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Off to Colorado! Morons in the News. The New Beatles Movie. The Catchiest Songs. Everyone Needs a Laugh. Chewing Gum is a Mouthful of Microplastics. Talback Callers. Can You Believe This? Lamar Dodges a Rescue Poodle. From the Vault. Pedestrians Holding Parking Spaces.
Today on the show, I'm sitting down with the charismatic frontman of the DC/Maryland punk rock outfit, The Submensas, a band with over 40 years of history.They're back, performing live, and have been releasing a steady stream of "piss and vinegar"-soaked singles since 2023, including the raucous "Reason Wrong," "Headache," and most recently, the unexpectedly funky "Return of the Strange."We're on a tight schedule to get this episode recorded and released, so without further ado, please join me in welcoming Damon Norko to the Mouthful of Graffiti Podcast. Sponsored by the Harford County Cultural Arts Board.
If insurance headaches are draining your energy and slowing your growth, you're not alone—and today's guest has the tools to help you take back control. In this episode, I sit down with Colleen Huff, an industry veteran with over 30 years of hands-on experience in dental insurance, revenue cycle management, and practice consulting. From her early days at MetLife to managing multi-location practices and now educating thousands through speaking, writing, and online courses—Colleen knows what it takes to turn insurance chaos into clarity. Her new book, A Mouthful of Insurance, is already making waves, and in this conversation, we dig into exactly why. We cover: The biggest insurance struggles dental practices are facing in 2025 Why practices need more than just an insurance coordinator—they need systems The truth about outsourcing verifications and what to look for in a partner How technology (like AI and practice management integrations) is changing the insurance game How to avoid common billing mistakes that can trigger audits or worse The role of accurate coding, documentation, and clear patient communication Why every team member—from front desk to back office—should understand the insurance landscape Whether you're in-network, out-of-network, or somewhere in between, Colleen's insights will help you make smarter financial decisions and run a more efficient, profitable practice. — Key Takeaways 00:45 Introduction to the Podcast and Guest 03:28 Understanding Dental Insurance Consulting 06:12 Challenges in Dental Practices 10:13 The Role of Team in Insurance Management 11:45 Outsourcing Insurance Verification Services 16:31 Technology in Dental Practices 18:00 AI and Its Impact on Insurance Claims 21:25 Navigating Insurance Payments and Estimates 23:40 The Importance of Accurate Billing Practices 27:48 Strategies for Increasing UCR Rates 28:28 The Debate on Pre-Authorizations 30:44 Overview of Colleen's Book 31:51 Lightning Round Q&A 36:29 Conclusion and Final Thoughts — Connect with Colleen
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Happy anniversary to the Mouthful of Graffiti Podcast! Can you believe it's been a year? To celebrate, we've got a fantastic show lined up. Today, we're thrilled to welcome the legendary Jimi HaHa of Jimmie's Chicken Shack, the Annapolis band that took the '90s by storm with hits like "High" and "Dropping Anchor." We're also excited to introduce Callum, an aspiring artist with dreams of rock 'n' roll stardom and a shot at American Idol. Join us as these two artists, with different journeys but the same passion, share their stories LIVE from Reb Records. Let's give a warm welcome to Jimi Davies and Callum!Sponsored by the Harford County Cultural Arts Board.
In this episode of That's a Mouthful, we dive deep into men's health with Matt as he shares his personal journey with testosterone levels, insulin resistance, and the importance of proactive healthcare. From navigating fatigue and hormonal imbalances to making informed diet and lifestyle changes, we explore why regular health checkups and self-advocacy are essential—especially as we age. Plus, we discuss the role of fitness trackers, blood glucose monitoring, and practical steps for staying ahead of potential health issues. Don't miss this insightful and candid discussion that might just inspire you to book that overdue doctor's appointment!
Headlines: Putin says he agrees 'in principle' to a 30-day ceasefire with Ukraine, Kevin Rudd says he's 'thrown everything' at getting a tariff exemption and Albo slams the US influencer who snatched a baby wombat. Deep Dive: Australia has been rocked by a recent spate of shark bites this week, reminding us of the risks inherent in ocean swimming. So, with hot weather predicted around the country this weekend, what’s going on and what do we need to know before we head to the beach? In this episode of The Briefing, Sacha Barbour Gatt speaks with Dr Leonardo Guida, shark campaign manager at the Australian Marine Conservation Society to unpack it all. Follow The Briefing: TikTok: @listnrnewsroom Instagram: @listnrnewsroom @thebriefingpodcast YouTube: @LiSTNRnewsroom Facebook: @LiSTNR NewsroomSee omnystudio.com/listener for privacy information.
After a successful trip to the dentist, Nick tells Norman all about the tooth fairy. Does the tooth fairy visit dogs? Along with the help of the Popcasters, they write a song about looking after your teeth.
