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In this episode of Behind the Knife, Dr. Patrick Georgoff sits down with Dr. Keri Seymour and Dr. Joey Lew to tackle the complex world of gastrostomy tubes. What may seem like a routine and straightforward procedure is anything but—full of nuanced patient considerations, timing dilemmas, technical challenges, and potential complications that can turn a “simple” consult into a 2 a.m. call you won't forget. From who truly needs a G tube and when to managing difficult post-op issues like dislodgement and buried bumper syndrome, this episode breaks down the practical, evidence-based approach every surgeon should know. Whether you're managing stroke patients, trauma cases, or navigating the tricky administrative obstacles around enteral access, this episode will equip you with the insights and strategies to confidently dominate your G tube consults. Hosts: · Dr. Patrick Georgoff (Acute Care Surgeon, Duke University) · Dr. Keri Seymour (Minimally Invasive & Acute Care Surgeon, Duke Regional) · Dr. Joey Lew (Surgical Resident, BTK MIS Team) Learning Goals: By the end of this episode, listeners will be able to: · Understand the nuanced indications for gastrostomy tube (G tube) placement. · Learn which patients truly benefit from G tubes, and when enteral access is not appropriate or indicated. · Appreciate the importance of goals of care discussions, assessment of comorbidities, and decision-makers—especially in neurocritical and elderly populations. · Know evidence-based timing for gastrostomy tube placement in stroke, TBI, and other complex scenarios. · Understand guideline recommendations and the clinical reasoning behind trial periods of nasogastric feeding versus early G tube placement. · Describe technical approaches to G tube placement and how to tailor the method to patient anatomy and clinical context. · Solidify knowledge of when to choose endoscopic, laparoscopic, open, or interventional radiology-guided placement. · Recognize, manage, and strive to prevent common and serious complications of G tubes, including early and late dislodgement, buried bumper syndrome, infection, bleeding, and gastrocutaneous fistula. · Discuss perioperative considerations, including anticoagulation, patient stability, and post-procedural care. · Understand why routine suturing of the G tube or bumper is not recommended, and how administrative and facility factors can drive clinical decisions. · Gain practical pearls and quick decision trees to dominate G tube consults and troubleshooting, day or night. References: · Braun R, Han K, Arata J, Gourab K, Hearn J, Gonzalez-Fernandez M. Establishing a clinical care pathway to expedite rehabilitation transitions for stroke patients with dysphagia and enteral feeding needs. Am J Phys Med Rehabil. 2024;103(5):390-394. doi:10.1097/PHM.0000000000002387 https://pubmed.ncbi.nlm.nih.gov/36867953/ · Burgermaster M, Slattery E, Islam N, Ippolito PR, Seres DS. Regional comparison of enteral nutrition-related admission policies in skilled nursing facilities. Nutr Clin Pract. 2016;31(3):342-348. doi:10.1177/0884533616629636 https://pubmed.ncbi.nlm.nih.gov/26993318/ · Chaudhry R, Kukreja N, Tse A, Pednekar G, Mouchli A, Young L, Didyuk O, Wegner RC, Grewal N, Williams GW. Trends and outcomes of early versus late percutaneous endoscopic gastrostomy placement in patients with traumatic brain injury: Nationwide population-based study. J Neurosurg Anesthesiol. 