Podcasts about naion

Optic neuropathies encompass all congenital or acquired conditions affecting the optic nerve and are often a harbinger of systemic and central nervous system disorders. A systematic approach to identifying the clinical manifestations of specific optic neuropathies is imperative for directing diagnostic assessments, formulating tailored treatment regimens, and identifying broader central nervous system and systemic disorders. In this episode, Gordon Smith, MD, FAAN speaks with Lindsey De Lott, MD, MS, author of the article “Optic Neuropathies” in the Continuum® April 2025 Neuro-ophthalmology issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. De Lott is an assistant professor of neurology and ophthalmology at the University of Michigan in Ann Arbor, Michigan. Additional Resources Read the article: Optic Neuropathies Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @gordonsmithMD Guest: @lindseydelott Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Smith: Hello, this is Dr Gordon Smith. Today I'm interviewing Dr Lindsey De Lott about her article on optic neuropathies, which appears in the April 2025 Continuum issue on neuro-ophthalmology. Lindsey, welcome to the podcast, and perhaps you can introduce yourself to our audience. Dr De Lott: Thank you, Dr Smith. My name is Lindsey De Lott and I am a neurologist and a neuro-ophthalmologist at the University of Michigan. I also serve as the section lead for the Division of Neuro-Ophthalmology, which is actually part of the ophthalmology department rather than the neurology department. And I spend a good portion of my time as a researcher in health services research, and that's now about 60% of my practice or so. Dr Smith: I'm super excited to spend some time talking with you. One, I'm a Michigan person. As we were chatting before this, I trained with Wayne Cornblath and John Trobe, and it's great to have you. I wonder if we maybe can begin- and by the way, your article is outstanding. It is such a huge topic and it was actually really fun to read, so I encourage our listeners to check it out. But you begin by talking about misdiagnosis as being a common problem in this patient population. I wonder if you can talk through why that is and if you have any pearls or pitfalls in avoiding it? Dr De Lott: Yeah, I think there's been a lot of great research looking at misdiagnosis in specific types of optic neuropathies; in particular, compressive optic neuropathies and optic neuritis. A lot of that work has come out of the group at Emory and the group at Washington University. But a lot of neuro-ophthalmologists across the country really contributed to those data. And one of the statistics that always strikes me is that, you know, for example, in patients with optic nerve sheath meningiomas, something like 70% of them are actually misdiagnosed. And a lot of those errors in diagnosis, whether it's for compressive optic neuropathy or some other type of optic neuropathy, really comes down to the way that physicians are really incorporating elements of the history in the physical. For example, in optic neuritis, we know that physicians tend to anchor pretty heavily on pain in general. And that often tends to lead them astray when optic neuritis was never the diagnosis to begin with. So, it's really overindexing on certain things and not paying attention to other features of the physical exam; for example, say presence of an afferent pupillary defect. So, I think it just really highlights the need to have a really relatively structured approach to patients that you think have an optic neuropathy when you're trying to sort of plan your diagnostic testing and your treatment. Dr Smith: I do maybe five or six weeks on our hospital service each year, and I don't know if it's just a Richmond thing, but there's always at least two people in my week who come in with an optic neuropathy or acute vision loss. How common is this in medical practice? Or neurologic practice, I should say? Dr De Lott: Optic neuropathies themselves… if you look across, unfortunately we don't have any great data that puts together all optic neuropathies and gives us an actual sort of prevalence estimate or an incidence estimate from year to year. We do have some of those data for specific types of optic neuropathies like optic neuritis and NAION, and you're probably looking around five-ish per one hundred thousand. So, these aren't that common, but at the same time they do get funneled to- often to emergency rooms and to neurologists from our ophthalmology colleagues and optometry colleagues in particular. Dr Smith: So, one other question I had before kind of diving into the topic at hand is how facile neurologists need to be in recognizing other causes of acute visual loss. I mean, we see acute visual loss as neurologists, we think optic neuropathy, right? Optic neuritis is sort of the go-to in a younger patient, and NAION in someone older. But what do neurologists need to know about other ophthalmologic causes? So, glaucoma or acute retinal disorders, for instance? Dr De Lott: Yeah, I think it's really important that neurologists are able to distinguish optic neuropathies from other causes of vision loss. And so, I would really encourage the listeners to take a look at the excellent article by Nancy Newman about vision loss in this issue where she really kind of breaks it down into vision loss that is acute and chronic and how you really think through distinguishing optic neuropathies from other causes of vision loss. But it is really important. For example, a patient with a central retinal artery occlusion may potentially be eligible for treatments. And that's very different from a patient with optic neuritis and acute vision loss. So, we want to be able to distinguish these things.  Dr Smith: So maybe we can pivot to that a little bit. Just for our listeners, our focus today is going to be on- not so much on optic neuritis, although obviously we need to talk a little bit about how we differentiate optic neuritis from non-neuritis optic neuropathies. It seems like the two most common situations we encounter are ischemic optic neuropathies and optic neuritis. Maybe you can talk a little bit about how you distinguish these two? I mean, some of it's age, some of it's risk factors, some of it's exam. What's the framework, of let's say, a fifty-year-old person comes into the emergency room with acute vision loss and you're worried about an optic neuropathy? Dr De Lott: The first step whenever you are considering an optic neuropathy is just making sure that the features are present. I think, really going back to your earlier question, making sure that the patient has the features of an optic neuropathy that we expect. So, it's not only vision loss, but it's also the presence of an apparent pupillary defect in a patient with a unilateral optic neuropathy. In a person who has a bilateral optic neuropathy, that apparent pupillary defect may not be present because it is relative. So, you really would have to have asymmetric vision loss between the two eyes. They should also have impairment of their color vision, and they're probably going to have some kind of visual field defect, whether that's central scotoma or an arcuate scotoma or an altitudinal defect that really respects the horizontal meridian. So, you want to make sure that, first and foremost, you've got a patient that really meets most of those- most of those features. And then from there, we're looking at the other features on their history. How acute is the onset of the vision loss? What is the progression over time? Is there pain associated or not associated with the vision loss? What other medical issues does the patient have? And you know, one of the things you already brought up, for example, is, what's the age of the patient? So, I'm going to be much more hesitant to make a diagnosis of optic neuritis in a much older patient or a diagnosis on the other side, of ischemic optic neuropathy, in a much younger patient, unless they have really clear features that push me in that direction. Dr Smith: I wonder if maybe you could talk a little bit about features that would push you away from optic neuritis, because, I mean, people who are over fifty do get optic neuritis- Dr De Lott: They do. Dr Smith: -and people who get ischemic optic neuropathies who are younger. So, what features would push you away from optic neuritis and towards… let's be broad, just a different type of optic neuropathy? Dr De Lott: Sure. We know that most patients with optic neuritis do have pain, but that pain is accompanied---within a few days, typically---with vision loss. So, pain alone going on for a number of days without any visual symptoms or any of those other things I listed, like the afferent papillary defect, the visual field defect, would push me away from optic neuritis. But in general, yes, most optic neuritis is indeed painful. So, the presence of optic disc edema is unfortunately one of those things that an optic neuritis may be present, may not be present, but in somebody with ischemia that is anterior---and that's the most common type of ischemic optic neuropathy, would be anterior ischemic optic neuropathy---they have to have optic disc edema for us to be able to make that diagnosis, and that is a diagnosis of NAION, or nonarteritic ischemic optic neuropathy. An APD in this case, again, that's just a feature of an optic neuropathy. It doesn't really help you to distinguish, individual field defects are going to be relatively similar between them. So then in patients, I'm also looking, like I said, at their history. So, in a patient where I'm entertaining a diagnosis of ischemic optic neuropathy, I want to make sure that they have vascular risk factors or that I'm actually doing things like measuring their blood pressure in the office if they haven't seen a physician recently or checking a lipid panel, hemoglobin A1c, those kinds of things, to look for vascular risk factors. One of the other features on exam that might push me more- again, in a patient with ischemic optic neuropathy, where it might suggest ischemia over optic neuritis, would be some other features on exam like a crowded optic disc that we sometimes will see in patients with ischemic optic neuropathy. I feel like that was a bit of a convoluted answer. Dr Smith: I thought that was a great answer. And when you say crowded optic disc, that's the- is that the “disc at risk”? Dr De Lott: That is the “disk at risk,” yes. So, crowded optic disk is really a disk that is smaller than what we see in the average population, and the average cup to disk ratio is 0.3. So, I think that's where 30% of the disk should be. So, this extra wiggle room, as I sometimes will explain to my patients. Dr Smith: And then, I wonder if you could talk a little bit about more- just more about exam, right? You raised the importance of recognizing optic disc edema. Are there aspects of that disc edema that really steer you away from optic neuritis and towards ischemia-like hemorrhages or whatnot? And then a similar question about the importance of careful visual field testing? Dr De Lott: So, on the whole, optic disc edema is optic disc edema. And you can have very severe optic neuritis with hemorrhages, cotton wool spots, which is essentially just an infarction of the retinal nerve fiber layer either overlying the disc or other parts of the retina. And ischemia, you can have some of the same features. In patients who have giant cell arteritis, which is just one form of anterior ischemic optic neuropathy, patients can have a pallid optic disc edema where the optic disc is swollen and white-looking. But on the whole, swelling is swelling. So, I would caution anyone against using the features of the optic nerve swelling to make any type of, sort of, definitive kind of diagnosis. It's worth keeping in mind, but I just- I would