Podcasts about PICC

Spencer Jones, Founder of XO Medtech and MedtechVendors.com, shares how frontline nursing experiences led him to patent vascular access innovations and ultimately take devices from idea to FDA clearance and product launch. Spencer walks through learning business fundamentals through accelerators, raising early funding, and building sales and distribution networks, then explains why launching a digital-first, AI-native ecosystem has enabled faster, leaner execution than traditional medtech pathways. Spencer also discusses leadership, clear communication, and why AI adoption is essential to accelerate and de-risk early-stage medtech.  Guest links: https://www.linkedin.com/in/medtech-innovation/ | www.xomedtech.com | https://medtechvendors.com/  Charity supported: Polaris Project Interested in being a guest on the show or have feedback to share? Email us at theleadingdifference@velentium.com.  PRODUCTION CREDITS Host & Editor: Lindsey Dinneen Producer: Velentium Medical   EPISODE TRANSCRIPT Episode 080 - Spencer Jones [00:00:00] Lindsey Dinneen: Hi, I'm Lindsey and I'm talking with MedTech industry leaders on how they change lives for a better world. [00:00:09] Diane Bouis: The inventions and technologies are fascinating and so are the people who work with them. [00:00:15] Frank Jaskulke: There was a period of time where I realized, fundamentally, my job was to go hang out with really smart people that are saving lives and then do work that would help them save more lives. [00:00:28] Diane Bouis: I got into the business to save lives and it is incredibly motivating to work with people who are in that same business, saving or improving lives. [00:00:38] Duane Mancini: What better industry than where I get to wake up every day and just save people's lives. [00:00:42] Lindsey Dinneen: These are extraordinary people doing extraordinary work, and this is The Leading Difference. Hello, and welcome back to another episode of The Leading Difference podcast. I'm your host Lindsey, and today I'm delighted to welcome to the show Spencer Jones. Spencer is the founder at XO Medtech and MedTechvendors.com. He is an RN, MedTech entrepreneur with 12 years of med device leadership. He's a two time med device CEO with 10 plus patents under his belt and has taken devices from idea to FDA clearance and product launch. Spencer has built sales and distribution networks, led product development teams, and raised over 10 million in VC and Angel Capital. Spencer founded XO MedTech in 2024 to create a digital first medtech ecosystem, deploy AI native tools for medtech operators through medtechvendors.com and cultivate the next generation of medtech innovators. All right, Spencer, welcome to the podcast. Thanks for being here. [00:01:43] Spencer Jones: Thank you for having me, Lindsey. I'm very, very excited to be here. Like it's, it's always more fun to be a guest than it is to host the pod, so absolutely thrilled to be a guest on the pod. Thank you for having me. [00:01:54] Lindsey Dinneen: Of course. Absolutely. Well, yeah, let's just, if you won't, don't mind just sharing a little bit about yourself, your background and what led you to medtech. [00:02:04] Spencer Jones: Yeah. Born and raised in Arkansas. I've lived, I traveled a ton and lived in Memphis and whatnot, but grew up in a healthcare household. Dad did anesthesia for, what was it, 36 years or something at the same place. So I thought I was gonna be a CRNA, like actually started pre-med. Took chemistry my freshman year while I was, you know, it was just, I got a C and I was like, maybe, maybe med school's not for me. But but anyways, did the nursing school thing, got out, started working, pretty quickly, knew if you've ever spent any amount of time in frontline healthcare, you just kind of get, it's like a barrage of things that suck. It's just, especially nursing, the devices you're using are commoditized. Like just the workflows are bad. You know, people, it's, healthcare is very broken. Every, it's no secret. Everybody says that. Everybody knows that. So anyways, I noticed pretty quickly that hey, like why isn't this better? Why can't this be like this? And, you know, kind of had that mindset. And before I could even go through like critical care enough to apply to a CRNA school, ended up patenting some devices in the vascular access space. Really leveraged accelerator programs and the entrepreneurial support organizations that were in my area, in my region to, I call it that get that dirt money, which is like the before the seed, you know, your pre kind of, your pre-seed /seed you know, before the pre-seed money. And, and also like the business training, right? Like I wasn't formally trained on business stuff like that. So did that. Did the venture capital hamster wheel a little bit, took a, you know, device through class two de novo clearance. Was doing ride-alongs training, sales reps, doing marketing stuff, you know, managing our ip, managing clinical you know, 300 patient RCT that we had to do in the middle of COVID, launched the product and then past couple years, I left, left that company in 2022. Products still on the market and they got, you know, clearance in, in Europe now and et cetera, et cetera. But just been working more in laparoscopic spine or laparoscopic surgery orthopedic spine and then doing some like consulting projects and, and things like that. And then yeah, XO Medtech and Medtech Vendors that's been. You know, for the past two years, like a big focus. And I know we're gonna talk more about that, but yeah. So it's just been, it's been a great journey. Medtech is one of my --I love it and hate it at the same time, but I wouldn't wanna be doing anything else, frankly. So. [00:04:17] Lindsey Dinneen: Awesome. That's a great intro. Okay. You were, I really, I enjoyed how you sort of went straight from okay, so, so "I, you know, started the career, started in the industry, and then I, I, you know, got a bunch of patents." What were the ideas for the patents? Where did those come from? If we could just go back, how did that, what was that inspiration like? [00:04:39] Spencer Jones: Yeah. So I was night shift, med-surg, big, pretty big hospital in Little Rock. It was like one of the, one of the bigger ones in Little Rock, St. Vincent's, which is like CHI, St. Vincent, et cetera. And like one of my patients --well the, the very first one was a dual lumen peripheral IV. A patient has a peripheral IV in, I need to get a blood draw. They're like, "Go stick his other arm." I'm like, "Why can't we get it out of his, you know, IV that's in his, that's in his forearm?" And, and they were like, "Well, you, you know, you don't want to contaminate, you know, the thing." And I was like, "Oh, okay. That kind of makes sense." And I was like, well, PICC lines have two lumens. So you know, I was like, why couldn't, you know, why couldn't we just have a second lumen on, you know? And I was like, do those exist? And they didn't really exist. There was kind of one that existed, but it was more of like a longer extended dwell peripheral and you know, you kind of needed ultrasound to place it. You didn't really place, you know, normal nurses on the floor weren't gonna place it. And so I kind of, that one was just sheer-- I experienced something that I was like, "Dude, you're kidding me. There's gotta be a better way to do this." You know what I mean? And you know, kind of similar approach in that one. We, you know, that was the very first one so I was like doing these drawings on note cards and then like meeting with a patent attorney and I was like, did that provisional filing and wrote the patent myself and the claims and all this stuff. And the guy thought I was like, just " Okay, yeah, I'll, I'll file the provisional for you, bro, whatever." Filed the provisional, you know, ended up like going to a different attorney 'cause that guy was kind of just not taking me seriously. And so, ended up going to a different person, filed a non-pro provisional, started raising all this money, and that original attorney reached out later, was like, "Oh, so glad, glad to see blah, blah, blah." I was like, "Yeah, yeah, whatever." But then the second one, I, which was Safe Break Vascular, had the, it's kind of similar. Patient was like, had patients pulling out their IVs, pulling out lines, you know, and it's a million things. It's, it's walkie talkie, so like Alzheimer's, dementia, memory care type stuff. You, it's TBIs, it's agitation, sundowners. It's, you're coming off medication, you're drowsy, you forget, you're hooked up. You need to go to the bathroom. You trip on it. The nurse trips on the tubing. There's like a million reasons how, you know. Where mechanical force can get applied to an IV line. And same thing, I was just like, man, like this, it, it feels holding on for dear life is like the wrong approach because skin is only so strong. You get skin tears. Adhesives, you only want them to be so, you know, so, so strong. And it just, you know, it, wrapping it up, then you can't assess the site, you can get infiltration. So it didn't feel like any of the options we had were great. That one, I started to do patent research literally on the floor at the hospital. Like that night. I was like, I, 'cause I knew enough then found someone that had patented it. Like same exact concept. It was a nurse. And design was bad. Like the design, it had springs in it and it was just like not manufacturable and not a good design, but there were like conceptually it was like spot on. And then there were some elements of it that I was like, this would be very useful to have if I was gonna like actually do this. So me and somebody I'd met, and in accelerator program, we bought the patent from 'em for 20 grand which was a steal of a deal. It was like 10K up front, 10K after 18 months. And yeah. And then we turned around and raised a, you know, million dollar seed round within like, within nine months after acquiring the patent, got into an accelerator, ZeroTo510, shout out to them. But acquired the patent in February. Got it, or March, got into ZeroTo510, April. Went there in May, closed our seed round of a million in December, so it was like a nine month, yeah, ordeal. [00:08:03] Lindsey Dinneen: Wow. That's okay. That's awesome. I love the story. I love the fact that it was from boots on the ground going, "Okay, I see this problem. There's gotta be a better solution." That's super cool. So. All right, so you have these patents, you're going and you're working with accelerators. Can you tell us a little bit about what that experience was like, especially since you mentioned, you know, you didn't necessarily have the business background, so there was, there was probably a bit of a learning curve to that whole, you know, how do you get your idea from your, your note card drawing to commercialization. So I'd just love to hear about your experience. [00:08:35] Spencer Jones: Yeah. The, so I did one accelerator before ZeroTo510. It, I basically did two within about a year, a year of each other. It was like back to back to back. But the first one I did, it was industry agnostic. So it was just a lot of like mentorship and lean canvas startup methodology kind of business practice stuff like accounting 101, you know, building financial forecasts and models and like all of that stuff. So I really learned a ton about kind of just non device specific stuff there. Obviously I was learning a ton about device stuff along the way, but then once I got to ZeroTo510, that's when things kind of like really, you know-- and I had, I had won, I won that first accelerator. It was like a competition, and so I had 150K. And I was like, "Oh wow. So maybe, maybe this is gonna be a career path," 'cause I was still working full-time as a nurse and then I got into the second one. ZeroTo510 was amazing. Allan Daisley was running it. James Bell was like the co-director, I think, and it was like bootcamp. It was like, you know, 8:00 AM to 5:00 PM. It was like sessions and mentor hours and office hours and " Alright, we're done with that. You guys work on this for an hour and a half, we're gonna come back and talk about like the finished product and you better have it done." You know what I mean? And it was every day. I lived up at this building. It was amazing sponge mode. You know, it was one of those environments where you're just like constantly soaking it in and learning and learning and like you can feel your brain expanding like every day. You know, you wake up excited. And that one was amazing. Met a ton of people that I still work with today. You know, met my co-founder at XO Medtech. Met him at that accelerator. But yeah, it was just, that one was amazing. I was like, life changing. Came back from that and I was like, "This is what I was meant to do." I felt like I you know, found my calling. And so, yeah, shout out to the people there that you know, we're a part of that. [00:10:20] Lindsey Dinneen: Love it. Excellent. So, okay, so you found your co-founder for XO Medtech, and this is great because I wanted to dive into that. So, so you've, you've now successfully taken like several products to market and of course you have a lot of other great industry experience. What was, how was it different starting XO Medtech and Medtech Vendors than perhaps other things that you'd done in the past? [00:10:47] Spencer Jones: Yeah. You know, I'm gonna say it was way easier just to be honest. I mean, I mean, you know, I think we, we were doing a lot. We started building XO Medtech in 2022, 2023, and at that time a lot of it was like, it was really focused on the community and the training platform and the resources and kind of all the videos and things that we put in there. Which I still like to this day, will stand on it, that like there, if you're an early stage innovator and you're, you wanna like kind of internally like level yourself up, right? There's no better place than like XO Medtech and the training and inside there to do that, right? But, but yeah, it was we started doing it at a time when AI was starting to become, like Chat GBT, what was it, four was coming out or whatever. So we started it kind of before the wave and then as we were continuing to build it in like 2023 which was like the meat of us building it. It was like kind of starting to become more of a thing, but we still weren't really using it that much. But then as we really went into kind of like launch and growth mode in 2024, it was just like a huge tailwind and like being able and, and it continues to be. But like not having to raise, you know, three, four, $5 million to get a business off the ground and to get to a point where you can start selling something is just incredible. I mean, like we are, we are so agile and can move so quickly and, you know, we don't have any investors. We don't want any investors. So like our speed at which we can move is unbelievable. And coming from somewhere where it's " Oh, you wanna put out something for marketing? Route it through the quality management system and like maybe it goes out in two weeks." You know, we can go from like idea to feature in a week. You know what I mean, you know, let alone like idea to like press release, right? That's 10 minutes if we want to be, right? So really it's just, it's a lot easier and this takes nothing away. There's some incredibly rewarding parts of kind of my, like my medtech journey and stuff like that, like the day we got FDA clearance and, and X, Y, and z whatever date, you know, first sale and getting our first GPO contract. But it's, it's definitely more I would say day to day, just like the exhilarating agility, excitement type stuff that you like, don't really get with with me. And I'm not, I'm not taking anything away from, I'm still a medtech person through and through and I'm sure at some at some point I'll you know, do another device. We're developing another device at Lapovations, so, in combo spine. So my hands are still in it, but I love, love, love what we do at XO Medtech. It's so much fun. [00:13:11] Lindsey Dinneen: Awesome. Well, I love hearing that. So tell us a little bit about both XO Medtech and Medtech Vendors and yeah, their, their focuses. [00:13:21] Spencer Jones: Yeah. So I think, you know, like I said, we started XO Medtech and it's, it's a online community. So think like Skool, like S-K-O-O-L School or Circle, or there's some other Mighty Networks, like one of the-- we use Circle-- but you know, it's whether you're ideation or just like curious about medtech all the way through like series A really, you know, we've got, you know, there's community feed, people are posting. I mean, we posted you know, Project Medtech, you know, event stuff, discounts a lot of exclusive stuff where, I think we added, it was like three or $4,000 worth of discounts. Like just for being like once you join XO Medtech. But then there's that primary feed people, it's like a massive exchange of value and it's it's not like LinkedIn. There's no promotion. Like we base, we will take your post down if you're like nakedly promoting your own stuff or your services, whatever. The whole point of it is to be massive exchange of value. So you know, "Hey, we did some like really cool testing, ETO sterilization testing on coil tubing to see how it retained its memory. Here's what we found, your pictures," you know what I mean? Just stuff like that where it's like kind of giving people behind the, behind the curtain peaks at your own organizations or that kind of, those, those moments of alpha, those nuggets that you've found and just sharing it so you can have you know, and they're doing the same and everybody's better for it. But then we have a training course and then some other like mini courses, probably a couple dozen downloadable resources. So these are like, you know, prebuilt, proformas, budget forecasts, you know, IP stuff, due diligence type stuff, like stuff to help you with, get your data room beef, you know, beefed up and looking good. And we do videos. There's some live events every now and then. So, so that was very focused on the founder side, you know what I mean, like the entrepreneur side. We, you know, my co-founder used to run a med device, venture studio, so like doing like business engineering, business development, engineering, you know, kind of market related stuff for like early stage, largely like clinician and inventors and stuff like that. He used to run a, a, a group that did that. And we knew we wanted to kind of start to do more offerings that kind of for that side of the table, like the CDMO contract manufacturer design and development group side of the table. So we launched, we started building MedTechVendors.com and launched it in 2025, February, 2025. And then did kinda a relaunch with adding some like agentic AI features in I think at the end of the summer last year. But it, but at its core, I always say this analogy, it's like Angie's List, right? You know, Angie's List, what do they do? Well, it connects people with local pros. Allows them to like, evaluate, engage them really easily, you know, get, get their stuff done quickly from trusted people. You know what I mean? So we have the same approach. We help device teams, and that could be device teams at large, medium, small, or startup organizations or tech transfer offices, whoever we help those device teams find, evaluate, and engage contract manufacturers, CDMOs testing facilities, design and development groups, one man band engineers, whatever through the platform. We have an an ag agentic AI chat. So like it'll ask you questions about your device. It'll start recommending, "Hey, do you need this? Do you need these types of services? Are you looking for this type of vendor? This type of vendor?" It pre-populates forms. It generates matches for you. You can review each vendor's profile, one click get email intros or request quotes, and we're adding some some really cool additional features around some different like skills that you can run. So, think like a reimbursement skill or market a, you know, different predicate device selection skill, whatever. And so those are all gonna be like linked up to the to this kind of AI agent. I don't wanna say too much 'cause we're still building it. I'm like really excited about, but there's other things that we're adding to it. The ability to do quote, visualization you know, and trying to make it kind of a, you know, a home away from home, a hub where you can track execution, get things done, engage vendors, and kind of evolve it more laterally in kind of the lifecycle journey. Not just " Hey, I'm looking for a vendor," 'cause that's a very acute point in time in a, you know, in a person's journey. But trying to expand it out to say the period of time when you're doing X and Y and Z and looking for a vendor so we can get some really was sticky, more sticky use and add more value. So, that was that. And we've started really focusing on some more like intimate, I would say, engagements with CDMOs contract manufacturers focused on giving their sales and marketing teams massive, massive leverage using AI and ai, AI native tools. [00:17:35] Lindsey Dinneen: Awesome. That's really cool. Yeah. Okay, so going back a little bit to the, to XO Medtech, I know you know you, you mentioned that there's a lot of resources available, but one of the things that I think is super cool, and I would love if you just share a little bit more about this, is you have a course that-- i don't remember the name off the top of my head-- but it's basically sort of Medtech Innovation 101. It's, I think... [00:18:00] Spencer Jones: Yeah, The Playbook. [00:18:00] Lindsey Dinneen: Call it like-- The Playbook! And you call it like the MBA for somebody who needs to learn. So can you just share the value of that and sort of what, what made you go, "Okay. I have, you know, the expertise in all these different areas enough to be able to share the journey from start to finish." [00:18:19] Spencer Jones: Yeah, absolutely. I think like the, the value there partially comes-- I mean, I think speaking about the value, you gotta speak about kind of like why there was a gap there, like how it, why it didn't exist, whatever. There's just a lot of really bad content in medtech. You know, there's a lot of stuff that reads I mean, there's guidance documents, you know, ISO and this and that. Like those are tough reads, right? And then, you know, the, the content around " "here's how you really fundamentally apply these guidance documents and here's how all this fits together." And it just felt like everything was I don't know what the opposite of like inside baseball is, right? Like that kind of " Hey, here's what you really need to know." Whatever the opposite of that is, is how medtech content felt like to me everywhere. It was just like polished press releases, really, like consulting speak. You know, "You gotta be strategic with your analysis." It's okay "You know, you know, you gotta find your champions." "How do I find them? What do I tell them? You know, how do I engage them?" So it was just, that was the big gap. So I think the value, what we tried to do with The Playbook was, you know, give, like I said, pre-seed all the way through Series A, the right information, like the right depth, on the right topics in the right order with the right assets, so resources, downloads, all that stuff along the way so that you can go cradle to grave on this, basically be a novice, or we've had people that have launched products and gone through it and they were like, "Holy crap, I wish I would've had this five years ago." But the whole idea is to basically not make you a supreme expert on any one of those topics. There's 46 different lessons, 47, and like you can get through each one in probably 20 minutes, right, 15 minutes. But not to make you an expert on each individual topic, but to give you like a dangerous level of information on any one, and then make you able to dive deeper on any of them, you know, very quickly and easily. So like when you meet with your, you know, a regulatory consultant or an IP attorney, or go down the list, you are not, they're not saying words you don't know for the most part. You're not paying them $300 an hour or $500 an hour to educate you on definitions and concepts. Right? You're, you're applying principles and evaluating strategy versus " What's that again? Like, how does this, what's the timeline for that?" 'Cause that you know, that's just not good for anybody. You know, so, so that, that's kinda the main, the main value prop thrust of it. And I just, I frankly didn't think it existed, but proof's in the pudding. Like we've sold it to accelerator programs, we've sold it to hospital, you know, innovation departments. We've sold it to incubators, like trade associations that have like their like kind of innovation arms. It works. Like when people do it, it works. It's funny-- we can talk about this too-- but like the, you can lead a horse to water thing. It's funny how many people say they want to be entrepreneurs and say they wanna be innovators and really they just want to just yap. And they don't actually wanna put the time in. I'm telling you, it's like crazy how many, you know, fake entrepreneurs there are out there. But it's okay. It's okay. You know, like there has to be, I think there needs to be some cleaving or weaning or calving of the herd to some degree because we've got, I don't know, and maybe we need to develop 'em more, but it's, it is frustrating seeing it firsthand when it's like "You have a really cool device, but you are so uninvestible and you have no interest in being coachable that it just hurts me." [00:21:30] Lindsey Dinneen: Oh yeah, absolutely. No, I love that you've done that resource and yes, super excited to see hopefully a lot of innovation actually happen and be successful as a result of that. So with, you know, okay, so you have, you have this community now and I'm wondering if there are any moments that kind of stand out to you, maybe as you've built the company, also Medtech Vendors that kind of enforce, "Wow, I am, I am in the right place at the right time." [00:22:00] Spencer Jones: You know, I definitely-- you know, it's, it's, it's really, there's not, I would say, any huge singular moments. I mean, we've had people like get business from coming on the XO Medtech podcast. You know, we've had people meet new clients, new strategic partners type stuff, like in the XO Medtech community. I mean, I've made a ton of friends in the XO Medtech community, people that I talk to you know, every, every week or two you know, Brad Shirley, I'll mention him. He's fantastic. And like I've learned from him, he's learned from me. We've both learned stuff from the community. I, I, I really do think it's though, it's like it's, you know, those-- whether it's a LinkedIn DM or you know, somebody messaging me in XO and they're like, "Hey, I just went through this lesson. It was like, so good. You know, blah, blah, blah." And I think those little things honestly like power me, power me up, give me juice, give me energy. You know, and, and like reading, we, we did a ton of, I mean we probably got 30 people that did kind of like a pre- and post- assessment and they gave their feedback on The Playbook so we could refine it like as we were, you know, after launch and all that stuff 'cause we're constantly trying to improve it. And have reading the testimonials and people just being like, yeah, like "This is, this is killer." People that are brand new, people that have been in the industry for 20 years that went through it. I think so, I think, I think it's kinda like a myriad of those things. I would say some of the stuff on-- and that's on the XO Medtech -- I think some of the stuff on the Medtech Vendor side and what we're doing with, you know, kind of campaigns and the tools that we're developing and the work that we're doing there, like we are fully an AI native organization. Like it, like we, it there is just not at all like a significant amount of people in medtech using AI to like actually do not in their products. I don't care about that. Like I'm talking about like in their day-to-day operations and, and whatnot and like we're trying to change that. And so like in that respect, like we will come out with things, you know, release features, release products, build custom tools for CDMOs and you know, the looks on their faces and like how amazed that they are at X, Y, and Z. And sometimes it's like stuff where it's hey, I'm like building them a just showing them how to do something with not even a tool that we built and like they're blown away. And anyways, all of that stuff, I feel like, man, like this is where I'm supposed to be because like. We, we've gotta make MedTech a more attractive investment opportunity. We've gotta compress the development cycles and the cost to develop and the time to develop and get things to market. You know, and I look at AI drug discovery for the pharma world as like a huge way that that's happening. But we have to have that similar type of like, when you to engage with this, it will be good for our ecosystem and industry as a whole, becoming more investible, becoming more cash efficient and all that stuff because you've seen other sectors, you know, software is taking money from early stage medtech, like nobody's business. You know, people are investing AI and you know, I just looked at the annual report from like HSBC, the Venture Report, and like me, early stage medtech funding continues to be down. You know what I mean? So we just gotta do something like, I, I feel like it's an existential, it's an existential issue for early stage medtech to get better at being scrappy and using AI. [00:25:03] Lindsey Dinneen: And there's so much opportunity there. Yeah, I love that you're helping to promote that. So you've gotten to lead a number of different companies now and through very challenging milestones. And so I'm curious, how has your own leadership philosophy developed over the course of your career so far? [00:25:24] Spencer Jones: Oh, what a good question. You know, I, I hate to say this, but I've almost gotten more cynical, you know. [00:25:30] Lindsey Dinneen: Okay. [00:25:31] Spencer Jones: Well, and it, it's, it's like I try to be very protective of my time and like protective of the time of the people that I work with, right. You know, and that doesn't mean I'm not willing to like go the extra mile and whatnot, but I think it's about respecting people's time. Right? And, and you know, I think honestly my leadership philosophy, I think a lot of it revolves around just like incredibly clear communication and like staying above the fray. No riff-raff, just just executing and moving fast and like keeping expectations really high, because I feel like when you've got complacency, you know, at the top, it just, it like doubles every rung of the ladder lower that you go in the org chart or whatever. You know, so I think like pace, you know, pace and hyper clear communication, like no subversive or passive aggressive or anything. It's just like straight up, like I'll just exactly tell you if I wasn't happy with something or whatever, but I just, I don't know, like I feel, I feel like you know, leadership style too, like I think, I think it, so much of it boils down to communication for me. It's just like really, really clearly communicating and like making sure that people understand what good work looks like and what a, them doing a good job looks like, and where... Yeah, I think, I think being clear about expectations, really clearly communicating those expectations around like work product, what it should look like, how fast it should get done, how many updates I need, or how many questions I expect to get as you're doing this, what resources I expect you to expend and explore before you come to me with something you could Google. Like all of that stuff, but honestly, I, it, it's kind of a tough question thinking in like the more immediate past, just because I feel like there's been such like, almost like a flattening of org charts, frankly, with the way that we're using technology and AI these days where I feel like in the companies I'm operating in right now, like it's mainly just principles and like lower level stuff, like we're either delegating to AI agents or delegating to like VAs that are in a different country or something, you know what I mean? And, and so there's just been a big flattening. You know, seven years ago, six years ago, I was managing, you know, new grads outta college, two or three at a time, and, you know, having to like, have these kind of like, you know, like brotherly, you know, like talks with, you know, these types of things, " Hey, like you really gotta do this" and like coaching and stuff like that, i, you know, there's a, we have to have that stuff. I'm just not in, in organization and honestly, the organizations I'm in right now in startup world I just feel I don't know. Like I, I feel like we're, I haven't seen that and I, I know a lot of organizations that are small and nimble and whatever, and I feel like the org charts are getting real flat in terms of like people that are getting managed, you know, it's a lot of agents getting managed, frankly. [00:28:21] Lindsey Dinneen: Yeah. Yeah, yeah. Interesting. Yeah, that, that's a really interesting insight too. But I really do think that to your point of coaching and mentorship and how much of a difference that makes, but especially, I was just on this conversation earlier today of the critical importance I feel that there is about establishing expectations across the board, whether it's your clients, your employees, your coworkers, just making sure that everybody's on the same page is such a critical aspect of, of setting yourself up for success. So yeah, I love that you touched on that 'cause like I said, literally earlier today. [00:29:00] Spencer Jones: Yeah. And, and can I, can I, quick aside here. It's, it's on topic, but before we move on, I mean, I, I'm not the first person to think this or say this, but I'll, I'll die on this hill. The more you use AI when, when you're using it the right way, right, the better leader and better specifically, the better communicator you'll become, right? Why? So much of interpersonal office drama, bad management, bad leadership is like what we talked about, right? It's poor communication. It's expecting people assumed something or had knowledge they didn't, right? It's not letting them know what you really wanted, what good work looks like, all that stuff. This is all context engineering, right, which is just a similar to prompt engineering, but context engineering is kind of the other more important piece these days with AI. What do I mean by that? Like I'm gonna give a prompt to a chat. Is it in just like a virgin chat or is it in a project? What context, what documents, skills, reference templates, et cetera, access to code bases does that project have, right? What am I telling it to do? How am I breaking that down? How am I, you know, big, high level goal? What do I want it to do? What does the output need to look like? How deep do I want it to go? Right? Like, how many questions I say, "Ask me like five or six questions" when I'm prompting, right, if I want that, right? Give, so giving the other person right in that space to say " What questions do you have?" Right? The, the, the best people at context engineering and leveraging AI in that way end up becoming more, better and better and better communicators because it's-- I mean, yes, you're talking to a machine, but at the same way, like those principles a hundred percent apply to good professional communication. So I'll die on that hill. There's a lot of people that are like brain rott using AI. It's " what's the weather today?" And you know, "how many calories does mayonnaise have?" And those people are not, you know, they're, they're not improving their leadership communication by using app, but the people actually doing it right a hundred percent are, [00:30:52] Lindsey Dinneen: Yes, I could not agree more. I think that is one of the coolest things that AI has taught me personally is-- to your point, to be a better communicator, to be clearer with the way that I communicate, to avoid assumptions that the other person, say, knows what I'm talking about or, or does have the context behind why I asked the question the way I did, or all those kinds of things. So I, I could not agree with you more. Yeah. And it's exciting to see how it continues to evolve. Okay. [00:31:22] Spencer Jones: Yeah. And why, real quick, why, like the AI models, especially with the reasoning models and stuff, Opus 4.6, all this stuff, telling them why they're doing something and why doing it, doing a certain task within that project flow is important is proving to be more effective than telling them how. And I think that's something where, you know, you tell someone what to do, they may do it, but if you tell them and make them believe why it's important, they do it that way, they're really gonna do it that way. [00:31:49] Lindsey Dinneen: Yeah. Love that so much. Okay. All right, so pivoting the conversation a little bit, just for fun. Imagine that you were to be offered a million dollars to teach a masterclass on anything you want, could be within your industry, but doesn't have to be. What would you choose to teach? [00:32:05] Spencer Jones: Does this, assume-- I have a question. Does this assume that I'm already I'm already capable and you know, have enough expertise to actually teach this class? Or is it like I choose this topic, I'm now an expert in that and I get to teach it? [00:32:19] Lindsey Dinneen: I like, I like I like both options, but I'm gonna go with option B because you have a million dollars to play with, right, so you could build up the expertise. Yeah. [00:32:29] Spencer Jones: You know, I would still say like building AI tools, AI agent systems, you know, skills and subagents and these flows and, and really tactically executing that for medtech. And that that goes from founder, you know, innovator to service provider, reg, quality ,reimbursement, like all the way up through sales and marketing and then like CDMO teams, you know, doing contract manufacturing, doing this. Like I, I just, I'm so passionate about it and I, I just see that there's so much untapped opportunity that that is the thing I think, and, and like we, we are doing that not a masterclass, but like we are working with groups to do some of that. But, I just, it's just so, so, so, so much opportunity to do it. And I think there's like weird structural reasons why it's not being adopted the same, you know, at the same clip it is in other industries. But you know, medtech's very rules-based game. You know, you've got your guidance docs, you've got your predicate devices, you've got your clinical trial protocols, you've got your stats analysis. You got your, you know, X, Y, Z hospitals get paid a certain way. Like lots of formulas, lots of reference material, lots of guidance docs. You know, it's very kind of rules and order based system in a lot of ways. And biology has its own kind of, prescriptive way that things happen, right? So I just feel like it's so primed for it. And anyways, I, I just, I wanna see it adopted more so we can see like what's happening with software now, where, you know, the cost to build and, you know, produce and get software to market has com has almost collapsed, but compressed to, you know, from like months, maybe years to, you know, days and weeks and, you know, you got a $200, 250 bucks worth of like software subscriptions, Claude this, that, the other, you can get it done in a week if you, you know, two weeks if you put your mind to [00:34:21] Lindsey Dinneen: Yeah. Yeah. No, that would be an incredible masterclass. I like it. All right. And then how do you wish to be remembered after you leave this world? [00:34:30] Spencer Jones: Oof. God, what a good question, Lindsey. You know, I hope to be remembered at all. [00:34:35] Lindsey Dinneen: Yeah. [00:34:36] Spencer Jones: You know, 'cause I, I'm definitely one of those people that's " nobody cares, nobody's thinking about you." You know, you may have, I, I mean, I think there's like some healthy main character syndrome that people can have that gives 'em confidence, but at the end of the day, no one cares. They're just, everyone's thinking about themselves. But if I am remembered, which I hope to be I wanna be viewed as like someone that was, I'd say, loved their family was a good dad, good husband. I would say brought people joy, was like fun to be around, but like from a interested in other people sense, you know, you know, genuinely cared about people. But I would say that on the professional side, like somebody that you know, would like consistently just delivered an absurd amount of value whether it was, you know, running a business or coaching and developing people at a company or working on behalf of clients or trying to make a positive change. I would say impactful and valuable, you know, with the work that I'm doing. That's, that's, that's how I wanna be remembered. I mean, we don't have big, I don't wanna be a unicorn billion dollar company. No, we have no desire to do that. We don't even have a, a desire to get acquired at any point. We're not raising money, you know, we've, we've deliberately chosen to bootstrap it. You know, we frankly just wanna employ really awesome smart people that we work with, you know, pay everybody well. And like I said, add a absurd amount of value you know, and joy to the people and the clients that we work with and like work at the company with, you know what I mean? [00:36:05] Lindsey Dinneen: Yeah. Yeah, that's a absolutely wonderful legacy to aspire to. I love it. All right. And then final question. What is one thing that makes you smile every time you see or think about it? [00:36:19] Spencer Jones: Oh, I gotta be, I've got a 1-year-old kid. Banks. Banks Austin Jones. So it's gotta be him, and my wife of course. One thing that makes me smile though, every time I see it, oh... you know, I am, I'll cry at a good TikTok, so I'm so I guess that's like a form of smiling, you know? But I'm a pretty big softie, honestly. You know, this is gonna sound weird, but it's kind of those moments where you know, people usually strangers and usually people that don't look like each other, just show humanity to each other. And that could be like holding a door open for somebody. It could be small things, you know what I mean? But I really love seeing those moments and capturing them like candidly, you know? Just you know, oh, I was in a restaurant, I saw this thing happen. You know? I really love that these days. [00:37:09] Lindsey Dinneen: Yeah. Yeah. We all need more of that these days too, so, yeah. Love it. Alright, well, Spencer, this has been a, a fantastic conversation. I really appreciate you and your time today. I love what you're building in the medtech industry and cultivating community and resources and providing value. So just thank you for everything you're doing to change lives for a better world. [00:37:34] Spencer Jones: Thank you. Can I ask you a question? I feel like you were so good, like with the questions and kind coming on the back of like my responses, but I have a question for you like what? You know, what about the medtech space, like most excites you? It can be a specific technology, it can be a specific, you know, company doing something. It can be anything, but what's most exciting to you, kind of looking at 2026 and, you know, kind of in the realm of medtech broadly. [00:38:00] Lindsey Dinneen: Yeah. Oh, I love that question. So I love this industry in general, but there, there's something really special about the energy of being around people who truly care about making a difference. Part of the reason I started The Leading Difference was because I, when I first joined, had sort of noticed this sort stigma from people from the outside who weren't very familiar with the innovation, what it takes to get from, you know, drawing to commercialization. Just didn't, just didn't know. And there was this stigma that people were here just for the money. And then I started meeting all of these incredible change makers who they had personal stories of what they were seeing, or a family member was impacted. And I just loved the fact that there were so many cool people doing such cool things and getting to play a small role in that was the coolest thing in the world. So, you know, I, I say I happily stumbled into medtech five years ago and found my people and my happy place, haven't looked back. I love it. I love being around people who are genuinely trying to do good things in the world. And I hear about new and you know, new ideas every day, and I get excited probably almost equally about most of them because it's just cool to see. So I don't know. Does that answer your question? [00:39:29] Spencer Jones: No, it, it does. I mean, it, it really the, it all comes back to the patient at the end of the day. And I definitely, I, I feel like when people think of like medical device stuff, like their minds immediately go to like Stryker sales reps or something, you know what I'm saying? And there's just so much more to it than that. And there's one of my favorite things about medtech is like the personalities, you know, like you got your wacky, you got your wacky inventors and you know, you got your straight laced regulatory people. But when you get to know 'em, they're, they're absolutely hilarious. You know, you got your attorneys, you got your like, and I, every industry, every industry has their personalities. But I think medtech, you know, you got your beef head sales reps that are like posting " What's up guys? I'm here in the locker room in my scrubs" and like "Motivation Monday." You're like, "Oh my God." But it's just like all these personalities and you go to these conferences and you just see 50 of the same person, but they're each different, they have their own dreams and conflicts and ideas and whatever, but they're still like so in the same box in some ways. I think that's one of the funnier, like funnier things about medtech that just makes it quirky, you know? [00:40:30] Lindsey Dinneen: I love it. And I also love the amount of respect that I see shared amongst people of very, very different backgrounds and areas of expertise. And that was one of the things that made me fall in love with the industry too. I was like, I, for instance, you know, I'm in, I'm in marketing and business development, so I play a very small role in, in sharing about these devices. But people, the engineers that I work with and the consultants that I work with, and everybody in the ecosystem is always just " Wow, well, I can't do what you're doing. And so I think what you're doing is fantastic." And so there's just, there's this mutual respect that I think is super cool about being here too. So yeah, I'm a fan. [00:41:08] Spencer Jones: Yeah, I agree. I agree. We could, we could keep going for, for days... [00:41:12] Lindsey Dinneen: I know. [00:41:13] Spencer Jones: ...On this. I really, I know, I know we have to wrap it, but but yeah. Well, Lindsey, thank you for having me. Seriously, this was a blast. And you know, I'll just maybe like quick sign off plug or something here. If anybody that's listening to this is like interested in, leveraging AI, leveraging AI in medtech or for you personally or whatever, follow me on LinkedIn and post a lot of content about it. You know, talk about it a lot on the podcast. But then if you're, if you're on the founder side, if you're an innovator, like join XO Medtech. If you're on the CDMO side, if you're, you know, on a sales and marketing team, contract manufacturer, CDMO, even like signed development groups, that kind of stuff like, you are like, "We know we need to be using AI to better leverage X, Y, Z, or do this thing. We have all these, we have HubSpot and this thing and that thing, and none of it works together well and we've got too many tools." Whatever. Just hit me up. Let's have a conversation. We're doing some absolutely incredible things leveraging AI, giving these sales and marketing teams like crazy leverage. So yeah, just drop a dm. I'd love to talk to you. [00:42:08] Lindsey Dinneen: Awesome. Sounds good. And we are so honored to be making a donation on your behalf as a thank you for your time today to the Polaris Project, which is a non governmental organization that works to combat and prevent sex and labor trafficking in North America. So thank you for choosing that organization to support, and we wish you continued success as you work to change lives for a better world. Looking forward to seeing the future of all the good things that you're doing. All right. Bye. [00:42:41] Dan Purvis: The Leading Difference is brought to you by Velentium Medical. Velentium Medical is a full service CDMO, serving medtech clients worldwide to securely design, manufacture, and test class two and class three medical devices. Velentium Medical's four units include research and development-- pairing electronic and mechanical design, embedded firmware, mobile app development, and cloud systems with the human factor studies and systems engineering necessary to streamline medical device regulatory approval; contract manufacturing-- building medical products at the prototype, clinical, and commercial levels in the US, as well as in low cost regions in 1345 certified and FDA registered Class VII clean rooms; cybersecurity-- generating the 12 cybersecurity design artifacts required for FDA submission; and automated test systems, assuring that every device produced is exactly the same as the device that was approved. Visit VelentiumMedical.com to explore how we can work together to change lives for a better world.