2018;30(3):251-257. doi:10.1097/ANA.0000000000000434 https://pubmed.ncbi.nlm.nih.gov/28459729/ · Cleverdon SA, Costantini TW, McGrew TM, Santorelli JE, Berndtson AE, Haines LN. Dysphagia in patients with traumatic brain injury, how often do they really need feeding access? Presented at: Academic Surgical Congress; February 2025; Washington, DC. Abstract 92.33. · Cmorej P, Mayuiers M, Sugawa C. Management of early PEG tube dislodgement: simultaneous endoscopic closure of gastric wall defect and PEG replacement. BMJ Case Rep. 2019;12(9):e230728. doi:10.1136/bcr-2019-230728 https://pubmed.ncbi.nlm.nih.gov/31488448/ · Galovic M, Stauber AJ, Leisi N, et al. Development and validation of a prognostic model of swallowing recovery and enteral tube feeding after ischemic stroke. JAMA Neurol. 2019;76(5):561-570. doi:10.1001/jamaneurol.2018.4858 https://pubmed.ncbi.nlm.nih.gov/30742198/ · Gallo RJ, Wang JE, Madill ES. Things we do for no reason™. J Hosp Med. 2024;19(8):728-730. doi:10.1002/jhm.13263 https://pubmed.ncbi.nlm.nih.gov/38180160/ · George BP, Hwang DY, Albert GP, Kelly AG, Holloway RG. Timing of percutaneous endoscopic gastrostomy for acute ischemic stroke. Stroke. 2017;48(2):420-427. doi:10.1161/STROKEAHA.116.015119 https://pubmed.ncbi.nlm.nih.gov/27965430/ · Goldberg LS, Altman KW. The role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review. Clin Interv Aging. 2014;9:1733-1739. doi:10.2147/CIA.S53153 https://pubmed.ncbi.nlm.nih.gov/25342891/ · Hartford A, Li W, Qureshi D, et al. Use of feeding tubes among hospitalized older adults with dementia. JAMA Netw Open. 2025;8(2):e2460780. doi:10.1001/jamanetworkopen.2024.60780 https://pubmed.ncbi.nlm.nih.gov/39976967/ · Hochu G, Soule S, Lenart E, Howley IW, Filiberto D, Byerly S. Synchronous tracheostomy and gastrostomy placement results in shorter length of stay in traumatic brain injury patients. Am J Surg. 2024;227:153-156. doi:10.1016/j.amjsurg.2023.10.012 https://pubmed.ncbi.nlm.nih.gov/37852846/ · Kobzeva-Herzog AJ, Nofal MR, Bodde J, et al. Implementation of a quality improvement initiative reduced adult inpatient gastrostomy tube dislodgements. Am J Surg. 2025;(article 116522). doi:10.1016/j.amjsurg.2025.116522 https://pubmed.ncbi.nlm.nih.gov/40782502/ · Kurt Boeykens, Ivo Duysburgh. Prevention and management of major complications in percutaneous endoscopic gastrostomy. BMJ Open Gastroenterol. 2021;8:e000628. https://pubmed.ncbi.nlm.nih.gov/33947711/ · Murphy LM, Lipman TO. Percutaneous endoscopic gastrostomy does not prolong survival in patients with dementia. Arch Intern Med. 2003;163(11):1351-1353. doi:10.1001/archinte.163.11.1351 https://pubmed.ncbi.nlm.nih.gov/12796072/ · Papavramidis TS, Mantzoukis K, Michalopoulos N. Confronting gastrocutaneous fistulas. Ann Gastroenterol. 2011;24(1):16-19. https://pubmed.ncbi.nlm.nih.gov/24714282/ · Rajan A, Wangrattanapranee P, Kessler J, Kidambi TD, Tabibian JH. Gastrostomy tubes: fundamentals, periprocedural considerations, and best practices. World J Gastrointest Surg. 2022;14(4):286-303. doi:10.4240/wjgs.v14.i4.286 https://pubmed.ncbi.nlm.nih.gov/35664365/ · Reddy KM, Lee P, Gor PJ, Cheesman A, Al-Hammadi N, Westrich DJ, Taylor J. Timing of percutaneous endoscopic gastrostomy tube placement in post-stroke patients does not impact mortality, complications, or outcomes. World J Gastrointest Pharmacol Ther. 2022;13(5):77-87. doi:10.4292/wjgpt.v13.i5.77 https://pubmed.ncbi.nlm.nih.gov/36157266/ · Singh D, Laya AS, Vaidya OU, Ahmed SA, Bonham AJ, Clarkston WK. Risk of bleeding after percutaneous endoscopic gastrostomy (PEG). Dig Dis Sci. 2012;57(4):973-980. doi:10.1007/s10620-011-1965-7 https://pubmed.ncbi.nlm.nih.gov/22138961/ · Thosani N, Rashtak S, Kannadath BS, et al. Bleeding risk and mortality associated with uninterrupted antithrombotic therapy during percutaneous endoscopic gastrostomy tube placement. Am J Gastroenterol. 2021;116(9):1868-1875. doi:10.14309/ajg.0000000000001348 https://pubmed.ncbi.nlm.nih.gov/34158462/ · Ward EC, Green K, Morton AL. Patterns and predictors of swallowing resolution following adult traumatic brain injury. J Head Trauma Rehabil. 2007;22(3):184-191. doi:10.1097/01.HTR.0000271119.96780.f5 https://pubmed.ncbi.nlm.nih.gov/17510594/ · Wick B. Timing of PEG tube placement in stroke patients with dysphagia: a multi-center retrospective cohort analysis using the TriNetX database. Am J Gastroenterol. 2024;119(10 Suppl):S1146-S1147. doi:10.14309/01.ajg.0001035684.98119.d5 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen BTK Fan Favorites: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US
