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In this Episode, Dr. Jennifer Stoskus PT, DPT, NCS, Advanced Vestibular Physical Therapist (UPMC course) provides us with a long over-due update on the management of Mal de Debarquement Syndrome (MdDS). Episode Resources: - Barany Society Diagnostic Criteria for MdDS (2020): https://content.iospress.com/articles/journal-of-vestibular-research/ves200714 - Advanced Vestibular Physical Therapist Certificate Program: https://www.shrs.pitt.edu/pt/continuing-education/advanced-vestibular-physical-therapist-certificate-program - MdDS Foundation: https://mddsfoundation.org/ - Gait Disorientation Test: https://pubmed.ncbi.nlm.nih.gov/33338462/ - Our discussion of “The Mind-Body Connection in Managing Dizziness” with Dr. Lisa Farrell, PT, DPT: https://youtu.be/ZWlrVh8Fz_U?si=uo5aIiFzdDvyBXEv Where to find Dr. Jennifer Stoskus PT, DPT, NCS, Advanced Vestibular Physical Therapist: - Website is www.NJDizziness.com - Research page: bit.ly/tech4hcp Hosted by Dr. Abbie Ross, PT, NCS, and Dr. Danielle Tolman, PT For Episode Recommendations or Requests, email us info@balancingactrehab.com Where to find us: https://link.me/balancingactrehabwww.BalancingActRehab.com Facebook: @BalancingActRehab Instagram: @BalancingActRehab Twitter: @DizzyDoctors TikTok: @BalancingActRehab Check out our self guided self help courses! How to Live with Dizziness How to Treat Positional Dizziness https://balancing-act-rehab-s-school.teachable.com/courses/
Welp, it's go time, folks! As in Josh is going to attempt to master his craft on his way to 10,000 hours. Gladwell believes 10,000 achieves mastery but Josh isn't even close yet. Luckily, Gladwell is likely full of shit. But on the other end of the spectrum (empty of shit) is a sobering discussion with Josh's former student Randy from Lebanon, a rant about alcohol and health, a pensive view of insomnia and MDDS, a celebration of the deep meaning of high school football season, a closer look at social media shaping thoughts and identities, an interesting example of playground graffiti, an examination of first grade today and first grade hootenanny memories, and chance to dissect the use of "um" in language. Only the important stuff, good people. Now, drop a nice rating or review on iTunes/Apple wontchya! Logo art by Brandon Lai Music by Micah Julius Insomnia by thoughts of having more insomnia
To be continued (from last time), tracking the MDDS journey, discussing flight beverages, piñatas required at parties, revealing the magic of the advertising world, the goals of education, freshmen 15, figs, planets, magic wands, pinballs, originality, and candles. Too many topics, too little time. Thanks for tuning in. Capture some mindful moments this week. Grateful for you all. Logo art by Brandon Lai Music by Micah Julius Barf puddle on Brandon Lai's green rug in 1995 by Micah Julius
Kimberly shares so much of herself in this conversation. After spending a couple of hours with her, I understood so much more about her soulful passion for not only sharing stories of those with chronic illness and rare conditions but really seeing them, loving them, and sharing how adversity can broaden our definition of what it means to live a “good life”. She shares these stories through UnFixed Media Productions which she founded in 2019. To understand her passion you must watch anything from UnFixed Media's portfolio, which currently includes docu-series, multiple mini-series, podcasts, a round table webcast, and features also documentary films, which are all in production. Her own experiences living with the rare neurological disorders of MdDS and Vestibular Migraine have empowered Kimberly to take a larger advocacy role within the chronic illness community where she writes and speaks about her own patient experience. When she isn't nurturing the many facets of unfixed media, she works a small, sustainable homestead with her husband, David in rural Oregon. She lives a life in full motion and I mean that in every sense of the word, but I'll save that for her to share. If you would like more information or to reach out to Kimberly please find her links: Website UnFixed Media Productions , Dylan Shanahan's Memoir, UnFixed Film Website, Instagram If you would like to reach out to me, Heather Davies, please find me: Instagram, Private Facebook Group email: Menieresmuse@gmail.com Or leave me a voice mail here - I love hearing from you! If you would like more information on vestibular disorders, please go to the Vestibular Disorder's Association website. Right around the corner is also VeDAs Steps 2 Balance, May 21 where we will be spreading awareness about vestibular disorders, and encouraging our fellow vesties to get out and take Steps 2 Balances – whatever that means for you. Walking, swimming, bowling (like our fellow VeDA Ambassador David G. just did last night), or anything you're comfortable doing to take one more step toward balance and to spread awareness about vestibular disorders to those that have ever heard of these disorders. If you enjoy this podcast PLEASE do me a favor and RATE, REVIEW and share. Thank you for being here, see you next week warriors
Stacey & Brian climb back in front of the mics for a wavy episode. Topics range from Stacey's battle with Mal De Debarquement Syndrome, choosing a single song to be played during intimacy for the rest of eternity, looking deeply into each others eyes. Musical Guests : A-Ha , Lewis Capaldi & Lady GaGa
Let's really jump into some deep stuff, including the electrical activity in our brains and endless mattress ads. One of those things is far less significant, but this episode jumps around a bit, y'hear. It also jumps into the original human leadership skills, Carl Sagan's wisdom, Triangle of Sadness, Artificial Intelligence replacing all of our jobs, dealing with MDDS and benzos. Lots of benzo talk to be honest. So, take a breathe, stream away, and settle into a moment of pure delight. Not a bad plan! You are loved, you are safe, you are valued. Logo art by Brandon Lai Music by Micah Julius Calmness prescribed by Dr. Nandipati (twice a day)
Kimberly shares so much of herself in this conversation. After spending a couple of hours with her, I understood so much more about her soulful passion for not only sharing stories of those with chronic illness and rare conditions but really seeing them, loving them, and sharing how adversity can broaden our definition of what it means to live a “good life”. She shares these stories through UnFixed Media Productions which she founded in 2019. To understand her passion you must watch anything from UnFixed Media's portfolio, which currently includes docu-series, multiple mini-series, podcasts, a round table webcast, and features also documentary films, which are all in production. Her own experiences living with the rare neurological disorders of MdDS and Vestibular Migraine have empowered Kimberly to take a larger advocacy role within the chronic illness community where she writes and speaks about her own patient experience. When she isn't nurturing the many facets of unfixed media, she works a small, sustainable homestead with her husband, David in rural Oregon. She lives a life in full motion and I mean that in every sense of the word, but I'll save that for her to share. Please welcome my friend and fellow VeDA Ambassador, Kimberly. If you would like more information or to reach out to Kimberly please find her links: Website UnFixed Media Productions , Dylan Shanahan's Memoir, UnFixed Film Website, Instagram If you would like to reach out to me, Heather Davies, please find me: Instagram, Private Facebook Group or email: Menieresmuse@gmail.com If you would like more information on vestibular disorders, please go to the Vestibular Disorder's Association website. Right around the corner is also VeDas Steps 2 Balance, May 21 where we will be spreading awareness about vestibular disorders, and encouraging our fellow vesties to get out and take Steps 2 Balances – whatever that means for you. Walking, swimming, bowling (like our fellow VeDA Ambassador David G. just did last night), or anything you're comfortable doing to take one more step toward balance and to spread awareness about vestibular disorders to those that have ever heard of these disorders. If you enjoy this podcast PLEASE do me a favor and RATE, REVIEW and share. Please rate, review and share! Thank you for being here, see you next week warriors
Seeking Balance: Neuroplasticity, Brain Health and Wellbeing
Joey Remenyi talks with Ryan from the US about his recovery of MdDS and PPPD with the ROCK STEADY Program. We discuss the many RS tools and the supportive container of the RS community, with self-study being a vital part of healing--something that no drug or therapist can provide.
Seeking Balance: Neuroplasticity, Brain Health and Wellbeing
Joey Remenyi talks with Pat from USA about healing MdDS and VM with the ROCK STEADY program. Pat talks about getting to the bottom of underlying fear and learning to cultivate a true sense of safety in her body. Pat has noticed that not only have her symptoms eased but she can also handle challenges in the outer world with more control and calm.
