Podcasts about Spinal cord

The March 2025 replay features four previously released episodes focused on peripheral neuropathy and radiculopathy. The episode begins with Dr. Anne Oaklander discussing the association between long COVID and the development of polyneuropathy affecting small-fiber axons. This is followed by another interview with Dr. Oaklander, where she shares key takeaways for clinicians regarding the management of small-fiber neuropathy. The third segment features Drs. Raymond Price and Brian Callaghan discussing practice guidelines for painful diabetic neuropathy. The episode concludes with Dr. Carmel Armon addressing the efficacy of epidural steroid injections in treating cervical and lumbar spinal stenosis and radiculopathies. Podcast Links: Peripheral Neuropathy and Prolonged COVID  Relapsing-Remitting Immunotherapy Responsive SFN  Practice Guidelines for Painful Diabetic Neuropathy Epidural Steroids for Cervical and Lumbar Radicular Pain and Spinal Stenosis Article Links:  Peripheral Neuropathy Evaluations of Patients With Prolonged Long COVID  Relapsing-Remitting Immunotherapy Responsive Small-Fiber Neuropathy  Epidural Steroids for Cervical and Lumbar Radicular Pain and Spinal Stenosis Systematic Review Summary  Disclosures can be found at Neurology.org.

Dr. Alex Menze and Dr. Carmel Armon discuss the efficacy of epidural steroid injections in cervical and lumbar spinal stenosis and radiculopathies, assessing short-term and long-term improvements in pain and disability. Show reference: https://www.neurology.org/doi/10.1212/WNL.0000000000213361 

Dr. Alex Menze talks with Dr. Carmel Armon about the efficacy of epidural steroid injections in cervical and lumbar spinal stenosis and radiculopathies, assessing short-term and long-term improvements in pain and disability. Read the related article in Neurology®. Disclosures can be found at Neurology.org. 

What does it take to recover from a spinal cord injury? In this episode, we sit down with Charlie Powell, a spinal cord injury survivor, to hear his powerful story of resilience, rehabilitation, and regaining independence. Charlie shares his journey from the initial injury to long-term recovery, highlighting the impact of Physical Medicine & Rehabilitation (PM&R) in restoring function and quality of life. We explore the challenges he faced, the role of a multidisciplinary rehab team, and the importance of setting realistic goals during the healing process. Key Takeaways: ✔️ The emotional and physical challenges of spinal cord injury recovery ✔️ How PM&R specialists and rehab teams shape a patient's journey ✔️ The power of goal setting in rehabilitation ✔️ Collaboration between rehab professionals ✔️ How healthcare providers can advocate for spinal cord injury patients Listen now for a firsthand look at how rehabilitation medicine transforms lives. Website: www.aocpmr.org Instagram: @aocpmr Youtube: AOCPMR

Have I got big news for you on the first episode of 2025... The QuadCast has officially spawned another exciting and informative podcast! Yes, and on today's episode, I interview my co-contributors in this new venture, the "3 Men And A SCI" Pod. Below are very brief bios of both amazingly accomplished gentlemen. I look forward to working with them on this exciting venture, and hope you'll join us for the ride! Barry Munro is a quadriplegic who sustained a spinal cord injury in 1987, and has been an active advocate in SCI research for over 37 years. He is the chief Development Officer of the Canadian/American Spinal Research Organization, which was established in 1984 to fund targeted research to maximize functional recovery and cure paralysis caused by spinal cord injury. Barry also currently holds the position of Treasurer for the North American Spinal Cord Injury Consortium, a community led organization which has the mission to bring about unified achievements in research, care, cure, and policy by supporting collaborative efforts across the spinal cord injury community. At the age of 19, Alexander “Sasha” Rabchevsky was a strong safety on the Hampden-Sydney College, VA football team when a motorcycle accident left him paralyzed from the chest down. Sasha transformed that turn of events into a career searching for ways to repair spinal cord damage and improve the lives of those living with spinal cord injury (SCI). Since 2002, Sasha has been a faculty member of the Department of Physiology at the University of Kentucky and core member in the Spinal Cord & Brain Injury Research Center (SCoBIRC). Not only will you find out more about Barry and Sasha, but what we hope to accomplish with our platform.

In today's episode, we look at mathematical models for understanding and predicting spine injury and spinal cord trauma. We will discuss the ways in which trauma is produced and which factors have the greatest effect on overall outcome. 

Ciarán McCarthy, Author of Closer to Walking Again and Prof. Fergal O'Brien, Deputy Vice Chancellor for Research & Innovation in RCSI and Head of the Tissue Engineering Research Group

Daily Dad Jokes (14 Dec 2024)The official Daily Dad Jokes Podcast electronic button now available on Amazon. The perfect gift for dad! Click here here to view!Email Newsletter: Looking for more dad joke humour to share? Then subscribe to our new weekly email newsletter. It's our weekly round-up of the best dad jokes, memes, and humor for you to enjoy. Spread the laughs, and groans, and sign up today! Click here to subscribe!Listen to the Daily Dad Jokes podcast here: https://dailydadjokespodcast.com/ or search "Daily Dad Jokes" in your podcast app.Interested in Business and Finance news? Then listen to our sister show: The Daily Business and Finance Show. Check out the website here or search "Daily Business and Finance Show" in your podcast app.Jokes sourced and curated from reddit.com/r/dadjokes.Joke credits: Masselein, Petethedude46, donttakethechip, SoNotCool, TheQuietKid22, essodei, IthinkIknowwhothatis, mrl33602, TLMoravian, tripn4days, Civil_Peacenik, NixNada, , bagofsleepybeets, RAVENGREENEMOON2, ricksevans, berkleysquare, Masselein, impiousPunsterSubscribe to this podcast via:iHeartMediaSpotifyiTunesGoogle PodcastsYouTube ChannelSocial media:InstagramFacebookTwitterTikTokDiscordInterested in advertising or sponsoring our show? Contact us at mediasales@klassicstudios.comProduced by Klassic Studios using AutoGen Podcast technology (http://klassicstudios.com/autogen-podcasts/)See omnystudio.com/listener for privacy information.

Holy crap that title is a mouthful and the Adventure Duo goes on one of the weirdest Christmas adventures ever! Hold on tight for an origami jet ski ride! Try the Adventure for yourself @ https://chooseyourstory.com/story/You-Are-A-Disc-In-My-Dad's-Spinal-Cord~2e-Can-You-Make-His-Back-Stop-Hurting-In-Time-For-Christmas~3f Music: https://pixabay.com/music/christmas-calm-christmas-piano-262888/ Sound effects: https://www.zapsplat.com

In part two of this two-part series, Dr. Stacey Clardy and Dr. Elias Sotirchos discuss abandoning the term lupus myelitis and emphasize the importance of accurately naming and identifying each autoimmune condition. Show reference: https://www.neurology.org/doi/10.1212/NXI.0000000000200329  

In part one of this two-part series, Dr. Stacey Clardy and Dr. Elias Sotirchos discuss key features of inflammatory myelopathy in rheumatologic disease, helping to better characterize the underlying causes of lupus myelitis. Show reference: https://www.neurology.org/doi/10.1212/NXI.0000000000200329 

Dr. Stacey Clardy talks with Dr. Elias Sotirchos about the underlying etiologies of myelitis in patients with rheumatologic disease. Read the related article in Neurology: Neuroimmunology & Neuroinflammation. Disclosures can be found at Neurology.org.

Spinal cord stimulation can be a useful tool for treating chronic low back and leg pain. In this BackTable Brief, Drs. Dana Dunleavy and Blake Parsons discuss the specifics of implanting lumbar spinal cord stimulation. They explore patient positioning, anesthesia, needle angulation, and the importance of targeting spinal levels correlated to pain. TIMESTAMPS 00:00 - Pre-Operative Setup 02:10 - Obtaining Access and Placing Leads 05:05 - Postoperative Considerations 08:43 - Evaluation of Patient Candidacy CHECK OUT THE FULL EPISODE BackTable MSK Ep. 48– SCS for Neuropathy: Clinical Insights & Patient Impact: https://www.backtable.com/shows/msk/podcasts/48/scs-for-neuropathy-clinical-insights-patient-impact

Moderator: Raphael Wurm (Vienna, Austria)Guest: Majda Thurnher (Vienna, Austria)For this episode, Raphaela Wurm welcomes Majda Thurnher to dive into the challenges and joys of diagnosing spinal cord ischemia as theyexplore MRI protocols, key imaging findings, and the impact of diffusion-weighted imaging.

Jim writes in to say, 'Sometimes when I pinch near my knee, I will feel a tingling or tickling sensation behind one of my shoulder blades. What's up with that?' James Tytko found him an answer, with help from neuroscientist Dr Mark Hoon from the NIH... Like this podcast? Please help us by supporting the Naked Scientists

Interventional radiologists can play a vital role in pain management and palliative care through spinal cord stimulation (SCS). In this BackTable Brief, Dr. Dana Dunleavy speaks with Dr. Blake Parsons about this technology and the learning opportunities it presents. Dr. Parsons reflects on his introduction to outpatient spinal cord stimulation during his training at the Medical College of Wisconsin, where he gained exposure to both palliative care and interventional oncology. He discusses the technical aspects and challenges associated with permanent SCS procedures, including accessing the epidural space and the risks of nerve injury. Additionally, Dr. Parsons explores the economic considerations of SCS, comparing reimbursement rates for trials and permanent implants across various settings. TIMESTAMPS 00:00 - Introduction 02:38 - Understanding Permanent Implants 04:38 - Procedure Details and Challenges 06:52 - Reimbursement and Financial Considerations 09:28 - Time Utilization and Efficiency 11:44 - Final Thoughts CHECK OUT THE FULL EPISODE BackTable MSK Ep. 48– SCS for Neuropathy: Clinical Insights & Patient Impact: https://www.backtable.com/shows/msk/podcasts/48/scs-for-neuropathy-clinical-insights-patient-impact

Hello, and welcome to Entangled! The podcast where we explore the science of consciousness, the true nature of reality, and what it means to be a spiritual being having a human experience.Today I'm joined by Dr. Danny Knowles, Founder of Network Wellness Center in Boulder, CO.  In this conversation, Danny describes how his health journey led him to the field of chiropractic, the largest, drugless healing modality in the world. We discuss the unity between man the physical and man the spiritual. Danny then explains the difference between NetworkSpinal care and those of other western chiropractors, which look more like physical therapy.Danny explains the spinal gateways tied to our nervous system, that everything is energy, and how their chiropractic care breaks the holding patterns that keep us trapped in ill health. We discuss how to optimize compromised nervous systems in the face of stress, and to increase the bandwidth of frequency we are able to experience.Danny describes how they turn nerves from “suck” to “joy” through a process of discover, transform, awaken and integrate. I ask Danny how he goes about adjusting patients, and Danny explains anchorage points, the spinal cord, and nerve fibers. We discuss how posture Is a window to the structure of your nerve system and that the heart, which has 40,000 neurons, can be considered a second brain.Next, we consider whether the increase in excess deaths in recent years could have resulted from mRNA vaccines. We conclude the conversation by discussing why this is a spiritual time to be working in the healing arts.This Outro is titled “Discover, Transform, Awaken, Integrate”. Outros are available for this and all episodes at entangledpodcast.substack.com. Music from the show is available on the Spotify playlist “Entangled – The Vibes”. If you like the show, please drop a 5-star review and subscribe on Substack, Spotify, Apple or wherever you listen to podcasts.Please enjoy the episode!Music: Intro/Outro: Ben Fox - "The Vibe". End Credits: Richard Farrell – “Soul Swinging”.Recorded: 01/29/24. Published: 10/07/24.Outro: “Discover, Transform, Awaken, Integrate” starts at 1:24:25. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit entangledpodcast.substack.com

