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Contributor: Taylor Lynch, MD Educational Pearls: A recent study published in a pediatric journal in April 2025 compared temporal and oral thermometers Paired temperature measurements (temporal and oral temperature within 30 minutes) were obtained from 1,412 pediatric patients 26% of patients had statistically different temporal and oral temperatures The temporal reading was always lower than the oral reading Children less than 12 years old were 2-3x more likely to actually have that statistical difference in temperatures The study also evaluated 1,000 adult patients 36% had a temporal temperature that was 0.5 degrees Celsius lower than the oral temperature Reasons for the statistical difference between the two types of thermometers: Environment: temporal thermometers are affected by ambient room temperature, diaphoresis, and inaccuracy in measuring temperature at the site of the temporal artery Physiologic: a patient with inadequate perfusion will not have an accurate temporal reading Impact: Obtaining an accurate temperature is crucial in patient care For example, in the setting of sepsis, temperature is a necessary component to identifying when a patient meets SIRS criteria References Salhi RA, Meeker MA, Williams C, Iwashyna TJ, Samuels-Kalow ME. Inaccuracy of Temporal Thermometer Measurement by Age and Race. Acad Pediatr. 2025 Apr;25(3):102620. doi: 10.1016/j.acap.2024.102620. Epub 2024 Dec 15. PMID: 39681266. Summarized by Meg Joyce, MS2 | Edited by Meg Joyce & Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/
In this episode, I'm sharing a special rebroadcast of my chat with Dr. Mikki Williden all about physiologic flexibility, including how to train your body to handle stress and adapt better. We cover metabolic flexibility, heat and cold exposure, sauna and cold therapy, lactate and buffering systems, plus CO₂ and O₂ tolerance. You'll learn how these systems connect to boost performance, recovery, and body composition in a healthy, sustainable way.Sponsor:Physiologic Flexibility Certification Course open Monday, Oct. 13 to Monday, Oct. 20: https://miketnelsons.samcart.com/products/physflex/Triphasic 2 book now available!Go to https://triphasic2.com/Episode Chapters:01:39 Introduction by Dr. Mikki Williden02:43 Dr. Mike T. Nelson's Background06:53 Discussion on Metabolic and Physiologic Flexibility15:09 Personal Experiences and Experiments16:28 Cold Exposure and Its Effects25:28 Heat Exposure and Adaptation31:36 Psychological Benefits of Cold Exposure34:31 Practical Recommendations for Cold and Heat Exposure39:52 Understanding pH Balance and Acid Tolerance41:52 Understanding Lactate and Its Role in Exercise43:19 Buffering Systems and Supplements49:11 High-Intensity Interval Training (HIIT) Insights53:02 Breathing Techniques and CO2 Tolerance57:44 Altitude Training and Oxygen Regulation01:06:34 Metabolic Flexibility and Ketones01:14:39 Conclusion and Final ThoughtsGet In Touch with Dr Mike:Instagram: https://www.instagram.com/drmiketnelson/YouTube: https://www.youtube.com/channel/UCn1aTbQqHglfNrENPm0GTpgEmail: https://miketnelson.com/contact-us/
In this episode of the Flex Diet Podcast, I chat with Dr. Blaine Lints, a former Navy SEAL and performance physiologist, about boosting performance, muscle, and resilience through flexible strategies. We dig into his research on ketones, caffeine, and theacrine, plus his work using Ibogaine for TBI recovery. I also break down how physiologic flexibility ties it all together for next-level performance and recovery.If you're into cutting-edge performance science, brain optimization, or just want to hear two nerds talk physiology and Navy SEAL mental toughness, this one's for you.Sponsors:Beyond Power Voltra 1: https://www.beyond-power.com/michael13Tecton Ketone Esters: https://tectonketones.comAvailable now:Grab a copy of the Triphasic Training II book I co-wrote with Cal Deitz here.Episode Chapters:07:30 Interview with Dr. Blaine Lints Begins08:20 Research on Caffeine and Theacrine22:12 Dr. Lints' Ironman Journey34:23 Exploring Ketones and Heat Stress52:56 Exploring Ketone Esters and Their Benefits53:52 Personal Experiences with Ketone Dosages55:28 Research Insights on Ketone Mono Esters57:34 Ibogaine Study for Special Operators01:00:12 Personal Journey with Ibogaine Treatment01:04:23 Potential of Psychedelic Medicines01:10:26 Safety and Legality of Psychedelic Treatments01:18:56 Future of Psychedelic Research and Applications01:26:32 Conclusion and Final ThoughtsFlex Diet Podcasts You May Enjoy: Episode 311: Maximizing Athletic Performance with Neurology: Insights from Dr. Dylan SeeleyYouTube: https://youtu.be/bnuYQ-GJ6to. Episode 167: The Physiologic and Psychologic Benefit of Doing Hard Things: Akshay Nanavati of Fearvana with Dr Mike T NelsonYouTube: https://youtu.be/G_iFVGHZSEsConnect with Blaine:Instagram: https://www.instagram.com/blaineketsGet In Touch with Dr Mike:Instagram: DrmiketnelsonYouTube: @flexdietcertEmail: Miketnelson.com/contact-us
Dr. Chelsie Huseman from Texas A&M University shares some tips and information about the physiologic changes that horses, ponies, donkeys, and mules undergo as they age.My Senior Horse - Episode 29 Guests and Links:Guest: Chelsie HusemanConnect with Host: Kimberly S. Brown of Editorial Director of My Senior Horse | Email Kim (kbrown@equinenetwork.com) | Follow Kim on LinkedIn (@kimberlylsbrown)
In this episode, we review the high-yield topic Physiologic Changes in Pregnancy from the Obstetrics section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
Interview with Margaret Infeld, MD, MS, author of Clinical Outcomes With Personalized Accelerated Physiologic Pacing in Heart Failure With Preserved Ejection Fraction: Follow-Up of the myPACE Trial. Hosted by Robert Bonow, MD. Related Content: Clinical Outcomes With Personalized Accelerated Physiologic Pacing in Heart Failure With Preserved Ejection Fraction
Interview with Margaret Infeld, MD, MS, author of Clinical Outcomes With Personalized Accelerated Physiologic Pacing in Heart Failure With Preserved Ejection Fraction: Follow-Up of the myPACE Trial. Hosted by Robert Bonow, MD. Related Content: Clinical Outcomes With Personalized Accelerated Physiologic Pacing in Heart Failure With Preserved Ejection Fraction
A 17 yo male presents for follow up on a “fainting” episode that occurred during football practice at the end of a running exercise. He states, “I do not know what happened. We finished a set of running sprints and next thing I knew, I was on the ground.” He denies injury from the event and history of prior episodes. His physical examination reveals a crescendo-decrescendo systolic murmur heart best at the apex, increasing in intensity with position change from supine to standing position. This most likely represents: A. Mitral regurgitation B. Physiologic murmur C. Hypertrophic cardiomyopathyD. Aortic stenosis Visit fhea.com to learn more!
Send us a textDoulas play a critical role in supporting women through childbirth—but their work is anything but easy, and their work isn't for the faint of heart. Many face disrespect from providers and routinely witness coercion, misinformation, and violations of informed consent. Even with their deep commitment to the women they serve, doulas often feel powerless in the face of hospital systems driven by profit and control. Still, many doulas are called to this work—and despite everything, they continue with resilience, purpose, and unwavering commitment.Doulas are indispensable. The evidence is clear: When a doula is present, C-section rates drop -- as do all other routine interventions. Physiologic birth is more likely. Breastfeeding is more successful. And most important, mothers walk away feeling more satisfied and supported. Doulas are, and always have been, the original birth keepers. Their presence makes birth safer, more humane, and more aligned with what women actually want and need.In today's episode, we hear directly from doulas about what they're up against—and why, despite it all, they keep showing up. We also share our reflections on what it means to support doulas as they continue this vital work.**********Our sponsors:Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Our favorite nutritional products for before, during, and after pregnancy. Use this link to save 20%DrinkLMNT -- Purchase LMNT with this unique link and get a FREE sample packConnect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWNWatch the full videos of all our episodes on YouTube Primally Pure: From soil to skin, Primally Pure products are made with down-to-earth ingredients that feel and smell like heaven for the skin. Promo code: DOWNTOBIRTH for 10% off. ENERGYBits: Get the superfood Algae every mother needs for pregnancy, postpartum, and breastfeeding. Promo code: DOWNTOBIRTH for 20% off. Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Watch the full videos of all our episodes on YouTube! Work with Cynthia: HypnoBirthingCT.com Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.