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The boys are back! Cody and Matt return for their first episode of 2025, catching up on life, books, and internet mysteries. From reading goals (Cody's aiming for 25 books this year!) to hilarious misconceptions about their age and Twitter drama, this episode has it all. Matt also shares the incredibly thoughtful (and emotional!) Christmas gift from his husband—his book, hand-bound in leather
On this episode I have a new, local, friend Brad Cox. Brad has been in the Baltimore music scene for a while performing and writing music with his band Skitzo Calypso; and he is a great advocate and champion of the Maryland Music Scene via his podcast "Mouthful of Graffiti". I'm looking forward to chatting with him and hearing about all the things he has going on in his world! Hosted on Acast. See acast.com/privacy for more information.
Alright, rock and roll faithful, welcome back to Mouthful of Graffiti LIVE! Today, we're cranking it up a notch with three titans of the Baltimore alternative rock scene. We've got a packed show for you, diving deep into the minds and music of these legends. Get ready for exclusive interviews, raw live performances, and the untold stories behind their iconic songs. We're talking about Will Sims, Justin Taylor, and Anthony Hurley – three musicians who've not only shaped the sound of Baltimore but have dedicated their lives to the craft. They've put in the years, honed their skills, and are here to share their expertise and passion with us. So, get ready to rock as we welcome these incredible artists to Mouthful of Graffiti LIVE, straight from Reb Records! Sponsored by the Harford County Cultural Arts Board.
The Death of Robin Hood Casting, Diego Luna To Direct A Mouthful of Ash, The Dog Stars Casting, VES Awards. Hosted on Acast. See acast.com/privacy for more information.
In this episode Bill talks with the members of the Canadian Rock band Sierra Pilot as they drive across the United States, literally. We talk about being on the road with Pop Evil and the Bad Wolves, contrasting that to their recent tour with Skid Row and Buckcherry, how sports injuries led to guitar playing, the Waterloo music scene or lack thereof, and how the thing mountain air can help with asthma. We also talk about how Sierra Pilot came to be, getting sober, the dirty love songs and their homage to addiction, how's Karma treating them, the story behind the song Mouthful, recovering from the Phantom Pains, playing Cleveland, plus so much more. Today's Boondoggle fans can receive 10% off their orders at dreemnutrition.com by using the promo code BOONDOG10 at checkout. Today's Boondoggle fans can receive 10% off their orders at TNT-Health.com by using the promo code BOONDOGGLE at checkout. So kick back with your headphones and cold one for this latest episode. Enjoy our additional segments featuring music from the Flo White Show and Stories from the VFW Hall. Please Follow us on Instagram, Facebook, Twitter, and TikTok. Please subscribe to our YouTube, Rumble, Odysee, Brighteon, and Bitchute channels, and hit the notification button. As well as seen on Wowza TV on Roku. Remember Boondoggle Listeners Matter, so e-mail us at todaysboondoggle@gmail.com and let us know your thoughts so we can read them on air. Tweet us @2daysBoondoggle and Follow us on Instagram @todaysboondoggle as well as on Facebook. Please subscribe and give 5 stars and review. Every review we receive on either Apple Podcast or Google Music we will mention you on a future episode and our Social Media pages. Follow Today's Boondoggle also on DomainCle.com and on Anchor.fm Today's Boondoggle logo designed by Stacy Candow. Intro music by Rich Stadtlander and Valor. Intro Video by Paul Travers and Big Picture Media. Additional music by Evan Crouse Also please consider financially supporting us at Todays Boondoggle using Venmo, our GoFundMe, or sponsoring us on our Anchor.fm page, so we can continue to provide you with quality entertainment. Today's Boondoggle Podcast Domain Cleveland Entertainment LLC
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New Yak penis activity unlockedYou can find every episode of this show on Apple Podcasts, Spotify or YouTube. Prime Members can listen ad-free on Amazon Music. For more, visit barstool.link/barstoolyak
Joe Teague's name and marketing are well-known, but his music truly shines. Blending punk, folk, and bluegrass, he crafts catchy, clever tunes with witty lyrics and a voice reminiscent of Mike Ness. This gifted local musician navigates the original and cover music scene, offering a unique and palatable sound. When he's not making music, he's either being a father or raccoon watching. We're thrilled to have him on. Join me in welcoming Joe Teague to the Mouthful of Graffiti podcast! Sponsored by the Harford County Cultural Arts Board.
Are you ready for a sonic experience? A journey through sound with a true multi-instrumentalist? He's a studio wizard, crafting epic progressive rock in his spare time and shaping the sound of tomorrow's biggest stars. He's graced our airwaves before, but now he's taking center stage! He's a guitar virtuoso, a melodic maestro, and a friend of the show. Get ready for an exclusive, in-depth conversation you won't hear anywhere else! He's back by popular demand and against his better judgement, to tell us what he's been up to. This week, on Mouthful of Graffiti, we welcome the one and only, Christopher Mooneyhan! Crank it.Sponsored by the Harford County Cultural Arts Board.
