American academic medical center
Why You Don't Want to Give Your Kids the Shot with Deane Waldman, MD, MBA Deane Waldman, MD, MBA is the author of Curing the Cancer in U.S. Healthcare and eleven other books as well as more than 250 articles and monographs. After nearly fifty years as a pediatric cardiologist, educator, researcher, medical administrator, and public policy advisor, Dr. Deane is in a unique position to help readers break free of the nightmare we call our healthcare system. Dr. Deane studied medicine and trained at Yale, Chicago Medical School, Mayo Clinic, Northwestern, and Harvard, and earned his MBA from Anderson Graduate Schools. As a consultant for hospitals, public and private organizations, as well as governments, Dr. Deane combines systems analysis and other management tools with the principles of good medical practice to diagnose and effectively treat sick systems, such as healthcare. Dr. Deane was Chief of Pediatric Cardiology at The Children's Hospital of San Diego, The University of Chicago, and The University of New Mexico. He was also Director of Center for Healthcare Policy at Texas Public Policy Foundation and a member of the Board of Directors of New Mexico Health Insurance Exchange. Now Dr. Deane is Professor Emeritus of Pediatrics, Pathology, and Decision Science. His proposals for StatesCare and market-based medicine have the potential to revolutionize healthcare in the U.S. Learn more and get free bonus items at www.deanewaldman.com and get social with him on Facebook!
Sydney E. Schultz, PharmD identifies signs, symptoms, and diagnostic criteria for multiple myeloma, reviews pharmacology of medications used as primary treatment for multiple myeloma and discusses recent literature regarding four-drug regimens. For more pharmacy content, follow Mayo Clinic Pharmacy Residency Programs @MayoPharmRes or the host, Garrett E. Schramm, Pharm.D., @garrett_schramm on Twitter! You can also connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
At the age of 15, Justin Vigile was diagnosed with hypertrophic cardiomyopathy, a genetic condition that causes the muscles of the heart to thicken, making it difficult for the heart to pump blood. Vigile had a cardiac defibrillator placed, but over time, his heart began to fail. When looking for answers and help, Vigile and his family turned to Mayo Clinic. Thanks to science, research and an innovative procedure performed by the man who developed it, Justin got his life back. At Mayo, Dr. Hartzell Schaff, a cardiovascular surgeon, gave Vigile an alternative to heart transplant in the form of apical myectomy, a surgical procedure to relieve symptoms caused by the thickening of muscle in the apex of his heart. It's a procedure that Dr. Schaff developed at Mayo Clinic in 1996. Vigile feels grateful for the surgery and the surgeon. "Dr. Schaff changed my life, which is obvious. But it also changed the lives of my friends and family. I was able to meet the woman that I fell in love with. I've been able to pursue my dreams." Those dreams include writing music for NFL films and becoming a podcaster.Now, almost 10 years later, Vigile and Dr. Schaff reunite on the Mayo Clinic Q&A podcast. Also on the program, Justin's podcast partner, Darrell Campbell, joins the conversation to talk about the Everyman Podcast and how they've found silver linings along the way.
(00:32):Can you tell us a little about yourself and your background? What is the role of a genetic counselor in the Genomics Laboratory?(01:59):The Genomics Laboratory performs a lot of different genetic tests. What is your area of focus?(03:00):Give a brief overview of congenital adrenal hyperplasia.(05:44):Which patients should have this testing, and when should it be performed?(06:35):Can you tell us a bit about what sets MCL's CYP21A2 offering apart from other labs?(08:18):What are some examples of external results that you have helped resolve?(10:51):Do you get calls asking for help interpreting CYP21A2 test results?
Today's guest is an oral and maxillofacial surgeon who specializes in alveolar cleft grafting, cleft orthognathic surgery, and distraction. Through these life-changing procedures, Dr. Chris Viozzi is doing his part to give back, and he does this not only through treating patients within the US, but also those outside of it during 10-day mission trips he was doing twice a year prior to the pandemic. In today's episode, Chris explains the variation that exists amongst the patients he treats, as well as amongst the techniques that can be used for the procedures he does. We also discuss donor sites, follow-ups, and common concerns relating to cleft surgeries. Chris is not fellowship-trained, and his OMS basic training was more than enough to get him to his current position on the Mayo Clinic's Cleft and Craniofacial Clinic team. Key Points From This Episode:The craniofacial team that Chris is a part of, and his niche within the team.Other medical professionals who make up the craniofacial team.Diversity amongst the patients that Chris and his team treat at the clinic. Vital understandings that anyone doing alveolar cleft grafting must have. Elements of alveolar cleft grafting that have evolved over time. Examples of the variety of techniques for alveolar cleft grafting that exist. Why the iliac crest is usually the best donor site. Common concerns around allografts. Chris shares why Infuse was black-boxed by the FDA, and his opinion on using it for alveolar cleft grafting.Timing of follow-ups post alveolar cleft grafting.Why Chris avoids corticocancellous blocks whenever possible. The approximate percentage of alveolar cleft grafting patients that need cleft orthognathic surgery later in life. Differences between Asian and Caucasian children in terms of the likelihood of requiring orthognathic surgery.Where Chris acquired the majority of his cleft surgery skills. Chris's experience doing mission trips, and the perspective he gained as a result. The lack of continuity of care in many countries outside of the US.Challenges to OMS involvement in cleft surgery. Book recommendations from Chris.Chris's favorite OMS tool. Links Mentioned in Today's Episode:Dr. Chris Viozzi — The Immortal Life of Henrietta Lacks — http://rebeccaskloot.com/the-immortal-life/ Quiet — https://www.quietrev.com/quiet-the-book-2/ Medical Missions for Children — https://www.mmfc.org/ Dr. Grant Stucki Email — firstname.lastname@example.orgDr. Grant Stucki Phone — 720-441-6059
Ashley Evenson lived with a lifelong illness known as Cockayne syndrome that prematurely aged her. Ashley lived with her disease for 32 years before passing away in 2019.Ashley received palliative and hospice care over the course of her life, and Ashley's mom, Lynn Evenson, wants people to know about the benefits of hospice care."To keep Ashley's memory alive, I want to tell her story," says Evenson. "And I want to make it open to people to understand and learn what hospice is really about and how it can make a big difference — not just for the patient but for the caregiver, as well."People are often confused about the difference between palliative care and hospice care. Palliative care is for anyone who has been diagnosed with a chronic illness. When a cure is not possible, a shift to hospice care can offer supportive measures for the patient and the family.And an early referral to hospice can help everyone involved. "Hospice can provide so much care and comfort in all aspects of the end of life experience for both the patient and the family, says Jennifer Larson LaRue, a Mayo Clinic psychotherapist. "So it helps that very difficult, painful time go more smoothly, I think."November is National Hospice and Palliative Care Month, a time to recognize the important work these programs do to help patients and their families when a cure is not possible. On the Mayo Clinic Q&A podcast, Larson LaRue joins Evenson, who shares her family's journey through illness and their wish to help educate others about the advantages of hospice care.
We want to thank you for joining us for another Quick Tips episode of All Home Care Matters. Today, we are talking about how to stay warm, stay safe, and stay active this winter. Winter can be beautiful, but dangerous for seniors. We want to make sure you can enjoy this cold weather safely! Now let's move on to the rest of the show. If you've been listening to the podcast for a while, you probably heard our episode on extreme heat. If you missed the episode, you can find our episode, Keeping Seniors Safe in the Heat, wherever you listen to your podcasts and also on our YouTube channel. In this episode, we talked about how our natural ability to regulate our body temperature diminishes as we age and seniors may have trouble cooling themselves off when exposed to heat for too long. Because of this, seniors often experience heat stroke and sickness. It's no different when it comes to colder weather. According to the National Institute on Aging, older adults can lose body heat fast—faster than when they were young. Changes in your body that come with aging can make it harder for you to be aware of getting cold. A big chill can turn into a dangerous problem before an older person even knows what's happening. Doctors call this serious problem hypothermia. Hypothermia is what happens when your body temperature becomes critically low. For an older person, a body temperature of 95°F or lower can cause many health problems, such as a heart attack, kidney problems, liver damage, or worse. Being outside in the cold, or even being in a very cold house, can lead to hypothermia. How cold is too cold? It can be hard to tell yourself if you are experiencing hypothermia. We found Bob's story from the National Institute on Aging that illustrates how one senior experienced hypothermia. Bob says that Vermont winters can be very cold. Last December, he wanted to save some money so he turned his heat down to 62°F. He didn't know that would put his health in danger. Luckily, his son Tyler came by to check on him. Tyler saw that his dad was only wearing a light shirt and that his house was cold. Tyler said he was speaking slowly, shivering, and having trouble walking. Tyler wrapped him in a blanket and called 9-1-1. It turns out that Bob had hypothermia. His son's quick thinking saved his life. Now on cold days, he keeps his heat at least at 68°F and wears a sweater in the house. Bob's story luckily has a happy ending, but if his son hadn't stopped by, it may have ended very differently. Hypothermia can happen when you least expect it. Knowing the signs ahead of time could save your life. According to HealthInAging.org, the warning signs of hypothermia include cold skin that is pale or ashy, feeling very tired, confused, and sleepy, feeling weak, problems walking, and slowed breathing or heart rate. If you notice any of these signs, call 911 immediately and try to warm up. HealthInAging.org also recommends taking the following precautions to prevent hypothermia: Stay indoors (or don't stay outside for very long). Keep indoor temperature at 65 degrees or warmer. Stay dry because wet clothing chills your body more quickly. Dress smart – protect your lungs from cold air and layer up! Wearing 2 or 3 thinner layers of loose-fitting clothing is warmer than a single layer of thick clothing. Think about getting your thermals! When going outside during the winter, make sure to wear a hat, gloves (or preferably mittens), winter coat, boots, and a scarf to cover your mouth and nose. You should also keep a backup of these items in your vehicle in case of an emergency. Another major concern for seniors during the winter is frostbite. According to The AGS Foundation for Health in Aging, extreme cold can also cause frostbite, which is damage to the skin that can go all the way down to the bone. Frostbite usually affects the nose, ears, cheeks, chin, fingers, and toes. In very bad cases, it can result in loss of limbs. People with heart disease and other circulation problems are also at a higher risk of getting frostbite. To protect against frostbite, cover up all parts of your body when you go outside. If your skin turns red or dark or starts hurting, go inside immediately. You should also know the telltale signs of frostbite: numbness, skin that's grayish-yellow or ashy, or skin that feels hard or waxy. If you think you or someone else has frostbite, call for medical help immediately. A person with frostbite may also have hypothermia, so check for those symptoms, as well. Seniors should also be cautious when walking outside. Snow and ice can make the ground hazardous by covering up cracks and making slick spots. Dr. Stanley Wang, a physician at Stanford Hospital in Palo Alto, California recommends older adults wear shoes with good traction and non-skid soles and stay inside until the roads are clear. Replacing a worn cane tip can make walking easier, and older people are advised to take their shoes off as soon as they return indoors, because often snow and ice attach to the soles and, once melted, can lead to slippery conditions inside. For more information about reducing your risk of a fall, you can listen to our episode on fall safety tips. If you don't have time for a full episode, we also have a quick tips episode on fall prevention. You can find these episodes on our website, our YouTube channel, and wherever you get your podcasts. Seniors should also be cautious shoveling snow. No one really enjoys this task, but it can be dangerous for older individuals. If you have heart problems, trouble balancing, or are feeling weak, you should avoid shoveling snow. If you have any health issues, ask your doctor if it is safe to shovel snow. During the winter, it's nice to sit in front of a fireplace or a heater, but make sure you are properly taking care of these heat sources to prevent fires and carbon monoxide poisoning. Make sure to properly vent and clean your fireplace and appliances and know the warning signs of carbon monoxide poisoning. According to HealthInAging.org, carbon monoxide poisoning can cause headaches, weakness, nausea or vomiting, dizziness, confusion, blurred vision, and loss of consciousness. Carbon monoxide poisoning is also behind several ghost sightings. Many people that believed they were living in a haunted house actually were suffering from carbon monoxide poisoning. Pacific Heating and Cooling warns that if you are hearing and seeing things, feeling zapped of energy, and sense a strange presence at home, it may be due to a carbon monoxide leak. If you suspect you may have a gas leak in your home, evacuate your home and call 911 immediately. You should also have a carbon monoxide detector in your house since we can't detect it ourselves. If anyone in your family is showing any signs of carbon monoxide poisoning, you should also get them to the emergency room as soon as possible. According to Pacific Heating and Cooling, even small amounts of carbon monoxide can cause irreparable damage, including brain and organ damage. See a doctor immediately if there is any evidence of carbon monoxide leaks in the home. Now that we've told you all about staying warm and staying safe this winter, let's move on to the final part of our episode, staying active. It may be harder to exercise in the winter when you can't walk outside as often, but you should still exercise in other ways. Signing up for indoor classes is a great way to exercise and socialize during the winter. If you don't want to leave your home to exercise, you can take a virtual class or use items around your home to work out. The Mayo Clinic suggests doing some of the following in your home workout routine: Use cans of soup or water bottles as hand weights. Go from a sitting to a standing position out of a dining room chair two to three times in a row instead of just once. Walk up and down a hallway or large open space. Go up and down your stairs multiple times. Turn up the music and dance in your kitchen. Staying active doesn't just mean exercising. You should keep up on other social activities, as well. If you normally go for walks with a friend, consider walking around an indoor mall. Going to the movies or a museum is a great way to get out of the house and both of these activities can be done solo or with a group. Whatever you do, don't let the cold weather stop you from doing what you enjoy. As long as you bundle up and listen to your body, you can still enjoy the cold weather. Just remember to stay safe, stay warm, and stay active. We want to say thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate these long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone who could benefit from this episode, please share it with them. Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. We look forward to seeing you next time on All Home Care Matters, thank you. Sources: https://www.hchcares.org/wp-content/uploads/2016/09/wintersafety_tips.pdf https://www.healthinaging.org/tools-and-tips/tip-sheet-winter-safety-older-adults https://www.nia.nih.gov/health/cold-weather-safety-older-adults https://www.care.com/c/winter-safety-tips-for-seniors https://www.pacificheatingcooling.com/2018/12/27/carbon-monoxide-hauntings-co-furnace-safety/ https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/ways-for-seniors-to-remain-active-this-winter
*content warning: pregnancy, pregnancy loss, childbirth trauma, and some graphic and potentially distressing imagery* Rachel talks about finding peace and love from within before jumping into this week’s conversation with Kelly. Kelly walks Rachel through her journey to motherhood: from the decision to have a baby, to struggles with infertility, to her traumatic experience giving birth. Episode Notes: Conversation with Kelly begins at 00:12:22. Kelly’s Woman’s Support Circle Facebook group: https://www.facebook.com/groups/150724176608150 Mayo Clinic article about placenta accreta: https://www.mayoclinic.org/diseases-conditions/placenta-accreta/symptoms-causes/syc-20376431MedLine Plus article about hypovolemic shock: https://medlineplus.gov/ency/article/000167.htm US ranks #1 in maternal death out of all developed countries: https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries --------Let’s keep talking! Have a question or idea for a topic? Email email@example.com!Podcast artwork by Yogesh Nankar (Design by Dreamers).Intro and Outro music by John Bartmann.
