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How many times have you gotten caught in the hot/cold dance? That dynamic that draws you in, makes you think everything is going to be ok and you start to hang onto every word they say. Then you start to sense them pulling away. They don't show up for you when they said they were going to. They said they were going to do something, or that they feel a particular way for you and then don't show up with the actions to match, and you quickly start to distrust the connection. Consistency = TRUST. Intimacy. Deep connection. (when with the right person) And we're doing a deep dive as to why consistency is so damn hot when it comes to relationships. Apply to book a private call with Emily to work together.   FIND EMILY ONLINE: @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast   REFERENCES Episode 288 | Tantra, Polarity, Pleasure & the Strong Independent Woman with Sophie Josephina Episode 269 | The Right People Feel Difference to Your Nervous System   Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren't your jam, send me a good old fashioned email!  info@emilygoughcoaching.com

In this solo episode, Megan Gillikin answers 5 questions from the Weddings for Real Facebook Group, including how to hire your #2, how to raise your prices, and how to take steps to make your business full time. References: Episode 151: Creating a digital welcome guide Episode 145: Margeaux Fraise on leveraging Facebook Groups For more client experience tips, visit ThePlannersVault.com/clientexperience This episode is also brought to you by The Planner's Vault, my online membership site for wedding planners who are hungry to grow, ready to hustle, and actively seeking community and education. In the vault, there are guest experts on many topics relevant to growing and cultivating a successful event planning business with new content added consistently, plus all of my templates that I have built out over the years, like How to Get on Preferred Vendor Lists, The Client Experience, and more. The mission with the vault is to elevate the industry (along with some amazing experts and fellow entrepreneurs) and I want it to be affordable so it's possible to stay invested in the community and yourself for the long haul. The doors are currently closed for The Vault, but join the wait list now so you can be the first to know when the doors re-open.   Weddings for Real on Social Media: Instagram: @weddingsforreal Facebook: @weddingsforreal twitter: @weddingsforreal The host of the show is Megan Gillikin, owner and lead consultant at A Southern Soiree Wedding and Event Planning.  She's also available for wedding and hospitality business consulting and can be reached at megan@weddingsforreal.com. Weddings for Real is edited and produced by Earfluence.

Dans un contexte de persécutions ou de menaces grandissantes de persécutions, l'auteur désigne sous ses bêtes l'oppression de l'empire romain et du culte impérial. Tout est maintenant prêt pour le combat final en lieu appelé Armageddon.REFERENCES•Episode disponible sur l'application TUMULT : https://tumult-podcast.com/au-large-biblique •«Au Large Biblique » est un podcast conçu et animé par François Bessonnet, enseignant bibliste et prêtre en Vendée. https://www.aularge.eu/blog/le-podcast/ •Image de couverture : Lambeth Apocalypse, Angleterre, 1260 - source : wikimedia-commons.•Musique : Erwan Marchand (D.R.)•Épisode enregistré en Vendée (85, France), juillet 2021.•Sous Licence Creative Commons (cc BY-NC-ND 4.0 FR)SOURCES ET RESSOURCES•Le livre de l'Apocalypse de Jean https://www.aelf.org/bible/Ap/1 •Les autres épisodes, les références et notes : https://www.aularge.eu/blog/lapocalypse-dhier-a-demain/ SUIVRE AU LARGE BIBLIQUE •Instagram : @aularge.eu https://www.instagram.com/aularge.eu/ •Twitter : @AuLargeBiblique https://twitter.com/AuLargeBiblique •Facebook : @aularge85 https://www.facebook.com/aularge85/ •LinkedIn : https://www.linkedin.com/in/fbessonnet/ •Youtube : https://www.youtube.com/user/aulargefbessonnet •Mail : podcast@aularge.eu •Newsletter : https://www.aularge.eu/blog/abonnement/ •RSS : https://www.spreaker.com/show/3266391/episodes/feed •VOS QUESTIONS sur https://www.aularge.eu/blog/votre-voix-minteresse/ Soutenir le podcast avec Tipeee : https://fr.tipeee.com/au-large-biblique

Today's guest is so special and rapidly becoming one of my favourite humans. We're talking to Traver Boehm again today, originally featured for an epic conversation back on episode 266 - a personal favourite and one of the most powerful episodes on the entire Room To Grow™ Podcast. Never have I received an outpouring of so much incredible feedback about a guest episode, and ever since we mentioned back on episode 266 that we would record a second one, I've had DMs and text messages demanding to know when the new one was being released. As you can tell by the title, this is another casual chat about some super light topics, ha! This conversation will leave you better than before you started listening, if you allow it. It will challenge you to think differently, to see the world through a different lens, and to question the way you show up. It may or may not also be the first time a guest and I have BOTH cried on an episode, so you know it must be a good one.    Traver Boehm is an author of two books, 2 time TEDx Speaker, men's coach and founder of the UNcivilized Men's Movement, which is radically redefining the way men around the globe experience their masculinity by uniquely blending both primal elements of manhood with massive doses of consciousness. Drawing upon an eclectic background ranging from professional bodyguarding and Mixed Martial Arts to Traditional Chinese Medicine and meditation, Traver also teaches people to skillfully use the inevitable pain of their lives as fuel for growth and positive change. In 2016 after losing a pregnancy, his marriage, and his business partnership all within weeks of each other, he created a radical social experiment and spent the next 12 months as if it were his last year to live, aptly naming it “The Year to Live Project.” A few topics we cover today: How to have conversations with people that can be highly triggering as you step onto your own path, and embark on your own journey that may likely go against the grain for many others around you  The unique challenges that can come with those conversations, including the likelihood of losing a lot of relationships too Why you have to keep showing up with courage every single day if you're going to get to where you're going, whatever that might look like for you AND to hang on to the little moments that will continue to propel you forward even when everything else might feel dark. And so much more….   If you're a human, this is not an episode to be missed. Traver has a powerful mission around what it means to be a man, and this is a topic that affects all of us, no matter how you identify. I urge you to check out Traver's work. His fantastic podcast, both of his books, men's group and the various exciting projects he's always juggling at any given time are transformative, and more people need to know about him. Buckle up, tune in, and then go connect with Traver.   REFERENCES Episode 266: Not All Men, But Almost Always with Traver Boehm of Man UNcivilized Episode 117 | The 9 Year Affair: Lessons in Infidelity Episode 54 | My Story with Alcohol   CONNECT WITH TRAVER Website Instagram: @traverboehm UNcivilized Nation Book: Man UNcivilized Podcast: The UNcivilized Podcast with Traver Boehm TEDx Talk: How to Make Pain Your Guru TEDx Talk: Why We Need More UNcivilized Men   FIND EMILY ONLINE: IG: @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast     Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren't your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY

Are you waiting to be chosen? There's a difference between simply hoping to be chosen and being an active participant in doing the choosing. Many times, a lot of us will just sit around waiting for somebody to choose us, and we then almost remove ourselves as being one of the conscious parties in that decision. We want someone to choose us so that we don't have to be vulnerable enough to put ourselves out there and risk rejection. So instead, we wait for someone to decide to take an interest in us, because it's the safer choice. Today we're talking about all of this, including: How to figure out the way you want to FEEL with your partner, rather than choosing based off of a laundry list of "must-haves" The difference between standards, boundaries & expectations - and why it's so important to note for the quality of your relationships Knowing what you're worth so you can get confident & clear on what you want to choose is what changes everything Some personal stories / experiences   Because let me ask you this: If you saw a job posting you really wanted, or a speaking opportunity come up, would you close your eyes and try to wish it into existence? Or would you actively apply for it, show that you were interested in it, allow your unique skills and talents to shine through so that it would be seen what a good fit you could be? And yet, we treat relationships so differently because they're so much more vulnerable and the idea of getting hurt is terrifying. Which is a completely valid fear - but we're going to talk about how to open instead of shutting ourselves off. Ready? Let's do it.   Find Emily Online: @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast   REFERENCES Episode #138, The Weight of Expectations & Attaching to Outcomes Episode #120, Listening to Your Intuition & Gut Instinct: Stop Ignoring Your Body Episode #269, The Right People Feel Different to Your Nervous System Episode #268, Trust is a Choice: Creating a Confident Relationship with the Unknown Episode #267, You're Not Needy, You're a Human with Needs   Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren't your jam, send me a good old fashioned email!  info@emilygoughcoaching.com   BRAND NEW EPISODES EVERY TUESDAY & THURSDAY

In today’s episode we explore:How to when to know it's time to rest and take a break,When it's time to dig a little deeper and show up deeper, even when you don't want to,The right way to dig deeper so you don't burn out and can show up with consistency.References: Episode on Entrepreneurial Burnout hereDig a Little Deeper From Disney's Princess and the FrogResources:Download your FREE Checklist to Being Seen HERE – And remove the 5 visibility blocks preventing your ideal clients from finding you.Join our community at She Grows Nation of over 1,000 soul-guided entrepreneurs HERE.

“The universe will remove anything you put your self worth in, to remind you it doesn’t live there.” -Mark Groves Your value and your worth is INNATE. You don’t have to earn it, fix something about yourself that you may have believed in the past was broken, you don’t need someone else to love you before your worth shows up. You are worthy. Period. Full stop. Todays we're talking all about; The deep work of cultivating your sense of self worth How to detach our self worth from our jobs, our income, or our partners Why showing up for yourself consistently is so important when doing this growth work And so much more! Have a listen now! For a copy of today's transcription, head over to EPISODE 270 Cultivating a Deep Sense of Self Worth WORK WITH ME Let's chat! Reach out to find out about coaching options. REFERENCES: EPISODE 268: You’re Not Needy, you’re a Human with Needs Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY Find Emily Online: Emily Gough Coaching Room to Grow Podcast    

Welcome to a shorter-than-usual (!), more spontaneous episode featuring us (co-hosts Catriona and Elizabeth) as its guides! We had planned to release an episode on Beauty - but events beyond our control meant we’ve had to postpone this. However, we decided to embrace the change of plans, and pulled out our mics to explore the timely concept of Adaptation. We touch on:Questions around individual and collective adaptations to new circumstances, both in our lifetimes and with future generations in mind.The role of conscious choice and the ability to influence when considering if and how to adapt.Examples from the natural world, including Emperor penguins, ants, and the human genome. Reflections on how we may want to adapt as a result of the COVID-19 pandemic and how vision, creativity and resilience may play a part. Enjoy! And if you'd like to explore this and other topics further, you're very welcome to join our private Facebook group, 'Unfurling Podcast'.---References: ~ Episode quote by Dolly Parton: “We cannot direct the wind, but we can adjust the sails.”~3: “Adapt”, Online Etymology Dictionary: Early 15c. "to fit (something, for some purpose)", from Old French, from Latin. Intransitive meaning "to undergo modification so as to fit new circumstances" is from 1956.~4: Bruce Lee: “Be like water making its way through cracks. Do not be assertive, but adjust to the object, and you shall find a way around or through it. If nothing within you stays rigid, outward things will disclose themselves. Empty your mind, be formless. Shapeless, like water. If you put water into a cup, it becomes the cup. You put water into a bottle and it becomes the bottle. You put it in a teapot, it becomes the teapot. Now, water can flow or it can crash. Be water, my friend.”~5: “Circle of Influence” mentioned in “Habit 1: Be Proactive” of the book, “The 7 Habits of Highly Effective People” by Stephen R. Covey. ~6: George Bernard Shaw: “The reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore, all progress depends on the unreasonable man.”~7: “A Project Supported by Bill Gates Is Set to Temporarily Dim the Sun” in Entrpreneur.com~9: “Adaptation” in National Geographic Resource Library~10: Types of Adaptations in “Adaptations” in BBC Bitesize ~12: Viktor E. Frankl in “Man's Search for Meaning”: “When we are no longer able to change a situation, we are challenged to change ourselves.” ~13: Ant behaviour in Royal Society Journal ‘Interface’, and specifically about behaviour in water in PBS blog ‘Nature’. ~14: “Emergence” chapter in “So Far from home: Lost and Found in Our Brave New World” by Margaret J. Wheatley.~18: “Why projects to adapt to climate change backfire” in News by the University of Oxford~20: Carbon offset projects that can harm, e.g. World Bank and UN carbon offset scheme 'complicit' in genocidal land grabs - NGOs and Offsetting carbon emissions: ‘It has proved a minefield’~22: “Himalayas seen for first time in decades from 125 miles away after pollution drop” in The Independent ~24: “Why 2020 Has Reminded Us To Play The Infinite Game”, Forbes ~24: Simon Sinek’s “Infinite Mindset” and “Infinite Game”. Note: The importance of a “just cause”. ~25: The Foot of Cupid from the BBC television series “Monty Python's Flying Circus”~25: “What Is to What If: Unleashing the Power of Imagination to Create the Future We Want” by Rob Hopkins ~28: The 17 Sustainable Development Goals~28: One Health concept See acast.com/privacy for privacy and opt-out information.

Dr. Rachel Botsman defines trust as "a confident relationship with the unknown" and I thought that was such a beautiful way of phrasing it. Trust will provide growth, which requires patience, uncertainty, vulnerability, and looking inward with the understanding that you don’t know what’s next in the abyss. Today we're talking: Giving people close to us the benefit of the doubt While also learning how to become more discerning with our trust The ways trust can be both built and torn down in the smallest ways that we may not even notice unless we pay close attention What happens when we're out of integrity in any area of our lives an dhow it shows up elsewhere Figuring out how to trust yourself first and foremost, regardless of circumstances How you can feel trust in the body   Take a listen!   WORK WITH ME Let's chat! Reach out to find out about coaching options.   REFERENCES Episode #266, Not All Men - But Almost Always with Traver Boehm of Man UNcivilized Episode #129, Liespotting: How to Detect Deception in Everyday Life My article in Thrive Global: My Former Partner Had an Affair for 9 Years Dr. Rachel Botsman on trust and her TED Talk   Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY Find Emily Online: Emily Gough Coaching Room to Grow Podcast

I told this to a friend going through some difficulties in her relationship months ago when she was wondering if she was asking for too much from her partner, and it’s something I’ve had to remind myself in various types of relationships over the years. You are not too much. You have needs, and if we avoid or sidestep communicating those needs for fear of losing the person, we’re actually being incredibly dishonest to both ourselves and the person we’re hoping will magically be able to meet those needs without even knowing what we want. And if they can’t meet those needs even after reasonable, respectful and open communication? Then perhaps they weren’t meant to stay in your life to begin with. Amir Levine says in his book Attached, “most people are only as needy as their unmet needs.” Would you rather stay silently in a relationship where resentment is constantly building because you aren’t communicating what you need out of a sense of fear? Or face showing up for yourself and letting the chips fall? There is no right or wrong answer here. It’s up to you, and you get to choose what feels best for you. But I’ll you that the second option requires much more self trust and innately knowing that you will be able to survive either way. And it also requires knowing and accepting that you cannot manage or control the reaction of the other person.   Ask me a question - I'll use this for future podcast episodes!   REFERENCES Episode #241, How to Have Hard Conversations & Improve Communication Episode #254, Forgive Yourself for Shrinking Into Spaces That Do Not Fit You Episode #139, The Transformative Power of Breathwork with Sara Silverstein Episode #263, The Value in Being Alone on Purpose (Whether Single or in a Relationship) Episode #130, Cancer, Depression & Strength: A Powerful Story of Hope & Resilience with Tom McClelland   Next Level Human Podcast, episode #88: Maturity in Romantic Relationships with Dr. Jade Teta & Emily Gough   Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY Find Emily Online: Emily Gough Coaching Room to Grow Podcast

Out of over 260+ episodes here on the Room to Grow Podcast, this conversation is hands-down one of my favourites to date. We're speaking with Traver Boehm, an author of two books, 2 time TEDx Speaker, men’s coach and founder of the UNcivilized Men’s Movement, which is radically redefining the way men around the globe experience their masculinity by uniquely blending both primal elements of manhood with massive doses of consciousness. With a background in professional bodyguarding, Mixed Martial Arts, Traditional Chinese Medicine and meditation, Traver also teaches people to skillfully use the inevitable pain of their lives as fuel for growth and positive change. One of the MANY reasons we’re planning a part two is that we didn’t even have enough time to get into a huge portion of his journey. After losing a pregnancy, his marriage and his business partnership all within weeks of each other, he created and embarked upon a social experiment to spend the next 12 months as though they were his last to live. This conversation is raw, real and unfiltered. Today, we’re talking about: -How men show up in relationships and the biggest reason why women end relationships (outside of abuse) and how men can cultivate a superpower to make the feminine feel safe in unexpected ways -The powerful message Traver has for men everywhere and how he’s looking to change the entire culture and spread his message, along with addressing where men need to take responsibility for their own emotional health -Men’s mental health, and the mountain of male trauma that often goes unaddressed as males have so much less social support than women and a suicide rate that is 3X higher -Traver’s take on one of the biggest reasons why he believes mass shootings end up happening and what to do about it. -What we can learn from our pain   Traver's fire and passion for what he does is so evident, and this episode is an absolute must-listen for anyone and everyone. Most importantly, please share! More people need to hear this powerful message.   CONNECT WITH TRAVER Website Instagram: @traverboehm UNcivilized Nation Book: Man UNcivilized Podcast: The UNcivilized Podcast with Traver Boehm TEDx Talk: How to Make Pain Your Guru TEDx Talk: Why We Need More UNcivilized Men Traver's IGTV about #NotAllMen   REFERENCES Episode #117, The 9 Year Affair: Lessons in Infidelity Episode #136, Communication, Betrayal, Infidelity & Self-Esteem with Renelle Nelson Episode #239, Communication: the Lubrication for Relationships with Renelle Nelson   Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY Find Emily Online: Emily Gough Coaching Room to Grow Podcast

In today’s episode, Anita and Jessie discuss what to expect - and what support to seek - at each stage of your Cesarean birth recovery journey. -    -    -    -    - If you liked this episode of To Birth and Beyond, tell your friends! Find us on iTunes and Stitcher to rate/review/subscribe to the show. Want more? Visit www.ToBirthAndBeyond.com, join our Facebook group (To Birth and Beyond Podcast), and follow us on Instagram @tobirthandbeyondpodcast! Thanks for listening and joining the conversation! Resources and References: Episode 07   Time Stamps: 1:01 - What we are talking about today! 1:45 - How soon to see a physiotherapist and fitness professional post-Cesarean birth 3:17 - What the typical initial physiotherapy appointment looks like 5:44 - How did Jessie feel around the 4 weeks mark (abdomen and mobility)? And supporting physical healing 9:10 - What to expect at 6 weeks out from Cesarean birth 16:10 - Beyond those 6 weeks… 19:40 - On the change in time for exercise postpartum

"Once you learn to let go that's when you are actually able to move on, to open yourself up to incredible possibilities that can come from the experience of releasing some things that you're maybe holding on to really, really tightly right now."   A major theme coming up over the past year has really been "letting go".  We've had to let go of ideas and plans and strategies, even some relationships during this last "weird" year.  So on today's episode we're going to talk about: -Several exercises that you can try, to really dig into the process of letting go in certain areas of your life. -Life story vs love story -Some tough but necessary questions to ask yourself when you are holding onto ideas or relationships for dear life. -My thoughts on the idea of "just taking the lessons and moving on" -And so much more!   Are you ready? Let's dive in! For the full transcription of today’s episode, head over to EPISODE 260 - How to Let Go & Recover From Loss   REFERENCES EPISODE 145 - The Need For Closure Is An Inside Job EPISODE 126 - Forgiveness Isn't Found it's Earned: Doing The Inner Work EPISODE 248 - Grief, Love & Why One Cannot Exist Without the Other Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com   BRAND NEW EPISODES EVERY TUESDAY & THURSDAY Find Emily Online: Emily Gough Coaching Room to Grow Podcast

CardioNerds (Amit Goyal & Karan Desai) join Dr. Alex Pipilas (FIT, Boston University) and Dr. Danny Pipilas (FIT, MGH) for in Boston, MA. Adult congenital heart disease expert Dr. Keri Shafer (Brigham and Women’s Hospital) provides the E-CPR expert segment. They discuss a case of heart failure secondary to sinus venosus defect with partial anomalous pulmonary venous return. Claim free CME just for enjoying this episode! Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Patient Summary A 78-year-old woman with atrial fibrillation and heart failure with preserved ejection fraction presented with recurrent dyspnea and volume overload. A transthoracic echocardiogram demonstrated severe right ventricular enlargement and dysfunction. A CT pulmonary angiogram demonstrated partial anomalous pulmonary venous return and a transesophageal echocardiogram revealed a sinus venosus defect with left to right shunting. A right heart catheterization with oximetry saturation (“shunt run”) demonstrated pulmonary hypertension and a large left to right shunt (Qp/Qs ~ 3). She was referred for cardiac surgery and underwent repair of the sinus venosus defect and baffling of the anomalous pulmonary venous flow to the left atrium. Case Media ABCClick to Enlarge A. CXR, B. ECG, C. TR Velocity TTE: PLAX TTE: RV Outflow TTE: AP4 TEE: Sinus Venosus ASD TEE: Sinus Venosus ASD 2 Episode Schematics & Teaching Pearls It is critical to determine whether there is more to a diagnosis of heart failure with a preserved ejection fraction. Utilize all available clinical data and risk calculators to determine if there are more appropriate diagnoses causing the patients symptoms, especially when certain aspects of the presentation does not add up.Right ventricular failure may be related to pressure overload (i.e., pulmonary hypertension, PV stenosis), volume overload (i.e., tricuspid regurgitation, left to right shunt lesions), or primary myocardial process (i.e., ischemia, infiltration, ARVC). In cases of severe right ventricular enlargement and dysfunction without apparent cause, look for a left to right shunt lesion (i.e., VSD, ASD, PAPVR). Sometimes further imaging (TEE, cardiac CT, cardiac MRI) is necessary to detect these lesions if not visualized on TTE.Left to right shunts can be quantified in the cardiac catheterization laboratory by measuring oxygen saturation in each chamber and detecting an O2 “step up” (increase in oxygen saturation from one chamber to the next). Large left to right shunts are quantified using the Fick principle and comparing the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs).Large left-to-right shunts can cause right ventricular volume overload and pulmonary hypertension. Patients often present with signs and symptoms of right ventricular failure including shortness of breath, exercise intolerance, volume overload, atrial arrhythmias, and recurrent heart failure. Some may develop right-to-left shunting and possible paradoxical embolism.ACC/AHA guidelines recommend closure of a sinus venosus defect if the PA systolic pressure is < 50% systemic pressures AND PVR is 2/3 of systemic systolic pressure and/or PVR >2/3 SVR. Quotable: About ACHD - “As we go through this physiology, I just want to remind all of the listeners out there that you have the opportunity to apply the knowledge you have from medical school about physiology to the adult human heart. You can’t make assumptions as we sometimes do in the setting of normal cardiac anatomy.