Are you ready for some rock and roll? For over thirty years, Harford County's own John Adams has been cranking out his signature sound! From Vicious Wishes to Clone to Private Nation, and now with his brand new self-titled release, "Through the Static," John's music is a testament to the power of reinvention!He's a man who loves the 80s, adorable guinea pigs, and a night at the theater; moreover specifically, the Theatre of Pain.Want to hear more about the man behind the music? Stay tuned to the Mouthful of Graffiti podcast! Join us as we sit down with John Adams and dive deep into his incredible musical journey. Sponsored by the Harford County Cultural Arts Board.
Introducing **maS**, an artist, songwriter, and producer from Connecticut who has been making music since he was just 17 years old. His journey into the music world began with a cypher among friends, where he discovered not only his passion for music but also his purpose as an artist.maS recently released his first EP, **“maS Beats Vol. 1: Speed,”** which features 10 tracks showcasing his diverse sound and musical abilities. Additionally, he has two singles out at the moment, **“Don't Numb It”** and **“Mouthful,”** both of which reflect his growth and dedication to his craft.In pursuit of his artistic vision, maS has also developed an interest in videography for music and films, further expanding his creative horizons. However, he faces the challenge of being a perfectionist, striving to balance his artistic ambitions with the realities of the creative process.A true music nerd at heart, maS is constantly tapping into different musical influences and trends, allowing him to stay inspired and innovative in his work. With his talent and dedication, **maS** is on an exciting path in the music industry, and fans can look forward to his future projects as he continues to evolve as an artist!
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Today on the show I'm sitting down with the director and one of the choreographers of Harford Dance Theatre's The Nutcracker. This show has been a Harford County tradition for over 40 years, and it's back in 2024 to keep the magic alive.Both Mckenzie Horseman and Spenser Cole are no strangers to the stage or dance theater and they're here today to give us a backstage look into what goes into bringing these holiday traditions to life. I couldn't be happier to have them on the show, so join me in welcoming Mckenzie Horseman and Spenser Cole to the Mouthful of Graffiti podcast. Sponsored by the Harford County Cultural Arts Board.
Today on the show I'm sitting down with three original singer-songwriters who need little introduction, but we'll give ‘em one anyways. Anthony Frijia, Jules Riser and Rich Presberry Jr. all surf the original and cover world circuits, and as a result have become staples in the Mid-Atlantic music scene. Anthony has a folksy, blues sound, as where Jules Riser is a child of the 90's and Rich, possibly the 80's. They all have developed large followings and have earned their spot in the sun. Tonight, they're coming onto the show to talk about their musical journey and what the songs mean to them. Join me in welcoming Jules Riser, Rich Presberry Jr. and Anthony Frijia to the Mouthful of Graffiti Podcast *LIVE* at Reb Records! Sponsored by the Harford County Cultural Arts Board.
SUBSCRIBE TO THE NEW BNC CHANNEL: https://bit.ly/45Pspyl Ad Free & Bonus Episodes: https://bit.ly/3OZxwpr NEW MERCH: https://shoptmgstudios.com This week, Brooke and Connor talk about in-flight etiquette and Brooke's scratch cornea. Plus, Connor preps for his big adventure across the pond and Brooke celebrates Wicked week with Jeff Goldblum's press interviews! Join our Facebook page: https://www.facebook.com/groups/5356639204457124/ Stay hydrated through the holidays and get 20% off your first order of Liquid I.V. at https://liquidiv.com with code BANDC at checkout. Give a gift that will be remembered forever, and save $10 on your first purchase at https://StoryWorth.com/bandc. This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/bandc and get on your way to being your best self. Go to https://Quince.com/bandc for free shipping on your order and 365-day returns. B+C IG: https://www.instagram.com/bncmap/ B+C Twitter: https://twitter.com/bncmap TMG Studios YouTube: https://www.youtube.com/tinymeatgang TMG Studios IG: https://www.instagram.com/realtmgstudios/ TMG Studios Twitter: https://twitter.com/realtmgstudios BROOKE https://www.instagram.com/brookeaverick https://twitter.com/ladyefron https://www.tiktok.com/@ladyefron CONNOR https://www.instagram.com/fibula/ https://twitter.com/fibulaa https://www.tiktok.com/@fibulaa Hosted by Brooke Averick & Connor Wood, Created by TMG Studios, Brooke Averick & Connor Wood, and Produced by TMG Studios, Brooke Averick & Connor Wood. Chapters: 0:00 You UGGly 1:01 Intro 1:21 Going Across The Pond 3:11 Mouthful of Panties 6:03 Happy Wicked Week! 6:58 Preparing For High T(ea) 9:19 Wake Me For Food 10:10 Pooping On Planes 11:58 LiquidIV 13:49 Connor's Flight Meals 17:02 The Balsamic Vinegar Debate 19:45 Farmer's Market Breakthrough 23:29 Storyworth 25:13 Brooke's Cornea 28:33 Hey Can We Talk? 30:00 People's Sexiest Man 2024 32:38 Cute Runny Noses 33:54 Jeff Goldblum Is Kooky 35:14 BetterHelp 36:38 Influencer Accents 39:27 Cann Jokes 41:05 Connor's Broken TV Experience 44:20 Brooke's Book Update 48:41 Quince 50:51 Smoking Ashes 52:28 Florida Man 57:34 Functional Freeze 1:00:04 Jonathan's Struggles 1:02:31 Connor's Man On The Street Interview 1:04:28 Teleportion Coming Soon 1:06:13 Getting Upgraded!! 1:08:55 Comfort Shows 1:09:40 Get Connor His Plaque!!! 1:11:19 See You In Bonus!!!