Comic Reviews: DC o        Absolute Power: Task Force VII 7 by Dan Watters, Fran Galan o        Batman: The Long Halloween – The Last Halloween 1 by Jeph Loeb, Eduardo Risso, Dave Stewart o        Lobo Cancellation Special by Kyle Starks, Kyle Hotz, Dan Brown Marvel o        Avengers Annual 2024 by Derek Landy, Salvador Larroca, Guru eFX o        Venom War: Daredevil 1 by Chris Condon, Lan Medina, Yen Nitro o        Marvel Unlimited §  Jeff Week by Gustavo Duarte §  Alligator Loki 40 by Alyssa Wong, Robert Quinn §  Lovable Lockheed 4 by Nathan Stockman Boom o        Mighty Morphin Power Rangers/Usagi Yojimbo 1 by Ryan Parrott, Shawn Daley, James Fenner Dark Horse o        Magic Order Five 1 by Mark Millar, Matteo Buffagni, Giovanna Niro o        Masters of the Universe/TMNT: Turtles of Grayskull 1 by Tim Seeley, Freddie Williams II, Andrew Dalhouse o        Survival Street: The Radical Left 1 by James Asmus, Jim Festante, Abylay Kussainov, Ellie Wright DSTLRY o        Missionary 1 by Ryan Stegman, Jason Howard IDW o        My Little Pony: The Storm of Zephyr Heights 1 by Jeremy Whitley, Andy Price, Heather Breckel Image o        Creepshow Volume Three 1 by Chip Zdarsky, Kagan McLeod, James Stokoe o        Knights vs. Samurai 1 by David Dastmalchian, Fede Mele, Ulises Arreola o        Manchurian (Horizon Experiment) 1 by Pornsak Pichetshote, Terry Dodson, Rachel Dodson o        Old Dog Operations 1 by Declan Shalvey; PJ Holden, John McCrea, Mike Spicer; Declan Shalvey, Matias Bergara, Sofie Dodgson; Rory McConville, David O'Sullivan; Sumeyye Kesgin; Declan Shalvey, Luke Sparrow, Dee Cunniffe; Leonardo Romero, Triona Farrell; Alex Paknadel, Chris Sprouse, Dexter Vines; Charles Soule, Gavin Guidry, Chris O'Halloran o        Violator 1 by Marc Andreyko, Piotr Kowalski, Brad Simpson o        Violent Flowers 1 by Maria Llovet Mad Cave o        Revolution 9 1 by Mark London, Carlos Reno, Jao Canola Valiant by o        Black, White, and Bloodshot 1 by Luciano Saracino, Ariel Olivetti; Marc Guggenheim, Agustin Alessio; Matts, Guillermo Fajardo; Tim Seeley, Rodrigo Rocha Magma o        Hell's Half Acre 1 by Denton Tipton, Jack Jadson Indie o        Yuletide Flame by Hayden Fryer OGN Countdown o        Transplants by Dave Collard, Domenico Carbone, Josh Rodriguez o        Grinch Takes a Vacation by Kaeti Vandorn o        New Adventure of Turning Red Vol 2: Panda Power by Sloane Leong, Sergio Algozzino, Sara Galanti o        Moosicians by Steve Behling, Jeff Crowther o        Inventor Vol 2: The Secret of the Scrap Goblin by Lars Henrik Eriksen o        A Quick and Easy Guide to Coming Out by Kristin Russo, Ravi Teixeira o        Spinal Cord by David Brana, Pahito o        Peter Pan in Kensington Gardens o        Amazing Grapes by Jules Feiffer o        Holler by Jeremy Massie Additional Reviews: Wild Robot, Justice League International, Wilderness, Agatha All Along ep3, Penguin ep2 News: rumors of a James Gunn/Jim Lee Superman comic in 2025, Justice League x Sonic, Hellboy: Crooked Man going straight to digital, superhero trademark Trailers: Sinners, Caddo Lake, Dream Productions, Killer Cakes, Sweatpea Comics Countdown (25 September 2024): 1.     Helen of Wyndhorn 5 by Tom King, Bilquis Evely, Mat Lopes 2.     Spectregraph 3 by James Tynion IV, Christian Ward 3.     Ultimate Spider-Man 9 by Jonathan Hickman, Marco Checchetto, Matt Wilson 4.     Lobo Cancellation Special by Kyle Starks, Kyle Hotz, Dan Brown 5.     Action Comics 1069 by Gail Simone, Eddy Barrows, Danny Miki, Jonas Trindade, Rex Lokus 6.     Standstill 2 by Lee Loughridge, Andrew Robinson 7.     Drawing Blood 6 by David Avallone, Kevin Eastman, Troy Little, Ben Bishop, Luis Antonio Delgado 8.     Detective Comics 1089 by Dan Watters, Ram V, Guillem March, Christopher Mitten, Luis Guerrero, Triona Farrell 9.     Batman: Brave and the Bold 17 by Michael Conrad, Christopher Mitten, Miguel Mendonca, Mike Spicer; Zipporah Smith, Mike Norton, John Kalisz; Alex Segura, Andy MacDonald, Patricio Delpeche; Troy Peteri, David Baldeon, Veronica Gandini 10.  Universal Monsters: Frankenstein 2 by Michael Walsh  

Lock Door Mystery. A 27 year old teacher found dead, inside her apartment,  completely alone- with 20 stab wounds to her body. Stabs in the chest, back of her head, in her abdomen, brusies in various staging of healing all over her body, a huge gash on her head- but yet with very little, if any investigation the death was ruled a suicide. More than a decade later and the family of Ellen still has zero answers about what happened that January evening.  Follow us on Instagram: https://www.instagram.com/crimesandcannapod/ Send us True Crime updates: https://twitter.com/CrimesnCannabis Join the discussion on Facebook: https://www.facebook.com/crimesandcannapod/ Listen ad free on Patreon: https://www.patreon.com/crimesandcannabis For case suggestions of feedback: crimesncannabis@gmail.com  --------------------------------------------------------------------If you or a loved one is struggling with suicidal thoughts please know that there is help: https://988lifeline.org/?utm_source=google&utm_medium=web&utm_campaign=onebox https://crisis.solari-inc.org https://www.nimh.nih.gov/health/topics/suicide-prevention https://vocal.media/criminal/ellen-greenberg-suicide-or-murder Sources:https://gavinfish.com/cases/ellen-greenberg/ https://www.nbcphiladelphia.com/local/woman-stabbed-manayunk/1912614/ https://whyy.org/articles/manayunk-woman-stabbed-to-death-at-venice-lofts/ https://whyy.org/articles/neighbor-greenbergs-voice-stood-out-in-a-crowd/ https://en.wikipedia.org/wiki/Death_of_Ellen_Greenberg https://www.tuko.co.ke/facts-lifehacks/celebrity-biographies/500670-where-samuel-goldberg-whereabouts-ellen-greenberg-case-updates/  https://www.lambmcerlane.com/wp-content/uploads/2022/03/inquirer.com-It-was-very-very-weird-A-civil-suit-reveals-new-details-in-the-case-of-Ellen-Greenberg.pdf https://www.independent.co.uk/news/world/americas/crime/ellen-greenberg-body-moved-evidence-b2531096.html https://www.chillingcrimes.com/blogs/news/ellen-greenberg https://www.pennlive.com/news/2019/05/suicide-or-homicide-parents-anguished-search-for-answers-lasts-years-after-daughter-dies-of-20-stab-wounds.html https://www.nbcnews.com/dateline/cold-case-spotlight/parents-ellen-greenberg-believe-new-evidence-submitted-philadelphia-attorney-general-n1286606 https://www.pennlive.com/crime/2023/09/ellen-greenbergs-parents-lose-court-case-to-overturn-daughters-suicide-ruling-beyond-tears.html https://www.newsnationnow.com/us-news/northeast/ellen-greenberg-family-civil-lawsuit-philadelphia-death-ruling/ https://www.newsweek.com/ellen-greenberg-pennsylvania-supreme-court-review-suicide-homocide-police-philadelphia-1936647 https://www.yahoo.com/news/ellen-greenberg-autopsy-discrepancies-photos-035624210.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAAzrupw5Rv9l4WX74fiso7x1MUui6UeGjm5eZycrzgNGeQ5G04UfRJ_R-itxSmj2jilfG_n3K9GSS7ya8hC79UiVXsCGzyDm1sWP1hjE9zKUMBj-dyA2_iaJL7eyeBsG-YozD6qil-jtCH5SUXDIKGleqzA4xHsoZRYelTQut9V4 https://www.change.org/p/justice-for-ellen-rae-greenberg-justiceforellen https://podcasts.apple.com/us/podcast/crime-junkie/id1322200189?i=1000546245560 https://podcasts.apple.com/us/podcast/the-prosecutors/id1513765512?i=1000577056688 https://podcasts.apple.com/us/podcast/morbid/id1379959217?i=1000536912718 https://whyy.org/articles/ellen-greenberg-suicide-stabbing-pa-supreme-court/ https://people.com/ellen-greenberg-case-death-ruled-suicide-parents-fight-change-homicide-8693229  

This episode of the Next Level Healing Podcast is the recording of a webinar hosted by Dr. Tara Perry and Leland Holgate, a former quadriplegic &  paraplegic who healed himself both times using his breath! Tune into this episode to hear from the man whose chance encounter, as he lay paralyzed from the neck down in his hospital bed, resulted in his learning the techniques that would ultimately set him free.Work with Dr. Tara PerryTune in every week for a new episode of Next Level Healing. Subscribe on your favorite podcasting platform and never miss an episode!

