female hormones until 11 years ago, but no other drugs.   Before 2014 all (non-hormonal) drugs that passed the FDA were not tested on women so the effect on women was unknown until it was tested on the public. The FDA left women out of drug-trials because it viewed women as “mini men”, or they didn't consider us important enough to test new drugs on…OR worse, they believed we were too complicated to easily test us because of pregnancy, menopause and other hormonal swings that normal healthy women have.  In any case, we are now suffering their decisions, when a medication works one way for men and another way for women! Finally, we are tested when drugs are being evaluated for approval by the FDA. Professional women have achieved a level of authority in medicine and pharmacology (2025) and are weighing in on the inequity. Women in the medical profession and the public are pulling back the curtain on the side effects of FDA approved drugs that are experienced by women only! Slowly, study by study investigators are now publishing the side effects and problems for women with FDA approved drugs….yet these findings are not included in the warnings on most of these drugs, even now over 15 year after they became obvious to the doctors who treat women! Drugs that either don't work for women, or that have severe side effects include that were approved before 2014. All statin drugs for high cholesterol (Crestor, rosuvastatin, atorvastatin, etc.) cause women to have muscle breakdown and muscle pain. Synthroid (levothyroxine), doesn't cure the symptoms of hypothyroidism in 80% of women, but just makes the TSH lower, so it appears as if it is working! This leads doctors to tell women that their symptoms are all in their heads!! Wrong.  It is the wrong medicine. Women have enzymes that differ from men that make it difficult for them to convert the inactive form (T4) into the active form (T3), so we can't convert Synthroid (all T4) into the active form. Synthroid, the FDA approved drug for hypothyroidism, shouldn't be given to most women. Women should be given the non-FDA approved drug Armour Thyroid or NP thyroid that have both T3 and T4 in them! Ambien Prednisone and other oral steroids We have reviewed the lack of testing on women before 2014, now we will discuss safe drugs that have been used for decades even before 1964 when the FDA required testing for FDA approval? Older, yet effective and inexpensive drugs have been tested by the public, some for almost 100 years that have saved thousands of lives, yet they are not given the FDA stamp of approval!  In fact, the FDA tries to put these drugs out of circulation, replacing them with very expensive drugs that are new! Or they just shut them down, because they are not FDA approved.  Young doctors are told not to use them by their medical schoolteachers who rarely have experienced these medications in private practice…. These doctors in training don't know the history of older safer, cheaper drugs, or even why the FDA tells them avoid them. They comply not knowing why, so you are left with no drug that works for you, or you pay 3-10 times the amount for a newer FDA version of the older drug which may even have more side effects. Some of these older very effective and cheap drugs are Penicillin, Nitroglycerine for chest pain, Morphine (pain), Phenobarbital (seizures), Codeine, Armour Thyroid, hormone injections including estradiol injections and testosterone, Thorazine for psychiatric use, (Pitocin) oxytocin for labor, lactation support and Autism Colchicine:Used to treat and prevent gout. Progesterone in oil (IM) Estradiol in oil (IM) B12 for injection Testosterone Cypionate for injection Compounded Estradiol in any form Compounded Testosterone for women These drugs have been used for so long that any safety risks or side effects have been found through the use of these drugs in the population. Yet the FDA won't grandfather them in and approve them based on their history! What do doctors do when the drug the FDA has approved a drug that doesn't work for a group of their patients (gender, race, blood type, etc.)?  What happens when a doctor can't find a drug that is FDA approved needed to treat a condition she is faced with? Why do we as citizens, allow the government to have power over doctors who are already controlled by their state licensing boards as to what medications they?  Lastly Why do taxpayers allow a government agency that they fund with tax dollars control their health by banning, or not approving drugs, or banning one drug so an outrageously expensive drug is put in its place? Compounded Medications/ Compounding Pharmacies: These drugs are made by mixing ingredients to meet individual patient needs and are not subject to premarket review for safety, effectiveness, or quality. However, they ARE subject to the success or failure for which they were prescribed. If a doctor prescribes a compounded drug that doesn't work, she is apt to be confronted by her patient who is not getting the expected results.  Compounding pharmacies usually don't get paid by insurance, so patients are more invested in getting a drug that works and that is one of the big reasons that Compounded medicines are at least as good or better than big pharma or generic drugs. I absolutely could not successfully treat the thousands of women and men that I have without compounding pharmacies.  They compound hormones/drugs that are safe and effective, mostly hormones that can't be patented because they occur in nature and won't ever be made by big pharma. More than that, big producers of drugs can't produce in mass quantities many doses of a certain hormone like compounding pharmacies do.  Compounding pharmacies provide what people need and they continue to do so because patients prefer their dosing and quality.  FDA approved Generic Drugs can be legally 25 % lower dose than what they say they are.  That would be a big problem if my compounded pellets had that kind of variability. People might need pellets every 2months or every 5 months instead of every 4 months..it would be like guessing what you need ahead of time…..I believe dedicated compounding pharmacists are more accurate than any generic on the market. Compounding pharmacies: Unsung Heros Compounding pharmacies serve the public when big pharma fails and hasn't developed a safety net for production if they have a problem and the FDA shuts them down. That situation leaves patients who take their medications, without an alternative. Compounding pharmacies step into the breech when big pharma has a problem with a particular drug and stop making a drug (e.g. Lidocaine, B12 injectable, IV Fluids, to name a few shortages and no production that have occurred in the recent past). What if patients couldn't get the meds they need, and if there were no compounding pharmacies—Chaos and suffering and dying patients would closely follow! The FDA is Fickle and is not on your side! For years the FDA did not approve of Bioidentical estrogen and testosterone in any form, and just a few months ago all of a sudden, long after they scared women from taking the hormones they needed to improve their length of life and quality of life, they decided bioidentical hormones are better than the FDA approved hormones!!!  That is a little too late.  Some of us will never forget the stress lack of approval of compounded hormones caused for doctors and patients alike.  Other doctors criticized us and now most of them aren't even in practice anymore.  Maybe the FDA read my blog!!! Compounded hormones have been approved by the masses of women who have taken them under my signature! Compounded BI hormones are medications with a long track record and should not have to be tested with the bloated expense required of testing for the FDA. For Gynecological Disorders that don't have an FDA approved hormone drug because testosterone and estradiol have been used for so long that they don't need testing. If there was a significant problem with them their history of use of over 5-7 decades has proven the efficacy and safety of the female hormones for treatment and hormone replacement. For Psychiatric Disorders: Some patients need compounded ketamine products for conditions like severe depression, despite lacking FDA approval for these uses and potential risks, yet it has been used for this purpose for decades and was used for childbirth for almost a century, until epidurals and saddle blocks took their place. Testosterone for women still is not recognized as a female hormone even though women produce over twice as much Testosterone as Estradiol when they are in their fertile years.   Replacement of T with bioidentical T pellets offers a treatment for dozens of symptoms women face after age 40, and it prevents the diseases of aging: osteoporosis, heart disease, sarcopenia, frailty, diabetes and more that have not been addressed by mainstream medicine and the FDA. Over a decade ago, the FDA turned down the approval of testosterone patch after over 3 years of positive research studies, the FDA said they didn't approve T for women is because the side effect of T for women, facial hair, was dangerous for women.…I cry B—–S—-!  That is really men not wanting to share testosterone replacement with women. I say leave us alone and let women and their doctors determine what they need.  It is proven that only 5% of all professionals in any profession are not trustworthy, so give doctors their due and trust that we are looking for answers to our patients' problems that you don't even know about! The FDA is paid for by us…everyone in this country. I say hands off! Speed up the approval process or forget it for older drugs and BI hormones! ~