16 months ago, yoga/meditation/sound teacher Reggie Hubbard had a near-death experience, a major stroke. He visits the podcast to describe the experience of his "neurological storm" and the path of collapse and healing that he's been on ever since, and how it has profoundly affected his views as a practitioner, teacher, and his views of the neurological storm that the United States and the world is currently experiencing. If there's such a thing as a "must-listen" episode of this podcast, this it it. Reggie Hubbard is a senior political strategist, certified yoga and meditation teacher, and founder of Active Peace Yoga. He bridges the worlds of activism and wellness, helping changemakers cultivate inner peace as a foundation for meaningful civic engagement. His mission is to support activists in finding balance while encouraging the wellness community to become more socially conscious. With a background in global marketing, government relations, and activism, Reggie holds a B.A. in philosophy from Yale and an M.B.A. in international strategy from Vlerick Business School. He turned to yoga in 2014 during a period of deepprofessional adversity, and has since studied with renowned teachers including Faith Hunter, Rod Stryker, Dharma Mittra, and Jack Kornfield. Through Active Peace Yoga, Reggie offers accessible yoga rooted in inclusion and healing, drawing inspiration fromartists like Prince and Jimi Hendrix. His teaching blends movement, meditation, and breathwork with honest conversation and compassion. Following a major stroke, his recovery journey further deepened his commitment to contemplative practice. A passionate advocate for equity in wellness, Reggie advises studios and organizations on diversity and inclusion. He has been featured by Yoga Journal, Kripalu, the Omega Institute, Be Here Now Network, and more. He also supports community programs including Black Boys Om and The Food Group. Reggie currently resides in Maryland. Please support the podcast via Substack and subscribe for free or with small monthly contributions. Additional links and show notes are available there. Paid subscribers will receive occasional extras like guided meditations, extra podcast episodes and more! The Thursday Meditation Group happens each week at 8am ET on Thursdays, and a special guided meditation on Open Awareness in Everyday Life was released this week. Another bonus podcast discussed a mindful take on the Revolutionary Astrology of Summer 2025 with Juliana McCarthy and Ethan Nichtern. These are all available to paid subscribers. You can also subscribe to The Road Home podcast wherever you get your pods (Apple, Spotify,Ethan's Website, etc). Ethan's most recent book, Confidence: Holding Your Seat Through Life's Eight Worldly Winds was just awarded a gold medal in the 2025 Nautilus Book Awards. You can visit Ethan's website to order a signed copy. Please allow two weeks from the time of your order for your copy to arrive. Don't forget to sign up for thee upcoming 5 day retreat at the lovely Garrison Institute Sep 29 - Oct 4, 2025 at this link ! Check out all the cool offerings at our podcast sponsor Dharma Moon, including a free webinar with David Nichtern on why become a meditation teacheron Sep 2th, 2025. Free video courses co-taught by Ethan and others, such as The Three Marks of Existence, are also available for download at Dharma Moon.
