Podcasts about PAP

Ladies, if you have ever been told your labs look normal while your body says otherwise, this one is for you. Dr. Amy Loden is a physician who nearly died from preeclampsia and now builds her practice around what medicine misses in women. She breaks down why pregnancy complications are a warning sign, what perimenopause is really doing to you, and why heart disease deserves your attention more than you think. You will walk away knowing what to ask for and why it matters.If you have any questions about this episode or want to get some of the resources we mentioned, head over to LesleyLogan.co/podcast https://lesleylogan.co/podcast/. If you have any comments or questions about the Be It pod shoot us a message at beit@lesleylogan.co mailto:beit@lesleylogan.co. And as always, if you're enjoying the show please share it with someone who you think would enjoy it as well. It is your continued support that will help us continue to help others. Thank you so much! Never miss another show by subscribing at LesleyLogan.co/subscribe https://lesleylogan.co/podcast/#follow-subscribe-free.In this episode you will learn about:How pregnancy complications reveal health risks that were already there.Why perimenopause symptoms get dismissed as normal aging.The heart disease signs that look nothing like the classic ones.Why good quality sleep matters more than hours in bed.How to eat and move to protect your metabolic health.Episode References/Links:Vitality Medical and Wellness - https://www.vitalitymwc.orgDr. Amy's TEDx talk on pregnancy - https://beitpod.com/amytedxDr. Amy Tiffany on Instagram - https://www.instagram.com/dramytiffanyDr. Amy Loden on LinkedIn - https://www.linkedin.com/in/amy-lodenThe Postpartum Pivot by Dr. Amy Loden - https://vitalitymwc.org/read-the-bookSubmit your wins or questions - https://beitpod.com/questionsGuest Bio:Dr. Amy Loden Tiffany is a St. Louis-based physician entrepreneur, author, and TEDx speaker dedicated to women's metabolic, hormonal, and cardiovascular health. After surviving severe preeclampsia and experiencing burnout in traditional, high-volume medicine, she pivoted her career toward a personalized, root-cause approach to patient care. As the founder of Vitality, she guides women through major life transitions—from postpartum to perimenopause—to help them recognize subtle warning signs and prevent long-term illness. Through her clinical work and her book, The Postpartum Pivot, Dr. Loden empowers high-achieving women to listen to their bodies, optimize performance, and take control of their long-term health.  If you enjoyed this episode, make sure and give us a five star rating and leave us a review on iTunes, Podcast Addict, Podchaser or Castbox. https://lovethepodcast.com/BITYSIDEALS! DEALS! DEALS! 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Then we have to ask, what are we stressing it for? And the way I'm looking at this is a little bit different than how I was trained, which again was if you got the problem, the solution is in the pregnancy. So what if we started looking at pregnancy from the perspective of this is an unveiling, an unveiling of what was already there, and that nothing's actually gone wrong. Lesley Logan 0:29  Welcome to the Be It Till You See It podcast where we talk about taking messy action, knowing that perfect is boring. I'm Lesley Logan, Pilates instructor and fitness business coach. I've trained thousands of people around the world and the number one thing I see stopping people from achieving anything is self-doubt. My friends, action brings clarity and it's the antidote to fear. Each week, my guest will bring bold, executable, intrinsic and targeted steps that you can use to put yourself first and Be It Till You See It. It's a practice, not a perfect. Let's get started. Lesley Logan 1:11  Oh my God, Be It babe. Get ready. Get your notepad out. Get ready. If you're driving, listen. You're gonna re-listen. You're gonna share this episode with everybody. I am so freaking stoked about the guest that we have. I fell in love with her with every single answer, and we need women like this in the medical world. So Dr. Amy Loden is our guest today. We're going to talk everything from postpartum to perimenopause and heart health, because ladies, you can't be it till you see it if you get sick, cannot. And I know it's confusing. There's so much information out there in the world, and it's like, who do we trust? What do we do? And I'm just so grateful I found her, and you're gonna love it. So make sure you get ready to hit share on this episode for women in your life and the men who need to know about what women are going through. My mind is blown on the episode. Here's Dr. Amy Loden.Lesley Logan 1:54  All right, Be It babe, I'm excited. I'm super stoked. We're gonna talk about all things women, health-related, with an amazing professional person who actually studies this stuff, not what I've read, and then I'm asserting to you because I don't want to be that influencer. I think those people need to take a little step back and let the professionals do it. We have Dr. Amy Loden here on the show, who's going to tell us everything we need to know. But Dr. Amy, we tell everyone who you are and what you rock at, kind of how you got here.Amy Loden Tiffany, MD, MBA 2:20  Sure, thanks for inviting me. I'm happy to be here, Dr. Amy Loden. I am in St. Louis, Missouri. I help primarily women over 40, but certainly anyone who's like, "How are my hormones working for my life or not? How is my weight in the mirror matching the weight in my head or not?" And all the things that come with life transitions from postpartum to perimenopause, beyond, my goal is that women who've interacted with our team will have a better care experience because it's the care experience we want each of us to have had ourselves, and because each of us are not only professionals within the medical nursing communities, we're patients too, or daughters and sisters and mothers and neighbors and all the things. We know how much it sucks to be patient, right? And so we've tried to redesign what is the best thing for our ladies. Now, in full transparency, we do have a few dudes, but most of them have had their arms twisted by our rock-star ladies, and they are the ones that are coming because they're forced to. And eventually, they decide they like us, but we're pretty cool too. So that's who we serve, and that's what we do. And happy to go into any detail or rabbit hole you want to chase?Lesley Logan 3:21  Oh my God, Amy! I love that. When people ask about the people who listen to this podcast, we have mostly women and a few good men because there are some men out there, including my husband. They want to be interested. They want to. They want their partners, the women, their lives. They want to get what's going on. They don't want them to feel like an alien or like they're alone in this journey. So I think that's really, really cool. I also just want to highlight. I love that you brought up your patients too, because as someone who I feel very lucky to go through my perimenopause journey in today's time when people actually are talking about it, versus even 10 years ago, generations were not talking about this stuff, and I just feel it's really nice because then there's information I would never have known about HRT unless my girlfriend had told me about it. Oh, that could be going on, and then I could talk to someone. Can we go back though? Yeah, I feel like to be a doctor like yourself, who has empathy and understands, like you must have gone through a journey as well. You don't just want to do this Amy Loden Tiffany, MD, MBA 4:13  Because you wanted to do this. That's true. Lesley Logan 4:16  Maybe there are a few. There might be a few, but typically, like there there has there's a story there that got you to be like I want to care about this. So can you tell us a little bit more about that?Amy Loden Tiffany, MD, MBA 4:24  Absolutely, yeah. So definitely with the traditional college to medical school road, really didn't understand that there's a and I say this with all the love in my heart, but there is a bit of brainwashing to be a good doctor, right? And what is a good doctor was who you've been told it is. It's not necessarily an external criteria. It's who does academic medical center say, and that was very different. I learned through transferring all of my non-medical student fears into the actual application of those fears, and then being a patient and living those fears. That I realized there's a whole lot we're not talking about. There's a whole lot that we're not being told, both as doctors and as women, as patients, and it's hard to realize you don't know what you don't know if you've been told you're the expert and you know everything, right? And most doctors don't go around saying they know everything, but there's enough patients who feel like that's what's communicated, that that's the language I'm using.Lesley Logan 5:18  Yeah.Amy Loden Tiffany, MD, MBA 5:19  And that's really frustrating as a patient, so I didn't realize how frustrating though it was until I was a patient, and I'm a mom of five kids, my third and fourth are twins, and really I am so grateful to live in the United States in a time in history where complicated pregnancies does not mean that mom dies, because I developed severe preeclampsia with heart failure, and my twins came 31 weeks instead of at least 37, and I nearly died the night they were born. They nearly died the night they were born, and I just am grateful that God let me be in this situation that I had the help I needed. Historically, these are not good situations. We see this on TV and in movies frequently. And something like 70,000 women a year across the globe die of the same disease I had, preeclampsia. So it's not nothing, even in our day and age, in certain countries, and even in countries where you have advanced medical care and they do everything right. It can still happen. So, that for me was the pinnacle of this isn't working. What we're telling people to do isn't working because I had done all the things.Lesley Logan 6:30  Right, you were a doctor. You did all the things. I did all the things. You enjoyed all the appointments. You were probably doing, and this is your third and fourth. So you knew what it should feel like. You knew what you should be eating. You knew all the vitamins to take.Amy Loden Tiffany, MD, MBA 6:41  Correct, and it didn't work, right? It didn't work, and so I think that is the fundamental kind of if you place a pivot on why did I change how I think about healthcare as a doctor, it was because of my experience as a patient for myself. My husband had cancer twice, so being the advocate for him in those types of things, guiding my children and now my parents through healthcare, you start to carry a lot of stories, and you start to see, wow, they're not doing what I think is just the bare minimum. And if they're not doing that for me or for my family, I know they're not doing it for everybody else.Lesley Logan 7:11  Yeah.Amy Loden Tiffany, MD, MBA 7:12  And then at the same time, holding a ton of grace in my heart because that's—they're doing what they were taught.Lesley Logan 7:17  Right?Amy Loden Tiffany, MD, MBA 7:17  Right. And they can't do differently if they don't know differently. You can't be better if you don't know to be better.Lesley Logan 7:23  Yeah.Amy Loden Tiffany, MD, MBA 7:23  So that is a really tight tension. But I thought I would just keep plodding through and just be a better doctor in that context of me being a patient until a little—I guess it was two years later. My daughter at that time, my oldest, was seven, and I had about 3000 patients. I was working somewhere between 65 and 80 hours a week, and had four kids at that time. And my daughter came up to me one night, and I'm opening the computer. I'm doing work like I do every night, and she says, "You're gonna make my birthday gifts. Like, can I help?" Right, totally innocent seven-year-old looking forward to her birthday knows that her mom shops online, right? And so she's like, "I want to pick my birthday presents," and I kind of stared at her. I was like, "No, no, I'm going to work. We'll do that later," and go watch whatever show. It's probably Paw Patrol for all I know, right? That's in the background. Go watch it. It's gonna be bedtime soon. And she just stands there, and I haven't even looked at her at this point. My eyes are on my computer. I'm just telling her this as I'm going. I'm totally not in the moment, right?Lesley Logan 8:19  Of course, because like you have so many, you have 3000 patients and four kids.Amy Loden Tiffany, MD, MBA 8:23   I can't keep up. I can't keep up. Right? I'm barely getting enough sleep. I'm not exercising, and I'm just trying to survive. And she doesn't move. And so I remember not totally slow motion, but I remember turning to her and feeling like I was going to be like, "What?" Right? What do you need? And she's just got out of the shower, so her hair's wet. She's got her pink pajamas on, bright big blue eyes, and they're full of tears. And there are just silent tears tracking down her face, and I'm horrified. Oh my gosh, what's wrong? Right now, I'm in fix-it mode.Lesley Logan 8:55  Yeah.Amy Loden Tiffany, MD, MBA 8:55  And she still doesn't really budge, and she just says in a very sad voice, "Mommy. Why do you love your job more than me?"Lesley Logan 9:05  Oh.Amy Loden Tiffany, MD, MBA 9:07  Yes. So the twins tried to kill me. She did kill me, right? Like, that was a knife in my heart because nothing ever had I wanted to be better than a so-called good doctor than to be a good mom.Lesley Logan 9:17  Yeah.Amy Loden Tiffany, MD, MBA 9:18  And that was for me the moment that I realized I'm not doing either of these well, and I'm not showing up how I want to be personally or professionally. I'm certainly not taking care of my health. I'm not doing the things I'm telling my patients to do. Like, it was a moment where I really felt the failures. I felt all the feelings, and I told my husband that night, "This is not working anymore." And he actually thought I thought was talking about our marriage, and so he was like, "Oh my gosh, what's wrong with our marriage?" Right? No, but I need to, like, redo. We have to redo this. I either have to retire, or I have to do something different.Lesley Logan 9:51  Yeah.Amy Loden Tiffany, MD, MBA 9:51  And he was like, "You're not retiring. You will drive me crazy. Go find something different to do, and I will make sure our family is okay." And so I did. And this June will be five years of having Vitality here in St. Louis and serving women and trying to lean into all the pain and the things and the feelings they're dealing with from all the things and the feelings I dealt with having walked that path.Lesley Logan 10:13  Yeah. Oh, Dr. Amy, I love that you shared that whole story because I think there's so many women who are listening here and, like, they don't have, they may have one kid or they have no kids, but, like, I think we can all relate to, like, having just too much on the plate because.Amy Loden Tiffany, MD, MBA 10:27  Right.Lesley Logan 10:28  Hello, my high-achieving woman. I see you, everyone here listening. We call recovering perfectionists and overachievers. There's nothing wrong with being a high achiever, but what happens is we tend to just keep saying yes to things, and we're like, yeah, we can fit that one more thing in, that one more thing. All of a sudden, it just comes to, like, a volcano breaking point. Yes, and because we don't, we don't see the signs early that we are at the breaking point. We don't, you know, we, it's almost, it's actually proven to be not true. But everyone uses the frog in the boiling water, right? Like, we just kind of, like, you don't realize how hot it's getting until it's until your daughter is crying in front of you. Oh, exactly.Amy Loden Tiffany, MD, MBA 11:05  Yes, it was awful. I never want to relive that moment.Lesley Logan 11:08  Yeah, but also, like, thank goodness for her because that she felt brave enough to say that. Like, what a badass she is. I mean, she's just going to be, like, she's just going to be a girl who speaks her mind. She does.Amy Loden Tiffany, MD, MBA 11:18  She's 13 now, and she heard me tell that story once, and now she's like, "Well, you have to credit me for opening your business because I hadn't said what I did." I was like, "Won't you just tone it down a notch, please?"Lesley Logan 11:27  It's called balance, babe. It's called balance. Yes. Okay. So, can we, like, let's get to some of the health stuff that I think our listeners want to—I want to definitely get into perimenopause, but I do want to, because we started with a pregnancy, and I have had family members who, you know, have had preeclampsia in their, and it's scary. So, how are pregnancy complications connected to long-term heart risk? I don't think anyone's thought about that. I just thought, like, if it's because I don't have kids, like it's going to screw up your pelvic floor, and you might have to rebuild your abs and these other things. But I didn't know it can affect your heart long term.Amy Loden Tiffany, MD, MBA 12:01  I had no idea. I'm so glad you brought that up. So I actually did a TEDx talk on this very topic, where the idea is pregnancy is so much more than just the birth of a kid. That's how we think about pregnancy in our culture. That's even how we think of it medically, right? Like if you have preeclampsia, you have gestational diabetes, you have high blood pressure, whatever in pregnancy, the answer is end the pregnancy, deliver the kid if they're old enough, right? Like, get, move it along and it's gone. But that I strongly believe is not true. We can't test this in a lab, so you have to do a little bit of extrapolation here. But if we're going to call pregnancy a stress test, which is becoming an increasingly common term, is pregnancy a stress test of a woman's metabolism and her cardiovascular system? Then we have to ask, what are we stressing it for? And the way I'm looking at this is a little bit different than how I was trained, which again was, if you got the problem, the solution is in the pregnancy. So, what if we started looking at pregnancy from the perspective of this is an unveiling, an unveiling of what was already there, and that nothing's actually gone wrong. It's scary. It's horrifying. And yes, absolutely, people die. So how can I say nothing's gone wrong? What I mean is nothing has gone wrong in the context of the situation we put your body in. It's exactly responding the way it should for the context it's in. So if I have underlying insulin resistance, and then I put a pregnancy on top of that or perimenopause, and I'm starting to have more insulin resistance. Well, of course I'm going to develop gestational diabetes. If I'm having a lot more fluid retention and I'm putting up a low weight, of course my blood pressure is going to go up, right? If I've got underlying inflammation, of course preeclampsia is going to develop. So I think we need to stop and think about it as it's not done; it is unmasked.Lesley Logan 13:42  Got it. Amy Loden Tiffany, MD, MBA 13:42  And then once you know it's unmasked, you treat it.Lesley Logan 13:45  I see. I see. Because again, we think of pregnancy as just the baby, so you have the baby, but it's well, but there's a problem, an underlying problem that the pregnancy revealed is what you're saying. And so great if having the baby is the safest thing for both people, we do that. But also, you still have this underlying issue.Amy Loden Tiffany, MD, MBA 14:01  Yes, it's still there. Correct.Lesley Logan 14:03  Yes, and I don't think anyone does that. I think they're just, "Okay. Now you don't have gestational diabetes anymore." But I have had clients who had it, and then afterwards, so what do we got? Oh, I'm fine. Are you correct? I don't think so. I'm not a doctor, but they're not fine. Don't just be diabetes. Yeah, for a moment. Yes.Amy Loden Tiffany, MD, MBA 14:19  So I actually experienced this as a patient too. I went in after my first pregnancy with gestational diabetes. At the time, I was living in New York City. I walked everywhere. I was a normal weight. I ate pretty clean, and despite being in residency, I'd got decent sleep. I didn't have any other kids. It's my first kid, so I got decent sleep. Right, but I had the baby after having had gestational diabetes. I go see my OB, and she's, "Oh, just follow up with your primary doctor." I go see my primary doctor, and he's, "Your weight's normal, your labs are normal. We're done," and that is how I was trained too. So again, lots of love in my heart. They're not; they're just not told. But for more than 10 years, we've known that women who have these high-risk pregnancies are at high risk not just for diabetes, but heart disease, stroke, kidney failure, dementia. Listen, I can't treat dementia well in the clinic, right? So why wouldn't I want all hands on deck trying to prevent it?Lesley Logan 15:07  Yeah.Amy Loden Tiffany, MD, MBA 15:07  But that's not how our medical professionals are trained—nurses, advanced practice providers, any of them. And so we're asking people and expecting people to fill in a gap they don't know exists, and so all these reproductive-age women are falling into it. And then where it gets really interesting is some of the same things you have immediately postpartum in all your different types of hormone fluctuations are matched intermittently for 10 to 15 years before menopause when you're in the perimenopausal years.Lesley Logan 15:32  What?Amy Loden Tiffany, MD, MBA 15:33  Correct, but that's why these women are feeling, "I'm going to my doctor, I'm putting on weight, I'm doing all the things, it's not working," and they're being gaslit, partly because their doctors don't know what they don't know, and partly because we're not acknowledging this is the same physiologic status of hormones that are different than baseline. So we're not in a country, and we don't have the testing that would promote or facilitate checking what is your normal hormone level at 18, so that we know what 18 should look like, and then by 45, you know, we're not. So we're trying to patchwork together a whole bunch of tests, and different labs have different testing, and different people say different things about testing. It's very confusing.Lesley Logan 16:10  Yeah.Amy Loden Tiffany, MD, MBA 16:11  And you end up with women suffering. And at the end of the day, that's the problem I'm trying to solve: is how do we stop these women from suffering? Because they are called to live big lives, to be ambitious for a purpose, for a calling. They have a lot to do, and their health is one of their biggest assets. It should not be a liability.Lesley Logan 16:27  Yeah.Amy Loden Tiffany, MD, MBA 16:27  And that's what's happening, especially for women who are trying to not work just in the home but outside the home. Right? There's a lot they're carrying. Yeah. So that's, I don't remember. Sorry, I'm having a total perimenopause moment. I don't remember where we started with that question here. I'll stop there. Lesley Logan 16:42  Don't worry, babe. I got my focus meds on the ADHD today, so I'm tracking. So we're good. But we were talking about the postpartum, and then we got into those hormones that switch as, and they can repeat into perimenopause. And I think this is fascinating. I love that you brought up. It doesn't matter if you're in the home or out of the home. We have big lives. Correct. We can't have our health be a liability, and I think for a lot of us, it feels like, like my girlfriend's a weight-loss coach for women over 40 who feel like their body gave a middle finger. That's what her coaching is, and it's all about not going to yo-yo diet. That's not going to work. We have to figure out what is the underlying issues, and it can only go so far because you said we don't test our hormones at 18. We don't do that, so we don't know what is normal for us, and I remember I was having a lot of health issues, digestive issues in my 30s, and no doctor could help me. In fact, one doctor sending me to, I was in this weird part where they study HIV and Ebola in the hospital, and she's like, "Do you know why you're here?" I don't know why I'm here. I don't. This scares the hell out of me. This feels like a department I should not be in. I'm not in any pain. I feel like I'm taking someone's spot, and so because he could, he just couldn't figure out what's going on my stomach. So I found someone who did an actual test of everything. He's so range normal. We don't know what normal is for you. We just know what the average person of this population of people that who knows who they were that were tested. So what is normal for you might not be the average. And I was, "Oh well, that's the first time anyone said anything that makes sense. That's the first time." So you can be in range, but for your hormones, but it wasn't in range for you because maybe you were used to higher testosterone, you're used to higher things. And so I love that people like you exist. I'm sorry for the frustration of your own journey, but also without people like you, women like me wouldn't have someone going, "Hey, actually, maybe you should be on testosterone right now," even though the, this is what it is. Mine was actually zero, but people, you know, we can actually get you help because I feel so much better because someone finally was listening to me and thought, "Yes, we're not going to compare you to a random person. We got to compare you to how you're used to feeling."Amy Loden Tiffany, MD, MBA 18:42  Correct. And for most people, that can't happen in the traditional system.Lesley Logan 18:47  Yeah.Amy Loden Tiffany, MD, MBA 18:47  You can't do that in a 10-minute visit.Lesley Logan 18:49  Right.Amy Loden Tiffany, MD, MBA 18:50  You can't do it when your doctor has 3000 patients, 10-minute visits, and they really don't actually know who you are.Lesley Logan 18:55  Yeah.Amy Loden Tiffany, MD, MBA 18:56  You just can't. So we've got a little bit of unrealistic expectations as a society, and then you know any women's magazine or journal article you read says, "Talk to your doctor about this." So then you go in, I'm all prepared. I have my list. I've done it too, folks. Right? This is not a criticism, but they, they can't. They don't have the ability to process it, and the way they're paid is based on the questions they ask you for insurance. So every incentive is misaligned, and at the end of the day, women, people are being screwed.Lesley Logan 19:22  Yeah, yeah. No, it's so true. So I'm glad we talked about the postpartum. I want to get into now. We're in the perimenopause, and yep, this is hard because you mentioned the hormone shift of people after postpartum is its own crazy world. I keep checking on my sister-in-law every day. How are you feeling? Are you feeling okay? Right. You feel okay? She's, "I'm fine." Are you fine? Let me just, I just want you to know. It's okay if you feel different, right? I think I'm crazy, but I know that that people don't realize how they're feeling, and it's hard to get to the doctor until it's too late. So I'm just, I'm on her. But for people like me, we didn't have children, so we have never experienced a crazy shift. We just start to experience, "I don't feel like my, anymore," and all the symptoms are so different for every single person. I'm not having hot flashes, but I'm, I got to keep my hair still here. But my inflammation was insane. I was putting on weight and working out and