Podcasts about mri

Have you ever opened a CT scan, MRI, or X-ray… and felt that wave of uh-oh? That moment of self-doubt when you're not 100% sure what you're looking at? You're not alone—and today's episode is for you.In this episode, Tracy introduces you to Guardian Lite, an interactive, case-based CME platform that helps clinicians build real imaging confidence. Whether you're a new grad or stepping into a new specialty, Guardian Lite helps you see it, know it, and catch it before it matters most in real life.Here's what you'll learn:

Radiology read to you! Andrew is joined by Christine (and a bonus guest) to discuss the imaging investigation of primary hyperparathyroidism. Ultrasound, 4D-CT and nuclear medicine. Plus, Frank reviews a gory MRI scene from the latest Final Destination movie!  Radiopaedia's parathyroid adenoma article ► https://radiopaedia.org/articles/parathyroid-adenoma Charlotte Gainsbourg - IRM ► https://youtu.be/D-ihfLPD6S8?si=sWT_RXc7siIyjpmK Become a supporter ► https://radiopaedia.org/supporters Get an All-Access Pass ► https://radiopaedia.org/courses/all-access-course-pass Radiopaedia Community chat ► http://radiopaedia.org/chat Ideas and Feedback ► podcast@radiopaedia.org   The Reading Room is a radiology podcast intended primarily for radiologists, radiology registrars and residents. 

Rover got his MRI results. Will there be merch this year? Is there a new DraftKings leader? Never bet for or against the Browns. See omnystudio.com/listener for privacy information.

Rover got his MRI results. Will there be merch this year? Is there a new DraftKings leader? Never bet for or against the Browns. 

Rover got his MRI results. Will there be merch this year? Is there a new DraftKings leader? Never bet for or against the Browns. JLR's weekend included a bike off marketplace, karaoke, and the Edmund Fitzgerald. Today is the Escrow deadline. Why was Rover in Los Angeles? Rachel in sales saw JLR do something she couldn't believe. Video of NFL analyst, Mark Sanchez, walking down the street after being stabbed. Mandy Moore. A YouTube prankster videos himself pretending to inject people with a syringe. Has country star Zach Bryan gone woke?

Rover got his MRI results. Will there be merch this year? Is there a new DraftKings leader? Never bet for or against the Browns. JLR's weekend included a bike off marketplace, karaoke, and the Edmund Fitzgerald. Today is the Escrow deadline. Why was Rover in Los Angeles? Rachel in sales saw JLR do something she couldn't believe. Video of NFL analyst, Mark Sanchez, walking down the street after being stabbed. Mandy Moore. A YouTube prankster videos himself pretending to inject people with a syringe. Has country star Zach Bryan gone woke? See omnystudio.com/listener for privacy information.

Mut and Handsome Johnny in studio. Riggs addressed the Kirk feud on Foreplay (0:06:50). Keith Yandle is on team Bob Does (0:16:00). Mut has an MRI at 9 PM (0:23:00). Dave Portnoy bought a new house in the Florida Keys (0:30:30). Mut's stock up/stock down from New York (0:38:30). Mut's game (0:59:00). Dave is hairless downstairs (1:05:00). Mut is upset Candace Owens is releasing Charlie Kirk's text messages (1:24:00). Blind Mike takes a shot at Mut (1:45:00).You 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/kminshow

This week's episode is a masterclass on vascular anomaly treatment. Brush up on your malformations with Dr. Cliff Weiss, the Director of the Vascular Anomaly Center at Johns Hopkins. He shares next-level techniques, precision diagnostics, and his 'gold standard' approach to alcohol sclerotherapy.---This podcast is supported by:RADPAD® Radiation Protectionhttps://www.radpad.com/---SYNPOSISThe episode begins with the most vital component of patient care: establishing a correct diagnosis through proper classification. Dr. Weiss shares his philosophy that “MRI is a conversation” - not just an image, detailing the specific MRI protocols to confidently make a diagnosis over 90% of the time. He then shares an overview of the classification system, differentiating vascular tumors like hemangiomas from high-flow and low-flow vascular malformations.Dr. Weiss explores a wide array of treatment strategies tailored to each diagnosis. He walks through his techniques for treating low-flow malformations with sclerotherapy—using agents like alcohol, doxycycline, and bleomycin based on a lesion's location and characteristics—and his use of cryoablation for vascular tumors. He then dives into the creative and high-stakes approaches for treating AVMs, comparing transvenous and transarterial embolization with agents like Onyx and coils, before concluding with his predictions on the future of IR in the field.---TIMESTAMPS00:00 - Introduction 02:36 - Vascular Anomaly Center at Johns Hopkins06:33 - Vascular Anomaly & Malformation Diagnosis with Imaging09:04 - Classifying Vascular Anomalies15:55 - Vascular Tumors18:46 - Low-Flow Malformations27:58 - Needle Placement29:56 - Retro-orbital & ENT Malformations32:44 - AVM Treatment Strategy40:41 - Following up with Patients

What do you do when your body forces you to hit pause?In this episode, I share my recent battle with back pain that quite literally knocked me off my feet. From the frustration of not being able to move, to sitting with a spinal specialist and hearing words like ‘bulging discs', it's been a humbling reminder that none of us are invincible.I'll talk about the treatments I've considered, the mental rollercoaster of dealing with injury, and the gratitude I've found through support from family, friends, and my community. More than anything, this experience has shown me that setbacks can become powerful opportunities to learn, adapt, and move forward in a smarter way.If you've ever felt stuck by injury or just life, I think this conversation will give you some perspective you can carry into your own journey.Episode Timeline:0:00 – Episode Preview 1:32 – Podcast Intro2:43 – Back pain knocks me down3:25 – How it happened (ego lifting + deadlifts)5:10 – Living with pain and frustration7:15 – Overwhelmed by too many treatment options9:40 – “Even professionals get confused”11:30 – Nobody has it all together13:55 – MRI results explained simply16:20 – Considering regenerative medicine18:40 – Lessons in gratitude and ego22:30 – Training smarter with core stability26:00 – Injuries as opportunities to pivot28:45 – Learning to be vulnerable and ask for help30:45 – Community support and closing thoughts30:45 – Podcast OutroLinks & Resources:Connect with Ben on Instagram: https://www.instagram.com/bodysystemscoaching/Learn more about Ben's coaching program: www.bodysystems.comSubscribe to the Smart Nutrition Made Simple Show on Apple Podcasts - https://podcasts.apple.com/us/podcast/the-smart-nutrition-made-simple-show-with-ben-brown/id1244912234 Spotify - https://open.spotify.com/show/4H8vUlwYvKcAXZOv84sFgT Youtube - https://www.youtube.com/@bodysystemscoaching Book Free Nutrition Strategy Call - https://bodysystems.com/free-strategy-call/

On today's Daily Puck Drop, Jason “Puck” Puckett starts off the show joined by the Go-2-Guy, Jim Moore from He-Shed in Bend, Oregon and they spend their time raving about the Mariners game two win against Detroit.  Puck describes what the atmosphere was like inside the stadium and how electric the environment was.  They chat about Jorge Polanco's two home run game, Julio's “clutch” factor, Dan Wilson's managerial moves and the reality that Seattle now has the advantage in the series.  After Puck says goodbye to Jim, he says hello to Michael-Shawn Dugar from The Athletic to discuss the Seahawks loss to the Bucs.  What is happening to Mike Macdonald's defense against good offenses?  How much were injuries to blame for the loss?  Sam Darnold continues to shine in the beginning part of the season.  Mike and Puck also discuss the Seahawks weird obsession with Jalen Milroe and Devon Witherspoon is headed for an MRI and that's never good news. Back to baseball  as Bill Krueger, host of the “Old School Baseball” podcast, and Puck discuss the Mariners game two win against Tarik Skubal and how they did it.  Louis Castillo was just good enough and the bullpen did their job for the most part.  So far, Julio and Cal are carrying the offense like the superstars they are but they'll need more from others if they want to advance.  Logan Gilbert gets the ball in game three and Bill is supremely confident in how he will perform. Puck wraps up with, “Hey, what the Puck!?”   Mariners fans delivered this weekend! (1:00) Puck and Jim (30:38) Michael-Shawn Dugar, The Athletic (53:20) Bill Krueger, “Old School Baseball” (1:25:53)  “Hey, What the Puck!?”

Contributor: Aaron Lessen, MD Educational Pearls: The cause of Alzheimer's disease is multifactorial, but the most widely suspected mechanism is the amyloid cascade hypothesis: Beta-amyloid proteins accumulate in the central nervous system, forming plaques that impair neuronal function. In recent years, advances have led to the development of targeted therapies with monoclonal antibodies. These drugs: Work by degrading amyloid plaques Slow the rate of cognitive decline and disease progression Have major side effects, most notably the development of amyloid-related imaging abnormalities (ARIA) ARIA may present as edema, effusion, or microhemorrhages, which are only detectable on MRI Symptoms can include headache, vertigo, or focal neurologic deficits that mimic stroke For patients presenting to the emergency department with stroke-like symptoms, it is important to consider whether they have a history of Alzheimer's disease and whether they are taking these medications. This guides decisions about imaging and treatment: The work-up may require MRI, which can delay thrombolytic or endovascular therapy in patients with true strokeConversely, treating a patient with ARIA using thrombolytics increases the risk of bleeding and other complications References Ebell MH, Barry HC, Baduni K, Grasso G. Clinically Important Benefits and Harms of Monoclonal Antibodies Targeting Amyloid for the Treatment of Alzheimer Disease: A Systematic Review and Meta-Analysis. Ann Fam Med. 2024 Jan-Feb;22(1):50-62. doi: 10.1370/afm.3050. PMID: 38253509; PMCID: PMC11233076. Ma C, Hong F, Yang S. Amyloidosis in Alzheimer's Disease: Pathogeny, Etiology, and Related Therapeutic Directions. Molecules. 2022 Feb 11;27(4):1210. doi: 10.3390/molecules27041210. PMID: 35209007; PMCID: PMC8876037. Perneczky R, Dom G, Chan A, Falkai P, Bassetti C. Anti-amyloid antibody treatments for Alzheimer's disease. Eur J Neurol. 2024 Feb;31(2):e16049. doi: 10.1111/ene.16049. Epub 2023 Sep 11. PMID: 37697714; PMCID: PMC11235913. Summarized by Ashley Lyons, OMS3 | Edited by Ashley Lyons and Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/

Upgrade your week in just 10 minutes with D(AI)ve Asprey's essential rundown on what matters most in longevity, biohacking, AI health tech, and medical freedom. This episode covers: • Apple Cider Vinegar Myth Busted A weight-loss study just got retracted. ACV will not melt fat, but it may blunt glucose spikes or ease digestion when diluted in water before carb-heavy meals. Skip the shots and protect your teeth. Source: https://www.sciencedaily.com/releases/2025/10/251001092216.htm • NMN Is Back The FDA reversal puts NMN back on shelves as a clean NAD precursor. Dave explains why quality, cycling, and stacking with anti-inflammatory strategies make the difference. Source: https://www.prnewswire.com/news-releases/renue-by-science-celebrates-fda-reversal-confirming-nmn-is-lawful-for-use-in-dietary-supplements-302573317.html • Poor Sleep Ages Your Brain Machine learning MRI studies show poor sleep makes your brain biologically older and raises dementia risk. Dave shares the three dials to track (deep sleep, REM, resting heart rate) and the three biggest levers to fix them. Source: https://www.sciencedaily.com/releases/2024/10/241023171543.htm • Psilocybin for Lasting Reset New research finds a single guided dose can unlock plasticity, ease pain patterns, and lift mood for weeks. Dave outlines safe protocols, integration steps, and why it is a strategic reset tool, not a party trick. Source: https://www.sciencedaily.com/releases/2025/06/250616040215.htm • AI Detects Cancer Earlier A new AI tool called DOLPHIN can find hidden genetic markers to flag cancer risk sooner. Pairing high tech scans with low tech terrain fixes like sleep, muscle, and insulin control is the prevention model that works. Source: https://www.sciencedaily.com/releases/2025/10/251001092206.htm All source links provided for easy reference to the original reporting and research above. This is essential listening for fans of biohacking, hacking human performance, functional medicine, and longevity who want actionable tools from Host Dave Asprey and a guest who embodies what it means to age with energy, clarity, and vitality. Dave Asprey is a four-time New York Times bestselling author, founder of Bulletproof Coffee, and the father of biohacking. With over 1,000 interviews and 1 million monthly listeners, The Human Upgrade brings you the knowledge to take control of your biology, extend your longevity, and optimize every system in your body and mind. Each episode delivers cutting-edge insights in health, performance, neuroscience, supplements, nutrition, biohacking, emotional intelligence, and conscious living. New episodes are released every Tuesday, Thursday, Friday (audio-only), and Sunday (BONUS). Dave asks the questions no one else will and gives you real tools to become stronger, smarter, and more resilient. Keywords: Apple cider vinegar, weight loss myths, NMN supplements, NAD precursors, cellular energy, sleep and dementia, brain aging, deep sleep optimization, REM sleep, psilocybin therapy, BDNF, neuroplasticity, pain relief, mood reset, AI cancer detection, early cancer screening, biohacking news, longevity science, Dave Asprey, Human Upgrade podcast Thank you to our sponsors! Screenfit | Get your at-home eye training program for 40% off using code DAVE https://www.screenfit.com/dave. LYMA | Go to https://lyma.sjv.io/gOQ545 and use code DAVE10 for 10% off the LYMA Laser. Vibrant Blue Oils | Grab a full-size bottle for over 50% off at https://vibrantblueoils.com/dave. Resources: • Danger Coffee: https://dangercoffee.com/discount/dave15 • Dave Asprey's BEYOND Conference: https://beyondconference.com • Dave Asprey's New Book – Heavily Meditated: https://daveasprey.com/heavily-meditated • Upgrade Collective: https://www.ourupgradecollective.com • Upgrade Labs: https://upgradelabs.com • 40 Years of Zen: https://40yearsofzen.com Timestamps: 0:00 — Introduction 0:18 — Story 1: Apple Cider Vinegar and Weight Loss 1:49 — Story 2: NMN is Back in Supplements 3:31 — Story 3: Sleep and Brain Health 5:39 — Story 4: Psilocybin and Lasting Relief 7:49 — Story 5: AI Tool DOLPHIN for Early Cancer Signals 9:48 — Conclusion & Weekly Roundup See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

• Promotion of Paisley Painting with listener testimonials and simple quote process • Streamline Mortgage Solutions ad: refinancing benefits, save money, skip two months payments • Endorsement for JustCallMoe.com: charity work, VIP events, personal attention for injury cases • Plug for upcoming events: Bad at Business Beer Fest and Sofas & Suds, Nov 22–23 with free beer, moonshine, mead, THC seltzers, charity pint glass proceeds to Yellow Brick Road • Live broadcast from Just Call Mo Studio • Introduction of new podcast Love Thy Neighbor with Colette Fair, media promotion and chart rankings • Appreciation to Fox 35 for featuring Love Thy Neighbor; encouragement to subscribe and review • Guest Seth Petruzzelli joins, with stories about contractors, lazy parenting, and under-motivated students • Seth on Kimbo Slice's son fighting; open to bouts himself with prize-money ideas • Emotional doctor visit, anxiety, crying, and nurturing roles at home • MRI scan relief after lymph node scare • Notes on aging, weight around 206 lbs, striving for mental balance • Anxiety medication started months ago, contemplating tapering • Joy from time with daughter Vera and teaching karate; funny class anecdotes • Karate programs for all ages; pricing, value, barter arrangements • Offer of free karate training promotions • Viral elephant attack on canoe tourists sparks debate over wildlife risks, internet siding with elephants, resentment toward wealthy tourists • Moose safari memory tied to online culture celebrating animal attacks on humans • Dark prank stories: nut symbol, Lemon Party, Meat Spin, new 'button wobble' joke • Funny mishaps: weed vape mistaken for pencil, producer calling host 'Ted' • Urine-cleaning story: debate over warm vs cold pee • Taylor Swift's new album criticized as flimsy and disconnected despite commercial success • Comparison to Billie Eilish and debates on authenticity of songwriting • Japanese TV show pits songwriter Akimoto Yasushi vs AI; AI-written song wins and tops Spotify • Debate on originality vs popularity in AI-era music • Hulk Hogan honored with 'Hogan Trail' by Governor DeSantis • Fox 35 news anchors impressions, insecurities, fantasies, and banter • Commentary on disturbing news stories and importance of comedians as palate cleansers • Conversation about luxury pool builds with extravagant features and costs exceeding $100K • Funny talk with Jamaican Uber driver about race, brains, and daggering videos • Football picks, Rams loss in survivor pool bet • Listener voicemail on FCC rules for on-air language; Moe once considered sponsoring 'shit' • Concrete Mike voicemail: lightning strike on truck, joked as superpower origin • Couch race debates: powerful teams, couch designs, bikini rider jokes • Closing thanks to BDMs and sign-off with comedic disclaimer ### **Social Media:**   [Website](https://tomanddan.com/) | [Twitter](https://twitter.com/tomanddanlive) | [Facebook](https://facebook.com/amediocretime) | [Instagram](https://instagram.com/tomanddanlive) **Where to Find the Show:**   [Apple Podcasts](https://podcasts.apple.com/us/podcast/a-mediocre-time/id334142682) | [Google Podcasts](https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkLnBvZGJlYW4uY29tL2FtZWRpb2NyZXRpbWUvcG9kY2FzdC54bWw) | [TuneIn](https://tunein.com/podcasts/Comedy/A-Mediocre-Time-p364156/) **The Tom & Dan Radio Show on Real Radio 104.1:**   [Apple Podcasts](https://podcasts.apple.com/us/podcast/a-corporate-time/id975258990) | [Google Podcasts](https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkLnBvZGJlYW4uY29tL2Fjb3Jwb3JhdGV0aW1lL3BvZGNhc3QueG1s) | [TuneIn](https://tunein.com/podcasts/Comedy/A-Corporate-Time-p1038501/) **Exclusive Content:** [Join BDM](https://tomanddan.com/registration) **Merch:** [Shop Tom & Dan](https://tomanddan.myshopify.com/)

Speaker-less speakers at bankruptcy box. How did Rover's MRI go? Who drives more Krystle or JLR? Nicole Kidman's earlobes. North Korea bans anti-socialist breast augmentation. Poop collecting to use as fertilizer. Samsung plans to play digital ads on their smart refrigerators. Teenagers walking through a neighborhood are confronted by an off-duty cop. Rover hates the Hey Dude shoe brand. Hoods for ICE. More details have been released about the attack on a synagogue in Manchester. Apartment hunt update and JLR's rent increased. An off-duty cop is facing administration charges after he went to the Ryder Cip dressed in full tactical gear to get into the event. Krystle found a phone in her yard. DraftKings bets. See omnystudio.com/listener for privacy information.

