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In this episode we discuss different pain management options w/ Dr. Kurtis Biggs. Are you heading to AAOS 2026 in March? Stop by booth 830 and chat with the consultants at St. John Associates Physician Recruiting. Their orthopedic surgery team, one of the top national recruiting teams in the ortho market, has over 30 years of combined experience in the market and hundreds of matches in all ortho subspecialties. Their services are always free to job seeking physicians. Stop by booth 830 at AAOS 2026 in New Orleans, March 3rd through the 5th or visit them at StJohnJobs.com/ortho.
In this episode of the Medical Sales Podcast, host Samuel Adeyinka sits down with Alex Kinsel, a medical device rep specializing in noninvasive pain management within the VA system. Alex breaks down how his electrotherapy technology works, how it helps veterans reduce chronic pain, improve mobility, and reclaim their daily lives, and what it takes to sell into an integrated delivery network like the VA. From navigating bureaucracy and building clinician trust to educating patients and driving long term outcomes, Alex shares a transparent look at the hunter mindset required to win in this space. He also opens up about his personal journey into medical device sales, the impact of patient follow up, and why purpose driven selling is the key to lasting success in healthcare. Connect with Alex Kinsel: LinkedIn Connect with Me: LinkedIn Love the show? Subscribe, rate, review, and share! Here's How »
I'd love to hear from you 'text the show'WelcomeHello and welcome to this week's episode of the Treat Your Business podcast. I'm so excited for today's conversation because we're continuing on from a couple of recent episodes about the shift in patient behaviour, what people want more of now in their rehabilitation and care, and why trust and choice matter.This one is a little different from our usual strict business advice. It's about what's changing in the industry, the exciting developments in medical technology, what is being taught at university, and what our new graduates may be expecting from us inside our clinics.Episode SummaryI'm joined again by Liz Clare and Dr Anna Schreiner to talk about what is happening with MBST, why demand is rising, and what the future could look like for conservative care.We cover MBST's expansion into new countries, why more patients want to avoid surgery, and how MBST can complement other modalities already used in clinic. We also talk about education and access in the UK, including the University of East London project and why community programmes and research matter.Key TakeawaysMore patients are questioning the ‘default' options and looking for conservative care.MBST is expanding internationally, with growing interest in regenerative approaches.UK demand is rising, alongside a bigger push for education and research.The University of East London project is focused on learning, data, and community access.MBST can complement existing clinic toolboxes rather than replace them.Resources & LinksConnect with Liz Clare on LinkedInConnect with Dr Anna Schreiner on LinkedInFollow MBST UK on social mediaThanks for listening to the Treat Your Business podcast. Hit subscribe and keep joining me for bigger insights and bolder conversations to help you build a clinic and a life you love.Treat Your Business podcast is proudly sponsored by MBST, the groundbreaking technology revolutionising recovery and rehabilitation. Offering a non-invasive, drug-free solution for musculoskeletal conditions and nerve injuries, MBST works at a cellular level to stimulate regeneration. Expand your services and deliver long-term patient improvements without increasing your workload.Learn more at mbstmedical.co.uk. Come and join me over on YouTube https://www.youtube.com/@thrivebizcoach?sub_confirmation=1 Resources & Links Clinic Growth Live: https://events.thrive-businesscoaching.com/cgl-tickets-2026
Send a textWhy are so many people dealing with chronic pain earlier than ever?In this episode, Dr. Kevin White sits down with Dr. Ashu Goyle, a double board-certified anesthesiology and pain medicine physician trained at the Cleveland Clinic and founder of Integrated Spine, Pain, and Wellness in Scottsdale, Arizona.Dr. Goyle shares how his philosophy shifted from simply interrupting pain signals to helping the body repair itself. They unpack why back pain, knee pain, and joint degeneration are rarely isolated problems, and why treating one body part without addressing sleep, nutrition, inflammation, stress, and biomechanics often leads to temporary relief instead of lasting change.They discuss regenerative approaches like PRP and other orthobiologic therapies, metabolic optimization before procedures, laser therapy, nervous system balance, and what it really takes to create an environment where healing can occur.“If you're going to put something powerful back into your body, make sure the environment you're putting it into is ready.”This conversation challenges the quick-fix mindset and reframes pain as part of a bigger story. If you want to stay strong, active, and capable as you age, this episode will change how you think about healing.Learn more about Dr. Ashu Goyle:Or find him on Instagram @DrAshuGoyleFollow The Daily Apple and leave a review to help more people find the show.www.primehealthassociates.com Instagram: @KevinWhiteMD YouTube: @KevinWhiteMD Prime Health Associates
Happy New Year! This month for the February 2026 episode of the RCEM Learning Podcast Andy and Dave discuss blood pressure targets in spinal cord injury. Becky and Chris talk through a New Zealand Chest Injury Guideline and Rob then talks with Charlotte Underwood and the role of gender in the assessment of abdominal pain. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (02:14) New in EM - Blood pressure targets in spinal cord injury Early Blood Pressure Targets in Acute Spinal Cord Injury: A Randomized Clinical Trial (Sajdeya et al., 2025) (17:06) Guidelines for EM - New Zealand Chest Injury Guidance Health New Zealand - National Chest Injury Guidance (2025) [PDF] (59:44) Gender and assessment of abdominal pain - Charlotte Underwood Expression of interest to join this study Gender disparity in analgesic treatment of emergency department patients with acute abdominal pain (Chen et al., 2008) Race and Sex Are Associated With Variations in Pain Management in Patients Presenting to the Emergency Department With Undifferentiated Abdominal Pain (Drogell et al., 2022) Women's experiences of seeking healthcare for abdominal pain in Ireland: a qualitative study (Windrim et al., 2024) Ending the neglect of women's health in research (Galea et al., 2023)
Why Progressive Overload Is the Missing Link in Rehab with Dr. Todd RiddleThere's a big difference between learning a technique…and understanding a system.In today's episode, we're pulling back the curtain on the FAKTR rehab methodology — not the marketing version, not the surface-level explanation — but the actual framework that drives how we assess, load, and progress patients.In Part 1 of this two-part series, Dr. Todd Riddle — our Director of Education — breaks down:The evolution of FAKTR from technique-based roots to a full rehabilitation continuumWhy progressive overload is the missing link in most rehab programsThe difference between treating a condition… and treating a personAnd how static, motion, resistance, function, and performance fit together inside the FAKTR systemYou'll also hear why we believe pain during exercise isn't automatically the enemy — and how to clinically differentiate between “injured” and simply “sensitive.”If you've taken a FAKTR course before, this will deepen your understanding.If you haven't, this will give you a behind-the-scenes look at how the system actually works.
In this episode of the Healthy, Wealthy and Smart podcast, Dr. Karen Litzy speaks with Dr. Orit Hickman about the evolving understanding of persistent pain and the implications for physical therapy practice. They discuss personal journeys in understanding pain, the importance of modern pain science, and the need for a supportive therapeutic environment. The conversation also covers practical steps clinicians can take to better serve patients with persistent pain, the challenges posed by healthcare systems, and the transition towards a more patient-centered model of care. Takeaways · Pain management requires understanding both the physical and psychological aspects of pain. · Modern pain science emphasizes the importance of education in treatment. · Therapists must create a safe environment for patients to discuss their pain. · Pacing and nervous system safety are crucial in treatment plans. · Capacity and tolerance must be assessed to tailor treatment effectively. · Healthcare systems often hinder the implementation of evidence-based practices. · Clinicians should focus on building trust and rapport with patients. · Transitioning to a patient-centered model can improve outcomes. · Listening to patients is key to understanding their unique experiences. · Team collaboration and shared vision are essential for successful practice. Chapters · 00:00 Introduction to Persistent Pain and Evolving Science · 03:06 Personal Journeys in Understanding Pain · 05:53 Modern Pain Science in Clinical Practice · 09:06 Therapeutic Environment and Patient Engagement · 11:52 Pacing and Nervous System Safety · 15:02 Capacity vs. Tolerance in Pain Management · 17:49 Healthcare System Challenges in Pain Treatment · 21:51 Transitioning to a Patient-Centered Model · 26:37 Practical Steps for Clinicians · 33:50 Lightning Round: Myths and Hope in Pain Care More About Dr. Hickman: Dr. Orit Hickman is a doctor of physical therapy and founder of Pain Science Physical Therapy in Burien, Washington, where she leads a clinic dedicated to evidence-based care for people with persistent pain. Drawing on 25 years of clinical experience and 16 years of business ownership, she is focused on redesigning how physical therapy is delivered so pain science can truly work in everyday practice. She mentors both new and experienced physical therapists and shares educational content through multiple social media platforms. Resources from this Episode: Pain Science PT Website Pain Science PT on YouTube Dr. Hickman on TikTok Pain Science PT on Facebook Pain Science PT on Instagram Dr. Hickman on LinkedIn Pain Science PT on LinkedIn Jane Sponsorship Information: Book a one-on-one demo here Mention the code LITZY1MO for a free month Follow Dr. Karen Litzy on Social Media: Karen's Instagram Karen's LinkedIn Subscribe to Healthy, Wealthy & Smart: YouTube Website Apple Podcast Spotify SoundCloud Stitcher iHeart Radio
I welcome my childhood friend Dr. Mike Meaney back on the show where we discuss how pain changes how a life moves. It sharpens every edge, tests every bond, and forces you to decide what you believe when there are no easy choices left. That's where our conversation begins: a candid account of failed orthopedic surgeries, a system that too often rewards the cut over the cure, and the daily reality of living inside a body that won't stop hurting. We examine how fee-for-service medicine, device royalties, and surgical center ownership can bend decisions, why second and third opinions matter, and what patients can do to avoid becoming a statistic in a volume-driven industry.From there, we turn toward the inner struggle—resentment, justice, and the long road to healing. We talk openly about opioids as a seductive solution to the human problem of physical pain, and the devastation they leave behind. We sit with the hardest question: when harm is done under anesthesia, what does forgiveness mean? Faith enters not as a slogan but as a practice. We return to the simple Catholic teachings we learned as kids—tell the truth, avoid violence, treat others as you wish to be treated, care for the marginal—and measure them against adult complexity. We explore the mystical claims of Christianity with clear eyes, and why daily sobriety can feel like proof enough for belief.Then we build forward. Our guest shares One Small Step, a platform delivering certified peer support on nights and weekends for people on Medicaid—exactly when the rest of the system is closed or the ER is the only option. We walk through how human-in-the-loop AI can safely triage, detect pre-crisis signals, and route people to real peers with lived experience, reducing avoidable ER visits and giving support that actually meets people where they are. It's a practical blueprint for reform: dignified care, data-informed decisions, and a focus on outcomes that matter.If this conversation resonates—about pain, faith, accountability, or access to real help—share it with someone who needs it. And if you appreciate these deep, unfiltered talks, tap follow, leave a quick review, and tell us: where do you draw the line between justice and mercy?To learn more about One Small Step head over to https://onesmallstep.io/Support the showWarmly,Nico Barraza@FeedTheSoulNBwww.nicobarraza.com
"It's important to clarify that most patients will experience and at least some side effects—and often several. So prevention really means reducing severity, complications, and long-term impact rather than avoiding side effects altogether. This process starts before radiation begins and continues throughout the treatment and includes dental evaluation, baseline swallowing assessments, and thorough patient education," ONS member Astrid Amoresano, RN, OCN®, lead oncology nurse specialist at New York Proton Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about side effects of radiation for head and neck cancer. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 13, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to radiation side effects in people with head and neck cancer. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Cancer Symptom Management Basics series Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices Episode 128: Manage Treatment-Related Radiodermatitis With ONS Guidelines™ ONS Voice articles: Highly Localized, Precision Radiation Therapies Require Nurses to Drive Care Coordination, Patient Education IMRT Shows Similar Quality-of-Life Outcomes to Proton Therapy in Head and Neck Cancer How to Handle Even the Worst Radiation Therapy Side Effects ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition) ONS courses: ONS/ONCC® Radiation Therapy Certificate™ ONS Oncology Symptom Management Clinical Journal of Oncology Nursing articles: The Role of Advanced Practice Providers in Radiation Oncology in 2025 Systematic Review of Malnutrition Risk Factors to Identify Nutritionally At-Risk Patients With Head and Neck Cancer Effects of a Nurse-Initiated Telephone Care Path for Pain Management in Patients With Head and Neck Cancer Receiving Radiation Therapy Radiation-Induced Skin Dermatitis: Treatment With CamWell® Herb to Soothe® Cream in Patients With Head and Neck Cancer Receiving Radiation Therapy ONS Radiation Learning Library ONS Symptom Intervention Resources ONCC: Radiation Oncology Certified Nurse (ROCN™) American Cancer Society CA: A Cancer Journal for Clinicians article: American Cancer Society Head and Neck Cancer Survivorship Care Guideline Cancer Survivors Network: Head and neck cancer Head and neck cancer resources Radiation therapy resources American Society of Radiation Oncology National Cancer Institute: Common Terminology Criteria for Adverse Events (CTCAE) National Comprehensive Cancer Network To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Many tumors in the region are very radiosensitive, and radiation can be used either as definitive treatment or after surgery to reduce the risk of reoccurrence, but in many cases, radiation is combined with chemotherapy to improve local control. Because so many vital structures are located in this small complex area, radiation allows us to treat the cancer while minimizing the need for extensive or disfiguring surgery." TS 2:40 "The most common acute side effects of head and neck radiation: effects to the mouth, the throat, the skin, and the energy level. Patients often experience a mucositis, pain or sore throat, difficulty swallowing, dry mouth, or thick saliva, and taste changes. Skin irritation and redness in the treatment field is also common and can progress to dry and moist desquamation. Fatigue is another frequent side effect and tends to build as treatment progresses. Emotional and psychological distress are also very common in this patient population and can have an impact on daily function and quality of life. Side effects usually develop gradually, often beginning in the second and third week of radiation and may be more severe or have an earlier onset in patients receiving concurrent chemotherapy." TS 4:02 "Pain management is essential so patients can continue eating and drinking. Supporting the energy level and maintaining hydration are also key, as fatigue and dehydration can significantly worsen other side effects. Oral care protocols help manage mucositis and nutrition support may include supplements or enteral feeding if needed." TS 11:24 "Sexual health might not be the first thing nurses think of in regard to head and neck radiation. … But even though radiation for head and neck cancer doesn't involve the reproductive organs, it can still have a significant impact on sexual health and intimacy. Like fatigue, pain, dry mouth, changes in speech and visible changes in appearance can all affect body image and relationships." TS 14:52 "One of the common misconceptions is that side effects end when radiation ends. In reality, some effects peak afterward or become long term. Xerostomia, or dry mouth, and taste changes are good examples. While some patients improve, others adjust to a new normal where dry mouth and altered taste are permanent." TS 19:53
Send a textSchedule an Rx AssessmentRapid growth is exciting but without the right metrics, culture, and plan, it can quietly put your pharmacy at risk.In this episode, Scotty Sykes, CPA, CFP®, Bonnie Bond, CPA, MBA, and Austin Murray sit down with Jim Hrncir, R. Ph. FACP, Owner of Las Colinas Compounding Pharmacy and Wellness Center veteran compounding pharmacist and owner, to unpack what it really takes to run a sustainable compounding pharmacy through industry cycles, GLP-1 volatility, and ownership transitions.We cover:The KPIs Jim actually tracks to manage a complex compounding operationWhy cash position may be the most overlooked metric in pharmacyHow GLP-1s changed the business—and why diversification still mattersInternal succession vs. private equity: the real tradeoffsAnd more!More About Our Guest:Jim Hrncir RPh and wife Jan founded Las Colinas Pharmacy, Compounding & Wellness in 1984. Recognized as one of the pioneers of modern pharmaceutical compounding, Jim's 1986 creation of Estradiol Transdermal Gel was the first of its kind in the United States. He is responsible for the formulation of many Bio-Identical Hormone, Dermatological, Nutritional, and Anti-Aging compounds in wide use throughout the United States. Jim was named the 2017 Compounding Pharmacist of the Year by Professional Compounding Centers of America (PCCA) and is a Fellow of the Alliance for Pharmacy Compounding (FAPC). NCPA's magazine America's Pharmacist featured Jim and Las Colinas Pharmacy as the cover story for December 2018.Jim has received extensive continuing education in the areas of Bio-Identical Hormones, Nutrition, Anti-Aging Medicine, Weight Management, Pain Management, Neurotransmitter Management, Natural and Functional Medicine including the use of botanical medicines, nutritional supplements, Detoxification and Purification, homeopathy and lab testing. He has lectured across the country on a variety of topics including Clinical Patient Consulting, BHRT Assessment and Case Management, Low Dose Naltrexone, Traumatic Brain Injury Treatment Protocols, and Ketamine for Treatment-Resistant Depression and PTSD.Jim is a member of Professional Compounding Centers of America (PCCA), American Academy of Anti-Aging Medicine, Age Management Medical Group, Texas Pharmaceutical Association, Alliance for Pharmacy Compounding, and the National Association of Community Pharmacists.Stay connected with Jim and Las Colinas Pharmacy: Jim's LinkedInLas Colinas Pharmacy WebsiteLas Colinas Pharmacy FacebookLas Colinas Pharmacy TikTokLas Colinas Pharmacy InstagramLas Colinas Pharmacy LinkedInStay connected with us: FacebookYouTube LinkedInInstagram More resources on this topic: Podcast - Driving Independent Pharmacy Profitability in 2026Podcast – The Startup Compounding Pharmacy Playbook