eating the same. And I don't understand what's going on. You know, so can we talk a little bit about what, I don't know where you want to start with that. So you tell me where you want to start with my post, my perimenopausal people who are not necessarily attributing these changes to that.Amy Loden Tiffany, MD, MBA 20:27  So I think the biggest confusion I see in the exam room conversations is that there's just question of, am I in perimenopause or not? And it's more of a less of a yes-no and more of, are you on the spectrum, and where on the spectrum are you? And so if you think of it as a sliding scale, because some months those ovaries are working really great, and you feel all the feels, and you're 18 again, but a lot of months maybe you're more like 20 or 25, right? And then maybe out of the blue, I feel like I got run over by shock. Nothing's working for two or three months, and then we're back to 25, right? And so it's ups and downs. You're like, what is happening? It is a roller coaster, and it runs anywhere from 10 to 15 years before you actually go through menopause. So I think of it as reverse adolescence, and I think it's completely ironic that God lets us have teenage girls when moms are going through perimenopause because that is just double-adolescence whammy, right?Lesley Logan 21:19  And no wonder, no wonder marriages don't survive certain things. Right, you have a daughter going through puberty and a wife with a pair of menopause. Good luck to the husband. Correct, becauseAmy Loden Tiffany, MD, MBA 21:28  I want to have sex. I don't want to have sex. I have pimples all over my face. I don't want to go to the house. I do. My belly's bloated. It's not like my mood's up. All the things, and it's all in reverse. So it's a it's a period of a woman's life that I think needs to be acknowledged, and then within the healthcare system, there's more noise about it over the last five years. You're seeing more and more people talk about this, but there's not a lot of standardization, and so you're getting chiropractic, functional medicine, traditional medicine. You're getting all sorts of different recommendations. So my hope is that over the next decade, we start to see some standardization, and we start to say this is what is normal for this population. You still have to apply it to the person. You cannot take population data and apply it to individuals and say that you're going to have good luck, bye. We'll see you in a year. That doesn't work. What I do think is that women need to know what's normal for that time, and then they need to decide, do they want to do something about it beyond what their body is experiencing? And here's some really interesting data that I hope your listeners suddenly stop and listen. If they don't hear anything I've said yet, this will be really important for women who have hot flashes and night sweats. Either one, they're actually the same thing. We call them vasomotor symptoms. When you have those at a certain degree, so that they're happening most days of the week, more than 10 times a day would be an easy target to kind of pay attention to. You have that, and you choose not to take hormones. You actually have an increased risk for cardiovascular disease and stroke. That does not mean every woman in that category can or should take it. There may be reasons they can't, but the hormones we use today are different than what in the Women's Health Initiative that came out in the early 2000s. So you're getting a lot of confusion because women are reading about data from that, not realizing that it has changed, and that study is not going to be redone. It was a huge study. We're not going to see data like that, so we have to make really informed decisions. But cardiovascular disease, hear me, ladies. Cardiovascular disease, which includes stroke and heart failure, kills more women every year than all your cancers combined. Yeah, I get the women and they come in religiously for their mammograms or their Pap tests, right? But they don't know that the bigger risk is that they're going to die of heart disease, cardiovascular stroke, and we know that one in eight women, roughly, have breast cancer risk, and those women get it. One in two women are getting heart disease. So there's one inLesley Logan 23:50  Two.Amy Loden Tiffany, MD, MBA 23:51  One in two. So that means there's two of us on this call, right? We already know I'm going to get it because I had preeclampsia. So I'm the one. Lesley Logan 23:56  I was going to say. I hope it's not maybe. I hope it's not you. But, like, thank God you know that because I think it's one and two, especially if you don't know. Because if you know that you're at risk, you do. Then you can you do something. I am. I'm double the risk for breast cancer, so I have to do an MRI and a mammogram every six months, and I have some decisions I might have to make in my life. But because I know.Amy Loden Tiffany, MD, MBA 24:18  Right, I can take.Lesley Logan 24:20  I can take action. Yeah, correct.Amy Loden Tiffany, MD, MBA 24:22  And you know, using that same kind of history, if someone comes in my office and says that I don't want to take hormones because I was a breast cancer, I'm like, that's fine. But let's look at all the facts. Let's lay it out like your financial advisor does, and then you can make an informed decision. Because just acting out of fear or reacting is not wise either.Lesley Logan 24:38  I actually really appreciate you mentioning that because it's true. If I'm, I'm very lucky in that I still get to do the HRT that I'm on, even with my risk. But also they're checking me every six months, and I'm checking me. So if anything's going to happen, we're going to catch it so much more quicker. Whereas the hard stuff, there's only so much you can do with that. And so if you're, especially if you're not aware. Say there's all conversations, but I liked the way you laid it out with the wealth manager. I just met with mine. He laid out here's where we're being aggressive. Here's where we're doing this. Here's what's going on here. We're going to move this over here because we're going to risk-manage these risks. And I think that's that's a better way to look at it because we're not going to, every single one of us is unfortunately going to experience something because it's a body. We're not a machine. Amy Loden Tiffany, MD, MBA 25:21  It wears out.Lesley Logan 25:22  I did not know it was one in two, girl.Amy Loden Tiffany, MD, MBA 25:26  Yeah, and what's even more disturbing, you may have heard a lot of women have by now that women's heart disease presents differently than men.Lesley Logan 25:32  Yeah, can you tell us just in case my people haven't heard because I didn't know it was one in two? So let's go over the signs.Amy Loden Tiffany, MD, MBA 25:38  A lot of times people think of what's the so-called traditional? It's the jaw pain, the radiation of pain from your chest up to your jaw, to your back, down your left arm. Very classic symptoms. Classic because it was studied in men, and then we have these so-called atypical for women because they're not typical compared to men, but they're classic for women. And so, got a little bit of lingo here that it doesn't make total sense. But for women, sometimes it's they just feel a lot more anxious than they've been for unclear reasons. They have this sense that something bad is on the horizon. They can't really place why their sleep is different. Maybe they're having some shortness of breath they didn't used to have. Maybe they go up the stairs in their house, with a laundry basket, and they're huffing and puffing when six months ago they weren't. So it can be very subtle differences. It could be a new fatigue. Check labs are normal, but the fatigue's still there. That worries me when I hear women say this. Unfortunately, the number one sign that you have heart disease is sudden death.Lesley Logan 26:33  Oh.Amy Loden Tiffany, MD, MBA 26:34  So let that sink in for a second. So we can't always wait on what the signs are.Lesley Logan 26:39  Yeah, we can't fix that. Right. Correct. Okay, so that's hard because our signs are also. I feel like high-achieving women would so easily brush away that anxiety.Amy Loden Tiffany, MD, MBA 26:51  All the stuff. Correct. Because I have a lot of tabs open.Lesley Logan 26:54  Yeah, I got this going on, or I haven't been working out, so of course I'm out of breath going up the stairs. They would just so easily.Amy Loden Tiffany, MD, MBA 26:58  It's May, it's graduation season. It's wedding season, right? This is just aging, and that's not the story at all. The problem is 10-minute visit with your doctor who has 3000 patients. They don't know who you are. They're not going to notice that this is different for you.Lesley Logan 27:13  Yeah.Amy Loden Tiffany, MD, MBA 27:13  Decreased exercise tolerance is a big one. And so, if you could walk three miles every day in your neighborhood, now you're like, "Wow, I'm really struggling to get through one." I'm worried about that. I want to know what's going on and why.Lesley Logan 27:25  Yeah. So I guess since one getting a 10-minute visit is hard. I, where I live in, I live in Las Vegas. Last I heard, we are short general practitioners by 1400. I don't have one. I go to a women's clinic, and I'm really grateful. It's a, it's also a student-teacher thing. So I actually, they've caught things because the students are asking the questions because they'reAmy Loden Tiffany, MD, MBA 27:44  Yes, yes.Lesley Logan 27:46  I love them. I'm so grateful for them, but are there things that women can do to check their heart, or is it just being, is it just noticing the one mile versus a three mile? What can we, what are the signs we need to be checking on?Amy Loden Tiffany, MD, MBA 27:57  Certainly be aware of what your body is telling you. Again, if you have to remember nothing else, this is another one: is that your body is smart; it will talk to you, but you have to listen.Lesley Logan 28:05  Yeah.Amy Loden Tiffany, MD, MBA 28:06  So that's really essential. If something's different, say something. You're right. There's a big collapse, if you will, of how much support we have in healthcare, whether it's nurse practitioners or chiropractor or whatever. And the issue is not all of them are trained the same way. So when I worked in the OB/GYN clinic, it became apparent to both of us, on both sides of it, that OBs know stuff about women's health. I don't know, but I know stuff about metabolic and heart health that the OBs aren't taught, and most women use their OBs as their primary care, at least to a certain age.Lesley Logan 28:32  Right.Amy Loden Tiffany, MD, MBA 28:33  And again, you don't know what you don't know, so you don't realize what you're not looking for that you should be. And our system's not set up for good collaboration. So if I could tell women, here's a checklist of things I want to make sure you get, your doctor is going to give you some resistance, most likely because they don't realize that lipoprotein with a little a, it's like in parentheses at the end of it, not the big A. Lipoprotein little a. If you have that mutation, and 10 to 20% of our population does, you have a different rate of plaque development, at least risk for that than the average risk will miss. If you have high insulin levels, you have a higher risk that you're going to be on a pathway toward diabetes. Those are not things that are standard checks. So knowing that there's other tests you can ask for, and even if your insurance doesn't cover it, they're not expensive tests. Just get it once, right? Have an idea of what's going on in your body once gives you a ton of information. I offer a lot of our patients to wear different glucose monitors, even if they're not on diabetes. And all my physicians who are listening to this are probably like, "You do what?" But the reason is, if you can figure out that your glucose and insulin are high before you develop diabetes or pre-diabetes, if you figured out that insulin-resistant stage, that's a lot easier to fix, and our doctors aren't even taught about what is insulin resistance, what is the criteria for it, and how do we reverse it?Lesley Logan 29:47  Right, because there's some prevention we can do if we have information.Amy Loden Tiffany, MD, MBA 29:50  There's a ton, and it's things women can do in their homes or their businesses. It's not stuff I'm doing in the exam room.Lesley Logan 29:56  Yeah, and that's also, you know, you're listening to this podcast, you're kind of a go. Anyway, so you're gonna, you'll take the action. Our health insurance is very bizarre. I thought it was crap because, but it has a lot of preventative stuff that goes on with it. Hey, we want to put this thing in your house and check your heart and some other levels every, I don't know, two or three times a week. They keep calling them. I have two adults. We have two ADHD adults in this household. The box is here. One of us will open it when it becomes the pressure. I just have to hang tight. We'll get there. But I'm really impressed by that because we don't have access to a regular doctor. So what information can we gather so we could be watching it and monitoring it? So we can advocate for ourselves if something comes up. So having that prevention is really amazing. Okay, so we talked a little bit about the perimenopause and the different things. What are some simple shifts that women can make now to protect their future? I mean, obviously we have a wide range of women, so the now is different. But what are some things that they could be doing? Because I do think that they are getting information from the magazines and the Instagrams, and we should get it from the person who's experienced it and has seen it. You know, so you.Amy Loden Tiffany, MD, MBA 31:00  Some easy things, and I say easy relative because they're easy to do, which means they're easy not to do. So acknowledging that, right? It's real. Number one, understanding that just because you get eight hours of sleep, if they're not high-quality hours, you've got a metabolic risk from your sleep not being normal. That's important to understand because you spend a third of your life asleep, right?Lesley Logan 31:19  What's a metabolic risk? Just in case my people. So.Amy Loden Tiffany, MD, MBA 31:22  If you don't get good-quality sleep, your cortisol goes up. It's one of your stress hormones, and when cortisol goes up, glucose goes up. When glucose goes up, insulin goes up. Insulin's your fat-storing hormone. So even without your sex hormones being involved, or the ghrelin and leptin you're hearing about with weight and GLPs and all that, just those, you're not getting good sleep. It's going to be a problem. Insulin resistance is going to go up. Insulin resistance means your cells are not listening to the insulin your body is giving it, so your body works harder to get more insulin, and the cells work harder to ignore it, and it just keeps going in a vicious cycle. So if we consider that that's the root cause of a lot of these problems we've been talking about, we fix that. Number one is get good sleep, get good-quality sleep, and it's not, not just enough time in bed.Lesley Logan 32:02  Yeah, so.Amy Loden Tiffany, MD, MBA 32:03  That's important. Number two is most people don't realize that they're doing it backwards. They're, if they're, if they're even able to get exercise in their life right now, right? So we're going to make the assumption that you figured out some exercise regimen you like. We're, we're at that level, but they're doing it at the wrong time, and they're doing it in a way that they're sabotaging their end result. So rather than going to the gym and then going and eating dinner, or going to the gym first thing in the morning and skipping breakfast and all these things, you need to eat protein and fat, and then you need to move your thighs. I don't care if that's jumping jacks, going for a walk, running up the stairs, something where your thighs are moving regularly for 10 minutes. So make it whatever you like doing. This can be the mom at home who's doing all sorts of fun class activity with her kid, right? Like moving the baby around or the teenager can be equally fun to move around for what it's worth. And then it could be the CEO who's getting ready for a meeting and has 10 minutes after eating whatever lunch she had in the five-minute break she did, right? So looking at what makes sense in your life, but 10 minutes of physical activity, ideally after every meal, that's not realistic, but that's ideal. And then you start with the one meal a day you can do, and you do it most days of the week to start with, because most of us have to figure out how to make it a habit.Lesley Logan 33:15  Yeah.Amy Loden Tiffany, MD, MBA 33:15  But movement for 10 minutes after eating, it's, it's crucial. I cannot stress that enough.Lesley Logan 33:20  I didn't realize it was. It makes total sense moving your body after eating because I like to go for a walk after I have lunch. Otherwise, I'm tired. Correct. I can't go back to work now. Amy Loden Tiffany, MD, MBA 33:30  The reason you're tired though is because your glucose goes up and your insulin went up to match it. When you walk right after you eat, glucose still goes up, but it's less, and so you have less insulin spike. Insulin is the bright driver here, and so you've got to do the movement after. And if it helps to understand why, think back to what our ancestors did 1000 years ago. Right? We weren't checking hormones. We weren't checking insulin. We weren't talking about hacks. We were trying to survive most of the time. Yeah. But the things they did is they, if they, what, after they ate, they moved around. Right? Like they were building their shelters. They were taking care of the kids. They were moving in the community, helping build, create, relocate, whatever. They were always moving, and they did not get the whole three square meals a day. That's bogus. You don't need three meals a day, okay? And most of my ladies don't realize that they're eating their nutrients potentially in the wrong order for their body. That they're eating them in the wrong time for the cycle of the month they're in, they're not getting enough protein, not getting enough fat for their hormones and their brain, and it doesn't happen quickly, right? It's months, years, maybe even a couple decades before they're, I don't know what happened, but my body in the mirror is not the body in my head. This is not who I am. There's a disconnect, and they finally are at that place where they have to do something, where the body is forcing them to stop because they've pushed it as hot as you know.Lesley Logan 34:44  Oh my God, that's a whole episode. We're having you back. I'm just telling you right now because I want to have a whole episode on the whole. Because what I do know is if you eat certain things, if you work out too late, if you get your cortisol up, sleep that. I have been trying to figure out sleep for over a decade, and I, I get good-quality sleep most of the time. But I'm obsessed with it because I'm like, I don't want Alzheimer's. I do not want heart problems. It doesn't really matter what I'm doing at the gym if I'm not sleeping. None of that matters. Doesn't matter what you're, If you don't get good sleep, all the rest is gonna just fall apart anyways. So it's interesting. It makes sense about the food because I remember when I was having problems with my cycle and I had my one of my doctor friends, she said you should try seed cycling because I just, the worst cramps and, like, the worst everything was just the worst in the world, and so I tried seed cycling and my goodness, you know, I'm not a woo-woo girl, but the seed cycling makes, I got, I had no more zits, my boobs didn't hurt as bad, everything leveled out, and I didn't need any extra hormones for it. I was, whoa, so now there must be more. We need to know about it. So we'll have to have you back for that. I can talk to you forever. So we'll just, this is part one of many. I'm just going to take a brief break and then find out if people can find you, follow you, and work with you. All right, Dr. Amy Loden, where do you hang out? You mentioned St. Louis. Can people work with you if they're not in St. Louis? How does this work?Amy Loden Tiffany, MD, MBA 36:03  Yes, absolutely. Best way to get into contact with our office is just going to our website, www.vitalitymwc.org. They can sign up for a consultation, and we can go through what their options are. There is also lots of opportunity if you don't want to work with us directly, but you want to continue the conversation and hear what we're seeing. I do all the social media I can so that people can hear what's being said in their exam rooms and have it in their real lives too. So you can do that on follow me at Dr. Amy Tiffany, whether it's on Instagram or TikTok or Facebook. You find it where they're also on LinkedIn at Dr. Amy Loden. So lots of places depends on what their needs are. One special offer I do have for your audience: we talked about pregnancy and perimenopausal bit through this conversation, they can contact my office for a free physical copy of my book, The Postpartum Pivot. And before you stop listening, ladies, and you think, "Well, I'm not postpartum." If you've had a baby, you're postpartum even it's 20 years ago. Your body's different than it was before that baby, and so you can understand what does this look like for perimenopause and other types of areas that we go through as we grow less young, but grow more wise.Lesley Logan 37:03  Oh my God! Every one of my female females, that's where your Christmas present is. Sorry, just gonna get a doctor because they don't. It's, if their doctor doesn't tell them, they don't know, right? And then they are just going through it. And I feel so bad because every woman in my life is such a badass, and then they get their body doesn't keep up with what they're wanting to do in life, and then it just becomes not just like a liability, but like this hangup. So you are amazing. Okay, you've given us some great stuff already. I mean, we're gonna have to rewind, and I'll listen to this. I've got, you know, getting my notepad out, but our bold, executable, intrinsic, or targeted steps people can take to be it till they see it. What do you have for us?Amy Loden Tiffany, MD, MBA 37:37  I want each one. When you be it as you see it, I want you to be true to what your body's telling you, and recognize nothing's gone wrong. Listen when things are happening and they seem like it's a crisis. Nothing's gone wrong. Your body's talking to you. Listen, and when you listen, you become more wise. You become a better version of yourself.Lesley Logan 37:55  Okay, I really love that. We talked about that earlier, but it's true. Some of us think our body is against us, and it's doing something to us. But really, it's like, hello. The alarm bells. Amy Loden Tiffany, MD, MBA 38:05  It's doing exactly what it should do for the situation we've put it in. That doesn't mean we like it. You get diabetes. No one's like, oh yeah, my body did exactly what it's supposed to do. But if we understand that, then it becomes a neutral thought. It's not bad or wrong. It's I didn't listen, so now I'm going to stop, and the best place to reverse is as soon as you realize you're going in the direction. Right? It's not to keep going in the wrong direction. So nothing has gone wrong. We just need to listen. We need to turn around, create a better story.Lesley Logan 38:33  Love it. Love it. This is and then so enlightening. This is so fun. Thank you so much for being you and your and and the journey that you've been on is something we can all benefit from. So thank you for that, you guys. We all need to share this episode with all the women in our lives, and I would love for you to make sure that Dr. Amy knows your favorite takeaways. Send them to the Be It Pod as well. And since I'm going to have her back, not that I even like asked her beforehand, but I'm just going to tell her she's doing that. You can send your questions, and we'll make sure we get that. So, beitpod.com/questions. Until next time, my loves, Be It Till You See It. Lesley Logan 39:03  That's all I got for this episode of the Be It Till You See It Podcast. One thing that would help both myself and future listeners is for you to rate the show and leave a review and follow or subscribe for free wherever you listen to your podcast. Also, make sure to introduce yourself over at the Be It Pod on Instagram. I would love to know more about you. Share this episode with whoever you think needs to hear it. Help us and others Be It Till You See It. Have an awesome day. Be It Till You See It is a production of The Bloom Podcast Network. If you want to leave us a message or a question that we might read on another episode, you can text us at +1-310-905-5534 or send a DM on Instagram @BeItPod.Brad Crowell 39:45  It's written, filmed, and recorded by your host, Lesley Logan, and me, Brad Crowell.Lesley Logan 39:50  It is transcribed, produced and edited by the epic team at Disenyo.co.Brad Crowell 39:54  Our theme music is by Ali at Apex Production Music and our branding by designer and artist, Gianfranco Cioffi.Lesley Logan 40:02  Special thanks to Melissa Solomon for creating our visuals.Brad Crowell 40:05  Also to Angelina Herico for adding all of our content to our website. And finally to Meridith Root for keeping us all on point and on time.Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Sahil Chopra to discuss research challenging a fundamental assumption: that residual AHI measurements from PAP device downloads accurately reflect whether patients' sleep apnea is adequately treated. Sleep medicine clinicians routinely rely on residual AHI from PAP downloads to determine treatment success, typically targeting an AHI under 5. But what if this metric significantly underestimates untreated sleep apnea? Dr. Chopra's study comparing PAP-determined residual AHIs to cardiopulmonary coupling (CPC)-derived AHIs reveals striking discrepancies: mean residual AHI was 2.4 via PAP download versus 12.1 via objective testing. Even more concerning, 85% of nights showing residual AHI under 5 on PAP downloads had elevated AHI based on objective CPC measurement. Dr. Chopra explains why he chose cardiopulmonary coupling as the comparator metric, using a PPG-based wearable ring worn for 7-10 nights. He clarifies why PAP devices may systematically underestimate residual disease through mask leak, unstable breathing, and periodic breathing patterns. A particularly concerning finding involves residual hypoxia. Dr. Chopra discovered significant hypoxic burden in many patients considered "well-treated" by PAP standards—important since hypoxic burden, not just AHI, drives cardiovascular risk. Dr. Chopra's conclusion isn't that PAP-derived AHI is "bad"—rather, that it shouldn't be the sole metric for assessing treatment efficacy. Even patients with good symptoms may have significant residual respiratory events and hypoxia that PAP downloads fail to detect. Clinical applications are discussed, including when to pursue objective testing and what interventions to consider when objective testing reveals inadequate control despite acceptable AHI. Whether you rely on PAP downloads to assess treatment efficacy, manage patients with residual symptoms, or seek emerging objective metrics, this episode provides essential perspectives on optimizing PAP therapy. Join us for this important discussion that challenges current assumptions about measuring treatment success in sleep apnea.