In this powerful episode of the Tick Boot Camp Podcast, Matt Sabatello and Rich Johannesen sit down with Marina Morgan, a professional singer, songwriter, real estate agent, and Lyme disease survivor from New York and New Jersey. Marina shares the deeply personal story of how a vibrant, high-energy young woman who loved running, fitness, and music suddenly found her life turned upside down by Lyme disease in her early twenties. What began as stomach issues quickly progressed into neurological symptoms, extreme fatigue, balance problems, and ultimately sudden vision loss in one eye — a terrifying turning point that led to her eventual diagnosis. After seeing multiple doctors and facing potential misdiagnoses such as multiple sclerosis and scleroderma, Marina was finally diagnosed with Lyme disease through a Western Blot test by Dr. Pollack. Her treatment included 18 months of IV antibiotics through a PICC line, followed by another year of treatment after a later flare-up. Today, Marina continues to navigate chronic Lyme symptoms while building a career in music, real estate, and fitness, demonstrating resilience, perseverance, and determination even on difficult days. Her story is a powerful reminder that Lyme disease can affect anyone — even young, healthy, active people — and that persistence, positivity, and support are essential in the healing journey. About Marina Morgan Marina Morgan is a professional singer and songwriter who has appeared on the Today Show, was named Elvis Duran's Artist of the Month, and has been featured on iHeartRadio and in multiple publications as an emerging artist. In addition to her music career, Marina works as a real estate agent serving New York and New Jersey and as a gym manager, continuing to stay connected to the world of fitness despite the physical challenges created by Lyme disease. Marina has also used her music to express the realities of chronic illness. Her song “Paralyzed” captures the emotional and physical struggle many Lyme patients face when their bodies no longer cooperate with the life they once lived. Watch Marina's Lyme-inspired music video “Paralyzed”:https://www.youtube.com/watch?v=6JT2lJDwd6I Follow Marina on Instagram:https://www.instagram.com/themarinamorgan Key Topics Discussed in This Episode Life Before Lyme Disease Before getting sick, Marina lived an extremely active lifestyle. She ran miles every day simply for enjoyment, maintained multiple jobs, and had a vibrant social life. Fitness and movement were central to her identity, and she describes having seemingly endless energy. Lyme disease dramatically altered that reality. Early Symptoms and Sudden Vision Loss Marina's illness began subtly with stomach issues and fatigue, but symptoms soon escalated. She began experiencing: Severe fatigue Weakness in her legs Balance and coordination issues Neurological symptoms Brain fog Loss of vision in one eye The sudden vision loss was the turning point that signaled something much more serious was happening. Misdiagnosis and the Search for Answers Before receiving a Lyme diagnosis, doctors suspected conditions such as multiple sclerosis (MS) and scleroderma. Marina visited several doctors and specialists before finally receiving the correct diagnosis. Her father, who had previously experienced Lyme disease himself, recognized the possibility and helped advocate for Lyme testing. She was ultimately diagnosed at age 23 through a Western Blot blood test by Dr. Pollack. Intensive Lyme Treatment Following her diagnosis, Marina underwent 18 months of intravenous antibiotic treatment through a PICC line, one of the more aggressive approaches used for severe Lyme disease. Years later, after experiencing a flare-up, she required another year of treatment. Today she is not undergoing active Lyme treatment but continues supportive wellness practices including: Infrared sauna Yoga Probiotics Living with Chronic Lyme Marina estimates she has recovered to about 60% of her pre-Lyme health. The most persistent symptom she continues to battle is extreme fatigue, which can make even simple daily activities exhausting. She describes the unpredictability of chronic Lyme — how a good day can be followed by days or weeks of exhaustion. Despite these challenges, Marina continues to work, maintain relationships, and pursue her passions. Music as a Voice for Lyme Patients Marina has channeled her experience with chronic illness into her music. Her song “Paralyzed” captures the emotional reality of Lyme disease — the feeling of being trapped in a body that no longer functions the way it once did. The song resonates deeply with Lyme patients and others living with invisible illness. Watch the video here:https://www.youtube.com/watch?v=6JT2lJDwd6I Advice for People Fighting Lyme Disease Marina encourages patients not to give up during the darkest moments of illness. Lyme disease can be physically and emotionally overwhelming, but maintaining hope and continuing to pursue healing strategies can make a meaningful difference. She stresses the importance of: Listening to your body Giving yourself grace Staying mentally resilient Continuing to search for solutions Key Takeaways Lyme disease can affect young, healthy, highly active people Neurological symptoms like vision loss can occur with Lyme disease Misdiagnosis is common in complex Lyme cases Long-term IV antibiotic treatment is sometimes required Chronic symptoms can persist even after treatment Mental resilience plays a major role in managing chronic illness Connect with Marina Morgan Instagramhttps://www.instagram.com/themarinamorgan Watch her Lyme-inspired song “Paralyzed”https://www.youtube.com/watch?v=6JT2lJDwd6I

The clock is ticking the minute a critically ill patient arrives in your clinic and requires long-term venous access. The choice between a traditional central venous catheter (CVC) and a peripherally inserted central catheter (PICC) is more than just a matter of location; it's a decision that impacts everything you do for the patient. Tune in to this episode of the VetFolio Voice podcast to navigate the ins and outs of each option—including central line and PICC line differences and advantages, where they can be utilized best, what to monitor for and how to sample from a central line—so that you can make the most informed choice for these patients.

   For the third time in 33 months, KU coach Bill Self has been taken to the hospital with a heart condition.  Self has had an aortic valve replacement, at least two procedures with stents and has worn a PICC line while coaching.  The team departed for a game at Colorado without the Hall of Fame coach and we'll break down where they turn and what this all means.    Meanwhile, what's old is new again with the Chiefs as Andy Reid is bringing back Eric Bieniemy as OC.  I hate this and if my emails are any indication, so do the fans.    Fernando Mendoza and his Indiana Hoosiers win the national title as the most celebrated college player in the land has a td run for the ages.    In Minneapolis, ICE is turning the table on the agitators in a way you're going to love.  America has eyed Greenland since at least 1867 and Trump is going to get what he wants.  And import/export numbers for the USA are insanely good and historic.    An elephant is killing people in India and is the  CBS Evening News really trying to be better?

In this episode of the INS Infusion Room, host Derek speaks with Carla Dillard about her extensive experience in nursing and the recent changes in the scope of practice for nurses in Louisiana. They discuss the introduction of electrocardiogram (ECG) technology for confirming catheter placements, the challenges faced in advocating for this change, and the successful presentation to the Louisiana Board of Nursing. Ms Dillard emphasizes the importance of data-driven advocacy and collaboration among nurses to improve patient care and outcomes.

刚做完PICC置管，总觉得手臂发胀？为什么有人恢复顺利，有人却反复不适？日常活动到底该怎么把握？本期节目为你揭秘PICC置管后的防栓护理要点，让你治疗更安心、恢复更顺利！

Send us a textTrials don't wait for a convenient time. One week you're serving thousands at a men's conference with a full heart, and the next you're in a hospital bed with a PICC line, two surgeries, and a choice to make: fear or faith. We walk through that sharp turn with James 1:2–3 as our compass, not as a slogan but as a lived reality. Consider it joy, not because pain is pleasant, but because endurance changes the man you become—at home, at work, and in the quiet moments your kids remember.Ever think, “I'm just a guy… what real difference can I make?” You're not alone. But God isn't looking for perfect men — just obedient ones. Our I'm Just a Guy Bible study on YouVersion has helped 20,000+ men see how God uses ordinary guys to do extraordinary things.Check it out at thelionwithin.us/youversion or search The Lion Within Us directly in the Bible app.It's time to stop sitting on the sidelines.Step into the fight and become the man God called you to be. Join a brotherhood built on truth, strength, and action. Visit thelionwithin.us right now and start leading with boldness and purpose. Iron sharpens iron — let's go.

PICC导管减轻了反复穿刺的痛苦，但日常护理同样关键！如何避免感染、堵塞、移位？本期节目教你“六大黄金法则”，从清洁、活动到饮食……全方位守护导管安全！点击收听，掌握科学护理方法，让治疗更安心！

Send us a textA mountaintop weekend can change your language; a hospital bed can change your life. Right after an energizing men's conference with voices like Joby Martin and John Tyson, I came home, peeled off a sock, and found a small, angry spot on my ankle scar. One Spirit-led decision—don't eat or drink—opened a door for same-day surgery, cultures, and a new road I didn't want: MRSA, a PICC line, and weeks of IV antibiotics. What felt like lost progress turned into a deeper lesson on endurance, gratitude, and the kind of brotherhood you can lean on when strength runs out.Ever think, “I'm just a guy… what real difference can I make?” You're not alone. But God isn't looking for perfect men — just obedient ones. Our I'm Just a Guy Bible study on YouVersion has helped 20,000+ men see how God uses ordinary guys to do extraordinary things.Check it out at thelionwithin.us/youversion or search The Lion Within Us directly in the Bible app.It's time to stop sitting on the sidelines.Step into the fight and become the man God called you to be. Join a brotherhood built on truth, strength, and action. Visit thelionwithin.us right now and start leading with boldness and purpose. Iron sharpens iron — let's go.

The coach cody podcast is back! We get into why we had to stop everything — including a sudden spine infection (dyskitis/osteomyelitis), repeating fevers, a PICC line, and the burnout that had been brewing long before any hospital stay.This is the most honest breakdown we've ever done about stress, burnout, creator pressure, chronic pain, and what happens when your body finally hits the brakes for you.We cover: The full story behind the dyskitis/osteomyelitis diagnosisHospital chaos, fevers, and the 3am “get to the ER now” phone callWhat burnout actually looks like (and why so many people miss it)How stress and overworking can wreck your immune systemThe pressure of being a coach/creator during burnoutIdentity, productivity, and learning to rest without guilt.Dez's perspective as a partner navigating the whole nightmare.Why we're shifting the tone of the show to be more real + sustainableWhat recovery looks like from here — mentally and physically. If you've been feeling burned out, overwhelmed, exhausted, or like you're pushing through when your body is begging you to stop… this episode is for you.

Em entrevista ao programa Escuta Aqui, da Rádio Sideral, nesta sexta-feira, 24 de outubro, Andressa Carolina Barato, coordenadora do curso Técnico de Enfermagem da IDEAU, anunciou a realização de mais uma edição do Projeto de Interação com a Comunidade (PICC), no Calçadão da Praça General Flores da Cunha, em Getúlio Vargas. O evento, que ocorre neste sábado, 25 de outubro, das 8h às 11h, reunirá pela primeira vez alunos e professores de todos os cursos da área da saúde do Centro Universitário IDEAU. A ação oferecerá gratuitamente à população serviços como aferição de pressão, testes de glicemia, orientações sobre primeiros socorros, saúde mental, e incluirá a vacinação antirrábica para cães e gatos. O objetivo do projeto, que existe há 14 anos, é oportunizar experiência prática aos acadêmicos e prestar serviços à comunidade.