Yannis prend l'avion pour le Japon avec son frère pour se rendre à la coupe du monde de rugby en 2019 et depuis « il n'a jamais atterri ». À ce stade, vous avez déjà identifié un point commun entre Yannis et moi : le syndrome du mal de débarquement. Si moi je suis restée en pleine mer, Yannis lui vit encore dans les airs… Mouvements internes, sensation de plénitude, incapacité à réfléchir… Yannis voyage avec de nombreux symptômes, particulierement présents en deuxième partie de journée. « Emprisonné dans son corps », Yannis démarre un traitement pour supporter la déprime que génèrent ces manifestations corporelles. Lorsqu'il arrête brutalement la prise de médicament, Yannis plonge dans une période d'extrêmes angoisses, d'insomnies et de déréalisations… Au point qu'il finit par oublier les fondements de sa personne. Suite à cette chute vertigineuse, Yannis développe un sentiment peu apprivoisé dans sa vie avant la maladie : l'empathie. Poussé par ce sentiment nouveau et sa toute nouvelle soif de connaissances en neuroscience, Yannis décide de s'engager ! Il crée l'AdEV (Association des désordres vestibulaires), la toute première association francophone pour patients et patientes vestibulaires ! Un soulagement non-dissimulé dans notre communauté pour qui les informations de qualité en anglais étaient pour nombre d'entre nous inaccessibles. Créer de la ressources pour les personnes vivant avec ces pathologies passées sous silence, défendre les malades, faire le lien entre eux, la médecine et la recherche, sont les objectifs principaux de Yannis. Consultant en informatique, Yannis a été projeté par la maladie dans de nouveaux rôles : président d'association et étudiant en neuroscience… Il est une ressource importante pour nous, patients et patientes vestibulaire et je suis en joie de vous le présenter !
This week I'm honored to have mother, survivor, content creator, dancer, voice for the voiceless, and literal walking miracle - Rachelle aka: Tiny Dancer and Beautifully Unbroken, back on the show for a continuation of the conversation we had about her upbringing and how she was able to find redemption amongst all the trauma and pain she faced in a generational abuse family cycle. If you missed Rachelle's first interview - you should absolutely go back and listen to it before or after this interview - I'll have it linked below! Rachelle's story is incredibly inspirational - to give some context to what we talked about in the first interview, we began her story talking about a rare medical condition she discovered she had called MDDS that reared it's ugly head on the last day of a cruise she took - shaking her world up and turning it upside down. Suddenly, she went from being a high-functioning mother, dancer, nurse, and wife to having an identity crisis while dealing with a debilitating condition that has very little research and discovery around the cause and so far, there is no cure. Having known her childhood wasn't ‘normal' through some memories she had remembered throughout her life, she began having a breakthrough of memory recall in the months and years after being diagnosed with MDDS that helped her begin to piece together more pieces of the mystery of her life. Her discoveries included familial sexual abuse, generational freemasonry, satanic ritual abuse, DID, and all the tell-tale signs of being born into an occult family. Rachelle is still putting together the pieces and discovering memories, but there are certainly some strange parallels between trauma, MDDS, and many of the events that have happened in Rachelle's life. Today, Rachelle will be elaborating on her story and talking about her teenage and later years and the memories she's remembered and recalled that outline and detail that part of her life as well as go deeper into the discoveries she's made through her online MDDS community and her own research. When I say this girl is going to change the world - I couldn't be more serious.Rachelle's story has deeply impacted me and I hope you pay attention and garner as much inspiration as I have from her. She's truly an embodiment of living the word of Jesus and a powerful example of what's possible on the other side of healing. From beautifully broken to beautifully whole, I am so thrilled to have back on the show this week - woman of God, child abuse advocate, artist, and my dear, dear friend - Rachelle!CONNECT WITH RACHELLE: Twitter: @beautifullybroken - (2) Beautifully Broken (@Beautif04333051) / TwitterYouTube: Beautifully Broken - YouTubeEmail: rachelleandkidz@yahoo.comVIDEO REFERENCED BY RACHELLE:My “receipt” of testimony. God saved me - YouTubeCONNECT WITH THE IMAGINATION:All links: Emma Pietrzak on Direct.meWebsite:Stand By Survivors - Everyone Has A Story...SXS Merch: https://my-store-c980d5.creator-spring.comSurvivor Store: Survivor Store (standbysurvivors.com) Support the show
What is software as a medical device (SaMD)? How does one test SaMD? What testing is required? What are the risks related to your SaMD and its testing? In this episode of the Global Medical Device Podcast, Etienne Nichols talks to Rahul Kallampunathil, Vice President of Arbour Group's Digital Compliance practice, about digitizing your SaMD testing.Rahul builds teams that help companies proactively manage compliance risks toward a true digital enterprise. He is an innovative thinker with more than 18 years of experience in risk management, compliance, and internal controls focused on information technology and data. Some of the highlights of this episode include:Rahul defines SaMD as software used to perform a medical purpose without being part of a hardware medical device. SaMD is capable of running on any general purpose platform, such as your Android or iOS mobile phone.SaMD is different from software in a medical device (SiMD). SaMD is independent from hardware; SiMD is embedded in a physical medical device.Also, there's differences between SaMD and medical device data systems (MDDS). MDDS only transfers, stores, or displays medical device data, but it does not have an algorithm or business rule to help make medical decisions.IEC 62304 impacts SaMD organizations and how they approach the risk of their solution. All SaMDs are not equal, and it's important to understand the level of risk in every SaMD.Companies should prepare for SaMD testing with a clinical evaluation to demonstrate a valid clinical association between SaMD's output and targeted clinical condition.Before thinking about designing and developing a product, a quality management system (QMS) should be established. Software companies need to adopt and modify their QMS to serve their product and its users, while fulfilling FDA requirements.Rahul discusses the pros and cons of manual versus automated/electronic documentation and testing, including risk management for patient safety.Best practices for SaMD testing are using agile and devops methodologies. Potential pitfalls are not testing continuously, even after the product is on the market. Memorable quotes from Rahul Kallampunathil:“Software as a medical device - it is software that is intended to be used for a medical purpose, and it performs that purpose without being part of a hardware medical device.”“There is no physical device, in this case, that you can touch and feel. It's purely software.”“The nature of software - it's something that you cannot touch or see. It's all code. From a testing perspective, especially, there's a lot of things that you need to pay attention to.” “The quality management system or quality management process, that has to be established even before you think about the product, even before you design the product.”Links:Rahul Kallampunathil on LinkedInEtienne Nichols on LinkedInArbour Group LLCFDA - SaMDFDA - Medical Device Data Systems (MDDS)FDA - CybersecurityIEC 62304International Medical Device Regulators Forum (IMDRF)Greenlight Guru YouTube ChannelGreenlight Guru CommunityGreenlight Guru AcademyMedTech NationGreenlight Guru
This week's episode is going to be extremely special - joining us today is a beautiful soul I met on Twitter recently who showed up in my life named Rachelle who goes by the handle, “Beautifully Broken”. Every week we do our Sunday YouTube premieres, Rachelle has continued to show up in the chat and I immediately noticed the compassion, attentiveness, and curiosity she had for absorbing all the information from the survivors was unparalleled. Having visited her YouTube page, I discovered that Rachelle is a survivor and victim of a rare and chronic medical condition called MDDS which currently has very limited treatment options and research to even begin to understand the underlying root cause of this debilitating condition. What I did not know was that there was a part of Rachelle's story not publicly broadcasted on her YouTube channel. Something even darker and more sinister than this horrific condition that literally threw her overboard and disrupted her entire life: What I learned about Rachelle in a gradual sequence of her opening up week after week… is that she is also a survivor of horrific abuse...When I realized this, my heart dropped - and even though she wasn't yet speaking out publicly about her story, I told her when she was ready that she'd have a safe space here on The Imagination to share, educate, and inspire all of you who are listening to her tremendous story as we speak. The thing that made me fall in love with Rachelle is that she has been through hell in every way, form, and fashion - and yet she shows up with more love, compassion and the spirit of God in her heart than just about anyone else I've ever met. I'd have never in a million years imagined what she's went through. The question I kept asking myself is, “How can someone like Rachelle grow into such a loving person after all she's went through when most people fall apart at the slightest inconvenience and take it out on everyone they know?” And the answer God whispered in my ear is that it's not for me to question - it's for me to learn. And that is exactly what I plan on doing. We ALL can learn how to embrace God's word through our actions and how we show up - and survivors like Rachelle are going to lead the way for us to leave this world better than we found it. Rachelle is brand new to telling her story publicly and I ask that you put away whatever you're doing and give Rachelle your upmost attention and respect. You may even want to take notes - you are going to learn so much and be blown away by what you're about to hear. Without further ado - I am honored to introduce - mother, wife, survivor, woman of God, child of God, voice for the voiceless, child abuse activist, and inspirational overcomer - Rachelle also known as ‘Tiny Dancer'! Thank you for being here Rachelle!CONNECT WITH RACHELLE: Twitter: @tinydancertruth - (1) Tinydancertruther (@Tinydancertruth) / TwitterYouTube: Beautifully Broken - YouTubeEmail: rachelleandkidz@yahoo.comCONNECT WITH THE IMAGINATION:All links: Emma Pietrzak on Direct.meWebsite:Stand By Survivors - Everyone Has A Story...SXS Merch: https://my-store-c980d5.creator-spring.comSurvivor Store: Survivor Store (standbysurvivors.com) Support the show
Seeking Balance: Neuroplasticity, Brain Health and Wellbeing
Joey Remenyi from Seeking Balance International talks with Maya from Canada about her healing process from multiple diagnoses (BPPV, PPPD, VM, MdDS, Labyrinthitis). Maya took her power back, reclaimed her healing after years of nothing working and now wakes each morning feeling joy. Learn about the Rock Steady program here: https://www.seekingbalance.com.au/rocksteady/
This is a very special episode of the Precarious Podcast. I feel like I met my soulmate in all things uncertain and precarious. Her name is Kimberly Warner. She is a filmmaker. In 2015 she developed cervicogenic vertigo and Mal de Débarquement Syndrome or MdDS that manifests as a constant perception of rocking, bobbing and swaying. After searching for treatments/cures and coming up empty, she had to accept her reality. She turned to her craft of filmmaking as a way to connect with others who are in the community of the "Unfixed".These are the stories of humans who are saying “yes” - the ones who believe their worth lives in the nexus of pain, uncertainty, gratitude and purpose. Through exploring these stories I hope to uncover insights and universal truths that can encourage us all to live more fully and radically Unfixed.