Can preterm birth be prevented? Historically the answer has been no, and the numbers back that up. In 2006 the U.S. preterm birth rate was about 12 percent. In 2024 it was 10.4 percent. Medicine has gotten dramatically better at keeping premature babies alive, but almost no better at keeping pregnancies from ending early. In this episode, Kristin and Dr. Abdelhak make the case that the answer is yes, preterm birth can be prevented far more often than it is now, and that the field has been looking in the wrong place. Preterm birth is not one condition. It is a grab bag: placental abruption, systemic infection like appendicitis or pyelonephritis, uterine overdistension from twins, triplets, or polyhydramnios, trauma, severe hypertension, stimulant and cocaine use. Every one of those causes announces itself. The woman with triplets is obviously carrying triplets. The woman with an abruption is bleeding and in pain. So what about the woman with none of that, doing everything right, who shows up at 30 weeks contracting and three centimeters dilated? For forty years the answer was "subclinical infection," a diagnosis Dr. Abdelhak takes apart in this episode. If it is subclinical, why is preterm labor the only clinical thing it ever does? Why does an appendicitis start with pain and fever and end in labor, while this mystery infection skips straight to the last step? And after four decades of amniocentesis studies cataloguing cytokines, interleukins, and prostaglandins, where is the treatment? There isn't one, because researchers found exactly what they went looking for. His answer is mechanical, not microbial. The cervix is a timekeeper on the pregnancy. Conventional teaching says contractions open the cervix. He argues it runs the other way: the cervix quietly gives way over weeks, and when it opens far enough, labor starts. That is why he says he is almost never surprised by a preterm labor. He was already watching the cervix shorten. Also covered: why previous preterm birth is the single strongest risk factor (it is the same cervix), why cone biopsy raises risk more than LEEP does, what funneling on ultrasound actually tells you, the difference between classic cervical insufficiency and the milder version that still lets you reach the third trimester, and why a three-hour precipitous labor at 38 weeks may be the same finding wearing a friendlier face. The practical takeaway: serial cervical length measurement for anyone with a red flag, first-time moms included, and cerclage when the cervix starts to open. Screening plus treatment, not a pill for an infection nobody can find. Plus: why the president and Taylor Swift would get their cervix measured every single week, and what that tells you about the standard of care the rest of us are offered. Topics covered, in order Why this topic is worth repeating, and why the framing here is not the conventional one The better question: preventing preterm birth, not preterm labor Fifty years, the March of Dimes, and a rate that has barely moved What we did get better at: neonatal survival and outcomes, not prevention Preterm birth as a grab bag, not a single disease Placental abruption Systemic infection: appendicitis, pyelonephritis, sepsis, severe pneumonia, COVID The subclinical infection theory, and the case against it Why the amniocentesis and cytokine studies found what they set out to find Uterine overdistension: twins, triplets, polyhydramnios Trauma, decidual hemorrhage Severe hypertension, pulsatile flow, and abruption risk before 20 weeks Cocaine, methamphetamine, smoking The patient nobody can explain, and what is actually going on The core claim: dilation causes the contractions, not the other way around Why Dr. Abdelhak is rarely surprised by a preterm labor Mild cervical insufficiency, and "dreamlike" cervical insufficiency at 38 weeks Why previous preterm birth is the number one risk factor LEEP versus cone biopsy, and why cone matters more Normal variation in cervical length, and the big nose analogy Length is not everything: bulk, thickness, and how the cervix feels Funneling on ultrasound as a warning sign The proposal: serial cervical length screening plus cerclage Why the numbers are U.S. numbers, and why international rates are not trustworthy The VIP standard of care, and who actually gets weekly scans Key takeaways Preterm birth is not one condition. Abruption, systemic infection, overdistension, trauma, and severe hypertension each have their own mechanism, and each is usually obvious on arrival. "Subclinical infection" is not a diagnosis, it is a placeholder. Forty years in, it has produced no treatment and no measurable drop in the preterm birth rate. The cervix is the timekeeper. When it is weak, it opens slowly over weeks, and labor follows the opening rather than causing it. Previous preterm birth predicts the next one because it is the same cervix. You cannot order a new one. Cone biopsy raises preterm birth risk more than LEEP, because more cervix is removed. Length is a clue, not a verdict. Plenty of women have naturally short cervixes and carry to term. Funneling, bulk, and change over time matter as much as a single number. The intervention that would move the needle already exists. Serial cervical length measurement in anyone with a risk factor, and cerclage when it starts to open. Screening and treatment, not a mystery pill. Terms mentioned Placental abruption — the placenta separating from the uterine wall before delivery. Pyelonephritis — kidney infection. Polyhydramnios — too much amniotic fluid. Uterine overdistension — the uterus stretched beyond its comfortable capacity, as with twins or triplets. Cervical insufficiency — a cervix that opens without labor. Funneling — the cervix opening from the inside out, visible on ultrasound before any external change. Cerclage — a stitch placed to reinforce the cervix. LEEP and cone biopsy — procedures removing cervical tissue after abnormal Pap or HPV findings. Precipitous labor — a very fast labor, often under three hours. Memorable quotes: "I am telling you what happened was the three centimeters dilated caused the contractions." "If it's subclinical, why doesn't it stay that way?" "The cervix is a mechanical timekeeper on the pregnancy." Got something you want to share or ask? Keep it coming. We love hearing from you. Email us or send a voice memo, and you might just hear it on the next episode. Don't forget to like, comment, and subscribe your questions could be featured in our next episode. For additional resources and information, be sure to visit our website at Maternal Resources: https://www.maternalresources.org/ You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: YouTube: youtube.com/maternalresources Instagram: @maternalresources Facebook: facebook.com/IntegrativeOB TikTok: NatureBack Doc on TikTok Grab Our Book: The NatureBack Method for Birth—your guide to an empowered pregnancy and delivery. Shop now at naturebackbook.myshopify.com

Alison welcomes Katie Kirklin, a registered nurse and certified functional nutrition counselor who is also training in nervous system regulation. The discussion focuses on digestive health and gut health, with an emphasis on both the science behind the topic and practical steps listeners can apply.Katie shares her personal health history and describes developing health problems in her teens and 20s, trying different diets and medications, and feeling that standard approaches did not address underlying causes.She then explains a major turning point in 2020 when an abnormal Pap smear and biopsy showed moderate cervical lesions. After choosing to make diet and lifestyle changes and working with a naturopath, she later received clear results, which led her to learn about functional nutrition and the idea of addressing root causes rather than isolated symptoms.The discussion moves to gut health and Katie explains that gut health affects nutrient absorption, the microbiome, and the gut lining. She describes leaky gut as increased permeability in the gut lining, which can allow proteins and pathogens into the bloodstream and contribute to inflammation.Katie identifies common inflammatory factors, including highly processed seed oils, ultra-processed foods, processed sugar, gluten for some people, and dairy for some people. She recommends reading ingredient lists rather than front labels and gradually increasing whole foods to crowd out processed foods.Alison and Katie also discuss the importance of individualized nutrition and reintroduction after elimination, since the gut microbiome benefits from diversity. Katie emphasizes that different people can respond differently to the same foods.They also cover the gut-brain connection. Katie describes the vagus nerve as a two-way communication pathway between the brain and gut and notes that most of the body's serotonin is produced in the gut. She says these connections help explain why digestion, mood, sleep, and overall health are linked.In her client work, Katie starts with blood sugar balance, sleep, digestion, hydration, movement, and fiber intake. She recommends tracking food, symptoms, and bowel movements, and suggests beginning with a nourishing whole-food breakfast to support stable energy and better choices throughout the day.HIGHLIGHTS:4:03 Functional Nutrition Journey7:29 What Gut Health Means10:47 Gut Inflammation Triggers14:58 Understanding Leaky Gut18:59 Body Systems Connected27:43 Start With Breakfastconnect with Katiewebsite: https://www.katiekirklin.comSPONSOR:Cellev8Discount code: THEALISONK 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

Papá, su futuro no es tuyo by Andres Gutierrez

When it comes to really getting to the bottom of anything new, exciting or interesting in the shooting or ballistics space, as it relates to hunting, it's a pretty short list of people you can trust to give you the straight goods...especially when it comes to actual hunting experience. "Pap" is one of those sources.  Some time is spent discussing yet another trip to Africa, and why his passion for African hunting is even more intense than it was after his last trip and then the conversation transitions to one of the truly hot topics in hunting ballistics at present: the proven performance of very fast, small diameter bullets on an increasingly wide range of game animals.   @papwinkle  ---------------------------  TRUSTED PARTNERS:  For over 100 years Leica has set the standard for premium optics. From spotting scopes to binoculars, rifle scopes and the new CRF MAX rangefinders, Leica is the choice for those who accept no compromises.  onX Hunt is the most powerful 3D mapping solution for hunters. Get your FREE trial today. If you're already a member, check out the exclusive offers and perks available when you upgrade to an Elite Member.   Spartan Precision Equipment is built for the mountains. Ultra-lightweight, packable, and versatile across shooting platforms. Be sure to check out their new Springbok line of products and the Ascent and Javelin series.  If you're interested in becoming a truly competent, confident and capable rifleman the Modern Say Sniper platform and Modern Day Rifleman community need to be on your radar. Digital courses, podcasts, videos, and in-person instruction taught by one of the best in the industry.  Tired of gut rotting instant coffee? Check out This Is Coffee and get yourself some great instant coffee for when you're in the backcountry or on the road.  ---------------------------  CONSERVATION ORGS TO SUPPORT:  Go to Wild Sheep Foundation to find a membership option that suits your budget and commitment to wild sheep.  Go to Wild Sheep Society of BC to become a member, enter raffles, buy merch and support BC's wild sheep populations.  Go to Rocky Mountain Goat Alliance to find a membership option that suits your budget and commitment to conserving mountain goats and their habitat. 

