Podcasts about Rems

"Until immunomodulators, patients [with myeloma] did not have a great overall survival rate. But when we introduced lenalidomide, we started seeing our patients have life expectancies between five and seven years—which was unheard of prior to these immunomodulators going forward. I think it's promising and allows patients to have quality of life versus therapy of life," ONS member Daniel Verina, DNP, RN, ACNP-BC, nurse practitioner for the multiple myeloma program at Mount Sinai Medical Center in New York, NY, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about immunomodulators. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by June 12, 2027. Daniel Verina is on the speakers' bureau for Johnson & Johnson, GlaxoSmithKline, and Pfizer. This financial relationship has been mitigated. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome:  Learners will report an increase in knowledge about the use of immunomodulators to treat cancer. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Pharmacology 101 series Episode 401: Multiple Myeloma Treatment Considerations for Oncology Nurses Episode 386: Interprofessional Navigation and the Oral Anticancer Medication Care Compass Episode 290: Cancer Symptom Management Basics: Peripheral Neuropathy ONS Voice articles: Maintain Oral Adherence With ONS Guidelines™ Multiple Myeloma Prevention, Screening, Treatment, and Survivorship Recommendations Sexual Considerations for Patients With Cancer Clinical Journal of Oncology Nursing article: Optimizing Transitions of Care in Multiple Myeloma Immunotherapy: Nurse Roles Oncology Nursing Forum articles: Changes in Health-Related Quality of Life During Multiple Myeloma Treatment: A Qualitative Interview Study Facilitators of Multiple Myeloma Treatment: A Qualitative Study ONS book: Multiple Myeloma: A Textbook for Nurses (third edition) ONS Symptom Intervention resource: Peripheral Neuropathy Risk Evaluation and Mitigation Strategies (REMS) Lenalidomide Pomalidomide Thalidomide International Myeloma Foundation: Using Immune Therapy to Fight Multiple Myeloma International Myeloma Society Multiple Myeloma Research Foundation: Treatments for Multiple Myeloma To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "We definitely want the diagnosis of multiple myeloma before initiating these drugs. We're going to look at serum protein electrophoresis. We want to make sure that we know the patient has serum free light chains and myeloma proteins to really confirm their disease. Plus, a bone marrow biopsy." TS 7:21 "Each immunomodulator has slightly different side effects. Thalidomide's biggest side effects are constipation, weakness, fatigue, somnolence, peripheral neuropathy, mood swings, hand tremors, and depression. With each generation, less of the side effects actually occurred. Most of lenalidomide's side effects, not discounting the deep vein thrombosis, are pancytopenia—the neutropenia, the anemia, and the thrombocytopenia. [The side effects] are very similar in pomalidomide." TS 15:40 "The REMS program is critical for oral immunomodulator therapies—thalidomide, pomalidomide, and lenalidomide. It was developed due to the risk of developing embryofetal toxicities. ... It is mandatory testing and counseling, so all females of reproductive potential must have two negative pregnancy tests prior to starting the therapy and then monthly pregnancy tests while on the therapy alone. Again, they must use two forms of effective contraceptives or abstain from heterosexual sex four weeks prior, during, and after. And the same thing for men. I focus on that because males may say, 'I have a vasectomy.' These therapies tend to bind to the semen. So, males must still use a latex or synthetic condom during any sexual contact with a female of reproductive potential, even if they did have a vasectomy." TS 18:31 "The capsule itself cannot be chewed, crushed, or opened. I bring that up because as healthcare professionals, we have educated our patients. If it's difficult to swallow capsules or tablets, we've always said to them, 'Oh, don't worry, just crush it into applesauce or open it up and sprinkle it on your mashed potatoes.' But because of this embryofetal toxicity, I advise my patients not to open the capsule. If they can't swallow it for any reason, they have a sore throat or they're just unable to, then [we tell them] to hold the therapy and then call us." TS 22:49 "We spoke about three generations already, but there's actually a fourth generation [of immunomodulators]. They're called cereblon E3 ligase modulators(CELMoDs). They're still in clinical trials but really showing promise in the therapy of myeloma. They're showing very good affinity to cereblons, just like the immunomodulators do. I think, in all cancer therapies, as newer generations come out or newer therapies move forward, some of the older generations might move aside, but they get integrated later on. So I don't think [immunomodulators] will disappear totally, but they will probably be modified." TS 36:39

Un altro caso di cronaca nera riporta in primo piano il disagio mentale.Nel milanese, un uomo affetto da disturbi psichici, ha dato fuoco al padre. Già nel 2015 aveva provocato la morte di una persona per le conseguenze di un cazzotto sferratogli senza motivo.Ne parliamo con Alessia Cicolini, direttore delle Rems di Castiglione delle Stiviere (Mn) e Antonella Zarri, madre di Alice Scagni, uccisa dal fratello, Alberto Scagni.