How can AI really help advance medicine? Should patients and care teams be seeking second opinions from LLMs? This week, Reid and Aria sit down with physician-scientist Dr. David Fajgenbaum, who repurposes existing drugs to save lives—including his own. David shares his journey from receiving last rites as a young medical student to co-founding Every Cure, a nonprofit using AI to come up with ways existing drugs can be repurposed to treat every disease and every patient possible. On this special episode, filmed live in New York City, David, Reid, and Aria explore the circuit of hope, action, and impact that drives medical discovery; the technical and ethical challenges around accelerating AI in healthcare; “agent optimization” as the new “search engine optimization;” and what a future of faster diagnoses and treatment could look like. The result is a conversation about resilience, innovation, and unlocking cures that are already within our reach. For more info on the podcast and transcripts of all the episodes, visit https://www.possible.fm/podcast/  Topics: 3:00 - Hellos and intros 3:29 - A promise to his mother and the origin of AMF 6:23 - From grief support to medical school 9:18 - Near-death experiences and founding a research network 14:38 - What kept David going at death's door 16:19 - Discovering a potential treatment and testing it on himself 19:42 - Why drug repurposing is a faster, cheaper complement to drug discovery 22:14 - Co-founding Every Cure and scaling discovery with AI 25:20 - Demo: Building MATRIX and how the algorithm makes predictions 28:41 - Breast cancer and Lidocaine as a case study 30:07 - Why human review is essential in AI for medicine 34:08 - Car exhaust fumes example and FDA pathways 37:31 - Reid's surprise million-dollar donation for Every Cure compute 39:24 - What AI can unlock across healthcare 41:46 - Building an impact team to close the repurposing loop 47:32 - Improving systemic incentives for generics 54:58 - FDA approval pathways and label change challenges 57:21 - Three life-saving repurposing stories 1:02:20 - Rapid-fire questions Select mentions:  Hidden Potential by Adam Grant Chasing My Cure by Dr. David Fajgenbaum Every Cure  David's TED Talk: https://youtu.be/sb34MfJjurc?si=GcVleWHZuJ9MqLgS Manas AI Possible is an award-winning podcast that sketches out the brightest version of the future—and what it will take to get there. Most of all, it asks: what if, in the future, everything breaks humanity's way? Tune in for grounded and speculative takes on how technology—and, in particular, AI—is inspiring change and transforming the future. Hosted by Reid Hoffman and Aria Finger, each episode features an interview with an ambitious builder or deep thinker on a topic, from art to geopolitics and from healthcare to education. These conversations also showcase another kind of guest: AI. Each episode seeks to enhance and advance our discussion about what humanity could possibly get right if we leverage technology—and our collective effort—effectively.