Welcome to the Mind Muscle Connection Podcast!In this episode, I'm joined by Dr. Mike T. Nelson to talk about Cardio For Lifters, Physiologic Flexibility & Stress Resilience, D9 Caffeine and more.We cover how much cardio you really need if your goal is muscle, ways to improve VO2 max without burning out, how to train around big life stressors, and Dr. Mike's concept of “Physiologic Flexibility” for building long-term resilience.This is a very informative episode, so don't miss out!Let's talk about:Dr Mike T. NelsonAerobic trainingCardio for liftersD9 CaffeinePhysiologic FlexibilityStress ResilienceHeat adaptationsCold exposureDr. Mike's Newslettter: https://miketnelson.com/ Follow me on Instagram for more information and education: jeffhoehn_FREE 30 Min Strategy Call: HEREBody Recomp Masterclass: HERENutrition Periodization Masterclass: HEREHow You Can Work With Me?: HERECoaching application: HEREBody Recomp Checklist 2.0: https://chipper-producer-6244.kit.com/26b5c9f94a
Send us a textLaktat und SvO2 als Transfusionstrigger? Dies besprechen wir diese Woche im Journal Club:Noitz M, Brooks R, Schlömmer C, et al. Central/mixed venous oxygen saturation and lactate levels might be of limited use as physiologic transfusion triggers in cardiac surgery: Results of a retrospective analysis. Eur J Anaesthesiol. 2025;42(6):536-542. doi:10.1097/EJA.0000000000002149Im Studie wieder dabei: Konstantin Urbach, wissenschaftlicher Mitarbeiter der Klinik für Anästhesiologie am UKHD.
Rock talks with Performance Coach, Ricardo Urbina about training NFL players, big waves surfers, and endurance athletes. Give a listen and click subscribe.TIME STAMPS2:15 Who is Ricardo Urbina?5:30 Life after Ironman triathlons9:00 Free dive training12:00 Big wave surfing and breath hold training18:00 Breath training for the NFL Combine23:00 Too much noise27:00 Variety of breath work31:30 Physiologic changes due to breath training35:00 Oxygen depletion and fatigue38:00 Safety protocols for breath training40:30 Integrating breathing into normal training44:00 Daily routine50:00 Lion breath for focus and sharpness53:00 Apex Peak PerformanceGET TO KNOW RICARDO URBINALINKEDIN: https://www.linkedin.com/in/ricardourbina/INSTA: https://www.instagram.com/rwurbina/APEX WEBSITE: https://www.apexapneappc.com/GET TO KNOW ROCKY SNYDERMEET: Visit the Rocky's online headquarters: RockySnyder.comREAD: Grab a copy of his new "Return to Center" book: www.rockysnyder.comINSTA: Instagram fan, check him out at https://www.instagram.com/rocky_snyder/FACEBOOK: https://www.facebook.com/rocky.snyder.77LINKEDIN: https://www.linkedin.com/in/rocky-snyder-cscs-cafs-nsca-cpt-a77a091/TRAIN WITH ROCKY WORKOUT: Want to meet Rocky and get a private workout: https://rfcsantacruz.com/INSTA: https://www.instagram.com/rockysfitnesssc/FACEBOOK: Facebook.com/RockysFitnessCenter
In this episode of the Rena Malik, M.D. podcast, Dr. Rena Malik talks with Dr. Nicole Prause about the complexities of orgasm and sexual response in the brain. Dr. Prause discusses her research on the changes that happen as individuals near climax, suggesting a possible undocumented phase in the sexual response cycle. They explore the role of cognitive control in achieving orgasm and examine the practice of semen retention, noting that its purported benefits lack scientific support. The conversation also highlights the challenges researchers face in the field of sexual health. Become a Member to Receive Exclusive Content: renamalik.supercast.com Schedule an appointment with me: https://www.renamalikmd.com/appointments ▶️Chapters: 00:00 Introduction 00:11 Brain activity during orgasm 01:27 Sexual response cycle theory 03:20 Orgasms and cognitive control 05:02 Edging and brain states 06:21 Semen retention discussion 08:52 Physiologic basis of focus 15:30 Online forum dangers 19:23 Pornography and pair bonding 21:26 Oxytocin and relationships Stay connected with Dr. Prause on social media for daily insights and updates. Don't miss out—follow her now and check out these links! X - https://x.com/NicoleRPrause Facebook - https://www.facebook.com/LiberosCenter LinkedIn - https://www.linkedin.com/in/nprause/ ResearchGate - https://www.researchgate.net/profile/Nicole-Prause https://bsky.app/profile/nicolerprause.bsky.social www.liberoscenter.com Let's Connect!: WEBSITE: http://www.renamalikmd.com YOUTUBE: https://www.youtube.com/@RenaMalikMD INSTAGRAM: http://www.instagram.com/RenaMalikMD TWITTER: http://twitter.com/RenaMalikMD FACEBOOK: https://www.facebook.com/RenaMalikMD/ LINKEDIN: https://www.linkedin.com/in/renadmalik PINTEREST: https://www.pinterest.com/renamalikmd/ TIKTOK: https://www.tiktok.com/RenaMalikMD ------------------------------------------------------ DISCLAIMER: This podcast is purely educational and does not constitute medical advice. The content of this podcast is my personal opinion, and not that of my employer(s). Use of this information is at your own risk. Rena Malik, M.D. will not assume any liability for any direct or indirect losses or damages that may result from the use of information contained in this podcast including but not limited to economic loss, injury, illness or death. Learn more about your ad choices. Visit megaphone.fm/adchoices
Welcome back to the Flex Diet Podcast. I'm your host, Dr. Mike T. Nelson. In this episode, I'm excited to announce that the Physiologic Flexibility Certification will be open from March 17th to March 24th, 2025.I'll also be heading to Parker University Talks in Las Vegas, where I'll be speaking alongside some incredible experts in the field.Today, we're diving deep into Physiologic Flexibility—the key to upgrading your performance by targeting homeostatic regulators like temperature, pH balance, expanded fuel sources, and oxygen/CO₂ regulation. These elements are critical for adapting to stress and pushing your resilience to the next level.I'll discuss practical applications for exercise, nutrition, and sleep and how to strategically apply stress to become more antifragile. Whether you're into high-tech solutions or prefer simple, low-tech methods, this episode has actionable insights to help you maximize your recovery and performance.Tecton Life Ketone drink! https://tectonlife.com/ DRMIKE to save 20%LMNT electrolyte drink mix: miketnelsonlmnt.comPhysiologic Flexibility Certification Course open Monday, March 17 to Monday, March 24: https://miketnelsons.samcart.com/products/physflex/Triphasic 2 book now available!Go to https://triphasic2.com/Episode Chapters:00:18 Physiologic Flexibility Certification Announcement00:43 Upcoming Events and Speakers01:57 Key Concepts of Physiologic Flexibility05:46 Understanding Antifragility10:52 Practical Applications and Interventions16:08 Conclusion and Contact InformationGet In Touch with Dr Mike:Instagram: https://www.instagram.com/drmiketnelson/YouTube: https://www.youtube.com/channel/UCn1aTbQqHglfNrENPm0GTpgEmail: https://miketnelson.com/contact-us/