Josh's MDDS journey continues into a wobbly world of danger, a perfect time to start discussing the remote controls of parents, humans evolving beyond mistakes, CNN, Fox News, Lo Coco's Pizza, Bob Saget, prescription meds, scary side effects, and Bieber. Yep, just a little Bieber. So take a breath and lock into a new episode of Here We Go with Jerrrrrsh. Drop a nice rating on iTunes and enjoy the good life. On Twitter sometimes @jrosenberg 957. Logo art by Brandon Lai Music by Micah Julius Joy by viewing pink sunsets.
Let's kick off 2022 with a hot combination of insight and nonsense. Roll those into one big fat sheet and jump in for some talk about traveling to Minnesota, Sun Country's misery, experiencing the rare motion disorder called MDDS, Viktor Frankl's wisdom on humor, tapping techniques for mental health, Enya's absurd sounds, Donna Lewis's beautiful sounds, fevers, and Ohhhhhmicron. Stream it, guilt-free, then repeat until the residue comes off. On Twitter kinda @jrosenberg957. Logo art by Brandon Lai Music by Micah Julius Sweatpants addiction by simply living in a winter wonderlandemic
Pour ce 7ème épisode les rôles ont été inversés ! Cette fois-ci c'est à moi que l'on pose les questions. Sous l'impulsion d'Alison, formatrice à l'IFSO de Rennes, 28 élèves aide-soignant.es en apprentissage ont souhaité me questionner sur la maladie avec laquelle je navigue depuis 1 an et demi. Au travers de mon expérience personnelle, cet échange a pour moteur, la sensibilisation du corps médical et paramédical aux pathologies chroniques et invisibles. Dans cet épisode vous trouverez mes réponses à de nombreuses questions telles que : - Comment conciliez-vous la maladie et la vie quotidienne ? - Est-ce que votre représentation du monde à changé depuis que vous vivez avec ce syndrome ? - Qu'attendez-vous des personnes qui vous entourent : famille et soignant.es? - Comment vivez-vous votre maladie dans votre rapport aux autres ? - Comment votre conjoint vit-il cela ? Je vous laisse découvrir les dizaines d'autres questions et réponses au travers de cet épisode ! Et c'est de tout que je remercie Alison et les 28 élèves qui ont porté leur attention bienveillante à mon vécu !
Many of us wear wireless, battery-powered medical sensors on our wrists in the form of our smartwatches or fitness trackers. But someday soon, similar sensors may be woven into our very clothing. Harry's guest this week, Nanowear CEO Venk Varadan, explains that his company's microscopic nanosensors, when embedded in fabric and worn against the skin, can pick up electrical changes that reveal heart rate, heart rhythms, respiration rate, and physical activity and relay the information to doctors in real time. And that kind of technology could move us one step closer to a world where we're far more intimately connected to the medical system and doctors can catch health problems before they turn into disasters.Nanowear's leading product is a sash called SimpleSense that fits over the shoulder and around the torso. Last month the company won FDA approval for the software package that goes with the SimpleSense sash and turns it into a diagnostic and predictive device. It's currently being tested in a network of clinics as a way to monitor and manage congestive heart failure.Varadan trained in biochemistry at Duke, earned an MBA at Columbia, and spent about a decade in pharmaceutical sales and marketing and technology investment banking before co-founding Brooklyn, NY-based Nanowear in 2014. His father Vijay Varadan, MD, PhD, now an emeritus professor in the Department of Engineering Science and Mechanics at Penn State, is the other co-founder and the company's chief innovation officer. "Nanowear's technology was actually the culmination of his life's work," Venk says.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 advocateswho are transforming the healthcare system and working to push it in positive directions.Everyone's used to the idea that if they're being treated in a hospital, they'll probably get wired up to sensors that track their heart rate or respiration rate or blood oxygen level.We've talked on the show before about a new generation of portable medical sensors for everyday life, like continuous glucose monitors for people with diabetes.And some people even wear medical sensors on their wrists in the form of their Fitbit or Apple Watch. Some of these devices can go beyond fitness monitoring to alert wearers to problems like cardiac arrhythmia.But what if medical sensors were woven into your very clothing? My guest this week is Venk Varadan, and he's the CEO and co-founder of a company called Nanowear that's taken a big step in that direction. Nanowear has developed a way to put microscopic nanosensors inside clothes .If that cloth is worn against the skin, it can pick up electrical changes that reveal heart rate, heart rhythms, respiration rate, and physical activity and relay the information to doctors in real time. Nanowear's leading product is a sash called SimpleSense that fits over the shoulder and around the torso. And last month the company won FDA approval for the software package that goes with the SimpleSense sash and turns it into a diagnostic and predictive device.But Varadan says that in the future the nanosensors and the software could be put into even more places, like headbands, conventional clothing, or bed sheets. That's just one example of the explosion in mobile health technology that's putting more power into the hands of patients. And it's also one of the topics in my book The Future You, which is available now in Kindle ebook format. You can get your copy by going to Amazon.com and searching for "The Future You," by Harry Glorikian. The book grows partly out of conversations like the ones I have here on the podcast with medical researchers and entrepreneurs. But it goes even deeper into the impact of wearable sensors, AI, and so many other technologies that have the potential to help us live longer, healthier lives. So I hope you'll check it out.And now on to my conversation with Venk Varadan.Harry Glorikian: Venk, welcome to the show.Venk Varadan: Thank you, Harry.Harry Glorikian: So, look, we all know that with with technology startups, there's always this sort of chicken and the egg question what what came first in the mind of the inventors: the market need or the product that needs to address it. You know, ideally they come together simultaneously and there's a back and forth dialogue between founders and potential customers. And you end up with what the startup community calls--what is it?--product-market fit, if I talk to my, you know, my Silicon Valley nephew of mine. So in the case of Nanowear, you know, did you start to think about the problem and how to solve it? Or did you start out with the technology? Which in your case involves a way to embed these tiny nano-pillar sensors into cloth and then look at ways to make it sellable. So which one was it for you?Venk Varadan: Great question, Harry, and again, thanks for having me on the podcast. We were squarely the latter and I think most entrepreneurs are the former. But we had this great advanced material, a cloth based nanotechnology that could pick up really, really high fidelity clinical grade biomarker data off the body. And we didn't really know what to do with it. Do we start as a consumer company? Work on fitness, B2B, sports? Do we think about industrial safety, military use cases? They've been trying to figure out smart textiles forever. Or do we go into health care? And I think stubbornly so, and a little bit of altruism, we chose the harder route, which was health care. But I think it was probably more premised on that we believed in the quality of the sensor. It was doing something from a quality and quantity standpoint that no other on body sensor or non-invasive sensor out there could do, whether it was consumer grade off the shelf or health care based electrodes. So all we really knew when we started is that we wanted to be a health care company, but we didn't know the right application to start with.Harry Glorikian: Yeah, I was going to say, let's, let's pick the hardest one and see if we can get over that hill. So let's back up here and talk about like the medical need you're trying to address. I mean, at a high level, why is portable diagnostic sensing so important for people's health?Venk Varadan: I think it was always important because of an access issue, right? Not everybody can go see a physician or can do high cost diagnostic tests that require a facility or diagnostic tools in person. And there's a cost even to running a blood pressure cuff or checking your heart with a stethoscope or running a hemodynamic monitor, all the way up to more expensive tests like sleep studies and sleep labs. So I think it started, remote diagnostic needs started with an access issue, and it's not like we haven't had telemedicine in the past. But even that was sort of limited due to access issues. You needed a broadband network, you needed particular devices, you needed smartphones, and there were a lot of industry, I guess, pressures holding this sort of need to sort of push health care out into the more wide stream for those that have access issues. And we all said that this was going to happen one day. Virtual care, telemedicine, remote monitoring at home, replacing offices at home. And it was a nice sound bite. And COVID kind of forced the issue and I think completely accelerated that 10 year frame on the need, right? Because folks were still sick. Folks still have chronic disease. Folks still needed acute procedures. But you weren't really able to do a lot before, during and after, if you had to have these people camped out in the hospital or in outpatient clinics or acute surgical centers. So that's when while everybody thought it was cool and one day I'll employ these digital technologies, it really took COVID to shut their business down or they didn't have any patients, to force them to adopt. So I think a lot of our, companies like us, we were all doing the right thing. And we also are the first to admit that we got fortunate that the pandemic sort of accelerated the need for our solutions.Harry Glorikian: Yeah, I mean, I remember I put together, god, it's got to be like 15 plus years ago, I put together a distributed diagnostics conference, because I was like, "This is going to happen." And, well, OK, eventually. But so let's talk about, let's step back for a minute and talk about some of the specific medical conditions where continuous, high resolution, high fidelity data is useful. Like, I know we need to probably start with congestive heart failure.Venk Varadan: Yes, so that's where we actually started before COVID. That was the sort of market need where our technology, our ability to sort of simultaneously and synchronously look at biomarkers from the heart, from the lungs, the upper vascular system in a sort of contiguous way and sort of map the trends over the same period of time as you would with a stethoscope