Podcasts about mri

The medical system expects you to chase 33 different screening appointments across multiple specialists and check your organs one at a time. But there's a smarter way that scans your entire body in under an hour to catch cancer, aneurysms, fatty liver, and other serious health issues before they become life-threatening. In today's episode, I sit down with Dr. Daniel Durand, Chief Medical Officer of Prenuvo, to talk about the real-world power (and limitations) of proactive whole-body MRI screening. Dr. Durand walks us through how this advanced screening method detects over 500 conditions, many of which traditional screenings miss. We talk about the importance of early detection for cancers and neurodegenerative diseases, and how this proactive approach to health can save lives.   "It's better to see things early when you can intervene, and see them in a controlled context when you're healthy." ~ Dr. Daniel Durand   In This Episode: -  Introduction to Dr. Daniel Durand and his background - Conventional vs whole body scans - Conditions that whole-body MRI can detect - Bringing scans to underserved populations - Imaging for risk identification vs. diagnosis - How often you should rescan and what to expect - EMF exposure concerns and MRI safety parameters - How consumer demand is driving change in medicine   Products & Resources Mentioned: Prenuvo Whole-Body MRI: My listeners get a special discount when you book at https://prenuvo.com/wendymyers  Bon Charge Blue Light Blockers: Get 15% off with code WENDY at https://boncharge.com  Organifi Happy Drops: Save 20% with code MYERSDETOX at https://organifi.com/myersdetox  Organifi Collagen: Use code MYERSDETOX for 20% off at https://organifi.com/myersdetox  Chef's Foundry P600 Ceramic Cookware: Get 20% off with code WENDY20 at https://chefsfoundry.com  Heavy Metals Quiz: Take it for free at https://heavymetalsquiz.com    About Dr. Daniel Durand: Dr. Daniel Durand is a dual board-certified adult & pediatric radiologist and Chief Medical Officer at Prenuvo, where he leads clinical operations, research, and the medical group for the world's largest network of proactive whole-body MRI clinics. Previously, he served as Chief Clinical Officer & Chief Innovation Officer at LifeBridge Health and held leadership roles in accountable care at Johns Hopkins. He is passionate about empowering primary care and shifting medicine toward true prevention through advanced imaging. Learn more at: https://prenuvo.com/wendymyers    Disclaimer The Myers Detox Podcast was created and hosted by Dr. Wendy Myers. This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast, including Wendy Myers and the producers, disclaims responsibility for any possible adverse effects from using the information contained herein. The opinions of guests are their own, and this podcast does not endorse or accept responsibility for statements made by guests. This podcast does not make any representations or warranties about guests' qualifications or credibility. Individuals on this podcast may have a direct or indirect financial interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.

In the final installment of this series, Dr. Justin Abbatemarco and Dr. Divyanshu Dubey discuss the latest findings and some non-occupational exposures.  Show citation:  Hinson SR, Gupta P, Paramasivan NK, et al. Neural synaptic vesicle autoimmunity following aerosolized porcine neural tissue exposure: insights into autoimmune inflammatory polyradiculoneuropathy. EBioMedicine. 2025;122:106053. doi:10.1016/j.ebiom.2025.106053 Show transcript:  Dr. Justin Abbatemarco:  Hello, and welcome back. This is Justin Abbatemarco. I'm here with Divyanshu Dubey, discussing his article, Neural Synaptic Vesicle Autoimmunity Following Aerosolized Porcine Neural Tissue Exposure: Insights Into Autoimmune Inflammatory Polyradiculoneuropathy. Div, maybe we could talk about non-occupational exposures? I think many of us don't see this cohort of patients commonly, but I really think this helps inform care, beyond just this specific occupational exposure. What did you guys find in your work? Dr. Divyanshu Dubey:  So, one of the inspirations for this study was driven by the phenotypic characterization of patients who were described in this 2010 paper, which is somewhat similar to some of the patients I currently see in my clinic who don't seem to meet GBS or CIDP criteria. But, based on their MRI findings, based on their CSF studies, the EMG nerve conduction studies, they seem to have this polyradiculoneuropathy presentation, often presenting with asymmetric disease onsets, starting on one leg and then sometimes transitioning to the other side. In some cases, even a non-length dependent pattern with sort of proximal cervical brachial nerve root plexus involvements, which don't really seem to have a blood test, or a biomarker right now. Currently, many of these cases are a diagnosis of exclusion. I was thinking if there's a biomarker that we can identify from this 2006 to 2008 unfortunate event, that might actually help us diagnose these patients. So, once we identified synaptophysin and GAP43 antibodies in the swine abattoir cohort, I went back to our storages of these patients with other inflammatory polyradiculoneuropathy, and found about 5% of these patients from a large cohort of close to 300 patients, did have these antibody biomarkers. Some of these patients had paraneoplastic trigger, where we had patients with neuroendocrine tumors, or hematological malignancies mounting a response to these antibodies. But a good chunk of these patients we did not truly understand, or know what the triggers were. That might be a potential for future studies, as we expand our cohort of these antibodies, as well as study further the phenotypic characterization of these cases. Dr. Justin Abbatemarco: Yeah, there's just so much there, really helping to inform future clinical care outside of this very specific occupational exposure. And then, as we talked about in the podcast, I think really helping to think through how neurological autoimmune diseases develop. So, just really exciting work. We really appreciate you coming on, sharing this. We're excited for how this evolves over the coming years. Dr. Divyanshu Dubey:  Thank you, Justin.  

Heavy alcohol use accelerates bleeding strokes by more than a decade, causing brain hemorrhages to occur around age 64 instead of 75 and leaving survivors with greater disability and cognitive decline MRI scans show that heavy drinkers develop more severe white matter damage, a sign of accelerated brain aging and small vessel disease, even before a stroke occurs Alcohol and seed oils both damage your mitochondria through toxic aldehydes that weaken blood vessels, increase inflammation, and raise the risk of brain bleeds and liver disease Eliminating alcohol and seed oils, while rebuilding your diet around nutrient-dense, low-linoleic acid foods, helps restore vessel integrity and reduce oxidative stress throughout your brain and liver Melatonin, dimethyl sulfoxide (DMSO), and N-acetylcysteine (NAC) support mitochondrial repair and antioxidant defenses, helping protect your brain and blood vessels from long-term oxidative damage

Broadcast from KSQD, Santa Cruz on 1-15-2026: An emailer from Switzerland asks about fluorescein angiography requested before her first retina appointment. Dr. Dawn suspects protocol-based medicine screening for macular degeneration and suggests negotiating to see the doctor first given her different reason for seeing a retinal specialist. She encourages patients to maintain agency in medical settings. An emailer asks about creatine supplements. Dr. Dawn notes it helps muscle development in people doing weight training at 3-5 grams daily, but does nothing for aerobic-only exercisers. Claims about cognition and mood lack solid research. She advises against high-dose "loading," and cautions that creatine causes fluid retention problematic for congestive heart failure and should be avoided with stage 3 or higher kidney disease. Dr. Dawn reminds listeners it's not too late for flu shots, noting this season's H3N2 strain emerged after vaccine formulation was finalized. She laments mRNA vaccine research defunding, as that technology allows rapid reformulation. She describes organoids—tissues grown from stem cells that self-organize into primitive organ structures, enabling rapid drug screening without animal testing. Stanford researchers created assembloids by placing four neurological organoids together that spontaneously connected and built the ascending sensory pain pathway, offering new approaches to studying chronic pain. Dr. Dawn explains research showing satellite glial cells transfer healthy mitochondria to spinal sensory neurons through tunneling nanotubules. When this transfer fails, neurons fire erratically causing pain. Infusing healthy mitochondria into mouse spinal columns cured peripheral neuropathy—suggesting future periodic infusion treatments for humans. She reports Texas A&M researchers created "nanoflowers" from molybdenum disulfate that double stem cell's mitochondrial production, potentially supercharging regenerative medicine for conditions including Alzheimer's and muscular dystrophy. A caller asks about flu vaccines with egg allergy. Dr. Dawn explains that his gastrointestinal reactions to eggs differ from dangerous IgE allergies causing hives or anaphylaxis—GI intolerance doesn't preclude vaccination. Dr. Dawn reveals that 20 years of Parkinson's research followed a false lead. MRI showed increased iron in patients' brains, prompting iron chelation trials—which worsened symptoms. The problem: MRI detects paramagnetic ferric iron (stored, inert) not ferrous iron (biologically active). Patients accumulate useless ferric iron but are deficient in usable ferrous iron. Earlier 1980s studies showing that iron supplementation helped were ignored and abandoned prematurely. She suggests Parkinson's patients discuss iron supplementation with neurologists. She will post the link in the resources page on her website. A caller concerned about early Parkinson's describes tremors and balance problems in darkness. Dr. Dawn suggests darkness-related symptoms sound more like peripheral neuropathy than Parkinson's, recommending neurological examination and screening for diabetes, B vitamin deficiency, or heavy metal exposure. She confirms that sedentary lifestyle reduces mitochondrial production while progressive exercise builds both muscle and mitochondria.

AI, AI, and more AI. Do you even live in Silicon Valley if you're not talking about it every episode? This week, we go deep on how open-source vibe-coding tools are starting to replace the need for traditional SaaS contracts. Dave shows (and tells) how he used the open-source “Claude bot” to reverse-engineer his Mural photo frames and spin up a better web UI in under 30 minutes. Brit test-drives Anthropic's new Cowork, auto-mapping the entire seed VC market while it runs her browser, and celebrates how much these agents are boosting household productivity. Sam loves the power but calls local agents a massive security backdoor, argues trust will consolidate with Apple and Google, declares that “software is not a business,” and announces we've officially entered the fart-app era of AI toys. Jessica flags rising panic among SaaS vendors. Don't miss Sam's hot-chick analogy and Brit's Pop Corner to close it out

AB gives advice about getting an MRI, and we wonder where you found food unexpectedly.

HEALTH NEWS   Can exercise turn back the clock on your brain? New study says yes Why leaving things unfinished messes with your mind Short-term, calorie-restrictive diet improves Crohn's disease symptoms Higher daylight exposure improves cognitive performance, study finds Breastfeeding may lower mums' later life depression/anxiety risks for up to 10 years after pregnancy     Can exercise turn back the clock on your brain? New study says yes AdventHealth Research Institute, January 13 2026 (Eurekalert) A simple, steady exercise routine may help your brain stay biologically younger, supporting clearer thinking, stronger memory, and a greater sense of whole-person well-being.   The study found that adults who followed a year-long aerobic exercise program had brains that appeared nearly a year “younger” than those who didn't change their activity levels.   Published in the Journal of Sport and Health Science, the study explored whether regular aerobic exercise could slow, or even reverse “brain age,” a magnetic resonance imaging (MRI)-based biomarker of how old your brain looks compared to your actual age. A higher brain-predicted age difference (brain-PAD), indicates an older-appearing brain and has been linked to poorer physical and cognitive function and increased risk of mortality in previous research.  In this clinical trial, 130 healthy adults aged 26–58 were randomly assigned to either a moderate-to-vigorous aerobic exercise group or a usual-care control group. The exercise group completed two supervised 60-minute sessions per week in a laboratory plus home-based exercise to reach about 150 minutes of aerobic activity per week, aligning with the American College of Sports Medicine's physical activity guidelines. Brain MRI and cardiorespiratory fitness, measured as peak oxygen uptake (VO2peak), were assessed at the beginning and end of the 12-month period.  Over 12 months, participants in the exercise group showed a measurable reduction in brain age, while the control group showed a slight increase. On average, the exercise group's brain-PAD decreased by about 0.6 years, indicating a younger-appearing brain at follow-up. In contrast, the control group's brains appeared about 0.35 years older, a change that was not statistically significant. Overall, the between-group difference in brain age was nearly one year, favoring the exercise group.     Why leaving things unfinished messes with your mind Yale University, January 12 2026 (Medical Xpress) In a new study, published in the Journal of Experimental Psychology: General, Yale professor of psychology Brian Scholl and lab members explored why humans so badly want to finish what we've started—in matters great and small. It turns out the brain just doesn't like dangling threads. The researchers had a hunch that visual clues could help explain the lure of the unfinished. Why is this state of leaving things undone so salient to us? It's an interesting quirk of human nature that science has not previously addressed. Unfinishedness has been found to decrease work satisfaction, impair sleep, and fuel ruminative thinking patterns. The researchers turned to the visual system. When we see unfinished events, are they somehow prioritized in memory?" To test their hunch that visual memory plays a role in making unfinishedness feel so sticky, the researchers ran four experiments involving a total of 120 participants who viewed computer animations of simple mazes populated by moving dots or lines. In several experiments, it seemed that the brain is wired to notice and remember incomplete things better than finished ones. The findings suggest that "unfinishedness" isn't just about motivation or satisfaction. It's built into the way people see and remember the world.   Short-term, calorie-restrictive diet improves Crohn's disease symptoms     Stanford University, January 13 2026 (News-Medical)   There have been few large studies of dietary interventions for IBD, a group of disorders that includes ulcerative colitis and Crohn's disease. Now a Stanford Medicine-led study finds a short-term, calorie-restrictive diet significantly improved symptoms. Their national, randomized controlled clinical trial found that a short-term, calorie-restrictive diet significantly improved both physical symptoms and biological indicators of mild-to-moderate Crohn's disease. A chronic condition affecting about a million Americans, Crohn's disease causes inflammation in the digestive tract, leading to symptoms of diarrhea, cramping, abdominal pain and weight loss. Steroids are the only approved therapeutic for mild Crohn's, but their use is limited due to significant side effects, particularly with long-term use. The study compared the symptoms and biological indicators of patients with mild-to-moderate Crohn's disease as they either followed a fasting mimicking diet or ate their normal diet for three consecutive months. The study enrolled 97 patients across the country, with 65 in the fasting mimicking group and 32 in the control group. Participants in the fasting mimicking group severely limited their calories for five consecutive days per month, eating between about 700 and 1,100 calories a day. Plant-based meals were provided during the fasting period. For the remainder of the month, the fasting mimicking group ate their normal diet. At the end of the study, two-thirds of the fasting mimicking group experienced improvement in their symptoms. The researchers found a significant decline in fecal calprotectin, a protein in the stool that indicates gut inflammation, in the fasting mimicking group compared with the control group. Some inflammation-promoting lipid mediators derived from fatty acids also declined in fasting mimicking group participants. Similarly, the immune cells of fasting mimicking group participants produced fewer of several types of inflammatory molecules.   Higher daylight exposure improves cognitive performance, study finds University of Manchester (UK), January 12 2026 (Medical Xpress) A real world study led by University of Manchester neuroscientists has shown that higher daytime light exposure positively influences different aspects of cognition. The first study of its kind showed that stable light exposure across a week and uninterrupted exposure during a day had similar effects. Participants in the study experienced improved subjective sleepiness, the ability to maintain focused attention and 7-10% faster reaction speeds under bright light when compared to recent dim conditions. Compared with their peers who went to bed later, participants with earlier bedtimes tended to be both more reliably wakeful under bright morning light and sleepy under dimmer evening light. Being exposed to bright, stable daytime light was linked to enhanced and more sustained attention in a visual search task in which participants were asked to find a specific target on a page. Higher daytime light exposure and fewer switches between light and dark were linked to improved cognitive performance. And higher daytime light exposure and earlier estimated bedtimes were also associated with stronger relationships between recent light exposure and subjective sleepiness. However, neither the time of day nor time awake significantly impacted cognitive performance; the effect of light was stronger than the effect of time of day.   Breastfeeding may lower mums' later life depression/anxiety risks for up to 10 years after pregnancy University College Dublin (Ireland), January 8 2026 (Eurekalert)   Breastfeeding may lower mothers' later life risks of depression and anxiety for up to 10 years after pregnancy, suggest the findings of a small observational study, published in the open access journal BMJ Open. The observed associations were apparent for any, exclusive, and cumulative (at least 12  months) breastfeeding, the study shows. The researchers tracked the breastfeeding behaviour and health of 168 second time mothers who were originally part of the ROLO Longitudinal Birth Cohort Study for 10 years.   At the check-ups, the mothers provided information on: whether they had ever breastfed or expressed milk for 1 day or more; total number of weeks of exclusive breastfeeding; total number of weeks of any breastfeeding; and cumulative periods of breastfeeding of less or more than 12 months.   The study concludes there may be a protective effect of successful breastfeeding on postpartum depression and anxiety, which in turn lowers the risk of maternal depression and anxiety in the longer term.

As men and their loved ones explore treatment options for prostate cancer, it's encouraging to know that ongoing innovation is shaping the management of this condition as technology advances. Today, we have the privilege of speaking with Dr. Mark Hong, a pioneer of an advanced treatment for men with prostate cancer and/or BPH, known as Transurethral Ultrasound Ablation, or TULSA. It is a minimally invasive MRI-guided procedure that destroys cancerous tissue while minimizing side effects. We're thrilled to partner with Profound Medical to introduce today's special guest. Dr. Hong is a board-certified urologist at Integrative Urology in Phoenix, Arizona, and a pioneer of MRI-guided TULSA-PRO incision-free surgery for prostate cancer. He completed his urology residency at Harvard Medical Center and earned selection as a national CAPTURE Scholar in prostate cancer. That allowed him to lead projects alongside world-leading scientists from the Dana-Farber Cancer Institute and the University of California, San Francisco. He also completed a fellowship in robotic and minimally invasive surgery at George Washington University in Washington, DC. He has published in almost every major international urology journal, having authored publications on topics ranging from prostate cancer detection to healthcare policy. Dr. Hong joins us today to share more about TULSA-PRO for men with prostate cancer. Having completed over 200 procedures, he has performed more TULSA procedures as an independent urologist, in the absence of a radiologist, than any other urologist in the world. Stay tuned for more! Disclaimer: The Prostate Health Podcast is for informational purposes only. Nothing in this podcast should be construed as medical advice. By listening to the podcast, no physician-patient relationship has been formed. For more information and counseling, you must contact your personal physician or urologist with questions about your unique situation. Show Highlights: Dr. Hong clarifies what the TULSA procedure is How the TULSA procedure differs from other technologies, in terms of its delivery, advantages, and outcomes Who are the ideal candidates for the TULSA procedure? The potential risks associated with the TULSA procedure What patients undergoing the TULSA procedure can expect How the development of new technologies leads to better outcomes for men with prostate cance Links:  Follow Dr. Pohlman on Twitter and Instagram - @gpohlmanmd.  Get your free What To Expect Guide (or find the link on our podcast website)   Join our Facebook group  Follow Dr. Pohlman on Twitter and Instagram  Sign up for the Prostate Health Academy   You can access Dr. Pohlman's free mini-webinar, where he discusses his top three tips to promote men's prostate health, longevity, and quality of life here. Podcast Partner: Profound Medical TULSA-PRO: https://tulsaprocedure.com/     

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making. ⚠️ SIGN UP FOR OUR FREE NEWSLETTER: [NEWSLETTER SIGN-UP]Topics included in this episode:Application of IV anesthetic pharmacology to real clinical case scenarios rather than just PK/PD theory How to choose between propofol, ketamine, etomidate, and dexmedetomidine based on patient and surgical factors Decision frameworks for managing high-risk situations like trauma, sepsis, cardiac disease, and difficult airways Common pitfalls with induction agents and how to prevent hypotension, apnea, and airway obstruction How anesthesia choices change across environments like OB, ICU, MRI, GI suite, and neurosurgery

We're joined by Tom Elliott, the founder of Hotspur Helium, who holds the largest multinational primary helium portfolio globally.  We discuss what Hotspur Helium is building and the ambition behind the company, before stepping back to look at why helium has become such a compelling focus for investors and operators alike. Tom shares insight into the critical uses of helium — from healthcare and advanced manufacturing to space and technology, and the demand trends reshaping the global supply landscape. We also discuss how Hotspur Helium thinks about where to operate globally, what differentiates the company in an increasingly competitive space, and where it currently sits in its growth journey. Finally, we dive into the commercial realities of helium projects, including off-take interest, project economics, payback potential, and what the outlook looks like over the coming years. This is a practical, forward-looking conversation about a niche commodity that plays an outsized role in modern industry, and how Hotspur Helium is positioning itself within that opportunity KEY TAKEAWAYS Hotspur Helium differentiates itself by targeting "elephant" prospects—large-scale deposits (at least 5 BCF of recoverable helium) in the Middle East and Southern Africa, rather than the smaller pockets often found in North America. While 95% of global helium is currently a byproduct of the oil and gas industry, Hotspur is focused on "primary helium" exploration. This ensures a stable supply that isn't subject to the volatility of LNG market prices. Helium is irreplaceable in high-growth sectors, specifically semiconductor manufacturing, MRI scanners, and space exploration. Each SpaceX launch, for instance, consumes roughly 6% of daily global helium production. Since its founding in 2024, the company has acquired 20,000 square kilometres of acreage. They aim to finalise surface exploration in 2026, begin drilling in 2028, and bring the first helium online by 2030. BEST MOMENTS "Hotspur Helium... holds the largest multinational primary helium portfolio globally." "Someone said to me the other day, 'Oh, so you're elephant hunting.' And that's essentially what we're doing... we're the first people through the door and we're able to acquire the best acreage."  "Right now, is helium the tail on the dog or is it the flea on the end of the tail of the dog? Right now, given the size of the LNG industry, it's pretty small... " "It's an extremely lucrative commodity... worth something like 200 to 300 times that of natural gas” GUEST RESOURCES Web: www.hotspurhelium.com Email: info@hotspurhelium.com  LinkedIn (Hotspur): https://www.linkedin.com/company/hotspurhelium/ LinkedIn (TE): https://www.linkedin.com/in/tom-elliott-230731316 VALUABLE RESOURCES Mail:        ⁠rob@mining-international.org⁠ LinkedIn: ⁠https://www.linkedin.com/in/rob-tyson-3a26a68/⁠ X:              ⁠https://twitter.com/MiningRobTyson⁠  YouTube: ⁠https://www.youtube.com/c/DigDeepTheMiningPodcast⁠  Web:        ⁠http://www.mining-international.org⁠ CONTACT METHOD ⁠rob@mining-international.org⁠ ⁠https://www.linkedin.com/in/rob-tyson-3a26a68/⁠ Podcast Description Rob Tyson is an established recruiter in the mining and quarrying sector and decided to produce the “Dig Deep” The Mining Podcast to provide valuable and informative content around the mining industry. He has a passion and desire to promote the industry and the podcast aims to offer the mining community an insight into people's experiences and careers covering any mining discipline, giving the listeners helpful advice and guidance on industry topics.  This Podcast has been brought to you by Disruptive Media. https://disruptivemedia.co.uk/

What would you want your clickbait title to be? What is a face? Why is an MRI so loud? Could Rome actually be built in a day? What is going on with the design of traffic lights? …Hank and John Green have answers!If you're in need of dubious advice, email us at hankandjohn@gmail.com.Join us for monthly livestreams at patreon.com/dearhankandjohn.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Dr. Aaron Zelikovich discusses the utility of neurofilament light chain as a serum biomarker in peripheral neuropathy.  Show citation: Karam C. Clinical Utility of Serum Neurofilament Light Chain in Peripheral Neuropathy. Muscle Nerve. 2026;73(1):86-92. doi:10.1002/mus.70073 Show transcript: Dr. Aaron Zelikovich: Welcome to today's neurology minute. My name is Aaron Zelikovich, a neuromuscular specialist at Lenox Hill Hospital in New York City. Today, we will discuss a recent article on the utility of neurofilament light chain as a serum biomarker in peripheral neuropathy. It has been studied in other neurological diseases like ALS and multiple sclerosis, as in the 2024 study by Robert Fox et al, which highlighted the limitations of serum neurofilament light chain in patients with multiple sclerosis, since the elevation was inconsistent and tended to occur weeks after MRI changes, and was really only found to be helpful in certain clinical situations. The study we highlight today is a single-center retrospective study that highlights the opportunities and limitations of using serum neurofilament light chain as a biomarker to monitor treatment response and peripheral neuropathy. Serum neurofilament light chain has been shown as an indicator of neuronal injury in both central and peripheral nervous system disease that has been associated with axonal injury or degeneration. It is now commercially available. The authors in this study provide a real-world single-center retrospective study that looked at various forms of peripheral neuropathy over 12 months. Patients had to be evaluated and meet criteria for peripheral neuropathy with either genetic testing, nerve conduction studies, and/or clinical exams. Neuropathies included TTR amyloid, vasculitis, CMT, CIDP, GBS, and anti-MAG neuropathy. Patients with TTR amyloid who were treatment naive and had elevated serum neurofilament light chain showed a reduction in neurofilament light chain levels with treatment. Additionally, patients with CIDP who were treatment naive with elevated serum neurofilament light chain also showed a reduction in neurofilament light chain levels with treatment. All patients with idiopathic peripheral neuropathy had normal serum neurofilament light chain levels. However, serum neurofilament light chain can vary in patients based on age, if they have diabetes, renal dysfunction, and body weight. And this makes it really challenging to interpret it in an isolated setting. Serum neurofilament light chain is a new biomarker for peripheral neuropathies. It can be a supplemental tool in the appropriate clinical context. Future studies are needed to identify its potential to be used as a treatment response biomarker in neuropathies like CADP, GBS, and TTR amyloid. Thank you so much, and have a wonderful day. 