With the holidays just around the corner, hosts Greer and Whitnie challenge you to carve out time just for yourself and practice self-care throughout the season. Whether you plan to prepare a lavish Thanksgiving dinner or attend social events, or maybe you volunteer to help those less fortunate than yourself, don't forget that pressure can mount without your even noticing or recognizing your vulnerability. Plan ahead—breathe deep, listen to soothing sounds (meditations, soft music, sound machines, etc.), and remember that perfection shouldn't be the goal. Family, friends, and fun should be your guide. For some helpful tips read Fit Bit's 7 Ways to Keep Calm During the Hectic Holiday Season and the Mayo Clinic's Stress, depression, and the holidays: Tips for coping. --- Send in a voice message: https://anchor.fm/lifelemonslemondrops/message Support this podcast: https://anchor.fm/lifelemonslemondrops/support
When a baby needs surgery, parents may be worried about how general anesthesia will affect their child. In place of general anesthesia, Mayo Clinic is using spinal anesthesia in some pediatric urology surgeries. The advantages of spinal anesthesia include a less time in the operating room and a quicker postop recovery. And since children are never fully sedated, they can feed or eat as soon as they return to the recovery room.Before surgery, numbing cream is used and preop medication is delivered to the child through the nose. Spinal anesthesia is given using a needle into the patient's back. This numbs and blocks movement below the belly button. Because spinal anesthesia only lasts no more than two hours, it is being used for shorter urologic procedures. During the surgery, the child's oxygen, temperature and blood pressure are monitored closely.On the Mayo Clinic Q&A podcast, Dr. Candace Granberg, a pediatric urologist and surgeon-in-chief of Mayo Clinic Children's Center, and Dr. Dawit Haile, chair of the Division of Pediatric Anesthesia at Mayo Clinic, discuss spinal anesthesia for pediatric urologic surgeries.
Every Minnesota adult will be eligible for COVID-19 vaccine booster shots by the end of the week — even if the federal government hasn't officially given the OK. State health officials made that decision based on what they're calling an “alarming surge” in COVID-19 cases. Is that the right call? Will giving boosters to adults who are already vaccinated really help? Or would it be better to focus on the almost 40 percent of Minnesota adults who haven't yet gotten a single shot? Dr. Abinash Virk, an infectious disease specialist at Mayo Clinic in Rochester, answered questions about the booster shots from host Cathy Wurzer and Minnesota Now listeners. Theme music by Gary Meister.
PSC Partners Seeking a Cure is pleased to present Living With PSC, a podcast moderated by Niall McKay. Each month, this podcast explores the latest research and knowledge about primary sclerosing cholangitis (PSC), a rare liver disease. From patient stories, to the latest research updates from PSC experts, to collaborations that are necessary to find better treatments and a cure, this podcast has it all! In episode 28, Host Niall McKay talks with Dr. Steven O'Hara, PhD, Associate Professor of Medicine, Assistant Professor of Biochemistry and Molecular Biology, and Research Scientist, Division of Gastroenterology and Hepatology at Mayo Clinic. They discuss the search for treatments and a cure for PSC. "We're interested in the gut microbiome, of course, because we know there's a link between inflammatory bowel disease and primary sclerosing cholangitis," says Dr. O'Hara. "The multitude of microorganisms in the gut certainly influence many different diseases. There's increasing evidence that it may influence PSC, as well. So, our link would be what's happening in the gut...How does it actually affect the biliary epithelial cell function in this disease?"
Stories mentioned in this episode: Day in History: 1946: Film of German concentration camps to be shown Collider Foundation leader to join Mayo Clinic's Platform initiative Rochester author finds respite from grieving in an unusual activity: Doodling. Area swimmers excited to make memories, head to state meet Read all stories in this episode at postbulletin.com.
This week on "Answers From the Lab," Shannon Bennett, director of Regulatory Affairs for Mayo Clinic's Department of Laboratory Medicine and Pathology, joins William Morice II, M.D., Ph.D., and Bobbi Pritt, M.D., to discuss tests that are developed by individual laboratories, rather than commercial manufacturers, and how upcoming regulation may affect those tests.
We welcome YOU back to America's leading higher education podcast, The EdUp Experience! It's YOUR time to #EdUp In this episode, President Series #122, YOUR guest is Dr. Brian A. Lenzmeier, President at Buena Vista University, YOUR special guest co-host is Cooper Jones, YOUR host is Dr. Joe Sallustio, & YOUR sponsor is MDT Marketing! Brian talks about the strength of the rural community college to serve the community employer needs. He also discusses being a first year president during CV & how Iowa was impacted at staff & faculty levels. There is also a great discussion around creating ease of access - don't miss this one! Buena Vista University celebrated the inauguration of President Brian Lenzmeier in a ceremony on Oct. 8, 2021 at Schaller Memorial Chapel. Lenzmeier, a native of Willmar, Minn., came to BVU in 2003 as a Professor of Biology, after having earned a Ph.D. in biochemistry from Colorado State University & completed post-doctoral research in molecular biology at Princeton University. The graduate of Saint John's University in Collegeville, Minn., would later serve as a visiting research fellow in molecular medicine at the Mayo Clinic. Another awesome episode with YOUR sponsor MDT Marketing! Get YOUR free marketing consultation today! mdtmarketing.com/edup Thank YOU so much for tuning in. Join us on the next episode for YOUR time to EdUp! Connect with YOUR EdUp Team - Elvin Freytes & Dr. Joe Sallustio ● Learn more about what others are saying about their EdUp experience ● Join YOUR EdUp community at The EdUp Experience! ● YOU can follow us on Facebook | Instagram | LinkedIn | Twitter | YouTube Thank YOU for listening! We make education YOUR business!
Minnesota has the nation's worst seven-day rate of new COVID-19 infections. The surge in cases is concerning to many families who are preparing for the long holiday weekend. So what can we expect in the coming weeks, and who is making that prediction? On Minnesota Now, host Cathy Wurzer talked about it with Curtis Storlie, a health science researcher at Mayo Clinic. He has been one of the statisticians working on Mayo's COVID task force and helped set an algorithm to gauge the rate of spread. Theme music by Gary Meister.
Cassandra J. Schmitt, PharmD (@cjschmitt2) Identifies the risk stratifications for submassive pulmonary embolism, discusses efficacy and safety outcomes for thrombolytics in submassive pulmonary embolism and selects the ideal candidate to receive thrombolysis for a submassive pulmonary embolism. For more pharmacy content, follow Mayo Clinic Pharmacy Residency Programs @MayoPharmRes or the host, Garrett E. Schramm, Pharm.D., @garrett_schramm on Twitter! You can also connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Cold weather, increased travel, waning immunity and the potential for new variants may serve up the perfect recipe for a holiday COVID-19 surge, according to Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "I have consistently said what's very likely to happen as we get to the cooler weather and see the trends in travel is that we will have another surge," says Dr. Poland. "We're in this unusual situation where the pandemic is actually getting worse because humans don't want to believe that the pandemic is just as important now as it was a year ago."In this Mayo Clinic Q&A podcast, Dr. Poland answers several listener questions and talks more about being vigilant against COVID-19 as the U.S. heads into a second winter with this coronavirus. He also addresses the recent news that wild deer have shown evidence of COVID-19 infection and what that might mean in the battle to eliminate the disease.
Welcome back to another episode of the LLVLC Show. Join Jimmy today as he welcomes Cheryl McColgan to talk about why Keto living should be simple and doable. “Fasting is not all about losing weight. People will give you looks like you have an eating disorder.” - Cheryl McColgan GET STARTED WITH THE KETO CHOW STARTER BUNDLE at JimmyLovesKetoChow.com In this episode, Jimmy has the pleasure of talking to a keto coach and recipe developer named Cheryl McColgan (@healnourishgrow) for an engaging conversation about the current state of keto. This interview was originally conducted over Instagram Live and for some reason the video was truncated and the first 20 minutes was cut off. So Jimmy invited Cheryl to come back on to do the beginning of the interview over again and then spliced in the original chat for you to enjoy. If you are a fan of ketogenic living, then you're gonna love this episode! As a person focused on “healthy lifestyle” over the last 25 years, it was hard to believe Cheryl had to go through such a crazy health scare (in case you're wondering, the Mayo Clinic in Scottsdale eventually removed 16 tumors that had implanted all over her abdomen, bowels and iliac artery). The possibility of cancer forced her to look even more closely at her health, life and career. As a result, Cheryl became deeply involved in the study of wellness and nutrition which resulted in multiple training programs and certifications focused on creating ultimate wellness.
Cindy Finch is a Licensed Clinical Social Worker (LCSW) who specializes in helping people through their darkest times. She trained at the Mayo Clinic and has been featured in the Los Angeles Times, HuffPost, and CURE magazine. A survivor of traumatic life events, Cindy writes and works from lived experiences. She's helped thousands of people through their suffering, encouraging them to move forward and keep enduring to come out invincible. Her latest book, When Grief is Good, was released this past September and, at some point during this interview, we actually talked about it. Before that, though, she turns the tables a few times and puts me in the hot seat. This is definitely one you have to buckle up for and stay to the end because if you do I've got two words for you—hot monogamy! You can learn more about Cindy at her website, cindyfinch.com. Additionally, Cindy would love it if you learned more about Love to Pivot, an organization that helps individuals, couples, families, and groups pivot from unhealthy relationships into healthy relationships.
Prostate cancer is the second most common cancer among men, but thanks to improvements in detection and treatment, the likelihood of surviving the diagnosis is good. Both the five-year and the 10-year survival rates for all stages of prostate cancer are 98%, according to the American Cancer Society. As a result, there more than 3.1 million men in the U.S. have been diagnosed with prostate cancer at some point. Living after a cancer diagnosis is often called "survivorship." The survivorship experience is different for every cancer survivor, but it's possible to predict some of what the survivor might experience based on the type of cancer. For example, both prostate cancer and its treatment can cause urinary incontinence and erectile dysfunction."I think survivorship is just a critical issue in prostate cancer management," says Dr. Matthew Tollefson, a Mayo Clinic urologist. "The location of the prostate is a factor, so many men are concerned about urinary function and sexual function, and to some extent bowel function, because these are all in the the general region of the prostate." After treatment, men may be hesitant to discuss their side effects or be self-conscious about sharing their feelings and worries. Health care providers can help."It's absolutely critical to have that discussion with your doctor, says Dr. Tollefson. "We have effective treatments to manage almost all the side effects that can come up, whether they be issues with body composition, or sexual function or urinary control. It's important to understand that that these are common things and recognize that your physician has likely heard this from many people before and really is well-equipped to help manage and get through some of the issues that that do arise."On the Mayo Clinic Q&A podcast, Dr. Tollefson discusses what men can expect after treatment for prostate cancer and how they can improve their quality of life going forward.