caution against using specific features, optic nerve swelling. And then for visual field testing, there are certain patterns that sometimes can be helpful. I think as I mentioned earlier, in patients with ischemic optic neuropathy, we'll often see an altitudinal defect where either the top half or, more commonly, the bottom half of the vision is lost. And that vision loss in the field corresponds to the area of swelling on the disk, which is really rewarding when you're actually able to see sectoral swelling of the disk. So, say the top half of the disk is swollen and you see a really dense inferior defect. And other types of optic neuropathy such as hereditary optic neuropathies, toxic and nutritional optic neuropathies, they often cause more central field loss. And in patients who have optic neuropathies from elevated intracranial pressure, so papilladema, those folks often have more subtle visual field loss in an arcuate pattern. And it's only once the optic nerves have sustained a pretty significant injury that you start to see other patterns of field loss and actual decline in visual acuity in those patients. I do think a detailed visual field assessment can often be pretty helpful as an adjunct to the rest of the exam. Dr Smith: So, we haven't talked a lot about neuroimaging, and obviously, neuroimaging is really important in patients who have optic neuritis. But how about an older patient in whom you suspect ischemic optic neuropathy? Do those patients all need a MRI scan? And if so, is it orbits and brain? How do you- how do you protocol it? Dr De Lott: You're asking such a good question, totally controversial in in some ways. And so, in patients with ischemic optic neuropathy, if you are confident in your diagnosis: the patient is over the age of fifty, they have all the vascular, you know, they have vascular risk factors. And those vascular risk factors are things like diabetes, hypertension, high blood pressure, hyperlipidemia, obstructive sleep apnea. They have a “disc at risk” in the fellow eye. They don't have pain, they don't have a cancer history. Then doing an MRI of the orbits is probably not necessary to rule out another cause. But if you aren't confident that you have all of those features, then you should absolutely do an MRI of the orbit. The MRI of the brain probably doesn't provide you with much additional information. However, if you are trying to distinguish between an ischemic optic neuropathy and, say, maybe an optic neuritis, in those patients we do recommend MRI orbits and brain imaging because the brain does provide additional information about other CNS demyelinating disorders that might be actually the cause of a patient's optic neuritis. Dr Smith: I wonder if you could talk a little bit about posterior ischemic optic neuropathy. That's much less common, and you mentioned earlier that those patients don't have optic disk edema. So, if there's a patient who has vision loss that- in a similar sort of clinical scenario that you talked about, how do you approach that and under what circumstances do we see patients who have posterior ischemic optic neuropathy? Dr De Lott: So, you're going to most often see patients with posterior ischemic optic neuropathy who, for example, have undergone a recent surgery. These are often associated with things like spinal surgeries, cardiac surgeries. And there are a number of risk factors that are associated with it. Things like blood pressure, drain surgery, the amount of blood loss, positioning of patient. And this is something that the surgeons and anesthesiologists are very sensitive to at this point in time, and many patients are often- this can be part of the normal informed consent process at this point in time since this is something that is well-recognized for specific surgeries. In those patients, though… again, unless you're really certain, for example, maybe the inpatient neurology attending and you've been asked to consult on a patient and it's very clear that they went into surgery normal, they came out of surgery with vision loss, and all the rest of the features really seem to be present. I would recommend that in those cases you think about orbital imaging, making sure you're not missing anything else. Again, unless all of the features really are present- and I think that's one of the themes, definitely, throughout this article, is really the importance of neuroimaging in helping us to distinguish between different types of optic neuropathy. Dr Smith: Yeah, I think one of the things that Eric Eggenberger talks about in his article is the need to use precise nomenclature too, which I plan on talking to him about. But I think having this very structured approach- and your article does it very well, I'll tell our listeners who haven't seen it there's a series of really great tables in the article that outline a lot of these. I wonder, Lindsey, if we can switch to talk about arteritic optic neuropathy. Is that okay? Dr De Lott: Sure. Yeah, absolutely. Dr Smith: How do you sort that out in an older patient who comes in with an ischemic optic neuropathy? Dr De Lott: Yeah. In patients who are over the age of fifty with an ischemic optic neuropathy, we always need to be thinking about giant cell arteritis. It is really a diagnosis we cannot afford to miss. If we do miss it, unfortunately, patients are likely to lose vision in their fellow eye about 1/3 to 1/2 the time. So, it is really one of those emergencies in neuro-ophthalmology and neurology. And so you want to do a thorough review systems for giant cell arteritis symptoms, things like headache, jaw claudication, myalgias, unintentional weight loss, fevers, things of that nature. You also want to check their inflammatory markers to look for evidence of an elevated ESR, elevated C-reactive protein. And then on exam, what you're going to find is that it can cause an anterior ischemic optic neuropathy, as I mentioned earlier. It can cause palette optic disc swelling. But giant cell arteritis can also cause posterior ischemic optic neuropathy. And so, it can be present without any swelling of the optic disc. And in fact, you know, you mentioned one of my mentors, John Trobe, who used to say that in a patient where you're entertaining the idea of posterior ischemic optic neuropathy, who is over the age of fifty with no optic disc swelling, you should be thinking about number one, giant cell arteritis; number two, giant cell arteritis; number three, giant cell arteritis. And so, I think that is a real take-home point is making sure that you're thinking of this diagnosis often in our patients who are over the age of fifty, have to rule it out. Dr Smith: I'll ask maybe a simple question. And presumably just about everyone who you see with a presumed ischemic optic neuropathy, even if they don't have clinical features, you at least check a sed rate. Is that true? Dr De Lott: I do. So, I do routinely check sedimentation rate and C-reactive protein. So, you need to check both. And the reason is that there are some patients who have a positive C-reactive protein but a normal sedimentation rate, so. And vice versa, although that is less common. And so both need to be checked. One other lab that sometimes can be helpful is looking at their CBC. You'll often find these patients with giant cell arteritis have elevated platelet counts. And if you can trend them over time, if you happen to have a patient that's had multiple, you'll see it sort of increasing over time. Dr Smith: I'm just thinking about how you sort things out in the middle, right? I mean, so that not all patients with GCF, sky-high sed rate and CRP…. And I'm just thinking of Dr Trobe's wisdom. So, when you're in an uncertain situation, presumably you go ahead and treat with steroids and move to biopsy. Maybe you can talk a bit about that pathway? Dr De Lott: Yeah, sure. Dr Smith: What's the definitive diagnostic process? Do you- for instance, the sed rate is sky-high, do you still get a biopsy? Dr De Lott: Yes. So, biopsy is still our gold-standard diagnosis here in the United States. I will say that is not the case in all parts of the world. In fact, many parts of Europe are moving toward using other ancillary tests in combination with labs and exam, the history, to make a definitive diagnosis of giant cell arteritis. And those tests are things like temporal artery ultrasound. We also, even though we call it temporal artery ultrasound, we actually need to image not only the temporal arteries but also the axillary arteries. The sensitivity and specificity is actually greater in those cases. And then there's high-resolution imaging of the vessels and the- both the intracranial and extracranial distributions. And both of those have shown some promise in their predictive values of patients actually having giant cell arteritis. One caution I would give to our listeners, though, is that, you know, currently in the US, temporal artery biopsy is still the gold standard. And reading the ultrasounds and the MRIs takes a really experienced radiologist. So, unless you really know the diagnostic accuracy at your institution, again, temporal artery biopsy remains the gold standard here. So, when you are considering giant cell arteritis, start the patient on steroids and- that's high dose, high dose steroids. In patients with vision loss, we use high dose intravenous methylprednisolone and then go ahead and get the biopsy. Dr Smith: Super helpful. And are there other treatments, other than steroids? Maybe how long do you keep people on steroids? And let's say you've got a patient who's, you know, diabetic or has other factors that make you want to avoid the course of steroids. Are there other options available? Dr De Lott: So, in the acute phase steroids are the only option. There is no other option. However, long term, yes, we do pretty quickly put patients on tocilizumab, which is really our first-line treatment. And I do that in conjunction with our rheumatology colleagues, who are incredibly helpful in managing and monitoring the tocilizumab for our patients. But when you're seeing the patients, you know, whether it's in the emergency room or in the hospital, those patients need steroids immediately. There are other steroid-sparing agents that have been tried, but the efficacy is not as good as tocilizumab. So, the American College of Rheumatology is really recommending tocilizumab as our first line steroid-sparing agent at this point. Dr Smith: Outstanding. So again, I will refer our listeners to your article. It's just chock-full of great stuff. This has been a great conversation. Thank you so much for joining me today. Dr De Lott: Thank you, Dr Smith. I really appreciate it.  Dr Smith: The pleasure has been all mine, and I know our listeners will be enjoying this as well. Again, today I've been interviewing Dr Lindsey De Lott about her article on optic neuropathies, which appears in the most recent issue of Continuum on neuro-ophthalmology. Be sure to check out Continuum Audio episodes from this and other issues. I already mentioned Dr Eggenberger and I will be talking about optic neuritis, which will be a great companion to this discussion. Listeners, thank you for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Dr. Drew Carey speaks with Dr. Tongalp H. Tezel on his study comparing patients with nonarteritic ischemic optic neuropathy (NAION) with healthy non-NAION patients with crowded discs and noncrowded optic discs. From his Ophthalmology article, “Vitreopapillary Findings in Nonarteritic Ischemic Optic Neuropathy versus Healthy Eyes.” Vitreopapillary Findings in Nonarteritic Ischemic Optic Neuropathy versus Healthy Eyes. Hondur, Ahmet M. et al. Ophthalmology, Volume 132, Issue 3, 327 – 334 CALL FOR ABSTRACTS! Now accepting paper, poster, and video submissions through April 8. Imagine presenting at AAO 2025; learn more and submit yours at aao.org/pod25