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We are happy to welcome Colleen Huff to the Growth in Dentistry podcast! Colleen is a Revenue Cycle Management expert with 30 years of dental industry experience. Listen in to hear Colleen and Steve discuss:Revenue Cycle Management challenges in dentistry, particularly after the Change Healthcare breach and how AR days are up since the breachImportance of understanding clearinghouse operations and insurance claim processesTips for managing claims and time management strategies…and so much more!Check out Colleen's book, *A Mouthful of Insurance*, out now: https://www.amazon.com/Mouthful-Insurance-Proper-training-tomorrow/dp/B0D8WLNZ3T. See a demo of DI and get a $50 gift card: http://get.dentalintel.net/podcast.
Dive into the urgency of Election Day with "That's A Mouthful." We break down why every vote matters, remind you to make a plan, and explore what's at stake—from trans rights to Supreme Court decisions. Tune in for a passionate, unfiltered discussion on the power of your voice, and let's work toward a future that reflects equality and progress. Remember, every ballot counts! #ElectionDay #Vote2024 #YourVoiceMatters #ThatsAMouthful #TransRights #KamalaHarris #BallotBox #SupremeCourt #LGBTQVotes #ProgressForAll --- Support this podcast: https://podcasters.spotify.com/pod/show/thatmouthful/support
Gen X can be funny about food. A lot of us were raised on a diet of Kate Moss, cigarettes and coffee. We were happy to talk openly about skipping meals, cutting carbs, and cabbage soup cleanses. We swam in a sea of celebrity diet tips, fads and…shame. In today's episode of MID, Holly is talking about food and the absolute necessity of small joys with Virginia Trioli. Virginia Trioli is one of the most highly-regarded journalists and broadcasters in Australia. She's a two-time Walkley Award winner, and her voice, on radio, on television has lent authority and comfort to some of the most difficult moments we've lived through as a nation. And this has given her a lot to say about…joy. That's what her new book, A Bit On The Side, is about. Because for her - and for Holly - food is part of that joy. And allowing ourselves to lean into the small pleasures that make a life, without guilt or shame, is a radical act, really. Particularly for women, when we have been taught that self-sacrifice and deprivation are our life's lot. So please feast on this conversation between Holly and Virginia - talking about food, love, and hard-fought parenthood and step-parenthood and losing your parents and wisdom and age and work and friendship and pleasure and letting go - and those times when you just have to… grow up, apologise and eat a shit sandwich. LINKS: You can follow Virginia here. You can find her book, A Bit On The Side, here. THE END BITS: Share your feedback! Send us a voice message or email us at podcast@mamamia.com.au Follow us on Instagram @MidbyMamamia or sign up to the MID newsletter, dropping weekly here. CREDITS: Host: Holly Wainwright Executive Producer: Naima Brown Producer: Tahli Blackman Audio Producers: Thom Lion Mamamia acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander cultures.See omnystudio.com/listener for privacy information.
Today on the show, you're in for a musical treat! We're covering all the bases, from pop to emo to beach rock and beyond. Adam Almony, Pat Renny, and Gabe Woodrow are three unique, original Mid-Atlantic artists carving their own path in rock n' roll. They're experts on the music and songwriting that made their genres shine, and they're here today to share the stories behind their music and perform live for you. Join me in welcoming The Three Musketeers to this special Halloween edition of Mouthful of Graffiti LIVE at Reb Records. Sponsored by the Harford County Cultural Arts Board.