We're human beings. Which means that inevitably we are going to both need to apologize at times, and be deserving of an apology at other points. And we often fuck it up royally. For a genuine, sincere apology, you have to mean what you say. Intention matters here. A true apology means genuine care, taking accountability, identifying the mistake, followed by changed behaviour - and sustaining that change, to the best of your abilities. You have to be willing to change your behaviour, to grow and learn from the experience. This requires empathy, compassion and understanding how the other person feels, especially based on their unique history and biography. True apologies are HARD. They require us to take full and total responsibility for our actions. We have to acknowledge we’ve done something wrong while also knowing that we can do better. When we hang onto a deep belief of needing to be right, we close ourselves off from intimacy.  When we can acknowledge and own up to our mistakes, however, it creates connection. It’s a reminder that we are all humans who make mistakes, and that act of vulnerability and courage give way to deeper connection. Today we're talking how to apologize sincerely, and how NOT to apologize - you're going to want to pay attention to this one!   Plus..... WORK WITH ME: I've opened up new spaces for 1:1 clients! Book a one-time breakthrough session, or we can work together for a longer period if you're looking for additional support. Let's chat.   REFERENCES Episode #241, How to Have Hard Conversations & Improve Communication Episode #126, Forgiveness Isn't Found, It's Earned: Doing the Inner Work Episode #78, Sorry, But Stop Apologizing   Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY Find Emily Online: Emily Gough Coaching Room to Grow Podcast

CardioNerds (Amit Goyal & Daniel Ambinder) join University of Maryland cardiology fellows (Manu Mysore, Adam Zviman, and Scott Butler) for some cardiology and an Orioles game in Baltimore! They discuss a rare cause of postpartum angina and cardiac arrest due to coronary vasculitis. Program director Dr. Mukta Srivastava provides the E-CPR expert segment and a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Rick Ferraro with mentorship from University of Maryland cardiology fellow Karan Desai. This case has been published in JACC Case Reports! Collect free CME/MOC credit just for enjoying this episode! Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo Support our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Patient Summary A woman in her early 30s with a past medical history of Hashimoto's thyroiditis and one prior miscarriage at 

“I forgive myself for shrinking to fit into boxes that do not belong to me” -Alex Elle Have you ever had the experience of noticing when you're shrinking yourself, your personality and your essence down? I was recently around someone where I could feel myself shrinking to fit into their life, and immediately my body started throwing up alarm bells. I didn’t WANT to feel that way, but I’ve also learned to trust my body.  It doesn't mean that anyone who makes you feel that way is a bad person, couldn't be farther from the truth. And it also doesn’t necessarily mean that the connection should end It’s simply one of many signals, and it’s something to pay attention to. Think of it this way: it might be less about the other person and more about how YOU are showing up and why. Are you fearful to let someone fully in, and therefore protecting yourself by shrinking down because you don’t know if they can handle the true version of yourself? Are you trying to manage the perceived outcome of a relationship by trying to force a connection? Or by showing up as who you believe they want you to be? Let’s turn it around: what if they liked the true version of you WAY more than the watered-down version you’re presenting?  Lots to explore here! Let's dive in

This solo episode of the Big Juicy Creative podcast is the second part of summing up the main AHA moments Suzy has had from her brilliant interviewees so far. You’ll find the first part in episode 31 – covering learnings from farmer Lynn Cassells, artist Ann Vastano, composer Ella Jarman-Pinto, performer Jennifer Blaine and entrepreneur Kelly Pietrangeli. In this episode, Suzy pulls out the main gems extracted when talking to chef Kirsten Gilmour, coach Lucy Sheridan, clown Holly Stoppit and actress Claire Merrick. As usual, she shares what she's been doing to nurture her creativity at this difficult time, ending with a 5 minute creative exercise that makes her feel better about her horrible homeschool day. References: Episode with chef KJ is 22 Episode with coach Lucy Sheridan is 8 Episode with clown Holly Stoppit is 30 Episode with actress Claire Merrick is 26 Episode with doctor Tash Pirie Burley is 13 Go check them out! And please do share with anyone who would benefit from a creative boost right now. Thank you!

I'm honoured to be able to bring you two incredible friends of mine - and this is also the first time I'm interviewing a couple on the Room to Grow™ Podcast! I met Luke and Claire in Bali and we basically worked out and ate our way around Canggu - they're my favourite people to third wheel with

CardioNerds (Amit Goyal & Karan Desai) join University of Illinois at Chicago cardiology fellows (Brody Slostad, Kavin Arasar, and Mary Rodriguez-Ziccardi) for a cup of tea from atop Hancock Tower! They discuss an illuminating case of altered mental status & electrical instability due to digitalis poisoning. Program director Dr. Alex Auseon and APD Dr. Mayank Kansal provide the E-CPR and a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Tommy Das with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor RollSubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Check out CardioNerds SWAG! Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A woman in her late 80s with history of systemic arterial hypertension and dementia presented with 2 weeks of nausea, vomiting, confusion, and yellow-tinted vision. When she presented to the hospital, initial history was limited as her caregiver was unaware of her medications and medical history. An initial ECG showed isorhythmic A-V dissociation and scooping ST segments laterally. Given her clinical history, this raised the suspicion for Digoxin toxicity, and a serum digoxin level was significantly elevated. However, this was not a home medication for the patient, nor did she have access to it! Listen to the episode now as the UIC Cardionerds masterfully take us through this case that would surely stump Dr. House!   Case Media through the Differential ABCDEFClick to Enlarge A. Initial ECGB. CXR- Patchy opacities of the left lower lobe consistent with pulmonary edema and/or aspiration​ pneumonia.C. Repeat ECG: AF with AV block, persistent scooped T waves​D. Post arrest ECG: Flutter/fib with AV block, VERY LONG PAUSES up to 6 secondsE. ECG post TVP: A flutter, slow V response (pacing picking up), intrinsic ventricular rate 20-40, PM set to 50 bpmF. Most recent ECG: Normal sinus rhythm TTE Episode Schematics & Teaching The CardioNerds 5! – 5 major takeaways from the #CNCR case 1) This episode featured a challenging case of digitalis toxicity. Cardionerds, what is the mechanism of action of cardiac glycosides?   Cardiac Glycosides (such as digoxin, digitalis, and oubain), inhibit the myocardial Na/K ATPase pump. This leads to an increased concentration of intracellular sodium, which then drives the influx of calcium into cardiac myocytes via the Na/Ca exchanger. This increase in intracellular calcium leads to further calcium release from the sarcoplasmic reticulum making even more calcium available to bind to troponin, increasing contractility. In addition to their effect on inotropy, cardiac glycosides increase vagal tone, reducing SA node activity and slowing conduction through the AV node by increasing the refractory period  2) The first published account of digitalis to treat heart failure dates back to the 18th century, when botanist and physician William Withering published "An account of the Foxglove and some of its medical uses with practical remarks on dropsy, and other diseases". A lot has changed over the years; what are some of the uses of digoxin in the modern day?   The DIG trial (1997) demonstrated a reduction in hospitalizations in patients with HFrEF treated with digoxin. However, no impact on mortality was shown. A major limitation from randomized trials of digoxin is the lack of contemporary background HF treatment (e.g., ARNI, SGLT2i, MRA, Device Therapy). Thus, its role in modern HFrEF management is typically limited to reducing hospitalizations in patients with persistent NYHA Class III or IV symptoms despite maximally tolerated guideline-directed medical therapy Digoxi...

What if you could have deep inner peace? Unflappable peace even in the face of external conflict? Today we explore the quantum issue of external judgement, internal judgement and how dropping one can actually lead to letting go of the other, and a happier internal life as well. Life is not meant to be a zero sum game, rather a beautiful exploration of the self as you journey to find wholeness. Today, learn to explore the shadow self, exercises to strengthen your inner acceptance, create space for soul, and quiet the inner critic. References: Episode 8: Spiritual Laws of Prosperity https://anchor.fm/kelly-ann-pierce/episodes/08--Prosperity-Spiritual-Laws-to-Achieve-It-ees56g Episode 29: Shameless https://anchor.fm/kelly-ann-pierce/episodes/29--Second-Arrow-Series-Shameless-eifj2i Bible Verse: Matthew 7:5 The theory of Dharma in Hindu and Buddhist culture, and more! For help integrating shadow work contact me: info@quantumhighways.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/kelly-ann-pierce/support

I'm honoured to have had the chance to bring listener favourite Renelle Nelson back onto the podcast for a continued discussion around sex, relationships, and communication - and this one is JUICY! Renelle is an infidelity/intimacy recovery Strategist assisting individuals and couples with healing from the residue of betrayal and learning how to reconnect back to themselves, life, relationships and pleasure. Renelle is a Licensed marriage and family therapist and also a certified sex therapist and coach. She has been assisting individuals and couples with change for over 10 years. Renelle's wisdom and knowledge in this field is astounding, and we went deep into a lot of topics including: Communication *before* getting to the bedroom - and why it will make your sex life far better Trust, transparency, and how to strengthen your relationship The difference between checking in with your partner and actually connecting with your partner - and how to start those kinds of deeper level conversations How to figure out if you feel emotionally safe with your partner Why expectations will break your heart, and making assumptions will kill your relationship faster than any affair The importance of active listening Why good relationships require you to leave your ego at the door Giving versus receiving pleasure This conversation was one of my favourites, and you can hear more of Renelle on episode 136 of the podcast as well. Make sure to connect with Renelle below and grab her brand new Pleasure Agenda!   CONNECT WITH RENELLE Renelle's Store, including the Pleasure Agenda IG: @noirsxtherapist IG: @theorgasmicwife Affair Aftercare Website   REFERENCES Episode #117, The 9 Year Affair: Lessons in Infidelity Episode #136, Communication, Betrayal, Infidelity & Self Esteem with Renelle Nelson   Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY Find Emily Online: Emily Gough Coaching Room to Grow Podcast

CardioNerds (Amit Goyal) joins Thomas Jefferson cardiology fellows (Jay Kloo, Preya Simlote and Sean Dikdan - host of the Med Lit Review podcast) for some amazing craft beer from Independence Beer Garden in Philadelphia! They discuss a fascinating case of atrioesophageal fistula (AEF) formation after pulmonary vein isolation (PVI). Dr. Daniel Frisch provides the E-CPR and program director Dr. Gregary Marhefka provides a message for applicants. Johns Hopkins internal medicine resident Colin Blumenthal with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A mid 60s male with relevant PMHx of paroxysmal atrial fibrillation presents to the ED with altered mental status after one week of mild chest pain. Given the long history of atrial fibrillation refractory to rate and rhythm control with diltiazem and flecainide, he underwent a pulmonary vein isolation 21 days prior to arrival. In the ED, T 39.4 and patient had a witnessed seizure requiring intubation for airway protection. Signs of hypoperfusion on labs, but white blood cell count not elevated. LP negative, but blood cultures positive for strep agalactiae. CT head with multiple tiny foci of intravascular air throughout the brain with MRI consistent with multiple areas of acute infarction. CTA of chest then obtained, which was notable for a small focus of air tracking along the esophagus. Taken together, findings most c/w atrial esophageal fistula causing sepsis and air emboli. Patient underwent surgical repair of left atrium and esophagus with a good outcome.  Case Media ABCDEFClick to Enlarge A. ECG: Normal sinus rhythm HR 105 bpmB. CXRC. CT head: Multiple tiny foci of air throughout bilateral cerebral hemispheres. Appearance is most suggestive of intravascular air, although it is unclear if it is venous, arterial or both.D. MRI: 1. Restricted diffusion in bilateral cortical watershed zones, as well as in the posterior medial left cerebellar hemisphere, most consistent with recent infarctions.E. CT Chest: A small focus of air tracking along the left mainstem bronchus anterior to the esophagus, may represent a small amount of pneumomediastinum versus air in an outpouching of the esophagus. No air tracking more cranially along the mediastinal soft tissues. No definite soft tissue defect in the esophagus.F. Surgical repair of LA & Esophagus Episode Schematics & Teaching Coming soon! The CardioNerds 5! – 5 major takeaways from the #CNCR case Coming soon! References Coming soon! CardioNerds Case Reports: Recruitment Edition Series Production Team Bibin Varghese,

CardioNerds (Amit Goyal & Daniel Ambinder) join Oregon Health & Science University cardiology fellows (Miranda Merrill, Timothy Simpson, Kris Kumar, and Stacey Howell) for a riverside chat at the Portland waterfront! They discuss a case of cardiac arrest associated with mitral valve prolapse (MVP) with mitral annular disjunction (MAD). Dr. Punag Divanji provides the E-CPR and program director Dr. Hind Rahmouni provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident, Eunice Dugan, with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary Coming soon! Case Media ABCDEFGClick to Enlarge A. CXRB. Rhythm Strips - ventricular fibrillationC. ECG: 1st degree AVB (PR ~ 215), borderline RAD, Qtc ~460 msec, slight ant. convexity with inferior terminal T waveD: TTE E: TTE with Pickelhaube Spike seen in mitral valve prolapse F-G: Cardiac MRI TTE 1 TTE 2 TTE 3 Cardiac MRI Episode Schematics & Teaching Coming soon! The CardioNerds 5! – 5 major takeaways from the #CNCR case Coming soon! References Coming soon! CardioNerds Case Reports: Recruitment Edition Series Production Team Bibin Varghese, MDRick Ferraro, MDTommy Das, MDEunice Dugan, MDEvelyn Song, MDColin Blumenthal, MDKaran Desai, MDAmit Goyal, MDDaniel Ambinder, MD

CardioNerd (Amit Goyal) join Emory University School of Medicine cardiology fellows (Sonali Kumar, John Lisko, and John Ricketts) for a lovely stroll on the BeltLine in Atalanta, GA. They discuss an interesting case of severe mitral stenosis treated with Valve-in-MAC transcatheter mitral valve replacement (TMVR) with LAMPOON. Drs. Vasilis Babaliaros and Adam Greenbaum provide the E-CPR and program director Dr. B. Robinson Williams III provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Bibin Varghese with mentorship from University of Maryland cardiology fellow Karan Desai.    Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary Coming soon! Case Media ABCDEFGHI JKClick to Enlarge A. CXRB. ECGC. TTE: Trasns-mitral PW Doppler D. Laceration in swineE-F: CT planningG. Transeptal catheters H. Trans-mitral PW Doppler (post procedure) I. LVOT gradients J-K. Post procedure CT TTE 1 TTE 2 TTE 3 TEE 1 TEE 2 Fluoroscopy 1 Fluoroscopy 2 Fluoroscopy 3 TEE 3 Fluoroscopy 4 TEE 4 TEE 5 Fluoroscopy 5 Fluoroscopy 6 Fluoroscopy 7 TEE 6 TEE 7 https://youtu.be/1gUyat6pg30 LAMPOON Procedure Episode Schematics & Teaching Coming soon! Click to enlarge! The CardioNerds 5! – 5 major takeaways from the #CNCR case Coming soon! References Coming soon! CardioNerds Case Reports: Recruitment Edition Series Production Team Bibin Varghese, MDRick Ferraro, MDTommy Das, MDEunice Dugan, MDEvelyn Song, MDColin Blumenthal, MDKaran Desai, MDAmit Goyal, MDDaniel Ambinder, MD

Aloha! CardioNerds (Amit Goyal & Karan Desai)  join University of Hawaii cardiology fellows (Isaac Mizrahi, Nath Limpruttidham, Nishant Trivedi, and Shana Greif) for some shaved iced on the Big Island's north shore! They discuss a fascinating case of a patient presenting with decompensated heart failure found to have a giant coronary aneurysm. Program director Dr. Dipanjan Banerjee provides the E-CPR as well as a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Tommy Das with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary Coming soon! Case Media ABCDClick to Enlarge A. CXRB. ECG: atrial fibrillation with RVR, left axis deviation, poor r wave progressionC. Wide complex tachycardia D. CT chest demonstrating giant aneurysm TTE Coronary Angiography Episode Schematics & Teaching Coming soon! The CardioNerds 5! – 5 major takeaways from the #CNCR case Coming soon! References Thibodeau, J. T., & Drazner, M. H. (2018). The Role of the Clinical Examination in Patients With Heart Failure. JACC. Heart failure, 6(7), 543–551.  Abou Sherif, S., Ozden Tok, O., Taşköylü, Ö., et al. (2017). Coronary Artery Aneurysms: A Review of the Epidemiology, Pathophysiology, Diagnosis, and Treatment. Frontiers in cardiovascular medicine, 4, 24. Kawsara, A., Núñez Gil, I. J., Alqahtani, F., et al. (2018). Management of Coronary Artery Aneurysms. JACC. Cardiovascular interventions, 11(13), 1211–1223.  Newburger, J. W., Takahashi, M., & Burns, J. C. (2016). Kawasaki Disease. Journal of the American College of Cardiology, 67(14), 1738–1749.  McCrindle, B. W., Rowley, A. H., Newburger, J. W., et al. (2017). Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. Circulation, 135(17), e927–e999.   CardioNerds Case Reports: Recruitment Edition Series Production Team Bibin Varghese, MDRick Ferraro, MDTommy Das, MDEunice Dugan, MDEvelyn Song, MDColin Blumenthal, MDKaran Desai, MDAmit Goyal, MDDaniel Ambinder, MD