Resources:  Rutherford Chapters (10th ed.): 174, 175, 177, 178 Prior Holding Pressure episode on AV access creation: https://www.audiblebleeding.com/vsite-hd-access/ The Society for Vascular Surgery: Clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access: https://www.jvascsurg.org/article/S0741-5214%2808%2901399-2/fulltext  KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update: https://pubmed.ncbi.nlm.nih.gov/32778223/    Venous Hypertension   Definition A functioning AV circuit delivers high volume arterial flow towards a stenotic venous segment, causing buildup in pressure and venous hypertension. If there are few or no branching veins between the access and stenosis, thrombosis could occur   Etiology The most common etiology is venous stenosis caused by a history of vessel wall trauma by centrally-inserted venous devices such as tunneled and non-tunneled dialysis catheters, central lines, pacemakers, or defibrillator. In a study performed at a large academic medical center1, new hemodynamically significant central venous stenosis was associated with the duration of catheter dependence (26% in patients with CVCs for more than 6 months, versus 11% in patients with CVCs for less than 6 months). PICC lines can directly damage cephalic and basilic veins Venous stenosis can often go undetected until AV access creation occurs   Patient Presentation Symptoms of venous insufficiency will be present– most commonly regional edema, in the area of venous stenosis. If there are patent venous branches between the AV anastomosis and the stenotic area, swelling can occur throughout the arm. Pigmentation, induration, dermatosclerosis, and ulceration may also be observed. An extensive collateral network of veins may be visible throughout anterior chest, shoulder, or flank SVC obstruction can result in swelling of the head, neck and shoulders, as well as a feeling of head and neck fullness, airway compromise, and visual problems Normal palpable thrill can be replaced by a strong pulse Dialysis can be complicated by difficulty with needle access, recirculation syndrome, and arm swelling after dialysis sessions. Workup  Central vein thrombosis can be hard to detect on ultrasound because clavicle and sternum can block transmission Venography is essential to determine the presence and severity of venous stenosis or occlusion.   Prevention The ideal scenario is to avoid central dialysis catheters completely, and this involves evaluating CKD patients and placing AVF or AVG before the need for dialysis arises.  If a patient presents placement of an AVF/AVG, it is important to perform venography if a patient has a history of a central venous catheter or clinical signs of venous hypertension. A history of SVC obstruction from any cause can preclude permanent AV access creation in both upper extremities Treatment Endovascular approaches to venous outflow stenosis can be first-line treatment options, due to their minimal risk. They can also be performed at the same time as a diagnostic venogram. Angioplasty alone or with stenting are the endovascular options. In a study by Bakken et al2 that compared primary high-pressure balloon angioplasty versus stenting, primary patency was equivalent between groups, with 30-day rates of 76% for both groups and 12-month rates of 29% for angioplasty and 21% for stenting. Assisted primary patency was also equivalent with a 30-day patency rate of 81% and 12-month rate of 73% for the angioplasty group,  84% at 30 days, and 46% at 12 months for the stenting group. This study, along with others, shows that the major downside of endovascular interventions, whether angioplasty or stenting, often require repeat intervention and have poor long-term patency. For subclavian vein stenosis, angioplasty alone is appropriate due to its anatomical location that can put a stent at risk for extrinsic compression from the first rib and clavicle. Surgical bypass can be performed Possible bypasses include axillary-axillary, axillary-jugular, axillary-right atrial, and axillary-femoral. In these bypasses, the preferred conduits are autogenous saphenous or femoral veins. In cases where the proximal subclavian vein is obstructed, a jugular vein turndown can be performed. In this procedure the distal jugular vein is transected, sewed end-to-side at the distal subclavian vein, effectively acting as a bypass route for that obstructed segment. The Hemoaccess Reliable Outflow (HeRO) Vascular Access Device can be used as a hybrid approach, combining endovascular and open surgical techniques to bypass a central venous occlusion  and provide a reliable outflow for dialysis.  This device has a PTFE inflow limb that is sewn end-to-side onto the brachial artery. This limb is tunneled subcutaneously and connected to a silicone-coated nitinol outflow catheter that is inserted into a central vein and tracked directly into the right atrium. This effectively bypasses central venous stenoses. In the largest study to date on HeRO access grafts placed in 167 patients,3 HeRO primary and secondary patency was 48.8% and 90.8%, respectively, at 12 months. Interventions to maintain or re-establish patency were required in 71.3% of patients resulting in an intervention rate of 1.5/year. Access-related infections were reported in 4.3% patients. The authors concluded that HeRO device had performed comparably to standard AVGs and had proven superior to tunneled dialysis catheters in terms of patency, intervention, and infection rates. If no treatment options for venous hypertension or outflow obstruction  are available, an alternate AV access site can be created, either in the contralateral arm if the SVC is uninvolved, or through placement of femoral AV access or a peritoneal dialysis catheter.   Bleeding Access Site   Etiology and Risk Factors Bleeding can be caused by high venous pressure after dialysis, pseudoaneurysm rupture, or trauma. Patients with end stage renal disease (ESRD) have a baseline elevated risk of bleeding due to uremia-induced platelet dysfunction and use of systemic anticoagulation within the hemodialysis circuit. Additional risk factors include dialysis through an AV graft, hypertension, longer duration of access use, and compromised integrity of the vascular access due to complications (clotting, infection) or invasive procedures. Dual antiplatelet therapy is also associated with overall bleeding events in ESRD patients. Dialysis patients could be on antiplatelet therapy for management of comorbid cardiovascular risk and/or patency of AV graft Patients with bleeding fistulas often present from their dialysis unit when standard digital pressure at the cannulation site fails to stop the bleeding. This is a very serious condition since most mature fistulas have high blood flow and the patients are at risk for hemorrhagic shock and death.    Initial Management  The first step of management is to obtain hemostasis. Elevate the limb above the level of the heart and apply firm and directed pressure at the site of bleeding using gauze for at least 30-40 minutes Milosevic et al4 reviewed non-operative management of bleeding fistulas and grafts and found that compared to standard dressings, the use of specialized hemostatic dressings decreased bleeding time at arterial and venous cannulation sites. These hemostatic materials included the IRIS compression bandage and cellulose-based, chitosan-based, poly-N-acetyl glucosamine-based, and thrombin-soaked dressings. There has been a “bottlecap method” described where the hollow side of a bottlecap is pressed on top of the puncture site. Maintaining pressure on the cap will cause the cap to fill with blood and clot, which tamponades the bleeding. The provider can also place a shallow figure-of-8 or purse string stitch just below the skin surface to aid in hemostasis. It is important to avoid placing the suture too deep as this can cause inadvertent fistula ligation. During this process, an assistant applies pressure just proximal and distal to the bleeding site to stop blood flow so the sutures can be placed. If these methods fail to achieve hemostasis, apply a tourniquet proximal to the fistula and tighten it until bleeding stops and the radial pulse is lost. This signifies complete occlusion of arterial inflow to the fistula. Tourniquet use should be limited to 3 hours or less, since limb ischemia beyond this timepoint is associated with permanent neuromuscular damage. Regardless of the method used for initial hemostasis, the patient is at risk for repeat hemorrhage, hematoma formation, vessel stenosis, and thrombosis. They should be evaluated by a vascular surgeon as soon as possible.  Definitive Management Definitive management depends on etiology of each case, and there are a variety of interventions that can be pursued (i.e. aneurysmorrhaphy for aneurysmal bleeding) If skin erosion over the conduit is present, it should be assumed that the AV access is infected and emergency intervention should be pursued. A jump graft can be placed through with healthy tissue.  A covered stent could be introduced through a separate percutaneous puncture site Finally, coagulopathy can be addressed by administering cryoprecipitate, DDAVP, erythropoietin, estrogen, tranexamic acid. Aneurysms and Pseudoaneurysms   Definition and Etiology Aneurysms involve all three layers of the vessel wall and they develop due to hemodynamic changes causing remodeling of the vein wall in an AV fistula. This is necessary for vein maturation, but becomes problematic if the post-anastomotic vein continues to dilate and becomes aneurysmal.  Aneurysms can also occur at anastomosis sites due to technical aspects of the surgery. Pseudoaneurysms only involve some layers of the vessel wall caused by repeated puncture for hemodialysis.  Both aneurysms and pseudoaneurysms can enlarge due to venous outflow stenosis causing increased intraluminal pressures. Both true aneurysms and pseudoaneurysms can lead to overlying skin erosion and subsequent hemorrhage, pain, AV access dysfunction, and cannulation difficulties.  Dialysis cannulation should be avoided at the aneurysmal sites to prevent bleeding complications. Diagnosis They can be diagnosed on ultrasound, which also provide information on flow rates, presence inflow/outflow/stenoses, and vessel diameters.  Indications for Treatment Treatment is indicated for aneurysms that are rapidly expanding or ulcerating through the skin surface. These are at high risk for rupture and hemorrhage, which is life-threatening. Treatment is also indicated when the aneurysm occurs at the anastomotic site of the AV fistula, the patient has a cosmetic concern, cannulation becomes difficult, there is concern for infection, or the patient has high-output heart failure that could be exacerbated by high flow through the fistula. Treatment is not indicated in asymptomatic aneurysms, regardless of their size. True  aneurysms and pseudoaneurysms are not prone to spontaneous rupture.   Treatment Options Aneurysmorrhaphy is the most common treatment. It involves the resection of the aneurysmal vein wall to restore a normal diameter and removal of excess skin. Anastomosis is performed along the lateral wall to prevent issues with cannulation along the suture line. Aneurysm resection with interposition grafting is also possible. If multiple aneurysmal segments require treatment, staging their repairs can allow for continuation of dialysis without needing to place a temporary dialysis catheter. AV access ligation is an appropriate alternative to AV access salvage in certain situations but usually requires excision of the aneurysm/pseudoaneurysm due to the potential to develop thrombophlebitis and the cosmetic appearance of the thrombosed segment. If there is concern for an infected pseudoaneurysm or aneurysm, surgery should include removal of all infected material. References   1. Al-Balas A, Almehmi A, Varma R, Al-Balas H, Allon M. De Novo Central Vein Stenosis in Hemodialysis Patients Following Initial Tunneled Central Vein Catheter Placement. Kidney360. 2022;3(1):99-102. doi:10.34067/KID.0005202021 2. Bakken AM, Protack CD, Saad WE, Lee DE, Waldman DL, Davies MG. Long-term outcomes of primary angioplasty and primary stenting of central venous stenosis in hemodialysis patients. J Vasc Surg. 2007;45(4):776-783. doi:10.1016/j.jvs.2006.12.046 3. Gage SM, Katzman HE, Ross JR, et al. Multi-center Experience of 164 Consecutive Hemodialysis Reliable Outflow [HeRO] Graft Implants for Hemodialysis Treatment. Eur J Vasc Endovasc Surg. 2012;44(1):93-99. doi:10.1016/j.ejvs.2012.04.011 4. Milosevic E, Forster A, Moist L, Rehman F, Thomson B. Non-surgical interventions to control bleeding from arteriovenous fistulas and grafts inside and outside the hemodialysis unit: a scoping review. Clin Kidney J. 2024;17(5):sfae089. doi:10.1093/ckj/sfae089

In this powerful episode of the Tick Boot Camp Podcast, we sit down with Ciara Gaglio, a 37-year-old from Woodside, Queens, New York, whose life was completely transformed by Lyme disease. Once a vibrant, social, and creative digital media professional, Ciara's health began to unravel in her late 20s. What followed was nearly a decade of relentless symptoms, countless misdiagnoses, and visits to over 100 doctors before finally receiving a Lyme disease diagnosis at age 36. Ciara opens up about her devastating symptoms, including unrelenting fatigue, neurological issues, full-body pain, kidney distress, and the emotional toll of isolation. She shares her treatment journey—beginning with antibiotics like doxycycline and Rocephin through a PICC line, and later expanding to supportive therapies like herbs, probiotics, yoga, ozone therapy, and more. This candid conversation sheds light on the financial, emotional, and social impact of chronic Lyme disease, as well as the resilience required to keep advocating for yourself in a medical system that too often dismisses patients. Listen to Ciara's journey of courage, humor, and persistence in the face of chronic Lyme disease. Her message is clear: be kind to yourself, advocate fiercely, and never give up.

In episode 54 of Going anti-Viral, Dr Ellen Eaton joins host Dr Michael Saag to discuss the treatment of substance use disorder in an in-patient setting. Dr Eaton is an Associate Professor in the Department of Medicine and Division of Infectious Diseases at the University of Alabama at Birmingham (UAB). Dr Eaton provides and update on a recent termination of a Center for Disease Control and Prevention (CDC) grant that provided overdose prevention education and treatment. She discusses the impact that a recent executive order on unhoused individuals that may have on access to care. Dr Eaton addresses a recent “bad batch” alert warning of contaminated street drugs leading to serious overdose events, and the most common reasons that people are admitted for in-patient care and review treatment of substance use disorder-related infections. They review acute withdrawal in the hospital and Dr Eaton shares her ideal response to substance use disorder in a hospital setting. Finally, Dr Saag and Dr Eaton look forward to the next 10 years of care for people with substance use disorder.0:00 – Introduction1:19 – Update on current issues including access to naloxone and a recent executive order on unhoused individuals4:43 – Update on recent “bad batch” alert regarding serious overdose events7:27 – The most common reasons why people are admitted for in-patient care 11:03 – Treatment of substance use disorder-related infections particularly where prolonged antimicrobial therapy is needed and discussion of the use of a PICC line16:07 – Treatment and preventing acute withdrawal in the hospital including administration of buprenorphine21:46 – The ideal response to substance use disorder in a hospital setting27:00 – How treatment of substance use disorder may improve in the next 10 years__________________________________________________Produced by IAS-USA, Going anti–Viral is a podcast for clinicians involved in research and care in HIV, its complications, and other viral infections. This podcast is intended as a technical source of information for specialists in this field, but anyone listening will enjoy learning more about the state of modern medicine around viral infections. Going anti-Viral's host is Dr Michael Saag, a physician, prominent HIV researcher at the University of Alabama at Birmingham, and volunteer IAS–USA board member. In most episodes, Dr Saag interviews an expert in infectious diseases or emerging pandemics about their area of specialty and current developments in the field. Other episodes are drawn from the IAS–USA vast catalogue of panel discussions, Dialogues, and other audio from various meetings and conferences. Email podcast@iasusa.org to send feedback, show suggestions, or questions to be answered on a later episode.Follow Going anti-Viral on: Apple Podcasts YouTubeXFacebookInstagram...

Activists are suing the Trump Administration for reforms to the Head Start program. Guest: Democrat State Rep. Mari Leavitt is calling out Governor Bob Ferguson for not renewing their contract with PICC. // Big Local: There’s been a surge of people turning in their pets to shelters in Snohomish County. Over 100 kittens were found abandoned in a van. Several pythons that were found in the wild in Mill Creek have been rehomed. // You Pick the Topic: Rick Springfield and Bill Maher say we need less children.

   We learned Thursday that Bill Self was taken to the hospital again for another heart procedure making it at least three times in four years.  A full recovery is expected after two more stents were inserted.  But what we didn't know is that Self has been coaching with a PICC line... a catheter to deliver medicine and nutrition to his heart.  We have the details and the ask the big question about this legendary coach.    In Columbia, Eli Drinkwitz gets a long contract extension but didn't take much of a raise.  Intstead, he got double the amount he can pay his assistants.  You have to love this guy.   Trump is headed to Scotland for five days after touring the Federal Reserve HQ and Jerome Powell on Thursday.  We were surprised there weren't more fireworks.    Chuck E. Cheese was hauled out of the famous pizza place in Florida and arrested by police.... right in front of all the kids.      And we remember the great Hulk Hogan and tie it in to the Song of the Week.

(The Center Square) – After 35 years, the Pediatric Interim Care Center in Kent – the only specialized medical facility in western Washington caring for drug-exposed babies – stopped accepting new intakes on Monday. That's because the Department of Children, Youth & Families canceled its contract with the Pediatric Interim Care Center, or PICC, citing state budget cuts.

(The Center Square) – After 35 years, the Pediatric Interim Care Center in Kent – the only specialized medical facility in western Washington caring for drug-exposed babies – stopped accepting new intakes on Monday. That's because the Department of Children, Youth & Families canceled its contract with the Pediatric Interim Care Center, or PICC, citing state budget cuts. Support this podcast: https://secure.anedot.com/franklin-news-foundation/ce052532-b1e4-41c4-945c-d7ce2f52c38a?source_code=xxxxxx Read more: https://www.thecentersquare.com/washington/article_13e3550b-a955-4a27-a29a-5ba079f2282a.html

Send us a textIt's a common scenario for a cancer patient. They're undergoing treatment and get what's known as a peripherally inserted central catheter or PICC (pronounced “pick”) line to make it more convenient to administer drugs. They are in and out of the hospital or just the clinic frequently to see various providers. The treatment they receive may run down their immune system a little bit. Just having cancer may have damaged their immune system.So then they get an infection.Perhaps it's no big deal. A round of antibiotics may take care of it. However, increasingly, these infections are resistant to antibiotics – something known as antimicrobial resistance or AMR.Then, the patient must wait weeks or even months to resume cancer treatment while the infection is treated. And, all too often, the infection itself may kill the patient. In fact, infections are the second-leading cause of death for cancer patients.Dr. Yehoda M. Martei, Assistant Professor of Medicine (Hematology-Oncology) at the Hospital of the University of Pennsylvania, and colleagues have been working to find out just how common these infections are. Among patients hospitalized for treatment, cancer patients were up to twice as likely to get a drug-resistant infection, she and colleagues found. Among outpatients – people getting treatment at clinics or offices but not staying in the hospital – cancer patients had three times the risk of drug-resistant infections.Listen as Dr. Martei tells One World, One Health host Maggie Fox about her findings, what they mean, and what must be done to protect cancer patients and ensure infections don't stop them from getting the treatment they need.

En un programa anterior, les hablamos sobre el informe del PICC (Panel Intergubernamental de las Naciones Unidas sobre el Cambio Climático) diseñado para asustar a la gente con las advertencias acerca de la destrucción de nuestro planeta si los gobiernos del mundo no toman medidas serias para combatir el calentamiento global provocado por el hombre… To support this ministry financially, visit: https://www.oneplace.com/donate/1235/29

El último día de Marzo del 2014, el Panel Intergubernamental de las Naciones Unidas sobre el Cambio Climático (PICC) publicó un informe que advierte que los efectos del cambio climático ya se están produciendo en todos los continentes… To support this ministry financially, visit: https://www.oneplace.com/donate/1235/29

In this episode, we're joined by two wonderful members of Pine Island Community Church's Hugs Program and Food Pantry team — Pat Downes and LaDonna Lippincott. Alongside their dear friend Dort Koetje, these women are affectionately known as “the Marthas” for their heart of service and gift for hospitality. Each week, they spend Mondays cooking meals with love and care, and on Tuesdays, they bring the prepared dishes to the church, setting up and serving them right next to the Food Pantry. It's a labor of love, fueled by faith and a deep commitment to serving God's people. Tune in to hear their inspiring story — and to discover the special reason they've earned the name “the Marthas.”

Former All Whites goalkeeper Jake Gleeson says he contemplated taking his life after prolonged surgeries turned into a battle for survival and forced his early retirement. In August 2018, while contracted to the Portland Timbers in the United States, Gleeson had surgery to treat stress fractures in both legs. It should have been a routine procedure, but he developed osteomyelitis from an infection. What followed was not only a physical struggle but an emotional descent that would push him to the brink. Fourteen surgeries later, and nearly five years after Gleeson began legal action, a jury found doctor Richard Edelson guilty of medical negligence for failing to properly disinfect the plates inserted into Gleeson's legs before the initial operation. Gleeson, now 34, was awarded US$20.4 million (NZ$35.7m) in damages. What was meant to be a three-month stint on the sidelines turned into a nightmare of medical complications and forced Gleeson to retire, having made 59 appearances for the Timbers and winning eight caps for the All Whites between 2011 and 2014. The fallout has been brutal for Gleeson, who struggles to complete mundane tasks such as exercising. The mental toll has been equally devastating. Speaking to Newstalk ZB's Jason Pine on Weekend Sport, Gleeson says he reached a point where he considered taking his life. “I'd been prescribed so many opioids, like painkillers and anti-anxiety medication, I filled this pill jar up with enough pills that I know that if I took it all at once it would kill me. “I drove out a few times to different places around Portland with that. I had that around me for ... a few months and there were some close calls where I thought that that was going to be the day. “There were points I just didn't want to live any more. Simple as that. “But I never went through with it, which I'm happy about. The last few years have been a slow climb out of a very deep, dark hole.” After his initial surgery, things appeared normal but, after two weeks, an infection on his right leg appeared. Antibiotics initially worked, but the infection worsened and he needed a second operation. At this point, pus was coming out of the wound and Gleeson was given a PICC line - a type of catheter - that was pumping antibiotics from his leg to an artery near the heart. It was a further two weeks before the plate in his right leg came out. Days later, problems began in his left leg. Portland Timbers goalkeeper Jake Gleeson shows his disappointment after the the 4-1 loss against Real Salt Lake in 2017. Photo / Getty Images “I saw that same redness, same warmth, same everything that was a sign of infection, and they pulled that plate out straight away. “Because I developed osteomyelitis in my right leg, essentially the infection had travelled through my blood and settled on the foreign hardware on my left leg. “If they had just removed the plate on the first surgery, or even checked the underside of it to know that that's where the infection was, we could have avoided a lot more of the surgeries that I went through.” Gleeson had another appointment with Edelson, who was pleased with the recovery of the left leg, but problems were still occurring with the right. Despite raising concerns, Gleeson was told “it's just bad blood flow, the wound will heal and you're fine”. An angry Gleeson consulted another team doctor and was immediately rushed to hospital, where he had three surgeries in five days to clear the osteomyelitis and dead bone. “They had to go in and chunk out parts of my bone and there was dead tissue in there,” he recalls. “My body had gone septic and I had a 40-degree temperature, cuddling a bag of ice on my couch with all this medicine still coursing through me every week.” It was at this point that he found out Edelson had not properly sanitised an orthopaedic plate, after realising he was missing one and bringing one in from an outside facility during the surgery. As Gleeson improved after working with a new doctor, he opted to have metal rods inserted into both legs in February 2019 in an effort to save his career. He had four more operations but the rod in his right leg became immediately infected. Three weeks later, doctors said the rods had to come out. In July 2020, Gleeson formally began legal action. Finally, on March 29, a Multnomah County jury in Portland agreed that Edelson had violated his duty of care and awarded NZ$35.7m to Gleeson. “This is the first step and, once again, a very long path,” says Gleeson. “I don't think it's sunk in yet. I'm very tired still. “The money is a bonus once we figure out what it all looks like, because I'm not currently sitting with a huge cheque in my account. “Once it settles and is confirmed, I've already started conversations with some local groups around here to highlight this, and I want to kind of utilise it also to bring attention to mental health, especially for athletes. “I would like to go somewhere nice with my fiancée and throw my phone in a lockbox somewhere and take a week to take some deep breaths and start to put this all behind us as we move forward with our lives.” He says the Timbers club was poorly managed at the time and “swept me under the rug”. The figures involved have since gone and he is excited about attending his first Timbers match since the ordeal later this month. He says he would do anything to be able to step onto the pitch one last time, but is looking forward to be involved again in the sport he loves, having initially walked away from it. He is also looking forward to seeing the All Whites in action at next year's World Cup, which is being co-hosted by the USA, Canada and Mexico. “I couldn't be more excited for the All Whites and the boys on the team that I know and all the young guns coming through. “They're an impressive bunch, so I'll be there supporting them for sure. Hopefully they can cause some upsets.” SUICIDE AND DEPRESSION Where to get help:• Lifeline: Call 0800 543 354 or text 4357 (HELP) (available 24/7)• Suicide Crisis Helpline: Call 0508 828 865 (0508 TAUTOKO) (available 24/7)• Youth services: (06) 3555 906• Youthline: Call 0800 376 633 or text 234• What's Up: Call 0800 942 8787 (11am to 11pm) or webchat (11am to 10.30pm)• Depression helpline: Call 0800 111 757 or text 4202 (available 24/7)• Helpline: Need to talk? Call or text 1737• Aoake te Rā (Bereaved by Suicide Service): Call or text 1737If it is an emergency and you feel like you or someone else is at risk, call 111 See omnystudio.com/listener for privacy information.

This week's topics include catheter material for PICC lines, a diabetes medication for kidney stones, driver mutation clearance and relapse prediction, and exercise and heart failure.

In this episode we talk about this years NFL Matchups and give my Picc'Em on the first round of the playoffs.