In this episode I break down the latest research on Ozempic and its potential link to NAION (non-arteritic ischemic optic neuropathy), a rare condition that can lead to sudden vision loss. I also reflects on UnitedHealthcare's continued public relations missteps, including its latest legal threats against physicians and anybody on social media, speaking out about the company. Takeaways: The Ozempic and Blindness Connection: Dr. Flannery explains a recent observational study that suggests Ozempic may increase the risk of NAION, a condition that affects the optic nerve. However, the data isn't conclusive yet, and more research is needed before drawing firm conclusions. Uveitis and the Syphilis Conversation: If you have eye inflammation (uveitis), your doctor may need to test for syphilis—leading to some of the most awkward conversations in ophthalmology. Dr. Flannery explains why this is necessary and how it helps with proper diagnosis. UnitedHealthcare's PR Nightmare: The insurance giant recently hired a law firm to threaten doctors on social media, proving once again that they're more focused on silencing criticism than improving patient care. Does Everyone Need Cataract Surgery at 60? Not necessarily! While cataracts affect nearly everyone with age, surgery should only be performed when they significantly impact vision. Dr. Flannery explains how doctors decide when it's time for surgery. Do We Really Need a Spleen? Dr. Flannery debates whether two livers would be better than one liver and a spleen, adding yet another hilarious (but oddly insightful) take on human anatomy. — 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: Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 Today's episode is brought to you by DAX Copilot from Microsoft. DAX Copilot is your AI assistant for automating clinical documentation and workflows helping you be more efficient and reduce the administrative burdens that cause us to feel overwhelmed and burnt out. 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

In Episode 51 of the Pound of Cure Weight Loss Podcast, Dr. Matthew Weiner and dietitian Zoe Schroeder tackle listener questions on NAION vision, mocktail ideas, limited weight loss after a sleeve gastrectomy, and managing the “murky middle” phase after surgery. Here's a quick recap of the insightful advice and tips offered in this Q&A episode.Understanding NAION Vision Risks with GLP-1 MedicationsThe episode kicks off with a question about the connection between GLP-1 medications (like Ozempic and Wegovy) and NAION vision, a rare eye condition that can cause sudden vision loss. Dr. Weiner explains that NAION is often linked to low blood pressure, a risk that can increase with weight loss. He advises patients on GLP-1 medications to monitor for symptoms like dizziness upon standing, as these may indicate hypotension and increased NAION risk. Adjusting blood pressure medications may be necessary as weight drops.Key Takeaway: If you're taking GLP-1 medications and blood pressure medicine, monitor your blood pressure closely. Weight loss may require medication adjustments to lower the risk of hypotension and NAION.Mocktails: A Fun, Alcohol-Free Way to Celebrate After SurgeryThe next question dives into mocktails, a perfect option for those who want to celebrate without alcohol after gastric bypass surgery. Zoe shares ideas for tasty, sugar-free mocktails, like mixing sparkling water with hibiscus tea and adding frozen watermelon cubes for flavor. She also encourages listeners to use fancy glasses and creative garnishes to make the drink feel special.Mocktail Idea: Hibiscus tea with sparkling water and frozen watermelon cubes makes a refreshing, celebratory drink that's low in sugar and calories.Key Takeaway: Mocktails can help you enjoy social occasions without alcohol. Use sugar-free ingredients and fun presentation to keep them bariatric-friendly and festive.Limited Weight Loss After A Sleeve GastrectomyA listener who had a sleeve gastrectomy but lost less weight than expected wonders why their experience differs from others. Dr. Weiner explains that weight loss results vary widely, with some patients experiencing more dramatic changes than others. He emphasizes the importance of combining surgery with lifestyle changes and, if necessary, GLP-1 medications to amplify weight loss.Key Takeaway: Every weight loss journey is unique, and surgery alone may not guarantee specific results. Combining surgery with lifestyle changes and, if needed, GLP-1 medications can enhance weight loss success.Navigating the Murky Middle Phase of Weight Loss After SurgeryThe episode concludes with advice on navigating the “murky middle” phase around six months after surgery. This stage involves adjusting to a slower weight loss rate and a returning appetite. Zoe suggests shifting from a protein-focused diet to one rich in vegetables, fruits, and nutrient-dense foods to avoid the “portion control trap,” where patients eat small portions of high-calorie foods, risking long-term regain.Key Takeaway: Use the murky middle to build healthy habits with nutrient-dense foods, setting up a foundation for sustainable weight loss and maintenance.Conclusion: Small Changes for Long-Term SuccessIn Episode 51, Dr. Weiner and Zoe underscore that bariatric surgery and GLP-1 medications are tools, not quick fixes. By making mindful adjustments and focusing on healthy eating, patients can set themselves up for long-term success.