Guest: Andrew Baker DDS MD https://www.instagram.com/andyomfs/ Guest: Jaclyn Tomsic DMD MD https://www.jaclyntomsic.com/about-jacci Host: Serv Wahan DMD MD https://www.drwahan.com/ Keywords local anesthesia, dental techniques, oral surgery, anesthesia management, patient comfort, dental education, anesthesia challenges, dental procedures, pain management, dental injections, Jacci Tomsic, Andrew baker, Dr. Wahan, IAN block Summary In this conversation, oral surgeons Andy Baker and Jacci Tomsic discuss the importance of local anesthesia techniques in dental procedures. They share their personal experiences and methods for administering anesthesia, including the use of topical anesthetics, buffering solutions, and various injection techniques. The discussion also covers challenges faced during inferior alveolar nerve blocks, managing patient anxiety, and addressing common questions about local anesthesia. The conversation emphasizes the significance of effective pain management and the need for continuous learning in the field of oral surgery. Takeaways Local anesthesia is crucial for effective dental procedures. Topical anesthetics can significantly improve patient comfort. Buffering local anesthetics may reduce pain during injections. Injection techniques vary among practitioners but should prioritize patient comfort. Managing patient anxiety is essential for successful anesthesia administration. Infections can complicate anesthesia effectiveness due to pH levels. Communication with patients about their comfort is vital during procedures. Using a variety of techniques can enhance anesthesia success rates. Understanding individual patient anatomy is key to effective anesthesia. Continuous education and adaptation of techniques are important in oral surgery. Titles Mastering Local Anesthesia Techniques The Art of Pain Management in Dentistry Sound bites "I think it makes a difference." "I do a lot more local because..." "I always aspirate no matter what." Chapters 00:00 Introduction and Guest Reintroduction 01:10 The Importance of Local Anesthesia Techniques 04:32 Local Anesthesia Techniques for Maxilla and Mandible 10:06 Injection Techniques and Tools Used 19:34 Managing Anesthesia for Anterior Teeth 28:07 Challenges with Inferior Alveolar Nerve Blocks 39:12 Addressing Patient Anxiety and Pain Management 51:35 Common Questions About Local Anesthesia
Ever wondered why the box your product comes in can matter more than the product itself?In this eye-opening episode of Start Up to Stock Exchange, host Seth Farbman sits down with Jason Grady CEO of NYSE-listed DSS and its powerhouse subsidiary Premier Packaging.From racing pro motocross as a teen to thriving in the "extreme sport" of public markets, Jason shares how DSS turns undervalued assets into high-ceiling winners across packaging, biotech, lending.Why packaging isn't boring cardboard it's strategic "pain management" that boosts sales, protects products, embraces sustainability, and creates addictive unboxing moments.The shocking truth: for brands (even iPhone-level), the box often gets as much engineering love as what's inside.A fast-paced, no-BS conversation blending high-adrenaline leadership, recession-proof business wisdom, and hidden secrets behind every shelf and delivery you see.Seth's CompaniesVstock Transfer – https://www.vstocktransfer.com/Share Media – https://www.sharemedia.co/Listen to the ShowApple Podcasts – https://podcasts.apple.com/us/podcast/seth-farbman-on-podcast-from-startup-to-stock-exchange/id1356667808Spotify – https://open.spotify.com/show/54i7xkWaAALAFrUvk4WZcNConnect with SethLinkedIn – https://www.linkedin.com/in/sethfarbman/Instagram – https://www.instagram.com/sethfarbmanstockTikTok – https://www.tiktok.com/@sethfarbmanTwitter (X) – https://x.com/sethfarbman1About the ShowFrom Startup to Stock Exchange, hosted by entrepreneur and investor Seth Farbman, spotlights the journey of founders and CEOs as they scale their companies from early ideas to public markets. Each episode features candid conversations with leaders across industries, offering insights on growth, fundraising, branding, and the mindset it takes to build a company that lasts.0:00 – Welcome & Guest Intro0:04 – Meet Jason Grady: CEO, COO, Leader of It All1:29 – Snapshot of DSS Today: Portfolio Powerhouse2:47 – How Jason Accidentally Became "The Packaging Guy"4:13 – Packaging as "Pain Management" – The Real Magic6:28 – Surviving (and Loving) the Public Markets Extreme Sport8:35 – Why Going Public Is an "Extreme Sport"9:52 – From Pro Motocross Racer to NYSE CEO18:30 – The Big Misconception: Packaging Is NOT a Commodity19:00 – Why the Box Can Matter More Than the Product (iPhone Example)21:46 – First Moment of Truth: Unboxing & Brand Power25:23 – Wrap-Up & Where to Learn More (DSS & Premier Sites)Connect with Seth LinkedIn – https://www.linkedin.com/in/sethfarbman/ Instagram – https://www.instagram.com/sethfarbmanstock TikTok – https://www.tiktok.com/@sethfarbman Twitter (X) – https://x.com/sethfarbman1
Can genicular artery embolization (GAE) relieve chronic knee pain after total knee arthroplasty (TKA)? In this episode of BackTable MSK, Argentinian interventional radiologist Dr. Rene Viso joins host Dr. Kavi Krishnasamy to discuss the status of GAE in South America, patient selection criteria, procedural techniques, and the challenges of treating post-TKA patients with GAE. --- SYNPOSIS Dr. Viso also highlights the importance of multidisciplinary collaboration and adjunctive therapies like genicular nerve blocks to improve patient outcomes. The episode concludes with a discussion on Dr. Viso's recent research and case studies, emphasizing the potential and complexities of GAE in managing chronic knee pain. --- TIMESTAMPS 00:00 - Introduction02:02 - GAE in South America03:57 - Patient Selection for GAE13:18 - Procedure Techniques and Device Choices23:54 - Challenges and Tips for TKA Patients Undergoing GAE27:17 - Patient Follow-Up After Intervention29:41 - Handling Treatment Failures32:57 - Adjunctive Therapies for Post-TKA Patients with GAE34:46 - Research Update: Dr. Viso's Recent Publication on GAE in Post-TKA Patients 39:44 - Case Studies and Discussion50:19 - Future Directions and Final Thoughts --- RESOURCES Dr. Rene Visohttps://www.linkedin.com/in/rene-viso-11a245132/ Genicular Artery Embolization for Persistent Pain after Total Knee Arthroplasty: Initial Clinical Experiencehttps://pubmed.ncbi.nlm.nih.gov/41320119/
Stroke Effects: What a Hemorrhagic Stroke Did to Jake Stroke effects aren't always obvious. Some show up immediately. Others arrive quietly, long after the hospital discharge papers are signed. For Jake, the stroke effects didn't end when his life was saved; they began there. Four months after a hemorrhagic stroke, Jake can walk, talk, think clearly, and hold a conversation that's thoughtful, articulate, and reflective. To someone passing him in the street, he might look “lucky.” But stroke effects don't ask for permission to be visible. They live beneath the surface, shaping movement, sensation, pain, identity, and recovery in ways few people prepare you for. This is what stroke did to Jake. The Stroke Effects That Came Without Warning Before his stroke, Jake's life was full and demanding. A husband. A father of four. An administrator coordinating drivers and operations. Active. Fit. Always moving toward the next opportunity. But in hindsight, the stroke effects were quietly signaling their arrival. Jake experienced severe headaches with a rapid onset. Nausea. Vomiting. Visual disturbances. At the time, they were dismissed as migraines. His blood pressure had been flagged as “pre-high” years earlier while living overseas, but after returning to Canada, he found himself without a regular doctor in an overloaded medical system. These were early stroke effects masquerading as manageable inconveniences. When the hemorrhagic stroke finally hit, it did so decisively, affecting the right side of his body, disrupting speech, movement, sensation, and cognition all at once. What Stroke Did to His Body One of the most misunderstood stroke effects is how specific and strange the deficits can be. Jake didn't just “lose strength.” He lost motor planning. When he tried to write the letter T, his brain sent the wrong instruction. Instead of a straight downward line, his hand looped as if writing an L. The muscles worked. The intention was there. The signal was wrong. To retrain that connection, he didn't practice ten times. He practiced thousands. This is one of the realities of stroke effects: recovery isn't about effort alone, it's about repetition at a scale most rehab programs don't explain clearly enough. Post-Stroke Pain: The Stroke Effect No One Warns You About If there's one stroke effect that dominates Jake's day-to-day experience, it's pain. Not soreness. Not discomfort. Neuropathic pain. Jake describes it as: Burning sensations Tingling Tightness, like plastic strapping wrapped around his limbs At its worst, a “12 out of 10” pain, like being tased while his hand is on fire This kind of post-stroke pain often resets overnight. One morning, he wakes up and feels almost normal. The next, the pain returns without warning, severe enough to stop him in his tracks. This is a stroke effect that confuses survivors and clinicians alike because it doesn't follow logic, effort, or consistency. It simply exists. And for many survivors, it's one of the hardest stroke effects to live with. The Non-Linear Reality of Stroke Effects Stroke recovery doesn't move forward in a straight line. Jake learned this quickly. One week brings noticeable gains. The next feels like a regression. Then progress returns quietly, unexpectedly. This non-linear pattern is itself a stroke effect. Early on, these fluctuations feel frightening. Survivors worry they're “going backwards.” But over time, patterns emerge. Rest days aren't failures. They're part of recovery. Silent healing days matter just as much as active ones. Understanding this changed how Jake viewed his recovery and how he measured progress. Identity Loss: An Overlooked Stroke Effect Some stroke effects don't show up on scans. Jake wasn't defined by his job, but work still mattered. Structure mattered. Contribution mattered. After the stroke, uncertainty crept in. Would he return to the same role? Could he handle the same responsibility? Should he? Stroke effects often force people to renegotiate identity, not because they want to, but because they must. The question shifts from “What do I do?” to “Who am I now?” For many survivors, this is one of the most emotionally demanding stroke effects of all. Recovery Begins With Action, Not Permission While hospitalized, Jake made a decision. He wouldn't wait passively. He brought in notebooks. Pencils. Hand grippers. Hair clippers. He practiced shaving, writing, and gripping, no matter how long it took. If writing the alphabet took all day, that was the day's work. By discharge, his writing had moved from scribbles to cursive. This wasn't luck. It was intentional engagement with stroke effects, meeting them head-on instead of avoiding them. What Stroke Effects Teach Us Jake's experience reveals something important: Stroke effects are not just medical outcomes. They are lived realities. They affect: How your body moves How pain shows up How progress feels How identity shifts How hope is tested And yet, understanding stroke effects, naming them, and normalizing them can reduce fear and isolation. That's why conversations like this matter. You're Not Alone With These Stroke Effects If you're early in recovery, you might recognize yourself in Jake's story. If you're years in, you might recognize where you've been. Either way, stroke effects don't mean the end of progress. They mean the beginning of a different kind of journey, one that rewards patience, repetition, and perspective. If you want to go deeper into recovery insights, lived experience, and hope-driven guidance: Learn more about the book here: The Unexpected Way That a Stroke Became the Best Thing That Happened Support the podcast and community here: Recovery After Stroke Patreon Final Thought Stroke effects don't define who you are, but they do shape how you recover. Jake's story reminds us that recovery isn't about returning to who you were. It's about learning how to live fully with what remains and discovering what's still possible. Disclaimer: This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. Living With Stroke Effects You Can't Always See Jake reveals the stroke effects that remained after the hospital—pain, motor issues, fatigue, and how he's navigating recovery four months on. Highlights: 00:00 Introduction and Background 05:10 Health Awareness and Signs 16:56 Personal Health Journey and Challenges 23:11 Recovery Process and Emotional Impact 38:28 Attitude Towards Recovery 46:30 Long-Term Recovery and Reflection 55:06 Work and Identity Post-Stroke 01:07:40 Pain Management and Coping Strategies 01:16:16 Community and Shared Experiences Transcript: Introduction and Background Bill Gasiamis (00:00) Today’s episode is one that really stayed with me long after we finished recording. You’re going to meet Jake, a stroke survivor who is very early in recovery and navigating the reality of what stroke actually does to a person long after the emergency has What makes this conversation so powerful isn’t just the hemorrhagic stroke Jake experienced. It’s how openly he talks about the stroke effects that followed. The pain, the confusion. the nonlinear recovery and the parts of stroke that are hard to explain unless you’ve lived them. I won’t give away Jake’s story that’s his to tell, but I will say this. If you’re early in recovery or you’re trying to make sense of symptoms that don’t quite fit the brochures or discharge notes, there’s a good chance you’ll hear something in Jake’s experience that feels confronting and reassuring at the same time. Now, before we get into the conversation, want to pause for a moment and say this, everything you hear, the interviews, the hosting, the editing exists because listeners like you help keep this podcast going. When you visit patreon.com slash recovery after stroke, you’re supporting my goal of recording a thousand episodes. So no stroke survivor has to ever feel like they’re navigating this if you’re looking for something you can lean on throughout your recovery or while supporting someone you love my book, the unexpected way that a stroke became the best thing that happened is available at recovery after stroke.com slash book. It’s the resource I wished I’d had when I was confused, overwhelmed and trying to understand what stroke had done to my life. all right. Now let’s get into the conversation with Jake. Bill (01:40) Jake Bordeaux, welcome to the podcast. Jake (01:42) Hi Bill, how are you this evening? Bill (01:44) I’m very well my friend. It is morning here. Just gone past 9am. We had a late night last night. We went to the opera and we saw Carmen. Jake (01:57) Hmm. How’s that? Bill (01:59) And for those who haven’t seen it, it’s in French and you have to read the subtitles because it has subtitles. I couldn’t read them because I was just a little too far. So I was squinting the whole night. But it’s a great opera, it was a great show, but we got home late so I’m quite tired. Jake (02:20) I couldn’t imagine that. Luckily I do speak French. So I wouldn’t need the subtitles, but that’s something I was afraid of actually, you know, coming out of the stroke is I was afraid almost that I had forgotten how to speak French or that I’d forgotten how to speak both languages. But luckily I speak ⁓ English and French. Bill (02:40) With a name like Bordeaux, I would definitely expect you to at least have some idea of French. Jake (02:45) Yes, indeed, sir. Half English and half French. I’ve been using that largely to my advantage. I’d been working up here in Northern Ontario with Federal Express. So I was working in administration here and sort of coordinating the management and the drivers being the liaison during the two during the day. so, you know, anytime the drivers might have equipment that needs any kind of repair or any kind of issues they might come up with on road as well as when they leave the station and when they come back into the station, I’m the guy that they would deal with. Bill (03:22) Wow, that’s cool. So tell me what was life like before stroke for you? What were you up to? What kind of things did you do? How did you spend your time? Jake (03:33) Well, life has had a lot of ups and downs for me in the last year’s bill. So, ⁓ I had been living for many years in, in Hong Kong and I’m originally from Canada and, I was born in the seventies, born in Ontario here. And by 2009, I had had various, you know, done grit, various career, choices or opportunities, job opportunities here. And I decided to. try my hand at a little something overseas. ⁓ I had an opportunity with a fellow Canadian named Noah Fuller who brought me over wanting to show me how to get into the watch business. And being two ⁓ enthusiasts, you know, being, ⁓ you know, I’d say we were into watch modification, watch restoration, and we were wanting to get a little bit more into building custom parts and building out custom watches. ⁓ working with various ⁓ people, military groups, et cetera, at working on their watch project. So he asked me to come to Hong Kong, learn everything that he knew about the business, and hopefully show me what I was gonna get into over there. That worked out, and while I was over there, I met my wife, I love my wife, I’m still with her. Stroke Effects: Health Awareness and Signs I got together with my wife in 2009 when I had first arrived in Hong Kong and I got married to her in 2010. During that time, Noah unfortunately passed away, so I lost my business partner, but the business continued to grow. So over the years, the business grew with my wife and I running that on our own. ⁓ Unfortunately, maybe it got some of the attention on the world stage. There’s been a lot of political, we’ll say issues in Hong Kong and leading into the pandemic, business was already suffering. ⁓ Once the pandemic hit and Hong Kong was locked down for a ⁓ big chunk of time. that really affected our business and took it down. By the time the pandemic had played its way out, our life over there was looking like it wasn’t panning out the way we’d wanted it to. And a lot of the opportunities that had been unfolding for us all of a sudden came to a close. ⁓ So we moved back to Canada. about two years ago and I started working up here and thinking about our next business opportunity. I’m a lot like you and I’m never really satisfied with what I’m doing and I kind of want to reach for the next thing and I kind of want to reach for more. So I like to work a lot. So while I was working on getting the next thing started, I was working with Federal Express. My days would be really, really busy. I would get up quite early in the morning and I’d chop wood here. I have a dog that I like to walk. I have a golden retriever. I have four children. So I have three girls and a boy and they’re ranging from four years old to 14 years old. They’re all in school. And of course, I was working full time at Federal Express and ⁓ working towards the next thing. So I guess life was pretty active. Bill (07:27) Pretty helpful. Did you have any sense that, you know, with regards to your health, things might take a turn? Was there any information coming to you that you might see now kind of in hindsight and go, well, that was probably a sign. Jake (07:45) Yeah, Bill. So I’ve watched a lot of your podcasts and I found them particularly helpful, especially a lot of the ones relating to hemorrhagic stroke. ⁓ Reason being that’s what happened to me. So ⁓ I had a hemorrhagic stroke ⁓ and it took out a large part of ⁓ my capabilities, I guess, mobility on my right side. So a lot of my body that’s affected is my right side. ⁓ Now, when I got back here from Hong Kong to Canada, unfortunately, I came here to a little bit of an overloaded medical system, to say the least. So I’m hoping that maybe some of what we’re talking today might help people who are in Canada if they suffer the ⁓ same thing as I did to try and get them on track for us, get them back into