CardioNerds (Amit Goyal & Daniel Ambinder) join Georgetown University/Washington Hospital Center cardiology fellows (Nitin Malik, AJ Grant, and Tsion Aberra) for some fresh Maryland blue crab cakes at the Georgetown waterfront in Washington, DC. They discuss a rare case of histoplasmosis pericarditis complicated by cardiac tamponade. Dr. Patrick Bering provides the E-CPR and program director Dr. Gaby Weissman provides a message for applicants. Johns Hopkins internal medicine resident Colin Blumenthal with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary Coming soon Case Media ABCDEClick to Enlarge A. Left: Admission chest x-ray (PA film), which was overall unremarkable. Right: Chest x-ray from hospital day 12 - which revealed pulmonary edema with bilateral perihilar haziness, increased prominence of pulmonary vascularity, and small-moderate bilateral pleural effusions. Note increased size of cardiac silhouette. At the corresponding time, pericardial effusion (without tamponade) had been diagnosed.B. EKG: Sinus tachycardia and low-voltage QRS complexes.C. CT abdomen/pelvis on hospital day 14. Free air noted within the abdomen (left). Moderate pericardial effusion also incidentally appreciated (right).D. Pulse-Wave Doppler of mitral inflow. Flow variation is present, but variation is less than

CardioNerds (Amit Goyal & Karan Desai) join Medical University of South Carolina cardiology fellows (Carson Keck, Samuel Powell, and Ishan Shah) at MUSC Children's Hospital cafeteria overlooking the gorgeous Charleston Harbor. They reflect on an informative case of exertional intolerance due to tricuspid regurgitation. Dr. Ryan Tedford provides the E-CPR and program director Dr. Daniel Judge provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident, Eunice Dugan, with mentorship from University of Maryland cardiology fellow Karan Desai. Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary Coming soon! Case Media ABClick to Enlarge A. Tricuspid valve CW DopplerB. Hepatic vein flow TTE: TV inflow TTE: TV inflow with color Doppler TTE: Apical 4 chamber TTE: RV focused color Cardiac MRI - 4 chamber CINE Cardiac MRI - Short-axis stack CINE Episode Schematics & Teaching Coming soon! The CardioNerds 5! – 5 major takeaways from the #CNCR case Coming soon! References Coming soon! CardioNerds Case Reports: Recruitment Edition Series Production Team Bibin Varghese, MDRick Ferraro, MDTommy Das, MDEunice Dugan, MDEvelyn Song, MDColin Blumenthal, MDKaran Desai, MDAmit Goyal, MDDaniel Ambinder, MD

CardioNerds (Amit Goyal & Daniel Ambinder) join Brown University cardiology fellows (Greg Salber, Vrinda Trivedi, and Esseim Sharma) for a gorgeous coastal boat ride in Providence, RI. They discuss an educational case of hypertrophic cardiomyopathy with superimposed stress cardiomyopathy. Dr. Katharine French provides the E-CPR and program director Dr. Raymond Russell provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Evelyn Song with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary Coming soon! Case Media ABCDEClick to Enlarge A. ECG 2 weeks prior to current presentation B. Current ECG C. CXRD. M mode though the mitral valve demonstrating systolic anterior motion of the mitral valveE. LVOT CW Doppler tracings with a peak velocity ~ 5 m/s Coronary angiography - 1 Coronary angiography - 2 TTE - 1 TTE - 2 TTE - 3 TTE - 4 Cardiac MRI Episode Schematics & Teaching Hypertrophic Cardiomyopathy InfographicClick to enlarge! The CardioNerds 5! – 5 major takeaways from the #CNCR case Coming soon! References Coming soon! CardioNerds Case Reports: Recruitment Edition Series Production Team Bibin Varghese, MDRick Ferraro, MDTommy Das, MDEunice Dugan, MDEvelyn Song, MDColin Blumenthal, MDKaran Desai, MDAmit Goyal, MDDaniel Ambinder, MD

“Gossiping is motivated by a desire to be closer to the person you’re talking to. When you notice you’re talking together about someone who isn’t there, pause and check in with yourself. What might you be avoiding talking about?” -Dr. Alexandra H. Soloman   We've all gossiped, let's be honest. In fact, for the average person, gossip makes up 80% of our conversations as human beings. And while most of us think of gossip as negative, there are actually evolutionary roots to gossip that have had positive benefits to us as human beings. But overall, there's a lot of gossip that can be harmful, both to the person being discussed and the one doing the gossiping. Because that’s the thing about gossiping: when I hear someone talking about somebody else in a really shitty way, my first thought is: what are they saying about me when my back is turned then? In this episode we'll get into: How gossip can be used as a form of bonding, and why that can be incredibly negative What gossiping can tell you about a person Turning around a connection with someone who only wants to gossip Why intention matters when it comes to gossip and how to spot the differences Asking yourself how you want to show up in the world and the kind of human you want to become   REFERENCES Episode #17 Rest for Success and How to Manage Metabolism with Dr. Jade Teta Episode #205 Purpose, Using Pain for Growth & Building Multi-Passionate Online Businesses with Dr. Jade Teta Episode #88, Save the Drama for Your Mama: Being Drama-Focused is Keeping You From Happiness with Christina Montalvo Time Magazine: Why Do People Gossip?   Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY Find Emily Online: Emily Gough Coaching Room to Grow Podcast

CardioNerds (Amit Goyal & Karan Desai) join Massachusetts General Hospital cardiology fellows (Daniel Pipilas, Rachel Frank and Kemar Brown) on a luxurious sailboat for iced coffees and Modern Pastry delicacies! They discuss a rare case of Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA). Program director, Dr. Doreen DeFaria Yeh provides the E-CPR and a message for applicants.  Episode notes were developed by Johns Hopkins internal medicine resident Evelyn Song with mentorship from University of Maryland cardiology fellow Karan Desai.  Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary Coming soon! Case Media ABCDEFClick to Enlarge A. CXRB. ECG C. Follow up ECGD-F. Cardiac CT TTE 1 TTE 2 Angiography 1 Angiography 2 Angiography 3 Angiography 4 Angiography 5 Episode Schematics & Teaching Coming soon! The CardioNerds 5! – 5 major takeaways from the #CNCR case Coming soon! References Coming soon! CardioNerds Case Reports: Recruitment Edition Series Production Team Bibin Varghese, MDRick Ferraro, MDTommy Das, MDEunice Dugan, MDEvelyn Song, MDColin Blumenthal, MDKaran Desai, MDAmit Goyal, MDDaniel Ambinder, MD

CardioNerds (Amit Goyal & Daniel Ambinder) join Brigham and Women’s Hospital cardiology fellows (Mounica Yanamandala, Simin Lee and Maria Pabon Porras) for some fun times at the Charles River Esplanade! They discuss a complicated case of prosthetic valve endocarditis with aortic regurgitation. Dr. Dale Adler provides the E-CPR and program director Dr. Donna Polk provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Bibin Varghese with mentorship from University of Maryland cardiology fellow Karan Desai. Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A male in his mid-40s with history of HIV on ART (undetectable VL, CD4 320) and idiopathic thoracic ascending aortic aneurysm (TAAA) with AR s/p bioprosthetic valve replacement 10 years prior presented with acute onset lightheadedness and pre-syncope. He was diagnosed with an idiopathic TAAA at age 30 after he was noted to have an incidental murmur. Over the next few years, his aortic root increased to over 7 cm with severe AR, LV dilation, and reduced LVEF of 45%. He underwent bioprosthetic aortic valve replacement and root repair with a Medtronic freestyle porcine aortic root with subsequent recovery of his  LVEF to 50% and improved LV dilation. Thereafter, he was doing well until he reported a flu like illness 3 weeks prior to presentation with reported fever up to 101.3 F and associated myalgias. He denied any sick contacts or recent travel and was adherent to his HIV regiment. On the day of presentation, he was walking his dogs when he developed acute onset lightheadedness with presyncope. On presentation, he had a low grade fever, tachycardia, tachypnea, and hypoxia. On exam, cardiac exam was notable for loud blowing diastolic murmur, non-distended JVP, decreased breath sounds, warm extremities with bounding pulses and without edema. There were no stigmata of endocarditis. Labs revealed elevated cardiac and inflammatory biomarkers. Blood cultures were initially NGTD. CXR corroborated the exam with bilateral interstitial and airspace opacification with effusions. TTE showed LVEF 35% with global hypokinesis, dilated LV with LVEDD 7.5 cm, mild RV systolic dysfunction, severe AR with holo-diastolic flow reversal in the abdominal aorta, no prosthetic stenosis, and aortic root 31 mm. TEE showed a well-seated AVR with leaflet thickening and several echodensities. CT surgery deemed patient to be high risk for the OR. After a few days, patient required intubation for increased work of breathing and acute decompensation requiring vasoactive infusions. After multidisciplinary discussions, the patient ultimately underwent ViV TAVR with successful placement of a 29 mm E...

There are two things you need to be asking yourself to create your own version of success: 1. Get clear on your WHY. Why do you do what you do? Dig deep - this can’t just be about the money. There has to be more to it than that. 2. What do you want? What feels good to you? And most importantly, when you make a decision (or someone offers you a suggestion) and you try it on for size, how does it feel for you?   REFERENCES Episode #221, Your Job is Not Who You Are: Trust the Journey   Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY Find Emily Online: Emily Gough Coaching Room to Grow Podcast

CardioNerds (Amit Goyal & Daniel Ambinder) join University of Washington cardiology fellows (Shannon McConnaughey, Betty Ashinne and Andrew Perry - host of the AP Cardiology podcast) for some tacos and beer at the water and discuss a puzzling case of recurrent troponin elevation. Dr. Kelly Branch provides the E-CPR and program director, Dr. Rosario Freeman, provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Eunice Dugan with mentorship from University of Maryland cardiology fellow Karan Desai.    Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary Coming soon! Case Media ABCClick to Enlarge A. ECG from MayB. Coronary angiography form MayC. ECG August (same year) TTE 1 (May) TTE 2 (May) TEE 3 (May) TTE 4 (May) TTE 1 (August) TTE 2 (August) TTE 3 (August) TTE 4 (August) Episode Schematics & Teaching Coming soon! The CardioNerds 5! – 5 major takeaways from the #CNCR case Coming soon! References Coming soon! CardioNerds Case Reports: Recruitment Edition Series Production Team Bibin Varghese, MDRick Ferraro, MDTommy Das, MDEunice Dugan, MDEvelyn Song, MDColin Blumenthal, MDKaran Desai, MDAmit Goyal, MDDaniel Ambinder, MD

CardioNerds (Amit Goyal) join University University of Mississippi Medical Center cardiology fellows (Catherine Lowe, Chris Latour and Adi Sabharwal) as they sit at the reservoir enjoying a great view of the water at the Pelican Cove Grill in Jackson, MS. They discuss and educational case of decompensated heart failure and shock in the setting of severe functional mitral regurgitation treated with MitraClip. Dr. Kellan Ashley provides the E-CPR and program director Dr. Trey Clark provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Richard Ferraro with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary Coming soon Case Media ADCBClick to Enlarge A. Right atrial pressure B. Right ventricular pressureC. Pulmonary artery pressureD. Wedge pressureC. Pre and post MitraClip right atrial pressure Episode Schematics & Teaching Coming soon! Click to enlarge! The CardioNerds 5! – 5 major takeaways from the #CNCR case Coming soon! References Coming soon! CardioNerds Case Reports: Recruitment Edition Series Production Team Bibin Varghese, MDRick Ferraro, MDTommy Das, MDEunice Dugan, MDEvelyn Song, MDColin Blumenthal, MDKaran Desai, MDAmit Goyal, MDDaniel Ambinder, MD

CardioNerds (Amit Goyal & Daniel Ambinder) join Boston University cardiology fellows (Yuliya Mints, Anshul Srivastava, and Michel Ibrahim) for some hotdogs at Fenway Park in Boston, MA. They discuss an educational case of carcinoid heart disease with severe tricuspid regurgitation. Program director, Dr. Omar Siddiqi provides the E-CPR and APD Dr. Katy Bockstall provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Bibin Varghese with mentorship from University of Maryland cardiology fellow Karan Desai.    Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary Coming soon! Case Media ABClick to Enlarge A. ECGB. TTE: CW Doppler through tricuspid valve Carcinoid - TTE 1 Carcinoid - TTE 2 Carcinoid - TTE 3 Carcinoid - TTE 4 Carcinoid - TTE 5 Carcinoid - TTE 6 Carcinoid - TTE 7 Carcinoid - TTE 8 Carcinoid - TTE 9 Episode Schematics & Teaching Coming sooN! The CardioNerds 5! – 5 major takeaways from the #CNCR case Coming soon! References Coming soon! CardioNerds Case Reports: Recruitment Edition Series Production Team Bibin Varghese, MDRick Ferraro, MDTommy Das, MDEunice Dugan, MDEvelyn Song, MDColin Blumenthal, MDKaran Desai, MDAmit Goyal, MDDaniel Ambinder, MD

CardioNerds (Amit Goyal & Daniel Ambinder) join Cleveland Clinic cardiology fellows (Ben Alencherry, Erika Hutt, Zach Il’Giovine, Kara Denby) for some delicious craft beer at Platform Brewery! They discuss a challenging case of Ehlers Danlos Syndrome with Papillary Muscle Rupture. Dr. Vidyasagar Kalahasti provides the E-CPR and program director Dr. Venu Menon provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident, Eunice Dugan, with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary Coming soon! Case Media ABCDEFClick to Enlarge A. ECGB. CXRC-F: Autopsy images TTE 1 TTE 2 TTE 3 TTE 4 TEE 1 TEE 2 TEE 3 TEE 4 Episode Schematics & Teaching Coming soon! The CardioNerds 5! – 5 major takeaways from the #CNCR case Coming soon! References Coming soon! CardioNerds Case Reports: Recruitment Edition Series Production Team Bibin Varghese, MDRick Ferraro, MDTommy Das, MDEunice Dugan, MDEvelyn Song, MDColin Blumenthal, MDKaran Desai, MDAmit Goyal, MDDaniel Ambinder, MD

CardioNerds (Amit Goyal & Daniel Ambinder) join UCSF cardiology fellows (Emily Cedarbaum, Matt Durstenfeld, and Ben Kelemen) for some fun in San Francisco! They discuss a informative case of ST-segment elevation (STEMI) due to coronary vasospasm. Dr. Binh An Phan provides the E-CPR and program director Dr. Atif Qasim provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Evelyn Song with mentorship from University of Maryland cardiology fellow Karan Desai. Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A man in his mid-50s with alcohol use disorder, cirrhosis, atrial fibrillation, and alpha thalassemia complicated by iron overload presented with hematemesis. He was tachycardic and hypotensive. Labs were notable for Hgb 8.1 (baseline of 10.2), INR 1.3, lactate 4.2, and ferritin 4660. He was started on IV PPI and octreotide. Course was complicated initially by Afib with RVR with hypotension. Subsequently, the patient developed unstable VT requiring CPR. Post-code EKG showed inferolateral ST elevations. Troponin-I rose from 19 to 225 and his pressor requirement continued to increase despite resolution of his GIB. TTE showed LVEF 42% with new inferolateral wall motion abnormalities, normal RV systolic function, severe mitral regurgitation, and small pericardial effusion. After treatment of his GIB by IR and GI, he underwent an urgent LHC which showed 30% stenosis in proximal LAD, 70% in LADD2, and 95% in distal RCA. Coronary spasm was noted in all vessels. Intracoronary nitroglycerin and nicardipine were administered with significant improvement in spasm and resolution of STE on EKG. Vasopressors were quickly weaned off after. He was eventually stabilized, extubated, and started on an oral nitrate and calcium channel blocker. Repeat TTE showed normalized systolic function without any wall motion abnormalities.   Case Media ABClick to Enlarge A. Baseline ECG - atrial fibrillationB. ECG with inferior STEMI CORS - left system CORS- RCA pre-vasodilator CORS- RCA post-vasodilator Episode Schematics & Teaching Coming soon! The CardioNerds 5! – 5 major takeaways from the #CNCR case What are the cardiac manifestations of hemochromatosis? Cardiac hemochromatosis encompasses cardiac dysfunction from either primary or secondary hemochromatosis. Initially, hemochromatosis leads to diastolic dysfunction and arrhythmias. In later stages, it can lead to dilated cardiomyopathy.  Diagnosis of iron overload is established by elevated transferrin saturation (>55%) and elevated serum ferritin (>300 ng/mL).

LIVE Podcasting Masterclass happening Wednesday, October 28th @ 8pm EST and I can't WAIT to see you there!  You'll learn: How to FINALLY launch your podcast Using a podcast to massively build your business for fast growth and bring in new clients/students Strategies to start increasing your podcast downloads, growth and visibility Grab your spot HERE. “More is lost by indecision than by a wrong decision.” -Cicero We hear a lot of things these days, along with the plentiful memes floating around out there around this idea of 'leap and the net will appear.' But that's much easier said than done. Because that leap of faith can feel like the most difficult decision in the world, and it's so hard to know if we're making the right choices or not. So what do we do? Take action and hope for the best? Or try to weigh out the options to prevent major mistakes? Let's get into it ;) REFERENCES Episode #221, Your Job is Not Who You Are: Trust the Journey Episode #152, [BIZ TIPS] Harness Your Creativity: Switching From Consumer to Creator Episode #120, Listening to Your Intuition & Gut Instinct: Stop Ignoring Your Body Are You Listening to Your Intuition? Emily is interviewed on episode #103 of the Do A Day Podcast by Bryan Falchuk: Accepting the Unknowns of the Journey     Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY Find Emily Online: Emily Gough Coaching Room to Grow Podcast

CardioNerds (Amit Goyal & Daniel Ambinder) join Summa Health cardiology fellows (Jack Hornick, Phoo Pwint Nandar, and Sideris Facaros) for a hike on the Towpath Trail at Cuyahoga Valley National Park in Akron, Ohio! They discuss an informative case of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) complicated by ventricular tachycardia & cardiogenic shock. Dr. Kenneth Varian provides the E-CPR and program director, Dr. Marc Penn provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident, Eunice Dugan, with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary Coming soon! Case Media 123Click to Enlarge A. Post cardioversion ECG: NSR, low voltage, incomplete RBBB, PVCB. TTE: RV enlargement C. TTE: Tissue Doppler velocity (S') low TEE Episode Schematics & Teaching The CardioNerds 5! – 5 major takeaways from the #CNCR case Coming Soon References Coming Soon! CardioNerds Case Reports: Recruitment Edition Series Production Team Bibin Varghese, MDRick Ferraro, MDTommy Das, MDEunice Dugan, MDEvelyn Song, MDColin Blumenthal, MDKaran Desai, MDAmit Goyal, MDDaniel Ambinder, MD

CardioNerds (Amit Goyal & Daniel Ambinder) join Scripps cardiology fellows (Christine Shen and Andrew Cheng) for some Cardiology and California Burritos in San Diego! They discuss an informative case of Wet Beriberi and Stiff Left Atrial Syndrome. Dr. Thomas Heywood provides the E-CPR and program director Dr. Malhar Patel provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Tommy Das with mentorship from University of Maryland cardiology fellow Karan Desai. Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A woman in her mid-60s with history of rheumatic mitral stenosis s/p mechanical mitral valve replacement, HFpEF, and paroxysmal atrial fibrillation s/p ablation presents with subacute worsening dyspnea despite escalating diuretic doses. TTE shows an EF of 62%, normal gradients across the mitral valve without mitral regurgitation, and a dilated IVC. She is admitted with a presumed diagnosis of decompensated heart failure, and started given IV furosemide. Her symptoms slightly improve though do not resolve, and her creatinine increases from 1.4 to 2.1.   In light of the unclear hemodynamic picture, a RHC is done, showing a RA pressure 9, RV pressure of 80/10, PAP 70/25 with mPAP 40, PCWP 30, SVR 872, CO 11 (by thermodilution), and CI 5.2. Notably, large V waves are noted on the RHC. Given concern for mitral regurgitation in the setting of large V waves, a TEE was pursued, which confirmed the lack of MR seen on TTE. Thus, her large V waves were felt to be due to stiff left atrial syndrome, and a cardiac CT showed a severely calcified "coconut left atrium". Labwork revealed a profoundly low thiamine level (21, with LLN of 70), raising concern for wet beri beri syndrome.   The patient's unifying diagnosis was indolent left atrial syndrome that was exacerbated by high outout heart failure due to Wet Beri Beri syndrome. The patient received thiamine supplementation, and was diuresed to euvolemia with dramatic improvement in symptoms. A repeat RHC after thiamine replacement showed a CO of 5.7 and CI of 2.74 by thermodilution, demonstrating resolution of her high output heart failure.   Case Media ABCDEFClick to Enlarge A. CXRB. ECGC. RHC: large V waves are noted on the RHCD. CO 11 and CI 5.2 by thermodilution pre-treatment E. Cardiac CT showed a severely calcified "coconut left atrium"F. Repeat CO of 5.7 and CI of 2.74 by thermodilution after thiamine replacement TTE 1 TTE 2 TEE 1 - Mitral Valve TEE 2 - Mitral Valve Cardiac CT Episode Schematics & Teaching Click to enlarge! The CardioNerds 5! – 5 major takeaways from the #CNCR case