We got our big juicy pumps for this amazing episode! We started by talking about a couple pieces of personal news, including a shockingly cool number 4 ranking in the Ultra Runner of the Year voting... and some tough health findings from an MRI. The newest shoe review is a medical boot. It's still better than most trail shoes.The big science discussion was on a pair of studies on advanced female runners, with both finding low carbohydrate intake on training days. One of the studies on elite athletes found that 94.3% had low energy availability! We broaden out the discussion into nutritional approaches generally. And David tries to broaden it out into a thinkpiece about the food pyramid. At a certain point, maybe your thinkpiece is so wrong that you eventually loop around and become right? Don't answer that.And this one was full of great topics! Other topics: our approach to training and health with the foot, a study on using heat training to substitute for other types of training, what we'd spend with $200 a month, how we are making money off AI, the Burrito League, some quick thoughts on continuous lactate monitors, Shelby Houlihan and Molly Seidel setting records at trail races, Raya for trail and ultra runners, sleep and FKTs, blood tests and training for downhills in a flat place.We love you all! HUZZAH!-David and MeganClick "Claim Your Sponsorship" for $40 free credit at The Feed here: thefeed.com/swapBuy Janji's amazing gear: https://janji.com (code "SWAP")The Wahoo KICKR Run is the best treadmill on the market: https://www.wahoofitness.com/devices/running/treadmills/kickr-run-buy (code “SWAP”)Athlete Blood Test (code "SWAP"): https://www.athletebloodtest.com/shop/For training plans, weekly bonus podcasts, articles, and videos: patreon.com/swap

We spent last week learning what the fellas lost inside themselves last year…..what about the ladies? And an early contender (and lover of tubers) for the 2026 wrap up! We also meet a couple that did it inside an MRI machine a former NFLer who is suing his ex-wife for talking about his package!

Dr. Refky Nicola speaks with Dr. Sven Haller about the current clinical use of AI-accelerated MRI, exploring how these techniques improve scan speed, patient comfort, workflow efficiency, and image quality. They also examine key challenges including hallucinations, validation gaps, economic considerations, and the need for clear standards to guide safe and effective adoption. The Current Status of AI-accelerated MRI Techniques in Clinical Use. Haller et al. Radiology 2025; 317(2):e24381

In this bilingual movie gathering (with Portuguese translation), David Hoffmeister uses a film about a woman who gains the ability to hear people's inner thoughts as songs to illustrate a profound truth: There are no private thoughts.Connecting the movie's plot—triggered by an MRI and an earthquake—to A Course in Miracles Workbook Lesson 19, David explores the reversal of cause and effect. We often believe that external events—like a flat tire, a grumpy boss, or sour milk—cause our bad days. However, David explains that the world is actually a projection of our own minds.Join this session to discover why the ego's version of reality is a "hallucination" and how the Holy Spirit offers a way to wake up from the dream of separation.For more information about bilingual movie gatherings, David Hoffmeister, and Living Miracles events, visit https://www.the-christ.net/eventsFree Bilingual Movie GatheringsThis January, we'll meet each Saturday for an online movie gathering with David Hoffmeister! Through David's deeply insightful commentaries and teachings, the mind is opened to a living experience of A Course in Miracles, offering a profound opportunity for healing and heartfelt connection. All sessions are in English, with live translation into one of the following languages each week: Spanish, Portuguese, Japanese, or German.Recorded live online on January 10, 2025, in Mexico.Follow us on:YouTube: https://www.youtube.com/DavidHoffmeister Facebook: https://www.facebook.com/ACIM.ACourseInMiracles Learn more about David & Living Miracles: https://livingmiraclescenter.orgLearn more about A Course in Miracles: https://ACIM.bizDavid's Spanish Youtube Channel is: https://www.youtube.com/channel/UCP9Gw00CldPUmiu43y7fdWw

What do you do when your world becomes so small that even the second floor of your own home feels like a place you need to escape?In this episode, I'm sitting down with Megan, a graduate of my Panic to Peace program, to talk about the raw reality of agoraphobia. Megan shares the "underwater" feeling of her first traumatic panic attack during an MRI and how her life eventually shrank until she was white-knuckling her way through every single day just to show up for her two daughters.Megan's story is a beautiful look at the shift that happens when you stop fighting the feelings and start changing the way you talk to yourself. We talk about how she went from being housebound to navigating a four-day hospital stay with her child with a newfound sense of calm. If you feel stuck in the "noise" of anxiety, this conversation will show you exactly how Megan turned the volume down and reclaimed her life.SIGN UP FOR DRIVE WITH PEACE & CONFIDENCE HERE: https://www.ahealthypush.com/drive-with-peaceTAKE MY FREE QUIZ AND FIND OUT WHAT'S CAUSING YOU TO STAY STUCK: https://www.ahealthypush.com/blocking-quizA HEALTHY PUSH INSTAGRAM: https://www.instagram.com/ahealthypush/GET THIS EPISODE'S SHOW NOTES: https://www.ahealthypush.com/post/anxiety-success-megan

Loneliness chips away slowly, not like a crisis you can diagnose with an MRI. Making friends as adults feels impossibly hard because we don't realize childhood forced us together, creating friendships that seemed magical but were really just proximity. Age-gap friendships carry a weird taboo, like something's inherently wrong with befriending people outside your generation, yet these connections offer nutrients your soul desperately needs. I share a personal story about a 20-year-old waitress that meets a couple in their 60s who show her what kindness looks like through small acts. WORK WITH NIKKI 1:1 :⁠⁠ https://EmotionalBadass.com/coaching⁠⁠ 30 DAYS TO PEACE:⁠⁠ https://EmotionalBadass.com/peace⁠⁠ NARCISSIST ABUSE RECOVERY WORKSHOP:⁠⁠ ⁠⁠⁠⁠https://www.EmotionalBadass.com/workshops⁠⁠ THE FREE MORNING ROUTINE :⁠⁠ ⁠⁠⁠⁠https://EmotionalBadass.com/morning⁠⁠ Services, Products & Content: PATREON: ⁠⁠https://Patreon.com/emotionalbadass⁠⁠ WEEKLY NEWSLETTER:⁠⁠ https://www.EmotionalBadass.com/newsletter⁠⁠ PATTERNSCAPES WELLNESS DECK:⁠⁠ ⁠⁠⁠⁠https://getpatternscapes.com⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of Own Your Health, Katie Brindle is joined by her close friend Katie Nicholl (Vanity Fair's royal correspondent and BBC contributor) for a conversation about stress, symptoms, and the wake-up call that changed everything. Katie shares how what looked like burnout, palpitations, and perimenopause stress turned out to be cholangiocarcinoma (a rare primary liver cancer), despite “normal” blood tests, and why pushing for a scan likely saved her life. They unpack the post-treatment reality: life doesn't magically get easier after a diagnosis, so self-care has to become non-negotiable.Chapters 00:00 — Meet the guest: royal correspondent, author, high-stress career00:33 — Building self-care habits that don't collapse in January01:05 — How they met: gua sha, “liver” themes… and what no one knew yet02:08 — The moment: “It's probably stress”… but the truth was liver cancer05:18 — The scary part: normal bloods, no tumour markers —why scans mattered06:14 — Diagnosis to surgery fast: MRI confirmed it, 11-hour operation, chemo08:00 — After the all-clear: life stays hard, so the system has to change09:25 — Stop the self-care guilt: how to restart without beating yourself up10:02 — The “diary-first” rule: schedule self-care before everything else12:32 — The non-negotiables: nature, internal vs external exercise, organ strength15:12 — Forest bathing + “tree hugging”: why nature became her anchor18:03 — Joy as medicine: shedding what wasn't serving her, gratitude as a practice22:31 — Reinvention: rage, resentment, marriage ending, rebuilding a new life25:16 — What she's adding now: foot baths, daily breathwork, simple routines30:47 — Guided practice: Healing Sounds for organs (follow along)-------------------------------------------More information here: https://katiebrindle.com/Subscribe to my newsletter: https://katiebrindle.com/newsletter-signup/Buy 'Yang Sheng: The Art of Chinese Self-Healing' athttps://www.hayoumethod.com/product/yang-sheng-the-art-of-chinese-self-healing/Buy the Hayo'u tools at https://www.hayoumethod.com/products/Hayo'uFit at https://hayoufit.com--------------------------------------------Join my channel and leave a comment about what you want to see next!Love, Katie Brindle.

In this episode of Knock Knock Eye, I start by breaking down Elon Musk's latest medical hot take. The idea that everyone should get a yearly full-body MRI interpreted by AI. Then I talk about why I finally said screw it and paid cash for my own medical care after insurance insisted my testicles might have magically regenerated. And finally, a mystery case that starts as blurry vision and floaters and ends with one of the rarest eye cancers we see: primary vitreoretinal lymphoma. It's a diagnosis so uncommon that even ophthalmologists joke it's a unicorn, but this patient had the real thing, and the outcome might surprise you. Takeaways: Why Elon's “everyone needs an annual full-body MRI” idea collapses the moment you ask, “Okay… and then what?” How insurance companies can deny treatment you've been on for years and why cash pay sometimes feels like freedom. The subtle signs that blurred vision and floaters might be something far more serious than posterior uveitis. Why diagnosing primary vitreoretinal lymphoma requires suspicion, surgery, and a pathologist who knows what they're looking for. How aggressive treatment, including injecting chemotherapy directly into the eye, salvaged this patient's vision and kept cancer from spreading. To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://glaucomflecken.com/glauc-to-me/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you are interested in buying a book from one of our guests, check them all out here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/dr.glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://anatomywarehouse.com/?aff=14⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information.  Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

“I kept saying...what is the best possible outcome right now?” Amanda is a 43-year-old ultra endurance athlete who began experiencing strange symptoms in 2024: pressure headaches, déjà vu, vision problems, and eventually bizarre behaviors like eating off an upside-down plate and walking out of her shoe without noticing. After an urgent care doctor dismissed her symptoms as TMJ (lockjaw?!), her leg buckled in her own bedroom, sending her to the emergency room where an MRI revealed the truth: glioblastoma, one of the most aggressive forms of brain cancer. Amanda's journey from diagnosis through an eight-hour awake craniotomy to her current life 16 months post-diagnosis is marked by perseverance and not anger or fear…but love. Drawing on her experience as an ultra endurance athlete—particularly a brutal 36-hour race in Stratton, Vermont, where she trained in relentless rain and mud—Amanda applies the same mindset that got her through the worst physical challenges of her life to this new reality. Today, she jokes in her hardest hours that “ In this episode, Amanda and Cody discuss the immediate acceptance she felt upon diagnosis, the "scanxiety" she experiences every 10 weeks, the heartbreak of losing friends with glioblastoma , and why she chose not to see her cancer as an enemy. Amanda has made it past the 16-month median survival time for glioblastoma and is currently training for the same endurance event she was preparing for when diagnosed, hoping to raise $5,000 for brain cancer research through Stash Strong. (You can help support Amanda at that link!) Amanda's athletic background provides a unique lens for understanding resilience, and her honest discussion of both the joyful and devastating aspects of her journey offers a masterclass in living fully while facing an uncertain future.

Full article: Persistence of Microvascular Obstruction From Early to Late Gadolinium Enhancement Images on Cardiac MRI: Prognostic Utility After STEMI—Analysis of EARLY-MYO-CMR Registry Data What is the role of early gadolinium enhancement images after STEMI? Radhika Rajeev, MD, discusses the AJR article by Xiang et al. evaluating the prognostic impact of persistence of microvascular obstruction between early and late gadolinium enhancement on cardiac MRI.

Injuries involving the posteromedial corner of the knee have become increasingly described and understood. Musculoskeletal Imaging Senior Editor Eric Chang, MD, speaks with Jie Nguyen, MD, MS, and Todd Lawrence, MD, PhD, regarding their article addressing the MRI and surgical evaluation of so-called ramp lesions of the knee.

In this episode of Quah (Q & A), Sal, Adam & Justin coach four Pump Heads via Zoom. Mind Pump Fit Tip: Become a Bodybuilder AND Run a Marathon! Here is How. (3:05) Red-light therapy for muscle gains! (26:48) Bathroom habits. (31:28) Daycare fraud. (34:12) ADHD drugs don't work the way we thought. (37:22) Video games and technology, the ultimate babysitter. (40:28) A not-so-known supplement for heart health. (45:23) Full-body MRI scan results. (46:25) #ListenerCoaching call #1 – Looking for training and diet advice going into the New Year. (54:42) #ListenerCoaching call #2 – What does long term "maintenance" look like? (1:03:46) #ListenerCoaching call #3 – Wanting to find a balance between gaining strength, building my endurance, and losing stubborn belly fat. (1:19:32) #ListenerCoaching call #4 – Needing some guidance and help on breaking an exercise addiction and overeating fear. (1:39:09) Related Links/Products Mentioned Get Coached by Mind Pump, live! Visit https://www.mplivecaller.com  Visit Butcher Box for this month's exclusive Mind Pump offer!  ** New users receive their choice of NY Strip, Ribeye, or Filet Mignon in every box for a year. ** Visit Joovv for an exclusive offer for Mind Pump listeners! ** Code MINDPUMP to get $50 off your first purchase. 0% financing available! ** January Promotion: Code NEWYEAR50 at checkout for 50% off the following programs: MAPS Starter, Transform, Anabolic, and Performance! Mind Pump Store Mind Pump #2585: How to Become the Ultimate Hybrid Athlete Effects of Light-Emitting Diode Therapy on Muscle Hypertrophy, Gene Expression, Performance, Damage, and Delayed-Onset Muscle Soreness Case-control Study with a Pair of Identical Twins What the MN Star Tribune found at day cares in viral video ADHD drugs don't work the way we thought | ScienceDaily Irresistible: The Rise of Addictive Technology and the Business of Keeping Us Hooked – Book by Adam Alter TikTok, Instagram Reels, And Shorts May Be Rewiring Your Brain, Study Warns New Study Reveals: High-Dose Supplement Shrinks Arterial Plaque by 36% Nattokinase benefits, dosage, and side effects - Examine Visit Seed for an exclusive offer for Mind Pump listeners! ** Code 20MINDPUMP for 20% off your first month of Seed's DS-01® Daily Synbiotic. ** Mind Pump #2763: Eat as Much as You Want, but Don't Get Fat (JUST follow these 2 rules) Mind Pump #1435: How to Kick Your Sugar Addiction in 5 Simple Steps Mind Pump #2652: How Undereating is Making You Fat & Unhealthy 7-Day Overtraining Rescue Guide | Free by Mind Pump Media Mind Pump Podcast – YouTube Mind Pump Free Resources  

It started with clumsiness at high jump. Then, midway through Year 12, Deanna Renee woke up partially blind in one eye. At just 17, she was diagnosed with *Multiple Sclerosis (MS). Her classmates shunned her, convinced MS was a contagious STI. The internet told her she’d be in a wheelchair by 25. Today, she is a viral content creator, proving them all wrong. In this raw and often hilarious episode of the Well Summer Series, Claire Murphy sits down with Deanna to discuss the reality of growing up with a chronic neurological condition. They cover the isolation of high school, the darkness of her early 20s and the "bohemian doctor" who finally gave her hope. Deanna also opens up about the unique challenges of living with an invisible disability - from being "uninvited" to Schoolies to battling "Karens" in car parks who don't believe she's sick enough to park in disabled spots. Plus, we learn how she turned her MRI scans into art and became a viral advocate on TikTok. Get ready to have your perceptions challenged by a woman who refuses to let a diagnosis define her future. *MS is the most common acquired chronic neurological disease affecting young adults, often diagnosed between the ages of 20 to 40 and, in Australia, affects three times more women than men. As yet, there is no cure. There is no known single cause of MS, but many genetic and environmental factors have been shown to contribute to its development. In MS, the body’s own immune system mistakenly attacks and damages the fatty material – called myelin – around the nerves. This results in a range of symptoms, but no two people experience MS in the same way.**Content Warning: This episode discusses suicide and mental health struggles. If you’re looking for more to listen to - every Mamamia podcast is curating your summer listening right across our network from pop culture to beauty to powerful interviews there’s something for everyone, explore here. We’ll be back to regular programming Thursday15th January. THE END BITS If this episode has raised any issues for you, or if you just need someone to talk to, please reach out to: Lifeline: 13 11 14 Beyond Blue: beyondblue.org.au All your health information is in the Well Hub. Follow Deanna Renee: Instagram TikTok Learn more about MS: Visit MS Australia for resources and the wellness guide mentioned in this episode. GET IN TOUCH Sign up to the Well Newsletter to receive your weekly dose of trusted health expertise without the medical jargon. Ask a question of our experts or share your story, feedback, or dilemma - you can send it anonymously here, email here or leave us a voice note here. Ask The Doc: Ask us a question in The Waiting Room. Follow us on Instagram and Tiktok. Support independent women’s media by becoming a Mamamia subscriber. CREDITS Hosts: Claire Murphy and Dr Mariam Guest: Deanna Renee Senior Producers: Claire Murphy and Sally Best Audio Producer: Scott Stronach Video Producer: Julian Rosario Social Producer: Elly Moore Mamamia acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander cultures.Information discussed in Well. is for education purposes only and is not intended to provide professional medical advice. Listeners should seek their own medical advice, specific to their circumstances, from their treating doctor or health care professional. +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++Support the show: https://www.mamamia.com.au/mplus/See omnystudio.com/listener for privacy information.