7-year-old Heaven was brought into the Budha House to be healed. The neighbors who brought her in tried to explain - she had been playing and hanging onto a bar when she fell and hit her head. She is now unconscious.  But the healers could just take one look at Heaven and know - the little girl is dead.  When Heaven's mom finally sees Heaven's little body - she finds something even more puzzling. Her mouth is filled with cement. Her autopsy shows she was assaulted “front and back” and had these weird little cuts all over her body.  On her neck, you could almost make out the 5 fingers that were wrapped around her. Suffocating her.  It feels like all the neighbors are in on some big conspiracy. Why do they keep insisting that she fell when it's so clear she did not. What are they hiding? Heaven's mom is going to figure out what the hell happened to her daughter.  https://www.change.org/p/justice-for-heaven-and-her-mother Full Source Notes: rottenmangopodcast.com To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

When Michelle discovered her patient was paralyzed, it surprised the whole medical team. This patient who was previously mobile and recovering from septic shock was now paralyzed and ultimately diagnosed with spinal cord ischemia, but could early intervention have changed the outcome?In this episode, we discuss the causes, signs, diagnosis and treatment of spinal cord ischemia. Michelle shares powerful insights from her work in neurocritical care, including a technique for detecting easy-to-miss neurological changes.Tune in to find out how you can improve patient outcomes when managing spinal cord ischemia!Topics discussed in this episode:Michelle's passion for patient care and nurse advocacyCritical case study: discovering a spinal cord abscessHow the patient developed spinal cord ischemiaPathophysiology and signs of spinal cord ischemiaNeurological assessment tipsPeripheral versus central nervous system assessmentsDiagnostic criteria and the diagnostic processPrognosis and patient recoveryTreatment options and challengesThe role of the ABCDEF bundle in critical careConnect with Michelle:https://www.michellededeo.com/https://www.instagram.com/michellededeo/Listen to Michelle's podcasts, the SCRN Prep Podcast and Narrative Nurse Project Podcast!Get 20% off Michelle's Stroke Review Bootcamp with code RAPIDRN20!https://www.nicolekupchikconsulting.com/booksAndCourses/online-courses/61/stroke-review-bootcamp-case-studies-in-optimizing-careMentioned in this episode:Rapid Response and Rescue Intro CourseCONNECT

The spinal cord serves as the main communication highway between the brain and body. Did you know that 80% of people with multiple sclerosis have spinal cord lesions on MRI? These lesions can disrupt specific neural pathways, leading to common MS symptoms like numbness, weakness, impaired coordination, balance issues, bladder problems, constipation, and sexual dysfunction. For instance, damage to the corticospinal tract on one side of the spinal cord can weaken an arm or leg. A remarkable autopsy study revealed that nearly 90% of people with MS still had active inflammation in the spinal cord. This finding brings new hope for potential treatments, even for older and progressive MS patients. Advances in imaging technology, including more powerful MRI scanners (3 Tesla and higher), are enhancing our ability to see inside the spinal cord, which is as thin as a pinky finger. Improved spinal cord imaging is driving the development of new therapies in clinical trials and helping identify those at risk for worsening disability, ultimately guiding better treatment decisions. Barry Singer MD, Director of The MS Center for Innovations in Care, interviews: Gabriele De Luca MD DPhil, Professor of Clinical Neurology and Experimental Neuropathology, University of Oxford, United Kingdom Bruce Cree MD PhD, Professor of Neurology at University of California, San Francisco School of Medicine

Dr. Robert Baranello the importance of patient selection when using neurmodulation. Part 2 identifies the patient criteria, as well as covers the Gate Control Theory pain and its application in Spinal Cord stimulation and other form of neuromodulation. Dr. Baranello is an Interventional Pain Management Specialist at EmergeOrtho. For more information from Dr. Baranello, check out Https://www.robertbaranellomd.wordpress.com/ https://www.instagram.com/baranello_paindoc/ Register for our next conference at PAOS.org! Join us in Nashville in September - spaces are filling quickly!

Topics covered in the show:Back Up's mission and values including embracing challengeThe importance of mindset to help us overcome thingsKindness - how to be more aware of others around youAbigail's drive to achieve change including her experience as a child carer and a Superintendent in the Met PoliceThe importance and power of communitySelf-care tips and toolsLINKSBack Up Trust WebsiteBack Up Trust in LinkedInSophie Elwes Podcast - A life Less Ordinary LINKSConnect with Natalie at Instagram, Facebook or LinkedInAre you ready to Be the Change? Join Natalie at her free community!Do you like journalling and are your wanting to create new habits? Your Morning Ritual is waiting and ready for you.Need some motivation on your Mondays - here's Natalie's Monday Quick Wins email.

What is Spinal Cord Stimulation and how does it work? What are the risks and how are those risks mitigated by medical professionals? Dr. Deer is at the forefront of spinal cord stimulation research and in this episode he discusses the various aspects of Spinal Cord Stimulators that patients and doctors need to be aware of. Dr. Deer may be reached through https://centerforpainrelief.com/doctor-timothy-deer/ Dr. Deer founded the Spine and Nerve Centers of the Virginias in 1994. The Center has grown to offer treatment to not only West Virginians and Virginians, but also to many patients from throughout the United States, and those who travel Internationally for ground breaking interventional treatments often pioneered with the help of the team at our facilities. Dr. Deer has led a revolution in interventional spine and nerve care by teaching thousands of physicians an algorithmic approach to care including methods that are less invasive at a lower risk for complications. Dr. Deer completed his Medical Degree at West Virginia University at the top of his class, and then went on to complete his advanced training at the University of Virginia. He currently holds the position of as a Clinical Professor of Anesthesiology at WVU and is active in teaching medical students, and hosts many residents and fellows for advanced training from both the United States and many countries. In addition to those positions, Dr. Deer is on the Board of Directors for the North American Neuromodulation Society. He is also on the editorial committee for the journals Neuromodulation, Pain Medicine, and Pain Physician.

Watch the video on You Tube Here: https://www.youtube.com/watch?v=FNbgPNRU4BA Starseed Transmission to guide you ro expand on your highest level Soul path with more ease. This powerful transmission is to help you align to a deeper understanding of your mind, body, nervous system and soul as a Starseed. Plus, help you navigate releasing stored emotions to shift to a higher level consciousness with more ease and grace. Enjoy Powerful Soul Light Language Academy - 50% Off for July https://www.melissabbates.com/lightlanguageacademy Light Language Workshop - Part One - Self-Guided - 50% Off for July https://melissa-bates-73d3.mykajabi.com/light-language-workshop  Light Language Workshop - Part Two - July 28th - 50% Off for July https://melissa-bates-73d3.mykajabi.com/light-language-workshop-1 1:1 - Nervous System + Spinal Healing Session https://melissabbates.as.me/nervoussystemreset  Quantum Money Embodiment Mastermind https://www.melissabbates.com/moneyembodimentmastermind   Step Into Overflow - 50% of Sale https://www.melissabbates.com/stepintooverflow Let's Connect Instagram: Melissabbates_

Ask the Experts: Neuromonitoring for Intramedullary Spinal Cord Tumor Resection Sheng-fu Larry Lo, MD, MHS; Richard Vogel, PhD, DABNM; Adam Doan, DC, DABNM

Pain and suffering were a major part of Estella Patrick's life ever since she was born with Spina Bifida in 2004. Fortunately Estella had surgery to correct this Spinal Cord disease when she was 3 months old and now is an extremely talented and successful artist and illustrator. Her illustrations have appeared in 3 books which have been published by authors who are well known members of the Pediatric Cancer community. 

In this episode, we review the high-yield topic of ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Spinal Cord Lesions⁠⁠⁠⁠ ⁠from the Neurology section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets

Send us a Text Message.We continue our general survey of neurology with an overview of the spinal cord.Things we cover in this podcast:Signs and Symptoms of MyelopathyBreakdown of some causes of compressive versus non-compressive myelopathiesInfectionsNeoplasmsTransverse MyelitisMetabolic CausesVascular MyelopathiesGenetic DisordersThe Neurotransmitters is starting live case based discussions beginning in June 2024.!If you or someone you know is interested in either presenting a case or being part of the discussion group send an email to contact@theneurotransmitters.com with the subject line “Case based discussion.”Looking forward to hearing from you! Check out our website at www.theneurotransmitters.com to sign up for emails, classes, and quizzes! Would you like to be a guest or suggest a topic? Email us at contact@theneurotransmitters.com Follow our podcast channel for The Neurotransmitters @neuro_podcast for future news! Find me on Twitter @DrKentris (https://twitter.com/DrKentris) The views expressed do not necessarily represent those of any associated organizations. The information in this podcast is for educational and informational purposes only and does not represent specific medical/health advice. Please consult with an appropriate health care professional for any medical/health advice.

An early study found that electrical stimulation could improve hand and arm function in people with spinal cord injuries. Also, for thousands of years, Indigenous communities in Guatemala have used observations and mathematics to track astronomical events.Zapping Nerves Into RegrowthResults of an early trial published this week in the journal Nature Medicine found that people with cervical spinal cord damage showed some improvements both in strength and movement in arm and hand function after they received electrical stimulation near the site of their injury. The improved function persisted even after the stimulation stopped, indicating that the treatment may be inducing nerve cells to regrow in the damaged area.Sophie Bushwick, senior news editor at New Scientist, joins Ira to talk about the work and what it could mean for people with severe spinal cord injuries. They also talk about other stories from the week in science, including creating the most powerful X-ray pulse ever reported, investigations into the microbiome of the scalp, and some epic cosplay—testing out the practicality of some ancient Greek armor in combat scenarios.Celebrating the Maya Calendar In Guatemala's HighlandsEvery 260 days, Indigenous communities in the highlands of Guatemala celebrate a new cycle of the Maya calendar. This ceremony has persisted for thousands of years, from pre-Columbian times to today. The latest of these ceremonies happened in early May.Joining Ira to talk about the importance of astronomical ceremony is Willy Barreno, a Maya calendar keeper based in Quetzaltenango, Guatemala, and Dr. Isabel Hawkins, astronomer and senior scientist at the Exploratorium in San Francisco, California.Transcripts for each segment will be available after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

Bay Area Icon, freestyle legend and rap battle king, Frak sits down for a dope conversation this week! We talk being the strengths of being both a rapper and comedian, freestyle tips and tricks, how it feels to be where he's at now and more. Frak freestyles to 10 words at the end so be sure to watch til then and we finish it off with passing four bars with each other. Follow Frak on IG: https://www.instagram.com/fraktheperson?igsh=MzRlODBiNWFlZA== Follow Frak on TikTok: https://www.tiktok.com/@fraktheperson?_t=8m3XSrZr9hf&_r=1 Follow us on Instagram: https://www.instagram.com/icbtbpodcast/ Rate and review us on Apple Podcasts: https://podcasts.apple.com/us/podcast/it-cant-be-that-bad/id1470379470 Or listen to us on Spotify: https://open.spotify.com/show/7FsYf47r7B8fyxgG9elgt9?si=o4k6CKcKS96N6k2t-_WBVw Subscribe to our YouTube Channel: https://www.youtube.com/channel/UCjEA7-SGoTV8a5_PfyrxDOg Get $25 off a Brite Lite Tribe Neon Light. Promo Code: ICBTB https://britelitetribe.comp #comedy #podcast #rapper #freestyyle #interview #frak #bayarea