Recently, Australian swimmer Lani Pallister made history by becoming the third-fastest woman ever in the 1500-meter freestyle. In this episode, we're diving into her stroke to see exactly what makes her technique so effective and what we can all learn from it. 00:25 2-Beat Kick 01:01 Head Position/ Breath Timing 02:26 Have The Head Turn In Time with the Shoulders 03:30 Catch Position 08:31 Kick Timing 10:01 Rotation 12:38 Recovery
Tune into the latest podcast from the American Neurological Association (ANA), ANA Investigates: 75 Years of NINDS. This year marks the 75th anniversary of the National Institute of Neurological Disorders and Stroke (NINDS)—an opportunity to reflect on the institute's past achievements and look ahead to the future of neurological research. This month, ANA Investigates welcomes Dr. Walter Koroshetz, Director of NINDS, in conversation with Dr. Adeline Goss, Neurohospitalist at Highland Hospital. Dr. Koroshetz joined the institute in 2007 as Deputy Director and became Director in 2015. Before joining the NINDS, he served as Vice Chair of Neurology, Director of Stroke and Neurointensive Care Services at Massachusetts General Hospital, and neurologist in the MGH Huntington's Disease Clinic. Tune in as they discuss highlights from the NINDS's 75-year history and explore what lies ahead for neurological research and innovation. Guest: Walter J. Koroshetz, MD, FANA Director National Institute of Neurological Disorders and Stroke Interviewer: Adeline Goss, MD Neurohospitalist Highland Hospital Disclosures: None
UW Medicine researchers reached an extraordinary milestone this summer. They successfully implanted a device onto the brain of a Seattle-area man who suffered multiple strokes. They believe the device can help him recover movement in his arm and hand. KUOW editor and producer Stephen Howie tells about what this could mean for the future of stroke recovery. We can only make Seattle Now because listeners support us. Tap here to make a gift and keep Seattle Now in your feed. Got questions about local news or story ideas to share? We want to hear from you! Email us at seattlenow@kuow.org, leave us a voicemail at (206) 616-6746 or leave us feedback online.See omnystudio.com/listener for privacy information.
Fiber is simple, yet Critical and Powerful to improving your overall Health and in Decreasing your chances of Heart disease, Cancer, Stroke, Type 2 Diabetes and more. Take a listen and learn how to simply take advantage of this Powerful Lever in Optimizing your Health today and SHARE WITH A FRIEND!Join my upcoming FREE workshop, "Younger, Stronger, for Longer!" How to turn back your biological age 10-20 years so you can do the things you want to do that you no longer thought possible due to your age. Perform at your best and live your best life!And, in my new Performance, and Longevity medical practice we specialize in turning back your biological age so you can feel a decade or more younger so you can do the things you want to do that you thought were no longer possible due to your age. SHARE with a Friend and please drop a Review:)*Don't wait to Prioritize your health, Start Today with the Simple and Powerful Steps detailed in my Best-selling book.*GET DIRECT ACCESS to DR. HEMINGWAY in these AMAZING COURSES!**Free resource: 'The truth about GLP-1s and their alternatives' - https://drthomashemingway.myflodesk.com/n1yyjkcb68
Send us a textTawny's husband has suffered a stroke, which resulted in a wholesale personality change, including the pursuit of other women. Wondering how much of his behavior is due to his medical condition, Tawny wants to know if she can continue to serve as both a caregiver and a wife. Sven probes for the deep truth, and possible answers for Tawny. Explicit content.