Alejandro Cabrera Muñoz, co-founder and CEO of Green Eagle Solutions, returns to discuss automating 70 GW of renewable assets and why operators are self-operating their fleets. Reach out to sales@greeneaglesolutions.com to learn more! Sign up now for Uptime Tech News, our weekly newsletter on all things wind technology. This episode is sponsored by Weather Guard Lightning Tech. Learn more about Weather Guard’s StrikeTape Wind Turbine LPS retrofit. Follow the show on YouTube, Linkedin and visit Weather Guard on the web. And subscribe to Rosemary’s “Engineering with Rosie” YouTube channel here. Have a question we can answer on the show? Email us! Welcome to Uptime Spotlight, shining light on wind energy’s brightest innovators. This is the progress powering tomorrow Allen Hall: Alejandro, welcome back to the program.  Alejandro Cabrera Muños: Thank you so much, Allen. It’s a pleasure to be here.  Allen Hall: Well, so last time we talked, you had so much happening at Green Eagle, and it is, uh, amazing to watch the progress there. You’ve been around for quite a while now. You started, what, in 2011 working on SCADA systems. Uh, uh, there’s been a lot of evolution since then. Walk me through, like, the process where you thought, “Hey, there’s a business here.”  Alejandro Cabrera Muños: Of course. Uh, we actually started officially back in 2012. It’s been a, quite a, of a long journey to, to get here. Uh, yeah, we started, uh, back, back then. We say it’s a whole new world, right? If we look backwards, like, almost 15 years. Makes me, makes me feel, like, extremely [00:01:00] old. Uh, but ne- nevertheless, um, yeah, back then we were trying to, to cover, like, a lot of issues that were based on OEM SCADAs, which by the way, we still are dealing with. But, but that, that was starting point. It was, um- It was, uh, based on understanding that the, the renewable energy industry is so complex. Every wind farm, every solar plant has different issues, different systems. Even, even the same models from the same manufacturer sometimes have complete different systems, which complicates everything. So it was very exciting to, to start our careers in a, in an industry where nothing is standard and where everyone is looking for something that is standard. So that’s, that’s where we fit in. Um, yeah, and in these years, we, we started basically creating the f- the foundations, uh, uh, on top of, uh, SCADA systems. [00:02:00] But as soon as we had that, those foundations, we realized that this sector is not gonna evolve, uh, it’s gonna cope up with the complexity, uh, of the technical complexity, market volatility, regulatory compliance. That’s not gonna be solved by just having more SCADAs. So we created a layer of automation in place, which is basically what we’ve been, um, evolving in the last 10 years now, um, with the, with the mindset and with the goal that every wind turbine should be running autonomously without having to have people behind it, uh, supervising and taking control of it. Allen Hall: Yeah, and that’s a great founding idea, but that has grown from an idea to you’re automating, what, 40 gigawatts of renewable assets right now?  Alejandro Cabrera Muños: Oh, we’re actually now connected to over 70 gigawatts.  Allen Hall: That’s amazing. Alejandro, that’s incredible.  Alejandro Cabrera Muños: And all of them are different.  Allen Hall: Sure. So that, that’s a combination– 70 gigawatts is a combination of wind and solar and anything else? Alejandro Cabrera Muños: Yes. [00:03:00] Well, actually, one of the, one of the main, um, needs that we try to cover from day one is to be able to connect to all, um, asset classes. So we understand that, um, the challenge of operating a large portfolio for our customers, um, can only be solved if we have the ability to connect to all type of asset classes. So we can have to connect to wind turbines, inverters, trackers, substations, um, energy meters, you name it. You– we have to connect to every single asset class, um, because what’s important is how you manage that data on top of that and how you react on the anomalies.  Allen Hall: Right. Because I think a lot of operators are now considering taking your model, the Green Eagle model of s-self-operating, but they need that help, they need that insight into the operation of a solar farm or a wind farm or, or any of those assets, renewable assets, ensure those inverter-driven assets. You’re, you’re seeing– I, I think we’re seeing the same thing, which is a lot of operators decide to [00:04:00] leave full service agreements globally, and what do you think is driving that now? Uh, is it a financial decision? Is it a performance decision, or is it both?  Alejandro Cabrera Muños: I think there are many factors, but I think the main driver is the financial aspects of it. I think when you, when you delegate the operations to a third-party, uh, entity They are gonna optimize their services to whatever service level agreement or availability they are committed to. And for that reason, you’re never gonna get– effectively, you’re never gonna get the extra mile. You’re never gonna get any extra from there. Um, and that’s okay when the market is– has great conditions and everything w- is going well. But we are seeing how in the last years we have, uh, a lot of market volatility, negative pricing. Everything is becoming more and more complex, so many projects are actually under stake financially. And I think that’s, um, that’s pressuring everyone to look for opportunities to squeeze their assets a little bit more or a little bit better, I would say.[00:05:00] Um, and part of that is to take operations in-house so you at least you have the opportunity to, to do, um, a better job, uh, let’s say.  Allen Hall: Yeah, and part of what we’re seeing is, at least in the United States and, and globally now, I think it’s, there’s more action globally than there has been on mergers and acquisitions. So an operator that has historically had a particular OEM in wind, you know, say it’s Vestas or Siemens or GE, whoever, Nordex, it could be any of them. Uh, when they acquire another competitor or another farm, they’re bringing in a f- a wind turbine they probably don’t know much about. And, and that’s a huge problem. And, and there’s not a lot of resources for them to grab hold of. Uh, that’s one of the marketplaces you’re trying to fill right now, right?  Alejandro Cabrera Muños: Of course. Uh, as I mentioned before, if something describes our sector is that nothing is standard, despite everyone is seeking standardization of everything, right? Uh, but nothing is standard for, [00:06:00] for– and that, that’s the reality. So the first thing when, when you have a portfolio and you are incorporating new assets into it, you need, um, a solution that is able to connect to all type of assets, right? Um, w-we call our solution a three-in-one solution because first of all, it acts as a second level SCADA, so you can connect everything there, uh, everything there, and you have access to all the data across all your assets. Then we have the SCADA automation layer, and then we have the data analysis layer on top of that. Okay. But let’s focus on the operations, which was, uh, your question, right? So you have a new bunch of assets. Sometimes you don’t have any documentation whatsoever, but these are Gamesas, Nordex, a bunch of them from different years. Um, the first thing that we provide is a second level SCADA, so you can connect to all of those. But We have, uh, something that we believe is very unique. So what we provide to our [00:07:00] customers is ability to automate all these assets autonomously. And what that gives you, it’s, um, set of data that can be analyzed, and we can learn from what’s working, what’s not working, beyond what the manufacturer’s gonna tell you to do, right? So we have thousands of General Electric turbines connected to our software, for instance. Um, we know what works, what doesn’t works, uh, what are the faults that can be resetted remotely, what are the ones that are not, what is the success ratio of those resets, ’cause that’s a metric that nobody else has unless you have automation in place. Uh, but we can actually understand, is it working? Is it not working? Is it creating fatigue for no reason to these turbines? So what– we have all this, this, uh, un- this knowledge and this, um, knowhow, uh, for all these models. Um- I believe one of the main, um, value that we provide to our customers is, is not only the, the solution itself, but it’s also the [00:08:00] ability to be somehow prescriptive. It’s, it’s not that we’re gonna know more about how to operate the assets than our customers, but, uh, we have a sense of what’s the benchmark, right? So I, I– And that benchmark is very, very useful for them as well.  Allen Hall: So th- that’s part of getting to scale, and 70 gigawatts is a, a lot of scale, where you have seen a number of turbines in different places operating in different environments and performing at different levels. That’s unique, right? That gives you insight into really what’s happening to a turbine or a solar asset globally and also locally. For a lot of operators that just happen to acquire or, or, or take on a- an older wind farm, uh, they tend to get stuck, right? They, they, they, they don’t tend to be able to, to find their way through those little nuances. That’s a huge financial impact to them eventually, right?  Alejandro Cabrera Muños: It is. And I, and I believe that for many years this was something that in a way got, um– [00:09:00] didn’t get a lot of visibility. I think people were not fully aware of how much revenue, how much production they were losing just because they were not operating their assets at the best capacity. Um, now we have the data to prove what, what better can look like. W- uh, we have data to prove that if you follow the OEM’s, uh, protocols, you may be creating fatigue for no reason. Um, and there are improv- there are ways to improve that thing. So I think it’s, um– We are, we are opening the door for a new, complete new way to operate your, your portfolio and get more benefit from it. Allen Hall: I think that’s a very interesting aspect of the sort of the structural aspects of how a, a wind turbine performs, and a lot of that is driven by software. And you, you realize if you’re paying close attention to the OEMs that some of the software updates are not necessarily performance enhancements. They’re more of protecting the turbine because they realize they may have a problem. So it may be a slight derate, it may be a, a different sort of power curve that happens. [00:10:00] But a lot of operators don’t really sense that that is happening up close because they’re not into the details of that. That’s where Green Eagle separates itself. You are into all those details. And do you have a lot of operators just reach out for help immediately saying, “Hey, I have this Siemens Gamesa or Gamesa wind farm,” think about an older wind farm, a Gamesa wind farm Help. Just please help. Uh, whatever you can do, just show us you can do it. Do you, do you start to run a little test campaign on that site, or do you, or do you go pull back from the 70 gigawatts and 15 years of history to, to show this is what you can do with that particular asset to, to get them involved in a thinking about the problem a little bit differently? Alejandro Cabrera Muños: Well, I wish, I wish it was that way. Um, but what, what– It, it was that transparent, but what happens is that we’re working with the largest, uh, some of the largest utilities and IPPs in the world. So what happens is that they, they will never come to us saying, [00:11:00] “We don’t know how to operate this turbine,” or, “We don’t have enough information.” Um, the way they ask for it is like, “Are you compatible with this?” And, “Do you know… Do you have some protocols? Do you know the standard protocols to run these turbines?” Um, and that’s the way we, we start the conversation, and then they, uh, they, they get confident that we can actually help them with that. We only know about how, how much or how little they know about a specific model once we start working with them. And it’s not all or nothing. I- Ev-Even the largest manufacturer, e-even the largest utilities, their portfolio is constantly evolving. They’re incorporating new sites almost every month. So there’s always one site that they don’t, they don’t have expertise in the, in the house, so it’s, it’s normal. Like, basically not many people have expertise in some of the models from old Nordex or Gamesas or you name it. It, it’s impossible basically to have to understand all models in the world. So I think we [00:12:00] have the, the data, the benchmarks, and experience, and on top of that, the of course, the, the tools, so you can actually operate better those, those assets.  Allen Hall: So the name of your system is called ARSOS, A-R-S-O-S, and for anybody listening to this podcast, you can just Google it, and it’s gonna take you to Green Eagle. What is that product? How would, how would you define or describe that product?  Alejandro Cabrera Muños: Well, ARSOS is a suite. Um, what– The way I like to think about it is a, is a three-in-one solution, right? So it’s first of all, it acts, it, it, it fits in between the SCADA world and the REMs, uh, the REMs, uh, solutions. Okay? And they’re complete different worlds even though you see dashboards and they look the same thing. But SCADAs must be, um, must be able to be installed on premises. They require OT enterprise cybersecurity level. They can be, they should be installed on air-gapped infrastructure, so no access to internet whatsoever. [00:13:00]Um, and that they tend to be extremely complex to configure and, and, uh, adapt to every, uh, every different site. So that’s one world. Um, on the other hand, we have the, the REM solutions that are like more like a SaaS platform, like a Power- it could be Power BI, it could be like the, the normal use cases that you need it. You need something, some tools to create the reports at the end of the month to understand the performance of your assets, right? So you have these two, two worlds. So what we are proposing here is a solution that has been built for the past 15 years, but it fits right in the middle. So it covers Almost everything that you need from a SCADA and second level SCADA solution. It puts automation in place, and then it also gives you all the data so you can consume it in the best way, uh, possible, which by the way, now with, uh, artificial intelligence, it’s incredible what you can do with it. So this is basically what we have built, um, right [00:14:00] now. And the main differentiation here is that since we are in the middle, we are trying to solve all this complexity from a SCADA world with a product that is already pre-configured. So you can basically connect to your sites in a completely easy way, um, doing clicks and not a lot of complexity because it’s already pre-made for your needs. Um, because of that, the time to market is extremely much, uh, faster compared to a SCADA solution, so you can have a solution in thing, in hours and not in months. It’s, it’s not a project anymore, right? Which is, which it sounds like normal when you, when you talk about applications, it sounds like a normal thing to do, that you have a, a system running in hours or minutes. But when you’re talking about SCADAs, that’s like sci- uh, sci-fiction, right? Um, that’s what we’re bringing to, into, onto the table. It’s, it’s, uh, something that you can connect to all your assets in a seamless way, painless, and, uh, and, uh, off the [00:15:00] shelf.  Allen Hall: Well, that’s a very interesting way of framing, uh, the product because, uh, you do see both ends of the spectrum here, where y- there’s a number of companies that are offering a c- completely SaaS product, which is a very pretty dashboard, and it still relies on a human to watch this dashboard and, and to make sense of it, and it provides some insight. And then you get to the other side, which is almost a completely mechanical system, where it’s just SCADA data and, and you’re just picking up data for datas, uh, to have, basically. So you, you f- you sort of find that middle ground. The, the, the amount of software and technology that it’s in that space, though, must be huge, and what is the effect of AI bring to you? Does that help you more with just on the, on the, on the model side or just the, the statistical analysis of all the data that you have access to now?  Alejandro Cabrera Muños: Let me make a, um, clarification. Because since, uh, we are, we are providing automation [00:16:00] in a world that is mission critical, right? So there’s no, a lot of, there’s no room for creativity or probabilistic approach. It all has to be the deterministic, right? Uh, so when we talk about automation, we’ve always been focused on deterministic automation, so rule-based, uh, automation, and that’s what we have implemented on top of the level of the SCADAs, right? So that’s, that’s the part where you know how to deal with an asset. You have the protocols. You want to understand how they work, but you want to have certainty of what happens if the turbine is on fault and the fault is related to the gearbox temperature and so on. So you wanna make sure that there’s a reset automatically executed only if the temperature of the gearbox is under X threshold. So this very deterministic approach. Uh, but we have, uh, something, um, very unique when we go on the, on the other side, when we go on the side of the REMs. Because we not only have the data of, of the assets, we [00:17:00] not only have statuses, performance, availability, uh, production. We also have the data of how these assets, assets have been operated, right? So we know how much fatigue they have received, how they’ve been operated, um, have they received curtailments or not? How many curtailments? What were the reasons? So we can actually have a 360, uh, degree of all the data, including all the control, not only how they’re performing, but also how we are operating those assets. And we believe that this is very unique because only if you have all these 360 data, then you can actually enhance what you have on top of that. And that is where AI come, comes in, right? So AI, AI is great in, um, helping our customers in doing root cause analysis, um, dealing with anomalies are not well, um, uh, procedure. Uh, there’s no course of action that is clear, that you don’t know. It’s, they’re not like too [00:18:00] frequent to, to have one. Uh, mixing different type of data. Like I mentioned before, you have, uh, market data, you have curtailments, you have, uh, commands to stop or start a turbine. You have a lot of information there, and you can put all together. Uh, also along with the CMMS information. Um- Lastly, they get– they can pull that together to do whatever they need, right? Uh, they can build with AI. You, you can now do your own dashboards. You can create your own APMs if you wanted to. Um, and I like to think about it, like, with these new tools that you can create disposable dashboards. And, uh, the concept is that it doesn’t matter how many different dashboards you have in an APM, but tomorrow you have a, a specific case. And I think it’s amazing that now with AI and the right, uh, data structure, you can now create a dashboard, and maybe it’s just for one use case, you know? And you just build it today, look at the data. You have [00:19:00] a, um, a case study, and that’s it. May– you never use it that again. The trick for being able to, to, to create this ecosystem where you analyze the data in a completely different way is that we have been working on how to structure the data so the AI is gonna be able to understand the data itself. So once that, that layer is structured in the right way, then you can actually create your own APMs or your own dashboards as you need to.  Allen Hall: That’s fascinating. So instead of just thinking of a turbine or a, a solar field as a asset where you’re trying to maximize performance necessarily, you’re looking at it from the marketplace, the, the, uh, the shutdowns, all the, the things that are contr- overriding the performance and trying to optimize performance in this market environment, which may be very turbulent, and I think for a lot of wind operators is very turbulent, uh, at, at the minute just [00:20:00] because of the nature of the electricity grid. So you’re, you’re then thinking about Having an AI tool to help you do investigative work on the particulars, not just the global data set of how this turbine globally operates, but the specifics, that’s fascinating because that allows you then to treat each turbine as its own separate power plant, in a sense, but also to, to think about lifetime issues and how to maintain that piece of equipment in a much more efficient way. That’s remarkable.  Alejandro Cabrera Muños: And you have the– With AI, you also have the capabilities to automate all these type of analysis. So once you have a specific, uh, case to be analyzed, then you can automate that case to be analyzed in a daily basis, in a weekly basis. But that’s, uh, that, that’s, uh, that’s, uh, the world that we are moving to. Allen Hall: So a lot of what’s happening at Green Eagle at the moment is being automated and, and making it easy for, for customers to get [00:21:00]onboarded to the RSO system. What does that look like today? Uh, how do, how do I get onboarded? I have an asset of I got 1,000 turbines and a couple of solar fields. What does it look like to get me started in the RSO system with Green Eagle? Alejandro Cabrera Muños: Well, if you’re using our cloud, it’s, it’s gonna be a process of If you have a, a portfolio of 500 gigawatts, you can connect to our, to our cloud in a matter of like one month to two months So that’s something that you can do by yourself. So, um, you can create the assets, you can create the connectivity. The connectivity is done through IP filtering or VPN tunnels. All that is from the, from the dashboards, from, from the cloud. Um, then you can, based on the model directory, you can choose which is the, the assets that you want to connect to and through what channels, whether you have Modbus, OPC, and so on. Um, but that’s a- as complex as, as it gets. Really? It’s n- it’s not easy either, because [00:22:00] you need to understand what is a Modbus, what is a OPC, but that’s what it is. It, it’s not a matter of, like, installing something on site and doing tons of, uh, complex, uh, um, configurations. You don’t need, uh, SCADA engineers to be, like, building these dashboards tailor-made for your sites and, and all that is, is something from the past in o- in our opinion. Allen Hall: So you’re not on the telephone, or you’re not on a, a online chat with the Green Eagle team, because it’s, it’s, it’s– you’ve, you’ve done enough capacity now that you’ve automated this.  Alejandro Cabrera Muños: You don’t have to.  Allen Hall: That’s amazing, because I think that’s the first worry for any operator that is gonna make that leap saying, “Hey, I need a little bit of help with this wind farm or this solar site,” is that, “Oh, I gotta be on the phone. I gotta– There’s a lot of im- of onboarding that has to happen,” and you’ve eliminated that.  Alejandro Cabrera Muños: Well, first, w- I, I totally understand this hesitation. Um, many of our customers are living in, in the, in the SCADA world, right? Uh, and which w- it was probably once a pain [00:23:00] to be configured to begin with, and I think half the sector is traumatized by these processes. So I, I tot- I totally understand that that pain is, is still there, right? I understand that. But what we’re trying to do is to, to move forward and say like, “Yeah, that, that’s gone. That was the past. Now we have a different way to do it.” And if you have, uh, either new assets that you need to connect or you even consider, like, moving to something more modern, something with more capabilities, something that comes with automation in place, uh, well, we have a solution that is painless. Allen Hall: Can I discuss, or can we go back and forth about the, the use of inverter-based resources, the solar and the wind sites, in terms of the, the move from grid following to grid forming and stabilizing the grid? I think there’s gonna be a lot of changes in the way that we operate these assets over the next year. Mostly, uh, I see action in the United States from the Iberian blackout about a year ago. They’re changing the thought process of how they want to run the grid so that the wind [00:24:00] and solar can keep the grid operating. Is– Are you involved in, are you involved in that aspect of how you operate those assets and how those inverters perform and, and configuring them to, to do more of the, of the grid forming and keeping the grid stable? Alejandro Cabrera Muños: I believe, to be honest, this is more related to power plant controllers and hybrid plants. So we have, we have made several projects with, um- With a mix, uh, of, uh, wind, solar, um, and storage. And wh- but what we’re doing here, uh, to be completely honest, we are not involved in the power plant controllers. Uh, we believe that that’s an electrical device and has, uh, uh, particularities that are out of us- our scope. But what we do is to, again, we connect to all asset classes, right? So we also w- connect to the PPCs, and we can monitor the PPC, the performance of the PPC, and we integrate that into everything else, right? So [00:25:00] that’s, for us, that’s another asset that we are connecting to, and that it make– it completes the view of, um, of sites that are now, like, almost like mini portfolios at, at the same place, right? ‘Cause you have, uh, different technologies, service stations. You have so many things that you need to orchestrate as well. So we’re, we’re w- moving into, into that area as well, uh, f- with the same concepts.  Allen Hall: B- so in a, in a sense, you’re able to monitor the health or status of the grid. Because you’re connected to so many of these assets, you have a pretty good understanding of how the grid is doing at any particular moment then. Alejandro Cabrera Muños: That’s right, yeah, especially in, in Spain, of course, ’cause we’re connected to, um, over 25 gigawatts at the, uh, at, in Spain, so.  Allen Hall: Alejandro, that’s amazing.  Alejandro Cabrera Muños: Over 25 gigawatts at the, uh, at, in Spain. So, so that’s s- it’s almost a third of the, of the installed capacity in Spain.  Allen Hall: Is there a movement in Spain to, to use technology like yours [00:26:00] to better monitor, regulate, control the, uh, wind and solar assets so- such that they stay engaged when, when the, the grid starts to, to vary a little bit? Has anybody asked you to, to be involved with that? Because it seems like you’re the right– you’re in the right place at the right time.  Alejandro Cabrera Muños: The challenge of all these grid codes, uh, in, in most of cases is just that There are tons of curtailments that are coming from many different reasons, technical restrictions, market, uh, dispatch, um, other type of compliance. Um, the, the first challenge is to just execute on them, right? So they’re coming, you need to apply on the, on the sites. Um, that was the first, the first phase. But now that we have so many gigawatts connected, and that we’re also participating in balance mechanis- balance mechanisms and ancillary services, what we are seeing is that depending on how your assets perform and how quickly they are in regulating, um, you are gonna [00:27:00] have penalties or more, uh, profitability in the participation of the markets. So that’s, that’s extremely important as well ’cause it’s, it’s quite difficult to, to measure. But we have all the– Since everything is automated, you can always track, and you can statistically understand which of the sites are performing better or worse, in what cases, and therefore you have opportunities to improve the regulation and get more revenue from it. Allen Hall: Okay. So Green Eagle then is, because of the scale that it has at the minute, can look at the grid and is involved in, in the, the grid requirements, so to speak, of, of, uh, curtailments and what assets are operating when, and also the voltage control aspects and frequency control, which is the other part of it. You, because you’re, because you have so many assets in Spain and globally, you, it’s amazing the number of assets you have. You, you then can actually, one, see health of the grid, two, [00:28:00] provide insights to operators on what that looks like. I mean, real time you could, you can do that. And then are, are, are the regulators then coming to, to you asking advice on how these assets should perform? Because it does seem like you would be a tremendous resource on how the grid is actually doing on a larger scale from a renewables standpoint.  Alejandro Cabrera Muños: Yeah. Well, fortunately, the, the regulator has its own also, uh, system, so it’s, uh, redundant, right? So as far as we, we are working to, to have, uh, the best system in the world, but, but it will be a lot of, uh, responsibility for us to just have the whole grid depending on us. That would be a lot of weight. Uh, but in a, in a way, in, in a, in a way, it already depends on us, uh, effectively. So, so the pressure is, is there. We have, we have talked to them, um, since we have so many customers, um, in the, in the– at this level, uh, we have to be very quick in implementing new grid codes and new [00:29:00] regulatory, uh, compliance issues and, and so on. So that’s, that’s, um… It’s a challenge, but at the same time, it’s, it’s very exciting that we are always ahead in, in this regard.  Allen Hall: Right. If, if I was an operator and I had Green Eagle as one of my, uh, helpers in a sense, uh, assistants in a sense, that helps with the, the grid code i-in terms of, one, understanding it, and two, being able to implement the changes that are coming down all the time. You have a resource there that understands it from a larger perspective because you see it from multiple operators in multiple places trying to do the same thing. That’s a huge advantage instead of you trying to na-navigate or try to understand all those grid code changes and why they’re happening and what it means to you and how do you operate your assets. So you can provide a little bit of guidance there for the operators.  Alejandro Cabrera Muños: Of, of course. Um, uh, the main, the main value proposition that we can have here for anyone that wants to participate or be part of the Spanish market is that we already have all this figured out. So if you wanna start from the scratch [00:30:00] with, uh, with a SCADA, industrial SCADA, well, let’s, let’s go with, let’s go with that. You’re gonna be probably traumatized in the future, right? Uh, but with us you have an off-the-shelf product that is already compliance. It, uh, h- we have already set, uh, the system certified by the TSO in Spain. So we have already gone through this process so many times, and it’s off the shelf, so you don’t have to worry about any of this. And on top of that, you have the Peace of mind that if tomorrow there’s gonna be a, a, a new change in the, in the, in a new grid code, well, which most likely is gonna happen, um, soon, uh, we have to, we have to do it. Because we have already, uh, a lot of customers that, that, that need it. So for us, it’s actually also, uh, strategic to, to be ahead and be fast in implementing these grid codes. Allen Hall: That’s amazing. That’s such a huge resource for Spain and the rest of the world. Yeah, that’s amazing. Well, I, I know people who are listening to this podcast right now are thinking, “Okay, I haven’t heard of Green [00:31:00]Eagle, but now I’m interested, and I need to f- find out more.” How do they contact you? Where do they go first? What’s the best first step?  Alejandro Cabrera Muños: Well, they can connect, uh, directly to me through LinkedIn, or they can just write to sales@greeneaglesolutions.com.  Allen Hall: Great, yeah, and Alejandro’s available on LinkedIn, so you can f- find him there. And we’ll put his contact information in the show notes to, so you have quick access. Alejandro, you gotta come back more often because the, the things that you’re doing with Green Eagle are amazing, and, uh, the, the scale is incredible. Congratulations on that. Uh, and, and I, I, I need you to come back and tell us what the next generation looks like because I know when you guys get ahold of AI and start thinking through some of these real challenging problems, Green Eagle will have solutions. So you’re welcome back anytime.  Alejandro Cabrera Muños: Super exciting to come back, uh, when you invite me. Thank you so [00:32:00] much.