CardioNerds (Amit Goyal & Karan Desai) join University Hospitals Cleveland Medical Center cardiology fellows (Tarek Chami, Jamal Hajjari, and Haytham Mously) for some amazing pizza and coffee in Cleveland, Ohio! They discuss an important case of effusive constrictive pericarditis. Dr. Brian Hoit provides the E-CPR and assistant program director Dr. Claire Sullivan provides a message for applicants. We are grateful to chief fellow Scott Janus for his leadership in planning this episode! Episode notes were developed by Johns Hopkins internal medicine resident Colin Blumenthal with mentorship from University of Maryland cardiology fellow Karan Desai. Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A woman in her mid-70s presented to clinic with subacute onset shortness of breath. Her past medical history includes metastatic breast cancer s/p mastectomy, chemo/radiation, and hormonal therapy. Exam notable for tachycardia without hypoxia, muffled heart sounds, JVD with Kussmaul's sign, and 1+ LE edema. The patient was sent to the ED for evaluation of possible pericardial effusion. CTA chest in ED did not demonstrate a PE, but did show bilateral pleural effusions, and a moderate pericardial effusion with evidence of metastatic disease extending into the mediastinum. TTE obtained showing normal LVEF, moderate pericardial effusion with thickened pericardium, and significant respirophasic tricuspid and mitral inflow variations. Pulsus paradoxus was manually checked and found to be 16 mmHg.  Due to concern for cardiac tamponade, she was taken to the cath lab for a RHC and pericardiocentesis. RHC prior to pericardiocentesis showed elevated left and ride sided filling pressures, blunted y decent in the RA, and equalization of diastolic pressures. Pericardiocentesis yielded 200 cc of bloody fluid with improvement, but continued elevation, in her L and R sided pressures. Blunted y decent did give way to a now rapid y descent concerning for constrictive pericarditis. She then underwent a cardiac MRI showing respirophasic septal motion suggestive of interventricular dependence and >1 cm thick pericardium with LGE c/w inflammation. Unfortunately, cytology of pericardial fluid was c/w a malignant effusion and despite treatment with a few months of anti-inflammatory therapy her symptoms did not improve. She then underwent a pericardial stripping with subsequent resolution of her symptoms. As her symptoms and hemodynamics were related to both the effusion and constriction, she was ultimately diagnosed with effusive constrictive pericarditis.  Case Media ABCDEFGHIJKLMNOClick to Enlarge A. ECGB. CXRC-F. TTE (inflow velocities (mitral and tricuspid),

---------------------- Appreciation written, produced, and narrated by Remedy Robinson, MA/MFA Twitter: https://twitter.com/slowdragremedy Instagram: https://www.instagram.com/slow_drag_with_remedy/   Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ---------------------- Elvis Costello Wiki Resource, “Miss Macbeth”: http://www.elviscostello.info/wiki/index.php/Miss_Macbeth   “Miss Macbeth”: https://www.youtube.com/watch?v=QQnpjwSq5vM   References: Episode 10 of “Slow Drag with Remedy,” “A Terrible Crime,” a slow drag with “Let Him Dangle”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/11524901 Episode 55 of “Slow Drag with Remedy,” “A Little Amused,” a slow drag with “…This Town…”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/15882878 “Spike” Liner notes: http://www.elviscostello.info/wiki/index.php/Spike_(2001)_liner_notes Fishbone Slide hairstyle instrument: https://www.youtube.com/watch?v=3nRHJQ9axxs First Foot Coal Explanation: https://www.historic-uk.com/HistoryUK/HistoryofScotland/The-History-of-Hogmanay/ New York Eve Traditions, first foot: https://www.telegraph.co.uk/property/home-improvement-tips/tradition-for-seeing-in-new-year/ 5 Scottish Hogmanay Traditions: https://www.tripsavvy.com/hogmanay-traditions-in-scotland-1661711 “Beware the Deadly Nightshade, the beautiful plant that can kill you”: https://allthatsinteresting.com/deadly-nightshade Macbeth quote: Act 1, scene 7: https://www.sparknotes.com/nofear/shakespeare/macbeth/page_42/ https://www.sparknotes.com/shakespeare/macbeth/quotes/theme/children/ The Golliwog Caricature, Jim Crow Museum of racist Memorabilia: https://www.ferris.edu/jimcrow/golliwog/ Chuck under the chin idiom: https://idioms.thefreedictionary.com/chuck+under+the+chin So, until next time, Adieu, my little ballyhoo   "Miss Macbeth" Lyrics: All the children testified that Miss Macbeth had a fishbone slide in her cobweb tresses Her eyes were black as first foot coal, clutched as white as chalk-dust Her fingers sweated India-ink and poison-pen letters There is a hungry hanging tree just below your bedroom window You can hear her take a broom to beat out a tattoo on the ceiling Her bloodless face ran red inside but was she really evil, was she only pantomime? Now the chalk on the wall says that somebody saves That somebody's face has just been washed off the pavement Into a puzzle where petrol will be poisoned by rain Miss Macbeth saw her reflection as confetti bled it's colors down the drain (Chorus:) And every day she lives out another love song It's a tearful lament of somebody done wrong But how can you miss what you've never possessed, Miss Macbeth? Well we all should have known when the children paraded They portrayed her in their fairytales, sprinkling Deadly Nightshade And as they tormented her, she rose to the bait Even a scapegoat must have someone to hate And every day she lives out another love song "You're up there enjoying yourself, but I know it's wrong" But how can you miss what you've never possessed, Miss Macbeth? Miss Macbeth Sometimes people are just what they appear to be With no redemption at all We try to walk upright when we can't even crawl Miss Macbeth has a gollywog she chucks under the chin  And she whispers to it tenderly, then sticks it on a pin And it might be coincidence, but a boy down the lane That she said "went white as he could do," then doubled over in pain

CardioNerds (Amit Goyal & Daniel Ambinder) join University of Connecticut (UCONN) cardiology fellows (Mansour Almnajam, Justice Oranefo, Yasir Adeel, and Srinivas Nadadur) as they enjoy the amazing view from the Heublein tower! They discuss a challenging case of left ventricular free wall rupture & pseudoaneurysm as a complication of a STEMI. Dr. Peter Robinson provides the E-CPR and program director Dr. Joyce Meng provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Bibin Varghese with mentorship from University of Maryland cardiology fellow Karan Desai.    Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A man in his mid 50s with no significant PMH presented with a 10-day history of chest pain that progressed to acute pleuritic pain and shortness of breath in the past 24 hours. On arrival, he was hypothermic, in rapid atrial fibrillation with HR in the 130-150s, and an initial BP was not able to be obtained. He was tachypneic with labored breathing, lethargic, and cyanotic. Exam revealed markedly elevated JVP, cool extremities, and diminished breath sounds with bibasilar rales. Labs demonstrated leukocytosis, significantly elevated liver enzymes, troponin-I at 10.91, elevated NT-proBNP, and lactate at 6. ECG demonstrated tall, broad R-waves in V1-V4 with downsloping STD and upright T-waves concerning for a posterior infarct. He was immediately intubated, cardioverted into NSR, and started on vasopressors. Bedside echocardiogram demonstrated diffuse LV hypokinesis with akinesis of the inferolateral wall, LVEF 25-30%, and pericardial fluid with hyperechoic material adherent to the inferior wall as well as tamponade physiology. Chest CTA was negative for aortic dissection and confirmed hemopericardium. He was taken to the OR where he underwent a subxiphoid pericardial window. They found significant clot burden (both old and new), but no frank rupture. Adherent clot was not removed to prevent further hemodynamic compromise. Intraoperative TEE additionally demonstrated severe eccentric MR with partial posteromedial papillary muscle rupture. An IABP was placed and inotropic and vasoactive support was continued to temporize pending definitive therapy and the patient improved hemodynamically. Repeat TTE prior to surgery demonstrated a large apical and inferolateral pseudoaneurysm. Coronary angiogram revealed proximal occlusion of the LCx and diffuse three vessel coronary disease otherwise. He ultimately underwent CABG, mechanical mitral valve replacement, and pericardial patch repair of the ventricular pseudoaneurysm. Final diagnosis: Free Wall Rupture & Pseudoaneurysm. Thankfully,

CardioNerds (Amit Goyal & Daniel Ambinder) join Virginia Commonwealth University (VCU) cardiology fellows (Ajay Pillai, Amar Doshi, and Anna Tomdio) for a delicious skillet breakfast and amazing day in Richmond, VA! They discuss a fascinating case of a patient with Wolff-Parkinson-White (WPW) and hypertrophic cardiomyopathy (HCM). Dr. Keyur Shah provides the E-CPR and program director Dr. Gautham Kalahasty provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Colin Blumenthal with mentorship from University of Maryland cardiology fellow Karan Desai. Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A man in his mid-60s presented to the ED after an episode of unwitnessed syncope while drinking. Patient had suddenly passed out from a seated position with no prodrome or post-ictal state. He had episodes like this in the past, which were thought to be seizures, but otherwise PMHx only notable for alcohol use disorder. He denied any FH of SCD or syncope. In the ED, exam was unremarkable. Labs notable for mild thrombocytopenia, mild hyponatremia with AKI, 2:1 AST/ALT ratio, elevated NT-proBNP, and a very high lactate that rapidly corrected with fluids. EKG was notable for sinus tachycardia, short PR interval, wide QRS, and delta waves consistent with Wolff-Parkinson-White (WPW) pattern. Echo showed preserved LVEF, thickened LV septum (1.6 cm) and posterior wall (1.3 cm) concerning for hypertrophic cardiomyopathy (HCM). No outflow tract gradient was noted at rest or with stress, and the strain pattern demonstrated apical sparing. Evaluation for cardiac amyloid, including plasma cell dyscrasia and PYP scan, was negative. Cardiac MRI confirmed severely thickened LV inferior and inferolateral walls at 1.7 cm with no LVOT obstruction. 25% of the myocardium demonstrated patchy LGE.   Due to concern for WPW syndrome, the patient underwent an EP study. This revealed a malignant septal accessory pathway that was successfully ablated with resolution of the WPW EKG features. Given large LGE burden in setting of HCM, patient underwent placement of primary prevention ICD. Genetic testing for PRKAG2 mutation is pending given comorbid WPW and HCM.  Case Media ABCDEFClick to Enlarge A. CXR: Slightly increased interstitial markings in the lung bases, an elevated right hemidiaphragm. No acute airspace disease or pulmonary edemaB. ECG: Sinus tachycardia rate 120bpm, PR interval 80ms, QRS 130ms, WPW pattern.  Arruda algorithm localizes to posterior septum.C. CMR:  Myocardium nulls before blood pool.D. CMR:  Delayed gadolinium enhancementE. Follow up ECG: NSR 78, repolarization abnormalities.  T wave memory inferior leads.F.

CardioNerds (Amit Goyal & Daniel Ambinder) join Baylor College of Medicine cardiology fellows (Khurrum Khan, John Suffredini, and Aliza Hussain) during restaurant week in Houston! They discuss an interesting case of STEMI in a patient with a recent diagnosis of e-cigarette or vaping product use-associated lung injury (EVALI). Dr. Vijay Nambi provides the E-CPR and APD Dr. Arunima Misra provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Bibin Varghese with mentorship from University of Maryland cardiology fellow Karan Desai.    Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A male in his mid 40s with a 30 pack year smoking history, EVALI (e-cigarette and vaping associated lung injury), and asthma presented with dyspnea and persistent chest pain. He had been vaping for the past year. One month prior , CT chest showed bilateral patchy infiltrates and he was diagnosed with EVALI and started on a steroid taper with resolution of his CT abnormalities. A nuclear stress test at that time was negative for ischemia. On arrival, he was in sinus tachycardia, normotensive, and not on oxygen supplementation. Physical exam was negative for volume overload or heart murmurs. EKG showed new Q waves with STE in V2-V4, with associated Q waves and TWI in the lateral leads and troponin returned moderately elevated. He was emergently taken to the cath lab which showed an abrupt cutoff of flow to the LAD. He received a single DES with resolution of coronary flow. A post-cath TTE showed an LVEF of 40-45% with apical anterior and anteroseptal WMA. He was monitored in the CCU the next day and he was treated with aspirin, ticagrelor, ACEi, metoprolol succinate and high intensity statin and subsequently discharged in stable condition with cardiac rehab follow-up. Case Media ABClick to Enlarge A. Presentation ECG (Anterior STEMI) B. Baseline ECG LAD occlusion Post PCI RCA TTE 1 TTE 2 TTE 3 Episode Schematics & Teaching Click to enlarge! The CardioNerds 5! – 5 major takeaways from the #CNCR case 1. The patient presented with a STEMI following a diagnosis of EVALI. What is known about the cardiovascular risks of vaping and e-cigarette use?  The overall cardiovascular risks of e-cigarette use remains to be elucidated In preclinical studies, e-cigarettes use have been linked to increased sympathetic activity, oxidative stress, endothelial dysfunction, vascular injury, and altered platelet activity One observational study has suggested that daily e-cigarette users were 1.79 times more likely to experience MI than individuals who had never used e-cigarettes.

CardioNerds (Amit Goyal & Daniel Ambinder) join University of Pittsburgh Medical Center cardiology fellows (Agnes Koczo, Natalie Stokes, and Kayle Shapero) for a boat cruise down the Allegheny river as we tour all over beautiful Pittsburgh! They discuss an important case of severe pre-eclampsia, and explore some of the exciting dimensions of cardio-obstetrics. Dr. Malamo Eleni Countouris provides the E-CPR and program director Dr. Katie Berlacher provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Tommy Das with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A G12P7 woman in her mid 30s in the third trimester of pregnancy presented with two months of progressive shortness of breath, orthopnea, and abdominal distension. She has a history of chronic HTN, untreated OSA, and obesity. Evaluation revealed a BP of 147/76 and spot urine protein:creatinine ratio elevated to 0.6, which in the context of her presentation was concerning for preeclampsia superimposed on chronic hypertension. TTE showed preserved ejection fraction, flattened interventricular septum during systole consistent with RV pressure overload, and moderate pulmonary HTN.  She was diuresed with IV furosemide with improvement in symptoms and kept on ASA 81mg. The etiology of her elevated PA pressures was thought to be multifactorial, including untreated OSA for which she was started on CPAP. She was ultimately discharged on oral diuretics, and underwent an uncomplicated spontaneous vaginal delivery at 37 weeks. After delivery, follow-up in a clinic specializing in improving cardiovascular health in women with history of hypertensive disorders of pregnancy was arranged.   Case Media ABCClick to Enlarge A. ECG: Sinus tachycardia otherwise unremarkableB. CXR: Within limitations of respiratory motion, no focal airspace consolidation; no pleural effusionsC. TTE: EF 55-60%, flattened IVS c/w RV pressure overload; normal RV size and function; mod TR; moderate pulmonary HTN (PASP 52mmHG); normal diastolic function Episode Schematics & Teaching Click to enlarge! The CardioNerds 5! – 5 major takeaways from the #CNCR case 1. Cardionerds, we all should be familiar with #CardioObstetrics. What are the hypertensive disorders of pregnancy?  There are four major categories for hypertensive disorders in pregnancy: (1) chronic hypertension (2) gestational hypertension; (3) preeclampsia (along with eclampsia and HELLP syndrome); (4) chronic hypertension with superimposed preeclampsia.  Chronic Hypertension: Note,

We've all had those moments where it felts as though the creative energy simply wouldn't flow. You know, like when you realize you've been staring at the same page of your book for 15 minutes without reading a word. Or looking blankly at a computer screen without actually accomplishing anything, spinning your wheels and getting caught in "busy" work because the words simply won't come for that post you're trying to push out.  Everything feels forced, ideas won't populate, and you're worried your creativity has left the building for good. I've got good news: it will come back. But you're going to have to take care of you first. In this episode I'm giving you all the tools you need to trust the process, get that creativity and inspiration back, and remind yourself who the f*ck you are.   REFERENCES Episode #230, Slow Down to Speed Up: Burnout & the Inherent Vulnerability of Entrepreneurship Episode #117, The 9 Year Affair: Lessons in Infidelity Episode #90, How to Sleep Like a Boss with Christine Hansen   Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY Find Emily Online: Emily Gough Coaching Room to Grow Podcast

CardioNerds (Amit Goyal & Daniel Ambinder) join  join UCLA cardiology fellows (Jay Patel, Hillary Shapiro, and Ruth Hsiao) for some beach bonfire in Santa Monica! They discuss a challenging case of Spontaneous Coronary Artery Dissection (SCAD) requiring heart transplantation. Dr. Jonathan Tobis provides the E-CPR and program director Dr. Karol Watson provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Evelyn Song with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A woman in her late 40s presented with a one day history of intermittent chest pain. EKG showed anteroseptal and lateral STE with reciprocal ST depressions in the inferior leads. High-sensitivity troponin was elevated at 333 ng/mL. Emergent LHC showed a long and narrow left main with areas of additional contrast filling into a false lumen with no flow in the LAD. RCA and LCx were normal appearing (make sure you check out the angiogram videos below!). IVUS showed dissection and heavy thrombus burden in the left main artery. Shortly after the diagnostic angiogram, the patient went into V-fib arrest and received one shock with ROSC. Amiodarone was started and an Impella CP was placed for additional left ventricular support. ECMO and emergent CABG were not readily available at this time so the interventional team attempted revascularization with PCI to the left main given patient's hemodynamic instability from ongoing ischemia. However, even after PCI to left main, flow to LAD remained poor and the LCx now also appeared occluded. The decision was made to cease further attempts at revascularization. Unfortunately, post-procedure TTE showed a reduced EF of 22% with anterior and anterolateral hypokinesis. She was transferred to CCU on maximal Impella support. Patient eventually developed acute renal and liver failure secondary to cardiogenic shock and suffered an additional V-fib arrest with ROSC. Eventually, Ronald Reagan UCLA was contacted for transfer and the mobile ECMO team was dispatched. They placed the patient on VA-ECMO in the outside facility and transferred her to Ronald Reagan UCLA. At Ronald Reagan, revascularization was attempted given persistent cardiogenic shock and 3 stents were successfully deployed in the LAD. She was eventually weaned off of both Impella and ECMO after successful PCIs to LAD. However, TTE showed persistently low EF and patient eventually underwent successful heart-kidney transplantation.  Case Media ABCDClick to Enlarge A. ECG: Anterior STE, STE in I/aVL but depressedions in V4-V6, inferior reciprocal ST depressionB.