Dr. Dan Ackerman talks with Dr. Urs Fischer about the optimal timing of anticoagulation after ischemic stroke in patients with atrial fibrillation. show reference: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00439-8/fulltext
TWiN discusses research showing that Lactobacillus acidophilus promotes cognitive function recovery after cerebral ischemia, by regulating microglial peroxisomal function. Hosts: Vincent Racaniello, Vivianne Morrison, and Tim Cheung Subscribe (free): Apple Podcasts, Google Podcasts, RSS Links for this episode MicrobeTV Discord Server Arc is pdb molecule of the month (PDB) Probiotics after stroke (Cell Host Microbe) Timestamps by Jolene Ramsey. Thanks! Music is by Ronald Jenkees Send your neuroscience questions and comments to twin@microbe.tv
Systematic Review Analyzes the Association Between Periodontal Disease and StrokeBy Today's RDH ResearchOriginal article published on Today's RDH: https://www.todaysrdh.com/systematic-review-analyzes-the-association-between-periodontal-disease-and-stroke/Need CE? Start earning CE credits today at https://rdh.tv/ceGet daily dental hygiene articles at https://www.todaysrdh.com Follow Today's RDH on Facebook: https://www.facebook.com/TodaysRDH/Follow Kara RDH on Facebook: https://www.facebook.com/DentalHygieneKaraRDH/Follow Kara RDH on Instagram: https://www.instagram.com/kara_rdh/
On Episode 55 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the August 2025 issue of Stroke: “Anticoagulation Timing in Acute Stroke With Atrial Fibrillation According to Chronic Kidney Disease: The OPTIMAS Trial” and “Risk of Intracranial Hemorrhage With Apixaban Versus Aspirin Therapy: A Meta-Analysis of Randomized Controlled Trials.” She also interviews Dr. Stephen Ryan and Prof. Anne Aamodt about the Tenecteplase in Central Retinal Artery Occlusion Study (TenCRAOS), presented in May at the European Stroke Organisation Conference. For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20250815.784085
Many have been advised by a financial planner, estate planning attorney or other professional that they have enough assets to "self-insure" future LTC needs. The question is not "can I afford it?" but "Is this the best use of assets to fund future care needs?" This episode is full of questions you should be asking yourself and your advisors if they tell you you can afford to self-fund. Listen and schedule some time with me to consider the risk and search for the most cost-efficient ways to pay for extended care View current and projected costs of care where you live Learn what your state Medicaid system lets you keep
Dr. Don and Professor Ben talk about the risks from squishing a bug that smells like maple syrup. Dr. Don - not risky
Approximately every 40 seconds, someone in the United States has a stroke. About 87% of all strokes are ischemic strokes, which blocks blood flow to the brain. When it comes to treating strokes, knowing the signs and symptoms is important so you can act fast. Dr. José Morales is a vascular neurologist and neurointerventional surgeon at Pacific Neuroscience Institute. Dedicated to serving his patients, Dr. Morales specializes in minimally invasive endovascular procedures that treat conditions and diseases of the brain and spine, such as strokes. Listen to this episode and find out how Dr. Morales treats stroke, the importance of early detection, and how lifestyle changes can help prevent it.
Homes That Heal | Transform Your Home Into a Health and Wellness Sanctuary
Dr. Dan Ackerman talks with Dr. Urs Fischer about the optimal timing of anticoagulation after ischemic stroke in patients with atrial fibrillation. Read the related article in The Lancet. Disclosures can be found at Neurology.org.
The chain of survival for ACLS is the same as was learned in your BLS class.The beginning steps of the Cardiac Emergency and Stroke chain of survival.ACLS's timed goals for first medical contact to PCI for STEMI and door-to-needle for ischemic stroke.Characteristics of areas that have significantly better stroke and out-of-hospital cardiac arrest outcomes.**American Cancer Society (ACS) Fundraiser This is the seventh year that I'm participating in Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission.I hope you'll consider contributing.Every donation makes a difference in the fight against breast cancer! Paul Taylor's ACS Fundraiser Page: http://main.acsevents.org/goto/paultaylorTHANK YOU for your support! Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn
It's 9 o'clock. Do you know where your traders are? Patreon: www.patreon.com/ditchdiggers Facebook: https://www.facebook.com/groups/ditchdiggerslistenershole Instagram: https://www.instagram.com/ditchdiggerspodcasts Find out more at http://tradingplacesminute.com
This podcast is comprised of various segments from a service that was streamed on August 17, 2025, led by Unity Temple Member Chuck Ruth. The theme for August is Courage. To read about our theme-based ministry, please visit http://www.unitytemple.org/faith-development/soul-connections on our website. To see a video of this complete service, click HERE. For information about how to join our Sunday morning live stream worship service on YouTube and our virtual community hour on Zoom after the live stream, please visit our website at http://www.unitytemple.org. Please note that the service is currently held at 9:00 a.m.