Did you know that Multi-Organ Dysfunction Syndrome (MODS) can result from both infectious and non-infectious causes? In our latest episode, we delve deep into the pathophysiology of MODS, exploring how different organs interact and fail in sequence. We discuss key concepts like organ functional reserve and the kinetics of organ injury, which aren't as straightforward as they seem. Tune in to learn about the non-linear progression of organ damage and how it impacts management strategies in pediatric critical care.We break down the case into key elements:Patient Background: A 15-year-old girl with chronic TPN dependence and a PICC line presented with septic shock and respiratory failure.Initial Presentation: Blood cultures confirmed Gram-negative rod bacteremia. She developed multi-system complications, including acute kidney injury (AKI), thrombocytopenia, and cardiac dysfunction.Management: Broad-spectrum antibiotics, mechanical ventilation, vasoactive agents, and supportive care for MODS.Key Case Highlights:Clinical case of a 15-year-old girl with sepsis from a gram-negative rodDependence on total parenteral nutrition (TPN) and prolonged PICC line useDiscussion of septic shock, acute respiratory failure, and acute kidney injuryOverview of multiple organ dysfunction syndrome (MODS) and its definitionsPathophysiology of MODS, including organ functional reserve and kinetics of organ injuryMolecular mechanisms involved in MODS, such as mitochondrial dysfunction and immune responsesSpecific phenotypes of sepsis-induced MODS, including TAMOF and IPMOFManagement strategies for MODS, emphasizing multidisciplinary approachesRole and complications of therapeutic plasma exchange (TPE) in treating MODSImportance of recognizing signs of MODS and timely intervention in pediatric patientsSegment 1: MODS Definitions and PhenotypesKey Definition: MODS is the progressive failure of two or more organ systems due to systemic insults (infectious or non-infectious).Phenotypes:TAMOF (Thrombocytopenia-Associated Multi-Organ Failure): Characterized by thrombocytopenia, hemolysis, and decreased ADAMTS13 activity.Immunoparalysis: Persistent immunosuppression and risk of secondary infections.Sequential Liver Failure: Often associated with viral triggers.Segment 2: Pathophysiology of MODSMolecular Insights:Mitochondrial dysfunction and damage-associated molecular patterns (DAMPs)Innate and adaptive immune dysregulationMicrocirculatory dysfunction and ischemia-reperfusion injuryOrgan Interactions: MODS evolves through complex multi-organ interdependenciesSegment 3: Diagnosis and Evidence-Based ManagementKey Diagnostic Pearls:MODS is not solely infection-driven; it requires a shared mechanism and predictable outcomes.Use biomarkers like ADAMTS13 and TNF-α response for phenotypic classification.Management Highlights:Supportive Care: Multisystem approach including lung-protective ventilation, renal replacement therapy, and hemodynamic support.Therapeutic Plasma Exchange (TPE): Especially effective in TAMOF by restoring ADAMTS13 and removing inflammatory mediators.Segment 4: Practical Tips for IntensivistsEarly recognition of MODS phenotypes for targeted therapyImportance of multidisciplinary teamwork in critical care settingsMonitoring for complications like TMA and immunoparalysis during prolonged ICU staysFollow Us:Twitter: @PICUDocOnCallEmail:

Dr. Jerry Brown, TIME Person of the Year, joins Mike Shanley to discuss Dr. Brown's work during the Ebola crisis, COVID-19 response and lessons learned for global pandemic preparedness, becoming TIME Person of the Year, and the role of international aid donors and implementing partners. Co-host: Care Africa Medical Foundation (CAMF) focuses on building clinics in rural Liberia, starting with their hometown of Buchanan in Grand Bassa County, where they have organized free health fairs to provide essential health resources. In addition to their nonprofit efforts, Henry and Gormah run successful businesses that cater to the aging population and assist the homeless in Colorado, creating over 60 local jobs. CAMF plans to open its first medical center in Grand Bassa County in the spring of 2025, addressing urgent healthcare needs. However, the lack of reliable electricity poses a significant challenge to operating medical equipment. As a registered 501(C)(3) organization, CAMF aims to make a lasting impact on healthcare in Africa and inspire others with its dedication to health and community service. https://www.linkedin.com/in/care-africa-medical-foundation-536206336/ https://www.camedfoundation.org/about/ Biography Jerry Fahnloe Brown was born on October 18, 1968. Dr. Brown has worked in several capacities as physician. He worked as Escort Doctor for MERCI on boats repatriating Sierra Leonean Refugees back to Sierra Leone. He then worked as the County Health Officer for Grand Bassa County and Medical Director for the Buchanan Government Hospital from 2006 to 2008 after working as a Volunteer Physician at the ELWA Hospital and General Practitioner from 2004 to 2006. In March 2014 he was employed as Medical Director and General Surgeon at the ELWA Hospital a position he held until February 2018 when he was appointed by the President of Liberia to serve as the Chief Medical Officer of the John F. Kennedy Medical Center, the premier teaching and referral hospital. During those years at ELWA, he worked tirelessly performing varieties of surgeries in this low resource setting. He became Clinical Supervisor and Clinician at the ELWA II Ebola Treatment Unit from July 2014 to June 2015. Under his leadership and guidance this unit produced the highest number of Ebola survivors changing the survival rate from ten percent to seventy percent of Ebola Patients at his Center. From October 2014 to December 2016, he served as Principal Investigator on two research projects with the Clinical Research Management on convalescent plasma and the sequelae of Ebola in survivors. In 2018, he was appointed by the President of Liberia as the Chief Executive Officer of the John F. Kennedy Medical Center, the premier referral hospital in Liberia, a position held until January 30, 2024, due to the political transition of power. While at JFKMC, he established the only active functional Intensive Care Unit in country with support from partners such as Project Cure International and NOCAL. Under his leadership JFKMC, obtained accreditation for training specialists in the areas of pediatrics, internal medicine, general surgery, ophthalmology and psychiatric. He also established the only histopathology unit; a state of the art executive private ward; a dialysis center among others. On May 23, 2019, he was elected Civilian Representative and Advisor to APORA. He also serves as Acting Faculty Head, Department of Surgery, A. M. Dogliotti College of Medicine for two years, and is currently a Part-Time Faculty member, in the Department of Surgery, Liberia College of Physician and Surgeon. In March 2020, he was appointed by the president of Liberia to serve as the Head of the National Case Management Pillar of COVID-19. He coordinated the management of COVID-19 patients across the country and the care of patients with COVID-19 vaccine related complications. He supervised the drafting of Liberia COVID-19 Clinical Guidelines. Dr. Brown has received many honors to include, Time Person of the Year in 2014; among Time 100 Most Influential Persons, 2014; Civil Servant of the Year, 2014, Republic of Liberia; President of Liberia Highest Honor, Star of Africa in 2015; Golden Key Awards, 2018; He has spoken as several places to include Keynote Speaker, PICC 2016, 8th World Congress on Pediatric Intensive and Critical Care, Toronto Canada, June 2016; keynote Speaker, Case Western University, Ohio, October 2015; Keynote Speaker, Risky Business Conference, London, UK, May 2017; Speaker, American Society of Tropical Medicine and Hygiene, (ASTMH) 64TH Annual Meeting, ASTMH Ebola 360 symposium, October 2015; Pepperdine University, Dean Honorary Speaker—Leadership June 2017.    Thank you for tuning into this episode of the Aid Market Podcast. Learn more about working with USAID by visiting our homepage: Konektid International and AidKonekt. To connect with our team, message the host Mike Shanley on LinkedIn  

Join us for an enlightening conversation with Carla Wrenn as she explores the critical intersection of gut health and oncology care. Drawing from her extensive clinical experience, Carla shares powerful insights into how practitioners can support oncology patients through evidence-based microbiome interventions.From groundbreaking research on microbiome patterns in cancer screening to practical strategies for managing treatment side effects, this episode offers valuable guidance for healthcare practitioners working with cancer patients. Carla's thoughtful discussion bridges the gap between conventional cancer treatments and integrative support, emphasizing safety, efficacy, and patient well-being.Key Episode Highlights:The emerging role of microbiome patterns in cancer detection and treatment, with specific bacterial signatures potentially serving as future screening tools.Critical safety guidelines for probiotic use in cancer care, including essential monitoring protocols for neutropenic patients and those with PICC lines.Practical strategies for supporting four distinct patient groups: newly diagnosed, post-treatment, end-stage, and those seeking preventive care.Evidence-based interventions for managing treatment side effects, including innovative approaches like glutamine supplementation and coffee/honey rinses for oral complications.The surprising connection between oral health and cancer outcomes, particularly in breast cancer, highlighting the importance of dental care during treatment.How proper microbiome support may enhance conventional treatment efficacy, with insights into implementing integrative strategies that align with current research.This episode is essential listening for practitioners seeking to enhance their oncology support protocols through evidence-based integrative approaches.Shownotes and references are available on the Designs for Health websiteRegister as a Designs for Health Practitioner and discover quality practitioner- only supplements at www.designsforhealth.com.au Follow us on Socials Instagram: Designsforhealthaus Facebook: Designsforhealthaus DISCLAIMER: The Information provided in the Wellness by Designs podcast is for educational purposes only; the information presented is not intended to be used as medical advice; please seek the advice of a qualified healthcare professional if what you have heard here today raises questions or concerns relating to your health

One frustrating thing about Hannah's care is that we rarely had the opportunity to talk privately with her healthcare providers.  Hannah was always present, listening attentively, while her doctors and nurses talked with us about her most recent scans, blood work results, treatment plans, etc.  I always wondered how honest they were really being when Hannah was sitting right there with us soaking it all in.When Hannah was taken back to have her PICC line inserted, I had a rare few minutes alone with her primary care nurse.  The nurse spent part of that time reviewing the at-home care that the PICC line was going to entail, then asked if I had any questions.  I did have a question ... a burning question ... but I wasn't sure I could pull myself together well enough to ask it.Thank you for joining me for another bonus episode of the While We're Waiting podcast in this year-long series in which I share our family's experiences as our teenage daughter Hannah battled glioblastoma brain cancer from February 2008 through February 2009.  My desire is to process through the events of those twelve months with the perspective that 16 years has brought … and point listeners to hope in Jesus along the way.I would love to hear your thoughts on the show. Click here to send me a message!** IMPORTANT** - All views expressed by guests on this podcast are theirs alone, and may not represent the Statement of Faith and Statement of Beliefs of the While We're Waiting ministry. We'd love for you to connect with us here at While We're Waiting! Click HERE to visit our website and learn about our free While We're Waiting Weekends for bereaved parentsClick HERE to learn more about our network of While We're Waiting support groups all across the country. Click HERE to subscribe to our YouTube channelClick HERE to follow our public Facebook pageClick HERE to follow us on Instagram Click HERE to follow us on Twitter Click HERE to make a tax-deductible donation to the While We're Waiting ministryContact Jill by email at: jill@whilewerewaiting.org

https://www.artscroll.com/ Books/lemynh.html  Living Emunah on Yamim Noraim Gaining faith from the Days of Awe A man told that from the moment his baby came home after his Brit Milah, he wouldn't stop crying. Nothing could calm him down. He would eat, doze, and immediately wake up crying again. It was obvious that something was hurting him, but nobody knew what it was. All different kinds of advice began coming their way. One person suggested one type of doctor, another suggested a type of counselor, another an allergy specialist. All of those professionals were prepared to see their baby, but for a high cost and a lot of effort on their part. The man said to himself, "Let me first set up a meeting with the Healer of All Flesh." The man wanted to dedicate an hour to the meeting, no less than he would if he were meeting some professional. He prepared for the meeting. He got dressed up. He took time out from work and sat at a table saying Tehillim . He had a full one-hour meeting with the greatest doctor of all. Before the hour was up, his mother-in-law called his wife and told her about a new idea she had just heard about, something they could try right away. His wife listened to the advice and immediately the baby was quiet. The baby slept for several hours and since then has been calm and happy. The problem was resolved. When we have the right approach with Hashem, all of His messengers suddenly "change their tune". A man told me he had to go with his father on Shabbat to the hospital in a Hatzalah truck, because the Hatzalah told them he needed a PICC line to get certain vital nutrients. They arrived at the hospital and had to wait for the cardiovascular team to arrive. They waited there the entire night, but the team still didn't come. In the morning, the man went to see if there was some type of Bikur Cholim room where he could find food for Shabbat. From the time that he left the hospital room until the time he got back was about 45 minutes. When he got back, the nurse told him he had missed the cardiovascular team. They were not able to put in the PICC line without his permission and so they left. She said they would be back the following day. The man couldn't believe his ears. He was waiting the entire night for them, and now he missed them? He started to cry. The nurse apologized, but said they were there more than a half hour ago and this was their last stop before they went home. The man was going to have a fit, but instead he decided to take the emunah approach. He went into a corner and began speaking to Hashem. He said, "Hashem, you brought me away from my family for Shabbat. I don't have my shul. I don't have my learning. I don't have my seudot, and now we didn't get the PICC line either. If you want me to come here just to spend the entire Shabbat in a hospital, then I'm going to do it b'simcha ." He strengthened himself and accepted the will of Hashem with happiness. Just a few minutes later, the cardiovascular team showed up. They said they decided to come back and try one more time. This man made the correct approach with Hashem and, suddenly, the messengers followed suit. Another man said he lost a business account and tried his hardest to accept it with love. Instead of not going out to learn that night, he pushed himself to add a second class. The next day his mortgage company called him and told him about an escrow surplus check that they sent a full year ago that never got cashed. The amount was more than the commission that he usually earned for the entire year from the account he lost. It's true we have to make hishtadlut in the way of the world, but when we first go to Hashem and accomplish what we need to with Him, everything else falls into place afterward.

The treatment landscape for Lyme disease has undergone significant evolution over the years, offering a wider array of options to manage this multifaceted illness. When I first began treating Lyme disease in 1987, the primary antibiotic prescribed was doxycycline. This choice was driven by doxycycline's effectiveness not only against Lyme disease itself but also against co-infections such as Ehrlichia and Anaplasmosis. These co-infections, often transmitted by the same ticks that carry Lyme, present additional challenges in patient management. However, when patients couldn't tolerate doxycycline due to side effects or failed to respond to the treatment, rifampin emerged as a viable alternative. For pediatric patients, the treatment approach required special consideration. amoxicillin was commonly used to avoid the risk of dental staining associated with doxycycline, which can be a concern for growing children. However, the limitation of amoxicillin lies in its inability to combat co-infections like Ehrlichia or Anaplasmosis. Over time, other antibiotics related to amoxicillin, such as Pen VK, IM Bicillin, Omnicef, and Ceftin, became available. Of these, Ceftin (cefuroxime axetil) is notably the only one FDA-approved specifically for Lyme disease, reinforcing its role in the treatment regimen. When dealing with neurologic Lyme disease, which can involve the central nervous system and present with symptoms such as memory loss, cognitive difficulties, and neuropathy, the approach often necessitates more aggressive treatment. Intravenous (IV) antibiotics like ceftriaxone (Rocephin) and Claforan were preferred due to their ability to cross the blood-brain barrier, a crucial factor in effectively treating neurological manifestations. These IV antibiotics are essential for some patients, particularly those with severe or persistent symptoms, but they are not without risks. The use of PICC lines for IV administration carries potential complications, including infections and blood clots. Interestingly, in my experience, many patients with chronic neurologic Lyme have shown significant improvement with oral antibiotics, allowing them to avoid the complexities and risks associated with IV treatments. For patients who are allergic to or unable to tolerate doxycycline, or for those who are sun-sensitive—a common side effect of doxycycline—Zithromax (azithromycin) and Biaxin (clarithromycin) have emerged as effective alternatives. These antibiotics belong to the macrolide class and have shown efficacy comparable to doxycycline in the majority of clinical studies, offering additional options for patient care. In the treatment of co-infections like Bartonella, the approach becomes more nuanced. Bartonella, initially identified as the causative agent of cat scratch fever, has been a subject of ongoing debate in the context of Lyme disease. This bacterium is traditionally associated with transmission through cat scratches, where the bacteria are introduced under the skin from cat saliva or flea feces. However, there is growing evidence suggesting that Bartonella may also be transmitted via tick bites, complicating the clinical picture for Lyme disease patients. In treating suspected Bartonella co-infections, I have employed antibiotics from the doxycycline, Zithromax, and rifampin families, drawing on research related to cat scratch fever. Additionally, I have used Bactrim (trimethoprim-sulfamethoxazole) in some cases. However, I generally avoid fluoroquinolones like ciprofloxacin due to their association with severe side effects, including joint pain, tendonitis, and tendon ruptures. Babesia, another common co-infection found in Lyme disease patients, requires a different treatment approach altogether. Babesia is a parasite that infects red blood cells, causing symptoms similar to malaria. For treating Babesia, I often prescribe atovaquone, availa

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.       Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. Welcome to "Ditch the Lab Coat," the podcast where we dive into pressing health issues with scientific skepticism and heartfelt curiosity. I'm your host, Dr. Mark Bonta, and in this episode, we are back with our second part to the two-part series focused on the intricate world of addiction treatment.Joining us today are two distinguished guests: Dr. Jon Mong, a general internal medicine and addictions physician, and Dr. Wiplove Lamba, an addiction psychiatrist. Together, Dr. Mong and Dr. Lamba will shed light on the promise and perils of new treatment approaches, underscore the necessity of comprehensive support systems, and point to the pivotal role of social supports and stable housing in fostering sustainable recovery.We also tackle the cultural and historical context of the opioid crisis, including the profound impact of Purdue Pharma and the Sackler family. Dispelling misconceptions about fentanyl, you'll learn about the real risks, the invaluable role of naloxone, and practical steps for overdose prevention.This episode is not just about groundbreaking therapies; we will discuss the critical need for rigorous, high-quality data to back new treatments and reflect on the significant influence of private companies in the field. Our guests will emphasize the paramount importance of addressing the root causes of substance use, building life skills, and creating supportive networks to prevent relapses.Lastly, this episode will feature discussions on opioid tolerance, withdrawal management, and the nuanced balance between the risks of prescribing medications versus the risks of untreated withdrawal. You'll gain insights into how healthcare teams can shift their perceptions and practices to better support patients with substance use disordersStay tuned as we unravel these topics and much more. So, grab your headphones and get ready for an enlightening conversation on addiction treatment with Dr. Jon Mong and Dr. Wiplove Lamba. Let's dive in!04:17 Challenges and future of addiction treatment discussed.09:36 Understanding withdrawal challenges in hospitals with unknown dosages.12:02 Provide proper care despite addiction-related complications.16:20 Colleague's guarded due to personal trauma, concerns.20:05 Conversations led hospital to adopt PICC lines.21:54 New grads integrate social responsibility with medical care.27:20 Risk from checking on overdose is minimal.29:15 There can't be too much widely accessible Narcan.34:00 Need rigorous study for psychedelics in treatment.35:39 Concerned new treatments overshadow foundational patient support measures.41:40 "Cured" involves functional life, stability, coping mechanisms.42:52 Substance use disorder: Patients can achieve long-term remission.46:01 Meet needs without substances to avoid relapse.

Augie Shanahan, CEO of Piccolo Medical, joins this episode to discuss the challenges and opportunities in the field of central venous catheter placement. He highlights the limitations of current Peripherally inserted central catheter (PICC) technologies and the need for more accurate and reliable navigation methods.Piccolo Medical is developing innovative solutions to address these challenges, including their proprietary ionic dilution technology that provides real-time blood flow visualization. This technology has the potential to improve the accuracy and safety of catheter placement, especially in patients with arrhythmias.Augie shares insights into the company's journey, from its origins as a spin-out from the TheraNova incubator to its recent FDA clearance for the Easy Guide Connector. As an engineer turned CEO, Augie has plenty of great perspectives of the numerous challenges in successfully developing a novel medical, insights sure to leave you informed and inspired.Be sure to join us on September 25-26 at MEDevice Boston where you can hear from other innovators leading the charge to help improve patient lives (use the code IMPACT to get your free expo pass and 20% conference ticket discount at the checkout).

Send us a Text Message.In this episode of Investing RN, we sit down with Jumer Adalin, a nurse and social media strategist, to discuss his journey from working in the ICU to launching a successful Instagram consulting business. Jumer shares his personal story, including the challenges of being a foreign-educated nurse in the U.S., and how he transitioned to becoming a PICC nurse and, eventually, a social media consultant. We dive deep into the importance of building a personal brand, creating a content strategy that works, and how social media can be more than just a tool for selling—it can be a gateway to freedom and financial independence.Whether you're a nurse looking to break free from the grind of bedside nursing or someone interested in leveraging social media to build a brand, this episode is packed with actionable insights and inspiration.Timestamps:00:00] - Highlight/Introduction[01:22] - Welcoming Jumer Adalin to the Podcast[05:30] - Jumer's Journey: From the Philippines to the U.S. Nursing Scene[10:12] - Challenges of Being a Foreign-Educated Nurse in the U.S.[14:30] - Transitioning from ICU to PICC Nursing[18:45] - Burnout and Finding a New Path in 2020[24:15] - Launching a Social Media Consulting Business[28:30] - Importance of Building a Personal Brand[35:50] - How to Create a Content Strategy That Works[42:20] - The Role of AI in Social Media and Marketing[50:15] - Balancing Authenticity and AI in Online Business[55:45] - Final Thoughts and Where to Find Jumer OnlineAbout the Guest:Jumer Adalin is a nurse and social media consultant who transitioned from working in the ICU to helping nurse entrepreneurs build successful online brands. With a deep understanding of the challenges faced by healthcare professionals, Jumer specializes in teaching nurses how to effectively use Instagram to grow their businesses and create financial freedom. His program, Scrubs to Social Academy, empowers nurses to leverage social media as a powerful marketing tool, helping them attract clients and achieve their business goals.Links & Resources:Follow Jumer Adalin on Instagram: www.instagram.com/jumeradalin/Jumer's Website: www.jumeradalin.comBe sure to follow us on instagram here Subscribe to our YouTube channel here Click the link, share your contact details, and we'll help you get started on your investment journey. Start now!

In our broadcast on August 12, 2024, co-hosts Wendy Rose Williams and Gregg Kirk analyze and discuss Gregg's personal story of Lyme disease diagnosis, treatment, and resulting spiritual awakening.During the course of the broadcast, Gregg's debunks some myths about the illness and gives tips on diagnosis and treatments before going into the details of his own struggles through the disease that lasted 12 years. He also focuses on the mental, emotional, and even spiritual components that helped him through a near-death experience from a botched PICC-line insertion. From there Gregg gives insight on some of the lessons he learned that helped him turn this seemingly disastrous situation into one of the most uplifting events of his life.To view the 85-minute broadcast in its entirety: Gregg's Lyme Story -- 8/12/24 - YouTubeCONTACT WAKING UP SPIRITUALLY HERE...Our website: https://wakingupspiritually.com/Wendy Rose Williams' website: https://www.wendyrosewilliams.com/Gregg Kirk's website: https://greggkirk.comWaking Up Spiritually YouTube channel: https://www.youtube.com/@wakingupspiritually6114/videosWaking Up Spiritually Facebook page (ask to be invited): https://www.facebook.com/groups/wakingupspirituallyEmail us: wakingupspiritually@gmail.com

In this podcast, Pastor Michelle Browne and Jen Jennings speak about the Pine Island Community Church.  Pastor Michelle describes the many services the community church offers and Jen, the Manager of the PICC Thrift Store, shares how she enjoys managing the thrift store.  You will hear how much these wonderful individuals love supporting the Pine Island community.  They will tell you, ‘Loving our neighbors is something we take seriously at PICC.  We believe in LOVE in ACTION.  We are a serving community'. To listen to the podcast, use your favorite podcast app or go to our website, https://pineislandexperience.com For more information, email pineislandexperience@gmail.com

Ospiti: Impallomeni:" Se torna con il rinnovo di Kvara, De Laurentis fa un capolavoro." Brambati:"Se Kvara non rimane è un bel casino." De Canio:" Sono fiducioso che Kvara possa rimanere, deve fare un patto." Maracana Con Marco Piccari e Stefano Impallomeni.