or blood pressure cuff and electrocardiogram or hemodynamic monitor if they were all in one platform. That's really what we're replacing as part of our solution and our device-enabled platform. But the economics of heart failure and the business need were really what was pulling us there in the sense that there were penalties from CMS to avoid that next hospitalization within 30 days. And many of these patients are, one in four are being readmitted within 30 days. One in two are readmitted within six months. So this isn't a problem that we can just medicate our way out of. We have to understand when decompensation of the heart is happening before symptoms show up, because once symptom show up in fluids accumulating in their lungs, it's already too late. So I think there was a good product need for us, as well as the economic need with reimbursement and solutions for something that can be done outside the body that a patient could be be using at home.Venk Varadan: And then I think, you know, COVID hit and the market applications really just exploded beyond heart failure. Heart failure is still on our roadmap. Our clinical study to prove that ALERT algorithm of, we take all these data points, send it into the cloud, do a risk based predictive algorithm to predict worsening heart failure or decompensated heart failure weeks before fluid accumulates in the lungs. That's still firmly on our roadmap. We've just got to restart the study that was halted due to COVID. But the same product that does the same parameters with a different sort of algorithmic use cases opened up a lot of other applications that now have a business need and economic need to use us. So the two that we're starting with is pos-procedural or post-surgical follow up in an acute use case setting. And the second is outpatient cardiology longitudinal care for someone who unfortunately probably has to see a cardiologist for the rest of their life.Harry Glorikian: And if I'm not mistaken, congratulations are in order because of an FDA approval.Venk Varadan: Yes, so we actually got our third 510K just two days ago. September 21st, sorry, September 22nd, we got our third 510K. This is actually an example of our of our first digital-only clearance. So our first two clearances, our first clearance in 2016 was primarily around the advanced material, the nanotechnology, to get FDA comfortable in its safety and efficacy profile. The second was for our product, which is the SimpleSense shoulder sash, which simultaneously and synchronously captures data across the heart, lung and upper vascular system biomarkers, feeds that data through a mobile application and into the cloud. And then this clearance is sort of for an end-to-end digital infrastructure that circularly includes ingestion of our 85 biomarkers and then analytics circularly across our spectrum that continues to sort of process and then has the ability to push insights or algorithmic alerts down. So that last part is not included. But if you think about it, Harry, we kind of had a strategy before we got to the AI part. Now everything we submit with FDA has nothing to do with the device, has nothing to do with software infrastructure, has nothing to do with what would be MDDS or what wouldn't be. We can simply send in statistical analysis on the AI algorithms based on the inputs that we've already cleared and then looking retroactively on the outcomes. So it was it's a nice win for us to kind of show that we're not a device company, we're a device-enabled platform. But I think what it's really exciting the market on is that we're ready for AI diagnostics. We hope to have a first one and our fourth 510K, I guess here with FDA pretty soon in the complex chronic disease state. So really exciting times for us.Harry Glorikian: Yeah. And I mean, as an investor, I mean, I, you know, I've been in diagnostics forever and I, you know, I'm so focused on Where's the data? Show me the exponential nature of the data and then what we can do with it and really like blow that up, right? That's where I see the value in these platforms and technologies. But there are technically other methods that had been used, right, that you might say you might or might not say are competitive in some way. But one of them is called a Holter monitor, right? Which people put on their skin to monitor, you know, electrocardiogram and EKG rhythms outside the hospital. And I don't want to say the name wrong, but I think it's SimpleECG for yours and then the SimpleSense vest, [how does it] compare to that. What are the alternatives? How long do you wear it and how do you compare it to the existing status quo?Venk Varadan: Sure. So, you know, a Holter monitor has a specific use case. It's looking at your electrocardiogram rhythm to see if you have a rhythm or abnormality, right? So we one of the metrics we capture is an electrocardiograph, right, and we do multiple channels of that. So it's not a single lead. So we could certainly compete against that application and just look at rhythm abnormalities in the same way. Companies like iRhythm have that, and Apple Watch has that 30 second feature on it. We are not playing in that space. And the difference between us, even though our signal quality, we would argue, is much cleaner than a Holter monitor that's using standard electrocardiographs, with those you have to shave your chest, you have to stand the dead skin down. You have to put gel on for the electrode to get a conductive signal. We don't have to do any of that because of the nanotechnology. But what the nanotechnology also affords, in addition to a better experience and better quality, is the ability to do more than just a Holter monitor, right? So imagine if that same Holter monitor wasn't just looking at rhythm abnormalities, it was also looking at the acoustics of your heart and your lungs, the sounds of your heart in your lungs. It was looking at the flow characteristics. The blood injection times, the fluid accumulation in your lungs. It was looking at your breathing rate, your breath per minute, your lung capacity, your changes in lung capacity over time, if it was looking at your pressure related issues at the aorta, systolic and diastolic blood pressure. In addition to being a better experience in all of these and sort of kind of replacing a Holter monitor and a stethoscope and what have you, the real value is being able to do all of that at the same period of time over the same period of time. So even if I'm monitoring for, our use cases are about 30 minutes to an hour in the morning, 30 minutes or at night. And because we're getting such dense quality and quantity of data over that time period, we can actually see trends across the cardiopulmonary and upper vascular complex, which is actually the first company and platform that can do that. And that may not have been important before COVID. But COVID, I think, was revelatory in the sense that COVID may have started as a respiratory disease, but it affects the heart. It affects the upper vascular system. You can get a DVT from it. And I think it opened the world's eyes into understanding. We're not looking at all of these systems, the heart-lungs-upper-vascular system that all work together and work uniquely in each of our own bodies. We're only getting a risk based signature on just cardiac rhythm or just breaths per minute or just the sound murmurs of your heart, whereas we're doing it now.Harry Glorikian: Yeah. So for a guy like me, like, I'm like, Oh my god, how do I get one of these? I want one of these right now. I'm thinking like, Oh, I could use it right after I work out. And I'm, you know, forget the I'm sick part of it. I want to use it as a wellness monitoring and sort of to see, get a baseline. Tell me where I'm going, right, over time. That's what I'm always discussing with my my physician is we need a baseline because I don't know how it's going to change over time. If I only look at it at that point in the future, I don't know what it was. So, but the other side, I think to myself, there are physicians listening to this show that are probably all excited about this. And there are physicians going, "That's a lot of different data points. How in the hell am I going to make sense of that?" And so I'm I'm assuming what you're going to tell me is you've got this amazing software that lets you visualize, you know, and make sense of all these different parameters together.Venk Varadan: And that's exactly right. You know, we were actually stubbornly annoying to our KOLs, our clinical teams, as well as our original customers in beta rollouts, because Harry, we agreed with you. We looked at where Gen 1 and Gen 2 sort of digital health companies struggled in health care. Health and wellness is a little bit different right? I mean, to each their own, right. I mean, if you market well, you'll find that pocket of people that want to be overwhelmed with data or what have you. But we really listened to what digital health was doing for the provider and patient relationship. There were some good things there and there were other bad things, and the bad things we realized actually wasn't monolithic between clinics. Some people thought that bad things were "I'm alerted too often." Others wanted to be alerted all the time. Some were like, "This is noisy data. It's too unclean." Others were saying, "I just need, you know, 70 percent C-minus level data," right? And then we were thinking about all of those aspects which we couldn't get consensus on. How do you bring all of those aspects that gives control to the provider so the provider can say, how often are they alerted, how much data and the raw signals do I want to look at, how much do I not want to look at? And really, with the thesis of building the platform on them, spending less time than what they do before? Because I think Gen 1 and Gen 2 products unfortunately actually added more time in adjudication and frequency of the provider being notified, and also cause some anxiety for patients as well because they were looking at their screen and their data at all times.Venk Varadan: So we really tried to be sponges of all of those different devices that were tech enabled and sort of moving from hundred-year-old devices to now Gen 1, Gen 2, pushing into the cloud. And really listened on... And I'll tell you, it was mostly from staff. It wasn't necessarily from the physicians and the surgeons themselves. It was mostly from triage nurse, from health care staff, the people that are running around coordinating the follow up visits, coordinating the phone calls from patients that were doing poorly or feeling bad after feeling sick after a procedure. And I just think we just kept our ears open and didn't go in saying, we know what you need. We were asking, What do you?Harry Glorikian: All right, so let's talk about the technology itself, the SimpleSense wearable sash. How does the cloth sensor in the garment work? I mean, on a microscopic level, what are the kind of changes that this nano pillar detects and