Today's episode will be the first in a series on the seven stages of Alzheimer's. For the first episode, we are going to be discussing what Alzheimer's is and what the common signs and symptoms are, and how it is being treated today. Then, we'll move on to a brief overview of the seven stages before taking an in-depth look at stages one and two. Now let's move on to the rest of the show. According to the Alzheimer's Association, Alzheimer's is a type of dementia that affects memory, thinking, and behavior. Symptoms eventually grow severe enough to interfere with daily tasks. Alzheimer's is the most common cause of dementia, a general term for memory loss and other cognitive abilities serious enough to interfere with daily life. Alzheimer's disease accounts for somewhere between 60 and 80 percent of dementia cases. Alzheimer's is a progressive disease. In most cases, symptoms worsen gradually over several years. After being diagnosed with Alzheimer's disease, a person usually lives anywhere from four to eight years, but in some cases, individuals have lived for over 20 years with Alzheimer's. Everyone experiences Alzheimer's differently. There are many different signs and symptoms of Alzheimer's that you should be aware of, especially if you are concerned that you or a loved one may be experiencing any of the symptoms. The Alzheimer's Association lists 10 early signs and symptoms of Alzheimer's that you should be on the lookout for. The first sign they suggest is memory loss that disrupts daily life. As we age, we may begin to forget things and not be able to easily recall information, like names or specific memories, but we may be able to recall the information later. Not being able to recall the information at all is an early sign of Alzheimer's. One example of this is your loved one asking the same question repeatedly because they don't remember asking it or hearing your answer. The second sign to look for is challenges in planning or problem solving. Trouble keeping track of finances or making a recipe they have made numerous times can both be examples of trouble planning or problem solving. Making the occasional mistake paying bills, however, is not an example of this. Mistakes happen but having an issue figuring out how to pay their bills or adding numbers may be a sign your loved one has Alzheimer's. Having difficulty completing familiar tasks is the third sign you should be looking for. Not remembering how to drive to a place your loved one has been to many times or not remembering how to write or organize their grocery list how they normally do can be an early sign of Alzheimer's. Another sign is being confused with times or places. Not knowing what day of the week it is can be an indicator that your loved one is confusing times or places, but it can also just be a normal sign of aging. Not knowing what season it is or not knowing where they are is mainly what we are referring to with this sign. Trouble understanding visual images and spatial relationships is the fifth sign that the Alzheimer's Association lists. Vision problems unrelated to cataracts can be a sign of Alzheimer's. Having trouble judging distance or being unable to differentiate colors are both examples of this sign. These things can also make driving difficult and possibly unsafe for your loved one as well. Another early sign to look for is new problems with words in speaking or writing. Someone with Alzheimer's may have trouble following or continuing a conversation. They may forget words or the entire rest of their train of thought. Forgetting a word on its own may not be an early sign of Alzheimer's, but constantly forgetting words or using the wrong word may be a sign your loved one has Alzheimer's. The seventh sign is misplacing things and losing the ability to retrace steps. For this sign, your loved one will lose things and not be able to figure out how to work backwards to find them. Many people with Alzheimer's also tend to put items in unusual places, such as putting their keys in the freezer. As the disease progresses, they may even accuse others of stealing their things. Decreased or poor judgement is another early sign of Alzheimer's. Your loved one may begin to make poor decisions frequently, like not bathing regularly or taking care of themselves as well as they should and normally would do. Making one bad decision occasionally, like skipping a shower occasionally, or not filling up their car with gas when they should may not be an early sign of Alzheimer's, but repeated decisions like these can be. Another early sign of Alzheimer's is withdrawal from work or social activities. This sign goes along with forgetting words and having trouble with conversations. Having difficulties following a conversation may lead to having difficulties in social settings and your loved one may withdrawal from activities they once loved. Occasionally being disinterested in hobbies or visiting with friends or family is not a sign that you loved one is withdrawing from their social life. There are times when you yourself don't feel like being social and your loved one experiences times like those, as well. Continuously withdrawing from social situations is the sign you should be looking for in your loved one. The tenth and last sign that the Alzheimer's Association mentions is changes in mood and personality. Your loved one may experience moods more strongly than they once did. They may become easily upset when they are uncomfortable and lash out at their friends and loved ones. If you notice any of these signs or symptoms in your loved one, schedule an appointment with their doctor. They may be experiencing normal age-related symptoms and not symptoms of Alzheimer's or another dementia, but their doctor will be able to determine whether they are showing signs of Alzheimer's. Early detection and diagnosis of Alzheimer's can help their doctor develop a treatment plan that will allow your loved one to maintain their independence longer and help control some of the symptoms right away, making their day-to-day life easier. Some symptoms of Alzheimer's disease may seem like they are just signs of the normal aging process, but they are not. Increasing age is a risk factor of Alzheimer's, but age itself is not a cause of Alzheimer's. Most cases of Alzheimer's happen after age 65, but some happen before that age. Alzheimer's that happens before age 65 is called younger-onset or early-onset Alzheimer's. Individuals diagnosed with early-onset Alzheimer's can be in any of the seven stages of Alzheimer's at the time of their diagnosis. As we said previously, early detection of Alzheimer's is crucial. The earlier someone is diagnosed, the faster they can start treatment and get back to enjoying their lives and time with their loved ones. Currently, there is no cure for Alzheimer's, but there are a few ways that doctors can treat the symptoms. A new drug called aducanumab has recently been approved by the FDA to be used to address the underlying biology of Alzheimer's disease. This drug is a treatment and not a cure. According to the Alzheimer's Association, it is the first therapy to demonstrate that removing amyloid, one of the hallmarks of Alzheimer's disease, from the brain is reasonably likely to reduce cognitive and functional decline in people living with early Alzheimer's. Approval of this therapy underscores the importance of early detection and accurate diagnosis. Treatment with aducanumab should be initiated in patients with mild cognitive impairment or mild dementia stage of disease, the population in which treatment was initiated in clinical trials. Aducanumab was studied in people living with early Alzheimer's disease and mild cognitive impairment due to Alzheimer's who showed evidence of a buildup of amyloid plaques in the brain. Because of this, this treatment has not yet been recommended for individuals with middle or end stage Alzheimer's. Other medications treat the symptoms of Alzheimer's, but not the underlying biology, like aducanumab does. There are medications that help treat cognitive issues, like memory problems, and there are medications that help with behavioral and psychological problems. There are also several clinical trials going on to help improve both memory problems and behavioral and psychological problems due to Alzheimer's. There are also alternative treatment plans that don't require medication. Some supplements and foods may help improve the symptoms of Alzheimer's. A fairly new idea that we recently talked about in a Quick Tips episode is a Dementia Friendly Community. These communities make it safer for those living with dementia to maintain their independence and help them be a part of society after they have been diagnosed with Alzheimer's. To learn more about treatments for Alzheimer's, talk to your doctor today. They can go over treatment options and recommend a best course of action. You can also call the Alzheimer's Association 24/7 helpline for any questions you may have regarding Alzheimer's disease. They can be reached at 1-800-272-3900. Now that we've discussed what Alzheimer's is, what some of the signs and symptoms to look for are, and how it is currently being treated, let's move on to a brief overview of the seven stages of Alzheimer's. You may be familiar with the three most commonly referred to stages of Alzheimer's, the beginning, middle, and end stages, but today we are going to be expanding upon those and talking about all seven stages of Alzheimer's. The Global Deterioration Scale for Assessment of Primary Degenerative Dementia, which is what we are referring to as the seven-stage model of Alzheimer's disease progression, was created by Dr. Barry Reisberg to provide caregivers an overview of the stages of cognitive function for those suffering from a primary degenerative dementia such as Alzheimer's disease. The first stage is referred to as no impairment or before symptoms appear. Changes in the brain are happening during this stage, but no noticeable signs or symptoms will be seen. Because there are no signs or symptoms during this stage, people are not normally diagnosed during stage one. Dr. Wolk, co-director of the Penn Memory Center states that “this time period — often called ‘pre-clinical Alzheimer's disease' — likely begins 10 or 15 years before people have symptoms. Currently, there is no treatment for this pre-clinical stage, but we hope in the future that we will have medicines that can halt the progress before people have symptoms and prevent the disease.” The second stage of Alzheimer's tends to show up as a very mild decline in cognitive health. According to Senior Link, in this stage, a person with Alzheimer's disease begins to experience the typical forgetfulness associated with aging. They may forget where they left their car keys or their purse. These symptoms are typically not yet noticed by the individual's family members or physician. The third stage of dementia shows noticeable memory difficulties and is sometimes referred to as a mild decline. Dr. Wolk explains that “for many, this stage brings noticeable changes, and it will become harder to blame age. It's common to be diagnosed in this stage, because this is when a person's daily routine becomes more disrupted.” These first three stages usually occur prior to a diagnosis. An early diagnosis is usually made in stage three, with early-stage dementia being stage four. Stage four is known as moderate cognitive decline and, as we just said, is what is usually referred to as early-stage dementia. According to Dr. Wolk, in this stage, damage to the brain often involves other aspects of cognition outside of memory, including some difficulty with language, organization, and calculations. These problems can make it more challenging for your loved one to perform daily tasks. Because of the damage to the brain cells, your loved one may also experience other personality changes, such as feeling suspicious of others, having less interest in things, or feeling depressed. These kinds of symptoms can often be improved with medications. Stages five and six make up mid-stage dementia. Stage five is known as moderately severe cognitive decline or decreased independence. According to the Premiere Neurology Center, from stages one through four, most people will continue to maintain their independence with only minor challenges. However, during stage 5, independence becomes harder since they begin to forget close friends and family, struggle to learn new skills, and may forget to perform basic tasks, like getting dressed. Additionally, emotional changes are also frequently seen during this stage. This can cause hallucinations, delusions, and/or paranoia. With stage six comes severe symptoms or severe cognitive decline. Dr. Wolk says that living on your own requires you to be able to respond to your environment, like knowing what to do if the fire alarm goes off or the phone rings. During stage six, this becomes difficult for people with Alzheimer's. Your loved one will be experiencing more significant symptoms at this time, which will impact their ability to manage their own care and they will be more dependent on others. Late or end stage dementia is also known as stage seven - very severe cognitive decline or a lack of physical control. The Premiere Neurology Center says that the final stage of Alzheimer's disease is when the brain has sustained so much damage that it fails to communicate with other parts of the body, causing mental and physical impairment. During this final stage, people require around the clock care and assistance for even the most basic parts of their daily routine. Now that you know what the seven stages of Alzheimer's are, let's take a closer look at stages one and two. Stage one is the preclinical Alzheimer's stage or the no impairment stage. Most people are not diagnosed during this stage, but it isn't impossible to be diagnosed during stage one. According to Healthline, you may only know about your risk for Alzheimer's disease due to family history or your doctor may identify biomarkers that indicate your risk. Your doctor will interview you about memory problems if you're at risk for Alzheimer's, but there will be no noticeable symptoms during the first stage, which can last for years or decades. Changes in the brain can happen up to fifteen years before any signs or symptoms of Alzheimer's even develop. While Alzheimer's may be undetectable in stage one, knowing the risk factors of Alzheimer's can help you spot signs and symptoms as soon as they appear, and as we have said a few times today, the earlier you can diagnosis Alzheimer's, the better. Age, gender, genetics, family history, head trauma, brain abnormalities, smoking, high blood pressure, obesity, limited physical activity, lack of mental activity, and a poor diet are all risk factors for Alzheimer's disease. According to Healthline, Alzheimer's is not a normal part of growing older. However, age is a risk factor for developing this condition. One in nine people over age 65 and one in three people over 85 have Alzheimer's. Women are one and half to three times more likely to develop Alzheimer's than men. Healthline also states that Researchers have found two classes of genes related to Alzheimer's. Deterministic genes guarantee that people will develop the disease if they live long enough. Usually, people with deterministic genes will develop Alzheimer's in their 30s, 40s, or 50s. The Mayo Clinic estimates that these genes caused the condition in about five percent of people with Alzheimer's. People with risk genes may or may not develop the disease. However, they are more likely to develop Alzheimer's than people without risk genes. If your family has a history of Alzheimer's, you are also at a higher risk. The more family members you have had that had Alzheimer's disease, the higher your risk will be, as well. Researchers have found that if you have had serious head injuries you are also at a higher risk for Alzheimer's disease. Healthline states that the risk increases if the injury involves losing consciousness or happens repeatedly, such as in contact sports. Along with head trauma, scientists have identified brain abnormalities in people who are likely to later develop Alzheimer's. One is the presence of tiny clumps of protein, also known as plaques. The other is twisted protein strands, or tangles. Inflammation, tissue shrinkage, and loss of connection between brain cells are other clues that Alzheimer's may develop. Smoking can also increase your risk of developing Alzheimer's, as well as numerous other health problems. High blood pressure is another risk factor tied to Alzheimer's. Researchers have found an especially strong correlation between high blood pressure at middle age and the chances of later developing the disease. Both obesity and limited physical activity increase your risk of Alzheimer's. Being overweight can double your risk. An article published in Maturitas, an international journal of midlife health and beyond found that exercising twice a week during midlife may lower your risk of developing Alzheimer's. Lack of mental activity is another risk factor for Alzheimer's. When we challenge our mental capabilities by trying new things and learning new things, playing an instrument, or doing other activities that use our minds, we create internal connections that can help protect against dementia. Lastly, a poor diet can be a risk factor of Alzheimer's. Eating plenty of fruits and vegetables and other healthy foods can help lower your risk of developing Alzheimer's later in life. Developing healthy habits early on can help you live a longer and healthier life overall. Now that we've taken a closer look at stage one and some things to look out for while you're younger, let's move on to stage two. With stage two comes some signs and symptoms that were not visible during stage one. According to Alzheimer's dot net, the senior may notice minor memory problems or lose things around the house, although not to the point where the memory loss can easily be distinguished from normal age-related memory loss. The person will still do well on memory tests and the disease is unlikely to be detected by loved ones or physicians. Healthline says that Alzheimer's disease affects mainly older adults, over the age of 65 years. At this age, it's common to have slight functional difficulties like forgetfulness. But for stage 2 Alzheimer's, the decline will happen at a greater rate than similarly aged people without Alzheimer's. For example, they may forget familiar words, a family member's name, or where they placed something. During this stage, a loved one may notice symptoms, but not usually the person with Alzheimer's. If you recognize any cognitive decline in your loved one, talk to them about scheduling an appointment with their doctor. In the next episode in our series we will dive into the next stage of Alzheimer's, which is stage three, noticeable memory difficulties. If you are interested in learning more about Alzheimer's before the next episode airs, visit our YouTube channel where you can find an entire playlist dedicated Alzheimer's and dementia. You can also check out the show notes for this episode for resources we used during this episode. We want to say thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate these long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone who could benefit from this episode, please make sure to share it with them. Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. We look forward to seeing you next time on All Home Care Matters, thank you. Sources: https://www.alz.org/alzheimers-dementia/stages https://www.alz.org/alzheimers-dementia/10_signs https://www.alz.org/alzheimers-dementia/what-is-alzheimers https://www.nia.nih.gov/health/what-are-signs-alzheimers-disease https://www.pennmedicine.org/updates/blogs/neuroscience-blog/2019/november/stages-of-alzheimers https://www.alzheimers.net/stages-of-alzheimers-disease https://www.seniorlink.com/blog/the-7-stages-of-alzheimers https://premierneurologycenter.com/blog/the-7-stages-of-alzheimers-disease/ https://www.alz.org/alzheimers-dementia/treatments/aducanumab https://www.alz.org/alzheimers-dementia/treatments https://www.alz.org/alzheimers-dementia/treatments/medications-for-memory https://www.fhca.org/members/qi/clinadmin/global.pdf https://www.healthline.com/health/stages-progression-alzheimers#stage1 https://www.healthline.com/health/alzheimers-disease-risk-factors https://www.maturitas.org/article/S0378-5122(09)00469-1/fulltext
Nick has shingles, it's horrible, and he needs to talk about it. In addition to the shingles talk, we also talk through upcoming Friendsgiving plans and lots more, so we hope you enjoy this week's episode as much as we enjoyed recording it.Here are links to everything we talked about on this week's episode:Is your interest in shingles now piqued? Do you want to know what exactly it is and if you can get it? Learn all about shingles from Mayo Clinic.Mollydooker makes really fun, yummy wines. You can learn about why their wine should be shaken (not stirred) by watching this video. We had a bottle of Enchanted Path Shiraz - Cabernet this week.Bridget loves these Dick's Sporting Goods holiday advertisements. They're festive and helping her get in the "fa la la" mood.The second most expensive house on Geneva Lake just sold, and Crain's Chicago Business has the scoop. We want to know who bought it!Shout out to the Antetokounmpo family for celebrating the birth of their second child (Maverick) by hosting a fundraiser for the Milwaukee Diaper Mission!Pyrex Bowls - it's leftover season and glass is better than plastic. Bridget recommends finding some at Goodwill or getting a set like these.Nick is finding shingles relief with CeraVe Moisturing Cream. If your skin ails you (and it's about to get itchy and dry!), you should get yourself some of this miracle cream. If you like what we're doing here on the Dinner Plus Drinks podcast, here's how you can follow along and get in touch with us:Watch on YouTubeVisit our websiteLike us on FacebookFollow us on InstagramGet links to follow the podcast in your favorite appOr email us at: hello /at/ dinnerlusdrinks /dot/ comThanks for listening, we hope you have a great week!~ Bridget and Nick*If you make a purchase using our links, we may get a commission. Thanks for supporting the podcast!