Dr. Deb 0:01Welcome back to another episode of Let’s Talk Wellness Now, and I’m your host, Dr. Deb, and today we’re pulling back the curtain on a topic that barely gets a whisper in conventional medicine. Chronic bladder symptoms, biofilms, and the hidden genetic drivers that keep so many women stuck in a cycle of pain, urgency, and infection that never truly resolves. My guest today is someone who is not only brilliant, but battle-tested, like myself. Dr. Kristen Ryman is a physician, a mom, and the author of Life After Lyme, a book and blueprint that has helped countless people reclaim health after complex chronic illness. After healing herself from advanced Lyme, she has spent her career helping patients recover their most vibrant, resilient selves through her Inner Flow program. Her Healing Grove podcast, her membership community, and her deep dive work on bladder biofilms and stealth pathogens. And what I love about Kristen is that she teaches from lived experience. In 2022, she suffered a stroke. And not only survived it, but rebuilt her brain, resolved lateral strabismus, restored balance, and regained her ability to multitask That journey uncovered her own genetic predisposition to clotting, the very same patterns she sees in her chronic bladder patients. And that personal revelation ultimately led to her Introducing this groundbreaking work that we’re talking about today. So let’s get into it, because bladder biofilms, clotting genetics, stealth pathogens, and real recovery is the conversation women have been needing for decades. And we’ll get started. Where did this one go? There we go. Alright, so welcome back to Let’s Talk Wellness Now. I have Dr. Kristen with me, and I am so excited to talk to her for multiple reasons. A, she’s got a fabulous story, and B, she’s an expert in a topic that nobody’s talking about, and I want to learn from her, too. So, welcome to the show. Kristin Reihman 3:07Thank you! I’m so happy to be here, Dr. Deb. Dr. Deb 3:10Thank you. Well, let’s dive right in, because we have so much to talk about, and you and I could probably talk for hours. So, let’s dive into this conversation, and tell us a little bit about yourself and how you got involved in this. Kristin Reihman 3:23Well, I mean, like so many people, I think, on this path, I had, had to learn it the hard way. You know, I had to find my way into a mystery illness, a complex, mysterious set of symptoms that sort of didn’t fit the… the sort of description of what, you know, normal doctors do, and even though I was a normal doctor for many years, nothing I’d been trained in could help me when I was really debilitated from Lyme disease back in 2011, 20212, 2023. And so I kind of had to crawl my way out of that, using all the resources at my disposal, which, you know, started out with a lot of ILADS stuff, you know, a lot of the International Lyme and Associated Diseases Society, resources online, found some Lyme doctors, and then my journey really quickly evolved to sort of, like, way far afield of normal Western medicine, which is what my training is in you know, I think within a year of my diagnosis, I was, like, you know, at a Klingheart conference, and learning all sort of, you know, the naturopathic approach to Lyme, and really trying to heal my body and terrain, and heal the process that had led me to become so, so ill from, you know. A little bacteria. Dr. Deb 4:29Yeah. Yeah, same here. Like, I’ve been an ILADS practitioner for over 20 years, and when I got sick with Lyme, I was like… how did I not realize this? And I knew I had Lyme before I even was ILADS trained, but when I got really sick and got diagnosed with MS, I never thought about Lyme or mycotoxins or any of that, because I was too busy, head down, doing what I’m doing, helping people. And I, too, had to take that step back, not just physically, but more spiritually and emotionally, and say, how did my body get this sick? Like, what was I doing, and what was I not doing? That allowed this to happen, and now look at this from a healing aspect of not just the physical side, but that spiritual-emotional side as well. Kristin Reihman 5:13Totally. I have the same… I have the same realization as I was coming out of it. I was like, wow, this wasn’t just about, sort of, physically what I was doing and not doing. There was something spiritual here as well for me, and I… I feel like it really was a wake-up call for me to get on the path that I’m supposed to be on, the path that I’m on now, really, which is stepping away from the whole medicine matrix model and moving into, you know, working with really complex people. Listening to their bodies, understanding intuition, understanding energy, understanding all these different pieces that doctors just aren’t trained to look at. Dr. Deb 5:46Right? We don’t have time to learn everything, right? Like, you have time to learn the body and the medical side of things, and that’s a whole prism of itself, but then learning the spiritual energy medicine, that’s a completely different paradigm. That’s a full-time learning aspect, and it’s so different than what we learn in conventional medicine. Kristin Reihman 6:04Yeah, it’s a complete health system. Like, it’s a complete healthcare system. Dr. Deb 6:10Yes, and nobody takes it that seriously, but I, for myself, I’ve been spiritual healing for decades, and it wasn’t until I got really sick that I dived deeper into that and looked at what is it in this world that I’m owning, what belongs to generational things that were brought to me from childbirth and other generations in my family that I’m carrying their old wounds. And how do I clear some of that so that it’s not still following me? And then how do I help my kids so that they don’t have to carry what I brought forth? And it’s just… a lot of people, that may sound crazy, but that’s the kind of stuff that we need to be looking at if we want to truly heal. Kristin Reihman 6:54Yeah, and I think it’s also, it’s inspiring, you know, because when people… and I would tell this to my patients with Lyme and these sort of mystery illnesses, like, look, you are on this path for a reason, and this is going to teach you so much that you didn’t necessarily want to learn, but you need to learn. And this… nothing that you learn or change about your lifestyle or the way in which you move through the world is gonna make you a worse person. Like, it’s only gonna sort of up-level you. You know, it’s gonna up-level your diet, and your sleep habits, and your relationships, and your toxic thinking, like, it’s all gonna change for you to get better, and that’s… that’s a gift, really. Dr. Deb 7:27It really is, and I tell people the same thing. Like, we can look at this as… something that’s happening to us, or we can look at this as something that’s happening for us. And that’s how I looked at my MS diagnosis. This was happening for me, not to me. I wasn’t going to be the victim. And you have a very similar story, so tell us a little bit about your story and what kind of catapulted you into this in 2022. Kristin Reihman 7:52Well, by 2022, I was, like, 10 years out of my Lyme hole, and I had been seeing patients, you know, I had opened my own practice, and I was working for another company, seeing, families who have brain-injured children. I was their medical director, still am, actually. And so I was doing a patchwork of things, all of which really fed my soul. You know, all of which felt like this is, like, me, aligned with my purpose on the planet. And so, based on a lot of my thinking, I sort of figured, okay, well, I’m good now, right? Like, I’m on my path now, like, the universe is not going to send another 2×4. And then the universe sent another 2×4. And in 2022, I had an elective neck surgery. You kind of still see the little scar here for my two-level ACDF. Because I had crazy off-the-hook arm pain for, like, a year and a half that I just finally became, like, almost like it felt like I was developing fasciculations and fiery, fiery pain, and I just got the surgery, and the pain went away. But when I woke up, I was different. I didn’t have a voice. Which is a common side effect, actually, of that surgery that resolves after a few months, and in many cases, and mine did. But I also didn’t have, normal balance anymore, and my right eye turned out a little bit, and I couldn’t multitask. And my job is all about multitasking. As you know, with very complex people in front of you, you’re hearing all these pieces of their story, and you’re kind of categorizing it, and thinking about where they fit, and you’re making a plan for what to work up, and you’re making a plan for what to wait until next time. It’s like all these pieces, right? You’re in the matrix. And I… I couldn’t hold those pieces anymore. And I didn’t realize that until I went back to work a couple months after my, surgery, because my voice came back and was like, okay, well, now I’m going back to work. And then I realized, I can’t do simple math. In fact, I can’t remember what this person just said to me, unless I read my note, and I can’t remember taking that note. What is going on? And so I had a full workup, and indeed, I had some neurological deficits that didn’t show up on an MRI, so they must have been quite tiny. Possibly were even low-flow, you know, episodes during my surgery when my blood pressure drops really low with the medicines that you’re on for surgery. But I, basically had, like, a few mini strokes, and needed to recover from that. So that was sort of the… that was the 2×4 in 2022. Dr. Deb 10:09Wow. So, what are, what are some of the things that you learned during that process of that mini-stroke? Kristin Reihman 10:17Well, the first thing I learned is that, something that I already knew from working with the Family Hope Center, which is that organization I mentioned that helps families heal their kids’ brains, I know that motivation lives in the ponds, and if you have a ding or a hit to the ponds, like, you don’t want to get out of bed in the morning, you don’t want to do the work it takes to heal your brain, in my case. And I remember spending several months in the fall of 2022 just sort of walking around my yard. With my puppies, being like, This is enough. I don’t really need to work anymore, right? Like, I don’t… why do I need my brain back? Like, I don’t need to have my brain back to enjoy life. You know, I’ll have a garden, I have people I love and who love me, like, why do I need to work? Like, my whole, like, passion, purpose-driven mentality and motivation to kind of do and be all the things I always strive to do and be in the world, was, like, gone. It was really interesting, slash very alarming to those who knew me, but being inside the brain that wasn’t really working, it wasn’t alarming to me. I was just sort of like, oh, ho-hum, this is my new me.Well, luckily I have some people around me, I like to call them my healing team, who sort of held up a mirror, and they’re like, this is not you, and we’re gonna take you to a functional neurologist now. And so, I ended up seeing a functional neurologist who, you know, within… within, like probably 6 visits. I had all these, like, stacked visits with him. Within 6 visits, my brain just turned on. I was like, oh! Right! I need my brain back! I gotta fix this eyesight, I gotta get my balance back, and I gotta learn how to do simple math again and multitask. So, after that sort of jumpstart, I actually did the program that I, you know, know very well inside and out from the Family Hope Center, where I’d been medical director for 10 years. And, it’s a hard program, it’s not… not for wimps, and it’s certainly… I wasn’t about to do it when I had no motivation, so I’m really grateful to the functional neurologist who helped me kind of, like get my brain… get my pawns back, and my motivation back, my mojo. And then I’m really grateful to the Family Hope Center, because if I didn’t have that set of tools in my back pocket, I would still have an eye that turns out to the side, I would still have a positive Romberg, you know, closing my eyes, falling over backwards, and I would still have, a lot of trouble seeing patients, and probably wouldn’t be working anymore. Dr. Deb 12:32I can totally relate to that. When I got my MS diagnosis, you know, there’s a period of time where you go, okay reality kicks in, and I’m thinking, okay, how long am I going to be able to work? How long am I going to be able to play with my kids and my grandkids and be able to be me? And I started looking at, how do I sell my practice, just in case I need to do this? How do I step back? And I spent probably about 9 or 10 months in that place of, this is gonna be my life, and it’s not gonna be what I’m used to, and, you know, how are we gonna redesign my house, and do this, and that, and… Finally, my husband looked at me one day, and he’s like, what the hell is wrong with you? And I was like, what are you talking about? He’s like, this is ridiculous. He’s like, you fix everybody else. He’s like you can fix yourself. Why do you think you can’t fix yourself, or you don’t know the people that can fix you? You need to get out of this, and pick yourself up, and start doing what you tell your patients. And… and I sat there, and at first I was like just did he know that I’m sick? Like, I have MS. I took that victim mode for a little bit, and then I went, no, he’s right. Like, this is my wake-up call to say, I can reverse this, I can fix this, and total, total turnaround, too. Like, I started reaching out to my friends and colleagues, because I kept myself in this huge bubble, like, I didn’t want anyone to know what was going on with me, because I was afraid my patients wouldn’t see me, what are my staff going to say? My staff are going to leave, and if I lose my business, what am I going to do? And da-da-da-da, all those fears. And then… when I finally started opening up and sharing with people, people started bringing me other people, and you need to talk to this person, you need to talk to this person. They connected me here and there, and this place, and 18 months later, I was totally back to normal again. And now my practice is growing, and we’re adding on, and it’s bigger, and I’m taking on more projects than I feel like myself, and… and I was a lot like you, too. Like, I couldn’t remember my protocols that I’ve done for 20 years. I had to depend on what was in the EHR to pull forward, because I always had them in my notes, so I didn’t have to type them all the time, but I was like I have to pull that forward, because I don’t remember the name of the supplement that I’ve used for 15 years. I don’t remember what laps I’m ordering. I don’t remember the normal values of this stuff. And now it’s back on the tip of my tongue, but at the time, it was a little scary, for sure. Kristin Reihman 14:47Wow, so scary. Well, that’s a remarkable story, and why I can’t wait to have you on my podcast, but I’m really… I’m really happy that you had a healing team around you, too, who was like, yeah, nope, that’s not your… that’s not the train we’re on. Get off that train. Come back on your usual train. What are you doing over there? Dr. Deb 15:03Yeah, and you know, I hope that a lot of patients have that, or people that are experiencing this have that, but there’s so many people who don’t have that. And they need somebody, they need somebody in their corner, like we had in our corners, to help pick them up and say, this doesn’t have to be your reality. It can change, but it is a lot of work, like you said. It’s a lot of work. It’s not… Kristin Reihman 15:25Yeah, no, it’s a lot of work. So when I started off. I was work… I was doing probably 4 hours a morning, like, 4… basically, my entire morning was devoted to brain training and healing my brain through the ref… you know, we… I mean, I can get into the details of it, but basically it’s a lot of, like, crawling on the floor. On your belly, creeping on your hands and knees, doing reflex bags to stimulate, you know, more blood flow to the brain, doing a lot of smells. You know, and just staying with it, you know? And I remember balking, even in the beginning, I was, like, seeing some changes, I was feeling more motivated. I remember feeling this… I started noticing it was changing about 2 weeks in, when I would get up in the morning. And I would… I noticed I would start… I would do my, like, beginnings of the day, I would get the kids on the bus, I would do everyone’s breakfast, I’d do the dishes, and I’d be, like, sitting down and being like, hmm, like, what am I supposed to be doing now? Like, where… What is my purpose today? And because I had this plan, I was just like, well, I know that has to happen, so I may as well do that now. And I would get on the floor, and I would start crawling down the length of our hallway. And within about 8 laps, I would feel my brain, like. I felt like it integrating. I would feel things, like, just coming online, and I’d be like, oh, right. I know who I am, I know what I’m doing today, I have these other things this afternoon, I gotta get this done before noon, and I would do it. But it was really interesting, and I’ve never been a coffee drinker, but when I thought of what that felt like, to me, that’s how people often describe, like, my brain doesn’t wake up until I have coffee. I never needed coffee to have… my brain woke up before I’d wake up, and I’d be like, bing, and I’m ready to go. But when I had the brain injury for those 9 months, it wasn’t that way the whole time. In the beginning, it was very hard to get my brain back in the morning, and it was creeping and crawling that would pull it in. Dr. Deb 17:08Wow. Is there one particular thing that you did that you felt made the biggest difference to rebuilding your brain? Kristin Reihman 17:15Crawling on my belly like a commando, wearing elbow pads, knee pads, actually two sets of knee pads, wearing toe shoes, and just ripping laps on my floor. Dr. Deb 17:26Oh, and that’s so simple to do. So why does that work? Kristin Reihman 17:31So interesting, and I… this is the kind of… this is the… the story of this is something that I think is bigger than all of us, and I wish everybody knew how to optimize your brain using just the simple hallway in your house. But essentially, if you take a newborn baby. And you put them on mom’s belly, and they’re neurologically intact, and maybe you’ve seen videos of this. There used to be a video circulating about a baby born onto mom’s belly, nobody touches the baby, and in about 2 minutes and 34 seconds, that baby crawls on its belly, like, uses arms, uses its toe dig with its little babinsky, and pushes its way up to mom’s breast. Latches on with its reflexes, and there you go. That baby keeps itself alive through its primitive reflexes. So it’s essentially telling its brain, every time it runs those reflexes, every time it does a little toe dig, every time it, like, swings its arm across in a cross-later, hetero… what do we call, a homolateral pattern. That little baby is getting a message to its brain that says, grow and heal and organize. And because all the reflexes come out of the middle and lower brain stem. That’s the part of the brain that’s organizing as a baby. And as a baby grows and does the various things a baby does using its reflexes, like eventually on its belly, crawling across the floor, and then popping up to hands and knees, and creeping across the floor, and eventually standing and walking, all of those things are invoking a different set of reflexes that tell the brain to grow and heal and organize. So it’s almost like the function creates the structure, and if you run those pathways again and again and again your brain will get the message to basically invoke its own neuroplasticity, and that’s how a baby’s brain grows. And it turns out, any brain of any age, if you put it through those same pathways, it will send a message of neuroplasticity to the brain, and the brain will grow and heal and organize. Dr. Deb 19:16That was going to be my question, is why aren’t we using this for elderly people with dementia, or Alzheimer’s, or stroke, or Parkinson’s, or things like that, to help them regrow their brain? Kristin Reihman 19:28Well, because number one, nobody knows about it. Number two, even when people do know about it, nobody likes to be on the floor like a baby, creepy and crawling. And least of all the stubborn old people with dementia who are, like, who don’t even think they have a problem. I mean, the problem with the brain not working, as I discovered, and it sounds like you discovered, too, is the brain that’s not working doesn’t know it’s not working, or worse, doesn’t care. You know, and so it’s tricky with adults. With kids who, you know, you have some sort of power over, you can often make your kids do things that they don’t want to do, like eat their vegetables, or creep and crawl on the floor for 80, you know, 80 laps before they get to go, you know, do their thing. But adults are a little trickier. Dr. Deb 20:10Is there another way for us to be able to do that same thing without the crawling on the floor? Like, could they do it in a sitting motion, or do they need that whole connection to happen? Kristin Reihman 20:21Well, they need to be moving in a cross pattern, and they need to be moving their arms and their legs in such a way that stimulates the reflexes. But you can do that on your bed, you can do it face down on your bed by getting into a pattern, and switching sides and, you know, moving your legs and your arms in the opposite… in the, you know, an opposite cross pattern, and that will get you some of the benefit. And we, in fact, we have… we work with kids who are paralyzed and who don’t… aren’t able to independently move forward in a crawling pattern, who have people coordinating their movements so that they get the same movement, and the brain registers it, and they do make progress, and some of them eventually. Crawl, and then creep, and then walk. Dr. Deb 20:59Wow, that’s so… and it’s so simple and easy for people to do. Kristin Reihman 21:04Well, it’s simple. I don’t know that it’s easy. I do… I do… having done it myself, I will say it’s probably the hardest thing I’ve ever done, was literally crawl my way out of that brain injury. And I’m so glad that I knew what to do, and I’m so glad I had people push me to remind me that it was important, because… I’ll even… I’ll share another story of my own resistance. So, about 2 or 3 weeks into it, I was up to 300 meters of crawling on my belly. And 600 meters of creeping on hands and knees, which was really killing my knees, which was why I was wearing two knee pads. And, I started to get this feeling that maybe I wasn’t doing enough. Like, even though I was noticing changes, and even though I was feeling more purpose, and I was getting organized in the morning, I could tell it was making a difference. I… I knew, I remembered that usually the kids on our program are doing a lot more than that, including my own… my youngest kids, but I made them creep and crawl, even though they didn’t have serious brain injuries, I just thought, we’re gonna optimize everyone, get on the floor, get on the floor. Lord so I was… I was nervous about not doing enough, so I… I reached out to the member… one of the members of the team, and I said, you know, hey, Maria, what’s… what do you think about my numbers? And here’s a… here’s a video of me creeping and crawling, what do you think? Am I doing it right? And she said, you’re doing it right, but how many, how many meters are you doing? And I said, I’m doing 300 meters of crawling on my belly, and 600 meters of creeping, and she’s like, oh. Yeah, that’s not nearly enough for an adult. She’s like, Matthew probably gave you those numbers because he felt bad for you and thought you were going to be still working. He didn’t know you were going to take off from patients. Now that you’re… since you’re not working, you need to do more. I was like, okay, tell me… tell me how much I’m supposed to do. And she goes, you need 900 meters of crawling on your belly, and 3,600 meters, 3.6 kilometers of basically crawling on my hands and knees. Dr. Deb 22:51Oh my gosh. Kristin Reihman 22:52And I just shut down. Dr. Deb 22:54Yeah. Kristin Reihman 22:55I was like, okay, screw it. I’m not doing it. Dr. Deb 22:58And I spent a day or two just not doing it and feeling petulant, and then I was like, you know what? Kristin Reihman 23:01Forget that, I was noticing some benefit. I’m gonna do my 300-600. So, the next day, I went and did 300 and 600 while my daughter was at physical therapy, and we got back in the car, and I said, hey, I’m so excited, I finished my… all my creepy and crawling, and it’s only 10 a.m. on a Saturday, I’m done for the weekend. And she did this. She’s sitting in the car, she looks at me, she goes. Was that your whole program, or was that a third of your program? Dr. Deb 23:28How old is she? Kristin Reihman 23:01Well, she’s, like, 20 now, but she was 18 at the time, and she… she had my number, and I was like, Tula! How can you say that? I’m working so hard! And she’s like, Mom? You need to stop seeing patients completely, and do what they tell you at the Family Hope Center. Because we’re your family, and this is your brain we’re talking about, and we need you to have all your brain back. And I must have looked terrible, because she goes, too much? Dr. Deb 23:54You raised a good daughter. Kristin Reihman 23:58And I was like, well, let me tell… let me ask you, do you mean that? She goes, yeah, I really mean that. I’m like, then it’s not too much. I needed to hear that. Thank you. And I went home, and I finished another 600 of crawls. I didn’t… I never got up to 3,600 of creeps. It was just too much for my knees. I got to 900 and 900, but that was the end of my resistance, and I just did it. Dr. Deb 24:17I just did it. Yeah, your family needed you, right? I mean, when somebody in your family that you love tells you they need you, that’s a huge motivating factor. Kristin Reihman 24:27Yeah, yeah, I’m so grateful for that. So, I did that for 9 months, and at the end of 9 months, my eye was straight and stayed straight, my balance was back, I was multitasking again, and I could take, you know, days and days off of creeping and crawling and not notice a dip. I was like, I’m done. Dr. Deb 24:45Wow, that’s awesome. Kristin Reihman 24:46Yeah. Dr. Deb 24:47During this process, you also discovered that you’re part of 20% of the people with clotting genetics. Tell us a little bit about that. What’s your understanding in that? Kristin Reihman 24:58Well, so, I’ll back up. So, before I had my stroke, I had already been seeing patients with really complex, you know, patients like yours, really complex stories, lots of different things going on, kind of the perfect storm for if they got a tick bite, they tanked. Dr. Deb 25:12and… Kristin Reihman 25:13And I’m one of those people, and my patients were those people. And about 7 years ago, I had one of these patients who said to me, you know, I’ve never told you this, but when I was in my 20s, I had so many bladder infections, so much, like, you know, kind of interstitial cystitis, they said it was, and they said it wasn’t an infection, but it felt like one. And I’ve been doing a little research, and I’ve learned about this woman whose name’s Ruth Kriz, she’s a nurse practitioner, and she sees Patients, and she has… she works with practitioners, and she basically heals interstitial cystitis. And I want you to work with her, I want you to learn from her. And I was like, I’m game. That sounds really interesting, I have no idea what she’s doing, and you don’t usually hear the words cure and interstitial cystitis in the same sentence, so, like, I’m in. So I reached out to Ruth, and long story short, I’ve been working with her for the last 5 or 7 years basically increasing the number of patients who I’m diagnosing now with these hidden bladder infections that are really often what’s at the root of these interstitial cystitis symptoms, meaning, you know, you go to the doctor, you pee in a cup, they look for something, they say there’s no infection here, so, you know, you’re probably crazy, or, you know, you probably have just a pain syndrome, we can’t help you. And actually, if you look with a much more sensitive test, and if you break down the biofilms where these bugs kind of are living in the bladder, you find them. And then you can treat them, and then people get well. So I knew about this, and I, didn’t have any bladder infections that I knew about, and what I did start to think about after my stroke was, well, maybe, since these people who have these bladder infections often have issues breaking down biofilms, the same genetics that lead you to have trouble breaking down biofilms, which are these places where the bugs are kind of hiding in your body, have trouble breaking down clots. And I just had some strokes. I wonder if I have maybe some of these clotting genetics that I’m looking for in all my bladder people. And so I looked, and surprise, surprise, I had not one, not two, but, like, six of them. Ruth said to me, Ruth said, Darlin, I don’t know how you’re standing up. This is more than I’ve ever seen in any of my patients. And she’s been doing this for, like, 4 years now. I was like, oh boy, that’s not good. But in retrospect, it made a lot of sense to me, because having the clotting genetics I have. puts me at risk for severe, you know, chronic Lyme that’s intractable, which I had. It puts me at risk for trouble with, you know, having surgery and clotting and, you know, low blood pressure and low flow states. It puts me at risk for the cold hands and cold feet that I had my entire life until I started treating the clotting issues by taking an enzyme that breaks down little microclots. I mean, I was the person in med school who’d put my hands on people, be like, I’m so sorry. My hands are ice. Warm heart, cold hands, warm heart. Yeah, not anymore, because I’ve treated it. But yeah, so I was surprised slash not surprised to find that I’m one of the people in my community who is a setup for chronic infections and, strokes and bladder infections. Dr. Deb 28:22So you just had that predisposition that took you down that path. Kristin Reihman 28:28Yeah, I think so. Dr. Deb 28:30What are some of the layers of biofilm and the stealth pathogens, like tick-borne diseases and things like that, hiding inside us that… what are some of the symptoms look like, and how do they look different in people with clotting disorders versus the common tick-borne disease? Kristin Reihman 28:47I would say they’re very similar, so it tends to be poor peripheral circulation, so if you put your hands on your neck, and your hands feel cold to your neck difference in the heat, right? The amount of blood flow in your sort of axial skeleton and area as compared to the periphery. And that can indicate a biofilm kind of predisposition or a clotting disposition. It doesn’t necessarily mean it’s there, but it’s a clue, right? Another clue is a family history of any kind of clotting disorders. So, miscarriages, heart attacks, especially early heart attacks, strokes, especially strokes in young people. These things are… are clues that we should probably look for some kind of clotting issue. And of course, in my population, I’m always thinking about it now, because if you have not been able to get well with the usual things for Lyme disease, for example, or Babesia or Bartonella, all of which, by the way, can form biofilms or, you know, love to live and hide in biofilms, then chances are your body’s having a hard time addressing those biofilms. And it turns out, so the connection between the clotting and the biofilm piece is that the same proteins that our body uses to break down Biofilms are used to break down microclots, blood clots, and soluble fibrin, which are the sort of precursors to those clots. And so, if we have an issue kind of grinding up those just normal flotsam and jetsam in our blood flow, then our blood flow is going to become sticky, and our blood will become sort of stagnant and sludgy, and that’s sort of a setup for not being able to heal from infections. Dr. Deb 30:25Is one of the genetic markers you look at MTHFR? Kristin Reihman 30:28I look at that, but I don’t consider that a clotting issue, unless it leads to high homocysteine. So, homocysteine can be either high or low, they’re both problematic. And MTHFR can create either an over-methylation situation, and sometimes if people have low homocysteine, it’s almost worse, because they’re such poor detoxers that they can’t actually get anything out of their system, and they get sludgy for that reason. But I think in terms of the clotting, the bigger issue is high homocysteine, which, you know, typically the MTHFRs, the 1298 would be more implicated for that. Dr. Deb 31:02Yeah, it kind of sets you up. Dr. Deb 31:04Yeah, yeah. Kristin Reihman 31:05I’m curious what you’re seeing. I know since the pandemic, we see a lot of people with elevated D-dimer levels.Are you seeing some of that in your practice, too? Like, we’re seeing more of it, and now that you’re talking about this, I’m wondering if some of those people are predisposed to some of these genetic makeups, and that’s why we’re seeing such a high rise in that.It… and this is connected, and it’s a piece we’re missing. Kristin Reihman31:29Yes, I do think it’s a piece we’re missing. There was a very interesting study that came out of South Africa. A physician in his office did a clinical study on his patients using 3 blood thinners. So he put people on Plavix, and Eliquis, and aspirin, all at once. It… yeah, you’d be hard-pressed to find a doctor in the States to, like, you know, kind of risk that, because most people don’t even want people on aspirin and Flavix at the same time. Dr. Deb 31:55But Kristin Reihman 31:56They put them on 3 different blood thinners, people with long COVID, and in 6 months, 80% of those people were completely free of symptoms. Dr. Deb 32:04Wow. Kristin Reihman 32:05Yeah, yeah. Now, my question is, what about that 20%? Like, what’s going on with them? And I suspect, they weren’t looking at the other half of the pathway, because when you give a blood thinner, you’re not doing anything to help the body break down clot. You’re simply stopping the body from making more of it. And you rely on the body’s own mechanisms, you know, plasminogen activating inhibitor, for example to kind of grind up those clots and take them out. But when people have a mutation, say, in that protein, they’re not going to be able to grind up the clots, and so my suspicion is the 20% of people who didn’t get well in that study were people who had issues on the other side of the pathway. Dr. Deb 32:44Yeah, they weren’t able to excrete that out and maybe have some fiber and issues and things like that, and that wasn’t being addressed. Kristin Reihman 32:50Yeah Dr. Deb 32:51Yeah Kristin Reihman 32:52Of course, COVID makes its own biofilm. There’s a whole… there’s a whole new, you know, arm of research looking at sort of the different proteins that get folded in the body when COVID spike proteins are in there, kind of creating these almost, like, little amyloid plaque situations in your blood vessels. So, I do think that people who can’t break those down are really at risk for both COVID and the shots. You know, the spike protein comes at you for both of those, right? Dr. Deb 33:17Yeah. Did you use any lumbrokinase or natokinase in your situation? Kristin Reihman 33:22So lumbar kinase is what I use. It’s my main player. I use the Canada RNA one, which is, you know, I think, you know, more studied than any of the other ones, and because of its formulation, it’s about 12 times more potent than anything else out there. So that’s what I’m pretty much on for life. You know, that’s… I consider that kind of my…My… my main game. Dr. Deb 33:44Yeah, I agree, I love Limerocheinase for that, that’s really good. So you recently hosted a retreat around this topic. What were some of your biggest aha moments for the participants as they started unraveling some of these biofilm layers? Kristin Reihman 34:00Yeah, no, it was so fun. My sister and I host retreats together. She came out from California and did the yoga, and I did the teaching about biofilms and bladder issues, and it was really fabulous, because a lot of these folks are people already in my community. A few of them were new, and so we had this wonderful Kind of connection, and learning together, and just validation of what it is to live with symptoms that are super inconvenient, you know? Like, one of the… one of the members even, or participants even brought a big bag of, like, pads, and she’s like, listen, ladies. This is what I’m going to use to get through the week. If you want to borrow, I’ll put my little stash over there, and I think they all went by the end of the week. So we… my aha moment was just how powerful it is to be, hosting community and facilitating conversations where people really feel seen and heard, and just how important that is, especially post-COVID, right? When we, you know, so many people just really missed that piece of other humans. And, yeah, I love… I love being able to help people connect around stuff like that. Dr. Deb 35:00That’s awesome. So, for people who are listening that have that mystery, quote-unquote bladder issue, frequent UTIs, interstitial cystitis symptoms, or pelvic pain, or bladder spasms. Where should they start, and what are the first clues that tell you this is biofilm-driven? Kristin Reihman 35:20So, I think it’s always a good idea to… to do a test, you know, to take a microgen test. There’s a couple companies out there, I think Microgen’s the one that I rely on more than any of the others, and it requires, you know, not only doing a very sensitive test like Microgen, but breaking down biofilm before you take it. So, I always encourage people to take a biofilm breaker like lumbrokinase for 5 days leading up to the test, so you’re really grinding into the bladder wall and opening up those biofilms so that when you catch whatever comes out of your bladder, there’s something in there. If you don’t have bladder biofilm, nothing will come out, and you’ll have a negative test, and that’s usually confirmatory. If you’ve done a good provoking with BLUC or, you know, lumbrokinase for 5 days, and nothing comes out then I usually say mischief managed. That’s… that’s a great… that’s great news for you, right? And most people in my community, when they look, they find something, because, you know, not for nothing, but you’re in my community for a reason, right? Dr. Deb 36:17And so… Kristin Reihman 36:18So, yeah, and typically then we need to get into the ring with those bladder biofilms, and it doesn’t… it doesn’t usually take one or two tests, it’s many tests, because the layers are deep. I’m working with children, too, and even in small kids, they… if they have the right genetics, and if they’re living in an environment that is… that kind of can also push them to make more biofilms, like living in mold, for example, is a huge instigator of inflammation and biofilms, and also, you know, microclots and fibrin in the body. then those layers can go deep. And so, we’re peeling the layers one at a time, and we’re treating what comes out, and supporting people along the way. Dr. Deb 36:57With these microgen tests, can you find biofilms in other parts of the body as well, or is it primarily bladder? Kristin Reihman 37:03No, you can find… you can culture… and you can send a microgen PCR for any… any, you know, secretion you want. So they have a semen test, they have a vaginal test, they have a nasal test, you can send sputum, you can culture out what… you can stick a swab in your ear. There’s all sorts of… anything that you can put a swab in, you can… you can send in there. Oh, that’s awesome, that’s amazing. Yeah. Dr. Deb 37:26So, once you identify the drivers, genetics, environment, stealth infections, what does an effective treatment or reversal process look like for people? Kristin Reihman 37:36For the… for the bladder in particular? Well, I wish I could say it was herbs or oxidation, which are my favorite things for Lyme. I haven’t found those to work for the bladder, and so I’m using antibiotics. Which, even though I’m a Western-trained MD, it was not my bag of tricks. You know, when I left, sort of, the matrix medicine model, I really stopped using those things as much as possible, and I’ve had to come back to them, because they really, really work, and they’re really, really needed. So I love it if someone else out there is getting results with something other than antibiotics, please contact me and let me know, because I have plenty of patients who are like, really? Another antibiotic? I’m like, I know. But they work. We also do a really careful job, you know, I work with Ruth Kriz on every case, and we do a very careful job in finding the drug that’s going to be the least broad spectrum, and that’s really only going to tackle the highest percentage bug there. So, MicroGen does this really cool thing. It’s a PCR, next-gen sequencing, they’re looking at genetics, so you don’t have to have it on ice, it can sit on your countertop for a month, and you can still send it in. And they, they, they categorize by percentage, like, what’s there. And they’re not just looking for the 26 or 28 different bacteria that you would get if you were looking at a culture in your doctor’s office. They’re looking for 57,000 different organisms. Fungal and bacterial, yeah? And so, this is why I say, if there’s something there, and you’ve broken down the biofilm, microgen will find it. Dr. Deb 39:06That’s really great. That was going to be my question, is does it pick up fungal biofilms as well? So I’m so glad you mentioned that, because a lot of times with bladder stuff, it’s fungal in that bladder, too, and then we’re throwing an antibiotic at it and just making it worse if it’s fungal in there. Kristin Reihman 39:21Yeah, yeah, that’s… they… and I recently saw one, I had a little Amish girl who came back with 5 different fungal organisms in her bladder. And a whole flurry, a slurry of bacteria, too. Yeah, pretty sick. And that’s usually an indication that you’re living in mold, honestly. Dr. Deb 39:37Now, conventional medicine treats the bladder as a sterile organ, and rarely looks at biofilms. Why do we believe that this has been overlooked for so long, and what are they missing? Kristin Reihman 39:53Dr. Dr. Deb 39:53I’m loaded up. Kristin Reihman 39:54One of the many mysteries of medicine. I have no idea why people are like, la la la, biofilms. I mean, we know, so when I say we know, so when I trained, you know, I trained at Stanford for my medical school, I trained at Lehigh Valley for residency. Great programs, and I learned that, oh yes, biofilms, they exist in catheters of bladders. When people have an indwelling catheter for more than a month and they spike a fever, it’s a biofilm, but it’s only in the catheter. Really? Why does it stop at the catheter? Dr. Deb 40:23Yeah. Kristin Reihman 40:25Or, you know, now chronic sinusitis, people are recognizing this is a bladder… this is not a bladder, this is a biofilm infection in your sinuses. But we’re really reluctant to kind of admit that there’s, you know, that we’re teeming with microorganisms, that they might be setting up shop, and for good, right? Like, it’d be great if they were in biofilms as opposed to our bloodstream. Like, we don’t want them in our bloodstream, so thankfully they wall themselves off. But yeah, I think they’re everywhere. I mean, they found a microbiome in the brain, in the breast, in the, you know, the lung. There’s microbiome, there’s bugs everywhere. And the question is, are they friend or foe? And the bladder really shouldn’t have anybody in it. Because, think about it, you’re flushing it out, you know, 6 times a day. You know, most people who can break down biofilm because their clotting genetics are normal, and because they’re peeing adequately, will never set up an organism shop in their bladder. Even though things are always crawling up, we’re always peeing them out. Dr. Deb 41:23Yeah. Kristin Reihman 41:23And then there’s the 20% of us who… Who aren’t that way. Dr. Deb 41:30Oh, so you run the Interflow program and a number of healing communities. What tools and teachings have been the most transformational for people going through this journey? And tell us a little bit about the Interflow program, too, please. Kristin Reihman 41:44Okay, maybe I’ll start there, because honestly, I have to think about the which tools are most transformational. The Interflow program is my newest offering, and we developed it because my team and I were looking around at the patients we had, and so many folks were needing to go down this… we call it the microgen journey, like, get on the microgen train and just start that process. And there was just a lot of hand-holding and support, and… education that they were requiring. And by the way, their brains aren’t working that great, because when you have these infections, you know, you’re dealing with, like, downloads of ammonia from time to time from the bladder organisms, you’re dealing with a lot of brain fog, overwhelm, you know, there’s just a lot of… you know how our patients are, they… they… they’re struggling, and they really need a lot of hand-holding, and so we were providing that. But we kept thinking, like, gosh, it would be great to get these guys in community, like you know, we can say all we want, like, you know, it’s important to check your pH, it’s important to, like, stay on top of the whatever, but it’d be great to have them hear that from one another, and to have them also hear, sort of, that they’re not alone. So, because we had some experience running communities online, which we started during the pandemic and has been super successful, we said, let’s do this, let’s create a little online community of our inner… of our, you know, call them… informally, we call them our bladder babes. But, like, let’s create a community of people who are looking to really heal and get to this deep, deep root that no one else is doing. And that was really the key for me, that nobody else is really doing this. Very few people are doing it or aware of it. I wish that weren’t the case, but as it stands now, it’s pretty hard to find someone to take this seriously. Most doctors, if you even take a microgen to them, they’ll say, oh, there’s 10 organisms on here, that’s a contamination. That must be contaminated. Well, yeah, buy your biofilms, but they don’t know about biofilms, so they think it just comes from the lab. Dr. Deb 43:31Something. Kristin Reihman 43:32I don’t know. But, yeah, basically it was because I felt called to do this service that no one else is providing, and I wanted to do it in a way that was going to be really optimally supportive for people. So we created a membership, basically. Dr. Deb 43:44Do you see a difference in men and women? Obviously, women have this problem more than men, but do you see a difference in how many men that have these self-infections or live in mold compared to women? Kristin Reihman 43:57I… it’s hard to know, really, what the, sort of, prevalence is out there, I will say, in terms of who calls our office. Dr. Deb 43:03It’s, you know, 95% women call our office. Kristin Reihman 44:08And occasionally, we’ve had someone call our office on behalf of a husband or a son. I just saw a woman whose 2-year-old son is in our Bladder Babes community. But typically, it’s the women who are seeking care around this, and I don’t know if that’s a function of their having more of the issues. I suspect it is, because as you said before, so many more women deal with these complex mystery illnesses than men.But there certainly are men who have them. Dr. Deb 44:33Yeah. So, you’ve lived through Lyme, chronic illness, stroke, and now biofilm-driven bladder issues, and you’ve come out stronger. What mind shifts helped you stay resilient through all of these chapters? Kristin Reihman 44:50I think there have been many. I think the first one I had to really, Really accept and lean into and kind of internalize. Was this idea that, I… I couldn’t… I didn’t have to do the work that I was doing. Dr. Deb 45:09You know? Kristin Reihman 45:09In order to be of value to the world. You know, I’d trained in a certain way, I had, you know, I had this beautiful practice. I was working in the inner city, I was working with my best friend, we were seeing really needy people who had no money, and it felt really, like, you know, I felt very sort of service-driven and connected to a purpose. And I think the hardest thing in the beginning for me was realizing, I can’t do that work anymore. That’s not the work that I’m… needing to do, and to make a leap into the unknown. It felt like, you know, having a baby at 45 and not doing any ultrasounds, or any tests, and just being like, I’m birthing something here. I don’t know what it is, it’s me, but who knows what she’s gonna look like, or… what this doctor is going to be, you know, what, you know, peddling in terms of her tools. That was a big leap of faith, and I think letting go of the kind of control of needing to be… needing to look a certain way and be a certain kind of doctor was a big step for me, my big initial step. Dr. Deb 46:05That’s really hard, because you’re taught and ingrained in who you’re supposed to be as a doctor, and what that person’s supposed to be, what your persona’s supposed to be. And doing a lot of the Klinghart work and some of those things, and I’m sure on the days crawling through the floor, you’re like, this is not what I was trained to do. If my colleagues could only see me now, they’d… they’d… Commit me, right? But like you said, just giving that leap of faith and saying, I’m gonna turn this over to your higher power, and you’re gonna bring me out on the other side, and trusting that, that is a vulnerability for us that is huge. Kristin Reihman 46:43Yeah, and I mean, I’d like to say it’s because I’m some sort of strong person, but truthfully, I feel like there was no other choice. Like, I had to surrender because there was… the alternative was death or something. I didn’t… I don’t know, right? There was no other choice. Dr. Deb 46:56Yeah. Kristin Reihman 46:56I couldn’t move. I was in so much pain. I couldn’t move. Couldn’t get out of bed. Dr. Deb 47:01Thank you so much for sharing all of this and being vulnerable with our audience. Where can people find you? Find your book, your podcast, your programs, if they want to go deeper with you? Kristin Reihman 47:12Yeah, thanks for asking. So, I have a website, it’s my name, kristenRymanMD.com, and all my programs are listed there. I have several, you know, I have a, sort of, a wellness… I have an online membership for well people who want to stay well and pick my brain every week around, sort of, healthy, holistic tools. It’s called The Healing Grove.I have a podcast that people can listen to for free, where I interview people like you, and you’re gonna be on it, right? She’s gonna be on it soon. Dr. Deb 47:38I’d love to. Kristin Reihman 47:39So I can share stories of hope and transformational tools with people. I also have a Life After Lyme coaching program, which is kind of the place where I invite people who are dealing with a mystery illness to come get some support, community, and guidance from someone like me, and also just from the other people in the room. There’s a lot of wisdom in those groups. And that’s… I guess that’s the answer I’ll share for what you asked earlier, like, what’s the main tool they take away? I think they take away an understanding that community really matters, and that they’re not alone. You know, I think it can be very lonely to be stuck in these… to feel stuck in these illnesses, and people need to be reminded that they’re… that they’re human, you know, and that they’re worthy of love and acceptance. I think that’s what people get from my… from my community, is kind of like, that’s the common thread. Dr. Deb 48:23They definitely need that. Kristin Reihman 48:25Man. Dr. Deb 48:26Kirsten, thank you so much for sharing your powerful story. Your work is so needed, and your ability to weave personal experience and advanced clinical insight is exactly what our community craves. And this kind of conversation helps women finally be seen and heard, which is my motto too, and gives them just the real tools to get their life back. And for everyone listening, if you’re struggling with unexplained bladder pain, frequent UTIs, pelvic discomfort, or symptoms that never match your labs, because they never quite do. You are not crazy, you are not alone. You need to find the answers, you need to be with community, and there are solutions, and conversations like this is how we bring them forward. So, thank you all for tuning in to Let’s Talk Wellness Now. I’m your host.And until next time… Kristin Reihman 49:15Thanks, Dr. Dove. Dr. Deb 49:16Thank you. This was awesome. Thank you so much. This was… Kristin Reihman 49:21You’re so welcome, you’re such a great interviewer.The post Episode 251 – Chronic Bladder Symptoms, Biofilms, and the Hidden Genetic Drivers first appeared on Let's Talk Wellness Now.