In this week's issue: A retrospective study suggests that semaglutide is not associated with increased risk for non-arteritic anterior ischemic optic neuropathy (NAION). Black patients were less likely to have conclusive genetic testing compared to White patients when screening for inherited retinal diseases. Sodium-glucose co-transporter 2 inhibitors were shown to decrease risk of glaucoma compared to other antihyperglycemic agents.

In this powerful and educational episode of It Happened To Me, we sit down with Rachel Schreiman who turned her personal struggle with vision loss into a mission to support others. Rachel shares her story of resilience after experiencing two episodes of Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION), a rare and debilitating eye condition caused by insufficient blood flow to the optic nerve. These episodes left her with significant central vision loss, but instead of giving up, Rachel embraced a new path.   Rachel Schreiman is a CPA and musician who holds an MBA from the University of California, Irvine. In 2019 while working as the Controller for a trade association in Washington DC, she suffered two episodes of Non-arteritic anterior ischemic optic neuropathy (NAION), rendering her legally blind with significant central vision loss. After receiving rehabilitation care and training she started a new "career" devoted to others with low vision. She now works for Dr. Suleiman Alibhai OD, a low vision rehabilitation optometrist, and as a Resource Navigator for the Prevention of Blindness Society of Metropolitan Washington (POB). Both of these positions allow her to give back to others with low vision by sharing information about resources and demonstrating how to use many of the devices, assistive technologies and applications available that allow users to live full and independent lives.   Key Topics Discussed:   The Onset of NAION:  Rachel recounts the initial episode of NAION in 2019, the symptoms she experienced, and her journey to diagnosis. She describes NAION as a "stroke in the eye," explaining how lack of blood flow to the optic nerve led to significant vision loss.   Risk Factors and Triggers for NAION: Rachel discusses possible risk factors, such as sleep apnea and cardiovascular issues, which can contribute to the development of NAION. She shares insights into lifestyle adjustments and precautions she now takes to help manage her health.   Navigating a Second Episode:   Five months after the first NAION episode, Rachel suffered another in her other eye. She reflects on the impact of this second event, the rapid response from her medical team, and the steps she took to prepare for further adaptation to vision loss.   Diagnosing and Treating NAION:   Rachel describes the challenges of diagnosing NAION, which can be easily mistaken for other conditions such as multiple sclerosis, brain tumors, or stroke. She also explains the diagnostic process and the types of specialists who are essential for accurate diagnosis and care.   Adapting to Vision Loss: Rachel opens up about the difficult decision to stop driving and the profound impact it had on her independence. She shares the changes she made in her home and daily routines, along with the support she received from her husband and family, which helped her navigate life with low vision.   Coping Strategies for Low Vision:   Rachel reveals the practical and emotional strategies she uses to cope with vision loss, from using assistive technologies to finding new hobbies and ways to stay connected with her passions.   Advocacy and Empowerment in Low Vision Care:   Through her roles with Dr. Alibhai and the POB, Rachel describes her work in educating others about low vision resources, providing hands-on training with assistive devices, and guiding patients and their families through the journey to independence. She also highlights the services POB offers for those with low vision and encourages listeners to seek support early in their vision loss journey. Resources Mentioned:   - Episode 24 with Dr. Andrew Carey – For more on optic neuropathies, including NAION, check out our conversation with neuro-ophthalmic specialist Dr. Carey. - Episode 27 with Prevention of Blindness – Learn more about POB's programs and resources for individuals with low vision on POB's website.  - Assistive Technology Resources – Recommended apps and devices for managing life with low vision: Seeing AI, VoiceDream, BeMyEyes, Aira.    Stay tuned for the next new episode of “It Happened To Me”! In the meantime, you can listen to our previous episodes on Apple Podcasts, Spotify, streaming on the website, or any other podcast player by searching, “It Happened To Me”.    “It Happened To Me” is created and hosted by Cathy Gildenhorn and Beth Glassman. DNA Today's Kira Dineen is our executive producer and marketing lead. Amanda Andreoli is our associate producer. Ashlyn Enokian is our graphic designer.   See what else we are up to on Twitter, Instagram, Facebook, YouTube and our website, ItHappenedToMePod.com. Questions/inquiries can be sent to ItHappenedToMePod@gmail.com. 

Dr. Peter Quiros joins host Dr. Amanda Redfern to discuss the recent JAMA Ophthalmology article "The Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide," the first study to report a possible association between semaglutide (Wegovy, Ozempic, Novo Nordisk) and nonarteritic anterior ischemic optic neuropathy (NAION). Dr. Quiros provides an overview of what the study showed and what remains unknown, and how ophthalmologists should discuss these recent findings with their patients. Check out the Semaglutide and NAION patient brochure, courtesy of the North American Neuro-Ophthalmology Society (NANOS), and available from www.nanosweb.org. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

In this episode of Knock Knock Eye, I explore the potential vision risks associated with Ozempic and similar medications. With recent studies suggesting a link between these popular diabetes and weight loss drugs and non-arteritic ischemic optic neuropathy (NAION), I look into the science behind this condition, the anatomy of the optic nerve, and the implications of these findings.  — 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 like the scrubs I'm wearing, here's a link and discount code to get some Jaanuu Scrubs link: https://bit.ly/4cAvXbs code: DRG20 for 20% off first-time purchases* *This code works on full-price items only excluding embroidery!  Today's episode is brought to you by the Nuance Dragon Ambient Experience (DAX). It's like having a virtual Jonathan in your pocket. If you would like to learn more about DAX Copilot check out http://nuance.com/discoverDAX and ask your provider for the DAX Copilot experience. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Ayesha spoke with Jerry McLaughlin, chief executive officer and board member of Life Biosciences, a company advancing innovative cellular rejuvenation platforms to reverse diseases of aging. Life Biosciences is developing a gene therapy for primary open-angle glaucoma (POAG) and non-arteritic anterior ischemic optic neuropathy (NAION), two types of optic neuropathies with significant unmet needs. The company is developing innovative therapies for these indications that are based on innovative partial epigenetic reprogramming and chaperone-mediated autophagy technologies. Jerry McLaughlin has over 30 years of experience in the biopharmaceutical industry and has been involved in the discovery, clinical development and global commercialization of more than a dozen FDA-approved drugs with multiple successful exits. Jerry began his career at Merck and was extensively involved in multiple blockbuster product launches. Most recently, Jerry was President and CEO for Neos Therapeutics, Inc., a commercial stage pharmaceutical company. He holds a BA in economics from Dickinson College and an MBA from the Villanova School of Business. Tune into the episode to learn more about the work Jerry is leading at Life Biosciences to better understand and target the biology of aging through innovative therapeutics for aging-related diseases with critical unmet medical needs. For more life science and medical device content, visit the Xtalks Vitals homepage. https://xtalks.com/vitals/ Follow Us on Social Media Twitter: https://twitter.com/Xtalks Instagram: https://www.instagram.com/xtalks/ Facebook: https://www.facebook.com/Xtalks.Webinars/

In a recent study published in JAMA Ophthalmology, researchers explored a possible link between the medication semaglutide and a rare type of eye stroke called non-arteritic anterior ischemic optic neuropathy (NAION). In this podcast, we'll explain what this means and why it's important. What is NAION? NAION is a condition that affects the optic nerve, leading to sudden vision loss in one eye. It's considered a rare eye stroke and is not related to artery disease. What is Semaglutide? Semaglutide is a medication used to help manage blood sugar levels in people with type 2 diabetes and is also prescribed for weight loss. It works by increasing insulin secretion in response to meals, which helps regulate blood sugar levels. Semaglutide also helps reduce appetite and increase feelings of satiety, leading to lower calorie intake. It slows the emptying of the stomach, prolonging the feeling of fullness after eating. The Study's Findings The researchers discovered a link between semaglutide and NAION. However, it's important to note that this is just a link. It doesn't prove that semaglutide causes NAION. Showing a connection is only the first step, and proving causation is much more challenging. Possible Explanations Rapid Changes in the Body: When someone starts taking semaglutide, their body undergoes quick cardiovascular and metabolic changes. These changes could trigger NAION, rather than the medication itself being the direct cause. Common Risk Factors: People who take semaglutide often have conditions like high blood pressure, obstructive sleep apnea, or diabetes. These conditions already put them at higher risk for NAION. Semaglutide might just be a common factor among these patients, rather than the cause of their eye issues. Study Limitations The authors note that since their institution specializes in eye conditions, they are more likely to encounter higher numbers of NAION cases. This may limit the generalizability of their findings to other settings. Additionally, the study's records indicate only whether a medication was dispensed to a patient, not whether it was actually taken as prescribed. This distinction is important for accurately assessing the medication's impact.  Furthermore, due to NAION's rarity, the analysis included only a small number of cases, which can complicate the interpretation of statistical results. What Does This All Mean? Scientists need to conduct further studies to determine if semaglutide directly causes NAION or if other factors are at play. And they should be conducted in a larger and more diverse population. Expert Picks: If you'd like to listen about the benefits of semaglutide, check out the following podcasts: Long-Term Health Benefits of Semaglutide for Weight Loss  How GLP-1 Agonists Like Semaglutide Fight Inflammation The Use of GLP-1 Agonists in Post-Heart Attack Care Thanks again for listening to The Peptide Podcast. We love having you as part of our community. If you love this podcast, please share it with your friends and family on social media, and have a happy, healthy week! We're huge advocates of elevating your health game with nutrition, supplements, and vitamins. Whether it's a daily boost or targeted support, we trust and use Momentous products to supercharge our wellness journey.  Momentous only uses the highest-quality ingredients, and every single product is rigorously tested by independent third parties to ensure their products deliver on their promise to bring you the best supplements on the market.

Does semaglutide cause blindness?What is NAION (nonarteritic anterio ischemic optic neuropathy)?What about worsening of diabetic retinopathy with semaglutide?What can you do to minimize the risk of NAION and retinopathy?Get the full study hereRead Dr. Brugger's blog

It's In the News! A look at the top diabetes stories and headlines happening now. Top stories this week: The Eversense CGM could soon be approved for one year of continuous use, the first generic GLP-1 medication is launched, a new company tauts and all-in-one sensor and pump infusion set, a new diabetes accessory in the Roblox game, and more! Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark XX The first ever generic GLP-1 medication will soon be available in the US. It's a generic of Victoza, originally approved by the FDA in 2010 for diabetes, is part of the same class of drugs that includes Ozempic and Mounjaro. Liraglutide is Glucagon-like peptide-1 receptor agonists (otherwise known as GLP-1s or GLP-1 RAs) are a class of incretin drugs that mimic the body's natural hormones to help treat diabetes and obesity. However, the popularity of the drugs has spiraled out of control at times, leading to shortages and supply chain issues in the US and abroad.  The arrival of a GLP-1 generic drug provides reasons to be hopeful for doctors and patients alike, but there are also caveats. Couple of caveats - liraglutide is injected once daily (vs. weekly) and many doctors say it doesn't work as well for as many people as semaglutide and terzepatide. No confirmation on the price Two other generic options are being developed and could launch in December 2024. Patents for newer GLP-1 medications like Ozempic and Wegovy won't expire until several years down the road https://www.healthline.com/health-news/victoza-generic-glp1-drug-available XX Senseonics plans to launch a 365-day sensor in the U.S. in the fourth quarter of this year. A one-year Eversense CGM could be a game changer for the company.   In 2024, Senseonics expects to more than double U.S. new patient starts and increase the global installed base by around 50%. The growth is built on the current 180-day version of Senseonics' implantable Eversense CGM. Eversense's 180-day sensor can need calibrating twice a day, something Senseonics CEO Tim Goodnow said “has been a competitive disadvantage.” Users calibrate the 365-day sensor once a week. Senseonics is in talks with insulin pump manufacturers about integrating its Eversense CGM with their devices but has yet to commit to a timeline for finalizing an agreement. https://www.medtechdive.com/news/senseonics-365-day-cgm-2025-sales/719717/ XX People who take Ozempic or Wegovy may have a higher risk of developing a rare form of blindness, a new study suggests. Still, doctors say it shouldn't deter patients from using the medicines to treat diabetes or obesity.   Last summer, doctors at Mass Eye and Ear noticed an unusually high number of patients with non-arteritic anterior ischemic optic neuropathy, or NAION, a type of eye stroke that causes sudden, painless vision loss in one eye.   The condition is relatively rare — up to 10 out of 100,000 people in the general population may experience it — but the doctors noted three cases in one week, and each of those patients was taking semaglutide medications. The risk was found to be greatest within the first year of receiving a prescription for semaglutide.   The study, published Wednesday in the medical journal JAMA Ophthalmology, cannot prove that semaglutide medications cause NAION. And the small number of patients — an average of about 100 cases were identified each year — from one specialized medical center may not apply to a broader population. The ways that semaglutides interact with the eyes are not entirely understood. And the exact cause of NAION is not known either. The condition causes damage to the optic nerve, but there is often no warning before vision loss.   For now, patients who are taking semaglutide or considering treatment should discuss the risks and benefits with their doctors, especially those who have other known optic nerve problems such as glaucoma or preexisting visual loss, experts say https://www.reuters.com/business/healthcare-pharmaceuticals/wegovy-ozempic-linked-with-sight-threatening-eye-disorder-study-2024-07-03/ XX We got some updates at ADA about the over the counter CGMS Dexcom Stelo and Abbot's Libre. Dexom plans a late august launch of stelo, which you'll order from their website – it won't be physically in stores. Abbott also plans to sell its wellness-oriented Lingo device this summer through an e-commerce website. That's a sensor that's been available in other coutnires for a while, but was recently okayed in the US. It's not meant for people with diabetes. The Libre Rio is designed or adulst with type 2 who don't use insulin. No timing yet on that product's launch. Neither Abbott nor Dexcom have disclosed pricing for the upcoming products. https://www.medtechdive.com/news/abbott-dexcom-over-the-counter-cgm-launch/719928/ XX Insulet is looking to expand the label for its Omnipod 5 insulin pump for people with Type 2 diabetes. The company said Friday it recently filed with the Food and Drug Administration. Insulet presented study results at the American Diabetes Association's 84th Scientific Sessions that evaluated Omnipod 5 in people with Type 2 diabetes who were taking basal insulin or multiple daily injections. The results showed “substantial improvements in blood glucose outcomes and overall quality of life,” said study chair Francisco Pasquel, an associate professor of endocrinology at Emory School of Medicine. Omnipod 5 is currently cleared in the U.S. for people with Type 1 diabetes. Insulet hopes to expand the pump to people with Type 2 diabetes, with an expected launch in early 2025. The FDA has not yet cleared any automated insulin delivery systems for people with Type 2 diabetes, Insulet said. The company has a basal-only insulin pump, called Omnipod Go, that was cleared for people with Type 2 diabetes last year, but it does not connect to other devices. Even though Omnipod 5 is not currently indicated for Type 2 diabetes, doctors prescribe it for their patients with full reimbursement since the pharmacy channel doesn't distinguish between Type 1 or Type 2 patients, J.P. Morgan analyst Robbie Marcus wrote in a research note on Sunday. https://www.medtechdive.com/news/insulet-omnipod-5-type-2-diabetes-study/719644/ XX In the keynote address at the American Diabetes Association annual conference, FDA Commissioner Dr. Robert Califf expressed concerns about the rising rates of diabetes in the U.S. Though revolutionary medications and technologies for diabetes and weight loss continue to emerge, these treatments are vastly underused. The silver lining lies with type 1 diabetes therapies, which are showing great promise in clinical trials. “For the larger epidemic of type 2 diabetes, we're failing right now,” Califf said. “I don't say that lightly.” A huge problem, Califf said, is access. While most health insurance plans cover medical devices and medications for diabetes, without insurance, costs add up quickly. Ozempic, for example, costs nearly $1,000 per month without insurance. Studies have found that regardless of insurance status, roughly 26% of Americans skipped or delayed treatment due to cost. https://diatribe.org/diabetes-management/fda-commissioner-says-were-failing-people-type-2-diabetes XX Embecta presented two abstracts at the American Diabetes Association Scientific Sessions last weekend making the case for its insulin patch pump for Type 2 diabetes. The company submitted the device for Food and Drug Administration clearance in late 2023. The diabetes device company developed a patch pump with a larger insulin reservoir that can hold up to 300 units. Embecta, which is better known for making equipment such as pen needles and insulin syringes, has been developing its first patch pump. The company found that a device with a larger insulin reservoir could provide longer wear times and fewer disposable patches. https://www.medtechdive.com/news/embecta-insulin-patch-pump-volume-american-diabetes-association/719779/ XX   Pump/CGM sensor in one The niaa signature patch pump, shown with a watch displaying current blood sugar level The niaa signature patch pump has a manual bolus button and is part of an in-development AID system. Swiss technology maker Pharmasens demonstrated a new semi-reusable tubeless patch pump and glucose sensor in the same compact device, called the niia signature, which the company says can be worn for five days.   The top of the device, which includes Bluetooth connectivity and the electronic and mechanical parts to control the pump, separates from the disposable 300-unit reservoir along with the adhesive used to attach the device to the body via a steel cannula. A small button on the device allows manual bolusing. The company says an AID system will manage the device, controlled by smartphone.   PharmaSens' simpler basal-bolus patch pump, the niia essential, was submitted for FDA approval in late December. Availability of the niia signature AID system has yet to be announced. https://diatribe.org/diabetes-technology/diabetes-technology-display-ada-2024 XX Edgepark Commercial XX New international consensus statement offers guidance on the care and monitoring of people who are at high risk for type 1 diabetes (T1D). This is all about screening and testing for islet autoantibodies. These individuals are classified as: At risk or Stage 0 (single autoantibody or transient single autoantibody), Stage 1 (two or more autoantibodies with normoglycemia), and Stage 2 (two or more autoantibodies with dysglycemia but without symptoms and not yet meeting diagnostic criteria for Stage 3 clinical T1D). The document was presented on June 24, 2024 in a 90-minute symposium at the American Diabetes Association's annual Scientific Sessions and published simultaneously in both Diabetes Care and Diabetologia. "This is not guidance around who to screen or when to screen. This is guidance for the hundreds of thousands of people around the world who have participated in screening, mostly through research programs, and have been identified with positive autoantibodies and need care in the clinical setting," panel co-chair Anastasia Albanese-O'Neill, PhD, APRN, CDCES, of Breakthrough T1D, told Medscape Medical News.   The recommendations also include when to start insulin, and how to provide education and psychosocial support to individuals and family members of those given the early-stage T1D diagnosis. https://www.medscape.com/viewarticle/experts-advise-early-risk-monitoring-type-1-diabetes-2024a1000bpo XX Roblox has added a diabetic option, complete with insuli pen and Dexcom You can find it in the marketplace JDRF – now breakthrough t1d – started a world in roblox a couple of years ago as well Roblox is a super popular online game that a lot of kids play. https://www.roblox.com/games/5823990610/Breakthrough-T1D-World XX FFL next week! Join us again soon!

In recent years, Ozempic has gained widespread attention, primarily due to its efficiency in aiding weight loss. Originally approved as a medication for type 2 diabetes, Ozempic's active ingredient, semaglutide, has been celebrated for its effectiveness in regulating blood sugar levels and its concurrent benefit of substantial weight reduction in patients. However, a new dimension has been added to the conversation surrounding this popular drug due to a concerning discovery associated with its use.A comprehensive study conducted by Harvard researchers has identified a rare but serious side effect linked to the use of Ozempic, involving vision loss. The specific condition cited in the study is non-arteritic anterior ischemic optic neuropathy (NAION), a form of vision loss that occurs when blood flow is blocked to the optic nerve. According to the study, patients taking Ozempic were found to be more than seven times more likely to develop this condition compared to those not using the medication.NAION typically affects one eye and can lead to sudden vision loss. The condition is especially concerning because it is often permanent. While the incidence of NAION among Ozempic users remains relatively low, the significant increase in risk highlighted by the Harvard study presents a potential concern for individuals utilizing the drug for diabetes management or weight loss.Physicians and healthcare providers are advised to be vigilant and discuss this potential risk with their patients who are either currently taking Ozempic or considering its use for managing type 2 diabetes or for weight loss. Patients are encouraged to report any sudden changes in vision immediately, as early detection and intervention can sometimes prevent more severe outcomes.As Ozempic continues to be a popular choice for weight loss and diabetes management, further research is needed to fully understand the range and frequency of potential side effects associated with its use. Researchers are calling for additional studies to ascertain the mechanisms by which Ozempic may impact blood flow to the optic nerve and to develop strategies that could mitigate this risk.For now, the medical community remains cautious, balancing the undeniable benefits of Ozempic in controlling diabetes and aiding weight loss against the heightened risk of serious side effects such as vision loss. This development serves as a reminder of the complexity of pharmacological treatments and the ongoing need for comprehensive post-market surveillance to protect patient health.

On this episode of Cell & Gene: The Podcast, Host Erin Harris talks to Life Biosciences' CSO, Sharon Rosenzweig-Lipson, Ph.D., about the Boston-based biotech's cellular rejuvenation therapies for the treatment of age-related diseases. They cover Life Biosciences' lead program, a gene therapy called OSK that is being advanced in two optic neuropathies – a rare eye disease of aging called non-arteritic anterior ischemic optic neuropathy (NAION) and glaucoma. They also cover they why behind gene therapy as a modality, as well as Life Biosciences' partnership with Forge Biologics to manufacture AAV for the cellular rejuvenation technology.

This Week In Car Audio S3 Ep19 Guest: Travis Young Owner and engineer of JY Power. Lets Talk about new batteries including NaIon. Guest Co-Host: David Bradshaw Tips for the hosts: Venmo: https://venmo.com/code?user_id=292587 Cash App: https://cash.app/$SonicFX

Frank Bruni: “Almost all of the difficulties we deal with are not visible to the naked eye.” Bruni, a New York Times columnist and bestselling author, joins mbg co-CEO, Jason Wachob, to discuss how nearly going blind helped him see more clearly, plus: - How to mentally recover from an invisible illness (~11:41) - How to feel empowered about your health (~13:54) - How to deeply connect with others on social media (~19:22) - How to be an independent thinker (~24:39) - How to have a productive conversation about health care & politics (~30:25) Referenced in the episode: - Bruni's book, The Beauty of Dusk: On Vision Lost and Found. - mbg's Invisible Illness series. - NAION Facebook support group. - Bruni's New York Times article on his NAION diagnosis. - Bruni's New York Times article, "Our Tribalism Will Be the Death of Us." - Watch Bruni on Real Time With Bill Maher. - Read Bruni's newsletter. - Crown Shy. - 4 Charles Prime Rib. Enjoy this episode! Whether it's an article or podcast, we want to know what we can do to help here at mindbodygreen. Let us know at: podcast@mindbodygreen.com.

jQuery(document).ready(function(){ cab.clickify(); }); Original Podcast with clickable words https://tinyurl.com/y93yzomp Controversial memorial wall in Glasnevin to be removed. Balla cuimhneacháin conspóideach i nGlas Naíon le baint anuas. The owners of Glasnevin Cemetery have announced their intention to remove a controversial memorial wall in the cemetery. Tá se fógartha ag úinéirí Reilig Ghlas Naíon go bhfuil sé i gceist acu balla cuimhneacháin conspóideach sa reilig a bhaint anuas. The list of dead from the Easter Rising and the War of Independence is on the wall, including the Defense Forces, the general public, British soldiers and the RIC police. Liosta na marbh ó Éirí Amach na Cásca agus ó Chogadh na Saoirse atá ar an mballa, idir Óglaigh na hÉireann, an gnáthphobal, shaighdiúirí na Breataine agus phóilíní an RIC. However, much controversy erupted when it was suggested that British forces, including the Blacks, would be included. Tarraingíodh conspóid mhór, áfach, nuair a tugadh le fios go mbeadh fórsaí na Breataine, na Dúchrónaigh ina measc, curtha san áireamh. In a statement, the Dublin Cemetery Trust said it had decided to remove it due to the vandalism of the wall. I ráiteas, dúirt Iontaobhas Reiligí Bhaile Átha Cliath gur mar gheall ar an lóitiméireacht atá déanta ar an mballa a chinn siad é a bhaint anuas. They regret the decision but have no strength in the face of the latest lesion, which they said was a real blow. Is oth leo an cinneadh ach níl aon neart air i bhfianaise an loit is deireanaí, ar fíor-dhrochlot é, a dúirt siad. The wall has been damaged on three occasions since it was erected and the owners said they believed it would be damaged again if it was repaired. Rinneadh damáiste don bhalla ar thrí ócáid ó cuireadh suas é agus dúirt na húinéirí gur chreid siad go ndéanfaí díobháil dó arís dá gcóireofaí é. They do not have the means, they said, to bear the huge cost of the refurbishment and security arrangements. Níl sé d'acmhainn acu, a dúirt siad, an costas mór a bhainfeadh leis an obair chóirithe agus le socruithe slándála a sheasamh. The decision to break down the wall has been criticized by RTÉ broadcaster Joe Duffy who wrote a book about the children killed during Easter Week. Tá an cinneadh an balla a bhaint anuas cáinte ag craoltóir RTÉ Joe Duffy a scríobh leabhar faoi na páistí a maraíodh le linn Sheachtain na Cásca. However, the independent councilor in Dublin, Nial Ring, said it was a wise decision as many people believe the wall is a great insult. Dúirt an comhairleoir neamhspleách i mBaile Átha Cliath, Nial Ring, ámh, gur cinneadh ciallmhar a bhí ann mar go gcreideann go leor daoine gur mór an masla an balla.

In this episode our guest is Judith Horn, a physical therapist. She came by to chat with us, not about physical therapy but about vision loss! Judith shares her experience with losing part of her vision to a rare condition called Non-arteritic anterior ischemic optic neuropathy (NAION). We get to learn about her diagnosis, how she would have preferred to hear the news that her vision may not improve, what she knows now that she wishes she knew before, (hint: abnormal vision is never normal) and so much more. Tune in for a great conversation!About Judith Horn, PT DPT MS GCSJudith Horn is a licensed Physical Therapist. She earned her BSPT from Northeastern University (Boston), MS in Health Education from St Joseph's University (Philadelphia) and Clinical Doctorate in Physical Therapy from Drexel University (Philadelphia). Judith is a current American Board of PT Specialties Geriatric Clinical Specialist (GCS).Her professional career settings have included Acute Care, Wound Care, Outpatient Rehabilitation, Home Health and Academic appointments at Stockton University and Atlantic Cape Community College.As a Lifetime American Physical Therapy Association (APTA) member, Judith has published in peer reviewed journals and presented at APTA Combined Sections. She is a past recipient of the APTA NJ James Tucker Excellence in Clinical Teaching award and Drexel University's Leadership in PT Practice Award.Judith shares a love of golf with her husband Jeff and they try to spoil their six grandchildren whenever possible. Podcast Sponsor Info:The Good Health Candle Companywww.goodhealthcandle.com@goodhealthcandle on Instagram and FacebookThe Good Health Cafe Feedback Form & Subscribe to the mailing listhttps://www.thegoodhealthcafe.com/submit-your-question@thegoodhealthcafe on Instagram and Facebook

Show Notes for Podcasting for Authors Featured: Kathy King is Center Stage Co-hosts: Cheryl McNeil Fisher and Kathy King Benefits of podcasts for authors? What are they, how can you do it? Can you podcast if you are blind or low vision? Absolutely, listen to how Kathy and Cheryl accomplish it! Why podcasts versus upload audio to websites? Steps to get started and where will you “travel” as a podcaster? How and why did Writing Works Wonders start podcasting? We were a Zoom call, then we started podcasting! Why did we do it and how do we do it as authors who are visually impaired? Kathy's podcasting technical and hosting experience began in 2005. She had several podcasts in 2005-2010 which spanned hundreds of hours and many millions of listens. BONUS: Cheryl and Kathy share multiple ideas about how authors may use podcasts to cultivate their followers and reader audience. More about Kathy King Dr. Kathy King not only has vast experience in podcasting, but also is an award winning author and editor publishing over 30 books and 200+ articles/papers. She is a retired professor of instructional technology and adult learning. As a series editor with Information Age Publishing and in her private coaching, she guides authors through the writing and publishing processes. “Kathy” is a popular keynote and conference speaker, mentor, and writing consultant. As a professor for 30+ years, she was a researcher, administrator, and educator. In 2019, Kathy began her journey with vision loss. A small, silent stroke (NAION – an optic nerve condition) left her with low vision. At this point, she was unable to read or see a computer screen. In 2021, another rare episode of NAION reduced her sight further. Although she is now legally blind, Kathy enjoys writing, virtual volunteering, podcasting, public speaking, and coaching authors. Podcasting Notes Pearl necklace comparison. Each episode is the pearl. They are all linked together into the feed. That feed automates distribution of the episodes to thee podcast directories Look for the Writing Works Wonders forthcoming book and tutorials on Podcasting. Can I podcast if I'm blind or low vision? Absolutely, listen to how Kathy and Cheryl accomplish it! Simple Podcasting Equipment Cell phone ( or tablet, or computer) Podcast platform /host Microphone (recommended) Free apps to record and edit audio (Click here to see list on our Author's Resource page) Steps involved Podcast platform/host (we use Pinecast) Content decisions Record audio file Edit audio file Upload to podcast platform (#1) Add title and shownotes Save (Automatic distribution to podcast applications) One -Time Setup Only (Click here to see list on our Author's Resource page) Author Podcast Topics! Cheryl and Kathy share multiple ideas to cultivate your followers and reader audience Contact Information: Website: www.WritingWorksWonders.com Podcast email: WritingworksPodcast@gmail.com Phone or text: 347-467-0221 (Not a toll-free number) Don't miss any special events! Sign-up for Email Alerts) Support this podcast through our Tip Jar or Patreon. Follow Us on Social Media Facebook @WritingWorksWonders Twitter @WritingWksPod Cheryl McNeil Fisher - Author, Keynote Speaker, Educator and Coach. Seminars and Workshops Adults and Children. https://www.cherylmcneilfisher.com/ Submit your work for publication on our site. Guest blogging, poetry, short stories at: https://www.livinginspiredfullyeveryday.com/ Dr. Kathleen P. King- Author, Author Coach, Speaker & Professor (Ret.). http://www.transformationed.com/ Interested in technology and adult learning? Check out Dr. King's newest book from Wiley: http://bit.ly/King2017 We are proud to be hosted by ACB Community. Find more resources and episodes for this podcast at https://writingworkswonders.com/ Support Writing Works Wonders: Advancing Beyond Barriers by contributing to their Tip Jar: https://tips.pinecast.com/jar/writing-works-wonders Check out our podcast host, Pinecast. Start your own podcast for free with no credit card required. If you decide to upgrade, use coupon code writing for 40% off for 4 months, and support Writing Works Wonders: Advancing Beyond Barriers.

Jordan BigPlume is a 30 year old citizen of Tsuut'ina Nation. In our conversation with Jordan Today we learn about her life on Tsuut'ina Nation and what being a Tsuut'ina Naion citizen is to her. Jordan shares with us the impacts of Bill C-31 and how she is working to break the cycle of that bill for herself and for future generations. Please join me I this important and beautiful conversation with Jordan Bigplume. 

This week, we cover non-arteritic anterior ischemic optic neuropathy (NAION), as well as diagnostic pearls to differentiate optic neuropathies and retinopathies in general, and how to differentiate NAION from AAION.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.11.18.388132v1?rss=1 Authors: Guo, Y., Mehabian, Z., Johnson, M. A., Miller, N. R., Henderson, A., Hamlyn, J., Bernstein, S. L. Abstract: Purpose : The rodent model of nonarteritic anterior ischemic optic neuropathy (rNAION) is similar in many of its pathophysiological responses to clinical NAION. However, little is known of the parameters associated with rNAION induction severity and if pre- or early post-induction biomarkers can be identified that enable prediction of lesion severity and ultimate loss of retinal ganglion cells (RGCs). Methods : Adult male Sprague-Dawley outbred rats were evaluated for various parameters including physiological characteristics (heart rate, respiratory rate, temperature, hematocrit), optic nerve head (ONH) appearance, pre- and post-induction mean diameter, and intravenous fluorescein and indocyanine green angiographic patterns of vascular leakage at 5 hours post-induction, performed using a spectral domain-optical coherence tomography (SD-OCT) instrument. These parameters were correlated with ultimate RGC loss by Brn3a (+) immunohistology. RGC loss also was correlated with the relative level of laser exposure. Results : The severity of ONH edema 2d, but not 5hr, post induction was most closely associated with the degree of RGC loss, revealing a threshold effect, and consistent with a compartment syndrome where a minimum level of capillary compression within a tight space is responsible for damage. RGC loss increased dramatically as the degree of laser exposure increased. Neither physiological parameters nor the degree of capillary leakage 5hr post induction were informative as to the ultimate degree of RGC loss. Conclusions : Similar to human NAION, the rNAION model exhibits marked variability in lesion severity. Unlike clinical NAION, pre-induction ONH diameter likely does not contribute to ultimate lesion severity; however, cross-sectional ONH edema can be used as a biomarker 1-2d post-induction to determine randomization of subjects prior to inclusion in specific neuroprotection or neuroregeneration studies. Copy rights belong to original authors. Visit the link for more info

In this episode, Ricky Enger speaks with New York Times columnist Frank Bruni, who shares the story of his sudden vision loss from NAION. Bruni speaks candidly on his adjustment to the change, maintaining a realistic attitude towards his vision loss, and the failure of medical professionals to provide resources after diagnosis.

This episode answers questions related to dry eyes, 6th nerve palsy, nearsightedness, floaters, parasites in the eyes, polarized lenses and NAION. Question 1 0:00 - 8:39 Dear Dr. Berne, please let me know if the MSM eye drops would help to ease my dry eyes, as well as my left eye, slightly swollen inferior eyelid. I have a discharge from my left eye that is white and sticky. I also have daily sinus headaches. Question 2 8:39 - 15:43 I was diagnosed with 6th nerve palsy. This has been the hardest challenge that life has presented me with. It's been more than 3 months since my diagnose. My doctor told me it would take 3-6 months to heal. I've started the healing process, but I am wondering if there is anything I can do to help with it. Please advise. Question 3 15:43 - 23:59 I've seen your videos on your youtube channel, and I wanted to ask about nearsightedness. I wear -0.75 diopters in the right eye and -1.00 diopters in the left eye. I came across your video on how the use of plus lenses can cause a very strong myopic defocus. I tried it today, and I did see a very temporary improvement. What else do you recommend? Thank you very much! Question 4 23:59 - 28:32 I have Iritis in my right eye and floaters in my left. Can/Should I use these MSM drops in both eyes? Question 5 28:32 - 34:00 What are your thoughts on parasites in the eyes? Do you have a protocol to remove them? I'm on a parasite cleanse. I'm having Giardia, Cryptosporidium, and yeast. Every month my eyes will get styes that are huge and half side of my face will become swollen. It can take up to a month to disappear, and I'll end up with a marble size hardball on my eyelid. The strange thing is I've never had a stye until I started this parasite cleanse. It's like they are migrating to my eyes. I've been to 2 ophthalmologists, and they say I have dry eyes, and that I need to take antibiotics. I love your videos, but I've not seen you cover this topic. Thank you for your time and thoughts! Question 6 34:00 - 38:57 Can you tell me about the issue with polarized lenses? Question 7 38:57 - 44:57 Do you have any experience with people with NAION?

This episode answers questions related to dry eyes, 6th nerve palsy, nearsightedness, floaters, parasites in the eyes, polarized lenses and NAION. Question 1 0:00 - 8:39 Dear Dr. Berne, please let me know if the MSM eye drops would help to ease my dry eyes, as well as my left eye, slightly swollen inferior eyelid. I have a discharge from my left eye that is white and sticky. I also have daily sinus headaches. Question 2 8:39 - 15:43 I was diagnosed with 6th nerve palsy. This has been the hardest challenge that life has presented me with. It's been more than 3 months since my diagnose. My doctor told me it would take 3-6 months to heal. I've started the healing process, but I am wondering if there is anything I can do to help with it. Please advise. Question 3 15:43 - 23:59 I've seen your videos on your youtube channel, and I wanted to ask about nearsightedness. I wear -0.75 diopters in the right eye and -1.00 diopters in the left eye. I came across your video on how the use of plus lenses can cause a very strong myopic defocus. I tried it today, and I did see a very temporary improvement. What else do you recommend? Thank you very much! Question 4 23:59 - 28:32 I have Iritis in my right eye and floaters in my left. Can/Should I use these MSM drops in both eyes? Question 5 28:32 - 34:00 What are your thoughts on parasites in the eyes? Do you have a protocol to remove them? I'm on a parasite cleanse. I'm having Giardia, Cryptosporidium, and yeast. Every month my eyes will get styes that are huge and half side of my face will become swollen. It can take up to a month to disappear, and I'll end up with a marble size hardball on my eyelid. The strange thing is I've never had a stye until I started this parasite cleanse. It's like they are migrating to my eyes. I've been to 2 ophthalmologists, and they say I have dry eyes, and that I need to take antibiotics. I love your videos, but I've not seen you cover this topic. Thank you for your time and thoughts! Question 6 34:00 - 38:57 Can you tell me about the issue with polarized lenses? Question 7 38:57 - 44:57 Do you have any experience with people with NAION?

In this podcast, Dr Neil Miller,one of the authors of the editorial entitled “A Nonarteritic Anterior Ischemic Optic Neuropathy Clinical Trial: An Industry and NORDIC Collaboration” talks about what is the leading cause of sudden optic nerve–related vision loss in individuals over 50 years old (caused by inadequate blood supply to the optic nerve head). Dr Miller discusses QRK207. QRK207 will be the first trial to use a potential neuroprotective therapy delivered early to reduce permanent injury and lessen the vision loss from acute NAION.

In this podcast, Drs. Michael S. Lee and Michael Vaphiades engage in a point-counterpoint debate over whether erectile dysfunction (ED) medications are causally related to NAION?

Host Andrew Lee, MD, interviews Alfredo Sadun, MD, and Neil Miller, MD. Dr. Andrew Lee leads a discussion on nonarteritic anterior ischemic optic neuropathy (NAION). The topics range from workup in the presence and absence of classic risk factors for NAION to various controversial treatment options. Finally, the participants discuss prognosis and the likelihood of a second attack on the same or fellow eye. (November 2011)

Guest: Byron L. Lam, M.D.Professor of OphthalmologyBascom Palmer Eye InstituteUniversity of Miami Miller School of MedicineMiami, Florida

Paper Discussed: G McGwin, Jr, M S Vaphiades, T A Hall, and C Owsley Non-arteritic anterior ischaemic optic neuropathy and the treatment of erectile dysfunction British Journal of Ophthalmology, February 2006; 90(2):154-7 Guest: Guest: Gerald McGwin, Jr., PhD Associate Professor of Epidemiology Department of Ophthalmology University of Alabama at Birmingham Birmingham, Alabama