recovery. ⁓ When I arrived here, the system was overloaded. I didn’t have a doctor. So unfortunately, while I had been warned for several years that I had pre high blood pressure and ⁓ the doctors in Hong Kong had been, you know, monitoring my blood pressure and keeping a pretty close eye on things after arriving here in Canada, that wasn’t a case. And so you know, it would look now that I think about it, that I was having some warning signs. I was having headaches and I’d say that some of those headaches were pretty severe. ⁓ The headaches would come on like a, like a very fast, ⁓ fast onset headache. I would get very nauseated very quickly. ⁓ And then sort of, would, I’d vomit the headache. would pass. At first, I thought I was getting migraine headaches. I’d had one when I was a lot younger. But ⁓ these were coming with some visual disturbance. I was having this horrible headache. was having nausea. So all the things you might expect from a migraine, except that it was going away within minutes and all of a sudden I was back at work. you know, in hindsight, that definitely was ⁓ a warning flashes. And ⁓ had I had a proper physician, if I had somebody watching out for me, they may have caught that. I don’t know, there’s no way for us to know that. So what I would say is, if anybody’s having pretty high blood pressure, keep an eye on that. I would say my blood pressure when I had the stroke was quite high. And if I had been monitoring that, I might’ve been on top of it. So would you like to hear about the day that it happened or? Bill (10:45) Yeah, I would in a moment. So with the blood pressure in Hong Kong, were you being monitored and also medicated or was it just you were being monitored? Bill Gasiamis (10:56) We’ll get back to Jake’s story in just a moment. I want to pause for a second and ask you something important. Why do you listen to this podcast? For many people, it’s because they finally hear someone who understands what they’re going through or because they learn something that helps them make sense of their own stroke effects without feeling overwhelmed or alone. And here’s the part most listeners never really think podcast only exists because people like you help keep it There’s no big company behind it. No medical organization funding the work. It’s just me, a fellow stroke survivor doing everything I can to make sure these conversations are available for the next person who wakes up after a stroke and doesn’t know what comes One of the biggest challenges after stroke is finding reliable information without spending years searching, reading and second guessing yourself. That’s why I want to mention turn2.ai. Turn2 isn’t a sponsor, it’s a tool I personally use. If you choose to sign up using my affiliate link, you’ll get 10 % off and I’ll receive a small commission and no extra cost to you. That commission helps support the podcast and keep these conversations free. What Turn2 does is simple but powerful. It saves you time. Instead of spending years trying to track down research, discussions and updates about stroke, Turn2 brings relevant information straight to you. If you’re already dealing with fatigue, pain or cognitive overload, saving time and mental energy matters. And if you want to go deeper on your recovery journey, you can also grab my book, The Unexpected Way That a Stroke Became the Best Thing That Happened at recoveryafterstroke.com slash book. If this podcast has helped you feel understood even once, consider supporting the mission in whatever way feels right for you. All right, let’s get back to Jake. Jake (12:46) No, so I wasn’t being medicated for high blood pressure at all. was kind of these, well, it’s not quite severe enough to really do anything about it, so we’ll just keep an eye on it. ⁓ I did have pre-existing ⁓ medical issues. When I was quite a lot younger, I had suffered from ⁓ what some people might call Crohn’s disease or an inflammatory bowel issue. and I had some back pain. But other than that, I wasn’t really on any other types of medications. I wasn’t on any kinds of blood pressure medications, any kind of heart medications. ⁓ I wasn’t on any kind of antidepressants or anything like that. ⁓ I would say that I was pretty much feeling like I was in fairly good shape. haven’t gained or lost a heck of a lot of weight since the stroke. So what you see is what you get. wasn’t overweight. I wasn’t eating a lot of junk. I don’t smoke cigarettes. So. Bill (13:56) Yeah. One of those things. I know what you mean. Like I’ve been diagnosed with high blood pressure in the last six months and headaches. Jake, I’ve had headaches for years. I’m talking maybe four or five years. And at the beginning, they were intermittent. They would come and go similar to what you mentioned. And I would be able to get through the day. And I thought they were migraines, although nobody really convinced me that they were migraines. I couldn’t really say. That sounds familiar if I look up what migraine is and all the people who I’ve ever asked about a migraine, it never sounded like, I was never convinced by it. And then a little while ago, was at home, excuse me, I was at home with my wife, feeling really unwell. Did my, checked my blood pressure and it was about 170 over 110, 120, somewhere there. And that was, I knew that’s way too high, know, previously. I’ve checked my blood pressure maybe on the on perfect day and it was 120 over 80. So for me that was pretty serious. We went to the hospital because of all my history and they said your blood pressure is high. It’s probably a migraine causing you to have a migraine which is then causing your blood pressure to go high rather than the other way around. They didn’t say it’s high blood pressure is causing the migraine and or the headache. And then they put me on some migraine medication and they said, if we give you this migraine medication, it’s going to knock you out. You’re going to sleep, but you should wake up without a headache. Well, I woke up with a headache. The migraine medication didn’t do anything. So within a couple of weeks of that particular hospitalization and then going to my general practitioner, he prescribed me a blood pressure medication, came to start on it’s called to help keep the blood pressure down. Now I’m trying to get to the bottom of why do I have high blood pressure? That’s the part that’s frustrating me, because no one can tell you why you have high blood pressure unless they check your arteries and they’re half clogged or you’ve got some other issues with your heart or something like that. And I don’t have any of those issues. So now ⁓ it’s one of those things. It’s kind of like, well, you have high blood pressure. It might be something that runs in your family. When I check with my dad, my dad says that he has high blood pressure. My dad’s 84. So it’s like, you know, and he says, I started taking blood pressure medication at around 50, which is my age. But that’s still, that’s not good enough for me. Like I’m still not comfortable with, well, your dad did. So you are, and then therefore, just move on with life, take this tablet and then move on. Now I’m happy to take the tablet because I do not want to have another hemorrhagic stroke. I’m very comfortable taking a tablet to prevent that, right? No trauma, no traumas. Personal Health Journey, Stroke Effects, and Challenges But ⁓ it’s a very interesting place to find myself in after going through all the three brain hemorrhages that I’ve already had since 2012, brain surgery, learning how to walk again. Now I’ve had enough. I don’t want… I don’t want to be doing this anymore, even though I am finding myself here and I’m tackling it. Part of me is going, man, this is too much. Why do we need to go through this now? Jake (17:29) Yeah, I wanted to ask you something actually, maybe if you’ve had the same, you brought something back to mind here, is that one thing I did have, again, in hindsight, I had visual disturbance. in 2018, my grandmother, bless her shit, my grandmother passed away and I was abroad and I took it pretty hard. was largely raised by my grandfather, my grandmother. And I took it, it was very emotional. And ⁓ when I was grieving, I had an episode where I had a rather bad headache. And again, I had one of these feelings, like I thought I had a migraine headache. Maybe I did, or maybe we’re reading something into it. But coming out of that, I had a visual problem. And it was one of my eyes. in my right eye, you know, again, I have my issues now with my right hand side. My right eye had gotten quite blurry. I was having ⁓ issues with my vision in my right eye. And ⁓ a doctor had decided that, well, maybe it’s a form of macular degeneration. And he decided to do a laser surgery. at the time in Hong Kong. However, it didn’t have any effect. It didn’t help me out at all. And the only thing that helped that was time. And I wonder again now if the reason why treating the eye didn’t take any effect is because he should have been treating or looking at the brain. I think that maybe the issue might have been a small stroke to begin with. and I didn’t realize it at the time. Bill (19:25) That sounds very plausible, right? That’s I think probably a very logical conclusion to get to. Sometimes, you you hear people lose their vision and the way they discovered they’ve had a stroke is they’ll go to the ophthalmologist and they’ll say, I can’t see. And the guy will go, well, your eye looks perfect. I there’s nothing wrong with your lens. There’s nothing wrong with the macula. The eye pressure is fine. Everything’s fine. And that definitely suggests that there is a ⁓ neurological issue of some kind, right? So it’s like, next step is go to the hospital, get it checked out. But ⁓ yeah, well, there’ll be no way of knowing, but I science, I had similar kind of things happen about a year and a half before my first bleed. was at our local football here, which ⁓ my team made the what we call the grand final. There’s usually a playoff series and then the last two teams get to the final game of the year and then the one that wins wins the championship. And my team made it and I was there cheering them on, screaming my head off, you know, just being a really passionate supporter and went home that weekend with a massive headache that lasted about five days and ended up in hospital. They did a lumbar puncture. They checked for a brain hemorrhage or anything along those lines and they didn’t find anything and they also didn’t find the faulty blood vessel that later would cause the first brain hemorrhage. But when I speak to people about it, everyone will say, well, we’ll never know, Bill. There’s no way of knowing whether they were linked. But in my mind, it’s pretty logical to conclude that that first massive five day headache was a sign that something wasn’t right in my brain. And although they had that suspicion of that, they didn’t know what they were looking for. So they couldn’t find the faulty blood vessel. just did a scan, a CT, sorry. Yeah, they just did a CT to actually see if there was any visible signs of a tumor or a bleed or something like that. And since there wasn’t, they weren’t able to diagnose the faulty blood vessel that would later. ⁓ bleed three times. Jake (21:55) That’s incredible, by the way, the three times thing, and that’s got to take a lot of strength to get through. ⁓ I don’t know if I had mentioned to you, how recent this has been. So ⁓ one thing that I’ve noticed with your podcast is that most of the guests who are on have had a considerable amount of time elapse in between when the event has taken place and when they’ve been able to get back lot of their capabilities, a lot of their abilities. So how long exactly did it take you to get back to the stage or the state that you’re in now? Bill (22:36) I would say that I had, ⁓ well, the first three years were tumultuous because every time I was on the road to recovery after the first bleed, then the second bleed happened, that was six weeks apart. And then after the second bleed, I was really unwell. ⁓ Memory issues, couldn’t type an email, couldn’t read, couldn’t drive, couldn’t work. Recovery Process and Emotional Impact angry, really angry. I was probably in that state for the best part of about six to nine months. And then it started to ease and settle down as the blood vessel stopped bleeding. And then the, and then the blood in my head started to dissipate and kind of dissolved, I suppose. And I think I thought everything was going fine. So between February, 2012 and November, 2014, that’s when I had the next bleed November, 2014. the third one. And then when I woke up from that, I had to learn how to walk again. So by the time I got to February 2015, I had been three years in you know, in the dungeon, you know, getting just smashed around by stroke again and again and again, and then brain surgery, then learning how to walk again. And I think personally, I turned the tide maybe at around 2018, 2019. So it took another three to four years for me to feel like even though I’m living with all these deficits, I have got enough of my cognitive function back, my physical function back to be able to go back to my painting company, which had been on pause for a number of years. yeah, so all up, you know, from first bleed, Jake (24:25) incredible. Bill (24:30) to back to the painting company, you know, it seven years. It was quite a long time. And I hear people have similar kind of stories about five, six, seven years. They’re still dealing with everything that the stroke caused, but they have some kind of a turn, like for the better, some kind of like a shift in whether it’s mindset, whether it’s emotionally or whether it’s physically, they have kind of some. Like a fork in the road moment where things change for the better. Jake (25:03) That’s incredibly inspiring for me. So yeah, you give me a lot of hope because I’ve been going through a lot and I’ve only been at this for four months now. so I had this stroke in late July and upon getting into the hospital, again, I wasn’t able to talk. I wasn’t able to use my, couldn’t move my right hand side at all. ⁓ I wasn’t able to go to the washroom, any of the things. I was basically left with kind of like ⁓ a blank slate and everything that I’ve gotten back has been pretty rapid. So I’m really extremely thankful for that, especially that, given that hemorrhagic strokes are rare, ⁓ consequences seem to be more severe and more often fatal. So, yeah, I’ve only been at this for a few months, Bill (26:10) Yeah, I was gonna ask what was it what happened on the day of the strike? What was it like? Jake (26:16) Yeah, so on the day of the stroke, let me get back there for just a second. Right, so on the day of, it was a pretty regular day and I had got up, it was a beautiful day, it was July. ⁓ My family had been on a trip recently, they’d gone to the nation’s capital and visited my family and I was happy to have them back. I just bought my wife a new bike and ⁓ I tuned it up. The dog had been out and I was starting work at 2 p.m. So I was about to go in for 2 p.m. and see the drivers for the whole second part of their day until the closing. ⁓ And I ⁓ was biking into work. again, I was incredibly active. ⁓ So I was biking to work and it would be generally about a 15 minute bike ride and it’s a lot of uphill, et cetera. And some of the route is through some residential areas and even some pathways that go through the woods. Again, I live in Canada and in particular in Northern Ontario in quite a small town named Kirkland called Kirkland Lake, which is a gold mining town. we’re in a gold mining boom right now. And so yeah, I was biking to work, feeling pretty good. ⁓ When I got to work, or when I was just getting to work, I was pretty close to being late ⁓ after messing around with the kids a little bit. And so I pushed myself a little bit harder than I usually do. ⁓ I got to work right on time. I got in a little bit winded. And I started getting my equipment together, got all of my equipment and headed to my office and headed to the window where I’d be greeting all of the drivers as they come into the station. And I started to feel a little bit dizzy. So my thinking was though, I probably just pushed it a little too hard and I probably should have had a drink of water. So I grabbed a drink of water. And ⁓ I sat back down at my desk and the first drivers started to come in. And as they started to come in, I started to feel like it was hard ⁓ to keep track of what they were saying. I was having a hard time concentrating and that’s really not like me. Usually I’m able to concentrate on four children, a wife, a pet, myself. And when I’m at work, I’m able to deal with the whole station full of FedEx workers, drivers, et cetera. So I started asking the drivers, can you just leave your things with me? I’m going to put them aside for a few minutes until I’m back in the game here. I think I’ve winded myself a bit. I’m just going to chill. And the equipment started to pile up, because it was one driver, two drivers. three drivers. And as this was starting to go on, I was looking over at a lady who was working next to me in the office. ⁓ And ⁓ I’m very lucky that she was there. And ⁓ I’ll let you know why in a second. But ⁓ I started to look at her and I started to look at the drivers. And I think at that point, she looked at me and ⁓ it struck her there’s something really not right with Jake. So she came over and started to ask me some questions and she started to try and direct the drivers away from me so that maybe they’d stop asking questions. And it became pretty apparent to her real quick ⁓ that I was having a stroke. Now, thankfully, this lady’s not usually sitting in the office next to me. It was one of those things where she just happened to be there this day and she happens to work with the fire brigade here. and she works with first responders and she’s incredibly well educated as far as first aid and strokes and heart attacks, et cetera. So she was able to recognize what was going on with me right away. ⁓ She had management and she had everybody ⁓ take a look at me and they had the first responders coming right away. The emergency crew showed up within minutes. and they started asking me all the appropriate questions and they started lifting me out of there and driving me away. So I got to work, I guess, at about 2 p.m. That was when my shift started. And ⁓ by 2.25, ⁓ my wife was walking home from the neighborhood park with our kids and heard an ambulance. go by here, not realizing it was me. I’d been taken off in the ambulance. They brought me to a nearby town and then they airlifted me to Sudbury, Ontario. I guess in our nearby town, they determined that yes, I was having a stroke. They did a very quick preliminary scan. They sent me to Sudbury, Ontario, where they started doing more scans and figured out exactly what was going on. Although the medical system had failed me and I didn’t have a doctor going into it, when the rubber hit the road there, they had it together and they got me the appropriate help as fast as possible. That’s probably what helped me to get my recovery online so quick. Bill (32:18) definitely does the time that you take to get to hospital makes a massive difference. That was a good outcome considering everything that was going wrong at the time. So then how does the hospital stay go? How long are you in the hospital and how does it play out? Jake (32:37) Yeah, so I arrived in in the hospital in in Sudbury and I was there for for a few days so ⁓ yeah, I was there for a few days and in that time my My ⁓ my wife and ⁓ one of my good friends one of our children there They managed to come and see me and from what they say I was incoherent at the time So I guess I was still able to talk ⁓ but what was coming out of me was a lot of garbled nonsense. I’ve seen some of your guests say, I thought I was saying, can you please hand me my bag and I need you to bring, and all that was coming out was sort of, blah, blah, blah, blah, like it wasn’t making any sense at all. ⁓ So I was in there for days. And once they had me stabilized in ⁓ Sudbury, Ontario, they decided to transfer me and I had my choice between a couple of different towns. So I would say that by the 25th, 24th, 25th, I was stabilized and I was heading to Sudbury on the 25th. ⁓ Once I arrived in Sudbury, I think I was visited, ⁓ by my folks and my wife and kids. And then I was sent to Timmins, Ontario for