how?Venk Varadan: Yeah, so not to get to sort of, you know, granular into the physics, although I'm happy to Harry, if you if your audience ends up sending me some questions. But think about our ability to just detect a difference in potential action potential from point A to point B. And it's an oversimplified way of describing what we do, but the reason we can do it better than anybody else with any other sensor -- and that's what really feeds the cleanliness and the quality of our data and allows us to derive so many biomarkers that other others can't, which obviously feeds the ability for AI -- is because we've got these billions of vertically standing nano sensors per centimeter of surface area. The differential or the potential difference that we can find because our signal quality so clean is so narrow. Whereas other sensors that might be treated as noise, we can consistently see deltas from point A to point B and know exactly what caused those deltas, right? And that's unique to us and our vector orientation. And it's probably a little too wonky here, but if you have a vector across the largest slice of the heart, across the largest slice of the lungs, across the upper vascular system in its entirety, with that finite ability to get really microscopic level changes in potential, irrespective of what signal you're looking at. Because once you we know what signal we're looking for, we just set the frequency bands for those, right? Right. And that's really, in a nutshell, how it works across the multiple parameters that we can capture from a biomarker standpoint.Harry Glorikian: So you said 85 biomarkers, right? We're not going to go through all of them because we'll be at the end of the show. But what are the kinds of, let's say, physiological data that you're pulling in and that you're differentiating on?Venk Varadan: Sure. So I probably summarize it into several different buckets that each have maybe 20 or 30 derivatives under it. But, you know, cardiopulmonary biomarkers. So the coupling between the cardio and pulmonary complexes, impedance cardiography, thoracic impedance and then looking at not only the means and the median trends across those metrics, but the standard deviation. So one of our board members famously said, Nadim Yared, the CEO of CVRx, You will learn so much more from the standard deviations than you will from the trends. Don't just look at the sort of the trend. So that's an example. Cardiopulmonary: We look at the electrical signals of the cardio complex and electrocardiographs. We look at a combinatorial methodology of cardiographs, acoustics, BMI, height and weight. And then we tie activity, posture, movement. What is your sleep orientation? Are you sleeping on your left side? Are you sleeping on your right side? All of these sort of things together actually enable some really interesting insights from a machine learning standpoint. And again, the beauty of our ability to sort of understand them and see more biomarkers. Eighty-five is where what we know right now, what we've validated. There's probably a lot more that we will discover under certain disease states. But what we're able to sort of mesh together from all of those are really cool aspects like blood ejection times. That's not a physical, raw metric we're getting. That's a derived metric and combining a lot of these aspects cardiac output, stroke volume, you know, these are things that could only have previously been done with an arterial line in your body and in a hospital system. So I don't know if that answers your question.Harry Glorikian: Well, no. I mean, listen, I mean, this is why I invest in this space because, you know, theoretically, as I get older, I may be a patient and you know, the better these technologies get, the better off I'm going to be. But so let's talk about for a second, where did where did this originate from? And I think your dad, your father had something to do with this, if my research is correct.Venk Varadan: He sure did. This may be a little bit of a long winded answer, Harry. But but for your audience, I'll tell the story because it's important for dad to be happy at all times, even though I'm 40 years old. So, Dr. Vijay Vardhan is our co-founder and Chief Innovation Officer. My father, 40 plus year academic researcher in the fields of materials, research and biomedical engineering and this was actually, Nanowear's core technology was actually a culmination of his life's work. Back in the 80s and the 90s when I was still a young pup and he was convincing me to go be a doctor, he was doing research in this field, and it wasn't even called nanotechnology back then. There wasn't a term for it, but he was doing defense related projects in the ability to detect very minute signals at very, very, very, very difficult detect detection environment. So an example is submarine coating, right? Submarines when they're below water are picking up their external environment information through sonar. The deeper they get in the ocean, the harder that sonar frequency is to be able to differentiate. Is that a a school of plankton? Is that a whale? Is that a thermal geyser that's sending me the signal? Or is it a Russian sub, right? And his thesis was, if I have a really big footprint of sensors and exponentially higher surface area of sensors and not just one sensor or two or one hundred but billions across the hull, I can start to differentiate over time the nuanced differences between the sonar a whale emits, the sonar a thermal geyser emits, or oh, by the way, what are our friends in the USSR emitting, right? And that's an example in really, really hard to detect environments. He did the same with observatory jets and missile defense systems at 75,000 feet, you know, the opposite, very high frequencies at very high speeds. So that original thesis, the human body is also a very complex environment and hard to detect environment as well, right? So long story short, he kind of took that same thesis over many years of playing around in the lab and publishing papers and doing great work for our government and our Department of Defense, but also with an eye to the future on what could this do in the human body one day?Harry Glorikian: Right. Well, that's great. I mean, it's I'm sure he's very happy that you two are working together to bring this to market.Venk Varadan: He's not as disappointed in me about not going to med school anymore. Let's put it that way.Harry Glorikian: Yeah. Keeping parents happy is is a is a difficult thing. I know many people are like, Are you going to be a doctor or are you going to be a lawyer? You know, I know the I know the joke. So you've got FDA approval for a number of, as you said, you're building on top of, this layering that you've been doing from an FDA approval standpoint. What did it take to get them to sign off? What sort of evidence did they need to see?Venk Varadan: Yeah, it's a great question. I think that we kind of had to create our own playbook with them. I'm sure if they're listening, they don't want to hear this because you're not supposed to sort of commend and compliment the agency. They're just supposed to be there as sort of the gatekeepers. But we used to hear just a lot of horror stories like, "Oh man, you know, working with the agency, it's really tough. You know, they're really tough on this." I mean, we always looked at them as our partners, you know, we were bringing a novel technology to the world. We chose to go into a regulated environment because we believed in the promise of saving patients. We were not taking a sort of anti-regulation attitude that I can fix this, government get out of my way. I'm a patient first. I like living in a country with FDA where something is scrutinized that I have to take when I'm sick. And I think that attitude and going into it from us as a product and R&D team, first of all, helped in clarifying our understanding of FDA's processes because it's a lot, and you really need to dig through the guidance in that. But I would say this is really hats off, Harry, to our founding engineers. I mean, they went from being engineers to really understanding process, and that's really what FDA is. Our first clients we met with, we went down to Washington 11 times in person to demo to ask questions continuously. And "Hey, we read this part of the guidance. Does this make sense for us?" And we shut up and listened when we didn't agree with them. We said, "But what do you think about this? Doesn't this solve it?" We weren't trying to go around them, and so we were trying to develop sort of new understandings of it.Venk Varadan: And I think collaboratively we put together a good playbook with FDA to clear a material that they had never seen before. Right? It would be one thing if we use the standard electrode like all Holter monitors do and combined it with something, and did different things on the software side. That would be somewhat straightforward because they know the data that's being generated is often the standard electrode. But for us, we had to do a lot of different and in many cases, much more rigorous testing, which that was painful. Don't get me wrong, but totally worth it, right? I mean, our sort of boundaries and our understanding of what FDA put us through, it turned out to be a boon in disguise. I mean, our whole team can sort of run through the needs now of FDA and we feel very experienced and very well equipped on how they think. And now that they're comfortable with the sort of data we capture, all the great things we can do on the AI side, which is still scary to a lot of people. You just say I've got a black box and I'm combing electronic medical records, and here's what the unsupervised learning tells me. I was a regulator. I'd be like, Wow, I'm not touching that with a 10-foot pole, you know? So it's different with us, right? I mean, we can define everything that's coming in and we can define the outputs. Yes, the AI in the middle is the magic, but we're not sort of defining everything until the outcomes, right, which is where I see a lot of companies got into trouble. So I think it was worth it with the FDA.Harry Glorikian: Well it's funny because, I mean, I always say to people, I'm like, Listen, they're not the enemy, actually. They can make your life easier because and I say, people tell me, "Well, I'm not going to go until I'm absolutely done." I'm like, If you wait that long and they tell you you're wrong, you just spent a whole lot of money for "and you're wrong." Right? So you should look at them as your partner. Right. And I'm assuming you went to, you worked with the digital health group at the FDA.Venk Varadan: We worked predominantly, consistently we work with CDRH [the Center for Devices and Radiological Health] and now actually as a as a board member on Advamed, sitting on the executive leadership group for digital health, Advamed is a trade association that helps with FDA and with CMS on on industry innovation. CDRH does have its own sort of digital health group within it that's focused on a lot of these issues that we're talking about A.I., data privacy, cybersecurity, which in this sort of next decade, I think is going to be the main sort of frontier for the industry government relationship that we all sort of signed up for when we decided to go into health care, because even the most sleepy widgets right that we use consistently, they're all tech enabled now. Everything is digital, you know?Harry Glorikian: So yeah, and I mean, they're they've been creating that from the ground up. I remember talking to the the gentleman that runs it and he's like, I feel like I'm running a startup because, right, most of the stuff that we're, you know, we need to figure out has never been done before at the regulatory agency. And so we're sort of creating it from scratch, right? So I mean, in a way that that's good because he understands the pains that the companies are having to go through in creating something that hasn't been done before.