In this video, Dr. Doug explains how estrogen dose, estradiol levels, and bone turnover markers can help show whether HRT is truly supporting bone health. He breaks down why DEXA and REMS can take 12 to 24 months to reflect change, while markers like CTX and P1NP can offer earlier insight. The key takeaway: bone health care should be individualized, tested, and optimized rather than based on a one-size-fits-all hormone dose.Study Linkshttps://pubmed.ncbi.nlm.nih.gov/10472854/https://pubmed.ncbi.nlm.nih.gov/10550454/https://pubmed.ncbi.nlm.nih.gov/10831925/https://pubmed.ncbi.nlm.nih.gov/34645447/https://pubmed.ncbi.nlm.nih.gov/12792297/https://clinicaltrials.gov/study/NCT05903820

In this episode, Dr. Doug explores the validity of REMs as a bone imaging technology, analyzing recent studies and expert opinions to determine its reliability compared to DEXA. It provides insights into the science behind bone density measurement and the ongoing research shaping the future of osteoporosis assessment.Dr. Doug's review of the 2025 Bobelyak study: https://youtu.be/oAsXX6FwxhoInternational Institute for Musculoskeletal Health Education (IIMHE): https://iimhe.org/IIMHE Dr. Tognarini webinar: https://iimhe.org/webinars/age-and-weight-webinar-deck/Study Linkshttps://pubmed.ncbi.nlm.nih.gov/41872364/https://pubmed.ncbi.nlm.nih.gov/40928527/https://pubmed.ncbi.nlm.nih.gov/27998716/https://pubmed.ncbi.nlm.nih.gov/39724183/

In this episode of Pharmacy Focus, moderator Bob Haight, PharmD, BCPP, AAPP Annual Meeting director and past president of American Association of Psychiatric Pharmacists (AAPP), discusses the AAPP 2026 Annual Meeting with Archana Jhawar, PharmD, BCPP, clinical assistant professor at the University of Illinois Chicago; and Chelsea Di Polito, PharmD, BCPP, psychiatric clinical pharmacist at the University of Maryland, Baltimore. The discussion centers on emerging trends in psychiatric pharmacotherapy across diverse practice settings. A major focus is on newer psychiatric medications, including sublingual dexmedetomidine for acute agitation, which offers a novel, patient-friendly administration route and potential benefits for inpatient care. Additional discussion covers agents like lumateperone and xanomeline-trospium, with attention to their safety profiles, tolerability, and evolving roles in treatment. The speakers emphasize the importance of real-world experience in determining how these newer therapies fit into clinical decision-making, especially given considerations like cost, monitoring requirements, and patient-specific factors.The episode also explores cutting-edge research and practice challenges, including the growing interest in GLP-1 receptor agonists for substance use disorders. While still considered “unproven but promising,” early data suggest these agents may reduce addictive behaviors by modulating reward pathways rather than through traditional metabolic effects. Additional highlights include evolving strategies for clozapine monitoring following REMS changes, where pharmacists play a central role in balancing safety and access, and advancements in long-acting injectable antipsychotics that improve flexibility, adherence, and patient-centered care. Across all topics, a consistent theme emerges: the expanding range of treatment options requires clinicians to stay informed, adaptable, and focused on individualized care. The speakers conclude that AAPP's annual meeting provides a valuable forum for translating emerging evidence into practical strategies that can be immediately applied in clinical practice.Read more about the AAPP here: https://aapp.org/ed/meeting/2026Additional information on the AAPP Annual meeting can be found here: https://aapp.org/ Key Takeaways: New psychiatric treatments are expanding options but require real-world context. Emerging therapies—such as sublingual dexmedetomidine, lumateperone, and xanomeline-trospium—offer novel mechanisms, improved tolerability, and alternative administration routes. However, clinicians are still determining where these agents fit in practice, making shared clinical experience and practical insights critical for informed use. Innovative research is reshaping how clinicians think about psychiatric and substance use treatment. GLP-1 receptor agonists are gaining attention for substance use disorders, with early evidence suggesting they may reduce addictive behaviors by acting on reward pathways. While still investigational, this highlights a broader shift toward targeting underlying neurobiology rather than just symptoms. Pharmacists play a central role in navigating evolving care models and improving patient outcomes. From optimizing clozapine monitoring after REMS changes to implementing long-acting injectable antipsychotics, pharmacists are key in balancing safety, access, adherence, and education. Their involvement is essential as treatment options become more complex and patient-centered.

Kevin Sabet debates Matt Johnson on the Illusion of Consensus podcast with host Rav Arora, covering Trump's psychedelic executive order, ibogaine, FDA approval, Right to Try, drug scheduling, and the future of psychedelic research. Sabet, a former White House drug policy advisor across the Clinton, Bush, and Obama administrations, argues for caution around psychedelics, marijuana policy, commercial incentives, and overstated medical claims. Johnson, a leading Johns Hopkins psychedelic researcher, responds on psilocybin studies, addiction treatment, depression, safety protocols, REMS, and why accelerated research may still follow the evidence. The discussion also covers Joe Rogan, RFK Jr., Marty Makary, Jay Bhattacharya, ketamine clinics, MDMA, MAPS, cannabis rescheduling, veteran suicide, and the risks of turning experimental drugs into public policy too quickly. Subscribe to Rav's Substack to get episodes straight to your inbox: https://www.illusionconsensus.com Chapters: 0:00 - Intro 2:05 - Sabet's Objection to Psychedelics 10:00 - Matt's Disagreement with Sabet 13:15 - Psychedelic Research Quality 21:10 - Kevin's Rebuttal 24:00 - Was Joe Rogan Wrong On Ibogaine's Efficacy 32:50 - Ibogaine Safety Concerns 40:50 - Could The Executive Order Go Too Far 46:10 - Rescheduling and FDA Approval