Join us as we talk with Prof Prash Sanders about the role of anticoagulation for patients with atrial fibrillation (AF), learn when patients should be screened for AF, how to perform a stroke risk assessment and strategies to reduce the risk of bleeding. This podcast is in collaboration with Medcast and the Quality Use of Medicines Alliance, a provider of health professional education in Australia focused on the quality use of medicines. Check out their resources here. Clinical guide: Anticoagulant management for AF Anticoagulant patient care plan Prof Prash Sanders is a cardiologist and electrophysiologist with a focus on heart rhythm disorders, particularly atrial fibrillation. He graduated with Honours from the University of Adelaide and completed advanced training in Melbourne and Bordeaux, France, earning national and international recognition for his research and clinical expertise. He is the Clinical Director of Cardiac Electrophysiology at the Royal Adelaide Hospital and holds the Knapman – National Heart Foundation Chair of Cardiology Research at the University of Adelaide. Dr Sanders has published over 600 papers and is a leader in advanced ablation techniques. He consults and performs procedures across multiple hospitals and regional clinics in South Australia. Jarrah is a clinical pharmacist with a passion for education and quality use of data. He has led national health programs, including GP audit and feedback initiatives and Indigenous health nKPIs. He is currently clinical lead at MedCast, supporting best practice care through the Quality Use of Medicines Alliance.
Program notes:0:40 Alteplase after stroke1:40 Expand time window2:40 Imaging crucial in use3:20 Use of health care and mortality in those with dementia4:20 Women used much less healthcare5:20 Focus on prevention in women5:50 IVF outcomes and weight loss6:50 Did not appear to increase success with IVF7:45 Ultraprocessed foods versus minimally processed foods8:45 Randomized to one diet or the other for 8 weeks9:45 Minimally processed foods improved risk factors10:45 Short period of study11:42 End
Drs. BJ Hicks, Birgitte Hede Ebbesen, and Boris Modrau discuss fatigue following transient ischemic attack and examine the characteristics of patients who experience pathologic fatigue. Show reference: https://www.neurology.org/doi/10.1212/WNL.0000000000213605
Are you looking to make a change in your life, but don't know how to do it? Look no further than Jeffrey Wetherhold! Jeff is a "change manager," which means that he knows how to help teams develop evidence-based tactics to change their course successfully. 88% of organizational change efforts fail to produce lasting results. But with Jeffrey's help, you can join the ranks of the top 12!Take note of Jeffrey's wise words about the nature of change..."Think of change as ambivalence.""Become comfortable with reflection.""Balance your conversations."See more at: MarkSpencerCook.com/Podcast/Links for Mark S. Cook: MarkSpencerCook.com | WindfallPartners.comLinkedIn for Mark S. Cook: LinkedIn.com/in/@MarkSpencerCookOther Social Media: @MarkSpencerCookQuestions Explored in this Discussion:• How to rehabilitate after a stroke?• How to change minds?• How to become a better listener?• How to become a solopreneur?• How to successfully change?• How to prevent burnout?Lessons Learned:• Find your niche• The importance of trial and error• Ask fewer questions• Relinquish control in your conversations• Nobody changes to feel worse about themselves• Understand what you can control• The importance of baby stepsRecruit Jeffrey to help build your business's path to change:https://www.jeffwetherhold.com/https://www.linkedin.com/in/wetherhold/0:00 Introduction4:04 Childhood8:40 Joining the workforce11:30 Surviving a stroke19:45 Rehabilitating your life22:45 Starting a business33:16 Change management37:55 Burnout41:45 Conversations46:48 Changing minds54:15 Motivational interviewing, 1:02:11 Advice