This time we get to hear from Paige Lewis, a clearly unstoppable leader and executive coach. Paige grew up in the Phoenix area until she went to college at the University of Texas where she learned about advertising and business. After college she spent a year in Japan selling products for Estee Lauder after which she returned to the U.S. Through an introduction from a friend she secured a position at Disney in Home Entertainment. Later she moved to DreamWorks and then to Universal where again she specialized in Home Entertainment. At Universal she rose to the position of Senior Vice President.   Paige thought she had reached the “pinnacle of her career”, but over a short time she became seriously ill and was hospitalized for a week. As she describes that time now, she experienced serious burnout. She quit her position at Universal and began an analysis of her life which lead her to realize that she truly enjoyed mentoring people. She became a certified coach and has spent the past six years with her own business coaching and helping mainly senior level women to not “make the same mistakes she made”.   I think you are going to hear some good observations from Paige. She has wonderful life advice we all can use. I hope very much you enjoy what she has to say.     About the Guest:   Paige Lewis is a leadership coach who spent over two decades as a highly regarded leader in marketing, building some of the world's most iconic entertainment brands for Disney, DreamWorks and Universal Pictures.  After being promoted to Senior Vice President of Marketing at Universal Pictures, Paige had reached what she thought was the pinnacle of her career.  But she ended up in the hospital with a deadly infection brought on by extreme burnout.    Soon after, she left the corporate world to heal her body and figure out why she had reached a breaking point without realizing what was happening along the way. She has turned her experience into her mission: turning executive burnout into career success. With a unique ability to transform complex challenges into actionable insights and the real-world business experience as a former executive, Paige is a trusted guide for leaders seeking to excel without compromising well-being. She is dedicated to helping organizations and people realize their greatest purpose and impact without sacrificing their productivity, health, values and most meaningful relationships.     Paige is one of the elite Founding Los Angeles coaches at CHIEF, a network recognized by Fast Company's Most Innovative Companies list, created to drive more women into positions of power and keep them there. She has coached over 200 individuals and groups across Fortune 100 companies, nonprofits, media and marketing agencies, and start ups. She holds an MBA from the Thunderbird School of Global Management and a Bachelor of Science in Advertising from the University of Texas at Austin. ** ** Ways to connect with Paige:   Website: ** https://paigeonecoaching.com; PaigeOneCoaching.com LinkedIn: https://www.linkedin.com/in/paige-lewis/;  Paige Lewis Sandford | LinkedIn     About the Host: Michael Hingson is a New York Times best-selling author, international lecturer, and Chief Vision Officer for accessiBe. Michael, blind since birth, survived the 9/11 attacks with the help of his guide dog Roselle. This story is the subject of his best-selling book, Thunder Dog.   Michael gives over 100 presentations around the world each year speaking to influential groups such as Exxon Mobile, AT&T, Federal Express, Scripps College, Rutgers University, Children's Hospital, and the American Red Cross just to name a few. He is Ambassador for the National Braille Literacy Campaign for the National Federation of the Blind and also serves as Ambassador for the American Humane Association's 2012 Hero Dog Awards.   https://michaelhingson.com https://www.facebook.com/michael.hingson.author.speaker/ https://twitter.com/mhingson https://www.youtube.com/user/mhingson https://www.linkedin.com/in/michaelhingson/   accessiBe Links https://accessibe.com/ https://www.youtube.com/c/accessiBe https://www.linkedin.com/company/accessibe/mycompany/   https://www.facebook.com/accessibe/       Thanks for listening!   Thanks so much for listening to our podcast! If you enjoyed this episode and think that others could benefit from listening, please share it using the social media buttons on this page. Do you have some feedback or questions about this episode? Leave a comment in the section below!   Subscribe to the podcast   If you would like to get automatic updates of new podcast episodes, you can subscribe to the podcast on Apple Podcasts or Stitcher. You can also subscribe in your favorite podcast app.   Leave us an Apple Podcasts review   Ratings and reviews from our listeners are extremely valuable to us and greatly appreciated. They help our podcast rank higher on Apple Podcasts, which exposes our show to more awesome listeners like you. If you have a minute, please leave an honest review on Apple Podcasts.     Transcription Notes:** Michael Hingson ** 00:00 Access Cast and accessiBe Initiative presents Unstoppable Mindset. The podcast where inclusion, diversity and the unexpected meet. Hi, I'm Michael Hingson, Chief Vision Officer for accessiBe and the author of the number one New York Times bestselling book, Thunder dog, the story of a blind man, his guide dog and the triumph of trust. Thanks for joining me on my podcast as we explore our own blinding fears of inclusion unacceptance and our resistance to change. We will discover the idea that no matter the situation, or the people we encounter, our own fears, and prejudices often are our strongest barriers to moving forward. The unstoppable mindset podcast is sponsored by accessiBe, that's a c c e s s i capital B e. Visit www.accessibe.com to learn how you can make your website accessible for persons with disabilities. And to help make the internet fully inclusive by the year 2025. Glad you dropped by we're happy to meet you and to have you here with us.   Michael Hingson ** 01:21 Well, hi, and we want to welcome you to unstoppable mindset. This is our latest episode, needless to say, and we're really glad that you're here with us today we get to chat with Paige Lewis Sanford and I'm sure you're all familiar with Paige. Oh, you're not? Well, you will be by the time we're done here. Paige is a fascinating individual. She's worked to help improve and greatly increase the brands of organizations such as Disney and DreamWorks universal and my gosh, I don't know what all and hopefully, her influence will rub off and help unstoppable mindset but we're gonna see about that. So Paige, welcome to unstoppable mindset. And whatever happens, we're glad you're here.   Paige Lewis ** 02:07 Thank you for having me. I'm excited to be here. Well,   Michael Hingson ** 02:11 it'll be a lot of fun. And we'll, we'll make it useful and fun in some way or another. And as I told you earlier, one of the rules of the podcast is we got to have fun. So that's as good as it gets. Well tell me a little about kind of the early page growing up and all that sort of stuff.   Paige Lewis ** 02:28 Well, I am a Phoenician, I grew up in Phoenix, Arizona. So I am a lover of the sun to this day, and had a really a really lovely childhood. I have a younger brother. He's 14 months younger, we were very close. And we spent a lot of our days inventing things and laughing a lot. My parents instilled a lot of curiosity in us. I'm grateful they exposed us to a lot of things. So whatever we wanted to try. We got to try even gymnastics, which I failed at. I was terrible. But thanks to my parents, I have a strong love of music. I have a lot of curiosity. And yeah, I am they made me who I am today.   Michael Hingson ** 03:15 So you grew up in in Phoenix in Arizona who have been there a number of times we've spent part of our honeymoon my wife and I a long time ago, at the point Tampa to hotel.   Paige Lewis ** 03:29 Oh, yes, I think I had a prom there.   Michael Hingson ** 03:35 Well, and our last night of the honeymoon, we went to the restaurant. At the point HEPA to which was up on the top of a mountain. And I think one way you look in there you see Phoenix and the other way, I think a Scottsdale if I recall,   Paige Lewis ** 03:50 a Scottsdale or Paradise Valley. Yes.   Michael Hingson ** 03:53 And I think it was a restaurant called a different point of view, which was cute.   03:58 Yes, yeah,   Michael Hingson ** 04:00 I've been there. My wife bought a lobster and she thought it would just kind of be a typical. So it ended up being a three pound lobster. And she didn't know what to do with it all.   Paige Lewis ** 04:10 Oh, my goodness. That's a lot of lobster was   Michael Hingson ** 04:12 a lot of lobster. But it was our honeymoon. So it was worth it. And the other thing is that that was when they made Caesar salad right at your table and actually created the dressing right at the table using rye eggs and everything's still the best dressing I've ever had.   Paige Lewis ** 04:27 Amazing, amazing. Well, I hope you were not there in the summer, because that can be brutal.   Michael Hingson ** 04:33 It was no Well, we got married on November 27 1982. So it would have been we'll see that was a Saturday. And so it would have been probably the well the third or the fourth that we went so of December so No it wasn't. It wasn't in the hot part or the hottest part.   Paige Lewis ** 04:57 That's good. That's actually a person Big time of year to beat. Yeah. Yeah, it   Michael Hingson ** 05:01 was great. We very much enjoyed our time there. So. So did you go to college in Arizona? Or did you go to college or what? I   Paige Lewis ** 05:10 did not stay in Arizona. I was 17 when I graduated high school, and I really, really, really wanted to leave Arizona. And I was very interested in getting a degree in advertising. And I'll tell you why. And it sounds silly now. But I was very determined and stubborn at that age. I always know. I know. I know, ask my mother she uses could not change my mind. So I was fascinated with how people described products. So if you looked at a box of cereal or a bottle of suntan lotion, how did they come up with the coffee? I was fascinated by how they would construct that, which seems very simple, but so I was really determined to find a good school and advertising. And one of them was the University of Texas at Austin. I also wanted a very traditional college college experience. I wanted the football I wanted to, you know, big Grecian looking buildings and grassy lawns and never thought I would like Texas, but fell in love fell in love with the campus. And so that is what I what I chose. In retrospect, it was way too big for me was 49,000. undergrad. I knew nobody. This is a this is a theme in my life is I put myself in situations where I don't know any anyone. It's uncomfortable. But I loved it. I did. I did enjoy it. I learned a lot. I had a minor in Japanese at that point, too. And after I graduated, I wanted to become conversationally fluent in Japanese. And surprisingly, in college, we didn't do a lot of speaking Japanese. It was a lot of fun and writing. Yeah. So I had an opportunity to go to Tokyo and work for one of the divisions of Estee Lauder, so cosmetics company. And some of you may remember the line prescriptives. Michael, I would not assume you would know this line. They had just opened in Japan. And so I got a job working in a department store selling makeup in Japanese. My Japanese was not very good. So it was trial by fire. Well,   Michael Hingson ** 07:37 my wife loved white linen. And when I worked in the World Trade Center, I discovered that there was an Estee Lauder second store in the tower one on the 46th floor. I think it was so little bit familiar with Estee Lauder and invaded the store often. Okay,   Paige Lewis ** 08:02 yes. So. So yeah, so I did that I knew nobody. And this was before the time of cell phones or even relatively affordable international phone plans. So I took two giant duffel bags, and my parents put me on a plane. And I showed up and they arranged for someone to meet me, a friend of a friend of a friend and I spent a year in Japan.   Michael Hingson ** 08:30 So why Japanese in the first place? Well, when I was   Paige Lewis ** 08:34 think I was a senior in high school, my high school turned into an international magnet program. And they offered what they thought were going to be the emerging important business languages of the world, which were Japanese, and Russian, in addition to what they already had French and Spanish. So I decided to Japanese my brother took Russian, I thought it would be handy no matter what I ended up doing. So that's why I went with it.   Michael Hingson ** 09:03 I took a year of Japanese in college as well. I did it was in graduate school. It was one year and we talked some but you're right. It was a lot of reading and writing. And I actually learned Japanese Braille, which was was kind of fun. I don't remember a lot of that now. But still, it was fascinating to you know, to take and people said it was simpler than Chinese and given everything I've learned I think that's probably very true. But I've spent time since in Japan when thunder dog our book was published. I was also published in Japanese. So in 2012 I went and spent two weeks over there and literally with the publisher of the book in Japan we traveled all around Japan took the bullet train from Tokyo to Hiroshima and all sorts of places in between which is a lot of fun.   Paige Lewis ** 09:53 Did you use any of your Japanese while you were there?   Michael Hingson ** 09:56 No, I didn't remember enough. It had been way too long. So, so I didn't didn't practice up enough to keep it going all that well.   Paige Lewis ** 10:06 I understand that 100% Yeah, but that's okay.   Michael Hingson ** 10:11 But I understood a lot about the customs and the people. And that was a big help as well.   Paige Lewis ** 10:16 Yes, absolutely.   Michael Hingson ** 10:18 So what did you do after a year in Japan?   Paige Lewis ** 10:23 Well, I came back. Yeah, it was a, it was a great growing experience. But it was challenging. And I missed, I missed America. So I came back. And I worked for a promotions company. And while I was there, the CEO introduced me one to Disney and to to his graduate school, which was an internationally focused MBA program. So I ended up going to Thunderbird. Some of you may have heard of it. It's the International Business School of International Management. It's now part of ASU and finished my International MBA studied more Japanese. And then at the end, when I was interviewing for jobs, there was a job at Disney. And I really thought I was going to do international business and work with Japanese companies. And you know, maybe Toyota or something like that. But this job at Disney came up. And I was fascinated by it. So luckily, I ended up getting it. It was in the home entertainment division of Disney, which was back then it was VHS tapes. You gotta remember those VHS? I do? Yes. The very, very beginning of DVD. So I took the job and I moved to LA and again, didn't didn't know anyone that my brother was there, but really didn't know anyone   Michael Hingson ** 12:01 and VHS and not beta. Yeah, that VHS had won   Paige Lewis ** 12:05 the war. So beta was gone. Yes. It was VHS. Yes. Thank you for remembering that   Michael Hingson ** 12:11 show. Your brother was in LA. He was in LA. Yes, it was he.   Paige Lewis ** 12:18 He went to school at Loyola Marymount to study Recording Arts. So he's a composer and he writes music for commercials. Okay. Yeah, he has a very cool job. Very successful.   Michael Hingson ** 12:33 So what did you do in home entertainment at Disney.   Paige Lewis ** 12:37 I started out in retail marketing, which means I was helping selling movies to the big brick and mortar retailers. So Walmart, Toys R Us, target all of those. And I did that for a few years. And then I moved into brand management, and was actually working on the strategy for selling some of the new releases. And I was there a couple of years and then a few of the Disney people moved over to DreamWorks. Everyone remembers DreamWorks. When DreamWorks started, Jeffrey Katzenberg went over there. And then a couple of people I knew from Disney, and they recruited me to come over to their home entertainment division, which was very small, very entrepreneurial, but a very exciting time to be there. As they were building the business and figuring out I got to work on track and the prince of Egypt and Gladiator Saving Private Ryan, a lot of those really great fun movies.   Michael Hingson ** 13:39 So that that kept you busy for a while.   Paige Lewis ** 13:44 And then I moved over to universal and spent 16 years at Universal Pictures and home entertainment. et   Michael Hingson ** 13:53 phone home.   Paige Lewis ** 13:56 Yes, exactly. Exactly. I didn't get to work on that movie. But I mainly worked on the family movies, so a lot of animated movies. Shrek continue with Shrek and Despicable Me. I actually worked on a lot of the Barbie movies, which was which was really fun. And I eventually worked my way up into to senior vice president which was my pinnacle, which was what I really wanted to achieve in my career. But then, as we talked about a little bit, some bad things happened at that point in my career,   Michael Hingson ** 14:34 what kinds of things happened that you want to talk about? Well,   Paige Lewis ** 14:40 I ended up in a very dangerous burnout situation. So I had been promoted to senior vice president. And soon after that a couple of major things happened in my life. My father died and then a couple of very close friends passed away So that sort of shifted how I approach life and what I thought about my priorities. At the same time, universal was having its biggest year ever. So it was the year of Jurassic World and the latest Fast and Furious movie. I think another Despicable Me It was, it was just a very, very busy year. And I noticed I started having these symptoms, so I was getting sick a lot. I was really irritable and cranky. People actually had to come mention to me that I was acting a little out of character. I was getting strange things like I had this rash on my face for no reason. And then, you know, I just ignored all this and kept, kept working because I was an achiever, and I just wanted to get the job done. So then I started having I had this pain, and I'll just say it on my butt on my right, but and it got so painful that I couldn't sit. And I thought, Okay, well, maybe a spider bit me or something. And then at one point, it got so bad that I couldn't I had to work from home, lying down. And at that point, a kind colleague said, you know, Paige, I think you might want to have that looked at. So I was like, alright, and you know, it was getting bigger and more and more painful. And so I went to my dermatologist, she took a look, she called in her colleagues to get a second opinion. And then they said, Alright, we've called the er, at the hospital next door, we need you to go there right now. So what I learned is that I had contracted Mersa, which is, yeah, an anti bot, antibiotic resistant staph infection. And it's so dangerous that if it gets into your bloodstream, it can kill you. So I was admitted to the hospital for a week, they gave me a very heavy duty antibiotic that works on this. It's so strong that it made my veins collapse. So they had to put in a PICC line. And it really, it was, you know, like they say, it was what it was my wake up call.   Michael Hingson ** 17:20 What year was this? That this was 2016. Okay, so that was your wake up call? That was   Paige Lewis ** 17:28 my wake up call. And then I went, and I had to take a month off of disability? Well,   Michael Hingson ** 17:34 certainly, that's understandable, given the severity of it, and so on. And what did you do her think about during that month, and then going forward?   Paige Lewis ** 17:45 Well, I realized, as I you know, wine there in the hospital, that something wasn't working, obviously. And I really, I really didn't understand how this happened. How did I get a staph infection on my butt. And I just, I just figured I really needed to make a change I wanted to live, I did realize that. And I wanted to get healthy. I mean, something was really, really out of whack. So this is what really did it for me. I came back in January. And this was the time when Carrie Fisher and Debbie Reynolds had passed away. And I went into the meeting into a meeting. And this was the first meeting my first day back. And what was brought up was, you know, Debbie Reynolds just died. Do we have any movies we can put out and leverage this. And that just hit me as being so distasteful. And I realized, this is not the business I want to be in anymore. This doesn't fit. So about a week later, I went in, I quit. I quit my job, nothing lined up. No idea what was I was gonna do. But I knew it was the right thing to do. Yeah,   Michael Hingson ** 19:08 that, that just certainly seems like a pretty insensitive thing to say. I understand. Some people do that. But gee, when do you draw the line and recognize maybe it's a time to just let people mourn? I mean, look at Debbie Reynolds for such a long time, and I are going to do is try to promote you in the brand. T does that really make sense?   Paige Lewis ** 19:33 Yeah, it just it just seems a little gross to me. So I quit and then I realized that I needed to figure things out. So the antibiotics I realized, after doing a lot of research had completely wiped out all the good bacteria in my gut. And I learned that you have to have that good bacteria to stay healthy. So and I also was a diet coke addict, big time diet coke addict. And I learned that one Diet Coke can destroy your gut biome. So I quit. I quit Diet Coke, it was not easy. I will tell you. I don't know if you drink it. It's   Michael Hingson ** 20:18 no, I'm more of a water drinker. I got to say, Okay. I've never been that much of a soda drinker.   Paige Lewis ** 20:24 That's a lot better for you. Yeah. So I figured out my health. And then I started trying to figure out why this all happens.   Michael Hingson ** 20:33 Now, I was just gonna ask you what you decided about why it occurred? Well,   Paige Lewis ** 20:38 one, I learned a lot about burnout. And that stress can kill you. And that this staph infection was a literal sign, it was a literal pain in my butt that my work was a pain in my butt. And I needed I needed to find something different and, and after really thinking about things, I realized my values had shifted. So my values were no longer aligned with the work I was doing. And that caused a lot of friction, and disengagement, and stress. And so then I wanted to figure out, okay, all right, I understand that this job. Marketing movies isn't a good fit anymore. But what is, so I let curiosity kind of leaves me and I did some research. I found this great book, I don't know if you've heard of it. It's called What color's your parachute? It's been around forever, I think, in my 20s, forever. And so I picked it up again. And it had me really think about what am I good at doing? How do I use my brain? What really drives me? And I also did some work, figuring out what my new values were. And I realized, I really like the mentoring part of what I do at work. I like solving problems. And I like helping people rise to their full potential. So then I started looking into, well, do I want to become a therapist? I'm not sure I want to go back to school again for that long and spend all that money. So then I started talking to coaches, executive coaches, and I realized, well, they do a lot of what I think I want to do. And they also can give you specific direction, and steps to take. So unlike the therapist model, where it's just a lot of questions, you can actually draw upon your experience and share that to help people. And so So I actually, because every day, what I would do is I would get up and I would read, I would read articles, and I would just sort of follow the breadcrumbs. And I stumbled upon a woman who wrote a really great article, I reached out to her, she was a coach. And she was so motivating in that one conversation, that I ended up writing an article and ended up deciding I wanted to go get my coaching certificate. So this was this was end of 2017 into 2018. So I ended up getting my coaching certificate and started working with women so that they wouldn't end up like, like I was, I really don't don't, there was no reason I needed to hit that level of burnout. Tell   Michael Hingson ** 23:46 me? Well, first of all, a little bit about why do you think you actually contracted versus and why do you think that? Or how do you think that happened? Do you really know?   Paige Lewis ** 23:58 I think my immune system was so beaten down and compromised. That it happened. I don't know how it got there. I honestly don't know. I promise you I'm a clean person. I take showers. I know like wandering around rubbing myself and dirt. I just I just think, you know, there were there were signs leading up to it other smaller illnesses and my body fine was like, Okay, you're done. But I don't know, I don't know the source. Good question. Well, so   Michael Hingson ** 24:31 you went off and you started to study about being a coach and so on. What does it mean to get a coaching certificate? What's the process?   Paige Lewis ** 24:39 Oh, that's a good question. Well, there are lots of different coaching programs and the one I chose is based on human needs psychology and behavior. So I had been through a lot of leadership programs through my my days as a marketing executive. So I knew a lot of the traditional Leadership, procedures, methods, whatever you models, whatever you want to call them. So I really wanted to get into almost kind of going back to why I got into marketing, why people do what they do what's driving them. So I learned all about the six core needs and what motivates people and really had to get into their brains and change behaviors and habits. So it was 100 hours of training. I think I did it pretty quickly. I was motivated, I think I did in about four months, and then was and then was certified. And then there are all different types of coaching programs, some people do mindfulness route, some people just do a very traditional corporate route. So I wanted to kind of balance out what I already knew.   Michael Hingson ** 25:47 Well, so you went ahead and did that. And you got certified, and have been coaching ever since. I have, I've   Paige Lewis ** 25:56 been coaching for about six years, and also doing excuse me marketing consulting, because I like to keep my toe and in that part of the world also.   Michael Hingson ** 26:06 So what Tell me a little bit about the the coaching program or what you do, then how do you help people? And where do you where do you help people all over? Or where does that all come from?   Paige Lewis ** 26:21 Well, luckily, I do everything virtually. So I can help people no matter where they are. My specialty is helping women executives, I want to help them excel in their careers without impacting their well being. Someone once told me, when you become a coach, your message becomes your message. So clearly, yeah, my my story of burnout is something that really drives me and it's a passion, a passion of mine. So I typically work with women executives, who are director level all the way up to C suite. And they come to me one because they aren't loving their job anymore. They don't know why they want a career change. They're in some sort of toxic work environments and don't know how to manage it, they are experiencing signs of burnout, they don't have the tools or skills to deal with it, I help a lot of people who are wanting just to jump jump a level or two in their career. So helping them with executive presence and managing teams, a lot of your traditional leadership development skills. So I love it tremendously. And it fits really nicely with my values.   Michael Hingson ** 27:44 I had a conversation yesterday with two women who also are very heavily involved in leadership and, and coaching. But a lot of corporate leadership training, they have developed a program that they describe basically is, well the company is missing logic. And the program is based on polarity, they talk about the fact that everything is really about polarity, and like breathing is polarity exhaling and inhaling, you got to do them both. And whether you're dealing with work, or life and polarity, again, you've got to really understand that both are part of what your world ought to be. And so many people get stressed out because they don't really look at trying to balance polarity, which is really pretty fascinating. We had a great discussion about it.   Paige Lewis ** 28:42 That's an interesting way to think about it. I have stopped saying work life balance, and I call it work life harmony, because it's never equally balanced.   Michael Hingson ** 28:52 Right. But at the same time, what what Tracy and Michelle would say is that you need both poles. And it's a matter of finding how to, to have a well, I keep saying balance, but to have some sort of that making both poles work to help each other because one or the other isn't going to work.   Paige Lewis ** 29:19 That's that makes a lot of sense. Yeah, I agree with them.   Michael Hingson ** 29:22 It's a lot of very fascinating discussion, but in your case. So you do that and you don't necessarily use those terms, but it sounds like you end up getting to the same place. So you've been doing that now. Six years. Yes,   Paige Lewis ** 29:36 that is true. Six years. It's gone quickly.   Michael Hingson ** 29:40 So you think you have now found a niche that's going to last a while?   Paige Lewis ** 29:46 I think so. We still have a long way to go and getting women to an equal playing field as men. Unfortunately it isn't. It is improving. But there are a lot of things that still Need to improve. So, for example, women experienced burnout much more than men 43% of women or executives experienced burnout men only 31%. And I think it just it has to do with the kind of silence responsibilities a lot of women take on, whether that's Child Care caring for elderly parents, it's taking more on at work, that's sort of outside the your job responsibility or your job description. And women also don't think that corporations are quite there yet. And having good strategies and good programs to have gender equity in the in the workplace. I mean, 92% of women don't believe that companies are kind of walking the talk in that area. So yeah, I think there will be a need for a while it would be my dream, if there isn't a need. For this, that means that women women are equal in the workplace in terms of opportunities and roles and pay. Yeah, that's a good piece of news. I have a good piece of news, though, that I just learned, sorry to interrupt you is that there was there were, you know, people would say for a really long time, and there were stats to back it up that women were afraid to negotiate for salary or promotions, it's actually changed. And women are just as likely, if not more, to negotiate for increased salary or promotion, whatever. So. So that's some good news. And a common belief that is now has now changed. And   Michael Hingson ** 31:42 should, by any standard, we haven't seen a lot of that yet, in the world of persons with disabilities, where we're still even though we're by any definition, the second largest minority, or maybe the largest minority will be the second because there are more women than men, although people keep saying women are the minority, but in physical sense, there are more women than men. So either way, you look at it disabilities as the second largest minority, but the most excluded from any of the conversations or any of the real involvement in the workforce, which is why we continue to face an unemployment rate in the 60 to 70% range among employable persons with disabilities, like, especially with blind people. And the reality is, it's fear, it's a lack of education. And it's not understanding that, just because we may do things in a different way, it doesn't mean that the technology and the tools that we need shouldn't be part of the cost of doing business. But yet, that's what happens. Those   Paige Lewis ** 32:49 are staggering numbers, Michael, but your company is doing a lot to help with that. Well,   Michael Hingson ** 32:54 accessiBe is doing a lot to help with that and is being pretty successful. And the number of people using the technology are are growing, or is growing, and excessive. He's working on some programs to really teach more people about Internet access and website development with access and accessibility. So hopefully, that will continue. And we'll be able to make more strides, but it is a thing that we face on a regular basis.   Paige Lewis ** 33:24 Yes, it is. So for   Michael Hingson ** 33:27 what you're doing and so on. You've talked a little bit about burnout, are there different kinds of burnout? And do you deal with them all the same way? How does that address get addressed?   Paige Lewis ** 33:39 Yeah, that's a great question. I think people generalize the term burnout and and the, you know, when someone is just stressed, they'll say I'm burned out that the actual technical definition of it from the World Health Organization is that burnout is chronic stress in the workplace that hasn't been successfully managed, which puts a lot of onus on on the person, right? If you haven't successfully managed it, the company's not really helping you set up any systems to help you with that you person has to have to deal with it. But   Michael Hingson ** 34:15 which is also I'd seems to be not totally fair either. Right?   Paige Lewis ** 34:19 Right. And there's not a lot of progress in that area. Everyone is going to be burned out at some point in time. Everyone, everyone's going to face it. But there are different types. There's physical burnout, which is you're tired, you're getting sick a lot like I was you're not moving around a lot. You've kind of forgotten to exercise or even stand up from your desk and those those signs can show up like headaches or just different physical things. And then there's emotional, which I also had, that can show up as being you're cranky, you're short tempered, you're impatient. and you're not spending time with the relationships that you know are strong. Yeah, just maybe a little bit of a change in your demeanor. Then there's there's mind, there's mind related burnout, which is, when you're kind of in that fight or flight mode, and you're spending a lot of time putting out fires at work, you're distracted. You can't focus. That's that type. And then the last one is burnout of the Spirit, which often can show up as being bored. So a lot of people get really bored or uninterested in their job or whatever is important to them, and they don't realize that it's burnout. And so that could be you're doing a lot of things at work that just really aren't aligned with what you do. Well, what you like doing. And so you just kind of just kind of check out.   Michael Hingson ** 35:59 Do you find, though, that people that are, that are in that situation? Oftentimes haven't really sat down and analyzed what they really want to do or analyzed? Am I really doing the right thing? And that contributes to that? Yeah, yeah.   Paige Lewis ** 36:17 100%, like, I didn't know, I had no idea. I just kept a lot of people, you know, they're on the treadmill. They just keep going every day. And it's rare that people stop and they reflect and they reassess. It's only when people get into a state of burnout, sadly, that they need to wake up and realize, okay, something isn't working. But there are always signals, they're always signals. And oftentimes, it's more than one one type of burnout that's hitting at the same time.   Michael Hingson ** 36:50 But you just you distinguish between emotional, mind and spiritual, if you will, they're they're all three different even though in one sense, it seems like they're all sort of mental in one way.   Paige Lewis ** 37:03 They are sort of mental in one way, but they come out in different ways. And they the route of them is different. So there are two main ways to, to sort of manage burnout, the traditional way that everyone thinks is how you, you manage burnout, unfortunately, this is what companies kind of latch on to is just go take some time off, go to a spa, get a massage, and that'll cure everything. This self care really only works for the body and the emotional burnout. Because that's you're just exhausted, those two are fall under exhaustion. And with that, you actually do need to take a timeout, and take care of yourself. You only need 15 minutes, but it could be you know, take a walk, walk away from your computer, or your phone, don't take your phone with you on your walk. You know, just leave it alone. Don't let anyone interrupt you. Call call a friend, just do something that's enjoyable for you that is, will reboot your system. For the mind in the spirit burnout, which you know, is you're just distracted and you're or you're bored. Or you're in fight or flight mode, you actually are having cynical detachment. So, okay, yeah, it's different. So you so self care actually does not work. Because when you're in this space, you're focused too much inward, and on yourself, and you've lost perspective. So what you do when you have that type of burnout is you need to clarify things. And it could be clarifying your role. So role clarity, write down the three to four most important things in your job. And then ask yourself are you spending time on the high value activities, because you may not be the other. There are three parts of this. The second one is relational clarity. So you may have lost perspective about other people in your life. So a way to break yourself out of this is write a note of thanks to someone, maybe someone on your team, remind yourself that you are not alone and all this. And then the last one is perspective, clarity. So a lot of people just completely lost perspective. So go do something totally different. Go watch a or listen to a comedy video. Call your mom and ask about you know, bring up an old memory just something that reminds you that work isn't everything because these two types mind and spirit burnout, as these are a lot of the workaholics too, and they keep working, working, working and they've just lost complete perspective about everything else in the world.   Michael Hingson ** 39:55 One of the things that I realized during In the pandemic is that although, on September 11, I escaped and wasn't afraid. And I knew why I wasn't afraid, which is that I prepared and knew what to do in the case of an emergency. And as I now say, that created a mindset. But what I realized is that, the fact is, we can control fear, and we can control a lot of what we do. But we have to be mindful. And we really need to keep things in perspective. And one of the best ways to do that is to be introspective in our lives. And really practice that, until it gets to the point of being a habit, and you develop that whole introspective and self analytical muscle. And I, so we're writing a book about all of that. And we're going to, I'm going to, it'll be out next year, and we're going to talk about how to control fear and not let it as I would say, blind you or paralyze you or overwhelm you, but how do we get people to start to be more introspective in their lives and in what they do, and recognize that that's an extremely valuable thing to do.   Paige Lewis ** 41:08 You make a really, really good point. I think a lot of it like, to your point about habits, a lot of us have, you know, that inner critic, who is just saying, you know, you're not good at this, you shouldn't try to do this. You always done it this way. If you can take yourself out of that, and almost become an observer. And look at your thoughts and what how you talk to yourself as just another person, you can even name it, that kind of helps you take yourself out of it so that you can change your habits. Because a lot of the what we tell ourselves are just habits. They're not even true anymore. They're based on beliefs that you you made up a long, long time ago and had value back then. But they're not even true anymore. So I think we just need to be aware and stop ourselves. And remind ourselves, when we're thinking things, you ask yourself, Is this really true? Or is this just the habit?   Michael Hingson ** 42:14 Good point. And I also learned that along the way, I always used to say, and I still do this, but I record presentations that I give, so I can go back and listen to them. And I always say that, I love to do that. Because I'm my own worst critic, I'm nobody's going to be as hard on me as I am. And I learned, that's the wrong thing to say. And that's the wrong way to approach it. Because in reality, even teachers can't teach me they can present me with information. But ultimately, I have to teach myself. And in fact, it's not that I'm my own. I'm my own worst critic. I'm my own best teacher. And if I turn it around and use that terminology, then it becomes more of a positive process, to look at things and think about them and teach yourself even when something doesn't go well. And even when it does go well. What can I better learn to even make it go better next time. I'm my own best teacher is such a more positive thing to say.   Paige Lewis ** 43:19 I love how you reframe that, that's a great way to look at it. And, and also, you know, we talked ourselves worse than we would talk to our friends. Yeah. Which is just crazy.   Michael Hingson ** 43:32 In reality, we should talk to ourselves and really get better at thinking about things and saying, Okay, well, how do I deal with it? Don't hide from it. And no matter what it is, allow yourself to teach yourself how to deal with it.   Paige Lewis ** 43:50 And it's practice it. And then it will become a habit. Yeah. And just like we talked down to ourselves and criticize ourselves. It's just the habit. Yeah.   Michael Hingson ** 44:05 And it is a habit that we can break.   Paige Lewis ** 44:08 Absolutely. And it's just practice. It's just practice, and it's micro micro steps. You don't have to get it perfect the first time. And we forget, you know, we're not supposed to be perfect beings. We're supposed to be in this world to try new things and learn from them. And we just are so hard on ourselves that we have to be perfect at every single thing we do. And oftentimes, other people aren't even paying attention. And they forget about it   Michael Hingson ** 44:38 much more quickly than we do. And yes, there's a lesson there too.   Paige Lewis ** 44:42 Yes, and I always I always tell my clients like when they're all worked up about something or ruminating and countless something go, Well, this really matter. In two weeks. Will this matter in three months in a year? No. No one will remember you probably won't ever remember To your point, learn from it, and just let it go. It's hard, it's practice, I get it. But just to put things in perspective, it usually is not as important as we think.   Michael Hingson ** 45:12 And if it really affects you, and you're thinking about it a lot, then take a step back, as you said, and think about why is this affecting me so much? It's appropriate to do that. It's appropriate to help to understand you better.   Paige Lewis ** 45:31 Yes. And I'll give you a tip that I give my clients that I actually learned from my dad, for people who ruminate a lot of worry a lot. Actually schedule worry time in your day. And don't do it right before bed? No, no, because then you won't sleep well, but schedule it at a time. Have no distractions, sit there for 20 minutes and worry about everything. And you have to sit there even if you've run out of things to worry make it up like, my my sock is starting to unravel, you know, stupid things. My dog is panting more than usual. Whatever it is,   Michael Hingson ** 46:14 I can't figure out anything to worry about. I'm worried about that. Right? Exactly.   Paige Lewis ** 46:18 I'm worried about that I have to sit here. And Paige said I can't move for 20 minutes. So you do that every day. And what'll end up happening is one, you'll realize you don't really have that much to worry about to you train yourself that you can only worry during a certain period of time. So you're not spending your whole day worrying and ruining your day. And if you start thinking about something out, or you're worried time you say, okay, Paige, no, you're scheduled to worry about that at 10am, from 10am to 1020. And it's remarkable how people improve with the ruminating and the worrying.   Michael Hingson ** 46:56 So what mostly do you coach about what what is your specialty, if you will, overall,   Paige Lewis ** 47:01 my specialty is helping women leaders excel in their careers without impacting their well being. So a lot of that is what we've talked about today, how to handle burnout, how to manage your thoughts, how to improve your leadership skills. You know, I mainly work with pretty senior women who don't have anyone else to talk to, and this is this is a theme that I've come across a lot, and I felt myself is a lot of women leaders don't think that they have people they can talk to at their companies or within their industries.   Michael Hingson ** 47:44 Yeah, that was what I was gonna get to. Is it true that they don't, or they just don't think they do have people to talk to?   Paige Lewis ** 47:54 Well, a lot of times, it's difficult to talk to people, I do work with an amazing organization called chief. And they're a private network for women. But what they've done is they have put together peer based groups, they curate these groups of women at similar points in their career, similar levels, so that they have a safe space of peers from whom they can learn, get different perspectives. Because I, when I was first, you know, talking with Chief about coming on, as one of their first coaches, I said, if this had existed when I was at Universal, and burning out, I would not have burned out, because a lot of a lot of the struggle is feeling like you're the only one and not having the tools and the skills to manage through it.   Michael Hingson ** 48:46 And a lot of times we don't look for people to talk with, because we just feel that we're an island in the middle. And oh, I don't want to talk to people who work for me because that that wouldn't be good. I mean, there are just so many excuses that we can come up with.   Paige Lewis ** 49:05 Yeah, or you're embarrassed and you are you're embarrassed. You know, I'm the only one who's dealing with this, I must be crazy. Imposter Syndrome comes in a lot. So, no, almost everyone is going through the same things. And it's just really reassuring and helpful to know that other people are going through it, and can share some ways that they have managed it. It's these these meetings are so powerful, I can't even tell you they really, really are amazing.   Michael Hingson ** 49:39 What do you say to people who are thinking of a career change or who don't know where to start? You know, because I'm sure that comes up and what you do?   Paige Lewis ** 49:48 It does and it can be really scary. And I think I think people don't give themselves enough credit. What what helps most of my clients and help me is having a having a mindset of curiosity. Because I know for a fact that people have transferable skills, it's just getting curious and following the breadcrumbs to find out what else is out there that aligns with my values that motivates me. And that uses my skill set I can do. So one, one of the exercises I have people do is to think about sample some activity that they're doing. It doesn't have to be related to work where they are completely what you would say in flow, meaning they lose track of time they forget to eat, they know that they're kicking ass and what they're doing. And they are loving it. So it could be for example, gardening. Who knows it could be gardening. And so then what I asked them to do is, okay, really, really dissect what you're doing. What, like, how are you using your brain? Maybe you are researching the different kinds of plants that work in your soil, maybe you are laying out where they go, maybe you are looking at the different seasons? And what works best and what time of year? And then how are you interacting with people? are you collaborating with the you know, the gardener at the nursery? Are you talking with friends who have who've made great gardens? And then what skills are you using, researching, maybe strategizing, maybe organizing, and then what you'll end up seeing, and it's something totally unrelated to your job is here, all the things? And the way here are all the different ways of thinking parallel the skills I use, and here's what I love doing, and you find this intersection. And then you use your curiosity to find out okay, what industries are interesting, and what are the jobs? You reach out to people, it's curiosity. If you lean into curiosity, you cannot go wrong. And   Michael Hingson ** 52:16 all too often, we don't.   Paige Lewis ** 52:21 Correct, we kind of block ourselves. And   Michael Hingson ** 52:24 many times were discouraged from it. I mentioned earlier, the whole concept of if I've been talking to people this morning about people with disabilities, and then somebody said, What can we better do to improve the world for people with disabilities, and my response was, include us in the conversation and so many times, I can be somewhere and when when I went to my wife was live with her, she was in a wheelchair, and people would come with their children, and we'd be in a store, whatever. And a child would ask a question and say, I want to go meet that person, I want to go look at that wheelchair. And the mother would say no, don't do that. They might not like it, or that dog might bite you. And we we we discourage curiosity, especially in children, who are the most curious people of all? Mm hmm.   Paige Lewis ** 53:12 Yes. And wouldn't it be great if we could bottle that curiosity and take it with us? Our whole lives? Yeah.   Michael Hingson ** 53:20 It's important to do that. I think I think you use the term superpower, everybody has a superpower? Or how do you how do you teach people to to find their superpower? What does that mean?   Paige Lewis ** 53:34 Yes, this is this is an important piece of finding a career that works for you. And so if you think about a Venn diagram, I'm a big fan of Venn diagrams, there are three components. So they're, they're your values, you have to get really clear on what your values are, what you are good at doing and what you love doing. So when what you love doing intersects with your values, you have a passion for what you're doing. So let's say your values are adventure, and learn learning and experiencing new cultures, you may be passionate about traveling. So you can kind of see how those work. Now, when your values connect with what you're good at doing, you're going to be engaged. So if you're really connected and aligned with your values at what you're doing for work, you'll be engaged, you'll be interested, you'll be connected, you'll still be excited to go in every day and do your job. And then what you what you love doing and what you're good at doing intersect. And I've mentioned this a little bit for you're in flow. So that's when you just are just completely happy because you're doing what you love and you know you're doing your best at it. So the superpower comes in when those three things connect, when your values, what you're good at doing and what you love doing connect. And I truly believe everyone can figure this out. Once you know that, you can find a career that meets that 80% of the time, if you have that, you will be happy, you'll be happy in what you're doing. So it's a little bit like the Japanese term of ek guy, which is finding your purpose. I don't know if you're familiar with that. Remember that. And that actually has been attributed to longer life. So this idea of IKI guy or finding your superpower, and living to that will make you happier. But it also helps extend your life because you're getting up every day, and you're doing what you love doing and what you're good at doing.   Michael Hingson ** 55:56 And I find that when people are happy, they self motivate themselves. And in general, they have better days. Yes,   Paige Lewis ** 56:06 yes. And the bad days can roll off a little easier. Yeah.   Michael Hingson ** 56:11 You need to learn to live more like dogs, you know, and live in the moment and forget all the other things. And there are so many things we can't control. And we worry about them. Dogs don't   Paige Lewis ** 56:20 write, I would like to come back as a dog. Dogs have the best lives. And I think we we also have this culture of busyness being the new status quo. And we forget that we're human beings and not human doings. And I think that's where people get in trouble.   Michael Hingson ** 56:44 We so greatly overanalyze everything and not necessarily in the right way. And again, as we talked about, we don't step back and really look at it, which is part of the problem.   56:55 Yes, yes.   Michael Hingson ** 56:58 Have you written a book or anything about all of this?   Paige Lewis ** 57:01 I've written some articles. I have not written a book. I have not written a book? Well, if   Michael Hingson ** 57:06 you do, you'll have to let us know.   Paige Lewis ** 57:08 I will, I will do that. Well, if people   Michael Hingson ** 57:11 want to reach out and get in touch with you, maybe explore using your services and skills. How do they do that?   Paige Lewis ** 57:19 Well, you can reach out via my website, which is page one coaching.com. And it's spelled out I'll spell it. It's P a i g e o n e. c o a c h i n g.com. And you can also find me on LinkedIn at Paige Lewis Sanford, my new married name, yeah, you can. Yeah, you can also email me at page at patreon coaching.com.   Michael Hingson ** 57:44 So what is your husband do?   Paige Lewis ** 57:45 He is a naturopathic doctor. Oh, so he focuses on root cause? And getting to you know, the bottom of what is causing your symptoms and, and managing that and addressing that versus just throwing things like antibiotics all the time, which, you know, don't always work out. Not very good for you overall, long term. No.   Michael Hingson ** 58:10 And ultimately, we have to take a little bit more mental control over ourselves. And that's another whole story. Yes,   Paige Lewis ** 58:20 I totally agree with that. Well, gee,   Michael Hingson ** 58:21 maybe we should explore getting him to come on and chat sometime. Oh,   Paige Lewis ** 58:25 I think he would love it.   Michael Hingson ** 58:26 I'll leave that to you to set up. Yeah. I want I want to thank you for being here. And I know, you've given us a lot of really wonderful ideas. And I'm very grateful for you being here. I'm glad we had the opportunity to meet and hopefully we will do more of this anytime you want to come back on. You just need to let us know.   Paige Lewis ** 58:46 Right? I would love it. Thank you for having me. It's been great talking with you.   Michael Hingson ** 58:51 Well, this has been fun and I hope that you enjoyed it listening out there. Reach out to Paige she I'm sure we'd love to hear from you and if she can help you in any of the decisions that you need to make. That's what coaches do. So reach out to Paige. You are also always welcome to reach out to me, we'd love to get your thoughts on what you heard today. You can email me at Michael M i c h a e l h i at accessibe A c c e s s i b e.com Or go to our podcast page www dot Michael hingson.com/podcast and Michael Hingson is m i c h a e l h i n g s o n.com/podcast. Of course as we asked and I really appreciate y'all doing it, please give us a five star rating wherever you're listening to us. We love your ratings. We appreciate your reviews, and any thoughts that you have and for all of you listening and Paige, as we sort of alluded to just now if you know of anyone else who would be a good guest for unstoppable mindset. love to have you let us know. We're always looking for guests. I believe everyone has a story to tell and this is As a way to get the opportunity to tell your story and help us all learn that we're more unstoppable than we think we are. So again, Paige, I want to just thank you one last time. Really appreciate you being here and hope that you had fun.   Paige Lewis ** 1:00:14 I did. Thank you so much.   Michael Hingson ** 1:00:20 You have been listening to the Unstoppable Mindset podcast. Thanks for dropping by. I hope that you'll join us again next week, and in future weeks for upcoming episodes. To subscribe to our podcast and to learn about upcoming episodes, please visit www dot Michael hingson.com slash podcast. Michael Hingson is spelled m i c h a e l h i n g s o n. While you're on the site., please use the form there to recommend people who we ought to interview in upcoming editions of the show. And also, we ask you and urge you to invite your friends to join us in the future. If you know of any one or any organization needing a speaker for an event, please email me at speaker at Michael hingson.com. I appreciate it very much. To learn more about the concept of blinded by fear, please visit www dot Michael hingson.com forward slash blinded by fear and while you're there, feel free to pick up a copy of my free eBook entitled blinded by fear. The unstoppable mindset podcast is provided by access cast an initiative of accessiBe and is sponsored by accessiBe. Please visit www.accessibe.com . AccessiBe is spelled a c c e s s i b e. There you can learn all about how you can make your website inclusive for all persons with disabilities and how you can help make the internet fully inclusive by 2025. Thanks again for Listening. Please come back and visit us again next week.