In this episode of the JIMD Podcast, we explore manganese transporter disorders with Dr Karin Tuschl, Dr Suvasini Sharma and Prof John Spencer, covering clinical red flags, MRI clues, EDTA chelation, and the urgent search for safer, oral treatments for hypermanganesemia with dystonia. Consensus of Expert Opinion for the Diagnosis and Management of Hypermanganesaemia With Dystonia 1 and 2 Sherry Fang, et al https://doi.org/10.1002/jimd.70031 Removal of Toxic Metabolites—Chelation: Manganese Disorders Hendrik Vogt, et al https://doi.org/10.1002/jimd.70107

Global Practices in Cardiac Imaging for Cardiac Sarcoidosis   Guest: Tahir Kafil, M.D. Host: Sharonne Hayes, M.D.   Cardiac imaging is a cornerstone in the diagnostic work-up and management of cardiac sarcoidosis. However, indications and use of advanced cardiac imaging vary from institution to institution, and even between providers at the same institution. We conducted an international Delphi consensus study of 89 global experts in cardiac sarcoidosis to evaluate real-world clinical practices and use of advanced cardiac imaging. We developed consensus for use of advanced cardiac imaging in cardiac sarcoidosis. Areas lacking consensus were noted as priority areas for research.   Topics Discussed: From a big picture perspective, how is cardiac sarcoidosis generally diagnosed? What exactly is the Delphi methodology your team used to build consensus?  The suggested algorithm for imaging in suspected cardiac sarcoidosis uses pretest probability, how was that defined? Was cardiac MRI superior to PET in your study? Does one have to be first? How do experts decide how often to do follow up PET imaging in established cardiac sarcoidosis? What were areas of priority research that were identified? The research study cited by Dr. Kafil was published on June 2, 2025. Click the following link to view the paper: https://www.jacc.org/doi/full/10.1016/j.jcmg.2025.02.010   Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode.   Podcast episode transcript found here.

-- On the Show -- Donald Trump orders a U.S. military operation that captures Nicolás Maduro and Cilia Flores in Venezuela and brings them to New York despite lacking clear legal authority -- Reporting says Donald Trump escalates to military action after Nicolás Maduro dances on Venezuelan state television and aides treat it as personal mockery -- Donald Trump bets the Maduro seizure will unlock Venezuela's oil, but allies, businesses, and markets resist a plan with no clear political transition -- Donald Trump gives rambling, conflicting answers about Venezuela, oil, and military escalation that raise questions about his decision making -- Donald Trump admits he did not brief Congress yet says he spoke with oil companies and calls the Maduro seizure a kidnapping -- The Wall Street Journal reports Donald Trump shows visible signs of decline, disputes doctors, and mislabels a CT scan as an MRI while aides manage optics -- The Wall Street Journal says Donald Trump takes more aspirin than doctors recommend and blames bruising on superstition instead of updated medical guidance -- Marco Rubio tells Kristen Welker the United States is running Venezuela but cannot explain elections, governance, or the legal rationale in real time -- Marco Rubio and Lindsey Graham indicate Cuba is a likely next target after Venezuela, signaling escalation rather than containment -- On the Bonus Show: Oil markets steady after Trump's Venezuela strike shocks the world, speculation grows that Donald Trump Jr. is being groomed for a 2028 run amid tension with J.D. Vance, and Minnesota politics take a twist as Governor Tim Walz looks ready to exit and Amy Klobuchar eyes a comeback. ⚠️ Ground News: Get 40% OFF their unlimited access Vantage plan at https://ground.news/pakman

This interview,Live from LEAD-26 in Zurich, links real leadership lessons to lived experience. Fabian, a CIO and ultra runner, talks limits, psychological safety, and practical steps. He also shares a clear, cautious view on generative AI and a smart fast follower strategy for regulated organizations. Key Learnings: Admit leadership limits: Openly share small, real limits with your team to build reflection and performance. Psychological safety matters: Create a safe team space so people speak up and help cover leadership gaps. Use smart fast follower: Experiment early, then buy enterprise-ready solutions to avoid costly long-term build and maintenance.   Summary:  Fabian Ringwald is the CIO of a Swiss health insurance company. He says they have the most satisfied customers in the industry. He is also a board member at lead 26 and helps shape conference content and speaker selection. Outside work he runs ultra trails. He runs over 100 kilometers and gains more than 6,000 meters of altitude. These runs can take more than 20 hours and include day and night. Night is more challenging. The long runs teach self-leadership and a clear view of personal limits. Fabian argues that every leader has limits. He says hiding limits wastes energy because close colleagues already see them. He encourages leaders to share limits openly with their teams. Open discussion builds self-reflection and helps form a high performance team. Teams can then help fill leadership gaps. He highlights psychological safety as the key trait that separates good leaders from great leaders. He recommends starting small when opening up. Share a minor limitation first, set an example, and scale openness gradually over time. Fabian says AI is not the solution for everything. He explains generative AI is a statistical tool and is not suited for fully deterministic tasks. He sees strong potential in areas like detecting anomalies on MRI or CT images, but he warns against using generative AI for direct medical advice. His company follows a smart fast follower strategy: experiment early with startups, then adopt enterprise-ready solutions rather than build long-lived custom systems. To keep agility, get top-down alignment with the board and enable bottom-up experiments with LLMs or ChatGPT for hands-on learning.   About Fabian Ringwald: CIO of SWICA - the leading Swiss health insurer with the most happy customers Prior: digital transformation in several different industries from freight railway (SBB Cargo), energy trading (BKW), consulting (Logica) to inustrial manufacturing (Siemens) and Ravensburger, the well known jigsaw puzzle company. Chapters: 0:00 - Intro 0:35 - CIO's Role in Health Insurance 1:12 - Leadership Lessons from Ultra Running 3:06 - Identifying Leadership Limits 4:21 - Creating Psychological Safety in Teams 5:37 - Taking Small Steps Towards Openness 7:40 - Insights from Conference Speakers 9:13 - Evaluating AI Applications in Leadership Resources  Fabian Rinwald Linkedin: https://www.linkedin.com/in/fabianringwald/ Please, hit the follow button and leave your feedback: Apple Podcast: https://www.cxgoalkeeper.com/apple Spotify: https://www.cxgoalkeeper.com/spotify About the host:  Gregorio Uglioni is a seasoned transformation leader with over 15 years of experience shaping business and digital change, consistently delivering service excellence and measurable impact. As an Associate Partner at Forward, he is recognized for his strategic vision, operational expertise, and ability to drive sustainable growth. A respected keynote speaker and host of the well-known global podcast Business Transformation Pitch with the CX Goalkeeper, Gregorio energizes and inspires organizations worldwide with his customer-centric approach to innovation. Follow Gregorio Uglioni on Linkedin: https://www.linkedin.com/in/gregorio-uglioni/  

Hollywood, we need to talk. If one more movie shows an eyeball dangling from someone's cheek, I might start mailing anatomy textbooks to Los Angeles. And while we're at it, can we please stop calling every wandering eye a “lazy eye”? After a quick rant about my personal ophthalmology pet peeves, I dive into one of the strangest mystery cases I've ever seen: a 47-year-old with sudden, complete ophthalmoplegia and normal imaging. Negative myasthenia testing, normal pupils, normal MRI, nothing made sense until one very specific antibody came back positive. Takeaways: Why “lazy eye” rarely means what people think it means and what the term actually refers to. The Hollywood eyeball trope that needs to be banned forever (optical nerves are short, folks). How a patient with zero eye movement and a normal MRI sent us searching for rare neuro clues. Why myasthenia gravis seemed like the obvious answer until every serology test came back negative. The surprising role a GI infection can play in triggering Miller Fisher syndrome, the rare Guillain-Barré variant that ultimately cracked the case. To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://glaucomflecken.com/glauc-to-me/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you are interested in buying a book from one of our guests, check them all out here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/dr.glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://anatomywarehouse.com/?aff=14⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information.  Today's episode is brought to you by Microsoft Dragon Copilot. Dragon Copilot is an AI clinical assistant that streamlines documentation, surfaces critical information, and automates routine tasks — empowering healthcare teams to focus more on patients and less on administrative work. Learn more at ⁠⁠⁠⁠https://glau.cc/Dragon⁠⁠⁠⁠ Go to http//www.cozyearth.com and use code KNOCKKNOCK for 40% off best-selling temperature-regulating sheets, apparel, and more. Trust me—you'll feel the difference the very first night. Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

A fire at a crowded bar in the Swiss Alps during New Year's Eve celebrations killed about 40 people and left 115 injured, many of them seriously, police said Thursday. Zohran Mamdani was publicly sworn in today as the 112th mayor of New York City. President Trump says he underwent a CT scan, rather than an MRI, during his October examination at Walter Reed National Military Medical Center. In a new interview, he also says it would have been better if he hadn't undergone the scan at all. 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

Learn how to fix your pain with our “Centralization Process” here! https://rebrand.ly/ytpainfreeSubmit an application to work with us 1:1 and learn how to fix your low back! ⁠www.therehabfix.com/low-back-program⁠To view hundreds of free low back videos please follow us on instagram at @rehabfix ⁠www.instagram.com/rehabfix⁠If you've ever had an MRI or X-ray for your low back pain and wondered.