All of this week's episodes of It Could Happen Here put together in one large file. - The Afterlives of Quentin Deranque - The Afterlives of Quentin Deranque, Pt. 2 - Journalism Under Attack in Lebanon - Economic Echoes of the Strait of Hormuz - Executive Disorder: A Billion for Trump’s Ballroom Security, RIP Spirit Airlines, Iran Stalemate You can now listen to all Cool Zone Media shows, 100% ad-free through the Cooler Zone Media subscription, available exclusively on Apple Podcasts. So, open your Apple Podcasts app, search for “Cooler Zone Media” and subscribe today! http://apple.co/coolerzone Sources/Links: The Afterlives of Quentin Deranque Donate: https://acu.nl/about/donate https://www.lemonde.fr/en/politics/article/2026/02/17/who-was-quentin-deranque-the-far-right-activist-killed-in-lyon_6750585_5.html https://www.lemonde.fr/en/opinion/article/2026/02/27/france-s-political-violence-has-risen-significantly-with-assaults-doubling-over-the-past-10-years_6750916_23.html https://www.lemonde.fr/en/m-le-mag/article/2026/02/18/nemesis-the-identitarian-activists-behind-feminist-masks_6750599_117.html https://www.sv.uio.no/c-rex/english/news-and-events/right-now/2024/extreme-right-violence-in-france-is-on-the-rise.html?utm_source=copilot.com https://www.france24.com/en/france/20260220-how-the-death-of-far-right-activist-quentin-deranque-became-france-s-charlie-kirk-moment https://jacobin.com/2023/06/france-far-right-neofascist-violence-politics?utm_source=copilot.com https://www.humanite.fr/politique/nemesis/nemesis-le-collectif-dextreme-droite-qui-provoque-le-cyber-harcelement-de-militantes-feministes-et-delues-de-gauche https://brusselssignal.eu/2026/02/french-nemesis-activist-says-group-traumatised-after-supporter-killed-in-lyon/ https://archive.is/VvPa4 https://www.humanite.fr/politique/nemesis/nemesis-photographiee-realisant-une-gestuelle-neonazie-alice-cordier-evoque-une-reference-au-rap https://archive.is/kjEUp https://www.lemonde.fr/societe/video/2026/02/18/mort-de-quentin-deranque-ce-que-montrent-les-videos-des-faits_6667296_3224.html https://contre-attaque.net/2026/02/16/revelations-de-nouvelles-images-et-un-temoignage-revelent-quune-embuscade-a-bien-ete-tendue-le-12-fevrier-par-des-fascistes-lyonnais/ https://www.franceinfo.fr/faits-divers/mort-de-quentin-militant-identitaire-agresse-a-lyon/reportage-il-a-refuse-d-aller-a-l-hopital-des-habitants-de-lyon-racontent-l-agression-mortelle-de-quentin-deranque_7808942.html https://contre-attaque.net/2026/03/27/affaire-deranque-scandale-detat/ Journalism Under Attack in Lebanon Report on killing of Amal Khalil - https://www.aljazeera.com/news/2026/4/23/what-we-know-about-israel-killing-lebanese-journalist-amal-khalil Report on “black Wednesday” - https://www.lemonde.fr/en/international/article/2026/04/11/lebanese-mourn-victims-of-black-wednesday-we-are-not-just-numbers_6752321_4.html Justin Salhani and Maram Humaid on killing of journalists in Gaza - https://www.aljazeera.com/features/2025/4/7/targeted-killed-burned-alive-journalists-in-gaza-attacked-by-israel Quadruple tap strike on paramedics in Lebanon - https://www.cbc.ca/news/world/lebanon-paramedics-strike-9.7173448 Forensic Architecture on Gaza’s hospitals - https://gaza-hospitals.forensic-architecture.org/ Economic Echoes of the Strait of Hormuz https://archive.vn/1qeiu https://thelensnola.org/2026/04/01/how-the-iran-war-is-disrupting-the-worlds-medicine-supplies/ https://archive.vn/pM5a6 https://archive.vn/u38pm https://www.reuters.com/business/energy/asia-battles-rising-uneven-toll-energy-crisis-caused-by-iran-war-2026-05-04/ https://eastasiaforum.org/2026/04/16/the-iran-war-widens-indonesias-fiscal-faultlines/ https://www.straitstimes.com/asia/plastic-bag-chaos-shortage-fears-highlight-taiwans-energy-security-concerns Executive Disorder: A Billion for Trump’s Ballroom Security, RIP Spirit Airlines, Iran Stalemate https://x.com/WhiteHouse/status/2051761247779979301?s=20 https://www.justice.gov/opa/pr/justice-department-sues-city-denver-unconstitutional-weapons-bans https://www.tonation-nsn.gov/sacred-site-located-in-cabeza-prieta-national-wildlife-refuge-destroyed-by-border-wall-construction/ https://www.state.gov/releases/bureau-of-political-military-affairs/2026/05/ukraine-joint-direct-attack-munitions-extended-range https://x.com/TedCGoodman/status/2051470245555052557 https://x.com/i/status/2052092791916806265 https://www.ms.now/news/fbi-investigating-leaks-to-journalist-who-wrote-explosive-article-on-kash-patel-sources https://apnews.com/article/cruise-ship-hantavirus-andes-strain-south-africa-cb424510bb0c934c781f6bd42ce2e7c8 https://www.reuters.com/world/europe/canarians-worry-arrival-hantavirus-cruise-ship-will-bring-repeat-covid-2026-05-06/ https://www.grassley.senate.gov/imo/media/doc/reconciliation_-_senate_judiciary_committee_title.pdf https://punchbowl.news/mdm26a11/?utm_source=Sailthru&utm_medium=email&utm_campaign=5/5/26%20AM:&utm_term=Punchbowl%20AM%20and%20Active%20Subscribers%20from%20Memberful%20Combined https://x.com/sentdefender/status/2051759811054727212?s=20 https://x.com/SkyNews/status/2051246490786394319?s=20 https://x.com/NotWoofers/status/2051640997482782939?s=20 https://www.cbsnews.com/news/2-us-navy-destroyers-transit-strait-of-hormuz-after-dodging-iranian-onslaught/ https://x.com/mercoglianos/status/2051381236950524095?s=20 https://truthsocial.com/@realDonaldTrump/posts/116512555123589170 https://x.com/WhiteHouse/status/2051798734850101462?s=20 https://x.com/_MartinKelly_/status/2051754245125181778?s=20 https://x.com/Southcom/status/2051723140254843043?s=20 https://x.com/Acyn/status/2051749649279762556?s=20 https://x.com/sentdefender/status/2051759811054727212?s=20 https://x.com/UK_MTO/status/2051749762538389668?s=20 in https://x.com/Reuters/status/2051567572454432996?s=20 https://x.com/Southcom/status/2051709553956266365?s=20 https://www.axios.com/2026/05/06/iran-us-deal-one-page-memo?utm_campaign=mrf-utm_campaign=editorial&utm_source=x&utm_medium=owned_social&mrfcid=2026050669f852024e34c652f4ad78a6 https://x.com/CENTCOM/status/2052070088233136553?s=20 https://x.com/Alihashem https://reproductiverights.org/wp-content/uploads/2026/05/2026-05-01-Fifth-Circuit-Order-Granting-Stay-of-2023-REMS.pdf https://x.com/SecKennedy/status/1973866621245567344?s=20 https://www.scientificamerican.com/article/fda-is-investigating-the-abortion-pill-mifepristone-despite-decades-of/ https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2840361 https://reproductiverights.org/news/5th-circuit-limits-telehealth-provision-of-abortion-pill/ https://reproductiverights.org/wp-content/uploads/2026/05/25A1208-Admin-Stay-and-CFR.pdf https://www.justice.gov/usao-dc/pr/texas-man-charged-shooting-secret-service-agent-near-washington-monument-national-mall https://www.nytimes.com/2026/05/04/us/politics/washington-monument-shooting-secret-service.htmlSee omnystudio.com/listener for privacy information.

What happens when three menopause podcasters sit down together with zero intention of staying surface level? You get a smart, honest, hilarious, and deeply validating conversation about some of the biggest midlife topics women are trying to figure out right now. In this roundtable episode, we get into bone health, hormone testing, HRT mistakes, libido, trauma, desire, and the much bigger cultural story around what menopause is actually meant to be. We talk openly about why so many midlife women feel disconnected from sex, why female arousal is so misunderstood, and how much emotional baggage, conditioning, and nervous system overload shape the whole experience. And finally, we end on a much bigger and more hopeful note: maybe menopause is not a decline at all. Maybe it is a threshold into wisdom, authority, healing, and a version of womanhood our culture has forgotten how to honor. In this episode, we cover: Why more women in their 40s and 50s are discovering osteopenia and low bone density earlier than expected The difference between DEXA scans and REMS scans, and why bone quality matters, not just bone density Estradiol, bone protection, and why some women may need more than a tiny dose of HRT The debate around testing hormones in perimenopause and why symptoms alone do not always tell the full story Why thyroid, cortisol, DHEA, progesterone, and estrogen symptoms can overlap in confusing ways What can go wrong when women are given HRT without the right assessment or follow-up Why libido is far more complex than just low testosterone or low desire How guilt, fear, shame, trauma, and nervous system overload affect female arousal Why so many women feel "broken" around sex when they are actually having a very normal response The spiritual and cultural meaning of menopause as a transition into wisdom, power, and authority Who this episode is for This episode is for women in perimenopause and menopause who want a more honest conversation about what is really happening in midlife. It is especially for women who are worried about bone loss, confused about hormone testing, frustrated by bad HRT experiences, struggling with libido, or craving a more empowering way to think about menopause than the usual narrative of decline.

In this episode, we explore new international guidelines for clozapine monitoring following the FDA's REMS rescission. Should patients on stable clozapine continue lifelong monthly blood draws, or can we safely reduce monitoring after two years? Dr. Seeber discusses how these evidence-based recommendations balance patient burden with safety. Faculty: Oliver Freudenreich, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 79 New Guidelines for Clozapine ANC Monitoring

Story 1- Kristine and her family kept seeing strange men outside their home— but there's no one around. Story 2- Rems shared three stories about school strange occurrences, a white lady saying hello and a haunted classmate. WATCH in Youtube youtube.com/@philippinecampfirestoriesLISTE via: bit.ly/PhCampfireStories Like, Follow and Join us in our social media channels!Email Address: campfirestoriesph@gmail.comFacebook: https://www.facebook.com/campfirestoriesphInstagram: https://www.instagram.com/campfirestoriesphTikTok @campfirestoriesphFB Group Messenger: https://m.me/ch/AbYMxBMNFZA6gEpa/ You can send over your support thru the following platforms:Patreon patreon.com/campfirestoriesphPaypal earlm.work@gmail.comGCash +639178807978 Audio Production by The Pod Network Entertainment #podcastph #philippinecampfirestories #santelmosociety #pinoyhorror #pinoypodcast #horror #horrortok #horrorstory #horrorstories #tagaloghorrorstories #tagaloghorror #tagaloghorrorstory #ghostmode #tagaloghorror #kakatakotFor any collaboration, brand partnership, and campaign run inquiries, e-mail us at info@thepodnetwork.com.Support this show http://supporter.acast.com/philippinecampfirestories. Hosted on Acast. See acast.com/privacy for more information.

What if most of what we've been told about hormone therapy was based on the wrong population, the wrong hormones, and the wrong timing? And what if 75% of women on HRT today are either under-dosed or over-dosed… because no one is actually testing? We cover: Why the largest menopause study does not apply to healthy perimenopausal women The "test, don't guess" philosophy Which tests are best to personalize dosing and optimize hormone metabolism Why up to 75% of women may be under- or over-treated on standard HRT protocols The little at-home device that can map daily hormone fluctuations Which scan is best for bones? REMS or DEXA? Dr. Betty Murray, Ph.D., M.S., I.F.M.C.P., is the Founder and CEO of The Menrva Project, a groundbreaking AI-powered platform & telemedicine service that personalizes menopause management by integrating symptoms, wearable data, and hormone metabolism with treatment in all 50 states. A functional medicine expert with over 20 years of experience, she previously founded Living Well Dallas Functional Medicine Center, one of the largest functional medicine practices in North Texas. Dr. Murray has appeared on Fox News, NBC, and CBS, and hosts the Menopause Mastery Podcast. Mastering the Pause: A Woman's Guide to Thriving Through Menopause https://guide.hormoneshelp.com Contact Dr. Betty Murray Website: https://drbettymurray.com/ Instagram: https://www.instagram.com/drbettymurray / Facebook: https://www.facebook.com/drbettymurray Linkedin: https://www.linkedin.com/in/bettymurray/ Youtube: https://www.youtube.com/@drbettymurray Give thanks to our sponsors: Try Vitali skincare. 20% off with code ZORA here - https://vitaliskincare.com Get Primeadine spermidine by Oxford Healthspan. 15% discount with code ZORA ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ - https://www.oxfordhealthspan.com/ZORA Get Mitopure Urolithin A by Timeline. 20% discount with code ZORA at https://timeline.com/zora   Join the Hack My Age community on: YouTube: https://youtube.com/@hackmyage Facebook Page: ⁠⁠⁠⁠⁠@⁠Hack My Age⁠     Facebook Group: ⁠⁠⁠⁠⁠⁠@⁠Biohacking Menopause⁠⁠⁠⁠⁠⁠ ⁠   Biohacking Menopause Private Women's Only Support Group: https://hackmyage.com/biohacking-menopause-membership/ Instagram: ⁠⁠⁠⁠⁠@⁠HackMyAge⁠    Website: ⁠⁠⁠⁠⁠⁠HackMyAge.com⁠    For partnership inquiries: https://www.category3.ca/  Some episodes of Hack My Age are supported by partners whose products or services may be discussed during the show. The host may receive compensation or earn a minor commission if you purchase through affiliate links at no extra cost to you. All opinions shared are those of the host and guests, based on personal experience and research, and do not necessarily represent the views of any sponsor. Sponsorships do not imply medical endorsement or approval by any healthcare provider featured on this podcast.