CardioNerds (Amit Goyal & Daniel Ambinder) join Houston Methodist cardiology fellows (Isaac Tea, Stephanie Fuentes, Peter Rothstein) for a trip to Hermann Park! They discuss a challenging case of right ventricular (RV) infarction leading to acute RV failure treated with right ventricular assist device (RVAD) support. Dr. Mahwash Kassi provides the E-CPR and program director Dr. Stephen Little provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Tommy Das with mentorship from University of Maryland cardiology fellow Karan Desai.  Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A man in his early 70s with ASCVD risk factors and known CAD (PCI to proximal LAD 4 years prior) presented with typical angina refractory to maximal medical therapy. A nuclear stress test showed a reversible perfusion defect in the RCA territory, and he was referred for PCI. Coronary angiogram showed severe stenosis of the proximal RCA and a DES was successfully deployed with TIMI 3 flow, though several large acute marginal branches were jailed.   The night following PCI, the patient developed bradycardia, hypotension, and tachypnea. Physical exam showed newly elevated JVP, lower extremity edema, and bibasilar crackles without a new cardiac murmur. ECG showed ST elevation in V1-V4, and bedside echocardiogram showed a severely dilated RV with decreased systolic function. With concern for acute RV failure, the patient was fluid resuscitated, started on dopamine for chronotropy, and was admitted to the CCU. A Swan-Ganz catheter was placed, showing a CVP 12, RV 41/15, PA 36/20 (25), PCWP 18, CI 1.6 (by Fick method). The calculated PAPi was 0.84.   The patient was transitioned to dobutamine to improve RV inotropy, epinephrine in the setting of hypotension, and inhaled nitric oxide in an attempt to decrease RV afterload. Despite these interventions, the patient had worsening shock, anuric renal failure requiring CVVH, and respiratory failure requiring intubation. A centrifugal RA to PA pump was placed (Protek Duo) for right-sided mechanical circulatory support, with improvement in RV hemodynamics and cardiogenic shock. Notably, a repeat angiogram was done, which showed a patent left coronary circulation as well as a right coronary artery without flow in the acute marginal branches. After 6 days of mechanical circulatory support, the patient was ultimately able to be weaned from vasoactive agents, and the Protek Duo was removed. He continued to have junctional bradycardia, and a permanent pacemaker was placed. After a nearly month-long admission, the patient was discharged to rehab; at 4 months follow-up,

CardioNerds (Amit Goyal & Daniel Ambinder) join Johns Hopkins Hospital cardiology fellows (Rick Vakil, Pranoti Hiremath, and Vasanth Sathiyakumar) for some gelato by the bay in Baltimore, Maryland! They discuss a challenging case of RV failure & shock after placement of an AV graft. Dr. Monica Mukherjee provides the E-CPR and program director Dr. Steven Schulman provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Colin Blumenthal with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A man in his early 40s, with a history of type 1 diabetes and prior failed renal and pancreatic transplants currently on iHD, was referred to Johns Hopkins Hospital for dialysis access. A left groin AV loop graft was pursued due to multiple access point failures in the past secondary to severe peripheral artery disease. Pre-op evaluation included risk stratification with RHC which was consistent with WHO Group 2 pulmonary HTN and diffuse atherosclerosis in the RCA on LHC. Intra-op, patient had an episode of significant hypotension after administration of protamine that required phenylephrine and ephedrine. In the PACU, his BPs continued to be low (70s/40s mmHg), requiring admission to the SICU where cardiology was consulted.  In the SICU, patient had ongoing hypotension despite pressors and fluids. Exam demonstrated a systolic murmur consistent with TR and elevated JVP. Labs were notable for a mild elevation in liver enzymes, elevated troponin, high NT-proBNP and elevated lactate. TTE demonstrated a moderately dilated and hypokinetic RV, elevated RVSP and evidence of pressure/volume overload. CTA abdomen/pelvis demonstrated extensive mesenteric atherosclerosis and signs of gastric ischemia. Patient was treated for RV failure with norepinephrine, inhaled epoprostenol, and CVVHD for volume removal. He became febrile and was treated empirically with broad spectrum antibiotics. Due to concern for the new loop graft causing high output heart failure vs RV failure, it was temporarily occluded for testing and then permanently ligated by vascular surgery with significant improvement in his BPs and RV function on repeat TTE.  Case Media ABCDEClick to Enlarge A. Plato's allegory of the cave by Jan Saenredam, according to Cornelis van Haarlem, 1604, Albertina, ViennaB-C. Anesthesia flow sheets D. CXR: Pulmonary vascular congestion, bibasilar atelectasisE. ECG: Sinus tachycardia to 110, RAD, RBBB, similar to prior TTE: LVEF 60-65%, mild to moderate concentric hypertrophy, trace effusion TTE: Flattened septum in systole and diastole c/f RV pressur...

CardioNerds (Amit Goyal & Daniel Ambinder) join Medical College of Wisconsin cardiology fellows (Katie Cohen, Div Mohananey, and Dave Lewandowski) for some cold brews by Lake Michigan in Cream City aka Milwaukee, WI! They discuss a case of a pregnant woman presenting cardiac arrest due to peripartum cardiomyopathy. Dr. Sarah Thordsen provides the E-CPR and program director, Dr. Gaglianello Nunzio, provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident, Eunice Dugan, with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A G2P1 woman in her early 30s with a history palpitations presented after a witnessed out-of-hospital cardiac arrest while at work. She received 6 rounds of CPR and 2 shocks before ROSC was achieved. She was intubated and given fluids but continued to remain hypoxic and hypotensive. Exam demonstrated sinus tachycardia, no murmurs, gravid abdomen and cool extremities. Initial labs demonstrated leukocytosis to 14k, lactic acid at 4.3 mmol/L, troponin-I peak at 0.07 ng/dL and elevated NT-proBNP. CXR demonstrated bilateral effusions and pulmonary congestion, and post-arrest EKG showed a wide complex tachycardia, leading to suspicion of VT arrest. In sinus, there  were no ST segment elevations and TTE showed LVEF 10-20%, global hypokinesis and no valvular disease. Given the severity of her shock, she was placed on central VA-ECMO with Impella support as an LV vent. During ECMO cannulation, she underwent emergent cesarean section due to fetal distress. Coronary angiography showed non-obstructive coronaries, but with sluggish flow in the setting of her cardiogenic shock and possible coronary spasm in setting of multiple vasoactive medications. Endomyocardial biopsy was negative for giant cell myocarditis. Within 4-5 days, she was weaned off all vasoactive agents and ECMO was decannulated; repeat echocardiogram showed LV functional recovery. GDMT was slowly titrated and a subcutaneous ICD was eventually placed before discharge. She and her child have done well over the course of a year!  Case Media ABClick to Enlarge A: ECG: Initially in sustained wide complex irregular tachycardiaB: CXR: Extensive consolidative changes throughout the lungs TTE: Parasternal Long Axis TTE: Apical 4 Chamber Episode Schematics & Teaching Click to enlarge! The CardioNerds 5! – 5 major takeaways from the #CNCR case 1. What is the differential for cardiac arrest in pregnant patients?  When thinking about a cardiac etiology of arrest, the differential should include pregnancy-induced hypertension,

---------------------- Appreciation written, produced, and narrated by Remedy Robinson, MA/MFA Twitter: https://twitter.com/slowdragremedy Instagram: https://www.instagram.com/slow_drag_with_remedy/   Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ----------------------   Elvis Costello Wiki Resource, “Distorted Angel”: http://www.elviscostello.info/wiki/index.php/Distorted_Angel   “Distorted Angel”: https://www.youtube.com/watch?v=aenmB8vjZdI   “Distorted Angel” Tricky Remix: https://www.youtube.com/watch?v=ICJDe5yAJwM   References: Episode 9 of “Slow Drag with Remedy,” “Grace and Virtue,” a slow drag with “All This Useless Beauty”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/11434418 Episode 23 of “Slow Drag with Remedy,” “False and Lovely Modesty,” a slow drag with “Little Atoms”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/12489932 Bruegel: a fall with the Rebel Angels [Virtual Reality]: https://www.youtube.com/watch?v=bXR9EEmb-JU Need2know Music Show – Part 2 Elvis Costello: https://www.youtube.com/watch?v=rcNJ9cNBCLU So, until next time, Adieu, my little ballyhoo "Distorted Angel" Lyrics: Strange things seem to occur, somewhere behind the nursery door Though I was just a bit of a kid, it was the bit that she was looking for Now I don't know where to begin confessing The way she's making me feel it can't be a sin I was taught to believe you were looking down on everyone And your benevolent face is beautiful to gaze upon Now I just don't know who to tell to go to hell Who put the old devil in the distorted angel? Distorted Angel Pure illuminated sweetness Frightening small children is just about your only weakness I thought that you would tell me what I'm living for But I can't see you anymore I don't know what they did but I'm sorry if it made you cry And if there's any justice at all I'd be punished for it I'd surmise It will mark the spot very well where I fell Under the shadow of the distorted angel Beneath the shadow of the distorted angel Below the shadow of the distorted angel Angel Beneath the shadow of the distorted angel Below the shadow of the distorted angel Angel  

In this episode we cover: - What is "Video-podcasting" and how it works - How to use video-podcasting for your podcast/business - My personal experience with Youtube - Why I decided to start a podcast - Questions you need to ask yourself BEFORE you start References: Episode 11 with Sarah Kuhn. How introverts (and INFJs) can Slay their Side Hustles Too! Connect with Olivia Powell: Instagram: @Becomeapodcastqueen  Facebook group: “Become a Podcast Queen Community”  Email: OliviaPowellCoaching@gmail.com

---------------------- Appreciation written, produced, and narrated by Remedy Robinson, MA/MFA Twitter: https://twitter.com/slowdragremedy Instagram: https://www.instagram.com/slow_drag_with_remedy/ Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ---------------------- Elvis Costello Wiki Resource, “…This Town…”: http://www.elviscostello.info/wiki/index.php/Spike “…This Town…”: https://www.youtube.com/watch?v=MjFfdp3922k Elvis Costello Wiki Page: http://www.elviscostello.info/wiki/index.php/Mouth_Almighty   References: Episode 10 of “Slow Drag with Remedy,” “A Terrible Crime,” a slow drag with “Let Him Dangle”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/11524901 Episode 39 of “Slow Drag with Remedy,” “The Secret It Arouses,” a slow drag with “Satellite”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/13951256 If Corporations are People: https://www.theatlantic.com/politics/archive/2015/02/if-corporations-are-people-they-should-act-like-it/385034/ “The Salt of the Earth” Idiom: https://www.merriam-webster.com/dictionary/the%20salt%20of%20the%20earth What is Absinthe and is it Legal?: https://www.distillerytrail.com/blog/what-is-absinthe-and-is-it-legal/ So, until next time, Adieu, my little ballyhoo "...This Town..." Lyrics That Charlie Sedarka was a-playing the piano like he was pawing a dirty book He bit a hole in his big bottom lip and gave his very best little boy look Well, it was a song with a topical verse which I'm afraid he then proceeded to sing Something about the moody doomed love of the Fish-Finger King (Chorus:) You're nobody in this town / You're nobody in this crowd You're nobody till everybody in this town knows you're poison Got your number, knows it must be avoided You're nobody till everybody in this town thinks you're a bastard Mr. Getgood moved up to Self-Made Man Row Though he swears that he's the salt of the earth He's so proud of the "kick-me-hard" sign that they hung on his back at birth He said "I appreciate beauty, if I have one, then it's my fault" "Beauty is on my pillow, beauty is there in my vault" You're nobody in this town / You're nobody in this crowd You're nobody till everybody in this town knows you're poison Got your number, knows it must be avoided You're nobody till everybody in this town thinks you're a bastard The girl with the eternity rock went down on her bookie to buy some stock Now all the signs in the shopping arcades Say "The corporation thief is the new Jesse James" Her clothes and her attention were scant Her eyes were everywhere, her eyes were like absinthe The little green figures that dance on your screen Say everything you want to hear and nothing they mean They made love while she was changing her dress She wiped him off, she wiped him out and then she made him confess A little amused by the belief in her power You must remember this it was the fetish of the hour You're nobody in this town / You're nobody in this crowd You're nobody till everybody in this town knows you're poison Got your number, knows it must be avoided You're nobody till everybody in this town thinks you're a bastard You're nobody in this town...

For one week only, I'm offering a $100 off discount to my course Podcasting for Impact™! All you need to do is use the discount code PODCASTLOVE when you buy Podcasting for Impact™. Don't delay! This offer is only good until Thursday, September 3rd 2020. I've *never* offered a discount before, so you're going to want to jump on this. Use PODCASTLOVE at checkout and go get started!   CONNECT WITH KELLY Website: www.kellyjanecoaching.com Email: info@kellyjanecoaching.com Instagram: @kellyjanecoaching Facebook: Kelly Jane Thorne  Facebook Group for Women Living Alongside Addiction: Finding Freedom From Within   REFERENCES Episode #117, The 9 Year Affair: Lessons in Infidelity Episode #220, Recognizing What Self-Betrayal Looks Like The War of Art, by Steven Pressfield   Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY Find Emily Online: Emily Gough Coaching Room to Grow Podcast

“If you possess the ability to learn from your mistakes, then failure is literally impossible, because each rejection brings you closer to perfection.” -Neil Strauss   REFERENCES Episode #58, Therapy, Coaching, Perfectionism & Why Feelings Are Not Facts with Topsie VandenBosch Episode #91, What to Do When You Feel like a Fraud as an Entrepreneur Episode #134, Shutting Down the Imposter Syndrome that Keeps You Stuck Vivian Kaye @itsviviankaye & What Would Chad Do™ TED Talk: How You Can Use Imposter Syndrome to Your Benefit with Mike Cannon-Brookes TED Talk: What is Imposter Syndrome & How Can You Combat It with Elizabeth Cox   Questions?  Comments? Want to connect and chat about this episode? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach or Facebook at Emily Gough Coaching.  I would absolutely love to connect with you and thank you for listening in real life and here any takeaways you had from this or other episodes!.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY Find Emily Online: Emily Gough Coaching Room to Grow Podcast  

---------------------- Appreciation written, produced, and narrated by Remedy Robinson, MA/MFA Twitter: @slowdragremedy Instagram: https://www.instagram.com/slow_drag_with_remedy/ Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ----------------------   Elvis Costello Wiki Resource, “Mouth Almighty”: http://www.elviscostello.info/wiki/index.php/Mouth_Almighty  “Mouth Almighty”: https://www.youtube.com/watch?v=CIDC1bKNp_Q   References: Episode 11 of “Slow Drag with Remedy,” “Blow the Whistle on the Whole Design,” a slow drag with “King of Thieves”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/13850447 Episode 38 of “Slow Drag with Remedy,” “His Tribute of a Rose,” a slow drag with “The Greatest Thing”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/13850447   What’s What idiom: https://idioms.thefreedictionary.com/tell+you+what%27s+what So, until next time, Adieu, my little ballyhoo "Mouth Almighty" Lyrics This town belongs to you and your tricks of confidence All the pavements for miles around are littered with your footprints Now every girl I get close to seems to be wearing your perfume And the clock strikes the letters of your name Both midnight and noon But I used to shoot my mouth off Till you'd had enough of me Once or twice nightly I know I've got my faults And among them I can't control my tongue But if you didn't believe me Why did you have to leave me With my mouth almighty Mouth almighty, that's what I've got Mouth almighty, telling you what's what Mouth almighty I wish I'd never opened my mouth almighty Wish I'd never opened my mouth almighty Wish I'd never opened my mouth almighty So I threw away the rose and held on to the thorn Crawling round with my crooner cufflinks and my calling card cologne But the realization of being replaced starts to tell tales across my face Without a soul to talk to or a hair out of place But I used to shoot my mouth off Till you'd had enough of me Once or twice nightly I know I've got my faults And among them I can't control my tongue But if you didn't believe me Why did you have to leave me With my mouth almighty Mouth almighty, that's what I've got Mouth almighty, telling you what's what Mouth almighty I wish I'd never opened my mouth almighty Wish I'd never opened my mouth almighty Wish I'd never opened my mouth almighty

If you ask most people what their "calling" in life is, you're likely to get either their job title or a blank stare. But what if your calling isn't meant to be a mystery? What if it's closer than you think? In this episode, we'll discuss the 5 questions that can help you discover your God-given calling, so that you can walk into your destiny with confidence. What am I better at than most people?It’s not enough for you to do something well. Something you’re good at is a gift, but something you’re exceptional at is more likely to be your calling.For example, I think I'm a good cook, but I'm not good enough to become a chef. I am, however, better than most people at writing.Thinking about your gifts in general terms will keep you confused. You need to drill down and focus if you want clarity. What do I love to do?There is a lot of debate online about whether you should pursue "passion or profit." I think that misses the point. Your passion is an important part of who you are, and it needs to be acknowledged, even if you don't make a living pursuing it.Your passions can change over time. Some passions are only for a season, and that’s okay.It’s also fine to have more than one passion. What makes you angry and keeps you up at night?For example, I have a friend who loves animals and hates when they're abused, which led to her taking a job as a veterinarian assistant.What problems are you uniquely equipped to solve?As queen of Persia, Esther was able to use her royal position and her connection to the Jewish people to save them from destruction.As a wealthy German businessman, Oskar Schindler was able to save over 1,200 Jewish people from being sent to concentration camps during World War II. Look at your upbringing, culture, personality and personal history to help you identify what problems you can solve that few others can.Who are your people?I like to call this your “belong group.” In other words, these are the people who speak your language and respond to your ideas with enthusiasm and support.In business, this is your audience. In church, it may be your area of ministry.No one is called to everyone. Even Jesus was limited in his area of ministry (See Matthew 15:24).Use these questions to help you decide whether a job, project or volunteer opportunity is the right fit for you. Each individual task you complete won’t check all of these boxes, but the combination of your life experiences (work, family, community, etc.) should.Action Step:Take 30 minutes to answer the 5 questions outlined in this episode. Did any of your answers surprise you? If so, how?References:Episode 2: "Purpose, Calling, Assignment: What's the Difference?"