Episode Summary: In this episode, Jimmy is joined by Tony Maritato and Dave Kittle to talk about how physical therapists can rethink pricing, marketing, and content creation. From charging what you're worth to repackaging accountability, they break down tactical strategies clinic owners can use right now.What You'll Learn:How to leverage content and podcasting like a proWhy "selling sessions" is outdated (and what to do instead)What PTs can learn from influencers, MRI clinics, and barbershopsHow to avoid the insurance trap and build premium offeringsGuest Links:Tony Maritato: https://www.youtube.com/c/MedicareBillingDave Kittle: https://www.youtube.com/@thedavekittleshow/featuredSponsor Mentions:Pre-Roll: Brooks IHL — https://www.brooksihl.orgMid-Roll: Empower EMR — https://www.empoweremr.comPre-Parting Shot: US Physical Therapy — https://www.usph.comPSA Feature:Wounded Warrior Project — helping post-9/11 veterans and their families with rehab, mental health, and support???? Subscribe: https://www.ptpintcast.com/

You're Good at Your Job. That's No Longer Enough.A wake-up call for radiologic technologists and medical imaging professionals who feel stuck, burned out, or invisible in their careers.Here's why:You can be excellent at your job and still quietly disappear from your profession.In this solo episode of A Couple of Rad Techs, we're talking directly to radiologic technologists and medical imaging professionals who are skilled, dependable, and tired—but starting to feel stuck, overlooked, or disconnected.This is not a motivational episode.It's a career reality check.Being good at your job used to be enough. In today's medical imaging landscape, it isn't.Technology is accelerating. Scope pressure is real. Decisions about radiology and radiation therapy are being made every day—and many working technologists are not in the room when they happen.In this episode, we cover:The silent career mistake many technologists make without realizing itWhy professional isolation feels safe at first—and costly laterWhat technologists actually lose when they disengage from the professionThe difference between being employed and being connectedWhy burnout grows faster in isolationWhat ASRT and professional societies really provide beyond CEUsWhy visibility—not just competence—is becoming the dividing lineThis conversation is for medical imaging technologists who:Are good at what they doCare about the professionFeel tired, skeptical, or burned outHaven't fully stepped away—but haven't fully stepped in eitherYou don't need to do everything.You do need to stop standing on the sidelines of your own profession.Key TakeawaysCompetence alone no longer protects your careerProfessional isolation is still a decision—even when it feels passiveYou can't negotiate, pivot, or prepare for changes you don't know aboutConnection creates visibility, leverage, and optionsProfessional societies function as career infrastructure—not extrasIf this episode hit, don't brush it off.Take one step that reconnects you to the profession.Visit asrt.orgReview the salary dataReconnect with your state societyYou don't need to do everything.You just need to stop being invisible.About the ShowA Couple of Rad Techs is a podcast for radiologic technologists, MRI techs, CT techs, radiation...

Allen and Joel are joined by Jeremy Heinks of CICNDT to discuss the critical need for pre-installation blade inspections, especially as safe-harbored blades from years past are rushed into service. They cover advanced NDT technologies including robotic CT scanning, blade bolt inspection for cracking issues, and how operators can extend turbine life beyond the typical 10-year repower cycle. Sign up now for Uptime Tech News, our weekly email update on all things wind technology. This episode is sponsored by Weather Guard Lightning Tech. Learn more about Weather Guard’s StrikeTape Wind Turbine LPS retrofit. Follow the show on Facebook, YouTube, Twitter, Linkedin and visit Weather Guard on the web. And subscribe to Rosemary Barnes’ YouTube channel here. Have a question we can answer on the show? Email us! Welcome to Uptime Spotlight, shining Light on Wind. Energy’s brightest innovators. This is the Progress Powering Tomorrow. Allen Hall: Jeremy, welcome back to the show. Thanks for having me. Well, the recent changes in the IRA bill are. Pushing a lot of projects forward very quickly at the moment, and as we’re learning, there’s a number of safe harbor blades sitting in yards and a rush to manufacture blades to get them up and meet the, uh, treasury department’s criteria for, for being started, whatever that means. At the moment, I think we’re gonna see a big question about the quality of the blades, and it seems to me. The cheapest time to quickly [00:01:00] look at your blaze before you start to hang them is while they’re still on the ground. And to get some n DT experience out there to make sure that what you’re hanging is appropriate. Are you starting to see that push quite yet? No, not not at Jeremy Heinks: the level we’d like to see it. Um, as far as getting the inspections in, yeah, we have been seeing the push to get the, get these blades out. Uh, but, uh, the, the, the few that we have been able to get our eyes on aren’t looking good. The quality definitely down. And we’ve just had a customer site come back with some, some findings that were surprising for a brand new blade that hasn’t been the up tower yet and in use. So, um, it is much easier for us to get the, uh, technology and the personnel to a blade that’s on the ground. It’s cheaper, it’s quicker. We can go through many, many more blades, uh, with inspections. Uh, it’s just access is just easier. Always comes down to access. Joel Saxum: That customer that you had there, like what was their [00:02:00]driver? Right? Did they feel the pain at some point in time? Did they, did they have suspicions of something not right? New factory? Like, I don’t know. Why would some, why is someone picking that over someone? Not because like you said, overwhelmingly. The industry doesn’t really do this. You know, even just getting visual inspections of blades on the ground before they get hung is tough sometimes with construction schedules and all these different things, moving parts. So you had someone that actually said, Hey, we want to NDT these blades. What was their driver behind that? Jeremy Heinks: So we, uh, we had done a previous, uh, route of inspections on some older ative of theirs that were, Speaker 5: um, Jeremy Heinks: getting. Kinda along in the tooth, if you will. Uh, so they’ve added some experience. They saw what we could bring to the table as far as results and, and, and information and data on those blades. Uh, and it all turned out to be, um, pretty reliable. So, um, you know, we educated them on, you know, if you have new blades coming in or even use the blades coming in for replacement, that it’s not a bad idea to get at least a, a sample it. And, uh, [00:03:00] basically that’s what they call us in to do. They had some brand new blades come in. For some new turbines they’re putting up. And, uh, they wanted the sampling. We did a sampling and the sample showed that, uh, they have an issue of these, these brand new blades. Joel Saxum: So, okay, so what happens then? Right? Because I’ve been a part of some of these factory audits and stuff, and when you catch these things in the factory, you’re like, Hey, where we got these 30 defects? And then the factory goes back against their form, their form, you know, their forms and they go, okay, material checklist is a, we’ll fix 24 of ’em. The other six are on you or whatever that may be. What happens when you find these things in the field at a construction site right? Then does that kick off a battle between the, the new operator and that OEM or, or what’s the action there? Jeremy Heinks: Yeah, so we’ve been on the OEM side and been through what you just explained, um, multiple times and helped a bunch of the OEMs on that stuff, that stuff. But unfortunately, when you’re in the field and you find the same thing, it’s, it’s a whole different ball game. Um, they typically. We won’t see any of that. We don’t, we won’t be able to [00:04:00] see what the OEM actually does unless we have informa, you know, information or channels that, that are a little bit different, uh, than normal to, uh, get that information. So, um, but yeah, so we, we’ll give this information over to the customer. Uh, they’ll go to their supplier and then that’ll turn into a. To a dance and, uh, where everybody’s trying to pass the buck, basically, right? So, um, unfortunately that’s the way it’s been. We will see how this one turns out. It, it all depends on, on the relationship between that OEM and the customer and the end user. Joel Saxum: So, so this is my, my last question about this and, and then I want to, of course, jump topics we have a lot of talk about here today. But the question being, okay, so say they do repairs. Is it then a good idea to bring you guys back in after those repairs are done to say NDT? Everything looks good here. Um, basically clear to fly. Jeremy Heinks: Yeah. [00:05:00] So, uh, post inspection on repairs is always a good idea. Um, the aviation side is, it’s commonplace to, uh, post in inspect repair. So yeah, definitely, uh, we’d wanna come back. Um, you know, and that’s something we’re working on too in-house as a, uh, working on a new training. Syllabus to where we can give some of the basic NDT tools to, uh, end users so that if a repair company would come in, they would be able to have their technicians do a quick, you know, quick test. Uh, it’s what we used to call like an operator level inspection. And then if they saw some of the stuff we trained ’em to that we could come back and, and bring in a level three or a level two and look at their information and then maybe do a reinspection if they thought they saw something that was bad. Allen Hall 2025: Joel, you and I had discussed a couple of months ago with an operator in the United States and the Midwest that was gonna be building a repowering, a wind farm with turbines, uh, that were a couple of years old. Remember that discussion about what version of [00:06:00] the blade are those? And it was an early version. I was surprised how long those blades had been sitting in the yard, and we said, well, it’s gonna have a B and C problem. You need to get somebody out there to inspect those blades before you hang them. That’s the perfect case for NDT to get out there and look because it wasn’t like every blade had a serial defect. It was just kind of a random thing that was happening. Do you remember that situation? Joel Saxum: Yeah, and it was really interesting too because you know, we’re on like that specific blade. We’re on like version nine of it out in the field right now. But since I think those were like in 20 19, 20 20, they had been safe harbored from they, those blades have the advantage of now having 3, 4, 5, 6 years of. History within the market of all of the issues that pop up. So we were able to tell that operator, Hey, since these things haven’t flown yet, we know it’s this, this, this, and this. You should have NDT come out here and do this. You should do this. This basically preemptive repair, this proactive measure before you fly these [00:07:00] things. Um, and I think what we see right now, Alan, like you said, just to open the episode with IRA bill changes and. And these new legislation coming up, there’s a lot of stuff coming out of Safe Harbor that’s gonna get flown. Allen Hall 2025: Oh, it’s gonna have a huge, uh, amount of blades that have been sitting there for a couple of years. And, but if you, the operator haven’t used those blades or don’t know the service history of those blades, it’s kind of a mystery and you better be calling other operators that are using them. But ultimately, when it gets down to it, before you hang those blades, and I know everybody’s in a rush to hang blades. You better take a look at ’em with NDT, especially if there are known issues with those blades. And the the problem is you can’t just do a walk down, which is what I think a lot of operators are doing right now. Send a technician down to make a look. Make sure the blade’s all in one piece, like I guess that’s where they’re at. Or we’ll walk inside and kick the tires and make sure all the bond lines are there. It’s a lot more complicated than that, and particularly if you know there’s a source of problem on a particular [00:08:00] blade, you can’t see it. It can be buried deep inside. How are you gonna know without having somebody with NDT experience? Joel Saxum: This is the interesting thing too, here with that specific case that that developer will call ’em. They said, I talked with the OEM. They said there’s nothing wrong with these blades. And they like, that was like, they’re like, they’re like, yeah, we checked with them. They said, there’s no issues. I said, you must have been talking to a sales guy because anybody from that engineering team is gonna tell you that. Or maybe they don’t want to, right? They, of course they don’t want to come clean with this, but that’s why we, that’s why we have the, like the uptime network and people that you can talk to and things of these sort out there and experts like Jeremy, right? The C-I-C-N-D-T guys, because they’ve seen the worst of the worst, Jeremy Heinks: right? We typically only get called in when it’s the worst of the worst, but to, uh, toss ’em with more wrinkle. Toss one more wrinkle into the whole storage thing. Uh, we got a project a few years back where the storage site, like, ’cause the blades had been stored for like 15 years, like seven years prior. The storage [00:09:00]site was underwater for like three weeks, like 20 feet. Like it was a massive flood, 20 feet of water or 10 feet of water, whatever it was. So the, it was a lot of water anyway. The bottom two thirds of these blades were. Rotted because of water logs being sitting in the water. And of course over the last seven years they got cleaned up. They looked good ’cause of the rain and everything and it looked bad. So we get out there, we’re scanning laminates and you get like halfway down the blade and it just with the, you know, terrible signal. And so we look back on the history and sure enough there was floods in the area. So those are things you gotta look at too. These blades are coming out of these long-term storage. I mean, how were they stored? How what has gone, what weather has been through that storage area in the last whatever years? Uh, because all that affects these blades when they’re on the ground. I mean, they’re, they’re, they’re fairly secure when they’re up tur up turbine and they’re meant to be in that environment. They’re not really meant to be getting just hit hard with weather when they’re on the ground. ’cause they’re [00:10:00] not sealed up. They’re not, you know, you know, a lot of different things there. Joel Saxum: Another ground issue, and I, I’ve, I’ve heard of this one through my insurance connections and stuff like that, is, um, when blades are on the ground, there’s, this is not an abnormal thing. It happens quite regularly that it shouldn’t, but it does. That heavy, strong winds will come through and can blow the blades over when they’re sitting in their chairs, right at the, or they’ll start, yeah, they’ll start fluttering in ways that they’re not designed to flutter. Right? They’re designed to take the gravity loads and take the force loads the way they are up tower when they’re sitting on the ground, it’s a completely different game. So if they’ve been there, if they’ve experienced an extreme weather event or something of that sort, NDT is the only way you’re gonna figure out if something is really wrong with ’em. Jeremy Heinks: Right. And that rolls into handling as well. So shipping, handling at the plant, handling from, you know, in between. Different movements. Uh, like you said, they, they’re designed to be in an environment that’s hung from a turbine and, uh, get those types of, you know, elements and the winds and everything on. That’s not everything we do to when on [00:11:00] the ground. So Allen Hall 2025: turbines, a lot of times, even at the blades are in storage. They get moved around a good bit. And what we’re finding, talking to operators is that a lot of the damage we’re seeing later on in some of these blades. Was most likely due to transportation. So maybe it was on the ship on the way over, or maybe when they got trucked to the, uh, storage site or they got bumped into. It does seem to be a lot more of that. And the lift points seem to be another area where, you know, you know, I think there’s some, uh, need to be taken a deeper look at. Obviously the root bushings are a problem area for almost everybody at the moment, but also further out on the blade. There seems to be. Uh, repeatable damage areas that you see that you wouldn’t be able to detect until you got the blade spin. And, and then you see these cracks develop. But a lot of that can be sussed out on the ground, especially with knowledgeable people. Jeremy Heinks: Yeah. So that’s just another reason for, you know, pre-installation inspection. Um, you know, a lot [00:12:00] of places you’ve got experts moving these things, you know, experts lifting ’em, whatnot. But when they’re in a, they’re on a ship or they’re in a yard. A lot of times the guys that are professionals at moving them aren’t there. So it’s gonna get moved by somebody and they’re not gonna know exactly what they’re doing, even if they’re trying their best to be, make sure they’re following procedure or whatnot. But, um, you never know who’s moving on, who’s, you know, what, what, what kind of skills or the experience they have. Joel Saxum: So, so that brings me into another question here, Jeremy. Right? We’re talking about skills and tools and these kind of things in the industry. When we say NDT, I would like everybody listening to know that when we say NDT, we’re talking about a wide gamut of technologies, of solutions, of products, of, uh, you know, methodologies for inspection here. NDT is just a broad scheme for non-destructive testing. We wanna see inside of something without cutting it, breaking it, whatever we have to do. [00:13:00]So, can you, can you walk us through the approach that kind of CIC will use? So, hey, customer comes to me, we have this issue. Okay. You guys have, I don’t know, 20, 30, 40, 50 different ways of doing things. Um, but how does that conversation usually start? What does that process look like for an operation? Jeremy Heinks: So it, I mean, it all depends on it’s case by case with what kind of issue they’re looking for. But, uh, we recently had our. Our, our lab opened up in, in Ogden, Utah, where we’ve got, um, a lot of in-house technologies now, like robotic ct, uh, laser ultrasound, um, and then urography, all the normal stuff. We typically throw out these things, but deposit focus, but we’re able to do just about anything. A lot of advanced materials, and of course a lot of that came from us servicing the DOD, the defense and the, the aviation, it’s space side of the house. But now that we have them all in one place. If a wind customer has an, let’s say they have, um, a root issue or they have a bottom line issue, or they’ve got, um, you know, or these, uh, carbon fiber [00:14:00] main spars, you know, you’ve got some new types of defects to out of these. Typically what would happen was you cut into these things to see what’s wrong. And of course, we’ve all seen what cutting composites does it, you know, it can be kind of messy and it can damage a defect that’s existing so you don’t have a good look at it. With these technologies we have in house now, especially with the CT part of it, we can do a inspection. We can see everything of a area that is unmolested, right? So we can, let’s say you find something and you’re scanning, let’s say you are an OEM and you’re doing ultrasonic inspection or thermography, and you find something in house, well, you can cut around that, send it to us, we can scan it and get a 3D image, you know, of the full material thickness. Really break that down without having the damage, the defect. Uh, and this is stuff that hasn’t been really gone into on the wind side yet. We do it on aviation and space all the time, um, for defect characterization. And then, you know, we have a really good picture of what’s going on there. [00:15:00] Uh, we characterize defects that way and we can also come up with better inspection solutions that way. Allen Hall 2025: Well, that’s interesting because I’ve seen it in aviation all the time. I assume they were doing it in wind. You have to have a way to understand what the defects are and when you see one, or especially if you don’t understand what is causing it, you just can’t cross section that you want to take a large section out and then scan it. Understand what is likely the source of that problem that’s not being done. And when, too much at the moment, I think it is, but it’s, Jeremy Heinks: it’s finally getting cheap enough that, uh, it’s. It’s an option, right? So it’s, it’s always been kind of expensive, but the equipment has come, is coming down in cost and we have a very unique system in-house. It’s not typical to your normal CT system. So we use, uh, a robotic system, a cobots, so we can, we do very large, very large parts, uh, and, uh, composites of course are typically lower energy. So [00:16:00] it’s, um, pretty much tailored for that type of part. Where other CT systems may, might be tailored to other, other types of parts. Allen Hall 2025: So then you can actually take some significantly large size pieces. Then what’s the, what’s the biggest size part you can take and, and get some data out of? Jeremy Heinks: I mean, again, comes outta the time and money. Uh, right now our largest piece is probably, um. Probably like a 10 foot by six foot section. Allen Hall 2025: Whoa. Jeremy Heinks: I mean, in theory we could do a, we could do a whole wing in theory, you know, um, which could be a, you know, a decent sized blade even. But, uh, that would require specialized bay, um, and some extra tooling. But, uh, right now in-house, yeah, we could do, uh, fairly large sample. Joel Saxum: The first time I ran into you, uh, Jeremy in the wind industry was probably three, four years ago. I think, and you may not even have known this, but it was on an, it was on an RCA case for an insurance company, and they’re like, we, [00:17:00] we did the, our, our initial, where the team I was with at the time, our initial RFI, Hey, we need this data, this data, this data. And they sent, they sent us this just library of stuff and they were like. Can you use this? What is this? And it was all NDT data from, from the issue that we were inspecting. It was like, this is the most amazing batch of data we have ever received on an RCA. Who are these people? Where did this come from? Um, and I think that, that, that was my first, ’cause, you know, from the oil and gas side, NDT, that’s just regular. You’re doing it all offshore platforms, like you’re always doing NDT. It’s just, it’s just an accepted thing. Uh, you know, and the, the, of course the offshore technicians for NDT, the, the rates are a lot different. Um, and so I was like, okay, yeah, we we’re using nd this is when I first was really getting going and win. I was like, oh, great, we’re using NDT and Win. But since then, it’s still, it’s been. Very specialized use, you know, RCAs or like a special repair or something like that. You just don’t see it very widespread. And, and it’s, it’s frustrating because, you know, from, I guess from my past, like you can see the value of this [00:18:00] tool and you see some tertiary kind of things out there where people are doing little NDT with robotics and this and that, but like, it’s like the industry hasn’t grasped onto it. Like, I don’t know if the engineers just don’t, just don’t know that it’s available or know the value of it or why they’re missing it. Because you go back to the idea of, um. You go to your general practitioner or the doctor and say like, okay, yeah, you got your knee hurts. Okay. Yeah. Shake it around a little bit. Like, okay, we’re gonna, we need to prob maybe do surgery here and before we do that, let’s go get an X-ray or a MRI. So we know exactly what we’re supposed to do. When we get in there, we make it efficient. We make bang, bang, bang, clean cut and all, and we’re done. That’s the same thing as like, uh, to me, a really deep lightning repair. You know what I mean? We hear these war stories all the time of people saying like, oh yeah, they quoted us 20,000. And this team quoted us 50,000, and then the $20,000 team, we gave the project to them, they got in there and it ended up being a hundred thousand. Well, if you would’ve spent 15 grand or 10 grand, or five grand or whatever it may be to get some NDT work done on this thing before [00:19:00] you opened it all up, you might know what you were getting into and be more efficient. Come with the right kit, less standby time, the right technicians on the job, all this stuff, just like your surgery on your knee. I mean, have you seen anybody picking up that idea in the wind industry? Jeremy Heinks: Not as, not as much as I’d like. Um, there’s been a coup, there’s some of the OEMs have tried to automate, tried to bring it in. Um, most of ’em do some inspection. Um, and it really is the plant by plant, depending on what kind of support they have. We all know whenever things are times are tight or, uh, or you need to have the cycle time as the most important thing. You know, quality is the first one to get cut. So, you know, that’s, that makes it a tough. A tough sell in a lot of people’s books ’cause we add cycle time and we add costs, uh, at the manufacturer. Um, but, um, you know, the other thing I’ve seen is, you know, when they do try and implement something where, let’s say some automation where they could do this stuff quickly and, [00:20:00] you know, over the mass produced parts that they have, um, you know, they, they go to an automation company that doesn’t know much about NDT. If they do know about NDT, it’s, it’s not wind. NDT. So. Um, you know, the, they would be better off if they would contact, you know, a company like ours or there’s a few of us out there where all we, like a majority of our work is in the wind industry. Um, there’s a, there’s a couple in Europe, there’s a couple over here. Get those guys in first. It doesn’t have to be us. Um, but get somebody with practical Yeah. You know, experience and that practical part is the most important part, and have them help you with a practical approach. To the inspection with automation. I mean, that’s, there’s simple and easy ways to do this that just haven’t been done yet. Allen Hall 2025: Um, Jeremy Heinks: not gonna say it’s gonna be cheap, but it should be, um, usable. It’s not gonna end up on a shelf. Like I always keep telling everybody, all these systems, just they, I’ve seen millions of dollars spent and it just sits on a shelf [00:21:00] collecting dust. Happens all the time. Um, and that’s in the field as well. Uh, we see a lot of really cool robotics sink coming out. A lot of, uh, drone. Interior drone stuff, exterior, drone stuff, uh, and just looking for a practical approach. You know, these guys, a lot of ’em come at it with, um, really good intentions, but, uh, they don’t have the experience needed to, uh, know what they’re gonna run into when they do these, these types of applications and therefore, kind of missed the mark. Allen Hall 2025: Jeremy, I’ve been to a site recently and noticed up on the whiteboard. Blade bolts were their particular issue. And I saw a couple of the blade bolts sitting in the shop there and they had cracks, big cracks and broken blade bolts. And I thought, man, that’s a huge problem. And the number of turbines that were listed was incredible. It’s not technicians and mechanics are out there all day fixing these blade bolts ’cause there’s so many bolts per blade. You just multiply the numbers like wow, they have a huge [00:22:00] problem. The issue is you can’t really tell which Blade Bolt has a crack in it while it’s installed, unless it falls out, and they were having that problem too. How can you attack that problem from an NDT standpoint? Can you suss out what bolts are likely to fail or, or in the process of failing? Jeremy Heinks: Yeah, so in bolt inspection is isn’t new. Um, it’s gonna, sounds kind of new to the wind industry, but uh, oil and gas aviation. We’ve all done, we’ve been doing bolt inspection on those for quite a long time. So even in, uh, on marine with the, you know, sail sailing vessels with the mask bolts. Uh, so, uh, these are things that we can do ultrasonically, um, you know, whether it’s stalled and look for cracks at different, uh, lengths. Um, of course we need a little bit of information about the bolt itself, the material, um, design length, all that stuff. But, uh, no, we can definitely do a, a, uh, inspection. Whether it installed or not installed on the bolts? Uh, you mean it wouldn’t even be a [00:23:00] bad idea to get the bolts inspected before they get used for installation? You know, that could be done with, uh, a few different methods that are pretty quick. Uh, but, uh, the other thing we’re working on, uh, actively is a monitoring system also where, uh, we’ll be able to attach the sensors to the end of the bolt and, uh, it’ll be able to, uh. Monitor the, the health of the individual bolts over time. Allen Hall 2025: Can you see inclusions, or what is the defect that’s causing these bolts to start to crack? Is it something in the casting of the bolts themselves or the machining? Are they overheating them when they’re getting machined or not tempering them correctly? All the Jeremy Heinks: above. So we can definitely see that, um, you know, on new bolts you’ll, you’ll be able to see if there’s manufacturing defects or if there’s material defects, um, that maybe didn’t get caught during manufacturing. Or, um, you know, receiving inspection. Allen Hall 2025: I have one of these bolts that’s like two and a half feet long you can actually see inside and tell me where that defect lies. ’cause you cannot see it on the outside when they’re all [00:24:00] finished. Jeremy Heinks: Right. Typically we use ultrasound, uh, for, uh, quick inspection on that. Um, I mean, if it’s out of the, the turbine, you know, first year x-ray and make particle, that kind of trend, you know, everything gets your to outta, but the ut seems to be pretty, pretty straightforward on those. We’d even signed the cracks that are in the threads if we had the right, um, bit jangle to the, uh, the beam. Allen Hall 2025: Okay. So if you just received a whole truckload of these bolts, which is sort of the quality that you’re coming in right now, you could ut inspect each one of those before you took ’em up tower and, and spent all the money to install ’em and make sure that the manufacturer actually is delivering a proper product. Are Joel Saxum: they doing that at the factory? Why are they not doing that at the factory? Jeremy Heinks: Because Allen Hall 2025: they’re told they’re Jeremy Heinks: good when they get ’em from a supplier. Allen Hall 2025: That seems like a huge, if I’m the attorney at Blade Bulk Company, China Limited, I would want to make sure that I won’t gonna kill somebody because, ’cause those things are falling out and they’re just gonna [00:25:00] lawn daughter it underneath the turbine. Joel Saxum: And a hard hat’s not gonna save you from a bolt coming down. Allen Hall 2025: Well, you could tell by the number of problems that they were having that they had replaced some of these bolts. The new bolts had also had problems. So as a, a sequence of replacements, at some point you have to stop that process. You have to validate the part. You’re putting in the turbine is correct, right? I mean, when you have to do that Jeremy Heinks: on my side, you, you get what you pay for. And if you’re gonna go for cheap, you should probably spend a little bit to make sure what you’re getting is Allen Hall 2025: somewhat decent. So how, what would that entail to check them in the o and m building and say, you got a hundred bolts show up on site. What are we talking about in terms of time to make sure that at least the, the sanity check is being done before you spend the money to install these bolts? I mean, if we put together something, it could be done a few minutes per bolt. Throw me a, throw me a time and a dollar amount. Are we talking about millions of dollars or thousands of dollars for this? Thousands of dollars [00:26:00] Strong. Jeremy Heinks: We could probably get a system together that would be extremely cheap and effective. So I mean, if there’s, if that’s something that needs to exist in the industry, then we can definitely put together something that we can sell. Allen Hall 2025: I think people don’t realize that that is a thing. They don’t know that that’s possible. You can’t go to Amazon and buy a blade, bolt checker that’s not there. You can buy a lot of things on Joel Saxum: Amazon though. Allen Hall 2025: Let me ask you about the thing. I’ve seen the sort of the unscientific blade bolt check. Where they, have you seen this Jeremy, where they hang the bolt on one end and they tap it in the other and it, and it rings right? It makes this kind of a bell noise and they think they can hear if there’s a defect inside of there. Can you hear if there’s an inclusion or some sort of crystalline defect inside this blade bolt by tapping it? That’s, it’s a resonance test and Jeremy Heinks: I, I think you could definitely tell, you can definitely tell if there’s something going on. I think you would have to have a good control though. So if you, you have to have, you’d have to have one bid [00:27:00] vote. To balance against, I would imagine, and someone with good hearing. Yeah, I, it’s tap testing with anything is always subject to so many things. So it’s, uh, it’s better than, Allen Hall 2025: better than nothing probably. But, uh, how much better than nothing? Is it just slightly better or is it like, well you get, at least you’re getting the worst ones out of the lot. Uh, would it even do that? Unless I had it announced to, to try it, um, I would wanna. Say either way, but you see the little tap hammers, I’ve been on site and seen the little tap hammers sitting on guys’ desks that are the, you know, the, uh, calibrated tap test tool to see for DAS, that is not an easy tool to use. And it’s not even right for all the applications because it only, it’ll see something on the surface, but where, what can’t it see? Jeremy Heinks: So there is a regulated. Way to do tap tests. There’s, [00:28:00]it’s, as you have a certified tap test that you have to have, uh, noise levels and the environment have to be at below a certain amount, your, your guy doing, the person doing the test has to have a hearing check annually, and it has to be at a certain level. Um, the tap hammer has to be, is proportional to the thickness of material you’re looking at. ’cause if you’re looking at some, I mean, it’s only good for so, so thick. Like if you’re looking at. 10 millimeters, 15 millimeters fine. But once you get past 20, you’re gonna use a heavy hammer. And I’ve seen hammers in some plants that were probably causing damage, you know, ’cause they were so heavy, like, and they’re just, it was a piece of rebar with a ball bearing welded on the end of it, and they’re just hammering away. And it was so loud in the bay that even when they got lucky, when it crossed the dry glass area, they didn’t hear it. They just kept on rolling. Joel Saxum: Man, I thought, I thought a tap test was literally like a technician with a, with a, like a one euro coin in their hand or something. Just like ding ding [00:29:00] d ding, ding, ding. Like, that’s my tap test. Like you got a quarter. Jeremy Heinks: I have done a lot of tap tests, but it was like on radars where you had like two layers of carbon fiber and it was super thin and you could really hear, it works sometimes, but you just have, it’s got limitations just like any other method of inspection. So, and if people just. Allen Hall 2025: Don’t abide Jeremy Heinks: by Allen Hall 2025: this. If you have a technician roll into the o and m building, listen to Def Leppard on 11, then you’re probably not picking the right guy to do the tap test because it does take a lot of sensitivity to hear these minor changes. It’s not easy. Or the Lake Green, Ozzy Osborne. Yeah, right. If you see a, an Ozzy sticker on the guy’s pickup truck, probably not the right choice for the uh, tap test expert. The funniest thing ever. Jeremy Heinks: On the aviation side, we’ve gone to so many aviation or space group areas that use tap test and it’s always the oldest guy that has the hardest hearing, that’s doing the test every time, every Allen Hall 2025: time [00:30:00] they pass the most stuff. That’s why production doesn’t slow down. You said it, not me. I wanna expand the scope just for a minute. Uh, there’s gonna be a lot of, a lot of sites right now because of the changes in the IRA bill that are not going to be able to. Uh, get their next round of production tax credits and reapply because they’re gonna miss this window, right? So you have blades that are seven and eight years old, or turbines eight, seven, or eight years old. You’re not gonna be in that window of opportunity pretty much depending on what happens with the treasury rules. That thing is like it’s going to force operators into taking a deeper look at the health status of their turbines, maybe more than they have in the past to know, am I good for another 10 years, or if I do a little bit of preemptive maintenance on my existing fleet, can I get ’em 10 years, maybe 15 years? That’s the look I think that everybody’s trying to evaluate right now, and I think the [00:31:00] key to all of that is to actually have some NDT data. To actually look inside and to see, do I have a blade root issue that’s still early, that it’s gonna pop up at year 12? Do I have a cracking issue that I need to go take a look at? How does that factor into the planning over the next year, 18 months? For me, it was a little eyeopening when we went Jeremy Heinks: down that and visited our friends in Australia, and that’s kind of how they live, right? With their, their wind farms. They, they have to make ’em last. And it was, it was eye-opening and I, I just had a conversation with one last week. One of the people we met down there and they were looking into, uh, main bearings, a pitch bearing, and they’re cracking, right? So these are things that can be inspected with ultrasound or other things, and we can find these cracks internally. Like this is stuff that we don’t get to see much in the US or, or, you know, markets like ours because they get replaced, right? Everything gets just, we have a throwaway attitude when it comes to blades because of, you know, repowering and other things. Um, [00:32:00] where. Places like Australia or like in the islands where we’ve got a customer, that’s not how they look at it. These things have to last 30 years, you know, or longer, you know. So, uh, inspection and preventive maintenance is, is is, uh, the way to look, way to go. It. I mean, again, oil and gas, the stuff they have has to last a long damn time. A lot. You know, they do preventative maintenance. They have repair schedules or replacement schedules, all this stuff. And maybe we gotta start looking at that stuff a little more smartly on our side. Um, and, uh, budget for more inspection on these things that we know will go bad over time. And it’s not necessarily just the blade, but other parts of the turbine as well. You know, we’ve got a a yup. Bearing we’re looking at too. And that’s, that’s a pretty large. Part you have a crack in it, but Joel Saxum: ha bearing. Jeremy Heinks: Yeah. So these are things that didn’t crack. So we’re looking at, uh, with different inspection methods as well. [00:33:00] So, Allen Hall 2025: so do you think the roles of reversing that the Australian European methodology to keep turbines up and running is going to be applied to the states, and how is that going to transfer that knowledge transfer gonna work because it. The staffs in. A lot of us operators are set up for that 10 year period. Like they, they don’t really think about year 11 anymore. They haven’t for a number of years. How do they get spooled up on that and what resources are they going to need to get to year 15 and 20? If I was them, I would be reaching out to Jeremy Heinks: our partners in Australia or Europe and ask those questions. And a lot of these comp, a lot of these large energy companies are not just us. They’re. Multiple, you know, areas of the world that they, they brought in. So they have, they should have the knowledge and the leverage in house. They’re just gonna have to connect those people or, you know, people, people, people like you guys are gonna be able to, you know, bring that knowledge and connect those people. ’cause I mean, you guys are great at connecting people for [00:34:00] sure. Joel Saxum: That’s what we, we try to say that to everybody though, too. Every time we go to, like, Hamburg is next year, right? The, the Hamburg is to me is the best wind show in the world. Hamburgers next year. Wind Europe is coming up. Like if you’re a US operator, if you, if you’re, you name it, one of the big conglomerates that has people on both sides of the pond. Yeah. Connect up internally. Come on. Get your act together. But the other side of it is, is there’s a lot of people here that aren’t, they just don’t know. You know, there’s a lot of operators that are very large here. They don’t have anything else anywhere else. Go to Hamburg, go to Wind Europe, go, go over there, just go to the conference, see the technology, see the innovations, talk to the people, have some conversations because it will be eye-opening and you know, and, and there is another one too that I think is a very important, um, there’s some ISPs that go across the pond, back and forth, and some of these good ISPs have a lot of really good knowledge about what goes on back and forth because there’s a different operating model over there as well. There’s a lot of the. Financial asset owners that [00:35:00] just have the plants and they entrust someone later on in life to manage it for ’em. Where these ISPs have 20 vestas engineers and 20 Siemens engineers and 20 SGRE engineer or you know, all these people there. So there’s, there is a way to get this information back and forth, but you’re a hundred percent correct here in this conversation. I guess the, all the three of us here. We’re staring at, uh, a cliff that we need to figure out how to get wings on before we, we don’t want it to be like the red, the red Bull thing, where every, just into the water. We don’t wanna do that. We wanna fly up the cliff. Jeremy Heinks: But we’ve seen, we’ve seen this too, at some of the, the o and m focused, you know, show or conferences or gatherings. The ISPs aren’t, aren’t brought in ’cause they’re scared. It turns into a sales pitch. Um, but again, I like the one we had in Australia last year. That was great. It was, hey. This isn’t a sales pitch, just tell ’em. I mean, most of us know, I mean, I, I’m gonna be up there speaking. I’m not, I don’t have to do a sales pitch. If I, if what I’m saying is valuable to somebody, they’re gonna come find me, [00:36:00] which is what happened after that. You know, people reach out, you know that they’re gonna be like, oh, that I have that issue. I’m gonna go talk to this guy. You don’t have to do a sales pitch, just say, Hey, this is what we, what we found. These are the things we ran into as we do these things. And just keep it about the, uh, about the, about the problems. That we’re facing? Allen Hall 2025: Well, yeah, that’s gonna be the key for the next couple of years, just because a lot of the engineers and staff on the United States, uh, have not been to a lot of conferences and talk to technical people because they haven’t needed to. It’s more of, Hey, I need to keep the blade running a couple more months and then we’re gonna move on to the next project. We got a Repowering project going on. It’s been in that sort of build mode for a number of years, and that whole. Logistics, uh, internal workflow is going to change where they need to be bringing outside resources in to help them understand what they’re missing or what key components do they have over in Denmark or Germany or France that we don’t have on staff at the minute, and why do [00:37:00] they have it? One of those is going to be NDT and a lot of it, I think just because of the age of the turbines and the. I would say the era in which they were built, it’s gonna lead themselves into more inspection. That’s, I think, an avenue for C-I-C-N-D-T to explore, obviously. But I think the key is to get the engineers and the sort of the maintenance staff out into the world again, and to come to some of these conferences. Like j when Jeremy speaks, you should be there listening because he’s gonna give you all the answers in about 30 minutes of what you need to go do. That’s the key. Right? Jeremy Heinks: Right, right. And I mean, not just myself, but anybody in a position where you’ve got knowledge and experience that would benefit the whole industry, um, you know, certain volunteering, get, get out there and uh, and pass the, you know, pass the word out. You know, it’s like, you know, we had this thing in the NDT industry where. A certain generation of the, the older guys that had all this experience, all our senior level threes, you know, back then it was, you [00:38:00] wanted to hold everything in because that was your key, that was your ticket to getting a payday. Right. But ended up is when those feasible people all retired or, or worse. Um, then though that knowledge got passed down and uh, it was all kept up. And you look at, look at the aviation industry, the fumbles they’ve had lately with quality. And that’s because of that. ’cause they don’t talk to each other, none of that. They, they this year, all these problems they’re having right now in aviation stuff that they took care of in the fifties, right. And they just forgot. So now we get, have a chance to try and not do that in the wind industry. Um, you know, if you’re an expert in something, get out there. And, I mean, it’s tough. Like I don’t like talking in front of big crowds or anything, but. It’s, uh, once you get rolling and people get engaged and with guys like you to help out, you know, it’s, it’s not a bad type. Just set the ball in the tee and let you take a whack at it. But you could be in the difference between somebody having a whole farm, uh, a wind farm, go, go down, or they have a, like we’ve come across people that have had [00:39:00] blades or turbines offline for weeks, if not months, because they have an issue they don’t know they can do anything about. And then they bring us in and like, Hey, we did the inspection. This is repairable. Or we did the inspection. You should just get rid of this blade or, or whatever. It’s just they’ve been paralyzed and that, I don’t think that’s, you know, something that needs to happen Allen Hall 2025: either. Well, they shouldn’t be paralyzed. They should be calling C-I-C-N-D-T or going to the website, cic ndt.com. Get ahold of Jeremy, get ahold of the staff because they have a, a tremendous amount of knowledge about blades, about how to inspect them and how to keep the turbines running. Quickly, yes, it costs a little bit of money, but it’s well worth it when you have these turbines down for months on end, and I’ve seen that this year. It’s insane. They should have called. C-I-C-N-D-T and gotten their turbines back up and running. Jeremy, how can people reach you directly? Can they get ahold of you on LinkedIn? Jeremy Heinks: Yeah, get on uh LinkedIn and just search Jeremy Hikes or you can go to our website, uh, ct.com and [00:40:00] we’ve Allen Hall 2025: got links to uh, get ahold of us there and go to some of the wind conferences because Jeremy’s gonna be there laying down the knowledge on NDT and you won’t want to miss it. So, Jeremy, thank you so much for being on the podcast. We love having you. Thanks for having me.