Speaker-less speakers at bankruptcy box. How did Rover's MRI go? Who drives more Krystle or JLR? Nicole Kidman's earlobes. North Korea bans anti-socialist breast augmentation. Poop collecting to use as fertilizer. 

Speaker-less speakers at bankruptcy box. How did Rover's MRI go? Who drives more Krystle or JLR? Nicole Kidman's earlobes. North Korea bans anti-socialist breast augmentation. Poop collecting to use as fertilizer. Samsung plans to play digital ads on their smart refrigerators. Teenagers walking through a neighborhood are confronted by an off-duty cop. Rover hates the Hey Dude shoe brand. Hoods for ICE. More details have been released about the attack on a synagogue in Manchester. Apartment hunt update and JLR's rent increased. An off-duty cop is facing administration charges after he went to the Ryder Cip dressed in full tactical gear to get into the event. Krystle found a phone in her yard. DraftKings bets.

Speaker-less speakers at bankruptcy box. How did Rover's MRI go? Who drives more Krystle or JLR? Nicole Kidman's earlobes. North Korea bans anti-socialist breast augmentation. Poop collecting to use as fertilizer. See omnystudio.com/listener for privacy information.

Sometimes the most important decisions for our health are the ones we don't think about until it's almost too late. Breast cancer screening is one of those things; we'd all rather not face it, but the truth is, the earlier we pay attention, the more power we have. That's why I wanted to have this conversation with two incredible leaders in women's health who are changing the way we think about mammograms and breast cancer detection.   Dr. Chirag Parghi, a Breast-Specialized Radiologist and Chief Medical Officer at Washington Radiology, explains why starting mammograms at 40 can make all the difference, especially if you have dense breast tissue. He also shares how new imaging tools, combined with artificial intelligence, are helping women avoid unnecessary biopsies and get clearer answers. Dana Brown, CEO of iCAD, brings such an inspiring perspective on how AI is transforming cancer detection around the world and why this matters to every single one of us.   We also talked about the simple, everyday choices we can make that support breast health and why being proactive really is the best gift we can give ourselves. After you listen, if you're struggling with energy dips, mood swings, or hormone changes, I'd love for you to join me in my Mastering Your Hormones Masterclass at dranna.com/hormones. It's where we dig into what's really driving those symptoms and how to feel like yourself again. And because I'm always looking for ways to support you: my Julva cream has been life-changing for women dealing with dryness or discomfort, and I have to say, I am obsessed with the new Mighty Maca Mango flavor. It's so refreshing in sparkling water, and it gives me the energy boost I need to keep up with life.   Key Timestamps: [00:00:00] Introduction. [00:03:44] Importance of mammography. [00:05:34] AI in mammography and its benefits. [00:09:31] iCAD and AI in breast imaging. [00:12:47] Breast density and calcifications. [00:19:51] Comparison of mammography techniques. [00:21:58] MRI and ultrasound in breast imaging. [00:49:10] Guidelines for mammography screening.   Memorable Quotes: "This is such an important topic. This saves lives. The more women you reach out to, if you can get 200 women to get their screening mammogram, you will save one life." [00:03:48] – Dr. Chirag Parghi   "The key takeaway is not all mammograms are created equal, and it's important to know what to ask for." [00:43:22] – Dana Brown   Links Mentioned: Mastering Your Hormones Masterclass: https://dranna.com/hormones Julva Cream: http://dranna.com/summeroflove Mighty Maca Mango: https://drannacabeca.com/products/mighty-maca   Connect with Dr. Chirag Parghi: LinkedIn: https://www.linkedin.com/in/chirag-parghi-279164b5/   Connect with Dana Brown: Website: https://www.icadmed.com/ LinkedIn: https://www.linkedin.com/in/dana-brown-a391a813/   Connect with Dr. Anna Cabeca: Website: https://drannacabeca.com/pages/show Instagram: https://www.instagram.com/thegirlfrienddoctor/ YouTube: https://www.youtube.com/@thegirlfrienddoctor TikTok: https://www.tiktok.com/@drannacabeca   Produced by Evolved Podcasting: www.evolvedpodcasting.com

Today, I'm joined by the remarkable Dr. Vonda Wright, an orthopedic surgeon, elite sports doctor, and a passionate advocate for redefining how we age. Dr. Wright's philosophy goes far beyond the operating room—she believes that saving our mobility is truly what saves us from the ravages of chronic disease and a life of unnecessary pain. Fresh from the operating room and still in her scrubs, she sits down to share her mission: empowering women (and men!) with the knowledge and actionable habits that protect our strength, bones, and brains as we move through midlife and beyond.   Episode Timestamps: Saving mobility to prevent chronic disease ... 00:07:17 Empowering women in healthcare decisions ... 00:09:04 Focusing on women's strength, aging, and research ... 00:11:23 Master athletes: mobility impact on aging bones and brain ...00:12:12 MRI evidence: active vs. sedentary muscle ... 00:15:51 Can seniors regain strength? Real-life transformation ... 00:19:54 Nutrition basics: protein, sugar, and inflammation ... 00:27:53 Critical decade: 35–45 and early warning signs ... 00:42:16 Hormone optimization and bone health ... 00:48:37 Dr. Vonda's personal menopause journey ... 00:52:08 Lifting, sprinting, and body recomposition ... 00:58:10 Fitness advice: women vs. men, VO2 max, and frailty ... 01:00:05 Rapid fire: exercise tips, nutrition, aging myths ... 01:05:41 Book announcement and key takeaways ... 01:09:09 Final thoughts: It's never too late ... 01:10:03   Our Amazing Sponsors: MitoLux Lite Sunlamp - UVB at 295 nm to naturally boost vitamin D, plus red light for collagen and infrared for recovery. Get 10% off your MitoLux Lite Sunlamp at https://mitolux.com/NAT10. NAT10 will be automatically applied at checkout.   BEAM Minerals - Mineral deficiency support. One shot in the morning, tastes like water, and you've just restored every essential mineral your cells are craving. Go to beamminerals.com, use code NAT20, and get 20% off your first order.   Nootropept by LVLUP - an advanced cognitive enhancement formula that combines fast-acting neuropeptides, cholinergic support, and mitochondrial-boosting compounds to sharpen mental clarity, memory, and long-term brain performance. Visit https://lvluphealth.com/ and use code NAT at checkout for 20% off.   Nat's Links:  YouTube Channel Join My Membership Community Sign up for My Newsletter  Instagram  Facebook Group

Broadcast from KSQD, Santa Cruz on 10-02-2025: Dr. Dawn opens by explaining how blood pressure treatment guidelines have been corrected back to 140/90 after the problematic 2015 SPRINT study temporarily changed recommendations to 120/80. That study used ideal measurement conditions - five minutes of quiet sitting, perfect cuff sizes, compliant patients - creating unrealistic targets that caused elderly patients to faint and break hips. The Veterans Administration and major cardiology organizations now recommend treating to 140/90, with statins only for LDL above 190 or 12% ten-year cardiovascular risk. An emailer asks about claims linking Tylenol to autism. Dr. Dawn thoroughly debunks this, explaining that Swedish studies of 2.5 million children found no association when controlling for sibling comparisons. She notes autism rates remained flat from 1960-1990 despite widespread Tylenol use, then spiked after DSM-4 in 1994 and DSM-5 in 2013 broadened diagnostic criteria. Recall bias skews studies since mothers of autistic children are asked leading questions about past Tylenol use during pregnancy when fever treatment was medically necessary. She discusses RFK Jr.'s mixed positions, comparing him to Isaac Newton who excelled at physics but believed in astrology. While criticizing vaccine misinformation, Dr. Dawn strongly supports RFK's stance on ultra-processed foods. She describes NIH researcher Kevin Hall's studies showing people consume 500 extra calories daily on ultra-processed diets versus whole foods, even when nutrients are matched. The US produces 15,000 calories per person daily, with the food industry engineered to promote overconsumption through hyper-palatable fat-sugar-salt combinations. A caller asks about Healthcare 4.0 plans for biometric tracking bracelets and digital twins. Dr. Dawn discusses privacy concerns around constant health monitoring and data collection, noting that while early disease detection could be valuable, mandatory participation raises serious civil liberties issues. She acknowledges voluntary research projects like the Million Man Study but emphasizes the importance of consent and protection against unauthorized data access by advertisers or government agencies. An emailer shares research on ultrasound brain stimulation helmets as alternatives to surgical electrode implants. Dr. Dawn explains how 256-element phased ultrasonic arrays can target brain regions like the visual cortex with high precision mechanical perturbation, potentially treating Parkinson's, Alzheimer's, and depression without surgery. The technology remains experimental, requiring MRI guidance, but could become portable and dramatically improve quality of life for neurological conditions currently requiring invasive deep brain stimulation. A caller with adrenal cancer asks about fasting-mimicking diets. Dr. Dawn explains that 14-hour fasting before chemotherapy improves outcomes because healthy cells can downshift metabolism while cancer cells cannot. Cancer cells rely only on glycolysis without mitochondrial function, making them vulnerable during fasting states. She recommends chronotherapy - scheduling treatments during fasting periods - and expresses optimism about new cancer therapies like CAR-T cells and CRISPR technologies. An emailer asks about inulin fiber for fatty liver disease. Dr. Dawn explains how this fiber found in chicory, Jerusalem artichokes, and root vegetables stimulates gut bacteria to break down fructose before it reaches the liver, preventing fructose-induced hepatic lipogenesis. Inulin supplementation protects against fatty liver disease, increases antioxidant production, and helps with obesity by reshaping the gut microbiome to better process dietary sugars.

Over the centuries, we have learned to peer into what was once invisible. Imaging devices like cameras, telescopes, microscopes, and MRI machines map the world around, beyond, and within us in ways the naked eye could never see. In so doing, these technologies have transformed our understanding of our place in the universe and our conception of our own bodies--and we may be on the cusp of an even greater revolution. Daniel K. Sodickson--a physicist and biomedical imaging innovator--explores the rich history and surprising future of vision, from the evolution of eyes to emerging high-tech devices. Beginning in the early oceans, when organisms first developed sight, The Future of Seeing: How Imaging is Changing the World (Columbia UP, 2025) tells the stories of the many remarkable tools people have invented to extend our natural vision. Ranging from the tales of brilliant inventors to profiles of everyday people, this book shows how imaging has transformed the practice of medicine, reshaped the global economy, and complicated the notion of privacy. In the era of artificial intelligence, Sodickson argues, it will be reinvented even further, emulating not only our senses but also our brains. Inviting and eye-opening, The Future of Seeing is a revelatory look at what imaging teaches us about the way we see the world, each other, and ourselves. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network

Why do women use so many skincare products? Rover and Krystle like to walk around naked. Rover has his MRI today. See omnystudio.com/listener for privacy information.

JLR's dry spell. A spy has been seeing a car outside of Duji's house, could it be her main man? Will JLR be moved into a new place by the end of the year? Guardians' baseball and new traffic patterns. The Browns are pulling Joe Flacco and will be starting with Dillon Gabriel. Mike Jones has a restraining order from seeing a 60-year-old woman after she breast fed him. Snitzer tasted breastmilk. A bouncer has been charged with assault after putting a patron in a chokehold. Greta Thunburg. They now say you need to spend $1.3 million to get into 10% of homes. Rover thinks people just spend more frivolously nowadays then they did 75 years ago. Why do women use so many skincare products? Rover and Krystle like to walk around naked. Rover has his MRI today. See omnystudio.com/listener for privacy information.

JLR's dry spell. A spy has been seeing a car outside of Duji's house, could it be her main man? Will JLR be moved into a new place by the end of the year? Guardians' baseball and new traffic patterns. The Browns are pulling Joe Flacco and will be starting with Dillon Gabriel. Mike Jones has a restraining order from seeing a 60-year-old woman after she breast fed him. Snitzer tasted breastmilk. A bouncer has been charged with assault after putting a patron in a chokehold. Greta Thunburg. They now say you need to spend $1.3 million to get into 10% of homes. Rover thinks people just spend more frivolously nowadays then they did 75 years ago. Why do women use so many skincare products? Rover and Krystle like to walk around naked. Rover has his MRI today.

Why do women use so many skincare products? Rover and Krystle like to walk around naked. Rover has his MRI today. 

LeBron is limited with a pain in his butt. Marcus Smart is out through the beginning of next week. Maxi Kleber is already getting an MRI. Enough! To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

Before the written word — and possibly even before speech — humans have communicated through drawing. From crude scratches in the dirt or on cave walls to the arcane symbology of the laboratory whiteboard, our instinct for conveying our thoughts visually is pretty extraordinary. We see or understand something in the world, we build an idea in our mind of what we think we see, and then using our hand and the utensil we re-create it to communicate the share our perception with others. Along the way, we add in our own understanding and experience to craft that communication in ways that might not correspond with a specific object in the world at all.How we do this — and how we can learn to be better visual communicators — is at the heart of our conversation with Judy Fan, who runs the Cognitive Tools Lab in Stanford University's Department of Psychology.We've been nominated for a 2025 Signal Award for Best Science & Education Podcast! Vote for us in the "Listener's Choice" category by October 9.Learn More:Cognitive Tools Lab, Stanford Department of PsychologyFan, J., et al. (2023) "Drawing as a versatile cognitive tool." Nature Reviews Psychology. (pdf)Hawkins, R., Sano, M., Goodman, N., and Fan, J. (2023). Visual resemblance and interaction history jointly constrain pictorial meaning. Nature Communications. [pdf]Fan, J., et al. (2020). Relating visual production and recognition of objects in human visual cortex. Journal of Neuroscience. [pdf]Fan, J., Yamins, D., and Turk-Browne, N. (2018). Common object representations for visual production and recognition. Cognitive Science. [pdf]More recent papersWe want to hear from your neurons! Email us at at neuronspodcast@stanford.eduSend us a text!Thanks for listening! If you're enjoying our show, please take a moment to give us a review on your podcast app of choice and share this episode with your friends. That's how we grow as a show and bring the stories of the frontiers of neuroscience to a wider audience. Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.