Ever had the *nudge* to start creating content to share your passion and impact as a NURSE but the thought of being seeen on social media makes you want to ~vomit~?Then you are ready to dive into an episode that's all about igniting your passion and finding your purpose beyond the nursing scrubs. In this episode we're peeling back the curtain on the life of a nurse, Jumer, who is making waves as a content creator himself and helping other nurses do the same WITHOUT the burnout. We're joined by the incredible Jumer Adalin, an Instagram strategist and content creator extraordinaire, who shares their journey from a burnout ICU pandemic nurse to now a PICC nurse + content creator. Jumer spills the tea on how he turned his creative itch into a thriving online presence, and how you, too, can leverage your nursing skills to build a brand that resonates with your true self. Get ready to be inspired and learn how to step into the spotlight WITHOUT fear!

Kristin Hansen is an enthusiastic, energetic, and highly skilled PICC nurse. However, she admits that it wasn't always easy for her to transition from starting IVs on premature babies in the NICU to placing PICC lines on adults. But with practice and persistence, she learned everything about this interesting nursing specialty and we are so lucky she is sharing her knowledge with us. Kristin explained the criteria for becoming a PICC candidate, the technologies used, the teamwork required, professional organizations, and much more. If you have decent IV skills, can work independently, and have an affinity for bright, shiny objects, PICC nursing could be for you. And if your hospital doesn't have a PICC team, step up and start one! In the five-minute snippet: well, you'll just have to hear this one for yourself. For Kristin's bio, visit my website (link below)InstagramProfessional Organizations:Certified PICC Ultrasound InserterVascular Access Certification (VA-BC)Vascular Access SocietySociety for Vascular Nursing (SVN)Association for Vascular Access (AVA)Infusion Nurse SocietyKristin's go-to for teaching:The IV Guy InstagramContact The Conversing Nurse podcastInstagram: https://www.instagram.com/theconversingnursepodcast/Website: https://theconversingnursepodcast.comGive me feedback! Leave me a review! https://theconversingnursepodcast.com/leave-me-a-reviewWould you like to be a guest on my podcast? Pitch me! https://theconversingnursepodcast.com/intake-formCheck out my guests' book recommendations! https://bookshop.org/shop/theconversingnursepodcast Email: theconversingnursepodcast@gmail.comThank you and I'll see you soon!

Have you ever met a radio DJ who went on to become a NURSE? In this episode, I interview Jumer, a nurse who grew up in the Philippines, worked as a radio DJ while in nursing school, and moved to the US to practice as a PICC nurse. He's now earning six figures per year while learning how to monetize social media and showing others how to do the same. Want to unlock the secrets to skyrocketing your nursing income or business in only 5 minutes a week? Join 2,000+ driven nurses leveling up their skills with my weekly newsletter - https://bit.ly/NtR-NewsletterYT --- Support this podcast: https://podcasters.spotify.com/pod/show/nurses-to-riches/support

In oncology we are always asking questions about which treatment option is best. And that focus on the next best treatment may prevent us from rethinking some fundamentals of current practice. Three recent studies illustrate this and made me ask: Do we need a Port or PICC for every testicular cancer patient? Study: https://doi.org/10.1200/OP.23.00580 Editorial: https://doi.org/10.1200/OP.23.00730 Is vaginal estrogen safe if breast cancer patients? Study: https://jamanetwork.com/journals/jamaoncology/article-abstract/2811413 Does paclitaxel work differently than we always thought? Study: https://doi.org/10.1371/journal.pbio.3002339