The Snowflake FairyRobed in white comes Snowflake Fairy,braving wintry winds and ice,pearly "Maid of February,"whom the glistening frosts entice.Gladly welcome Snowflake Fairy,on your terrace give her room.She alone in Februarybraves the cold to shed her bloom.—Elizabeth GordonMusic by James Milor from PixabayInformation provided by:Flowers and Their Meanings: The Secret Language and History of Over 600 Blooms by Karen Azoulay (2023)https://www.bloomandwild.com/the-blog/snowdrop-flowers-meaninghttps://www.chicagobotanic.org/plantinfo/plant_profiles/snowdropsPlants That Kill: A Natural History of the World's Most Poisonous Plants by Elizabeth A. Dauncey and Sonny Larson (2018)Galanthus trojanus: a new species of Galanthus (Amaryllidaceae) from north-western Turkey by Aaron P. Davis and Neriman Ozhatay (2001). Botanical Journal of the Linnean Society, 137, pg. 409-412. DOI: 10.1006/boj1.2001.048.Peterson Field Guide to Medicinal Plants and Herbs of Eastern and Central North America (3rd ed.) by Steven Foster and James A. Duke (2014)https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:77118772-1/general-informationGalantamine for Alzheimer's disease and mild cognitive impairment by Clement Loy and Lon Schneider (2006). Cochrane Database of Systematic Reviews, 1. https://doi.org/10.1002/14651858.CD001747.pub3https://plants.ces.ncsu.edu/plants/galanthus-nivalis/Homer's Moly identified as Galanthus nivalis L.: Physiologic antidote to stramonium poisoning by Andreas Plaitakis and Roger C. Duvoisin (1983). Clinical Neuropharmacology, 6(1), pg. 1-6. [Abstract]. Collins Gem: Wild Flowers by Martin Walter (2002)https://en.m.wikipedia.org/wiki/Galanthushttps://www.woodlandtrust.org.uk/trees-woods-and-wildlife/plants/wild-flowers/snowdrop/
Welcome to the Mind Muscle Connection Podcast!In this episode, we're thrilled to welcome back Dr. Mike T. Nelson for his third visit to discuss how to support cognitive function, physiological flexibility, and more!We dive into practical steps you can take to enhance your daily movement, break free from sedentary habits, and integrate more physical activity into your life—leading to significant improvements in both body composition and mental clarity. Plus, Dr. Mike shares valuable tips on supporting cognitive function, the importance of recovery, and the concept of metabolic versus physiological flexibility.This episode is packed with actionable advice, so be sure to tune in!Let's talk about:IntroductionUpdate on Dr. Mike T. NelsonWalking and daily movementExercise energy expenditureCognitive functionPhysiologic flexibility vs. Metabolic flexibilityBody temperatureWhere to find Dr. MikeDr. Mike's Newslettter: HEREFollow me on Instagram for more information and education: @jeffhoehn_FREE 30 Min Strategy Call: HEREBody Recomp Masterclass: HERENutrition Periodization Masterclass: HEREHow You Can Work With Me?: HERECoaching application: HERE
In this podcast, Dr. Valentin Fuster discusses a study on the long-term outcomes of two surgical approaches—anatomic and physiologic repair—for congenitally corrected transposition of the great arteries. The findings suggest that while the complex anatomic repair offers better survival and reintervention-free outcomes, patient selection is crucial, with careful consideration needed, especially for asymptomatic infants or those with preoperative pulmonary artery banding.
Send us a textAnnouncement: Between now and year-end, we will be releasing a 50/50 mixture of new episodes interspersed with old-favorites, due to the sudden loss of Cynthia's husband in November. We have a new episode coming next week, and will be back to our usual production schedule by New Year's. If you'd like to donate a gift to the GoFundMe that was set up for Cynthia and her family, you may do so here. Thank you to everyone for your beautiful messages, gifts and prayers.Please keep an eye out for new content and an expanded Down to Birth platform on Patreon, including a new Community feature where listeners can post questions for us and each other. To join and gain instant access to our entire library of video content, go to our Patreon and sign up.Onto the show:In this episode, we have Barbara Harper on the podcast with us. Barbara is a midwife, author, and the founder of WaterBirth International, which she founded exactly 40 years ago. She is a world-expert in birthing and to this day travels the globe educating obstetricians, nurses and midwives on physiologic birth.Few mothers are given the opportunity to birth their placentas in the water, but is it really necessary to move women post-birth into a bed to complete the third stage (placental birth) of labor? In order to explain whether this is the right choice for any mother and baby, Barbara walks us through the most common causes of postpartum hemorrhage, how to prevent it, and the critical understanding of newborn transitional physiology: what she says is literally the most important moment in any human being's life.Is fundal massage necessary? When is the optimal time to cut the cord? What is the case for keeping the cord attached until the placenta is fully birthed? Is manual extraction of the placenta ever justified? These are some of the questions we answer in today's episode with Barbara.Barbara HarperWaterbirth International#100 | The Benefits of Water Birth: Interview With Barbara Harper of Waterbirth International#122 | Provider Green Lights: Interview with Barbara Harper on Holistic, Respectful & Supportive Birth Providers**********Our sponsors:Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Our favorite nutritional products for before, during, and after pregnancy.Use promo code: DOWNTOBIRTH for all sponsors.Support Cynthia's family here: https://www.gofundme.com/f/support-cynthia-overgards-family-after-tragic-loss Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.
In this episode of Happy Hour with Bundle Birth Nurses, Sarah Lavonne dives into the journey behind the creation of the Physiologic Birth Class. From working in a highly medicalized L&D unit to later experiencing a contrasting approach in a more affluent hospital, Sarah's nursing career shaped her vision for promoting physiologic birth. Driven by a desire to empower nurses, she designed this class to equip them with the knowledge and hands-on skills essential for supporting physiologic labor and birth. Thousands of nurses have since been trained and seen the impact on their practice while enhancing birth outcomes, decreasing cesarean rates, reducing trauma, and reshaping the culture of obstetric care. Sarah underscores the power of a nurse's deep understanding of birth physiology to provide truly patient-centered care. Helpful Links:Sign up for our most popular Physiologic Birth ClassMotion takes all the concepts taught in class and practically applies them to your practiceWe train hospitals! Drop your manager's info hereSign up for our monthly newsletter for news & free educationCheck out our physical products that you can use to apply to your physiologic birth practice
On this episode of Marni on The Move' series, Road To The Race: NYC Marathon 2024, Hosts Marnii Salup and Dave Mendelsohn Chat with Physiologist, Sydney Brackett of NYC Performance Lab in NYC. Syncing up about key physiologic tests you can do to level up your performance and dial up your fitness VO2 Max, Lactate Threshold, BMR and 3D Body Composition Analysis and more. Chapters 0:00 Intro 3:13 Understanding V02 Max Testing 6:05 The Imp Of Regular Testing For Athletes 8:53 Comprehensive Testing Service at NYC Performance Lab 11:49 The Role of Grip Strength in Longevity 15:08 Movement Analysis and Injury Prevention 18:02 Lactate Threshold Testing Explained 21:01 The Benefits of Data Driven Training 23:49 Recommended Tests For Athletes 26:57 Conclusion and Final Thoughts