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John Feitelberg joins Brendan to talk about priesthood, relationships, and getting E. Coli on Christmas. WATCH BRENDAN'S NEW SPECIAL "THIN LIPS" HERE! Who do you want to see on the show next? Got topic ideas? Email us at sagdaddydapod@gmail.com. FOLLOW JOHN: Instagram: https://www.instagram.com/feitelberg OUT OF ORDER: Instagram: https://www.instagram.com/outttoforderrr Tickets: https://www.barstoolsports.com/events/outoforderlive KFC RADIO: Apple: https://podcasts.apple.com/us/podcast/kfc-radio/id536209167 Spotify: https://open.spotify.com/show/3v1yJRkx4GxTzfQT5HmEZK?si=TcB8GIcdT1Ou2CrSmBf5 qQ Instagram: https://www.instagram.com/kfcradio YouTube: https://youtube.com/@kfcradio X: https://x.com/kfcradio Tik Tok: https://www.tiktok.com/@kfcradio Facebook: https://www.facebook.com/kfcradio FOLLOW BRENDAN: Tickets: https://brendansagalow.com/ Instagram: https://www.instagram.com/brendansagalow X: https://x.com/BrendanSagalow TikTok: https://www.tiktok.com/@brendansagalow Facebook: https://www.facebook.com/Brendansagalow4 YouTube: https://www.youtube.com/@BrendanSagalow FOLLOW NICOLE: Instagram: https://www.instagram.com/nicoleclyons/ SUBSCRIBE TO THE POD ON YOUTUBE: https://www.youtube.com/@BrendanSagalow CREDITS: Producer: Nicole Lyons Assistant Producer: Madison Lambert Theme Song: Brendan Sagalow and Linds Cadwell Show Art: Doctor Photograph Learn more about your ad choices. Visit megaphone.fm/adchoices
Are you ready to spin a tune that can change lives? Today on the Mouthful of Graffiti Podcast, we're sitting down with a local non-profit from Harford County that's making a real difference in their community.The Turntable Fund is using the power of music to energize the community and provide opportunities for musicians who need them most. Their upcoming Positive Spin music festival on October 12th is a must-attend event. Join us as we chat with Tracey Jones DuBree to learn more about their incredible work and how you can get involved. Join me in welcoming The Turntable Fund to the Mouthful of Graffiti Podcast. Sponsored by the Harford County Cultural Arts Board.
Welcome back to Silver Screen Social, listeners! I am your host Jackson Vickery. On this episode, I spoke to composers John Gürtler and Jan Miserre about their work on “The Outrun”. John Gürtler and Jan Miserre, both born in 1981, are award-winning composers known for their collaborative work in film music, particularly in international co-productions. John Gürtler, a London-born, Berlin-based multi-instrumentalist, is recognized for his ability to create diverse and emotionally resonant scores. He has received awards such as the European Film Award for his work on Nora Fingscheidt's “System Crasher” and the German Film Award for Best Sound for “No One's With the Calves.” His other notable projects include “A Mouthful of Air,” the Netflix series “Dig Deeper,” and “A Pure Place,” which won the German Film Critics Award for Best Score. Gürtler has also been acclaimed for his work on “Space Dogs” and “System Crasher,” the latter earning him the European Original Score 2019.Gürtler's collaborations span artists like Berghain resident Efdemin, Thomas Bloch, and the Film Orchestra Babelsberg. Additionally, he's dedicated to fostering new talent through his teaching at film schools across Germany. Jan Miserre, from Erlangen, Bavaria, was influenced by his jazz saxophonist father and began playing piano at age four and drums at twelve. He studied Jazz Piano at the University of Arts in Berlin and has toured internationally, working with artists such as Till Brönner and Curtis Stigers. Miserre has received several awards, including the GEMA Musik Author's Prize for New Talent and the German Documentary Music Award. In 2022, he and Gürtler won Best Score from the German Film Critics Association for “A Pure Place.” Together, Gürtler and Miserre focus on international co-productions, often working on projects from their base in Berlin. They frequently travel to other countries or invite musicians from around the globe to collaborate with them in Berlin. Their diverse backgrounds and collaborative energy create compelling scores for film and television, earning them widespread acclaim and numerous awards. MORE ABOUT THE OUTRUN: A vivid and unflinching adaptation of Amy Liptrot's wrenching personal memoir of addiction, powered by an extraordinary central performance from Saoirse Ronan. Addicted to hedonism, drink and drugs, a young woman must wrestle with recovery in the remote islands of Orkney whilst reckoning with her complex family history. Powered by a pounding soundtrack, a kinetic visual style and intricate narrative structure, this extraordinarily moving film is redemptive, cathartic and utterly riveting.
Today on the show I'm sitting down with three well-oiled and seasoned local, original artists from none other than Harford County, Maryland. These three pickled lads have run the gauntlet, from covers to originals and have provided inspiration to countless up-and-coming artists. Bands like Vicious Wishes, Think Again and Starbelly resonate with the local music scene because their good vibrations connected in a way that made them unforgettable. I wouldn't likely have to introduce them to anyone in the local scene, but for the sake of our out of state and international listeners, let's give a jolly good MOG welcome to John Adams, Dennis Schocket and Dan Houtz.Sponsored by the Harford County Cultural Arts Board.
Jess Simmonson, Julia Eakes, Samantha Jednorski and Eric Bray Jr. from Phoenix Festival Theater's Fiddler on the Roof stopped by for a quick episode to talk about their upcoming production, opening on SEP 20 | 7 PM at the Harford Community College (Amoss Center).Sponsored by the Harford County Cultural Arts Board.