my actual recovery. So it was pretty fast. I had the stroke on the 21st and by the 26th, I was in Timmins where I’d spend the rest of my ⁓ recovery time. Bill (34:27) How did they deal with leaking blood vessel? Jake (34:30) ⁓ They didn’t. So they had determined that they were going to probably do a surgery. When they were taking me into the hospital, they had told me that there was a ⁓ brain hemorrhage, ⁓ that it was leaking, that they were going to be monitoring it, that it would be likely there would be a surgery, and that I should probably be be prepared not to make it through. ⁓ So I guess, you know, they gave me some hope. I mean, they told me that we can hope for the best, but they were quite honest with me at the time in saying you might be going for the rest of your life ⁓ wearing diapers or unable to talk. ⁓ And it’s quite probable that you might not make it out of this. Uh, so they monitored it and they continued to bring me while I was in the Sudbury for scans and they continued to monitor the situation. Um, but they didn’t do any surgery. So, uh, I was put on medications to bring the blood pressure down, to keep the blood pressure down. And, uh, and I was placed on those while I was in, in hospital. And I continued to. recover all the way through August. And by the end of August, I had come back home. ⁓ while I was in hospital, I was only visited twice because it was far away from, from my home. And, ⁓ I’m honestly, Bill, I’m glad. ⁓ I was really happy. I was able to see my, my, my wife and kids by phone, obviously, you know, the wonders of modern technology. ⁓ but I was left with a lot of time on my own to reflect and I was left with a lot of time on my own to get better. you know, one of the things I decided once I got to the hospital was I’m not going to spend any time in the lounge. I’m not going to spend any of the time with the other patients who are ⁓ in here, nothing against them or anything like that. But the very first thing I did, was I started to try and find more information about what exactly happened to me and ⁓ what are my chances of getting better and what gives me the best chances. And what I came up with was I had better start working on my recovery immediately. yeah, so one of the very first things that I did is I got my notebook into me. notebook, got pencils, I got a pencil sharpener, I got one of those, ⁓ you know, hand gripper ⁓ exercise, you know, for your hands. ⁓ And I got a razor blade, and I got my wife and kids to bring in a hair trimmer. And I decided that no matter how long it was going to take me to shave, I was going to do that on my own. no matter how long I thought I’m in here, I don’t have anything else to do today. If it’s going to take me all day to cut my hair and shave my face, I’m going to do that. ⁓ If it takes me all day to do the, write the alphabet down, I’m going to get through that. And I went from again, ⁓ scribbles from just scribbles and barely being able to hold onto the pencil to, ⁓ by the time I left the hospital, I was writing in perfect cursive. Attitude Towards Recovery Bill (38:22) Yeah, that’s brilliant. I love that attitude. That attitude is probably ⁓ something that holds people in very, like creates a great outcomes for people, regardless of how much the stroke has affected them, regardless of how bad their deficits are, you know, regardless of what version of stroke they caught, they, they had to experience. And this is what I was doing when I was in rehab as well. So I did the same thing when I came back from hospital. So My first stay, I came back and we were on the internet checking, you know, is a blade in the brain? What is all this stuff? What does it all mean? Trying to get some answers. The second time, ⁓ six weeks later, I was searching for what kind of food should I be eating? If I’ve had a stroke, what should I be avoiding, et cetera? That was pretty cool to find out and learn, wow, there is actually a protocol that you can ⁓ take that supports your brain health instead of one. that doesn’t support your brain health. So that was pretty awesome. And then ⁓ in rehab, I was searching YouTube for videos about neuroplasticity. was searching videos for ⁓ anything that had to do with recovery of a neurological challenge, et cetera. And it was just way better than being ⁓ sort of worrying about my own situation and focusing on me like. internalizing it, you know, I was externalizing it and becoming proactive and I found, ⁓ and I found some great meditations. So I’m lying there. I can’t walk. I’m very sleepy. I need to sleep most of the time because I’m exhausted from all of the rehab. I’ll put on a meditation and just let it do its thing in the background while I was healing, resting, you know, recuperating. ⁓ so I think that approach just changes the way that your body responds as well because your body wants to step up to the plate. If you set an intention, we’re going through the healing process, this is the path that we’re gonna take, the body follows. If you go through the other part, if you take the different path and go, well, things are not going good for us, we’re doing it really tough, we’re feeling sorry for ourselves, we’re not gonna put any extra effort in. the body’s going to go, no, I’m listening. I’ll do exactly what you want. And you get the results that, that your intention has set. Right. So I think that’s brilliant. The way that you went about that and not interacting with other people. kind of get that too, because it can bring you down. Like seeing other people doing it hard can bring you down. And also ⁓ sometimes other people’s attitudes can rub off as well. And they can bring you down if They’re feeling bad about this situation and you don’t want to be around people who are going to ruin your vibe. Doesn’t matter who they are or where they are. Jake (41:27) Right. And one thing that where I think the hospitals and doctors and therapy where I think they really let us down is something that I believe it was on one of your podcasts and someone talking about neuroplasticity is that when we do something for therapy, we should be doing it thousands of times. We shouldn’t be doing it a few times. I think where we’re let down is like, ⁓ for instance, I went for my physiotherapy today and I find it helpful and I definitely do go, I would recommend it to anybody. But we will do each of these exercises 10 times. Do this 10 times, do this 10 times, do this 10 times. But what we’re failing to see is that, you know, To really make those connections, need to do things hundreds or thousands of times. ⁓ I have a, know, a, for instance, for you, you know, I mentioned the writing. So a place where I have an incredible block is, ⁓ I will go to try and begin something, particularly where I’m going to write something down and I’ll have the intention of writing one thing and something different will come. So, I would try and begin a word with the letter T and instead of beginning by going up and then straight down and crossing my T, instead I’m doing a loop like it’s an L. So in order to, you know, retrain, sort of get that, get that connection made, to go and start doing words that begin with the letter T. Bill (43:17) I have Jake (43:24) and a lot of times, mean like thousands of times before I could sit down and write a letter T. if people are feeling like they’re not getting anywhere or it’s not coming along for them and they are doing the exercises, I would say don’t give up and do them more. Don’t give up and do them less, do them more. Bill (43:33) Wow. Jake (43:53) ⁓ If you’re going to be doing something like walking, if you’re finding that difficult, then I think maybe if you walked around the block on Tuesday, go another 10 steps further and do that for the following week and always just keep adding to it because it does get better. And I don’t know about you, do you find Bill like I know one of your recent guests mentioned that it was a challenge for him to deal with how non-linear the recovery is. And I think that only hearing that from other people allowed me to accept that. Because a lot of the time I’ll feel like I’m doing great and things are incredibly better. And then maybe I have a week where I’m doing in respects, I’m doing worse than I was when I was in hospital. And I think that that’s really hard to deal with. you have that too, or did you find that? The non-linear kind of feeling? Yeah. Bill (44:55) Indeed, and then what happens four months, five months, six months, 10 months, is you start seeing the pattern and the pattern is, okay, I’ve made some inroads, okay, here’s the quiet time or the downtime coming and then you feel better about it because it’s not a big deal. You see the pattern and you notice it and it’s less frustrating because that’s actually, it appears as though you’re doing nothing to your head. Your head might be going, oh, I’m not doing anything. Long-Term Recovery and Reflection sitting on my butt, I’m not able to get through a day of physical exertion or anything like that. I must be going backwards. Well, in fact, your body’s just doing a different version of recovery and it looks different. It looks still and it looks silent and it looks fatigued, but it isn’t going backwards. It’s just a different phase and it needs all of it. You need to do that silent, still, quiet, fatigued resting one. And then you need to do the one which is to whatever extent you can, full on, full out, doing too much, going too far, ⁓ over-exerting yourself. And they kind of, you can’t have one without the other. You have to have them both. And ⁓ if you understand that, then you don’t get anxious or upset about it or bothered about it. And you start playing the long game. You stop focusing on today, I didn’t have a lot of effort, but… If I reflect on my last six months or nine months, there was maybe only seven days that I was really low or didn’t feel great. The rest were better days or I felt okay or whatever it was. if you start playing when you’re only four months out, it’s hard to play the long game. But when you get to a year or 12 months out, you look back and reflect, you can see that majority of what you were doing was getting. outcomes that were favorable and therefore, you know, and therefore you can sort of be okay with the quiet days, rest, the rest of all those. I used to go to loud events, whether they were a concert, a family event, a party, wedding, whatever. If they were long drawn out days, I would have to plan for the next day to be completely a write off, nothing on the calendar. No going anywhere, seeing anybody, doing anything so that I could rest properly and get my brain back online so that I could have a good day, the third day, you know? And that’s how we did it for many, many years. And I remember one time when the shift came, when I said to my wife, I am not doing anything tomorrow. You make sure that whatever you do, you do without me. You’re going to go and do your thing, but I’m not going to be involved. And then waking up in the morning and going, hey, I feel fantastic. What are we doing today? And she’s like, I didn’t plan for you, but okay. ⁓ let’s get the ball rolling on something. So we did something minor, but it was more than nothing. And that was my, okay. My moment of things are shifting and I’m able to recover overnight with a good night’s sleep quicker than I was. doing previously. Jake (48:19) That’s great. That’s great. Yeah. A lot of this, I really appreciate talking to you and I appreciate hearing your guests who have been at this a lot longer than I have. ⁓ I’m incredibly encouraged by how well I’ve done so far, but it’s also, there’s a lot of questions. ⁓ For instance, I’m in this stage where I don’t know, Bill, if I’m going to make it back to the same job as I was doing before, don’t know whether it’s reasonable to think that. Right now I’m doing, you know, going through all the steps that I need to go through and doing all the evaluations that I need to do. ⁓ But I’m not sure what the outcome is going to be. And that’s a little bit hard because I’m, you know, like most people who are entrepreneurs or, you know, have large families, we like to have an element of control, you know, with things. So it’s been hard to just sort of sit back here and not know what’s coming along. As far as work goes, I don’t know. Luckily, you know, I have a building here where I do own the building and I do have commercial space downstairs. So maybe I have the option to now use that space for myself. And ⁓ maybe I’ll have to be, maybe I’ll be forced to go back into. entrepreneurship and open my own business. Maybe going back to work ⁓ is not the path for me. We’ll have to wait and see. Bill (49:56) It will emerge. You’ll get a sense of it. I had ⁓ three years where I worked for another organization and it was a completely different field and they were, the role was a very entry level administrative role. Very, we’re talking a role that would probably be replaced by AI now. ⁓ So we, I was doing that for three years and what was good about planning and trying to get back to that level of effort and work was that it served a purpose. And part of the purpose was talking to people, traveling, ⁓ doing work on the computer. It was retraining me as I was getting comfortable with the role, getting used to traveling, getting back to being in loud environments, et cetera. So it was difficult, was tiresome, it was challenging, but it was… kind of like its own therapy. And when it served its purpose after three years, I was done. I just said, okay, I’m out of here. going back to running my own business again. And I’ll be, I’ll do that as slowly or at my own pace in any other way that I can so that ⁓ I create the whole, all the rules around the amount of hours that I attend, the type of work that I take on. You know, so if I was too tired to work the following week, I would just tell my clients I’m busy for a week and I can book you in two weeks down the road, you know. So that was what was good about going back to my business. And also what was good about going back to a job for somebody else because their expectations, you know, working for a corporation, the expectations are far lower than the ones that we put on ourselves when we’re working. for ourselves. So I know some people think working for a corporation is really stressful and all that kind of stuff. And it probably is. No. But I mean, I was barely working six hours a day. Whereas working for myself six hours a day that the day’s just starting, you six hours. You haven’t even hit lunchtime yet. So it’s interesting to think about work and how ⁓ and how you can use it as a therapy. Jake (52:23) It is well, I mean the difference for me is that I was actually in that role that you’re explaining right now when I had the stroke so I I’d gone through a whole bunch of very difficult things in Hong Kong and upon coming back here to Canada, I was almost feeling like I I had a lot of stress going on and I had a lot of things that I needed to sort out and ⁓ there was a lot of things that we need to settle with the kids. There was all sorts of stuff that needed to be done. So the job that I was working was actually, it was already fulfilling that role that you explained. I was having that less responsibility. was going in for a specific amount of hours that they were letting me know. So that was exactly it. was an administration job, but it was really not close to the amount of responsibility that I was used to having. ironically, now that this has happened to me, it might be the amount of control that I have over the amount of worked that might be an advantage after going to stroke. I’d be interested to see or to hear more about ⁓ how people deal with the change that comes with the different type of work they might be forced into, forced out of, and how they deal with that. Because I think that a lot of people deal with, ⁓ they think of their employment or they deal with their life in this sort of way, like people often ask, especially in Asia. What do you do? The first thing that people do if you’re in Hong Kong is they hand you a business card. They call it a name card there. And the very first thing that you do when you meet somebody before you even speak is you hand them the card and you each examine each other’s cards. So this idea of like, what I do is who I am. And I, and I think that when you have something like this happen to you often what you do must change. when you’re identifying with what you do, you’re sort of declaring that as your title, who you are, I would imagine that’s pretty tough. Luckily, I wasn’t tied to Federal Express, thankfully. Work and Identity Post-Stroke Bill (55:00) Yeah, I hear you. is, people will work as a lawyer for 20 years or 30 years, have a stroke, and then it’s like, well, who am I now? What am I now? And that’s the challenge with working and identifying as the work that you do. know, those days are gone in theory. You know, you don’t get named John lawyer anymore. You don’t get named John banker. anymore, you you don’t get the your surname from the occupation that you do back in the day, you know, Baker, carpenter, plumber, you know, all those people, they were their entire job, they did it for 3040 5060 years, that was what they did. And then when they couldn’t work anymore, well, they still identified as john plumber, because they had the name, the name was given to them or John Carpenter or whomever. The thing about it is now with jobs being so ⁓ not long term anymore, you get a job or you go to a particular employer and then two, three years you’re in another role or another title, et cetera, ⁓ or you’ve moved up the corporate ladder, et cetera. Well, if you’ve never even done that, if you’ve only ever worked and you haven’t explored your interests, ⁓ hiking, walking, running, playing ball, ⁓ becoming a poker player, ⁓ whatever, whatever it is other than my job, you’re very, it’s understandable that it’s very narrow how you can explain to somebody how you occupy your time. Like what do you do? Well, I do plumbing, but I also do poker. ⁓ I do this, but I also do that. I’m that guy. Like when you ask me, sometimes I will literally be in a painting outfit, not so often now, but my painting clothes, and then I’ll take them off and I’ll sit in front of the computer and I’ll record a podcast episode. And then at the end of the day, I’ll be doing a presentation somewhere, speaking publicly on a particular topic at the moment. My favorite topic is post-traumatic growth. When somebody asks me, what do you do? If they know me, they know I do podcasting. They know I do painting. They know I do speaking. They know I’ve written a book. ⁓ they know all these things about me. If they don’t know me, depending on which room I’m in, I’m a podcaster. If I’m in one room, I’m an author. If I’m in another room, if I’m in another room, I’m a painter and so on. And what that allows me to do is. not be tied down to my entire existence being about only one thing, because I think that would be boring as, and I would hate to be the guy that only knows something about painting, how to paint the wall fantastically. mean, great, maybe, but not really rewarding, and not a lot of ⁓ spiritual and existential growth in painting a wall. I solve a problem for you, but I haven’t gained anything. other than money for me. It’s not really, you know, it’s not my cup of tea anymore. Now I get to have a podcast, I get to make way less money out of a podcast episode and yet reach hundreds and thousands of people and feel really amazing about that. And what that does is that fills up my cup. That allows me to fill up my cup on the down days where I’m not earning a living. And then it allows me to go earn a living. and then not feel like all I’m doing is working and going through the maze all day every day and just being on the constant cycle of the boredom and the sameness and all that kind of stuff. So I sprinkle a little bit of this and that into my life so that I don’t have ⁓ the same day twice because I can’t cope with the same day three times. Twice is a real bad sign for me. If there’s a third day coming, that’s gonna be the same as yesterday. I’m not up for that, I don’t want to know about it. Jake (59:21) Right. Well, that also helps with your recovery. I think like, as you say, you do a lot of different things and that helps a lot. Right. So, you know, one, for instance, is, know, the, of the first things I started to think of when I was in the