In this episode Amy Della Rocca, PMHNP joins to discuss Spravato, the FDA-approved prescription esketamine nasal spray, and its place in the field of psychedelic medicine. Amy is a psychiatric nurse practitioner and the Clinical Director of Marpa, a Spravato treatment center in New York. In this conversation, Amy offers a grounded and practical look at Spravato as one of the most accessible forms of psychedelic medicine currently available, especially for patients with treatment-resistant depression who may be priced out of intravenous or intramuscular ketamine treatments. She explains how insurance coverage, prior authorizations, and the 2025 shift allowing Spravato to be used as monotherapy have expanded access, while also walking through what treatment actually looks like in practice - from REMS monitoring and nasal spray administration to maintenance schedules and the importance of outside therapeutic support. Throughout, Amy emphasizes that Spravato can produce a wide spectrum of psychedelic effects, that it should not be dismissed as a "lesser" medicine because it is FDA-approved or pharmaceutical, and that the most effective treatment happens in a relational container that balances medical safety, emotional support, and realistic expectations about what the medicine can and cannot do.   In this episode, you'll hear: What Spravato is and how it differs from other forms of ketamine treatment How insurance coverage, Medicaid, and copay assistance can make psychedelic care more financially accessible Which two diagnoses Spravato is approved to treat Why the 2025 approval of Spravato as a monotherapy meaningfully changed patient eligibility What a typical Spravato session looks like, including dosing, REMS monitoring, and maintenance treatment Why therapy, integration support, and external community can strongly influence treatment outcomes How patients' experiences can range from subtle relaxation to deeply psychedelic states Why stigma within psychedelic spaces can invalidate ketamine experiences - and why Amy argues that needs to change What makes a patient a good candidate for Spravato treatment How clinicians can carefully work with complex cases, including suicidality, trauma histories, and bipolar depression   Quotes: "Generally we have Medicaid covering [Spravato treatments]. We have no co-pays on that or maybe it's a five-dollar co-pay. With some insurances, if there's a big deductible, they will have to pay the deductible like other treatments." [6:38] "In 2025, the FDA changed that requirement [to be on an antidepressant to receive Spravato treatments]. And now Spravato is… approved for monotherapy. So, as you know, so many of the people that are coming to us are not taking daily antidepressants because they've had terrible side effects. Or… they've felt worse, it increased their [suicidal ideation] or, you know, whatever it was. And so to have them still have to take one just felt like the wrong thing to do." [8:34] "I would say 30% of the patients continue [regular Spravato treatments] on some level—40% maybe of maintenance. And that can be every two weeks; it can be every week. There are plenty of folks that find that the glutamate activity of this medicine helps them more than anything they've ever taken and so they end up tapering off of other meds and continue to get weekly sessions with us." [14:28] "This treatment feels, in a way, like a half-treatment without outside therapy" [15:25]   Links: Amy on LinkedIn Marpa Minds website Journey Clinical website Psychedelic Medicine Association Course: Managing Medical Risk in Patients Seeking Psilocybin Therapy Previous episode: Ending Pill Shaming: How Psychedelics and Pharmaceuticals Can Both Support Healing with Erica Zelfand, ND Previous episode: Ketamine Therapy Explained: The Science Behind Mental Health Treatment with Dr. Jason Wallach Psychedelic Medicine Association Porangui

Drs. Maron and Rowin provide an overview of hypertrophic cardiomyopathy, explaining how it is diagnosed by heart imaging and classified into obstructive and non-obstructive forms. They highlight that obstruction is a major cause of symptoms and stress the importance of carefully assessing patients' day-to-day limitations to guide treatment decisions.

Send a textBones don't complain until they break—so we went straight to the source to decode how to measure, protect, and strengthen them before trouble starts. Dr. Thacker sits down with Dr. Kristi Tough-DeSapri, a leading women's bone health specialist, to break down what DEXA really tells us, how trabecular bone score adds vital nuance about bone quality, and where newer ultrasound-based REMS fits when access is limited.Strong bones start with fundamentals—calcium, vitamin D, protein, resistance and impact training, and fall prevention—but often need targeted therapy to truly cut fracture risk. We cover where hormone therapy can help near menopause, how SERMs and antiresorptives reduce fractures, and when bone-building agents are warranted.Support the show

In Part 2 of Debi Robinson's conversation with Dr. Wendy Warner, the discussion goes deeper into the limitations of bone density testing, the real drivers of bone loss, and why many women are being unnecessarily pressured into medication.Debi shares a recent case of a woman whose severe scoliosis likely distorted her DEXA scan results—yet those numbers were being used to push additional medications. Dr. Warner explains why DEXA scans can sometimes produce misleading readings and why newer technologies like REMS scans may provide a more complete picture of bone strength.The conversation also explores the role of lifestyle medicine in bone health, including nutrition, stress management, gut health, and movement practices like yoga, Tai Chi, and Qigong. Dr. Warner emphasizes that in her clinical experience, only a very small percentage of women actually require medication—and often only temporarily while the root causes of bone loss are addressed.This episode is about shifting from fear-based messaging to empowerment and education.What You'll Learn in This EpisodeWhy DEXA scans can sometimes produce misleading resultsHow structural issues like scoliosis can affect bone density readingsThe difference between bone mineral density and true bone strengthHow REMS scans evaluate both mineral density and the collagen matrix of boneWhy ultrasound-based REMS scans avoid radiation exposureWhy most women do not need lifelong osteoporosis medicationThe lifestyle factors that contribute to bone loss and bone rebuildingWhy gut health and nutrient absorption matter for bone strengthHow Tai Chi, Qigong, and yoga support bone health and fall preventionWhy awareness tools like sleep trackers can help improve overall healthAction StepsLook beyond your T-score. Understand that DEXA scans measure density, not the full strength of bone.Ask questions about your scan results, especially if there are structural issues like scoliosis that could affect accuracy.Focus on root causes such as inflammation, stress, blood sugar balance, and gut health.Incorporate regular movement, including balance-focused practices like yoga, Tai Chi, or Qigong.Evaluate your lifestyle habits including sleep quality, stress levels, and nutrition.Support your microbiome, which plays a role in nutrient absorption and vitamin K metabolism.Consider working with a practitioner who evaluates the whole body, not just bone density numbers.Resources & LinksDebi's website: https://debirobinson.comHealthy Gut Healty Bones Program: https://debirobinsonwellness.thrivecart.com/hghb-self-paced-group-program-pp/Join the Community: https://debirobinson.com/the-stronger-bones-lifestyle-community/Yoga Therapy MasterClass: https://debirobinson.com/yoga-therapy-for-bones-health-mc/28-Day Stronger Bones Method: https://debirobinson.com/28-day-stronger-bonesmorning-method/Instagram: https://www.instagram.com/debirobinsonwellness/Youtube Channel: https://www.youtube.com/@debirobinsonwellness/Debi's TakeawayBone health is not just about one scan or one number.For decades, women have been conditioned to believe that osteoporosis is simply a density problem that req

What if you did absolutely everything right: the hormones, the biohacking, the exercise, the nutrition…and STILL ended up needing hip replacement surgery at 54? That is exactly what happened to gerontologist Zora Benhamou, founder of the Hack My Age podcast, and her story is one of the most important and relevant bone health conversations we have had on this show to date. In this conversation, Zora breaks down the critical difference between osteoporosis (bone density loss) and osteoarthritis (joint degeneration) that too many women (and even many doctors) get completely wrong. She walks through the risk factors that set her up for surgery despite a lifetime of doing things right, what an early warning sign of osteoarthritis actually feels like in your body, and why the DEXA scan your doctor ordered may only be telling you part of the story.  We are discussing the REMS scan, a newer ultrasound technology that measures bone quality and strength rather than just density, and she shares the jaw-dropping story of her husband whose results would have landed him on medication he did not need. She covers the science of what forces bones actually require to rebuild, why jumping off a step beats the treadmill, how hormones and bone health are connected, and what protein and minerals actually have to do with fracture prevention. This is also a conversation about bone loss fear and why understanding the full picture is far more powerful than a single scan result. Key take away: bone loss is not a life sentence. Osteoporosis is reversible. And midlife is exactly the right time to take action.  Learn More About Zora Benhamou Instagram ➜ https://www.instagram.com/hackmyage  Website ➜  https://hackmyage.com  Thank you to our show sponsors! QUANTUM UPGRADE: Try Quantum Upgrade completely free for 15 days—no credit card required. Use code NATALIEJILL at checkout on https://quantumupgrade.io/ TIMELINE: Timeline is offering up to 39% off your order of Mitopure! Go to https://timeline.com/NATALIEJILL   Free Gifts for being a listener of Midlife Conversations! Mastering the Midlife Midsection Guide: https://theflatbellyguide.com/ Age Optimizing and Supplement Guide: https://ageoptimizer.com   Connect with me on social media! Instagram: www.Instagram.com/Nataliejllfit Facebook: www.Facebook.com/Nataliejillfit   For advertising inquiries: https://www.category3.ca/  Disclaimer: Information provided in the Midlife Conversations podcast is for informational purposes only. This information is NOT intended as a substitute for the advice provided by your physician or other healthcare professional. Do not use the information provided in this podcast for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before making any changes to your current regimen.  Information provided in this podcast and the use of any products or services related to this podcast does not create a client-patient relationship between you and the host of Midlife Conversations or you and any doctor or provider interviewed and featured on this show. Information and statements may have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent ANY disease. Advertising Disclosure: Some episodes of Midlife Conversations may be sponsored by products or services discussed during the show. The host may receive compensation for such advertisements or if you purchase products through affiliate links. Opinions expressed about products or services are those of the host and/or guests and do not necessarily reflect the views of any sponsor. Sponsorship does not imply endorsement of any product or service by healthcare professionals featured on this podcast.

Shatterproof Bones: Strength for Life with guest expert Dr. Vonda WrightSTRONG MUSCLES = LONGER LIFE (AND STRONGER BONES, A SHARPER BRAIN, AND MORE INDEPENDENCE)What if aging “gracefully” wasn't about slowing down—but about getting stronger?In this episode, orthopedic surgeon and longevity expert Dr. Vonda Wright flips everything we've been taught about aging, menopause, bone loss, and frailty—and replaces fear with power, science, and action.From the biology of longevity proteins to why a single fall can change everything, this conversation is a wake-up call (and a roadmap) for building a body that can carry you through every decade of life.In this episode, you will learn:Why muscle contraction—not age—drives longevity, and how exercise boosts powerful longevity proteins like Klotho.How muscle, bone, brain, and gut constantly communicate, shaping metabolism, glucose control, and overall resilience.Why frailty and hip fractures are not inevitable, and how strength and balance act as protective shields against aging.How exercise functions as a “health savings account”, determining how well you recover from illness, surgery, or injury.Why bone health requires both density and quality, and when to ask for tools like DEXA scans and REMS ultrasound.What to do after a fracture at any age to support healing, protect future bone health, and prevent decline.Why smoking and vaping are devastating for bones, impair healing, and increase fracture risk.How chronic inflammation quietly weakens bone and muscle, accelerating frailty and loss of independence.Why upper-body strength is essential for daily function, including getting off the floor, out of chairs, and recovering from injury.How simple challenges like push-ups, planks, and grip strength translate directly to real-life independence.How to improve balance and fall prevention with easy “exercise snacks” like standing on one foot or tree pose.Why perimenopause changes the rules, and how to prepare your body with smarter training, nutrition, and recovery.How to use baseline data (lean muscle mass, bone density, fracture risk) to track progress and train more effectively.About Our Guest Expert:Dr. Vonda Wright is a renowned orthopedic surgeon, researcher, and leading authority on aging, bone health, and longevity through movement. She specializes in women's musculoskeletal health, strength training for midlife and beyond, and preventing frailty, fractures, and loss of independence as we age.Dr. Wright brings a rare and powerful perspective—combining decades of surgical experience with cutting-edge research on how muscle, bone, brain, and metabolism communicate. She is a passionate advocate for proactive strength training, balance work, and...