Join me, Dr. Mike T. Nelson, on this episode of the Flex Diet Podcast as I introduce the Physiologic Flexibility Certification, a comprehensive course designed to enhance recovery and resilience. I summarize the 4 pillars of the course: temperature regulation, pH balance, energy sources and breathing. I also discuss the importance of integrating these systems to improve performance and resilience and address common misconceptions. The course is available from October 14th to October 21st, 2024. Tune in for insights into advanced aspects of nutrition, exercise, and recovery and how these can be applied to improve stress management and overall health.Sponsors:Tecton Life Ketone drink! https://tectonlife.com/ DRMIKE to save 20%Dr. Mike's Fitness Insider Newsletter: Sign up for free at https://miketnelson.com/.Episode Chapters:00:23 Physiologic Flexibility Certification Announcement01:08 Course Design and Overlapping Systems03:54 Four Pillars of Physiologic Flexibility05:18 Importance of Systems in Physiology08:20 Practical Applications and Examples13:09 Course Details and ConclusionGet In Touch:Instagram: https://www.instagram.com/drmiketnelson/YouTube: https://www.youtube.com/channel/UCn1aTbQqHglfNrENPm0GTpgEmail: https://miketnelson.com/contact-us/
In my experience hospital staff tend to be more supporting of a natural, hands off birth in the first stage of labor. They may still push for pitocin or cervical checks, but they still tend to leave you to labor on your own. And all that changes once a mom hits transition or starts to feel pushy, then even the most hans off birth may turn intervention heavy. You'll learn: What it means to support physiology and how walking into the hospital disrupts natural labor. The stages of labor and the difference between interventions from beginning to end. The three things you must know to support physiology at any stage or birth. ---- Join the unmedicated girlies and get informed with Unmedicated Academy
Let's get informed on postpartum hemorrhage, so you can make the best decision in the third stage of your birth. Bleeding is a completely normal part of the birth process, but how much is too much?? Hospital providers are terrified of PPH and are treating every single woman preventatively, even when she just had a physiologic birth and there is no reason to assume this stage of birth needs help as well. In this episode I discuss: The current definition of PPH versus the older definition that labels a normal amount of blood loss as concerning. How PPH is assessed and what can cause a hemorrhage in postpartum. If you birth in the hospital, you will have PPH actively managed. Know the difference between active vs expectant management. All of your options and how to avoid PPH ---- Start the 5 Day Empowerment Challenge Get informed on all the stages of hospital birth (and how to support physiology instead) inside Unmedicated Academy
This fascinating interview is with Dr. Eva Selhub who worked at Harvard with Herb Benson developing and understanding about the mind body connection to health. Dr. Selhub is an internationally recognized resiliency expert who has worked as a physician, author, executive coach, keynote speaker, and spiritual advisor. She has written many books, including Burnout for Dummies, Resilience for Dummies, Your Health Destiny, The Stress Management Handbook, The Love Response, and co-authored Your Brain on Nature. Life is filled with opportunities to practice new techniques for resilience, and many in the medical field have had ample chances to refine their skills in this area from personal challenges. This lived experience with investigations into problem-focused solutions is then commonly shared through science-based pursuits and practices. These mixed techniques increase what we know as personal or societal health through medicine. We all benefit from a more mentally and physically flourishing self and society. Dr. Eva Selhub, M.D. has fostered this idea throughout her career, culminating in a resilience strategy for modern times. Learn more about your ad choices. Visit megaphone.fm/adchoices
Rémi Coudroy, PhD, joins journal CHEST Podcast Moderator Alice Gallo De Moraes, MD, to discuss the results of a study into the physiologic effects of reconnection to the ventilator for 1 hour following a successful spontaneous breathing trial.
How is each release of the TAR contributing to the final tension on the anterior and posterior fascia? Join Drs. Michael Rosen, Benjamin T. Miller, Sara Maskal, and Ryan C. Ellis as they discuss their group's recent cohort study of tensiometry in 100 TARs. Hosts: - Michael Rosen, Cleveland Clinic - Benjamin T. Miller, Cleveland Clinic - Sara Maskal, Cleveland Clinic - Ryan C. Ellis, Cleveland Clinic, @ryanellismd Learning objectives: - Review the steps of a TAR - Understand the changes in tension on the anterior and posterior fascia with each step of the TAR - Think about the application this data has to similar operations References: Miller BT, Ellis RC, Petro CC, Krpata DM, Prabhu AS, Beffa LRA, Huang LC, Tu C, Rosen MJ. Quantitative Tension on the Abdominal Wall in Posterior Components Separation With Transversus Abdominis Release. JAMA Surg. 2023 Dec 1;158(12):1321-1326. doi: 10.1001/jamasurg.2023.4847. PMID: 37792324; PMCID: PMC10551814. https://pubmed.ncbi.nlm.nih.gov/37792324/ Miller BT, Ellis RC, Walsh RM, Joyce D, Simon R, Almassi N, Lee B, DeBernardo R, Steele S, Haywood S, Beffa L, Tu C, Rosen MJ. Physiologic tension of the abdominal wall. Surg Endosc. 2023 Dec;37(12):9347-9350. doi: 10.1007/s00464-023-10346-w. Epub 2023 Aug 28. PMID: 37640951. https://pubmed.ncbi.nlm.nih.gov/37640951/ Ramirez OM, Ruas E, Dellon AL. "Components separation" method for closure of abdominal-wall defects: an anatomic and clinical study. Plast Reconstr Surg. 1990 Sep;86(3):519-26. doi: 10.1097/00006534-199009000-00023. PMID: 2143588. https://pubmed.ncbi.nlm.nih.gov/2143588/ Hope WW, Williams ZF, Rawles JW 3rd, Hooks WB 3rd, Clancy TV, Eckhauser FE. Rationale and Technique for Measuring Abdominal Wall Tension in Hernia Repair. Am Surg. 2018 Sep 1;84(9):1446-1449. PMID: 30268173. https://pubmed.ncbi.nlm.nih.gov/30268173/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
The best way to avoid unnecessary interventions in labor is to optimize the conditions for physiologic birth to progress. How do we do that? In this episode, we are covering the 5 key practices that have been proven by research to support your body's natural blueprint for birth and reduce the risk of unnecessary interventions.Don't forget to check out the blog postResources mentioned:>> Clear Your Birth Fears Guide>> A Path to A Powerful Birth Class>> FREE Birth Plan Template***If these topics light you up, please rate and review the show on Apple Podcasts, Spotify, or wherever you're listening.After you review the show - snap a pic and upload it here - and I'll send you a little surprise as a thank you.Your feedback helps this podcast grow, and I am so grateful for your support!Disclaimer: The information provided in this podcast is for educational and informational purposes only. Consult with a qualified healthcare professional for personalized advice.