[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 let's go back for a second to, you know, 2020 in the first wave of coronavirus pandemic, right? You partnered with some medical centers in New York and New Jersey to start using it to monitor patients. And what did you learn from those studies and how did the device help improve treatment?Venk Varadan: There were two things I think. One, it was all anybody was talking about, and there were so many unknowns about it that we recognized that this was a, you know, a virus that was affecting the cardiopulmonary complex. Those that were getting sick and we're going to the E.R. had issues there, and that's what we were doing. And so in the same way that we're looking at potential use cases with the ultimate goal of assessing someone's risk, right, which is really what we're what we're doing as a remote diagnostic company or a remote hospital at home patient monitoring company, we went into COVID with that same thesis in doing so. And obviously in our backyard in New York, we got punched in the mouth first in the USA. With that, pretty much everybody I know was infected in March. We were all riding the subway together, you know, up until the last day as sardines. So it was not escapable here. And we're a dense city, right? We all sort of live on top of each other and our hospitals almost in a week. There were patients in the cafeteria. They were we were making tent villages for additional beds in Crown Heights, Brooklyn. It was completely overwhelming. And so we really feel it felt like we wanted to do something about it now. We would have gotten on patients right away, but. We did have to go through the IRB processes, which would take time, unfortunately, but we learned a couple of things and the two things actually that we learned are is that we're not necessarily super helpful in a acute virus that hits you really fast.Venk Varadan: The patients that this is sending to the ICU, it's doing so very quickly. It's rare that someone is sick for three or four weeks. They progress so badly that then they go to the ICU. They have a drop pretty quickly when it happens. So what we found was, our study was really to go on patients while they were in the general ward, and the endpoint would be when they were transferred to the ICU because they had gotten so sick a morbidity event or they were discharged. And I think we were unable, to be candid, we were unable to find the lead up to that point because we just simply didn't know what patients were coming in. I would have loved data on them from 48 hours beforehand. Right? We could have learned so much, even very basic functions that Fitbit and the Apple Watch are trying to market. "I saw a spike in heart rate from the all patients that got infected with COVID 48 hours before." That is the premise of where I would have loved to go with our granular data, but we're not the type of device that somebody just wears at all times, whether they're sick or not, right? So I think that was a learning experience for us that if there's an unknown of when something's going to hit, it'll be challenging. Venk Varadan: For infectious disease that becomes chronic disease, I think we're going to be in much better shape, and I think we could definitely do a longitudinal study for the long hauler community, right> You know, the folks that have been infected with COVID and have literally seen symptoms for a year or two, I think there's a lot we can learn longitudinally from there. And that's really where I think our study with our with our great partners at Maimonides Medical Center in Brooklyn and Hackensack, New Jersey and others across the country would, we would be more than happy to to participate in some of those longitudinal studies because, you know, we don't know what the long hauler is going to look like in five to 10 years, right? Or even people that have been infected before the vaccines now. That's still a let's figure it out type thing. So it's not you have to balance sort of running a sales product business versus a research part, but with the right resources and the right partners we would love to continue that work in COVID because it's not going anywhere as you know.Harry Glorikian: Well, listen, I actually want you to put it into a T-shirt and send me one so that I can wear it and monitor myself. But let's talk about where this technology is going in the future, right? The SimpleSense sash looks, you know, comfortable, convenient, way more comfortable than, say, a Holter monitor. But you'll correct me if I'm wrong, but it's still a specialty device. It isn't made from off the shelf materials, et cetera. But do you think there's like we're moving to a day where you can sort of embed these sensors in, as I said, a T-shirt, familiar cloth items. I'm looking at digital health and saying it has the ability to monitor me and sort of help identify problems before they come up so I can get ahead of them. And so that's how I'm thinking about this technology, because those sensors look pretty small and thin, at least from what I could see visually in the picture.Harry Glorikian: We're the first to say we don't know when we don't know, Harry. I know the market wants you to always have an answer for everything. A lot is going to depend on the additional aspects that we all use in technology stack. Where does 5G take us? Where does increased broadband take us? You know, 10 years ago, we didn't realize everyone in the world would have a smartphone, right? Villages in India and Africa, they have these now, you know what I mean? They may not have running water, but they've got, you know, a Samsung device, right? And so we may have never thought that monitoring in remote places like that because we couldn't find an economic model to sell shirts or bed sheets for a dollar out there. But maybe with the volume and with the right partners, that's where we could go. We certainly built our our stack with that sort of dream in mind. We filed IP and got patents awarded to embed in clothing and bed sheets and upholstery on cars and seatbelts and on the steering wheel and. You know, this could be in the gloves of a pilot one day. You know, this could replace your sort of neurological monitoring. We've got a prototype of a headband that's calculating all your EEG and EOG signals could replace an 18 lead one day. I think when you throw in real good advances in automated supply chain and 3D printing, there's a lot that can be done in this space and it's going to be done through partnership. We're not going to do it all on our own.Harry Glorikian: No way. I was going to say Venk, get to work, man! What are you doing? Like, you're using this in a in a medical application, but I really want to understand: so especially if, you must have believed in it because you filed the patents, but do you think that this sort of sensor technology could just be a normal part of preventative health care in healthy patients?Venk Varadan: I think that was always the goal, Harry. What can we do to really help a physician provider and ultimately a payer understand someone's risk without them coming in to a hospital or doing a visit? Because really the only people you should be seeing in person are people that need to be seen, not me, for an annual physical. Not you for an annual physical. Not, you know, somebody in the villages in Africa who really just needs to understand why they have a fever, whether there's something really wrong inside them. That's where I think this should go. It always was that case. We never knew what the right problem was to start to build a business around it. But this should replace your your annual physical, your annual checkup for healthy people. This should replace the follow up visit for your post-surgical, whether you get a knee replacement and angioplasty or a stent in your heart and should replace your chronic disease visits. If you have sleep disorder or heart failure where you know, do you really have to go get a $10,000 test every three months to see if you're regressing, improving or if you're staying the same? I think that this can democratize all of that in some way, and it's cloth. We all wear clothes every day, right? So yeah.Harry Glorikian: I mean, I look at I've looked at all these technological advances and I look at them as deflationary in a sense right. We're allowing people to get higher quality care from these technologies because of the information that comes off of it and then utilizing AI and machine learning and, you know, different forms of data analytics to sort of highlight trends and problems or hopefully, no problems, and then if one comes up, it sort of sticks out like a sore thumb, but it gives you a longitudinal view on that patient. And that's where I see all of this going, I mean, COVID has just pulled everything forward a lot faster than. You know, anybody could have guessed, and I agree with you, if you look at 5G and all these things coming together, it's just it's going to take it one more leap forward that much faster. I mean, I can imagine a partner for you would be Apple or Google thinking about, you know, clothing. Or Lululemon, for that matter, I guess. But somebody that that can incorporate this into their into their materials and make it more available. Because I got to believe that there's a consumer application that somebody could take advantage of rather than just a hardcore medical need, if that makes sense.Venk Varadan: No, you're absolutely right, and again, this sort of went through our strategic thinking when we were thinking about what we wanted to be when we grew up. And we think that the our unique cloth nanosensor technology, which good luck trying to replicate and copy that for anybody who's interested, I mean that again, this was 40 years of work that sort of how to create it and we're bulletproof, protected from a from a patent standpoint. But we think this can enable all of those markets. Our thesis was always, Harry, if we could start in health care we'd have the need-to-have population. The