In Part 2 of this important two-part conversation, Debi Robinson continues her discussion with Dr. Nick Birch, a former spinal surgeon who began questioning conventional bone density testing after decades of surgical experience.While Part 1 explored the limitations of DEXA scans and the difference between bone density and bone strength, this episode goes deeper into the broader implications: informed consent, the blind spots of specialty medicine, polypharmacy, and why bone health must be viewed through a whole-body lens.Dr. Birch explains how REMS technology evaluates bone fragility and toughness — not just density — and why women deserve access to better information when making decisions about their bone health.This episode is about empowerment through education.What You'll Learn in This EpisodeWhy bone density and bone strength are not the sameHow REMS measures fragility and bone toughnessThe limitations of the traditional “T-score model”What medical “blinkers” are — and how they affect careThe risks of polypharmacy in aging womenHow medications can unintentionally impact bone healthWhy informed consent must include lifestyle optionsWhy bone health reflects overall metabolic, hormonal, and digestive healthAction Steps You Can Take TodayLook beyond your T-score and ask about fracture risk.Ask your provider about all options, including lifestyle interventions.Evaluate medication interactions if you are on multiple prescriptions.Support digestion and gut health to improve nutrient absorption.Address inflammation and stress, which directly impact bone remodeling.Think holistically — bone health is whole-body health.Resources & LinksDebi's website: https://debirobinson.comLearn more about REMS (Radiofrequency Echographic Multi Spectrometry) technology (as discussed in the episode): https://www.osteoscanuk.com/about-usHealthy Gut Healty Bones Program: https://debirobinsonwellness.thrivecart.com/hghb-self-paced-group-program-pp/Join the Community: https://debirobinson.com/the-stronger-bones-lifestyle-community/Yoga Therapy MasterClass: https://debirobinson.com/yoga-therapy-for-bones-health-mc/Instagram: https://www.instagram.com/debirobinsonwellness/Youtube Channel: https://www.youtube.com/@debirobinsonwellness/Debi's TakeawayYou are not your T-score.You are not a prescription.You are not a number on a scan.Bone health is influenced by hormones, digestion, stress, inflammation, movement, and metabolic balance. When we expand the conversation beyond density alone, we give women the information they need to make empowered decisions.Information replaces fear.Understanding builds confidence.And empowered women build stronger bones.

In Part 1 of this two-part conversation, Debi Robinson sits down with Dr. Nick Birch, a former spinal surgeon from the UK who began questioning conventional bone assessment tools after years of surgical experience.Dr. Birch shares how DEXA scans often indicated “good bone density,” yet during surgery he encountered bone that was structurally weak and unable to securely hold surgical hardware. This clinical disconnect led him to question whether bone density alone truly reflects fracture risk.This episode explores the limitations of the T-score model, how DEXA became the dominant screening tool in the 1990s, and why bone strength — not just density — should be the primary focus when assessing fracture risk.What You'll Learn in This EpisodeWhy bone density does not equal bone strengthHow DEXA scans became the gold standard in the 1990sThe limitations of T-scores in predicting fracture riskWhy nearly half of fragility fractures occur in women without osteoporosisHow surgical experience challenged conventional assumptionsWhat REMS technology is and how it differs from DEXAWhy fracture risk should be the real measurement goalAction Steps You Can Take TodayReframe your T-score as one piece of information — not a diagnosis of destiny.Focus on fracture prevention, not just density numbers.Support bone strength through movement, balance, and alignment.Reduce inflammation to improve bone remodeling.Ask informed questions about how your bone health is being assessed.Stay curious about emerging technologies like REMS.Resources & LinksDebi's website: https://debirobinson.comHealthy Gut Healty Bones Program: https://debirobinsonwellness.thrivecart.com/hghb-self-paced-group-program-pp/Join the Community: https://debirobinson.com/the-stronger-bones-lifestyle-community/Yoga Therapy MasterClass: https://debirobinson.com/yoga-therapy-for-bones-health-mc/Instagram: https://www.instagram.com/debirobinsonwellness/Youtube Channel: https://www.youtube.com/@debirobinsonwellness/Stronger Bones Lifestyle Podcast: https://debirobinson.com/podcastLearn more about REMS (Radiofrequency Echographic Multi Spectrometry) technology (as discussed in the episode): https://www.osteoscanuk.com/about-usDebi's TakeawayBone health is not just about density — it's about strength, structure, and resilience. When we shift the focus from numbers to function, the entire conversation changes.Your bones are living tissue.They deserve better measurement.And you deserve better information.

Concerned about medication use during pregnancy? You're not alone.  In this episode of The MotherToBaby Podcast, host Chris Stallman, MS, CGC (genetic counselor, mom of four, teratogen information specialist) sits down with Dr. Judy C. Morrow of Harvard Medical School to break down how FDA REMS (Risk Evaluation and Mitigation Strategy) programs help reduce the risk of birth defects and protect pregnant patients. Together, they discuss: ✔️ What REMS programs are and why they exist ✔️ How REMS programs support safe medication use ✔️ The role of manufacturers, prescribers, and pharmacists ✔️ Common medications with REMS programs (including isotretinoin/Accutane) ✔️ Pregnancy testing requirements & pharmacy restrictions ✔️ Why some drugs don't have REMS (even if risks exist) ✔️ What patients should ask if they're prescribed a REMS-covered medication  Dr. Morrow shares how researchers use real-world data to identify medication-related adverse events in pregnancy, how REMS programs try to prevent exposed pregnancies, and why communication between patients, providers, and pharmacists is essential.  If you're pregnant, planning a pregnancy, breastfeeding, or support patients in these settings, this episode offers clear, practical insights to help guide informed decision-making.

In this video, Dr. Doug speaks with Dr. Jeff Epstein about his personal experience with osteoporosis, from diagnosis to recovery. Dr. Epstein shares the challenges he faced navigating the medical system, even as a physician, and what ultimately helped him improve his bone health. They discuss DEXA versus REMS imaging, the impact of lifestyle and hormones on bone health, and why patients must take an active role in understanding their data and treatment options.

What are your thoughts on the benefits of magnesium threonate?Is creatine helpful in building bone strength in osteoporosis?What are your thoughts on the REMS ultrasound to diagnose bone mineral density status?What should I do about my PSA, which appears to be trending upward?  Are my diabetes meds causing erectile dysfunction?Does maltodextrin spike blood glucose tremendously?

In this episode, Dr. Doug sits down with orthopedic spine surgeon Dr. Nick Birch to break down why the T-score alone is not an accurate measure of fracture risk. Dr. Birch explains how REMS imaging adds bone toughness and the fragility score, giving a far clearer picture of real-world bone strength. Together they explore how misinterpreting T-scores leads to fear, misdiagnosis, and unnecessary lifestyle limitations, and how better data can help women stay active and confident.*Get the science behind changing T-scores and REMS results in this live webinar with leading experts.* Register here: https://us02web.zoom.us/meeting/register/sI1HCl8vSuuWKfapFN6Fpg?fbclid=IwZXh0bgNhZW0CMTAAYnJpZBEwMEpFeW1HeW12NzdXSGZPSAEeZXcxUyBosU4K09yxVS2yRX5_pt7aB76KvOjYJLsAhrbbXSJy8Hu0TbeKj2M_aem_G467WAHSeZOk5H9IRxNyrQ*Connect with Dr. Nick Birch*Osteoscan UK: https://www.osteoscanuk.com/International Institute of Musculoskeletal Health Education (IIMHE): https://iimhe.org/

In this video Dr. Doug interviews Ludovic Humbert, co-founder and chief science officer of 3D Shaper, to unpack how this new imaging software turns a standard 2D DEXA hip scan into a 3D analysis of cortical and trabecular bone. They explore how it compares to DEXA, REMS, and CT, why it may improve fracture risk prediction, and how it could guide more personalized treatment decisions. They also discuss FDA clearance, clinical adoption, and future possibilities like strength modeling and spine analysis. *3D Shaper Medical*Website: https://www.3d-shaper.com/*Body Analytics*Website: https://bodyanalytics.fit/Facebook: https://www.facebook.com/knowyourbodyownyourhealthYouTube: https://www.youtube.com/@bodyanalytics8964Phone: 314-471-5373

We are back with lots of OncoPharm updates: 1. The belantamab mafodotin REMS program details are available....and it's a lot. How will belantamab mafodin-regimens be used with the upcoming MAJESTIC-3 data of teclistamab-daratumumab? 2. The capecitabine label is updated and calls for pre-treatment DPYD testing 3. Daratumumab gets an FDA approval for high-risk smoldering myeloma based on the AQUILA study Critique of AQUILA: https://doi.org/10.1093/oncolo/oyaf216 4. A pertuzumab biosimilar (Poherdy) is approved 5. Epcoritamab nets regular approval and a new indication with lenalidomide/rituximab (RR) for Follicular Lymphoma 6. Ziftomenib, a new menin inhibitor, is approved for NPM1 relapsed/refractory AML 7. Sevabertinib, a new HER2 inhibiting TKI, is approved for ERBB2 mutated NSCLC, with evidence of activity in patients previously treated with HER2-antibody-drug conjugates 8. Expected FDA approvals for durvalumab + FLOT in preoperative gastric/GEJ cancer; neoadjuvant pembrolizumb + enforumab vedotin in bladder cancer (non-cisplatin eligible), and tarlatamab regular approval for small cell lung cancer 9. Happy Thanksgiving!

In this episode of the Movement Logic Podcast, Sarah discusses two primary methods for measuring bone density: DEXA (Dual-Energy X-ray Absorptiometry) and REMS (Radiofrequency Echographic Multi-Spectrometry). The episode explains what each method measures, their technologies, reliability, and practical applications. It compares their availability, cost, accuracy, and limitations. DEXA is recognized as the clinical gold standard but has some limitations, while REMS, although newer, shows promise with advantages in certain clinical situations.Movement Logic Site Wide Sale now on!Follow Movement Logic on InstagramReferences:77: Are You Getting DEXA Scammed?FRAX toolBest Practices for Dual-Energy X-ray Absorptiometry Measurement and ReportingNew technology REMS for bone evaluationCould radiofrequency echographic multispectrometry (REMS) overcome the overestimation in BMD by dual-energy X-ray absorptiometry (DXA) at the lumbar spine?DXA beyond bone mineral density and the REMS techniqueCost-effectiveness of radiofrequency echographic multi-spectrometry for the diagnosis of osteoporosis in the United States

Today, I'm thrilled to welcome Dr. Doug Lucas for the first episode of a two-part masterclass on bone health. Dr. Lucas is double board-certified as both an orthopedic surgeon and an osteoporosis specialist. He is on a mission to show the world that osteoporosis is both preventable and reversible.   In our discussion today, we take a deep dive into existing guidelines and their limitations and examine how Depo-Provera and oral contraceptives affect women's bone physiology, particularly in younger women. We clarify why no ovulation means no bone balance, how breastfeeding affects bone health, and the importance of peak bone density. We explore the importance of early interventions and screenings, risk factors for poor bone health, the concept of relative energy deficiency, and the limitations of DEXA scans compared to REMS technology. Dr. Lucas also discusses bone health markers and the effects of frailty, falls, and sarcopenia, and shares the foundational pillars of health and longevity. Stay tuned for part two of our masterclass on bone health. IN THIS EPISODE, YOU WILL LEARN: How existing osteoporosis guidelines tend to overlook the key nuances of prevention and care The importance of early bone-health screening  How Depo-Provera and the contraceptive pill disrupt bone physiology in younger women How bone balance becomes disrupted with suppressed ovulation  Why peak bone density is a critical target in early adulthood How breastfeeding affects bone density  Where DEXA scans fall short and how REMS technology offers a clearer picture of bone health How relative energy deficiency impacts bone health in active women Why muscle mass is essential for protecting bone health and preventing frailty  The lifestyle pillars for long-term bone health and longevity Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website Submit your questions to support@cynthiathurlow.com Connect with Dr. Doug Lucas The OsteoCollective Community The Dr. Doug Show

Send us a textStigma keeps more people from hearing help than price does, and we're tackling that head on with a model that puts privacy, speed, and clinical integrity at the center. Blaise sits down with Dr. Melanie Hecker, founder of BLUEMOTH and owner of five brick‑and‑mortar clinics, to unpack a digital prescription approach that feels modern without sacrificing professional care. Think premium devices you can test at home, real clinicians guiding each step, and service that moves at the speed of life.We dig into the full customer journey: a private online consult, candidacy confirmed through a recent audiogram or a shipped test kit that includes air, bone, speech, and speech‑in‑noise, plus clear referrals when red flags pop up. The standout moment is the Experience Box—three sets of top‑tier hearing aids, first‑fit to about 85–90 percent, so users can compare sound quality, comfort, and features in the real world. An audiology assistant handles unboxing and setup, and follow‑ups in the first weeks keep progress on track. When issues require deeper adjustments, BLUEMOTH ships a laptop and Noahlink Wireless to unlock full software‑level tuning and feedback testing from home.We also confront the big question: validation. Dr. Hecker explains why she won't “check the box” on remote real-ear measurements (REMs) until it can be done with accuracy and integrity, and she lays out a realistic path forward—referrals for REM today, and future 3D ear scans to model real‑ear targets without probes. Add rapid response times, overnight loaners for device failures, strong connectivity, and pricing that sits between OTC and boutique clinics, and you get a hybrid that serves GenX, younger boomers, busy professionals, and families supporting older adults with mobility challenges.If you care about access, outcomes, and the future of hearing healthcare, this conversation is a blueprint. Subscribe, share with a friend who's been putting off a hearing check, and leave a review telling us which part of the hybrid model you'd adopt first. Connect with the Hearing Matters Podcast TeamEmail: hearingmatterspodcast@gmail.com Instagram: @hearing_matters_podcast Facebook: Hearing Matters Podcast