---------------------- Appreciation written, produced, and narrated by Remedy Robinson, MA/MFA Twitter: @slowdragremedy Instagram: https://www.instagram.com/slow_drag_with_remedy/ Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ----------------------   Elvis Costello Wiki Resource, “Monkey to Man”: http://www.elviscostello.info/wiki/index.php/Monkey_To_Man “Monkey to Man”: https://www.youtube.com/watch?v=QsAe1X1gNzA Companion Blog: https://slowdragwithremedy.home.blog/2020/08/05/episode-52-monkey-to-man-2/ References: Episode 16 and 17 of “Slow Drag with Remedy,” “I Might Recite a Small Prayer,” a slow drag with “Bedlam,” and the supplement “The Quickening Art”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/11977772 https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/12057494 Episode 27, “Or Maybe I Really Love You,” a slow drag with “Needle Time”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/12795641 “The Monkey” w/ The Dirty Dozen Brass Band: https://www.youtube.com/watch?v=GUKLjtqWPuM “The Monkey” Speaks His Mind: https://www.youtube.com/watch?v=LNjuxtjtuWg “The Monkey” Original 45rpm quality: https://www.youtube.com/watch?v=_qdMPxImd3E “The Monkey” song lyrics: Dave Bartholomew: http://www.songlyrics.com/dave-bartholomew/the-monkey-lyrics/ Dave Bartholomew Quick bio: https://www.allmusic.com/artist/dave-bartholomew-mn0000577590/biography So, until next time, Adieu, my little ballyhoo   "Monkey to Man" Lyrics: A long time ago, our point of view Was broadcast by Mr. Bartholomew And now the world is full of sorrow and pain And it's time for us to speak up again You're slack and sorry / Such an arrogant brood The only purpose you serve is to bring us our food We sit here staring at your pomp and pout Outside the bars we use for keeping you out You've taken everything that you wanted Broke it up and plundered it and hunted Ever since we said it You went and took the credit It's been headed this way since the world began When a vicious creature took the jump from Monkey to Man Every time man struggles and fails He makes up some kind of fairytales After all of the misery that he has caused He denies he's descended from the dinosaurs Points up to heaven with cathedral spires All the time indulging in his base desires Ever since we said it He went and took the credit It's been headed this way since the world began When a vicious creature took the jump from Monkey to Man Big and useless as he has become With his crying statues and his flying bomb Goes 'round acting like the chosen one Excuse us if we treat him like our idiot cousin He hangs up flowers and bells and rhymes Hoping to hell someone's forgiven his crimes Fills up the air with his pride and praise He's a big disgrace to our beastly ways In a fashionable nightclubs and finer precincts Man uses words to dress up his vile instincts Ever since we said it He went and took the credit It's been headed this way since the world began When a vicious creature took the jump from Monkey to Man

---------------------- Appreciation written, produced, and narrated by Remedy Robinson, MA/MFA Twitter: @slowdragremedy Instagram: https://www.instagram.com/slow_drag_with_remedy/  Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ----------------------   Elvis Costello Wiki Resource, “After the Fall”: http://www.elviscostello.info/wiki/index.php/After_The_Fall   “After the Fall”: https://www.youtube.com/watch?v=z2wS1Y2rw4s   Companion Blog: https://slowdragwithremedy.home.blog/2020/07/20/episode-50-after-the-fall/   References: Episode 5 of “Slow Drag with Remedy,” “Well, Heaven Knows what Fills the Heart,” a slow drag with “Georgie and her Rival”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/11192174 Episode 34, “Lost Legs and Fingernails,” a slow drag with “Invasion Hit Parade”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/13352381 Readability Formulas: https://readabilityformulas.com That Obscure Object of Desire, user reviews: https://www.imdb.com/title/tt0075824/reviews That Obscure Object of Desire Trailer: https://www.youtube.com/watch?v=gba_tu2-EMY The Arthur Miller Society, Guide to “After the Fall”: https://arthurmillersociety.net/guide-after-the-fall/ “After the Fall,” a play by Miller: https://www.britannica.com/topic/After-the-Fall Types of Rhyme: https://www.dailywritingtips.com/types-of-rhyme/ So, until next time, Adieu, my little ballyhoo   "After the Fall" lyrics:  In an anonymous rendezvous Where the forbidden lovers repair They're burning down another damn candle They're melting the tables and chairs Beneath them applause from the balcony Whenever they accomplished making love Other times they thought they heard laughter Coming from the balcony above (chorus): She lies to his right and she carelessly recites All of her brand new appetites She seems brittle and small, it don't sound like her at all Since she came back to him after the fall She said "You never visit the countryside So I've made you a country to order" She put up a little tent in the bedroom Crickets played on a tape-recorder The ceiling was festooned with phosphorous stars She noticed his skin turning cold Burning all his clothes on the bonfire "Relax" she whispered and tightened the blindfold (chorus) You've changed but not for the better babe I'd tell you why but what's the use 'Cos it's the same kind of pity A drunkard gives as his excuse You were sharp and ideal as a bobby pin Now your eyes are deserted and quiet We both look like those poor shattered mannequins Thrown through the window in the riot She lies in his arms and without any qualms Revels in shallow delights She seems brittle and small, it don't sound like her at all Since she came back to him after the fall

In this week's episode, Katrina lets her guard down to keep it 100 with her listeners. She shares the struggles she's recently been navigating in her own attempt to be more aligned with her authenticity. She also shares how practicing stillness and presence has been a great aid in helping her reset as she continues to learn how to human. References: +Episode 14- Giving Yourself Permission To Be Unmotivated + Episode 29- Self Correction and Sarah Lemon's Dark Night Of The Soul Book a free consultation with Katrina: www.practicalalignmentkm.com Instagram: https://www.instagram.com/practicalalignment/ Facebook: https://www.facebook.com/practicalalignment Newsletter & Free Guided Meditation: https://www.practicalalignmentkm.com/newsletter --- Support this podcast: https://anchor.fm/katrina-macias/support

In this episode we cover: - What is a 'Podcast Queen'? - How podcasting has changed my life for the better - How I discovered podcasting + got into podcasting - What you can expect from my NEW show! - How you can have a podcast BEFORE you start a business - What you can expect from this new podcast! Tune in if you want to start your own podcast, but have no idea where to start. Connect with Olivia Powell Instagram: @OliviaPowellCoaching (https://www.instagram.com/oliviapowellcoaching/) Facebook group: “Become a Podcast Queen Community” (https://www.facebook.com/groups/1262823320498060/) Email: OliviaPowellCoaching@gmail.com References: Episode 6 How to launch your own podcast with my previous podcast manager Dana Drahos

---------------------- Appreciation written, produced, and narrated by Remedy Robinson, MA/MFA Twitter: @slowdragremedy Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ----------------------   Elvis Costello Wiki Resource, “My Science Fiction Twin”: http://www.elviscostello.info/wiki/index.php/My_Science_Fiction_Twin   “My Science Fiction Twin”: https://www.youtube.com/watch?v=7aymF6j4Si8   Companion Blog: https://slowdragwithremedy.home.blog/2020/06/10/episode-45-science-fiction-twin/   References: Episode 8 of “Slow Drag with Remedy,” “The Word She Wanted.” It’s a slow drag with “20% Amnesia,” another gem from “Brutal Youth”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/11408294 Episode 26 of “Slow Drag with Remedy,” “Before You Start to Cry.” It’s a slow drag with “You Tripped at Every Step,” another gem from “Brutal Youth”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/12703019 So, until next time, Adieu, my little ballyhoo   "Science Fiction Twin" Lyrics:  My science fiction twin Is doing better than expected He captured a little blonde trophy wife Who's really very well connected And when he calls home with his alibi She says "Is this really necessary?" But she knows that a man can't be a man Unless he's punishing his secretary He sips in the glow of a '61 vintage Just as the day is dimming With every intention of surrendering To fifty-foot women Who put the fascination back into my science fiction twin My science fiction twin Decided to become invisible He has my eyes, my face, my voice But he's only happy when I'm miserable The words flew from his mouth And they were gently gathered by reporters Trying to frame his once infamous flame With tattered pictures of her daughter "Her hair is all made out of porcupine Her figure is fantastic" But as you know, they corrupted her So they're being sarcastic To put the fascination back into my science fiction twin He'll scream and shout Everything is working out just as he predicted Pride and position in the gallery of attempted people Oh and the pain is so sweet That he'll stamp his little feet And you'll even have time to pity me How can you feel content? You'll wonder where this fellow went My science fiction twin Escorted by his lovely nieces Filled up his purse dictating verse While painting masterpieces His almost universal excellence Is starting to disturb me They asked how in the world he does all these things And he answered "Superbly" He's trapped in his own parallel dimension That's why I'm so forgiving But how could I possibly forget to mention Those fifty-foot women Who put the fascination back into my science fiction twin

---------------------- Appreciation written, produced, and narrated by Remedy Robinson, MA, MFA Twitter: @slowdragremedy Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ----------------------   Elvis Costello Wiki Resource, “Glitter Gulch”: http://www.elviscostello.info/wiki/index.php/Glitter_Gulch   “Glitter Gulch”: https://www.youtube.com/watch?v=c7bZNShqoVQ   Companion Blog: https://slowdragwithremedy.home.blog/2020/05/25/episode-43-glitter-gulch/   References: Episode 4 of “Slow Drag with Remedy,” “The Hangover This Morning Had a Personality.” It’s a slow drag with “The Big Light,” another gem from “King of America”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/11158313 https://podcasts.apple.com/us/podcast/04-the-hangover-this-morning-had-a-personality/id1478037117?i=1000448878517   Episode 33 of “Slow Drag with Remedy,” “Friends Think of Her Fondly.” It’s a slow drag with “Our Little Angle,” another gem from “King of America”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/13256063 https://podcasts.apple.com/us/podcast/33-friends-think-of-her-fondly/id1478037117?i=1000466347849 “Glitter Gulch” and Vegas Vic and Vickey: https://www.stripclubconcierge.com/glitter-gulch-las-vegas/   http://vegas4visitors.com/museum/downtown-las-vegas-the-heyday-of-glitter-gulch/   The dismantling of Vegas Vickie: https://www.youtube.com/watch?v=OnQDOd1FHBc So, until next time, Adieu, my little ballyhoo     Enter Madam X painted in a shocking pink spangled dress Her teeth are perfect but her mouth is loose Rubbing their hands together she persuades them that it's better to confess Which unpleasant fate they'd like to choose Chorus:Every step might be your last Money signs are in your eyes, sucker You've been taken in this time You might just get out alive if you're lucky All the vultures tuning in to Glitter Gulch Are looking in on you / And they're hungry He stood five feet tall in his elevator shoes and stovepipe hat He was known by several different names Prompted by Madam X he answered all their questions And then after that he said I'm sick and tired of stupid games (Chorus) We've got prizes if you can afford Some small humiliation before you get your reward And I'd rather be an outlaw than an in law to you And to live my life in miserable poverty Than to have to grovel to have some dream home hovel So watch me while I get away with prime time robbery As he enters Madam X he thinks of red raged faces and the sweet greenbacks He climbed upon his honey and he covered her with money As they do their victory dance He thinks I hope they choke upon their laughter tracks We can all go straight to hell while we howl down the whole hotel

---------------------- Appreciation written, produced, and narrated by Remedy Robinson, MA, MFA Twitter: @slowdragremedy Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ----------------------   Elvis Costello Wiki Resource, “Tart”: http://www.elviscostello.info/wiki/index.php/Tart “Tart”: https://www.youtube.com/watch?v=2FnYK0Icf8E Companion Blog: https://slowdragwithremedy.home.blog/2020/05/04/episode-42-tart/ References: Episode 2 of “Slow Drag with Remedy,” “And You Only Wanted to Be Famous.” It’s a slow drag with “Alibi,” another gem from “When I was Cruel”: https://directory.libsyn.com/episode/index/show/slowdragwithremedy/id/11068049 https://podcasts.apple.com/us/podcast/02-and-you-only-wanted-to-be-famous/id1478037117?i=1000448238224 “Do You Always Use a Lip Trill on a Trumpet?”: https://www.youtube.com/watch?v=QO6ed7GuQT4 Lip Trill on a Trumpet: https://www.youtube.com/watch?v=Tyd5XyFz--k Trumpet in C – Trills, Vienna Symphonic Library: https://www.vsl.co.at/en/Playing_Techniques/Trumpet_in_C-Trills   “The Arab Seville”: https://www.visitasevilla.es/en/route/arab-seville “Orange Types: Sweet, Bitter, Mandarin”: https://harvesttotable.com/oranges_the_basics_there_are/ “Moro Blood Oranges”: https://www.froghollow.com/products/organic-moro-blood-oranges “Ashfield” meaning: https://www.houseofnames.com/ashfield-family-crest So, until next time, Adieu, my little ballyhoo   "Tart" Lyrics: Hear silver trumpets will trill In the Arabic streets of Seville Oranges roll in the gutter And you pick them up And pull back the skin To the red fruit within But the flavor is... Tart And the flavor is...Tart Is it something you crave? And you say that you only feel bitterness When you know it's a lie, lie, lie... Wild with a blackberry bush There were blossoms of cherries to crush There, at the edge of the ashfield tempting fingertips You stain your hands, press too hard They'll color your lips… Chorus: But the flavour is...  Tart And the flavour is... Tart Is it something you crave? 'Cos you say that you only feel bitterness Would it kill you to show us a little sweetness? Odd, where nothing else grows It was something like love that she chose Always a creature of habit When pity would do She wore down that heel with no feeling She kept on her shoes (Repeat Chorus) Tart And the flavour is... Tart And the flavour is... Tart And the flavour is... Tart Nylon was hung from a peg And a kohl black seam ran down her leg Fishermen look for their nets And send their regrets The bug lay there broken She spoke, "Is this some kind of joke?" (Repeat Chorus) Tart And the flavour is... / Tart And the flavour is... /Tart And the flavour is... /Tart

---------------------- Appreciation written, produced, and narrated by Remedy Robinson, MA, MFA Twitter: @slowdragremedy Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ----------------------   Elvis Costello Wiki Resource, “Clubland”: http://www.elviscostello.info/wiki/index.php/Clubland   “Clubland”: https://www.youtube.com/watch?v=1kZXYqc8IL4   Companion Blog: https://slowdragwithremedy.home.blog/2020/04/24/episode-41-clubland/   References: Episode 18 of “Slow Drag with Remedy,” “Rowdiest but Slightest.” It’s a slow drag with “Luxembourg,” another gem from “Trust”: https://podcasts.apple.com/us/podcast/18-rowdiest-but-slightest/id1478037117?i=1000457312611  How to Jerk | Club Dancing: https://www.youtube.com/watch?v=-2zA85C_d6I “The Jerk” Dance: https://www.youtube.com/watch?v=Owea_NH-6lE So, until next time, Adieu, my little ballyhoo   "Clubland" Lyrics: With a handful of backhanders and a bevy of beauty Going off limits / Going off duty / Going off the rails Going off with booty The telltales of fiction found on all the criminal types Lead to a higher-ranking man or a face with thin red stripes The boys next door The mums and dads New weds and nearly-deads Have you ever been had in Clubland? There's a piece in someone's pocket to do the dirty work You've come to shoot the pony They've come to do the jerk They leave him half way to paradise They leave you half way to bliss The ladies' invitation never seemed like this (Chorus) The long arm of the law slides up the outskirts of town Meanwhile in Clubland they are ready to pull them down Hey The right to work is traded in for the right to refuse admission Don't pass out now, there's no refund Did you find out what you were missing The crowd is taking forty winks minus ten percent You barely get required sleep to go lingering with contemptment Thursday to Saturday Money's gone already Some things come in common these days Your hands and work aren't steady (Chorus)  

---------------------- Written, produced, and narrated by Remedy Robinson, MA, MFA Twitter: @slowdragremedy Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ----------------------   Elvis Costello Wiki Resource, “Hand in Hand”: http://www.elviscostello.info/wiki/index.php/Hand_In_Hand   “Hand in Hand”: https://www.youtube.com/watch?v=_XKgrSY5Mi4   Companion Blog: https://slowdragwithremedy.home.blog/2020/04/22/episode-40-hand-in-hand/   References: Episode 20 of “Slow Drag with Remedy,” “Now It’s Much Too Dangerous.” It’s a slow drag with “Living in Paradise,” another gem from “This Year’s Model”: http://slowdragwithremedy.libsyn.com/website/20-now-its-much-too-dangerous Guardian: Songs that start with the chorus: https://www.theguardian.com/music/2018/mar/22/readers-recommend-playlist-songs-that-start-with-the-chorus Quora list of songs that start with the chorus: https://www.quora.com/What-are-some-examples-of-songs-that-begin-with-the-chorus Bully Boy Idiom: https://www.collinsdictionary.com/dictionary/english/bully-boy “Darling Fascist Bully Boy” from “The Young Ones: https://www.youtube.com/watch?v=VbOlJAU8llY So, until next time, Adieu, my little ballyhoo   "Hand in Hand" Lyrics: No, don't ask me to apologize. I won't ask you to forgive me. If I'm gonna go down, you're gonna come with me You say 'Why don't you be a man about it, like they do in the grown-up movies?' But when it comes to the other way around, you say you just wanna use me. Oh, you sit and you wonder whether it's gonna be syndicated. You sit with your knees together. All the time your breath is baited. Hand in Hand. No, don't ask me to apologize. I won't ask you to forgive me. If I'm gonna go down, you're gonna come with me Don't you know I got the bully boys out changing someone's facial design, sitting with my toy room lout, polishing my precious china Don't you know I'm an animal? But don't you know I can't stand up steady? But you can't show me any kind of hell that I don't know already. Hand in Hand. No, don't ask me to apologize. I won't ask you to forgive me. If I'm gonna go down, you're gonna come with me Hand in hand, hand in hand, hand in hand...

What we're dealing with right now on a global scale is a wide range of emotions that largely come down to....grief.   This is obviously complex on so many different levels, but ultimately we're grieving in all kinds of different ways. The grief of normalcy.  The grief of our old routines and lives.  The grief of being separated from loved ones, human touch, and everyday interactions we've always taken for granted.  The grief of our entire lives being put on hold.  The grief of the financial losses, the fear, the overwhelm, loneliness, loss of connection, and the cancelled plans.  The grief of relationship that are potentially ending (both romantic and otherwise) that may not survive this situation, as it is times like this that can often bring out the true colours of people.  And that doesn't even begin to cover the grief of front line workers, nor the families of anyone who doesn't survive this virus.  This shit is really, really hard.  Global pandemics don't come with emotional guidebooks on how to deal with what's being thrown at us right now, made worse by the fact that no one has an exact end date for this, which makes it infinitely harder to manage when you're in the thick of things.   Here's the good news: we're in this together.  We will get through this together, and we will hold each other up to make it through to the other side.   Let's talk.    REFERENCES Episode #102 Practicing the Pause & Examining What We Tolerate with Tory Eletto Episode #35 Empowerment, Grief & Letting Go of Expectations with Athena Concannon   Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY

---------------------- Written, produced, and narrated by Remedy Robinson Twitter: @slowdragremedy Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ---------------------- Elvis Costello Wiki Resource, “Satellite”: http://www.elviscostello.info/wiki/index.php/Satellite “Satellite”: https://www.youtube.com/watch?v=TCj1Fgj28i8 Companion Blog: https://slowdragwithremedy.home.blog/2020/04/12/episode-39-satellite/ References: Episode 10 of “Slow Drag with Remedy,” “If Killing Anybody is a Terrible Crime.” It’s a slow drag with “Let Him Dangle,” another gem from “Spike”: https://podcasts.apple.com/us/podcast/10-if-killing-anybody-is-a-terrible-crime/id1478037117?i=1000452426652 When the WWW opened to the public: https://thenextweb.com/insider/2011/08/06/20-years-ago-today-the-world-wide-web-opened-to-the-public/ Unmask Us: an explanation of Spike songs: https://www.unmask.us/songwriters-c-e/elvis-costello-p3/ 1989 interview with Spin Magazine: https://www.spin.com/featured/elvis-costello-spike-may-1989-cover-story-the-man-who-would-be-king/ So, until next time, Adieu, my little ballyhoo "Satellite" Lyrics She looked like she learned to dance from a series of still pictures She's madly excited now, she throws her hands up like a tulip She looks like an illustration of a cocktail party Where cartoon bubbles burst in the air Champagne rolls off her tongue like a second language And it should have been her biggest night The satellite looks down on her as she begins to cry All over the world at the very same time, people sharing the same sorrow As the satellite looks down, her darkest hour is somebody's bright tomorrow He pulled on a cigarette, in the crook of his first finger Felt the static electric charge of her perfect hour-glass figure As he undressed her with his eyes, her weakness was his talent How could she know as she stepped through the lights  That her dress would become transparent And with his face pressed to the screen, He muttered words he'd never dare to say if she could see him All over the world at the very same time, people sharing the same cheap sensation The thrill of watching somebody watching those forbidden things we never mention The satellite looks down right now and forever What it is pulled apart, let no man tether his own body to his dream, His dream is someone else Oh no, oh no. She went back to a pitiful compromise He'd go back to his family But for the matter of a thousand miles that separated them entirely In the hot unloving spotlight, with the secrets it arouses Now they both know what it's like inside a pornographer's trousers And in a funny way it's anonymous The satellite, it blesses us and makes these dreams come true All over the world at the very same time All over the world The satellite looks down right now and forever What it has pulled apart, let no man tether his own body to his dream, His dream is someone else Oh no, oh no Oh no, oh no

FIRST UP: I’ll be going live on Instagram & Facebook every single day at 8am ET until the global pandemic / quarantine / isolation is over, whenever that may be. Each day has a different theme, and overall the idea is to create more connection in a time we desperately need it more than ever as we are physically isolated. Please join me – and so far we’ve been managing to have some laughs, and the lives are getting spicier by the day! We’re covering everything from online business, podcasting and entrepreneurship to mental health and figuring out how to manage life in these uncertain times.  See you at 8am ET! I never thought this would be a topic I'd have to cover, but we're talking being single in the age of a global pandemic today, and all of the unique challenges that brings. My dear friend Steph Connolly is the most amazing human.  She's empathetic, brilliant and wise, and she posted an IGTV video last week about some of the issues that have come up for her with all of this and it was so well done that I knew we needed to have a chat about it to share with you! Steph is an ex specialist teacher and educational consultant, who decided to stop chasing the happiness dream and create her reality now. Currently working as an online business coach specialising in messaging, frameworks and offers - creating clarity and confidence to communicate effectively.  Steph's natural warmth radiates throughout, and she's so incredibly open with us on today's episode.  Her wicked sense of humour is on full display as she walks us through some real-life scenarios she's been dealing with that we never could have dreamed would be a challenge compared to "normal" life. We're talking: Relationships, loneliness & dating - when you can't physically go near potential partners Whole new levels of trust issues and trying to break down emotional walls under very unique circumstances Getting creative about talking to people right now and why communication has NEVER been more crucial Finding comfort in the unknown Life as a digital nomad and offering a different perspective around some of the judgements that come with that I'm pumped for you to meet Steph! HOMEWORK ASSIGNMENT: Make a list of your boundaries, prettify them in Canva and save them to your phone. CONNECT WITH STEPH Instagram: @steph.connolly   REFERENCES Episode #117, The 9 Year Affair: Lessons in Infidelity Overheard in Canggu Instagram: @overheard_in_canggu   Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY  

---------------------- Written, produced, and narrated by Remedy Robinson Twitter: @slowdragremedy Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ----------------------   Elvis Costello Wiki Resource, “The Greatest Thing”: http://www.elviscostello.info/wiki/index.php/The_Greatest_Thing   “The Greatest Thing”: https://www.youtube.com/watch?v=dAizlY5yzd8   Companion Blog: https://slowdragwithremedy.home.blog/2020/04/05/episode-38-the-greatest-thing/   References: Episode 11 of “Slow Drag with Remedy,” “Blow the Whistle on the Whole Design.” It’s a slow drag with “King of Thieves,” another gem from “Punch the Clock”: https://podcasts.apple.com/us/podcast/11-blow-the-whistle-on-the-whole-design/id1478037117?i=1000452881853 http://slowdragwithremedy.libsyn.com/website/slow-drag-with-king-of-thieves      So, until next time, Adieu, my little ballyhoo   "The Greatest Thing" Lyrics: Everyone stopped when she walked into the room Isn't this the greatest thing Everyone own up but nobody could touch her Isn't this the greatest thing Punch the clock, keep boxing clever You'll be young enough forever Isn't this the greatest  Isn't this the greatest thing Isn't this the greatest thing The greatest thing I heard some new confection Said we can't afford to feel affection 'Cos it's the latest thing In and out of matrimony Never once removed the Sony 'Cos it's a status thing So girls like that above described Are not to be so easily bribed With a white frock and a ring Punch the clock and in time you'll get pulled apart When you're married on paper and not in your heart But I won't be told that life with the one you love is sordid Just because some authority says you can't afford it And it's the greatest thing, and it's the greatest thing And it's the greatest thing, and it's the greatest thing Oh, it's the greatest Isn't this the greatest thing Isn't this the greatest thing The greatest thing Since nights were long and days were olden Woman to man has been beholden But since then times have been changing She sends back his tribute of a rose And says this ring is better suited to the nose you're always fingering I punch the clock and it's OK I know a girl who takes my breath away And it's the greatest Isn't this the greatest thing Isn't this the greatest thing The greatest thing, the greatest thing...