people that don't have a choice, right? I mean, I can go out for a jog or I don't need to go out for a jog, right? I can run with a monitor but I don't need to. But there's a good percentage of the population that doesn't have a choice. They must be monitored. If we could start with that, need to have population and prove it, prove that it works, that it's changing outcomes. Why would the nice-to-have market use something that you know, is already working for for sick people, right? And that was kind of always our thesis. We don't really have a timeline on when we're going into the consumer market, but because, you know, there are different aspects that are involved there from a business standpoint, customer acquisition marketing are the obvious ones, but sexiness, fit, we did not focus on "Do we look cool?" We were focusing on, you know, design is important on everything, don't get me wrong, but we first started with "make it work." We didn't start with "It has to be this big" and then figure it out, right? We started the other way around.Harry Glorikian: Well, and if you think about all the existing wearable technologies, they incorporate a sensor that everybody understands very well, right? There's no question that temperature monitoring, there's no question that, you know, if you can have a CGM on you, you can sort of understand what foods affect you positively or negatively. You're right. We need the scientific publication to prove that the technology that you built does what it needs to do, and it's probably all the time going to give you new information. You're going to be like, I didn't know we could figure that out, right? Which is the beauty of having 85 biomarkers. You're going to find something new all the time, but you could easily see that certain applications would then become accepted and then make its way into mainstream.Harry Glorikian: Yeah, absolutely. And I think the more that folks are using and the cool thing or not, maybe not cool, maybe it bothers some people, I'm sure, but technology goes one way. It does not go backwards, right? And COVID sort of shifting virtual care into the forefront, which is what technophiles did before. "Oh, I just talked to my doctor on the phone." I would have laughed. I was like, What can they do with that right before I started Nanowear, right? But that's not going back right. If you don't have to go see your position in person and you've got an alternative now that replaces it, why wouldn't you do that right? So. Yeah, I think as people get more accustomed with devices, they'll understand how to differentiate from them. You know, I'm not taking shots at our friends in Cupertino, but there's only so much you can do on the wrist, righHarry Glorikian: Absolutely.Venk Varadan: If you're not going across the heart, across the lungs, across the brain, you're going to be limited in what you can do if you just have an armband device that's picking up your pulse rate and your skin temperature, you're limited in what you can do, right? So I think what we're excited about, maybe not just on this form factor in this product, but understanding its application around the body. You can't put a smartwatch around your body, but you can put a cloth around your body. You can put a sheet around your body, right? I think that hopefully the understanding is going to come that there is a delineation between something that's great for the consumer and something that's great for, you know, the health care population. And where does that nexus come together? I think that's going to be driven by patients. I don't think it's going to be driven by us. I don't think it's going to be driven by the provider or the payer. I think the patients are going to demand, you know, as they are doing now, right? I mean, the reason providers are buying our solution right now is because the patients are demanding it right. The payers are kind of demanding it. To some extent, cardiologists would love to see 40 patients a day in their office again. They were really used to that, right?Harry Glorikian: Yeah. This is a longer debate over a beer at some point.Venk Varadan: It is Friday!Harry Glorikian: Listen, it was great to talk to you. Healthy congratulations on the on the latest approval and look forward to seeing other approvals as as you're taking this thing forward. And you know, I can only wish you great success. I mean, obviously since I'm an investor, I have a soft spot in my heart for every entrepreneur out there.Venk Varadan: Thank you, Harry, and thank you for the opportunity to spend some time with you and and your audience. Hopefully, it's the first of many and I can come back and give an update in a year or so. And hopefully by then, it's not just about FDA approvals, but I'm showing we really built sales here because I know investors care about that. Just selling our product in the enterprise for the first time this month in September, and early numbers are great. So it's a really exciting time. I think six and a half years into the journey and being able to do it starting with dad has been pretty special. So so thanks for having us and appreciate you following our progress going forward. Harry Glorikian: Excellent.Thanks for participating.Venk Varadan: Thanks, 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.
Vestibular Specialists Dr. Danielle Tolman, PT and Dr. Abbie Ross, PT, NCS sit down with Neuro-otologist Dr. Catherine Cho, MD from NYU Langone Health to talk more about MdDS, working with the Dai protocol for MdDS, and about what it's like to work with a more complicated vestibular patient population. Episode Resources: Where to find Dr. Cho: https://nyulangone.org/doctors/1730151895/catherine-cho Dr. Scott Grossman: https://nyulangone.org/doctors/1487074522/scott-n-grossman VR pilot study: https://pubmed.ncbi.nlm.nih.gov/33013617/ Dr. Sergei Yakushin, PhD website: https://icahn.mssm.edu/profiles/sergei-yakushin Follow the link to submit topic or guest requests: https://forms.gle/81vh89WKCX2kx6zg7l Hosted by Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman, PT Where to find us: www.Vestibular.Today www.BalancingActRehab.com Facebook: @VestibularToday / @BalancingActRehab Instagram: @ Vestibular.Today / @BalancingActRehab Twitter: @VestibularToday / @BalActRehab
Dr. Shin Beh, MD is back to talk to Dani and Abbie about Mal de Debarquement Syndrome (MdDS)! Dr. Beh is a neurologist specializing in vestibular and balance disorders with a focus on vestibular migraine, dizziness and migraine, MdDS, and PPPD. On this episode, we discuss what MdDS is, its most current diagnostic criteria, and what is being done for treatment. Dr Beh is on twitter at: @TheDizzyDoc His website: https://www.vestibularmd.com/ Dr. Dai's Protocol at Mount Sinai in NYC: https://labs.icahn.mssm.edu/dailab/ Relevant Studies/Articles Discussed: - Cha, Y. H., Baloh, R. W., Cho, C., Magnusson, M., Song, J. J., Strupp, M., ... & Staab, J. P. (2020). Mal de débarquement syndrome: Diagnostic criteria consensus document of the classification committee of the bárány society. Journal of Vestibular Research, (Preprint), 1-9. https://content.iospress.com/articles/journal-of-vestibular-research/ves200714 - Dai, M., Cohen, B., Smouha, E., & Cho, C. (2014). Readaptation of the vestibulo-ocular reflex relieves the mal de debarquement syndrome. Frontiers in neurology, 5, 124. https://www.frontiersin.org/articles/10.3389/fneur.2014.00124/full - Dai, M., Cohen, B., Cho, C., Shin, S., & Yakushin, S. B. (2017). Treatment of the mal de debarquement syndrome: a 1-year follow-up. Frontiers in neurology, 8, 175. https://www.frontiersin.org/articles/10.3389/fneur.2017.00175/full You can find his book on amazon at: https://www.amazon.com/Victory-Over-Vestibular-Migraine-Healing/dp/B08C92JB3R/ref=sr_1_2?dchild=1&keywords=victory+over+migraine&qid=1621987495&sr=8-2 Follow the link to submit topic or guest requests: https://forms.gle/81vh89WKCX2kx6zg7l Hosted by Dr. Abbie Ross, PT, NCS and Dr. Danielle Tate, PT Where to find us: www.Vestibular.Today www.BalancingActRehab.com Facebook: @VestibularToday / @BalancingActRehab Instagram: @ Vestibular.Today / @BalancingActRehab Twitter: @VestibularToday / @BalActRehab
"Eating carnivore helped me to lose 100 lbs, gave me the best digestion I've ever had, relieved sciatic and joint pains and drastically reduced MdDS symptoms." - Heather This episode is hosted by MeatRx coach Amber. Find her at https://meatrx.com/product/amber-w/ Donate to the Carnivore Diet Clinical Trial: https://gofundme.com/f/carnivore-research
Many people take their first wobbly steps into the financial world because they understand money is meant to do something. What exactly that “something” is, is often left to someone else to figure out. However, once they start learning about the financial environment for themselves they realise there might be products better suited to their needs. Moving a lump sum away from a provider you've trusted for a few years is a daunting process. Even if your reasons are sound, it's not an easy decision to make. In honour of the brand new tax year, we spend this week's episode helping Carmen decide what she should do with her existing high-cost retirement product. We hope the discussion will help you decide what to do with an investment product that no longer suits you. We apologise for the ear worm. This week's show is also the last of our shows sponsored by OUTvest. We are deeply grateful to them for their support. Also remember tomorrow at 11:00, Bobby from AJM Tax will talk about how the tax changes announced last week will affect your pocket. Join the Facebook community group to watch it live and ask your questions. Subscribe to our RSS feed here. Subscribe or rate us in iTunes. Carmen Do I keep pumping money into my high cost actively managed RA at Old Mutual (I like the idea of money going somewhere that I do not think about)? Do I transfer the current balance to my low cost EE and let it sit there and grow (along with the increased monthly premium plan)...but then continue the R3500 contribution to OM (which will likely have even higher fees because now my base amount is R0). Do I reduce my RA contribution to Old Mutual to the minimum R500 per month (so that I don't incur an “admin fee”) and increase the RA amount to my EE RA immediately by R3000 per month? Do I get outta dodge re: Old Mutual RA and move alles completely? Ancillary reasons for sticking with an actively managed fund at a big investment house are: not to have all my eggs in the EasyEquities basket; my personal risk insurance side is sitting with Old Mutual (disability, illness etc) and my OM is invested in other items than my EE portfolio (bit of diversification); keep contributing to one RA up to age 60 and only pull from it from 65...and other RA only pull from later. Win of the week: Nalisa I started this email about four months ago, and listening to this week's podcast made me decide to get it done. Especially when pet expenses came up! To clarify, I'm a vet and best you believe my