hospital in Sudbury and thinking of getting home is my gosh, it’s going to start getting cold soon. Winter’s going to hit. And I really have to start getting that wood all stacked. Right. So So, you know, here I am, I’m benefiting from it now. I burn wood all winter, but, ⁓ you know, I spent a lot of my rehab ⁓ stacking wood. And I mean, that’s incredibly great physiotherapy, right? Whether you’re stacking wood or like you said, you made me think when you’re talking about painting, I’m thinking about like the karate kid, right? Like with wax on wax on paint on, this is the kind of stuff that gets you out of one particular mold. And with your brain sort of like focused on recovering in one single area, you can recover in all these different areas. And I think they contribute to like a big picture of your recovery. Bill (1:00:34) I agree with that. It’s exactly right. It’s you know standing on the ladder which I do less of these days because I Felt off about a year and a half ago. So standing on the ladder and Getting down the ladder holding a paint can and applying paint ⁓ Putting drop shades down and picking up tubs of paint, you know ⁓ That whole every part of that physical activity is using a different part of the brain. Writing a book, even if it’s only 10 minutes a day, writing half a page or 10 paragraphs or whatever it is, that uses a different part of the brain. ⁓ Public speaking, that trains and uses a different part of the brain. Everything that I do definitely kind of helps to rewire the brain in many, different ways and supports my ongoing recovery and… ⁓ is and the idea behind it amongst other things, the idea behind it from a neurological kind of perspective is that it activates more of the brain. The more of the brain that’s activated, the more chance you are of creating new neuronal pathways and having ⁓ more options for healing or recovery. And then it works emotionally for me, it works mentally for me. Do you know, so I get… the emotional fitness and the mental fitness out of it. Speaking on the podcast, meeting people gives back. you know, that serves my, I need to serve other people purpose. Do you know, like, it’s just so much, everyone ⁓ who knows me kind of knows that I wear a lot of hats. I kind of. I kind of like, I do it. I show people like when they’re saying, what are you up to today? I’ve been wearing a lot of hats today. And if I’m not wearing a hat, like I pretend that I put another one off or just took one off when I’m sitting with them or talking with them. It’s crazy how many things I do. And about the only hat I would prefer not to wear right now is I prefer to put the painting hat down. and just hand that over to somebody else and just go, I think that part of my life’s done and I’ll move on to other things. Jake (1:02:57) If you don’t mind, have one, there’s one more thing that right now that I’d like to mention just before I forget. Is that all right? All right. All right. So the only other thing, the thing that I’ve been dealing with myself and I don’t know how many people deal with it or don’t deal with it. I know that not everybody does. don’t, I deal with a lot of post, uh, post stroke pain. So while I don’t have Bill (1:03:04) Yeah, of course. Jake (1:03:25) ⁓ the misfortune of losing use of my feet or losing use of my hand. I mean, it’s limited. do therapy, but I’m able to use my hands. I’m able to write and all this. But coming along with that is an incredible amount of ⁓ burning, tingling ⁓ sort of ⁓ feelings like there is ⁓ almost like the, know, if you can think of newspapers when they’re delivered in a bundle and they’ve got this kind of plastic strapping around it. ⁓ It’s usually it’s yellow, you know, this sort of plastic strapping. I feel often like that is wrapped around my arms, like it’s wrapped around my leg. I deal with a lot of this kind of stuff, unfortunately. So again, I mean, I’m not going to sit here and whine about it because again, ⁓ I can walk, I can do all the things that I need to do and I’d rather have that than what I do. But I’m wondering if it’s really common for a lot of people to have this, you know, post stroke pain. Bill (1:04:44) If 10 was the worst pain you’ve ever experienced in your life, that’s like we’re talking about 10 is somebody’s cut your limb off ⁓ and one is no pain at all. Like where would the pain be for you? Jake (1:05:00) Well, thankfully, again, thankfully ⁓ I’ve had some progress in this. So when I first came to, when I was first starting to get all the feeling back, ⁓ I started to notice that some feeling wasn’t coming back. But while I was in the hospital, I was on quite a lot of medication. So I was on some pretty heavy painkillers. ⁓ I think hydro-morphone, things like this. And I came off of those when I was coming home and a lot of the feelings started coming back. I would say that some days and at some times that pain can be what I would say maybe it’s a 12 out of 10. Like it’s bad. at some points I’ve been left doing nothing but be able to just really just sit there and cry. I’m going to be honest with you. And the pain could be quite severe. Now luckily those days are few and far between. It’s not all the time. ⁓ And here’s the deal. The thing that’s very strange with the post stroke pain or the intensity of it is that it’s like going to sleep or it’s like the start of a new day, the beginning of a new day is like a reset button’s been hit. So for instance, I could wake up on a Monday and I could be hit with the worst pain that I’ve ever had in my life. It feels literally like I’m being hit with a taser gun on the right side of my body and that while somebody’s hitting it with the taser gun, they’ve lit my hand on fire. And, ⁓ And then the very next day after I’ve gone to sleep, I woke up and I’ve had the rest. I wake up almost scared to move because for me, sort of when I wake up and I haven’t moved yet, it’s almost like nothing’s happened to me. It’s like I wake up and I don’t know that I’m numb. don’t know that I’m in pain. don’t know that all this is going on. And then I start to move and sometimes I can sit there and feel a relief. Think, wow. There’s nothing severe going on. This is pretty good and it’s going to be a great day. Or sometimes I can be struck with a type of debilitating pain that I can’t even describe. Yeah. Pain Management and Coping Strategies Bill (1:07:34) Well, what you’re describing is very common. I know a lot of people going through post stroke pain. ⁓ It is a thing. I have a very minor version of exactly the thing that you described about how the tightness and things wrapped around ⁓ your hand, like the newspaper. that’s kind of what I feel on my left side, the whole left side all the time and the burning and tingling sensation all the time. And okay, on my worst days, these days, like it’s probably, you know, I know, it’s probably a four and a terrible one would be a five, but it doesn’t get there much. And what I’ve noticed is that the, either I’ve become more tolerant of it or my my pain has decreased in my awareness. Like I’m aware of the fact that my limb is in the state that it’s in. And sometimes I’ll go to get a massage to get the muscles loo
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In this episode of the PFC Podcast, Dr. DeMello discusses the complexities of managing burn injuries in a pre-hospital setting. He emphasizes the importance of following established guidelines, understanding the nuances of fluid resuscitation, and the critical role of pain management. The conversation also covers the indications for escharotomy, the significance of cooling burns, and common mistakes made in burn management. Dr. DeMello shares valuable insights from his extensive experience in military medicine, highlighting the need for compassion and effective communication in trauma care.TakeawaysBurns are a major cause of panic in trauma situations.Follow the MARCH guidelines for initial assessment.TBSA calculations are often overestimated in pre-hospital settings.Fluid resuscitation should be based on available resources.Pain management is crucial and should prioritize patient comfort.Escharotomy should be performed with careful planning and timing.Cooling a burn can significantly reduce its severity if done promptly.Compassionate care can greatly improve patient outcomes.Monitoring urine output is essential for assessing kidney function.Avoid common mistakes like neglecting the back in assessments.Chapters00:00 Introduction to Burns and Trauma Care02:07 Initial Assessment and Management of Burns05:58 Fluid Resuscitation Strategies09:58 Pain Management in Burn Patients21:57 Escharotomy: Indications and Techniques34:10 Cooling Burns and Managing Hypothermia40:10 Common Mistakes in Burn ManagementFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
A new month arrives for the STA Clinician Podcast, and with it new focus topic: ‘Understanding Pain in 2026'. In this first part of four episodes, host Matt Phillips of runchatlive.com is joined by Dr. Bronnie Lennox Thompson (Occupational Therapist, Psychologist, Academic Coordinator, Postgraduate Programmes in Pain & Pain Management at University of Otago, New Zealand, Mentor & Content Expert for Modern Pain Care) and Ben Whybrow (Pain Specialist Physiotherapist in the NHS, Communication Skills Facilitator for Cambridge Medical School, host of “Clinical Communication Podcast," Community Manager & Content Expert for Modern Pain Care). With so much changing & evolving information out there regarding pain, how to explain it, when to treat it, HOW to treat it, it can often be tricky for healthcare professionals to stay up-to-date, but we must as we have an ethical, moral, and professional obligation to stay current with modern understandings of pain, in order to provide competent, compassionate, evidence‑based care. But fear not, for that's what this month is all about. Dr. Bronnie L. Thompson & Ben Whybrow review recent shifts in pain science, discuss the limits of over-explaining neurobiology, and why context matters more than lecture-style patient education. The conversation focuses on practical approaches: ask patients their main concerns, prioritize collaborative problem-solving and graded doing over long explanations. Chapter Markers 00:00:00 - Welcome to the STA Clinician Podcast 00:04:04 - Introducing Dr. Bronnie L. Thompson & Ben Whybrow 00:07:12 - The Role of Communication in Pain Management 00:15:16 - Shifts in Pain Understanding 00:20:52 - The Importance of Hope 00:24:07 - Rethinking Pain Treatment Approaches 00:31:54 - The Power of Doing 00:35:38 - Engaging with Patients' Concerns 00:42:06 - Addressing Patients' Main Concerns 00:45:51 - Confidence in Moving Again 00:53:28 - Practical Tips for Clinicians 00:59:37 - Conclusion and Future Discussions Useful links Dr. Bronnie L. Thompson - Blog Dr. Bronnie L. Thompson on Facebook Dr. Bronnie L. Thompson on Instagram Ben Whybrow on Instagram Clinical Communication Podcast on Spotify Modern Pain Care Website Guests in Future Episodes Part 2 - Wed Feb 11th with special guests Professor Dave Newell, Head of The Centre for Pain & Active Inference Research at Health Sciences University, and Anna Maria Mazzieri, Director of The ST School & current PhD student at Health Sciences University Part 3 Tues Feb 17th with special guest Dr. Rachel Dewar-Haggart, Postdoctoral Qualitative Researcher within the Medical Sociology & Health Experiences Research Group at the Nuffield Department of Primary Care Health Sciences, University of Oxford. Part 4 Wed Feb 25th with special guest Dr. Rachel Zoffness, Pain scientist, International Speaker, Science Writer, with her new book “Tell Me Where It Hurts” coming out March 26th Want to join the live recordings? Episodes of the STA Clinician Podcast are recorded live every TUESDAY at 8pm on the Sports Therapy Association YOUTUBE CHANNEL and FACEBOOK page. Everyone is welcome - you do not have to be an STA member! If you cannot join us live, be sure to subscribe to the 'Sports Therapy Association Podcast' on all popular podcast apps to be notified when new episodes are available. Interested in joining the STA? Use the code PODCAST25 to get 3 MONTHS EXTRA when you join for a single year! In other words, £75 will get you 15 months instead of 12! Only valid for NEW members. If you are Level 3 (qualified after 2014) make sure you choose the ‘associate member' option.
Pain management touches nearly every patient and every site of care, yet most health systems still struggle to define it as a cohesive strategy. In this episode of Sg2 Perspectives, host Trevor DaRin is joined by Sg2 experts Justin Cassidy, PhD, Donnelle Jageman and Kate Zentner to explore why pain is a critical front door to health care services. The conversation examines new non-opioid innovations, shifting reimbursement policy and the expanding role of ambulatory and virtual care. Listeners will learn how a more comprehensive, system-wide approach to pain management can improve access, capacity and financial performance. Sg2 Perspectives Listener Feedback Survey: We would love to hear from you - Please click here We are always excited to get ideas and feedback from our listeners. You can reach us at sg2perspectives@sg2.com, or visit the Sg2 company page on LinkedIn.
Today, I'm joined by Michelle Larivee, founder & CEO of WTHN. With five NYC clinics and a recent Ulta Beauty launch, WTHN is modernizing acupuncture — offering personalized TCM treatment plans and tools to address bodily dysfunction at its root. In this episode, we discuss taking ancient healing practices mainstream. We also cover: Ulta and Canyon Ranch partnerships The healthcare-meets-wellness studio model Breaking down barriers like myths, access, and education Subscribe to the podcast → insider.fitt.co/podcast Subscribe to our newsletter → insider.fitt.co/subscribe Follow us on LinkedIn → linkedin.com/company/fittinsider WTHN's Website: www.wthn.com Discount Code: FITTINSIDER25 for 25% off products Visit studios in New York or shop products nationwide Michelle's LinkedIn: https://www.linkedin.com/in/michelle-larivee-35640012/ The Fitt Insider Podcast is brought to you by EGYM. Visit EGYM.com to learn more about its smart fitness ecosystem for fitness and health facilities. Fitt Talent: https://talent.fitt.co/ Consulting: https://consulting.fitt.co/ Investments: https://capital.fitt.co/ Chapters: (00:00) Introduction (01:17) WTHN's mission (02:02) Personal healing journey (03:35) Why acupuncture is inaccessible (05:30) Barriers to entry (07:00) Progress in New York (08:22) Education as the key (09:21) Following yoga and meditation's path to accessibility (10:32) Omnichannel strategy (12:00) Core of the business (14:15) Physical expansion strategy (15:15) Why New York (16:33) Operational challenges (19:43) Consumer trends (21:00) The original longevity tool (22:15) Healthspan over wellness (23:30) Balancing medical legitimacy with accessibility (24:24) Membership model (26:15) 2026 priorities (27:00) Ulta and Canyon Ranch partnerships (27:30) Corporate wellness and hospitality convergence (29:43) Breaking down barriers between practitioners (30:30) Where to try WTHN (31:32) Conclusion Keywords: Fitt Insider, Joe Vennare, Michelle Larivee, WTHN, Acupuncture, Traditional Chinese Medicine, Wellness, Longevity, Preventative Healthcare, Pain Management, Fertility, Stress Management, Nervous System, Studio Model, Omnichannel, Corporate Wellness, Health Span, Business, Entrepreneurship, Fitt Insider Podcast
Dr. Paul RochonDr. Paul Rochon is a Biopsychologist, Doctor in Cognitive Sciences about Sleep, State of Consciousness and Cognitive process, Master in Biology, Physiology and Neuroscience, and Master in Cognitive Psychology from the University of Bordeaux, France.He is also a clinical behaviour specialist, former director of the mental health department, and current director of the sleep center at Raffles Hospital Beijing. As well as certified in Social Cognition from the Military Academy of Lisbon (Portugal), and Cognitive Linguistics from the University of Mons (Belgium).Dr. Rochon has been practicing biopsychological counselling for 20 years, working mostly with athletes, companies, schools, and individuals. He is making science accessible to everyone with clear and easily implementable behaviour management programs.He is a certified Hypnotherapist from the American Hypnosis Association and the Hypnosis Motivation Institute, Los Angeles. He uses hypnosis for Smoking Cessation, Weight Loss, Anxiety, Guilt and Shame, Mindfulness Cognitive therapy, Sport Performance, Pain Management, and Childbirth.He is also a serial entrepreneur, certified in Executive Business Management from SKEMA Business School, with 25 years of experience in the food and beverage industry, and Director of the North Asia International Area of the Entrepreneur Organisation.In addition, as a former professional rugby player and coach, he is passionate about the impact of mindset on athletes' performance.Insights from this episode:Emotions start in the body, not the mindWellbeing is a hard skillSleep is a performance multiplierPsychological safety beats motivationEngagement rises when emotions are supportedRecovery must be designed, not assumedEnvironment matters more than programsWearables can increase anxietyPresenteeism is the real productivity drainEmotional literacy is foundationalQuotes from the show:“We are not thinking machines that feel. We are feeling machines that think.” - António R. Damásio“Emotion is not just linked to performance — it is the base of everything you do.” - Dr. Paul Rochon“People don't burn out from too much work. They burn out from too much threat.” - Dr. Paul Rochon“If you are a dysregulated leader, you will create a dysregulated team.” - Dr. Paul Rochon“When people feel safe, they perform at their full potential.” - Dr. Paul Rochon“Presenteeism costs two to three times more than absenteeism.” - Dr. Paul Rochon“The future of work is not resilience workshops — it's biological and emotional skills to stay human.” - Dr. Paul Rochon“What you can name, you can tame.” - Dr. Sue Johnson “The best trick to have a good sleep is to wake up at the same time.” - Dr. Paul Rochon“When people feel supported, even if they never use the support, engagement rises.” - Dr. Paul RochonSTAY CONNECTED—Dr. Paul RochonLinkedInhttps://www.linkedin.com/in/rochonpaul/Engineering Wellbeinghttps://mp.weixin.qq.com/s/vC91-IoW4sLjUMNbkWpjLwEngineering Sleephttps://engineeringsleep.com/ *Emotional inclusion:https://www.emotionalinclusion.com/https://www.instagram.com/emotional_inclusion/https://www.linkedin.com/company/emotional-inclusion/ *Get your copy of Emotional Inclusion: A Humanizing Revolution at Work:https://www.penguin.sg/book/emotional-inclusion/
Dr. Neil Nathan is Board Certified in Family Medicine and Pain Management as well as a Founding Dip-low-mitt of the American Board of Integrative Holistic Medicine & International Society for Environmentally Acquired Illnesses.He spent over 50 years treating patients with chronic conditions related to environmental factors & now dedicates himself consulting & mentorship, writing several books for both health care professionals & patients.In this episode, you'll hear mold allergy vs illness, what symptoms mold toxicity can imitate, how to really test & what healing protocol can look like. If you liked this episode, you'll also like episode 234: FELON TO MILLION DOLLAR BUSINESS OWNER [REMASTERED] Guest: https://neilnathanmd.com/ Host: https://www.meredithforreal.com/ https://www.instagram.com/meredithforreal/ meredith@meredithforreal.comhttps://www.youtube.com/meredithforreal https://www.facebook.com/meredithforrealthecuriousintrovert Sponsors: https://www.jordanharbinger.com/starterpacks/ https://www.historicpensacola.org/about-us/ 01:35 — Conditions mold mimics04:00 — “It's not psychological”05:00 — Why medicine lags behind06:00 — The mold hoax narrative08:00 — How common mold really is11:00 — Mold and Alzheimer's risk12:00 — GI symptoms decoded13:00 — Fatigue that doesn't resolve18:00 — Mold toxicity vs allergy19:00 — Immune system tipping points20:00 — Stress, illness, and timing21:00 — Hive consciousness explained22:00 — Candida cravings aren't you23:00 — Zombie mold metaphor24:00 — EMFs enter the picture27:00 — Testing for mold toxicity38:00 — Low-carb for mold healing41:00 — Alcohol's real impact42:00 — Magnesium's critical role43:00 — Chronic deficiency mystery47:00 — Hormones after mold48:00 — Limbic system overload49:00 — Vagus nerve dysfunction50:00 — Mast cell activation51:00 — Rebooting nervous systems52:00 — Brain retraining programs58:00 — Detox hygiene at home59:00 — Why bleach backfires01:00:00 — Dust vs airflow01:01:00 — Water damage vigilance01:02:00 — Detox tools worth using01:04:00 — Balance over biohacking01:05:00 — What healing really requires01:06:00 — Living with intention01:07:00 — Final takeaways & resourcesRequest to join my private Facebook Group, MFR Curious Insiders https://www.facebook.com/share/g/1BAt3bpwJC/