Doug issues an apology for ruling the Cardinals out. They may give you a free ticket for today's game if you just ask nicely. Big night for Tyler O'Neil. Wedding SZN for JB. Bringing your male friends coffee. Scissoring at the VMAs last night. We need a flow chart for all the wars. An elevator story brings the show to a screeching halt. Hookin' up with townies. Carnies. The Pillsbury Throw Boy. Is Sharon an old person's name? Jackson's got a mouthful of man. The missing hat investigation is heating up. Ken Strode is reporting Taylor Swift is registering voters. STDs back in the day. PAC-12 news. Jackson is NOT leaving for 670 The Score. Learn more about your ad choices. Visit megaphone.fm/adchoices
Today on the show I'm sitting down with the man, the myth and the legend of everyone's favorite local sandwich shop and burger joint, Vagabond Sandwich Company, Mr. Ben Meyers. Ben remains unconventional, unpolitical and authentically himself. His style is the happy blend of rustic and urban, garnished with gobs of fun. Beneath it all, and something he'd likely downplay, is a hidden layer of business acumen that has made him successful in all of his pursuits. He's a fun-loving cook, business owner and serves his community with whatever available time he has left; and, today, he's taking time out of his busy week to talk to us about how it all got started, what's next and his upcoming and annual Sandwich Stock event. Sponsored by the Harford County Cultural Arts Board.
Are you ready for a shot of pure adrenaline? Get ready to crank up the volume because Bad Mary is back! This New York punk powerhouse is bringing their explosive sound to the Mouthful of Graffiti podcast. That's right, Amanda Mac and Mike Staub are here to talk about their new reimagined EP, "Better(er) Days." Think The Ramones meets Green Day with a sprinkle of Blondie. It's punk perfection! And this is on the heels of their 2023 release, “Trash and Glamour.” Don't miss this electric interview. Now, sit back, smear your make-up, tease your hair and immerse yourself in this follow-up interview with Bad Mary!Sponsored by the Harford County Cultural Arts Board.
Brea and Mallory test out the CAWPILE rating system! Plus, they settle a debate about sleep reading and if it counts, and recommend books based on favorite TV shows. Email us at readingglassespodcast at gmail dot com!Reading Glasses MerchRecommendations StoreLinks -Reading Glasses Facebook GroupReading Glasses Goodreads GroupAmazon Wish ListNewsletterLibro.fmTo join our Slack channel, email us proof of your Reading-Glasses-supporting Maximum Fun membership!CAWPILE SpreadsheetBook RoastBooks Mentioned - All This & More by Peng ShepardThe God of the Woods by Liz MooreThe Reading Glasses Book!!!Mouthful of Birds by Samanta Schweblin, translated by Megan McDowellFoe by Iain Reid
The Fellowship is pleased to present our discussion of the 2019 film Avengers: Endgame, wrapping up our little Movie Month. Has the MCU set a bar so high they can't reach it again? Plus our usual crazy talk, geek news, and tangents
A quick promotional episode to support Double Groove Brewing's 4th Annual Beer, Vinyl & Vittles Arts and Music Festival benefiting the Harford Community Action Agency on SEP 7 | 12 - 8 PM. On this episode, I sat down and spoke with Michael SummerSesh, brewmaster and vocalist for Harford County favorites, Point Break Band.Check it out!Sponsored by the Harford County Cultural Arts Board.
Dr. Justin Dunaway // #ClinicalTuesday // www.ptonice.com In today's episode of the PT on ICE Daily Show, Spine Division lead faculty Justin Dunaway takes a deep dive into a series of three studies tracking the same cohort of patients over 10 years and what they say about the importance of short term changes! Take a listen to the episode or check out the full show notes on our blog at www.ptonice.com/blog. If you're looking to learn more about our Persistent Pain Management course or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. EPISODE TRANSCRIPTION JUSTIN DUNAWAYAll right, team, good morning. I am Justin Dunaway, lead faculty with the Institute of Clinical Excellence, coming at you live from Portland, Oregon. Welcome to another Clinical Tuesday. I am lead faculty for Total Spine Thrust and also our Persistent Pain Comprehensive Management course. 32nd cohort just began yesterday. So if you're thinking about jumping in that will the registration will remain open for another day or so So if you're thinking about it, go ahead and take a look But enough about that. Let's get into today's topic today we're gonna talk about full thickness a traumatic rotator cuff tears and looking at physical therapy or Surgery and what what kind of predicts that stuff? and it's really cool because it's a series of three studies over a decade that looked at the same same kind of cohort of humans and And while I'm going to talk a bunch about these three studies, realize that this really is more than a story about rehab for rotator cuff tears. This is really a story about the importance of our ability to demonstrate within session and between session change, early, often, and frequently. And at Ice, we often hear that we are obsessed with incessant change. We are obsessed with our ability to show short-term changes. And I couldn't agree with that sentence more. Like, totally. I am absolutely obsessed with that. The second half of that, though, which I don't agree with, is that short-term change, within-session change, those things don't matter. What we're really talking about is regression of mean or natural history. And short-term change doesn't predict long-term change. And I couldn't disagree with those sentences more on lots of different levels. But I think that the story I'm about to tell, the three studies that we're about to walk through, give some of the best evidence and support for the need for short-term and within-session change, for at least one of the many reasons why this stuff is so important. So let's dive in. First study, study number one, the effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears, multi-center prospective cohort study by Kuhn and Dunn, 2013. Mouthful. But basically what they did is they took a whole bunch of humans, 452 of them, that had full-thickness chronic degenerative rotator cuff tears, and all of them got six weeks of physical therapy. And then at the end of the six weeks, they