creatures are on insurance! Yes, I'm a vet and proper medical care is still expensive for me! Akina, my eldest, decided to go ahead and twist her spleen (after hours, fucking typical) and the resulting bill came to about R20 000, and the medical aid paid me back in under a week. Even if it wasn't for that incident the peace of mind we get from it is worth every cent. But do your research and (I can't stress this enough) read the fine print! Know what they cover and what they exclude, and especially look at their limits (per claim and annual limits). They're still insurers, they're still trying to screw you. My fiancé and I were discussing how one could become completely self insured. We only insure our cars, our home and our pets. We both have life insurance ( to cover the bond), medical aid and I have income protection. We've always agreed that our home contents (aside from his laptop) are considered self-insured because our quote for insurance was exorbitant. In an ideal scenario, we'd need to have enough saved to be able to replace everything with cash, and have about R50k for the animals. The figure gets big really quickly. The main concern would be that you'd have such a huge pile that needs to be fairly liquid and would earn very little (but still more than handing it over to someone else every month). Are there any strategies for self insurance? Or is it actually a silly goal and we should resign ourselves to gamble on bad luck against insurance companies, while trying to save whatever else is left? Solly I really like how you break down things for us that are so complex and make it consumable. I started listening to Just one lap last year around February and I have gained life changing insight. I just thought my first email to Just one lap is to say thank you so much!...for all the effort, the laughter and swearing
What are the implications of buying two ETFs that have similar holdings? Raesetsja is trying to figure out if they should add MSCI World to a portfolio of S&P500 holdings. In this week's episode, we show you how to figure out what doubling up would mean for your portfolio using local Satrix ETFs as an example. Remember, you can find the minimum disclosure documents (MDDs) on each issuer's website, or find everything in one place on the etfSA.co.za website. Subscribe to our RSS feed here. Subscribe or rate us in iTunes. Raesetja I currently hold the Satrix S&P 500 ETF in a TFSA, into which I make R500 monthly contribution. I have another R500 to invest monthly. Often you guys suggest the Satrix MSCI World ETF. I just had a glance at the MDD and the top 10 equity holdings in the S&P500 and the World are exactly the same. Is it worth buying the World if my exposure (at least of the top 10) is the same as in the S&P 500? Should I rather invest R1000 a month into the S&P 500? Win of the week: Javier I discovered your Podcast and just listened to the last 40 of them — that's 40hours of questions which have been awesome and fun. Though I'm extremely lucky and I have quite a few things already lined up, your podcast has made it clear how to make it even better. Johann I have a few dollars in a local USD account. If the government loses its mind and confiscates part of people's savings like the Greeks did a few years ago, will this money be safe? Leonora I am 59. Retired at 57. I have a living annuity with Momentum, invested in Deutsche Bank Coreshares S&P 500 at a 2.5% drawdown. I have other income for the time being and wanted to escape regulation 28. I am looking for lower admin costs. 10X could not assist me in 2017 and on enquiry now, they still seem to be unable to do so. Any other suggestions? Sygnia? Ruben I invest in the Satrix MCSI world ETF and the dividends are automatically reinvested. When the time comes and I one day reach FIRE can I change the way the dividends are paid out, or do I need to sell the ETF shares? Jorge I am currently investing in PTXTEN and have done so for the past three years or so. However, the PTXTEN seems to be going one way and that's down. Is it not time to move to another property ETF and if so, what are the options and if not, why should I continue with PTXTEN. What is the largest liquor company listed on the JSE as SA Breweries is no longer listed? I have found Distell (DGH) on the JSE but they only registered in 2018. Mike Given the short/medium and longer-term risks in the SA economy, what are your thoughts about the % of offshore exposure in a portfolio (medium to high risk)? If I backtest a portfolio of 20% Fairtree income fund and 80% Satrix MSCI world index I get 6.5% above inflation for 5 years annualised (11.5% gross) and 6.2% above inflation (11.6% gross) for 10 years. In ZAR. That's well ahead of my long-range target of inflation plus 4%. Dave My plan is to live off the cash I have saved until I am 60 or older. At that time I'll decide if I convert any of my annuities to a pension draw-down. How do I invest my current cash savings, which I will use as income for the next couple of years? I will obviously be drawing from this on a monthly or quarterly basis, but would like to preserve as much as I can. My thoughts are to just transfer all the funds to a Coronation Money market account. What is the best vehicle to use from a tax perspective? I'm currently in the highest income tax bracket. Aubrey I am building emergency fund for at least six months to a year. Which cash account or investment options I can use to grow my savings? I have a seven days notice saving account with one month salary for emergencies. I want to open another account where I can put my six months emergency account. I was thinking of money market account or should I open another Tax Free? Another question is safe to have all your TAX FREE with one organization? Nico-Ben A few people have written you about student loans and the very low interest rates. I had a student loan. The interest rate is low (8% in my case), but you start paying interest immediately. By the time I finished studying, my loan capital was just short of R90,000. By that time I already paid R45,000 in interest without paying a single cent on capital. I struggled for a while to get a stable job and was only able to pay the absolute minimum. The loan period is so long that the cost multiple looks worse than a home loan. It was only after four years of working that I finally managed to aggressively settle the loan. On the upside, working through the loan, and listening to your podcasts made me learn about finances and looking at these costs. One expects a high salary with a degree, which I have seen in my field (engineering) is not the case. The point is that the interest rate is not the only factor. Just as with any compounding a long-term loan is expensive, even if the interest is lower. I had no alternative but to take a loan, but if you can avoid it I would strongly recommend it. The repayment period does put a hamper on you ability to fully utilize a TFIA and/or RA. Jack I started listening to your show a few months after I read the book Expat Millionaire — where cost of funds and fund damagers was highlighted. I don't mind sitting in traffic anymore. Since then my wife complains that I have become a little obsessed with personal finance and budgets. If a very nice family member wants to give another family member a lump sum of between R500k and R1m to assist in paying of his home loan. What are the tax implications? What is the best way of doing this?
On this Zen Den Health Talks episode, Mary and Michael discuss vertigo and Mal de debarquement (MdDS), more commonly know as disembarkment syndrome. Later in the episode, we will hear from Kennedy and Liz, both patients who have gone to the Zen Den to deal with issues stemming from vertigo and MdDS. Follow Kennedy on Instagram @downtownkennedy Visit us at www.zendengroup.comFollow us on Facebook and Instagram @zendengroup For any questions about sales feel free to contact tiffany@zendengroup.com
Seeking Balance: Neuroplasticity, Brain Health and Wellbeing
Joey Remenyi from Seeking Balance International talks about Mal de Debarquement Syndrome (or MdDS). Learn about this condition and how to heal it. Learn about neuroplasticity for re-calibrating the balance brain to return to normal. Learn more about ROCK STEADY: https://www.seekingbalance.com.au/rocksteady/ Work with Joey: https://www.seekingbalance.com.au/beautiful-balance/
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Host Mike Koriwchak, M.D. tackles the latest news in this episode of Doctor's Lounge. Expect updates on the plight of Charlie Gard, an 11 month old UK baby with infantile onset encephalomyopathy mitochondrial DNA depletion syndrome (MDDS). The UK NHS (socialized medicine) denied Charlie experimental treatment outside the country at the parent's expense. The NHS revisited in light of the public outcry and a USA pediatrician has traveled England to evaluate the case. The Senate debacle on health care reform is still unfolding and Dr. Mike will analyze the latest turn of events.
Part One - Single Payor Morality Social media has been on fire with the story of Charlie Gard, an 11 month old UK baby with infantile onset encephalomyopathy mitochondrial DNA depletion syndrome (MDDS). President Trump and the Pope offered support for free experimental nucleoside therapy in the face of the socialized British NHS deciding to pull life support. Dr. Koriwchak does analysis and connects the dots to the philosophical debate laid bare in the Cruz/Sanders CNN debate he attended several months ago.
[New Video Added] MPT Podcast 20 - Medical Device Regulations and EMR, with guest Mike Meikle, Hawkthorne Group. This Issue (5:38): What is the Medical Device Data System (MDDS) regulation? How does this affect practices that use EMR? Why your EMR vendor may not be giving you accurate information about MDDS Does the MDDS rule have any "teeth"? [smart_track_player url="http://mptaudio.s3.amazonaws.com/$emed$podcast/MPT_podcast_20.mp3" title="MPT Podcast 20: Medical Device Regulations and EMR" ] Right-click to download
For those not familiar, MdDS is a condition where an individual continues to feel as though they are moving for longer than one month when returning to land after being at sea (most common cause). Unfortunately, many patients continue to have disabling symptoms and responses to medications have been less […]
Hosts Kat Kanavos and Lori Boyle: Guest Retired General Gordon Sullivan. The Marshall Legacy Institute was founded in 1997 by General Sullivan, Dan Layton, Bill Foster, and Perry Baltimore to extend the vision of Nobel Peace Laureate George C. Marshall which aims to help war torn countries help themselves using MDDs, Mine Detection Dogs.
Hosts Kat Kanavos and Lori Boyle: Guest Retired General Gordon Sullivan. The Marshall Legacy Institute was founded in 1997 by General Sullivan, Dan Layton, Bill Foster, and Perry Baltimore to extend the vision of Nobel Peace Laureate George C. Marshall which aims to help war torn countries help themselves using MDDs, Mine Detection Dogs.