Ever wonder how to make your body bounce back and strengthen? That's where the power of physiologic flexibility comes in. Diving headfirst into the Physiologic Flexibility Certification, you'll get a front-row seat to the intricate ballet of CO2 and oxygen in your body and learn why context is, without a doubt, the ruler of fitness protocols, along with the other key markers of physiologic flexibility I cover in the certification.Enrollment opens today, March 18, 20204 and closes at midnight, March 25, 2024: https://miket.me/PFC-podSponsors:Enroll in the Physiological Flexibility Certification March 18 - March 25: https://miket.me/PFC-podSee discounts for all the products I use and recommend: https://miketnelson.com/faves/Get a Free Sample Pack of all LMNT Flavours with your first box at http://drinklmnt.com/mikenelson (automatically applied at checkout)Friends of Mike, create an account and get 25% off your first order of Tecton: https://blog.tectonlife.com/ambassador/dr-mike-t-nelson/Episode Chapters:(0:00:00) - Physiologic Flexibility Certification and Core Concepts(0:15:36) - Physiologic Flexibility Certification OverviewGet In Touch:Instagram: https://www.instagram.com/drmiketnelson/YouTube: https://www.youtube.com/channel/UCn1aTbQqHglfNrENPm0GTpgEmail: https://miketnelson.com/contact-us/
Join me, Dr. Mike T Nelson, as I embark on a journey through the heart of one of the most extreme environments on Earth with the awe-inspiring Akshay Nanavati, who's gearing up for a solo ski crossing of Antarctica. Together with performance nutrition experts Mike Chesney and UJ from Tecton, we unravel the intricate tapestry of mental and physical preparation required for such an endeavor. Akshay shares his riveting story of overcoming PTSD and transforming into an ultra-runner and explorer, all while we dissect the importance of ketones in fueling such monumental feats of endurance.Episode Chapters:(0:00:01) - Expedition Preparation With Ketones(0:11:16) - Antarctica Expedition and Key Tones(0:19:26) - Preparing for Solo Antarctica Expedition(0:27:58) - Benefits of Ketones for Endurance Expeditions(0:41:00) - Navigating the Pain Cave(0:52:34) - Monitoring and Improving Performance in Endurance(1:01:35) - Importance of Sleep and Expedition PreparationSponsors:See discounts for all the products I use and recommend: https://miketnelson.com/faves/Get a Free Sample Pack of all LMNT Flavours with your first box at http://drinklmnt.com/mikenelson (automatically applied at checkout)Friends of Mike, create an account and get 25% off your first order of Tecton: https://blog.tectonlife.com/ambassador/dr-mike-t-nelson/Phys Flex Cert opens March 18: http://www.physiologicflexibility.comAkshay: https://bliss.fearvana.com/greatsoulcrossing?r_done=1Episodes You Might Enjoy:Episode 167: The Physiologic and Psychologic Benefit of Doing Hard Things: Akshay Nanavati of Fearvana with Dr Mike T Nelson: https://miketnelson.com/the-physiologic-and-psychologic-benefit-of-doing-hard-things-akshay-nanvati-of-fearvana/Episode 226: A Deep Dive into Ketones, Astaxanthin, and Cognitive Enhancement with Dr. Hunter Waldman: https://miketnelson.com/deep-dive-into-ketones-astaxanthin-and-cognitive-enhancement-dr-hunter-waldman/Flex Diet Podcast: Dr. Dom D'Agostino on Red Light, Ketones, Fasting, Zapping Monkeys and More: https://miketnelson.com/dr-dom-dagostino-on-red-light-ketones-and-more/Get In Touch:Instagram: https://www.instagram.com/drmiketnelson/YouTube: https://www.youtube.com/channel/UCn1aTbQqHglfNrENPm0GTpgEmail: https://miketnelson.com/contact-us/
In today's episode, Cynthia and Trisha break down some of the current guidelines published by ACOG (the American College of Obstetricians & Gynecologists). You'll see many of these guidelines favor physiological birth and stand for minimal medical intervention in exactly the ways we recommend, which makes it all the more perplexing why so many of today's obstetricians don't follow along. By understanding ACOG's position on common concerns in pregnancy and birth, you can feel more empowered to advocate for what you know is best for you and your baby. Did you know that ACOG clearly and strongly states that the use of medical coercion is harmful and should never be practiced or that delivery of a baby is not warranted for suspected fetal macrosomia (big baby)? Or that ACOG knows that routine amniotomy (breaking the bag of water) is not necessary and suggests its use does not improve outcomes? Furthermore, ACOG states that ultrasound performed in late pregnancy is associated with an increase in cesarean section, with no evidence of neonatal benefit (yet how many OBs recommend third-trimester ultrasound)? Tune in to hear what this revered medical authority has to say, and stand tall in defense of your physiological birth plan. You'll see ACOG is on your side more than you might have believed, particularly in light of how today's American obstetricians tend to practice.**********Down to Birth is sponsored by:Needed -- Optimal nutritional products to nourish yourself before, during, and after pregnancyDrinkLMNT -- Purchase LMNT with this link today and receive a free sample kit.Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort. Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.
Hosts:Pradip Kamat, Children's Healthcare of Atlanta/Emory University School of MedicineRahul Damania, Cleveland Clinic Children's HospitalCase Introduction:6-year-old patient admitted to PICU with severe pneumonia complicated by pediatric Acute Respiratory Distress Syndrome (pARDS).Presented with respiratory distress, hypoxemia, and significant respiratory acidosis.Required intubation and mechanical ventilation.Despite initial interventions, condition remained precarious with persistent hypercapnia.Physiology Concept: Dead SpaceDefined as the volume of air that does not participate in gas exchange.Consists of anatomic dead space (large airways) and physiologic dead space (alveoli).Physiologic dead space reflects ventilation-perfusion mismatch.Pathological Dead Space:Occurs due to conditions disrupting pulmonary blood flow or ventilation.Common in conditions like pulmonary embolism, severe pneumonia, or ARDS.Clinical Implications:Increased dead space fraction (DSF) in PARDS is a prognostic factor linked to severity and mortality.Elevated DSF indicates worse lung injury and inefficient gas exchange.DSF can be calculated using the formula: DSF = (PaCO2 – PetCO2) / PaCO2.Practical Management:Optimize Mechanical VentilationEnhance PerfusionConsider Positioning (e.g., prone positioning)Summary of Physiology Concepts:Bohr equation for physiologic dead space.Importance of lung-protective ventilation strategies.Monitoring and trending dead space fraction.Strategies to improve airway patency and mucociliary clearance.Connect with us!PICU Doc on Call provides concise explanations of critical concepts in pediatric intensive care.Feedback, subscriptions, and reviews are encouraged.Visit picudoconcall.org for episodes and Doc on Call infographics.
Many unmedicated birth moms report having orgasmic birth, but not all moms share the same sentiment. Physiologic birth can be both painful AND orgasmic but there are several reasons why you may have had an unmedicated birth without that orgasm at the end. In this episode I discuss: -How the definition of natural birth has become a lie -The differences and similarities between natural, physiologic, undisturbed, and unmedicated birth -What an orgasmic birth feels like -How orgasms and birth are similar -What to do to support and encourage an orgasmic birth Enter the Season 3 Giveaway and win a box of Frownies 1. Leave a rating and review of the podcast OR share about the podcast on social media and tag me @unapolgoeticallyunmedicated 2. Follow @Frownies, @UnapolgoeticallyUnmedicated on IG 3. Comment on the giveaway post your thoughts on the episode 4. Tag friends in separate comments for extra entries Want to order Frownies? use the code LIZZIE for a discount Next steps... Have questions? Birth Options Workshop: Get clarity on your next step, whether that is choosing a provider, deciding on a birth place or where to start with birth education. RSVP now. Ready to start your birth prep? Birth Prep Class: This 30 minute class will teach you what you can do now to help prepare your mind and body for an unmedicated birth. It's FREE ️ Want to work with me? Unmedicated Academy: The signature program for moms who want to be the boss of their unmedicated birth and be educated, informed and empowered. We will chat each week and you'll be blown away by how much support is inside. Join the empowered mom club Submit a question or testimonial for the show: Leave me a voice message
Women everywhere are talking about the Mrs World Pageant. This is the most attention this pageant has received in years all thanks to Ballerina Farms and her 8 Million followers. But is competing in a pageant at 12 days postpartum really truly empowering? In this episode I discuss: The empowering vs irresponsible debate on glamorizing the early postpartum days. How the homestead community feels deceived by Ballerina Farms and how all Instagram homesteaders are also boss babes. Mom shaming does effect those who are confident and secure in their decisions and know they are doing their best. What is normal? Physiologies normal is different than American's normal. Mentioned on the show: Farm House on Boone - No Knead Bread Farm House on Boone - Birth Video Ballerina Farms - the photo Start the EMPOWERED MOM CHALLENGE, 5 days of episodes and resources for you to take control of your birth now. xo, Lizzie
Additional content and educational resources at ICUedu.org
On July 30, 2023 we released an episode describing the hypertensive “rule of 55” otherwise known as the physiologic approach to hypertension management. The rule of 55 breaks down hypertension into either hyperdynamic/high cardiac output in origin, or systemic vascular resistance in origin. There is plenty of evidence to support this management approach. Late this evening, on November 30, 2023, Obstetrics and Gynecology released a new research letter ahead of print, providing more insights on the physiologic approach to hypertension management. In this episode, we will briefly cover this brand new publication, released just 2 hours ago, and provide clinical application perspectives.