Pav Grover is a medical doctor and addiction specialist recognized for his frontline work addressing the opiate crisis. Drawing on clinical experience, public health data, and patient-centered care, Dr. Grover examines how prescription practices, trauma, mental health, and socioeconomic factors have converged to fuel widespread opioid dependence and overdose. His work emphasizes evidence-based treatment, harm reduction, compassionate recovery pathways, and systemic reform, advocating for approaches that treat addiction as a medical condition rather than a moral failing. Through education and advocacy, he contributes to a clearer public understanding of one of the most urgent health crises of our time.Become a supporter of this podcast: https://www.spreaker.com/podcast/the-x-zone-radio-tv-show--1078348/support.Please note that all XZBN radio and/or television shows are Copyright © REL-MAR McConnell Meda Company, Niagara, Ontario, Canada – www.rel-mar.com. For more Episodes of this show and all shows produced, broadcasted and syndicated from REL-MAR McConell Media Company and The 'X' Zone Broadcast Network and the 'X' Zone TV Channell, visit www.xzbn.net. For programming, distribution, and syndication inquiries, email programming@xzbn.net.We are proud to announce the we have launched TWATNews.com, launched in August 2025.TWATNews.com is an independent online news platform dedicated to uncovering the truth about Donald Trump and his ongoing influence in politics, business, and society. Unlike mainstream outlets that often sanitize, soften, or ignore stories that challenge Trump and his allies, TWATNews digs deeper to deliver hard-hitting articles, investigative features, and sharp commentary that mainstream media won't touch.These are stories and articles that you will not read anywhere else.Our mission is simple: to expose corruption, lies, and authoritarian tendencies while giving voice to the perspectives and evidence that are often marginalized or buried by corporate-controlled media
Discover all of the podcasts in our network, search for specific episodes, get the Optimal Living Daily workbook, and learn more at: OLDPodcast.com. Episode 3269: Marianne Pierce outlines eight effective approaches to help manage chronic pain, offering practical solutions that address both body and mind. From mindfulness and movement to dietary and therapeutic interventions, these strategies aim to reduce discomfort and improve daily quality of life. Read along with the original article(s) here: https://ellymcguinness.com/blog/therapeutic-modalities-chronic-pain/ Quotes to ponder: "You can stretch your muscles and ease your mind without straining your joints." "Research shows that physical activity is an effective intervention for chronic pain." "Exercising the mind is just as important as exercising the body." Learn more about your ad choices. Visit megaphone.fm/adchoices
Discover all of the podcasts in our network, search for specific episodes, get the Optimal Living Daily workbook, and learn more at: OLDPodcast.com. Episode 3269: Marianne Pierce outlines eight effective approaches to help manage chronic pain, offering practical solutions that address both body and mind. From mindfulness and movement to dietary and therapeutic interventions, these strategies aim to reduce discomfort and improve daily quality of life. Read along with the original article(s) here: https://ellymcguinness.com/blog/therapeutic-modalities-chronic-pain/ Quotes to ponder: "You can stretch your muscles and ease your mind without straining your joints." "Research shows that physical activity is an effective intervention for chronic pain." "Exercising the mind is just as important as exercising the body." Learn more about your ad choices. Visit megaphone.fm/adchoices
Your body doesn't need a complicated reset. It needs more movement today and fewer hours spent frozen in the same position.Amy sits down with Dr. Dan Ginader, a physical therapist and author of The Pain-Free Body, to talk about why so many pain issues stem from long stretches of stillness rather than a lack of effort. Drawing from his work in sports therapy and his one-on-one clinical practice, Dr. Dan explains how consistent movement often matters more than perfect exercise plans. Whether the goal is pain management, injury prevention, or long-term wellness, the most effective approach is choosing exercise you actually enjoy and will repeat.The conversation brings clarity to common issues many people quietly live with. Dr. Dan explains restless leg syndrome and why symptoms tend to surface at night, unpacks how neck pain often starts in the shoulders or from poor desk setup, and reframes arthritis as a normal part of aging rather than a life-limiting diagnosis. From sports therapy and youth injury prevention to simple health tips you can use at home, the focus stays on moving more, supporting your joints with strength, and building habits that fit real life.Episode Breakdown:00:00 Meet Dr. Dan Ginader, Physical Therapist And Broadway Sports Therapy Specialist07:30 Daily Movement For Wellness, Pain Management, And Injury Prevention09:30 The Best Exercise For Long-Term Health And Consistency12:30 At-Home Exercises For Back Pain And Mobility15:30 Restless Leg Syndrome: Causes And Relief20:30 Neck Pain, Shoulder Strength, And Desk Setup Fixes30:30 Arthritis, Joint Pain, And Strength-Based Movement39:00 Sports Therapy And Injury Prevention For Youth And AdultsConnect with Dr. Dan Ginader:Follow Dr. Dan on TikTok @dr.dan_dptFollow Dr. Dan on Instagram @dr.dan_dptFor More on this Episode: Read the full show notes here
Take the next step in your veterinary dentistry journey — discover how you can join Dr. Beckman's elite training community! https://ivdi.org/inv ----------------------------------------------------------------- Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM In this episode of The Vet Dental Show, Dr. Brett Beckman explains how properly performed regional nerve blocks dramatically improve anesthesia safety, efficiency, and patient recovery in veterinary dentistry and surgery. He walks through how nerve blocks prevent pain signals from reaching the brain, allowing patients to remain at a lighter plane of anesthesia while maintaining stable physiologic parameters. Dr. Beckman also shares his real-world anesthesia protocols, how nerve blocks reduce hypothermia risk during long procedures, and why patients recover faster, stand sooner, and go home happier. This episode highlights how nerve blocks not only benefit patients — but also improve workflow efficiency and owner confidence in anesthesia. ----------------------------------------------------------------- What You'll Learn: ✅ How regional nerve blocks block pain at the C-fiber level ✅ Why lighter anesthesia planes improve patient safety ✅ How nerve blocks support stable heart rate, respiration, and blood pressure ✅ Anesthesia protocols used for dogs and cats in clinical practice ✅ How nerve blocks reduce hypothermia during long procedures ✅ Why patients wake up faster and recover more smoothly ✅ How quick recovery improves practice efficiency ✅ How to communicate anesthesia safety benefits to pet owners Key Takeaways: ✅ Regional nerve blocks allow safer, lighter anesthesia ✅ Stable physiologic parameters improve perfusion and oxygenation ✅ Reduced anesthesia depth lowers hypothermia risk ✅ Faster recoveries shorten turnover time between patients ✅ Patients go home alert, comfortable, and pain-controlled ✅ Clear owner communication builds trust and reduces anesthesia fear Questions This Episode Answers: ❓ How do regional nerve blocks work in veterinary patients? ❓ Why do nerve blocks improve anesthesia safety? ❓ Can patients feel surgery while under light anesthesia? ❓ Why do some patients move but still feel no pain during procedures? ❓ How nerve blocks allow lighter anesthesia planes ❓ What anesthesia protocols are commonly used with nerve blocks? ❓ How nerve blocks help prevent hypothermia during long procedures ❓ Why veterinary patients wake up faster with nerve blocks ❓ How nerve blocks improve recovery time and efficiency ❓ How to explain anesthesia safety to concerned pet owners ----------------------------------------------------------------- Transform your dental practice today — request your invite to the Veterinary Dental Practitioner Program: https://ivdi.org/inv Explore Dr. Beckman's complete library of veterinary dentistry courses and CE resources! https://veterinarydentistry.net/ ----------------------------------------------------------------- Questions? Leave a comment below with your thoughts, experiences, or cases related to veterinary anesthesia and dentistry! ----------------------------------------------------------------- Veterinary Dentistry, IVDI, Brett Beckman, Veterinary Anesthesia, Regional Nerve Blocks, Vet Dental Show, Pain Management, Anesthesia Safety, Veterinary Surgery, Dog Dental Care, Cat Dental Care, Veterinary Education, Veterinary CE, Patient Recovery, Hypothermia Prevention
Alison sits down with Alex Crowther, the CEO of Pain Academy, who shares his profound journey of navigating chronic pain and the lessons he's learned along the way. As they embark on this enlightening discussion, they focus on the myriad ways that our perceptions and narratives shape our experiences with pain, especially at a time when many of you are contemplating your goals for the New Year.Alex's story is one of resilience, overcoming despair, and ultimately discovering a new path through pain coaching. Throughout their conversation, they examine the emotional and psychological dimensions of chronic pain, emphasizing the often-overlooked aspect of how our mental narratives can contribute to our physical experiences.Understanding the mechanics of pain is crucial, Alex explains. He shares insights into how our brains process pain signals and how acknowledging our experiences can trigger a path to healing. Alex highlights the importance of reframing the language we use about our pain, shifting our mindset from one of suffering to one of safety and empowerment. He provides practical strategies that he has adopted, such as mindfulness meditation, deep breathing techniques, and recognizing triggers that exacerbate pain, to illustrate how small changes can lead to significant improvements in one's quality of life.Their conversation also touches on the inherent isolation that accompanies chronic pain. Alex discusses the power of feeling seen and heard, especially in a medical context where patients often find their voices dismissed. He recounts his experience with a pain coach who validated his struggles, offering the compassionate support that was pivotal in his healing journey. In doing so, Alex encourages listeners to consider seeking out a pain coach or a supportive community to navigate their own pain experiences.HIGHLIGHTS:20:38 Meditation Insights and Techniques33:15 Connecting with Pain Coaching34:06 Final Thoughts on Self-Care Journeyconnect with Alex:website: https://paincoachacademy.comfind a coach: https://paincoachacademy.com/pca-alumniSPONSOR:Cellev8Discount code: THEALISONK2024 ALISON'S LINKS:Website | Facebook | Twitter | InstagramGET MY FREE 4 part Pop-up Podcast SeriesJOIN Borderless Hybrid Innovators FB GroupINNOVATION AVENUE: Fitness and Self-Care Revolution
Ashley is a Doctor of Physical Therapy with over 20 years of expertise in seating, posture, and pressure management. She began her career leading a pediatric seating clinic before bringing her knowledge to the wheelchair manufacturing industry, where she thrived in clinical sales and training, mentoring new therapists in foundational seating principles.Her career has been built on a deep understanding of how the way we sit affects everything from musculoskeletal health to long-term function and comfort. Ashley has spoken at regional and international conferences, guest lectured at universities, and now leads the Ambassador Community at Anthros—an ergonomic seating company rooted in spine science.Known for her high energy, humor, and ability to connect with anyone, Ashley is on a mission to fix the way people sit—and help others feel and function at their best, wherever they are.SHOWNOTES:
"[Multiple myeloma] is very treatable, very manageable, but right now it is still considered an incurable disease. So, patients are on this journey with myeloma for the long term. It's very important for us to realize that during their journey, we will see them repeatedly. They are going to be part of our work family. They will be with us for a while. I think it's our job to be their advocate. To be really focused on not just the disease, but periodically assessing that financial burden and psychosocial aspect," Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer Center at Jersey Shore University Medical Center in Neptune, NJ, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about multiple myeloma. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 16, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the pathophysiology and diagnosis of multiple myeloma. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Episode 332: Best Nursing Practices for Pain Management in Patients With Cancer Episode 256: Cancer Symptom Management Basics: Hematologic Complications Episode 192: Oncologic Emergencies 101: Hypercalcemia of Malignancy ONS Voice articles: AI Multiple Myeloma Model Predicts Individual Risk, Outcomes, and Genomic Implications Cancer Mortality Declines Among Black Patients but Remains Disproportionately High Financial Navigation During Hematologic Cancer Saves Patients and Caregivers $2,500 Multiple Myeloma: Detecting Genetic Changes Through Bone Marrow Biopsy and the Influence on Care Multiple Myeloma Prevention, Screening, Treatment, and Survivorship Recommendations Nurse-Led Bone Marrow Biopsy Clinics Truncate Time for Testing, Treatment Diagnose and Treat Hypercalcemia of Malignancy ONS books: BMTCN® Certification Review Manual (second edition) Multiple Myeloma: A Textbook for Nurses (third edition) Clinical Journal of Oncology Nursing articles: African American Patients With Multiple Myeloma: Optimizing Care to Decrease Racial Disparities Music Intervention: Nonpharmacologic Method to Reduce Pain and Anxiety in Adult Patients Undergoing Bone Marrow Procedures Other ONS resources: Financial Toxicity Huddle Card Hypercalcemia of Malignancy Huddle Card Hematology, Cellular Therapy, and Stem Cell Transplantation Learning Library American Cancer Society article: What Is Multiple Myeloma? Blood Cancer United educational resources page International Myeloma Foundation homepage Myeloma University homepage Multiple Myeloma Research Foundation (MMRF) article: Understanding Multiple Myeloma To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Epidemiologically, myeloma is a cancer of older adults. The median age is about 69. It is more common in men than women. It's a ratio of about three men to two women that are diagnosed. It is much more common in people of African American descent with increasing global incidence linked to aging populations. Although, the highest rates are in high-income countries. So, if we look at some of the risk factors, and several have been identified, including MGUS. MGUS is a benign precursor of myeloma, and it stands for monoclonal gammopathy of undetermined significance. Older age is also a risk factor, although we do see patients that are younger who are diagnosed with myeloma." TS 1:54 "Bone pain, specifically in the back, and fatigue, are very common symptoms that relate to things that are going on behind the scenes with myeloma. But also, patients can be bothered by frequent and long-lasting infections. So, they find that they get sick more frequently than their family and friends, and they take a longer time to recover. That could also be a presenting sign. I think there can be some presenting signs and symptoms related to electrolyte abnormalities, especially in later stages. They might be nauseated, vomiting, or constipated. Also, signs and symptoms related to cytopenias. You have to remember that this is a bone marrow cancer. So, we do have some problem with development of normal blood cells. So, we can see not only infections, but bleeding issues related to thrombocytopenia and factors related to anemia from low red blood cell counts." TS 7:15 "About 20%–25% of our patients who are diagnosed are asymptomatic. They have no symptoms. They're living their lives, they're going to work or they're traveling, playing golf on the weekends, taking care of their children or grandchildren. They are just living their lives. And at times, they go to the primary care physician and then they're referred to a hematologist-oncologist, and they're pretty surprised when they're sent to a cancer center. The way they are diagnosed in this matter is that their routine lab work, the complete blood cell count may be normal, there may be some slight differences in their hemoglobin. But what we see in the chemistry, the complete metabolic panel, is an elevation in their total protein and or an elevation of the total globulins." TS 9:22 "The bone marrow biopsy serves many purposes. You want to determine the percentage of bone marrow plasma cells. So, you want to get the degree of plasmacytosis. And then you want to do really specific tests on those plasma cells. So, you want to isolate the malignant plasma cells and determine, via analysis. So, we do the karyotype, chromosomal studies, fluorescence in situ hybridization (FISH) studies, immunohistochemistry studies, and molecular studies. All of these studies are looking for specific genetic changes in the myeloma cells—looking for translocations or deletions. And it's very important to get that information because we can put patients in a category of having standard-risk disease versus high-risk disease. And that can give us a better picture of what this patient's journey with myeloma may look like." TS 13:41 "When I used to work in lymphoma, I spoke with the physicians who were lymphoma specialists, and they said that they foresee a future in having these assays that detect circulating tumor cells actually take the place of imaging studies like restaging positron-emission tomography (PET), computed tomography (CT) scans. So, it's really amazing, these tests that are on the market now and maybe not as widespread as we'd like, but there's a lot of nice assays out there that will become more popular and used more commonplace in the future that I think are going to help identify myeloma more precisely. ... If you think about myeloma, even with measurable residual disease (MRD), MRD for leukemia, for lymphoma, you take a blood sample, you test it for MRD. For myeloma, you need a bone marrow biopsy. You need a bone marrow sample. You can't do MRD on a blood sample for myeloma. Not yet. But if we perfect these assays and we can eventually detect this, then you're looking at a whole new ballgame. You can even perfect your MRD testing as well. So, it's a very exciting time for some of these heme malignancies." TS 28:09
1- Sex & the Rheum Patient (12:17) 2- Pain Management (17.58) 3- Lifestyle (15.38)
VetFolio - Veterinary Practice Management and Continuing Education Podcasts
Veterinarians, veterinary technicians/nurses and pet owners all have a crucial role to play when it comes to pets and pain management, including pain assessment, diagnosis, patient monitoring and care. Tune in to the episode of this VetFolio Voice podcast as Dr. Cassi chats with Mary Ellen Goldberg about the importance of taking a collaborative approach, communication and the role of tools—such as videos—in accurately assessing a patient. Learn about objective measures, such as clinical metrology instruments, and the importance of tailoring treatment plans to patients. They also briefly cover medications and modalities, such as NSAIDs, Adequan, acupuncture, TENs units, Assisi loops, cold laser, physical therapy, and more.