High Yield Antiarrhythmic Drugs Review:Class I (Sodium Channel Blockers)Class II (Beta Blockers)Class III (Potassium channel blockers)Class IV (Calcium Channel Blockers) for your PANCE, PANRE, Eor's and other Physician Assistant exams.Review for your PANCE, PANRE, Eor's, Physician Assistant exams, Medical, USMLE, Nursing Exams.►Paypal Donation Link: https://bit.ly/3dxmTql (Thank you!)Included in review: Pathophysiology of antiarrhythmics, cardiac action potential, phases 0–4, Phase 0 depolarization, Phase 1 initial repolarization, Phase 2 plateau, Phase 3 repolarization, resting membrane potential, cardiomyocytes, pacemaker cells, funny current (If), L-type calcium channels, T-type calcium channels, effective refractory period (ERP), conduction velocity, reentry, rate control, rhythm control, AV node, SA node, QT prolongation, torsades de pointes, post-MI arrhythmias, structural heart disease, supraventricular tachycardia, atrial fibrillation, atrial flutter, ventricular tachycardia, ventricular fibrillation, ACLS, catecholamines, cAMP, PKA, beta-1 receptors, calcium influx, nodal blockade, non-dihydropyridine vs dihydropyridine, Disopyramide, Quinidine, Procainamide, Lidocaine, Mexiletine, Flecainide, Propafenone, Metoprolol, Atenolol, Bisoprolol, Betaxolol, Esmolol, Acebutolol, Propranolol, Carvedilol, Labetalol, Nadolol, Pindolol, Timolol, Sotalol, Amiodarone, Dronedarone, Ibutilide, Dofetilide, Verapamil, Diltiazem, Amlodipine, Nifedipine, Nicardipine, Amiodarone adverse effects, blue-gray skin discoloration, interstitial lung disease, thyroid dysfunction, corneal microdeposits, hepatotoxicity, beta-blocker contraindications, asthma caution, bradycardia, AV block, cardiogenic shock, diabetes caution, CCB adverse effects, constipation, AV block, bradycardia.Become a supporter of this podcast: https://www.spreaker.com/podcast/cram-the-pance--5520744/support.

Feminist Buzzkills is officially BACK! WHEEEEE! Lizz is still out meeting with activists and speaking at screenings of the AAF documentary, “No One Asked You,” at The Colombia International Human Rights Festival (dopeness alert). And HUZZAH—joining Moji is AAF's inimitable Head Writer, Alyssa “Dooks” Al-Dookhi to guest co-host! They're diving into abortion providers handling IUD insertion pain like pros, the rollercoaster of Planned Parenthood's Medicaid funding, and fake clinics sneaking into telehealth. GUEST ROLL CALL!Moji and Dooks chat with real-life clinic superstar, Ali Kliegman, Co-Founder and Executive Director of Care for All Clinic, a brand-spanking-new nonprofit abortion clinic in the heart of Milwaukee. Ali spills the tea about going from concept to real-ass clinic in basically one year, the violence and harassment Care for All has already faced, and how their community model can be a blueprint for healthcare clinics! PLUS! Get your serotonin boost courtesy of comedian, matchmaker, and lawyer Yasmin Elhady! She yaps with us about her dating reality show on Hulu, “Muslim Matchmaker,” figuring out she's funny AF, and the deets on diversity in the Muslim Ummah. She's bringing it ALL. Scared? Got Questions about the continued assault on your reproductive rights? THE FBK LINES ARE OPEN! Just call or text (201) 574-7402, leave your questions or concerns, and Lizz and Moji will pick a few to address on the pod! Times are heavy, but knowledge is power, y'all. We gotchu.  OPERATION SAVE ABORTION: WE DID A THING IN AUGUST! The Feminist Buzzkills took some big patriarchy-smashing heat to The Big Easy and recorded a live workshop that'll train you in coming for anti-abobo lawmakers, spotting and fighting against fake clinics, AND gears you up on how to help someone in a banned state access abortion. You can still join the 10,000+ womb warriors fighting the patriarchy by listening to our past Operation Save Abortion pod series and Mifepristone Panel by clicking HERE for episodes, your toolkit, marching orders, and more. HOSTS:Moji Alawode-El @MojiLocksAlyssa Al-Dookhi @TheDookness SPECIAL GUESTS:Ali Kliegman IG: @careforallwiYasmin Elhady IG: @yasminelhahahady TikTok: @yasmin_elhady GUEST LINKS:Care for All WebsiteVOLUNTEER: Care for AllDONATE: Care for AllName Care for All's New Aspiration MachineYasmin's WebsiteYasmin's Youtube Find Love, Muslim Matchmaking Website NEWS DUMP:Amy Coney Barrett: Reports of a Constitutional Crisis Have Been Greatly ExaggeratedJudge: Planned Parenthood Clinics Can Remain Medicaid Providers While Lawsuit ContinuesUPDATE: Planned Parenthood's Medicaid Funding Can Be Blocked for Now, Appeals Court RulesTrump Loses Bid to Overturn $83.3m E. Jean Carroll Defamation JudgmentDigital Deception: Beware the Rise of Fake Telehealth Abortion ClinicsWant an IUD, but You're Afraid of the Pain? Try an Abortion Provider. EPISODE LINKS:Plan C PillsI Need an AAbortion FinderExpose Fake Clinics ADOPT-A-CLINIC: Care for All Community Clinic Amazon WishlistBUY AAF MERCH!SIGN UP 8/9: Operation Save AbortionEMAIL your abobo questions to The Feminist BuzzkillsAAF's Abortion-Themed Rage Playlist SHOULD I BE SCARED? Text or call us with the abortion news that is scaring you: (201) 574-7402 FOLLOW US:Listen to us ~ FBK Podcast Instagram ~ @AbortionFrontBluesky ~ @AbortionFrontTikTok ~ @AbortionFrontFacebook ~ @AbortionFrontYouTube ~ @AbortionAccessFront TALK TO THE CHARLEY BOT FOR ABOBO OPTIONS & RESOURCES HERE!PATREON HERE! Support our work, get exclusive merch and more! DONATE TO AAF HERE!ACTIVIST CALENDAR HERE!VOLUNTEER WITH US HERE!ADOPT-A-CLINIC HERE!EXPOSE FAKE CLINICS HERE!GET ABOBO PILLS FROM PLAN C PILLS HERE! When BS is poppin', we pop off! 

Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP.Indications for use of an antiarrhythmic after ROSC.Determining which antiarrhythmic to use post cardiac arrest.Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC.Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.**American Cancer Society (ACS) Fundraiser This is the seventh year that I'm participating in Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission.I hope you'll consider contributing.Every donation makes a difference in the fight against breast cancer! Paul Taylor's ACS Fundraiser Page: http://main.acsevents.org/goto/paultaylorTHANK YOU for your support! Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

BLS & ACLS's Adult Cardiac Arrest algorithm makes it easier to act as team leader during a code by following an If/Then methodology.Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest.If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm.If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm.An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered.We will follow the algorithm until the patient has ROSC or we call the code.**American Cancer Society (ACS) Fundraiser This is the seventh year that I'm participating in Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission.I hope you'll consider contributing.Every donation makes a difference in the fight against breast cancer! Paul Taylor's ACS Fundraiser Page: http://main.acsevents.org/goto/paultaylorTHANK YOU for your support! Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Review of antiarrhythmic medications Amiodarone & Lidocaine for use in ACLS's Adult Cardiac Arrest, Post Arrest, and Tachycardia algorithms.The two first-line ACLS antiarrhythmics that are generally used.Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Use of antiarrhythmic infusions post-cardiac arrest to suppress ventricular ectopy.Amiodarone use & dosing for stable patients in V-Tach with a pulse.**American Cancer Society (ACS) Fundraiser This is the seventh year that I'm participating in Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission.I hope you'll consider contributing.Every donation makes a difference in the fight against breast cancer! Paul Taylor's ACS Fundraiser Page: http://main.acsevents.org/goto/paultaylorTHANK YOU for your support! Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

In this episode of Grade 1 View, we had the privilege of speaking with Tom Baribeault, DNP, CRNA, a pioneer in the field of opioid-free anesthesia. As the president and founder of the Society of Opioid Free Anesthesia, Tom has dedicated his career to advancing pain management techniques that prioritize patient safety and comfort. Today he'll share how his own clinical curiosity led him to abandon intraoperative opioids altogether, and what happened next. From reducing postoperative nausea to improving respiratory safety, this conversation will challenge you to question the status quo and expand your definition of what anesthesia can look like. Here's some of what we discuss in this episode:

The 2017 NEJM study, ALPS, compared amiodarone, lidocaine, and placebo for refractory shockable rhythms in adults with out of hospital cardiac arrest. They found no significant difference in survival to hospital discharge or functional survival between any of the arms. If that study has left you confused, you're not alone. And you're in luck. Tanner Smida joins us again to discuss his latest paper using something called target trial emulation to assess the difference in ROSC and survival to discharge between amiodarone and lidocaine. This is a great discussion of his paper, the methodology, and how we can put his results into the context of ALPS.Citations:1.Smida T, Crowe R, Price BS, Scheidler J, Martin PS, Shukis M, Bardes J: A retrospective ‘target trial emulation' comparing amiodarone and lidocaine for adult out-of-hospital cardiac arrest resuscitation. Resuscitation. 2025;March;208:110515.2. Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, et al.: Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2016;May 5;374(18):1711–22.3.Hernán MA, Robins JM: Using Big Data to Emulate a Target Trial When a Randomized Trial Is Not Available: Table 1. Am J Epidemiol. 2016;April 15;183(8):758–64.

Listen as Michael S. Benninger, MD, describes his approach to the diagnosis and management of chronic cough and refractory chronic cough in the context of a clinically relevant case.PresenterMichael S. Benninger, MDProfessor of Otolaryngology-Head and Neck SurgeryLerner College of MedicineThe Cleveland ClinicPresident, International Association of PhonosurgeryCleveland, OhioLink to full program:https://bit.ly/4kweynG

Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP.Indications for use of an antiarrhythmic after ROSC.Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC.Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Listen to the commentary of Dr. Eric Sarkissian on the article "Mixture of Lidocaine and Ropivacaine as a Local Anesthetic in WALANT Surgery: A Prospective Randomized Study" that appears in the July 2025 issue of The Journal of Hand Surgery.