In this episode, Kristen explores three steps to help listeners work through anxiety, guilt, and shame while creating meaningful change through deeper self-awareness and healing. You'll Learn: How to process and connect with your core emotions. Why acknowledging your feelings is essential for healing. How the PAP method works. Why jumping into problem-solving can disrupt someone's emotional process. How self-compassion, vulnerability, and awareness can help you create lasting change.   Subscribe HERE and get a free 5-day journal to begin closing the chapter on what doesn't serve you and open the door to the real you. Connect with Kristen: Get Kristen's newsletter, packed with tangible tools, resources, and inspiration Watch the episodes on YouTube Follow Kristen on Instagram   Kristen's TikTok   Have Kristen Speak at Your Event  Disclaimer This information is being provided to you for educational and informational purposes only. It is being provided to you to educate you about ideas on stress management and as a self-help tool for your own use. It is not psychotherapy/counseling in any form. This information is to be used at your own risk based on your own judgment. For counseling services near Indianapolis, IN, visit www.pathwaystohealingcounseling.com. Pathways to Healing Counseling's vision is to provide warm, caring, compassionate and life-changing counseling services and educational programs to individuals, couples and families in order to create learning, healing and growth.

Obstructive sleep apnea affects approximately one in four adults and is especially common among patients with neurologic disorders, including stroke, Parkinson disease, dementia, epilepsy, and neuromuscular conditions. In this episode, Dr. Stephanie Stahl discusses why neurologists should routinely screen for OSA, highlights key symptoms and risk factors, reviews important considerations when interpreting sleep studies, and outlines current treatment options beyond CPAP. Learn how recognizing and treating sleep apnea can improve quality of life, optimize management of neurologic disease, and reduce long-term health risks. In this episode, Aaron L. Berkowitz, MD, PhD, FAAN, speaks with Stephanie M. Stahl, MD, FAASM, author of the article "Obstructive Sleep Apnea" in the Continuum® August 2026 Sleep Neurology issue. Dr. Berkowitz is a Continuum® Audio interviewer and a professor of neurology in the Department of Neurology at the University of California, San Francisco, in San Francisco, California. Dr. Stahl is an Associate Professor of Clinical Medicine and Sleep Medicine Fellowship Program Director at Indiana University School of Medicine in Indianapolis, Indiana, where she also serves as Sleep Laboratory Medical Director in the Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine. Additional Resources Read the article: Obstructive Sleep Apnea Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @AaronLBerkowitz  Full episode transcript available here Dr Berkowitz: Obstructive sleep apnea is very common. It can cause or contribute to common neurologic symptoms, such as headache and impaired cognition, and it's a risk factor for stroke. And yet, if you're like me, you may not know too much more about sleep apnea than that. Today, I have the pleasure of talking to sleep expert Dr. Stephanie Stahl to learn what every neurologist should know about OSA.  Dr Jones:  This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Berkowitz: This is Dr. Aaron Berkowitz. Today I'm interviewing Dr. Stephanie Stahl about her article on obstructive sleep apnea. This article appears in the 2026 Continuum issue on Neurology of Sleep. Welcome to the podcast, Dr. Stahl, and could you please introduce yourself to our audience?  Dr Stahl: Yeah. Thank you for having me. I'm a sleep medicine physician and neurologist and medical director of the Indianapolis Sleep Lab at Indiana University Health. I serve as the director of the Sleep Medicine Fellowship program. I'm faculty advisor for our very first student interest group in sleep medicine at Indiana University School of Medicine. I'm also actively involved in some national leadership roles, including the incoming chair of the American Academy of Sleep Medicine's Education Committee and co-chair of the Academy's Inter-Scorer Reliability Gold Standard Panel. So, I really appreciate this opportunity. I look forward to our discussion.  Dr Berkowitz: Me too, and we appreciate the opportunity too to get to talk to you. You have so much expertise in this area, and I certainly encourage our listeners to look at your article, which is very comprehensive and up to date, and I learned a ton from it. I didn't get much exposure to sleep neurology as a trainee, and I've always worked in academic centers where we have a sleep group and we can refer patients there. So, I have to admit, sleep may probably be the area of neurology I know the least about, and felt like I was learning something new from pretty much every line of your article, and I know our readers will too. So, your article has a lot of excellent detail for our readers on the diagnosis and treatment of this very common condition. But I'd like to keep our interview relatively high level today and focus on the essentials for the practicing general neurologist. So, to start, can you just give us a sense of what obstructive sleep apnea is, and what every neurologist should know about it?  Dr Stahl: Yeah. So obstructive sleep apnea is characterized by either partial or full obstructions in the upper airway. That may sound pretty simple, but this leads to a whole bunch of issues. It leads to oxygen desaturations, arousals from sleep, leading to sleep fragmentation. This can then lead to sympathetic nervous system activation, cerebral hypoperfusion, leading to a whole bunch of symptoms or neurologic conditions.  Dr Berkowitz: Great. And you mentioned this in your article, but just to emphasize, how common is obstructive sleep apnea in the general population?  Dr Stahl: Yeah. So, about a quarter of the general population have obstructive sleep apnea. Much more common in many neurologic conditions.  Dr Berkowitz: Yeah, so very common disorder. We are seeing patients with it quite frequently, whether that's the reason they are seeing us in neurology or not. And this leads to my next question, which is what neurologic symptoms or presenting concerns of a patient should make us think about OSA and the differential diagnosis, and what factors based on the history or the exam or the context would make you suspicious for OSA as the cause of a neurologic symptom? In other words, the patient's presenting with classic symptoms of OSA, and that's why they're seeing a neurologist or seeing a primary care doctor, but is coming for evaluation of, say, headache or other symptoms. And what symptoms would make you think of wanting to consider OSA, and then what aspects of the history or otherwise would make you want to evaluate the patient for OSA?  Dr Stahl: I think a really important takeaway is for neurologists to know that obstructive sleep apnea is very common in neurologic conditions and has that potential to worsen a lot of these conditions or their associated symptoms. And so, it should be on our radar. There are certainly some basic questions and signs and symptoms that we can ask patients about or, or take a look at on exam. And so particular symptoms include snoring. Anybody that snores loudly or frequently, that's a strong risk factor for obstructive sleep apnea. If someone's seeing them stop breathing in their sleep, if they are waking up a lot throughout the night. There are some other symptoms that we may not necessarily attribute upfront to obstructive sleep apnea, such as nocturia, nocturnal reflux, night sweats. There are some daytime symptoms, of course, too, like unrefreshing sleep, daytime sleepiness, morning headaches, an important one in neurology. And then we take a look at the patient's exam. And so, some things that neurologists might want to be thinking about are people with obesity are certainly at a risk for obstructive sleep apnea. But it's also very important to know that someone does not need to have obesity in order to have obstructive sleep apnea. We look at neck size, other morphologic characteristics, such as how much that we can see in the back of their mouth. Can we see their uvula? Does their tongue size appear large in their mouth? And then some other risk factors too, such as male gender, older age, family history, post-menopausal state in women. All that being said, though, sometimes in neurologic conditions, we don't have all of those symptoms or risk factors to be thinking about. And so, in certain neurologic conditions such as stroke where obstructive sleep apnea is very common and has the potential to increase the risk of another stroke, we may need to be thinking about testing these patients even with minimal symptoms or other risk factors.  Dr Berkowitz: That's very helpful. So, you mentioned their headache might be the presenting symptom, right, to a neurologist, and we should certainly be thinking about obstructive sleep apnea as a potential diagnosis, even the cause of the patient's headache, particularly you said patients with morning headache. I often try to think about in patients presenting with, for memory loss, or other cognitive concerns, and that may be due more to inattention from poor sleep, so asking about sleep and symptoms of sleep apnea in those contexts. Are there any other presenting neurologic symptoms not particularly related to sleep? I'm thinking of headache, memory loss, other symptoms that would make you think, "Oh, I should actually screen this patient for sleep apnea also."  Dr Stahl: Yeah, other symptoms to think about in pediatrics, hyperactivity, people that have impaired vigilance, as you alluded to, that poor attention. Sometimes people get misdiagnosed with ADHD, and it's actually just a manifestation of obstructive sleep apnea.  Dr Berkowitz: You alluded to this, Dr. Stahl, that stroke, for example, patients are at higher risk of developing sleep apnea as a result of stroke, and it's also a risk factor for stroke. What other neurologic conditions, primary neurologic diseases, put patients at a higher risk of OSA? And again, similar to the last question I asked you, what are some clues that we should evaluate for? We might be following a patient for their post-stroke care over time and not necessarily thinking about diagnosing a separate condition in them since we're following them for their stroke or their degenerative disease. What are the conditions that put patients at a higher risk of OSA as a result of the condition, and then when would you think about screening them for it?  Dr Stahl: Some particular neurologic conditions where obstructive sleep apnea are very common, in addition to stroke and, and TIA, include Parkinson disease. It can worsen a lot of the motor, cognitive symptoms, sleep disruption that we can see in Parkinson disease. Very common in all causes of dementia, but in particular Alzheimer disease and Lewy body dementia. Very common in neuromuscular conditions. We should definitely have obstructive sleep apnea and all forms of sleep-disordered breathing high on our radar. In conditions like myotonic dystrophy. Charcot-Marie-Tooth is another one where obstructive sleep apnea is very common. Myasthenia gravis, it can worsen the symptoms of that. In particular, a pearl is if somebody has morning weakness in myasthenia gravis, obstructive sleep apnea should be high on your radar. And also, as you mentioned, any forms of headaches. There are some other things too. If somebody has poor seizure control, especially nocturnal seizures, you might have obstructive sleep apnea on your radar as well.  Dr Berkowitz: So, I think you've covered essentially every category of neurologic disease, right? We have cerebrovascular, movement, neurodegenerative, neuromuscular, epilepsy, all conditions where either the disorder itself, such as stroke or the, correct me if I'm wrong, the neurodegenerative disease puts the patient at risk. Or the patient may be at risk for exacerbations of their disease, as you mentioned in myasthenia. I love that pearl. Not fatiguable at the end of the day, but if the patient with myasthenia is telling you they're feeling weaker at the beginning of the day, then think about obstructive sleep apnea and that obstructive sleep apnea worsening control of epilepsy due to poor sleep. So really a lot of bidirectional interactions with this common condition. Okay, so if we're concerned about obstructive sleep apnea, again, myself, a general neurologist speaking perhaps on behalf of other general neurologists, we see a patient with headache or reporting memory loss that we find to be impaired attention, or we see exacerbation of their underlying primary neurologic disease. As you mentioned, we think, "Oh, I've listened to this podcast. I've read Dr. Stahl's article. I should probably be thinking about OSA in this patient, and I should order a sleep study." Now, I admit when I get the sleep study back, I scroll to the bottom, I see they do have obstructive sleep apnea, I'm going to send them over to a sleep specialist. But for the general neurologist, what are some high-yield pearls and some pitfalls to be aware of when we get sleep studies for obstructive sleep apnea, and we are looking at the results? Dr Stahl: The first thing is to understand that there are two main types of sleep studies: in-lab polysomnography and home sleep apnea test. In-lab studies are typically what we consider the more accurate type of study. Main reason for that is that we have EEG, so we can see if someone is awake versus asleep. Most home sleep apnea tests do not utilize EEG, and so when we're looking at respiratory events, apneas or hypopneas, we're looking at over the total recording time rather than the total sleep time. So, we know we're going to capture some time where a person is awake, where we don't have sleep apnea events, and that can be a big amount of time in people with insomnia, poor sleep efficiency. And as a result of that, it can lead to an underestimation of the apnea-hypopnea index. That's really important for people to understand that that means we can end up with a false negative home sleep apnea test, or it can put them in a category of lower severity than what they actually have. And so, if you get a home sleep study report back that's negative for sleep apnea and you remain concerned, you need to go on to do an in-lab study, where about twenty to fifty percent of people will go on to have a positive in-lab study. You can also get false positives with home sleep apnea tests too, and so ideally, we should only be doing home sleep apnea tests in people that are at high risk of having obstructive sleep apnea to decrease our chance of false positive study. When we get that sleep study report, what's important to take a look at? So the main number that we look at currently is the apnea-hypopnea index. The number of apneas, which are full obstructions in that upper airway, or hypopneas, partial obstructions in the upper airway where either there's an oxygen desaturation or an arousal associated with that. Less than five is considered to be normal. Anything five or more gives them a diagnosis of obstructive sleep apnea, and then we stratify them based on the AHI. But it's important to take a look at more than just the apnea-hypopnea index. And while my eyes too on various reports like echocardiograms want to jump to the impression, it is important to take a look at that full report, see what their oxygen levels averaged and what they dipped down to. The arousal index, which is how many times a patient may have woken up briefly throughout the night. Take a look at the histogram, usually an image at the bottom of their report that shows what sleep fragmentation may have been like so that you can take that all in and make that decision. How important are these study findings, and is this a person that would benefit from treatment?  Dr Berkowitz: That's a fantastic overview of sleep studies and some of the highlights to look out for, even if we won't be understanding every detail as you would to know most importantly the caveats about home sleep testing having a fairly high percentage of false negative and false positive results. So being wary if our suspicion is high, and that test is normal or inconclusive to get an in-lab sleep study. And if our suspicion is low or maybe we haven't ordered the test and the patient has had it done elsewhere, and the history doesn't really match up to know that there are false positives on the home studies as well, and again, an in-lab study to settle the diagnosis. Is that right?  Dr Stahl: Yes.  Dr Berkowitz: Okay. Now, for most neurologists, probably if we diagnose OSA, we will be referring the patient to a sleep specialist like yourself for treatment. I think we're all familiar with CPAP and patients being on CPAP. Your article mentions a number of treatment modalities I admit I have not heard of before or maybe heard of in passing, acknowledging most general neurologists are not going to be prescribing or knowing with the nuance that you do as an expert how to decide which treatment a patient would most benefit from or most qualify for. So, can you just give us a broad overview, again, for the general neurologist acknowledging we might see a patient whose past medical history says OSA being treated with fill in the blank. What are the different treatment modalities, and how do you think, just so we can learn from you in broad brush strokes, about particular treatments for particular patients?  Dr Stahl: As you mentioned, most people are familiar with positive airway pressure or PAP therapy, and that does remain our most efficacious treatment. The way I explain it to patients is why PAP therapy is the most effective treatment is it's the only treatment that can take all of the tissues of that upper airway and open them up. Whereas all of our other treatments, we're going to target smaller spaces of that upper airway. So, our first option is if we can get somebody on PAP therapy, we know that that's going to be the best option for the majority. PAP therapy works by basically acting as an air splint to open up the air tissues. Know that masks are not interchangeable. There are masks that cover the nose and go over the nose and mouth and under the nose. Full face masks that cover the nose and mouth, they do typically require higher pressures, also tend to be less comfortable for a lot of patients as well. In addition to different PAP masks, there's different modalities of positive airway pressure therapy too. There are machines that auto-adjust, some that provide fixed pressure, bi-level PAP that provides a higher inspiratory pressure, lower expiratory pressure. Then outside of PAP therapy, there are, as you alluded to, a lot of options and more, continuing to come down the pipeline as well. Mandibular advancement devices or a form of oral appliances has been around for a while. This is device that somebody wears in their mouth. It's preferably customized for their teeth and titratable, meaning that they can make adjustments that pulls their mandible forward in relation to the maxilla in order to pull those tongue tissues further away from the back of the upper airway. That's ideally managed by a qualified sleep dentist or someone that specializes in oral appliance management. Other treatments include surgical options, including hypoglossal nerve stimulation, which is an implanted device that causes the tongue to protrude repetitively throughout their sleep period to hopefully open up the airspace. There's some other surgical options too that open up various places of the upper airway. There's a daytime treatment of obstructive sleep apnea, transoral neuromuscular electrical stimulation that changes the muscle fiber type of the tongue. And then there's some adjunctive treatments that can be helpful too, such as positional therapy, oral facial myofunctional therapy that helps a person breathe better through their nose and may help train the upper airway muscles.  Dr Berkowitz: Great. Well, that's a very helpful overview, and again, I refer our listeners to your article, which talks about all of those modalities in very comprehensive detail. So, Dr. Stahl, as we wrap up our conversation, you have a captive audience of neurologists and neurology trainees here. What would you like to leave us with that every neurologist should know about obstructive sleep apnea?  Dr Stahl: The most important, again, is for neurologists to know that obstructive sleep apnea is so common in your patient population, and it can have a significant negative impact on quality of life and health, including many neurologic conditions. And at the same time, obstructive sleep apnea is very treatable. We have so many options nowadays that we can usually get someone onto adequate treatment. And treatment has that potential to improve several neurologic symptoms and disorders, even at times when you don't think that there's an opportunity to improve symptoms such as say in, headache. So, neurologists really should be screening for signs and symptoms of obstructive sleep apnea, as well as considering testing in high-risk, potentially asymptomatic or minimally symptomatic patients.  Dr Berkowitz: That's a fantastic overview of some of the many pearls that you shared with us today, as well as in your article. So, thank you so much again. Today, I've been interviewing Dr. Stephanie Stahl about her article on obstructive sleep apnea. This article appears in the August 2026 Continuum issue on neurology of sleep. Be sure to check out Continuum Audio episodes from this and other issues. And thank you so much to our listeners for joining today, and thank you again, Dr. Stahl.  Dr Stahl: Thank you again for having me.  Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.  