Today is our last installment of our mini-series on Seniors and Nutrition and to finish the series we will be talking about how to prevent and detect malnutrition in the elderly. First, we will discuss what malnutrition is and what it looks like in older adults. Then, we'll cover some of the factors that contribute to malnutrition. Finally, we'll end with ways you can help your loved one avoid poor nutrition, and in turn, malnutrition. Now let's move on to the rest of the show. Good nutrition is important for everyone, regardless of age, but is especially important for older adults. According to the World Health Organization, malnutrition refers to deficiencies, excesses or imbalances in a person's intake of energy and/or nutrients. The term malnutrition covers 2 broad groups of conditions, undernutrition and overweight, obesity and diet-related noncommunicable diseases, such as heart disease, stroke, diabetes, and cancer. Undernutrition includes stunting, which is low height for age, wasting, which is low weight for height, underweight, which is low weight for age, and micronutrient deficiencies or insufficiencies, which are a lack of important vitamins and minerals. Approximately 2.4 billion adults worldwide are experiencing malnutrition, with 1.9 billion being overweight and 462 million being underweight. In some cases, people may be overweight and also exhibiting micronutrient deficiencies or may be underweight and have diabetes. Because there are many types of malnutrition, it can be hard to spot if your loved one is experiencing a form of malnutrition or not. But left unchecked, malnutrition can cause a host of other issues. According to the Mayo Clinic, malnutrition in older adults can cause them to have a weakened immune system, which increases the risk of infections. It also can cause poor wound healing, muscle weakness and decreased bone mass, which can lead to falls and fractures, a higher risk of hospitalization, and an increased risk of death. The Alliance for Aging Research has created a pocket film that covers who is at risk for malnutrition, the debilitating impact it can have on older adults, tips for identifying the condition, and how it can be treated and prevented. We're covering some of the key points of the video, but if you would like to watch the full thing, you can find the link to it in our show notes for today's episode. According to the Alliance for Aging Research, Malnutrition can happen to anyone, but older adults are particularly at risk, as they are more likely to have chronic conditions that put them at risk for malnutrition. Some illnesses and diseases, like cancer and Alzheimer's, can change an older adult's appetite and metabolism and they can also require dietary restrictions that can make eating difficult. When we picture malnutrition, we often picture starving children in third world countries or even the animals on the ASPCA commercials, but malnutrition is everywhere and far more common than we think. Malnutrition doesn't always look like someone is starving. Actually, most malnutrition cases, at least in the US, tend to look like the opposite. What's even more concerning about malnutrition, it can be impossible to see until it's too late. Older adults often experience illnesses, diseases, or accidents that require them to be hospitalized or require them to be in a long-term care facility, both of which lead to a higher risk of malnutrition. As we age, our bodies go through changes that also can lead towards malnutrition, which is another reason that older adults are at a higher risk. As we get older, our sense of smell and taste weakens, and things that we once enjoyed may not taste as good as they once did. Our digestive system can also slow with age, and take longer to digest meals, making us feel fuller throughout the day, but leave us lacking essential calories and nutrients. As we get older, our bodies may not be able to absorb nutrients as well, either. So, your loved one may be eating the same foods that once brought them a lot of energy, but now doesn't have the same effects. According to the American Society for Prenatal and Enteral Nutrition, or ASPEN, malnutrition in seniors often mirrors the signs of aging. Unplanned weight loss, feeling weak or tired, loss of appetite, swelling or fluid accumulation, and being able to eat only in small amounts are all signs that your loved one is malnourished, but they are also signs of aging. If you suspect your loved one may be malnourished, talk to their doctor immediately so they can get the calories and nutrients their body needs. Now that you know what malnutrition is and what it can look like in older adults, let's move on to factors that contribute to malnutrition. Cognitive diseases like Alzheimer's can make it difficult for your loved one to remember to eat. Mobility issues can also make it more difficult for your loved one to shop for their groceries, cook their own meals, and eat on their own. Some treatments and medications can also require dietary restrictions and cause your loved one to have a loss of appetite, leading them to become malnourished. According to ASPEN, the causes of malnutrition in older adults are a complex blend of physical, social, and psychological issues — from the loss of appetite due to depression to the inability to get to the store for groceries. Prompt diagnosis and treatment of malnourished older adults is critical. If it goes on undetected for too long, irreversible damage and even death can occur. Mayo Clinic lists several factors that contribute to malnutrition in older adults. Normal age-related changes in taste, smell and appetite generally decline with age, making it more difficult to enjoy eating and keep regular eating habits. Disease-related inflammation and illnesses can contribute to declines in appetite and changes in how the body processes nutrients. Impairment in ability to eat, like difficulty chewing or swallowing, poor dental health, or limited ability in handling tableware can contribute to malnutrition. Behavioral or memory problems from Alzheimer's disease or a related dementia can result in forgetting to eat, not buying groceries or other irregular food habits. Some medications can affect appetite or the ability to absorb nutrients. Dietary restrictions for managing medical conditions — such as limits on salt, fat or sugar — might also contribute to inadequate eating. Older adults may have trouble affording groceries, especially if they're taking expensive medications. The lack of socialization can also cause malnutrition. Older adults who eat alone might not enjoy meals as before and lose interest in cooking and eating. Adults with limited mobility may not have access to food or the right types of food. Grief, loneliness, failing health, lack of mobility and other factors might contribute to depression — causing loss of appetite. Older adults that suffer from Alcoholism are also at a higher risk of malnutrition, in addition to numerous other health problems. Too much alcohol can interfere with the digestion and absorption of nutrients. Misuse of alcohol may also result in poor eating habits and poor decisions about nutrition. There are several factors that can contribute to malnutrition, as you have just seen, but the list goes on and on. Knowing some of these factors to look out for can make malnutrition easier to spot in your loved one. And it is important to know that just because they are eating, does not mean they are eating well or eating enough. If your loved one seems to be eating regularly, but is losing weight or experiencing low energy levels, they may have a nutrient deficiency and need to be on a special diet, so it is important that you talk to their doctor about any changes in their behavior, and their diet, that you notice, especially if your loved one is unable to notice it on their own. Now that we have discussed what malnutrition is, what it looks like in older adults, and the factors that contribute to malnutrition, we can move on to our final section, how to help your elderly loved one avoid poor nutrition. Mayo Clinic says that as a caregiver or adult child of an older adult, you can take steps to monitor nutritional health, watch for weight loss and address risk factors of malnutrition. You can monitor your loved one's weight by checking their weight at home and keeping a weekly record of it. You can also do a visual check of how their clothes fit, as it can indicate weight loss, as well. Observing their habits is another good way to keep track of their nutrition. You can spend mealtimes together at home — or during mealtime in a hospital or care facility — to observe eating habits and note what kinds of food are eaten and how much. Keeping a record of all medications, the reason for each medication, dosages, treatment schedules and possible side effects can also help your loved one avoid poor nutrition. As we age, many people need medication every day, and those medications can come with side effects that involve loss of appetite or other things that make eating more difficult. When consulting a doctor about poor nutrition, having all of this information on hand can help them determine if your loved one is malnourished faster, resulting in faster treatment that could potentially save their life. Helping your loved one plan healthy meals or preparing meals ahead of time for them can help ensure that they have access to the nutrients they need. Helping them prepare a shopping list or shopping together can also help them make sure that they always have the items they need to make healthy choices at mealtimes. There are many agencies and organizations that exist just to ensure that seniors have access to nutritional meals. Contact your local service agencies that provide at-home meal deliveries, in-home visits from nurses or dieticians, access to food pantries, or other nutrition services to see what help your loved one can be receiving. The local Area Agency on Aging or a county social worker can provide more information about services in your area. If your loved one lives alone and is having trouble eating, they may benefit from social interactions during meals. You could try dropping by during mealtime or invite your loved one to your home for an occasional meal. Going out to eat at a restaurant can be a special treat for them, and they can use their senior discounts. Lastly, daily exercise — even if it's light — can stimulate appetite and strengthen bones and muscles. Encourage your loved one to go on walks if they are able to. Not only can it help stimulate their appetite, but it can help improve their mood. If they are suffering from depression, even a slight mood improvement can increase their appetite, as well. If your loved one needs help improving their nutrition, there are a few things you can do. Before starting anything new, always make sure you discuss the change with their doctor first. When planning meals for your loved, make sure you are including a variety of nutrient-rich foods. A good rule of thumb is to include the rainbow on their plate. Really, all that means is make sure you are including a variety of colored foods, as they all contain different nutrients. Using different herbs and spiced to add flavor to meals can help your loved one improve their interest in eating. Experimenting with these things can help your loved one find a new favorite and cause them to be excited for their next meal. If eating on their own is not enough, you can use supplemental nutrition drinks to help with calorie intake and you can add things like egg whites or whey powder to meals to increase proteins without adding saturated fats. Observing your loved one during mealtimes is the best way for you to prevent and detect malnutrition in your loved one. Actually, being able to see what they eat and don't eat and being able to witness any problems they have with eating can help you determine if your loved one has any problems that their doctor should be aware of. If you notice they are coughing a lot when they are eating and having trouble swallowing, they may have a medical condition that is causing that that if their doctor was aware of, could be fixed. Knowing your loved one's eating habits can also help when shopping or cooking. If your loved one is unable to go to the store or cook their own meals, know what they like and what they are able to eat can help ensure that they eat more, or less if that is the problem. Now, you don't want to make your loved one feel like they have no control over their eating time or like they have lost their independence. We are not suggesting that you stand over them at mealtime. When you take them out to dinner or come visit for lunch, just be aware while you are with them and take note of their habits. It may be useful in the future, and it may not, but it is always better to be safe than sorry. If your loved one is having difficulty eating or you notice any changes in their diet or weight, even if you don't think they are malnourished, talk to their doctor. Malnutrition often goes undetected and undiagnosed until it is too late, so if you have any suspicions, it is always better to tell your doctor sooner rather than later. You may also find you need the help of a nutritionist when figure out what your loved one should be and needs to be eating. Your doctor or your local senior center can give you resources and referrals for nutritionists in your area. Your local senior center may even have a nutritionist on staff that you can meet with. We want to say thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate these long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone who could benefit from this episode, please make sure to share it with them. Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. We look forward to seeing you next time on All Home Care Matters, thank you. Sources: https://www.mayoclinic.org/healthy-lifestyle/caregivers/in-depth/senior-health/art-20044699 https://www.who.int/news-room/q-a-detail/malnutrition https://www.agingresearch.org/campaign/malnutrition/ https://www.nutritioncare.org/Guidelines_and_Clinical_Resources/Spotting_Malnutrition_in_Seniors/
The Community Health Assessment and Planning (CHAP) process uses a collective approach to improving population health. The CHAP administers the Community Health Improvement Plan (CHIP) and Community Health Needs Assessment (CHNA). Since 2012, CHAP has been working with partners from across the community to find solutions to challenging health issues. Olmsted County Public Health Services, Olmsted Medical Center, Mayo Clinic, and many community groups lead the collective community efforts. Our membership comes from the public, private and nonprofit sectors and includes health care, housing, education. Olmsted County works with Mayo Clinic and Olmsted Medical Center for CHAP's overall work and is accountable for our outcomes. Three core groups also fund the CHAP process. These include the Rochester Area Foundation, United Way of Olmsted County, and Zumbro Valley Health Center. Contact: If you have questions or are interested in learning more about getting involved in the CHAP process, please contact: Olmsted County Public Health Services Performance Management, Quality Improvement, and Accreditation Team Derrick Fritz, Community Health Assessment and Planning (CHAP) Coordinator https://www.olmstedcounty.gov/government/county-departments/public-health-services/health-assessment-and-planning-partnership CDC Community Health Assessments & Health Improvement Plans. https://www.cdc.gov/publichealthgateway/cha/plan.html
Sean McEligot is Section Head of medical device research and development at the prestigious Mayo Clinic. He's Division of Engineering, Quality Manager, has second line managerial responsibility for the Applied Computational Engineering Unit, the Biomechanical Development Unit, and the Biomechanical Shop. He is the Director of the Mayo Clinic Division of Engineering Additive Manufacturing Facility and oversees the Division of Engineering Microfabrication Facility. He has a BS in mechanical engineering from Stanford University and a Masters of Healthcare Administration from the University of Minnesota. In this episode we'll discuss what it's like working at the Mayo Clinic's engineering department, what the Mayo Clinic looks for in engineers they hire, translational medicine, and the latest engineering technologies they're working on. (Hint: Titanium 3D printing)Machine Design Magazine article, “ How do Medical Organizations Use Additive Manufacturing?”Rafael Testai (cohost) Please consider rating us “5 stars” on your preferred podcast platform. It's the ultimate way to thank us. The Being An Engineer podcast is brought to you by Pipeline Design & Engineering. Pipeline partners with medical & other device engineering teams who need turnkey equipment such as cycle test machines, custom test fixtures, automation equipment, assembly jigs, inspection stations and more. You can find us on the web at www.teampipeline.us.
Innovation in health care is being driven by technology and data. At Mayo Clinic, the Center for Digital Health is the hub for this digital transformation. "The Center for Digital Health has the vision of bringing Mayo Clinic to a global community so that we can deliver Mayo Clinic anywhere in a manner that is simple," says Dr. Bradley Leibovich, medical director for Mayo Clinic's Center for Digital Health.Current projects at the Center for Digital Health include developing a digital front door and improved consumer experience for patients, expanding virtual care, and transforming health care delivery through data and analytics.One example is Mayo Clinic's advanced care at homeprogram, which provides comprehensive care to patients in the comfort of their own homes. Partnering with Medically Home, technology-enabled services company, some patients with conditions previously managed in a hospital now have the option to transition to a home setting for care and recovery services. "This enables people who traditionally would need to be in the hospital for a serious condition to stay in their home, having nurses and physicians checking on them via technology, and having data streamed to those providers from their home," explains Dr. Leibovich. "It allows people to stay in their homes more, with their families more. It will enable them to continue working more. It will cure them faster. It will do so with less expense, less frustration. And everybody benefits if we can accomplish that."On the Mayo Clinic Q&A podcast, Dr. Leibovich discusses work that is underway at Mayo Clinic's Center for Digital Health to improve the patient's health care experience.
This week on the podcast, Elitza Theel, Ph.D., director of Mayo Clinic's Infectious Diseases Serology Laboratory, joins "Answers From the Lab" with Bobbi Pritt, M.D. In this episode, Dr. Pritt and Dr. Theel discuss antibody testing for COVID-19, including why this testing is done and when it's most useful.
Shawn and James talk about friendship. This is an Episode Out of Time, meaning that it was recorded out the flow of episodes you've been listening to. When was it pulled together? When was it recorded? When was it edited? No one knows.... We start off the episode reviewing our Digital Declutter from earlier this year before moving into a discussion on what it means to be a friend and how to go about finding friends. Do you know how many hours to make someone your best friend? Listen to find out. It would be great to hear from you about your friendships. Do you have a best friend? If so, how did you become best friends? Please share your friend-making tips and tricks. James really needs your help! Email: firstname.lastname@example.org Website: lookingoverlife.com FWIW: patreon.com/lookingoverlife LOL Episode 1: 2020 Yearly Themes Digital Minimalism by Cal Newport "How many hours does it take to make a friend?" study by Dr. Jeffrey A. Hall Dunbar's number - Wikipedia "Can you have more than 150 friends?" NYT article "Friendships: Enrich your life and improve your health" Mayo Clinic article "Why friendships are so important for health and wellbeing" Everyday Health article
COVID-19 cases are once again spiking in Minnesota. On Monday, the state posted its highest single-day count of new cases since December. For some people who have contracted COVID, symptoms can linger months after they've recovered. The lingering side effects are known as long-haul COVID and can include persistent joint pain, fatigue, shortness of breath, brain fog and headaches. Early studies show that anywhere between 10 and 30 percent of COVID patients will experience long COVID symptoms. MPR News host Angela Davis spoke with two doctors about long-haul COVID — what we know about the condition, and how to treat it. And she hears from a woman who has long COVID. Guests: Dr. Craig Bowron is a physician and writer based in St. Paul. Dr. Greg Vanichkachorn is a preventive, occupational and aerospace medicine specialist who leads the COVID Activity Rehabilitation Program at Mayo Clinic. Use the audio player above to listen to the full conversation. Subscribe to the MPR News with Angela Davis podcast on Apple Podcasts, Google Podcasts, Spotify or RSS.