Being the team leader during a cardiac arrest is challenging. Using an algorithm helps by standardizing & prioritizing our interventions using an If/Then methodology. Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest.If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm.If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm. An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered. We will follow the algorithm until the patient has ROSC or we call the code.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn Other Pass ACLS episodes mentionedObjective Measures of Good CPR https://passacls.com/bls/objective-measures-of-good-cpr

In the Adult Cardiac Arrest algorithm, we should administer an antiarrhythmic medication to patients in V-Fib or pulseless ventricular tachycardia approximately two minutes after the first dose of epinephrine.The two first-line ACLS antiarrhythmics that are generally used are Amiodarone and Lidocaine.Review of Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Review of Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach. Use of antiarrhythmic infusions post-cardiac arrest to suppress ventricular ectopy.Amiodarone use & dosing for stable patients in V-Tach with a pulse.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Show notes at pharmacyjoe.com/episode1030. In this episode, I’ll discuss adding dexmedetomidine to lidocaine for topical application to prevent cough during extubation of thyroidectomy patients. The post 1030: Adding dexmedetomidine to lidocaine for topical application to prevent cough during extubation appeared first on Pharmacy Joe.

There are defining moments that split your life into before and after. Moments when everything you thought you knew gets stripped away, leaving only what truly matters. For Dr. David Fajgenbaum, that moment came not once, but five times, each bringing him closer to death and, paradoxically, teaching him how to live.This week's episode explores what happens when the system fails you and you refuse to accept failure. When David was diagnosed with Castleman disease at 25, a rare condition where your immune system turns against your own body, traditional medicine reached its limits. But David didn't. Instead of surrendering, he became both patient and researcher, ultimately discovering the treatment that would save not just his life, but potentially thousands of others.In our conversation, David reveals the mindset shifts that kept him fighting when hope felt impossible, how AI is revolutionizing our approach to drug discovery, and why the cure for your condition might already exist in a pharmacy right now. His story challenges everything we think we know about medicine, healing, and what's possible when you refuse to take no for an answer.What struck me most about our conversation wasn't just David's survival story, but how he turned personal crisis into a mission that's reshaping medicine. His ability to stay curious even when doctors said there was nothing left to try, and his belief that the answers we need might already exist, just waiting to be discovered. David showed me that breakthrough thinking isn't always about creating something new, but seeing what's already there differently.About Dr. David Fajgenbaum:Dr. David Fajgenbaum is a physician-scientist, bestselling author of Chasing My Cure, and co-founder of Every Cure, a nonprofit on a mission to unlock the full potential of every approved drug to treat every disease it possibly can. Recently named to TIME's 100 Health list for 2025, he's revolutionising medical research by repurposing existing drugs to treat rare diseases. His TED Talk has inspired millions, and his nonprofit work continues to unlock life-saving treatments hidden in plain sight.Connect with Dr. David Fajgenbaum:Website: https://everycure.orgInstagram: @dfajgenbaumFacebook: David FajgenbaumTwitter: @DavidFajgenbaumBook: Chasing My Cure – Available on AmazonLove,Sarah Ann

Can lidocaine… mess up your brain?!

Researchers Find the Mechanism Behind Potential AnticancerProperties in LidocaineBy Today's RDH ResearchOriginal article published on Today's RDH: https://www.todaysrdh.com/researchers-find-the-mechanism-behind-potential-anticancer-properties-in-lidocaine/Need CE? Start earning CE credits today at ⁠⁠⁠⁠⁠https://rdh.tv/ce⁠⁠⁠⁠⁠Get daily dental hygiene articles at ⁠⁠⁠⁠⁠https://www.todaysrdh.com⁠⁠⁠⁠⁠ Follow Today's RDH on Facebook: ⁠⁠⁠⁠⁠https://www.facebook.com/TodaysRDH/⁠⁠⁠⁠⁠Follow Kara RDH on Facebook: ⁠⁠⁠⁠⁠https://www.facebook.com/DentalHygieneKaraRDH/⁠⁠⁠⁠⁠Follow Kara RDH on Instagram: ⁠⁠⁠⁠⁠https://www.instagram.com/kara_rdh/

Adult Performer Brickzilla Joined The Bougie Show For The Second Time And He Talks About Female Performers Not Knowing How To Perform Oral Sex On Him Without Their Teeth Scrapping His Cock. Brick Also Responds To Adult Film Star Connie Perignon "Energies Don't Match" Comment. Zilla Also Informs Xay That He's Changed His Diet And Now Reminding Females Prior To Performing With Him To Warm Up With A Toy Before They Get Destroyed (LOL) And So Much More!! Make Sure To Subscribe To The Page And Get Notifications On All New Releases.The Bougie Show Merchandise Is Finally Here And Going Nowhere! Now Available To Be Delivered To Your Front Door! "It Is Time 2 Stop The Fuckery" U Know We "Friieed" Out Here! Shout Out To The "Bonafied Freaks". We "Wear Bougie" ⁠https://bougieshow.com

Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP.Indications for use of an antiarrhythmic after ROSC.Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC.Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn Discover medical podcasts with CE at https://conveymed.io