Send us a textWe map a practical path from “is this dangerous?” to “what actually helps." We also talk about some specific headache types such as:  IIH, medication overuse, trigeminal neuralgia as well as the rise of CGRP therapies.• separating primary from secondary headache with SNOOP4• recognizing thunderclap, GCA, IIH, and low-pressure patterns• uncovering hidden chronic headache burden and medication overuse• exam essentials including fundoscopy and neck palpation• trigeminal neuralgia in MS and targeted MRI protocols• rescue strategy with effective OTC dosing and triptan timing• antiemetic choices matched to daily function• preventives matched to sleep, anxiety, weight, and goals• carbamazepine and oxcarbazepine for trigeminal neuralgia• role of acetazolamide and topiramate in pressure states• CGRP therapies, access hurdles, and practical selection• empowering patients with education, logs, and portable plansSupport the show Check out our website at www.theneurotransmitters.com to sign up for emails, classes, and quizzes! Would you like to be a guest or suggest a topic? Email us at contact@theneurotransmitters.com Follow our podcast channel on

A 2025 analysis of over 13,500 knee MRI scans revealed that men have more anterior cruciate ligament (ACL) tears overall, including ACL plus meniscus combinations, contrary to earlier data focused on female athletes Men under 40 were more likely to have trauma-driven medial collateral ligament (MCL) and meniscus injuries, while women over 40 had a higher rate of degenerative MCL and meniscus damage These patterns suggest trauma dominates in male injuries, while age-linked tissue breakdown plays a bigger role in older female patients These results can aid clinicians and radiologists in recognizing patterns of injury so they can tailor imaging protocols, risk assessments, and early intervention strategies for patients Researchers say these gender-specific patterns may change the screening, prevention, and rehabilitation for knee injury across lifespans

Answer my survey to get a chance to win a $100 Amazon Gift Card!

While endometriosis is highly associated with Chronic Pelvic Pian (CPP), some women may suffer from a different primary or coexistent secondary etiology: pelvic vascular congestion, called vascular origin (VO)- CPP. Although controversial as an entity, there have been diagnostic algorithms published (via pelvic ultrasound. MRI, or venography) for this condition. Approximately 10-40% of chronic pelvic pain cases may be attributed to pelvic vascular congestion (now termed pelvic venous disorder), though estimates vary considerably depending on the population studied and diagnostic criteria used. In premenopausal women specifically, the prevalence appears higher. One study found that 8% of all premenopausal women had documented chronic pelvic pain of unclear etiology along with dilated ovarian and pelvic veins on cross-sectional imaging. Therapies for this have been limited. Flavonoids are abundant in a colorful diet of fruits, vegetables, tea, and wine, with common sources including citrus fruits (flavanones), berries, apples, grapes (flavan-3-ols/anthocyanins), onions, kale, broccoli (flavonols), and tea, cocoa, red wine (flavan-3-ols), plus soybeans (isoflavones), all providing antioxidants and potential health benefits like better heart and brain health. On Dec. 23, 2025, in the journal Phlebology, researchers published a systematic review on the potential benefits of specific flavonoid mixtures which may provide relief to VO-CPP. Listen in for insights and details.1. Gloviczki ML, Demetres MR, Salazar G, Khilnani NM. Venoactive drugs for venous origin chronic pelvic pain in women: A systematic review. Phlebology. 2025 Dec 23:2683555251411027. doi: 10.1177/02683555251411027. Epub ahead of print. PMID: 41432346.2. Knuttinen MG, Machan L, Khilnani NM, Louie M, Caridi TM, Gupta R, Winokur RS. Diagnosis and Management of Pelvic Venous Disorders: AJR Expert Panel Narrative Review. AJR Am J Roentgenol. 2023 Nov;221(5):565-574. doi: 10.2214/AJR.22.28796. Epub 2023 Apr 5. PMID: 37095667.

President's Day Weekend 2025 started like any other legendary Colorado ski day: fresh “pow,” bluebird vibes, and me—Skier Sof—feeling like the queen of Tucker Mountain. Copper locals know Tucker used to be snowcat- and hike-only, which gave it this mysterious backcountry allure. Now it's still expert terrain, but with lift access…and on Presidents Day, that means crowded.But hey, what's a little crowd when you're vibing on run #5, skiing powder next to Valentine's and Boulderado with a good friend, and life feels like a Patagonia commercial?Spoiler: It all goes downhill. Literally. And painfully.  The Scene: Fresh Powder, Bad Visibility, and One Very Unpredictable Skier (and no, the unpredictable skier was not me)My friend Ryan and I were shredding through some fantastic powder. We reached the bottom of Boulderado, where you have to cut hard left through a tree trail to avoid looping all the way back to the chair.Only two sketchy paths go through these trees. You need to keep up the speed, loosen your legs, and blast through bouncing along till you get to the chair. One dude was sitting in the absolute worst possible spot. Not moving. Not looking around. Not reading the room!I told Ryan, “Follow me, I'm going now!”And that's when the guy—out of nowhere—decides to stand up and slowly drift right into my line without looking uphill.PSA: ALWAYS look uphill before you move. Don't be a “Jerry.” Yield to the above skiers. These things matter.I tried to change my line to the lower track, but visibility was trash: I had my sun lenses on when I should have swapped to snow lenses (don't get lazy, ladies and gents!). I caught the top of a massive mogul, went flying, landed, but my feet were suddenly two feet apart—never a good sign when skiing trees.Then came mogul #2.The left leg slid down it.The right leg stayed at the top.My legs did a pretty epic split that nobody asked for.Cue: the pop of my ACL Fired off like a gunshot (I have the video to prove it). A full tear. I also partially tore my right MCL and my meniscus (just for funsies).  The Fall, the Flailing, and the Insta360 That Captured It AllI twisted, flew over the “do not cross” rope (10/10 do not recommend), and slammed into soft powder at the base of a tree. My left ski did NOT release—because my bindings weren't adjusted after losing weight—and my leg twisted way farther than human legs should.I screamed like an angry man who just lost a Mill in the stock market. It was not cute.Ryan came over the hill, saw me lying up with my heat against a tree, panicked, thinking I broke my neck or something like that, whipped off his snowboard, climbed down into the powder, and dug my buried leg out like a heroic golden retriever. “My Hero.” No, seriously, this guy is a great friend, especially since I just ruined his epic ski day. As I writhed in pain, I told him, “Find the camera,” because naturally that matters more… He found the Insta360.Another skier—who had literally followed my line earlier went to call ski patrol.Ski irony is alive and well.  Ski Patrol to the Rescue (Eventually)There's a patrol hut at the top of Tucker, but storms were rolling in, and it took about 45 minutes before they reached me. By then, I'd somehow crawled out of the trees (pain makes you feral) and tried to stand on that leg—nope.Once the full patrol team arrived, they loaded me into the rescue sled for the hour-long journey to Copper Mountain's Center Village. There were blizzard-like snow conditions that covered my face in about 5 minutes. It was about 15 degrees Fahrenheit. A full team of 5 was needed to get me out of the trees. They snowmobiled me up Copper Bowl and skied me down the front face of the mountain. At least I finally got to go snowmobiling!Crowds gasped like I was being transported post-avalanche. I could see nothing, and hear a whole lot, so I was desperately hoping no one T-boned the sled while the patrol kept yelling, “MOVE! LOOK UP! ON YOUR LEFT! YIELD!”It was like being royalty—if royalty were frozen, freaking out, and strapped to a tiny snow coffin. At least the ski patrol guy even kept checking on me to make sure I was still alive.  Diagnosis: Basically… Everything ToreUrgent Care X-rays said: “Good news, no broken bones!”MRI later said: “Bad news…everything else is broken.”Final injury roster:Full ACL tearPartial right MCL tearTorn meniscusMassive bone bruise on the left side of my kneeA whole lot of regret I stayed in Colorado for a month doing PT and trying to maintain dignity and not slip on the ice with crutches. Eventually, I flew home, got an MRI, and scheduled surgery for April 24.  ACL Surgery & the Recovery GrindSurgery went great, but recovery? OOF.Two weeks of sleeping in the braceCrutches for two monthsPT bending (which basically felt like they were breaking), my knee twice a weekPain meds (which my body hated), but I so needed because the pain was astronomicalAlmost fainted in PT twice because of the drugs and physical exhaustionI learned Advil was my friend after the first few weeks and ditched the nasty hydrocodoneLots of tears, lots of naps, lots of gratitude when I could A) not be in so much pain, B) get off the meds, C) walk again without crutches! By week six, pain finally chilled out, and the muscle-rebuilding process started. Every tiny improvement felt like winning Olympic gold. Its the little things in life.  What This Injury Taught Me (AKA: The Travel Brats Safety Sermon)1. People on the mountain are unpredictable.Even on expert runs, don't assume anyone knows what they're doing, or where they are going. And most likely they do not care about YIELDING!2. Altitude is no joke.Hydrate, acclimate, and don't push your body if you've been traveling or skiing hard and are feeling the fatigue from it.3. Train before ski trips.Strong quads save knees. Don't skip leg day. I repeat: don't skip leg day.4. Pace yourself.Take breaks. Take a day off on long trips. Ski easier runs when fatigue kicks in.5. Gear matters.Helmet alwaysProper lenses for conditionsRegular ski tuningCheck your bindings if your weight changes! 6. Ski with a buddy.Especially in trees, bowls, or sketchy conditions. My friend being there changed everything.7. Stay positive.This injury was rough. But it could've been so much worse. I'm grateful, healing, and counting the days until I'm back on snow—stronger, smarter, and maybe a little sassier.  Final Thoughts: Misadventure or Badge of Honor?At The Travel Brats, we believe travel isn't just beaches and cocktails—it's wipeouts, lessons learned, and stories that make you laugh later (like… much later).My ACL tear was painful, expensive, and humbling. But it taught me how resilient the human body (and spirit!) can be. And when I finally click back into my skis, I'll be ready—with sharpened edges, proper goggles, adjusted bindings, and a whole lot more patience for the unpredictable humans around me.Until then…Stay safe, stay adventurous, and ski smart, Brats. ❄️❤️⛷️

0:00 - Last night, Nikola Jokic left the game with an apparent knee injury he suffered in the 2nd quarter. Hopefully, it's nothing structural and he just suffered a bone bruise. We won't know anything until Joker undergoes a full evaluation with an MRI. As we await the results...we imagine/try not to imagine a world without Jokic on the court.16:35 - Yesterday, Jim Harbaugh announced that he will rest Justin Herbert and other starters TBD vs the Broncos on Sunday. The AFC #1 seed is now on a SILVER PLATTER for Denver. All they have to do is beat the JV San Diego Superchargers of Los Angeles AT HOME, and the crown is theirs.34:09 - The Avs grinded out another grimy win vs the LA Kings last night. They're continuing to prove they can win all sorts of games, including gross ones where they power past mistakes. Speaking of power past mistakes, Bednar said he's concerned with the lack of production on the power play.