A new study claimed REMS bone scans are “just a fancy calculator.” In this episode, Dr. Doug Lucas breaks down the data, highlights major flaws in the research, and explains why experts say the study's conclusions don't hold up. Learn what REMS actually measures, how it compares to DEXA, and what this controversy means for bone health assessment.*Study Links*https://pubmed.ncbi.nlm.nih.gov/40928527/

Alicia Silver, senior director at ADVI Health, highlights the evolving landscape of cell and gene therapy and the need to improve patient access and payment for these treatments. Availability of these therapies for solid tumors and genetic diseases like sickle cell disease is expanding due to the transition from inpatient to outpatient and community settings. The FDA's decision to remove REMS requirements for specific therapies has accelerated the growth of facilities to provide care, particularly for vulnerable populations. Alicia explains, "We work with a number of different cell and gene therapy clients throughout the sector. So we work with manufacturers who have commercialized cell and gene therapy products. So they have products that are currently on the market, manufacturers who are going through the process of clinical trials right now, working with the FDA to get approved products. But we also work with trade organizations that are working behind the scenes at the sector level, trying to get different policies and access changes for patients."   "To date, there's probably close to a couple of dozen FDA-approved cell and gene therapies, and they treat everything from blood cancers, which were the first approvals in something called CAR T. We saw blood cancers as the first approvals, and then everything through to solid tumors in oncology. But also, we have newer gene therapies for conditions like sickle cell disease. And that's an area that's been incredibly underserved and definitely will benefit from a durable gene therapy that hopefully corrects some of the issues that patients with sickle cell disease have, like pain crises that end up in a hospital. So from that perspective, we see a really wide range of treatments available to patients today and many more on the horizon." "I think the price tag is definitely somewhat of sticker shock for people who don't understand how cell and gene therapy products are valued. And so what we do a lot of times, educating on, is helping payers understand that it's not necessarily $2 million for a treatment that's going to be a recurrent payment, but something that's kind of an investment in the patient's and the plan's future." #ADVIHealth #CellTherapy #GeneTherapy #AcesstoCellGeneTherapy #ClinicalTrials  advi.com Download the transcript here

Alicia Silver, senior director at ADVI Health, highlights the evolving landscape of cell and gene therapy and the need to improve patient access and payment for these treatments. Availability of these therapies for solid tumors and genetic diseases like sickle cell disease is expanding due to the transition from inpatient to outpatient and community settings. The FDA's decision to remove REMS requirements for specific therapies has accelerated the growth of facilities to provide care, particularly for vulnerable populations. Alicia explains, "We work with a number of different cell and gene therapy clients throughout the sector. So we work with manufacturers who have commercialized cell and gene therapy products. So they have products that are currently on the market, manufacturers who are going through the process of clinical trials right now, working with the FDA to get approved products. But we also work with trade organizations that are working behind the scenes at the sector level, trying to get different policies and access changes for patients."   "To date, there's probably close to a couple of dozen FDA-approved cell and gene therapies, and they treat everything from blood cancers, which were the first approvals in something called CAR T. We saw blood cancers as the first approvals, and then everything through to solid tumors in oncology. But also, we have newer gene therapies for conditions like sickle cell disease. And that's an area that's been incredibly underserved and definitely will benefit from a durable gene therapy that hopefully corrects some of the issues that patients with sickle cell disease have, like pain crises that end up in a hospital. So from that perspective, we see a really wide range of treatments available to patients today and many more on the horizon." "I think the price tag is definitely somewhat of sticker shock for people who don't understand how cell and gene therapy products are valued. And so what we do a lot of times, educating on, is helping payers understand that it's not necessarily $2 million for a treatment that's going to be a recurrent payment, but something that's kind of an investment in the patient's and the plan's future." #ADVIHealth #CellTherapy #GeneTherapy #AcesstoCellGeneTherapy #ClinicalTrials  advi.com Listen to the podcast here

Election day a tinte dem quello di ieri negli Stati Uniti: Mamdani è il nuovo Sindaco di New York (primo musulmano), Sherrill e Spanberger nuove Governatrici di New Jersey e Virginia. Con noi Mattia Diletti, professore di public policy alla Sapienza, esperto di politica americana, autore di "Divisi. Politica, società e conflitti nell'America del XXI secolo" (Treccani Libri). Settimana dell'economia circolare e della raccolta differenziata in occasione di Ecomondo: Genova aderisce al Piano straordinario nazionale per la raccolta differenziata degli imballaggi. Sentiamo Fabio Costarella, vicedirettore generale CONAI. L'accoltellamento in Piazza Gae Aulenti riporta a galla il dibattito sulle misure di prevenzione per i soggetti con patologie psichiatriche, e quindi sulle REMS (Residenze per l'Esecuzione delle Misure di Sicurezza) . Ne parliamo con Alessia Cicolini, Direttrice delle REMS di Castiglione delle Stiviere in provincia di Mantova.

Subscribe to UnitedHealthcare's Community & State newsletter.In this episode, Rob Lott interviews Jennifer Kao of the UCLA Anderson School of Management in front of a live audience about her paper in the October 2025 issue of Health Affairs exploring the impact of risk evaluation and mitigation strategies on generic approvals of US pharmaceutical products.Order the October 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast Subscribe to UnitedHealthcare's Community & State newsletter.

Kerry Mello-Parker, Director of Rare Diseases and REMS programs at Shields Health Solutions, addresses the complexities and challenges faced by patients with rare diseases including diagnostic delays and limited access to medication. Using an integrated specialty pharmacy model, Shields works with pharmacists to have direct access to the EHR, enabling better patient monitoring, shorter time to initiate medication, tracking outcomes, and providing patients with a direct line of communication to their care team. Pharmacists treating rare diseases are also supported with specialized information on medication administration, side effects and complex billing.  Kerry explains, "Shields Health Solutions is a specialty pharmacy accelerator. We partner with over 80 health systems across the United States. We support them in establishing and growing a specialty pharmacy. We help them to access critical medications. Some of them are not available at traditional pharmacies, and we support them in managing clinical quality care programs for their patients." "I'd like to step back a little and talk about what a rare disease is and how we define it. Currently, it is defined as a condition that affects fewer than 200,000 people. However, over 7,000 rare diseases exist. So when we do the math, we come to see that they are not so rare. And some estimates show that up to 10% of the US population may actually have a rare disease. And what I've seen is that there are really three main complexities of treating rare diseases and challenges that patients may face. One of them is that there is a lack of available treatment options when compared with more common diseases. So, for example, only about 10% of rare diseases have an FDA-approved treatment option, but that is changing. We have the Orphan Drug Act, which has actually changed the landscape. It has incentivized and facilitated the development of medications to treat rare diseases." #ShieldsHealthSolutions #IntegratedCareModel #SpecialtyPharmacy #RareDiseases #MedicationAdherence shieldshealthsolutions.com Listen to the podcast here

Kerry Mello-Parker, Director of Rare Diseases and REMS programs at Shields Health Solutions, addresses the complexities and challenges faced by patients with rare diseases including diagnostic delays and limited access to medication. Using an integrated specialty pharmacy model, Shields works with pharmacists to have direct access to the EHR, enabling better patient monitoring, shorter time to initiate medication, tracking outcomes, and providing patients with a direct line of communication to their care team. Pharmacists treating rare diseases are also supported with specialized information on medication administration, side effects and complex billing.  Kerry explains, "Shields Health Solutions is a specialty pharmacy accelerator. We partner with over 80 health systems across the United States. We support them in establishing and growing a specialty pharmacy. We help them to access critical medications. Some of them are not available at traditional pharmacies, and we support them in managing clinical quality care programs for their patients." "I'd like to step back a little and talk about what a rare disease is and how we define it. Currently, it is defined as a condition that affects fewer than 200,000 people. However, over 7,000 rare diseases exist. So when we do the math, we come to see that they are not so rare. And some estimates show that up to 10% of the US population may actually have a rare disease. And what I've seen is that there are really three main complexities of treating rare diseases and challenges that patients may face. One of them is that there is a lack of available treatment options when compared with more common diseases. So, for example, only about 10% of rare diseases have an FDA-approved treatment option, but that is changing. We have the Orphan Drug Act, which has actually changed the landscape. It has incentivized and facilitated the development of medications to treat rare diseases." #ShieldsHealthSolutions #IntegratedCareModel #SpecialtyPharmacy #RareDiseases #MedicationAdherence shieldshealthsolutions.com Download the transcript here

Bone health is something most of us don't think about until much later in life, but the reality is that the foundation for strong, healthy bones is built decades earlier – and what we do in our 20s, 30s and 40s can make all the difference to our health and strength in later years. Today, I'm delighted to welcome Dr Vonda Wright. Vonda is an orthopaedic surgeon and internationally recognised authority on active ageing and mobility. She believes that with mobility, smart nutrition and building relationships, we can harness our own power to control 70% of our health and ageing. Vonda specialises in sports medicine and is one of only a few female orthopaedic surgeons in the United States. She currently serves as the inaugural Chief of Sports Medicine for the Northside Hospital Orthopaedic Institute and is the founding director of the Performance and Research Initiative for Masters Athletes (PRIMA). She is also the author of several books, including her latest, Unbreakable: A Woman's Guide to Ageing With Power, combines cutting-edge science with practical tools to help us protect our bones and our future health. In this fantastic conversation, we discuss: Why osteoporosis isn't just a disease of old age, but one that begins much earlier in life, often decades before the first fracture. The idea of the “critical decade” – why our mid-30s to mid-40s are such a pivotal window for building bone strength, especially for women approaching menopause. The key lifestyle factors that influence bone density, from nutrition and protein intake to resistance training and impact exercise, and why it's never too late to start. How scans such as DEXA and REMS can give a clearer picture of bone quality and help us take action before problems arise. The cultural and societal pressures that shape women's health behaviours, and how these can sometimes work against long-term bone resilience. Simple, practical strategies for protecting your bones at every stage of life, supporting independence, mobility and confidence as we age. Vonda also shares her vision of ageing with strength, independence and vitality, and why she believes we can all take proactive steps to remain “unbreakable”. As Vonda explains, we have more control over our bone health than we might realise - and that knowledge should feel both comforting and empowering. Caring for our bones is really about caring for our future selves. By taking simple, consistent steps today, we can build the strength and confidence to live the way we want for years to come. I hope you enjoy listening. Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts https://apple.co/feelbetterlivemore. For other podcast platforms go to https://fblm.supercast.com.   Thanks to our sponsors: https://www.betterhelp.com/livemore https://www.vivobarefoot.com/livemore https://join.whoop.com/livemore   Show notes https://drchatterjee.com/588   DISCLAIMER: The content in the podcast and on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

Thank you for joining us for our 2nd Cabral HouseCall of the weekend!   I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks…   Raina: Hi Dr. Cabral! Hope you're feeling groovy and vibrant on this fine day! :) I recently had a baby.. I was planning for a home birth but things didn't go as planned. After 100+ hours of labor I went to the hospital and ended up with an emergency c section. My baby was taken to the NICU because of struggling to breathe - she had swallowed meconium which quickly came out and she was then breathing fine. While I was in recovery from surgery and she was in the NICU the med team gave her a vit K shot, despite the fact that i previously told them no injections. Now I'm trying to right their wrongs. Is there anything I can do to help her body after receiving the vit K shot? Also, how could I best support her body after a c section and not getting the benefits of a natural vaginal birth? Thanks!!!!!                                                                     Jennifer: Hi Dr. Cabral! I would like to get your thoughts on mesenteric panniculitis. I am a healthy 50 year-old female, currently IHP level 1 student. I had a CT abd/pelvis a few months back for a pretty bad GI virus. Scan showed enterocolitis however incidentally noted “mesenteric panniculitis, likely chronic”. I have read this (mesenteric panniculitis) can be autoimmune related and wanted to get your thoughts and any recommendations. By the way, I will be completing my first Dr. Cabral 21 day detox in 2 weeks and already feel great! Thank you so much for all you do!                                                 Jill: Dr. Cabral, I enjoy and learn so much from your podcast and appreciated learning about mammogram alternatives in episode 3049. Similarly, I'd love to find DEXA alternatives with no radiation and wanted to get your feedback on REMS (Radiofrequency Echographic Multi Spectrometry). This technology has no radiation and is made by the Echolight company in Italy. It is currently available through Precision bone imaging in CA and AZ and because the technology is portable was also available to book at my local OsteoStrong location in Las Vegas, NV. Additionally, can you give your feedback on the FDA cleared device called OsteoBoost?                                                                                       John: He doc. Just wondering if you read the book the one minute cure and if you did what did you think about it . Thanks keep up the amazing work                                                                                                                                                                   John: Hey doc . In one of your previous podcast you mention how good the sauna is to do post workout, I'd like to know iif that's only after an anaerobic workout or if it's good after an aerobic workout to . Thanks       Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes and Resources: StephenCabral.com/3502 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let's dive into the latest updates impacting clinicians and healthcare providers like you! Interested in a more traditional, text rundown? Check out the HCPFive! FDA Accepts Priority Review Application of Omidubicel for Severe Aplastic Anemia  The FDA accepted a priority review application for omidubicel, a cell therapy under investigation for severe aplastic anemia. FDA Approves REMS Label Update for Sparsentan (Filspari) in IgA Nephropathy  The FDA approved an updated REMS label for sparsentan, easing monitoring requirements for patients with IgA nephropathy. FDA Issues CRL to Outlook Therapeutics' ONS-5010 for the Treatment of Wet AMD The FDA issued a complete response letter for ONS-5010 in wet AMD, citing insufficient efficacy evidence from the phase 3 program. ACC Releases Respiratory Disease Vaccination Guidelines for Adults with Heart Disease The ACC released new guidance recommending vaccination against respiratory infections for adults with cardiovascular disease to improve prevention and access. Orforglipron Delivers Weight Loss, A1C Reductions in Phase 3 ATTAIN-2 Trial Eli Lilly reported phase 3 results showing orforglipron improved weight and glycemic control in adults with obesity or overweight and type 2 diabetes.