- What OMFS Programs Look For In A Resident- Trust But Verify: The #1 Rule That Could Save Your Dental Career- The Truth About Sedation Safety: Why Dental Assistants Should Be DANCE CertifiedYouTube Link:https://youtu.be/haD0ReGjZRw Podcast Link:https://spotifycreators-web.app.link/e/8PolF4NrxSb Quotes & Wisdom:“Taking a year off was the hardest decision I've ever made—but I don't regret it for a minute.” – Benji“Sometimes you've got to evaluate and say, ‘I need to give 120% to this priority right now.'” – Brendan“Confidence and self-awareness. That's what directors are really looking for.” – Brendan“Pick up the hose and hold it. That taught me to always be doing something, and that stuck with me through everything.” – Benji (on working with his dad)“Nothing is beneath any of us—turning over chairs, cleaning, setting trays—do it all. Especially when no one's watching.” – Brendan“Trust but verify—every single thing.” – Brendan“You don't know where sabotage can come from. It's not always personal, but you need to be ready.” – Brendan“People love to be taught. When you provide structure and knowledge, the whole profession gets safer.” – Benji“Life is life. If you have the time to speak with others, share ideas, and learn from great people—you grow more than you realize.” – BenjiQuestions:06:33 – "How's the CBSE studying going?"08:25 – "Are you going to be working during that time?"08:54 – "What did they say about that?"09:25 – "Did any of them say don't work and solely study for the CBSE?"10:37 – "What about your roommate? What does your roommate do?"11:46 – "Did you see the stats of LECOM? How many students matched into OMFS?"15:50 – "Any interest in head and neck, or fellowship?"18:33 – "How important do you think it is to have a competent anesthesia team?"29:43 – "What would you say program directors are looking for in residents to interview?"Now available on:- Dr. Gallagher's Podcast & YouTube Channel- Dose of Dental Podcast #139- 4.2025#podcast #dentalpodcast #doctorgallagherpodcast #doctorgallagherspodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #doctorlife #dentistlife #oralsurgeon #doctorgallagher

Being the team leader during a cardiac arrest is challenging. Using an algorithm helps by standardizing & prioritizing our interventions using an If/Then methodology. Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest.If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm.If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm. An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered. We will follow the algorithm until the patient has ROSC or we call the code.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

In the Adult Cardiac Arrest algorithm, we should administer an antiarrhythmic medication to patients in V-Fib or pulseless ventricular tachycardia approximately two minutes after the first dose of epinephrine.The two first-line ACLS antiarrhythmics that are generally used are Amiodarone and Lidocaine.Review of Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Review of Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Use of antiarrhythmic infusions post-cardiac arrest to suppress ventricular ectopy. Amiodarone use & dosing for stable patients in V-Tach with a pulse.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP. Indications for use of an antiarrhythmic after ROSC. Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC. Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting. Donations at Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated and will help ensure others can benefit from these tips as well.Good luck with your ACLS class!Helpful Listener Links:Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/*FREE to anyone in the U.S. Save $$ on prescription medications for you and your pets with National Drug Card - https://nationaldrugcard.com/ndc3506 *Indicates affiliate links. I may get paid a small commission if you purchase products or memberships using my link. It doesn't affect the price you pay.Discover medical podcasts with CE at https://conveymed.io

Being the team leader during a cardiac arrest is challenging. Using an algorithm helps by standardizing & prioritizing our interventions using an If/Then methodology. Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest. If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm. If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm. An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered. We will follow the algorithm until the patient has ROSC or we call the code.Objective Measures of Good CPR https://passacls.com/bls/objective-measures-of-good-cprConnect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting. Donations at Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated and will help ensure others can benefit from these tips as well.Good luck with your ACLS class!Helpful Listener Links:Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/*FREE to anyone in the U.S. Save $$ on prescription medications for you and your pets with National Drug Card - https://nationaldrugcard.com/ndc3506 *Indicates affiliate links. I may get paid a small commission if you purchase products or memberships using my link. It doesn't affect the price you pay.

In the Adult Cardiac Arrest algorithm, we should administer an antiarrhythmic medication to patients in V-Fib or pulseless ventricular tachycardia approximately two minutes after the first dose of epinephrine.The two first-line ACLS antiarrhythmics that are generally used are Amiodarone and Lidocaine. Review of Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach. Review of Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach. Use of antiarrhythmic infusions post-cardiac arrest to suppress ventricular ectopy. Amiodarone use & dosing for stable patients in V-Tach with a pulse.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting. Donations at Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated and will help ensure others can benefit from these tips as well.Good luck with your ACLS class!Helpful Listener Links:Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/*FREE to anyone in the U.S. Save $$ on prescription medications for you and your pets with National Drug Card - https://nationaldrugcard.com/ndc3506 *Indicates affiliate links. I may get paid a small commission if you purchase products or memberships using my link. It doesn't affect the price you pay.