Mental health and mental performance are plummeting. Having witnessed this dramatic decline over the past few years, I've believe it is my mission to connect with the people and technologies that can intervene and stop this cognitive crisis. That's why I am pleased to introduce my guest Dr Reza Ghomi, one of the most qualified guests in nearly 300 episodes, with his own unique pain to purpose story, who is leveraging the best of science and technology to save your brain.Dr Reza Hosseini Ghomi is a neuropsychiatrist, engineer, and serial healthcare entrepreneur founding four health tech companies including Frontier Psychiatry and MedFlow. A cancer survivor at 22, I pivoted from naval engineering to medicine, training in biomedical engineering and neuropsychiatry. My work spans MR image registration software, MRI-compatible exercise devices, EHRs and numerous enhancements, digital cognitive testing, and voice-based digital biomarkers. Now focused on transforming healthcare using AI enhanced workflow automations to drive value based care models and improve patient outcomes.Contact:Website - https://www.brainmindedmd.comJoin us as we explore:The fracturing of attention, memory and mental performance due to technological atrophy and neurological hijack.How to assess and track your cognitive performance in an objective, data centric way.The most critical interventions to recover and reboot your mental performance, and why the most important ones are available to anyone everyday.Why lax treatment and tolerating things as “fine”, from blood pressure to other routine blood markers has been more damaging than realized.Using AI prompting to prepare yourself with the right questions for your next appointment with someone in the medical field.Creatine, hyperbaric chambers, light therapy and more.Mention:Tool - BrainCheck, https://braincheck.comTool - Creyos, https://creyos.comSupport the showFollow Steve's socials: Instagram | LinkedIn | YouTube | Facebook | Twitter | TikTokSupport the show on Patreon:As much as we love doing it, there are costs involved and any contribution will allow us to keep going and keep finding the best guests in the world to share their health expertise with you. I'd be grateful and feel so blessed by your support: https://www.patreon.com/MadeToThriveShowSend me a WhatsApp to +27 64 871 0308. Disclaimer: Please see the link for our disclaimer policy for all of our content: https://madetothrive.co.za/terms-and-conditions-and-privacy-policy/

Dr. Monty Pal and Dr. Matteo Lambertini discuss a compelling global study on the clinical behavior of breast cancer in young BRCA1 and BRCA2 carriers, the association of pre-diagnostic awareness of BRCA status with prognosis, and the importance of identifying healthy people who are at risk of carrying the BRCA1/2 pathogenic variants. TRANSCRIPT Dr. Monty Pal: Well, hello everyone, and welcome to the ASCO Daily News Podcast. I'm your host, Dr. Monty Pal. I'm a medical oncologist, professor, and vice chair of medical oncology at the City of Hope Comprehensive Cancer Center in Los Angeles. Now, when we think about genetic testing, whether for patients diagnosed with breast cancer or for other family members of them, it seems to be widely underutilized. Today, we're going to be discussing a recently published study in the Journal of Clinical Oncology that reported on the clinical behavior of breast cancer and specifically young BRCA1 and BRCA2 carriers, and the association of pre-diagnostic awareness of BRCA status with prognosis. I thought this was just a fascinating piece, and I honestly couldn't wait to have this conversation. It's a really compelling paper that highlights the importance of identifying healthy people who are at risk of carrying the BRCA1/2 pathogenic variants, and really the need for genetic counseling and testing to inform people about early detection that could lead to a better prognosis. I'm really delighted to welcome the study's lead author, Dr. Matteo Lambertini. He really needs no introduction. He's very well known in the breast cancer world for his amazing contributions to fertility in the context of breast cancer, to pregnancy in the context of breast cancer, and genetic testing. He's an associate professor at the University of Genova, and a breast cancer medical oncologist at the San Martino Polyclinic Hospital in Genova, Italy.  Dr. Lambertini, thank you so much for joining us today. Dr. Matteo Lambertini: Thank you very much, Dr. Pal. It's a great pleasure. Dr. Monty Pal: Oh, thanks. And just FYI, if you're listening in and you want to hear our disclosures, they're all listed at the transcript of this podcast.  So, I poured through this paper [Clinical Behavior of Breast Cancer in Young BRCA Carriers and Prediagnostic Awareness of Germline BRCA Status] yesterday, Dr. Lambertini, and first of all, congratulations on this study. This was a huge international multicenter effort, 4,752 patients. How did you pool all these patients with young breast cancer? Dr. Matteo Lambertini: Thanks a lot for the question. Yes, this was an effort made by several centers all over the world. The main idea behind the creation of this network that we have named as BRCA BCY Collaboration, was to get as many data as possible in a sort of niche patient population in the breast cancer field, meaning women diagnosed with breast cancer at the age of 40 years or younger, and all of them being BRCA carriers. We know that around, in the Western world, around 5% of breast cancer cases are being diagnosed under the age of 40 years, and among them around 10-15% are BRCA carriers. So, I would say it's a relatively rare patient population where we did not have a lot of evidence to support our choices in terms of counseling on treatment, prevention, and oncofertility as well. That was the idea behind the creation of this network that includes many centers. Dr. Monty Pal: Yeah. You know, what's so interesting about this is that you sort of draw this line between patients who have BRCA testing at the time of diagnosis and then BRCA testing earlier in their course and then leading to a diagnosis perhaps. And I think that's where really sort of the dichotomy in outcome sits. Can you maybe elaborate on this and tell us about timing of genetic testing in this study and what that meant ultimately in terms of prognosis? Dr. Matteo Lambertini: In this specific analysis from this large network, including almost 5,000 women with breast cancer diagnosed at the age of 40 years or younger and being a BRCA carrier, we looked specifically into the timing of genetic testing because this is a retrospective study and the criteria for inclusion are those that I have just mentioned, so diagnosis at a young age plus carrying germline BRCA pathogenic or likely pathogenic variant. In this analysis, we have looked into the time the patient has got the genetic testing and particular we focused on two populations: those that were diagnosed, knowing already to be a BRCA carrier, and those that got tested after being diagnosed with breast cancer. And the main findings from this analysis have been that knowing to be a BRCA carrier was associated with a lower stage at the time of diagnosis, meaning more T1 tumors, so a tumor less than 2 cm, more node-negative disease, and this translated into less aggressive treatment, so less often axillary dissection, less often use of chemotherapy and anthracycline-based chemotherapy. And even more importantly, we have seen a better overall survival for those patients that were diagnosed already knowing to be BRCA carriers as compared to those tested after breast cancer diagnosis. These results after adjusting for all the confounding, stage, treatment and so on, there was not significant anymore, meaning that it's not the timing of test per se that is probably leading to a better survival, but it is the fact that knowing to be a BRCA carrier would likely translate into having access to all the preventive measures that we have in this setting and this will translate into an overall survival benefit, so in terms of saving more lives in young BRCA carriers. Dr. Monty Pal: I think it's such an important point, and it's one that I think might sound implicit, right, but it needs to be proven, I think, through a study like this. You know, the fact that finding this early, identifying the mutation, doing enhanced screening, and so forth, is really going to lead to superior clinical outcomes. One of the things that I think many people puzzle over, including myself, is what to do? I personally occasionally will see BRCA altered patients in the context of prostate cancer. But that's a very different population of individuals, right? Typically older men. In young females with BRCA mutation, I guess there's a specific set of considerations around reproductive health. You'd already highlighted preventive strategies, but what sorts of things should we be talking about in the clinics once a patient's diagnosed and once perhaps their breast cancer diagnosis is established? Dr. Matteo Lambertini: Yes, exactly. Knowing to be a BRCA carrier has a lot of implications from prevention to treatment to survivorship issues including reproductive counseling. And this is important not only for the patient that has been diagnosed with breast cancer but also for all the family members that will get tested and maybe identify with this sort of genetic alteration before diagnosis of cancer. Why this is important is because we have access to very effective preventive measures, a few examples: MRI screening, which starts at a very young age and normally young women don't have an effective screening strategy outside the BRCA field. Also, primary preventive measures, for example, risk-reducing surgery. These women are known to have a high risk of breast cancer and high risk of ovarian cancer. So the guidelines are suggesting to undergo risk-reducing salpingo-oophorectomy at a young age, so 35 to 40 years in BRCA1 carrier, 40 to 45 years in BRCA2 carrier. And also risk-reducing mastectomy should be discussed because it is a very effective way to prevent the occurrence of breast cancer. And in some situations, including the setting that we are talking about, so young women with breast cancer, BRCA carrier, also risk-reducing mastectomy has shown to improve overall survival.  On the other side, once diagnosed with breast cancer, nowadays knowing to be or not a BRCA carrier can make a difference in terms of treatment. We have PARP inhibitors in the early setting, in the adjuvant setting as well as in the metastatic setting. And in terms of survivorship implication, one of the critical aspects for young women is the oncofertility care which is even more complicated when we talk about BRCA carriers that are women candidates for gynecological surgery at a very young age. So this sort of counseling is even more complicated. Dr. Monty Pal: One of the other things, and this is subtle in your paper and I hope you don't mind me bringing it up, is the difference between BRCA1 and BRCA2. It really got me thinking about that because there are differences in phenotype and manifestation. Do you mind just expanding on that a little bit for the audience because I think that's a really important reminder that you brought up in the discussion? Dr. Matteo Lambertini: The difference between BRCA1 and BRCA2 carriers has been known that there are different phenotypes of breast cancer that are more often diagnosed in these two different populations. Normally BRCA1 carriers have a higher likelihood to develop a triple negative breast cancer as compared to BRCA2 carriers, more likely to develop a hormone receptor-positive HER2-negative disease. In this study, again, a specific population of young women with breast cancer, we have seen the same findings, mostly triple negative disease in BRCA1 carrier, mostly luminal-like disease in BRCA2 carrier. But what's novel or interesting from this study is to look also at the age at the time of diagnosis of this disease. And particularly in BRCA1 carriers, we should be sort of more careful about diagnosis of breast cancer and also other primary tumors including ovarian cancer because the risk of developing these malignancies is higher even at a younger age as compared to BRCA2 carriers. And this has implications also in the primary and secondary prevention that we were talking about earlier. Dr. Monty Pal: Oh, interesting. I guess the fundamental question then from your paper becomes, how do we get at the right patients for screening for BRCA1 and BRCA2? And I realize our audience here is largely oncologists who are going to be listening to this podcast, oncology providers, MDs, nurses, etc. But maybe speak for a moment to the general practitioner. Are there things that, for instance, a general practitioner should be looking for to say, “Wait a minute, this patient's high risk, we should consider BRCA1, BRCA2 testing or germline screening”? Dr. Matteo Lambertini: Yes, it's a very important question for the breast cancer community. After the updated ASCO guideline, the counseling is way easier because right now the age cutoff goes up to 65 years, meaning that all the patients diagnosed with breast cancer below the age of 65 years should be tested these days. And then above the age of 65, there are different criteria like triple-negative disease or family history. From a general practitioner standpoint, it's of course a bit more difficult, but knowing particularly the family history of the person that they have in front will be crucial to know if there are cases of breast cancer diagnosed at a young age, maybe triple-negative cases, knowing cases of ovarian cancer in first-degree relatives or pancreatic cancer in first-degree relatives, and of course cases of prostate cancer as well. So, I would say probably mostly the family side will be important from a general practitioner perspective.  From an oncology one, the other point that I think is important to stress also based on the data that we have shown in this publication is that having a case of breast cancer known to carry a BRCA pathogenic or likely pathogenic variant. It means that all the people around this case should get tested and if found to be BRCA carrier and healthy carrier, these people should also undergo the primary and secondary prevention strategies because this is very critical also to improve their outcomes and try to avoid the developing of breast or ovarian cancer, but also in the case of diagnosis of this disease, a diagnosis at an earlier stage, as we have seen in this paper. Dr. Monty Pal: Brilliant. I'm going to diverge from our list of questions here and close by asking a question that I have at the top of my mind. You're very young. I know our podcast listeners can't see you, but you're very, very young. Dr. Matteo Lambertini: Thank you. Thank you for that. Not so young but yeah. Dr. Monty Pal: You have nearly 300 papers. Your H-index is 67. You've already made these seminal contributions, as I outlined it from the outset, regarding fertility, regarding use of GnRH analogs, regarding pregnancy and breast cancer. What are you studying now? What are you really excited about right now that you're doing that you think might potentially be practice changing? Give us a little teaser. Dr. Matteo Lambertini: Yeah. Thanks a lot, Dr. Pal. Receiving this compliment from you is fantastic. So, thanks a lot for that. From my side, in terms of my research, I've been interested in the field of breast cancer in young women since the start of my training. I've had very good mentors from Italy, from Europe, from the U.S. I'm still interested in this field, so I think we still have a lot to learn to try to improve the care of young women with breast cancer. For example, the oncofertility care, which is something I worked a lot over the past years. Now with all the new treatment options, there's a sort of new chapter of oncofertility counseling. So, what's the impact of immunotherapy? What's the impact of the new targeted agents?  More on the genetic aspects, now we know that there's not only BRCA1 or BRCA2. There are a lot of other different genes that may increase the risk of breast cancer and other malignancies. And also for these genes, we really don't have a lot of evidence to counsel women on prognosis, treatment, prevention strategy. So we need to learn way more for this special patient population that are quite rare, and so we really need a multicenter academic effort to try to give some evidence in this field. Dr. Monty Pal: Yeah. It's tough because these are rare circumstances, but, you know, I think that you've done really well to sort of define some collective experiences that I think really define therapy. I mean, I just remember when I was in training 25 years ago, just reading through textbooks where all the experience around breast cancer and pregnancy was really just very sort of anecdotal almost, you know? And so it's great to see that the state of the science has moved forward.  Well, gosh, I really enjoyed our conversation today. I think your study really reminds us how powerful genetic information is in terms of improving outcomes. And, you know, hopefully this will lead some individuals to perhaps test more broadly in appropriate settings. So, thank you so much, Matteo, for joining us today with your fantastic insights on the ASCO Daily News Podcast. Dr. Matteo Lambertini: Thank you very much, Dr. Pal. It's a real pleasure. Dr. Monty Pal: And thanks to our listeners too. You'll find a link to Dr. Lambertini's study in the transcript of this episode. Finally, if you value the insights that you heard today on the ASCO Daily News Podcast, please rate, review, and subscribe wherever you get your podcasts. Thanks a ton. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers:    Dr. Sumanta (Monty) Pal  @montypal  Dr. Matteo Lambertini @matteolambe   Follow ASCO on social media:     @ASCO on Twitter    ASCO on Bluesky   ASCO on Facebook     ASCO on LinkedIn     Disclosures:    Dr. Monty Pal:   Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview  Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical  Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis  Dr. Matteo Lambertini: Consulting or Advisory Role: Roche, Novartis, Lilly, AstraZeneca, Pfizer, MSD, Exact Sciences, Gilead Sciences, Seagen, Menarini, Nordic Pharma Speakers' Bureau: Takeda, Roche, Lilly, Novartis, Pfizer, Sandoz, Ipsen, Knight Therapeutics, Libbs, Daiichi Sankyo, Gilead Sciences, AstraZeneca, Menarini, AstraZeneca, Menarini Research Funding (Inst.): Gilead Sciences Travel, Accommodations, Expenses: Gilead Sciences, Daiichi Sankyo Europe GmbH, Roche

No Shoes At Work Is The New TrendA trend of workers going barefoot in the office has spread across Silicon Valley startups, sparking a debate as to whether shoeless workplaces could drive creativity or create conflict. Cursor, an AI coding company valued at nearly $10billion, as one of several firms adopting shoeless policies.  Some commenters saw it as aspirational, one calling it a “bucket list” workplace. Others mocked the idea with sneezing emojis or worried about hygiene. We put up a poll, I clocked the "barf" emoji.Cozy Cardio Trend                                                                                                                        Imagine swapping sweaty gym vibes for fuzzy socks, candles, and your favorite show while strolling on a walking pad — that's cozy cardio, the revived TikTok-born fitness trend that blends light exercise with maximum comfort.Here's how to get started:                                                                                                                                Gather cozy basics like candles, soft lighting, and a favorite beverage                                                Choose a simple cardio option: stationary bike, treadmill, or elliptical                                       Set the mood with a movie, TV show, book, or music you enjoy                                                            Go at your own pace at a time of day that feels rightCorey's Neck UpdateI've been dealing with crazy pain since I tripped over my German Shepherd's dog hammock. It was dark and the hammock was put together with metal bars. My neck landed on the metal bar. I have been seeing a chiropractor, but the pain just got worse and worse. I had an MRI and it showed stenosis, However, that wasn't the culprit. The nerves were already somewhat arthritic, but the fall exacerbated the situation and my nerves are in the seventh circle of hell. This is where "ablation" comes in. It's basically burning the nerve endings...which could keep pain at bay for up to 16 months. They do grow back but that is better than all of the pain killers I am taking. Thank god I am not pregnant; I'm keeping Tylenol in business. #autismSecond Date UpdateAlex said he met Marissa online and their rooftop dinner felt magical. He booked a table with a view, ordered a bottle of champagne, and said their conversation flowed all night. He figured they were lining up a second date for sure. She ghosted, and he wanted to know why.

Coverage that provides news and analysis of national issues significant to regional Australians.