COVID-19 vaccine approvals; CDC leadership in turmoil; orforglipron weight loss trial results; Ixchiq license suspended by FDA; REMS updated for Filspari

COVID-19 vaccine approvals; CDC leadership in turmoil; orforglipron weight loss trial results; Ixchiq license suspended by FDA; REMS updated for Filspari

In this video, Dr. Doug Lucas discusses the advancements in osteoporosis care, focusing on the limitations of traditional DEXA scans and introducing REMS technology as a revolutionary alternative. *Check out 4Well's Saw Palmetto For Men here:* https://tinyurl.com/4WellSawPalmetto *Interested in checking out 4Well's products?* https://tinyurl.com/DRDOUG4WELL. Use promo code DRDOUG4WELL to save 10%!*STUDIES*https://boneandjoint.org.uk/Article/10.1302/1358-992X.2023.16.046https://pmc.ncbi.nlm.nih.gov/articles/PMC6763416/https://link.springer.com/article/10.1007/s00198-018-4686-3https://www.sciencedirect.com/science/article/pii/S8756328220305743?via%3Dihubhttps://pmc.ncbi.nlm.nih.gov/articles/PMC10115670/https://pmc.ncbi.nlm.nih.gov/articles/PMC9923405/https://pmc.ncbi.nlm.nih.gov/articles/PMC11631096/https://pmc.ncbi.nlm.nih.gov/articles/PMC10300972/https://www.sciencedirect.com/science/article/pii/S8756328220300776?via%3Dihubhttps://pubmed.ncbi.nlm.nih.gov/27033331/https://ieeexplore.ieee.org/document/7169892https://journals.viamedica.pl/rheumatology_forum/article/view/64529https://pubmed.ncbi.nlm.nih.gov/38904870/

In this podcast episode, we tackle bone health in perimenopause and menopause with expert guidance and real-world solutions. Host Andrea Donsky—a nutritionist with over 20 years of experience, menopause educator, published menopause researcher, and co-founder of WeAreMorphus. Joining her is Harleen Laroia, director of Osteostrong Oakville and Toronto, who has dedicated her career to helping women regain strength and vitality.In this episode, Andrea and Harleen break down the science behind bone loss during perimenopause and menopause, share practical tips on nutrition and supplements, and introduce innovative, non-invasive technologies like Osteostrong's axial-loading system. You'll hear real success stories, learn how to stack lifestyle, nutrition, and movement for optimal bone health, and get the inside scoop on the latest research and diagnostic tools. If you're looking for actionable advice, inspiration, and a fresh perspective on thriving through menopause, this episode is a must-listen.Topics Discussed:Perimenopause causes rapid bone density loss, which increases the risk of osteoporosis (00:10:15).Nutrition and protein intake are crucial for maintaining bone health during menopause (00:25:30).Natural supplements, such as magnesium, vitamin D, and minerals, support bone strength (00:26:05).OsteoStrong's axial-loading exercises improve bone density and joint health (00:12:10, 00:23:40).Hormone therapy can restore energy and help prevent bone loss (00:06:35).OsteoStrong offers a safe, non-drug option for osteoporosis reversal (00:14:35).Bone density is tracked with DEXA scans and REMS ultrasound (00:19:20).Lifestyle changes—such as exercise, nutrition, and supplements—are essential for maintaining bone health (00:24:55).Weight-bearing exercise alone isn't enough; a multi-pronged approach is most effective (00:17:40).Consulting a menopause specialist and requesting DEXA testing is recommended (00:06:55).New research shows axial-loading exercise improves bone density and blood sugar (00:22:35).Related Links:Reverse Osteoporosis with Proven Midlife Strategies with Dr. Doug Lucas https://youtu.be/Who3x4TKyvwSend us a text ✅ Fill out our surveys: https://bit.ly/4jcVuLh

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I'm about to share something that completely changed how I think about bone health – and it might shock you, too. For years, I've been getting DEXA scans and feeling confident about my bone health because my scores looked great. Then I discovered a revolutionary new test called REMS (radiofrequency echographic multi-spectrometry), and guess what? Despite my "perfect" DEXA results, I actually have mild osteopenia. This was my wake-up call, and it's why I'm passionate about sharing the complete truth about bone health supplements women over 40 need to know. Here's what no one tells you: traditional DEXA scans only measure bone mineral density – how much bone you have – but they miss the crucial piece of bone quality. You could have normal bone density but still have fragile bones if your bone architecture, turnover rates, and collagen integrity aren't optimal. That's why I'm diving deep into the cutting-edge strategies that go far beyond calcium supplements, including specific exercises that load your spine and hips, the power of creatine for postmenopausal women, and why a simple weighted vest might be one of the best investments you'll ever make for your future self. What you'll learn: Why waiting until 65 for your first bone density test is setting you up for failure (and when you should really start testing) The game-changing difference between bone mineral density and bone quality – and why you need both for truly strong bones How REMS testing provides a radiation-free, real-time assessment that's revolutionizing personalized aging care The specific exercises that create the bone-building stress your skeleton craves, including the magic of weighted vest walking Why bone health supplements women over 40 should include creatine HCL and how it works synergistically with resistance training The hidden risk factors stealing your bone strength (hint: it's not just menopause) My complete protocol for women 40+ to build and maintain strong bones from the inside out How to overcome anabolic resistance as you age and why protein timing matters more than you think Love the Podcast? Here's what to do: Make My Day & Share Your Thoughts! Subscribe to the podcast & leave me a review Text a screenshot to 813-565-2627 Expect a personal reply because your voice is so important to me. Join 55,000+ followers who make this podcast thrive. Want to listen to the show completely ad-free?  Go to subscribetojj.com Enjoy the VIP experience for just $4.99/month or $49.99/year (save 17%!) Click “TRY FREE” and start your ad-free journey today! Full show notes (including all links mentioned): https://jjvirgin.com/bonehealth Learn more about your ad choices. Visit megaphone.fm/adchoices

Do you need to filter your water?More on the REMs test for osteoporosis

Could everything you've been told about bone scans be outdated?In this game-changing episode, I welcome back Dr. Andy Bush, orthopedic surgeon and bone health innovator, to explore a revolutionary new technology: REMS (Radiofrequency Echographic Multi Spectrometry).Unlike the traditional DEXA scan that only measures bone density, REMS analyzes bone strength, structure, and real fracture risk. Together, we break down what REMS actually does, why it matters, and how it's reshaping the future of osteoporosis diagnosis and prevention—especially for women who want to avoid unnecessary medications and take charge of their health.What You'll Learn:Why T-scores and DEXA scans are incomplete—and sometimes misleadingHow REMS technology uses sound waves to assess true bone strengthWhat a Fragility Score is and how it can predict fracture risk more accuratelyWhy orthopedic surgeons like Dr. Bush are leading the shift to structural bone assessmentsThe importance of viewing bones through a mechanical AND biological lensHow muscle loss (sarcopenia) and bone loss are linked—and what you can do about itWhy women deserve more than a “diagnosis and a drug” when it comes to bone healthDebi's Takeaway:Your bones are more than a number. What we need is not just more medication, but better diagnostics and stronger education. REMS is offering both — and giving women the power to understand their real risk and make informed decisions.About Dr. Andy Bush:Dr. Andy Bush is a board-certified orthopedic surgeon based in North Carolina. After 30+ years of surgically repairing fractures, he now leads a prevention-focused bone clinic using REMS technology to assess and improve structural bone health—without radiation or outdated density-based models. You can find out more about Dr. Bush here.

Lawsuit filed against RFK Jr over vaccine policy changes; oral on-demand treatment approved for HAE; OTC cuffless blood pressure monitor gets greenlit; dosing schedule update for Alzheimer treatment; REMS requirement removed for endothelin receptor antagonist meds.

Is a single number determining your treatment plan? For many women, the T-score from a DEXA scan becomes the full story of their bone health. But what if that story is incomplete—or even misleading?In this episode, I sit down with orthopedic surgeon Dr. Andy Bush, who has shifted his focus from fixing fractures to preventing them. Together, we dive into the flaws of the traditional DEXA scan, why your T-score might not reflect your actual fracture risk, and the power of a better diagnostic: REMS (Radiofrequency Echographic Multi-Spectrometry).If you've ever been told you have osteoporosis — or felt confused and fearful about your scan results—this is the episode for you.

In this episode, Dr. Doug Lucas and Sarah Glicken delved into the complexities of bone health, emphasizing its crucial role in longevity. Dr. Doug noted that while osteoporosis is often seen as a condition affecting older adults, its roots can be traced back to earlier life stages, making early intervention vital. They shared the limitations of DEXA scans, particularly their inability to assess bone quality, and why they advocate for the use of REMS technology, which offers a more comprehensive evaluation by assessing bone density and microarchitecture. We also touched upon the potential dangers of conventional bone medications, such as bisphosphonates, which can lead to side effects like jaw necrosis and atypical fractures. They emphasized the importance of exploring alternative therapies that focus on lifestyle modifications that include osteogenic loading and supplementation such as vitamin K2 and vitamin D3 (not calcium!) This episode serves as a comprehensive guide for individuals seeking to understand and improve their bone health through informed choices and proactive measures.Dr. Doug Lucas is a double board-certified orthopedic surgeon turned osteoporosis specialist on a mission to show the world that osteoporosis is preventable and reversible. As the VP of Women's Health, Hormone and Lifestyle Optimization at LifeMD and the creator of The OsteoCollective, he empowers individuals to optimize bone health, hormones, and HealthSpan through classic and cutting-edge strategies.Sarah Glicken is the co-founder of Precision Bone Imaging, a company dedicated to shifting the narrative around aging—starting with skeletal health. Using REMS ultrasound technology, PBI provides radiation-free, highly accurate bone scans that help people take proactive steps toward long-term strength and resilience. Sarah also owns multiple OsteoStrong centers in Los Angeles, where members use science-backed osteogenic loading to strengthen bones, joints, and muscles in just minutes a week. With a Master's in Spiritual Psychology and certifications in holistic health, she brings a grounded, heart-centered approach to everything she does.SHOW NOTES:0:39 Welcome to the show!2:25 About Dr. Doug Lucas2:50 About Sarah Glicken3:20 Welcome them to the podcast!4:09 How is bone health essential to Longevity6:02 Renee's bone health journey7:40 DEXA Scan vs REMS11:58 The challenges with DEXA13:58 Advantages of REMS19:55 Bisphosphonates & other bone drugs26:10 Nutrition for bone health31:25 What kind of water is the healthiest?32:43 Is calcium bad for bones?34:49 *ALIGN MAT*36:28 Magnesium, Vitamin D & Vitamin K42:36 Science of lifting heavy47:08 How to do Osteogenic Loading49:30 How hormones affect bones59:22 Stress in perimenopause & menopause1:03:03 Sleep, Toxins & Periods1:10:01 Can we reverse bone loss?1:12:10 More Info: Precision Bone Imaging1:12:43 More Info: Dr. Doug Show1:14:03 Dr. Doug's final advice14:53 Sarah's final advice1:15:42 Thanks for tuning in!RESOURCES:precisionboneimaging.comYouTube: The Dr. Doug ShowInstagram: @drdouglucasFacebook: Dr. Doug LucasPodcast: The Dr. Doug ShowWebsite: The OsteoCollectiveInstagram: Sarah Glickenosteostrongla.com My Align Mat - $250 off with code: BIOHACKERBABESPuori - 20% off with code: BIOHACKERBABESEffecty - $50 off with code: BIOHACKERBABESOur Sponsors:* Check out Puori: https://Puori.com/BIOHACKERBABESSupport this podcast at — https://redcircle.com/biohacker-babes-podcast/donationsAdvertising Inquiries: https://redcircle.com/brands