In this throwback episode Dr. Russell Schafer joins Kevin and Zach to talk about his second love in dentistry...pediatrics!  Key Topics & Discussion Points: Early Childhood Exams (Under 5): Importance of parent/caregiver relationship and communication. Lap-to-lap/Knee-to-knee exam technique. Focus on diet (sugar intake) and sleep (snoring). Identifying early signs of demineralization. Goal: Creating a safe dental home. Older Children (5-6 and up): Expectation of tolerating bitewing and PA radiographs. Addressing parent's anxieties and managing expectations. Importance of behavior management with both child and parent. Interproximal Decay: Varying treatment philosophies (aggressive vs. conservative). Stainless steel crowns vs. composite restorations. When to refer to a pediatric dentist. Pulpotomies: Different techniques and materials (Formocresol, Ferric Sulfate, MTA). Discussion on necrotic pulp and treatment options (extraction). Pulpotomies for diagnosis vs. therapy. Nitrous Oxide: Benefits of nitrous oxide for pediatric patients. Dosage and administration techniques. Anesthesia: Choice of anesthetic (Lidocaine vs. Septocaine). Techniques for minimizing discomfort during injections (e.g., shaking, "cold water" analogy). Importance of adequate anesthesia for procedures. Sealants: Concerns about over-prescription and improper technique. Discussion on the effectiveness of sealants. Alternative approach: Occlusal composites. Silver Diamine Fluoride (SDF): Use of SDF for caries management. SDF as a "time-buying" strategy. When to use SDF vs. restorative treatment. Very Clinical is brought to you by Zirc Dental Products, Inc., your trusted partner in dental efficiency and organization. The Very Clinical Corner segment features Kate Reinert, LDA, an experienced dental professional passionate about helping practices achieve clinical excellence.  Connect with Kate Reinert on LinkedIn: Kate Reinert, LDA  Book a call with Kate: Reserve a Call  Ready to upscale your team? Explore Zirc's solutions today: zirc.com  

Here's another great podcast from early '24. This was a great conversation and finished the year at #9. In this podcast episode, Winston and I delve into the intricate world of pain and its pathways. They explore the nervous system's role in pain transmission, the different types of pain including nociceptive, neuropathic, and nociplastic pain, and the significance of sensitization in chronic pain conditions. The discussion also highlights practical approaches to pain management, including the use of multimodal therapies and the impact of neuroplasticity on pain perception, particularly in cases like phantom limb pain. In this conversation, Dennis discusses the complexities of pain management, emphasizing the importance of understanding the patient's history and the trajectory of their pain. He highlights the shift from opioid reliance to a multimodal approach that includes various analgesics such as acetaminophen, NSAIDs, lidocaine, capsaicin, cannabinoids, and ketamine. Dennis also covers the role of anticonvulsants and antidepressants in managing chronic pain, providing practical recommendations for healthcare practitioners. Takeaways Understanding pain pathways can enhance treatment effectiveness. Pain transmission involves complex processes in the nervous system. There are three main types of pain: nociceptive, neuropathic, and nociplastic. Peripheral and central sensitization play crucial roles in chronic pain. Ketamine is effective in reducing central sensitization. The placebo effect can significantly influence pain management. Recognizing nociplastic pain is essential for proper treatment. Mirror therapy can help alleviate phantom limb pain. Neuroplasticity affects how pain is perceived and treated. A multimodal approach is necessary for effective pain management. History taking is crucial in understanding pain types. The goal of pain management is to improve function and quality of life. Acetaminophen can be as effective as opioids in certain cases. Lidocaine should be used with caution due to potential side effects. Capsaicin is a natural option for neuropathic pain relief. Opioids have significant side effects and should be used carefully. Cannabinoids are gaining popularity but require more research. Ketamine offers a new avenue for pain management. Anticonvulsants can help with neuropathic pain but take time to work. Amitriptyline is a cost-effective option for chronic pain management. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this episode of The Vet Dental Show, Dr. Brett Beckman, a board-certified veterinary dentist, shares valuable insights into pain management, anesthesia protocols, and best practices in veterinary dentistry. The episode discusses the cautious use of lidocaine in cats, the role of bupivacaine for effective local blocks, and the potential applications of Renia for managing chronic pain in refractory stomatitis cases. Packed with actionable advice, this episode is a must-listen for veterinarians and technicians looking to elevate patient care in their practice.     Podcast Details Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM     Key Highlights Topic 1: Lidocaine Use in Cats Question: Should lidocaine be used with caution in cats? Answer: Yes, lidocaine can potentially cause seizures in cats, especially when used as a continuous rate infusion (CRI). Recommendation: Replace lidocaine with bupivacaine for local nerve blocks to ensure longer-lasting analgesia (6-10 hours). Use lidocaine sparingly and with proper discretion. Topic 2: Lidocaine for Intubation Discussion: Historically, lidocaine was applied to the larynx for intubation in cats. Dr. Beckman and his team now prefer using a blunt cannula for safer intubation without the risks associated with lidocaine.     Topic 3: Pain Management for Chronic Cases Case Example: Use of Renia (NK1 antagonist) in refractory stomatitis Mechanism: Blocks Substance P at the postsynaptic membrane to prevent ascending pain signals. Clinical Context: Effective for managing chronic pain when combined with ketamine (NMDA receptor antagonist). Outcome: While Dr. Beckman's team hasn't used it extensively, anecdotal feedback from the veterinary community is positive.     Topic 4: Local Blocks with Bupivacaine Best Practice: Use 0.5% bupivacaine for local nerve blocks in cats and small animals. Dosage: 0.2 mL per foramen ensures safety and efficacy. Rationale: Provides prolonged analgesia compared to lidocaine, minimizing the risk of complications.     Actionable Takeaways Transition to bupivacaine for local nerve blocks to enhance patient comfort and safety. Consider using Renia for managing chronic pain in severe stomatitis cases. Adopt safer intubation techniques, such as using blunt cannulas, to mitigate risks in feline patients. Leverage evidence-based pain management protocols to improve patient outcomes.     Sponsor Mention: This episode is brought to you by the Veterinary Dental Practitioners Program. Learn more and request an invitation at ivdi.org/inv. Closing Note: "I hope you enjoyed this episode filled with actionable items to elevate your dentistry practice. Implement these tips today and see the long-term benefits for your patients and practice!"     If you're ready to take your dentistry skills to the next level, visit ivdi.org/inv to join the Veterinary Dental Practitioners Program!  