A Szuverenitásvédelmi Hivatal alig két évig működött, mégis az Orbán-rendszer egyik legvitatottabb egykori intézménye volt. A Papíron szép új adásában felidézzük, hogyan jött létre a hivatal, milyen politikai célt szolgált, miként próbálta megfélemlíteni a független sajtót és a civil szervezeteket, illetve hogyan zajlott az Átlátszó és a hivatal közötti per. Arról is szó esik, mit jelent a hivatal megszüntetése, és vajon eltűnt-e vele együtt az a politikai gondolkodásmód is, ami létrehozta. A tartalomból 00:00:00 – Bár a Szuverenitásvédelmi Hivatal már a múlté, ez nem jelenti azt, hogy felesleges beszélni róla. Így jött létre, és így vált hamar az egyik legvitatottabb állami intézménnyé. 00:01:14 – Az öröksége még sokáig itt marad velünk – és nem csak a célba vett civilekkel, újságírókkal, ellenzékiekkel. 00:04:23 – Felidézzük azt a politikai környezetet, amiben a hivatal megszületett, és azt, hogy miért pont a független sajtó és a civil társadalom lett a rendszer egyik fő célpontja. 00:08:19 – Milyen szerepet vállalt (önkéntelenül is) a független média a politikai változások előkészítésében, a Tisza felemelkedésében? 00:12:10 – Így működött és nem működött a SzuHi. Miért kapta ezt a nehezen értelmezhető nevet? Hogyan szolgálta ez a politikai kommunikáció céljait? 00:19:22 – Körbejárjuk, hogyan illeszkedett az intézmény az Orbán-rendszer hatalmi struktúrájába, és miben hasonlított a titkosszolgálatokhoz. 00:28:47 – Átlátszó vs Szuverenitásvédelmi Hivatal. Mindent a perről és arról, melyik ügyekkel hívhattuk fel magunkra Láncziék figyelmét. 00:33:00 – A gödi Samsung-akkugyár, a GödÉrt Egyesület, az Átlátszó és a külföldi támogatásokról szóló narratíva esete. 00:39:00 – A hivatal jogkörei korlátozottak voltak, de így is nagy károkat tudott okozni. 00:41:45 – Miyen érzés volt úgy dolgozni, hogy egy állami intézmény jelentéseket készített a szerkesztőségről? Milyen hatással volt ez ránk, újságírókra? 00:49:00 – A SzuHi kudarca: hiába a milliárdos költségvetés és a széles jogkör, bizonyítékot nem tudtak felmutatni. 00:54:10 – Szuverenitásvédelmi? Átláthatósági? Ellehetetlenítési? 00:57:40 – A hivatal megszűnésével eltűnt-e az a politikai gondolkodásmód is, ami létrehozta? Milyen tanulságokat érdemes levonnunk a történtekből?

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Se reforzará seguridad en carreteras: Sheinbaum Industria automotriz mantiene buen ritmoEl Vaticano revela gira del Papa por FranciaMás información en nuestro podcast#grc

En este episodio de Vibra En Las Mañanas conversamos con Tavo Bernate, periodista, comunicador y uno de los participantes de MasterChef Celebrity 2026. En una charla cercana y llena de anécdotas, Tavo cuenta cómo vive el reto de la cocina dentro del programa, incluyendo un divertido incidente con unos patacones, y revela que toma clases privadas de cocina y aprende técnicas por redes sociales para prepararse cada semana. Más allá de la competencia, Tavo se abre sobre su vida personal: habla del camino difícil que atravesó junto a su pareja, Claudia Marcela, para convertirse en padre, los miedos que enfrentaron y el momento de alto riesgo que vivieron durante el parto debido a un cuadro de preeclampsia. También presenta su nuevo show "Papá Luchón", donde narra con humor y honestidad su experiencia como padre primerizo con la llegada de su hijo Emiliano, y adelanta detalles de la próxima temporada de la obra "La Culpa", que iniciará funciones en agosto en el teatro de Juan Pis. Una conversación honesta sobre cocina, familia, miedos y nuevos proyectos profesionales.See omnystudio.com/listener for privacy information.

Pracuje s tradičnými i novými materiálmi (betón, kameň, drevo, železo, silikón, sklo, vosk, živice a pod.). Východiskovou a základnou tvorivou platformou jeho sochárstva je ale životná vášeň pre horolezectvo. Jeho diela vystavujú galérie na celom svete. | Hosť: Štefan Papčo (akademický sochár). | Repríza z 20. 10. 2025. | Moderuje: Blažena Bóoczová. | Tolkšou Nočná pyramída pripravuje Slovenský rozhlas, Rádio Slovensko, SRo1.

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Siyabonga Motha is joined by Dr Nhlamulo Hlungwane, a Family Doctor and Clinical Director of the Myclinic and Dr Mandy Mpatlanyane is a medical doctor to unpack the essential yearly screenings every woman needs, why they are so important, and how to make the most of your annual health check. Tags: 702, Aubrey Masango show, Aubrey Masngo, Bra Aubrey, Siyabonga Motha, Medical Matters, Dr Nhlamulo Hlungwane, Dr Mandy Mpatlanyane, Health screenings, Annual health check, Menopause, Pap smear, Mammogram The Aubrey Masango Show is presented by late night radio broadcaster Aubrey Masango. Aubrey hosts in-depth interviews on controversial political issues and chats to experts offering life advice and guidance in areas of psychology, personal finance and more. All Aubrey’s interviews are podcasted for you to catch-up and listen. Thank you for listening to this podcast from The Aubrey Masango Show. Listen live on weekdays between 20:00 and 24:00 (SA Time) to The Aubrey Masango Show broadcast on 702 https://buff.ly/gk3y0Kj and on CapeTalk between 20:00 and 21:00 (SA Time) https://buff.ly/NnFM3Nk Find out more about the show here https://buff.ly/lzyKCv0 and get all the catch-up podcasts https://buff.ly/rT6znsn Subscribe to the 702 and CapeTalk Daily and Weekly Newsletters https://buff.ly/v5mfet Follow us on social media: 702 on Facebook: https://www.facebook.com/TalkRadio702 702 on TikTok: https://www.tiktok.com/@talkradio702 702 on Instagram: https://www.instagram.com/talkradio702/ 702 on X: https://x.com/Radio702 702 on YouTube: https://www.youtube.com/@radio702 CapeTalk on Facebook: https://www.facebook.com/CapeTalk CapeTalk on TikTok: https://www.tiktok.com/@capetalk CapeTalk on Instagram: https://www.instagram.com/ CapeTalk on X: https://x.com/CapeTalk CapeTalk on YouTube: https://www.youtube.com/@CapeTalk567See omnystudio.com/listener for privacy information.

Namibië vier Nasionale Kankerbewustheidsweek van vandag tot Vrydag, en die Kankervereniging van Namibië nooi vroue tussen 20 en 65 jaar oud uit na bekostigbare Pap-smeer-ondersoeke en borsondersoeke in Windhoek. Siftings sal plaasvind op Dinsdag, Woensdag en Donderdag, 4 tot 6 Augustus, vanaf 8-uur die oggend by die vereniging se mediese sentrum by sy hoofkantoor in Windhoek-Wes. Die vereniging se uitvoerende hoof, Rolf Hansen, sê vroue moet 100 Namibiese dollar, hulle ID's en 'n japon of handdoek saambring. Hy het meer.

For seventy years, cervical cancer screening has meant a table, stirrups, and a speculum. Now it can mean a padded envelope on your kitchen counter. MamaDoc goes solo to unpack what's actually in those at-home cervical cancer screening kits, how self-collection works, why the FDA cleared it, and what the American Cancer Society said when it folded self-collected samples into its screening guidelines. After thirty years of doing this exam the old-fashioned way, I'll tell you honestly what I think we gain and what I worry we lose. We'll cover: why an HPV test isn't a Pap test (and why that distinction matters more than the marketing suggests); who's a good candidate and who isn't; what happens if your result comes back positive; and the piece nobody's putting on the box — a mail-in swab doesn't check your ovaries, your blood pressure, or the thing you were finally going to bring up at that appointment. For the sixty percent of cervical cancers that show up in people who were never screened or under-screened, this is genuinely good news. Let's talk about how to use it well.

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Laura Donahue, an assistant professor of sleep medicine at Vanderbilt University with a background in internal medicine and a researcher in sustainable healthcare, to discuss the environmental impact of sleep medicine practice and practical strategies for reducing carbon footprint and medical waste. Recent environmental challenges—heat waves exacerbating insomnia, wildfires affecting respiratory and sleep health—highlight how climate directly impacts patient wellbeing. But do sleep medicine clinicians have an obligation to reduce their own environmental footprint? Dr. Donahue explores this question, examining the waste generated by sleep testing, PAP therapy, and ongoing supplies. The conversation begins with foundational concepts: How does climate change impact sleep health? What exactly constitutes medical waste, and how does it differ from carbon footprint? Dr. Donahue explains methods for calculating carbon footprint and how the US healthcare system compares globally. She introduces life cycle analysis—a comprehensive tool for understanding environmental impact across product lifecycles. Sleep lab waste assessments receive detailed attention. Dr. Donahue walks through how to conduct a waste audit of sleep facilities and why examining both carbon footprint and waste matters, acknowledging that these metrics don't always move directionally. Her research on PAP device waste, conducted with Dr. Morgenthaler, revealed substantial environmental costs associated with standard OSA therapy—findings that prompted examination of alternatives. Telemedicine emerges as a potential sustainability strategy. Dr. Donahue compares carbon footprints of virtual versus in-person sleep consultations, exploring how practice model choices affect environmental impact. However, the analysis doesn't focus solely on PAP therapy—hypoglossal nerve stimulators and other non-PAP treatment options receive consideration as alternatives with potentially different environmental profiles. SHAPE, an organization dedicated to helping healthcare providers examine their carbon footprint and waste generation, receives discussion. Dr. Donahue explains SHAPE's mission and practical resources available to sleep medicine programs. She provides concrete guidance on reducing environmental impact: waste audits, supply chain evaluation, and transitioning to circular economy models where possible. A particularly relevant discussion addresses plastic waste from CPAP devices and consumable supplies. Dr. Donahue explains how waste audits serve as the first step toward identifying reduction opportunities and discusses strategies for minimizing single-use plastics in sleep medicine practice. The episode acknowledges that sustainability requires institutional commitment and individual awareness. Dr. Donahue emphasizes that small changes—from supply selection to practice model design—accumulate to meaningful environmental impact. Whether you're interested in sustainable healthcare, concerned about medical waste, seeking to reduce your sleep practice's carbon footprint, or wanting to better understand climate impacts on sleep health, this episode provides practical guidance and evidence-based approaches. Join us for this important conversation about environmental responsibility in sleep medicine practice.

Esto es lo que tienes que saber para empezar el día.IKEAAprovecha las Rebajas de IKEA para renovar tu sala, terraza o cualquier espacio de tu hogar con descuentos en muebles y decoración. Visita sus tiendas o entra a IKEA.com.do y llévate tus muebles a casa el mismo día.PRODUCTOS LINDAProductos Linda acompaña tus comidas, parrilladas y momentos en familia. Porque este mes, con Papá, todo sabe mejor. Conoce más en @productoslinda.

Welcome back to another episode of BUTT HONESTLY! We've got a Booty Gangster who's wondering whether years of living in the closet have been wreaking havoc on his gut, another listener who got his very first anal Pap and is now facing HPV, biopsies, and surgery, and one listener whose weekend adventures somehow escalated from the dance floor to double F's before breakfast.Plus, we'll talk about why France just shut down one of the world's most famous gangbang venues and what the ruling actually means…So lube up your curiosity... because we're going in.Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Today I'm chatting with Nurse Amber, a board-certified women's health nurse practitioner, to discuss sexual health and STIs. We cover the prevalence and stigma of herpes, common STIs like chlamydia and gonorrhea, testing frequency, and prevention methods including PrEP and DoxyPEP. Our conversation also addresses female health concerns such as UTIs, bacterial vaginosis, and pelvic floor health, as well as men's sexual health topics. Nurse Amber emphasizes open communication, regular testing, and finding a sex-positive healthcare provider.Understanding Herpes Transmission (00:02:11)Discussion on HSV-1 and HSV-2, how both can be transmitted genitally or orally, and why blood testing has limited utility.Most Common STIs (00:08:18)Chlamydia, gonorrhea, and trichomonas are identified as the most common STIs seen in clinical practice, with chlamydia being most frequent.Symptoms of Common STIs (00:08:50)A description of potential STI symptoms in people with vaginas and penises, noting that 50% of cases are asymptomatic.What is Trichomonas? (00:10:02)An explanation of trichomonas, a common parasitic STI that often causes no symptoms but can cause severe inflammation.Long-Term Risks of Untreated STIs (00:11:50)Untreated bacterial STIs can lead to serious complications like Pelvic Inflammatory Disease (PID), chronic pain, and impaired fertility.STI Incubation Periods (00:14:39)Genital STIs are detectable 1-2 weeks post-exposure, while blood-borne infections like HIV and syphilis can take 1-3 months.How to Disclose an STI to a Partner (00:15:53)Advice on having a direct conversation with partners about a positive STI test and the need for mutual treatment.STI Testing Frequency (00:17:19)Recommendations for testing frequency based on sexual activity, ranging from every 6-12 months to every 2-3 months for active individuals. PrEP and DoxyPEP Explained (00:21:49)An overview of PrEP for HIV prevention and DoxyPEP, a post-exposure prophylaxis to reduce the risk of bacterial STIs.Syphilis is Not Gone (00:26:47)Syphilis, known as "the great pretender," is still prevalent and can have sneaky symptoms, making regular screening important.The Current State of HIV (00:29:00)HIV is now a highly treatable chronic condition, and transmission rates are much lower than for other STIs like Hepatitis C.What to Ask For at the Gynecologist (00:31:59)Clarifying that a pelvic exam is not always a Pap smear and what specific STI tests patients should request.The Importance of Triple Testing (00:37:23)Why testing genital, oral, and rectal sites is crucial for a comprehensive screening, as infections can exist in one area.Myth-Busting: Partner Testing (00:42:04)Debunking the myth that if one partner tests negative, the other is also clear. Each person needs individual testing.Vaginal Health and Hygiene (00:44:01)Advice on maintaining vaginal health, emphasizing that vaginas are self-cleaning and harsh soaps or douching should be avoided.Squirting and Prolapse (00:50:31)Explaining that squirting is largely urine and discussing bladder prolapse, a common condition that can cause stress incontinence.Pelvic Floor Health (00:54:39)How to maintain pelvic floor health through exercises like Pilates and yoga, which can improve sex and prevent incontinence.Hormone Replacement Therapy (HRT) (00:58:16)A discussion on the benefits and considerations of HRT for perimenopausal symptoms, cautioning against unproven testing methods.When Men Should See a Doctor (01:02:54)An overview of symptoms like itching, discharge, pain, or sores that should prompt a person with a penis to seek medical care.Finding a Sex-Positive Provider (01:17:29)The importance of finding a healthcare provider you can be open with about your sexual health for accurate testing and treatment.Follow The Open Bedroom:https://www.instagram.com/theopenbedroompodcast/

No one saw this one coming on The Masked Singer South Africa! Travel content creator Popi Sibiya was revealed as the celebrity behind Pap & Wors, leaving the detective panel completely stumped. Despite clues about her engineering degree, big family and life-changing career switch, detectives Somizi, J'Something, Sithelo Shozi and guest panellist Jason Goliath guessed everyone from Ayanda Thabethe and Anele Zondo to Candice Modiselle, but not a single one landed on Popi. The episode also introduced the show's first-ever masked duo, Sheep, while Gogga, Koeksister and Pap & Wors battled it out on stage. In the end, Pap & Wors was sent home, where Popi admitted she'd loved every minute of the experience. The Masked Singer South Africa airs Saturdays at 7pm on SABC 2. Hang out with Anele and The Club on 947 every weekday morning. Popular radio hosts Anele Mdoda, Frankie du Toit, Thembekile Mrototo, and Cindy Poluta take fun to the next level with the biggest guests, hottest conversations, feel-good vibes, and the best music to get you going! Kick-start your day with the most enjoyable way to wake up in Joburg. Connect with Anele and The Club on 947 via WhatsApp at 084 000 0947 or call the studio on 011 88 38 947Thank you for listening to the Anele and the Club podcast..Listen live on Primedia+ weekdays from 06:00 to 09:00 to Anele and the Club broadcast on 947 https://buff.ly/y34dh8Y For more from the show go to https://buff.ly/gyWKIkl or find all the catch-up podcasts here https://buff.ly/K59GRzuSee omnystudio.com/listener for privacy information.