Jackie Celske was born in Chicago. Around the age of 4 she and her family including two siblings moved to just outside London England for her father's job. One pretty unique fact about Jackie's family is that her brother, one year younger than she, was born with autism. In one sense, due to the specifics of his situation, Jackie's brother Matt was fortunate as his diagnosis came when he was two years old. However, as with many children with disabilities, including me for that matter, Matt's and Jackie's parents were advised to send him to a home as he could never amount to anything. Jackie's parents rejected that advice. When the family moved to England Jackie went to a girls school and Matt was put in special segregated classes. Jackie's younger sister also was put in a different classroom environment. As Jackie will tell us, she flourished pretty well, but Matt did not. When Jackie was 14, the family moved to a small town in Illinois. For Matt it was a wonderful change because his aunt taught 5th grade and Matt was put into a much more integrated school environment. Life wasn't so great for Jackie. She experienced a brutal sexual assault while in her sophomore high school year. As she will explain, it really wasn't until the past two years that she was able to really move beyond that experience and heal. Jackie went to college and then secured employment. Jackie's degrees revolved around communications which clearly she demonstrates by how she and I interact. Jackie will tell you about her chronic illness that stemmed in part from her assault and how only through the use of an experimental treatment she seems to be in remission or cured. Jackie's latest major step on her life journey is that a month ago she left teaching in a higher education institution and started her own business, The Prose Co. She will tell you about her new marketing and PR agency. Be sure to check it out. By any standard, Jackie is unstoppable. Her story will be well worth your time. About the Guest: Having grown up in London, England with a sibling with Autism, Jackie Celske learned at a young age that the way we communicate matters. She believes the right words heal us, inspire us, and unite us. Most importantly, the right words - the right stories - have the power to change the world. Jackie has spent the last 13 years of her career providing professional marketing, communications, and PR services in industries spanning non-profit and healthcare to financial services, manufacturing, and higher education. No matter the field, she has always been inspired by the stories that highlight the people and purpose behind brands. Three weeks ago, this passion led her to leave her full-time job and start her own business titled The PROSE Co. On a mission to change the world with stories that get write to the heart of it, The PROSE Co. is a marketing communications agency specializing in creating compelling content that connects with your audience and helps you stand out from the crowd. Whether you need advertising and copywriting support, fund development strategies, social media and event management or team-building workshops (and more!), The PROSE Co. is a one-stop shop for all your branding and content needs. Jackie holds a master's degree in Public Relations and Digital Communication from Johns Hopkins University and a bachelor's degree in Communication Studies and Psychology from Augustana College. A relentless advocate for women and other survivors in her community, Jackie participates as a member and past president of Junior League of the Quad Cities, serves on the board of directors for Argrow's House, and sits on both the YWCA of the Quad Cities YES SHE CAN Advisory Committee and Family Resources Stewardship Committee. She also loves spending time learning and growing with her mentee through Lead(h)er. When she's not working, you can find her traveling the world, playing with her rescue doodle, or writing her next parody song. Ways to connect with Jackie: Here is a link to my LinkedIn page: https://www.linkedin.com/in/jacquelinecelske/. Here is a link to my new business website, The PROSE Co.: https://theproseco.com Here is a link to my goFundMe for my experimental medical treatment. It lays out my story in more detail: https://www.gofundme.com/jackies-medical-treatment-expenses About the Host: Michael Hingson is a New York Times best-selling author, international lecturer, and Chief Vision Officer for accessiBe. Michael, blind since birth, survived the 9/11 attacks with the help of his guide dog Roselle. This story is the subject of his best-selling book, Thunder Dog. Michael gives over 100 presentations around the world each year speaking to influential groups such as Exxon Mobile, AT&T, Federal Express, Scripps College, Rutgers University, Children's Hospital, and the American Red Cross just to name a few. He is Ambassador for the National Braille Literacy Campaign for the National Federation of the Blind and also serves as Ambassador for the American Humane Association's 2012 Hero Dog Awards. https://michaelhingson.com https://www.facebook.com/michael.hingson.author.speaker/ https://twitter.com/mhingson https://www.youtube.com/user/mhingson https://www.linkedin.com/in/michaelhingson/ accessiBe Links https://accessibe.com/ https://www.youtube.com/c/accessiBe https://www.linkedin.com/company/accessibe/mycompany/ https://www.facebook.com/accessibe/ Thanks for listening! Thanks so much for listening to our podcast! If you enjoyed this episode and think that others could benefit from listening, please share it using the social media buttons on this page. Do you have some feedback or questions about this episode? Leave a comment in the section below! Subscribe to the podcast If you would like to get automatic updates of new podcast episodes, you can subscribe to the podcast on Apple Podcasts or Stitcher. You can also subscribe in your favorite podcast app. Leave us an Apple Podcasts review Ratings and reviews from our listeners are extremely valuable to us and greatly appreciated. They help our podcast rank higher on Apple Podcasts, which exposes our show to more awesome listeners like you. If you have a minute, please leave an honest review on Apple Podcasts. Transcription Notes **Michael Hingson ** 00:00 Access Cast and accessiBe Initiative presents Unstoppable Mindset. The podcast where inclusion, diversity and the unexpected meet. Hi, I'm Michael Hingson, Chief Vision Officer for accessiBe and the author of the number one New York Times bestselling book, Thunder dog, the story of a blind man, his guide dog and the triumph of trust. Thanks for joining me on my podcast as we explore our own blinding fears of inclusion unacceptance and our resistance to change. We will discover the idea that no matter the situation, or the people we encounter, our own fears, and prejudices often are our strongest barriers to moving forward. The unstoppable mindset podcast is sponsored by accessiBe, that's a c c e s s i  capital B e. Visit www.accessibe.com to learn how you can make your website accessible for persons with disabilities. And to help make the internet fully inclusive by the year 2025. Glad you dropped by we're happy to meet you and to have you here with us. **Michael Hingson ** 01:21 Welcome once again to unstoppable mindset. You know these are really fun things to do these episodes and getting a chance to meet so many people. Today I get to talk to a communications expert and a person who I've gotten to know a little bit since we started chatting and exchanging email several months ago, but Jackie Celske blew me away last week when she said I need to update my bio and all of that because I've just changed I quit my job. I've started my own company. And everything is now different. And I went okay, perfect. Exciting. No wonder we didn't do it before now. So Jackie, welcome to unstoppable mindset. **Jackie Celske ** 02:02 Thank you so much for having me. I'm really excited for our conversation today. Well, **Michael Hingson ** 02:06 we are as well. And I certainly hope our audience is going to be as excited as I am. But let's start with the younger Jackie, you grew up in London. Were you born in England and then grew up or what? **Jackie Celske ** 02:20 No, I actually was born in Chicago, Illinois. Good place. Yes. My well, great other than Chicago sports. I'm a Wisconsin sports fan, ironically. **Michael Hingson ** 02:31 But Wisconsin doesn't have Garrett Popcorn. Oh, that **Jackie Celske ** 02:35 is true. That is true. It's a hard. Ooh, toss up there. Yeah, I didn't spend a lot of time in Chicago. I'm the oldest of three. We my parents had three kids and three years. So we are all really close in age. And thanks to them and their adventurous spirit. They believed that moving halfway across the world with three kids under five and one who was newly diagnosed with autism was a fantastic I DIA and adventure. So there we were, we went from Chicago to just south of London. Actually, we were about 30 minutes outside of the city in the country. And I spent the majority of my formative years there. We were there for almost a decade. So I grew up in all girls school school uniforms. I promise I did have a really great British accent back in the day. I've unfortunately, lost it, which makes my story a lot less cool. But we you could go back and get it. I could you know, it's hard to fake. Sometimes it comes out naturally, but I can't force it. Yeah. I've realized that the hard way. It sounds really silly if I tried to just make it be. **Michael Hingson ** 03:45 So you go ahead. So you you live there until you're but probably close to 15 or so. Yeah, **Jackie Celske ** 03:51 closer to 14. So I moved back to the states, middle of junior high. So talk about shock to the system. And we actually we did not move back to Chicago. So my relatives were all in a very small farming community in Western Illinois. So we moved to the small farming town in the middle of my junior high years. And, you know, I went from all girls school to boys in the classroom who were riding their tractors to school and everybody looking exactly the same. And the whole town being pretty much made up of about five different families. So completely opposite experiences. But I haven't ventured too far from that little community since we moved back. So I now live about 45 minutes 15 minutes north of that little town and have made this area my home since then. **Michael Hingson ** 04:44 So what kind of work did your parents do when you're growing up that cause them to move to England and then back and so on? **Jackie Celske ** 04:54 Yeah, great question. My, you know, we always get asked if my dad is in the military, he was Not he actually worked in finance. So in Chicago, he worked on the Chicago Board of Options Exchange floor and was a stock, an options trader. And so I always forget exactly which job opportunity it was that took him over there. But I think he was offered a originally a one year opportunity to work for a bank, over in the UK, and we went for the year and then my parents just really loved it and ended up staying a lot longer. **Michael Hingson ** 05:28 What's not to love and what a great adventure. It **Jackie Celske ** 05:32 sure was, you know, I wouldn't trade it for anything. I love England, I still try to go back about once a year. I've got a lot of great friends over there. Well, **Michael Hingson ** 05:40 and I'm glad that you, you have friends, you have people that you know, and that you have those memories, and you keep building on them, which is which is really great. But when he moved or when they moved back and brought you are back to the States, was he still doing finance or what did he do? When you guys moved to the little town in Illinois? What town? Was it? **Jackie Celske ** 06:03 The name of the town is Alito **Michael Hingson ** 06:05 Lido. Okay. Yeah. So when you move to Alito, what, what did he do? So **Jackie Celske ** 06:11 at my dad actually quit the work that he was doing at the time. So it was we moved in the year 2000, which, you know, if you're familiar with the stock market, trading floors were becoming obsolete at that time, the, that whole industry was completely changing. So I think my dad was ahead of the curve there a little bit and saw that coming and decided, you know, we just need to make a change. And so and in addition to his job changes, I have a younger sibling with autism. My brother Matt, who is just the coolest person I've ever met, and Matt was in a special school for kids with autism over in the UK, their special education system is drastically different than what we're used to here in the US. And so the conversation opened up to, you know, do we move back here and potentially explore transitioning Matt into mainstream school. And that was how we identified Alito as the place to go, I had an aunt, who at the time was a fifth grade teacher, and Matt would have been going into fifth grade that year. And we decided as a family that it made a lot of sense to help him through that transition with somebody he knows and, you know, familiar family member. And so I think those two things combined lots of things changing in my dad's career and world and just the needs of our unique family. **Michael Hingson ** 07:39 So what did he go into for a career? **Jackie Celske ** 07:43 Oh, golly, that could be a whole other podcast interview. He's, if you think my announcement last week was a shock. My dad's been all over. I think I get a little bit of that from him. But he ended up actually becoming mayor of our little town Alito, for a while while I was in high school. And that took us on a host of other adventures. The Lido actually has a sister city in Spain, a lado Spain and so we were able to go over there and they treated us like we were the president of the United States. It was just the coolest trip of all time, from little dinky Alito, Illinois, but so he he was in politics and local government for a while. He has started a few different businesses. I guess kind of there's been a running theme in the construction world. So he has since now moved to Florida, and received his general contractor's license. So he's running a business down there building really beautiful homes in the southwest area of Florida. **Michael Hingson ** 08:48 And your mom. Yeah, **Jackie Celske ** 08:50 my mom. So my mom while we were growing up was actually a stay at home mom, with everything going on with my brother. She was just the champion for us kids growing up. And in England, the school system is different also. So we had three kids go into three different schools in our lives were just pretty chaotic over there. And then when we moved back here, my mom ended up in higher education. So she actually has her doctorate in instructional design. And so she is is really into all things training and does a lot of advocacy work and she now since they moved to Florida works for their amazing church and their community. We're in Florida today. They are in Cape Coral, which is right next to Fort Myers, right. Okay. **Michael Hingson ** 09:40 I was in Fort Myers speaking a few years ago it's been three or four years but it was a good time of year it wasn't too hot and to humans, so **Jackie Celske ** 09:49 I kept roughly when it's not too hot. **Michael Hingson ** 09:53 Yeah, when the book when the bugs have decided that it's not the great weather it is a lovely place in a good time to be there. **Jackie Celske ** 09:59 Yes. It is I always say I have great vacation spots. Thanks to my family. I've got family in Florida and family in Nashville, Tennessee area. **Michael Hingson ** 10:07 And friends in London and yes, exactly. I **Jackie Celske ** 10:10 know there. You're right. Yes, exactly. **Michael Hingson ** 10:13 So for you, so you have a brother and as your other sibling, a brother or sister, **Jackie Celske ** 10:19 my youngest sibling is a sister. **Michael Hingson ** 10:21 So you have a sister and a brother. That's pretty cool. **Jackie Celske ** 10:23 I know best of both worlds, one of each. And we are all very close. We call ourselves the Celski trio. So my poor brother in law is trying to assimilate into that club, most of his life, and he puts up with us pretty well. We all have our challenges. Yes, yes, for sure. What **Michael Hingson ** 10:41 was it like when you move back to the US as a young teenager in terms of assimilating back into the culture of the US as opposed to what you had experienced in England, **Jackie Celske ** 10:51 it was incredibly difficult. So if you can imagine I had a very noticeable British accent. I had never been, you know, I had a brother, but I had a brother with autism and special needs. And so my experience around boys for preteen boys was very minimal. And the educational system in the UK is drastically different as well, they're a little bit advanced in some ways. So they start school sooner. So I was actually a couple of grades ahead, book wise, if you want to say it that way. But maturity level was the same as any other kid my age. So my parents, you know, what I'm thankful for this did decide to keep me in the grade level for my age, instead of accelerating my education in high school at age, you know, 13 or 14, being too early or too young for that. So I was able to at least hang out with kids my age, but it just was incredibly difficult to be in a place where I stood out so much, I remember we moved in August of that year of so right before the school year started, by Christmas, I had a completely a complete American accent, I just forced myself to change my outward identity very quickly, because it made it difficult for people to see me as me, I just, I was too different. You know, and I think, that experience at an early age. And now also, in my adult years, seeing how I'm treated differently in both countries, when I appear as either American or British. You know, I remember what it's like to be in England as a Brit, and how people treat you and now how they treat me as an American tourist when I go and same here. And so I think I just became hyper aware at a young age that about this, the concept of identity, and this idea of communication and the way we interact with each other and why that matters. And it also happened to be at the forefront of social media and instant messaging. And so I was kind of in the middle of this first wave of digital communication, which was amazing, I was able to stay in touch with some of my friends in England, but I was also being introduced to some of that cyber bullying and that anonymous kind of attack. And it was really easy for people to, you know, have negative comments, or essentially just pick on me as a young kid for what I sounded like, or what I looked like, or the things that I wanted to wear. And you know, I had grown up with school uniforms. So I had no idea. I had no concept of cool clothing I didn't, I had to figure out a whole different way to really express outwardly who I was as a person. And I remember being so excited about my first day of school and Aledo wearing this glittery butterfly shirt that I picked out at Walmart and I had no idea that you absolutely do not buy your shirts from Walmart as a 13 year old kid. So it just was all downhill from there. It was a really, for me, it was incredibly challenging. And I think I struggled a lot more than both of my siblings after talking to them about their experience. They just seemed to assimilate a little bit quicker because they were younger. And some of those preteen cultural norms hadn't really started for them yet. **Michael Hingson ** 14:36 Now you move back, you said in 2000. Yes. Okay. So what immediately comes to mind, I want to come back and talk about Matt a little bit in a sec. But one of the things that must have been in ways you look back on it fascinating, although I don't know whether that be the right word to use or not is. So the next year of course, September 11 happened What was that like? So you and all the folks in Lido? Oh **Jackie Celske ** 15:03 gosh, yeah, that's a great question. I just remember being very scared. You know, we, my parents are very proud Americans and did. As much as I became a very British child, I was also a very proud American child who just happened to live in the UK. So, I mean, we celebrated Fourth of July and Thanksgiving and things over there that are a little bit frowned upon for the typical Brits. But you know, I did have a very lot of pride about being American, even at that age. And despite the fact that I grew up in a different country. And so I think I shared similar emotions, as many of the people in our town and in some ways, I almost think that United that little community a lot more than it had ever been, or at least for a really long time, because that was just one moment in history. I remember us all being the same. United Yes, yes. **Michael Hingson ** 16:12 We're, we're a mirror Americans, generally well respected and, and welcomed, let's say pre 2000 wings, do you think **Jackie Celske ** 16:23 I, you know, in my case, I was a child. So it's a little bit harder to know, for sure. I mean, our friends over there in the UK, were they just welcomed us with open arms. And I had a very positive experience being American over there. I think the area in which we lived was also, it's just very common to have what we would probably call transplant families. So our group of friends were all families who had moved from other countries. And so we were all in some ways, going through the same experiences together, and sharing in those learning curves, or, you know, celebrating our heritage and things together, which was really special. And then moving to small town, Illinois, completely different. There was nobody had really ever left that city, it was almost the opposite. So new people didn't come in and people didn't leave. And so from my experience, and where we just happen to live in the UK, I always had a very positive. **Michael Hingson ** 17:30 Well, I'll tell you why. I'll tell you why I asked the question. The one of my salespeople who I hired why I always say as the best sales guy ever hired, when we were doing product trainings for him at the time, and quantum wasn't international company, the blast, best place for him to go to get the media training to be able to start to really sell or, and he had actually been selling for a while. But then the training opportunity came along was London. So he went over and visited the quantum folks in London. And whenever he would go to a bar, he was a sports guy. So he liked to go to sports bars and stuff. But if he went into a bar, and they discovered they had a Yank in their midst, he said, I was treated like royalty everywhere I went. And, and so you know, I'm curious. And the reason for thinking about all of this was, Do you think that's changed a lot over the years that, that it's any different or people still, probably whatever they were about the same as they were before in terms of dealing with Americans and all that. I mean, our world has just gotten so crazy in so many different ways. I'm just curious to get your perceptions on internationally or in England, if things are different than they used to be, do you think? Yeah, **Jackie Celske ** 18:58 I would say yes. A resounding yes. I mean, I feel the differences when I go over and visit. And you know, I'm obviously very familiar with where I'm going, when I'm over there. I'm not necessarily going as a tourist, I'm going most of the time just to visit people and maybe go back to my favorite places. But I tend to perceive that the Brits think we are just kind of arrogant and annoying and would prefer we just kind of get out of the way and not be there a lot of the times and so with my friend group over there, it's just a running joke and especially with the political climate of our current politics, so yes, that definitely, I think contributes to it. I mean, I will say the last election, my I had several friends saying we're just over here eating our bowl of popcorn watching the US like it's a movie right now. So it's almost as if they don't take us too seriously. But I do think There is respect for the independent lifestyle that we live in some of the autonomy we have in, in our culture over here that they don't always experience over in the UK or in Europe in general. And vice versa, I've learned, I've developed a very deep respect for the way that they value work life balance, that we don't get right here, in my personal opinion. So I agree. Yeah, I think I have the luxury of having exposure to both sides and getting to understand what is really great about both countries, and not everybody gets to experience it that way. **Michael Hingson ** 20:43 So what is it? What would you say the work life balance is like over there as opposed to here? **Jackie Celske ** 20:50 Very healthy, they just value relationships and people in a different way, in my opinion, I they get a lot more time off work, they are nobody there is overworked, which I think can be perceived as almost laziness, sometimes to us. But you know, there's nobody getting physically and mentally unwell from work. I mean, I'm sure there are I shouldn't make extreme claims like that. But the cases of you know, mental health concerns from work or physical. You know, well being issues and concerns that can come from overly stressed workloads, they just don't seem to have that same experience there. And my friends are just always traveling always on vacation, they typically work shorter work weeks, they get much more time off with their kids. You know, both both the women and men getting up to a year off when, after giving birth. A lot more quality time with the people that are important to you. And I, in my opinion, that's really what life is about. You **Michael Hingson ** 22:05 traveled much to other places other than just London or England into other parts of Europe. **Jackie Celske ** 22:10 I have Yeah, I have. And I think you know, it's not true across the entirety. But I've been to probably 10 or more other countries, so. And a lot of my friends from the UK actually live all across the world now too. So I kind of get their indirect experience from the new places that they've moved to as well. Maybe **Michael Hingson ** 22:34 you think about the whole thing that's been in the news occasionally, over the past few months about the whole issue in France, where they want to raise the minimum retirement age from 62 to 64. That's gotten pretty violent. **Jackie Celske ** 22:49 Yes, it has. Yeah. And I don't know what I don't know if I have a specific personal opinion yet. I think I'm still forming that myself. Every I don't. And I also am not as familiar with France as I would be with the UK and how that's all structured. But gosh, yeah, it's just in Europe is interesting, because similar to the US, when you think about how different all of our states are, you know, that's what it's like over there, it's just on a more extreme level, you're not just crossing a border to another state, you're crossing a border to a different world, almost, they speak a completely different language and have completely different cultural norms. And so, within a matter of, you know, hours, you can be in a completely different place that just where people don't think like you act like you talk like you. And that's something that I don't think Americans can really even fathom unless they've left the US, or **Michael Hingson ** 23:48 they don't spend enough time thinking about the possibility. That's the case. And as a result, they're less prone and think, in large part, to understand it. And I know for me, I have a hard time understanding the whole issue of just so you're moving from 62 to 64 is the minimum retirement age. Why is it so violent, but at the same time, I also realize that's a marked difference for them. And it's no different than with anyone else. A lot of times, no matter what we say we really don't like a lot of change. No, **Jackie Celske ** 24:30 I know humans don't really appreciate change. We certainly do. Yeah. Yes, yeah, it's the change is hard. Change is very hard. Yeah. **Michael Hingson ** 24:41 Well, tell me a little bit more about growing up with math that had to have some influence in shaping your life and your outlooks and so on. Having a brother who has autism, what was that like? **Jackie Celske ** 24:54 Yeah, you know, I actually think Matt helped me find My life, passion and my life's work. So his specific diagnosis, I think when he was about two or three, in the early 90s was a time when people didn't really understand autism much at all. And so my mom will recount the doctor saying, you know, your son is going to be institutionalized, and he's never going to do any of the things that you think he's going to be able to do. And my mom just looked at them in the eye and said, No, you're wrong. And **Michael Hingson ** 25:34 where have I heard that story? We'll see, same thing my parents did. Yeah, **Jackie Celske ** 25:40 I remember that. When we first connected I remember you sharing something similar and the power in those words, man when I think about it now. Thank God for my mom. Right. I mean, Matt was very behind at when we were in the UK, he, like I said, he went to a school for children with autism, and most of them were nonverbal. So Matt was developing very slowly, he was nonverbal for quite a while, and then when he did begin to speak, it didn't, you know, it didn't often make a lot of sense, we used a what they call over there Makaton sign language to communicate with him. We had a very, I would love to see one of these now. But we had almost like a digital tablet, from the 90s that had pictures on it. So he could press things that he wanted to, you know, if he wanted french fries that day or something, but he had a lot of the just stereotypical repetitive behaviors. He was incredibly tactfully defensive. And so you couldn't even touch him with the tip of your finger without him screaming. And so my mom, she dedicated her a solid 1015 years of her life, to just care for my brother and find the best resources for him. I mean, she would brush his body with a hairbrush several times a day, she would take him to the movie theater and train him on how to adapt to the overstimulation of the loud sound. You know, we laugh about it now that Matt would only eat Mcdonald's chicken nuggets, we would go to McDonald's and buy like 4020 packs of nuggets and have a freezer full of those chicken nuggets for years. That's all guity. And by he started to show these just magnificent gifts. And one of them was his ability to understand directions. So we would go on a road trip as a family, we'd come home, and before he could even really speak, he would take printer paper, lay it out on the floor. And he would to scale draw out and map out the trip that we had just taken. And I remember, as he began to communicate verbally a little bit more, I remember him just randomly saying things like, oh, you know, there was 34,000 dotted yellow lines on that street that we just drove by. It just hit the way that his brain worked, he would memorize the TV Guide. You know, most people don't remember having TV guys, but you know, those giant thick books that would tell you everything that's on the TV for the month on every channel. And Matt would memorize that. And we could ask him, you know, next next week on Saturday, what is on at 8pm on these three channels, and he would know, he just had a photographic memory. So he could read Yes, he could read. Yes. So he started to to show abilities in his communication that I think were being stunted at the school that he was at. And that was kind of the catalyst for my parents in their decision to you know, he's never going to be pushed and challenged in the way that he needs to be unless he is surrounded by all types of kids, not just kids who have autism. And we need to find a way to get them into mainstream schooling. And so they don't do that. As far as I know, at least in the region we were at in the UK, they that wasn't an option for him with his diagnosis. So moving to Alito, he transitioned at first into fifth grade with my aunt as his teacher and he had a full time aide. And, you know, I remember I remember I was just saying he was tactfully defensive as a child and you couldn't hug him. You couldn't touch him. Well, by the time he was a senior in high school, he was an AB student with no aid, a varsity wrestler. He was the lead in the school musical and just an all around stellar, teenage kid just have All the things that a kid should be doing, you know, you're **Michael Hingson ** 30:03 absolutely right. He needed to be in that environment just stimulating. Yeah. Yeah, it was the musical. **Jackie Celske ** 30:11 He was in well, he was in the musical every year, but he was guest on and Beauty and the Beast. Oh, okay. And he did a great job. He did a wonderful job. **Michael Hingson ** 30:21 Even though he didn't get the girl in the end. No. **Jackie Celske ** 30:23 And he played the wizard and the Wizard of Oz as well, trying to think which other ones but he he would always be in the talent shows. And yeah, he's got perfect pitch is another just wonderful gift with his autism. So his musical talent is just absolutely phenomenal. And he went on to get a four year college degree, and he is just a lovely young man. Now he get a major in music business. Makes sense? Yes. Yes. He's not doing that professionally right now. But he has a lot of interests in that field still. So on the side, he and I dabble in kind of writing songs and making little music videos and mashups, and things just for fun, as well, right? **Michael Hingson ** 31:12 Well, you, you obviously had a lot of challenges to overcome and moving back and just being a teenager and going through all the things that you did, much less Matt, but Matt sounds like, as I would describe it a whole lot more of a blessing than, than a lot of people might think. And so yeah, he had autism. And so what, he's come through it, you've come through it, and it's made a whole big difference in your life and how you look at things, which is really cool. So what kinds of did well have challenges or what major things happen to you personally, as a teenager, and in school, and and growing up? Once you move back? **Jackie Celske ** 31:55 Yeah, I, I mentioned that, you know, Matt helped me identify this curiosity, I would say about communication and words and stories. And, you know, one thing that was really challenging for me moving back to the states, coming from the education system that I was in, I gravitated towards older groups. So as a freshman in high school, for example, my core group of friends were all of the seniors. And that just felt more natural to me, that's kind of at the level I had been at in school in the UK. And so I was hanging out with kids that were just probably too old for me at 13 and 14 years old, and getting exposed to things at too young of an age, not that kid should be exposed to anything bad as a teenager, but just hanging with the crowd that I shouldn't have been with yet. And unfortunately, as a sophomore in high school, I found myself at a party with some friends and was we still don't know a lot of the details about that event. But I remember waking up, away from the party away from my friends, I had been drugged with something and was very brutally sexually assaulted that evening by multiple people who know me and knew me well enough to drop me off at my house at the end of the evening. **Michael Hingson ** 33:25 Even though they did what they did, yes, **Jackie Celske ** 33:27 yes. And so that for me, that was the turning point in my life. And I honestly would say I would say, I'm not sure I've, I really even began to fully wholly heal from that until about a year or two ago. It just changed the trajectory of, of everything for me. And the first time I talked to an adult about it, you know, the words were basically, I don't believe you. And you know, I talked about the power of words. I mean, those words changed the trajectory of the next several years for me as well. And so I found myself pretty shortly after that event, just having really extreme physical medical challenges that were unexplainable. I was at the doctor all the time, I was getting sick all the time. And it wasn't until I was 19 when I had a part of my intestines collapsed, so I needed a pretty immediate surgery. And the doctor asked my mom to leave the room. And it was that doctor who actually asked, all right, what has happened here because we don't see internal damage like this. In somebody or age and less. There's been a lot of trauma. And that was the first time I really started opening up so that had been three years. **Michael Hingson ** 34:56 What were your parents thinking or thoughts about it? So **Jackie Celske ** 35:00 I, my mom knew a little bit, my dad actually did not even know me. I never shared it with him until I was in my 20s it was a very difficult thing for me to talk about. And I, like I said, when I started to speak up, it was not well received, I was not getting the support I needed, I was not given access to resources to heal and get help. And so that just really shut me down. And my coping mechanism was to just, you know, get involved in everything in school and be tried to be the perfect student and the perfect teenager and the perfect big sister and I just distracted myself with all of those things in life, and my physical health became such a distraction, honestly, that I didn't understand the connection between the mental health aspect of what I had gone through, and how that was impacting my body, on a physical level for many, many years, and my family was amazing at supporting me and getting the help I needed physically. But we just didn't connect the dots for a really long time. And it took a lot of really hard years and multiple surgeries and multiple doctor visits and trips to different medical systems to really figure that out. **Michael Hingson ** 36:33 And I would imagine no more parties for Jackie for a while. No, **Jackie Celske ** 36:37 no. Yeah, it was. It, you know, in some ways, I remember every detail of the event. And in some ways, I don't it's, they I've learned now that that's really common for sexual assault and trauma survivors to remember very specific details, but not the actual moment of the. So I've written a lot about that and spoken a lot on that. As part of just my advocacy and awareness, **Michael Hingson ** 37:07 and your healing, yes to talking about it helps. And I mean, I, it's not my place to make you just talk a lot about it. But talking about that kind of thing, or whatever goes on in your life always has to help. I know that. And I love to say this that I chose to let people interview me after September 11. And I believe that I did so much better by allowing the media to come into our home and ask me questions, because I got to ask all sorts of questions, some even really intelligent questions, but a lot of questions just about September 11, and anything you could possibly imagine. And occasionally, even now, I'll get a question that I have been asked before, but it doesn't happen very often. But still talking about it was the best thing. **Jackie Celske ** 38:00 Yeah, it's I, I'm a big advocate for either writing or, or verbally talking through your story. For me, support groups. And that kind of community was the best way for me to do that. Because I could sit in a room. And if I didn't feel like speaking, there was still someone next to me, who had a similar lived experience and their words often helped me process, what was going on in my brain. And you know, maybe they were at a different stage of that processing than I was. And so listening and learning from what worked with other for other people, was a huge healing step for me. And that's why I'm just such a big advocate for stories and words. Now, I mean, words are so powerful. And the stories we tell are so powerful, and they're, they're what bring us together. They're what, you know, we said at the beginning, it's what unites us it it's what makes us better, more self aware human beings. And we just go about the world as better people that way. And **Michael Hingson ** 39:07 I'm a firm believer that everyone has a story to tell. And sometimes people save when we discuss them coming on the podcast. Oh, my story isn't interesting. It's just like everybody else. And I said, No cheer story. And sometimes they'll not want to come on. They just don't want to get past that. But I've been blessed that lots of people do come on and tell their stories. And the reality is everyone's story is different. And my job is to help people communicate and tell their story and help to inspire because I think that most of us could be a whole lot more unstoppable than we think we can and I mean that in a very positive way in stories help that. **Jackie Celske ** 39:46 I 100% agree and honestly, that was what made me really excited to be on your podcast because I have not written a book. I have not founded a nonprofit. I have not On on to transform this trauma into something above and beyond, I have just learned how to find my own purpose in it, how to heal so that I am the best version of myself. And I just choose to, you know, use it as part of the one chapter in how I got to who Jackie is today. And I haven't done anything more than that with it. And I think that's an equally important for people to hear. Because you know, there are people out there doing amazing things from the trauma that they've experienced in life. But it's also amazing, to just keep going, and to survive through it and to be on the other side of it. And to keep learning about yourself and learning about what helps you feel better, and how to help other people feel better, that is equally amazing and powerful. So it's not about what you do to change the world. You know, in a big grandiose way we can change the world, in our own small ways every single day when we choose to take care of ourselves. **Michael Hingson ** 41:13 And amazing is such a sometimes overly used word. And the fact is, what you just said is absolutely correct. It doesn't need to be that amazing as well. Because you go out and you speak and you do all sorts of different things to tell the world about what you do or don't do. Ultimately, it's how you feel it's in your brain that really matters in the fact that you're able to move forward. And also, I think it's it's good that you recognize that, that it's really how you approach it and how you feel with it. And that the amazing part is that you do it. And it's something that we all ought to learn a lot more about, and grow to understand. Yeah, **Jackie Celske ** 41:57 I think so too. I've listened to several of your guests, interviews, as well. And I've learned a lot from their perspective and experiences to on just different resources or different tips and tricks on you know how to minimize stress or how to focus on, you know, I listened to I think it was Jennifer's interview that was a day or two ago. And I also tried EMDR. And I was listening to her experience with EMDR. And how it was it was different from mine. And that was really interesting to me to just know that we both benefited from it for different reasons. And, and she goes and shares that as a resource to other people. And I do the same. And so it's those small moments of exchange in those small stories, I think that are the most impactful. **Michael Hingson ** 42:42 Yeah, I talked with someone just yesterday about sound wellness and how different sounds affects us. And what affects some of us one way with a particular sound or set of sounds is totally different to someone else. Like I'm not a great fan of heavy metal, and that kind of music. But some other people are. And that's okay. I can appreciate it. It is still whether I like to think so or not. Heavy Metal is music, and I appreciate that it's music. It's different than what I like, but that's okay. **Jackie Celske ** 43:18 Yeah, exactly. We just need to be okay with it being okay. Right. That's, that's the lesson I think **Michael Hingson ** 43:25 I haven't really totally come to grips of thinking that rap is music in the same way that heavy metal and other kinds of music or music because it's so much more talking. And yes, there's a there's music in the background. But the main part of it isn't necessarily singing. But that may be me. And it may be that the definition of music is just changing from what it used to be. But I'm, I'm still working on that. **Jackie Celske ** 43:50 Well, you'll have to hang out with me a little bit more because I like to write parody rap songs for fun. I've been known to do a surprise parody rap speech or for internal communications, messaging it at work or something, I will dress up and help communicate a message in a very unique and memorable way just for fun. And so I think, you know, I've never been a fan of rap myself. But getting to put a little jakie twist on it like that has made me appreciate it and have a lot of fun with it. **Michael Hingson ** 44:22 I think rap is absolutely an art form. I'm just not sure that I would classify it as music. I think it's an art form. It's a wonderful art form. I've listened to some rap, you know, rap songs or rap music or whatever you want to call it. And clearly the people are very intelligent. They're talking about their life experiences, and are doing it in a very articulate way. So I think it's an art form. I'm just not sure I put it in the category of music as such. **Jackie Celske ** 44:50 And that's where words matter, right? Whether it's music at all. Yeah. **Michael Hingson ** 44:58 It does. Well, you been through a lot? What kind of advice would you give to someone who's maybe been through some of the kinds of things that you have? Whether they've gotten the support or not? What would you encourage people to do to help them move through some of this stuff a little bit more effectively? **Jackie Celske ** 45:14 Yeah, that's an excellent question. I think, to me, it always depends on where you're at in your journey. I think if you are actively surviving something really hard, right? Now, then, first and foremost, you need to take care of yourself, and you need to sleep and you need to eat well, and you need to get some exercise and all the basic foundational things to just keep yourself well. And give your body and your mind the best chance at making it through the challenge ahead of you. I think if you are somebody who is, you know, maybe a little bit further along the journey, and just wants to continue healing and continue growing, I am a huge believer in practicing gratitude. And, you know, again, I think somebody recently on your podcast was talking about morning and evening routines and making intentional time in the day to stop and just appreciate the good that is happening around you. However small or however big. I'm a huge believer in the power of humor, I think the ability to laugh at ourselves is what humbles us, it's what makes stories and human connection a little bit more approachable when we talk about hard subjects like this. So, you know, for me, I battled this autoimmune disease for almost 20 years after that sexual assault that I really am only just now, realizing what that is, and what that means. But one of the organs that was significantly affected was my bladder. And so I genuinely used to pee my pants, quite often, I used to have accidents at work or in professional settings. And I just had to laugh about it. And it, it became something that, you know, my friends and peers and co workers could ask about because it was I made it a safe thing to talk about. And when I had an implant put on my spinal cord to help regulate some of those issues. I named him Pedro. So that when I started talking about Pedro, people would say, well, who's Pedro, and then it would open a conversation, right, so that I could approach really tough subjects. But, you know, I love I love the power of humor, and jokes. And so if you think about the word humor, and humility that both of those words, actually the origin is the same, and it comes from humanity. So when you want to go back to the power of words, you know, those are two powerful words right there. It's what our shared human experience is all about. So and then I guess, ultimately, I would always encourage people to just find ways to mitigate and control and minimize your stress. If I've learned anything, in the last couple of years, or even the last couple of weeks, with some of the big life changes I made, it's that the energy you surround yourself with is really important. Whether that's the people or your work environment, your home and where you live, just making sure that you're creating happy spaces for yourself and safe spaces for you to be yourself where you can be vulnerable. When you need to be when you can be authentic, and your true self and your best self. I think that is really important. **Michael Hingson ** 48:38 You went off to college, and you learned a lot about communications, and certainly learned a lot about how to interact with people. And that certainly has to help shape some of your thinking. But you you have come a long way in in your, your journey in terms of getting better and improving and so on. But you You keep saying especially in the last couple of years, how come so much so quickly lately? **Jackie Celske ** 49:07 Yeah, great question as it again, probably a podcast interview all on, its on its own, but I can shorten it to the best of my ability. So early in 2022. Actually, my medical condition was deteriorating really quickly. So I mentioned I had what we understood to be at the time, actually a neurological disease. So for about 20 years, my doctors were suggesting that I had something wrong with my nervous system. And we were treating it as such. So I would have days where my legs would not work or certain organs would be shutting down for no reason, no apparent reason and it wasn't until early 2022 I just became so sick and so unwell that my doctors here locally who had seen me for about 16 years, threw their hands up in the air and we're out of ideas and I did not know what the next step was going to be. So I decided to quit my job here in Iowa, I moved to Florida where to be with my family. And I just prayed that I would find a new doctor down there who might have a different idea. And man did I get lucky I was at such a point of desperation I had, I've found one doctor down there, we tried a couple additional surgeries. So I had two surgeries and 2022. And the implant that I had on my spinal cord was replaced in hopes that that would maybe make a difference. It did not. And so I found myself calling doctors to try to have organs removed. I mean, I was at a very desperate level, just not well, and I came across an article in a medical journal, about a woman who sounded very similar to me. And she was claiming that she had been cured by this doctor by this experimental treatment. And so I called their office completely in tears. And he, I understood him to be a leukemia doctor, so he specialized in bone marrow transplants, and I just thought, you know, he's not going to see me, I don't have cancer, this isn't going to work out. And to my surprise, they, he and his receptionist are both from the UK, ironically. And we just bonded over the phone about that. And they said, You know what, come on, in we, we would love to speak with you. So I drove about three and a half hours to the other side of the state of Florida and met with his team. And he was able to do some testing on my immune system. It was the first time in about 20 years that any doctor had identified on paper, what was actually wrong with me. So my immune system had been so severely damaged from all of the trauma and all of the stress that my body had been under for the last two decades, that it had aged to the point of, you know, I should have been about 90 to 100 years old with what the data was showing. So all of the illnesses I was acquiring inside my body had nowhere to go, my body wasn't fighting them. And then those, that bacteria that those viruses were living in my nervous system, which is what was causing all of the physical symptoms I was experiencing. So he offered to try the experimental treatment. But you know, obviously, we couldn't guarantee it would work. But it was a combination of infusions and injections for multiple weeks at a time. So I would get a PICC line put into my arm, similar to chemotherapy type treatment. And I was all on board. The only challenge in my way was that, of course, insurance did not cover it. And it was going to be a crazy expense for me and my family. And we decided, You know what, let's just tell Jackie's story. And let's see what happens. And this just beautiful community was formed around me sharing my story, and we were able to raise, I think we're up to about $45,000 in my GoFundMe, my friends back home hosted a benefit for me, and we raised another 10 or so $1,000 to help me pay for that first round of treatment, which cost a little over 80,000 the first time. And that was the biggest blessing I could have ever asked for because I came out of that treatment with almost all of the damage to my immune system reversed. And unfortunately, we just we couldn't do any more at the time financially. So I was feeling a lot better, I decided to move back home. And what we found was that because we didn't complete the entirety of the treatment, I just continued to regress after moving back home. So earlier in 2023, March, I went back down and we completed another round and we extended it this time. So I had to take a second mortgage out on my house to make that happen and you know, make a big gamble on myself, but it paid off because going for that extra amount of treatment, we were able to hopefully knock on wood permanently reverse the damage in my immune system. And it has so far cured me of almost all of the physical impairments that I had been battling for about 20 years. **Michael Hingson ** 54:28 On top of everything else you decided to go off and start your own business and quit what you're doing before What were you doing and what did you quit? Yeah, 54:37 I did. So I like I said I was kind of in and out. I went from Iowa to Florida. I went to Florida over the last year and a half and so I moved back to Iowa for a while and started a job in higher education. discovered pretty quickly that that just was not for me. The particular culture of the place that I worked was a I'm very toxic and very unhealthy. And I started to develop stress and do seizures and other symptoms that were, you know, a clear sign that my body was not going to be well in this environment. And so I, in talking to my family and loved ones, I remember saying, you know, everyone was encouraging me to leave, I kept thinking, wow, that looks bad, I've been putting jobs right and left, I'm not sticking around anywhere very long. I don't have a plan B. And somebody just said, Well, you have to be alive to have a plan B. There you go. And it was those words, again, going back to the power of words, that convinced me that I just, I needed to make a change, and I would figure it out. And so that's what I did. I went in and quit pretty much the next day. A couple days later, I incorporated my own LLC, the PROSE, CO, and PROSE, which means written and spoken language. And I started my own communications and marketing firm. And now I'm a month into that, actually, this week will be an official month of full entrepreneurship. And I have already, you know, replaced my full time job income. And I'm already doing full time work with a host of different clients, wonderful, awesome clients that believe in me and chose to take this leap with me. So it's been an exciting couple of months. **Michael Hingson ** 56:28 That is really exciting. And so what what are you doing for customers now? Exactly? Yeah, 56:36 great question. So I chose the PROSE CO. A, because PROSE stands for basically communication. But PROSE is also an acronym for the different services that I provide. So P would be promotional communications, which was everything from website content, advertising and events. Are stands for relational communications. So for my nonprofit clients, that's a lot of fundraising and stewardship strategy. For others. It's more public and media relations. O stands for organizational. So that's all things internal communications, from newsletters to change management, we laughed earlier about how difficult changes, helping to navigate that for some of our clients from a messaging standpoint, S is social media. So I do a lot of social media management, community management. And I love analytics. So diving into digital analytics is kind of my my thing. And then E stands for executive. So anything that we we call it transformational or inspirational. So I do everything from speech writing, to strategic planning, and brand strategy workshops. And I keep saying there's just a giant plus sign on the end of that too, because already in my short month, I've had a lot of custom projects pop up that weren't in that original scope that I had designed or imagined. So it's just kind of ever evolving right now. But mainly, you know, the miss the mission of the Prosecco is to change the world through stories. That's what I want to do. And anything that's going to help tell a client's brand story and help engage their clients in a way that goes beyond just creating a positive affinity towards that brand. But transforming that into some sort of action and change that's going to move that mission forward is really ultimately what my goal is with this company. **Michael Hingson ** 58:32 And you certainly have done something major to get rid of a lot of stress over which you don't have any control over, you're going to have challenges because you're going to have deadlines, and you're going to have people who want different things. But you are the one who set that up, which makes it just so much better than stress in an office environment where as you said, it can be very toxic. **Jackie Celske ** 58:56 Yes, it sure does. I, you know, it's a little bit more, there's new challenges, right, which is kind of the fun of it. But it's I'm asking myself silly things like do I want to just wear pajamas today? Or do I want to put normal pants on and go to the coffee shop, but it's it's a little bit of a different level of stress. But, you know, ultimately, I I want to provide the top quality service to clients that I can. And I'm very fortunate to have a great network, the community that I live in, where there's several other freelancers. And we've all started partnering together so that we can still provide a full service agency experience, just at a lesser cost for clients essentially without that overhead. So it really does feel community and team driven, which is not what I was expecting branching off on my own. I thought I would be giving that part up and it almost feels like I've gained more of that than I had before. And it also feels like we're really solving problems and we're really meeting a need in our commune. Any that maybe wasn't there before. So it's, it's exciting to be a part of it. **Michael Hingson ** 1:00:03 That is super cool if people want to reach out to you and learn more about pros CO and maybe, hopefully work with you and use your services and so on, how do they do that? And how do they reach out to you and learn more about you, I 1:00:16 would love for people to reach out and just connect at a minimum share your stories doesn't have to be for business purposes, formally, but my website is the proseco.com I keep joking that it's basically the prosecco.com without the extra c, because I do love my Prosecco and wine. So it's a good fit. But there's a contact form on there. If folks want to reach out and just get connected there. They can also email me info at the pros wcco.com Or feel free to look me up on social media. I'm, I'm on most of them. And I'm Jackie Celske, I think I'm the only one in the world. So I'm pretty easy to find whether that's a good thing or bad thing. So selfkey is spelled C E L, S K E. **Michael Hingson ** 1:01:02 So its J A C K I E C E L S K E. Yes, perfect. Well, this has been absolutely wonderful. And I am so glad that we finally made connections. And if you want to come back on in the future, and continue the discussion and tell more of the story, whether you write a book or not, we're glad to have you come back on but I bet one of these days you'll decide to sit down and write it or find someone to help write a book and and help inspire other people. But whatever you do, you've already done such amazing stuff. And you've been so committed to making it happen. And that's as good as anybody could ask for. So I really appreciate you being on and giving us so much of your time. Well, **Jackie Celske ** 1:01:47 thank you so much. I think yeah, I've surprised myself in the last few weeks and months for sure. So who knows, I might surprise myself and do something like that one day, we'll **Michael Hingson ** 1:01:57 see. If you want to talk about it ever. Don't hesitate to reach out. **Jackie Celske ** 1:02:01 I thank you very much. And thank you for the platform and opportunity to just be part of this community that you're building. It's it's been really special to me. So thank you. Well, **Michael Hingson ** 1:02:09 this has been fun. Well, I hope that you've enjoyed listening to us and that you enjoyed everything that Jackie had to say I'd love to hear from you. Please feel free to reach out you can email me, Michaelhi m i c h a e l h i accessibe A C C E S S I B E.com. Or go to or and go to our website, www dot Michael hingson H i n g s o n.com/podcast. Check out more episodes if you're new. And if you've heard a bunch you can always go find them there easily anyway, we really appreciate it. Wherever you're listening, please give us a five star rating. We all do appreciate that. And we do really want to hear your thoughts. And Jackie for you and all of you listening if you know of anyone else who we ought to have as a guest on unstoppable mindset, bring them on, we'd love to hear from other people. And we'd love to bring more people on and help inspire and motivate all of us because that's really what it's all about, and having fun. So you can't do better than that. But Jackie, once more. I want to thank you for being on and hope we can do this again.  **Jackie Celske ** 1:03:15 I would love that. Thank you so much.  **Michael Hingson ** 1:03:20 You have been listening to the Unstoppable Mindset podcast. Thanks for dropping by. I hope that you'll join us again next week, and in future weeks for upcoming episodes. To subscribe to our podcast and to learn about upcoming episodes, please visit www dot Michael hingson.com slash podcast. Michael Hingson is spelled m i c h a e l h i n g s o n. While you're on the site., please use the form there to recommend people who we ought to interview in upcoming editions of the show. And also, we ask you and urge you to invite your friends to join us in the future. If you know of any one or any organization needing a speaker for an event, please email me at speaker at Michael hingson.com. I appreciate it very much. To learn more about the concept of blinded by fear, please visit www dot Michael hingson.com forward slash blinded by fear and while you're there, feel free to pick up a copy of my free eBook entitled blinded by fear. The unstoppable mindset podcast is provided by access cast an initiative of accessiBe and is sponsored by accessiBe. Please visit www.accessibe.com . AccessiBe is spelled a c c e s s i b e. There you can learn all about how you can make your website inclusive for all persons with disabilities and how you can help make the internet fully inclusive by 2025. Thanks again for Listening. Please come back and visit us again next week.