When treating patients having an MI or stroke, more minutes equals more dead cells.Because the majority of strokes are the ischemic type, the treatment for stroke is similar to an MI – to reestablish perfusion to the ischemic tissues.The first four steps in the Stroke Chain of Survival.Time criteria for the administration of tPA (or a similar fibrinolytic medication) or EVT of LVO strokes.Stroke benchmarks for door to:assessment;completing a non-contrast CT; andadministration of fibrinolytic medication such as tPA (door-to-needle).EMS interaction with stroke teams and destination protocols to reduce time to definitive care.The difference for timed goals for the identification & treatment of AMI vs Stroke.Additional information about timed goals for stroke and how EMS affects outcomes, can be found on the PassACLS.com pod resources page.**American Cancer Society (ACS) Fundraiser This is the seventh year that I'm participating in Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission.I hope you'll consider contributing.Every donation makes a difference in the fight against breast cancer! Paul Taylor's ACS Fundraiser Page: http://main.acsevents.org/goto/paultaylorTHANK YOU for your support! Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn
After surviving a stroke in July 2023, Manny completely transformed his life—losing 80 pounds, giving up alcohol, and embracing a Mediterranean-style diet. In this inspiring conversation, he shares how lifestyle changes, family support, and adaptive tools have helped him regain independence, improve his health, and rediscover joy in fishing, gardening, and his dream of returning to the grill. Manny emphasizes that your commitment to recovery defines its speed and impact. You are in control of your progress.Send us a textSupport the showYou can find this episode's transcript here.New episodes drop every other Thursday everywhere you listen to podcasts.
On this episode of the BobbyCast, Bobby sits down with singer/songwriter, Drake White. Drake told the story about the night he had a stroke on stage and had to be rushed to the hospital. Drake got into details when he knew he felt weird on stage, when everything slowed down and having a moment of peace in the room alone. He also told Bobby the story where encountered God, why he fought through initial signs of struggle, his road to recovery, more! Follow on Instagram: @TheBobbyCast Follow on TikTok: @TheBobbyCast Watch this Episode on YoutubeSee omnystudio.com/listener for privacy information.
We begin by reading the last will and testament of Anas al-Sharif, a 28-year-old journalist for Al-Jazeera that was among those slain in Gaza by Israel yesterday. We then resume our Epstein coverage, including a look at his Manhattan lair and celebrity dinner guests. Then, two pieces on venture capitalists driven insane by The Computer and a story by Pamela Paul on conservative women…with careers? Stick around until the end for another Stroke of Genius and a special announcement from Chris. Pre-order Seth Harp's book The Fort Bragg Cartel here: https://www.penguinrandomhouse.com/books/730414/the-fort-bragg-cartel-by-seth-harp/ And check out his book launch with TrueAnon at the Bell House this Wednesday: https://www.ticketmaster.com/an-evening-with-trueanon-and-seth-brooklyn-new-york-08-13-2025/event/300062F5CD8E3E2D
In this episode, my guest is Dr. Michael Kilgard, PhD, a professor of neuroscience at the University of Texas at Dallas and a leading expert on neuroplasticity and learning across the lifespan. We discuss the need for alertness, effortful focus, post-learning reflection and sleep to induce neuroplasticity, and how dopamine, acetylcholine, serotonin and norepinephrine are each involved. He explains the behavioral steps for neuroplasticity, as well as vagal nerve stimulation (VNS) and other therapies for tinnitus, stroke, depression, PTSD and paralysis. This episode ought to be of use to anyone interested in understanding the modern