In this episode, I explain how to strengthen and build a stable, pain-free back and how to reduce or eliminate existing back pain. I explain the anatomy and physiology of the spinal cord and vertebrae, intervertebral disks and nerve pathways, and the abdominal and back muscles that together can be leveraged to stabilize the back.  Then, I describe protocols: “McGill's Big 3” exercises, a highly effective psoas stretch, abdominal stabilization, breathing techniques, and protocols to reinforce essential supports for the back, including the neck, pelvis, feet, and toes.  I also explain how you can reduce and potentially eliminate back pain and sciatica using a specific type of bar hang, “cobra push-ups,” medial-glute strengthening exercises, and more.  Back pain greatly impedes one's ability to enjoy daily activities; this episode provides zero-cost, minimal time-investment protocols to improve your back strength and stability and allow you to move through life pain-free and with ease and mobility.  For show notes, including referenced articles and additional resources, please visit hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman AeroPress: https://aeropress.com/huberman Joovv: https://joovv.com/huberman Waking Up: https://wakingup.com/huberman Plunge: https://plunge.com/huberman Momentous: https://livemomentous.com/huberman Timestamps (00:00:00) Back Health (00:03:47) Sponsors: AeroPress, Joovv & Waking Up (00:07:57) Back Anatomy: Spine, Vertebrae, Spinal Cord (00:12:07) Spinal Cord & Nerves; Herniated Discs (00:19:50) Build Strong Pain-Free Back; Bulging Discs (00:24:26) Back Pain & Professional Evaluation; Tool: Spine Self-Assessment  (00:34:58) Sponsor: AG1 (00:36:29) Tool: McGill Big 3 Exercises, Curl-Up (00:44:40) Tool: McGill Big 3 Exercises, Side Plank (00:53:13) Tool: McGill Big 3 Exercises, Bird Dog; Back Pain (01:04:10) Sponsor: Plunge (01:05:37) Tool: Back Pain & Oreo Analogy, Bar Hang (01:10:34) Time & Back Pain; Tool: Reversing Disc Herniation, Cobra Push-Ups  (01:21:28) Sciatica, Referred Pain, Herniated Disc (01:24:21) Tool: Improve Spine Stability, Strengthen Neck (01:29:23) Tools: Strengthen Feet, Toe Spreading (01:34:35) Tools: Belly Breathing; Stagger Stance (01:42:03) Tools: Relieve Low Back Pain, Medial Glute Activation; Rolled Towel (01:50:59) Tool: Psoas Stretching (01:57:00) Tool: Back Awareness; Strengthen & Pain-Proof Back (02:05:49) Zero-Cost Support, Spotify & Apple Reviews, Sponsors, YouTube Feedback, Momentous, Social Media, Neural Network Newsletter Disclaimer

(4/18/24) - In today's Federal Newscast: The IRS received over 100 million individual tax returns this year. The big membership numbers for AFGE, make it the fastest growing major union in the country. And children at a New Mexico Air Force base appear to have a higher rate of a rare brain-and-spinal- cord cancer. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this conversation, Renata Nehme and Hilary Bilkis discuss craniosacral therapy and its benefits. Hilary explains that craniosacral therapy is a gentle hands-on technique that helps balance the bones, membranes, and fluids in the skull, spinal cord, and connective tissue system of the body. The training for craniosacral therapy is usually a series of four-day workshops, and practitioners often have a background in massage therapy or other touch-based professions. The therapy can be beneficial for people of all ages, from babies to adults, and can help with a variety of issues such as breastfeeding difficulties, torticollis, anxiety, unregulated emotions, and chronic pain. The therapy works by quieting and regulating the nervous system, releasing tension in the body, and promoting overall well-being. It is not a massage and is performed with the client fully clothed. The frequency of sessions varies but is typically weekly for a few weeks, followed by less frequent sessions.____________________________________________________________________________________________ABOUT OUR GUEST: Hilary D. Bilkis, LMT, MS  is a Gifted Healer and Intuitive, with 25 years experience. She is the owner of  Awakening Wellness, a light touch, hands on healing practice located in Savannah, GA. She works with you in a way that is gentle, compassionate and supportive.https://awakening4wellness.com/To find a CST Practioner go to: www.IAHP.comor to find many airway practioners go to:www.airwaycircle.com/directory _________________________________________________________________________________ABOUT OUR HOST: Renata Nehme RDH, BSDH, COM® has been a Registered Dental Hygienist since 2010. In 2016, when she was introduced to the world of "Myofunctional Therapy" she immediately knew that was her calling, especially when she learned that it encapsulated many of her passions- breastfeeding, the import of early childhood development, and airway health. In 2021 Renata founded Airway Circle with the intention of creating a collaborative and multidisciplinary group of like-minded health professionals who share the same passion for learning and giving in the dental health and airway space. Myo Moves - Become a Patient: www.myo-moves.com Airway Circle - Become a Member: www.airwaycircle.com

We're back with a new episode of, Be Advised, the podcast from the Mary Free Bed Advisory Group. This episode digs int the world of spinal cord injuries and with Dr. Michelle Meade and Dr. Jonathan Vandenberg.Dr. Meade is the Director of the University of Michigan Center for Disability Health and Wellness, and principal investigator and director of the Michigan Spinal Cord Injury Model Systems. Dr. Jonathan Vandenberg is a physiatrist at Mary Free Bed Rehabilitation specializing in spinal cord injury.The conversation explores the goals of the Michigan Spinal Cord Injury Model Systems and how it aims to improve the lives of Michiganders with spinal cord injuries. It also covers how they are collecting data on new spinal cord injuries and using that data to improve clinical practices and patient outcomes.Dr. Meade and Dr. Vandenberg also highlight the importance of education and community outreach. They discuss various educational events offered and emphasize the value of including people with lived experience in research and advocacy efforts.If you or someone you know is living with a spinal cord injury, this episode offers valuable insights and resources. You'll learn about the Michigan Spinal Cord Injury Model System and how it's working to improve care for patients throughout the state.If you'd like more information regarding the information in today's podcast email us at AdvisoryGroup@maryfreebed.com. Find out more about the Mary Free Bed Advisory Group. 

Episode 10 is here! Behold, the story of a genuine MEDICAL MIRACLE! Bode was a happy, able-bodied, athletic 14-year-old kid— until a completely random, totally freak accident left him with a nearly severed spinal cord, entirely unable to move from the neck down. His doctors warned him not to even HOPE to walk again, as literally no one in the history of medicine has recovered from such an injury. (Not one!!!) Somehow, against all possible odds, he not only began to recover— but he was suddenly recovering at an astonishingly rapid clip. Which bred hope, optimism, and determination. Which in turn sped the pace of his recovery even further. Until one day he was completely back to full health, walking and talking and LIVING as he always had, even getting back into his sport of choice (which, being that he is from the American Northeast, is of course lacrosse).