Today's topic is big. Today is about decoding what your body's really saying so you can live happier, healthier, and pain-free for the long haul.Pain. Tightness. Stiffness. Weakness. You've felt them all. But what if I told you… Most people are responding to them in the completely wrong way.They're stretching when they should be strengthening. They're resting when they should be moving. They're fearing pain instead of understanding it.So let's flip the script. Let's teach you how to speak the language of your body—so you can finally start a conversation with it, instead of fighting a war.Resources:Brain.fm App (First month Free, then 20% off subscription)Discount Code: coachdamiensdCaldera Lab Skin Carewww.calderalab.comDiscount Code: CoachDLinks:IG:@coachdamien_sd@damienrayevans@livinthedream_podcast YouTube:https://www.youtube.com/channel/UCS6VuPgtVsdBpDj5oN3YQTgFB:https://www.facebook.com/coachdamienSD/
Take the next step in your veterinary dentistry journey — discover how you can join Dr. Beckman's elite training community! https://ivdi.org/inv ------------------------------- Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM In this episode of The Vet Dental Show, Dr. Brett Beckman shares five critical statements that should never be uttered in your veterinary dental suite. He emphasizes the importance of adequate procedure time, obtaining owner consent for extractions, the necessity of full-mouth radiographs, avoiding rushed treatments, and the crucial role of preemptive nerve blocks for optimal patient outcomes. What You'll Learn: ✅ Understand the impact of scheduling adequate time for dental procedures. ✅ Discover the importance of clear communication and owner consent for extractions. ✅ Recognize the necessity of full mouth radiographs for detecting hidden pathology. ✅ Master strategies to avoid rushing through dental treatments. ✅ Appreciate the benefits of preemptive nerve blocks for anesthesia and analgesia. ✅ Apply best practices for pain management using agents like liposome bupivacaine. Key Takeaways: ✅ Properly scheduling dental procedures is crucial for quality care and patient outcomes. ✅ Owner communication and consent are vital to avoid misunderstandings and maintain client trust. ✅ Full mouth radiographs uncover hidden pathology, leading to better treatment plans. ✅ Rushing dental procedures compromises quality and patient well-being. ✅ Preemptive nerve blocks improve anesthesia, reduce pain, and enhance post-op recovery. Questions This Episode Answers: ❓ How long should a veterinary dental procedure take? ❓ Why do veterinary dental procedures take so long? ❓ Is an hour and a half too long for a veterinary dental cleaning? ❓ How many dental procedures should a veterinary practice schedule per day? ❓ Why rushing veterinary dental procedures is dangerous for patients ❓ Are full-mouth dental radiographs necessary in veterinary dentistry? ❓ What dental disease is missed without dental X-rays in dogs and cats? ❓ Why skipping dental radiographs harms patient outcomes ❓ Should veterinarians extract teeth without owner permission? ❓ Why client communication is critical before veterinary dental extractions ❓ What are the most common mistakes made in veterinary dental suites? ❓ Why nerve blocks should be used in veterinary dentistry ❓ When should nerve blocks be placed during dental procedures? ❓ How dental nerve blocks improve anesthesia safety in dogs and cats ❓ How proper pain management improves veterinary dental outcomes ------------------------------- Transform your dental practice today — request your invite to the Veterinary Dental Practitioner Program: https://ivdi.org/inv Explore Dr. Beckman's complete library of veterinary dentistry courses and CE resources! https://veterinarydentistry.net/ ------------------------------- Questions? Leave a comment below with your thoughts, experiences, or cases related to veterinary dentistry! ------------------------------- Veterinary Dentistry, IVDI, Brett Beckman, Dog Dental Care, Cat Dental Care, VetTech Tips, Animal Health, Veterinary Education, Veterinary Dental Practitioner Program, Vet Dental Show, Tooth Extraction, Dental Radiographs, Nerve Blocks, Pain Management, Anesthesia
In this episode of Clinical Research Coach, host Leanne Woehlke sits down with Dr. Rohan Lall for a candid, thought-provoking conversation on what it truly takes to modernize clinical research—without losing sight of patients, providers, or purpose.Dr. Lall brings a rare dual perspective as a practicing physician and clinical research leader, offering firsthand insight into the structural, cultural, and operational challenges that slow progress across trials today. Together, Leanne and Dr. Lall explore how clinical research must evolve to better reflect real-world care, rebuild trust with patients, and support sites and investigators who are stretched thin.In this episode, you'll hear about:Why many clinical trials still feel disconnected from everyday clinical care—and how to close that gapThe growing tension between protocol complexity and patient participationWhat physicians actually need to stay engaged in research long-termHow trust, communication, and operational empathy impact enrollment and retentionWhere technology helps—and where human connection remains irreplaceableDr. Lall's vision for a more sustainable, clinician-friendly, patient-ready research ecosystemThis conversation is a must-listen for sponsors, CROs, sites, and innovators who believe the future of clinical research depends not just on better technology, but on better alignment between medicine, operations, and the lived experience of patients.Rohan Lall, MD M Health FarviewUniversity of Minnesota Medical Center Spine Surgery / Neurosurgery/ Chief Medical Officer SynerFuse BIO:Dr Rohan R. Lall is a neurosurgeon in Edina, Minnesota and is affiliated withmultiple hospitals in the area, including M Health FairviewUniversity of Minnesota Medical Center and M Health FairviewSouthdale Hospital. He received his medical degree from University of Chicago Division of the Biological Sciences The Pritzker School of Medicine. He has expertise in treating spinalfusion, spinal stenosis and spondylosis, among other conditions Dr Lall is a former investigator of the SynerFuse Proof of Concept trial and pioneered the e-TLIF procedure He performed the world's firstsolo SynerFuse e-TLIF procedure as well as the first 2-level procedure. SynerFuse®e-TLIF™ procedure, a ULE™ Therapy (Ultra Low Energy), is used to addresschronic low back and leg pain for spinal fusion patients. Dr Lall specializes in robotic and minimally invasive surgery, complex spinal surgery, brain for brain and spinal tumors and skullbase surgery/ pituitary tumor surgery. He has been a leader in robotic spinal surgery and actively involved in the development of new technologies in spine surgery. The Innovative procedure integrates conventional spinal surgery techniques with targeted nerve stimulation to address chronic back pain at its source. These nerve stimulators fundamentallyalter the nerve's ability to transmit pain signals to the brain. The innovative implant allows patients to control nerve stimulation via smartphone, with early trial participants reporting significant pain reduction and improved quality of life without opioid dependence.
Carolyn McMakin, MA, DC Kim Pittis, LCSP, (PHYS), MT https://frequencyspecific.com https://fsmsports365.com 00:00 Introduction to Food Sensitivities 00:11 The Role of Biomechanics and Food Sensitivity Panels 00:57 Welcome and Introductions 03:49 Understanding Food Sensitivities and Their Development 10:36 Elimination Diets and Food Sensitivity Testing 14:31 FSM as an Adjunct in Treating Food Sensitivities 28:53 Case Study: Genetic Neurologic Condition and FSM 35:34 Challenges of Long COVID 36:16 Temporary Solutions and Their Limitations 36:42 Holistic Approach to Pain Management 38:18 Case Study: Hip Replacement Recovery 41:03 The Importance of Feeling Safe in Treatment 43:34 Rehabilitation Techniques and Balance Training 46:13 Complexities of Athletic Injuries 49:44 Case Study: Young Athlete with Spinal Issues 56:30 Genetic Factors in Pain and Recovery 01:05:54 Concluding Thoughts and Advice Food sensitivities have gained significant attention as people seek to understand the complexities behind their health issues. They may not develop overnight and often come with complex precursors. Examining the role of Frequency Specific Microcurrent (FSM) as an adjunctive treatment reveals insightful perspectives for managing these sensitivities effectively. This article highlights key discussions from experts on this topic. **The Genesis of Food Sensitivities** It's essential to recognize that food sensitivities originate from several factors, including genetics and environmental influences. Dr. Carol explains that the immune system, primarily located around the digestive tract, reacts to foreign proteins after they pass through a possibly compromised gut wall, leading to what's referred to as "leaky gut." Stress, medication, and diet intricacies all play crucial roles in how these sensitivities manifest. *Food Sensitivity Testing: A Billion-Dollar Industry** Kim Pittis emphasizes the burgeoning business of food sensitivity panels. Despite their prevalence, the accuracy of these tests has raised skepticism. Instances where identical blood samples sent under different identities yield varied results underscore the need for caution. This discrepancy further emphasizes the importance of alternative approaches, such as elimination diets and dietary adjustments. **Introducing FSM as an Adjunct Treatment** Frequency Specific Microcurrent (FSM) emerges as a promising supportive tool for those navigating the complexities of food sensitivities. FSM addresses underlying issues that exacerbate food sensitivities, such as leaky gut and vagus nerve dysfunction. It works in tandem with elimination diets to enhance recovery and comfort for patients experiencing these health challenges. **Unraveling the Body's Complex Reactions** As detailed by Dr. Carol, food sensitivities often result in IgG antibody formation, leading to histamine release and systemic responses like body pain and inflammation. These reactions can persist and significantly affect quality of life. Understanding the body's complex immune response to continuous exposure to specific foods and the subsequent formation of food sensitivities is crucial. **Practical Applications: Case Examples** The narrative includes practical applications and real-life examples illustrating how FSM can effectively complement traditional treatments. By repairing compromised gut linings and modulating immune responses, FSM aids in reducing the duration and intensity of food sensitivity reactions, thus promoting more efficient healing.
Meralgia Paresthetica Education and the Pain Boards This podcast episode from the NRAP Academy features Dr. David Rosenblum discussing Meralgia Paresthetica, a mononeuropathy affecting the lateral femoral cutaneous nerve. The condition involves entrapment or compression of this purely sensory nerve as it passes under the inguinal ligament near the anterior superior iliac spine, causing burning pain, tingling, and numbness in the anterior lateral thigh. Key clinical points covered include the nerve's L2-3 origin from the lumbar plexus, common causes such as obesity, tight clothing, pregnancy, and diabetes, and the absence of motor weakness or reflex changes. Diagnosis is primarily clinical, though ultrasound can visualize nerve entrapment effectively. Treatment approaches range from conservative management including weight loss, avoiding tight clothing, physical therapy, and neuropathic pain medications (gabapentinoids, duloxetine, tricyclics) to interventional procedures. Dr. Rosenblu strongly advocates for ultrasound-guided nerve blocks over fluoroscopic or blind approaches, citing better visualization and reduced risk of nerve trauma. Advanced treatments mentioned include peripheral neuromodulation and cryoablation for refractory cases. The episode emphasizes that this condition is commonly tested on pain management board examinations (ABA, ABPM, FIPP, osteopathic boards) and can be significantly more painful and disabling than typically appreciated. Upcoming Courses and Training Opportunities: Ultrasound training available at nrappain.org Regenerative medicine training courses Comprehensive Question Bank for Pain Management board preparation covering ABA, ABPM, FIPP, and osteopathic examinations CME credits available through the platform Clinical consultation services available at Dr. Rosenblu's Brooklyn office for patients seeking treatment Meralgia Paresthetica Education and Clinical Guidance Overview: Focused on definition, anatomy, diagnosis, management, and board exam relevance for meralgia paresthetica. Anatomy and Pathophysiology: Nerve: lateral femoral cutaneous nerve (sensory only), typically arising from L2–L3. Course: traverses across the iliacus, passes under or through the inguinal ligament just medial to the ASIS, then enters the thigh. Sensory distribution: anterolateral thigh; anterior cutaneous division extends toward the knee. Etiology and Risk Factors: Common contributors: obesity, tight belts or clothing, pregnancy, prolonged sitting, diabetes, prior pelvic or hip surgery. Entrapment site: under the inguinal ligament near the ASIS (most frequent). Clinical Presentation: Symptoms: burning pain, tingling, numbness, dysesthesia localized to the anterolateral thigh. Provocation/relief: worse with standing or walking; relief with sitting or hip flexion. Neurologic exam: no motor weakness; no reflex changes. Diagnosis: Primarily clinical; Tinel's sign over the inguinal ligament may reproduce symptoms. EMG and nerve conduction studies are typically normal. Ultrasound: superficial nerve, generally easy to visualize, including in obese patients; can identify entrapment. Management Recommendations: First-line conservative care: weight loss; avoidance of tight belts/clothing; physical therapy; NSAIDs for inflammation. Pharmacologic options: gabapentin, pregabalin, duloxetine, tricyclic antidepressants; consider topical analgesic creams (e.g., lidocaine or anti-inflammatory combinations). Interventional approach: Ultrasound-guided nerve block is strongly recommended; the nerve lies lateral to the sartorius; real-time visualization enables precise, safe injection. Avoid fluoroscopic and blind approaches due to risk of further nerve trauma and post-procedure pain. Advanced interventions: Peripheral neuromodulation may provide benefit in select cases. Cryoablation has shown beneficial outcomes for the lateral femoral cutaneous nerve. Surgery is rarely required; options include neurolysis, decompression, or neurectomy as a last resort. Board Exam Preparation Emphasis: Key facts commonly tested: Involved nerve: lateral femoral cutaneous nerve. Nerve roots: L2–L3 (with population variants). Sensory-only nerve; absence of motor deficits. Compression site: under the inguinal ligament near the ASIS. First-line therapy: conservative measures; refractory cases: ultrasound-guided nerve block. Keywords to study: meralgia paresthetica; lateral femoral cutaneous nerve (also called lateral cutaneous nerve of the thigh). Practice Considerations: Severity: can be profoundly painful and disabling; often underappreciated. Referral: clinicians not trained in interventional techniques should refer patients to an interventionalist for diagnosis and treatment. Decisions and Recommendations Ultrasound guidance is the preferred modality for lateral femoral cutaneous nerve interventions, superseding fluoroscopic or blind approaches. Rationale: superior visualization, real-time feedback, and reduced risk of nerve trauma and post-procedural pain. Outreach and Resources NRAP Academy resources: Ultrasound training, regenerative medicine training, CME credits, and a comprehensive pain board question bank (ABA, ABPM, FIPP, osteopathic, and related exams). Clinical availability: Patient consultations for meralgia paresthetica offered in Brooklyn at www.AABPpain.com 718 436 7246 .
Meralgia Paresthetica Education and the Anesthesiology Boards This podcast episode from the NRAP Academy features Dr. David Rosenblum discussing Meralgia Paresthetica, a mononeuropathy affecting the lateral femoral cutaneous nerve. The condition involves entrapment or compression of this purely sensory nerve as it passes under the inguinal ligament near the anterior superior iliac spine, causing burning pain, tingling, and numbness in the anterior lateral thigh. Key clinical points covered include the nerve's L2-3 origin from the lumbar plexus, common causes such as obesity, tight clothing, pregnancy, and diabetes, and the absence of motor weakness or reflex changes. Diagnosis is primarily clinical, though ultrasound can visualize nerve entrapment effectively. Treatment approaches range from conservative management including weight loss, avoiding tight clothing, physical therapy, and neuropathic pain medications (gabapentinoids, duloxetine, tricyclics) to interventional procedures. Dr. Rosenblu strongly advocates for ultrasound-guided nerve blocks over fluoroscopic or blind approaches, citing better visualization and reduced risk of nerve trauma. Advanced treatments mentioned include peripheral neuromodulation and cryoablation for refractory cases. The episode emphasizes that this condition is commonly tested on pain management board examinations (ABA, ABPM, FIPP, osteopathic boards) and can be significantly more painful and disabling than typically appreciated. Upcoming Courses and Training Opportunities: Ultrasound training available at nrappain.org Regenerative medicine training courses Comprehensive Anestheisia and Question Bank for Pain Management board preparation covering ABA, ABPM, FIPP, and osteopathic examinations CME credits available through the platform Clinical consultation services available at Dr. Rosenblum's Brooklyn office for patients seeking treatment. Call 718 436 7246 or go to www.AABPpain.com Meralgia Paresthetica Education and Clinical Guidance Overview: Focused on definition, anatomy, diagnosis, management, and board exam relevance for meralgia paresthetica. Anatomy and Pathophysiology: Nerve: lateral femoral cutaneous nerve (sensory only), typically arising from L2–L3. Course: traverses across the iliacus, passes under or through the inguinal ligament just medial to the ASIS, then enters the thigh. Sensory distribution: anterolateral thigh; anterior cutaneous division extends toward the knee. Etiology and Risk Factors: Common contributors: obesity, tight belts or clothing, pregnancy, prolonged sitting, diabetes, prior pelvic or hip surgery. Entrapment site: under the inguinal ligament near the ASIS (most frequent). Clinical Presentation: Symptoms: burning pain, tingling, numbness, dysesthesia localized to the anterolateral thigh. Provocation/relief: worse with standing or walking; relief with sitting or hip flexion. Neurologic exam: no motor weakness; no reflex changes. Diagnosis: Primarily clinical; Tinel's sign over the inguinal ligament may reproduce symptoms. EMG and nerve conduction studies are typically normal. Ultrasound: superficial nerve, generally easy to visualize, including in obese patients; can identify entrapment. Management Recommendations: First-line conservative care: weight loss; avoidance of tight belts/clothing; physical therapy; NSAIDs for inflammation. Pharmacologic options: gabapentin, pregabalin, duloxetine, tricyclic antidepressants; consider topical analgesic creams (e.g., lidocaine or anti-inflammatory combinations). Interventional approach: Ultrasound-guided nerve block is strongly recommended; the nerve lies lateral to the sartorius; real-time visualization enables precise, safe injection. Avoid fluoroscopic and blind approaches due to risk of further nerve trauma and post-procedure pain. Advanced interventions: Peripheral neuromodulation may provide benefit in select cases. Cryoablation has shown beneficial outcomes for the lateral femoral cutaneous nerve. Surgery is rarely required; options include neurolysis, decompression, or neurectomy as a last resort. Board Exam Preparation Emphasis: Key facts commonly tested: Involved nerve: lateral femoral cutaneous nerve. Nerve roots: L2–L3 (with population variants). Sensory-only nerve; absence of motor deficits. Compression site: under the inguinal ligament near the ASIS. First-line therapy: conservative measures; refractory cases: ultrasound-guided nerve block. Keywords to study: meralgia paresthetica; lateral femoral cutaneous nerve (also called lateral cutaneous nerve of the thigh). Practice Considerations: Severity: can be profoundly painful and disabling; often underappreciated. Referral: clinicians not trained in interventional techniques should refer patients to an interventionalist for diagnosis and treatment. Decisions and Recommendations Ultrasound guidance is the preferred modality for lateral femoral cutaneous nerve interventions, superseding fluoroscopic or blind approaches. Rationale: superior visualization, real-time feedback, and reduced risk of nerve trauma and post-procedural pain. Outreach and Resources NRAP Academy resources: Ultrasound training, regenerative medicine training, CME credits, and a comprehensive pain board question bank (ABA, ABPM, FIPP, osteopathic, and related exams). Clinical availability: Patient consultations for meralgia paresthetica offered in Brooklyn at www.AABPpain.com 718 436 7246 .