FIRST UP: I’ll be going live on Instagram & Facebook every single day at 8am ET until the global pandemic / quarantine / isolation is over, whenever that may be. Each day has a different theme, and overall the idea is to create more connection in a time we desperately need it more than ever as we are physically isolated. Please join me – and so far we’ve been managing to have some laughs, and the lives are getting spicier by the day! We’re covering everything from online business, podcasting and entrepreneurship to mental health and figuring out how to manage life in these uncertain times.  See you at 8am ET!   Alea Lovely is a energy coach, medium and card reader that hosts the up and coming podcast “Spiritual Shit: Your guide to the down and dirty of modern spirituality.” I had the pleasure of meeting Alea at a birthday dinner in Bali for a mutual friend and was immediately drawn to her energy and bright personality.  She described herself as an energy worker (which is a relatively common phrase in Bali) and because I sensed she was someone I wanted to connect with, I immediately booked a session with her.  It wasn't until after I booked it that I realized she was also a medium, and got a little nervous, ha!   Not my usual type of activity and with no idea what to expect, I was fairly nervous heading into my session with her.  And yet Alea made me feel completely comfortable and I left our session feeling so much lighter, empowered, and fully supported.  My entire experience was incredibly moving and Alea held space for me such an amazing way that I've been referring people to her ever since! This interview is going to give you some insight on: What a session with Alea is like, and some of the things that she covered with me in my own session, how it helped me move through some major mental blocks and some of the mind blowing aspects of the whole situation Fear, overwhelm, managing your consumption on information, especially during this difficult time.  Navigating the minefield of judgement from others. Loving yourself through the fear Taking on everyone else’s stuff as an empath or anyone sensitive to the energy of others Being observant of how you’re feeling and introspective in this time of quiet The fact that everyone can be intuitive    This was SUCH a fun episode to record and I can't wait for you to meet Alea!    CONNECT WITH ALEA Website Instagram @thelovelyalea Spiritual Sh*t Podcast   REFERENCES Episode #116, Reiki, the Healing Power of Energy & Protecting Yourself with Kim Schweitzer Episode #139, The Transformative Power of Breathwork with Sara Silverstein   Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY

FIRST UP: I’ll be going live on Instagram & Facebook every single day at 8am ET until the global pandemic / quarantine / isolation is over, whenever that may be. Each day has a different theme, and overall the idea is to create more connection in a time we desperately need it more than ever as we are physically isolated. Please join me – and so far we’ve been managing to have some laughs, and the lives are getting spicier by the day! We're covering everything from online business, podcasting and entrepreneurship to mental health and figuring out how to manage life in these uncertain times.  See you at 8am ET!   It's never been more important to tune into your intuition as an entrepreneur, and learning how to figure out when and how your body is talking to you is a very important practice in a noisy world.  One reason this is extra important right now is because the type of adversity that we're dealing with at the moment is something that will actually breed creativity in the longer term, and I want you to be very protective of those ideas as they come to you.  Whenever some sort of new idea comes to us, it's so easy for fear to get in the way of taking it to the next level.   Our brains want us to stay comfortable, and that means that negative thoughts will enter our heads nearly immediately.  Or, we might share new ideas with people close to us and they may offer criticism or feedback that can crush a new idea before it ever even takes off.   I'm giving you some homework from this episode that's going to help you keep on track and take action on those big, incredible ideas as they come to you!  Let's dive in.    REFERENCES Episode #117, The 9 Year Affair: Lessons in Infidelity Episode #120, Listening to Your Intuition & Gut Instinct: Stop Ignoring Your Body Big Magic: Creativity Living Beyond Fear, by Elizabeth Gilbert   Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY

Written, produced, and narrated by Remedy Robinson Twitter: @slowdragremedy Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ----------------------   Elvis Costello Wiki Resource, “A Voice in the Dark”: http://www.elviscostello.info/wiki/index.php/A_Voice_In_The_Dark   “A Voice in the Dark”: https://www.youtube.com/watch?v=k-CJTZMKh7E   Companion Blog: https://slowdragwithremedy.home.blog/2020/03/27/episode-37-a-voice-in-the-dark/   References: Episode 16 of “Slow Drag with Remedy,” “I Might Recite a Small Prayer.” It’s a slow drag with “Bedlam,” another gem from “National Ransom”: https://podcasts.apple.com/us/podcast/16-i-might-recite-a-small-prayer/id1478037117?i=1000456392629 Episode 17 Supplement of “Slow Drag with Remedy,” “The Quickening Art” https://podcasts.apple.com/us/podcast/17-the-quickening-art/id1478037117?i=1000456956290 A slow drag with Live solo performance of “A Voice in the Dark,” with “Pennies from Heaven” Prelude: https://www.youtube.com/watch?v=Szu-y3n9ubg Elvis Costello in Isolation: https://www.youtube.com/watch?v=nfXyl0fBcTY&feature=youtu.be      So, until next time, Adieu, my little ballyhoo   "A Voice in The Dark" Lyrics: You can read right through a book of matches But that won't make you smart You can laugh in the face of watches But time will only break your heart Kings reign beneath umbrellas Hide pennies down in cellars And money pours down and yet Not everyone gets soaking wet When bores and bullies conspire To stamp out your spark Listen for… A Voice In The Dark Not a moment too soon as we blue the moon And a wolf began to howl in tune I announced for all mankind / A boon Stand aside you big baboon Now I'm the a prize invention You're the image of yourself Forget your cares your disapproving stares I'm not here to try to jump your borders Just ask your nieces and daughters I'm flat as sole, I'm happy as a clam But you don't know the kind of man I am Little fish swimming in a jealous shoal Now my net is overflowing And suddenly I seem to be all seeing and all knowing I got something right there You might want to hear I have no fear Lend a hand / Lend an ear If your rent-money is in arrears We'll be striking up a symphony bandstand Long of hair and loose of tooth There'll be pirouettes and startling handstands And who but acrobats know how to tell the truth When all is said and then redundant They gallivant in peg-leg pants I‘ll be your servant You'll be my pal and I'll be faithful you know I shall There's no fool like an old fool Who blames it all upon his youth When times are tough and you find you're down Without a star to wish upon Listen for… A Voice In The Dark I was striking through a box of matches Hoping that one would spark I heard somebody calling to me A voice in the dark A voice both wild and gentle Daring and confidential I thought there was music playing But it was all and only talk When liars and bullies conspire to stamp out spark Fill up that empty space in your heart Listen up as the herald says, "Hark" Believe in the voice in the dark…

Written, produced, and narrated by Remedy Robinson Twitter: @slowdragremedy Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ----------------------   Elvis Costello Wiki Resource, “Miracle Man”: http://www.elviscostello.info/wiki/index.php/Miracle_Man   “Miracle Man”: https://www.youtube.com/watch?v=O2Jso4D-caQ   Companion Blog: https://slowdragwithremedy.home.blog/2020/03/15/episode-36-miracle-man/   References: Episode 22 of “Slow Drag with Remedy,” “And His Castanets.” It’s a slow drag with “Waiting for the End of the World,” another gem from “My Aim is True”: https://podcasts.apple.com/us/podcast/22-and-his-castanets/id1478037117?i=1000459634912   “Baseball Heroes” Lyrics: http://www.elviscostello.info/wiki/index.php/Baseball_Heroes “Baseball Heroes”: https://www.youtube.com/watch?v=m5oELSntnpQ “Miracle Man” (Flip City version) lyrics: http://www.elviscostello.info/wiki/index.php/Miracle_Man_(Flip_City_version) An excellent stroll through the past before many of these songs found a final home, Flip City Demos: https://www.youtube.com/watch?v=zL64vJLMIf4   So, until next time, Adieu, my little ballyhoo   "Miracle Man" Lyrics: You never asked me what I wanted. You only asked me why. I never thought that so much trouble was restin' on my reply, I could say it was the nights when I was lonely and you were the only one who'd talk. I could tell you that I like your sensitivity, when you know it's the way that you walk. Why do you have to say that there's always someone who can do it better than I can? But don't you think that I know that walking on the water won't make me a miracle man? Baby's gotta have the things she wants. You know she's gotta have the things she loves. She's got a ten-inch bamboo cigarette holder and her black patent leather gloves. And I'm doing everything just tryin' to please her, even crawling around on all fours. Oh, I thought by now that it was gonna be easy, but she still seems to want for more. (chorus) I hear they're givin' you a bad reputation just because you've never been denied. You try to say you've done it all before. Baby, you know that you just get tired. But  everybody loves you so much, girl. I just don't know how you stand the strain. Oh, I, I'm the one who's here tonight, and I don't wanna do it all in vain.

---------------------- Written, produced, and narrated by Remedy Robinson Twitter: @slowdragremedy Email: slowdragwithremedy@gmail.com Podcast music by https://www.fesliyanstudios.com Rate this Podcast: https://ratethispodcast.com/slowdrag ----------------------   Elvis Costello Wiki Resource, “Turpentine”: http://www.elviscostello.info/wiki/index.php/Turpentine   “Turpentine”: https://www.youtube.com/watch?v=Wpd-wd4ZqfQ   Companion Blog: https://slowdragwithremedy.home.blog/2020/03/08/episode-35-turpentine/   References: Episode 7 of “Slow Drag with Remedy,” “Let’s See How Brave You Are.” It’s a slow drag with “No Hiding Place,” another gem from “Momofuku”: https://podcasts.apple.com/us/podcast/07-lets-see-how-brave-you-are-when-im-about-this-far/id1478037117?i=1000450581432  Momofuku name and restaurant history: https://momofuku.com/our-company/team/   So, until next time, Adieu, my little ballyhoo   "Turpentine" Lyrics:  I can't tell if this is real or if I am sleeping I'll embroider the truth And that's so I shall reap I took things that didn't belong to me I didn't mean to do you wrong   Looking back on all that stolen time (turpentine) Back when I was drinking turpentine Don't blame me / I only took you in It takes time to do the poisoning So let's close the door on this and lock it   And that's all it will ever be Just an accident of chemistry   You did everything to me but stopped short of murder Couldn't move me much closer to keeping my word While the crowds threw stones at the hangman The sky fell down / The bells rang   Looking back on all that stolen time (turpentine) Back when I was drinking turpentine Don't blame me / I only took you in It takes time to do the poisoning So let's close the door on this and lock it And that's all that it will ever be Just an accident of chemistry   Airless shaft of an underground railway Effete assassin with a hawk in a sack The earth will offer us in when our hearts fail As it swallowed the river running under the track Under the track yeah   I can't tell if I'm dreaming or if I'll awaken With a song in my heart that is longing to break Let it out and let it fly high Up where the spires scrape the sky   Looking back on all that stolen time Back when I was drinking turpentine Don't blame me / I only took you in It takes time to do the poisoning So let's close the door on this and lock it   And that's all that it will ever be Just an accident of history Yeah   Airless shaft of an underground railway Cute assassin with a hawk in a sack The earth will offer us in when our hearts fail Swallowed the river running under the track That's right

When we hear that someone is dating or married, one of the first questions we usually ask is, "how long have you been together?" I LOVED it when people would ask me that when I was in a relationship with my previous partner.  I was validated by their reaction when I could tell them how many years we had been together.  Although we now know that relationship turned out not to be quite as solid as I thought it was. #The9YearAffair Ultimately, we tend to attach too much relevance to length of time as opposed to really getting clear about the health of a relationship and defining it based on qualities that often have very little to do with time. “You can meet someone who has better intentions for you than someone you’ve known forever. Time means nothing, character does.” -unknown We need to change the questions we ask others and ourselves around what qualifies as "success" when it comes to relationships.  This applies to ALL relationships, whether it's friendships, business partnerships or acquaintances.  Time isn't what matters most.  It's love, connection, and a willingness to grow and have a LOT of uncomfortable conversations.  We can start with this uncomfortable conversation.  Tune in and listen!  REFERENCES Episode #117, The 9 Year Affair: Lessons in Infidelity Episode #124 Affair Aftermath & Holding Space for a Friend in Crisis with Christina Montalvo Episode #108, How to Set Boundaries: The Key to Healthy Relationships Episode #93, Choosing Your Family & Establishing Healthy Boundaries   Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY

I'm so excited to have today's guest Stephanie Kwong on the podcast today! Stephanie Kwong is a Mindset Mastery Coach, Hypnotherapist and Host of the Rise Higher Podcast. She supports high achievers to identify and remove mental and emotional roadblocks, and redesign their subconscious mind to achieve their next level through hypnosis, breathwork, subconscious reprogramming, and other techniques to master their mind and elevate their energy. Through subconscious reprogramming, her clients effortlessly achieve the results they want personally, professionally and financially.  Her clients shift from a life of limitation and stress to one of joy and freedom. Stephanie’s Self-hypnosis Mastery online course, BELIEVE, shows you how to partner with your subconscious mind to reprogram your beliefs so you can manifest your dream life and have it all. Stephanie is also a teacher of self-love. Her 40 Day Self-Love Transformation online program shows the ‘how’ of self-love, and has thousands of students around the world develop a more loving relationship with themselves to experience greater happiness, inner peace and fulfillment. Her deep passion is to empower people to transform their lives and to turn their dreams to reality by aligning their inner world to the outer results they want to create. Having recently been working through some of my own personal blocks and mindset shifts, it seemed particularly timely that Stephanie and I crossed paths recently at an event in California, and I'm grateful we were able to make this episode happen. This podcast is diving into: What hypnotherapy actually is and what it is NOT: we have a very different idea of what we believe hypnotherapy to be The unconscious beliefs we all hold that are usually established as very young children Weaving self love into our everyday life, because many of us (including me) can be so hard on ourselves Examining manifestation on an energetic level The relationship between our parasympathetic nervous system and our ability to manifest Using breath work as a tool to calm the nervous system and open us up to releasing old beliefs that are no longer serving us There is incredibly powerful information in this episode that can allow you to begin shifting long-held beliefs that are blocking us from reaching the levels we can sense we are meant to achieve. Can't wait for you to tune in!    CONNECT WITH STEPHANIE Website Instagram: @iamstephaniekwong BELIEVE: Self-hypnosis Mastery Course 40 Day Self-Love Transformation Course   REFERENCES Episode #139, The Transformative Power of Breathwork with Sara Silverstein Episode #120, Listening to Your Intuition & Gut Instinct: Stop Ignoring Your Body Episode #110, Emotional Mastery: Becoming the CEO of our Brains with Omozua Isiramen Episode #19, Re-Programming Your Brain for Habit Change with Elizabeth Sherman   Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY

Most women experience a lot of pressure to get married and have children by a certain age. The truth is that there are many benefits in being single, and if you’re only focused on pursuing marriage, you can miss them.Debunking myths about single hood:Myth #1: Marriage is a reward for good behavior in single hood. The reality is that marriage comes with its own set of troubles and challenges. Even healthy marriages have their downsides.Myth #2: Single hood is a negative thing and single women must have something wrong with them. Single hood is not punishment for being promiscuous or not going to church. Many churches in particular have done a terrible job of shaming single women for their singleness, and that needs to change.Myth #3 (Unpopular opinion): I'm concerned about the narrative that says you need to spend years “preparing to be a wife.” Premarital counseling and books are important, but be careful not to base your whole identity on whether you get married or not. That kind of message comes dangerously close to idolatry.It’s not wrong to desire marriage. You can “be content in your singleness” while still desiring a husband. You just need to keep that desire in its proper place.5 Things to Focus On When You're Single 1. Spend time with God.Singles are able to fully devote themselves to God. Married people, in contrast, are focused on each other---“their interests are divided” (1 Corinthians 7:32-35).Paul argues that single hood is actually a gift, and it’s his personal preference for everyone (1 Corinthians 7:7).Again, it’s okay to desire marriage, but don’t make it an idol. If all your prayer time is spent asking for a husband, there’s a problem.2. Heal from the trauma in your past.The earlier you heal from your mental and emotional baggage, the less likely you are to bring them into your marriage.3. Get clear about your calling.You are a whole, complete person with a whole entire calling outside of your future husband. It's good to support your husband, but don't dismiss your own dreams and God-given purpose just to focus on his.4. Invest in your relationships, especially friendships. Friendships provide support, encouragement and accountability, which is even more important in singlehood.5. Do something that helps your community.Serving helps you maintain gratitude and avoid obsessing about your own needs.Action Step: Choose one of the 5 suggestions mentioned in this episode and focus on it for the next 30 days.References:Episode 2: “Purpose, Calling, Assignment: What’s the Difference?”Episode 5: “5 Questions to Help You Discover Your Calling”

This phrase floats around a lot in the personal growth / mindset / mental health world about "doing the work." But it's an incredibly abstract concept, and I've found myself have moments of wondering what the hell it even means.  What's involved? What do I have to do?  I'm prepared to "do the work" but someone tell me where to start! It's weird. So I want to break this down a little bit more for you with everything I've learned about "doing the work" to move through issues, to grow and evolve, and to take yourself to the next level rather than holding yourself back and staying stuck. (and no, the answer is NOT always to journal and meditate.  So don't worry, that's not going to be what I dump on you here) It's going to help you move past old hurts or wounds where we've unconsciously created thoughts or behaviours that may not be serving us. The answers are within you.  But sometimes you need to do some digging to uncover them. What I want you to remember most: We will ALL always have work to do. There will always be more to learn, more to grow from This isn’t an end game or a destination to be reached permanently.  It’s a journey. Let's do this - bring a notebook and get ready.   REFERENCES Episode #183, It's OK to Be Angry: Breaking Down a Misunderstood Emotion Episode #108, How to Set Boundaries: The Key to Healthy Relationships Episode #93, Choosing Your Family & Establishing Healthy Boundaries Episode #116 Reiki, The Healing Power of Energy & Protecting Yourself with Kim Schweitzer Atomic Habits,by James Clear   Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY

It's the age-old question in this fast-moving world: how to get more done? This episode is more about maximizing the time that you do have to leave room for space to do the things you love most, to spend time with the people you adore and to use your energy in the best possible ways. Because that to-do list isn't what your entire day should consist of all the time, and *especially* if you're a business owner, it's likely that you got into this whole thing for more freedom, am I right?  How free do you feel right now?  If you're reading this, I'm guessing you're looking for some sort of magic pill that will make your life simpler and easy to manage.  While I can't promise that, what I CAN promise is that you'll walk away after listening with a number of tools to start implementing that will make your day flow, keep you on task, and produce better results than the system you likely have in place right now.  We're covering:  Getting to know yourself well enough to figure out when your most productive times of day are Auditing your time How to accomplish tasks faster and with more ease, creativity and joy Determining where your energy is and staying in your zone of genius Gettingsuper clear on your dial-moving activities.  The ones that will propel you forward closer to your goals, rather than wasting time on the small stuff.  I'm excited to share this one! Let's hop to is ;)   REFERENCES Episode #90, How to Sleep Like a Boss with Christine Hansen Social Triggers: Why You Need to Take Breaks   Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY

Here's what I want you to know before we get into anything else: there are no 'bad" or negative emotions.  Any emotion that you can experience is normal, human, and completely OK.   Anger is one of those emotions we can tend to believe should be avoided at all costs, and that's one of the myths that we're going to get into on this episode.  Something else to know is that anger is often masking other more deeply felt emotions such as fear, sadness, grief, embarrassment or disappointment. Often, that can be much harder to come to terms with depending on the root of those emotions. We're covering: What to pay attention to when you can feel yourself getting angry and how to start feeling where anger shows up in your body How to know when your anger is becoming unhealthy Why anger is often shining a light on a part of ourselves that we need to address on a deeper level Identifying common threads that come up when you experience anger, whether it's people, environment or circumstances How anger can help us better determine our boundaries Anger can fuel and motivate positive change   REFERENCES Episode #117, The 9 Year Affair: Lessons in Infidelity Episode #108, How to Set Boundaries: The Key to Healthy Relationships The Anger Iceberg, by the Gottman Institute    Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY

First up: if you're a biz owner and you've ever even considered starting a podcast or feel left behind as you watch those around you build powerful connections, grow their businesses and get their voice heard in the podcasting world, my course Podcasting for Impact™ is available for a very limited time.  Doors close first week of February! You have unique stories and experiences that others need to hear.  Join now to get a jump start on those big goals of yours and stop feeling like you're sitting on the sidelines.   Onto the episode... If you're feeling like you've "fallen off the wagon" a month into the new year, this episode is for you. (This is also why I don't recommend making BS New Years resolutions, but I digress) I believe people are capable of change.   It's not to say that everyone *does* change, but I think that fundamentally we as human beings have the capabilities to change and become better versions of ourselves.  But this can present a few different issues.   For one thing, we often doubt our own abilities to change or get so comfortable believing ourselves to be one way, that we box ourselves in and never even allow ourselves to grow and evolve in the ways that we could.  And then even if we do change, it often makes people around us uncomfortable.  They're used to use being one ways, and changing that means that we're altering the rules of the game without their permission.   We all do this.  We create a version of someone in our heads based on the knowledge and past experiences we have with them, and it can be quite jarring to realize that they are someone else, even if it's for the better. I'm here to remind you that you don't have to be who you were.  You don't have to be the exact same person you once behaved as. Think about who you were 10 years ago and how much you have grown and evolved in that time, and you probably do things or have developed habits or skills that you never would have believed possible back then.  If you met someone from 10 years ago for the first time today, they would be meeting someone completely new in many ways.  And how they react to that new version of you is not your responsibility.     REFERENCES Episode #146, Positive Reinforcement Might Be Doing More Harm Than Good Episode #163, Aligning Values Over Goals Episode #59, The Anti-Resolution Way to Accomplish Goals That Don’t Suck New Year, Same You: Reflections Over Resolutions   Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY

We're living in one of the most polarizing moments of human history.  Everyone has access to more information than ever, everyone has an opinion, and many of us are actually less likely to have our minds changed even when presented with new information on various topics than ever before. Being dead-set in our beliefs without the willingness to explore other options, opinions and educating ourselves on the opposite of what we currently believe is a very one-dimensional way of living, and makes it difficult to have empathy or compassion. We allow everything from our natural instinct towards confirmation bias to simply not wanting to hear a differing opinion get in the way of opening ourselves up to explore new ways of thinking, and examining situations from entirely different angles than the one we tend to take most often.  We're going to be discussing: Some examples where we can not only get stuck in our own dogma, but end up having a VERY different opinion or changing our minds once we live through a situation that previously seemed unthinkable. Developing greater compassion and empathy Noticing how we justify our own beliefs and opinions, even in the face of information that proves us wrong The moral & ethical code that governs being a human being, along with the feelings and emotions that are such an incredible gift and allow us to better understand another's opinion, situation or circumstances.  And to wrap things up, I'm giving you 6 ways (plus a bonus 7th!) to move past thinking in black and white terms, and to instead get used to the very uncomfortable exploration of the grey area. Put yourself in someone else’s shoes Question yourself.  Ask if what you believe is 100% true, no matter ANY circumstances.  Acknowledge your priviledge.  Many times we make decisions from a place that doesn’t even take into consideration the gifts we are given simply by the colour of our skin, the country and/or neighbourhood we live in, the job we have, the money in our bank account, and countless other factors that play an enormous role impacting our daily lives, and yet we take them for granted because we’ve never known any differently. There are people who have to take an entirely different view on the same issue as you out of necessity, not out of choice.  Understand that someone else believing something different than you doesn’t necessarily make them wrong.   You can accept that someone else has a different belief than without needing to believe the same as them.  Don’t be so arrogant to assume you have all the answers, and realize that you will naturally believe what you WANT to believe.   BONUS: Listen more than you speak.    REFERENCES Episode #117, The 9 Year Affair: Lessons in Infidelity Episode #126, Forgiveness is Earned, Not Found: Doing the Inner Work   Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY

First brand new episode of 2020 after taking a few weeks off while airing best-of episodes from 2019, and I'm pumped! Today is a bit of a bonus episode, because I'm announcing some changes coming to the podcast and wanted to fill you in the details around why I'm making some shifts, give you a behind-the-scenes look at what's been happening over here from a business and marketing standpoint, and explain the reasons behind some of the changes.   Not only do I always commit to showing up in an honest and transparent way, which is why I wanted to let you in on why I'm making some of these changes, but I want you to take under consideration some of the things I'm going to be discussing today for your own business as well. Something that can be easily forgotten when it comes to running a biz is managing your own energy in a really significant way, and I don't know about you, but this seems to be a constant learning curve for me.  Just when I think I've thoroughly learned lessons on how to manage my energy and how much I'm pouring into my business, I learn another lesson that changes things yet again. Today we're talking: Why you deserve to be paid for your knowledge and expertise Restoring the balance between free content and paid What to do when you can feel yourself becoming resentful of your business, your clients, or some aspect of you biz and what that means you might need to do instead How taking a step back and giving yourself some breathing room and space can MASSIVELY increase your creativity in the most beautiful, organic way Quality > Quantity and maintaining the integrity of your greater purpose Getting hyper-clear on your priorities, going big-picture, and focusing in on the things that will move you closer towards those big goals I'm really excited about the changes, and most of all, I'm looking forward to your feedback!  Please reach out to me at info@emilygoughcoaching.com or DM me over on Instagram @emilygoughcoach to let me know what types of content you're loving the most, what you might like to see less of, and how I can better support you, especially with this podcast. Most of all, thank you for tuning in week after week.  It means more to me than I'm able to even express, and allowing me to do something that I love is an incredible gift that I never want to take for granted, I'm so grateful.    **Want to start a podcast, or even thinking about how you might get started?  You need to grab this Podcasting Checklist & Tutorial I created after MANY requests!   REFERENCES Episode #125, Re-Purpose That Sh*t: Stop Being a Content Creation Machine   Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY & THURSDAY

OPEN FOR ENROLLMENT: PODCASTING FOR IMPACT: The Course. If you’ve been on the fence about starting a podcast for months or even years and feeling unsure about how to get started, worried about everything from editing and cover artwork to what you would talk about or if anyone would even listen, this course is for you. Learn how to start the kind of podcast that gets people talking.  Because your voice can have a massive impact beyond anything you can imagine. All the details here!   Being decisive matters to your success. It requires confidence to make a decision, to take a step forward, take action and build momentum. It also gives others confidence in your abilities, because f you can’t make up your mind about anything or trust your own judgement enough to make a decision, how do you expect anyone else to do the same?  Being decisive doesn’t mean you can never make a different choice, either.  It means that you trust yourself to make the best decision with the information at hand, and when the time comes that that particular decision is no longer working for you, then you can make a different one.  In this episode we're talking about how to get better at making decisions, why it's so important to your success in life, and making the choice to trust your own instincts.  “In any moment of decision, the best thing you can do is the right thing. The worst thing you can do is nothing.”  ― Theodore Roosevelt   REFERENCES Episode #120, Listening to Your Intuition & Gut Instinct: Stop Ignoring Your Body   Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY, THURSDAY & SATURDAY

OPEN FOR ENROLLMENT: PODCASTING FOR IMPACT: The Course. If you’ve been on the fence about starting a podcast for months or even years and feeling unsure about how to get started, worried about everything from editing and cover artwork to what you would talk about or if anyone would even listen, this course is for you. Learn how to start the kind of podcast that gets people talking.  Because your voice can have a massive impact beyond anything you can imagine. All the details here!   Want to know the big secret behind the people you see growing their businesses, expanding their reach and accelerating their growth? It's collaboration.  When you open yourself up and put in the effort to join with others, everyone wins.  It's why things like masterminds have become so popular, and in an age when we're feeling rather disconnected, that collaboration goes a long way on a personal level too.   This episode is exploring the various ways you can collaborate with others including examples of how I've done that in my own business, specific things you can do to create more connections and build relationships that can lead to collaborations, and what not to do when it comes to reaching out. Tune in for all the details!   REFERENCES Episode #144, [BIZ TIPS] How An Awkward Introvert Makes Friends Around the Globe Episode #143, Impact, Optimism & Chasing the Bright Side with Jess Ekstrom Episode #24, Victim Mindset with Christina Montalvo Episode #43, The Art of Maintaining Friendships with Christina Montalvo Episode #79, How Your Money Mindset is Holding You Back From More Success with Christina Montalvo Episode #88, Save the Drama for Your Mama with Christina Montalvo Episode #98, Bridezilla: Our Unconventional Thoughts on Weddings & Showers with Christina Montalvo Episode #104, The Tall & Short of It: How Your Height Changes Your Experience in the World with Christina Montalvo Episode #112, Navigating Entrepreneurship: What Doesn’t Get Shared Publicly with Christina Montalvo Episode #124, Affair Aftermath & Holding Space for a Friend in Crisis with Christina Montalvo   Want to join the conversation or connect with Emily?  Connect below!  CONNECT WITH EMILY Instagram @emilygoughcoach info@emilygoughcoaching.com Emily Gough Coaching Room to Grow Podcast Facebook: @ Emily Gough Coaching   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com BRAND NEW EPISODES EVERY TUESDAY, THURSDAY & SATURDAY

A lot of personal finance advice is geared toward married couples, but single women have their own struggles with money that need to be addressed. This episode is designed to do just that, and in a way that doesn't have to be intimidating or overwhelming.Disclaimer: I am not a financial advisor or CPA. The details of this podcast are shared for informational purposes only. Please seek assistance from a certified finance professional who can help you with your unique situation.1. Set a monthly budget and stick to it.There are a lot of excellent budgeting apps out there, but I personally recommend the following: Every DollarYNABMintAll of these apps link to your bank account and encourage you to assign a job to every dollar that comes into it. They also make it easy for you to set and reach short-term financial goals.2. Find a reliable accountability partner.This should be someone you can trust with your sensitive financial information (income, debt, financial goals, etc.)This person must be someone who makes wise choices with money.Ideally, this person should also be your financial opposite, meaning they are a spender if you are a saver. Spenders and savers both have their strengths and weaknesses and need each other for balance.3. Make an effort to develop friendships with financially responsible people.“You are the average of the 5 people you spend the most time with.” - Motivational speaker Jim Rohn4. Avoid "H.A.L.T." spending (spending when you're hungry, angry, lonely or tired) and emotional spending in general.For example, you should avoid going to the grocery store when you’re hungry.At the same time, "loneliness spending" could be going out and spending money just to avoid staying at home alone.Be aware of your personal spending triggers. (i.e., “treat yourself syndrome”)5. Set and pursue financial goals for your future, regardless of whether or not you get into a relationship. In other words, don’t attach your financial future to a hypothetical relationship that may or may not happen.Action Steps:Choose a budgeting app, download it and begin to familiarize yourself with it.Identify at least one person in your life who could serve as your accountability partner.Identify your spending triggers and brainstorm ways to avoid giving into them.Create a list of financial goals for the future and set dates for when you would like to achieve them.References:Episode 4 - "5 Personal Finance Books That Changed My Life"

Casey Haugen was our very first guest on Prime Time back in April 2017. Tonight, he makes his return to the Thursday Show. We’ll talk Crux Cigars. Some changes have been happening at Crux Cigars and we will get the low-down on what they are and what cigar enthusiasts can expect. In our Alec Bradley Live True segment, we discuss seasonal release products. Finally, in our Deliberation Segment we will look at whether Tobacco Products Expo (TPE) is ready to challenge the premium cigar industry’s leading industry trade show. Tune in live at 10pm Eastern/7pm Pacific. If you miss us, you can catch Prime Time any time on Google Play Music, iTunes, Podbean, and YouTube. The Prime Time Show – all about industry people and industry talk. References: Episode 1: Casey Haugen, Crux Cigar Company Special Edition #30: Casey Haugen, Crux Cigar Company

Casey Haugen was our very first guest on Prime Time back in April 2017. Tonight, he makes his return to the Thursday Show. We’ll talk Crux Cigars. Some changes have been happening at Crux Cigars and we will get the low-down on what they are and what cigar enthusiasts can expect. In our Alec Bradley Live True segment, we discuss seasonal release products. Finally, in our Deliberation Segment we will look at whether Tobacco Products Expo (TPE) is ready to challenge the premium cigar industry’s leading industry trade show. Tune in live at 10pm Eastern/7pm Pacific. If you miss us, you can catch Prime Time any time on Google Play Music, iTunes, Podbean, and YouTube. The Prime Time Show – all about industry people and industry talk. References: Episode 1: Casey Haugen, Crux Cigar Company Special Edition #30: Casey Haugen, Crux Cigar Company

If you ask most people what their "calling" in life is, you're likely to get either their job title or a blank stare. But what if your calling isn't meant to be a mystery? What if it's closer than you think? In this episode, we'll discuss the 5 questions that can help you discover your God-given calling, so that you can walk into your destiny with confidence. What am I better at than most people?It’s not enough for you to do something well. Something you’re good at is a gift, but something you’re exceptional at is more likely to be your calling.For example, I think I'm a good cook, but I'm not good enough to become a chef. I am, however, better than most people at writing.Thinking about your gifts in general terms will keep you confused. You need to drill down and focus if you want clarity. What do I love to do?There is a lot of debate online about whether you should pursue "passion or profit." I think that misses the point. Your passion is an important part of who you are, and it needs to be acknowledged, even if you don't make a living pursuing it.Your passions can change over time. Some passions are only for a season, and that’s okay.It’s also fine to have more than one passion. What makes you angry and keeps you up at night?For example, I have a friend who loves animals and hates when they're abused, which led to her taking a job as a veterinarian assistant.What problems are you uniquely equipped to solve?As queen of Persia, Esther was able to use her royal position and her connection to the Jewish people to save them from destruction.As a wealthy German businessman, Oskar Schindler was able to save over 1,200 Jewish people from being sent to concentration camps during World War II. Look at your upbringing, culture, personality and personal history to help you identify what problems you can solve that few others can.Who are your people?I like to call this your “belong group.” In other words, these are the people who speak your language and respond to your ideas with enthusiasm and support.In business, this is your audience. In church, it may be your area of ministry.No one is called to everyone. Even Jesus was limited in his area of ministry (See Matthew 15:24).Use these questions to help you decide whether a job, project or volunteer opportunity is the right fit for you. Each individual task you complete won’t check all of these boxes, but the combination of your life experiences (work, family, community, etc.) should.Action Step: Take 30 minutes to answer the 5 questions outlined in this episode. Did any of your answers surprise you? If so, how?References:Episode 2: "Purpose, Calling, Assignment: What's the Difference?"

I'm here in Bali, and I've been doing something I rarely do a lot of, even on vacation: Relaxing.   Yes, I talk about energy management and how important it is to make time for yourself, and I do, regularly.   But I always keep a pretty tight time limit on myself, because I feel guilty if I spend what I deem to be "too much" time doing something fun when I could be doing something productive.  And by productive, I mean some sort of task that somehow moves the dial, either in my life or my business or both.  Nothing that is purely playful.   On this particular trip, I've been feeling especially drawn to slowing down, doing things simply because I can and because they bring me joy, and it has felt wonderful, and incredibly indulgent in a way that has made me super uncomfortable at first.   I was speaking with one of my coaches about it, and we had an entire discussion around joy and stillness, and how joy is productive.  All by itself. No asterisks needed, no checklist required, and no time limit necessary.  And this can be the simplest things, by the way - no need to hop on a flight to Bali just to create more joy in your life.  Take the time to read a book, lie on the grass and stare at the sky, dance around the house, anything that brings you JOY.   I'm also extending to you the same challenge my coach gave me: take a photo of yourself doing something that brings you PURE JOY, and tag me or send it to me directly in the DMs over on Instagram!   REFERENCES Episode #87, The Underrated Power of Stillness: Leaving Space for Miracles in a Noisy World Episode #84, Breaking Negative Thought Patterns with Lisa Carpenter   FIND EMILY Emily Gough Coaching Room to Grow Podcast info@emilygoughcoaching.com Instagram @emilygoughcoach Private Facebook Group: Room to Grow Podcast Facebook: @ Emily Gough Coaching   PLUS!  Want to be a badass podcast guest?  You’re going to want to grab this highly requested guide walking you through every step of the way to have your interviewers begging you to come back on, and the listeners wanting to learn everything they can from you!  Grab your guide HERE.   DON’T MISS… Questions?  Comments? Want to connect and chat? You can email me at info@emilygoughcoaching.com, or DM me over on Instagram @emilygoughcoach with any questions, comments, or takeaways!  Plus, I would absolutely love to connect with you and thank you for listening in real life.  It makes me day to see you listening to the podcast and fills me up with pure joy. Seriously.  See you on the ‘gram! Questions?  Comments?  If Instagram and Facebook aren’t your jam, send me a good old fashioned email!  info@emilygoughcoaching.com New episodes every Tuesday and Thursday! 

Today, I'm kick off a new series specifically on niche marketing and business development. This episode is focused on the foundation for any business: identifying needs to fill. In addition to sharing some of my own experiences, I'll also show companies like EZ Laundry and Netflix used similar principles as other artists in order to launch their businesses! References: Episode #190: How to Find Your Niche People I've Interviewed with a Unique Niche: Episode #6: DaRealWordSound Episode 48: Dez Cadena Episode #162: Manafest Episode #258: Shannon Curtis

If you're slightly obsessed with productivity (like I am), then you probably think a lot about how to make the most of your time. In fact, the idea of "free time" seems like kind of a misnomer because you think of it as more time to work on your music business. However, today's episode is about taking a healthy look at developing a sustainable music business career - and that includes using your free time wisely. References: Episode #40 - Strategic Philanthropy and Your Music