0:00 - We can speculate all we want about how good or bad Jokic's injury is. But none of it matters until we get the MRI results back. The rumors are just that: rumors.14:43 - FINALLY! MRI confirmed no structural damage to Jokic's left knee. It was a hyperextension injury. He'll be re-evaluated in 4 weeks. That doesn't mean he'll be back in 4 weeks. He'll be re-evaluated. So the Nuggets will be without him for at least a month, maybe more. Still, that's really good news considering how bad his injury looked yesterday.31:45 - 4 weeks minimum without Nikola Jokic. The Nuggets will need to adapt and re-invent themselves. David Adelman, time to earn your stripes as a coach. Show us how deep the playbook goes. 

Ever wonder what happens in those first few moments after you tear your ACL? What is the exam happening on the field? Should I get a MRI right away? What is optimal surgical timing? When is the best time to get surgery? Listen to our latest podcast for the answers!

Stroke etanercept injection 18 months on: what lasted, what changed, and what Andrew learned after the PESTO trial Some stroke survivors are told a version of the same sentence in hospital: “After three months, what you have is what you'll have.” Andrew Stops didn't buy it, not because he was naïve, but because he needed a reason to keep showing up for rehab when nobody could give him a straight answer about what “recovery” would look like. Four years after his ischemic stroke, and 18 months after a stroke etanercept injection, Andrew is back to share what improved quickly, what continued to evolve, and how he made peace with research results that didn't match his lived experience. The question so many survivors are really asking When people reach out about perispinal etanercept (often discussed as “etanercept after stroke”), they're rarely asking for a science lecture. They're asking: Will this help me get my life back? Will I be the person it works for… or the person it doesn't? How do I decide without being misled by hype, fear, or my own desperation? Those questions are valid. They're also heavy, because the stakes are high: the treatment is expensive, travel can be intense, and the emotional cost of hoping—then not getting results—can be brutal. Andrew's baseline: what his stroke took at the start Andrew's stroke most impacted his right side. Early on, he had: No use of his right arm or hand A weaker right leg Right foot drop A slight speech impediment He worked hard to walk again quickly, using practical supports early (including an elastic extension on his shoe to help keep his foot up). But his bigger mission was clear: find ways to complement rehab—because medical staff couldn't give him a timeline, and he felt a “lack of hope” from their perspective. That's a common moment for survivors: you're doing the work, but you also want a map. The “complement” phase: why hyperbaric helped, even without perfect measurement Before etanercept entered the picture, Andrew leaned on what had helped him before: hyperbaric oxygen therapy (HBOT). He had a history of a brain tumor and had used hyperbaric previously for healing, so he rented a soft-shell chamber at home for three months and went in daily for 90 minutes. Andrew was careful with his claims: he couldn't measure physiological changes in real time at home. But he could measure something important, his ability to cope. HBOT became a daily “warm cocoon” where he could breathe oxygen-rich air and calm his nervous system. For him, that mental-health benefit wasn't a side note. It was fuel. And when you're rebuilding your life after stroke, fuel matters. The etanercept decision: hope, uncertainty, and the reality of the “roll the dice” problem Andrew discovered perispinal etanercept through a media story about Dr. Tobinick's clinic, and after about a year, decided he needed to know he'd tried everything he reasonably could. He crowdfunded to afford the trip and treatment. That detail matters because it introduces the single biggest ethical challenge around treatments like this: Even if you try to stay balanced, it's hard not to hang hope on something that costs time, money, energy, and pride. Andrew doesn't tell people to go. In fact, when people contact him now (he's spoken to more than 50), he's careful: He explains it worked for him, but might not work for them He encourages going without expectation He frames it as “knowing you tried everything,” not a guaranteed fix That's responsible guidance from someone who understands how fragile hope can become when it's under financial pressure. What changed fast (and what stayed improved 18 months later) Andrew's report of early changes is striking not because it proves causality, but because it describes specific, functional shifts: Cognitive fatigue and sensory overload He noticed cognitive fatigue dial down immediately. He still experiences it, but it takes far more to trigger now. The most vivid example: on the way to the clinic, he used an eye mask, noise-cancelling headphones, and had medication ready for overload. On the return flight 24 hours later, he didn't need any of it. He stood in the airport like any other traveler. Pain and cramping A persistent cramp in his right calf eased significantly. Emotional regulation He noticed improvement in emotional control, something many stroke survivors quietly struggle with and often feel ashamed about. Hand function and fine motor control His right hand went from feeling like it moved “in molasses” to loosening up. And here's where the “18 months on” part becomes powerful: Andrew recently discovered he could play scales on his clarinet again, covering holes with independent finger movement, something he hadn't been able to do since the stroke. That's not framed as: “etanercept did this.” It's framed as: recovery kept unfolding. “Your stroke recovery doesn't stop. There's no end date.” The PESTO trial: when research challenges your story Then came the PESTO trial results, which (as discussed in your episode) reported that etanercept was not more effective than placebo in the studied group. This is where Andrew's story gets even more human. He didn't just shrug it off. He described feeling guilt, even fraudulence, because he couldn't reconcile the research headline with his lived experience. That response is deeply relatable: when something helps you, and others don't get the same outcome, it can feel like survivor's guilt, especially when people have spent enormous money and emotional energy. A careful theory: the blood–brain barrier question In your conversation, Bill raises a hypothesis, not a proven conclusion that deserves careful attention: If etanercept struggles to cross the blood–brain barrier in general, could certain people have a more permeable barrier due to factors like stroke, surgery, or radiation therapy (which Andrew had)? Andrew himself wonders if radiation could be part of his “why.” This isn't a sales pitch. It's a research direction, a possible explanation for why outcomes might vary so dramatically between people. If that line of thinking ever becomes clinically actionable, it could change the whole decision-making process for survivors, because the question would shift from “roll the dice” to “are you likely to be a candidate?” What a stroke survivor can take from this without being sold to If you're reading this because you're considering a stroke etanercept injection, here are the grounded takeaways from Andrew's 18-month update: Recovery can continue for years. Don't let a timeline kill your momentum. Treatments don't have to be “proven” to feel meaningful, but meaning isn't the same as certainty. Hope needs guardrails. Don't stake your whole future on one intervention. If you pursue something controversial, protect your mindset. Go in informed, realistic, and supported. You deserve respect, not ridicule, for wanting your life back. If you want ongoing encouragement and tools to navigate recovery (and the emotional complexity that comes with it), Bill's work is built for that: Book: recoveryafterstroke.com/book Patreon: patreon.com/recoveryafterstroke This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. Andrew's 18-Month Etanercept Update: Fatigue, Function, and What the Research Says 18 months later, Andrew shares what improved after etanercept fatigue, function, and the tough questions raised by the PESTO trial. Highlights: 00:00 Introduction and Background 06:15 Exploring Treatment Options 08:59 Stroke Etanercept Injection And It’s Impact 12:14 Research Findings and Controversies 17:59 Conversations with Other Survivors 23:26 Reflections on Treatment and Guilt Transcript: Stroke Etanercept Injection – Introduction and Background Bill Gasiamis (00:00) Hey again there everyone. Welcome back to the Recovery After Stroke podcast. Before we get started, a quick thank you to everyone who supports this podcast on Patreon. Your support helps cover hosting costs and after more than 10 years of doing this largely solo, it’s what helps me keep showing up for stroke survivors who need hope and real conversations. A huge shout out to everyone who comments on YouTube, leaves reviews on Spotify and Apple podcasts. has bought my book, The Unexpected Way That a Stroke Became the Best Thing That Happened, and even the folks who don’t skip the ads, thank you. All of it helps this podcast reach the people who are searching for answers late at night when recovery feels heavy. Now today’s episode is a follow-up many of you have asked for. Andrew Stopps is back, and we’re talking about stroke and etanusept injections 18 months on. We’ll unpack what changed for him, what’s continued to improve and how he processed the PESTO trial results that found Etanercapt wasn’t more effective than the placebo. If you’re considering this treatment or you’re trying to make sense of conflicting stories and research, this conversation will help you think more clearly without hype and without fear. All right, let’s get into it. Bill Gasiamis (01:17) Andrew stops. Welcome back. Andrew (01:20) Thank you for having me. It’s good to back. Bill Gasiamis (01:22) It is so good to have you back. The last time we spoke, was March 26, 2024. At least that’s the date that I uploaded the podcast Andrew (01:30) it would have been before that even, probably a couple of weeks before that. Bill Gasiamis (01:34) Yeah, something like that. So a good 18 months since we last spoke. And the original reason why you reached out and kind of we connected was I think because you had found my podcast, I had maybe had a couple of conversations about Etanercept like, and I had no idea what it was, how it worked, if it worked. And then you reached out and said, hey, I’ve had this injection. I’ve tried it. Why don’t connect about it? Andrew (01:36) So a good 18 months. Bill Gasiamis (02:03) And then we connected and we had a really great conversation and that interview has had like 19 and a half thousand views since then. And then what’s been happening a lot about that interview is heaps of people have reached out to me to say, can I speak with Andrew? Can you connect me with Andrew? Andrew (02:23) And he’s people reached out to me because of that. And also they found me on the interwebs somehow and contacted me that way. So I’ve probably been spoken now, well over 50 people. Bill Gasiamis (02:40) Wow, man, that is fascinating. So and what I love about it is that we put out information. What we hope is we hope people make a more informed decision. Right. That’s kind of the idea is like, how do I help people make people make a more informed decision, especially when I haven’t experienced something and I’m trying to get across the benefits or the pitfalls or, you know, what to avoid on a product. It’s just impossible. But You were very gracious as well as you. I’ve interviewed, by the way, a bunch of other about Etanercept. And one of them was Dwayne Simple. Dwayne also gets a few people who I sent to him that are in Canada because Dwayne is in Canada. He’s had Etanercept and it worked out for And then I’ve spoken to another lady from Australia, Karen. who also a shot or two of Etanercept and had positive results. But of course, Etanercept is extremely controversial. And one of the challenges with it is that it doesn’t work for everybody. And there’s only one way of knowing if it’s going to work is to go and get the injection to pay the money and then to kind of roll the dice and see what happens. Now, that’s what we’re going to talk about today. But before we talk about the new Andrew (03:37) Mm-hmm. Mm-hmm. Bill Gasiamis (03:58) research that has come out, the PESTO trial research. Before we talk about that, we’ll briefly talk about your condition, where you started. We’ll have a real short version of that, where you started, what happened, and then how you ended up overseas experiencing Dr. Tobinick’s procedure, and then update us on what happened in the last 18 months. Andrew (04:17) Okay, so I had my stroke exactly four years ago last Thursday. So I’m a four year old stroke survivor now. And my most damage was done to my right side. So I had no use of my right arm or hand at all. My right leg was weak, but it was okay. But my right foot just fell. I had a slight speech impediment. But otherwise physically that was really it for the stroke. And I worked really hard to get myself walking again as quickly as I could. And so when I got home I could walk but I’d had an elastic extension on my shoe to help keep my foot up. And I… From that moment, I was looking for ways to complement my rehab to help me recover fully from the stroke because the doctors and people in the hospital, no one could say to me like how long, how I was going to be, how much recovery, what I could expect, like anything. was just everyone’s unique. And I understand that, but there was a ⁓ lack of like hope from their perspective. So the first thing we did when we got me home was I’d heard, well, I knew that hyperbaric chambers helped healing. And I knew that because I had a, previously had a brain tumor and I used hyperbaric to help me heal from that. It was really, really good. So we hired one, we rented one for three months and had a soft shell chamber at home, which I went in every day. for 90 minutes and it was fantastic. I can’t say how, if that physiologically helped because I don’t have access to an MRI at home or anything. Yeah, I can’t measure it, but it did wonders for my mental health. Like it was brilliant because for an hour and half every day, I got to sit in this nice warm cocoon shell, they do not over me. Bill Gasiamis (06:01) You can’t measure it. Exploring Treatment Options Andrew (06:15) and listen to really nice music and breathe in almost, you know, pure, very heavily oxygenated air. And so it was like meditation for an hour and half. And the hour and a half went just like that. It was so quick. And I was really sad to have to, you know, give it up after three months. But yeah, it very much helped with my mental health during that time. And I mean, It’s hard to say if it helped me physically, but I certainly got back my ability to move my foot. My arm was another beast though, and that took a long time. That took about two months before it even moved slightly before I could just, you know, move it up and down. So getting back the function of my arm was a longer process. So I kept researching online and finding, you know, other ways that I could help myself to recover. That’s when came across the 60 minutes interview with Dr. Tobinick and the clinic and the lady from Australia. Bill Gasiamis (07:17) Which by the way, 60 minutes has taken down. You can only find that on Dr. Tobinick’s YouTube channel now. Yeah, right. So that’s interesting just as a thing that I observed that people might find interesting as well to hear. It doesn’t mean anything perhaps. Andrew (07:24) really? Interesting. Yeah, I mean, yeah, can be anything anyway, so I found that I watched it. I was really really inspired and I thought well I’ve got to know that I have tried everything like if this is how I’m going to be and this was After one year and I was told that you know after three months or That pretty much what I had after three months was was how I was going to be so I figured after one year, I’ve got to try everything. And so I crowdfunded and had about 30 or 1000. Bill Gasiamis (08:13) You raised how much? US, New Zealand dollars. Andrew (08:22) Yes, so that was to that was to fly that was for the flights accommodation the shots like the whole the whole package And yeah, and we flew out in in February Last last year 2025 Was it last year? can’t remember Bill Gasiamis (08:37) I did 20, 24, 18 months ago. Stroke Etanercept Injection And It’s Impact Andrew (08:40) 2024. And yeah, had the shot and it was it was amazing how fast I found things start to to wake up and recover. By then I had had more movement in my arm, but my hand was very sluggish. And I really didn’t have any fine motor control at all. ⁓ So yeah, that was the 32nd story of Andrew’s stroke recovery. Bill Gasiamis (09:04) Yeah, that’s a cool story. So we did a full deeper dive interview for Andrew’s story, an hour and 18 minutes worth of conversation. And the link to the original interview with Andrew about Etanercept will be available in the show notes, right, and in the YouTube description of this video. So anyone who wants to go back and watch that can do that as well. Now, like I said, it’s had 19,000 views. It’s 521 likes and it has just a ton of comments, just a ton, a ton of comments. Now, one other thing that has happened since then is I haven’t been able to find people who are willing to talk about Etanercept who did not have positive results when they went to Dr. Tobinick’s clinic. just, people don’t want to be interviewed if it’s about that. It seems as though it’s been really hard, right? So. I can’t give this balanced view of here’s somebody who has had good results, here’s somebody who hasn’t had results. They comment on the YouTube comments and they send me emails about it, but they don’t really tell me whether or not they will join me on the podcast to discuss it properly. recently the Griffith University study came out about Perispinal Etanercept and it had some positive results. It didn’t find that it was able to help restore certain functions, et cetera, but it did have an impact on pain relief for some people. Now, after that, the highly anticipated study was the one from the Flory Institute here in Australia called the PESTO trial. I’ll share my screen and I’ll put it on the screen while we chat about it, right? We’re gonna chat about what if. what it found, Andrew, just so that we can bring people up to speed so they can just hear a conversation about it. Bill Gasiamis (10:50) We’ll be back with more of Andrew’s story in just a moment, but if you’re listening right now and you feel stuck, want you to hear this clearly. Recovery isn’t a three month window. It’s not even a one year window. Your brain can keep adapting for a long time. And the real challenge is learning how to keep hope without putting all your hope in one thing. In the second half of this episode, Andrew shares what actually lasted 18 months on. What still improved over the time. And we’ll talk about the biggest question. If the PESTO trial says the Etanercept shouldn’t work better than the placebo, then why do some people still report a night and day difference? Bill Gasiamis (11:30) OK, so this is the PESO trial. Now, I interviewed recently ⁓ Vincent Thijs the doctor who headed the study. but the Flory Institute is basically reporting on his findings. He has presented these findings at stroke conferences around the world. And what was interesting was that this study started in, I think, 2018. And then because of COVID had to be paused, amongst other things. And then finally, all the research was reviewed and it became available at the beginning of 2025. And then it’s been out probably for about seven or eight months now. Stroke Etanercept Injection Research Findings and Controversies And what they found was that the, and they’re being a little bit provocative here calling it a miracle cure, but what they found was that a perispinal etanusept, the arthritis drug, ⁓ was not effective in treating people that were experiencing symptoms because of a stroke anymore. than the placebo. So what they found was that the people on the placebo who ⁓ received the placebo, 56 % of them had a positive result from the placebo as opposed to less than 56 % of people who were actually using the Etanusept. And the reason being, they say, is because the drug doesn’t have the capability of crossing the blood-brain barrier to get to where the ⁓ inflammation is and to actually ⁓ decrease the inflammation. In arthritis, for example, the inflammation is in the joints, which are not part of the brain. There is no blood-brain barrier or some barrier that stops the atanasip from going there. And therefore, when people get injected to experience relief from ⁓ the symptoms of rheumatoid arthritis, they do experience that relief sometimes almost immediately, et cetera. And ⁓ as a result of that, the guys published the study and basically concluded that it is not effective and more research needs to be done to understand why or why not it works for some people and why it doesn’t for others. And I’ve had a couple of kind of ideas since then. And I’ll stop sharing my screen now because we can go back to just you and I, Andrew. And I’ve had some ideas as to how do I then talk to people about that, right? So I know I’ve interviewed Andrew, five other people that I’ve interviewed at least who said they had a positive result. And I should tell people there’s people who had a positive result, right? And then there’s the other people on the other side of the spectrum, which are really hostile saying like, it’s snake oil. My idea is that even if you go there and you receive Etanercept and it works when it’s not meant to and it’s just a placebo working because you’ve got high expectations of it working. You need it to work. You’ve invested $30,000. You you’ve traveled half a way across the world. Even if it works and it didn’t cross your blood brain barrier, to me, that’s a tick, right? That’s like. It worked fantastic. People improve their function. They got their life back. The body is very powerful. It can achieve amazing things. Who cares how it did that? A B, your blood brain barrier might be compromised. So there is a thing called leaky gut. We’ve heard about leaky gut. It is a compromised gut barrier which allows toxins to escape the gut and get into the blood. and causes a lot of autoimmune conditions. The same thing is possible for the blood brain barrier. If you’ve got a really compromised blood brain barrier because you’ve had a stroke or you’ve had brain surgery or something like that, it’s possible. Andrew (15:47) we’ve had radiation therapy, which I have. Bill Gasiamis (15:50) or you’ve had radiation therapy because of previous medical conditions, et cetera, then there could be a more permeable blood brain barrier, which enables the Etanercept to actually penetrate it and get to the root cause of the stroke inflammation or the root location of the stroke inflammation. And therefore, some people through no… ⁓ you know, through no fault of their own, I either have a really healthy blood brain barrier and Etanercept can’t cross it or have a compromised blood brain barrier and Etanercept can cross it. And therefore they experience positive results. But the issue then is how do we know? How can we work that out for people, you know, before they go and drop 30 grand on a treatment that they may not get a result for. Now. That’s my thinking about it, right? But I still send people to you and I still send you these studies as they come up, just so that I can say, Andrew, I need your feedback. I need you to talk to me. I need you to tell me something. Like, where do you stand on all of this? I’m going to keep sending people to you who reach out to me to speak to Andrew because they’re interested. So like, how does that conversation go in your head and then with the people that you connect with? Andrew (17:09) Okay, so having having been a teacher, career teacher, I’m really careful of what I advise people like I would be really careful what I advise my students. So I never say to people, yes, you’ve to do it because it worked for me. God, do do it, do drop it again. I never ever say that I tried to give them the balance for you. And and even though it worked for me, I make sure it’s I’m very clear that they understand that it worked for me, but it might not work for you. Conversations with Other Survivors So you’ve got to go like I did and don’t go with any expectations. Just go, just know that you’ve tried everything you can to help your recovery. That’s all. And so that’s how that conversation usually goes. They ask me lots of questions about what it feels like, what the place is like, what Dr. Tobinick was like. just all the sort of the mechanical questions around it. But generally, it’s, I don’t know whether I should go. And it’s also, I want to go, but my family don’t want to go. And I can’t go because they don’t support me, because they think it’s snake oil. Bill Gasiamis (18:18) Okay, that’s an interesting conversation. So I often try and advise stroke survivors to be careful who they share information with. Not saying that you shouldn’t share information with your loved ones and your family members after a stroke. What I’m saying is like, even in situations where things are not that critical, where you’re not talking about spending 30 grand, I’m just talking about people who have the experience sometimes Andrew where they say, oh, I wanna try this meditation thing, you know, and. somebody hasn’t meditated before, thinks it’s woo woo and says, don’t worry about that stuff. What do you wanna be? Like a hippie or something? There’s those types of people who hang out in our world who do intervene with things that we’re curious about and we wanna kind of shift away from perhaps old habits to new habits, especially around alcohol as well. I found that people would go, aren’t you gonna have one drink? Like what’s the point of going out if we can’t have a drink? It’s like, dude, like I’m a completely different version of myself. I’ve had a stroke, I can’t drink. But understanding how to deal with people like that is a bit of an issue. So then you’ve spoken to about 50 people who have either gone or not gone. Like have some people gone and contacted you and said it worked and some people gone and contacted you and said it hasn’t worked. Andrew (19:40) Yes. Yep. And I’ve. The contact normally starts to go quiet once they actually go, whether it works or doesn’t work. And I usually just get a quick message saying, hey, I went and it worked and that’s great. And, you know, have a good life. You know, I don’t want to keep bugging them. But the people that it didn’t work for have been pretty gutted. Bill Gasiamis (20:03) Right. Andrew (20:04) Because I’ve, you know, even though I’ve tried not to make it something they hang all their hopes on, you know, they still do to a certain extent. And so they come back pretty, not bitter or angry at me, just at the situation, that it didn’t work. And they don’t know where to turn next. Bill Gasiamis (20:22) So they might’ve had all their hopes kind of set on this working, all their eggs in one basket, so to speak, didn’t work and now they feel like maybe they’ve lost hope or they haven’t got another alternative or option. Andrew (20:35) Yeah, yeah. And what I’ve learned in the last 18 months is that your stroke recovery doesn’t stop. There’s no end date. So when you’re told in hospital that after three months that’s what you’ve got, no, no. doesn’t, like your brain is constantly evolving and working and learning and repending itself. If you want to work something and exercise something and rehab part of your body, eventually it’s going to improve. Even if it’s only by a little bit and it’s really slow, it’s going to improve. Bill Gasiamis (21:09) Yeah. So you’ve been 18 months down the track. One of the questions I got asked recently was, does the procedure need to be repeated every couple of years? Does it last? What have you found about how you have changed or experienced your body in the last 18 months? ⁓ Tell us first what you got back and how quickly and then what that led to, what you were able to achieve as a result of what you got back. Andrew (21:34) Yeah, okay. So, um, immediately the things that came back is is that my cognitive fatigue like just just lowered like straight away. Um, and I was when I had the shot, I was exhausted because they take it through a battery of tests. So I like was an hour and a half of tests. And so I was I was done. I was ready to go lie down. Um, And that just lifted like straight away and it didn’t come back. I still get cognitive fatigue now, but I really have to be doing stuff that that really taxes my brain to do it. And or I have to be really tired. But before I had the injection, I would get I would be on the verge of fatigue all the time. So it wouldn’t take much to push me over into it. So that was gone. I had a ⁓ really nasty cramp in my right calf that never went away. That went away. That literally just dialed down as I was sitting there after the shot. the emotional control also came back. Bill Gasiamis (22:42) Uh-huh. Andrew (22:43) which was good. Now, for me, I was, for the first shot, I was only in Florida for 24 hours. So we flew down from Memphis and I had the shot the next day and then we flew back that afternoon. So when we flew down, because of my cognitive fatigue and sensory overload, I had eye mask, had noise-canceling headphones, had like, lorazepam in my pocket. Like, you know, I had all the, you know, all this stuff to, you know, save my senses. When we flew back, I didn’t need any of it, and that was 24 hours later. So I just stood in the airport like any other traveler. And that was… Reflections on Stroke Etanercept Injection Treatment and Guilt Bill Gasiamis (23:26) Yeah. Andrew (23:28) That was the biggest sign that something profound had happened. Bill Gasiamis (23:33) Yeah. Andrew (23:34) The other thing was that my hand, my right hand went from feeling like it was sort of like moving in molasses really slow to loosening up and being more independent. And I found only a month ago that I was able to start to play scales on my clarinet again. So I can move my fingers independently. I could cover the holes with my clarinet here. Bill Gasiamis (23:52) Wow, man. Andrew (23:57) I can the holes in my fingers. It’s something that I haven’t been able to do since the stroke. To be able to play the thing, to be able to just play a scale, just says to me, at some point in the future, you’re gonna be able to play the thing again. Bill Gasiamis (24:11) So things are still improving. Your function is changing still. you, being able to play the clarinet, would you can attribute that to a tenor sept that long ago or just things getting better? Andrew (24:26) I think because it was if I come home and was able to play the clarinet then I would have a definite causality you know so I would rather say the definite yeah it was a tenor step that did it because before I went away I couldn’t even you know I couldn’t pick up things one more right hand so but because it’s been 18 months I think it’s because that that skill has come back Bill Gasiamis (24:50) Yeah, okay. What about work wise? Were you working or not working before the injection? Andrew (24:57) No, no. So I was able to go back to relief teaching. The classroom as a music teacher is ⁓ in a high school is too busy and there’s too many moving parts. So that’s not something I’ll be able to do again, at least not in the foreseeable future. And I don’t know if I want to now. Bill Gasiamis (25:11) Wow. Andrew (25:20) I have done some relief teaching. There are days where I’m in a school and I just feel that it’s a bit too much. And that could be because I had a bad night the night before or it was hot and I couldn’t sleep. And that wasn’t like that before the stroke. yeah, coming up with a new career now has been an interesting journey itself. Bill Gasiamis (25:41) Yeah. So there isn’t a need for another injection or anything like that. Nobody ever told you about another injection or what will happen in two years or anything like that. Andrew (25:51) No, If I can go there and get one, if I think it’s going to make even more improvement, because I had improvement from, you know, from the first. But yeah, there was no compelling sort of needs to go back. And I’m thinking that I probably would like maybe to have a second one, a second trip there and have. having the shot but ⁓ I don’t know I’ll see how my improvement goes. Bill Gasiamis (26:20) Yeah, okay. Andrew (26:22) It’s so hard to One of the things I did do, I had an MRI about two months ago. And it was an MRI to check the status of my tumor and to see where it was. And obviously they also had a look at the stroke site. And comparing the stroke site now to when it was taken when I had the stroke. there’s a day and night difference. Whereas I had a hole in my brain after the stroke, all I had was a little bit of glial, called glial scar tissue. So scar tissue of the brain cells, a little white line in my brain. ⁓ Bill Gasiamis (27:08) as opposed to a round circle of what appeared to be offline or dead brain cells. Yeah, which, you know, it sounds like to me, it’s like where the inflammation was, that area they usually call, they often call, sometimes called the penumbra, which is the area that’s able to be rehabilitated, which is around the site of the stroke, which is offline but not dead, which HBOT targets, the right kind of, Andrew (27:15) Yes. Yeah. Bill Gasiamis (27:38) hyperbaric oxygen therapy can target those as well and try and reduce them. So day and night, like a proper difference between one and the other. Andrew (27:47) Yeah, I was expecting to see when I saw the scan, know, where my brain tumor was and also the big hole and the hole was gone and there was just this like, this is a little, a little line there with scar tissue. Bill Gasiamis (28:01) Yeah, fabulous. How long has the brain tumor been there for? Andrew (28:05) 20 years. Bill Gasiamis (28:07) Okay, and what does it do just sort of sit around and ⁓ Andrew (28:10) Yeah, so ⁓ what happened is it just gradually grows bigger and bigger and bigger and then eventually if you don’t get it treated, it crushes your brain stem and that kills you. So I had mine irradiated 20 years ago and it’s got growing and it’s just started dying off and now it’s just like a… dead mess in there and they check every four years to make sure it hasn’t done anything naughty and It hasn’t so they actually said of this last scan look it hasn’t changed in the last 12 years, so no more scans Bill Gasiamis (28:41) I hear you, okay. So it’s benign now. Andrew (28:46) Yeah. Bill Gasiamis (28:47) Yeah, okay. So you’ve through the rigor, mate. You’ve had an interesting neurological experience, Andrew (28:54) Yeah, yeah, yeah, yeah, feels like my brain’s out to get me. Bill Gasiamis (29:00) Yeah. Well, seems like the interventions have been really helpful in prolonging your life and then your life experience, like how you go about life. So as far as you’re concerned, like it’s all it’s all. You know, it’s been a good outcome, both both interventions. Andrew (29:19) Yes. Yeah. Yeah, I think so. I mean, my biggest challenge this year has actually not been the stroke or the brain tumor, but it’s been the medications for stroke to prevent another one. So my stroke was caused by an overactive adrenal or adrenal glands producing too much aldosterone. Bill Gasiamis (29:31) What man which man say you want? Andrew (29:43) And that was only diagnosed and found last year. So What was happening is that my body was? Was was keeping salt it was it was send my blood pressure sky-high and then crash it down And for 10 years we thought that was anxiety. But what it was was that because my blood pressure wasn’t consistently high, I could go to the doctors and I could be normal. And then my other doctors didn’t have high blood pressure. It was not consistent. So I was just treated for anxiety and given a sort of a low dose blood pressure medication. But actually what it was is both glands like over producing this hormone and that’s what gave me the stroke. So they’ve they’ve given me a hormone suppressant which helps, but they’ve been trying to. to juggle multiple types of blood pressure medication to also bring my blood pressure down to a consistent normal. And so up until about three weeks ago, my blood pressure was still all over the place. And they had me on a really nasty cocktail at one point this year where I literally could not function. I couldn’t even get up. It suppressed my whole system so much. that every time I stood my blood pressure would drop 50 points and I would almost pass out. So I was like a zombie. ⁓ It was just the combination of too many blood pressure medications at once. And finally, I’ve seen a different specialist and he changed my medication and I’ve just got one little pill at the minimum dose and it’s actually stabilized my blood pressure to normal. Bill Gasiamis (30:51) All right. Righto, that’s good. Andrew (31:18) So like when I took it today, was 122 over 72. So it hasn’t been like that for I don’t even know how long. Bill Gasiamis (31:25) Yeah. Fantastic, what kind of stroke did it cause? Andrew (31:31) are ischemic, so a clot. Bill Gasiamis (31:34) ⁓ huh, okay. Wow, man. What an interesting journey you’ve been on. And this insight into Etanercept and how and why it might work for some people and not for others is probably helpful for it again, for a whole bunch of people to hear and kind of get a better understanding about scientifically speaking, Etanercept is not a viable solution for people who have had stroke and there will be some people who will become all, what’s the word? Like they will, they’ll be all, this is snake oil stuff. And then there will be people who brag about it as being the best thing they’ve ever done, which seems to be kind of the camp that you’re in. I think, no, no, no, no. I mean, it’s one of the best things you’ve ever done with regards to your stroke recovery, right? Andrew (32:18) I don’t feel like complaining about it though. Yeah, yeah, and I found that when I got the results for the for the pesto test I really had to do a lot of soul searching because because I couldn’t explain to myself Why it seemed to have worked for me and yet the study was saying hey, doesn’t really have any effect and and I had to to Bill Gasiamis (32:36) Wow. Did you feel remorse or guilt about that? Wow, Wow. Andrew (32:47) Yes, very much. I felt like a fraud. Because why? I couldn’t explain how I had such a huge night and day difference. And that couldn’t be placebo and it’d be still working 18 months later. Bill Gasiamis (33:08) Yeah, I think our hunch about the blood brain barrier is where the research needs to go. And I don’t know how you investigate the blood brain barrier. But if you can go there and investigate the blood brain barrier and if you can understand who has a compromised blood brain barrier and therefore. Andrew (33:15) Yeah. Bill Gasiamis (33:31) due to a compromised blood-barrier barrier, a candidate for a Etanercept I think that’s kind of where it needs to go. Because the biggest issue that people have with clinics who offer a Etanercept perispinally, like Dr. Tobinick’s, the biggest issue that people have that makes it hard for them to make a decision is will I be the right candidate? Will I be the one who will it work for? Or will I be the one that it doesn’t, you know? But I… I find it very fascinating that you would respond that way, that you would feel guilty and remorseful that it worked for you and the pesto child says it shouldn’t have. Andrew (34:10) I feel guilty that it worked for me and didn’t work for someone else. You know, as well. Yeah, yeah, I mean, it’s like survivor’s guilt in a way. Yeah, that’s that and that’s how I felt. so the way I’ve thought of it is, well, OK, if it was placebo, it worked for me. Bill Gasiamis (34:14) Yeah. just wishing for the best for everybody. Yeah, I can relate to that. Yeah. Andrew (34:37) like it just it worked for me whatever it was it worked for me so and that’s that’s that’s all I can all I can say but I think this blood brain theory is is a good one and I would like to I would like to research and understand what what makes the brain leaky like what what events can make your brain Bill Gasiamis (34:41) Yeah. Yeah. Andrew (35:00) ⁓ better suited to receiving Etanercept Like for me, probably the main cause could have been the fact that I had radiation on my brain years ago. Bill Gasiamis (35:05) Yeah. Andrew (35:13) Or it could be that I have a high blood pressure for 10 years. Or it could be I have my appendix out when I’m 17. But I would like to do some research into what it is, what factors make people more likely to have a leaky brain. Bill Gasiamis (35:17) Who knows? Yeah, I think that’s a great thing. I want to research that too, because I have known about it. I’ve understood it. I appreciated that I might be somebody who has had a leaky brain because of the strokes that I experienced, the brain surgery and all the stuff that I went through. And I know that if you restore the blood brain barrier, you can really decrease the fatigue that happens to people after a stroke. And you can make it impenetrable again to toxins. and heavy metals and all that kind of stuff, which is often the cause of real chronic neurological fatigue, even in people who haven’t had a stroke, who are, quote unquote, normal. So that’s fascinating. I really appreciate your continued willingness to have conversations about this topic and sharing your story more than once with me. And then also being being an ear to the people who are curious about whether or not they should go down this path and then kind of just like, you know, being honest about your story, sharing what happened to you, what you experienced and even your own reservations because I don’t think you have anything to, and you probably know this cognitively anyway, right? You don’t have anything to be guilty about or feel bad about or. anything like that. But I understand why emotionally you might go down that path because you’re a guy that cares deeply for other people. You appreciate how hard it is for people to go through stroke and you wish them the same solution or other solutions that you had so that we don’t have to suffer. I know exactly what’s behind it. Andrew (37:08) Yeah, yeah, that’s exactly right. Yeah. Bill Gasiamis (37:12) Yeah. Well, hopefully this continues the conversations to give people more things to think about. Leave us a comment in the YouTube comments section. Reach out via email. Yeah, drop us a comment. Reach out to us and we’d be happy to continue the conversation, support you, guide you. Just being here and I don’t know, help you make a more informed decision. That’s all we can do. We’re not going to suggest. Andrew (37:35) Yeah, definitely. Bill Gasiamis (37:41) that you should or should not go and experience Perispinal Etanercept one way or another. Bill Gasiamis (37:46) Well, that was Andrew Stopps again. What a fascinating conversation. If today’s episode connected with you, I’d love to hear your thoughts in the YouTube comments, especially if you’ve looked into Etanercept Try it. I decided not to. Your experience can help someone else make a more informed decision. And if you found this helpful, please subscribe on YouTube and follow the podcast on Spotify or Apple podcasts. Reviews and comments genuinely help more. stroke survivors find these conversations. If you want to go deeper, you can grab my book at recoveryafterstroke.com slash book. And if you’d like to support the podcast and help keep it going, you can join us on Patreon at patreon.com slash recovery after stroke. Thanks again for being here. You’re not alone in this recovery journey and I’ll see you in the next episode. The post Stroke etanercept injection 18 months on: Andrew's update after the PESTO trial appeared first on Recovery After Stroke.