Priya Bhaskar, M.D. is an Associate Professor of Pediatrics at UT Southwestern and an attending in the Cardiac ICU at Children's Medical Center Dallas. She completed her pediatric residency at Inova Children's Hospital in Virginia and critical care fellowship at UTSW prior to completing a 1 year CICU fellowship at Laurie Children's in Chicago. Prior to her current position here at UTSW she was a cardiac intensivist at Arkansas Children's Hospital. Her professional interests include extracorporeal support and education. She serves on the ECMO team as a core staff physician, and she has co-authored a review on this topic that we will use to guide our conversation. Learning Objectives:By the end of this podcast, listeners should be able to discuss:The general indications for VA-ECMO in pediatrics.The anatomic and physiologic rationale supporting various VA-ECMO cannulation strategies.Physiologic targets to ensure adequate oxygen delivery for patients on VA-ECMO.Hemodynamic complications of VA-ECMO such as left atrial hypertension and harlequin syndrome and general strategies in their management. Liberation strategies for VA-ECMO either to decannulation or conversion to ventricular assist device.How to support PedsCrit:Please rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.References:Bhaskar, P., Davila, S., Hoskote, A., & Thiagarajan, R. (2021). Use of ECMO for Cardiogenic Shock in Pediatric Population. Journal of clinical medicine, 10(8), 1573. https://doi.org/10.3390/jcm10081573Brown G, Moynihan KM, Deatrick KB, Hoskote A, Sandhu HS, Aganga D, Deshpande SR, Menon AP, Rozen T, Raman L, Alexander PMA. Extracorporeal Life Support Organization (ELSO): Guidelines for Pediatric Cardiac Failure. ASAIO J. 2021 May 1;67(5):463-475. doi: 10.1097/MAT.0000000000001431. Erratum in: ASAIO J. 2022 Jul 1;68(7):e129. PMID: 33788796.Xie A, Forrest P, Loforte A. Left ventricular decompression in veno-arterial extracorporeal membrane oxygenation. Ann Cardiothorac Surg. 2019 Jan;8(1):9-18. doi: 10.21037/acs.2018.11.07. PMID: 30854308; PMCID: PMC6379183. https://www.elso.org/ecmo-resources/elso-ecmo-guidelines.aspx https://www.congenitalheartacademy.com/home Support the show
Nick and Fei are on their respective parental leaves (not planned, but we're having babies at the same time!) In the meantime, we hope you enjoy some re-runs of our most loved episodes. Check out the website for the Rosh Review question of the week. Twitter: @creogsovercoff1 Instagram: @creogsovercoffee Facebook: www.facebook.com/creogsovercoffee Website: www.creogsovercoffee.com Patreon: www.patreon.com/creogsovercoffee You can find the OBG Project at: www.obgproject.com
Proshad Efune, MD is an Assistant Professor at UT Southwestern. She completed both her pediatric critical care and pediatric anesthesia fellowships here at UT, and she now practices in both the operating room and the pediatric ICU here at Children's Medical Center in Dallas. She is interested in pre-operative management of critically ill children.Learning Objectives After listening to this episode, learners should be able to:Identify clinical scenarios at high risk for cardiovascular collapse surrounding endotracheal intubation.Discuss a clinical approach to minimize the risk of peri-intubation cardiovascular collapse in the following high-risk scenarios:Severe hypoxemiaSevere metabolic acidosisHypotension/septic shockObstructive lung diseaseHemorrhagic shockCardiac tamponadeHow to support PedsCritPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.To help improve the podcast, please complete our Listener Feedback Survey (< 5 minutes)!Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.Support the showSupport the show
Nick and Fei are on their respective parental leaves (not planned, but we're having babies at the same time!) In the meantime, we hope you enjoy some re-runs of our most loved episodes. Check out the website for the Rosh Review question of the week. Twitter: @creogsovercoff1 Instagram: @creogsovercoffee Facebook: www.facebook.com/creogsovercoffee Website: www.creogsovercoffee.com Patreon: www.patreon.com/creogsovercoffee You can find the OBG Project at: www.obgproject.com
ReferencesJC mentioned that the diagnostic accuracy of 24 hour urine collection increases with more collections! Metabolic evaluation of patients with recurrent idiopathic calcium nephrolithiasisWe didn't refer to a particular study on sodium intake and the 24 hour urine but this meta-analysis Comparison of 24‐hour urine and 24‐hour diet recall for estimating dietary sodium intake in populations: A systematic review and meta‐analysis - PMC 24‐hour diet recall underestimated population mean sodium intake.Anna looking up ace i and urinary sodium Effects of ACE inhibition on proximal tubule sodium transport | American Journal of Physiology-Renal PhysiologyThe original FENa paper by Espinel: The FeNa Test: Use in the Differential Diagnosis of Acute Renal Failure | JAMA | JAMA NetworkSchreir's replication and expansion of Espinel's data: Urinary diagnostic indices in acute renal failure: a prospective studyHere's a report from our own JC on the Diagnostic Utility of Serial Microscopic Examination of the Urinary Sediment in Acute Kidney Injury | American Society of NephrologyJC shared his journey regarding FENa and refers to his recent paper Concomitant Identification of Muddy Brown Granular Casts and Low Fractional Excretion of Urinary Sodium in AKIAnd Melanie's accompanying editorial Mind the Cast: FENa versus Microscopy in AKI : Kidney360 (with a great image from Samir Parikh)JC referenced this study from Schrier on FENa with a larger series: Urinary diagnostic indices in acute renal failure: a prospective studyNonoliguric Acute Renal Failure Associated with a Low Fractional Excretion of Sodium | Annals of Internal MedicineUrine sodium concentration to predict fluid responsiveness in oliguric ICU patients: a prospective multicenter observational study | Critical Care | Full TextA classic favorite: Acute renal success. The unexpected logic of oliguria in acute renal failure Marathon runners had granular casts in their urine without renal failure. Kidney Injury and Repair Biomarkers in Marathon RunnersCute piece from Rick Sterns on urine electrolytes! Managing electrolyte disorders: order a basic urine metabolic panelThe Urine Anion Gap: Common Misconceptions | American Society of NephrologyThe urine anion gap in context CJASNExcellent review from Halperin on urine chemistries (including some consideration of the TTKG): Use of Urine Electrolytes and Urine Osmolality in the Clinical Diagnosis of Fluid, Electrolytes, and Acid-Base Disorders - Kidney International ReportsRenal tubular acidosis (RTA): Recognize The Ammonium defect and pHorget the urine pH | SpringerLinkOutlineChapter 13- New part: Part 3, Physiologic approach to acid-base and electrolyte disorders - Do you remember the previous two parts? - Renal physiology - Regulation of water and electrolyte balance- Chapter 13: Meaning and application of urine chemistries - Measurement of urinary electrolyte concentrations, osmolality and pH helps diagnose some conditions - There are no fixed normal values - Kidney varies rate of excretion to match intake and endogenous production - Example: urine Na of 125/day can be normal if patient euvolemic on a normal diet, and wildly inappropriate in a patient who is volume depleted. - Urine chemistries are: - Useful - Simple - Widely available - Usually a random sample is adequate - 24-hour samples give additional context - Gives example of urinary potassium, with extra renal loss of K, urine K should be < 25, but if the patient has concurrent volume deficiency and urine output is only 500 mL, then urine K concentration can appropriately be as high as 40 mEq/L - Table 13-1 - Seems incomplete, see my notes on page 406 - What is Gravity ARF?