were asked, you know, how are you doing? And they got one of three options. They could stay cured, in which case they were done, and we'll just check in at 12 weeks, and then at a couple time points over the next two years, or they're improved, in which case they would get another six weeks of physical therapy, or no better, and then they could opt for surgery. And then at the 12-week mark, the people that were left, that weren't cured in the first six, asked them the same question. If they were cured, awesome. If they were anything but cured, they were offered surgery, and then tracked over the next two years. The physical therapy protocol, I couldn't get my hands on the full version of Appendix A that went into detail about what they actually did, but in the study, in the methodology they just talked about doing the physical therapy was range of motion, was postural control, was scapular training, was mobilizations, was general strength training stuff. And I've got some thoughts on that and we'll dive into here in just a second. But the outcome here is what they found is that less than 25%, okay, full thickness chronic degenerative rotator cuff tears, less than 25% of the 452 people in the trial at the end of the 12 weeks needed surgery. At the six week mark, only 6% of people opted for surgery. At the 12 week mark, that number was up to 15. And then over the next two years, a few more trickled in and that went up to like 24%. So at gut shot, 75% of people with full thickness rotator cuff tears went on to have excellent results in pain, disability, range of motion, strength, functional stuff, and went totally back to life. That's awesome. That's huge, right? The second piece The thing I want to think about here, though, is I think that number could be a bit better, right? I'm going to make an assumption that once we dive into the exercise protocols there, were they really doing strength stuff? Were they really looking at multi-joint movements, overhead presses, rows, pushes, horizontal presses, things like that, and dosing them appropriately for strength? you know, thinking about low or high sets, low reps, two to three minute rest at roughly 80% of their calculated one rep max, or are they doing like three sets of 15 with a band? And call it strength. I have no idea. My assumption is that we probably could be a bit more aggressive with exercise, and I bet that number could get a bit better. But 75% is awesome. So let's run with that. And the conclusion of this first study, which is super important, That if I'm just gonna read the quote if a patient avoids surgery in the first 12 weeks He or she is unlikely to undergo surgery at a later time point up to 12 up to two years So this is the first point here if the patient doesn't opt for surgery in the first 12 weeks They're probably not going to get surgery so our ability to to show them functional improvements in the first six, in the first 12 weeks, is absolutely huge. Because if they don't feel like they need surgery at the end of the 12 weeks, they're not going to get it probably ever. And when we think about conservative management versus surgery, both these things can be effective. But there is massive risk to surgery, right? There's massive financial risk. It's super expensive. And then thinking about the risks of anesthesia, of something going wrong during the surgery, of infection, of interactions, adverse events with the medications, opioid addiction. All of these things are risks of surgery that don't exist in conservative management. Okay, so that's the first study. If you don't opt for surgery in the first 12 weeks, it's unlikely that you're going to. 75% of humans got totally back to life without needing surgery. Study number two, predictors of failure of non-operative treatment of chronic symptomatic full thickness rotator cuff tears. Same research team. This was published in 2016. Again, looking at the same cohort of 452 individuals, This time what they wanted to see is, okay, 25% of you failed conservative management, failed physical therapy. Why? Is there anything in there? Is there anything about you that predicts whether you will or won't do well with physical therapy? And this was really cool. So they looked at all the patient demographics. They looked at age, they looked at sex, they looked at pain, severity of the tear, disability, chronicity, activity levels. They looked at work status and education and handedness and really everything under the sun. And what they found, the first thing they found is that structural factors were not predictive at all. Tear didn't matter, pain didn't matter, disability didn't matter, what your MRI didn't look like. None of that stuff predicted whether you needed surgery or not. The number one most powerful and really only significant predictor of whether you went on to need surgery or not for your full thickness rotator cuff tear was belief that physical therapy wouldn't help you. That was it. If you believe physical therapy would help you, you succeeded, you didn't need surgery. If you didn't believe that, then you opted out and went for surgery. And then smoking status moved the needle just a little bit, which makes sense. If you're smoking, your body is widely inflamed. Things heal slower. Your pain systems are far more sensitive. And then the other thing that was a very small predictor was activity levels. If you had higher activity levels, you were slightly more likely to opt for surgery early. And that makes sense too, right? My shoulder hurts. I can't do all the things I want to do. I'm still trying to do them. Things aren't getting better quick enough. Give me the magic bullet. The important thing here, again, one, structure was not predictive. Two, the only real strong predictor was your belief in physical therapy. Now, this is where it gets interesting, right? If that is the thing that determines whether you get surgery in the first six to 12 weeks, or that's the thing that determines whether you get surgery, and most humans are gonna make that decision within the first six to 12 weeks, you cannot make the argument that within session change and short term changes don't matter and probably aren't the most important thing there is, right? Because I cannot, if the thing that determines whether you need surgery or not, whether you get into that MRI tube, whether you get in the OR suite, whether