Tumors affecting the spine are fortunately uncommon, and may arise within the spine or metastasize from malignancies elsewhere. Effective treatment is determined by tumor type, location, and urgency. In this episode, Allison Weathers, MD, FAAN, speaks with J. Ricardo McFaline-Figueroa, MD, PhD, author of the article “Spinal Cord Neoplasms,” in the Continuum February 2024 Spinal Cord Disorders issue. Dr. Weathers is a Continuum® Audio interviewer and the associate chief medical information officer at Cleveland Clinic in Cleveland, Ohio. Dr. McFaline-Figueroa is a physician at Dana-Farber Cancer Institute and instructor in neurology at Brigham and Women's Hospital and Harvard Medical School in Boston, Massachusetts. Additional Resources Read the article: Spinal Cord Neoplasms Subscribe to Continuum: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Transcript  Full transcript available on Libsyn Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, a companion podcast to the journal. Continuum Audio features conversations with the guest editors and authors of Continuum, who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article by visiting the link in the show notes. Subscribers also have access to exclusive audio content not featured on the podcast. As an ad-free journal entirely supported by subscriptions, if you're not already a subscriber, we encourage you to become one. For more information on subscribing, please visit the link in the show notes. AAN members, stay tuned after the episode to hear how you can get CME for listening. Dr Weathers: This is Dr Allison Weathers. Today I'm interviewing Dr Riccardo McFaline-Figueroa on spinal cord neoplasms, which is part of the February Continuum issue on spinal cord disorders. Dr McFaline-Figueroa is a physician at Dana Farber Cancer Institute in Boston, Massachusetts, an instructor in neurology at Brigham and Women's Hospital and Harvard Medical School in Boston, Massachusetts. Welcome to the podcast. You do a really fantastic job in the article providing a comprehensive overview. But if you had to come up with the most important clinical takeaway from the article that you want our listeners to walk away with, what would that be? Dr McFaline-Figueroa: I think the most important thing to remember about tumors of the spinal cord is, one, that there is no specific diagnostic feature on imaging that can be used to determine what a neoplasm of the spinal cord is or even if it is a neoplasm - I think, going in broadly, when you're looking at a mass lesion of the spinal cord, is very important. Then the second is just to know that there's just such a wide range of cancer possibilities that can do this, that getting an appropriate diagnosis becomes very important. Dr Weathers: I think two really salient points right there. I want to explore something that you said a little bit more. You talk about the concept that there's no one diagnostic feature of the MRI, and actually, I was thinking about this as I was reading your article. What struck me, too, is that that holds true, actually, for the patient's presenting signs and symptoms, right? As a neurohospitalist, I'm constantly struggling with always how to balance not missing a diagnosis such as this (a diagnosis of spinal cord tumor), versus putting a patient through what can be an often unnecessary and very costly workup, right? So, this is such a rare diagnosis, but the presenting symptoms and signs, just back radicular pain and weakness, are shared by so many common conditions. What's your approach to distinguishing between them, and what are some of the red flags you look for to know when further workup really is indicated? Dr McFaline-Figueroa: Certainly. I think there's not one way to decide whether you need to go down the route of exploring a neoplasm of the spinal cord, but there are certainly things that would clue someone into this needing to be the case. I think, one, as opposed to a lot of the monophasic illnesses that we see in neurology, certainly it's something that is progressive; is certainly something that increases the certainty, and it's different from ischemia of the spinal cord or an acute demyelinating event. I think another important feature is also just the context. I think, even though these are rare, when you're dealing with a patient with a known history of cancer, that's when “the rare” becomes common, and that's when you have to really start thinking about it being a neoplasm of the spinal cord. It's still not perfect; it covers some of the side effects of treatment that can look a little bit like a spinal cord neoplasm. But certainly, that should increase the level of suspicion for something going on in that compartment that's neoplastic. Dr Weathers: I think that's such a great take-home quote for our listeners to think about - when the rare becomes common. You actually hit on the point that I wanted to ask you about next. In neurology, we always talk about how important the history and the exam are - it's kind of our core of what we do. But it feels especially true when talking about neoplasms of the spinal cord. You mentioned, obviously - the big one is that if they have a history of cancer, especially in active history, that's a pretty big clue that something more serious could be going on. But what else is key in the history? Why are the history and the exam so especially important when you're concerned about or dealing with neoplasms of the spinal cord? Dr McFaline-Figueroa: When we're dealing with the spinal cord, we're dealing with a lot of different compartments. I think, to your question, the one where thinking about history and physical becomes the most important is when you're thinking about the possibility of leptomeningeal involvement, right? The leptomeningeal space is not easily imaged, right? We can't really see much what's going on in the CSF. And so, we rely on - imaging-wise - on there being deposition of cancer cells along the dura or along the direct surface of the cord. But oftentimes, that's not the case. That's when knowing exactly what someone's cancer history is, what their stage in the natural history is, whether they're progressing or not progressing, have some knowledge of what the oncologic medications that they're on are (because brain penetration is different for several of them), and then really hearing for those signs and symptoms that are connected to that compartment - signs of increased intracranial pressure, signs of cranial neuropathy that may or may not be evidence on imaging, radiculopathies. So those are the things that are very important in all investigations of spinal cord tumors. But certainly for leptomeninges, it's often the case that, really, history and physical are all you have to try to get the diagnosis right. Dr Weathers: You make, actually, a really great point in the article that I think it bears mentioning here. Because I was embarrassed when I read it, because I said, “I have been guilty of that” - that the history of, kind of, these very generic histories of cancer; you know, “Oh, they had lung cancer” - is probably not sufficient, right? That there's value in getting really specific. Why is that? Dr McFaline-Figueroa: That's certainly why we all specialize in different things, right? For a neuro-oncology standpoint, it sounds very different to me to hear the same history in a patient with melanoma versus the patient with bladder cancer. You think of melanoma from a neuro-oncologic standpoint, you're thinking of a cancer that is incredibly trophic for the brain and spinal cord, probably because it's derived also from ectoderm (so it's kind of the same origin of the cells), and it just makes your level of suspicion go so much higher when you are in that mind space. Thinking of a melanoma patient versus someone with a tumor, that very rarely (if it all) goes to the central nervous system. I think that's something that's really important. And those are two big extremes. But even - like I mentioned - even in lung cancer, certainly, small cell versus non-small cell are very different in terms of when and how they can affect the spinal cord or any part of the central nervous system. So, that one is a little bit more nuanced and, being a neuro-oncologist - but still, it's specific as you can be when you're discussing with your neuro-oncology colleagues or medical oncology colleagues, and the better for trying to figure these things out. Dr Weathers: An excellent pro tip right there. You were very gracious about it - about that we all have different specialties. I was reflecting on that, too - this is such an important yet definitely pretty specialized topic; how did you become interested and develop your expertise in it? Dr McFaline-Figueroa: My clinical work is on all sorts of tumors of the central nervous system. Actually, in neuro-oncology, we also do a little bit of peripheral nervous system tumors, depending on how they present. And it's all a continuum. Not to use that - well, we just happen to be on Continuum. But it's all a continuum: brain, spinal cord - it's all one big compartment. And it forces you to be really familiar with all of those. And I think it's an interesting topic - we don't talk about it as much as we do for some of the other – you know, cancers of the brain, for example. In terms of becoming an expert, for me, I mean a lot of it is just, at this point, experience. And I will say, a lot of reading, because you don't see all of these. I cover some topics, like primary glioneuronal tumors of the leptomeninges, which are incredibly rare - I've never seen a patient with one. But it's one of those things where you should know the basics of these, at least for my field, and certainly beyond. Dr Weathers: What about neuro-oncology in general? How did you decide that you wanted to specialize in that? Dr McFaline-Figueroa: Well actually, me, personally - I spent a lot of my residency trying to decide between being a neurointensivist and being a neuro-oncologist. I think, for me is that I like taking care of patients who are potentially very sick. I think I just enjoyed the process of the more longitudinal relationship you have as a neuro-oncologist - seeing people in clinic, walking them through all these treatments and difficult disease courses – and that, to me, I just found really fulfilling, while still having lots of internal medicine to think about, lots of interesting neurology, just in a different context. Dr Weathers: It's such an interesting field. And I was also really thinking about this - that while neurology overall has had so many incredible advancements in terms of diagnostic and therapeutic capabilities in the last several years, neuro-oncology, in some ways, is almost like an entirely different field since I was in residency training, which wasn't all that long ago. How have these changes impacted how you diagnose and manage spinal cord tumors? Dr McFaline-Figueroa: Certainly, there's been a lot of changes in technology that I think have been helpful. And then, certainly, slowly but surely, we are coming up with better treatments for patients. When I speak of technologies, one thing that, for example, comes to mind is - historically, it's just so difficult to diagnose. I keep coming to the same anatomic compartment, but it's so difficult to diagnose leptomeningeal carcinomatosis or leptomeningeal involvement by a tumor, even more so, I think, in the spinal cord, because it's just difficult to catch on imaging. But over the last few years, so many advances in, like, molecular testing of cerebral spinal fluid to be able to look for cell-free DNA; to be able to enrich for rare cell populations and then identify them, which really, kind of, have changed that “we need to do three LPs” mentality. We have things that are sensitive enough that are rolling out. And in terms of treatment, certainly, the field is changing. There's so many now targeted therapies emerging for tumors as we understand the biology, which is probably the biggest roadblock to better care for the primary spinal cord tumors - it's also a very exciting time to be in neuro-oncology because of that. Dr Weathers: On perhaps a less positive note - the fields change so quickly; has this led to any controversies in the field? Dr McFaline-Figueroa: I think the biggest controversies are less so controversies in the traditional sense, in that I don't think anyone's fighting with each other. But it's become really difficult to know, particularly as those therapies that I mentioned come out, what is the right first step. Is the right first step for somebody to have, for example – well, actually, this is less controversial now - but for example, someone with von Hippel-Lindau, who might have multiple hemangioblastomas. We're reaching a point that, with approvals of targeted therapies for that disease, you might not necessarily go for surgery (which could be quite morbid in some instances) or radiation for progressive disease. So, I think one of the issues there is that we're not necessarily at the point where we are sure that, you know, definitely the intervention with the longest survival is targeted therapy first, and then maybe surgery, and then maybe radiation, versus the other. I think the order at which we treat these tumors is just a little bit in flux. Dr Weathers: Hopefully, with time and more evidence, that will become more definitive and clear. You just mentioned - just in that answer alone - surgery and radiation. The other really fascinating thing about this topic (about neoplasms of the spinal cord) is how truly a multidisciplinary effort the management of patients with spinal cord tumors is. What other specialists do you work with to diagnose and manage this patient population, and what's everyone's role in these cases? Dr McFaline-Figueroa: Certainly, neurosurgery still plays a huge role, particularly because even when you are relatively sure that it's a tumor of the spine (particularly if you think it's a primary tumor of the spine), there's really no - again, just no diagnostic test; that's just imaging. The only way that we have to establish the diagnosis is through tissue examination. In neurosurgery, in a lot of diseases, still plays a huge role. For example, ependymoma is one where, really, gross total resection is one of the biggest (if not the biggest) prognostic factor in treatment. Radiation oncology - there are still histologies that we have no good systemic therapies for. For example, for diffuse midline gliomas, most of them are not very sensitive to the therapies that we have that are systemic. So, for these tumors, it becomes important to do radiation as the most significant step in management that we have - we just don't have anything efficacious for those tumors, at the moment, although we're learning a lot about the biology. A lot of these have histone mutations that people are trying to target for more effective treatments. So, radiation oncology, again, still plays a huge role in the treatment of our patients. Certainly, when you're dealing with patients with metastatic cancer to the spine, medical oncology is huge. And that's where - me, as a neuro-oncologist, I'm less of an oncologist and more as a person who the medical oncology can bounce ideas from. We talk about - sit down and talk about - their expertise in how to treat these tumor types. And then, me bringing in what might be brain-penetrant, what things may or may not be toxic to the nervous system - stuff like that. It's really a group effort, and that's not even mentioning nurses, nurse practitioners, amazing people who coordinate care, and stuff like that. And like I mentioned early on, one of the most important things is to know exactly what type of tumor or cancer these are before proceeding with any conversation about treatment. And that's where our neuropathologists really drive the direction of what we're doing. Dr Weathers: Even as I was thinking about this question, in my mind, what I thought your response point may be - that was even more of a complex team than I think I had envisioned, and it really speaks to, again, the true multidisciplinary effort, the “team of teams” that's needed to provide care for these patients. And I think I heard you say this in your - that wonderful answer, but that as things are evolving and as we are better understanding the biology, that we're getting better with our targeted treatments. But that could possibly include, at some point, even targeted therapies for midline gliomas, which would be incredible. I know that's always been one with, not only especially poor prognosis, but given the population it tends to affect (younger patients), it can be quite devastating. That definitely struck me as I heard you say it. So, I think this is a field where we're going to continue to see so many breakthroughs. And that leads me, actually, into my last question. I always like ending these on a hopeful note, and I think that certainly does it. But we've talked about so many changes already, and again, I know even more to come. What do you think the next big breakthrough will be? Did we cover it already? Is there anything else that you're excited about that's coming down the pike? Dr McFaline-Figueroa: I think we covered some of it, which is really being able to bring more systemic therapies (more oral therapies or intravenous therapies) that treat these tumors, as opposed to things like aggressive surgery or radiation, which are effective. But the hope here is that we can delay those so that we can have people living longer with these cancers, or cured of these cancers, and trying to spare them as many side effects of treatment as we can - which historically, in the spinal cord, is quite significant because it's a difficult space to do surgery on and it tolerates only a certain amount of radiation before coming into toxicity. So, I think it's a really exciting time to be on the medical side of things as a neuro-oncologist and see all these treatments coming in that really improve people's quality of life. Dr Weathers: Definitely an exciting time to do what you do. Well, again, thank you for the incredible article, for taking the time to speak with me today. Any last thoughts for our listeners? Dr McFaline-Figueroa: Just be mindful when working up those spinal cord tumors. There's a lot to think about, but there's also a lot of good can be done by doing good diagnostic workup. Dr Weathers: Thank you, Dr McFaline-Figueroa for joining me on Continuum Audio. Again, today we've been interviewing Dr. Riccardo McFaline-Figueroa, whose article on spinal cord neoplasms appears in the most recent issue of Continuum, on spinal cord disorders. Be sure to check out Continuum Audio podcasts from this and other issues. And thank you to our listeners for joining today. Dr. Monteith: This is Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, please consider subscribing to the journal. There's a link in the episode notes. We'd also appreciate you following the podcast and rating or reviewing it. AAN members: go to the link in the episode notes and complete the evaluation to get CME for this episode. Thank you for listening to Continuum Audio.

Starting with small practices of advocacy at a very young age, Breanna Medcalfe, 21, is setting out on a journey to educate others and be a young voice for people with disability. Already making waves in medical alum by being a Health Consumer Disability Representative Advocate we were very lucky to have this time with her before her stratospheric launch into high profile advocacy! Moving from New Zealand to Australia after having a misdiagnosis. Breanna speaks to the support she's been shown here in Australia including accessible events, horseback riding and mentoring from a previous ListenABLE favourite Dinesh Palipana. This episode also discusses the importance of a good support worker who in this case is happy to work the night shift in exchange for a good dance floor boogie. Chair users also stick around as Breanna has a trick to keep track of where your friends are when out on the town, and it's more simple then sending a text.  Watch this episode on our YouTube with captions: https://youtu.be/7fZwwK35gC8 Connect With Breanna on LinkedIn Here: https://www.linkedin.com/in/breanna-medcalfe-0975b3209 Instagram here: https://www.instagram.com/breanna_medcalfe_advocate/ Join the 10,000+ legends on Instagram: @ListenABLE_ Podcast https://www.instagram.com/listenable_podcast/ Grab our first merch release at our website From Your Pocket https://fromyourpocket.com.au/work/listenable/merch Recorded, edited and produced by Angus' Podcast Company https://fromyourpocket.com.au/See omnystudio.com/listener for privacy information.