Bongani Bingwa speaks to travel content creator Popi Sibiya about her surprise reveal as Pap & Wors on The Masked Singer South Africa. She reflects on keeping her identity a secret, the panel's reaction to her unmasking, and shares how her passion for travel inspired her content creation journey. 702 Breakfast with Bongani Bingwa is broadcast on 702, a Johannesburg based talk radio station. Bongani makes sense of the news, interviews the key newsmakers of the day, and holds those in power to account on your behalf. The team bring you all you need to know to start your day Thank you for listening to a podcast from 702 Breakfast with Bongani Bingwa Listen live on Primedia+ weekdays from 06:00 and 09:00 (SA Time) to Breakfast with Bongani Bingwa broadcast on 702: https://buff.ly/gk3y0Kj For more from the show go to https://buff.ly/36edSLV or find all the catch-up podcasts here https://buff.ly/zEcM35T Subscribe to the 702 Daily and Weekly Newsletters https://buff.ly/v5mfetc Follow us on social media: 702 on Facebook: https://www.facebook.com/TalkRadio702 702 on TikTok: https://www.tiktok.com/@talkradio702 702 on Instagram: https://www.instagram.com/talkradio702/ 702 on X: https://x.com/Radio702 702 on YouTube: https://www.youtube.com/@radio7See omnystudio.com/listener for privacy information.

Welcome to How Humans Heal. In this episode I'm going to be covering the most important first step you can take to improve your ability to clear high-risk HPV and for your general health: Avoid Sugar. Many women who are dealing with an abnormal Pap and HPV ask me: what can I do to start turning this around and prevent HPV from causing abnormal cells? I'm so glad you're asking, because in a standard doctor's office, you are likely to be told to wait six or twelve months to see if things get worse or turn into cancer. That's unsettling, to say the least! It is much better to take action and ask what you can do between now and your next appointment to help prevent progression. That's exactly what I help women and men do: prevent progression and help your body clear high-risk HPV to negative. Where do I begin? Helping to balance your blood sugar levels by decreasing sugar consumption. I'm here to help you! LINKS FROM THE EPISODE:   Join Dr. Doni's Kickstart Program: https://hpv.doctordoni.com/hpv/hpv-kickstart-program   Schedule A Chat With Dr. Doni: https://intakeq.com/new/hhsnib/vuaovx    Read the full episode notes and find more information: https://doctordoni.com/blog/podcasts/ MORE RESOURCES FROM DR. DONI:   Quick links to social media, free guides and programs, and more: https://doctordoni.com/links     Disclosure: Some of the links in this post are product links and affiliate links and if you go through them to make a purchase I will earn a commission at no cost to you. Keep in mind that I link these companies and their products because of their quality and not because of the commission I receive from your purchases. The decision is yours, and whether or not you decide to buy something is completely up to you.

Esto es lo que tienes que saber para empezar el día.PRODUCTOS LINDAProductos Linda acompaña tus comidas, parrilladas y momentos en familia. Porque este mes, con Papá, todo sabe mejor. Conoce más en @productoslinda.———BMWLa nueva BMW X5 anticipa una etapa de diseño más limpio, tecnología más integrada y una experiencia más conectada. Conoce más en @bmwrd.———SLEEP IN MATTRESSSleep In Mattress ofrece colchones y soluciones pensadas para mejorar tu descanso y ayudarte a dormir más cómodo. Conoce sus opciones y visita sus tiendas en Santo Domingo, Santiago y Puerto Plata.———MISS RDVive la final de Miss República Dominicana 2026 este jueves 30 de julio, a las 8:00 p. m., en el  Watch Party de La Magacín en Dave & Buster's, BlueMall. Los cupos son limitados, así que reserva tu espacio.

Howard Herrell and Stuart Winkler question long-standing OB-GYN habits that feel “routine” but do not add value, then replace them with evidence and practical decision-making. We move from hysterectomy follow-up and cuff dehiscence management to the data behind cesarean sutures, endometrial cancer evaluation in postmenopausal bleeding, and the ongoing shift to HPV-based cervical cancer screening. • why routine 6 to 8 week vaginal cuff exams after hysterectomy may not prevent or predict dehiscence • how telehealth post-op care can improve access while keeping symptom-driven safety nets • four tips for evaluating and managing vaginal cuff dehiscence, including when laparoscopy matters • what Ethicon discontinuing chromic and plain gut could mean for cesarean technique choices • how the CORONIS trial informs chromic vs Vicryl decisions and why transfusion risk is part of the conversation • where the 4 mm endometrial stripe rule came from and why it can fail in real-world care • why persistent postmenopausal bleeding still warrants endometrial biopsy despite reassuring ultrasound • how race, tumor subtype, and fibroids affect endometrial cancer detection and counseling • the arc from Pap smear cytology to HPV DNA testing, vaccines, and primary HPV screening • why self-collected HPV testing may raise screening uptake for patients avoiding speculum exams Be sure to check out thinking about obgyn.com for more information, and be sure to follow us on Instagram.0:00 Welcome And Today's Game Plan0:35 Rethinking The Six-Week Pelvic Exam13:25 Four Practical Tips For Cuff Dehiscence24:42 Chromic Gut Is Disappearing35:40 CORONIS Trial And Cesarean Sutures42:22 Postmenopausal Bleeding And The 4 mm Rule53:12 HPV Testing Takes Over ScreeningFollow us on Instagram @thinkingaboutobgyn.

It has been quite a week in Singapore politics, with adjustments to the Cabinet line-up and the surprise resignation of Acting Minister-in-charge of Muslim Affairs Faishal Ibrahim. In this episode, Natasha takes a deep dive into the implications of blooding younger politicians such as Jasmin Lau into the Cabinet and junior ministerial roles now, and if the PAP’s high moral standards will cost them future talent. Singapore Management University law professor Eugene Tan and independent political observer Dr Felix Tan weigh in on the diversity of the new Cabinet and why politics is not priesthood. Highlights (click/tap above): 1:26 Was the new Cabinet line-up surprising? 5:45 Newbie politician Jasmin Lau’s fast rise 9:00 Is the 5G leadership team taking shape? 13:05 Does politics need politicians with private-sector experience? 16:38 Know how to communicate ideas, says Felix 19:16 Is Ng Chee Meng out of the “political wilderness”? 23:39 What’s the public “obsession” over Ng Chee Meng? 28:25 Who will eventually succeed Shanmugam at MHA? 32:30 Does having different generations in the Cabinet matter? 35:26 Should the Government reveal more about Faishal Ibrahim’s exit? 39:37 Why do conduct breaches keep happening despite the code? 45:47 “Politics is not priesthood.”: Eugene Host: Natasha Ann Zachariah (natashaz@sph.com.sg) Read Natasha’s articles: https://str.sg/iSXm Follow The Usual Place podcast on IG: https://str.sg/8KNT Follow Natasha on LinkedIn: https://str.sg/v6DN Filmed by: Studio+65 Edited by: Eden Soh & Natasha Liew Executive producer: Danson Cheong Producers: Natasha Ann Zachariah, Elizabeth Law & Zachary Lim Follow The Usual Place Podcast and get notified for new episode drops every Thursday: Channel: https://str.sg/5nfm Apple Podcasts: https://str.sg/9ijX Spotify: https://str.sg/cd2P YouTube: https://str.sg/theusualplacepodcast Feedback to: podcast@sph.com.sg --- Follow more ST podcast channels: All-in-one ST Podcasts channel: https://str.sg/wvz7 Get more updates: http://str.sg/stpodcasts --- Get The Straits Times app, which has a dedicated podcast player section: The App Store: https://str.sg/icyB Google Play: https://str.sg/icyX -- #tup #tuptrfSee omnystudio.com/listener for privacy information.

Disclaimer: This article is for educational purposes only and is not a substitute for individualized medical advice. Talk to your own physician before making decisions about cancer screening, testing, or treatment.TL;DR* A healthy 58-year-old gets a routine full-body scan, finds a “cancer” that would never have hurt him, and ends up with permanent incontinence from unnecessary treatment. This is more common than most people realize.* Dr. H. Gilbert Welch, a Dartmouth-trained cancer epidemiologist, spent 30 years documenting overdiagnosis — the discovery of cancers that meet the technical definition but would never have caused harm. His estimate: roughly 60% of PSA-detected prostate cancers and 25% of mammography-detected breast cancers fall into this category.* The “5-year survival rate” you hear cited as proof screening saves lives is often distorted by lead-time bias — finding a cancer earlier can make survival numbers look better without adding a single day to anyone's life.* Not all screening is suspect. Colonoscopy, low-dose CT for high-risk smokers, and cervical cancer screening (Pap/HPV) have strong randomized-trial evidence behind them.* The piece conventional screening misses: metabolic health. A 2026 Nature Communications study using machine learning on UK biobank data linked insulin resistance to increased risk across at least 12 cancer types — independent of body weight — and standard checkups rarely test for it.* Want a personalized look at your own metabolic terrain? Book a Metabolic Audit Call — link in show notes, spots limited weekly.The Test That Didn't Save His LifePicture a 58-year-old man. Healthy weight, active, doesn't smoke, feels completely fine. He goes in for a routine total-body scan — the kind now available at imaging centers with no doctor's referral required. Two hours later, a radiologist flags a small spot on his prostate.Six months, two biopsies, and one surgery later, he has a diagnosis: permanent incontinence. And the cancer itself? “Clinically insignificant.” It almost certainly would never have caused him harm. He would have lived out a full life and died of something else entirely, never knowing it was there.The test didn't save his life. It changed it — for the worse.This scenario happens thousands of times a year, and it's exactly what Dr. H. Gilbert Welch — a general internist, cancer epidemiologist, and senior researcher at Brigham and Women's Hospital — spent his career warning about. His book, Should I Be Tested for Cancer?, makes a case that runs against decades of public health messaging: more testing is not automatically better testing, and early detection does not automatically mean lives saved.This article unpacks what Welch got right, where his argument leaves a gap, and what a more complete, proactive approach to cancer risk actually looks like.The Cancer Reservoir: Why Finding More Doesn't Mean Saving MoreFor decades, the operating assumption in medicine has been simple: catch cancer early, save the life. No asterisk, no nuance.Welch's research complicates that. His central idea is the cancer reservoir — the observation that most people carry small clusters of abnormal cells somewhere in their bodies right now. In the prostate, thyroid, breast, or lung. Under a microscope, these cells look like cancer. But many of them will never grow, never spread, and never threaten a life. A person could carry one for thirty years and die at 87 of heart disease, never knowing it existed.The problem is that increasingly sensitive tools — full-body scans, PSA tests, low-dose CT — are very good at finding these dormant clusters. And once something is found and labeled “cancer,” the medical system is built to treat it.Welch's numbers, drawn from randomized trial data, are striking: approximately 60% of PSA-detected prostate cancers are overdiagnosed, meaning they meet the technical definition of cancer but would never have caused symptoms or death. For mammography-detected breast cancers, the estimate is around 25% — meaning roughly one in four women treated for a screen-detected breast cancer may never have needed that treatment: the chemotherapy, the radiation, the surgery, the fear, the financial cost.This isn't an anti-medicine argument. It's a call for a conversation that rarely happens: here's the case for this test, and here's the case against it — here's what we might find that helps you, and here's what we might find that sets off a chain reaction you'll spend years managing. For most patients, that conversation never occurs.The 5-Year Survival Stat Is Misleading YouFive-year survival rates for cancer are often cited as evidence that screening works — and they sound like exactly that. But Welch shows why the number can be deceptive, and it comes down to lead-time bias.Here's the mechanism. Imagine a woman whose cancer will kill her at 65, regardless of when it's found. If screening catches it at 62, she lives three years with the diagnosis before dying at 65 — a five-year survival rate under five years. But if that same cancer isn't found until symptoms appear at 64, she lives one year with the diagnosis and dies at 65 — a five-year survival rate of zero.Same woman. Same cancer. Same date of death. But the version of her found earlier through screening appears, statistically, to have “survived longer.” Screening didn't add a single day to her life — it just moved up the start date of her diagnosis. It's the equivalent of claiming a win in a race because someone moved your starting line 200 meters ahead of everyone else's: you didn't run faster, you just started earlier. The finish line never moved.Now layer in overdiagnosis. If 1,000 people are diagnosed with cancers that would never have hurt them, and all 1,000 are alive five years later — which they would have been regardless — the survival statistics look dramatically better without a single life actually being saved. Welch's research shows that 5-year survival rates can climb while actual cancer death rates stay flat. More survivors on paper. Same number of people dying.None of this means medicine isn't making genuine progress in some cancers — colon cancer being a clear example, discussed below. It does mean that 5-year survival statistics, on their own, are not proof that a screening program is saving lives.Where the Evidence for Screening Is Actually StrongIt would be a mistake to leave this discussion thinking all screening is suspect. Welch himself is careful to draw a distinction, and there are tests with solid, randomized-trial evidence behind them.Colonoscopy for colorectal cancer is arguably the strongest case for screening that exists. It's unique because it doesn't just detect cancer — it can prevent it, by removing precancerous polyps before they ever become malignant. Colon cancer incidence and mortality have both dropped measurably in populations with high screening rates. If you're 45 or older, or have a family history, this is worth a serious conversation with your doctor.Low-dose CT for lung cancer, in high-risk individuals specifically, showed a 15–20% reduction in lung cancer deaths in the National Lung Screening Trial — but only among heavy smokers (roughly a pack a day for 20+ years). The risk-benefit math works because the baseline risk in that population is high.Cervical cancer screening — Pap smears and HPV testing — is a genuine public health success story. Rates have dropped dramatically since routine screening began, because cervical cancer has a long, slow, detectable precancerous stage that can be caught before it turns invasive.The common thread: these screenings either catch a long, slow precancerous process, or they target a population where the risk is already high enough that the math clearly favors testing. That's the question worth bringing to your doctor: given my specific risk factors, does the math on this test work in my favor?By contrast, the evidence is much weaker for consumer-marketed total-body scans, full-body MRI as a general “optimization” tool, universal PSA screening in all men over 50, and mammography in average-risk women in their 40s. These aren't mandates — they're conversations, and informed consent means understanding both sides before deciding.The Harms Nobody Talks AboutHealthcare marketing tends to present testing as one-sided: test early, catch it early, save your life. Welch's research catalogs the costs that rarely make it into that pitch.False positives. A mammogram flags a shadow. It isn't cancer — but you don't know that yet. Six weeks of follow-up imaging, maybe a biopsy, and the stress hormones flooding your body during that stretch are a real physiological cost, even when the final answer is “you're fine.”Unnecessary treatment. When a cancer that would never have caused harm is treated anyway — with surgery, radiation, or chemotherapy — the harm is real and the benefit is zero.The cancer label itself. Research shows that being labeled a cancer patient, even for a cancer that's never actively treated, changes a person's psychology, relationships, insurability, and life trajectory. Welch identifies this as a form of harm medicine rarely accounts for.Radiation exposure. Repeated CT scans carry cumulative radiation risk. A full-body scan can expose a person to the radiation equivalent of hundreds of chest X-rays — a real risk added to the body in pursuit of a cancer that may never develop.Welch's central reframe: the question isn't “should I get tested,” it's “given my risk factors, my age, my family history, and my values, does the math on this specific test work in my favor?” That's informed consent — and most people never get that conversation.The Missing Piece: Your Metabolism Is an Early Warning SystemWelch's work is thorough on what not to do. Where it leaves a gap is the proactive question: if blanket screening of healthy people isn't the answer, what is?The answer lies in the years — sometimes decades — before a tumor ever forms. Cancer doesn't appear overnight. The cellular environment that allows it to take root and grow develops gradually, and it leaves metabolic fingerprints long before any scan could detect a tumor.The clearest evidence for this comes from a 2026 study published in Nature Communications, which used machine learning on a massive UK database and linked insulin resistance to a significantly increased risk of at least 12 types of cancer. Pancreatic cancer risk was elevated by roughly 29%, colon cancer by 18%, and breast cancer by 13% — and critically, this risk showed up independent of body weight. A person at a healthy weight can still be carrying the metabolic dysfunction that drives cancer risk, and a standard annual physical would miss it entirely, because most doctors check fasting glucose, not fasting insulin. By the time glucose is elevated, insulin regulation has often been off for years.Layer in chronic inflammation (measured by hs-CRP), elevated ferritin, low vitamin D, rising homocysteine, and a poor triglyceride-to-HDL ratio, and what emerges is a picture of a metabolic environment that is increasingly hospitable to cancer. Think of it as soil: a healthy garden doesn't grow weeds easily, but depleted, imbalanced soil invites them. Cancer is the weed. Metabolic dysfunction is the depleted soil. The strategy, then, is to work on the soil rather than wait to spot the weed.What to Actually Do About ItPath A: Testing to ask your provider forThese tests build a real metabolic picture — the kind that shows soil quality before any weed appears.* Fasting insulin + HOMA-IR — not just fasting glucose. This is likely the single most important test most doctors aren't ordering.* Hemoglobin A1c — your 3-month blood sugar average.* hs-CRP — a high-sensitivity marker of systemic inflammation.* Full lipid panel, including TG/HDL ratio — a ratio above 3 is a strong metabolic red flag.* Ferritin — elevated levels are increasingly linked to inflammatory cancer environments.* Vitamin D (25-OH) — low levels are associated with higher cancer risk across multiple types; optimal is 60–80 ng/mL, not just “in range.”* Homocysteine — a methylation marker that, when elevated, signals oxidative stress.* LDH (Lactate Dehydrogenase) — rises when cells are under metabolic stress.For a deeper look, consider a comprehensive nutrient and organic acids panel (NutrEval), a gut microbiome panel (GI-MAP) — the gut-cancer connection is real — and a full hormone panel including cortisol, estrogen, testosterone, and SHBG.Path B: Lifestyle changes to start today* Eat in this order: protein and fat first, vegetables second, starches last. This alone can meaningfully blunt post-meal blood sugar spikes.* Cut refined sugars and seed oils — the two most direct dietary drivers of insulin resistance and inflammation.* Move daily. At minimum, 150 minutes of moderate activity per week, resistance training twice a week, and even a 10-minute walk after meals to improve glucose metabolism.* Prioritize sleep. Poor sleep disrupts glucose metabolism after a single bad night. Seven to nine hours is non-negotiable for metabolic health.* Manage stress. Chronic cortisol elevation drives insulin resistance — this is biochemistry, not soft advice.You don't need to do all of this at once. Pick one test to ask for at your next appointment, and one lifestyle change to start this week.Summary & Next StepDr. Welch's research makes an uncomfortable but important case: early detection is not automatically synonymous with lives saved, the 5-year survival statistic can be misleading, and testing healthy people carries real costs — false positives, unnecessary treatment, radiation exposure, and the psychological weight of a cancer label. At the same time, some screenings — colonoscopy, cervical cancer screening, low-dose CT for high-risk smokers — have strong evidence behind them and are worth pursuing for the right person.What's missing from that picture is a proactive strategy, and that's where metabolic health comes in. Insulin resistance, chronic inflammation, and blood sugar dysregulation show up years before cancer does, and unlike a full-body scan, they're both measurable and fixable.If you want a clear picture of where your own metabolic terrain stands — and what your highest-leverage next steps are — book a Metabolic Audit Call. It's a complementary 45-minute session where we review your current labs, symptoms, health history, and goals together. Spots are limited each week; the link is in the show notes.References* Welch, H.G. Should I Be Tested for Cancer? Maybe Not and Here's Why. University of California Press.* National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening.* Nature Communications (2026). Machine learning analysis of UK biobank data linking insulin resistance to increased risk across 12 cancer types, independent of body weight.* Thrive 120 Podcast, Episode 126: “Should I Be Tested for Cancer? What Dr. Welch Got Right — And What He Missed,” This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit tripleplaydoc.substack.com/subscribe