you're getting those injections, pills, things like that, is your belief that physical therapy can help you, I cannot think of a more powerful way to foster that relief than having some tools in my toolbox that when you walk in the door, very quickly, I can modulate your pain, I can change your pain, your pain pressure threshold, turn on painfully inhibited muscles, gain some access to proprioception, and then get out into the gym and do some things that actually build capacity in humans, and demonstrate that thing within session, and then session after session after session. Short-term change and within-session change are the things that get patients to believe in physical therapy. And belief in physical therapy is the thing that keeps the patient out of the OR. Simple as that. That is the most important tool we have to foster those beliefs. Okay, study number three. This one just came out like last month. The predictors of surgery for symptomatic, atraumatic, full thickness rotator cuff tears change over time. Same research team, again, looking at these same humans that were in this study. Now this is tracking them down 10 years later. The first thing that pops out is that at the 10 year mark, only 27% of these people went on to get surgery. So you think about that, at the two-year mark, it was around 24%. So just a few more people kicked into the surgery over the next two, between two years, year two and year 10. Most of them, over half, opted for surgery before the six-month mark, and then the rest of them slowly trickled in over the next 10 years, with it kind of being less and less each year down the road. At the six-month mark, And everything prior to that, the most predictive thing, again, whether you need surgery or not, was belief in physical therapy and nothing else, right? So those beliefs are gonna be powerful all the way up to the six month mark. Everything we can do in that window to convince patients. that this is the path they need is gonna be the thing that keeps them off the other path. Beyond six months, it doesn't switch to structure, it doesn't switch to pain and disability and any of that stuff. The only two predictors beyond six months were if you were on worker's comp, and again, if you reported high levels of activity. Now this is super important too, right? Because okay, we're six months, we're a year, we're two years, we're five years out. We've done physical therapy, it didn't work, we've kind of forgot about it, that's off the table. And now, the stuff that's really bugging us is the fact that, okay, we're still having trouble at work, we're on workers' comp, we're kind of in that system, we still have all these activities that we want to do that we can't do the way we want to do them, now it's time to do something else. It's important to realize that overall, at the 10-year mark, 70-ish percent of humans, again, didn't need the surgery. And this is an interesting bullet point, too, because one of the things that you'll frequently hear is that, great, people do well with conservative management for rotator cuff tears. But if you don't repair it anyway, you set the patient up for degenerative changes, arthritis, problems down the road. What this study showed us is that the 10-year mark, the 70% of humans that did well with conservative management 10 years ago in that six to 12-week PT window, All of them were successful. And the success that they gained 10 years ago didn't decline over time. They didn't have more disability. They didn't have increased pain or arthritis or things like that. Their gains stuck. And this is one of a few studies that look at conservative management for rotator cuff tears, track them out over long periods of time, and show that there is no negative mechanical effects from not repairing that thing. So, the important stuff here, the key clinical factors here, is that team, at the end of the day, beliefs and expectations are the foundation. They're everything. They're the thing that drive the decisions that patients make, right? And if we don't have the ability to demonstrate change to our patient, if we don't have the ability to show them, not just tell them, But show them time and time again, ruthlessly, within session and between sessions, slowly building up functional outcomes, session after session after session, they're not going to buy this. And if they don't believe in what they're doing, if they don't believe in physical therapy, if they don't think that this is the thing, that's the stuff that determines, OK, am I going to get shots? Am I going to be taking pain medications? Am I going to end up in the OR suite? We need, what this research tells me is that we really need to drill down on our ability to have tools in the toolbox that create quick, transient changes in pain, range of motion, muscle activation. And I get that that's transient, but what we're doing is we're open a window. And then once that window is open, we absolutely have to jump through it, get right into the gym and start doing the large functional movements that build capacity in humans. And then be ruthless about your comparable measures, your functional stuff between sessions and your objective stuff within sessions. and make sure that multiple times every session, you're showing patients change. In every session, when they walk in the door, you can show them change over time. This is where you started. This is where we were after the first week. This is where we were after the second week. The better we get at that, the better we get at demonstrating change in the moment and showing them incremental change over time in the short term, the better our odds of keeping these patients out of the surgical suite. If the only thing that separates these two groups, physical therapy or going under the knife, is their belief in the power of what we're doing in the clinic, then we have to invest everything we have in our ability to demonstrate those changes. All right, team, hope you're half as excited about these three studies as I am. I think it's a really cool thing to look at and then track these patients over the last 10 years. If you got any questions, throw them in the chat. Have an awesome day in the clinic, and I look forward to seeing you out there. OUTROHey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.
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