Hannah M. Brokmeier, PharmD (@hannahbrokmeier) compares and contrasts the pharmacokinetic and pharmacodynamic properties of heparin and bivalirudin in extracorporeal support, identifies clinical scenarios that favor either heparin or bivalirudin for anticoagulation in ECMO and selects a preferred agent for ECMO when either heparin or bivalirudin are acceptable. For more pharmacy content, follow Mayo Clinic Pharmacy Residency Programs @MayoPharmRes or the host, Garrett E. Schramm, Pharm.D., @garrett_schramm on Twitter! You can also connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Although COVID-19 has been seen as a disease that primarily affects the lungs, it can affect other organs, including the heart. Organ damage can lead to health complications that linger after being infected with COVID-19. People with heart disease are at an increased risk of more severe complications from COVID-19, but anyone infected with COVID-19 could be at risk for heart problems. "Not only have we learned that COVID-19 can cause cardiac injury through multiple mechanisms, but the virus in rare cases, particularly in young males, can cause myocarditis, a specific form of cardiac injury," says Dr. Leslie Cooper, chair of the Department ofCardiology at Mayo Clinic in Florida. Many people who are infected with COVID-19 experience shortness of breath, which could be a sign of heart complications and needs further investigation. "The illness itself leads to deconditioning because you're not as active you normally are," explains Dr. Cooper. "So going back to activity take time." It's hard for the individual to tell which is the cause of their symptoms. Is it the heart, the lungs or deconditioning? I would recommend seeing a medical provider if you've still got symptoms. We can sort that out with generally noninvasive and simple testing," says Dr. Cooper.While there is a slight risk of myocarditis as a temporary side effect of vaccination for COVID-19, particularly in young males, the Centers for Disease Control and Prevention still recommends vaccination for everyone 5 and up.Dr. Cooper agrees."The likelihood of a bad thing happening — a hospitalization or dying from the virus itself — is greater with the virus than it is with a vaccine in every case, every analysis, in every study done."On the Mayo Clinic Q&A podcast, Dr. Cooper discusses COVID-19 infection and the heart.
Chances are you or someone you love has had a biopsy to check for cancer. Doctors got a tissue sample and they sent it into a pathology lab, and at some point you got a result back. If you were lucky, it was negative and there was no cancer. But have you ever wondered exactly what happens in between those steps? Until recently, it's been a meticulous but imperfect manual process where a pathologist would put a thin slice of tissue under a high-powered microscope and examine the cells by eye, looking for patterns that indicate malignancy. But now the process is going digital—and growing more accurate.Harry's guest this week is Leo Grady, CEO of, Paige AI, which makes an AI-driven test called Paige Prostate. Grady says that in a clinical study, pathologists who had help from the Paige system accurately diagnosed prostate cancer almost 97 percent of the time, up from 90 percent without the tool. That translates into a 70 percent reduction in false negatives—nice odds if your own health is on the line. This week on the show, Grady explains explain how the Paige test works, how the company trained its software to be more accurate than a human pathologist, how it won FDA approval for the test, and what it could all mean for the future of cancer diagnosis and treatment.Please rate and review The Harry Glorikian Show on Apple Podcasts! Here's how to do that from an iPhone, iPad, or iPod touch:1. Open the Podcasts app on your iPhone, iPad, or Mac. 2. Navigate to The Harry Glorikian Show podcast. You can find it by searching for it or selecting it from your library. Just note that you'll have to go to the series page which shows all the episodes, not just the page for a single episode.3. Scroll down to find the subhead titled "Ratings & Reviews."4. Under one of the highlighted reviews, select "Write a Review."5. Next, select a star rating at the top — you have the option of choosing between one and five stars. 6. Using the text box at the top, write a title for your review. Then, in the lower text box, write your review. Your review can be up to 300 words long.7. Once you've finished, select "Send" or "Save" in the top-right corner. 8. If you've never left a podcast review before, enter a nickname. Your nickname will be displayed next to any reviews you leave from here on out. 9. After selecting a nickname, tap OK. Your review may not be immediately visible.That's it! Thanks so much.Full TranscriptHarry Glorikian: Hello. I'm Harry Glorikian. Welcome to The Harry Glorikian Show, the interview podcast that explores how technology is changing everything we know about healthcare.Artificial intelligence. Big data. Predictive analytics. In fields like these, breakthroughs are happening way faster than most people realize. If you want to be proactive about your own health and the health of your loved ones, you'll need to learn everything you can about how medicine is changing and how you can take advantage of all the new options.Explaining this approaching world is the mission of my new book, The Future You. And it's also our theme here on the show, where we bring you conversations with the innovators, caregivers, and patient advocates who are transforming the healthcare system and working to push it in positive directions.Chances are you or someone you love has had a biopsy to check for cancer. Doctors got a tissue sample and they sent it into a pathology lab, and at some point you got a result back. If you were lucky it was negative and there was no cancer.But have you ever wondered exactly what happens in between those steps?Well, until recently, it's been an extremely meticulous manual process. A pathologist would create a very thin slice of your tissue, put it under a high-powered microscope, and examine the cells by eye, looking for patterns that indicate malignancy. But recently the process has started to go digital. For one thing, the technology to make a digital scan of a pathology slide has been getting cheaper. That's a no-brainer, since it makes it way easier for a pathologist to share an image if they want a second opinion.But once the data is available digitally, it opens up a bunch of additional possibilities. Including letting computers try their hand at pathology. That's what's happening at a company called Paige AI, which makes a newly FDA-approved test for prostate cancer called Paige Prostate.The test uses computer vision and machine learning to find spots on prostate biopsy slides that look suspicious, so a human pathologist can take a closer look.So why should you care?Well, in a clinical study that Paige submitted to the FDA, pathologists who had help from the Paige system accurately diagnosed cancer almost 97 percent of the time, up from 90 percent without the tool.That translates into a 70 percent reduction in false negatives. At the same time there was a 24 percent reduction in false positives. I gotta tell you, if I were getting a prostate biopsy, I'd really like those improved odds. And it's a great example of the kinds of AI-driven medical technologies that I write about in The Future You, which is now available from Amazon in Kindle ebook format.So I asked Paige's CEO, Leo Grady, to come on the show to explain how the test works, how Paige trained its software to be more accurate than a human pathologist, how the company got the FDA to give its first ever approval for an AI-based pathology product, and what it could all mean for the future of cancer diagnosis and treatment.Here's our conversation.Harry Glorikian: Leo, welcome to the show.Leo Grady: Hi, Harry. Glad to be here.Harry Glorikian: Yeah. You know, I've been watching the company for some time now, and the big story here seems to be that we're really entering the area of digital pathology, also known as sort of computational pathology, and it's funny because I've been talking about digital pathology since I think I started my career back when I was 25, which seems like a long time ago at this point. But for a lot of laboratory tests that we use, like it's usually done by eye, and now we can get a lot from sort of AI being assistive in this way. So keeping in mind that some of the listeners are professionals, but we have a bunch of sort of non-experts, could you start off explaining the term maybe computational pathology and summarize where the state of the art is, which I assume you guys are right at the cutting edge of it?Leo Grady: Yeah, so I think it actually might help just to jump back a level and talk about what is pathology and how is it done today? So today, so pathology is the branch of medicine where a doctor is taking tissue out of a patient through a biopsy, through surgery and making glass slides out of that tissue, looking at it under a microscope in order to make a diagnosis. And today, all of that process of taking the tissue out, cutting it, staining it, mounting it on slides. Then gets looked at under a microscope by a pathologist to make a diagnosis, and that diagnosis the pathologist makes is the definitive diagnosis that then drives all of the rest of the downstream management and care of that patient. When pathologists are looking through a microscope, sometimes they see something that they're not quite sure what it is. And so they may want to do another test. They may want to do another stain. They may want to cut more out of the tissue, make a second slide. Sometimes they want to ask a colleague for their opinion, or if they really feel like they need an expert opinion, they may want to send that case out for a consultation, in which case the glass slides or are put in a, you know, FedEx and basically shipped out to another lab somewhere. All of those different scenarios can be improved with digital pathology and particularly computational pathology and the sort of technology that we build at Paige. So in a digital world, what happens instead is that the slides don't go to the pathologist as glass. They go into a digital slide scanner, and those slide scanners produce a very high resolution picture of these slides.Leo Grady: So these are quarter-micron resolution images that get produced of each slide. And then the pathologist has a work list on their monitor. They look through those those cases, they open them up and then that digital workflow, they can see the sides digitally. When they have those slides digitally, if they want to send them out to a second opinion or or show them to a colleague, it's much easier to then send those cases electronically than it is to actually ship the glass from one location to another. Once those slides are digital it, it opens up a whole other set of possibilities for how information can come to the pathologist. So if they want additional information about something they see in those slides, rather than doing another stain, doing another cut, sending for a second opinion, what we can do and what we do at Paige is we we identify all the tissue patterns in that piece of tissue, match those against a large database where we have known diagnoses and say, OK, this case, this pattern here has a high match toward to something that's in this database. And by providing that information to the pathologists on request that pathologists can then leverage that information, integrate it and use it in their diagnostic process. And this is the product that the FDA just approved. It's the first ever AI based product in pathology that is specifically aimed at prostate cancer and providing this additional information in the context of a prostate needle biopsy.Harry Glorikian: Well, congratulations on that. That's, you know, that's amazing. And I'm. You know, the fact that the FDA is being more aggressive than I remember them being in the past is also a great thing to see. But, you know, we've been talking and quote digitizing things in pathology for for quite some time, let's say, separate from the AI based analytics part of it moving in that direction. What was the kind of technology advance or prerequisite that you guys came up with when you started Paige that that took this to that next level.Leo Grady: Well, as you're pointing out, Harry, most slides are not digitized today, single digits of slides in a clinical setting get digitized. And the reason for that has been you need to buy scanners, you need to change your workflow, you need to digitize these slides. They're enormously large from a file size and data complexity. So then you have to store them somehow and you make all of that investment and then you get to look at the same slide on a monitor that you look at under a microscope. And so pathologists for years have said, why? Why would we make this investment? Why would we go through all of that expense? And that trouble and that change and learn a new instrument when we don't really get a lot of value out of doing so? And furthermore, there was even a question for a long time, do you get the same information on a digital side that you get on glass through a microscope? Yep. There have been a number of things that have been changing that over time. So one is the maturity of the high capacity digital side scanners. There are now a number of hardware vendors that produce these. Storage costs have come down. And one thing that we offer at Paige is is cloud storage, which is really low cost because we're able to effectively pool costs with the cloud providers from multiple different labs and hospitals, so we can really drive those prices down as far as possible.Leo Grady: So that lowers that barrier. And then back in 2017, the first digital side scanner got approved, which demonstrated there was equivalency in the diagnosis between looking at the slide on a monitor and looking at it under a microscope. And that is something that that we also replicated with our digital side viewer, demonstrated that equivalency between digital and glass. But all of those barriers were barriers just to going digital in the first place. And now, really, for the first time, because of the maturity of the scanners, because of the FDA clearance of just the viewer, because of lower cost storage, many of those barriers have come down. Now what has not happened is still a major clinical benefit for going digital in the first place. Yes, you can share slides easier. Yes, you can retrieve slides easier. Yes, you can do education easier. It's still a lot of cost and a lot of changed your workflow, so I really think that that the introduction of the kinds of technologies that that the FDA approved, which we built with Paige Prostate, that actually adds additional information into the diagnostic workflow that can help pathologists use that information help them. You get to a better diagnosis, reduce false positives, reduce false negatives, which is what we showed in the study that for the first time is is going above and beyond just going digital and some of these conveniences of a digital workflow to providing true clinical benefit.Harry Glorikian: Yeah, I mean, whenever I look at this from an investment perspective, like if you take apart something and break it into its first principles, you know, levels, you have to have certain milestones hit. Otherwise, it's not going to come together, right? And I've, you know, looking at digital pathology, it's the same thing. You have to have certain pieces in place for the next evolution to be possible, because it's got to be built on top of these foundational pieces. But, you know, once you get there, the exponential nature of of how things change, once it's digitized and once you're utilizing it and prove that it works is sort of where you see the, you know, large leaps of benefit for the pathologist as well as, you know, ultimately we're doing this for better patient care. But you know, your product was I think the FDA called it the first ever FDA approval for an AI product in pathology, which is a big deal, at least as far as I'm concerned, because I've been doing it for a long time. But because it was first, it must have been a one hell of a learning process for you and the FDA to figure out how to evaluate a test like this. Can you sort of explain maybe a little bit about the process? You know, how did you win approval? What novel questions did you have to answer?Leo Grady: It was a long process. You know, as you point out, this is this is the first ever technology approved in this space. And I think you saw from the FDA's own press release their enthusiasm for what this technology can bring to patient benefits. Fortunately, we applied for breakthrough designation back in early 2019, received that breakthrough designation in February of 2019. And as a result, one of the benefits of breakthrough designation is the FDA commits to working closely with the company to try to iterate on the study protocol, iterate on the the validation that's going to be required in order to bring the the technology to market. And so because of that breakthrough designation, we had the opportunity to work with the the FDA in a much tighter iterative loop. And I think that they are they were concerned, I mean, primarily about the impact of a misdiagnosis and pathology, right? Which is really understandable, right? Their view is that, yes, maybe in radiology, you see something and maybe aren't totally sure. But then there's always pathology as a safety net, you know, in case you ever really need to resolve a ground truth. You can always take the tissue out and look at it under a microscope. But when you're dealing with a product for pathology, that's the end of the road. I mean, that is where the diagnostic buck stops. And so anything there that that was perhaps going to misinform a pathologist, mislead them, you know, ultimately lead to a negative conclusion for the patients could have more severe consequences.Speaker2: The flip side, of course, though, is that if you get it right, the benefits are much greater because you can really positively impact the care of those patients. So I think they they, you know, appropriately, we're concerned with the exacting rigor of the study to really ensure that that this technology was providing benefit and also because it was the first I think they wanted to be able to set a standard for future technologies that would have to live up to the same bar. So there were a lot of meetings, you know, a lot of trips down to Silver Spring. But I have to say that that the FDA, you know, I think in technology, there are a lot of companies that are are quick to, you know, malign regulators and rules. I frankly both at Paige and my previous experience at HeartFlow, at Siemens, I think the FDA brings a very consistent and important standard of clinical trial design of of, you know, technology proving that is safe and effective. And I found them to be great partners to work with in order to really identify what that protocol looks like to be able to produce the validation and then to, you know, ask some tough questions. But that's their job. And I think, you know, at the end of the day, the products that get produced that go through that process really have met the standard of of not only clinical validation, but even things like security and quality management and other really important factors of a clinical product.Harry Glorikian: Oh no, I'm in total agreement. I mean, whenever I'm talking to a company and they're like, Well, I don't know when I'm going to go to the agency, I'm like, go to the agency, like, don't wait till the end. Like there, actually, you need to look at them as a partner, not as an adversary.Leo Grady: Yeah. And a pre-submission meeting is is easy to do. It's an opportunity to make a proposal to the FDA and to understand how they think about it and whether that's that's going to be a strategy that's going to be effective and workable for them. So I always think that that pre subs are the place to start before you do too much work because you generally know whether you're on the right path or not.Harry Glorikian: Yeah, I agree. And it's funny because you said, like, you know, they're concerned about the product, but it's interesting. Like from all the College of American Pathology studies where you send slides to different people, you don't always get the exact same answer, depending on who's looking at it. So I can see how a product can bring some level of standardization to the process that that helps make the call so uniform, even across institutions