Spinal cord disorders are common and frequently disabling. Despite advances in our ability to diagnose and treat patients with spinal cord disease, many are underserved by their health care systems due to gaps in knowledge and care. In this episode, Lyell K. Jones Jr, MD, FAAN, speaks with Shamik Bhattacharyya, MD, FAAN, who served as the guest editor of the Continuum® February 2024 Spinal Cord Disorders issue. They provide a preview of the issue, which publishes on February 8, 2024. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Bhattacharyya is the Anne M. Finucane Distinguished Chair in Neurology and chief of the division of spinal cord disorders at Brigham Women's Hospital and an assistant professor of neurology at Harvard Medical School in Boston, Massachusetts. Additional Resources Continuum website: ContinuumJournal.com Subscribe to Continuum: shop.lww.com/Continuum American Academy of Neurology website: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @LyellJ Guest: @shamik_b Full transcript available here Transcript  Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, a companion podcast to the journal. Continuum Audio features conversations with the guest editors and authors of Continuum, who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article by visiting the link in the show notes. Subscribers also have access to exclusive audio content not featured on the podcast. As an ad-free journal entirely supported by subscriptions, if you're not already a subscriber, we encourage you to become one. For more information on subscribing, please visit the link in the show notes. Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today I'm interviewing Dr. Shamik Bhattacharyya, who recently served as Continuum's Guest Editor for our latest issue, on spinal cord disorders. Dr. Bhattacharyya is a neurologist at Brigham and Women's Hospital, where he serves as Chief of the Division of Spinal Cord Disorders and as an Assistant Professor of Neurology at Harvard Medical School, in Boston, Massachusetts. Dr.  Bhattacharyya, it's great to see you - welcome. Thank you for joining us today. Dr Bhattacharyya: Good to see you, Dr. Jones. I look forward to speaking. Dr Jones: So, for our listeners who are new to Continuum, Continuum is a journal dedicated to helping clinicians deliver the highest neurologic care to their patients. We do so with high-quality clinical reviews and content in our journal and in our audio format. For our long-time listeners to Continuum Audio, you'll notice a few different things with our latest issue and our latest author interviews. For many years, Continuum Audio has been a great way to learn about Continuum articles. Starting with this issue on spinal cord disorders, I'm happy to announce that our Continuum Audio interviews will now be available to all on your favorite open podcast platforms. We'll hear some exciting new content in our interviews, and we're also going to introduce interviews with our guest editors, like Dr Bhattacharyya, who are really indispensable in putting these issues together. In this issue, specifically, Dr. Bhattacharyya is full of extremely helpful clinical descriptions and treatment strategies for patients with spinal cord disorders. As the editor, you got really a broad view of the whole range of spinal cord disease. What was the most surprising thing when you were reviewing these articles? Dr Bhattacharyya: I think as a field, neurology - the knowledge base in neurology - grows bigger and bigger and bigger each day and in fields hard to keep up and how to integrate all of it together, right? I think all of us deal with it. And that's the hope of Continuum, is that you can provide these periodic refreshers. I got refreshed myself! Even though I see the patients day in and day out, when you actually read about the advances, for example, in hereditary spastic paraplegias, or the nuances of how neoplasms in the spinal cord are now classified- you say “wow”, I didn't actually know that. The knowledge spreads and grows, and I think that's the beauty of being an editor of some of these issues - is that you get to learn yourself and maybe perhaps even apply them in the clinical situation. Dr Jones: You and I are both educators. And that's, I think, one of the secret joys of teaching is that you end up learning a lot, sometimes from the people you're teaching, right? I guess maybe that's not a surprise - that you learn something by reading it. I guess it was probably pretty nice, huh? Dr Bhattacharyya: It was very good. I think the authors all come from different geographic backgrounds, even from different training backgrounds. In spinal cord disorders, there are trials in some aspects, but in other aspects it's really opinion-based practice, right? So, it was good to also see how other institutions do it. And I imagine it's the same for readers when they see how they do it at their institution and also get a viewpoint of how it's done at other places. That's the valuable perspective piece for putting together a different of authors and see how people do it at different places. Dr Jones: Always nice to learn from others. And speaking of learning - for our clinicians who are listening to our interview today, Shamik, tell us a little bit about the basics of how spinal cord disorders present. I know as an educator, sometimes for, especially junior learners, it's a little mysterious and I'm not really sure why that is, but what are some of the basic clinical tenets of how spinal cord disorders present? Dr Bhattacharyya: I'm glad you brought this up, because in some ways, spinal cord is the orphan child of neurology, right? I think for most neurology trainees, the nervous system stops at the brainstem and then progresses again at the nerves. The spinal cord is really just viewed as this conduit of tracts up and down, and that's all it does is a big set of wires, which is not true, right? A lot of primary neurological processing happens at the level of the spinal cord, and it really is a continuation of the central nervous system. And I hope, with this issue, people get a sense of that. For spinal cord disorders (also called myelopathy; the name goes, synonymously, hand in hand), I think one of the principal functions of the spinal cord is balance. A lot of the program - the neural programming of balance on postural reflexes are hard wired into the spinal cord. I think one of the key aspects of spinal cord disorders is imbalance. I think that people should think of this as a core feature of myelopathy. If you take an example for cervical spondylotic disease, people think, is it going to be off your hands? Well, I think most patients with cervical spondylotic myelopathy actually complain of gait imbalance as one of the early features of the disease. So, imbalance, bilateral weakness, and/or bilateral numbness, tingling, paresthesia - those aspects are suggestive of spinal cord disorder. Bowel and bladder dysfunction can be, but it's not universally true. Now, there's some specific symptoms that I think are especially suggestive of spinal cord disorders I think that are kind of fun to ask about, and if true, can help you localize. One is the Lhermitte sign; you ask people to flex their neck and say, like, “Do you feel sharp, shooting thing, like, down your hands or your back?” In your legs? If true, you have something, right? That's a spinal cord disorder. The other sign that I think is clinically helpful is weakness on one leg and numbness on the other, like Brown-Séquard syndrome or hemicord syndrome. If you find that to be true - and you often see that with multiple sclerosis lesions or other traumatic lesions - that is a spinal cord disorder. I think those clues can come out in history and on exam, and can help you localize it better. Dr Jones: It's nice to know those specific features - in other words, those things that, when you do see or hear them, really should make us think about spinal cord disorders, right? Again, they might not be the most common way they present, but it's good to have those in your pocket, right? Dr Bhattacharyya: Right. Dr Jones: You mentioned this - spinal cord pathology occupies kind of an interesting place in the neurological world, right? There really aren't “myelopathists,” but you direct a division on spinal cord disorders, which is - I think is pretty uncommon. Tell us a little about that. How does that work at your institution? Dr Bhattacharyya: Maybe I can start with the history of this, right - of how this actually came about. I was graduating as a fellow and entering as a faculty in our neurology department. Initially, my interest was in autoimmune neurological disorder - it still is in autoimmune neurological disorders. And yet, when they saw patients who came in for myelitis and turned out they didn't have an inflammatory myelopathy, there really was no home for them, right? - it's a strange space. And that includes even for garden-variety, cervical spondylotic disease that's causing myelopathy - there is no good neurology home for those patients. After the first year of seeing patients, I felt that we need to do better for that. That's why we ended up opening the spinal cord disorders clinic, which was actually the only neurology-based one in our system. There are plenty run by physiatry, surgery, pain management, and other services. But the only neurology one in our system focused specifically on neurologic management of patients with any type of spinal cord pathology. Dr Jones: That's a distinctive way that it came about at your institution and in your own career. It sounds like this does need to be a team effort. Who are the other disciplines or specialists who need to be involved in the care of these patients? Dr Bhattacharyya:  Our spinal cord clinic itself is a part of the comprehensive spine center in our hospital. In that center are pain management doctors, physiatry, as well as different spine specialties, including orthopedics and neurosurgeons and interventional radiologists. So, it's kind of a multidisciplinary group effort to take care of these patients. Dr Jones: I know it'll vary according to the problem with the spinal cord, right? There's dozens or hundreds of different diseases that can affect the spinal cord. So, treatments are different for different diseases, right? But what do you see, therapeutically, as being some of the next big things on the horizon for patients with spinal cord disease? Dr Bhattacharyya: I think one of the common, unifying aspects is pain from spinal cord injury. Especially if there's interruption in the spinothalamic tracts, the pain can be a very severe thing that ranges all the way from neuromyelitis optica, the tonic spasms, to spinal cord infarcts, chronic sequelae of pain, to trauma (spinal cord trauma) - pain is such a big aspect. And our both interventional and oral neuropathic pain medicines don't do a good job with it. I think there's a wave of new medications that are in trials for neuropathic pain and I'm hopeful that they will be helpful and that they will improve pain control and quality of life for our patients. The medication approaches to pain also come with side effects that all of the medicines have. Some of our patients are on high doses of multiple medicines and have cognitive impairment, right? I think that was also the motivation behind our getting a specific section in this issue on symptomatic management of spinal cord injury. Because I think no matter where you are in the spectrum of spinal cord disorders, whether you're a vascular doctor or a family doctor, you will be prescribing gabapentin and baclofen, right - as for helping the patient, and it's good to know how to do it. The other aspect that I'm really hopeful about are sort of second-generation prosthetic devices. These are some of the electrostimulation devices where there's intelligence built into the device that detects you moving your leg and then artificially stimulates a peroneal nerve. This is much better than foot braces, for example, for foot drops. And there are now multiple companies who make these devices, and for some of our patients who have had spinal cord disorders and had difficulty walking or tripping, these have actually made a big difference. I think prosthetic and electric stimulation also has potential of helping a broad range of patients with spinal cord disorders. Dr Jones: And I'm glad you mentioned that article on the symptomatic management of the problems with spinal cord disease, regardless of the cause. And it's a wonderful article that will encourage our listeners to seek out. To go back to the pain, this is something that - many of us who care for patients with spinal cord problems - we encounter is this. And I think it's underrecognized (the pain complications of spinal cord disease). Medications on the horizon - what about devices and neuromodulation? This is another thing I get asked about a lot. Dr Bhattacharyya: Exactly. I think the - for example, spinal cord stimulators for pain management - I think it's been controversial in the sense of who are the best people for it. The history of neuromodulation in spinal pain in some senses has been unfortunate because it was first approved for so-called “failed back syndrome,” right? And the name is terrible. The patient population is heterogeneous. And it has come to a point where it was unclear who it was helping and what the right indications were. I think for neuropathic pain and, in particular, for spinal cord injury pain, I think there is now a renewed push to study neuromodulation, both implantable devices and external devices, to see if those aspects can help. I think they're part of the new wave of things. I think the question patients often ask me is, “Can you regrow my spinal cord?” - right? “Is there something on the horizon yet?” As far as I know, right at this moment, there is not, that's clinically applicable, but perhaps in the future that might be true. But I think, short of regrowing the spinal cord, we can help function and help pain in meaningful ways. Dr Jones: We'll be hopeful about cell therapies and other regenerative therapies down the road. I don't think it's in our immediate future, but we maintain hope. You know, I know this is an area that, again - spinal cord problems are common, spine disease is common - but it does kind of fall between the cracks clinically. If there were one point, Dr Bhattacharyya, that you would want to make to our listeners about the one thing not to miss, or the thing that you most commonly see being missed in the clinical evaluation and/or care of these patients, what would that one thing be? Dr Bhattacharyya: I think the time to clinical evolution of myelopathy probably has the biggest value in determining the cause of it. I think this was beautifully brought out by the article by Dr. Pardo, where he talks about an integrative approach to myelopathy, and in contrast to prior conceptions of whether it's inflammatory based on your CSF cell count or your MRI features, it's actually based on time - time from onset of symptom to nadir of symptom. Is it a few hours, is it days, is it months, right? And having that diagnostic framework is, I think - I go back to it time and time again - is key in trying to figure out, because none of the measures we use, both on imaging or CSF or laboratories, are very sensitive or specific, and actually do not outperform just categorizing by time alone, right? So, I think the one take-home message is, if you have sudden, rapid-onset myelopathy that evolves over minutes, it's probably a vascular process. Even if you find ten cells in the CSF, it's still vascular, right? If it's something that evolves over days, maybe 7, 8, 9 days, and then you find diffusion restriction in the spinal cord on imaging, it's probably still an inflammatory process rather than a sudden spinal cord infarct, right? So, I think that the time aspect cannot be ignored and should play a central role in decision making. Dr Jones: That's very helpful. And I think maybe the corollary to that is - there are chronic spinal cord disorders, right? And I think clinicians, especially if you're not familiar with spinal cord disease, it's terrifying, right? As soon as you start to think, “Wow, this patient's telling me a story and I'm worried this could be a spinal cord problem - should I send them to the emergency department?” - right? They have some bladder dysfunction; they have some gait disorder. But if it has been going on for years, the emergency department is probably not the best place to evaluate that, is it? Dr Bhattacharyya: I'm glad you mentioned it because we see that in the emergency room, right? Someone clearly has a myelopathy; you asked him how long it's going on – it going for months or even years sometimes, right? And it was first noticed and sent out. So, yes - there are multiple causes of chronic myelopathies. They range all the way from structural causes, where you can have things like, for instance, webs, of arachnoid webs, that cause slow progressive myelopathies, to vascular malformations of myelopathies, to nutritional causes (even that can cause a slow, progressive myelopathy), Not to speak of infections; I think we often think of infections as causing fast myelopathies, but especially with HTLV-1-associated myelopathy, the usual clinical progression is slow and progressive. I think across all categories of disease, there are instances of slow, progressive myelopathies that really require thoughtful workup but doesn't require an emergency workup. Dr Jones: Yeah, it's good to know that not every spinal cord problem is an emergency. I think it does terrify clinicians, right? I mean, this is the broadband connection between the brain and the body, and it's fragile, and it's unforgiving, and it's every command sent to the body - every piece of information sent back to the brain, all traveling through a billion neurons with a maximum diameter slightly larger than a dime, right? I think that's why it creates consternation. But I imagine it's also - on the clinical side - it's probably in part challenging and in part rewarding to care for these patients. When you think about what's most rewarding about the care of patients with spinal cord disorders, what comes to mind for you? Dr Bhattacharyya: I think, a couple of aspects. And just thinking back to my last clinic - I put it on Fridays, just because I get the most joy out of this clinic, right? The first is that there's no single piece of test that gives you the answer totally, right? It's usually about putting the history together, the labs, the imaging, and talking about it together, right? And I think it's that integrated piece that, as clinicians, I think that brings us joy; it's that figuring something out, that's more than saying, “Is there diffusion restriction or not on the brain MRI?” – right? The second piece that I think is helpful is that, that patients really want to learn, and for spinal cord disorders in particular, there's easy anatomic things that you can point to patients and say, like, “This is why you are weak in the arm and maybe numb in the leg, and that's causing your problem, and this is what we're going to do about it.” And I think, the ability to communicate that with the patient through images is, I think, unique in the sense that patients understand it - that this is the connection and there's something wrong here and that's why I'm having these symptoms. I think those are aspects of spinal cord disorders that I think are really neat. I will say that I also hope that, for our trainees, right, - I think their comfort with imaging stops at the brainstem, right? The moment it gets below the spine, whether looking at foraminal narrowing or canal stenosis, it's about, “Do they have a T2-hyperintense lesion or not?” And beyond that, people are hesitant. I hope that if this issue can give a different categories of spinal cord disorders, our trainees also become a little bit more facile with different aspects of spinal pathology. Dr Jones: I think a lot of neurologists are drawn to our field because of the problem-solving nature, right? Which is what you have to do before you start helping the patient. And you clearly have a lot of enthusiasm for this - I mean, it's contagious, right? There aren't a lot of myelopathists right now, but maybe after listening to your interview, Dr Bhattacharyya, reading your issue in Continuum, maybe you've created some myelopathists. Dr Bhattacharyya: And just remind, there's an AAN spine section that exists in the American Academy of Neurology, and it's very small and can use more members. Certainly, you're welcome to join. Dr Jones: Well, that's a great plug and, Dr Bhattacharyya, once again, I want to thank you for joining us and thank you for such a thorough, fascinating, engaging discussion on spinal cord disorders. Thank you for guest editing a really phenomenally well-done issue that I think is going to be really informative to our readers and our listeners. Again, we've been speaking with Dr Shamik Bhattacharyya, Guest Editor for Continuum's most recent issue, on spinal cord disease. Please check it out, and thank you to our listeners for joining today. Dr. Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, please consider subscribing to the journal. There's a link in the episode notes. We'd also appreciate you following the podcast and rating or reviewing it. Thank you for listening to Continuum Audio.