#191: Ever wondered why your doctor seems to rush you through your medical history? Or why getting that MRI your provider ordered takes weeks of insurance battles? The disconnect between what patients experience and how the healthcare system actually functions creates frustration on all sides.Drawing from 15 years of healthcare experience, as both a provider and a patient, I'm pulling back the curtain on how medicine really works. When patients say "no one is doing anything for me," they're expressing a genuine frustration born from a system that often fails to communicate its processes effectively.Medical providers use differential diagnosis, a detective-like process, to narrow down possible causes based on specific symptoms. This explains why they ask such targeted questions and sometimes seem to cut you off mid-story. It's not rudeness; it's their training to find the most critical information quickly. Meanwhile, nurses use structured communication methods like SBAR (Situation, Background, Assessment, Recommendation) to deliver life-saving information efficiently.Behind the scenes, insurance companies create enormous barriers through prior authorization requirements that delay necessary care for 94% of physicians. Your provider may be fighting battles you never see, writing appeals and conducting peer-to-peer reviews just to get you the test they know you need. America spends more on healthcare than any other wealthy nation yet has worse outcomes because our system prioritizes "sick care" over prevention.Whether you're a patient trying to be heard, a nurse communicating critical information, or a provider navigating systemic barriers, better communication is the key. Remember that medicine is humans helping humans, we're all learning together how to create better healthcare experiences through clearer communication.If you've ever felt frustrated with healthcare, this episode offers practical insights from someone who's seen it from every angle. Share it with someone who might need a new perspective on navigating our complex medical system.You can now send us a text to ask a question or review the show. We would love to hear from you! PodMatchPodMatch Automatically Matches Ideal Podcast Guests and Hosts For InterviewsFollow me on social: https://www.instagram.com/babbles_nonsense/

When radiology meets surgery, endometriosis care becomes more precise, personalized, and proactive. In this BackTable OBGYN Brief, host Dr. Mark Hoffman is joined by Dr. Wendaline VanBuren, an associate professor of radiology at Mayo Clinic, and Dr. Tatnai Burnett, a minimally invasive GYN surgeon at Mayo Clinic, to discuss the complexities of diagnosing and managing endometriosis. The discussion covers the roles of advanced imaging techniques like MRI and ultrasound, the importance of pre-surgical planning, and the need for multidisciplinary collaboration. They share their approach to managing symptomatic and asymptomatic patients, the use of hormonal treatments, and the significance of monitoring potential malignant transformations in endometrioma cases. The episode underscores the critical role of imaging in planning effective surgical interventions for patients while highlighting the progression of endometriosis management protocols. TIMESTAMPS 00:00 - Introduction  01:07 - Discussing Endometriosis Management 02:18 - Imaging Techniques and Their Importance 04:24 - Interdisciplinary Collaboration 05:40 - Advanced Imaging Protocols 08:12 - Monitoring and Follow-Up Strategies 08:50 - Concerns About Malignancy 11:04 - Future Directions CHECK OUT THE FULL EPISODE OBGYN Ep. 69 https://www.backtable.com/shows/obgyn/podcasts/69/imaging-protocols-to-guide-endometriosis-treatment

Send us a textWelcome to PT Stocks podcast! In this episode, we dive into the fundamentals of using MRIs in physical therapy. MRIs are a great tool, but we need to learn how to use them appropriately to maximize their effectiveness. We'll explore key topics such as common asymptomatic MRI findings, when to order imaging, and how to educate and empower patients. Expect to learn about the cervical and lumbar spine, knee, rotator cuff, and hip labral tears, and get actionable tips on integrating MRI with clinical assessments. Tune in for practical takeaways that will enhance your diagnostic skills without over-relying on imaging.00:00 Introduction to PT Stocks Podcast00:55 Understanding MRIs: Asymptomatic Findings03:42 Clinical Examples of MRI Findings08:59 When to Order an MRI12:34 Cases Where MRI May Not Be Needed14:50 Conclusion and Additional ResourcesBrinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811–816. doi:10.3174/ajnr.A4173Culvenor AG, Øiestad BE, Østerås N, et al. MRI features of knee osteoarthritis in patellofemoral pain: a cross-sectional case–control study. Br J Sports Med. 2018;52(12):817–823. doi:10.1136/bjsports-2017-098349Tempelhof S, Rupp S, Seil R. Age-related prevalence of rotator cuff tears in asymptomatic shoulders. J Shoulder Elbow Surg. 1999;8(4):296–299. doi:10.1016/S1058-2746(99)90148-9Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA. The demographic and morphological features of rotator cuff disease: a comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am. 2006;88(8):1699–1704. doi:10.2106/JBJS.E.00835Register B, Pennock AT, Ho CP, Strickland CD, Lawand A, Philippon MJ. Prevalence of abnormal hip findings in asymptomatic participants: a prospective, blinded study. Am J Sports Med. 2012;40(12):2720–2724. doi:10.1177/0363546512453291Cardinal E, Buckwalter KA, Braunstein EM, Pope TL, Montgomery WJ. MGo to PT Final Exam using this link to access great studying options to conquer the NPTE!Support the showStay Connected! Make sure to hit follow now so you don't miss an episode! Got questions? Email me at ptsnackspodcast@gmail.com or leave feedback HERE. You can also join the email list HERE Need CEUs Fast?Time and resources short? Medbridge has you covered: Get over $100 off a subscription with code PTSNACKSPODCAST: Medbridge Students: Save $75 off a student subscription with code PTSNACKSPODCASTSTUDENT—a full year of unlimited access for less! Prepping for the NPTE? Get all the study tools you need to master it at PT Final Exam. Use code PTSnacks at checkout to get a discount! Want to Support the Show?Help me keep creating free content by: Sharing the podcast with someone who'd benefit. Contributing directly via the link...