Meralgia Paresthetica Education and the PM&R Boards This podcast episode from the NRAP Academy features Dr. David Rosenblum discussing Meralgia Paresthetica, a mononeuropathy affecting the lateral femoral cutaneous nerve. The condition involves entrapment or compression of this purely sensory nerve as it passes under the inguinal ligament near the anterior superior iliac spine, causing burning pain, tingling, and numbness in the anterior lateral thigh. Key clinical points covered include the nerve's L2-3 origin from the lumbar plexus, common causes such as obesity, tight clothing, pregnancy, and diabetes, and the absence of motor weakness or reflex changes. Diagnosis is primarily clinical, though ultrasound can visualize nerve entrapment effectively. Treatment approaches range from conservative management including weight loss, avoiding tight clothing, physical therapy, and neuropathic pain medications (gabapentinoids, duloxetine, tricyclics) to interventional procedures. Dr. Rosenblu strongly advocates for ultrasound-guided nerve blocks over fluoroscopic or blind approaches, citing better visualization and reduced risk of nerve trauma. Advanced treatments mentioned include peripheral neuromodulation and cryoablation for refractory cases. The episode emphasizes that this condition is commonly tested on pain management board examinations (ABA, ABPM, FIPP, osteopathic boards) and can be significantly more painful and disabling than typically appreciated. Upcoming Courses and Training Opportunities: Ultrasound training available at nrappain.org Regenerative medicine training courses Comprehensive PM&R Question Bank for Pain Management board preparation covering ABA, ABPM, FIPP, and osteopathic examinations CME credits available through the platform Clinical consultation services available at Dr. Rosenblum's Brooklyn office for patients seeking treatment Meralgia Paresthetica Education and Clinical Guidance Overview: Focused on definition, anatomy, diagnosis, management, and board exam relevance for meralgia paresthetica. Anatomy and Pathophysiology: Nerve: lateral femoral cutaneous nerve (sensory only), typically arising from L2–L3. Course: traverses across the iliacus, passes under or through the inguinal ligament just medial to the ASIS, then enters the thigh. Sensory distribution: anterolateral thigh; anterior cutaneous division extends toward the knee. Etiology and Risk Factors: Common contributors: obesity, tight belts or clothing, pregnancy, prolonged sitting, diabetes, prior pelvic or hip surgery. Entrapment site: under the inguinal ligament near the ASIS (most frequent). Clinical Presentation: Symptoms: burning pain, tingling, numbness, dysesthesia localized to the anterolateral thigh. Provocation/relief: worse with standing or walking; relief with sitting or hip flexion. Neurologic exam: no motor weakness; no reflex changes. Diagnosis: Primarily clinical; Tinel's sign over the inguinal ligament may reproduce symptoms. EMG and nerve conduction studies are typically normal. Ultrasound: superficial nerve, generally easy to visualize, including in obese patients; can identify entrapment. Management Recommendations: First-line conservative care: weight loss; avoidance of tight belts/clothing; physical therapy; NSAIDs for inflammation. Pharmacologic options: gabapentin, pregabalin, duloxetine, tricyclic antidepressants; consider topical analgesic creams (e.g., lidocaine or anti-inflammatory combinations). Interventional approach: Ultrasound-guided nerve block is strongly recommended; the nerve lies lateral to the sartorius; real-time visualization enables precise, safe injection. Avoid fluoroscopic and blind approaches due to risk of further nerve trauma and post-procedure pain. Advanced interventions: Peripheral neuromodulation may provide benefit in select cases. Cryoablation has shown beneficial outcomes for the lateral femoral cutaneous nerve. Surgery is rarely required; options include neurolysis, decompression, or neurectomy as a last resort. Board Exam Preparation Emphasis: Key facts commonly tested: Involved nerve: lateral femoral cutaneous nerve. Nerve roots: L2–L3 (with population variants). Sensory-only nerve; absence of motor deficits. Compression site: under the inguinal ligament near the ASIS. First-line therapy: conservative measures; refractory cases: ultrasound-guided nerve block. Keywords to study: meralgia paresthetica; lateral femoral cutaneous nerve (also called lateral cutaneous nerve of the thigh). Practice Considerations: Severity: can be profoundly painful and disabling; often underappreciated. Referral: clinicians not trained in interventional techniques should refer patients to an interventionalist for diagnosis and treatment. Decisions and Recommendations Ultrasound guidance is the preferred modality for lateral femoral cutaneous nerve interventions, superseding fluoroscopic or blind approaches. Rationale: superior visualization, real-time feedback, and reduced risk of nerve trauma and post-procedural pain. Outreach and Resources NRAP Academy resources: Ultrasound training, regenerative medicine training, CME credits, and a comprehensive pain board question bank (ABA, ABPM, FIPP, osteopathic, and related exams). Clinical availability: Patient consultations for meralgia paresthetica offered in Brooklyn at www.AABPpain.com 718 436 7246 .
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from January 3-9, 2026.
Strong execution is what separates momentum from noise and Delivra Health Brands (TSXV: DHB | OTCQB: DHBUF) continues to build on the progress achieved in 2025. In this interview, President & CEO Gord Davey shares how the company is translating product innovation, disciplined cost control, and channel expansion into real market performance.The discussion covers how Dream Water® and LivRelief™ are impacting everyday lives, why new product formats and international expansion matter, and how the company continues to deliver positive EBITDA while reinvesting in growth. Furthermore, the CEO offers a look at what investors should be watching as the company moves into 2026.Learn more about Delivra Health Brands: https://www.delivrahealthbrands.com/Watch the full YouTube interview here: https://youtu.be/uxY95lHlApEAnd follow us to stay updated: https://www.youtube.com/@GlobalOneMedia
The KARE podcast series unveil the wisdom of Ayurveda, the Science of Life.
Join me, as I talk with one of my Calm Labor Confident Birth Class students, Laura.Laura's birth story is definitely best friend squad goals! Laura's bestie (who's studying to become a birth doula) was with her during it all - to cheer her on, and to help her through the intense moments.Join the Calm Mama Membership: labornursemama.com/cmsLeave a review and include your Instagram username for a chance to win our monthly raffle!In this episode, she shares her journey to a positive, unmedicated vaginal delivery of a healthy baby boy!She tells us all about laboring at home and delivering in a birth center. She also shared how our birth course helped her have an empowered birth experience.Laura gets real with us and shares the nitty-gritty details of what a water birth includes. You won't hear this anywhere else.Plot twist: her best friend/Doula was the one who actually told her about Labor Nurse Mama and encouraged her to join one of the meet-and-greets we have.Helpful Timestamps:01:40 Pregnancy Journey and Joining the Birth Course03:04 Preparing for Birth and Community Support10:32 Labor Begins: Early Signs and Home Labor14:36 Transition to Birth Center and Water Birth22:41 Pain Management and Labor Experience24:07 The Role of the Partner25:26 Catching the Baby28:11 Post-Delivery Procedures31:27 Returning Home with the Newborn37:42 Reflections on the Birth ExperienceJoin the #1 Birth Course for Confident Birth!Over 15,000 women have used our classes to prepare for birth with the knowledge and tools provided by a Labor Nurse.
What if we spent as much time nurturing our joy as we do babysitting our pain? Phoenix “P” Ash isn't here for your “joy management plans”—she's kicking open the door to full, unfiltered bliss. In this episode of Life As P..., she unpacks why we're trained to brace for impact but never taught to bask in sunshine.From a five-week CEO-level career rollercoaster (cue dramatic music) to childhood pain, motherhood miracles, and dodging narcissists like emotional dodgeballs, P drops storytelling gems that are equal parts healing and hilarious. She makes a bold call: stop hedging your happiness like it's a risky stock and start living like joy pays dividends. Whether you're the type to dive headfirst into love or squint suspiciously at good news, this episode will challenge you to reframe your “setbacks,” embrace your wins (no matter how small), and stop putting your happiness on a leash. Also, PSA: joy is not a long-term rental—it's yours. Use it.
SummaryIn this episode, Dr. Grant Elliot discusses his personal journey from being a competitive athlete to becoming a chiropractor focused on pain management. He emphasizes the importance of movement as a form of medicine, the impact of beliefs on pain perception, and the need for a holistic approach to treatment. The discussion covers the complexities of lower back pain, the risks associated with surgery, and the significance of unique movements in rehabilitation. Dr. Grant also highlights the emotional factors that contribute to pain and offers insights into managing hip pain, particularly in relation to pregnancy. He concludes by providing practical advice on time commitment for pain management and resources for further assistanceEPISODE SPONSORS: LMNTOFFER: Right now, for my listeners LMNT is offering a free sample pack with any LMNT drink mix purchase at DrinkLMNT.com/FEELGOOD. That's 8 single serving packets FREE with any LMNT any LMNT drink mix purchase. This deal is only available through my link so. Also try the new LMNT Sparkling — a bold, 16-ounce can of sparkling electrolyte water.USE LINK: DrinkLMNT.com/FEELGOODFEEL DIGESTIVE ENZYMES OFFER: Go to mysolluna.com and use the CODE: PODFAM15 for 15% off your entire order. USE LINK: mysolluna.com CODE: PODFAM15 for 15% off your entire order. Chapters00:00 Introduction and Setting the Stage00:13 Exploring Wellness and Nutrition00:16 Introduction to Pain and Healing03:21 The Journey to Chiropractic Care06:23 Understanding Lower Back Pain09:12 The Mechanics of Movement12:26 The Role of Perception in Pain15:18 Surgery vs. Conservative Care18:22 Movement as Medicine20:44 Understanding Pain: Beyond Posture24:29 The Emotional Impact on Pain29:05 The Multifactorial Nature of Back Pain29:57 Exploring Hip Pain and Its Connections34:14 Efficient Movement Protocols for Pain Relief37:12 Resources for Pain Management and AssessmentSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Happy Holidays to all of our listeners! This week we wanted to discuss a topic that impacts almost every pet and pet owner and that is pain that your animals may be dealing with at some point in their lives. If you've had a pet go through difficult struggles with pain it can be terrible to watch them struggle. In this times we wanted to give them something to make it feel better and often times people think they can simply give human drugs to their pets. It is important that you don't! We talk about the different types of medication and pain management options available for animals. Always consult your vet before giving anything to your dogs and cats! Thanks so much for listening and be sure to subscribe and review!
In this episode, the Ski Moms welcome Chemmy Alcott, a British former World Cup alpine ski racer who competed in all five disciplines and represented Great Britain at four Olympic Games. Growing up in London, Chemmy's journey to elite ski racing is extraordinary, she trained on eight-second dry ski slopes made of plastic "hairbrushes" and at age 10 convinced her parents to let her travel alone to New Zealand for two months of training, a pattern she continued for eight years.Chemmy opens up about skiing at only 80% capacity for eight years due to fear of failure before her breakthrough at Sölden, where she embraced 100% effort and risk-taking. After coming within 1.8 seconds of an Olympic medal at Sochi 2014, her surgeon's warning about potential leg amputation led to her retirement. Now a mother of two boys (ages 8 and 6), she's achieved her childhood dream as presenter of BBC's iconic Ski Sunday and co-founded Carpe Diem Coaching with her husband Dougie, running camps across Europe for ages 6 to 89 focused on building confidence and resilience. She also founded Swiss Mountain Rescue after discovering CBD and meditation eliminated her chronic pain in just two weeks after 10 years of suffering.Resources:Carpe Diem Coaching: https://www.cdcperform.com/Instagram: @chemmyskiBBC Ski SundaySwiss Mountain Rescue (health and wellness brand)Imbrace (compression leggings)Key Quotes:"I always say that I was made to be a ski racer. I got his glutes and her lungsShop the 2025 Ski Moms Holiday Gift Guides here www.theskimoms.co/gift-guides SHOP HEREUse Code SKIMOMS for 15% off all labels. Code is not valid on sale items or stamps. Other restrictions may apply. Still shopping for the skier or rider in your life? The Ski Haus has you covered. Stop by the Ski Haus or grab a gift card online — and give the gift of snow this season. They've got locations in Salem, NH and Woburn, and Framingham in MA. Head to skihaus.com to check store hours and directions. Plan your winter getaway now at VisitUlsterCountyNY.com.
Scholarship winner Melanie Reyes, MPH, PA-S discusses Esketamine and its applications for post operative pain management following hip surgery.
Send us a textDr. Grant Elliott is a chiropractor and the creator of the #1 online low-back pain program, helping thousands of people worldwide eliminate pain without unnecessary treatments, surgeries, or endless chiropractic visits.His mission is deeply personal—after a career-ending injury as a competitive athlete, Grant discovered just how broken and outdated traditional back pain care really is. Instead of accepting the status quo, he built a science-backed, disruptive approach that puts healing back in the hands of the individual.Today, Grant is a leading voice challenging myths about back pain—proving that your spine is stronger than you think, posture isn't everything, and most diagnoses actually keep people stuck in pain unnecessarily. His no-nonsense, empowering approach is revolutionizing how people recover, while calling out the “sick care” system that profits from keeping people dependent.Grant's mission is clear: to end the back pain epidemic by educating, empowering, and equipping people with the tools to heal themselves. His journey from injured athlete to health disruptor makes him an inspiring and high-impact expert for his followers.Find Dr. Grant Elliott at-IG- @rehabfixFREE GIFT!! DM "PODCAST" to the ReHab Fix IG page for a free gift!!YT- @Rehab FixFind Boundless Body at- myboundlessbody.com Book a session with us here!
After more than 80 hours of labor, Erica Wright found herself exhausted, emotional, and determined to keep trusting her body. With the steady support of her doulas (including EBB Instructor Tara Thompson), she discovered that birth doesn't have to go "according to plan" to be powerful. In this episode, Dr. Rebecca Dekker talks with Erica and Tara about how preparation, advocacy, and teamwork carried them through a marathon labor filled with unexpected turns. From switching hospitals late in pregnancy to finding strength through challenges, their story exemplifies flexibility, informed choice, and the power of doula support. (05:55) Tara's updates from Atlanta and her path to becoming an IBCLC (09:17) Erica's lightbulb moments from the EBB Childbirth Class (11:22) Switching hospitals at 35 weeks and advocating for the right fit (16:18) Labor begins: prodromal labor, GBS, and waiting for spontaneous birth (24:30) Hospital admission, challenges with staff, and early interventions (32:17) The Pitocin battle and advocating for movement and monitoring choices (35:40) Finding a supportive nurse and regaining freedom during labor (39:53) Tara's night shift: rest, affirmations, and encouragement (44:20) Deciding on the epidural and reframing "failure" as flexibility (49:18) The final stage: rest, relief, and meeting baby (55:12) Postpartum recovery and breastfeeding challenges (01:00:25) Tara's advice for navigating long labors (01:02:43) Erica's reflections on flexibility, intuition, and informed choice Resources Get in touch with Tara: tarasbirthservices.com | @taras.birthservices Connect with Tara's teammate, Brittany: @wellpreparednest Listen to EBB 146 - How Doula and EBB Instructor Tara Thompson Supports Families in Atlanta Listen to EBB 357 – Making Decisions about Elective Induction of Labor with Dr. Ann Peralta & Kari Radoff, CNM, from Partner to Decide The Evidence on: GBS (Group B Strep): evidencebasedbirth.com/groupbstrep/ The Evidence on: Pitocin During the Third Stage of Labor: evidencebasedbirth.com/evidence-on-pitocin-during-the-third-stage-of-labor/ Epidural during Labor for Pain Management: evidencebasedbirth.com/epidural-during-labor-pain-management/ Learn more about the Evidence Based Birth Childbirth Class: evidencebasedbirth.com/childbirthclass For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.
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