Editor's Summary by Preeti Malani, MD, MSJ, and Chris Muth, MD, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from November 23-December 6, 2024.

We've reviewed several papers in the past that suggest there might be an advantage to using IV access compared to IO access for medications in cardiac arrest. Is that really a thing? Wouldn't it be great if we had some randomized controlled trials to help answer the questions?  Funny you should mention RCTs. Dr Jarvis reviews three (THREE!) new RCTs that compare IV to IO access in out of hospital cardiac arrest to try to shed some of that bright light of science on this question!Citations:1. Vallentin MF, Granfeldt A, Klitgaard TL, Mikkelsen S, Folke F, Christensen HC, Povlsen AL, Petersen AH, Winther S, Frilund LW, et al.: Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest. N Engl J Med.2. Smida T, Crowe R, Jarvis J, Ratcliff T, Goebel M: A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Prehospital Emergency Care. 2024;28(6):1–23.3. Nielsen N: The Way to a Patient's Heart — Vascular Access in Cardiac Arrest. N Engl J Med. doi: 10.1056/NEJMe2412901 (Epub ahead of print).4. Ko Y-C, Lin H-Y, Huang EP-C, Lee A-F, Hsieh M-J, Yang C-W, Lee B-C, Wang Y-C, Yang W-S, Chien Y-C, et al.: Intraosseous versus intravenous vascular access in upper extremity among adults with out-of-hospital cardiac arrest: cluster randomised clinical trial (VICTOR trial). BMJ. doi: 10.1136/bmj-2024-079878 (Epub ahead of print).5. Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, et al.: Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2016;May 5;374(18):1711–22.6.Daya MR, Leroux BG, Dorian P, Rea TD, Newgard CD, Morrison LJ, Lupton JR, Menegazzi JJ, Ornato JP, Sopko G, et al.: Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. Circulation. 2020;January 21;141(3):188–98.7. Nolan JP, Deakin CD, Ji C, Gates S, Rosser A, Lall R, Perkins GD: Intraosseous versus intravenous administration of adrenaline in patients with out-of-hospital cardiac arrest: a secondary analysis of the PARAMEDIC2 placebo-controlled trial. Intensive Care Medicine. doi: 10.1007/s00134-019-05920-7 (Epub ahead of print).

Send us a Text Message (please include your email so we can respond!)We are LIVE at CHEST2024! Thank you to the organizers of the conference for inviting us do a live show and thank you to everyone who came out to listen! We talk about a few articles that were recently published in CHEST - "Prophylactic Minocycline for Delirium in Critically Ill Patients: A Randomized Controlled Trial" published by Dal-Pizzol et al and then "Comparative Effectiveness of Amiodarone and Lidocaine for the Treatment of In-Hospital Cardiac Arrest" by Wagner et al.We then touch briefly on some articles being presented later at the conference which we might cover soon (stay tuned)!Minocycline for Delirium (pubmed): https://pubmed.ncbi.nlm.nih.gov/38043911/Minocycline for Delirium (CHEST): https://journal.chestnet.org/article/S0012-3692(23)05833-6/abstractAmio vs Lido (pubmed): https://pubmed.ncbi.nlm.nih.gov/36332663/Amio vs lido (CHEST): https://journal.chestnet.org/article/S0012-3692(22)04039-9/abstractIf you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

On this episode of the Real Life Pharmacology podcast, I continue my coverage with the Top 200 Drugs Podcast. Here's the list of medications we will cover. Lorazepam (Ativan) is a benzodiazepine well known for its anxiolytic and anti-seizure properties. Phenazopyridine (Pyridium) is a urinary analgesic that can change the color of the urine to a reddish/orange color as one of its adverse effects. Hydroxychloroquine (Plaquenil) is a DMARD used in rheumatoid arthritis and Lupus. One highly testable and unique nugget to remember is that it can cause retinopathy. Lidocaine patch (Lidoderm) is used topically to help with various types of pain including neuropathy and postherpetic neuralgia. Diclofenac (Cataflam) is an NSAID used as an analgesic and anti-inflammatory. It can increase the risk of GI bleed, edema, renal failure, and thrombosis.

Events of the day leads to thoughts of events of the past – with a little Lidocaine thrown in for good measure.

Join us as we review recent practice-changing articles on E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, lidocaine patches for mechanical neck pain, Cdiff risk by antibiotic type, and “dosing by clicks” for GLP1 agonists. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatra MD, MPH Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Introduction and disclaimer E-cigarettes for smoking cessation Gabapentinoids and COPD exacerbations Topical lidocaine for neck pain Association between specific antibiotics and C. diff infection Shortage of GLP-1 agonists and “dosing by clicks” Sponsor: Locumstory Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts. Sponsor: Freed  You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.