Psalm 119:67, which says, “Before I was afflicted I went astray, but now I keep your word.”   *Transcription Below*   Doug Rumbold is a child of the living God, a loving husband to Jessica, and father to Jada, Oliver, and Pierce. Currently he is the Pastor of Counseling & Discipleship at Northfield Christian Fellowship where he has pastored since 2006. He desires for others to be transformed into Christlikeness through authentic relationships. He holds a biblical counseling certificate from CCEF, a Bachelor's in Youth Ministry/ Adolescent Studies, and a Master's of Ministry in Theology.   Connect with Doug on Instagram, Facebook, or schedule a counseling session through his website or order Doug's Book.   Presence over Pain Podcast When did you experienced your first major loss? What are the three types of suffering you see laid out in the Bible? Will you share one of your conversations with the Lord where He responded with alliteration?   Thank You to Our Sponsors: Chick-fil-A East Peoria and The Savvy Sauce Charities (and donate online here)   Connect with The Savvy Sauce on Facebook or Instagram or Our Website   Gospel Scripture: (all NIV)   Romans 3:23 “for all have sinned and fall short of the glory of God,”   Romans 3:24 “and are justified freely by his grace through the redemption that came by Christ Jesus.”   Romans 3:25 (a) “God presented him as a sacrifice of atonement, through faith in his blood.”   Hebrews 9:22 (b) “without the shedding of blood there is no forgiveness.”   Romans 5:8 “But God demonstrates his own love for us in this: While we were still sinners, Christ died for us.”   Romans 5:11 “Not only is this so, but we also rejoice in God through our Lord Jesus Christ, through whom we have now received reconciliation.”   John 3:16 “For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life.”   Romans 10:9 “That if you confess with your mouth, “Jesus is Lord,” and believe in your heart that God raised him from the dead, you will be saved.”   Luke 15:10 says “In the same way, I tell you, there is rejoicing in the presence of the angels of God over one sinner who repents.”   Romans 8:1 “Therefore, there is now no condemnation for those who are in Christ Jesus”   Ephesians 1:13–14 “And you also were included in Christ when you heard the word of truth, the gospel of your salvation. Having believed, you were marked in him with a seal, the promised Holy Spirit, who is a deposit guaranteeing our inheritance until the redemption of those who are God's possession- to the praise of his glory.”   Ephesians 1:15–23 “For this reason, ever since I heard about your faith in the Lord Jesus and your love for all the saints, I have not stopped giving thanks for you, remembering you in my prayers. I keep asking that the God of our Lord Jesus Christ, the glorious Father, may give you the spirit of wisdom and revelation, so that you may know him better. I pray also that the eyes of your heart may be enlightened in order that you may know the hope to which he has called you, the riches of his glorious inheritance in the saints, and his incomparably great power for us who believe. That power is like the working of his mighty strength, which he exerted in Christ when he raised him from the dead and seated him at his right hand in the heavenly realms, far above all rule and authority, power and dominion, and every title that can be given, not only in the present age but also in the one to come. And God placed all things under his feet and appointed him to be head over everything for the church, which is his body, the fullness of him who fills everything in every way.”   Ephesians 2:8–10 “For it is by grace you have been saved, through faith – and this not from yourselves, it is the gift of God – not by works, so that no one can boast. For we are God‘s workmanship, created in Christ Jesus to do good works, which God prepared in advance for us to do.“   Ephesians 2:13 “But now in Christ Jesus you who once were far away have been brought near through the blood of Christ.“   Philippians 1:6 “being confident of this, that he who began a good work in you will carry it on to completion until the day of Christ Jesus.”   *Transcription*   Music: (0:00 – 0:09)   Laura Dugger: (0:09 - 1:38) Welcome to The Savvy Sauce, where we have practical chats for intentional living. I'm your host, Laura Dugger, and I'm so glad you're here.    I want to say a huge thank you to today's sponsors for this episode, Chick-fil-A East Peoria, and Savvy Sauce Charities.   Are you interested in a free college education for you or someone you know? Stay tuned for details coming later in this episode from today's sponsor, Chick-fil-A, East Peoria. You can also visit their website today at https://www.chick-fil-a.com/locations/il/east-peoria.    Doug Rumbold is my guest today. He is a pastor of counseling and discipleship, and he has recently written a book entitled Presence Over Pain. With Doug's biblical foundation and his sense of humor, he's now going to share some personal stories of suffering and God's continued faithfulness.   He illustrates how a yearness of God is oftentimes born through trial. So, regardless of what each of us are walking through today, Doug's going to remind us that we have the opportunity to turn toward Christ. Here's our chat.   Welcome to The Savvy Sauce, Doug.   Doug Rumbold: (1:39 - 1:42) It's exciting to be here, even virtually.   Laura Dugger: (1:42 - 2:02) Well, and its always kind of special to have a local friend join me as a guest on the podcast. But for those who don't know you yet, I think it would be really helpful to hear your story and gain some context around what led you to write this book. So, will you just begin by sharing your story with us?   Doug Rumbold: (2:03 - 6:09) Yeah, I love stories in general. I think when I look at Scripture, three-quarters of it, roughly, is a narrative. It's a story.   And so, God's heart for story is just critical, even in His communication of truth and His love for us. So, it means everybody's story matters. So, my little story matters.   And I think mine's an interesting one. To begin with, I was born and raised in Morton, Illinois. And I was born the seventh of eight children.   So, my parent's kind of did this, like, unbelievable quantity of births in a short amount of time. I'm not a woman, so I don't understand how this works. But I assume that having eight children in 10 years is crazy.   And they somehow managed to do that. So, I grew up in a loving Christian home. My dad was a phenomenal example of intention and direct when it came to conflict, merciful and forgiving when it needed to be called upon.   My mom was and still is somebody who she could have a conversation with anyone. I love my mom, her ability to just dive deep into conversation. I remember my college years.   My friends from college would actually love to come home to be with my parents, which is kind of odd. A bunch of college guys like, “Hey, can we come back from the big city of Chicago and go hang with your parents in the farm town?” Sure.   Yeah, enjoy. So, I grew up seventh of eight. My oldest sister passed away before I was born at the age of four.   She was actually buried on her fourth birthday, sadly. She passed away from leukemia. And then my youngest brother passed away my freshman year of college, which I talk about in the book a little bit.   So, for all of my growing up years, there were seven of us, not eight. And then the family just kind of continued to expand. Everybody eventually got married and had children.   And now on my side of the family, there's 35 grandkids. So, those are like pre-Medicaid type family backgrounds. You know, like you get together and everybody's going to take a Tylenol before because it's gonna be nice and loud and crazy.   But I would say from just a believing perspective at eight years old, I remember being in the basement of my church in Morton. My Sunday school teacher just giving a really compelling description, not just of how like, oh, you're going to burn, but more of a what does it look like to be separated from God for eternity? What might that be like?   And I was terrified but also had enough of these people pleasing mentality that I also didn't want to be the person who asked another question and held the class up. So, later on, I found out that it was easier for me to have that conversation. I think my mom discovered me kind of in tears, maybe even later that day.   And it was like, I don't think I know Jesus. And she's like, well, we can like, let's have a conversation. What's that look like?   And let's pray together. And so, at eight was when that became a reality in my life. And then really at 15 years old, coming home from a mission trip to Mexico, I ended up having just an awesome experience there and got baptized by a minister from our church.   His name was Dwayne. He was awesome. And then as I think through just, I mean, I mentioned it already, our family is really well acquainted with loss.   My oldest sister, my youngest brother, and then just some of our ongoing journey. My wife has an ongoing illness that requires a lot. It is a challenge for sure for her.   And then I think all of that kind of balls up together to frame a lot of where the content from my book comes from. Just living a life of non-ease has really kind of brought me to this place of if it's not going to go away or if it hasn't been taken away, what is it that sustains and how do I move through it and past it?   Laura Dugger: (6:09 - 6:32) And I definitely want to hear more elements of the book. But first, I'm just thinking through this. You said seven of eight and your youngest brother and you all are close in age.   So, to bring us into your story further, what age were you when you suffered that major loss of your brother and how did he pass away?   Doug Rumbold: (6:32 - 9:06) Yeah, that's a great question. So, my parents had all of us in 10 years. So, in 1969, they were married.   1970 is when they started cranking out children. And then 1980 was when my brother after me was born. And then it was 1997.   So, it's actually Halloween night of 1997. So, I was a freshman in college. I just moved away.   This was before cell phones. It's almost hard to imagine. But I was lying in my bed at night.   And my brother, my other brother, Ed, was at college with me as well as my sister, Jennifer, in the West suburbs in Elgin. And my brother tried to contact me because Ben had been in a car accident. So, he had been taking a walk with this girl he was getting to know.   And we live out in the country in Morton. So, you'll recognize these road names just because we're local. But if you know Tennessee, Tennessee and Harding, there's that intersection.   And my family grew up on Harding. But going down Tennessee Avenue, going north, a gentleman who actually ended up being our neighbor was coming over top of the hill. And he was changing a cassette tape, also a relic of the past.   And he was changing the cassette tape. And my brother was walking on the side of the road with traffic. So, his back was to oncoming traffic.   And the car struck him from behind. And he was essentially and effectively dead at the scene, but kind of for the benefit. And I will talk about this in the book a little bit.   The benefit of us, my other two siblings and I in Chicago, they, you know, rushed him straight to the hospital and then put him on life support. But he never had brain activity or anything from the moment that he arrived at the hospital till the following morning. We were asked, you know, how we wanted to continue.   And probably in the hardest decision that I've watched my dad make was to pull the power cord on life support. I mean, my dad was all about responsibility and he wasn't going to let somebody else do that. And my dad was also very quick in his ability to make a decision, even if the decision was hard.   And so, he just knew this was not, you know, technically Ben could have survived on life support. But he would have none of the vitality that he had had his entire 17 years prior. And so, that just was not an option.   Laura Dugger: (9:07 - 9:29) Goodness, Doug, I can't imagine that's one of those decisions you hope to never have to make as a parent. And then with your family grieving this sudden loss and then also working through forgiveness of a neighbor. What did that look like?   Doug Rumbold: (9:30 - 14:14) That's actually one of the most redeeming. I mean, again, God does this where he just kind of the Genesis 50 moment where it's like what the devil intended for harm. God meant for good.   And I remember his name was Mark. He's since passed. It happened in 97.   And I remember him coming to the door, you know, how people come to your house, and they provide condolences after a loss. And so, Ben was well known at high school. He worked with special needs children and was in the performing arts.   And so, he was just really well liked. And so, there was a high school kid. So, there's a steady stream of people coming, grieving kids, all that.   And I remember coming back from college and I remember not saying, I literally did not say a word for three days. My way of processing then was very inward. And so, I just remember being very silent.   I should correct myself. I didn't say a word other than what I'm about to tell you. Mark came to the house and Mark was in his mid-40s at the time.   And he was crushed. I mean, can you imagine what that would be like? And so, he shows up at the house.   And as he's coming up to the door, I remember my dad saying he pulls all of us kids aside. He says, “I want to tell you something. Mark is here.   He's coming up to the door. And right now, you have a choice. Forgiveness is never about how you feel.   It's about obedience. If you will forgive him now, I promise you will never struggle with bitterness toward him in this way. But it is an act of your will.   You must choose to forgive. But I'm not going to make you do so, like if you don't want to forgive him, that's fine. But I'm telling you right now, forgiveness is key.”   And I remember walking out to the door and greeting Mark and just giving him a hug and then looking at him in the eyes as a 19-year-old freshman in college and saying, “hey, Mark, I've done what you've done 100 times. You know, I've swerved off the side of the road. And so, I just want to let you know, I hold no ill will against you, and I completely forgive you.”   And he didn't really know what to say, just kind of mumbled some level of gratitude, I think. But it was kind of quiet. I had no idea the power in that moment that was happening where I was not bound to hold it against him.   And my dad was right. How many years are we removed from this? And I still had I never once thought, oh, what a jerk.   I can't believe you. I never struggled with anger toward God over the loss of my brother. These were things that I think could have happened had I held on to not being forgiven and not released Mark from that.   And probably the greater redemption happened over the years where over the next seven years, he would see my parents or my family around town, and he would always kind of hang his head. And my dad would always make it a point to say hi and to try to contact him and be kind. But Mark was just sullen, and it was difficult.   And then later on, Mark ended up having a pretty aggressive form of cancer. And by this point, my wife and I got married in January before. And I'll never forget.   We went to Carolina Beach. We lived in North Carolina at the time for just a quick getaway, the two of us. And we were coming back.   And on the drive back, I remember receiving a call from my dad and he's crying on the phone. He says, “Well, Mark just passed away.” And he goes, “but before he did, he invited your mother and I up to his hospital room.”   And when we walked in the room, he looked at me, he said, “Gary, I have I have often wondered why and how. Why would you forgive me? How did you muster the strength to do such a thing?”   And my dad, in his simplicity or whatever, was like, “Well, it's easy. I've you know, I've been forgiven. Do you know how much I've done?   Do you know what hurt I've caused other people?” And he says, “It's only natural that I should forgive you for what happened. It wasn't your intention.   Jesus forgave me. And so, I forgive you. Just real simple.”   And in that moment, Mark then began to ask what motivates. And my dad got to explain a relationship with Jesus Christ. And so, literally on his deathbed, just prior to passing, Mark turned his heart over to the Lord.   I mean, it was awesome. And so, just such a powerful story of forgiveness.   Laura Dugger: (14:16 - 19:48) And now a brief message from our sponsor. Did you know you can go to college tuition free just by being a team member at Chick-fil-A East Peoria? Yes, you heard that right.   Free college education. All Chick-fil-A East Peoria team members in good standing are immediately eligible for a free college education through Point University. Point University is a fully accredited private Christian college located in West Point, Georgia.   This online self-paced program includes 13 associates degrees, 17 bachelor's degrees and two master's programs, including an MBA. College courses are fully transferable both in and out of this program. 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We are all about sharing around here, sharing resources, sharing joy and sharing the good news about Jesus Christ.   We ask that you also will share by sharing financially, sharing The Savvy Sauce podcast episodes, and sharing a five-star rating and review. You can also share any of our social media posts on Instagram or Facebook. We are grateful for all of it, and we just love partnering together with you.   Now, back to the show. What are the three types of suffering you see laid out in the Bible?   Doug Rumbold: (19:50 - 21:29) Yeah, I'm not a theologian by any stretch, and so I'm sure I might be missing some. But I think when I look at all of Scripture, I guess I just kind of come away with three different forms of suffering. I see the first one that you kind of come across is the most poignant one is the suffering of Job.   Here's somebody who didn't do anything wrong, and he experiences catastrophic pain. So, the suffering that God allows in his sovereignty is the first form. The second one is the suffering that I caused.   Now, obviously, this is the one we first confront in Scripture, in the narrative. We see it in Genesis 3. But the story that most poignantly points this out to me is the story of David and Bathsheba.   Here's a king who has everything he needs and wants, and he should be out protecting and defending his kingdom. And instead, he's on his rooftop looking and taking what is not his. And so, there's suffering that I cause.   My pastor in college used to say, “You choose to sin, you choose to suffer.” And I think it's an apt description. And then the third form of suffering is the suffering that my faith brings.   I think about the apostles where they are called in by the council and arrested and beaten and told not to speak in the name. And what do they do? They walk out rejoicing, like, yes, we've been counted worthy to suffer.   Like, yeah, that's so different than the American version of Christianity at the present moment. We don't necessarily think that way. So, in short order, the suffering that God allows in his sovereignty, the suffering I cause in my sin, and the suffering my faith brings with persecution would be the three.   Laura Dugger: (21:30 - 21:42) Well, and I loved one of your quotes where you write, the earnest desire of my heart is that you come to understand the presence of God in and through suffering, no matter its cause.   Doug Rumbold: (21:43 - 22:03) Well, when I think about that, think of your own life, Laura. When you go back through ever since you just you surrendered your heart to Jesus, can you point to where were the deepest learning moments for you? What do you think? How would you answer that question?   Laura Dugger: (22:04 - 22:26) I do feel like I may be an anomaly here because some of it is from those seasons of grief or searing loss. But also, I would say in the really good times, the gratitude and joy that he provides, those have been some of my greatest leaps in faith.   Doug Rumbold: (22:28 - 24:32) Yeah, I think that's huge. I think it's one of those reasons why you see in Scripture this idea of we're supposed to be people who are thanking God even through our suffering. I think it's that rhythm or that habit of gratitude that can transform even what may appear hard or difficult.   In the book, that quote that you just read, I think comes from this idea that God communicates his presence to us in different ways because of the form of suffering or hardship that we're facing. If I'm somebody who is suffering because of what God has allowed, I look at the idea of our daughter with cancer, for example, and I think, okay, the hardship that she faced, it would not make sense for her to frame her life and her hardship with suffering in terms of confession and forgiveness of sin. She didn't sin to get sick.   And so, the idea of how God's going to communicate his presence to her in the suffering that he allows is more about what does it mean to endure with patience and joy? How does she endure hardship with patience and joy? In those ways, in that way, rather, I think that's how God begins to communicate his presence to her.   His nearness to her means he's not far because something is wrong with her and she needs to be discarded. It's more that he is quite near, and it's the recognition of that. It's this like my heart can be glossed over by the pain I'm facing, whether God allows it, I cause it, or my faith brings it.   It can be glossed over if I have an inward curve, if I have like this inward turn of sin and I can miss. How does God want to communicate his presence to me through this? I think that overall, most of us focus more on the suffering that we're experiencing at times than we do on God's provided presence.   Laura Dugger: (24:33 - 24:54) And that reminds me of something else where you later write about Psalm 119:67, which says, “Before I was afflicted, I went astray, but now I keep your word.” So, Doug, how did you experience the truth of this scripture through your experience with your daughter Jada?   Doug Rumbold: (24:56 - 27:57) Yeah, I think probably the safest and quickest description is pain has a way of getting our attention. Like your toe is just fine when you're walking to the kitchen at 2:00 a.m. to grab a drink of water and go back to bed. And then your toe makes its presence known when you kick the chair, right?   And you're like, oh, and then you're acutely aware of it. You know, you go back to bed and it's throbbing. You might put some ice on it.   Now it's cold. And pain is like that where it gets my attention when it's hit. And so, I was not aware, I don't think, of the depth of my self-reliance until every bit of control was removed from me.   So, particularly when I think of Jada's challenge, you know that before I was afflicted, I went astray, but now I keep your word. There's this mercy in suffering that says ever so slightly, we are people who easily turn to ourselves and our resources before we will turn to God. My wife would say it this way, and I agree with her.   I think it's an excellent understanding of parenting. We both view parenting as a form of stewardship. So, if I get paid, which I do, you know, for my work as a pastor, I get paid, I steward that money.   It's not my money. The Lord owns the cattle on a thousand hills, right? So, if he owns everything, he owns even the finances that are put into my back pocket.   And the way that I steward it is the degree to which I am surrendered to him. And so, parenting is like that. God has given you the currency of children, and you have children that you are to steward back to God as an offering to him.   And my wife would say this, I just didn't know. I'm supposed to lay them down every day before the feet of God in full reliance and trust that he is a better parent than I will ever be. What happened in particular with our daughter showed how quickly we will take them back again, how quickly we will be people who will say, “Oh, well, I actually think I can make a better decision here than the Lord will.”   We would never say that out loud, but our control and our actions will illustrate that every day. It's one of the reasons why it's so easy to get offended when your kid sins against you. It's one of the reasons why it's so easy to be overwhelmed when your kid is far from you.   We can get to a place where though we are to steward our children back to God, like finances given to us, like children given to us, there's this idea we are supposed to be stewards. And so, I learned that I went astray from God. And I still do every day.   It's a thousand opportunities to return to him. Does that make sense or am I talking crazy?   Laura Dugger: (27:58 - 28:24) No, that makes that makes sense. And even I think you're talking about something probably a lot of us are relating to as parents of certain times where we really grasp we are not in control. So, will you even take us to that day where that first became a realization for you? Because you're a parent of I believe she was a five-year-old at the time. Is that right?   Doug Rumbold: (28:25 - 37:11) Yes, that day was awful. I would never want to repeat it. Jessica had it's not really a day, but a kind of a progression from kind of like a Thanksgiving time frame until January.   So, the short order is my wife was pregnant with our youngest and her date for delivery was supposed to be right after January 1st, because I remember thinking, are you kidding me? I'm going to miss the cutoff for claiming this dependent. And anyway, Thanksgiving, we had gone down to visit some dear friends of ours.   So, a shout out to John and Katrina. I'm sure they'll listen to this who live in Oklahoma. It's where I did my internship in college on like this orphan boys ranch.   It was awesome. I loved it and grew a great friendship with them. So, we were down there visiting them.   And my wife has this gallbladder attack. And the way she describes it, she felt like she was dying. And of course, she didn't wake me up because, you know, women can apparently experience pain and not make a big deal of it.   Men, that doesn't work. So, there's definitely a gender difference there. And so, she realizes as she's homeschooling Jada, this is not tenable.   I can't keep this up, especially if I'm going to have a child and everything. And so, we decided, oh, no big deal. We'll have just come back from our trip and decided we were going to put Jada in public school just for the last part of kindergarten.   And Jessica was going to give birth to the child and hopefully get the treatment that she needed because we took an ultrasound, and they discovered a bunch of gallstones. And it was rough. And so, we get back, and we go to the school, get the forms.   And basically, it was just filling out a couple of forms. Oh, yes. A bunch of check marks here, and a bunch of check marks there.   Get the dental form and all that. You need one last thing that we can't just sign away. You need to do a quick physical.   Now, Jada was feeling great doing everything. You know, all of her markers were fine. We go to a doctor from our church at the Tremont Medical Clinic and he performed just a simple physical.   And Jada was, you know, everything was just fine. And as he's palpating around her stomach, he's just kind of pressing there. And I don't know how doctors do this where they, you know, press on your stomach and they're like, OK, your organs are in the right place.   OK, I trust you. So, his face, like his countenance, just shifted. And Jessica and I were both in the room and he just kind of looks at me because I just can't reconcile this.   But to rule anything out, we're just going to have her get an ultrasound and be on our way. I remember thinking I had a hernia when I was young, maybe six months or something. I can't remember how old I was.   And so, Jessica and I went home that night and I mean, we were shedding tears like, oh, my goodness. Our sweet daughter has a hernia. Can't believe it.   What does this mean? She's going to have surgery, all this stuff. And never were we prepared for what happened next.   You know, the next morning she wakes up, and she takes Jada and Oliver, who's two at the time, to get the ultrasound in Peoria at a place called Peoria Imaging. And I stayed home. I was writing a sermon.   So, I'm sitting there working on a sermon from Mark, Chapter eight. And Jessica goes and I'm not hearing from her. I'm not hearing from her.   And then about three hours later, I got a call and she's like, so, they did an ultrasound and then they did like another one. And then they ordered a CT, and they just got done with the CT. And she goes and I just looked out in the waiting room and it's full and nobody's coming in.   And now they said that she needs an MRI. And I'm like, “What?” This doesn't seem like a hernia.   And she said, “Honey, I just asked the nurse, and they won't commit.” “Like they won't say anything,” I asked.   I kept asking if it's a hernia. And finally, I just asked one of the nurses, “Is it bad?” And the nurse said, “That she thinks it's significant.”   And I'm like, oh. And I remember that day then calling my dad or my parents and just kind of giving them updates along the way. Like, okay, you know, Jay is going in for a quick ultrasound, probably a hernia.   But then I remember calling my dad and my dad's on the phone with me right after I got off with Jess. And I just said, “So, it went from just a quick ultrasound to CT to an MRI.” And I said, “They just finished the MRI or they're in process.”   And they said, “That after the MRI, they want to send her to the hospital for blood work.” And my dad's only response was, “Oh, boy. I mean, it was just like,” and his voice quivered.   You know, the quiver of like the I don't know if I'm ready for this sort of quiver. And I can only imagine what's going through his head, having already lost two children and particularly one to cancer. He knows that feeling.   So, the day only got longer from there. I got a ride over there with my sister-in-law to Puri Imaging. And then we went to the hospital together and had to get blood drawn and all that stuff.   And that's a whole story in and of itself, the trauma of that for her. But I remember leaving the hospital and Jessica and I know at this point with the full weight of this is not a hernia, but we still don't have answers. Like every time I'm asking a question to a doctor or a nurse, they are deferring and deferring and deferring.   And my anger internally is kind of growing. And so, I'm a little, I'm not aggressive, but I'm assertive. And I remember driving away from OSF in Peoria.   And as we're driving away, Jade is just in the back seat looking out the window. And Jessica and I are in the front seat, just crying, but trying to hold it together, you know. And I look in my rearview mirror.   I'm like, “Hey, sweetie.” And she's like, “Yeah.” “Like, what are you thinking about?”   She goes well. I just can't decide what smoothie I want at Smoothie King. That was the day where they, you know, the scan that she had to have was an NPO, which means she can't have any food or liquid unless it's clear.   And so, she was starving. And at this point it was like 6:30 at night. So, she's super hungry.   And so, we went to the first location and the second location. They were all closed between Christmas and New Year's. So, no Smoothie King for her.   And that was the last time we remember eating at McDonald's as a family. And then that night the diagnosis finally came. We got back home.   We were home for 10 minutes. And we received a call from what ended up being her surgeon from Illinois Medical Clinic. And we were asked to come back into an after-hours appointment, which those are never good.   And so, we walk in the door. We sit down. There's not even a secretary.   The lights in the building are off. We were walking down this hallway to this last, you know, exam room. And Jada is just sitting there on the table.   Jessica is about ready to pop pregnancy-wise. And the doctor walks in and says, so, I assume you know why you're here. And I said, actually, we haven't been able to get a straight answer.   And we have no idea what's happening. And she goes, are you kidding me? She's like, I have to be the one to tell you this, that your daughter has kidney cancer.   And I think the thing that caught me was Jessica sitting on a chair kind of at the foot of the exam table. And instinctively, I mean, it was like it wasn't even – it was no coaching. There was no – Jada just kind of crumbled and her body just kind of fell onto Jess.   And Jess's mom has walked through cancer twice. And so, Jessica has lived this journey as well, just the difficulty of it. And so, for her, she's just like I know what this required of me when my mom had it.   And I had to take care of her when I was in junior high and then again when I was in college. And now I'm pregnant and now my daughter has cancer. It was unreal.   And then I wrote about it in the book, but the walk from the front door to the van where Jada's face was buried in my neck. And the warmth of her tears and just her body just kind of melted into mine as we're walking back to the van. And it's like I never want to forget that because the usefulness of it, how helpful it is for me to recall some things, to live in that place of like this is what you redeem, this is what you restore.   But it was hard as heck. And so, that would be what I remember from the day of diagnosis.   Laura Dugger: (37:13 - 37:26) It is so hard to imagine what that would look like to get that news. And I'm just wondering for you and Jess, what did your faith look like and what were your conversations like with the Lord at that point?   Doug Rumbold: (37:29 - 39:10) You know, I – because of the loss of my brother earlier, I don't – I mean that's a great question. And I don't mean this how it might sound or come across, but my faith was never – I don't think that my faith was an issue in terms of am I still going to cling to Jesus. It was just more of a – it was just – it was so hard.   I really wish I had words for it. I talk about this in another podcast that I did. I remember just feeling so overwhelmed and more of a feeling like we were treading water in the middle of an ocean.   And someone – you're like begging for a life raft and they hand you a cinder block. And you're like, not helpful. So, my faith, our conversations with the Lord, they were hard, and we were certainly super sad.   My wife would probably talk about how she was broken and quiet and learning afresh what it means to surrender. But she is methodical and consistent in her pursuit of the Lord and extremely faithful. And so, hers was sitting in solitude and just waiting and cry and lament and work through it all and then come out the other side stronger.   I process things a little bit more verbally. But I think our faith was strong. We were just shattered for the pain that she was experiencing for sure.   Laura Dugger: (39:11 - 39:35) That's a great way of putting it. And just like He promises, I have spoken – Mark and I have talked with you and Jess before. And you've shared how God continued to be an ever-present help in these times of trouble.   But will you share one of your conversations with the Lord where he responded to you with alliteration?   Doug Rumbold: (39:35 - 45:50) Yeah, the one that I think of is – and I write about it a little bit in my book. But I just remember thinking kind of two questions that I would ask. One was right after Pierce was born and we obviously weren't having any sleep.   So, if you look at the timeline, Jada was diagnosed on the 30th of December. The 2nd of January was Jessica and my anniversary. The 3rd was Jada's surgery.   The 10th was when her pathology came back. And the diagnosis went from 95, 98% cure rate, survival rate just fine to like 40 to 60% survival rate. And a different stage of cancer and the size of the tumor was much larger than they originally anticipated.   And so, we came home that night from the pathology report and wept and wept and wept. And then Jessica started labor that night. And it was a blizzard.   Our midwife didn't make the birth. And then Pierce is born on the morning of the 11th, which is the same morning that Jada and I were supposed to go back in now to have more MRIs, more blood work to determine had the cancer metastasized throughout her whole body instead of just in that one tumor. And it was assumed that it had and so, that's why they were checking everything.   And so, it was an urgent, you need to get there for this. I just kind of felt like the one question, one of two questions I was asking, but one of them was with conversation with the Lord was when will you relent? Won't you just relent?   So, I was never like struggling in my faith to the degree that I was going to toss it, but I was angry with God. I was like, come on, like, how does this work? Can you give, throw me a bone, basically.   So, that was one conversation. But the conversation that's most poignant is after he started to frame those things up a little bit and give more of a trellis to build on. I remember treatment had begun, which timeline, if you're looking at it, the 11th is when Pierce is born.   The 13th is when Jada started treatment. So, from like the 13th to the 18th, she had radiation. And then after that, for the rest of the year, eight months, whatever, she had chemo.   I remember one morning I never slept at the hospital. It was just not comfortable. It was always beeping, stuff like that.   So, I would often go down to the playroom. There's an activity room at the end of the hall on the sixth floor there at OSF. And I'd be down there with a lackluster cup of coffee and my Bible and journal.   And I'd watch the sunrise over the city of Peoria. And it would just be kind of like; I really couldn't hardly read. It would be more of me just like, because no one was awake.   That was the only time when it was semi quiet. And I would just have these out loud conversations with the Lord. Like, what's happening?   And the conversation, the question that I kept asking was, Lord, how in the world are we going to do this? How in the world are we going to make it through? That's really when he began to kind of press back in.   And I'm not, I don't know how to explain this, but more of a, I had a very tangible sense that as I'm sitting there on the sixth floor, that he was almost in the chair next to me. And he's just, he's like, okay, tell me more about your struggle. What's it like?   Help me to understand the pain of your heart. And so, I'm, I'm unloading these things to Him. And all of a sudden I noticed the time and it's like, oh, Jada is going to be waking up soon.   I need to get back there before they do rounds, you know, and the whole dance starts again. And so, I kind of like, oh, I want to return. It's like when you wake up from a dream and you're like, oh no, I want to finish the dream.   And you try to go back to sleep quickly. That's a little bit of how that conversation was working out. And I remember going back to the room and jotting a few more things down in my journal.   And then after that it goes, okay. The day was now full of motion. And I had forgotten about the conversation quite honestly.   And until that evening, I was like, okay, I'm just gonna, I told Jada, I'm like, “Honey, I'm going to run home real quick and shower, get a change of clothes and maybe get some real food. And then I'll be back. Okay.”   Don't worry. And so, I hopped in my car, I turned on my headlights, and I got out of the parking garage, and I got on 74. And right as I was getting on the bridge to cross over the Illinois to go back toward Tremont, it was, I mean, I don't know how people feel about this.   So, sorry if I start a theological controversy on your podcast, but, um, I, as I'm sitting there as audible as you and I talking back and forth, there's this sense of my spirit of like, you asked how you're going to get through Christ community and confession. But there was really beyond that, there was really no discussion. You know, it was more just like those three words got tossed out.   And so, I remember driving down the highway and almost like, uh, you're in a zone where it's like, you see the headlights, you know, going like right past you and, and nothing is distracting to me. And I remember thinking some of those things made sense to me, like, you know, yes, Christ suffered. Yes.   I need community around me, things like that. But confession was the one that I struggled with the most. Like what do you mean by that?   You know, because I had a courtroom idea of confession, like, okay, I got caught doing something I shouldn't have. I need to confess. What I did was wrong.   And there definitely is that element. But I came to learn later that confession is the Hebrew word. One of the Hebrew words for it actually means praise.   And so, there's this, there's this idea of caught up, being caught up in understanding the presence of God and you're confessing. It's the word that actually, more accurately, fits is declaration. And so, I'm like, oh, wow.   Okay. So, what you're saying then is these scriptures that I've been studying for years now, I I'm actually, it's about declaring them in praise over my life, over my circumstances, over my daughter as a way of help to get us through. Okay.   Laura Dugger: (45:51 - 47:09) By now, I hope you've checked out our updated website, thesavvysauce.com so that you can have access to all the additional freebies we are offering, including all of our previous articles and all of our previous episodes, which now include transcriptions. You will be equipped to have your own practical chats for intentional living. When you read all the recommended questions in the articles or gain insight from expert guests and past episodes, as you read through the transcriptions, because many people have shared with us that they want to take notes on previous episodes, or maybe their spouse prefers to read our conversations rather than listen to them.   We heard all of that and we now have provided transcripts for all our episodes. Just visit thesavvysauce.com. All of this is conveniently located under the tab show notes on our website.   Happy reading. And I just want to go back to something that you said, because you use the word relent. God, how long until you relent?   And yet he flipped that word and taught you that he will relentlessly continue to pursue you with his presence.   Doug Rumbold: (47:10 - 49:26) I'm glad that you draw that out because I think the relentless pursuit is in that question of when will you relent? It was one of our darker moments, even in marriage where my wife and I were both stretched to the max, totally thin and struggling. And it was an argument, you know, where I'm lying on the ground after my wife and I had just kind of like, I need you to take care of this.   And she's asking me to take care of something I'm not wanting to, and I'm holding my ground and I'm tired. She's tired. And aren't your best moments between midnight and 7am anyway?   And so, I remember laying on the ground. That moment was laying on the ground at the foot of my son's crib in our bedroom. And he was not sleeping.   He's a newborn. Newborns don't sleep easily. And I remember pounding the ground and actually saying, you know, when, when will you relent God?   Like when will you let up? And to see the connection between my question was the assumption that God had left the building that God had kind of punched the clock. Okay.   I'll be back by five. You know, like when instead, the way that He wants to communicate His presence to me in my suffering shows that He's relentlessly digging through every bit of self-reliance that I've set up to try to manufacture outcomes. And so, there, there's a way that His relentless presence is like, like waves on a shore one after the other, the rhythmic nature of it, the dependable nature of it, you can't stop it.   Nature of it is the way that He can and will use any circumstance trial in your life to communicate His presence to you. So, yeah, that's right. Its relenting is a releasing and letting go, but relentless pursuit is also this like dogged pursuit of us.   it's been said before that, that God or Christ is the hound of heaven, you know, like a blood hound with your scent who won't give up until He finds you. And so, similar to our experience for sure.   Laura Dugger: (49:27 - 50:00) Well, and you go into these stories and then also offer hope and offer so much scripture where you have poured over to help us make sense of suffering. And even see things where it's a very upside-down economy as God often has, where there's blessing in the affliction, but yet to close the loop on this story. Can you give us a picture of where your family is at today? Even the ages of your children and Jada's status?   Doug Rumbold: (50:01 - 52:27) Yeah, for sure. So, it's been a long journey for sure. Jada now is 18 and we are in preparation for her.   She is going to be going to Arizona Christian University in the fall. So, a nice short 24-hour drive away. And so, again, we're learning afresh what it looks like to lay down our children, but we're super excited about it.   We are super excited about the new friends she'll make. My wife and I have always said Jada is a spread your wings and fly sort of girl and cancer only proved that. So, we're super excited about that for her.   Our son, Oliver, who was two at the time, is now 14 where he's a freshman. He turns 15 this summer and I'm sure we'll be driving soon after. No concerns there.   And then my son, Pierce, is in sixth grade. And yeah, they all have their own interest's kind of across the board. Jada loves music and singing and playing piano.    Oliver is relationally. He's just this guy who enjoys mature conversation. So, like when we get together with our life group, you'll find him talking to the adult men just because he fits there. He's more of an old soul.   Pierce is our creative kid. He's always doing trick shots. And I mean, it's pretty crazy the stuff that he does. He's kind of fun like that and loves fishing and things of this nature.    So, yeah, all of my kids are very interesting and different like that. My wife is doing homeschooling for the boys, and she continues to be somebody who is a silent influencer in the lives of many, usually and primarily through prayer.   But I am amazed at how often the Lord uses her in the lives of other people to bring about change and transformation. She's just an excellent gifted counselor of people with the word of God and prayer. So, that's kind of where our family's at.   I've been at the time that Jada was ill, I was the youth pastor at Northfield and I'm still at Northfield though. I'm in a different role. I'm pastor of counseling and discipleship here at Northfield.   So, I have never left this community. So, I'm trying to think if there's anything else update wise. I don't think so.   I think it's pretty much it.   Laura Dugger: (52:27 - 52:30) And so, Jada is in remission.   Doug Rumbold: (52:30 - 55:11) Yes. She did have one other occurrence where she started having really acute headaches in 2013. Then, those acute headaches turned into taking her back for a checkup and the checkup revealed a lesion on her frontal lobe. So, a brain tumor.   We had to wait eight weeks to scan again. Those eight weeks were the hardest and worst that I think we've faced even from the first cancer. It was like, “Oh my goodness, we're going to have to go through this again.”   And then we had this season of waiting, you know, the eight weeks and then she was going back in for another scan to determine scope and growth. Also, you know, what type of craniotomy or brain surgery they were going to perform, to address it or whether it was going to be treated medically. Or how was that going to happen? And so, that all took place. Then, they did the scan, and we had to wait.   Normally we would have these scans, and it would be like a four-to-eight-hour turnaround. And you know that same day or even the next day we get a call from the St. Jude office, and they would say all clear. This one went one day, that was two days.   And I called and they said, “Oh, well, you know, the doctor will call you.” And I'm like, “Come on Beth.” You know, she was the head nurse that I've had relationship with for a while.   And she's like, “No, you know, the doctor will tell you.” And I'm like, “That's never good.” And come to find out, we had to wait until the end of that week.   So, it was not one day, not two days, not three days, not four days, but five. So, it went from Monday to Friday. And on Friday, the doctor called me after hours.   And I thought for sure it was, you know, here we go treatment time. And, um, she called back and said, the reason it's taken so long is because I had to have conference calls with, uh, Memphis, DC, LA, all these different cancer centers and looking at the imaging together. But when, when we laid the last image that shows the lesion over the newest one, the newest one shows nothing like it's completely gone.   And she goes, and it's definitely here. It's definitely something that requires intervention. And now it doesn't.   And so, she goes, I just wanted to confirm the anomaly. I'm like, that's not an anomaly. That's a healing.   And so, uh, Jada has been in remission, ever since. So, she's been, she's been doing good. In fact, her last cancer follow-up appointment was like three weeks ago and got the all clear.   So, praise God.   Laura Dugger: (55:11 - 55:44) Praise God. What an awesome, miraculous healing. I'm so thankful you shared that and really Doug with your unique career that you're in and the journey that you and Jess have been through and your love of scripture, you're putting all of this together and it really is such a gift, this book that you've written.   So, can you tell us just a little bit more of who this book is for and what people could expect to find when they read it?   Doug Rumbold: (55:45 - 57:54) Yeah. So, the book is for anyone because, and you would know this as well, but you're either heading into a trial, you're in the middle of a trial or you're on the backside of a trial. And there's never a moment in which you can say, “Oh, okay, well now I've learned and now I've arrived and now we're good.”   I do think that the preparation of our heart for trial is critical because it's going to come like we are going to face suffering of some form at some point. And so, it's good to know how to approach it. It's for anybody who wants to learn and grow and be encouraged.   But specifically, one of the things that I struggled with during our trial, and it's ongoing, you know, because of some of the stuff that we mentioned before ongoing health issues in our family and stuff like that. But I, what I found was people would be like, “Oh, here's a book.” It's only 320 pages on suffering.   I'm like, really? Thanks for that. I've got no capacity to do that.   So, I purposely wanted to write a book that you could personally sit and read like in an afternoon. It's so, it's short. It's like, you know, a hundred pages and it's digestible.   So, you could jump from one chapter to the eighth chapter if you wanted, and you would, you would still hopefully gain something. So, I wanted to make it uniquely accessible and heart focused. So, you'll find kind of like throughout the chapters, I have these like, so, truth to life.   And what I'm basically doing is trying to say, “Okay, we talked about something at a 30,000-foot view. What does it look like boots on the ground here?” I don't usually just spell it out for you.   I usually ask questions that are going to force you to address heart issues because scripture is pretty clear that all of our conduct flows from a heart that's filled with good or bad. So, people can expect to be challenged. They can expect to not have something that's too long and too hard to read, but they can also expect to find it kind of built around story a little bit.   That's one of the reasons why I use those different stories from scripture. I think we relate well and explain things well in a story.   Laura Dugger: (57:55 - 58:14) Definitely agree. We learn so much from Jesus's stories. Those stick with us and yours do too.   So, thank you for sharing all of those today. And if anyone desires more help and healing after today's conversation, where would you direct them?   Doug Rumbold: (58:15 - 59:59) The first thing that I would do is just encourage prayer. The idea of silence and solitude is where you can be begun to become aware of the healing that you may need and being able to just journal it down and have it right in front of you. That is probably one of the first steps.   Second thing I would say is to lean into community. COVID has kind of wrecked things in some ways where some people have gotten used to this idea of either online attendance or whatever. Nothing, nothing, nothing replaces the body of Christ in the tangible way.   And so, the idea of being with and around other like-minded believers is critical. But in terms of myself, the book that I wrote, it's available on Walmart, Amazon, Barnes and Noble. You can just search Presence Over Pain in a search engine and find it pretty easily.   I am currently in the works of working through like an audio version of it because some people prefer that. So, that will be forthcoming. You can find me on Facebook or Instagram.   I provide biblical counseling in person or virtually so, people can contact me through those platforms if they want to have a conversation. And the cool thing is those things happen. There's a number of different connections that God has made where people have either read the book or they know someone who read the book and my name was recommended and here I am a couple of months later having a conversation with someone who found me online.   And I love technology for that purpose. How can we come together and build around something in Christ? It's pretty awesome.   Laura Dugger: (59:59 - 1:00:31) That is awesome. And we will certainly add all of those links in the show notes for today's episode. In addition to the link to your own podcast where you dig a little bit deeper into the book.   And the name of that is also Presence Over Pain podcast. And Doug, you know that our podcast is called The Savvy Sauce because savvy is synonymous with practical knowledge. And so, as my final question for you today, what is your Savvy Sauce?   Doug Rumbold: (1:00:32 - 1:04:48) I love the question because practical is helpful. So, I think probably just some brief stories and then a couple of suggestions. So, I remember when I was younger, all seven of us children kind of growing up in the same house.   My dad had such a passion for us to know the word of God that he wanted us to all like sit down at the same time. And he was going to read a chapter of Proverbs. Well, can you imagine seven kids on a Tuesday morning trying to get ready for school?   And then your father saying, “Okay, everybody sit down.” Like nobody's going to be able to do that. And so, after a few failed attempts, what my dad did was he would, he would have a section that he was going to read, and he would start with the oldest child, and he would follow them around literally like follow them.   And he would just, he would read the word of God to them and then he would move to the next one and to the next one and to the next one and the next one. And I have memories of like even walking out the door, going to get on the bus and my dad following me right up to the door, reading the last bit of Proverbs to us. And so, practically speaking, you really cannot underestimate the value of intentionally diving into God's word daily personally.   Like don't let somebody else do it for you. It's so, personal. It's so, needed.   And just when you feel like it's not going to matter, the fruit of it will come forth. So, that's, that's one. And then the other story that kind of points to a practical reality is my wife grew up through her parents splitting up when she was, I think, second or third grade.   And just the difficulty of that, like the life of a single mom as she and her sister watched her mom go through that. But Jessica tells a story often of like not understanding and now understanding, but like she would knock on her mom's door and she would hear her mom crying and she would, she'd open the door and her mom would be face down on the floor, just, just praying and weeping. And she's like, hold on, honey.   Mommy just needs to be with Jesus. And it communicated this idea. And my wife has carried this on in our own family and in her practice of just like prayer and particularly prayers of lament are huge.   And so, practically speaking, what's that look like? I mean, I have an exercise. I'm sure you are being a counselor by nature would, would appreciate this.   But one of the things that you can do to learn how to lament is to look at a good number of the Psalms are lament Psalms. Like they're sad Psalms. Like Lord, my life stinks.   The wheels have fallen off and you're nowhere to be found. So, being honest with God is critical, but a simple assignment would be to read a lament Psalm, like Psalm 13 or Psalm 88 or Psalm 77, Psalm 42, any of those. And then as you read that Psalm, just the simple assignment is to like write your own Psalm of lament and then read it back to the Lord. You know, Lord, I felt like you were absent when my daughter was diagnosed with cancer, but I am going to trust in your unfailing love.   Like you see those pictures all throughout the Psalm. So, that's a practical, simple way to engage God. I think the last thing that I would say in terms of practical is the idea of rest from a perspective, you know, biblically it's called Sabbath.   Do you have a 24-hour period of rest? Because what you do when you Sabbath is you say something to God and to everyone else. It doesn't depend on me.   When I choose to rest, I'm choosing not to be productive. I'm choosing not to perform. I'm choosing only to receive.   I'm choosing to rest. I'm choosing to fall back into his arms. Rhythmically reminding ourselves of that for me, the way that that works out is like, you know, I'm a pastor.   So, Sundays are a workday. So, once I get home after Sunday until like noon, the following day is the time when it's like, okay, this is where I'm not going to be on my screen. I'm going to take a walk with the family.   We're going to have dinner together. Things that are filling and receiving are critically helpful. And I would say savvy.   Laura Dugger: (1:04:49 - 1:05:08) That's so good. And Doug, Mark and I are just so grateful to know you and Jess. We learn from both of you, and we've learned from your stories. They've been so impactful today.   So, thank you for writing this resource and thank you for being my guest today.   Doug Rumbold: (1:05:09 - 1:05:11) It was a total pleasure. Thank you for having me on.   Laura Dugger: (1:05:12 - 1:08:54) One more thing before you go. Have you heard the term gospel before?   It simply means good news. And I want to share the best news with you. But it starts with the bad news.   Every single one of us were born sinners, but Christ desires to rescue us from our sin, which is something we cannot do for ourselves. This means there is absolutely no chance we can make it to heaven on our own. So, for you and for me, it means we deserve death, and we can never pay back the sacrifice we owe to be saved.   We need a savior. But God loved us so much, he made a way for his only son to willingly die in our place as the perfect substitute. This gives us hope of life forever in right relationship with him.   That is good news. Jesus lived the perfect life we could never live and died in our place for our sin. This was God's plan to make a way to reconcile with us so that God can look at us and see Jesus.   We can be covered and justified through the work Jesus finished if we choose to receive what He has done for us. Romans 10:9 says, “That if you confess with your mouth Jesus is Lord and believe in your heart that God raised him from the dead, you will be saved.” So, would you pray with me now?   Heavenly Father, thank you for sending Jesus to take our place. I pray someone today right now is touched and chooses to turn their life over to you. Will you clearly guide them and help them take their next step in faith to declare you as Lord of their life?   We trust you to work and change lives now for eternity. In Jesus' name we pray. Amen.   If you prayed that prayer, you are declaring him for me, so me for him. You get the opportunity to live your life for him. And at this podcast, we're called The Savvy Sauce for a reason.   We want to give you practical tools to im