OverviewLast episode as of Dec 2023Emily Ana Levy is a distinguished social impact entrepreneur, renowned patient advocate, healthcare Key Opinion Leader, and acclaimed international public speaker. Emily's journey led her to co-found Mighty Well in 2016. It's a startup driven by her personal experiences as a patient grappling with chronic neurological Lyme disease and autoimmune conditions, along with the challenges of managing vascular access devices. Mighty Well's direct-to-patient brand offers innovative medical products and comprehensive digital learning on vascular access, empowering patients to confidently navigate their health journey. With an unwavering commitment, Levy and her team have successfully launched seven adaptive medical products, notably the Class 1 FDA-registered PICCPerfect® Pro. Emily and Mighty Well's impact has been featured across various media outlets such as The New York Times, The Wall Street Journal, Who What Wear, The Boston Globe, PBS, Forbes, and more. In 2021, inspired by her transformative healing journey in the Amazon and stepping into her gifts as a seer, medium, and deathwalker, Emily established Hamsa Healing. In her practice, she is dedicated to facilitating clients in experiencing profound healing practices from the Amazon and the spiritual realm — practices that played a vital role in saving her life and putting her chronic illnesses into remission. Currently residing in Providence, the heart of the Ocean State of Rhode Island, Emily finds solace in cold water plunges that invigorate her senses and ground her in the present moment. She cherishes moments at home with her two adopted poodles, a warm blanket, and a cup of tea; valuing introspection over bustling networking events. Emily remains devoted to self-discovery, eager to share her insights with folks who, like her, have felt marginalized within a business and medical system that often overlooks their needs for visibility, understanding, and validation. What started as an entrepreneurial journey to 'turn sickness into strength' has now become one of learning strength from sickness.Key LinksMighty WellDr. Casey Kelley on UP - Ep 118TakeawayTune in as Emily shares:* that she'd blocked out a memory of being bitten by a tick at the age of six; she was bitten again at the age of 12, alongside having confirmed EBV* what her initial symptoms were like* how she was overlooked because of her age and gender — and initially put on birth control to control her “hormones”* that she finally found a Lyme-literate NP in her home state when in college — and received the diagnosis of Lyme and tick-borne illnesses at the age of 19* her additional diagnoses: POTS/dysautonomia, Hashimoto's disease, CIDP (chronic inflammatory demyelinating neuropathy), C-PTSD, and Gilbert's syndrome* that she went to see Dr. Casey Kelley after hearing her episode of the show!* how her lived experience informs the creation of adaptive devices and wearables for Mighty Well* how she was able to embody her identity as a disabled person — coming from a family of athletes* that she had a lot of Lyme support in college, but also felt “othered” in the sense that she had to advocate for her health for the first time* what a typical day was like for her before remission* her rumination on the invisibility of her diagnoses — and their few visible signifiers, which included her PICC line and chest port, as well as her occasional use of a cane* how exhausting it can be to tell people your life story when you live with invisible illness and have to provide validation to others* the epidemic affecting women in healthcare: acute infections, especially those presenting with multiple and varied symptoms — and how important it is to listen to and include women, both in treatment and in research* how her family background in textiles informed the Mighty Well product line* her advice for fellow spoonies and entrepreneurs* why living near the water is so important for her* that she has trained her dog, Olive, as a medical alert service animal* her belief that ketamine therapy saved her life, with regard to the diagnosis of C-PTSD* her endorsement of plant medicines and herbs, and why she has moved in that direction where her ongoing treatment is concerned Get full access to Uninvisible Pod at uninvisiblepod.substack.com/subscribe

Welcome back to another compelling episode of The Winners Paradigm! In today's installment, we delve into the captivating world of overcoming adversity with our special guest, Matt Fleming. Join us as we explore the transformative power of pushing oneself, finding accountability, and making positive changes. From battling addiction to conquering physical challenges, our guests share their personal experiences and offer invaluable insights into the journey of personal growth. Get ready to be inspired, motivated, and equipped with the tools you need to thrive. So sit back, relax, and let The Winners Paradigm guide you on a path to greatness. Let's dive in! Timestamps: [00:03:02] Openness and lessons in personal growth. [00:04:54] Struggling with health issues, but finding motivation. [00:09:57] Antibiotics and PICC line for infection. MRI for back pain, found something. [00:13:25] Struggle with body image, finding grace. [00:14:23] Grateful for life despite past struggles. [00:17:26] Bro, crazy thoughts mess me up mentally. Antidepressants don't work. Relatable struggles with workouts. [00:21:43] Achieved fitness goals despite setbacks and limitations. [00:26:29] Ditch drugs, find healthy friends in gym. [00:27:49] Big dude's happiness inspires self-reflection in gym. You'll Learn: 1.How did I use burpees as a way to improve his fitness journey?  2. What role did accountability play in Matt's ability to overcome adversity during marathon training? 3. How do both speakers observe unhealthy habits in most people and why do they believe it's important to strive for improvement? 4. What personal obstacle did I face in his fitness journey and how did he seek help to overcome it? 5.How did I find motivation and respect through his interactions with bodybuilders at the gym? The Journey of Sobriety: "Getting sober won't solve all your problems, but it will make it possible to start solving all of your problems."— Matt Fleming 00:07:1600:07:19 Connect With Matt https://www.instagram.com/mattflemingofficial/ Top Recommended Resources:www.thewinnersparadigm.com Now Sponsored By My Fit Life   DISCOUNT CODE: TWP20 For 20% OFF https://myfitlife.net/?ref=3Ogi6ygr  Get More Involved with The Winning Community: Click Here to join our Facebook group where we discuss what it takes to calibrate your mindset and get to the next level Thanks for Rocking With US! To share your thoughts: Leave a note in the comment section below. To help out the show: Leave a 5 Star Rating and honest review on Apple Podcast. Your ratings and  reviews really help and I read each one. Subscribe on Apple Podcast --- Support this podcast: https://podcasters.spotify.com/pod/show/thewinnersparadigm/support

Welcome back to another compelling episode of The Winners Paradigm! In today's installment, we delve into the captivating world of overcoming adversity with our special guest, Matt Fleming. Join us as we explore the transformative power of pushing oneself, finding accountability, and making positive changes. From battling addiction to conquering physical challenges, our guests share their personal experiences and offer invaluable insights into the journey of personal growth. Get ready to be inspired, motivated, and equipped with the tools you need to thrive. So sit back, relax, and let The Winners Paradigm guide you on a path to greatness. Let's dive in! Timestamps: [00:03:02] Openness and lessons in personal growth. [00:04:54] Struggling with health issues, but finding motivation. [00:09:57] Antibiotics and PICC line for infection. MRI for back pain, found something. [00:13:25] Struggle with body image, finding grace. [00:14:23] Grateful for life despite past struggles. [00:17:26] Bro, crazy thoughts mess me up mentally. Antidepressants don't work. Relatable struggles with workouts. [00:21:43] Achieved fitness goals despite setbacks and limitations. [00:26:29] Ditch drugs, find healthy friends in gym. [00:27:49] Big dude's happiness inspires self-reflection in gym. You'll Learn: 1.How did I use burpees as a way to improve his fitness journey?  2. What role did accountability play in Matt's ability to overcome adversity during marathon training? 3. How do both speakers observe unhealthy habits in most people and why do they believe it's important to strive for improvement? 4. What personal obstacle did I face in his fitness journey and how did he seek help to overcome it? 5.How did I find motivation and respect through his interactions with bodybuilders at the gym? The Journey of Sobriety: "Getting sober won't solve all your problems, but it will make it possible to start solving all of your problems."— Matt Fleming 00:07:1600:07:19 Connect With Matt https://www.instagram.com/mattflemingofficial/ Top Recommended Resources:www.thewinnersparadigm.com Now Sponsored By My Fit Life   DISCOUNT CODE: TWP20 For 20% OFF https://myfitlife.net/?ref=3Ogi6ygr  Get More Involved with The Winning Community: Click Here to join our Facebook group where we discuss what it takes to calibrate your mindset and get to the next level Thanks for Rocking With US! To share your thoughts: Leave a note in the comment section below. To help out the show: Leave a 5 Star Rating and honest review on Apple Podcast. Your ratings and  reviews really help and I read each one. Subscribe on Apple Podcast --- Support this podcast: https://podcasters.spotify.com/pod/show/thewinnersparadigm/support

In this episode, Kyle Molina, PharmD, BCIDP, discusses key considerations for successful implementation of long-acting lipoglycopeptides into clinical practice. Listen as he gives perspectives on:Reasons to consider use of long-acting lipoglycopeptides (eg, poor adherence to oral antibiotics, PICC-related costs and complications)Data supporting and challenging cost effectiveness of long-acting lipoglycopeptides Identifying the target patient populationSelecting the right location to provide long-acting lipoglycopeptides Strategies to maximize institutional impact with key stakeholders (eg, hospital avoidance, reduced ED and hospital length of stay) Key characteristics of available long-acting lipoglycopeptides Addressing logistical challenges, including navigating the reimbursement process Faculty:Kyle Molina, PharmD, BCIDPInfectious Diseases Clinical PharmacistScripps Green HospitalLa Jolla, CaliforniaLink to full program: CCO: https://bit.ly/3J4mg8hProCE: https://bit.ly/3P0vB4E

On episode #21 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the previous two weeks, 1/18/23 – 2/1/23. Hosts: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of Puscast! Links for this episode The impact of cold temperature in the pattern of influenza virus infection (OFID) Janssen to discontinue Phase 3 Mosaico HIV vaccine clinical trial (JNJ) Randomized trial of vaccines for Zaire Ebola virus disease (NEJM) PD-1 blockade and lenalidomide combination therapy for Epstein-Barr virus infection (CMI) Outcomes of Daptomycin plus Ceftaroline vs alternative therapy for persistent MRSA bacteremia (IJAA) Detection of a novel strain of multidrug-non-susceptible Neisseria gonorrhoeae (The Lancet) Impact of a device to reduce blood culture contamination and false-positive central-line bloodstream infections (ICHE) Addition of anaerobic coverage for treatment of biliary tract infections (JAC) High dose Cefepime vs Carbapenems for bacteremia caused by Enterobacterales(OFID) Assessing the diagnostic performance of IGRAs for Mycobacterium tuberculosis (CID) Infective endocarditis after transcatheter aortic valve replacement (JACC) Discordant clinical and microbiological outcomes are associated with late clinical relapse in clinical trials for complicated UTIs (CID) Real-world use of bezlotoxumab and fecal microbiota transplantation for the treatment of Cdiff (OFID) Blastomycosis in New England (OFID) Management of invasive candidiasis in hematopoietic cell transplant recipients (TCT) Short course of Antifungal therapy in patients with uncomplicated Candida Bloodstream infection (OFID) Parasites and childhood stunting (Cell) Comparing complication rates of midline catheter vs. PICC line (OFID) Novel prion strain as the cause of chronic wasting disease in a moose (EID) Agreement of respiratory viruses' detection between nasopharyngeal swab and bronchoalveolar lavage in adults with pneumonia (CMI) Music is by Ronald Jenkees

EMS is well-trained in peripheral intravenous as well as intraosseous access. However, central lines remain off-limits for many clinicians in various response areas. If accessing these types of lines is allowed, it's usually permitted when the patient is (nearly) dead. This isn't very surprising since the scope of practice of the EMS clinician usually focuses on emergent treatments. Unless it's learned during a critical care class, little thought is typically given to topics like central, dialysis, and PICC lines in EMS. Why not?