Why is there a Christian book about women's health and fertility? What does faith have to do with PAP smears and endometriosis?? Too often, the only time we see religion take part in conversations around reproductive health is when there's controversy or debate. That is not what we're about, or what our book is about. If you're interested in hearing just a hint of why we talk about faith alongside women's health, this episode is for you.NOTE: This episode is appropriate for most audiences but does mention sex ed.SHOW NOTES:Learn more about the Woven Well BookWoven Well on bookshop.orgWoven Well on AmazonWoven Well on ChristianbookCaitlin's article in Christianity TodayFertile Faith: Caitlin's SubstackSend Us a Text!Support the showOther great ways to connect with Woven Natural Fertility Care: Learn the Creighton Model System with us! Register here!Get our monthly newsletter: Get the updates!Chat about issues of fertility + faith: Substack Follow us on Instagram: @wovenfertilityWatch our episodes on YouTube: @wovenfertilityLove the content? The biggest gift you could give is to click a 5 star review and write why it was so meaningful! This podcast is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Always seek the advice of your doctor or other qualified health provider regarding a medical condition. If you think you may have a medical emergency, call 911 or go to the nearest emergency room immediately. Neither Woven nor its staff, nor any contributor to this podcast, makes any representations, exp...

Filmbarátok Podcast #330 (Július 2026) 207 perc Beszélgetnek: Márk, Gergő, Sorter, freddyD Téma: -Felvezető (00:00:00) -Borítókép (00:11:35) -Nép akarata (00:15:40) -Villámkérdés (00:27:13) -80-as évek rovat (00:43:50) -Supergirl (01:03:50) -Meghívás (01:23:20) -Gonosz Halott: Égj (01:34:20) -A zongorahangoló (02:05:55) -Cannibal Holocaust (02:21:45) -Papírvárosok (02:58:38) Csatolmányok: Holocaust Cannibal előzetes (NSFW) https://www.youtube.com/watch?v=iS8OLiXniac

Rok 2007 byl zvláštní mezistanice. Papírové herní časopisy ještě vládly, DVD přílohy byly malý datový kamion, internet už brousil kosu… a do kapsy nám právě lezla budoucnost v podobě prvního iPhonu.V tomhle Rewindu se vracíme do července 2007. Čekají vás tři herní hádanky, listování Levelem a Score, vzpomínka na dobu, kdy nová hra uměla poslat grafickou kartu do předčasného důchodu, první velké dotykové sny – iPhone, začátky Kindle, nástup Androidu, filmy Ratatouille a Vratné lahve – a na úplný závěr demoscénová šílenost fr-041: Debris, která vypadá jako video z budoucnosti, ale má velikost, která vás šokuje – dozvíte se na konci videa!Poznáte všechny tři hry? Svoje tipy pište do komentářů nebo posílejte na rewind@retronation.cz⁠ .Podcasty a další obsah ⁠RetroNation.cz⁠ můžeme natáčet kvůli podpoře ⁠od komunity na Patreonu⁠. Děkujeme vám za ni! Jakékoliv dotazy a připomínky pište na email ⁠retronationrulez@gmail.com⁠.

What if everything you thought you knew about menopause was either wrong, incomplete, or decades behind the science?Tammy Hadfield has been a women's health nurse practitioner for over 35 years — 25 of those as a hormone specialist. She was in the field in 2001 when the Women's Health Initiative scared an entire generation of women away from hormone therapy. Instead of backing down, she leaned in. She spent years being called one of the "crazy gals" giving hormones to women when most of the medical community said not to. The science eventually caught up. Her patients were better long before it did.This conversation covers everything you've been wondering about perimenopause and menopause — bioidentical versus synthetic hormones, why your cholesterol and your weight might have more to do with estrogen than your diet, what the hormone cascade actually looks like, and why the annual Pap smear is not the appointment to bring up your hot flashes, your mood changes, or your missing libido.But this episode also becomes something deeply personal. Tammy attended the BEST LIFE Retreat in Sun Valley in October 2025 — and what happened in the months after, including a planning meeting where she took a black Sharpie to her patient load and crossed out the number she'd been chasing, is one of the most honest things Laurie has heard in a recording studio.What we coverTammy's origin story: from postpartum nursing to military service in Alaska to hormone trailblazerWhat happened on the Today Show in 2001 — and how a single news segment derailed decades of women's healthWhy Tammy was considered "crazy" for giving hormones to women — and what the data eventually showedBioidentical versus synthetic hormones: what the difference actually means and why it matters for dosing and side effectsPremarin — the story behind the name, and why Tammy tells patients "I'm not a veterinarian and you're not a horse"Why all your hormones come from cholesterol — and what that means for women who are told their cholesterol is too highWhy your body holds onto fat when estrogen is low — and why estrogen is not making you fat; excessive estrogen isThe full hormone picture: estrogen, progesterone, testosterone, and DHEA — what each does and why all four matterWhy women who've had a hysterectomy are often wrongly told they don't need progesteroneThe difference between progestin (synthetic) and progesterone (bioidentical) — and why they are not the same thingADHD in menopause: why symptoms spike when estrogen and testosterone declineAlzheimer's, brain protection, and why 70% of new Alzheimer's cases are womenWhen hormone deficiencies actually start — and why Tammy says mid-30s, not menopauseWhy your annual Pap smear is the wrong appointment for this conversationTammy's biggest pet peeve: the male testosterone formulation being prescribed to women with instructions to use "a tenth of the packet"The four cornerstones that support hormones: nutrition, sleep, movement, and connectednessWhy Tammy closed her brick-and-mortar practice, stopped taking insurance, and launched Only HormonesHow to work with Tammy — including insurance, labs, FSA/HSA, and what the process looks likeThe BEST LIFE Retreat: what shifted for Tammy, the planning meeting with the blank calendar, and why she took a Sharpie to the patient number she thought she wantedRedefining success: from 30 patients a week to 12 — and why that's the better versionPermission to dream again — and why wanting what you want is not selfishWhat Tammy loves most about being a midlife womanWhat she'd tell her 20-year-old self: glimmers, breathing, and relaxingQuotable moments"I'm not a veterinarian, and you are not a horse — so we're not going to use this for your hormone replacement therapy.""All of your hormones come from cholesterol. Every single hormone.""Estrogen is not going to make you fat. Excessive estrogen will. But we need some estrogen so that our body can actually get rid of fat.""I just do hormones. I love hormones. That's all I wanna do.""Your appointment with me should be the easiest appointment you ever have.""I'm just your girlfriend on FaceTime.""We are taught as little girls not to be selfish — over and over again. And it's not selfish. It is figuring out what kind of life I want.""I took a freaking black Sharpie to that number of patients and said, 'Screw it. I'm gonna see 12.'""It's a redefinition of what I think success is. That's probably the bottom line.""I don't have to accept a smaller version of what I want my life to look like.""I would just tell myself: take a moment for yourself and breathe, girl. Just breathe."Resources + links mentionedThe Menopausal Brain by Lisa MosconiOnly Hormones — Tammy Hadfield's practiceApply for the BEST LIFE MastermindBook a 15-minute call with LaurieConnect with Tammy HadfieldWebsiteEmailInstagram

Több százmilliárd forint közpénzből építette fel a Fidesz azt a nemzetközi think tank-hálózatot, aminek hatása messze túlmutatott Magyarországon. A Papíron szép, az Átlátszó szerkesztőségi podcastjának negyedik adásában Zubor Zalán és Sarkadi Nagy Márton oknyomozó újságírókkal beszéljük végig, hogyan működött ez a rendszer, kiket és hogyan finanszírozott, milyen politikai eredményeket hozott, és mi várhat az MCC-re, a Batthyány Lajos Alapítványra, az Alapjogokért Központra vagy a Danube Institute-ra a kormányváltás után. 00:00 – Hogyan épült fel a Fidesz nemzetközi think tank-hálózata, és mit vásárolt vele a kormány? 03:00 – Végigvesszük a legfontosabb szervezeteket (MCC, Batthyány Lajos Alapítvány, Danube Institute, Alapjogokért Központ), és azt, hogy milyen szerepet töltöttek be a rendszerben. 07:30 – Így lett Magyarország a nemzetközi populista jobboldal találkozóhelye. 09:30 – A közpénz útja az alapítványokon keresztül vezet a think tankekhez. 22:20 – Mihez kezd a Tisza-kormány az MCC-vel és a Batthyány Lajos Alapítvánnyal? (Adásunk felvétele után jött a hír, hogy július 31-ével Ruff Bálint Miniszterelnökséget végző miniszter megszünteti az MCC alapítványát – a szerk.) 28:50 – Elmeséljük, milyen akadályokba ütközött az Átlátszó, amikor megpróbálta feltárni a think tank-hálózatok finanszírozását. 34:10 – Mit ért el valójában a Fidesz a több százmilliárdos szerződésekkel? 42:50 – Az MCC és a BLA kiemelt politikai szerepéről. 55:42 – Orbán Viktor sajátos mentőakcióba kezdett a választási vereség után. 58:52 – Miért tűnik úgy, hogy a Fidesz maga mondott le a think tank-hálózat jelentős részéről? 1:00:57 – Csontvázak a szekrényből: ez maradhat a Fidesz médiájából és nemzetközi kapcsolatrendszeréből. 1:05:22 – Hogyan értelmezik a nemzetközi konzervatívok a Fidesz választási vereségét? A podcast az Európai Unió társfinanszírozásával készült. Tartalmáért kizárólag az Átlátszó felel, és nem feltétlenül tükrözi az Európai Unió álláspontját.

Cientos de personas abandonaron el lugar esa noche. Brian no estaba entre ellas. Su auto seguía estacionado. Sus tarjetas, intactas. El vuelo a Miami que tenía reservado con su novia, perdido. Dos años después, alguien dejó un mensaje en el libro de condolencias de su padre fallecido: "Papá, te amo. Con amor, Brian. Islas Vírgenes."  El mensaje fue rastreado hasta una computadora pública en Ohio. Alguien había decidido jugar. Brian Shaffer nunca apareció.

Al, Zach, Christian, and John Luke wrap up Ancient Christianity with stories about sermon critiques, mispronounced words, and the kind of mentorship that only works when trust has been earned. Al shares how a gift from his granddaughter brought Phil's larger-than-life legacy to mind, while John Luke explains how he turned the Roman Empire into a summer camp lesson about Jesus, persecution, and the kingdom of God. The guys dig into Augustine's impact on the Trinity, the incarnation of Christ, and why God must reveal himself before we can truly know him.  In this episode: John 1:1; Genesis 1:28; John 17:3; John 14:6; Ephesians 3:10; Luke 15; Psalm 48:1-8; 1 John 4:8-10; Romans 1-2; Romans 7:24-25 Today's conversation is a recap of Ancient Christianity taught by visiting Hillsdale Professor of History Kenneth Calvert. Take the course with us at no cost to you! Sign up at http://unashamedforhillsdale.com/. More about Ancient Christianity: Christ entered the world during the reign of Caesar Augustus. The tensions between Christianity and the Roman Empire shaped the daily practice of the Christian faith and led many Romans to distrust and persecute the early Christians. But Christianity also benefitted from the Roman world. And when Rome collapsed in the West, Christianity provided the hope for preserving civilization. In this free, eleven-lecture course, Professor Kenneth Calvert will explore: How the Jewish, Greek, and Roman cultures all contributed to preparing the world to hear the Gospel. Why many Romans distrusted and persecuted the early Christians. The inspiring stories of Christ, His apostles, and faithful ones throughout the first four centuries of Christianity. The arguments of key early Christian apologists—Ignatius, Irenaeus, Justin, Athanasius, and more—who defended and defined the Christian faith amidst the animosity of the Roman world. The conversion of Constantine and how he brought stability to Rome, and how the rivalry between his sons almost returned Rome to paganism. How Augustine's writings helped preserve the message of Christianity during the collapse of the Roman Empire in the West. You will discover the uncertainties, trials, and triumphs of the earliest Christians as they confronted controversies within the faith and persecutions from outside it. Join us today to discover the improbable and miraculous story of Christianity. Sign up at ⁠http://unashamedforhillsdale.com/ Listen to Not Yet Now with Zach Dasher on Apple, Spotify, iHeart, or anywhere you get podcasts. Check out At Home with Phil Robertson, nearly 800 episodes of Phil's unfiltered wisdom, humor, and biblical truth, available for free for the first time! Get it on Apple, Spotify, Amazon, and anywhere you listen to podcasts! https://podcasts.apple.com/us/podcast/at-home-with-phil-robertson/id1835224621 Chapters 00:00 Pap's Shuttle Service 04:38 Getting Called Out for Mispronunciation 10:11 Learning to Land the Plane 16:28 John Luke Brings the Roman Empire to Camp 20:48 Knowing the God We Can't Fully Grasp 26:53 Why the Incarnation Reveals Who God Is 30:20 Who Was Jesus in the Old Testament? 36:35 The City of God Still Reigns 43:02 Augustine's Wounds & the Power of Surrender — Learn more about your ad choices. Visit megaphone.fm/adchoices

In this special live episode recorded from the SLEEP 2026 annual meeting in Baltimore, host Dr. Seema Khosla welcomes Dr. Sanjay Patel, director of the clinical sleep program at University of Pittsburgh Medical Center, to discuss groundbreaking medications for sleep disorders poised for FDA approval in 2026 and 2027. The pharmaceutical landscape for sleep medicine is undergoing unprecedented transformation. Dr. Patel surveys the emerging drug pipeline that will fundamentally change how clinicians treat obstructive sleep apnea, narcolepsy, and idiopathic hypersomnia. For obstructive sleep apnea, Dr. Patel discusses AD-109 (atomoxetine and R-oxybutynin), explaining the mechanistic rationale and practical considerations including use with tirzepatide. The Incannex drug combining dronabinol and acetazolamide receives analysis for different patient populations, and sultiame is discussed as a carbonic anhydrase inhibitor option. A critical framework emerges: Should treatment be symptom-based or airway-focused when PAP-intolerant patients present? Tirzepatide, the GLP-1 agonist FDA-approved for moderate-to-severe OSA, receives comprehensive coverage including muscle loss concerns, long-term use, and emerging oral GLP-1 options. Retatrutide, the triple-hormone agent combining GLP-1, GIP, and glucagon, is also discussed. The episode's most exciting segment focuses on orexin agonists for narcolepsy. Three pharmaceutical companies—Alkemeres, Centessa (purchased by Lilly), and Takeda—are developing these mechanistically novel agents. Dr. Patel clarifies how these medications differ, discusses why one medication disrupted nocturnal sleep (suggesting continued roles for oxybates), and addresses how clinicians will choose between similar medications. Dr. Patel emphasizes a fundamental question: Should the field prioritize symptom management versus airway patency for OSA, and mechanistic approaches versus symptom management for narcolepsy? Whether you're interested in emerging OSA treatments, narcolepsy innovations, or the future of pharmacological sleep medicine, this live episode provides essential updates on medications that will soon reshape clinical practice. Join us for this exciting conversation about how sleep medicine will transform in the coming years.

Vivir distraído es la nueva forma de muerte. Mientras tú estás en WhatsApp, en redes, en cualquier lado menos donde importa, el mundo se está transformando. Batch Spring 2026. La caída de SAS. $41 billones en deuda. Drones bombardeando. Porsches eléctricos. Y tú sin enterarte.Carlos analiza cómo la distracción nos está matando en cámara lenta. No es sobre tener un teléfono. Es sobre no ver lo que está pasando alrededor mientras jugamos a distraernos.