In a conversation with CancerNetwork® following the FDA approval of the gemcitabine intravesical system (Inlexzo; formerly TAR-200) for patients with high-risk, Bacillus Calmette-Guérin (BCG)–unresponsive non–muscle-invasive bladder cancer (NMIBC), Gary Steinberg, MD, discussed how this regulatory decision may impact the treatment paradigm. Steinberg, a professor in the Department of Urology at Rush University, highlighted an unmet need for those with BCG-unresponsive, high-grade NMIBC. With a different mechanism of action compared with prior therapeutic choices in the field, he stated that the gemcitabine intravesical system may allow patients and physicians to benefit tremendously. Based on supporting data from the phase 2 SunRISe-1 trial (NCT04640623), he described how the gemcitabine intravesical system may replace prior standards such as intravesical gemcitabine plus docetaxel. The conversation also touched upon considerations for preventing the risk of progression to metastatic disease with delayed cystectomy, as Steinberg emphasized following up with patients via cystoscopies, urinary cytologies, CT scans, or MRI imaging after treatment with the intravesical system. Steinberg also detailed strategies for mitigating urinary frequency, dysuria, and other toxicities associated with the therapy. He noted a “fine line” regarding bladder medication administration to older patient populations, as these practices may cause adverse effects such as dry mouth, constipation, and blurry vision. Looking ahead, Steinberg illustrated a need to clarify the immunologic effects of regimens like the gemcitabine intravesical system, which can inform the use of additional therapeutic combinations down the road. He highlighted how other novel agents like cretostimogene grenadenorepvec (CG0070) may further improve outcomes in the NMIBC landscape. “One of the key questions that we all need to ask with all our treatments is not about the patients who respond, but about the patients who do not respond,” Steingerg stated regarding the potential next steps for research. “We can begin to understand mechanisms of resistance so that we can target those mechanisms of resistance and treat them better.” Reference U.S. FDA approval of INLEXZO (gemcitabine intravesical system) set to transform how certain bladder cancers are treated. News release. Johnson & Johnson. September 9, 2025. Accessed September 22, 2025. https://tinyurl.com/4zjz22z7