when you send the slides. So I think that's moving the whole field in a really positive direction.Leo Grady: Well, only if that uniform call is correct, right? Or better? Great. I mean, if you bring everybody down to the lowest common denominator that that standardization, but it's not moving the field forward. So. Correct. One of the curses of of bringing that level of standardization is that you have to really meet the highest bar of the highest pathologists and not not just the average. That said, you know, we're fortunate to come from Memorial Sloan-Kettering and to have the opportunity to work with some of the the leading pathologists in the world to really build in that level of rigor and excellence into the technology.Harry Glorikian: Yeah. So that brings me to like, you know. The algorithms are built on a fairly large training set would be my assumption and of pre labeled sort of images, where do you guys source that from? Is it you have like a thousand people in the background sort of making sure that everything is labeled correctly before it's fed to the to the algorithm itself?Leo Grady: Well, what you're describing is very common where you have pathologists or in radiology radiologists or other experts really marking up images and saying this is the important part to pay attention to. This part is cancer. That part's benign. Our technology actually works differently. Our founder, Thomas Fuchs, and his team at Memorial Sloan-Kettering actually really made a breakthrough not only in the the quality of some of the the AI systems that were building, but also in the technology itself. And what what they did, this was all published in Nature Medicine a couple of years ago, is basically find a way to just show the computer a slide and the final diagnosis without having a pathologist, you know, mark up the slide, but just show them the final diagnosis. And when you show the computer enough examples of the slide and the final diagnosis, the computer starts to learn to say, OK, this pattern is common to all grade threes. This pattern is common to all grade fours. Or whatever it is. And the computer learns to identify those patterns without anybody going through and marking those up. Well, this technology is important for a few reasons.Leo Grady: One, it means we can train systems at enormous scale. We can not just do thousands of cases, but tens of thousands, hundreds of thousands of cases. Second, it means that we can really build out a portfolio of technologies quickly that are very robust and not have to spend years annotating slides. And third, it allows us to start looking for patterns that no pathologists would necessarily know how to mark up. You know, can we identify which tumors are going to respond to certain drugs or certain therapies? You know, no pathologists are going to be able to say, OK, it's this part of the the tumor that you need to look at because they don't really know. But with this technology where we we know these tumors responded, these tumors didn't it actually helps us try to ferret out those patterns. So that that's one of the real key benefits that differentiates Paige from from other companies in this space is just the difference in the technology itself.Harry Glorikian: Yeah. I mean, it's funny because I must admit, like when we talk about stuff like this, I get super excited because I can see where things can go. It's. It's always difficult to explain it where somebody else can envision what you've been thinking about because you've been thinking about it so long, but it's super exciting. So let's jump to like the most important benefits, like if you had to rank the benefits of the technology, I mean, I've I read on your website that in the clinical study you guys submitted to the FDA, pathologist used using the Paige Prostate were seven percent more likely to correctly diagnose the cancer. Is that the major innovation? Would that by itself be enough to justify an investment in the technology? I mean, I'm trying to. You know, if you were to say God, this is the most important thing and then go down the list, what would they be?Leo Grady: Yeah, that's right. So so the study that we did was like this. We had 16 pathologists. They diagnosed about six hundred prostate needle core biopsy patients and they they did their diagnosis. They recorded it and then they did it a second time using Paige so they could see the benefit of all this pattern matching that that Paige had done for them. And what we did is we compared the diagnosis. They got the first time and the second time with the ground truth, consensus diagnosis that we had from Memorial. And what we found is that when the pathologists were using Paige, they had a 70 percent reduction in false negatives. They had a 24 percent reduction in false positives, and their interest in obtaining additional information went down because they had more confidence in the diagnosis that they were able to provide. And what was interesting about that group of 16 pathologists is it it included pathologists that were experienced, that were less experienced, some that were specialists in prostate cancer, some that were not so specialized in prostate cancer. And among that entire group of pathologists, they all got better. They all benefited from using this technology. And what's more, is that the gap between the less experienced, less specialized pathologists and more experienced, more specialized pathologists actually decreased as they all used the technology. So it allowed them to, like we were talking about before, actually come up to the level of of the better pathologists and even the better pathologists could leverage the information to get even better.Harry Glorikian: So as a male who you know who's going to age at some point and potentially have to deal with, hopefully not, a prostate issue, we want them to make an accurate diagnosis because you don't want the inaccurate diagnosis, especially in in that sort of an issue. But what about the speed? I mean, you've you talk about that, you know, it helps streamline the process and reduce reduce turnaround time for for patients. What does that do to workload and and how quickly you're able to turn that around compared to, say, a traditional method.Leo Grady: Our study was really focused on clinical benefit and patient benefit. We were not aiming to measure speed and the way in which the study was designed and the device is intended to be used is that the pathologist would look at the case, decide what they they think the result is, and then pull up the Paige results and see if it changes their thinking or calls their attention to something that they may have missed. So the focus of the the product was really on the the benefit to the the clinical diagnosis and the clinical benefit to patients by providing more information to the doctors. And the result of that information was, you know, clearly demonstrated benefit. Now if they can get to that result by looking at the Paige results and they don't need another cut, they don't need another stain, they don't need another consultation, then that's going to get the results back to the urologists faster, back to the patient faster and will ultimately enable them to start acting on that diagnosis more quickly. But the intention of the study, the intended use of the device is not around making pathologists faster. It's really around providing them this additional information so that they can use that in the course of their diagnosis and get the better results from patients.[musical interlude]Harry Glorikian: Let's pause the conversation for a minute to talk about one small but important thing you can do, to help keep the podcast going. And that's to make it easier for other listeners discover the show by leaving a rating and a review on Apple Podcasts.All you have to do is open the Apple Podcasts app on your smartphone, search for The Harry Glorikian Show, and scroll down to the Ratings & Reviews section. Tap the stars to rate the show, and then tap the link that says Write a Review to leave your comments. It'll only take a minute, but you'll be doing us a huge favor.And one more thing. If you like the interviews we do here on the show I know you'll like my new book, The Future You: How Artificial Intelligence Can Help You Get Healthier, Stress Less, and Live Longer.It's a friendly and accessible tour of all the ways today's information technologies are helping us diagnose diseases faster, treat them more precisely, and create personalized diet and exercise programs to prevent them in the first place.The book is now available in Kindle format. Just go to Amazon and search for The Future You by Harry Glorikian.And now, back to the show.[musical interlude]Harry Glorikian: So I asked this out of naivete because I didn't I didn't go looking for it. But have you guys done a health economic analysis of the system?Leo Grady: We have one. It certainly it's, as you know, it's really key to be able to look at that we have a model that we've built. We're still refining it with additional data. There was a study that was announced in the U.K. a couple of weeks ago where the NHS is actually funding a prospective multicenter trial that includes Oxford, Warwick, Coventry, Bristol to be able to evaluate the the health, economics and clinical benefits of using this technology in clinical practice prospectively. So that's something that we engaged with NICE [the National Institute for Health and Care Excellence] on in order to try to get the design correct that will help feed in real world data into the model. But we have a model that we've been using internally and are continuing to build and refine.Harry Glorikian: So. Again, incredible that you guys got FDA approval, I think the company was founded in 2017, if I'm correct. Can you talk about, you know, the founders and yow you guys, you know, built this so quickly, I mean time scale wise, it's a pretty compressed time scale, relatively speaking.Leo Grady: Well, yeah, it isn't, it isn't, ...so the company started in 2017, our first employee was actually middle of 2018 and we had our first venture round and in early 2018. However, the work that went into the company that spun out of Memorial Sloan-Kettering started earlier. So there is a group of really visionary individuals at MSK that back, I want to say, 2014, 2015, actually had started this push toward digital pathology, computational pathology, really seeing where the puck was going and building this technology. They formed something called the Warren Alpert Center, and the Warren Alpert Center provided some initial funding to really get this going and to hire some of the founders and to really move this technology in the right direction. And it was really because that technology started to show such promise that MSK made the decision that that was at a point where it could be better, you know, more impactful to actually go outside of MSK into a company where where we could industrialize the technology and really bring it to hospitals and labs around the world. So the technology started earlier, 2014, 2015. Paige was really launched in, I would say, 2018, although technically it was incorporated earlier and and then from that point I personally joined in 2019. And so I'm not I'm not a founder, but when I joined in 2019, you know, we we really spun up a significant team and and brought to bear some of my own experience and industrializing AI technology and bringing it out to clinical benefit.Harry Glorikian: Well, you know, most founders don't take the company all the way. It's a rare breed that's able to get it that far. So you know this a great story, but let's step back here and talk about like now you have to like, get people to accept this technology right, which is the human factor which I always find much more confounding than the the the the computational factor. So you've got to get, you know, somebody inside a hospital or pathology lab. Do you run into resistance or pushback from the technology, I mean, are they skeptical about the algorithm? How do you get a human to sort of buy off on this? I remember when we were presenting this, oh God, again, 25 years ago, they hated it. I mean, just hated it. And as time has gone by, you've seen that that digitization is slowly taking effect and where you know, it's assistive as opposed to something, I remember when we first launched this, it was, "This is going to be better than" or "take your job," which is a great way to make an enemy on the other side. And I see that the two actually being better than one or the other per se on on its own. So how are you guys approaching this? And do you have any anecdotal stories that you might be able to share?Leo Grady: Yeah, and so I think there are two elements are one is, you know. Are people resistant by the nature of the technology because they feel threatened by it, and then the other is how does market adoption start with this sort of technology to just the first point? You know, I tend to be very careful about the term AI. I feel like it know it often introduces this concept of, you know, people think of a robot doctor that's going to run in and start doing things. And it's just it's not. I mean, AI is a technology that's been in development for four decades. I did my PhD in AI, in computer vision, 20 years ago, and it's just a technology, right? It's like a transistor. It can be used to build many different things. At its core, it's just complex pattern matching, which is what we how we leverage that technology. In the case of Paige Prostate was to help provide that information. I think, you know, the better frame to think about this technology is as a diagnostic. This is just like a diagnostic test. You validate it with a standalone sensitivity and specificity. The information gets provided the doctor. You have to do a clinical trial that samples the space effectively of the patient population and the intended use.Leo Grady: And you have to make sure the doctors understand the information and know how to use it effectively. It's before my time, but I heard that when immunohistochemistry was first really introduced in pathology, that there is a discussion that this was going to take all the pathologists' jobs. And who needs a pathologist if you can just stain with IHG and get get a diagnostic result out of it? Well, you know, 20 years, IHT is an essential component of of pathology, and it's a key element of of the diagnostic workflow for pathologists. So, far from replacing any pathologists, it's empowered them. It's made there the benefit that they can provide to the clinicians, even more valuable and even more important. And I think we're going to see a similar trajectory with this computational technology. Now your first question about market adoption, how people adopting this, I would say that, you know, last week I went to the College of American Pathology meeting, which was in person in Chicago. It's my first in-person meeting since COVID, so a year and a half ago. And I noticed--and this was this was right after the announcement by the FDA of of the approval for Paige Prostate--I noticed there was a market shift in the conversations I was having with pathologists.Leo Grady: It was a shift away from "Does this technology work? Is it ready for prime time? What does it really do?" Toward, "Ok, how do we operationalize this? How do we bring it in house, how do we integrate this into a workflow and how do we how do we pay for it?" You know, those are the conversations that we were having in Chicago at CAP. Not does this work? Is it ready for prime time? So I do think that there is a market understanding that the technology is real, that it works, that it can provide benefit. Now it's just a question of how do we operationalize and how do we get it paid for? Because today there's no additional reimbursement for it. But you know, again, with market adoption, you're got your Moore adoption curve for anything. You get them and you get your innovators and early adopters, your early majority, late majority and your laggards. And you know where I think we're at a stage where we've got innovators and early adopters that are excited to jump in and start leveraging this technology. And I think, you know, we're going to get to your early majority and the late majority over time. It's always going to be a process.Harry Glorikian: Yeah, no. I mean, you know, reflecting on your IHC [immunohistochemistry], that's where I started my career. Like, I think I taught like two hundred and fifty IHC courses over the first, say, three or four years that I was in the in the business. Three or four years. And you know, I agree with you. There's no way that any one of these technologies takes the place of [a pathologist]. They're additive, right? It's just a tool that helps. Make the circle much more complete than it would be in any one component, all by itself.Leo Grady: Could you ever hear when you were teaching these classes? Did anyone ever say that like, are we even going to need pathologists anymore?Harry Glorikian: No, it was when the is is when imaging systems came out that said the imaging system would then replace the pathologists. The IHC was was really the cusp of precision medicine, where I remember when I first started because we were working with ER and PR and, you know, when I first learned, you know about like, you know, the find and grind method, I would always be like, OK, it's x number of femtomoles. Like, What does that really telling you, right? Compared to this stain over here where I can see, you know, the anatomy, I can see where the cells are. I can see. I mean, there's so much more information that's coming from this that lets me make a better call. I will tell you selling it was not that hard to a lot of people, they they could see the benefit and you could you could really sort of get them to adopt it because they saw it as a tool.Leo Grady: Was that post-reimbursement?Harry Glorikian: Uh, even pre-reimbursement.Leo Grady: Really interesting. Yeah, there's there's a lot we can learn from you then.Harry Glorikian: Yeah, it was. It was. It was an interesting ride back then. I mean, I remember my first day at work. My boss comes to me and says. By the way, you're going to give a talk in Arizona in two weeks, and I was like, What do you mean I'm going to go? Who am I going to give a talk to you? He goes, Oh, you got to give a talk on the technology and how to use it. And I said, who's in the audience? And he said histo techs, and there'll be some pathologists. And I was like, Are you kidding me? And he goes, You got two weeks to get ready. Oh my God, I was cramming like crazy. I was in the lab. I was doing all the different types of assays that we had available. And you know, it was you went out there and I learned very quickly like, the show must go on, like you got to get out there and you got to do your thing. But it was it was a great time in my career to be on that on that bleeding edge of what was happening. So quickly, like, why did you guys start with prostate cancer, though like? It's not the most common cancer, although it's high on the list, so. Or maybe it's the second most type of cancer, but why did you guys start with that and where do you guys see it going from there, I guess, is next.Leo Grady: Well, the the decision of how to rank the different opportunities for, you know, ultimately we believe this technology can benefit really the entire diagnostic process, no matter what the question is in pathology. However, we did have to prioritize right and elements of of where to start, right. The elements of prioritization had a few factors. So one factor was how how prevalent is the disease? I mean, as you know, prostate cancer is one of the big four. Second, is there are a lot of benefit that we can provide today with prostate cancer. You know, man of a certain age goes in, gets a PSA test. It's high, they go and they get 12 cores, 14 cores, 20 cores out of their prostate and that produces. You know, it can be 30 slides, it can be 50 slides, I mean, it really depends, and this can take the pathologist a long time to look through. Most of those cores are negative. In fact, most of those patients are negative, but the consequence of missing something is really significant. And so we felt that this was a situation where there was a big need. There's a lot of there's a lot of screening that goes on with prostate cancer. Prostate cancer is prevalent and the consequence of missing something is really significant. So that's where we felt like we could provide maximum benefit, both in terms of the patient, in terms of the doctor, and also that it was a significant need across the space.Leo Grady: We also had the