Las redes sociales, los celulares, están teniendo efectos en niñas, niños y adolescentes: falta de sueño, atención, autoestima, violencia digital, ansiedad, adicción comparable al tabaquismo. El Departamento de Salud de EUA ha advertido sobre los riesgos del uso excesivo y dañino de pantallas en niños y adolescentes. Habla de impactos en sueño, aprendizaje, salud mental, actividad física y relaciones cara a cara. Josefina Vázquez Mota, política y escritora, nos presenta su más reciente libro: Mamá, Papá. Me hiciste adicto. ¡Ayúdame, te necesito!

What if CPAP isn't the only option for treating obstructive sleep apnea?In this episode of SleepTech Talk, we sit down with Eric Mongeau, Chief Commercial Officer at Daybreak, to discuss the growing role of oral appliance therapy in the treatment of obstructive sleep apnea (OSA).While CPAP remains the gold standard treatment for OSA, many patients are surprised to learn that oral appliance therapy can be an effective option for certain individuals. Eric explains how oral appliances work, who may benefit from them, and why having more treatment choices can help more patients achieve successful outcomes.We also explore how oral appliance therapy and PAP therapy can sometimes work together, creating personalized treatment plans that improve comfort, adherence, and long-term success.Key Takeaways:✅ Oral appliance therapy is a viable treatment option for obstructive sleep apnea✅ CPAP remains the gold standard therapy for OSA✅ Patients today have more treatment choices than ever before✅ The ultimate goal is effective treatment and better health outcomes✅ Oral appliance therapy can sometimes be used alongside PAP therapyWhether you're a sleep professional, DME provider, clinician, or someone living with sleep apnea, this episode offers valuable insights into the expanding landscape of sleep apnea treatment options.You can find Eric on LinkedIn and learn more about Daybreak at https://www.thedaybreak.com/A huge thanks to our sponsors:Philips Healthcare   See how Philips is supporting you and your patients with meaningful innovation. Visit https://www.philips.com/matters Fisher & Paykel Healthcare  Discover how F&P full-face masks have led millions of people to a great night's sleep at https://www.fphcare.com/curiosityhttps://www.fphcare.com/us/homecare/sleep-apnea/Soliish https://www.soliish.com/React Health  https://www.reacthealth.com/myWaveshttps://mywaves.tech/More resources for clinicians can be found at Sleep Review Magazine  https://sleepreviewmag.com/Don't forget to Like, Share, and Comment! Subscribe to SleepTech Talk for more insights into sleep apnea, CPAP therapy, and innovations shaping the future of sleep care.Whether you're a sleep professional or a healthcare innovator, this episode explores the intersection of technology, patient care, and sleep medicine.Learn more about the show at https://www.sleeptechtalk.com/thetechroomCredits:Audio/ Video: Diego R Mannikarote; Music: Pierce G MannikaroteHosts: J. Emerson Kerr, Robert Miller, Gerald George MannikaroteCopyright: ⓒ 2026 SleepTech Talk ProductionsEpisode 126The views and opinions expressed by guests on SleepTech Talk are their own and do not necessarily reflect those of the podcast hosts or SleepTech Talk as a whole. This podcast is intended for educational and informational purposes only and should not be considered medical advice. Listeners are encouraged to consult with a qualified healthcare professional for any medical concerns or questions.Subscribe for more conversations with leaders shaping the future of sleep medicine, sleep technology, and patient care.#SleepApnea #DentalSleepMedicine #OralApplianceTherapy #CPAP #SleepTechTalk #SleepMedicine #SleepHealth #Dentistry #HealthcarePodcast #SleepDentistWe're turning the mic on ourselves for this episode of SleepTech Talk

¡¡NUEVO PODCAST!!-Carlos Humberto Delgadillo García… El nuevo rol del papá: Prevención, educación y espacios seguros en el hogar.  -Dra. Marilenca Bailey Jáuregui… “Relación entre la emocionalidad y lo psicosomático”  -Cartelera Cinematográfica... José Antonio Valdés Peña.    -Dra. Susana Canalizo… “La Piel de Papá”

In this episode of GynoCurious, host Dr. Amy Novatt welcomes Dr. Miriam Cremer, board-certified OBGYN, master of public health, and founder of Basic Health International, for a deep dive into cervical cancer. Together they unpack the science of human papillomavirus (HPV), explaining how 13 high-risk HPV types cause 99% of all cervical cancers and why HPV is so ubiquitous that it's often compared to the common cold. They walk through the evolution of cervical cancer screening, from the classic Pap smear to co-testing with HPV, and discuss how primary HPV testing — already standard across Europe — is likely the future of care in the United States. Dr. Cremer shares the origin story of Basic Health International, which grew from a formative medical school rotation in rural El Salvador where she witnessed a young mother die from cervical cancer — a death that was entirely preventable. The conversation covers cutting-edge developments in screening and treatment, including HPV self-sampling kits, AI-assisted cervical imaging apps, and portable thermal ablation devices that can be carried in a backpack and used in remote communities. These innovations are enabling same-day "screen and treat" programs that are reaching women in underserved regions across Latin America and beyond, including a now-national HPV screening program in El Salvador. They also cover patient fears and misconceptions head-on — from the stigma of an HPV diagnosis to questions about condom protection, the HPV vaccine (including catch-up vaccination up to age 45), and when screening can safely stop. Dr. Cremer and Dr. Novatt emphasize that cervical cancer is almost entirely preventable, and that the women most at risk today are those who have fallen through the cracks of healthcare access — not those who are regularly screened. Questions of comments? Call 845-307-7446 or email comments@radiofreerhinecliff.org Produced by Jennifer Hammoud and Matty Rosenberg @ Radio Free Rhiniecliff

¡¡NUEVO PODCAST!!-Dr. Juan Francisco Rivera Ramos… “Medidas de precaución durante el mundial: Si vas al estadio que debes hacer para  evitar enfermarte”-Gianco Abundiz... “Homonimias”  -Gabriela Ávila… ¿Mi hijo come bien? Señales de alerta que los papás ignoran…  -Laura Díaz…  Productora y Compositora de Cantares de México. Lute Reyes. Cantautora… “Cantares de México presenta: Esto es México”  -Raquel Flores… “¿Dónde ver el mundial?”    -Dalila Carreño… “Los mejores libros acerca de Papá”

In this explosive episode of Exopolitics Today, Dr. Michael Salla welcomes Jorge "JP" Papón to discuss a startling experience that allegedly occurred during a recent trip to Colorado. JP describes being approached by individuals posing as police officers, transported to a suspected underground facility, and subjected to medical examinations that resulted in missing time and unexplained physical evidence.JP also shares reports emerging from rural regions of Brazil, where witnesses claim to have observed massive unidentified craft and encounters with Nordic-looking extraterrestrials. The discussion explores themes of UFO disclosure, secret programs, consciousness technologies, military surveillance, and the growing global wave of contact experiences.Topics Covered:✅ Alleged transport to a secret underground facility✅ Missing time and unexplained medical procedures✅ Space Force connections and covert operations✅ Reports of Nordic ET activity in Brazil✅ Large UFO sightings over rural areas✅ Disclosure, consciousness, and emerging revelations✅ The future of extraterrestrial contactWhether you're a long-time UFO researcher or new to the disclosure movement, this episode presents one of the most intriguing and controversial testimonies to date.

In this episode of Medsider Radio, we sat down with Kara Egan, founder and CEO of Teal Health.Teal Health is the company behind the first FDA-authorized at-home cervical cancer screening wand.Before founding Teal, Kara worked in healthcare and software investing at .406 Ventures and Emergence Capital, and held product and marketing roles at Zendesk and Stitch Labs.  In this interview, Kara discusses building support and follow-up into at-home screening, how Teal expanded its comparative clinical study to support broader market adoption, and how healthcare incentives, reimbursement, and institutional trust shape new care models.Before we dive into the discussion, I wanted to mention a few things:First, if you're into learning from medical device founders and CEOs and want to know when new interviews are live, head over to Medsider.com and sign up for our free newsletter.And if you're ready to level up your medtech game, you should check out Medsider Courses — 8-week masterclasses covering topics like fundraising, M&A and exit planning, design and development, clinical and regulatory strategy, and commercialization.These courses, featuring hard-earned lessons from elite medtech CEOs, can be purchased individually or come free with our All-Access Pass.If you'd rather read than listen, here's a link to the full interview with Kara Egan, which includes a link to ScottBot — an AI version of host Scott Nelson trained on every Medsider interview and playbook. Feel free to ask ScottBot any questions you'd like!KEY MOMENTS FROM THE INTERVIEW(02:49) - Kara's background in health technology investing and software that shaped Teal's consumer-first approach (05:14) - How Teal turned the traditional Pap smear into the first FDA-authorized at-home screening product (07:30) - Turning at-home testing, telehealth, and clinician follow-up into a single care experience (13:48) - Raising Teal's first $1M with mockups and consumer-grade design (22:17) - Teal's comparative study that matched physician-collected screening with 96% sensitivity (23:40) - How asking women what they actually wanted changed Teal's view of the market opportunity (32:05) - “Take off the healthcare hat” — Kara's framework for fundraising, incentives, and commercialization (41:48) - What investors actually care about beyond the company's mission

Prevén mayor consumo de agua por torneo de fútbol  Corea del Sur primera en llegar a Guadalajara  Felipe VI, Letizia y sus hijas dieron la bienvenida a León XIV a España  Más información en nuestro podcast#grc

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Abhishek Goyal, Professor and Head of Respiratory Medicine in Dehradoon, India, and Dr. Prakhar Agarwal, a pulmonologist in private practice in Bhopal, India, to discuss their research comparing fixed CPAP versus auto-titrating CPAP (APAP) on blood pressure control and autonomic nervous system response. For years, difficult-to-treat hypertension has been recognized as an indication for sleep studies, reflecting the assumption that treating sleep apnea improves blood pressure. But does the method of PAP therapy matter? Beyond achieving a residual AHI under 5, are there treatment nuances that could optimize cardiovascular outcomes? Dr. Goyal and Dr. Agarwal's research addresses these questions, building on landmark work by Dr. Pepin examining fixed versus auto-titrating PAP therapy. The motivation includes both clinical and economic considerations. A 2021 Portuguese study examined cost implications, and similar economic pressures exist in India where APAP is significantly more expensive than fixed CPAP. The study used a crossover design comparing fixed CPAP to APAP, measuring blood pressure dipping patterns and autonomic response to assess cardiovascular effects. The results have prompted Dr. Goyal to reconsider his clinical practice regarding pressure selection, raising important questions: If fixed CPAP offers superior blood pressure outcomes, should the standard practice of prescribing APAP devices be reconsidered? This challenges assumptions about adaptive algorithms and raises questions about prioritizing cardiovascular outcomes beyond AHI reduction. The episode contextualizes these findings within India's unique healthcare landscape, exploring surprising OSA incidence data and examining whether craniofacial anatomy or arousal patterns differ from Western populations. Dr. Agarwal discusses how pressures are typically determined and the practical differences between APAP 4-20 versus narrow-range settings. Whether you're prescribing PAP therapy for hypertension, optimizing cardiovascular outcomes, or seeking evidence-based approaches to pressure selection, this episode provides important international perspectives. Join us for this discussion that may prompt reconsideration of how we set PAP pressures and what outcomes we should prioritize.

Welcome to How Humans Heal. In this episode, I'm interviewing Kelly Kennedy, the Lymph Queen and Head Practitioner at the True Wellness Center, who has been helping people improve their lymph function and flow for over twenty years. I'm so grateful to have her here to share with you what the lymph is, how you know if you need help with your lymph, and where you can begin to reset your lymph system. Healthy lymph flow is essential for helping you to clear HPV, so this episode is essential if you have an abnormal Pap. We're here to help you! LINKS FROM THE EPISODE:   Connect with Kelly: https://www.flowintohealth.com/21day-lymphatic-breakthrough-week1?am_id=drdoni6723    Sign up for Dr. Doni's 5-Day HPV Workshop: https://doctordoni.com/HPV-workshop/   Schedule A Chat With Dr. Doni: https://intakeq.com/new/hhsnib/vuaovx    Read the full episode notes and find more information: https://doctordoni.com/blog/podcasts/ MORE RESOURCES FROM DR. DONI:   Quick links to social media, free guides and programs, and more: https://doctordoni.com/links     Disclosure: Some of the links in this post are product links and affiliate links and if you go through them to make a purchase I will earn a commission at no cost to you. Keep in mind that I link these companies and their products because of their quality and not because of the commission I receive from your purchases. The decision is yours, and whether or not you decide to buy something is completely up to you.  

Whoa there… steady on now! You seem like you're just about ready to take on this episode of The Chris Moyles Show on Radio X podcast! There's a lot in this episode, folks! But when isn't there, am I right? The team recorded the Pubcast – you know, that charity podcast from a pub they do – so they felt a little ‘crispy' (Dom's favourite word for hungover) afterwards on Wednesday's show. We also get excited about all that soccer in the summer, so our producer Polly has been working on a sweepstake for the team, and I'll say it now in case you don't clock on it, she's not the biggest football fan in the world!We also have a host of wonderful guests to entertain those little ears of yours…Am I bovvered? Do I look bovvered? You bet I am bovvered, as the team caught up with comedy royalty, Catherine Tate. She's in a show on the West End called Oh, Mary! She also has her legendary character Nan, and as Captain and Catherine haven't met before, did Nan and him meet? (If you know, you know!)Chris met one of his pop music heroes, a massive 80's icon… it's only Nik Kershaw! Chris loves his music, and has been on the radio over thirty years and somehow has never interviewed Nik, so Chris was particularly giddy that morning, which you, undoubtably, will pick up on!Baby, she was ready to go… on The Chris Moyles Show! Saffron from Republica stopped by the Radio X studio to catch up with the team about more Republica shows, and the thirty-year anniversary of their massive hit “Ready To Go!”It felt weird having the next person as an actual guest… especially as he does the show after Chris, so they see each other every day. However, Toby Tarrant had an announcement to make, so he was our next “guest” oddly. (Funny how he didn't get his name in the title of this week's episode, right?)And you're telling me that isn't enough for you? Fine then, have some more:Dom's shop on the A1Toby Lerone returns?Pop Rap, or Pap?

Send us Fan MailThe hardest part of health care isn't always treatment, it's figuring out who should treat you in the first place. Speaking of Women's Health Podcast host Holly L. Thacker, MD sits down with Laura Lipold, MD, Director of Primary Care Women's Health at Cleveland Clinic, to map out how primary care, OB-GYN care and consultative women's health specialists can work together across every life stage.They talk candidly about why so many patients feel stuck right now, from limited access to primary care to the long shadow of menopause misinformation after the Women's Health Initiative. You'll hear practical guidance on what primary care can often handle (Pap tests, HPV and cervical cancer screening, mammogram orders, chronic disease management, obesity and metabolic health, behavioral health support) and when it's time to bring in a specialist for complex menopause and hormone therapy decisions, severe osteoporosis, cancer survivorship, blood clots, transplants, or major cardiovascular history.Support the show

In this episode the guys break down six training secrets discovered by Soviet Union sports scientists — the methods that made them the most dominant strength athletes in the world before steroids were even part of the conversation. They also get into the surprising dopamine-boosting effect of exogenous ketones, a study on how a father's attractiveness influences his daughter's looks more than the mother's, which group of young men is happiest (married dads by a wide margin), and Gen Z data showing 1 in 8 believe scrolling is more pleasurable than sex. Then they answer questions submitted through their Instagram page, coaching callers live on air.   MAPS 15 BOGO — https://maps15bogo.com Buy 1 get 1 FREE — limited time   Submit a live caller question: https://mplivecaller.com Mind Pump Store: https://mindpumpstore.com Instagram: @mindpumpmedia   SPONSORS   Ketone IQ — https://ketone.com/MINDPUMP 30% off subscription orders + free gift with second shipment (6-pack, merch & more) — no code needed.    Crisp Power — https://www.crisppower.com/mindpump Code: MINDPUMP — 10% off. High protein, high fiber, low carb.   Our Place (cookware) — https://fromourplace.com Code: MINDPUMP — 10% off sitewide. 100-day trial with free shipping and returns.   Mind Pump Fitness Coaching — https://mindpumpfitnesscoaching.com 1.9 NASM CEUs   0:00 - Intro & sponsors 2:04 - 6 Soviet Union training secrets that built the greatest strength athletes ever 12:52 - Prolev's chart — the exact optimal reps & sets at every intensity level 15:33 - Soviet secret #2: Plyometrics & the depth jump — how power training was born 20:12 - Soviet secret #3: Undulating periodization — why structured deloads beat linear training 23:13 - Soviet secret #4 & 5: Sub-maximal reps & complex contrast methods (PAP) 24:25 - Ketone IQ deep dive — exogenous ketones raise dopamine without stimulants 28:44 - Dad's attractiveness influences daughter's beauty more than mom's (study) 30:38 - Face swap app nostalgia & grocery store facial recognition cameras 32:29 - Amazon TV ads you can add to cart mid-commercial 38:44 - Study: Married dads 22–35 are 2x happier than single childless men 44:47 - Gen Z study: 1 in 8 say scrolling is more pleasurable than sex 52:13 - Crisp Power snack break & Our Place cookware sponsor 55:35 - Caller: Josh (Vermont) — 100lb weight loss, 5 years sober, CrossFit addiction & sobriety 1:08:18 - Caller: Kelly (Massachusetts) — RED-S, under-eating, lost menstrual cycle, needs a reverse diet 1:17:41 - Caller: Ted (Indiana) — Truck driver on a brutal sleep schedule, how to stay healthy on the road 1:28:06 - Caller: Alexandra (Washington) — Hypermobility/EDS, training with joint laxity, and personal training career path