- Sodium Excretion - Kidney varies Na to maintain effective circulating volume (I'd say volume homeostasis) - Urine Na affected by RAAS and ANP - Na concentration can be used to determine volume status - Urine Na < 20 is hypovolemia - Says it is especially helpful in determining the etiology of hyponatremia - Calls out SIADH and volume depletion - Used 40 mEq/L for SIADH - Also useful in AKI - Where differential is pre-renal vs ATN - In addition to urine Na (and FENa) look at urine osmolality - Again uses 40 mEq/l - Mentions FENa and urine osmolality - Urine Na can estimate dietary sodium intake - Suggests doing this during treatment of hypertension to assure dietary compliance - 24 hour urine Na is accurate with diuretics as long as the dose is stable and the drugs are chronic - Diuretics increase Na resorption in other segments of the tubule that are not affected by the diuretic - Points to increased AT2 induced proximal Na resorption and aldosterone induced DCT resoprtion - In HTN shoot for less than 100 mEq/Day - Urine Na useful in stones - Urine uric acid and urine Ca can cause stones and their handling is dependent on sodium - Low sodium diet can mask elevated excretion of these stone forming metabolites - 24-hour Na > 75 and should be enough sodium to avoid this pitfall - Pitfalls - Low urine sodium in bilateral renal artery stenosis or acute GN - High urine sodium with diuretics, aldo deficiency, advanced CKD - Altered water handling can also disrupt this - DI with 10 liters of urine and urine sodium excretion of 100 mEq is 10 mEq/L but in this case there is no volume deficiency - Opposite also important, a lot of water resorption can mask volume deficiency by jacking up the urine sodium - Advises you to use the FENa - THE FENA - < 1% dry - >2-3% ATN - It will fail with chronic effective volume depletion - Heart failure, cirrhosis, and burns - Suggests that tubular function will be preserved in those situations - Also with contrast, rhabdo, pigment nephropathy - Limitations - Dependent on the amount of Na filtered - Goes through the math of a normal person with GFR of 125/min and Na of 150 has filtered sodium of 27,000/day so if they eat 125-250 mEq their FENa will be 600-800 - Urine osm < plasma osm in face of hypernatremia indicates renal water loss due to lack of or resistance to ADH - In ATN urine OSM < 400 - In pre-renal disease it could be over 500 - Specific but not sensitive due to people with CKD who are unable to concentrate urine- Specific gravity - Plasma is 8-10% igher than plasma so specific gravity is 1.008 to 1.010 - Every 30-35 mOsm/L raises urine Osm of 0.001 - so 1.010 is 300-350 mOsm/L H2O - Glucose raises urine specific gravity more than osmolality - Same with contrast - Carbenicillin- pH - Normally varies with systemic acid-base status - PH should fall before 5.3 (usually below 5.0) with systemic metabolic acidosis - Above 5.3 in adults and 5.6 in children indicate RTA - PH goal 6.0-6.5 - Separate individual RTAs through FR of HCO3 at various serum HCO3 levels - Also can monitor urine pH to look for success in treating metabolic alkalosis - Look for pH > 7 - In treatment of uric acid stone disease - Want to shift eq: H + urate – uric acid to the left because urate is more soluble - PH goal 6.0-6.5
In this episode of the Flex Diet Podcast, I discuss physiologic flexibility and the Physiologic Flexibility Certification, which is the Level 2 to the Flex Diet certification. The main focus is on understanding the four pillars of homeostatic regulation in the body: body temperature, blood pH, the fuel system (carbohydrates and fats), and air (oxygen and carbon dioxide).This podcast is brought to you by the Physiologic Flexibility Certification course. In the course, which opens again today, September 18, to Monday, September 25, 2023, I talk about the body's homeostatic regulators and how you can train them. The benefit is enhanced recovery and greater robustness. We cover breathing techniques, CWI, sauna, HIIT, diet, and more.Episode notes:[0:30] The Phys Flex Cert[2:21] 4 Pillars of Homeostatic Regulation[7:55] Metabolic Flexibility[12:37] Temperature Regulation[17:58] pH Regulation[19:47] Air (Oxygen and CO2) Regulation
The NP is seeing a 35 year-old well woman for a health promotion and physical exam woman. She has not complaints, is a nonsmoker, a light social drinker with 1-2 glasses of wine per month, and exercises about 30 mins 5 days a week. Her BMI is 22 and vital signs are unremarkable with BP= 110/70. Which of the following is an anticipated finding on her funduscopic exam?A. Retinal arteries wider than veinsB. Arteriovenous nickingC. Physiologic cup-to-optic disc ratio of less than 0.5 D. Blurred optic disc margins---YouTube: https://www.youtube.com/watch?v=Vmb7IXP68m4&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=33Visit fhea.com to learn more!
Dr. Mike T Nelson is an exercise physiologist, researcher, speaker, author, personal trainer, and coach. In the world of sports optimization, his approach to coaching world-class athletes is innovative and science-driven. Dr. Mike's years of research and coaching experience, paired with an open mind to new ideas, have garnered his clients amazing results. A teacher at heart, he also offers several key training opportunities and certifications to help athletes, coaches, and healthcare professionals to fully understand the physiology that drives meaningful changes. In today's episode, Dr. Mike T Nelson outlines the basics of physiologic flexibility and ways to train our metabolism to become more resilient and anti-fragile. Today on The Lab Report: 3:00 Mike T Nelson is back and so is the Flex Diet certification 7:00 Diet Wars and Keto 9:45 Physiologic flexibility and homeostatic regulators 14:00 Regulating respiration and pH 20:15 Controlling temperature, metabolism, and mental fortitude for resiliency 27:15 Advanced recovery methods and wearable devices 38:15 Volume vs. intensity 40:20 The Fireball Additional Resources: miketnelson.com Physiologic Flexibility Certification Course Subscribe, Rate, & Review The Lab Report Thanks for tuning in to this week's episode of The Lab Report, presented by Genova Diagnostics, with your hosts Michael Chapman and Patti Devers. If you enjoyed this episode, please hit the subscribe button and give us a rating or leave a review. Don't forget to visit our website, like us on Facebook, follow us on Twitter, Instagram, and LinkedIn. Email Patti and Michael with your most interesting and pressing questions on functional medicine: podcast@gdx.net. And, be sure to share your favorite Lab Report episodes with your friends and colleagues on social media to help others learn more about Genova and all things related to functional medicine and specialty lab testing. To find a qualified healthcare provider to connect you with Genova testing, or to access select products directly yourself, visit Genova Connect. Disclaimer: The content and information shared in The Lab Report is for educational purposes only and should not be taken as medical advice. The views and opinions expressed in The Lab Report represent the opinions and views of Michael Chapman and Patti Devers and their guests. See omnystudio.com/listener for privacy information.
Research shows it can take 5-7 years to balance after having a baby, in this episode Katie, a functional practitioner who specializes in prenatal and postpartum health, shares about nutrient depletion, nervous system changes, digestion changes, hormonal changes, and how this can affect your physical and mental health in postpartum. Grab the free resources & meet the Mom 2 Mom Special speakers: fiercelizzie.com/podcast/mom2mom Find Katie on IG @katengalvin Liked the episode? Share and tag us both! @katengalvin & @unapologeticallyunmedicated And if you have a minute, rate and review the show. Thanks for listening in!
[5:27] The biggest mistake when using temperature interventions[8:35][11:11] Tradeoffs in training[17:20] Training hot or cold first[21:56] How to get started[23:52] When to consider contrast therapy
Active management of the third stage of labor refers to interventions that are taken to speed up the delivery of the placenta and reduce the risk of postpartum hemorrhage. This typically involves the administration of an oxytocic drug like Pitocin or Syntocinon to increase the contraction of the uterus and the use of techniques like fundal pressure and controlled cord traction to guide the placenta out of the uterus. Expectant management, on the other hand, is a more hands-off approach in which the placenta is left to detach and be delivered naturally, without the use of drugs, manual manipulations or interventions. This approach is usually used when there are no risk factors for postpartum hemorrhage and the mother and baby are both in good condition.In this episode, we have Barbara Harper on the podcast with us. Barbara is a midwife, author, and the founder of WaterBirth International, which she founded exactly 40 years ago. She is a world-expert in birthing and to this day travels the globe educating obstetricians, nurses and midwives on physiologic birth.Few mothers are given the opportunity to birth their placentas in the water, but is it really necessary to move women post-birth into a bed to complete the third stage (placental birth) of labor? In order to explain whether this is the right choice for any mother and baby, Barbara walks us through the most common causes of postpartum hemorrhage, how to prevent it, and the critical understanding of newborn transitional physiology: what she says is literally the most important moment in any human being's life. In this episode we also answer questions like: Is fundal massage necessary? When is the optimal time to cut the cord? What is the case for keeping the cord attached until the placenta is fully birthed? Is manual extraction of the placenta ever justified?This episode is incredibly powerful and loaded with essential birth knowledge. It is a must-listen for every woman who wants to give her baby the best possible start to life. If your provider doesn't support your plans for a hands-off third stage of labor, please send them this episode.Barbara HarperWaterbirth International#100 | The Benefits of Water Birth: Interview With Barbara Harper of Waterbirth International#122 | Provider Green Lights: Interview with Barbara Harper on Holistic, Respectful & Supportive Birth ProvidersConnect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.