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On this Healthy Waves episode, host Avik digs into how aerospace-level problem-solving meets wellness tech. Guest Mark Fox (former Space Shuttle chief engineer, hot-air balloonist, and airplane builder) explains why he shifted from aircraft to energy-based wellness devices. We unpack what pulsed electromagnetic field (PEMF) and resonance-frequency approaches claim to do, how protocols are designed, portability and cost tradeoffs vs. legacy gear, and where AI-driven biometrics might steer the next decade. Direct, no fluff—just a clear look at what this tech promises, what users report, and what still needs rigorous proof for platforms like YouTube, Facebook, Instagram, and LinkedIn. About the guest  : Mark Fox is an aerospace engineer turned wellness tech founder at Resona Health (resona.health). Drawing on systems thinking (including TRIZ creative problem-solving), he designs portable, non-invasive devices intended to support general well-being through frequency-based protocols. Key takeaways: Why the pivot: engineering skills can transfer from avionics to wellness when the goal is simpler, more accessible tools for everyday use. Frequency-based view: the talk frames the body as chemical, mechanical, and electrical—arguing wellness tools shouldn't ignore bio-electromagnetic processes. How protocols are built: “frequency pairs” change over time like chords in a song; many protocols emerged from decades of practitioner iteration. Portability and access: a pocket device aims to make sessions simpler and more affordable than clinic-only mats or large systems. Reported use cases: the guest discusses user-reported improvements in stress, HRV, sleep, pain, and more—presented as claims and ongoing studies, not medical advice. Safety framing: energy level and frequency matter; the device output described is far below MRI fields, though MRI safety analogies should not be read as equivalence in efficacy. AI + biometrics: future direction includes watches, cloud trends, and automated recommendations—raising opportunities and the need for privacy and validation. Bottom line: intriguing engineering applied to wellness; further independent, peer-reviewed evidence is essential before making health decisions. Medical Disclaimer This content is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding a medical condition, symptoms, or health objectives. Never disregard professional medical advice or delay seeking it because of something you heard in this episode or read in the show notes. Any products, devices, protocols, or practices discussed are presented as general wellness information only. They are not intended to diagnose, treat, cure, or prevent any disease. Statements made by guests are their personal opinions and experiences and have not been evaluated by the U.S. Food and Drug Administration (FDA) or other regulatory authorities. Results vary from person to person. If you are experiencing a medical emergency or mental health crisis, call your local emergency number immediately or contact your nearest crisis hotline. How to connect with the guest   Website: https://resona.health/ Email: info@resona.health Want to be a guest on Healthy Mind, Healthy Life? DM on PM - Send me a message on PodMatch DM Me Here: https://www.podmatch.com/hostdetailpreview/avik   Disclaimer: This video is for educational and informational purposes only. The views expressed are the personal opinions of the guest and do not reflect the views of the host or Healthy Mind By Avik™️. We do not intend to harm, defame, or discredit any person, organization, brand, product, country, or profession mentioned. All third-party media used remain the property of their respective owners and are used under fair use for informational purposes. By watching, you acknowledge and accept this disclaimer.   Healthy Mind By Avik™️ is a global platform redefining mental health as a necessity, not a luxury. Born during the pandemic, it's become a sanctuary for healing, growth, and mindful living. Hosted by Avik Chakraborty—storyteller, survivor, wellness advocate—this channel shares powerful podcasts and soul-nurturing conversations on: • Mental Health & Emotional Well-being• Mindfulness & Spiritual Growth• Holistic Healing & Conscious Living• Trauma Recovery & Self-Empowerment With over 4,400+ episodes and 168.4K+ global listeners, join us as we unite voices, break stigma, and build a world where every story matters.

Still waiting for that MRI test to get approved? Physicians are just as frustrated as patients with the prior authorization process, and too often, they take the blame for delays caused by a system they don't control. Tune in as Dr. Daniel Davis, Shoulder & Elbow Surgeon at Rothman Orthopaedics, explains what a prior authorization is, why it was created, who's reviewing your requests, and what physicians can do to reduce denials. To learn more about Rothman Orthopaedics, or to schedule an appointment with Dr. Davis, visit RothmanOrtho.com today!

Live from Old Crow in Wrigleyville, Leila Rahimi, Marshall Harris and Mark Grote opened their show by breaking down the Cubs' 10-3 win against the Mets on Wednesday at Wrigley Field. After that, they shared their concerns over Cubs right-hander Cade Horton (back) getting an MRI. Later, they reacted to the news that the Cubs are hopeful to get star right fielder Kyle Tucker back in the lineup Friday. He has been sidelined since early September by a calf injury.

Leila Rahimi, Marshall Harris and Mark Grote shared their concerns over Cubs right-hander Cade Horton (back) getting an MRI.

In the final hour, Matt Spiegel and Laurence Holmes were joined by Score reporter/host Mark Grote, who shared a Bears report live from Halas Hall after practice Wednesday. Later, Spiegel and Holmes shared their concern over Cubs rookie right-hander Cade Horton getting an MRI after experiencing back tightness in his outing Tuesday.

Matt Spiegel and Laurence Holmes shared their concern over Cubs rookie right-hander Cade Horton getting an MRI after experiencing back tightness in his outing Tuesday.

In today's rapidly evolving business landscape, scaling enterprise sales teams presents unique challenges and opportunities. As the Chief Revenue Officer of Motive, Adam Block brings a wealth of experience in building high-performance sales organizations. In this episode, we explore effective strategies for scaling enterprise sales teams in the AI era.                   Scaling Enterprise Sales: Key Insights ·         Building a robust playbook for enterprise sales success ·         Implementing effective hiring and onboarding processes ·         Leveraging AI and technology to enhance sales efficiency ·         Developing a strong sales culture and team dynamics The Power of People in Scaling Sales One of the core themes Adam emphasizes is the importance of hiring and developing top talent. He outlines: A comprehensive interview process, including panel interviews Assessing candidates' resilience, accountability, and discipline Creating a "farm system" for developing sales talent internally Develop Clear Playbooks Adam outlined three crucial elements of effective sales playbooks: Product knowledge - Understanding what you sell and how it impacts customers Clear expectations - Outlining exactly what's expected in each role Unified approach - A consistent philosophy for engaging prospects Boosting Seller Efficiency and Pipeline Growth Adam provides practical strategies for improving sales performance, including:                          ·         Focusing on pre-hello activities to secure initial conversations ·         Utilizing AI for account research, territory planning, and meeting assessments ·         Balancing technology with human touch in the sales process The Role of AI in Modern Sales While AI is transforming many aspects of sales, Adam cautions against over-reliance: ·         AI tools for enhancing productivity and insights ·         The continued importance of human connection in sales ·         Balancing AI automation with personalized outreach This episode offers a comprehensive look at scaling enterprise sales teams, blending time-tested strategies with cutting-edge AI applications. Whether you're a sales leader looking to grow your team or a sales professional aiming to enhance your skills, you'll find actionable insights to elevate your sales game. Key Moments 00:00:00 - Effective Sales Strategies for Market Contact 00:00:42 - Introduction to Adam Block and Motive 00:04:32 - Adam Block's Guilty Pleasure: 80s Music 00:07:19 - Scaling Enterprise Sales Organizations 00:15:36 - Finding and Assessing Top Sales Talent 00:20:58 - Panel Interview Process for Sales Candidates 00:32:46 - Boosting Seller Efficiency and AI Integration 00:47:50 - Closing Thoughts and Career Opportunities at Motive About Adam Block Adam oversees Motive's global Revenue and Go-To-Market functions, including sales, business development, strategy, operations, sales engineering, and partnerships. Prior to Motive, he served as Vice President over the Public Sector, Healthcare, Manufacturing, High Tech, and Life Sciences teams at Medallia, the leading enterprise experience platform. During his tenure, Medallia went public and was later acquired for $6.4B. Before Medallia, Adam was Vice President, Sales and Marketing for TenMast software (now MRI software) and previously served as Partner and Vice President of Sales at Zeta Marketing, an internet marketing startup. Adam earned his Bachelor of Business Administration (BBA) in Finance and Management from the University of Kentucky. Follow Us On: ·         LinkedIn ·         Twitter ·         YouTube Channel ·         Instagram ·         Facebook Learn More About FlyMSG Features Like: ·         LinkedIn Auto Comment Generator ·         AI Social Media Post Generator ·         Auto Text Expander ·         AI Grammar Checker ·         AI Sales Roleplay and Coaching ·         Paragraph Rewrite with AI ·         Sales Prospecting Training for Individuals ·         FlyMSG Enterprise Sales Prospecting Training Program Install FlyMSG for Free: ·         As a Chrome Extension ·         As an Edge Extension  

Only a few years ago John suddenly went from FIT to FATIGUED with debilitating headaches. A MRI lead to a misdiagnosis and without being proactive John would have never found his solution. Without being proactive it could have potential led to John's death. Searching to regain qualify of life through social media groups led John to doctors passionate about finding answers. The answer was a misdiagnosis, issues with his pituitary gland and secondary adrenal insufficiency. John is now on the road of healing. He is regaining his strength, learning to adapt to his new journey and refining his journey thriving at life.POPULAR VIDEOS

While traveling with her family, 17-year-old Malia experienced a grand mal seizure while she was sleeping. Her parents immediately brought her back to Los Angeles to the care of Dr. Walavan Sivakumar at Pacific Neuroscience Institute South Bay, in Torrance, Ca. An MRI showed that Malia had an Arteriovenous Malformation which likely had been growing for a few years. Learn more about the life-saving surgery and treatment that Dr. Sivakumar and the multi-specialty team at PNI-South Bay and Providence Little Company of Mary Torrance performed to put Malia back on course to live a long and full life.