data and the technology that we could go after that one well. But that said, you know, we announced that we have a breast cancer product that is got a CE mark in an enabling clinical use in Europe. We're doing a number of investigational studies with that product in the US right now and and working toward bringing that one to market. You know, after our our recent funding round, we spun up a number of teams and a number of of verticals that were we're going after in other cancer types and ultimately even beyond cancer. So there's more to come. We wanted we really take seriously the quality, the regulatory confirmation as well as the deployment channel. I mean, we built the whole workflow to be able to leverage this technology throughout the workflow in a way that is meaningful to the pathologist. So the development is is maybe a little bit more heavy and validation than some other companies where you have a PhD student that says, Oh, you know, I won some challenge and I went to go bring this to market building real clinical products, validating them, deploying them, supporting them is a real endeavor. But prostate was just the first, breast is second, and we have a whole pipeline coming out. So stay tuned.Harry Glorikian: So before we end here, I want to just tilt the lens a little bit towards the consumer and say, like, you know. Why would consumers show interest or at least be aware that these things are coming? Because I always feel like they're almost the last to know, or they just don't know at all. But, you know, in the future, you know, with technologies like this, do you see it identifying tumors sooner, faster, more accurately? Or, you know, will it will it help increase survival or help us find better drugs? I mean that that's I think, what people are really... If you went down one level from us of the people that are affected by this. Those are the sorts of things they'd want to know.Leo Grady: Well, I think, you know, a useful analogy is what happened with the da Vinci robot. You know, when it was necessary for a patient to get prostate cancer surgery, they often chose centers that had the da Vinci robot. Why? Because they believed that they were able to get better care at those centers. And it's not because the surgeons at the other centers were no good. It's because the the da Vinci added elements of precision and standardization and accuracy that could be demonstrated that would enable the the patient to feel more confident they're getting the best treatment at those centers. So as I think about Paige Prostate and and ultimately the other technologies that we're bringing to market behind that, I would imagine that from the standpoint of the patient, they would want the diagnosis done at a lab where they had access to all of the available information, all the latest technology that could inform the pathologists to get the right answer, right? So would you want to go to a lab where the pathologists had no access to IHC? Would you want to send it to a lab where the pathologist had no ability to do a consultation? Do you want to send your your sample to a lab where the pathologist doesn't have access to Paige? I think in the future the answer is going to be no.Leo Grady: And I think that we're going to see ultimately, insurance companies and Medicare recognize that those labs are able to provide better care to patients and are going to encourage them and incentivize them to adopt these technologies. So, you know, ultimately from a patient standpoint, they they want to choose centers where they're going to get the best care, they're going to get the best diagnosis. I think one of the exciting elements of digital technology is that not everybody is able to go to Memorial Sloan-Kettering, not everyone's able to go to MD Anderson or Mayo Clinic. I think the opportunity with digital technology is to really increase the accessibility and increase the availability of these diagnostic tools that can really empower and enable pathologists in many parts of America, as well as beyond to really get to better results for their patients. And ultimately, you know, every patient cares about getting those those results accurately for themselves and for their loved ones.Harry Glorikian: Yeah, I mean, I'm always explaining, you know, to different people like once you digitize it, there's so many opportunities that may open up to make things better, faster, easier, more accurate and even start to shift the business model itself of what can be done and where it can be done. So it's it's a super exciting space, and thanks for taking the time. It was great to talk to you. I mean, I don't get to talk to people in pathology all the time anymore. I'm sort of all over the place, but it's it's near and dear to my heart, that's for sure.Leo Grady: Well, thank you so much, Harry. We're so excited by these recent developments with the first ever FDA approved technology in this space and, you know, really excited to help roll this out to labs and hospitals around the country and around the world to really benefit those doctors and patients.Harry Glorikian: Excellent. Well, I look forward to hearing about the next FDA approval.Leo Grady: Working on it. Look forward to telling you.Harry Glorikian: Thanks.Leo Grady: All right. Thanks so much, Harry.Harry Glorikian: That's it for this week's episode. You can find past episodes of The Harry Glorikian Show and MoneyBall Medicine at my website, glorikian.com, under the tab Podcasts.Don't forget to go to Apple Podcasts to leave a rating and review for the show.You can find me on Twitter at hglorikian. And we always love it when listeners post about the show there, or on other social media. Thanks for listening, stay healthy, and be sure to tune in two weeks from now for our next interview.
(00:32):Today, we will be discussing staphylococcal testing at Mayo Clinic Laboratories. Before we start, Dr. Schuetz, could you please provide our listeners with a little bit about you and your background? (01:02):As we get started on this initiative, can you provide a brief overview of this testing and its intended use? (02:36):Could you describe for us which patients should have this testing and when it should be performed — including how this new testing improves upon previous testing approaches? (04:47):What makes our testing unique? (05:45):How are the results from this PCR testing used in patient care?
Unhealthy or damaged lungs can make it difficult for the body to get the oxygen it needs to survive. A variety of diseases or conditions can damage the lungs and hinder their ability to function effectively. When lung disease doesn't respond to medical therapy, a lung transplant may be needed. A lung transplant is a surgical procedure to replace a diseased or failing lung with a healthy lung, usually from a deceased donor. Depending on your medical condition, a lung transplant may involve replacing one or both of your lungs. In some situations, the lungs may be transplanted along with a donor heart. For patients with diseases that damage the lungs, an early referral to a transplant center is an important step."If you have a disease that you think could merit or benefit from lung transplant, it's extremely important to talk to your physician early in the process," says Dr. Tathagat Narula, a Mayo Clinic transplant medicine physician. "The physician can refer you to a transplant center, where you can receive a complete evaluation. There's nothing wrong in getting established with a transplant center relatively early in the process of your lung disease. " On the Mayo Clinic Q&A podcast, Dr. Narula discusses evaluation for lung transplant and research working to make more lungs available to those on the transplant waitlist.
We talk about how to ride it our when first getting through life with our alcohol, but what then? At some point drinking's not the problem, so we choose what we want an how to proceed. We want to have fuuuuun and peace and balance, and we figured out how. We reference a Mayo Clinic article about the health benefits of positive thinking, here's the link! https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/positive-thinking/art-20043950Also don't forget to search images for the Partridge Family. Our "Glide Don't Trudge" tats are in that groovy cool rad '70's aesthetic,
Child health experts condemn the use of violence in any form, but some people still use corporal punishment, such as spanking, as a way to discipline their children. Any corporal punishment can leave emotional scars. Parental behaviors that cause pain, physical injury or emotional trauma — even when done in the name of discipline — could be child abuse.The American Academy of Pediatrics recommends healthy forms of discipline, such as positive reinforcement of appropriate behaviors, limit setting, redirecting, and setting future expectations. The American Academy of Pediatrics recommends that parents not span, hit, slap, threaten, insult, humiliate, or shame children.On the Mayo Clinic Q&A podcast, pediatrician and #AsktheMayoMom host Dr. Angela Mattke discusses positive ways to discipline your child with Dr. Chris Derauf, a Mayo Clinic pediatrician, and Dr. Arne Graff, a Mayo Clinic family medicine physician, who both specialize in child abuse at the Mayo Center for Safe and Healthy Children and Adolescents.
In 2006, a man named William Ramsey went to the Mayo Clinic in Jacksonville, Florida for a life-saving liver transplant. It was a success, and so when his health started to decline after the procedure, doctors couldn't figure out why. Say hello on Twitter, Facebook and Instagram. Sign up for our occasional newsletter, The Accomplice. Artwork by Julienne Alexander. Learn more about our upcoming live shows at thisiscriminal.com/live. Check out our online shop. Criminal is a proud member of Radiotopia from PRX. Please review us on Apple Podcasts! It's an important way to help new listeners discover the show: iTunes.com/CriminalShow. We also make This is Love and Phoebe Reads a Mystery.
I was on LinkedIn, and someone was saying, “Oh, there's no real money in generic drugs. It's not a huge issue if patients are paying 10 bucks instead of 93 cents for something. It's not like anyone is getting rich off of that, and it's not like patient impact here is super meaningful.” This is a pretty common refrain, actually; and from a conventional wisdom perspective, I get it, especially for those living comfortable middle- or upper-middle-class lives where an extra $9.07 for a prescription isn't a huge deal—except there are big-time issues with the generic supply chain that are worth billions and billions of dollars and that have a major impact on patient health. So, let's discuss. I started casting my eye over to what was going on on the generic drug front mainly because of the huge lawsuits in the news lately that were either filed and/or settled. Generic drug manufacturers are and have been the defendants in these lawsuits, accused of price collusion amongst other things. These lawsuits aren't fighting over chump change either, unless you consider hundreds and hundreds of millions of dollars as chump change, that is. The number of zeros on the table in these lawsuits may strike you, as they did me, as a factor of interest. I mean, we're talking about generic drugs here. The cost of goods on these drugs—there was a WHO study on this—and the cost of goods to manufacture a small molecule generic is, a lot of times, pennies. Further, there's no innovation undertaken by generic manufacturers in their manufacture of generic meds. Just so no one gets confused here, the rationale branded pharma manufacturers tout for high-cost branded (ie, new) drugs is that branded pharma manufacturers have to spot the R&D (research and development) dollars to come up with the new therapies and they take a lot of risk therein. Generic manufacturers, on the other hand, are getting a recipe that has been handed down to them. There is no R&D. There is no innovation. So, to restate the situation analysis, we have generic manufacturers spending no money on innovation and enjoying, many times, a low cost of goods. If the price were set using a cost plus methodology, you'd expect the prices paid by payers and patients to be correspondingly low—except they aren't. Depending on what study you look at, somewhere between 29% and 44% of patients who have been prescribed a med say they aren't taking it because it is unaffordable. Considering that 90% of the prescriptions written in this country are for generics, one could logically assume that there's some generics in that mix that are unaffordable due to their high prices. But there's a compounding factor here: The patient affordability problem has another aspect to it beyond just patients having to pay a portion, or all, of the price of generic meds that may be, let's just say, higher than one might expect them to be given the cost of goods. But here's this other factor: The share of patient out of pocket is weirdly high when it comes to generics. Consider that generics and branded generics account for 19% of invoice-level spending but represent 65% of patient out-of-pocket costs (IQVIA National Prescription Audit, 12/2020). So, that seems out of whack. But keep in mind, as I mentioned earlier, that 90% of prescriptions written in this country are for generics. That's five billion scripts a year. As my guest in this healthcare podcast, Steven Quimby, MD, says, generic medications touch many more lives than new branded drugs. Obviously, GoodRx comes up in the conversation in this episode. If you want to learn more about pharmacy list prices and how GoodRx makes money, listen to the conversation I had with Ge Bai (EP306 and AEE13). Several people actually mentioned on LinkedIn and Twitter that hers was one of the best explanations they had heard on these topics, so I recommend those shows. The show also with Vinay Patel dives pretty deeply into the “what's the what” between PBMs and pharmacies (EP241) if you're looking for more on that. Dr. Quimby also mentions how important it could be for providers to know at the point of prescribing what the cost of medications are for a patient and get this information right in their EHR system. Refer to the episode with Carm Huntress (EP284) for more info on that. My guest, as I said, Steven Quimby, MD, is an author and newly retired physician. His father was a pharmacist with a little drugstore that thrived in the late 1960s and early 1970s, so he literally grew up in the business. Dr. Quimby recently wrote a book called Billions in Your Generic Drugs. In sum, it's a supply chain where not only is nobody watching the henhouse, but everybody within that supply chain has a very, very vested interest to see prices go up. This is kind of a theme in healthcare, but nonetheless. Oh, and one last point to ponder before we get started here: Dr. Quimby mentions at one point that 86% of Americans believe that their health insurance plan always offers the lowest price for a generic and 67% (two-thirds) of people in this country have never heard of GoodRx or other shopping tools. So, yeah … really makes you realize you live in a bubble. You can learn more by reading Dr. Quimby's book Billions in Your Generic Drugs. You can also reach Dr. Quimby on Twitter and LinkedIn. Steven Quimby, MD, is a physician who has worked in academic medicine at the Mayo Clinic and in private practice. He has been involved in drug treatment studies, including major pharmaceutical trials, and maintained an active interest in the interface of corporate business, pharmacy, and medicine for over 50 years. Dr. Quimby is concerned escalating prices for generic drugs, which fill 90% of our prescriptions, threaten access to needed medications and patients going without treatment risk worsening of their medical conditions and further costs. Too often controversies over high new drug prices and the funding of new drug development and innovation obscure addressable problems in the generic drug supply and financing chain. 05:54 What are the current lawsuits involved in the generic drug space right now? 06:52 How is price fixing happening in the generic drug space? 07:58 “If I was the major payer for drugs … I'd want to know answers.” 08:06 What's the scale on new and generic drugs? 09:02 What's the problem with using price tools for generic drugs? 10:22 “I think right now, virtually everyone should be checking [those sites vs] their insurance price.” 10:47 Are payers paying too much for generic drugs? 11:53 Who are these generic manufacturers? 12:10 “They're distinctly different corporations than those that we have called Big Pharma.” 13:55 Why is it important to have adequate numbers of manufacturers for generic drugs? 17:03 “We just can't get legitimate acquisition and then sale prices of the actual drugs.” 17:17 “The industry's opaque to all of these things.” 19:39 “The prices that patients are getting at the prescription counter are so high that some studies say a third of them or more are walking away without buying the drug.” 20:02 AEE13 with Ge Bai, PhD, CPA, on the GoodRx model.20:50 EP241 with Vinay Patel.22:05 What and who should be on formulary? 26:24 “If they'd give us the numbers, we could see when it happens.” 28:58 How can we overcome the challenges of these high generic drug costs? 30:38 EP284 with Carm Huntress.30:46 EP334 with Sunita Desai, PhD. 31:26 “How can we judge value when we don't know price?” You can learn more by reading Dr. Quimby's book Billions in Your Generic Drugs. You can also reach Dr. Quimby on Twitter and LinkedIn. @QuimbyMD discusses #genericdrugpricing on our #healthcarepodcast. #healthcare #podcast #genericdrugs #drugpricing How is price fixing happening in the generic drug space? @QuimbyMD discusses #genericdrugpricing on our #healthcarepodcast. #healthcare #podcast #genericdrugs #drugpricing “If I was the major payer for drugs … I'd want to know answers.” @QuimbyMD discusses #genericdrugpricing on our #healthcarepodcast. #healthcare #podcast #genericdrugs #drugpricing What's the problem with using price tools for generic drugs? @QuimbyMD discusses #genericdrugpricing on our #healthcarepodcast. #healthcare #podcast #genericdrugs #drugpricing Are payers paying too much for generic drugs? @QuimbyMD discusses #genericdrugpricing on our #healthcarepodcast. #healthcare #podcast #genericdrugs #drugpricing “They're distinctly different corporations than those that we have called Big Pharma.” @QuimbyMD discusses #genericdrugpricing on our #healthcarepodcast. #healthcare #podcast #genericdrugs #drugpricing Why is it important to have adequate numbers of manufacturers for generic drugs? @QuimbyMD discusses #genericdrugpricing on our #healthcarepodcast. #healthcare #podcast #genericdrugs #drugpricing “We just can't get legitimate acquisition and then sale prices of the actual drugs.” @QuimbyMD discusses #genericdrugpricing on our #healthcarepodcast. #healthcare #podcast #genericdrugs #drugpricing “The industry's opaque to all of these things.” @QuimbyMD discusses #genericdrugpricing on our #healthcarepodcast. #healthcare #podcast #genericdrugs #drugpricing “The prices that patients are getting at the prescription counter are so high that some studies say a third of them or more are walking away without buying the drug.” @QuimbyMD discusses #genericdrugpricing on our #healthcarepodcast. #healthcare #podcast #genericdrugs #drugpricing “If they'd give us the numbers, we could see when it happens.” @QuimbyMD discusses #genericdrugpricing on our #healthcarepodcast. #healthcare #podcast #genericdrugs #drugpricing “How can we judge value when we don't know price?” @QuimbyMD discusses #genericdrugpricing on our #healthcarepodcast. #healthcare #podcast #genericdrugs #drugpricing Recent past interviews: Click a guest's name for their latest RHV episode! Dr David Carmouche (EP343), Christin Deacon, Gary Campbell, Kristin Begley, David Contorno (AEE17), David Contorno (EP339), Nikki King, Olivia Webb, Brandon Weber, Stacey Richter (INBW30), Brian Klepper (AEE16), Brian Klepper (EP335), Sunita Desai, Care Plans vs Real World (EP333), Dr Tony DiGioia, Al Lewis, John Marchica, Joe Connolly, Marshall Allen, Andrew Eye, Naomi Fried, Dr Rishi Wadhera, Dr Mai Pham, Nicole Bradberry and Kelly Conroy, Lee Lewis, Dr Arshad Rahim, Dr Monica Lypson, Dr Rich Klasco
William Morice II, M.D., Ph.D., chair of the Department of Laboratory Medicine and Pathology at Mayo Clinic and president of Mayo Clinic Laboratories, joins the "Answers From the Lab" podcast for his weekly leadership update with Bobbi Pritt, M.D. In this episode, Dr. Morice and Dr. Pritt discuss the state of COVID-19 now, along with factors that could influence how the pandemic plays out from here.