Our modern disconnection from land and lineage mirrors the culturally normal- but biologically abnormal- separation between mother and baby, parents and children. The consequences of these intertwined attachment wounds are vast. But many of us are dreaming into a different way forward. Let us speak truthfully about what isn't working, divest from the systems that break our sacred bonds to the Earth and to one another, and heal into the wholeness that is our ancestral inheritance. Join me on my Costa Rica Forest Bathing Retreat in September. RESOURCES: Aimee's website The Stoned Chrysalis Aimee on Instagram Medicine Stories Patreon (podcast bonuses!) Take our fun Which Healing Herb is Your Spirit Medicine? quiz Reclaiming Childbirth as a Rite of Passage: Weaving Ancient Wisdom w/ Modern Knowledge by Rachel Reed Related Medicine Stories episodes- Episode 38 Healing Our Indigenous European Ancestors w/ Lyla June Episode 48 Matriarchy in Action & Ancestor-Assisted Birth w/ Emilee Saldaya Episode 51 Maternal Mammalian Ecstasy: The Ancient Hormonal Blueprint for Optimal Birth & Bonding w/ Sarah Buckley Episode 52 Decolonizing the Mind: You Belong to Your Ancestors w/ Tamira Cousett Episode 61 Revillaging: Maternal, Cultural, and Planetary Wellness are One w/ Rachelle Garcia Seliga Episode 75 Learning is Innate: Ancestral Childhood, Unschooling, and Healing w/ Akilah Richards Episode 76 Nature's Ancient Design: Exalting Life by Honoring the Physiologic Truths of Childbearing w/ Rachelle Garcia Seliga My website MythicMedicine.love Mythic Medicine on Instagram Instagram Medicine Stories Facebook group Facebook group Music by Mariee Siou (from her beautiful song Wild Eyes)
I'm kicking off the new year with a really important episode about physiologic birth. I was inspired to cover this topic by our guest from episode 168, CNM Gianna Fay. She wrote to me asking if I would be willing to cover it and my response was - sure… but how? It's not a topic that OB/GYNs are taught much if anything about. The term gets used a lot in the online space but it's not often defined. So I decided to roll up my sleeves and see what information I could find. I learned about it myself and I'm going to share that information with you today. In this Episode, You'll Learn About: -How normal physiologic birth is defined -Which factors disrupt physiologic childbirth -What are the benefits of normal physiologic birth -Whether any one position should be mandated or prescribed -What are the factors that influence physiologic birth -Why it's vital for your medical team to support your wishes -What makes it necessary to intervene --- Full website notes: drnicolerankins.com/episode190 Check out The Birth Preparation Course Register for the class How to Create a Birth Plan the Right Way Take a quick, fun labor pain quiz
CardioNerds Cofounder Dr. Amit Goyal is joined by Dr. Douglas Salguero (Internal medicine resident), Dr. Francisco Ujueta (Cardiology fellow), and Dr. Priscilla Wessly (Chief cardiology fellow) from the Columbia University Division of Cardiology at Mount Sinai Medical Center in Miami to discuss a rare case of isolated non-compaction cardiomyopathy. Expert commentary is provided by Dr. Christos Mihos (Director, Echocardiography Laboratory, Columbia University Division of Cardiology, Mount Sinai Medical Center). Audio editing by CardioNerds Academy Intern, Shivani Reddy. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Case Media - Non-Compaction Cardiomyopathy Episode Schematics & Teaching The etiology has been a constant debate since 1980. It has been debated among researchers and clinicians whether LVNC is a physiologic or a pathologic manifestation. Waning et al., classified 327 unrelated patients into 3 categories: 1) genetic, 2) probably genetic, or 3) sporadic, identifying the most common mutations: MYH7, MYBPC3 and TTN in the genetic LVNC patients, which mostly encode for sarcomere, Z-disc and nuclear-envelope proteins. This supports the hypothesis that the inherited phenotype can arise from a gene mutation possibly during embryogenesis, disrupting the physiologic compaction of normally developing myocardium, which progresses from the base to the apex of the cardiac tissue. It is estimated that genetic LVNC accounts approximately 18-44% of cases, with autosomal dominant transmission being the most common form of inheritance. Physiologic remodeling with prominent trabeculations may be noted in athletes and pregnant women, in comparison to pathologic remodeling which may be encountered in patients with cardiomyopathy (e.g. pressure or volume load). (1) There is no pathognomonic signs or symptoms in LVNC. LVNC patients may encounter various potential clinical characteristics. Presentations are myriad and include heart failure symptoms (HFrEF or HFpEF), ventricular tachycardia (VT/VF), atrial fibrillation, thromboembolism including cerebrovascular accident (CVA), and syncope. In a cohort of 95 probands with LVNC investigated in Europe, as many as 32.3% had an ICD/CRT-D implantation, with 11.8% experiencing a cardiovascular death and 18.2% having an appropriate ICD shock. (2) Imaging plays a key role in diagnosis for LVNC. The identification and diagnosis of LVNC is evaluated using 2D echocardiography. The initial proposed method by Chin et al., evaluated the size of the trabeculation in the center. (3) The most commonly used criteria, Jenni et al. (4), entail the following four finding: Two-layer structure, with a thin compacted layer and a thick non-compacted layer measure at end-systole at the parasternal short-axis view. LVNC is defined by a ratio of N/C > 2 Absence of co-existing cardiac structural abnormalities Prominent, excessive trabeculations and deep intra-trabecular recesses Recesses supplied by intraventricular blood on color doppler Cardiac MRI has increased the diagnostic accuracy in the diagnosis of LVNC. It has been suggested that a NC/C ratio of > 2.3 in diastole distinguished pathological non-compaction, with sensitivity of 86% and a specificity of 99%, respectively. Although studies have shown an increase specificity with cardiac MRI, caution is needed as it may overestimate the presence of LVNC. Late gadolinium enhancement which suggests myocardial fibrosis or scar has been shown to have some prognostic value in LVNC patients. (5) Management for LVNC is multifaceted. As above,LVNC has a variety of presentations and prevailing manifestations will differ among patients. Therefore, the diagnostic and management approach much be personalized for a given patient...
SHR # 2945:: Become Antifragile: Physiologic Flexibility - Dr. Mike T. Nelson, Ph.D - The concept of being antifragile eludes many people. Antifragile may seem like a play on words, but it's not. Antifragile harnesses damage for its hermetic effects and makes the being stronger and more durable than the un-theatend un-damaged being. There's a reason the time-tested saying "That which does not kill you makes you stronger". Learning to leverage the techniques that make one antifragile not only physically but from a nutritional standpoint is the scope of today's show. Brought to you by Mike T. Nelson - MikeTNelson.com - CARL RECOMMENDS: superhumanradio.net/carl-recommends - - View and download all shows at https://superhumanradio.net - Visit us on Instagram: @superhumanradio - Support SHR - https://superhumanradio.net/make-a-donation
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