Paroxysmal movement disorders refer to a group of highly heterogeneous disorders that present with attacks of involuntary movements without loss of consciousness. These disorders demonstrate considerable and ever-expanding genetic and clinical heterogeneity, so an accurate clinical diagnosis has key therapeutic implications. In this episode, Kait Nevel, MD, speaks with Abhimanyu Mahajan, MD, MHS, FAAN, author of the article “Paroxysmal Movement Disorders” in the Continuum® August 2025 Movement Disorders issue. Dr. Nevel is a Continuum® Audio interviewer and a neurologist and neuro-oncologist at Indiana University School of Medicine in Indianapolis, Indiana. Dr. Mahajan is an assistant professor of neurology and rehabilitation medicine at the James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders at the University of Cincinnati in Cincinnati, Ohio. Additional Resources Read the article: Paroxysmal Movement Disorders Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @IUneurodocmom Guest: @MahajanMD Full episode transcript available here Dr Jones: This is Doctor Lyell Jones, editor in chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Nevel: Hello, this is Dr Kait Nevel. Today I'm interviewing doctor Abhi Mahajan about his article on diagnosis and management of paroxysmal movement disorders, which appears in the August 2025 Continuum issue on movement disorders. Abhi, welcome to the podcast and please introduce yourself to the audience. Dr Mahajan: Thank you, Kait. Thank you for inviting me. My name is Abhi Mahajan. I'm an assistant professor of neurology and rehabilitation medicine at the University of Cincinnati in Cincinnati, Ohio. I'm happy to be here. Dr Nevel: Wonderful. Well, I'm really excited to talk to you about your article today on this very interesting and unique set of movement disorders. So, before we get into your article a little bit more, I think just kind of the set the stage for the discussion so that we're all on the same page. Could you start us off with some definitions? What are paroxysmal movement disorders? And generally, how do we start to kind of categorize these in our minds? Dr Mahajan: So, the term paroxysmal movement disorders refers to a group of highly heterogeneous disorders. These may present with attacks of involuntary movements, commonly a combination of dystonia and chorea, or ataxia, or both. These movements are typically without loss of consciousness and may follow, may follow, so with or without known triggers. In terms of the classification, these have been classified in a number of ways. Classically, these have been classified based on the trigger. So, if the paroxysmal movement disorder follows activity, these are called kinesigenic, paroxysmal, kinesigenic dyskinesia. If they are not followed by activity, they're called non kinesigenic dyskinesia and then if they've followed prolonged activity or exercise they're called paroxysmal exercise induced dyskinesia. There's a separate but related group of protogynous movement disorders called episodic attacks here that can have their own triggers. Initially this was the classification that was said. Subsequent classifications have placed their focus on the ideology of these attacks that could be familiar or acquired and of course understanding of familiar or genetic causes of paroxysmal movement disorders keeps on expanding and so on and so forth. And more recently, response to pharmacotherapy and specific clinical features have also been introduced into the classification. Dr Nevel: Great, thank you for that. Can you share with us what you think is the most important takeaway from your article for the practicing neurologist? Dr Mahajan: Absolutely. I think it's important to recognize that everything that looks and sounds bizarre should not be dismissed as malingering. Such hyperkinetic and again in quotations, “bizarre movements”. They may appear functional to the untrained eye or the lazy eye. These movements can be diagnosed. Paroxysmal movement disorders can be diagnosed with a good clinical history and exam and may be treated with a lot of success with medications that are readily available and cheap. So, you can actually make a huge amount of difference to your patients' lives by practicing old-school neurology. Dr Nevel: That's great, thank you so much for that. I can imagine that scenario does come up where somebody is thought to have a functional neurological disorder but really has a proximal movement disorder. You mentioned that in your article, how it's important to distinguish between these two, how there can be similarities at times. Do you mind giving us a little bit more in terms of how do we differentiate between functional neurologic disorder and paroxysmal movement disorder? Dr Mahajan: So clinical differentiation of functional neurological disorder from paroxysmal movement disorders, of course it's really important as a management is completely different, but it can be quite challenging. There's certainly an overlap. So, there can be an overlap with presentation, with phenomenology. Paroxysmal nature is common to both of them. In addition, FND and PMD's may commonly share triggers, whether they are movement, physical exercise. Other triggers include emotional stimuli, even touch or auditory stimuli. What makes it even more challenging is that FND's may coexist with other neurological disorders, including paroxysmal movement disorders. However, there are certain specific phenom phenotypic differences that have been reported. So specific presentations, for example the paroxysms may look different. Each paroxysm may look different in functional neurological disorders, specific phenotypes like paroxysmal akinesia. So, these are long duration episodes with eyes closed. Certain kinds of paroxysmal hyperkinesia with ataxia and dystonia have been reported. Of course. More commonly we see PNES of paroxysmal nonepileptic spells or seizures that may be considered paroxysmal movement disorders but represent completely different etiology which is FND. Within the world of movement disorders, functional jerks may resemble propiospinal myoclonus which is a completely different entity. Overall, there are certain things that help separate functional movement disorders from paroxysmal movement disorders, such as an acute onset variable and inconsistent phenomenology. They can be suggestibility, distractibility, entrainment, the use of an EMG may show a B-potential (Bereitschaftspotential) preceding the movement in patients with FND. So, all of these cues are really helpful. Dr Nevel: Great, thanks. When you're seeing a patient who's reporting to these paroxysmal uncontrollable movements, what kind of features of their story really tips you off that this might be a proximal movement disorder? Dr Mahajan: Often these patients have been diagnosed with functional neurological disorders and they come to us. But for me, whenever the patient and or the family talk about episodic movements, I think about these. Honestly, we must be aware that there is a possibility that the movements that the patients are reporting that you may not see in clinic. Maybe there are obvious movement disorders. Specifically, there's certain clues that you should always ask for in the history, for example, ask for the age of onset, a description of movements. Patients typically have videos or families have videos. You may not be able to see them in clinic. The regularity of frequency of these movements, how long the attacks are, is there any family history of or not? On the basis of triggers, whether, as I mentioned before, do these follow exercise? Prolonged exercise? Or neither of the above? What is the presentation in between attacks, which I think is a very important clinical clue. Your examination may be limited to videos, but it's important not just to examine the video which represents the patient during an attack, but in between attacks. That is important. And of course, I suspect we'll get to the treatment, but the treatment can follow just this part, the history and physical exam. It may be refined with further testing, including genetic testing. Dr Nevel: Great. On the note of genetic testing, when you do suspect a diagnosis of paroxysmal movement disorder, what are some key points for the provider to be aware of about genetic testing? How do we go about that? I know that there are lots of different options for genetic testing and it gets complicated. What do you suggest? Dr Mahajan: Traditionally, things were a little bit easier, right, because we had a couple of genes that have been associated with the robust movement disorders. So, genetic testing included single gene testing, testing for PRRT2 followed by SLC2A. And if these were negative, you said, well, this is not a genetic ideology for paroxysmal movement disorders. Of course, with time that has changed. There's an increase in known genes and variants. There is increased genetic entropy. So, the same genetic mutation may present with many phenotypes and different genetic mutations may present with the similar phenotype. Single gene testing is not a high yield approach. Overall genetic investigations for paroxysmal movement disorders use next generation sequencing or whole exome sequence panels which allow for sequencing of multiple genes simultaneously. The reported diagnostic yield with let's say next generation sequencing is around 35 to 50 percent. Specific labs at centers have developed their own panels which may improve the yield of course. In children, microarray may be considered, especially the presentation includes epilepsy or intellectual disability because copy number variations may not be detected by a whole exome sequencing or next generation sequencing. Overall, I will tell you that I'm certainly not an expert in genetics, so whenever you're considering genetic testing, if possible, please utilize the expertise of a genetic counsellor. Families want to know, especially as an understanding of the molecular underpinnings and knowledge about associated mutations or variations keeps on expanding. We need to incorporate their expertise. A variant of unknown significance, which is quite a common result with genetic testing, may not be a variant of unknown significance next year may be reclassified as pathogenic. So, this is extremely important. Dr Nevel: Yeah. That's such a good point. Thank you. And you just mentioned that there are some genetic mutations that can lead to multiple different phenotypes. Seemingly similar phenotypes can be associated with various genetic mutations. What's our understanding of that? Do we have an understanding of that? Why there is this seeming disconnect at times between the specific genetic mutation and the phenotype? Dr Mahajan: That is a tough question to answer for all paroxysmal movement disorders because the answer may be specific to a specific mutation. I think a great example is the CACNA1A mutation. It is a common cause of episodic ataxia type 2. Depending on when the patient presents, you can have a whole gamut of clinical presentations. So, if the patient is 1 year old, the patient can present with epileptic encephalopathy. Two to 5 years, it can be benign paroxysmal torticollis of infancy. Five to 10 years, can present with learning difficulties with absence epilepsy and then of course later, greater than 10 years, with episodic ataxia (type) 2 hemiplegic migraine and then a presentation with progressive ataxia and hemiplegic migraines has also been reported. So not just episodic progressive form of ataxia has also been reported. I think overall these disorders are very rare. They are even more infrequently diagnosed than their prevalence. As such, the point that different genetic mutations present with different phenotypes, or the same genetic mutation I may present with different phenotypes could also represent this part. Understanding of the clinical presentation is really incomplete and forever growing. There's a new case report or case series every other month, which makes this a little bit challenging, but that's all the more reason for learning about them and for constant vigilance for patients who show up to our clinic. Dr Nevel: Yeah, absolutely. What is our current understanding of the associated pathophysiology of these conditions and the pathophysiology relating to the genetics? And then how does that relate to the treatment of these conditions? Dr Mahajan: So, a number of different disease mechanisms have been proposed. Traditionally, these were all thought to be ion channelopathies, but a number of different processes have been proposed now. So, depending on the genetic mutation that you talk about. So certain mutations can involve ion channels such as CACMA1A, ATP1A3. It can involve solute carriers, synaptic vesicle fusion, energy metabolism such as ECHS1, synthesis of neurotransmitters such as GCH1. So, there are multiple processes that may be involved. I think overall for the practicing clinician such as me, I think there is a greater need for us to understand the underlying genetics and associated phenotypes and the molecular mechanisms specifically because these can actually influence treatment decisions, right? So, you mentioned that specific genetic testing understanding of the underlying molecular mechanism can influence specific treatments. As an example, a patient presenting with proximal nocturnal dyskinesia with mutation in the ADCY5 gene may respond beautifully to caffeine. Other examples if you have SLC2A1, so gluc-1 (glucose transporter type 1) mutation, a ketogenic diet may work really well. If you have PDHA1 mutation that may respond to thiamine and so on and so forth. There are certain patients where paroxysmal movement disorders are highly disabling and you may consider deep brain stimulation. That's another reason why it may be important to understand genetic mutations because there is literature on response to DBS with certain mutations versus others. Helps like counselling for patients and families, and of course introduces time, effort, and money spent in additional testing. Dr Nevel: Other than genetic testing, what other diagnostic work up do you consider when you're evaluating patients with a suspected paroxysmal movement disorder? Are there specific things in the history or on exam that would prompt you to do certain testing to look for perhaps other things in your differential when you're first evaluating a patient? Dr Mahajan: In this article, I provide a flow chart that helps me assess these patients as well. I think overall the history taking and neurological exam outside of these paroxysms is really important. So, the clinical exam in between these episodic events, for example, for history, specific examples include, well, when do these paroxysms happen? Do they happen or are they precipitated with meals that might indicate that there's something to do with glucose metabolism? Do they follow exercise? So, a specific example is in Moyamoya disease, they can be limb shaking that follows exercise. So, which gives you a clue to what the etiology could be. Of course, family history is important, but again, talking about the exam in between episodes, you know, this is actually a great point because out– we've talked about genetics, we've talked about idiopathic paroxysmal movement disorders, –but a number of these disorders are because of acquired causes. Well, of course it's important because acquired causes such as autoimmune causes, so multiple sclerosis, ADEM, lupus, LGI1, all of these NMDAR, I mentioned Moyamoya disease and metabolic causes. Of course, you can consider FND as under-acquired as well. But all of these causes have very different treatments and they have very different prognosis. So, I think it's extremely important for us to look into the history with a fine comb and then examine these patients in between these episodes and keep our mind open about acquired causes as well. Dr Nevel: When you evaluate these patients, are you routinely ordering vascular imaging and autoimmune kind of serologies and things like that to evaluate for these other acquired causes or it does it really just depend on the clinical presentation of the patient? Dr Mahajan: It mostly depends on the clinical presentation. I mean, if the exam is let's say completely normal, there are no other risk factors in a thirty year old, then you know, with a normal exam, normal history, no other risk factors. I may not order an MRI of the brain. But if the patient is 55 or 60 (years) with vascular risk factors, then you have to be mindful that this could be a TIA. If the patient has let's say in the 30s and in between these episodes too has basically has a sequel of these paroxysms, then you may want to consider autoimmune. I think the understanding of paraneoplastic, even autoimmune disorders, is expanding as well. So, you know the pattern matters. So, if all of this is subacute started a few months ago, then I have a low threshold for ordering testing for autoimmune and paraneoplastic ideology is simply because it makes such a huge difference in terms of how you approach the treatment and the long-term prognosis. Dr Nevel: Yeah, absolutely. What do you find most challenging about the management of patients with paroxysmal movement disorders? And then also what is most rewarding? Dr Mahajan: I think the answer to both those questions is, is the same. The first thing is there's so much advancement in what we know and how we understand these disorders so regularly that it's really hard to keep on track. Even for this article, it took me a few months to write this article, and between the time and I started and when I ended, there were new papers to include new case reports, case series, right? So, these are rare disorders. So most of our understanding for these disorders comes from case reports and case series, and it's in a constant state of advancement. I think that is the most challenging part, but it's also the most interesting part as well. I think the challenging and interesting part is the heterogeneity of presentation as well. These can involve just one part of your body, your entire body can present with paroxysmal events, with multiple different phenomenologies and they might change over time. So overall, it's highly rewarding to diagnose such patients in clinic. As I said before, you can make a sizeable difference with the medication which is usually inexpensive, which is obviously a great point to mention these days in our health system. But with anti-seizure drugs, you can put the right diagnosis, you can make a huge difference. I just wanted to make a point that this is not minimizing in any way the validity or the importance of diagnosing patients with functional neurological disorders correctly. Both of them are as organic. The importance is the treatment is completely different. So, if you're diagnosing somebody with FND and they do have FND and they get cognitive behavioral therapy and they get better, that's fantastic. But if somebody has paroxysmal movement disorders and they undergo cognitive behavioral therapy and they're not doing well, that doesn't help anybody. Dr Nevel: One hundred percent. As providers, obviously we all want to help our patients and having the correct diagnosis, you know, is the first step. What is most interesting to you about paroxysmal movement disorders? Dr Mahajan: So outside of the above, there are some unanswered questions that I find very interesting. Specifically, the overlap with epilepsy is very interesting, including shared genes, the episodic nature, presence of triggers, therapeutic response to anti-seizure drugs. All of this I think deserves further study. In the clinic, you may find that epilepsy and prognosis for movement disorders may occur in the same individual or in a family. Episodic ataxia has been associated with seizures. Traditionally this dichotomy of an ictal focus. If it's cortical then it's epilepsy, if it's subcortical then it's prognosis for movement disorders. This is thought to be overly simplistic. There can be co-occurrence of seizures and paroxysmal movement disorders in the same patient and that has led to this continuum between these two that has been proposed. This is something that needs to be looked into in more detail. Our colleagues in Epilepsy may scoff this, but there's concept of basal ganglia epilepsy manifesting as paroxysmal movement disorders was proposed in the past. And there was this case report that was published out of Italy where there was ictal discharge from the supplementary sensory motor cortex with a concomitant discharge from the ipsilateral coordinate nucleus in a patient with paroxysmal kinesigenic cardioarthidosis. So again, you know, basal ganglia epilepsy, no matter what you call it, the idea is that there is a clear overlap between these two conditions. And I think that is fascinating. Dr Nevel: Really interesting stuff. Well, thank you so much for chatting with me today. Dr Mahajan: Thank you, Kait. And thank you to the Continuum for inviting me to write this article and for this chance to speak about it. I'm excited about how it turned out, and I hope readers enjoy it as well. Dr Nevel: Today again, I've been interviewing doctor Abhi Mahajan about his article on diagnosis and management of paroxysmal movement disorders, which appears in the August 2025 Continuum issue on movement disorders. I encourage all of our listeners to be sure to check out the Continuum Audio episodes from this and other issues. As always, please read the Continuum articles where you can find a lot more information than what we were able to cover in our discussion today. And thank you for our listeners for joining today. And thank you, Abhi, so much for sharing your knowledge with us today. Dr Monteith: This is Dr Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Prostate cancer deaths have been climbing over the last decade in part due to confusion over who should be screened and treated. In part 1 of a three-part series on prostate cancer, host Sandra Lindsay speaks with Samir Taneja, MD, a trailblazer in urologic cancer innovation, to explore how modern diagnostics and treatments, such as the groundbreaking use of MRI technology, are transforming patient outcomes. As Northwell's senior vice president and system chair of urology, Dr. Taneja provides invaluable insights into the shifting landscape of prostate cancer care and the critical importance of early detection. Tune in to understand the vital steps needed to increase awareness and save lives. About Northwell Health Northwell Health is New York State's largest healthcare provider and private employer, with 21 hospitals, 850 outpatient facilities and more than 16,600 affiliated physicians. We're making breakthroughs in medicine at the Feinstein Institutes for Medical Research. We're training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Nursing and Physician Assistant Studies. For information on our more than 100 medical specialties, visit Northwell.edu and follow us @NorthwellHealth on Facebook, Instagram, X and LinkedIn. Get the latest news and insights from our experts in the Northwell Newsroom: Press releases Insights Podcasts Publications Interested in a career at Northwell Health? Visit http://bit.ly/2Z7iHFL and explore our many opportunities. Get more expert insights from leading experts in the field — Northwell Newsroom.  Watch episodes of 20-Minute Health Talk on YouTube.  For information on our more than 100 medical specialties, visit Northwell.edu and follow us @NorthwellHealth on Facebook, Instagram, X and LinkedIn. Interested in a career at Northwell Health? Visit the health system's job portal and explore our many opportunities.    

Send us a textClick here for ResourcesHave you ever found yourself caught in an endless loop of replaying conversations, wondering if you said the right thing or how others perceived you? You're not alone. Overanalyzing isn't just an annoying habit. It is rooted in our evolutionary biology and neurological wiring.When we replay social interactions, our brains are actually seeking validation and safety. MRI studies show that rejection activates the same regions of the brain as physical pain, while approval triggers dopamine, creating a temporary high that keeps us stuck in the cycle. From childhood, many of us, especially women, were conditioned to equate fitting in with safety. Be good. Follow the rules. Don't stand out. Over time, our nervous systems learned to chase approval instead of trusting our own compass.The cost is enormous. Overthinking drains our energy and keeps us stuck in the past or anxious about the future. Our real power is only available in the present moment. Research shows that successful people share one key trait: they care less about others' opinions and act boldly from their inner vision.In this episode of my self help podcast for women and growth minded listeners, I, Dr. Amen Kaur, share a simple three step framework to break free. First, catch yourself in the overthinking loop. Second, regulate your nervous system through breath and presence. Third, take one small action that affirms who you are in this moment.I also share my mantra “So Be It,” which helps you embody the version of yourself who takes action. Clarity doesn't come from thinking more. It comes from being who you truly are.Whether you are navigating overthinking, seeking personal growth, or building the confidence to follow your dreams, this episode will give you the tools to move forward.If you are ready to step into who you want to be, book a free consultation with me, Dr. Amen Kaur, and discover how to embody your vision and release the old conditioning that is keeping you stuck. The power is within you. So be it.Support the show

John Kippen is an entrepreneur, professional magician, speaker, resilience and empowerment coach and published author.  John was dealt a bad blow in 2002 when he was diagnosed with a large benign brain tumor. Its removal, although successful, left him with permanent facial paralysis which stopped his forward momentum forcing him into hiding for more than 12 years. As John hit bottom, he rediscovered his childhood love for performing magic and storytelling . Now filled with passion and hope , he discovered that his facial difference had become  his greatest superpower. This new mindset gave John the strength to live life with joy and become a sought after resilience and empowerment coach who uses the lessons and methodologies he learned overcoming his adversity to inspire and assist his clients to get out of their own way and live their best lives. His two mottos are  “ Being Different is your Superpower!” and  “Feed your Heart with your Art” John Kippen Vroom Vroom Veer Show Summary John's Journey Through Health Challenges John shared his personal story, beginning with his childhood in Los Angeles and his education at a private school where he became involved in theater. He described his early career in computer consulting, which he started in the 1980s after setting up a computer lab at Cal State University, Northridge. John then explained how his health issues began in 2002 with hearing problems, specifically difficulty hearing men's voices, followed by dizziness a month later, leading him to undergo an MRI despite his claustrophobia. Brain Tumor Discovery Experience John shared his experience of discovering a brain tumor through medical imaging in 2002. After getting X-rays at a hospital and taking them to an ENT specialist, he was referred to the House Ear Clinic where a surgeon diagnosed a 4.5 centimeter acoustic neuroma brain tumor that was killing him. John emphasized the importance of having someone present during medical consultations to help remember details and ask questions, as he found himself struggling to recall important information after the shock of the diagnosis. Brain Surgery and Recovery Journey John shared his experience undergoing brain surgery, describing the pre-surgery preparation and the challenging recovery process. He recalled being confronted by his anesthesiologist about insurance coverage just before the procedure, and waking up to find his face paralyzed, which affected his mother's reaction to his condition. John also mentioned developing a spinal fluid leak that required a second surgery after returning home. Embracing Difference Through Curiosity John shared his personal experience of hiding for 12 years after brain surgery, during which he isolated himself from social activities and work. He described a pivotal moment at a restaurant when a young boy asked about his face, which inspired John to reflect on how children's natural curiosity and lack of judgment differ from adults' reactions. John used this experience as the basis for his TED Talk about treating people who are different with respect and compassion. Transforming Challenges into Magic Performances John shared his journey of using his personal story of brain surgery and facial paralysis to enhance his magic performances. He explained how he transformed his condition into a storytelling asset by incorporating it into his act and sharing personal experiences with audiences. John also described how his story resonated with others facing medical challenges, including a specific instance where his performance inspired a man named Ron to fight his cancer diagnosis. John's Magical Trebek Encounter John shared his experience writing a book titled "Playing the Hand You Are Dealt" and offered listeners a PDF version if they listen to the end of the show. He recounted performing magic for Alex Trebek at Trebek's 75th birthday party,