In this episode, guest host Dr. Dana Dunleavy and guest Dr. Douglas Beall delve into the transformative potential of neuromodulation in the treatment of chronic pain, particularly for painful diabetic neuropathy (PDN). Dr. Beall is an interventional musculoskeletal radiologist practicing at Oklahoma Spine in Edmond, Oklahoma. Dr. Beall recounts his journey, from his beginnings in the military to his experiences with navigating institutional resistance to his clinical practice, and finally the process of moving to private practice. He discusses the positive impact of spinal cord stimulation on patients with PDN and reflects on its effectiveness in reducing pain and improving neurologic function. He underscores the crucial role of interventional radiologists in managing PDN, while also advocating for the integration of these specialists in pain management clinics. Dr. Beall argues that interventional radiologists possess unique skill sets adept for neuromodulation, which opens up new treatment possibilities in the process. He shares insights on the evolution of spinal cord stimulation technology, reimbursement considerations, and the importance of clinical trials in refining treatment approaches. The episode ends with an invitation for interested physicians to participate in professional forums and learn more about this burgeoning field. --- CHECK OUT OUR SPONSOR Nevro HFX Spinal Cord Stimulator https://www.hfxforpdn.com --- SHOW NOTES 00:00 - Introduction 02:30 - Challenges and Triumphs of a Solo Practice 14:44 - Evolution of Neuromodulation in Practice 17:05 - Impact of Neuromodulation on Painful Diabetic Neuropathy 31:53 - Unique Mechanism of High Frequency Neuromodulation 46:02 - Role of Interventional Radiologists in Neuromodulation 54:11 - Future of Neuromodulation in Interventional Radiology --- RESOURCES Douglas Beall, MD Research Gate Profile: https://www.researchgate.net/scientific-contributions/Douglas-P-Beall-39583252 Long-term efficacy of high-frequency (10 kHz) spinal cord stimulation for the treatment of painful diabetic neuropathy: 24-Month results of a randomized controlled trial: https://pubmed.ncbi.nlm.nih.gov/37536514/ High-Frequency 10-kHz Spinal Cord Stimulation Improves Health-Related Quality of Life in Patients With Refractory Painful Diabetic Neuropathy: 12-Month Results From a Randomized Controlled Trial: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9256824/ Neuromodulation Interventions for the Treatment of Painful Diabetic Neuropathy: a Systematic Review: https://link.springer.com/article/10.1007/s11916-022-01035-9 High-frequency spinal cord stimulation at 10 kHz for the treatment of painful diabetic neuropathy: design of a multicenter, randomized controlled trial (SENZA-PDN): https://link.springer.com/article/10.1186/s13063-019-4007-y

There are a series of spinal cord disorders that are not addressed in many review resources but have an uncanny ability to show up on all the USMLE exams. In this podcast, I collate these disorders together, discuss their classic presentations, emphasize differences between them, and also try to explain relevant pathophysiology where necessary. I … Continue reading Divine Intervention Episode 506: Weird But HY Spinal Cord Disorders (for Step 1-3)

Dear Johnny, My name is Arianna, I am sending you this letter because my family could really use some help. On September 5, 2023 I had to take my oldest daughter Piper (9) to Children's Mercy Hospital in downtown KC because she was having constant headaches, her left eye was presenting as a lazy eye out of nowhere, she was not wanting to eat, and she was very sluggish. That morning I decided I needed to get her to the hospital to see what was going on. They got her into the emergency room immediately and within an hour she was getting a CT scan. The ER Doctor that was with her came in to tell us the results of the CT Scan. They had my fiancé and I step out of the room and I knew something was wrong. They pulled us into a separate room to tell us that they found a mass on my daughter's brain. The Neurosurgeon told us that he was 99% sure it was a Brain Tumor and told us that she would need an MRI that day, a biopsy the next day and surgery sometime in the next week most likely. I stayed at the hospital with Piper while they got the MRI set up for her. It did end up being a Brain Tumor located directly on her Spinal Cord, he told us that it had to be removed immediately. So, Piper was rushed into surgery that afternoon. After about 8 hours of surgery, the Neurosurgeon came out and told us that the Brain Tumor was huge and he got 97% of it, he wasn't sure what kind of tumor it was yet until the pathology comes back in a few weeks. He said she did great and that she would be in the PICU for a few days but he was hoping she would recover nicely. We spent 2 days in the PICU and then were moved to the Neurosurgery follow up floor and we spent the next 2 1/2 - 3 weeks there. After the tumor removal, her right side of her face is paralyzed for the time being and she could not walk, talk, use the restroom or anything on her own. She is now wheelchair bound and requires a 5 point harness car seat. We found out that she has what's called Posterior Fossa Syndrome from the tumor removal, she is relearning everything at this moment and has been since she came out of surgery. She is now wheelchair bound and has to have full physical support daily. The Pathology came back and it is a low grade (slow growing Cancer) Pilocytic Astrocytoma tumor. She does have to get MRI's every 6 months for the time being. If her tumor decides it wants to start growing then she will have to have more treatment. My fiance is working full time, but I had to quit my job to be Piper's full-time caregiver. I have been taking care of her and her two sisters. I am currently taking her to Ability KC Rehab facility here in Kansas City because they are really the only Pediatric facility that does intensive therapy that she needs at this moment! I drive her every week 5 days a week up here to get the rehab she needs. With help from my brother I bought a minivan that is lower, has more room, and is easier to load Piper in and out of. The last few months have been tough basically living off of one income, but I'm so happy to bring my oldest girl home and we can be a family again. It has put a strain on us financially. I am worried about rent coming due, getting tags for the minivan and the cost of gas to drive so much from Wellsville into KC.  Thank you for listening to my story and I hope you have a happy holiday. With Love, Arianna Phares & Luke Campbell Who Helped: Brad, Mark, Candy, Brian, Rob, Gene and Consentino'sHow You Helped: Van tax and tags, December rent, gas cards, Christmas for the kids, groceries

Looking 4 Healing Radio with Dr. Bryan Ardis – Join me this Thanksgiving as I delve into flu vaccines, their ingredients, and potential side effects during National Flu Vaccine Awareness Week. Discover shocking truths about common medications, their link to autoimmune diseases, and why we must question Big Pharma. Embrace natural healing as we explore the intersection of health and faith. Don't miss this eye-opening episode!

Looking 4 Healing Radio with Dr. Bryan Ardis – Join me this Thanksgiving as I delve into flu vaccines, their ingredients, and potential side effects during National Flu Vaccine Awareness Week. Discover shocking truths about common medications, their link to autoimmune diseases, and why we must question Big Pharma. Embrace natural healing as we explore the intersection of health and faith. Don't miss this eye-opening episode!