Listen, Subscribe, Share the Show, Donate. Help us keep this train rollin! Notes & Links from Today's Show (5) Ian Rapoport on Twitter: "#Packers QB Aaron Rodgers is unvaccinated, per me and @MikeGarafolo. That's why he's out for Sunday vs. the #Chiefs." / Twitter Companies mull ending government contracts over vaccine mandate (msn.com) Major League Baseball considers dramatic change with "robot umpires" (msn.com) Workers protest impending firing of up to 8,000 Mayo Clinic employees - Alpha News Expanding Our Climate Science Center | Meta (fb.com) October 2021 Coordinated Inauthentic Behavior Report | Meta (fb.com) https://apnews.com/article/virginia-election-ap-votecast-survey-75520c5c9a245bee384526abc138a61a https://www.cnn.com/2021/11/03/politics/winsome-sears-virginia-lieutenant-governor-race/index.html https://www.wsj.com/articles/behind-the-numbers-of-the-virginia-gubernatorial-election-11635923354 https://www.nytimes.com/2021/11/03/us/politics/black-voters-in-virginia-refuse-to-be-blamed-for-a-major-democratic-defeat.html?utm_source=pocket_mylist https://www.wsj.com/articles/new-jersey-governor-race-is-still-too-close-to-call-11635940355 https://www.startribune.com/minneapolis-opens-door-for-rent-control-st-paul-approves-strict-cap/600112089/ https://freakonomics.com/podcast/rent-control/ https://www.who.int/news/item/31-12-2020-who-issues-its-first-emergency-use-validation-for-a-covid-19-vaccine-and-emphasizes-need-for-equitable-global-access https://www.ndtv.com/india-news/covaxin-bharat-biotechs-india-made-covid-vaccine-cleared-by-who-sources-2598395 https://www.wsj.com/articles/youngkins-virginia-win-offers-midterm-road-map-for-gop-warning-for-democrats-11635942003?mod=series_election2021 The Propaganda Report on Rokfin CCDH Spreads Hate (with Help from Biden) | Rokfin The Propaganda Report on Patreon The Propaganda Report Store Support Our Sponsors! Donate... If you find value in the content we produce and want to help us keep this train rollin, drop us a donation via Paypal or become a Patreon. (links below) Every little bit helps. Thank you! And thank you to everyone who has and continues to support the show. It's your support that enables us to continue producing shows. Paypal Patreon Subscribe & Leave A 5-Star Review... Subscribe on iTunes Subscribe on Google Play Music Listen on Google Podcasts Listen on Tunein Listen on Stitcher Follow on Spotify Like and Follow us on Facebook Follow Monica on Twitter Follow Binkley on Twitter Subscribe to Binkley's Youtube Channel https://www.paypal.me/BradBinkley https://www.patreon.com/propagandareport https://twitter.com/freedomactradio https://twitter.com/MonicaPerezShow https://www.youtube.com/bradbinkley https://www.youtube.com/monicaperez
If you have recently found it difficult to obtain objective information to inform your own important decisions, this episode is for you. Anthony G. Jay, PhD and Ben hone in on facts about DNA, viruses, and vaccination. Dr. Jay brings a wealth of information, cultivated from years of lab research, about both the human body and the medical system. Anthony G. Jay, PhD is the president and CEO of AJ Consulting Company, which offers full-scale DNA analysis, with software that Dr. Jay developed himself. After years of research on viruses and hormones, Dr. Jay earned his PhD in Biochemistry. Dr. Jay recently left the Mayo Clinic after several years of work researching stem cells, epigenetics, and infrared light. Ready to hear the facts from a true expert in the world of modern-day science? This episode is about straightforward information. Listen and learn: What the mechanisms are behind gene expression. How natural immunity works. Who is at a higher risk for COVID-19 complications. Why certain research studies aren't public knowledge. When the media overshadows the science. Learn more about Dr. Anthony Jay: AJ Consulting DNA Analysis Instagram @anthonygjay YouTube: Anthony Jay Cast ====== Today's show is sponsored by BUBS Naturals. Check out their Collagen and MCT powder, which goes in Ben's morning "Intelligence" coffee every day without fail! Collagen is an unbeatable post-workout supplement that is amazing for joint health, skin vitality, and balancing blood sugar. Powdered MCT oil offers fast-acting, clean, ketogenic energy; heals gut inflammation, and supports immunity. BUBS Naturals supports an amazing cause with every purchase made, and gives 10% of all sales proceeds to help special operations soldiers transition back into civilian life. Use code MUSCLE at checkout to get 25% off sitewide in November at https://www.bubsnaturals.com ====== Want updates from Ben on his upcoming Webinars, Masterclasses, and coaching programs? Head over to muscleintelligence.com/subscribe for early admission to Ben's programs, exclusive sponsor deals, and Ben's latest insights into fitness, nutrition, and optimum performance. ====== If you're a man over 40 looking to add 10 lbs of muscle, lose fat and increase your testosterone, we have just a few spots left in our Muscle Intelligence Men Over 40 Coaching Program. This program is designed for men over 40 who are looking for a completely tailored optimization system based around the top pillars of an exceptional life; a community of like-minded leaders who are committed to excellence, integrity and growth in everything they do; the best, cutting-edge information, backed by a combination of research, experience and deep contemplation; and a coaching team who is uniquely trained and qualified to predict success, prevent simple mistakes and develop the exact formula for YOU... you might just be our next Muscle Intelligent Man. CLICK TO APPLY NOW ====== www.muscleintelligence.com - The world's leading resource on intelligent muscle building. We have taught and certified hundreds of coaches all over the world in our methods that emphasize a holistic approach to physical and mental optimization through a harmonious blend of modern science and ancient wisdom...check out www.muscleintelligence.com JOIN THE FREE COMMUNITY and become part of the Muscle Intelligence Movement as we support a shift in the HEALTH & CONSCIOUSNESS of humanity. The Muscle Intelligence Community empowers men and women with the knowledge, skillset and inspiration to thrive by applying the 6 Pillars of a Lean, Healthy and Muscular Body. Check us out on Facebook: https://www.facebook.com/groups/muscleintelligence If you are looking for bodybuilding guidance, videos, workouts, the proper training split to build muscle, see how IFBB PRO Ben Pakulski builds big muscle through the best online program here https://www.muscleintelligence.com - For Students Of IFBB Pro Ben Pakulski. Where the Smartest People Come To Build Muscle FAST - www.muscleintelligence.com/bodypart Don't miss any of Ben Pakulski's workout or training tips by subscribing to the channel: https://www.youtube.com/user/BenPakIFBB And "LIKING" the fan-page here: https://www.facebook.com/BenPakulskiMuscleIntelligence Make sure to HIT SUBSCRIBE before you go, and leave Ben a comment or question for a future episode.
Danielle M. Hess, PharmD (@dhess_09) describes the pathophysiology of opioid-induced constipation (OIC), evaluates literature depicting the safety and efficacy of peripherally-acting mu-opioid receptor antagonists (PAMORAs) for the treatment of OIC and applies the clinical pearls of PAMORAs to patient care. For more pharmacy content, follow Mayo Clinic Pharmacy Residency Programs @MayoPharmRes or the host, Garrett E. Schramm, Pharm.D., @garrett_schramm on Twitter! You can also connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
On this episode I am joined by Leslie Lindsay. Leslie is the author and narrator of SPEAKING OF APRAXIA: A Parents' Guide to Childhood Apraxia of Speech, now in its 2nd edition with an audio edition from Penguin Random House (July 2021). Her writing and photography have been featured in various print and online literary journals. Leslie is a former Mayo Clinic child/adolescent psychiatric R.N. and resides in the Chicago area with her family. Her daughter, Kate, now 16, inspired SPEAKING OF APRAXIA.
In anticipation of more COVID-19 vaccine approvals this week, Dr. Elie Berbari, chair of the Division of Infectious Diseases at Mayo Clinic, says it's good news that younger children will now have more protection against COVID-19."It's important that we reach a very high level of vaccination rates to achieve kind of a wall of immunity that could prevent transmission and prevent us from these repeated peaks that we've been dealing with over the last year and a half during this pandemic," says Dr. Berbari. In this Mayo Clinic Q&A podcast, Dr. Berbari also talks about the rare cases of myocarditis and how the Food and Drug Administration is monitoring those cases. Dr. Berbari also addresses additional COVID-19 vaccine doses for immunocompromised people, the importance of masking, even if vaccinated, and he answers a number of listener questions.
Superfan Big Will The Champ calls into hotline to share a video of another famous podcaster saying the TCB catch phrase "Best To You!". Bryan and Krissy debate wether they are being imitated or if "Best To You!" is phrase making it's rounds in the lexicon. Then Bryan recalls a TCB bit that mysteriously made it to Howard Stern Show (Spoiler....clearly Stern is NOT listening to TCB!). Then the gang talk about cults in their many forms. Gyms, diet fads, churches, yoga studios and other ways we get sucked in. Finally, the gang review some of the fitness fads from the 1980's. LINKS:Want a TCB limited edition collectible sticker? Each series sticker is limited and first come, first serve. Click HERE to find out how!Send us show ideas, comments, questions or hate mail by texting us or leaving a voicemail at 1-661-Best-2-Yo (1.661.237.8296)Watch Us on YouTubeTCB Live On Fireside AppAll Sponsor Codes & Links Get A Free DOZEN Tamales From Texas Lone Star Tamales (Use Code TCB at Checkout)Streamlight Lending By SunTrust Bank (Use Code TCB for additional interest savings)BeachBound is beach focused vacation travel planning agency...online!Special Thanks:Special Thanks To Moon Cheese For The Snacks! Use Code TCB For 15% Off Moon Cheese Products...Click HereSpecial Thanks To Project Pollo Our Vegan Burgers!Studio Snacks Provided By Siete Chips! (Try The Fuego Flavor!)Castbox is the TCB publishing partner . Download The App Here!New Episodes on Tuesdays and now Fridays everywhere you listen to podcasts!1-(661)-BEST-2-YO | (1-661-237-8296)
An old friend's life comes to an end, however her spirit never dies. Here is a preview of the story. “Now a few months ago Margaret found out she is sick too and is going to die - so she sold the house to move three hundred miles south, closer to Mayo Clinic where she needs to be. She hired a great moving company and had me come make sure she did not forget anything she needed to do. Two moving trucks showed up on a Thursday and they started packing the house up. At one point Margaret had told me she was going to have the urn in her car with her on the way to her new home, but she forgot to tell the movers, and I did not remember either until they were working in her room. I said, "excuse me, but did you see a wooden box on the floor by her bed?" Oh yes ma'am, we have that all packed and ready to go. You should have seen the looks on their faces when I told them "Can you please unpack that box again because that is actually Margaret's husband, and she wanted him in the car with her." lol. It was so funny! They assured us it was the first time they had ever packed a husband. lol. They handed me the box, all wrapped in a moving blanket and shrink wrapped and I put it in the passenger seat of the car for her. No worries. Until the next day.”