In this My DPC Story Patreon episode, Dr. Ashlee Hendry of Mid South DPC in Petal, Mississippi, for an inspiring update on her Direct Primary Care journey. Nearly four years after her clinic's rapid growth, Dr. Ashlee Hendry discusses the evolution of healthcare access in her community, the power of patient advocacy, and the impact of price transparency. She shares invaluable business tips on scaling her practice, hiring staff, and navigating financial decisions like raising membership fees. Listeners will hear how social media - especially a viral TikTok on MRI and maternity cash pricing - has recently helped expand awareness (and in some cases enrollment!) of DPC nationwide. Dr. Ashlee Hendry also opens up about balancing motherhood with entrepreneurship and details her vision for a direct imaging center to further disrupt traditional healthcare barriers. Tune in for actionable advice on starting, growing, and marketing a DPC clinic, plus insights for medical students, residents, and physicians seeking burnout relief and sustainable careers in direct care. Whether you're opening your first practice or expanding, this episode is full of practical wisdom, business strategies, and motivation for the future of primary care.VOTE HERE for My DPC Story in as many categories in the Doctor Podcast Awards! Vote HERE for My DPC Story in as many categories as you want today!Support the showVOTE FOR MY DPC STORY! Help My DPC Story and DPC get more visibility by voting for My DPC Story in the Doctor Podcast Awards (voting closes Dec 29th)! Become A My DPC Story PATREON MEMBER! SPONSOR THE PODMy DPC Story VOICEMAIL! DPC SWAG!FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

You hurt your knee, got an MRI, and the doc says surgery might help. What to do? How Marcus assessed Mark's situation, and what he recommended instead. Sponsor: LMNT drinklmnt.com/marcusfilly Look good, move well - try Functional Bodybuilding free with a 2 week trial of my Persist training program: https://functional-bodybuilding.com/persist/

Thank you for joining us for our 2nd Cabral HouseCall of the weekend!   I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks…   Sophie:  Hi Stephen, I really appreciate all that you do and I was hoping you would be able to give me some much needed guidance. I was diagnosed with ventricular tachycardia last year and the only explanation the consultant could provide was it was due to a tiny scar on my heart. I had a ultrasound & an MRI and the results were fine, and my heart was structurally sound. I have taken the big 5 and nothing was out of the ordinary apart from high cortisol at night and candida. I consequently completed the CBO last year. I am currently on beta blockers to control the fast/erratic heartbeats. These do not work all the time. The consultant said my only other option is for them to preform an AF abrasion. What are your thoughts on this procedure, as I really want to get off the beta Blockers and find a natural alternative to fixing my heart. I have heard you talk about how Enzymes are good for the heart, is there one in particular that would help or anything else I can try? I really do not want to have the abrasion or carry on with the BB and am desperate to find a natural solution to fixing my symptoms. I am taking omega 3, magnesium-complex, VD + K2, vitamin c, b-complex, hawthorn, zinc, coq10 & taurine, is there anything else I should be taking to help. When my symptoms are at there worst, I get a big rush to the head and black out for a few seconds, whilst shaking. I have a clean diet, and do not smoke and have cut out alcohol, coffee & sugar, as I find any stimulant does not help, including over exercising. Please help, any advise would be greatly appreciated.                                                                                                                                                                                Anonymous: Hi Dr. Cabral! Over the last year my cycle has gone from 28 days to 23–24 days, and my PMS symptoms have gotten extreme—like night sweats, heavy emotions, breast tenderness, and migraines right before my period. I'm only 34, so perimenopause feels early. Could this be stress-related, estrogen dominance, or something deeper? Thank you for all you do!                                                                                                                                                                                                   Sarah: Hello dr C! Curious if you're familiar with the eating disorder Avoidant Restrictive Food Intake Disorder (ARFID)? I suffered with it from the age of 2 until 20 - eating nothing other than 2 "safe" foods which were very processed. I'm now 29 and can happily say I no longer suffer with this ED after years of work and eat ALL the foods (all healthy, organic, wholefoods). I'm worried if having this ED for this length of time and during my developing years has permanently impacted my health, specifically my digestion and my gut microbiome. I've drastically changed my life around, have done a bunch of your testing and protocols but still dealing with some issues and curious if my past means i'll never be able to reach optimal health? How resilient is the body?                                                                          David: Hello Dr. Cabral, appreciate your work and dedication. I've been experiencing persistent muscle twitches throughout my body for about six months. My doctor says magnesium levels look "normal," but I know that doesn't always tell the full story. Could this be related to electrolytes, stress, or a nervous system imbalance? Any suggestions on testing or protocols to help calm the twitches would be appreciated.     Tommy: Hi Dr. C, I'm so frustrated. I had a gut issue for a long time and only the healthy belly product kept it at bay. Stool test showed citrabacter Freudi which I ran before I had the digestive issues. I did 2 para protocols, then the CBO, and dealt with frequent urination all the way through. By week 8, my bowells were much better and things had improved, however, I had to stop the protocol there as I couldn't handle the supplements at a lower dose. 2 weeks later I picked up a stomach bug, and since then I'm back to square one. I'm working on CBT because I have a lot of trauma and I believe that's why I've been so succeptible to stomach issues. I'm considering another stool test but the only issue is, what can I do about the result if I can't handle so many herbs and supplements I feel stuc   Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right!   - - - Show Notes and Resources: StephenCabral.com/3607 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter In this "Ask Me Anything" (AMA) episode, Peter tackles a wide-ranging set of listener questions spanning lifespan interventions, exercise, cardiovascular risk reduction, time-restricted eating, blood pressure management, hormone therapy, diagnostics, and more. Peter reveals the single most important lever for extending healthspan and lifespan, and explains how he motivates midlife patients using the Centenarian Decathlon framework. He discusses the importance of addressing high apoB and cholesterol even in metabolically healthy individuals with calcium scores of zero, how to manage high blood pressure, and how to accurately evaluate metabolic health beyond HbA1c. Additional topics include time-restricted eating, practical considerations around ultra-processed foods, nuanced approaches to HRT for women and TRT for men, and why early and expanded screening for chronic disease—colonoscopy, PSA, coronary imaging, low-dose CT—can be lifesaving. He also offers insights into treating prediabetes, crafting exercise programs for those short on time, and safely incorporating high-intensity training in older adults. If you're not a subscriber and are listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #78 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Introducing a wide-ranging AMA: practical perspectives on lifespan interventions, metabolic health, diet, hormones, diagnostics, and more [2:45]; Why exercise is the most powerful single intervention for lifespan and healthspan [4:15]; How Peter motivates midlife patients to prioritize exercise [6:00]; Why lifespan and healthspan should not be treated as competing priorities and how choosing sustainable interventions benefits both [9:30]; Why high apoB deserves treatment even in a metabolically healthy patient with a CAC score of zero [14:00]; Managing hypertension: ideal targets for blood pressure, lifestyle levers, and why early pharmacology matters [18:15]; Assessing metabolic health beyond HbA1c: fasting insulin, triglycerides, lactate, zone 2, and more [23:30]; How to avoid common self-sabotaging patterns by choosing sustainable habits over extreme health interventions [26:00]; Time-restricted eating: minimal effect beyond calorie control, implications for protein intake, and practical considerations for implementing it [28:00]; Ultra-processed foods: definitions, real-world risks, and practical guidelines for smarter consumption [30:30]; How women should prepare for menopause and think about hormone replacement therapy: early planning, symptom awareness, and guidance on HRT [36:45]; Testosterone replacement for aging men: indications, benefits, and safe clinical management [39:45]; Why Peter recommends earlier and more aggressive screening tests than guidelines suggest: colonoscopies, coronary imaging, PSA, Lp(a), and low-dose CT scans, and more [43:30]; Full-body MRI screening: benefits, limitations, potential false positives, and the importance of physician oversight [47:15]; Prediabetes: individualized treatment strategies using tailored combinations of nutrition, sleep, and training interventions [51:00]; Time-efficient training plans for people with only 30 minutes per day to exercise [53:00]; How to safely introduce high-intensity exercise for older adults [55:00]; Timed dead hangs and ripping phone books: a playful look at Peter's early attempts to impress his wife [57:15]; Peter's carve out: The Four Kings documentary about a golden era of boxing [1:01:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube