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43 episodes with Otology
2 episodes with Otology
4 episodes with Otology
2 episodes with Otology
2 episodes with Otology
2 episodes with Otology
2 episodes with Otology
2 episodes with Otology
2 episodes with Otology
Meet pediatric otolaryngologist Alisa Timashpolsky, who joins the podcast to discuss the latest in otology, rhinology and multidisciplinary care for complex ENT conditions found in children.
Send us a textIn this episode of Doctors at Work, Manuela shares her tips on planning a fellowship. It's important to start early and to make contacts with fellowship directors and current fellows, and to ask open questions about the clinical opportunities, timetabling, and trainer support. Every doctor is different and every fellowship is different, so the key for trainees is to know what they want, need, and aim for, and to align their fellowship training with their personal objectives.Manuela Cresswell is a consultant ENT surgeon with interest in Otology and lateral skull base at University Hospitals Plymouth. She is passionate about teaching and humanitarian work and has received grants to teach ear surgery in low resource countries. Find her on instagram @ent_cresswell.Listen at https://matdaniel.net/podcast/; https://open.spotify.com/show/1j8uLaUU1g5bYTRVuwUX7j?si=672ec26a73164d7f; https://podcasts.apple.com/gb/podcast/doctors-at-work/id1701284564; or watch on www.youtube.com/@dr-coach/videos. Production: Shot by Polachek You can find out more about Mat's coaching to help doctors create successful and meaningful careers at www.MatDaniel.net.
Send us a textLearning practical skills such as surgery is challenging. In this episode of Doctors at Work, Brian Westerberg tells me about mental imagery. This is a technique that he has found through his elite sport contacts. It helps him anticipate and "practice" surgical steps, and is a way to train new surgeons too. We also talk about mindfulness, exercise, the importance of having non-judgemental support.You might also like episodes 56, 80, 82, 108 on performance psychology, and episode 98 on the impostor syndrome.Dr. Brian Westerberg, an Otolaryngologist specializing in Otology and Neurotology is based at the B.C. Rotary Hearing and Balance Centre at St. Paul's Hospital in Vancouver British Columbia. Dr. Westerberg graduated from Queen's University Faculty of Medicine in 1989, completed two years of Residency training in General Surgery at Queen's before transferring to University of British Columbia to complete further training in Otolaryngology-Head and Neck Surgery. He subsequently completed a Fellowship in Otology and Neurotology at the California Ear Institute at Stanford University in 1996 and a Master degree in Health Care and Epidemiology at UBC in May 1999. He is currently a Clinical Professor in the Department of Surgery. Dr. Westerberg has served the Royal College of Physicians and Surgeons of Canada as a Program Director at UBC, as a member of the Examination Committee, and as Vice-Chair and Chair of the Specialty Committee for his specialty. In addition, he has been a member of the Residency Accreditation Committee and a member of the International Residency Program Review and Accreditation Committee. He has supervised numerous Master and PhD candidates, and Clinical and Research Fellows. His interest in global surgery is apparent in his involvement in Zimbabwe and Uganda Hearing Health Care Programs, and local outreach to improve access to care for patients in rural and remote communities within British Columbia. As former Medical Director of the Branch for Global Surgical Care, he has been instrumental in improving education within the field of global surgical care through approval for and subsequent development of a Master degree program in Global Surgical Care at UBC. As an amateur athlete and as an academic surgeon, he has always been interested in the influence of our mental state on physical performance.Listen at https://matdaniel.net/podcast/; https://open.spotify.com/show/1j8uLaUU1g5bYTRVuwUX7j?si=672ec26a73164d7f; https://podcasts.apple.com/gb/podcast/doctors-at-work/id1701284564; or watch on www.youtube.com/@dr-coach/videos. Production: Shot by Polachek You can find out more about Mat's coaching to help doctors create successful and meaningful careers at www.MatDaniel.net.
In this repeat episode, Dr Karl uncovers a lifelong Australian quest to restore comfort and hearing with custom made eardrum transplants. Called Cleardrums, Professor Marcus Atlas is close to passing regulatory hurdles for human trials. drkarl.com
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Dr. Alan Micco, Chief of the Section of Otology and Neurotology at Northwestern Medicine, joins Lisa Dent to discuss cochlear implants. Dr. Alan explains the process of hearing loss and when someone should look into a possible cochlear implant surgery.
Linda Broenniman was raised a church-going Catholic, only to uncover a long-hidden family secret that her father was Jewish. Thus began a multi-year journey of discovery and research, tracing the family back eight generations to a lineage established in Budapest, Hungary. One that includes Adam Politzer, the father of Otology. Linda chronicles this epic journey in her book "The Politzer Saga" and provides a wealth of historic photos. This book is timely and important in terms of much historical perspective. www.politzersaga.com
Linda Broenniman was raised a church-going Catholic, only to uncover a long-hidden family secret that her father was Jewish. Thus began a multi-year journey of discovery and research, tracing the family back eight generations to a lineage established in Budapest, Hungary. One that includes Adam Politzer, the father of Otology. Linda chronicles this epic journey in her book "The Politzer Saga" and provides a wealth of historic photos. This book is timely and important in terms of much historical perspective. www.politzersaga.com Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Dr. Kevin Zhan, Assistant Professor of Otology & Neurotology and Medical Director of the Northwestern Medicine Cochlear Implant program, explores the critical issue of cochlear implant underutilization in the United States. In this session, originally part of the 2024 Future of Hearing Healthcare Conference, Dr. Zhan delves into the current literature, highlighting the major public health implications of underutilization, and discusses the relationship between audiology services and cochlear implant usage across the country. For the full experience, we highly recommend watching the video on YouTube: https://youtu.be/FKrhHewj4LI
Dr. Richard E. Carmen holds three academic degrees in mainstream science with a Doctor of Audiology (Au.D.) from the Kirksville College of Osteopathic Medicine. Spanning over half a century he has served the deaf, deaf-blind, hard of hearing, and underprivileged. He's been an award-winning author with over 50 publications within and outside the hearing industry including feature articles, cover stories, chapters, books, and peer-reviewed scientific papers.Dr. Carmen's work has appeared in top medical periodicals such as the American Journal of Otology; in the long-running eminent magazine The Saturday Evening Post; and in op-ed pieces in industry publications and on CBS 60 Minutes. He has been a consultant to state and federal governments, participated in think-tank forums, and served on eight national boards as an editorial consultant and/or adviser including the acclaimed Better Hearing Institute. Before founding his publishing company in 1997, he authored books with Little, Brown & Company; Prentice-Hall; G.K. Hall; and Rodale Press. Through his publishing endeavors and research, he teamed up with over a hundred scholars worldwide with scientists from renowned U.S. institutions like Harvard, Johns Hopkins, Children's Hospital, Mayo Clinic, NIH, and others.
Subscriber-only episodeDigitising public life in the US – making America e-smartMany governments and local authorities around the world have moved many, if not all their public services online, from filing tax returns to e-passports and food assistance schemes. However, the United States is lagging behind, with many civic services providing lengthy and user-unfriendly systems. CEO of Code for America, the nonprofit social organisation that's bringing about much of this digital change in public life, Amanda Renteria explains why the US needs to make e-access to its public services easier.Train your brain to overcome tinnitus with an appA new app, called MindEar can reduce the impact of tinnitus in just a few weeks. It uses sound, relaxation and cognitive behaviour therapy which can be accessed through a smart phone. It's estimated that up to one in four people may have the condition worldwide and the cause of this debilitating buzzing or ringing sound is still unknown. Current treatments are expensive and hard to come by. But this new chatbot app helps train your brain's reaction to the sound, tuning out the tinnitus. Scientists from Australia, New Zealand, France and Belgium report the findings in the journal Frontiers in Audiology and Otology. The lead author and co-founder of MindEar app, Dr Fabrice Bardy, is on the show.The programme is presented by Gareth Mitchell and the studio expert is Ghislaine Boddington.Editor: Ania LichtarowiczProduction Manager: Liz Tuohy Recording and audio editing : Lansons | Team Farner For new episodes, subscribe wherever you get your podcasts.Follow us on all the socials: Join our Facebook group Instagram Twitter/X If you like Somewhere on Earth, please rate and review it on Apple PodcastsContact us by email: hello@somewhereonearth.coSend us a voice note: via WhatsApp: +44 7486 329 484Find a Story + Make it News = Change the World
Digitising public life in the US – making America e-smart Many governments and local authorities around the world have moved many, if not all their public services online, from filing tax returns to e-passports and food assistance schemes. However, the United States is lagging behind, with many civic services providing lengthy and user-unfriendly systems. CEO of Code for America, the nonprofit social organisation that's bringing about much of this digital change in public life, Amanda Renteria explains why the US needs to make e-access to its public services easier.Train your brain to overcome tinnitus with an app A new app, called MindEar can reduce the impact of tinnitus in just a few weeks. It uses sound, relaxation and cognitive behaviour therapy which can be accessed through a smart phone. It's estimated that up to one in four people may have the condition worldwide and the cause of this debilitating buzzing or ringing sound is still unknown. Current treatments are expensive and hard to come by. But this new chatbot app helps train your brain's reaction to the sound, tuning out the tinnitus. Scientists from Australia, New Zealand, France and Belgium report the findings in the journal Frontiers in Audiology and Otology. The lead author and co-founder of MindEar app, Dr Fabrice Bardy, is on the show.The programme is presented by Gareth Mitchell and the studio expert is Ghislaine Boddington. More on this week's stories: Code for America Amanda Renteria Cognitive behavioral therapy and telepsychology in tinnitus via an app Everyday AI: Keep up and get ahead by making AI work for yourCan't keep up with AI? We've got you. Everyday AI helps you keep up and get ahead.Listen on: Apple Podcasts SpotifySupport the showEditor: Ania LichtarowiczProduction Manager: Liz Tuohy Recording and audio editing : Lansons | Team Farner For new episodes, subscribe wherever you get your podcasts.Follow us on all the socials: Join our Facebook group Instagram Twitter/X If you like Somewhere on Earth, please rate and review it on Apple PodcastsContact us by email: hello@somewhereonearth.coSend us a voice note: via WhatsApp: +44 7486 329 484Find a Story + Make it News = Change the World
The Daily Quiz - Science and Nature Today's Questions: Question 1: What is Otology the study of? Question 2: What is the name of a shape with four sides of unequal length? Question 3: Which of the following is a symptom of asthma? Question 4: What are the two main types of bone fracture? Question 5: What is Paleoanthropology the study of? Question 6: Who Took The First Practical Photograph? Question 7: What is the term used for a burn in which only the epidermis is affected? Question 8: What is the chemical potassium nitrate often used for? Question 9: What is Semitology the study of? This podcast is produced by Klassic Studios Learn more about your ad choices. Visit megaphone.fm/adchoices
https://politzersaga.com/ Did you knowthat March 9th is recognized as Genealogy Day? In our fragmentedworld, tracing genealogy has become a passion project for people worldwide.Think, PBS Finding Your Roots and History Detectives. LindaAmbrus Broenniman has set an amazing example by documenting her family lineage– filled with shocking secrets found in a house fire in a book called The Politzer Saga. There's even a correspondingmuseum exhibition of this family story in Budapest.Imagine growing up as a church-going Catholic and then later in lifediscovering your father was Jewish (a secret he took to his grave) with 8generations of Hungarian Jews before him and from where he and his wifeemigrated to Buffalo, NY in the 1940's. Clara Ambrus, Linda'sCatholic mother hid Jews during the Holocaust and was later recognized as“Righteous Among Nations” at Yad Vashem, the International Holocaust Museum among figures likeSchindler. The story getsbetter. In that lineage were characters like Adam Politzer, known to ENTsas TheFather of Otology. Art collectors, lawyers, and musicians. ForJews, harkening back that far in one's family is rare, hence the moniker of“wandering Jews.” Clara and Julian Ambrus were prominent physicians in theiradopted American hometown of Buffalo,Sadly, Clara lost her life after a house fire – the source of many of thehidden family documents. She will be celebrated there in May with a muraldedication. GenealogyDay might be the ideal time to get a conversation going about family trees,family secrets and where we come from. The Politzer Saga has changed the livesof author Linda Ambrus Broenniman and many of her relatives. Perhaps it's agood time to celebrate our roots.
Dr. Michal Kaufman, head of the Ear Surgery and Cochlear Transplantation Center at Hadassah Hospital Ein Kerem, talks us through the causes and treatments of hearing loss.
Linda Broenniman was raised a church-going Catholic, only to uncover a long-hidden family secret - that her father was Jewish. And thus began a years-long journey of discovery and research, tracing the family back eight generations to Budapest, Hungary with an amazing "cast of characters," including Adam Politzer, the father of Otology. Linda chronicles this epic journey in her book "The Politzer Saga" and provides a wealth of historic photos. This book is timely and important, in terms of much historical perspective. With the holiday season looming, this is a great gift idea, and considering that Hanukkah begins December 7, is once again timely.www.politzersaga.com Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Linda Broenniman was raised a church-going Catholic, only to uncover a long-hidden family secret - that her father was Jewish. And thus began a years-long journey of discovery and research, tracing the family back eight generations to Budapest, Hungary with an amazing "cast of characters," including Adam Politzer, the father of Otology. Linda chronicles this epic journey in her book "The Politzer Saga" and provides a wealth of historic photos. This book is timely and important, in terms of much historical perspective. With the holiday season looming, this is a great gift idea, and considering that Hanukkah begins December 7, is once again timely. www.politzersaga.com
Subscribe to get access to the full episode, the episode reading list, and all premium episodes! www.patreon.com/OrdinaryUnhappinessIn the latest installment of the Standard Edition, we begin the Fliess Extracts section of SE Volume 1 in conversation with novelist and literary critic Christine Smallwood. We discuss the figure of Wilhelm Fliess and what he meant to Freud; the history of the Freud-Fliess correspondence, only half of which survives; Fliess's theories of noses, periodicity, and bisexuality; Freud's anxiety about Fliess's professional reputation and influence on his own ideas; Freud's issues with condoms and coitus interruptus; and how Freud was thinking about categories like anxiety, depression, melancholia, and obsessional neurosis during this period.Articles discussed in this episode include:Young, Annie Riddington. "Freud's friend Fliess." The Journal of Laryngology & Otology 116.12 (2002): 992-995: https://www.cambridge.org/core/journals/journal-of-laryngology-and-otology/article/abs/freuds-friend-fliess/7F87416E73813F4EFEB9B46CB38B3D8BZucker, Arthur, and David Wiegand. "Freud, Fliess, and the nasogenital reflex: did a look into the nose let us see the mind?" Otolaryngology–Head and Neck Surgery 98.4 (1988): 319-322: https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/abs/10.1177/019459988809800409Blum, Harold P. "Freud, Fliess, and the parenthood of psychoanalysis." The Psychoanalytic Quarterly 59.1 (1990): 21-40:https://www.tandfonline.com/doi/abs/10.1080/21674086.1990.11927262Have you noticed that Freud is back? Got questions about psychoanalysis? Or maybe you've traversed the fantasy and lived to tell the tale? Leave us a voicemail! 484 775-0107A podcast about psychoanalysis, politics, pop culture, and the ways we suffer now. New episodes on Saturdays. Follow us on social media:Linktree: https://linktr.ee/OrdinaryUnhappiness Twitter: @UnhappinessPod Instagram: @OrdinaryUnhappiness Patreon: patreon.com/OrdinaryUnhappiness Theme song: Formal Chicken - Gnossienne No. 1 https://open.spotify.com/album/2MIIYnbyLqriV3vrpUTxxO Provided by Fruits Music
Welcome back to "From Our Neurons to Yours," a podcast where we criss-cross scientific disciplines to take you to the frontiers of brain science. This week, we explore the science of dizziness with Stanford Medicine neurologist Kristen Steenerson, MD, who treats patients experiencing vertigo and balance disorders.In our conversation, we'll see that dizziness is not a singular experience but rather a broad term encompassing a variety of different sensations of disorientation. We learn about the vestibular system, a set of biological "accelerometers" located deep within the inner ear that detect linear and angular acceleration, helping us perceive motion, orientation, and our connection to the world around us. We also discuss a wearable medical device Dr. Steenerson and colleagues at the Wu Tsai Neurosciences Institute are developing a wearable device to measure the activity of the vestibular system by tracking a patient's eye movements. With the ability to study this mysterious system in unprecedented detail, we're on the verge of learning more than ever about this misunderstood "sixth sense."Learn MoreDr. Steenerson's Stanford academic profileDr. Steenerson's Stanford Healthcare profile (Neurology and Neurological Sciences, Otolaryngology)The wearable ENG, a dizzy attack event monitor (DizzyDx)ReferencesPopkirov, Stoyan, Jeffrey P. Staab, and Jon Stone. "Persistent postural-perceptual dizziness (PPPD): a common, characteristic and treatable cause of chronic dizziness." Practical neurology 18.1 (2018): 5-13.Harun, Aisha, et al. "Vestibular impairment in dementia." Otology & Neurotology: Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 37.8 (2016): 1137.Brandt T, Dieterich M. The dizzy patient: don't forget disorders of the central vestibular system. Nat Rev Neurol. 2017 Jun;13(6):352-362. doi: 10.1038/nrneurol.2017.58. Epub 2017 Apr 21. PMID: 28429801.Allison S. Young, Corinna Lechner, Andrew P. Bradshaw, Hamish G. MacDougall, Deborah A. Black, G. Michael Halmagyi, Miriam S. Welgampola Neurology Jun 2019, 92 (24) e2743-e2753; DOI: 10.1212/WNL.0000000000007644Episode CreditsThis episode was produced by Michael Osborne, with production assistance by Morgan Honaker, and hosted by Nicholas Weiler. Cover art by Aimee Garza.Thanks for listening! Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.
When you think of foundational clinical vestibular research, there is no doubt you think of one if not both of these individuals. Separately, they have contributed significantly to the profession and together, their collaborations have been transformative to the future of vestibular. Watch to hear us talk to Gary and Devin about where they started, how to promote successful research collaborations, and where they see the future of vestibular going. Here are some research articles Dr. Jacobson and Dr. McCaslin wanted to share with you: Development of the Tinnitus Handicap Inventory. Newman CW, Jacobson GP, Spitzer JB.Arch Otolaryngol Head Neck Surg. 1996 Feb;122(2):143-8. doi: 10.1001/archotol.1996.01890140029007.PMID: 8630207 Test-Retest Reliability of the Dizziness Symptom Profile. Landon-Lane RL, Piker EG, Jacobson GP, Hatton K, Roberts RA.Ear Hear. 2021 Jan/Feb;42(1):206-213. doi: 10.1097/AUD.0000000000000918.PMID: 32701727 Development and Preliminary Findings of the Dizziness Symptom Profile. Jacobson GP, Piker EG, Hatton K, Watford KE, Trone T, McCaslin DL, Bennett ML, Rivas A, Haynes DS, Roberts RA.Ear Hear. 2019 May/Jun;40(3):568-576. doi: 10.1097/AUD.0000000000000628.PMID: 29979254 Effects of age on the tuning of the cVEMP and oVEMP. Piker EG, Jacobson GP, Burkard RF, McCaslin DL, Hood LJ.Ear Hear. 2013 Nov-Dec;34(6):e65-73. doi: 10.1097/AUD.0b013e31828fc9f2.PMID: 23673615 Free PMC article. Intraoperative evoked potential monitoring. Jacobson GP, Tew JM Jr.J Clin Neurophysiol. 1987 Apr;4(2):145-76. doi: 10.1097/00004691-198704000-00004.PMID: 3305572 Review. A Comparison of Dizziness Handicap Inventory Scores by Categories of Vestibular Diagnoses Graham, M. K., Staab, J. P., Lohse, C. M., & McCaslin, D. L. (2021). A Comparison of Dizziness Handicap Inventory Scores by Categories of Vestibular Diagnoses. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 42(1), 129–136. https://doi.org/10.1097/MAO.000000000... The Component Structure of the Dizziness Handicap Inventory (DHI): A Reappraisal Van De Wyngaerde, K. M., Lee, M. K., Jacobson, G. P., Pasupathy, K., Romero-Brufau, S., & McCaslin, D. L. (2019). The Component Structure of the Dizziness Handicap Inventory (DHI): A Reappraisal. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 40(9), 1217–1223. https://doi.org/10.1097/MAO.000000000... The dissociation of video head impulse test (vHIT) and bithermal caloric test results provide topological localization of vestibular system impairment in patients with "definite" Ménière's disease McCaslin, D. L., Rivas, A., Jacobson, G. P., & Bennett, M. L. (2015). The dissociation of video head impulse test (vHIT) and bithermal caloric test results provide topological localization of vestibular system impairment in patients with "definite" Ménière's disease. American journal of audiology, 24(1), 1–10. https://doi.org/10.1044/2014_AJA-14-0040
Hearing is different than listening. Dr. Matthew Kircher is not only a talented surgeon, a brilliant doctor, and an all-around good person, but Shailushi and Kosha also are lucky enough to call him family. He is married to their cousin (and previous guest on IAS) Sheetal. He sits in the Speaker's Chair this week to discuss his work as an ENT surgeon, how an ear functions, and why Q-tips should never go near your ears. Matthew L Kircher, MD is currently an Associate Professor of Otology, Neurotology and Skull Base Surgery in the Department of Otolaryngology – Head and Neck Surgery at Loyola University Medical Center. His practice includes the medical and surgical treatment of patients afflicted with ear disease. He has authored numerous peer-reviewed publications and book chapters. He currently serves on several national ENT committees, Co-Editor for Audiology and Neurotology Journal and is an active member of the American Neurotology Society and the American Academy of Otolaryngology-Head and Neck Surgery.
A/Prof Nigel Biggs discusses acoustic neuroma with Dr. Agustina Lagioia.
Courtney Voelker, MD, PhD (DPhil Oxon), is a Rhodes Scholar and board certified neurotologist. She is Director of Otology/Neurotology-Lateral Skull Base Surgery; and Director of the Adult & Pediatric Cochlear Implant Program at Pacific Neuroscience Institute. She is an otolaryngology – head & neck surgeon who takes care of adult and pediatric patients seeing a wide range of inner ear and skull base conditions. A Super Doctor Rising Star award recipient, she is committed to offering top quality, compassionate care to all her patients.Prior to joining PNI, Dr. Voelker was at USC Caruso Department of Otolaryngology – Head and Neck Surgery, Keck School of Medicine of USC as Division Chief of Otology, Neurotology and Lateral Skull Base Surgery, and the Director of the Pediatric Cochlear Implant program at Children's Hospital Los Angeles (CHLA). She has conducted leading-edge research on the physiology and diseases of the inner ear at Brown University, the University of Oxford, Washington University in St. Louis, and the National Institutes of Health (NIH).Dr. Voelker has authored numerous research publications and textbook chapters in her field. She is a member of the American Academy of Otolaryngology – Head and Neck Surgery and the American Neurotologic Society.Dr. Voelker graduated with Honors from Brown University and earned her medical degree from The Warren Alpert Medical School of Brown University. As a Rhodes Scholar she earned her PhD from the University of Oxford in developmental neurobiology. She completed her residency in Otolaryngology – Head and Neck Surgery at the Washington University (Barnes-Jewish Hospital) in St. Louis and her fellowship at the world-renowned House Ear Clinic in Los Angeles.Learn more about Dr. Voelker and other PNI Doctorshttps://www.pacificneuroscienceinstitute.org/people/courtney-voelker/
Kristin is joined by Dr Timothy Matthews, to discuss Sudden Sensorineural Hearing Loss (SSNHL). Dr Matthews is an Ear, Nose and Throat Surgeon with additional fellowship training in Otology and Neurotology (ear surgery/diseases). He has a special interest in minimally invasive endoscopic ear surgery and hearing implants (including cochlear implantation).
Cliff A. Megerian, MD, is Chief Executive Officer of University Hospitals (UH), a comprehensive health system with annual revenues of $5.3 billion, 21 hospitals (including 5 joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices located throughout 16 counties. He assumed this position in February 2021 and joined UH in 2002. He is also the Jane and Henry Meyer Chief Executive Officer Distinguished Chair.In December 2019, Dr. Megerian was appointed the system's President, where he led the organization through an unprecedented pandemic. Prior to that, he served as President, University Hospitals Physician Network, Physician Services and System Institutes. In these positions, he was charged with managing the clinical integration strategies, policies and practice guidelines for more than 2,500 UH employed physicians as well as the operations and infrastructure for UH system institutes. These clinical care institutes bring highly trained subspecialists together from multiple disciplines to collaborate on the best treatment for patients – promoting uniform, standard care protocols and the sharing of best practices.Additionally, he raised physician productivity to its highest level and significantly increased physician engagement and research funding. UH's physician network includes the full-time academic medical practice at UH Cleveland Medical Center and UH's community-based, multi-specialty physician network throughout Northeast Ohio.Dr. Megerian is also a Professor in the Department of Otolaryngology, Head and Neck Surgery at Case Western Reserve University (CWRU) School of Medicine, where he was Chair from 2012 – 2018 and held the Julius McCall Professorship at CWRU, as well as the Richard and Patricia Pogue endowed Chair in Auditory Surgery and Hearing Sciences at UH. He also serves as an Adjunct Professor of Surgery at Northeast Ohio Medical University.Prior to UH, he served on the physician staffs of the Louis Stokes Cleveland Veteran Affairs Medical Center and MetroHealth System Medical Center. At the University of Massachusetts Medical Center, Dr. Megerian was the Director of Otology and Neurotology, as well as the Director of Residency Training, the Medical Director, Cochlear Implantation Program, and the Co-Director, Center for Skull Base Diseases. He also served on the medical staff of Massachusetts Eye and Ear Infirmary and Boston Medical Center.Dr. Megerian's clinical career has been devoted to the management of hearing loss, chronic ear disease, cholesteatoma, otosclerosis, vertigo, and other otology and neurotology issues. As a surgeon, Dr. Megerian co-founded UH's Cochlear implant program and he and his team have performed over 1,500 cochlear implant surgeries, making it one of the largest programs in the country.He is also an expert in the diagnosis and treatment of acoustic neuroma. He has published over 130 peer-reviewed manuscripts and abstracts and has served as visiting professor at numerous medical schools and institutions throughout the world.His research interests in the pathogenesis of Meniere's disease have been funded by a number of agencies including the NIH and DRF. He previously served as a consultant to the FDA in the regulation of Ear, Nose and Throat Devices. He is co-author of a textbook in its second publishing, “Surgery of the Cerebellopontine Angle.”Dr. Megerian is a graduate of the University of Michigan Medical School and completed a residency in otolaryngology-head and neck surgery at University Hospitals of Cleveland and CWRU. He completed a research and clinical fellowship in otology and neurotology at Harvard Medical School, Massachusetts Eye and Ear Infirmary. He also completed a certificate program in healthcare management at Weatherhead School of Business at CWRU.Dr. Megerian serves on the American Hospital Association's Health Systems Committee. In addition, he serves on the boards of the Ohio Hospital Association, the Ohio Business Roundtable and the Greater Cleveland Partnership. He is also Chair of the Cleveland Innovation District/Jobs Ohio Consortium.In 2022, Becker's Healthcare named Dr. Megerian one of 113 Great Leaders in U.S. Healthcare and one of 7 Highly Successful Health System CEO-CFO Duos. Ohio Business Magazine appointed him to the Ohio 500, recognizing the most powerful and influential leaders who are working to make Ohio great. Crain's Cleveland Business named Dr. Megerian to the Power 150 – a list of executives leading some of Northeast Ohio's most influential organizations who are in a position to move the region forward.As CEO of University Hospitals, Dr. Megerian also led the system to attain the 2022 AHA Quest for Quality Prize – the industry's most prestigious honor recognizing its member organizations for their commitment to quality. Dr. Megerian and his wife Lynne Sheffler Megerian, MD, reside in Shaker Heights. They have three adult children.Visit University Hospitals: https://www.uhhospitals.org/
Moderator: Prof. Michael Strupp (Munich, Germany)Guest: Dr. Tatiana Bremova (Bern, Switzerland)For the final episode focusing on Neuro-Ophthamology and -Otology, Prof. Michael Strupp (Germany) meets with Dr. Tatiana Bremova (Switzerland) to discuss eye-movement disorders in neurometabolic diseases.
In this week's episode, we are joined by Dr. Jeff LaCour to discuss masculine suffering, marriage, life as a doctor with 6 children, and how to grow in holiness. Suffering is not only something that happens to everyone alive today, it is the choice means God uses to move men along in holiness. Jeff gives a great testimony to the role his father played in leading him in the Catholic faith, an example all fathers need to hear. Dr. Jeff LaCour is a board-certified otolaryngologist (ENT). He studied at LSU Medical School in New Orleans and UNC-Chapel Hill. He then completed a year-long Otology fellowship in Pittsburgh, followed by a year-long Rhinology fellowship in Savannah, Georgia. He has been practicing in Hammond, Louisiana for over 10 years and is the Director of Compassio Medical Education. He is married and lives with his wife in 6 children! Compassio Medical - Click Here
Do you want to improve your health and lose weight? Are you tired of feeling sluggish and bloated? If so, then it's time to try intermittent fasting! Intermittent fasting is a powerful tool that can help you reset your metabolism, burn fat, and improve your overall health. But it can be tough to get started. That's why we're excited to have Gin Stephens on the show today. Gin Stephens is the author of the NY Times and USA Today bestseller Fast. Feast. Repeat., and Delay, Don't Deny: Living an Intermittent Fasting Lifestyle, an Amazon #1 best seller in the weight loss category, as well as Clean(ish): Eat (Mostly) Clean, Live (Mainly) Clean, and Unlock Your Body's Natural Ability to Self-Clean (2022), another Amazon #1 bestseller in several categories. Gin has lived the intermittent fasting lifestyle since 2014, losing over 80 pounds. She is the host of 2 top-ranked podcasts: Intermittent Fasting Stories and the Life Lessons podcast (w/Sheri Bullock). You can join her private community by going to ginstephens.com/community. Gin will share her secrets for success with intermittent fasting, including how to overcome obstacles, what to eat (and what not to eat), and how to make fasting a sustainable lifestyle. In this episode, you'll learn: ► The benefits of intermittent fasting ► How to get started with intermittent fasting ► How to overcome obstacles to success ► What to eat (and what not to eat) while intermittent fasting ► How to make intermittent fasting a sustainable lifestyle So, if you're ready to learn how to lose weight, feel great, and take control of your health, then this episode is for you! Tune in now and start your journey to better health today. (00:00): So the big question is how do women over 40, like us keep weight off, have great energy balance. Our hormones in our moods feel sexy and confident and master midlife. If you're like most of us, you are not getting the answers you need and remain confused and pretty hopeless to ever feel like yourself. Again. As an OB GYN, I had to discover for myself the truth about what creates a rock, solid metabolism, lasting weight loss, and supercharged energy. After 40 in order to lose a hundred pounds and fix my fatigue. Now I'm on a mission. This podcast is designed to share the natural tools you need for impactful results. And to give you clarity on the answers to your midlife metabolism challenges, join me for tangible natural strategies to crush the hormone imbalances you are facing and help you get unstuck from the sidelines of life. My name is Dr. Kyrin Dunston. Welcome to The Hormone Prescription Podcast. (00:53): Hey everybody. And welcome back to another episode of The Hormone Prescription with Dr. Kyrin. Thank you so much for joining me today. I have a special guest you're gonna love when I met her recently at one of our masterminds. I loved her immediately and you will too. She is a wealth of knowledge and just so warm and relatable and has such a gentle way of making what I can kind of make really complicated, pretty easy and simple to follow, which is a gift. So I'll tell you a little bit about her, and then we'll get started. Gin Stephens is the author of the New York Times and USA Today Best seller, Fast. Feast. Repeat., and Delay, Don't Deny: Living an Intermittent Fasting Lifestyle, an Amazon number one bestseller in the weight loss category, as well as Clean(ish): Eat (Mostly) Clean, Live (Mainly) Clean, and Unlock Your Body's Natural Ability to Self-Clean (2022), another Amazon. Number one best seller in several categories. Jen has lived the intermittent fasting lifestyle since 2014, losing over 80 pounds. Choose the host of two top rank podcast, Intermittent Fasting Stories and The Life Lessons podcast with Sheri Bullock. And you can join her private community by going to ginstephens.com/community. Welcome Gin. (02:18): Well, so nice to see you. Good to be here with you today. (02:22): Yeah, I'm so excited to have you here. And we are doing a live podcast interview with masterclass. So some of the ladies from my midlife metabolism programs are here and they're gonna get to listen and watch live and then ask questions later, which is a super fun benefit of being in my programs. So I think they'll really enjoy that. So how did you get started with intermittent fasting? It sounds like you were overweight. What was going on for you? (02:54): Yeah, I was actually obese and , it's a hard word to say, right? I was 210 pounds at five five, and you know, I have a long weight loss, weight loss story, just like so many people do that involves lots of years of yo-yoing, right? Probably most women and men these days can relate to that. And I was always looking for a way to lose the weight and keep it off for good, but it never happened. You know, I, I thought about this recently and it just struck me, you know, I've been at my goal now since 2015, I've been in the same goal range, wearing the same clothes. This is the first time I'm 53. I just turned 53. This is the only time in my life from birth that I have maintained a stable weight for a period of time. Cause you know, the first, you know, whatever it is, 18 years you're growing. (03:42): So I was growing and then right for the next years I was yo-yoing. I mean, there was always a time when every year I was getting bigger than I was dieting, then I was gaining and I was losing and it just kept going. And like probably so many people listening the yo-yo years get, get higher. Right. You lose some, then you gain more, then you lose a little, then you gain more. And so that's pretty much what happened to me. You know, I did all the things starting from my first diet. Really. I was counting calories during college. Like so many of us were mm-hmm and my first like real diet though, I think was the low fat era. When I graduated from college, it was the early nineties. So I started with the low, low fat loss. A lot of weight, looked awful, ate a lot of snack Wells oh my gosh. (04:29):I remember those. And also, do you remember SpaghettiOs had zero grams of fat, zero grams of that 11 on spaghetti and snack Wells, which is certainly not what, what they meant with eat low fat. Right. But that's what I was doing. Probably most people too, but I just kept trying everything over the years, you know? And it got wackier and wackier from the HCG diet lost a lot of weight gained even more back. I took doctor prescribed diet pills. It was super get those. They'll give 'em to you. You lose the weight long as you keep taking 'em. Right. But that was no good, but it basically, I trashed my metabolism with all of those diets. Now I first heard about intermittent fasting, probably around 2009. You know, I was the person that would go to the Amazon weight loss category and look at all the books that were bestsellers and see what people were doing. (05:21): And I would buy them. And actually I would first read the comments, right? What everybody said on Amazon, looking for that next best diet. So it's no surprise that I stumbled upon intermittent fasting and I would dabble in it here and there from oh nine to 14. But you know, we didn't know anything about it. Back then. Mm-Hmm everyone who was writing about intermittent fasting in the early days all said it works cause you're eating fewer calories. So here are some ways to eat fewer calories through intermittent fasting. And there was like a five hour window that was Dr. Burt hearing's fast five plan. There was alternate daily fasting. You could do. You were having a down day followed by an up day. You know, one day you did it one day, you didn't. And but every single plan talked about, it's just calorie restriction in an eating window or every other day. (06:08): So I would dabble in it. But you know, I didn't understand so many things. I know now I didn't understand about insulin. I didn't understand about being metabolically flexible and what that means. And so I dabbled and my body never became adapted to fasting any of the times that I tried it. Cause I didn't give it long enough. Mm-Hmm I also didn't understand something. I now call the clean fast, which you can talk about a little bit later, but basically I lived in the hard part and it never got to be something that felt easy or good mm-hmm so I just kept dieting and all those years still wasn't doing well until finally in 2014, I went on a family cruise and we were in the Caribbean for seven days. It was a wonderful trip, but I looked at the pictures of me with my family and like those formal night pictures on a cruise ship. (06:59): Mm-Hmm yeah. I was like, who is that in the picture? I looked like myself, but like inflated, like someone had put a pump in my mouth and my whole body just felt inflated. And I remember on that trip, we did this wonderful excursion where we were hiking up the Mayan ruins and it was really hard to carry my body, which was 80 pounds heavier than it is today. Up those Mayan ruins up those steps. I was like, I just can't do this. And so I was just miserable the whole time. So I came back home and said, this is the time I've gotta do something. Well, I turned to HCG one more time. and of course, you know, I was like, I can't do this ever again. I can't do this ever again. So I quit that. And that summer, August of 2014, I found my way back to intermittent fasting for the last time. (07:43): Meaning that I stuck with it. There's the difference. I stuck with it and I never quit doing it. And so I wanted to lose 75 pounds. I lost those 75, went on to lose about five more. And I've been maintaining the loss since 2015, which is wow. Astonishing. Because like I said, I had never been the same weight season after season after season. So that's, what's, what's changed for me is maintenance has been, you know, pretty easy. My honesty pants get a little tight. I know what to do. You know, I've now been through menopause. I went through that at 51 and yeah, my body just keeps feeling great and intermittent fasting is not so secret. (08:27): Well, not so secret secret, that sounds like a book. So I know everybody will dive into the details, but I know some people are thinking really Jen, you didn't exercise and work out at the gym, like crazy. Really Jen, you didn't, you know this, that or the other, none of that. (08:43): No. And you know, really, I've never been someone who loved to do a lot of exercise. And interestingly enough, I had my DNA analyzed through 23. Me ran it through a couple of different third party websites. That'll tell you things about yourself. I was so not surprised when it came to exercise, my DNA report said not likely to lose weight with exercise and some people get the opposite. Some people have a genetic profile where exercise is required for them to lose weight. But for me, I mean, I, I do exercise. Don't get me wrong. I'm now doing water aerobics. We just moved. I do water aerobics every single day that I can get to it. And I'm an active person. I'm not sedentary, but exercise has never been that. Like I never once started an exercise program and bam, the weight came off. It's always had to be something else. (09:30): Right. Okay, great. So let's dive into it. You talked about when intermittent fasting first came out, there were different people with different plans and you kind of bopped around and tried different ones. Mm-Hmm talk about what was the plan that you initially started with? Are you still with that? What are the details kind of, and then also maybe break down some lingo. I think hopefully most people have heard of intermittent fasting so they know what you're feeding window needs, right? You're fasting interval, things like that, but maybe they don't so feel free to fill in the basics. I'm always doing the podcast as a listener and some people are gonna be newbies and others are gonna be experts. So I try to keep them all along for the ride. So feel free to detail us. (10:13): All right. Well the most common intermittent fasting approach is the daily eating window approach, which is formally known as time restricted eating, which some people like a lot better because you know, the word fasting is a little scary. You know, I didn't make this up. There's a saying that that goes along with fasting and it's brilliant. And the saying goes like this diets are easy in contemplation, but hard in execution. Right. You know, we've all like thought about a new diet, oh, this is gonna be fabulous. But then we crash and burn. Cause it's really hard to keep up a restrictive diet long term. Well, fasting is completely opposite. Fasting is hard in contemplation, but it's easy in execution. It only sounds like it's gonna be hard. You know, what was really hard was all the diets that I was doing when I was eating, you know, small meals all throughout the day that was miserable. (11:02): The low calorie diets I did before. But with intermittent fasting, once your body adapts and you find what really works well for you and your body is metabolically flexible. Mm-Hmm you get to figure out what your ideal eating window is, what time of day that works best for you. We're not all the same. I have an evening eating window. Some of my foundations, I mentioned earlier with Dr. Burt, hearing's fast five approach and he's 19 five. That's what he did himself. And that was one of the very earliest. I think that was the earliest book out about eating windows. He just kind of figured it out and he didn't start eating till five and he had a five hour eating window. So that's fast five. He started five. You go for five now. Of course, that's not exactly how I do it. I don't wait till five to open my window, but that's what worked for him. (11:50): So his program was wait till five, then have a five hour eating window. He's like, or you can move it around. However you want. Mm-Hmm , which is really what I did. So a five hour eating window is a great eating window length for me. And I feel better when I opened my window in the afternoon today I opened three 30 and I had like a little snack. And then I had dinner with my husband before we started talking today. We usually don't eat till around seven, but I ate a little earlier today just for y'all mm-hmm and, and my window is closed. So I probably had a three hour eating window today. And that's just how it worked because by the time we're done, I'm not gonna want to eat again. And I've had enough. I'm not hungry anymore, but it's a very flexible way to live. (12:31): But just this morning, you know, you mentioned, I have a podcast called intermittent fasting stories today. I interviewed, I think it was number 249 on the podcast and she has a morning eating window. She opens her eating window at seven 30 in the morning and she has a light breakfast. And then she has a really hearty lunch around one o'clock then she closes her window and that's it. And then she fast till the next morning. So she has about a six hour eating window every day. And that works really well for her, but hers is in the morning. So, you know, if you hear people telling you, here's how you must do it, here's how you must structure your day. Here's when the best time to have it is ignore all that. My mission in life is to teach people that you're very much a study of one when it comes to how long your eating window should be, how long your fast should be, what you're eating and your eating window, all of that is gonna be very individual for you. And I want people to feel empowered, to experiment and find what feels right to them. I have a chapter in my book, fast FET repeat, and it's called tweak it till it's easy. And I mean that mm-hmm, , it's your role as someone who's trying something to tweak it until it feels easy till it feels like a lifestyle, because when you find what works best for you, it really does become an easy lifestyle. (13:50): Yeah. I hear that from people I've tried it and my biggest challenge, and maybe we can talk about this a little cause I'm sure I'm not the only one is with the exercise. I work out a hard first thing in the morning. And what was happening is I was trying to open my feeding window in the afternoon and I was working out like a feed in the morning and I just started having, literally I noticed my skin sagging and then someone said to me, well, you're probably losing collagen cuz you're not getting enough protein cuz you're working out like that. I was like, you know what? That's true. And so how do you navigate this with exercise? (14:29): Well, again, that is you haven't found your sweet spot. You, that was obviously not your sweet spot. And also I would like to ask when you were fasting, were you fasting clean? What were you having to drink during the fast (14:42): Water? (14:43): Okay. Just water. Well then that's good. That's that's important. Cause a lot of people are not. So I wanted to throw that out there, but you know, it sounds to me like perhaps with the amount of working out that you were doing waiting until afternoon to open your eating window was not your sweet spot. (14:59): Right? (14:59): You gotta squeak. It feel it's easy. (15:01): But my challenge is so I need to eat because I'm gonna go work out, but I'm really not hungry until, so it's like, (15:10): Well, so the issue was the skin sagging and that was it. (15:14): No, I also didn't feel good. Okay. (15:16): Well if you didn't feel good then that's not a good sign. You wanna feel good? Yeah. Cause the key is you wanna feel good, but like for me, and I guess I'm doing water aerobics. That's not maybe as intense as what you're doing, but a lot of people in the fasting community are able to work out hard and then keep asking for hours. How long were, did you try it? How long did you give it? (15:35): Oh gosh, I'd have to look back. But it was for a few months. (15:38): Okay. Okay. Yeah. Well by then, you know, you would expect that you would be adapted by then. So it sounds like to me, perhaps your eating window, wasn't best for you to wait till the late afternoon. (15:49): Yeah. So I know that's one thing I struggled with. I've heard other people talking about it too. And then the other concern I know a lot of people have, maybe you can speak to, this is getting enough protein in, in a shorter eating window. (16:04): You know, that's an interesting question. We do get that a lot. And something to keep in mind is not all of our protein needs have to come from the foods that we're eating. Now that might sound crazy. So let me explain. You've heard ology before, right? Yeah. Otology is our, body's basically it's our body's recycling and upcycling system, but I was an elementary teacher for 28 years. So I like to explain things in a simple way. It's our body's upcycling program. So when you're in the fasted state, your body is looking around, well, nothing's coming in, let's see what's around. And so your body breaks down old proteins and recycles them and can use those old proteins to build new things. So when you're fasting clean, now, if you're eating all day long, like breakfast, snack, lunch snack that actually Downes Autophy and downregulated Autophy, it gets worse and worse. (17:01): The older we get mm-hmm . And so, you know, living in the modern world where we are eating all the time, most people are down regulated. Autophy leads to a lot of the problems that come along with aging. But when we're fasting, especially when we're fasting clean, we have increased Autophy. So Autophy is upregulated. We're better able to recycle those old junky proteins. So I'm able to build muscle. When I, when I just started doing my water aerobics in the past month or so since we just moved to a new, a new place, new neighborhood doing the water aerobics, I am building muscle, working out in the fasted state every morning, just doing that water aerobics. And I haven't increased the amount of protein that I'm eating, but I mean maybe I have without realizing it because I also am a big believer in the protein leverage hypothesis. Have you heard that that before? (17:49): No. Talk about that. (17:51): All right. Well, I can't remember who came up with a protein leverage hypothesis. Was it professor Nokes? I'm not sure Tim Nokes maybe, but basically it says that we have in our bodies, like we're a lot smarter than we give ourselves credit for our bodies, let us know what they need. So if you're not getting enough protein, your body is going to crave more protein until you give it what it needs. And so, you know, if, if you were like, you're eating and you're finding that you're unsatisfied, that might be your body saying, Hey, we need more protein. It's not gonna let you not get enough protein over time. And so, you know, when you think about what I said, auto, our body is recycling the protein plus during your eating window, if you are hungry for protein, we just really might not need also as much as we've been led to believe Dr. Jason fun. I'm sure you're familiar with his work. He has a great blog post about that. I think it's called how much protein is excessive or something. Mm-Hmm . And basically that people are always worried about not getting enough protein when really it's less of an issue than we realize. (18:59): Okay. So is that something that you usually recommend that people track? How many grams of protein they're getting? Yeah. So it's more of an intuitive, let your body decide what it was. Well, (19:09): You know, really, like I said, our bodies are pretty smart and I haven't noticed muscle loss. Like I said, I'm 53. I don't do anything harder than water aerobics. with my little weights in the water and I've not had trouble with muscle wasting and I've been doing fasting for years now and I was going to happen. It would've happened, right? (19:29): Yeah. Oh yeah, for sure. Definitely would've but I know that's something (19:32): That I have large communities and I left Facebook in early 20, 21 and we had almost half a million group members when I left. And one other thing about fasting is when, when you're fasting clean, we have upregulated human growth hormone. So when you have upregulated human growth hormone and you have a lot of apathy going on and you're nourishing your body well during your eating window, you're absolutely going to be fine. You know, if you do notice that, oh gosh, you know, maybe I'm losing a little muscle, just add a little 13, but you don't have to count it. It doesn't have to be that hard. We've got people doing all sorts of things in our community, building muscle, like crazy, just eating intuitively with their bodies and not counting in a single macro. (20:17): Yeah. Let's dive into that. Cause we're so we come from that calorie counting culture, the macro culture and this many grams of this and this many grams of that. And people oftentimes will even say to me like, well, how many grams of protein carbs fats should I be getting and what types and they want, they want the rules and I'm pretty much an intuitive eater. So , but I will tell people if they ask, so what is your take on that? Well, (20:45): I mean, how did people ever survive before we had ? I mean, right. I mean, like if you go back in time, you know, people were not like dropping dead from if food was plentiful, any environment in the world where food was plentiful, people just knew what to eat and how much to eat. Right. They did not make it hard. And if you go to like the blue zones, now that mm-hmm, , you're familiar with the blue zones. Yeah. Yeah. Mm-Hmm five pockets in the world. National geographic has researched them where people live to be over a hundred. If you walked into some of those blue zones and said, let's talk about macros. They would look at you. Like you're nuts. Those people are living to be over a hundred. They're not counting a single calorie. They're not counting a single macro they're living long and healthy lives. And there's a lot of factors that go together to make that happen. But they're eating real foods like their ancestors did. Mm-Hmm and they're not counting a thing. (21:41): Right. And so that's how you usually teach and work with peoples just intuitively. But there are some people who would try that and they would go for the Hogan dos and the Ben and Jerry's and you know, all the things. (21:54): Here's the beautiful thing about intermittent fasting. There's something we call appetite correction. And Dr. Bur hut hearing came up with that phrase as well. But it's just a beautiful phrase. And it means that your body will direct you to what you need as far as how much food you need. And also what you know, most of us find when we're intermittent faster, as you, you know, people may start off eating the standard American diet, but over time your tastes change. Yes. Weirdest thing, you actually tune back into your hunger and satiety signals. Our bodies do not count calories. Our bodies count nutrients. So when you are intuitive and you are not just cramming every emotion down all day long with food, like I'm gonna say, I used to do when I was obese, I was eating for morning till night, because of course that was also what we were told to do. (22:46): We were told to eat breakfast within 30 minutes of your feet, hitting the floor and have frequent snacks, cuz that would boost your metabolism. That's what we were all told and how come I was 210 pounds. Right? I was doing all the things. And so I could not hear any signals from my body at that point. But now that I'm an intermittent faster, like, oh the Brussels sprouts look good. And so you may start off eating the standard American diet, but over time, it's amazing how your body directs you to like the first time you eat something that used to be your favorite thing. Like I can remember the first time I had a, a Starbucks, pumpkin spice latte after I'd lost the weight and been maintaining for a while. And that had always been my favorite, you know, when it was latte season and my window was open one day I was at target, there was a Starbucks in there. I'm like, I'm gonna have a pumpkin spice latte and my window was open. It's gonna be delicious. And I tasted it and I'm like, why does this taste like bug spray? This tastes awful. And I'm like, they have changed the recipe of no, they didn't change the recipe. my taste buds changed. The more real food you eat, the more you're fasting and living that lifestyle, your body just, it really changes in a way you just couldn't expect. (24:01): Yeah. You know, for me it was CBOs. When I weighed 2 43, I would eat Cinnabons (24:07): And those are not even good. Are they? I had one in an airport in like maybe 2018 cuz you know, it smelled so good. I was with my sister, we were flying down. It tasted like, like poison. (24:18): Yes. Like poison. It tastes like chemicals, (24:21): Chemicals. Exactly. (24:22): Right. So I love the intuitive and I noticed for me, if I'm not stressed, I will intuitively eat very healthy things. And it's only when the stress comes that I want sugar. (24:35): They're looking for soothing. Right. (24:38): They're right. All right. So we talked about that. No macros, I loved what you said. That's a quotable. Our bodies do not cap calories counts, nutrients mm-hmm . And then in terms of, you know, you hear so many things, are you also recommending a flexible kind of intuitive window that changes all the time based on how you feel or do you find that people do better when they set it and stick to it? And (25:07): That depends on the person that's gonna be very individual. There are some people that need more structure just because if it's too loosey goosey, then the next minute they're not fasting anymore. Right. Right. Like it's so flexible. They forgot to do it. So in fast Fe repeat, I have something called the 28 day fast start. And that is a period of time when people are, are learning how to do it. Your body is developing the skills that it needs behind the scenes to flip that metabolic switch to fat burning. And so that you're metabolically flexible. And so it is very much more like here is how you're going to do it day to day as your body is adapting. But then after those 28 days, that's where the tweak till a dizzy part comes in, and you start to figure out what works for you. (25:50): And there's a lot to be said for mixing things up from day to day, you know, like one day, if you have a one-hour eating window, cuz you were super busy and crazy that day, but that doesn't mean you need to do that tomorrow. Tomorrow. You're probably gonna need a little bit longer. So we don't want to be too rigid and overs restricting for our bodies. So it's really like for me, I would just stick to, you know, as long as I have like a five-hour eating window, pretty much from day to day, I could move it around. When I was losing weight, that really worked well for me. Other people find they might need an eight-hour eating window. Maybe five hours is too restrictive, but someone else might find they need a four-hour eating window because they tend to overeat. If they eat for five, it just really is all about learning about yourself and responding to how it's going. (26:35): I love that. That's something that I talk about all the time I called your body. She, you know, talked to her what she's gonna tell you what she needs, but we are so socialized out of listening internally and we're so externally directed. So it really is this re acquaintance. And it sounds like you are really teaching that too. Like your body knows what it needs and what it doesn't need. And if (27:00): It doesn't feel good, it's telling you for a reason, there's something that is not feeling good. Like what you were doing before your body told you that was not working. That was not your asking protocol for whatever reason you hadn't found it yet. (27:14): No, and I haven't, I haven't (27:15): Tried it person. (27:16): No, see that's a thing I'm not hungry till the afternoon, but I like to work out. So I haven't figured out how to fix that. So I just stopped doing it. I'm like, this is not working. I don't feel good. I'm not doing it, but (27:29): I guess it might be hard for you to work out later in the day. Yeah. (27:33): Yeah. It's a morning thing. So, well, I'll figure it out. I'm wondering you have this great podcast where people talk about their stories with intermittent fasting. Could you share some of your favorite stories from people you've had on the podcast? (27:48): You know, one of the most fun that I've had that I enjoyed so very much, I talked to a guest and she had been on extreme weight loss that extreme makeover, weight loss edition, Jackie arena is her name. And she's been in my community from way back when we were on Facebook. She's been in my group now she's in my off Facebook, private community. And she told her story, she lost over 200 pounds. Mm-Hmm in a year of doing extreme makeover, weight loss edition. And she talked about, and it was fascinating to talk to her because when I wrote fast Fe repeat, I talked about weight loss and all of that. Are you familiar with the Minnesota starvation experiments that they (28:28): Take? No, what's (28:30): That well in the Minnesota starvation experiments, basically trying to figure out, you know, how much food do people need to live? What happens if we really restrict how much that people are eating? So they had these conscientious objectors who weren't fighting in world war II and they're like, we'll use y'all. And so they put 'em on this, like I think a college campus in Minnesota and they studied them and what these were men and they put 'em on 1500 or something calories a day mm-hmm , which we probably are like, that's just what you do. You eat 1500 calories a day, but they studied them on this. What they called that a starvation diet. And so it was fascinating. I, I write about this in the introduction to fast FEAS repeat, but it talked about all the things they went through. Like they started to become obsessed with food. (29:13): They started to have feelings of wanting to bend and all these things that were happening to their bodies as they were restricting, restricting, restricting. And when I talked to Jackie, I mean it was like textbooks when the, the experiences that she went through going through that extreme weight loss, cuz it was basically just eat less and less and less and less. As you continue to lose that much weight, you have to just eat less and even more, less, more restriction, less and less and more and more working out. We've all seen those shows. And so by the end of it, I mean she had tanked her hormones. She was no longer having cycles. She had textbook. I mean obviously the Minnesota starvation experiment was men, but everything that they went through, as far as like on that, that starvation regimen she was going through and it took her years to get her hormones back in a good place. (30:05): And so, I mean that just lets you know how dangerous diet culture is, but she, after that, you know, she regained weight obviously, cuz your body is fighting back mm-hmm whenever you have, you know, they also did the biggest loser studies did you? Right. I saw that one. That was so interesting. Similar kind of a thing. They restricted so much that everything's, their metabolism slowed down. And then of course, as soon as they couldn't keep up that level, bam here came the way back and then their metabolisms were slower than when they had started. Right. So it was just fascinating to talk to her. And then she found intermittent fasting how that has been completely different and how she has finally been able to lose the weight through intermittent fasting and found peace around food that, that she didn't have before. And it was just so interesting to hear the, all the theory basically she's lived it all the, the bad diet theory followed watching. (31:03): She's a living example. She's a living example of every single theory that I talk about in fast fees, repeat of like, here's what they found. Here's what the research says. She's lived it and all of her experiences really show it. So I loved that episode. I mean, I've talked to, like I said, 249 today and most of them are just normal people. One that I really loved was Dr. Mark Matson. Are you familiar with his work? No, I haven't heard of him. You may have heard of his work and not known it. Do you remember in the end of 2019, when there was that big new England journal of medicine article about fasting, it came out on like December 26th, 2019 and suddenly, and fasting was all over the news. Yes. People were talking about how healthy it was. Well, Dr. Mark Matson was the author of that new England journal of medicine article. (31:51): And it turns out he wrote it because a lot of doctors were having patients starting to come in to their practice and saying I'm doing intermittent fasting, but the doctors didn't really know a lot about it. So they were like, we need to know more about this. And so the new England journal of medicine reached out to Dr. Mathson and asked him to write that review article. So it's a review article. So it covers all the science, all the, the best information that's out there. And it was really amazing when that came out in 2019, because I was running these Facebook groups and when people would join, we're like, why do you wanna join? And people always said, I wanna lose weight. I wanna lose weight. But all of a sudden people started saying, I wanna get healthy. I wanna live longer. I wanna prevent Alzheimer's because suddenly the conversation was shifted and people realized intermittent fasting is a very healthy way to live. (32:38): And I really credit mark Mathson for that. But he came on my podcast and intermittent fasting stories and talked about his story. And you know, he worked at John's Hopkins for his whole research career mm-hmm and he actually started doing intermittent fasting in the eighties wow. As grad student or something and just how he, he naturally gravitated towards, but he studied fasting and the effects on the brain, he's a neurological researcher, and you know, the anti-Alzheimer's properties and all the things like that and how it helps our neurological health in so many ways. But it was really fascinating to talk to him. And then everything in between just, you know, normal people who are fascinating. I've talked to doctors who live a lifestyle. I've talked to the mom next door, the dad next door. And I love talking to everybody because in 249 stories, everyone has something new to bring to the table to talk about how intermittent fasting has changed their life. (33:31): I love that you mentioned something earlier about this starvation experiment, which I didn't know about. That sounds horrible. What is the difference with calorie restriction, where you're eating all the time and the food obsession and the wanting to binge versus having a shortened eating and a great (33:52): Question. And I love that you asked it. Okay. So let's talk about how our bodies get fueled. Most people, especially now, if you look around, most people are carrying a whole lot of energy around in their bodies, right? (34:04): a lot of energy equals fat. You're (34:06): Carrying a lot of calories or like, like a calorie suit, right? People are wearing a calorie suit and those calories, if you can access them, the calories you have in stored fat, they provide great fuel for your body. And the key is you wanna be able to tap into those fat stores and use that energy. Well, that's where low calorie diets, where you're eating all day long. That's where it breaks down. We're not meant to eat tiny little amounts of food all day long, like a little drip, drip of a feeding tube or something. We're not meant to do that. And it has to do with the hormone. Insulin. Insulin is our storage hormone. And when insulin is high and when insulin levels are high, like if someone has insulin resistance type two diabetes, basically you have high fasted levels of insulin. Your insulin's high all the time. (34:57): Insulin is anti lipolytic, meaning it locks down your fat stores. So when you have high levels of insulin all the time, you have a really hard time accessing your stored fat and burning it for fuel. We have all experienced that when you're doing the low calorie diet and you're having your tiny little breakfast and you're drinking your diet soda, and then you're having little snack. You are keeping your insulin high all the time. And I'll talk in a minute about why diet sodas do that and why they're not part of the clean fast, because they cause an insulin response. But in the meantime, your insulin is up, up, up all the time. You cannot tap into your fat stores very well. It's like they're locked away, right? So you are not well fueled. You're having a low calorie diet, but because insulin is high that the low calorie diet isn't fueling you and you can't get to your fat stores. (35:47): So now your body has to, downregulate your metabolism, it's in a panic. Well now how fasting is different. Yeah. Once your metabolically flexible and you're fasting and you're keeping your insulin levels low during the fast, suddenly your body can now see all that fat too, and your body can start using the fat for fuel. And so just as I talked about your meeting, some of your protein needs through Autophy you're meeting some of your fuel needs through the fat that your body is burning. So we actually have one study that was really interesting. They followed people over a 72 hour F. Now I'm not recommending people start bathing for 72 hours. I eat every day. But when they were studying the people over these 72 hours, they looked at what their metabolic rate was doing. And everyone had like a baseline metabolic, right when they started. (36:38): And then as time went on, their metabolic rate actually went up over the course of this fast. It was a 72 hour fast, like I said, and then it reached a peak at a certain point. And then it started to trim slowly down again. And so by the time they got to the 72, the end of the 72 hours, their metabolic rate was actually higher than it had been at baseline, but trending downward. So, you know, what does that tell us that tells us that fasting, when we start tapping into those fast stores, our bodies get going and they can actually ramp up that metabolic rate, but it also tells us that we don't wanna just keep fasting forever and ever cuz if you follow that trajectory down, I mean, eventually it would've gone below baseline. So that's why extended fasting for days and days at a time that is gonna affect your metabolic rate over time. So you wanna find the balance between fasting and feasting and that's really important cuz you can over fast and that's not a good thing. (37:36): Yes. That's a great explanation. Thank you for explaining that. And I think some people might not know what metabolic flexibility is. I mean, you've kind of described it, but can you talk a little bit more about that? (37:48): It's really how we're we're designed to be. Our bodies are designed to be able to use whatever fuel source is available. At the time we have the ability to store fat for when we need it. Our body can take that stored fat and our livers can turn fat into keytones, which fuels our brain beautifully. And we have plenty of energy to do what we need when there's, when there's not food around. But when food is available, we can flip that switch and we're, you know, using that food for fuel. So what happens when there's no food for fuel, your body flips the switch back to using your fat stores. So we are meant to be metabolically flexible and have the ability to switch from one source to the other. And we lose that metabolic flexibility in today's modern world with the eating all the time, nobody ever has to flip that switch to fat burning. And that is why, you know, I talked about the 28 day fast start when people have to let their bodies adapt. That's why, because when you first start your body, it doesn't wanna do that. And you also may not even have those fat burning enzymes built up your body just really cannot do it yet. And you also have to get insulin down over the over time. But at first you you're gonna be hangry. You're gonna be tired. Your body's like, come on. Where's the latte that I'm used to having at 10:00 AM. (39:04): where's (39:05): The breakfast burrito from the drivethrough or whatever it is. And eventually though your body's like, all right, fine, fine. I'll go tap into the fat store. Then it flips that switch. And there you go. (39:19): Yeah. It's kind of like, you have to be your body's parent and like, Nope, you're not getting that. Nope. You're not getting that. Exactly. You know, the kids are like, can we have a cookie? Can we have a cookie? And I'm getting to know dinners coming. And they devour the Brussels spout cuz they didn't get the cookie. So now I'm (39:35): Not, your body wants the cookie. And if you don't give it the cookie, if you eat your fat, (39:39): eat your fat, go eat fat. Right. Right. So there's so much to talk about with this. I definitely want to recommend that people get your books, read your books during your community. I just love the titles that you have. There's so descriptive and clear. And I think that makes it very accessible to pretty much everyone. And I love that and you're so real and it's just great. So we'll have links to the books in the show notes. We'll also put a link to your community so that people can go there and actually grab links to your podcast too. And put those in there so everybody can listen. Thank you for staying up late to meet with us. (40:26): It's not really that late. I just don't usually do things that I have to be active after dinner. Cause I had dinner usually after dinner I'm in wind down mode. (40:36): Got it. Got it. Well, we will get you there soon. We'll have a few questions and answers any last things that you wanna share with everyone before we wrap? No, I didn't. (40:46): Didn't talk about the clean fast, which is super duper important. Okay. Go ahead. Have during the fast and a lot of people have tried intermittent fasting and for whatever reason, they were not successful. And when I talk to people who are like, oh yeah, I tried that. It didn't work for me. There are usually two things that come up time. And again, one, they didn't give it long enough. Mm-Hmm and two, they were not fasting clean. So let's talk about what it means to fast clean. You know, I just talked about how we wanna keep insulin down. That's so important. So we can tap into our fast stores. Well, what causes to have an insulin response? Eating? Obviously we're not eating we're fasting, but also it turns out the taste of sweetness. If our brain thinks food is coming in, right? Even if it's a diet Coke, our brain doesn't understand the cephalic phase insulin response is when you taste something like that, diet soda, your brain says, we know what sweetness means. (41:38): It means that sugar is coming in because in nature, everything that is paired with sweetness is like, you know, sugary or fruit or honey or whatever. Right? And so your pancreas goes ahead and pumps out some insulin because it knows you're gonna have high blood sugar soon. But then again, you're having this diet soda because it has zero calories. No sugar comes in, but you still have high insulin. And so you wanna keep your insulin down so your body can tap into your fat stores. So avoid anything. That's sweet. See all these miracle sweeteners. You're like this one doesn't raise your insulin. This one doesn't your brain doesn't know the difference. It doesn't milk fruit. It's like, no, it just tastes sweetness. And so you wanna avoid anything sweet. Don't put anything in your coffee to add sweetness or your tea. Don't add anything like that. (42:26): But, and you wanna avoid things like lemon, apple, cider vinegar, anything that might have a food like taste, avoid those things. Cinnamon, all that avoid all that. The second goal is we wanna have, we wanna be tapping into our fat stores for fuel. So you don't wanna take in sources of fat during the fast don't put the butter in your coffee, the cream in your coffee. Don't put anything in your coffee. other than the coffee, don't take exogenous. Keytones cuz if you're taking in another source of fuel, your body's gonna use that. It's not gonna tap into your fat stores. We don't just wanna have keytones. We wanna make 'em from our stored fat. Yeah. If you're putting MCT oil in your coffee, your body's gonna take that MCT oil and turn it into keytones. But you want to get your keytones from your own body, fat, not from something you're putting in your coffee cup. (43:16): And so the third thing we wanna do, our third fasting goal is we wanna have that increased auto and to do that, we don't wanna take in any sources of protein because protein, halts auto. So don't have bone broth or anything like that, you know? And if you start, you know, listening to people here and there there's all sorts of really bad recommendations, like oh 50 calories, doesn't break a fast. That is not true. Like in that case you could literally just like eat a jelly bean every five minutes and like fasting and that is not fasting. And some people are like, well what about a little splash of cream? Because this fasting expert over here says it's okay to put in a little splash of cream. Well, what is cream? Well it's dairy. If dairy is nature's perfect food for growing a mammal baby at the time of their life where they're growing the most rapidly. (44:06): Does that sound like fasting? No, no anti dairy. Keep it in your eating window. If, if dairy works for you, but dairy is in no way, shape or form fasting, neither is almond milk. That none of that is that's not fasting yeah. So stick to the clean fast plain water, plain sparkling water, no flavors added. Don't add anything in there for flavor. It's not supposed to be a flavor adventure. We're taking a break from that. You can have all the flavor adventure you want in your eating window. You can have black coffee, plain tea. Now why can we have the black coffee and the plain tea? Well, those have a bitter flavor profile and that is not associated with the cephalic phase insulin response. (44:48): That is very important. Thank you for explaining that. And you know what I realize we didn't talk about which we gotta hit on. This is like you said, when the new England journal article came out in 2019, people shifted from it. Wasn't about weight loss. They wanted to be healthy. Right? Can you just hit on the highlights of all the diseases that intermittent fasting is recruiting to help (45:12): I cannot because the list would be so long. I (45:15): Know like, (45:16): You know, as a medical professional yourself, anything that's connected with insulin resistance, metabolic syndrome inflammation. I mean, that's like the root of like everything, right? (45:27):Everything, (45:27): Insulin resistance, metabolic syndrome, inflammation. Those are the things that intermittent fasting helps with. So anything that would be, if you go downstream from whatever medical condition and the downstream (45:40): Problem, (45:42): If you ever read B's book why we get sick? (45:45): I have not. No, (45:46): You gotta read that next. Get that book. Okay. If you will, if you haven't read fast, Pete, read that, but then need to read then Dr. Benjamin Bick. Men's why we get sick. And it basically makes the case. He's like the premier insulin resistant expert in the world, I think. And it basically talks about how insulin resistance, how it CA and he walks you through it, you know, how does it affect us in menopause? How does it affect, oh yeah. His health. How does it? And it's really the root of everything. So getting your insulin and can under control is just so important. It, it will, I mean, you type two diabetes. I mean, I think people say crazy things on the podcast that have been helped by, you know, I mean simple things. Yes. But people have had crazy results that you wouldn't even expect. I talked to somebody last week, she was wheelchair bound due to, she had some autoimmune type things that were going on and intermitent, festing, she's not been in a wheelchair. I mean, she's now like gained her mobility bag and I mean, it it's like you would never write all this in a book, cuz it sounds like too far fetched, but when people tell you their own story, you know that it's true. (46:51): Yeah. That's amazing. I mean, I always say that insulin is that loose thread on the knotted ball of yarn of all your hormones and you gotta get it right. And I'm a big believer in, there are two prescriptions we need as women, as we age, we need the written one for natural hormones and we need this kind of life prescription. So thank you very much, Gin Stephens for coming on the podcast and sharing your wisdom with all of us. (47:20): Well, I love doing it (47:22): and thank you all for joining us for another episode of The Hormone Prescription Podcast. Hopefully you've heard something today that has sparked your interest and maybe you're willing to take the plunge and try it start with one of Gin's books, fast beast, repeat or delay don't deny, join one of her communities. Try out her 28 day program, do something don't just listen and say, oh yeah, that's great. I'll think about it later. I want you to take action. So I wanna hear about it on social media. Yeah. Jump on Instagram, Facebook and let me know what you're trying and how it's working for you. And I will see you next week. Thanks so much for spending this time with us until then peace, love and hormones. Y'all (48:09): Thank you so much for listening. I know that incredible vitality occurs for women over 40. When we learn to speak hormones and balance these vital regulators to create the health and the life that we deserve. If you're enjoying this podcast, I'd love it. If you give me a review and subscribe, it really does help this podcast out so much. You can visit the hormone prescription.com, where we have some free gifts for you and you can sign up to have a hormone evaluation with me on the podcast to gain clarity into your personal situation until next time, remember, take small steps each day to balance your hormones and watch the wonderful changes in your health that begin to unfold for you. Talk to you soon. ► Clean (ish) Supplemental Materials Download the free companion pdf that contains all of the reflect and take action pages from Clean(ish), as well as the activities from part 3 of the book. CLICK HERE. ► Gin Stephens Membership Community: The Delay, Don't Deny Community. CLICK HERE to join. ► Feeling tired? Can't seem to lose weight, no matter how hard you try? It might be time to check your hormones. Most people don't even know that their hormones could be the culprit behind their problems. But at Her Hormone Club, we specialize in hormone testing and treatment. We can help you figure out what's going on with your hormones and get you back on track. We offer advanced hormone testing and treatment from Board Certified Practitioners, so you can feel confident that you're getting the best possible care. Plus, our convenient online consultation process makes it easy to get started. Try Her Hormone Club for 30 days and see how it can help you feel better than before. CLICK HERE to sign up.
Theme: Environmental Medicine. Participants: Dr Scott Squires, A/Prof. Andrew Coggins (emergency physician), Tim Selvaraj, Yelise Foon, Mariez Gorgi, Shreyas Iyer, Kit Rowe, and Harry Hong. Discussion:Livingstone, D., Smith, K., & Lange, B. (2017). Scuba diving and otology: a systematic review with recommendations on diagnosis, treatment and post-operative care. Diving And Hyperbaric Medicine Journal, 47(2), 97-109. https://doi.org/10.28920/dhm47.2.97-109.Presenter: - Yelise Foon - emergency medicine trainee at Westmead Hospital.Music/Sound Effects: Ascension by Keys of Moon | https://soundcloud.com/keysofmoon, Music promoted by https://www.free-stock-music.comAttribution 4.0 International (CC BY 4.0), https://creativecommons.org/licenses/by/4.0/. Dance by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US. Keep Going by Jay Someday | https://soundcloud.com/jaysomeday, Music promoted by https://www.free-stock-music.comCreative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US. Nostalgic Marshmallows by Arthur Vyncke | https://soundcloud.com/arthurvost, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution-ShareAlike 3.0 Unported, https://creativecommons.org/licenses/by-sa/3.0/deed.en_US. Sound effects from https://www.free-stock-music.com. The Times by Jay Someday | https://soundcloud.com/jaysomeday, Music promoted by https://www.free-stock-music.comCreative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US. Disclaimer:Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.Thank you for listening!Please send us an email to let us know what you thought.You can contact us at westmeadedjournalclub@gmail.com.You can also follow us on Facebook, Instagram, and Twitter!See you next time!~
Courtney Voelker, MD, PhD (DPhil Oxon), is a Rhodes Scholar and board certified neurotologist. She is Director of Otology/Neurotology-Lateral Skull Base Surgery; and Director of the Adult & Pediatric Cochlear Implant Program at Pacific Neuroscience Institute. She is an otolaryngology – head & neck surgeon who takes care of adult and pediatric patients seeing a wide range of inner ear and skull base conditions. A Super Doctor Rising Star award recipient, she is committed to offering top quality, compassionate care to all her patients. Prior to joining PNI, Dr. Voelker was at USC Caruso Department of Otolaryngology – Head and Neck Surgery, Keck School of Medicine of USC as Division Chief of Otology, Neurotology and Lateral Skull Base Surgery, and the Director of the Pediatric Cochlear Implant program at Children's Hospital Los Angeles (CHLA). She has conducted leading-edge research on the physiology and diseases of the inner ear at Brown University, the University of Oxford, Washington University in St. Louis, and the National Institutes of Health (NIH). Dr. Voelker has authored numerous research publications and textbook chapters in her field. She is a member of the American Academy of Otolaryngology – Head and Neck Surgery and the American Neurotologic Society. Dr. Voelker graduated with Honors from Brown University and earned her medical degree from The Warren Alpert Medical School of Brown University. As a Rhodes Scholar she earned her PhD from the University of Oxford in developmental neurobiology. She completed her residency in Otolaryngology – Head and Neck Surgery at the Washington University (Barnes-Jewish Hospital) in St. Louis and her fellowship at the world-renowned House Ear Clinic in Los Angeles. Learn more about Dr. Voelker and other PNI Doctors https://www.pacificneuroscienceinstitute.org/people/courtney-voelker/
This week Bobbi Conner talks with Dr. Habib Rizk about the role that certain foods and drinks can play in triggering migraine episodes for people who suffer from migraines. Dr. Rizk is an Associate Professor in Otology and Neurotology and Director of the Vestibular Program at MUSC.
The Daily Quiz Show | Science Today's category is Science, how many can you get right? Quiz content sourced from https://opentdb.com/ and https://the-trivia-api.com/ Follow on Social Media: Instagram: https://www.instagram.com/dailyquizshow/ Facebook: https://www.facebook.com/dailyquizshowpodcast Twitter: https://twitter.com/thedailyquizpod TikTok: https://www.tiktok.com/@dailyquizshow YouTube: https://youtube.com/channel/UCHb1Y98Oxpq-AQNc0SfxUrg/ Learn more about your ad choices. Visit megaphone.fm/adchoices
ABOUT DR. CHARLES LIMB:USSF Health: https://www.ucsfhealth.org/providers/dr-charles-limbhttps://ohns.ucsf.edu/charles-limb https://profiles.ucsf.edu/charles.limbWikipedia: https://en.wikipedia.org/wiki/Charles_LimbTED Profile: https://en.wikipedia.org/wiki/Charles_LimbTED Talk: https://www.ted.com/talks/charles_limb_your_brain_on_improvKennedy Center:https://www.kennedy-center.org/artists/l/la-ln/charles-limb/https://www.kennedy-center.org/video/center/discussionspoken-word/2017/jazz-creativity-and-the-brainsound-health-music-and-the-mind/https://www.kennedy-center.org/video/digital-stage/discussionspoken-word/2019/music-and-the-voice-brain-mechanisms-of-vocal-mastery-and-creativity--sound-health/https://www.kennedy-center.org/video/center/discussionspoken-word/2019/sound-health-inside-esperanza-spaldings-brain--the-kennedy-center/https://www.kennedy-center.org/video/center/classical-music/2018/music-and-the-mind-with-piano-prodigy-matthew-whitaker/The Art of The Spark: Musical Creativity Explored with Dr. Charles Limb: https://www.youtube.com/watch?v=PQmGOVr8aJ0Articles: https://www.artsandmindlab.org/charles-limb-md-mapping-the-creative-minds-of-musicians/On Creativity: mihaly csikszentmihalyihttps://en.wikipedia.org/wiki/Mihaly_Csikszentmihalyi DR.CHARLES LIMB Bio:Dr. Charles Limb is the Francis A. Sooy Professor of Otolaryngology-Head and Neck Surgery and the Chief of the Division of Otology, Neurotology and Skull Base Surgery at UC San Francisco. He is the Director of the Douglas Grant Cochlear Implant Center at UCSF and holds a joint appointment in the Department of Neurosurgery. Dr. Limb received his undergraduate degree at Harvard University, medical training at Yale University School of Medicine, and surgical residency and fellowship training at Johns Hopkins Hospital. He completed a postdoctoral fellowship in functional neuroimaging at the National Institutes of Health. He was a faculty member at the Johns Hopkins University School of Medicine, Peabody Conservatory of Music and the School of Education between 1996 and 2015. Dr. Limb joined the UCSF Department of Otolaryngology-Head and Neck Surgery in 2015.Dr. Limb is the 2021-22 President of the American Auditory Society and the Co-Director of the Sound Health Network sponsored by the National Endowment for the Arts, NIH and the John F. Kennedy Center for the Performing Arts. He is the PI of an NEA Research Lab and Co-PI of an NIH R61/R33 grant. He is the past Editor-in-Chief of Trends in Amplification (now Trends in Hearing), and an Editorial Board member of Otology and Neurotology. Dr. Limb was selected as the 2022 NIH Clinical Center Distinguished Clinical Research Scholar and Educator in Residence. He was also named in 2022 as one of the Kennedy Center's Next 50, a group of fifty national cultural leaders who are “moving us toward a more inspired, inclusive, and compassionate world”.His current areas of research focus on the study of the neural basis of musical creativity and the study of music perception in deaf individuals with cochlear implants. His work has received international attention and has been featured by National Public Radio, TED, 60 Minutes, National Geographic, the New York Times, PBS, CNN, Scientific American, the British Broadcasting Company, the Smithsonian Institute, the Library of Congress, the National Endowment for the Arts, the Sundance Film Festival, Canadian Broadcasting Company, the Kennedy Center, Baltimore Symphony Orchestra, the Discovery Channel, CBS Sunday Morning, and the American Museum of Natural History.SHOW INTRODUCTION:A number of years ago I attended a series of lectures at the Kennedy Center in Washington DC that focus on music and the brain and as I sat and watched and listened to these presentations, I was absolutely amazed with the interrelationship between brain activity, spontaneous creativity, music, language meaning and all these things that we share as human beings.For years I've been fascinated with the creative process. It seems natural I suppose given that I'm an architect, an artist, an author and occasionally I might even consider myself a novice musician because I can bang out five chords of a James Taylor song on my guitar. I do however have the extraordinarily good fortune of living with three musicianS. MY sons who are jazz musician, a pianist and a drummer, and a wife who is also a pianist and composer/songwriter and have been surrounded by music and love it for years.In fact, when I paint, and I happen to be focusing on a series of portraits of famous jazz musicians and other musical artists, I only listen to their music as I'm creating. Somehow I think I'm channeling John Coltrane or Miles Davis or Keith Richards or Janis Joplin or Prince.But it helps, it really does. It gets me into a flow state and the world outside me just disappears. For a long time now I have held that creativity is part of who we are. We are equally Homo Faber man the maker as we are Homo Sapiens man the wise.I deeply believe that the creative process is something that is intrinsic to building community and connections with other people for years. We have danced around fires and stamped out meaning with our feet and sang songs and beat on drums and created extraordinary symphonies or rock concerts and in doing so we come together and better understand ourselves our community culture and, in some strange cosmological sense, our relation to the larger whole of humanity.It seems to me that vocal utterances (not speech as we now know it) or producing melodic or rhythmic sounds, beating on drums etc., predated organized or syntactic speech. Since adapting to changing circumstances in the environment around you required some degree of creativity, it seems that there would be a natural connection between the development of creative thinking processes as a matter of survival and what we now know as music as a way to exchange these ideas. Music and music with language, lyrics, are extremely powerful mechanisms to evoke and share emotion and communicate with each other. Building strong social groups and the use of communication tools like language and certainly music has been part of our evolutionary process. Our brains have evolved into these immensely complex systems of functional areas that provide us with the magic of music and art and creative invention. We humans have survived at the top of the food chain not because we have bigger brains than other creatures on the planet, but as I understand it, because our brains are wired differently. And how all of this relates to creativity is particularly interesting. When you see jazz improvisation happening, what has always amazed me is the speed with which the brain is making decisions and the amount of information it is processing:…what note to hit next? – how does it related to the last? – where is the improv going? - is there a structure of any kind? – how the brain makes those decisions and then send signals to motor areas and then electrical impulses to muscle groups that produce fine motor movements in hands and /or other body parts to create sounds… this is all happening with electricity and chemicals moving between cells…this is a bit overwhelming to figure out! It's like the brain is out ahead of the body in its thinking…When I sat in the audience of those early Kennedy Center music and the brain sessions, there was one that was particularly interesting to me. Dr. Charles Limb had intriguing conversations with musicians including Jason Moran - the Artistic Director for Jazz at the Kennedy Center - and he described some of the work he was doing with trying to understand the neural correlates of creativity.How was he doing that? Well, he was taking some of the best jazz musicians on the planet and putting them into fMRI machines and observing their brain activity while they were in moments of spontaneous creation - jazz improvisation. And what he's begun to discover is something pretty remarkable.Certain areas of the brain are deactivated in these moments of spontaneous improvised creation while others are lit up.From Dr. Limb studies, it seems that conscious self-monitoring, a function of the Prefrontal Cortex, is deactivated opening a gateway for spontaneous creation unencumbered by self-monitoring or concerns about inappropriate or maladaptive performances and areas that are connected to autobiographical narratives are more active.“In jazz music, improvisation is considered to be a highly individual expression of an artist's own musical viewpoint. The association of the MPFC activity with the production of auto biographical narrative is germane in this context, and as such, one could argue that the improvisation is a way of expressing one's own musical voice or story.”Dr. Limb's own story is nothing less than remarkable. From his early years as a young musician, to his study of medicine, he has become one of the preeminent scientists looking into music, the brain and the neural correlates of creativity.His list of professional accomplishments and appointments to various medical institutions is extensive and include:Being the Francis A. Sooy Professor of Otolaryngology-Head and Neck Surgery and the Chief of the Division of Otology, Neurotology and Skull Base Surgery at UC San Francisco. The Director of the Douglas Grant Cochlear Implant Center at UCSF and he holds a joint appointment in the Department of Neurosurgery. Dr. Limb received his undergraduate degree at Harvard University, medical training at Yale University School of Medicine, and surgical residency and fellowship training at Johns Hopkins Hospital. He was a faculty member at the Johns Hopkins University School of Medicine, Peabody Conservatory of Music and the School of Education between 1996 and 2015. Dr. Limb is the 2021-22 President of the American Auditory Society and the Co-Director of the Sound Health Network sponsored by the National Endowment for the Arts, NIH and the John F. Kennedy Center for the Performing Arts. He was also named in 2022 as one of the Kennedy Center's Next 50, a group of fifty national cultural leaders who are “moving us toward a more inspired, inclusive, and compassionate world”.His current areas of research focus on the study of the neural basis of musical creativity and the study of music perception in deaf individuals with cochlear implants. His work has received international attention and has been featured by TED, 60 Minutes, National Geographic, the. New York Times, PBS, CNN, Scientific American, the Smithsonian Institute, the National Endowment for the Arts, the Sundance Film Festival, the Kennedy Center, Baltimore Symphony Orchestra, the Discovery Channel, CBS Sunday Morning, and more.It is my distinct honor to be able to talk with Dr. Limb about music, creativity and the brain. ABOUT DAVID KEPRON:LinkedIn Profile: linkedin.com/in/david-kepron-9a1582bWebsites: https://www.davidkepron.com (personal website)vmsd.com/taxonomy/term/8645 (Blog)Email: david.kepron@NXTLVLexperiencedesign.comTwitter: DavidKepronPersonal Instagram: https://www.instagram.com/davidkepron/NXTLVL Instagram: https://www.instagram.com/nxtlvl_experience_design/Bio:David Kepron is a multifaceted creative professional with a deep curiosity to understand ‘why', ‘what's now' and ‘what's next'. He brings together his background as an architect, artist, educator, author, podcast host and builder to the making of meaningful and empathically-focused, community-centric customer connections at brand experience places around the globe. David is a former VP - Global Design Strategies at Marriott International. While at Marriott, his focus was on the creation of compelling customer experiences within Marriott's “Premium Distinctive” segment which included: Westin, Renaissance, Le Meridien, Autograph Collection, Tribute Portfolio, Design Hotels and Gaylord hotels. In 2020 Kepron founded NXTLVL Experience Design, a strategy and design consultancy, where he combines his multidisciplinary approach to the creation of relevant brand engagements with his passion for social and cultural anthropology, neuroscience and emerging digital technologies. As a frequently requested international speaker at corporate events and international conferences focusing on CX, digital transformation, retail, hospitality, emerging technology, David shares his expertise on subjects ranging from consumer behaviors and trends, brain science and buying behavior, store design and visual merchandising, hotel design and strategy as well as creativity and innovation. In his talks, David shares visionary ideas on how brand strategy, brain science and emerging technologies are changing guest expectations about relationships they want to have with brands and how companies can remain relevant in a digitally enabled marketplace. David currently shares his experience and insight on various industry boards including: VMSD magazine's Editorial Advisory Board, the Interactive Customer Experience Association, Sign Research Foundation's Program Committee as well as the Center For Retail Transformation at George Mason University.He has held teaching positions at New York's Fashion Institute of Technology (F.I.T.), the Department of Architecture & Interior Design of Drexel University in Philadelphia, the Laboratory Institute of Merchandising (L.I.M.) in New York, the International Academy of Merchandising and Design in Montreal and he served as the Director of the Visual Merchandising Department at LaSalle International Fashion School (L.I.F.S.) in Singapore. In 2014 Kepron published his first book titled: “Retail (r)Evolution: Why Creating Right-Brain Stores Will Shape the Future of Shopping in a Digitally Driven World” and he is currently working on his second book to be published soon. David also writes a popular blog called “Brain Food” which is published monthly on vmsd.com.
This week Bobbi Conner talks with Dr. Habib Rizk about the role that certain foods and drinks can play in triggering migraine episodes for people who suffer from migraines. Dr. Rizk is an Associate Professor in Otology and Neurotology and Director of the Vestibular Program at MUSC.
In Episode 13 of Entrepreneur Rx, I have the pleasure of speaking with Dr. Sanjay Prasad, a surgeon, and physician with over 30 years specializing in Neurotology and Otology. Sanjay is the CEO of SurgiPrice, SurgiQuality, SurgiConnect, and the author of Resetting Healthcare. Sanjay shares his background, how his companies allow patients to choose their surgeon based on quality scoring, what his company is focusing on now, his monetization strategy, and advice for others interested in becoming entrepreneurs. His insightful and enlightening discussion is one you won't want to miss.
Ken Landau talks with Dr. Mark J. Syms, an expert in Otology and Neurotology, who explains the early signs and prevention of hearing loss, and how lawyers can overcome these issues in communicating with their affected clients, and how to help them testify effectively in legal proceedings.
Dr. William James Azeredo, MD and Jeff Walter, PT, DPT, NCS from the Otolaryngology Vestibular and Balance Center at Geisinger Medical Center in Danville, PA join Abbie and Dani to discuss various indications for when it is appropriate for providers seeing patients to refer to an Otologist. Where to find Dr. Azeredo: https://providers.geisinger.org/provider/William+James+Azeredo/757871 Where to find Jeff and his resources: https://www.vestibular.today/ Follow the link to submit topic or guest requests: https://forms.gle/81vh89WKCX2kx6zg7l Hosted by Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman, PT Where to find us: www.Vestibular.Today www.BalancingActRehab.com Facebook: @VestibularToday / @BalancingActRehab Instagram: @ Vestibular.Today / @BalancingActRehab Twitter: @VestibularToday / @BalActRehab
Ashkan Monfared, Associate Professor of Surgery and Neurosurgery at the George Washington School of Medicine & Health Sciences, and Director of Otology and Neurotology at The George Washington Medical Faculty Associates discuss acoustic neuroma and the recent advances in treatment and detection.
Happy August! This month, we review superior semicircular canal dehiscence (SSCD)! Join us! Follow us on instagram @adoseofdizzypodcast References: Gioacchini, F. M., Alicandri‐Ciufelli, M., Kaleci, S., Scarpa, A., Cassandro, E., & Re, M. (2016). Outcomes and complications in superior semicircular canal dehiscence surgery: a systematic review. The Laryngoscope, 126(5), 1218-1224. Lagman, C., Ong, V., Chung, L. K., Elhajjmoussa, L., Fong, C., Wang, A. C., ... & Yang, I. (2017). Pediatric superior semicircular canal dehiscence: illustrative case and systematic review. Journal of Neurosurgery: Pediatrics, 20(2), 196-203. Ward, B. K., Van De Berg, R., Van Rompaey, V., Bisdorff, A., Hullar, T. E., Welgampola, M. S., & Carey, J. P. (2021). Superior semicircular canal dehiscence syndrome: Diagnostic criteria consensus document of the committee for the classification of vestibular disorders of the bárány society. Journal of Vestibular Research, (Preprint), 1-10. Ziylan, F., Kinaci, A., Beynon, A. J., & Kunst, H. P. (2017). A comparison of surgical treatments for superior semicircular canal dehiscence: a systematic review. Otology & Neurotology, 38(1), 1-10. Weber, P, (2017). Vertigo and Disequilibrium: A Practical Guide to Diagnosis and Management. Thieme Publishers, New York, Stuttgart. 2017
This episode has special meaning as I approach my 1 year cochlear implant birthday; the honor to interview my own CI surgeon, Dr. Oliver Adunka. Oliver Adunka, MD, FACS, is the Director of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology, Head and Neck Surgery at The Ohio State University Wexner Medical Center. Dr. Adunka is also part of the Department of Pediatric Otolaryngology at Nationwide Children’s in Columbus, Ohio. Join Dr. Adunka and I as we talk about how cochlear implant candidacy has changed, the surgery has changed, why patients/audiologists are hesitant to take the next step, and the vision of what this exciting technology holds in the future. To find out more about Dr. Adunka and his work visit: https://medicine.osu.edu/find-faculty/clinical/otolaryngology/oliver-adunka-md
Hear from the experts in our conversations on a rare genetic disorder: Neurofibromatosis type 2 (NF2). We cover NF2 diagnosis, new treatment options, and how to connect with the NF2 community. Experts in this episode include: *Oliver Adunka, MD, FACS: Director of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology, Head and Neck Surgery, at The Ohio State University Wexner Medical Center. *Lauren Hanrahan: Ambassador for NF2 Bio Solutions, and recently diagnosed with NF2. * Nicole Henwood, MD: Physician, President and CEO of NF2 Bio Solutions, and parent of a child with NF2. More resources and information for you: https://raredisease.com/nf2
In this episode, we'll speak with Associate Professor Holly Teagle from the University of Auckland in New Zealand and explore how we can address the growing hearing loss epidemic. We'll also gain a broader perspective on why treatment guidelines and a standard of care for hearing loss are so crucial when we hear from two additional experts in the field, Dr Leo De Raeve, Scientific Adviser of the European Association of Cochlear Implant Users, and Associate Professor Robert Briggs, Head of Otology and Medical Director of the Cochlear Implant Clinic at the Royal Victorian Eye and Ear Hospital in Australia. We value your feedback so please take a few minutes to complete our engagement survey: https://forms.office.com/r/LyLfHCUKup Boisvert I, Reis M, Au A, Cowan R, Dowell RC (2020) Cochlear implantation outcomes in adults: A scoping review. PLoS ONE 15(5): e0232421. https://doi.org/10.1371/journal.pone.0232421 This is a podcast for hearing health professionals. If you are a person with hearing loss or a member of the general public, please seek advice from your health professional about treatments for hearing loss.
In this episode, we'll speak with Associate Professor Holly Teagle from the University of Auckland in New Zealand and explore how we can address the growing hearing loss epidemic. We'll also gain a broader perspective on why treatment guidelines and a standard of care for hearing loss are so crucial when we hear from two additional experts in the field, Dr Leo De Raeve, Scientific Adviser of the European Association of Cochlear Implant Users, and Associate Professor Robert Briggs, Head of Otology and Medical Director of the Cochlear Implant Clinic at the Royal Victorian Eye and Ear Hospital in Australia.Boisvert I, Reis M, Au A, Cowan R, Dowell RC (2020) Cochlear implantation outcomes in adults: A scoping review. PLoS ONE 15(5):e0232421. https://doi.org/10.1371/journal.pone.0232421This is a podcast for hearing health professionals. If you are a person with hearing loss or a member of the general public, please seek advice from your health professional about treatments for hearing loss.
Today, we'll continue our theme on telemedicine and hear from another expert, Dr. Allison Biever, researcher and audiologist from Rocky Mountain Ear Centre in Denver, Colorado, who'll give her perspective on how clinics can use telemedicine in practice and also provide insight into what's in store for the future of hearing health care, both challenges and opportunities. We value your feedback so please take a few minutes to complete our engagement survey: https://forms.office.com/r/LyLfHCUKup This is a podcast for hearing health professionals. If you are a person with hearing loss or a member of the general public, please seek advice from your health professional about treatments for hearing loss. Slager HK, Jensen J, Kozlowski K, Teagle H, Park LR, Biever A, et al. Remote Programming of Cochlear Implants. Otology & Neurotology. (2019 Mar); 40(3):260-66.
Today, we'll continue our theme on telemedicine and hear from another expert, Dr. Allison Biever, researcher and audiologist from Rocky Mountain Ear Centre in Denver, Colorado, who'll give her perspective on how clinics can use telemedicine in practice and also provide insight into what's in store for the future of hearing health care, both challenges and opportunities. This is a podcast for hearing health professionals. If you are a person with hearing loss or a member of the general public, please seek advice from your health professional about treatments for hearing loss. Slager HK, Jensen J, Kozlowski K, Teagle H, Park LR, Biever A, et al. Remote Programming of Cochlear Implants. Otology & Neurotology. (2019 Mar); 40(3):260-66.
Episode 12 features Nitin Pagedar, MD, MPH, Associate Professor of Otolaryngology and Co-Leader of the Head and Neck Cancer MOG at University of Iowa Hospitals & Clinics. Dr. Pagedar discusses the article Survival Outcomes for Advanced Cutaneous Squamous Cell Carcinoma of the Head and Neck recently published in the Annals of Otology, Rhinology, and Laryngology.
Ioana Agache (President of the EAACI) discuss the importance of Endotype-driven approach as a step towards precision medicine in Asthma condition and Allergic Diseases. "ADHER-ENT 1st-15th" is the new Scientific-Educational project by Associazione Naso Sano Non-Profit Organization & CME-Provider. A series of interactive live broadcast Grand Rounds, in English. Every 1st and 15th of the month an International Faculty will discuss the most updated researches & surgical techniques regarding Otorhinolaryngology, Neurosurgery and Allergology. Chairman: Dr. Puya Dehgani-Mobaraki (Italy) “Naso Sano” is Scientifically Supported by the: -European Rhinologic Society Juniors (ERS) -European Allergology and Clinical Immunology Juniors (EAACI) -World Skull Base Fellowship Foundation (WSBF) -Italian Academy of Rhinology (IAR) Visit www.nasosano.it for more information
ALBERTO MACCHI, MD (Actual President Of The Italian Academy Of Rhinology, Varese-Italy) discuss the importance of Nasal Citology as a A New Diagnostic Tool in rhinology. "ADHER-ENT 1st-15th" is the new Scientific-Educational project by Associazione Naso Sano Non-Profit Organization & CME-Provider. A series of interactive live broadcast Grand Rounds, in English. Every 1st and 15th of the month an International Faculty will discuss the most updated researches & surgical techniques regarding Otorhinolaryngology, Neurosurgery and Allergology. Chairman: Dr. Puya Dehgani-Mobaraki (Italy) “Naso Sano” is Scientifically Supported by the: -European Rhinologic Society Juniors (ERS) -European Allergology and Clinical Immunology Juniors (EAACI) -World Skull Base Fellowship Foundation (WSBF) -Italian Academy of Rhinology (IAR) Visit www.nasosano.it for more information
Dr. Sampath Chandra Prasad Rao (President Of The World Skull Base Fellowship WSBF - Bangalore-India) discuss the Management of The ICA in Lateral Skull base, focusing on pre-operative and intra-operative tests for a safe and effective surgical plan. "ADHER-ENT 1st-15th" is the new Scientific-Educational project by Associazione Naso Sano Non-Profit Organization & CME-Provider. A series of interactive live broadcast Grand Rounds, in English. Every 1st and 15th of the month an International Faculty will discuss the most updated researches & surgical techniques regarding Otorhinolaryngology, Neurosurgery and Allergology. Chairman: Dr. Puya Dehgani-Mobaraki (Italy) “Naso Sano” is Scientifically Supported by the: -European Rhinologic Society Juniors (ERS) -European Allergology and Clinical Immunology Juniors (EAACI) -World Skull Base Fellowship Foundation (WSBF) -Italian Academy of Rhinology (IAR) Visit www.nasosano.it for more information
A Father's Day Special! My father Joseph DiBartolomeo born in New York has been in practice as an Otolaryngologist for the past 45 years in Santa Barbara. Before his practice, he attended Saint John's University as an undergraduate student then went on to complete his M.D. at Georgetown Medical School graduating first in his class & ended up completing his residency at NYU/Bellevue. He then moved out to Santa Barbara California to start his venture into practice while taken medical initiative on ground breaking concepts in surgeries & medicine year after year. Join host Dr. Ray as Dr. Ray's father Joseph DiBartolomeo M.D. gives an indepth look into a rare physical disorder inside the ear where the Eustachian tube, which is normally closed, instead stays intermittently open.
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