In this episode of Remarkable People, join host Guy Kawasaki for an enlightening conversation with Dr. Jerry Silver, a distinguished neuroscientist and innovator. Dive into the world of neuroregeneration as Dr. Silver discusses his groundbreaking work in spinal cord injury research. Learn about the incredible potential for repairing and restoring function to the injured spinal cord. Discover how Dr. Silver's passion for science and determination are driving advancements that offer hope to millions.---Guy Kawasaki is on a mission to make you remarkable. His Remarkable People podcast features interviews with remarkable people such as Jane Goodall, Marc Benioff, Woz, Kristi Yamaguchi, and Bob Cialdini. Every episode will make you more remarkable. With his decades of experience in Silicon Valley as a Venture Capitalist and advisor to the top entrepreneurs in the world, Guy's questions come from a place of curiosity and passion for technology, start-ups, entrepreneurship, and marketing. If you love society and culture, documentaries, and business podcasts, take a second to follow Remarkable People. Listeners of the Remarkable People podcast will learn from some of the most successful people in the world with practical tips and inspiring stories that will help you be more remarkable. Episodes of Remarkable People organized by topic: https://bit.ly/rptopology Listen to Remarkable People here: https://podcasts.apple.com/us/podcast/guy-kawasakis-remarkable-people/id1483081827 Like this show? Please leave us a review -- even one sentence helps! Consider including your Twitter handle so we can thank you personally! Thank you for your support; it helps the show!

Welcome to part 2 of episode 36 on the “Love at First Science'' Podcast where Mike Golden about the spinal cord as it is more than you could ever imagine. Mike Golden is back on the podcast explaining more about the spinal cord. He starts by talking about his journey in personal training and coaching and being a part of Z-health. He loves breaking down difficult topics to make it accessible to everyone. He shares how the Z-health program on the brain and nervous system is divided into smaller parts to make learning easier. In the model the knowledge is translated into simple steps. In addition, he precisely explains what the spinal cord is. He talks about the way that it is built and the function behind it. He discusses the importance of the pathways and briefly explains what they are capable of. He also talks about visual or auditive activation, and what effect they have on treating pain. During his work he has realized that neuro anatomy should be a bigger part of the general knowledge about the body and should be accessible to many people.  --------------------------------------------------------------------------------   Learn More About Mike Golden: Mike Golden is the Director of Education for Z-Health Performance Solutions, a world leader in innovating advanced, neurologically-centered rehabilitative and sports performance programs based on emerging research. Mike received his undergraduate degree from Dartmouth College in 2005 before beginning his career teaching martial arts full time and using brain-based training to fast-track his clients' pain and performance successes. Over the course of two decades, he has relentlessly pursued professional development through the Z-Health curriculum and in the broader fields of fitness, functional neurology, and pedagogy, and he has been leading national and international certification courses for Z-Health since 2013. --------------------------------------------------------------------------------   Check out & learn more with Mike: ⁠Z-health⁠⁠ ⁠⁠Z-health Instagram⁠ --------------------------------------------------------------------------------  My Socials:   ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Celest's Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Celest's Website ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Too Flexible To Feel Good Book

Welcome to part 1 of episode 36 on the “Love at First Science'' Podcast where Mike Golden about the spinal cord as it is more than you could ever imagine. Mike Golden is back on the podcast explaining more about the spinal cord. He starts by talking about his journey in personal training and coaching and being a part of Z-health. He loves breaking down difficult topics to make it accessible to everyone. He shares how the Z-health program on the brain and nervous system is divided into smaller parts to make learning easier. In the model the knowledge is translated into simple steps. In addition, he precisely explains what the spinal cord is. He talks about the way that it is built and the function behind it. He discusses the importance of the pathways and briefly explains what they are capable of. He also talks about visual or auditive activation, and what effect they have on treating pain. During his work he has realized that neuro anatomy should be a bigger part of the general knowledge about the body and should be accessible to many people.  --------------------------------------------------------------------------------   Learn More About Mike Golden: Mike Golden is the Director of Education for Z-Health Performance Solutions, a world leader in innovating advanced, neurologically-centered rehabilitative and sports performance programs based on emerging research. Mike received his undergraduate degree from Dartmouth College in 2005 before beginning his career teaching martial arts full time and using brain-based training to fast-track his clients' pain and performance successes. Over the course of two decades, he has relentlessly pursued professional development through the Z-Health curriculum and in the broader fields of fitness, functional neurology, and pedagogy, and he has been leading national and international certification courses for Z-Health since 2013. --------------------------------------------------------------------------------   Check out & learn more with Mike: Z-health⁠ ⁠Z-health Instagram --------------------------------------------------------------------------------  My Socials:   ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Celest's Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Celest's Website ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Too Flexible To Feel Good Book

Today, I am excited to have here with me Dr. Tunis Hunt. He is an expert in chiropractors and the doctor at Hunt for Wellness. This chiropractic wellness center helps people uncover and resolve their underlying health problems to achieve optimal health.  Dr. Hunt grew up in a chiropractic household. His father is a chiropractor, which helps him see the impact of it on the lives of people. As a child, Dr. Hunt could not fully grasp the power of chiropractic until he enrolled in the chiropractic school, where he learned the philosophy of chiropractic and its potential.  A chiropractor's job is to evaluate the vertebral column of the spine and put something called an adjustment on those areas to remove subluxations and enhance the body's ability to function.  With 18 years of experience, Dr. Hunt is passionate about helping others by relieving them of pain and improving overall health. He encourages us to understand the wonders chiropractic can do to our body because everyone deserves a happier and healthier life.  In this episode, Dr. Hunt explains why people should not be afraid to try chiropractic and feel the relief they'll get. He also talks about the recommended frequency of chiropractic adjustments, reversing type two diabetes, and finding the right diet for your body. Tune in as we chat about the chiropractor, reversing type 2 diabetes, carnivore diet, and more!  4 Secrets to Reversing Diabetes LIVE Training With Ben Azadi. Reserve your FREE spot here: https://www.ketokamp.com/4-secrets-to-mastering-diabetes-web-class / / E P I S O D E   S P ON S O R S  Wild Pastures: $20 OFF per Box for Life + Free Shipping for Life + $15 OFF your 1st Box! https://wildpastures.com/promos/save-20-for-life-lf?oid=6&affid=132&source_id=podcast&sub1=ad BonCharge: Blue light Blocking Glasses, Red Light Therapy, Sauna Blankets & More. Visit https://boncharge.com/pages/ketokamp and use the coupon code KETOKAMP for 15% off your order.  Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list. [9:32] Try Chiropractic and Feel The Comfort you'll Get From It -       There are different styles and techniques; some are less physical. Some techniques are simple or as non-invasive as the way the energy flows through the body. -       As a profession, part of what they do is to help people understand what we're doing and not doing. -       Sometimes, the adjustments are sensationalized on social media to make people think it's a violent act. What you see on TikTok is different from what you'll get at most chiropractic offices nationwide. -       Chiropractic is an art, so how chiropractors adjust and what they do can be slightly different. Google reviews and recommendations are a great way to find the best chiropractor. -       Chiropractic care has so many options available. Unless you live or work close to the chiropractic office, receiving high-quality, dependable care may be difficult. So, choose a chiropractor that is close to you.  [22:51] What Is the Recommended Frequency for The Chiropractic Adjustments?  -       Depending on what chiropractic you go to, you may have been sold or influenced to do a gamut of different adjustments. -        At the very minimum, from a wellness perspective, most patients do it about once every month. -       Patients come in twice a month if they're more tuned in to wellness and want to do it more frequently. -       Some love to make adjustments multiple times a week.  [29:38] Having a Back Pain? How Chiropractor may help  -       The most common reason people seek chiropractic care is unspecified back pain. -       Other reasons people seek chiropractic care are neck pain, headache, and sciatica. -       It is up to the chiropractors to help people understand why they might want to consider lifestyle chiropractic care because back pain or other reasons are just symptoms of a bigger issue, and the bigger issue could benefit from ongoing lifestyle care. -       The nice thing about chiropractic is there are so many nuances that a practitioner can choose to go down and specialize in. -       It is about just finding that solution. Keep looking. Don't give up. Chiropractors are here to help. Life's too short to live miserably.  [36:48] Reverse Type Two Diabetes by Doing This -       The key to reverse diabetes is through diet. Storing too much glucose and an overabundance of simple carbohydrates all lead to diabetes. -       This high omega-6 diet, which is prevalent in vegetable oils, raises insulin resistance, the body's inability to pull the glucose out of the blood. And therefore, we get these things called ages or advanced glycogen in products. -       The number one reason people die from diabetes is cardiovascular health. They're not dying from diabetes. They're dying from the diseases connected to it. -       It's all about recognizing what you put in your body matters. Whether good or bad, your current health status is 100% your responsibility. [44:53] Carnivore Diet: The Surprising Benefits of this Elimination Diet  -       At first, Dr. Hunt used a balanced diet perspective. He taught people the plant-based diet with some meat but primarily consisted of eating fruits and vegetables. -       Dr. Paul Saladino inspires Dr. Hunt to switch from a plant-based base to a meat-based diet. -       In addition to chiropractic, Dr. Hunt runs a Healthy Impact Man coaching program. And as he coaches men, he helps them get them closer to an animal-based diet than they were.  [53:10] Meat or Plant-Based Diet? Which One Should You Choose?  -       There's a difference between a healthy diet and an optimal diet. A healthy diet is just the avoidance of refined carbohydrates, refined sugars, refined seed oils, and trans fats. Anything you eat outside of those four can be considered a human healthy diet. -       Recognize plant toxins that are not good for your body and avoid them. -       Some may find that adding some carbohydrates, vegetables, and grain to their diet is absolutely capable of still having optimal fitness and feeling great. -       You can test around the ideal diet for your body. AND MUCH MORE! Resources from this episode: ●  Website: https://www.huntforwellness.com/ ●  F3 Nation: https://f3nation.com/ ●  Follow Dr. Hunt ●  Linkedin: https://www.linkedin.com/in/drtunisjr/ ●  Facebook: https://www.facebook.com/HuntforWellness ●  Twitter: https://twitter.com/TunisHunt ●  Instagram: https://www.instagram.com/hunt4wellness/ ●  Join the Keto Kamp Academy: https://ketokampacademy.com/7-day-trial-a ●  Watch Keto Kamp on YouTube: https://www.youtube.com/channel/UCUh_MOM621MvpW_HLtfkLyQ 4 Secrets to Reversing Diabetes LIVE Training With Ben Azadi. Reserve your FREE spot here: https://www.ketokamp.com/4-secrets-to-mastering-diabetes-web-class / / E P I S O D E   S P ON S O R S  Wild Pastures: $20 OFF per Box for Life + Free Shipping for Life + $15 OFF your 1st Box! https://wildpastures.com/promos/save-20-for-life-lf?oid=6&affid=132&source_id=podcast&sub1=ad BonCharge: Blue light Blocking Glasses, Red Light Therapy, Sauna Blankets & More. Visit https://boncharge.com/pages/ketokamp and use the coupon code KETOKAMP for 15% off your order.  Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list. // F O L L O W ▸ instagram | @thebenazadi | http://bit.ly/2B1NXKW ▸ facebook | /thebenazadi | http://bit.ly/2BVvvW6 ▸ twitter | @thebenazadi http://bit.ly/2USE0so ▸clubhouse | @thebenazadi Disclaimer: This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast including Ben Azadi disclaim responsibility from any possible adverse effects from the use of information contained herein. Opinions of guests are their own, and this podcast does not accept responsibility of statements made by guests. This podcast does not make any representations or warranties about guests qualifications or credibility. Individuals on this podcast may have a direct or non-direct interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.