science of brain rewiring and learning to improve cognitive or motor skills or treat sensory or motor disorders. Read the episode show notes at hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman Eight Sleep: https://eightsleep.com/huberman Wealthfront*: https://wealthfront.com/huberman Carbon: https://joincarbon.com/huberman Function: https://functionhealth.com/huberman *This experience may not be representative of the experience of other clients of Wealthfront, and there is no guarantee that all clients will have similar experiences. Cash Account is offered by Wealthfront Brokerage LLC, Member FINRA/SIPC. The Annual Percentage Yield (“APY”) on cash deposits as of December 27, 2024, is representative, subject to change, and requires no minimum. Funds in the Cash Account are swept to partner banks where they earn the variable APY. Promo terms and FDIC coverage conditions apply. Same-day withdrawal or instant payment transfers may be limited by destination institutions, daily transaction caps, and by participating entities such as Wells Fargo, the RTP® Network, and FedNow® Service. New Cash Account deposits are subject to a 2-4 day holding period before becoming available for transfer. Timestamps (00:00) Michael Kilgard (03:24) Neuroplasticity (05:13) Child vs Adult Plasticity, Childhood Development & Learning (09:37) Sponsors: Eight Sleep & Wealthfront (12:41) Kids, Real vs Artificial Experiences & Balance, Video Games, Natural World (21:13) Social Media & Videos, Kids, Overstimulation & Development (33:42) Early Language Development, Passive vs Real Experiences, Kids & Adults (39:23) Sponsors: AG1 & Carbon (42:44) Learning & Plasticity Requirements; Focus, Friction, Rest & Reflection (52:24) Brain Connections, Complexity, Life Experiences & Plasticity (1:02:51) Learning, Reflection, Visualization, Testing (1:09:45) Experience Diversity & Time, Happiness, Life Appreciation (1:18:05) Sponsor: Function (1:19:53) Learning & Life Meaning (1:23:25) Neuromodulators, Brain Complexity, Synaptic Eligibility Trace & Learning (1:34:28) Synapses, Therapy for PTSD, Rewiring the Brain (1:39:01) Vagus Nerve Stimulation (VNS), Stroke, Spinal Cord Injury, Tinnitus, PTSD (1:47:33) Psychedelics, Neurostimulation, Importance of Timing (1:57:47) Electroconvulsive Therapy (ECT) & Major Depression (2:01:51) Psychedelics/SSRIs as Plasticity Tools, SSRIs & Bone Strength, Failed Clinical Trials (2:13:18) Can VNS Accelerate Learning? (2:16:01) VNS Surgery, Patient Use & Specificity, Closed-Loop Vagus Nerve Stimulation (2:18:18) Tinnitus Cause, Incidence & Self-Amplification; PTSD & Control (2:28:12) VNS for Tinnitus; Disease Complexity & Treatments, Lazy Eye (2:41:05) Complexity of Disease Treatments & Combination Therapies (2:48:50) Brain-Machine Interfaces, Information & Experiences; Closed-Loop Feedback; Resilience (2:59:09) Evolving Clinical Trials, Combination Treatments & Disease Complexity (3:05:21) Acknowledgements (3:07:04) Zero-Cost Support, YouTube, Spotify & Apple Follow & Reviews, Sponsors, YouTube Feedback, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures Learn more about your ad choices. Visit megaphone.fm/adchoices
Dr. BJ Hicks talks with Drs. Birgitte Hede Ebbesen and Boris Modrau about the study's methodology, findings, and implications for clinical practice, emphasizing the need for better awareness and support for TIA patients. Read the related article in Neurology®. Disclosures can be found at Neurology.org.
Kevin's ischemic stroke began with symptoms most men overlook — his recovery shows why awareness and action matter. The post The Subtle Stroke Signs Kevin Almost Ignored appeared first on Recovery After Stroke.
Like it or not, this is baseball's time of the year and as such this is a re-release of our interview with long-time MLB General Manager Thad Levine. Thad shares his incredible journey from being a young baseball fan to playing Division III baseball at Haverford College to eventually leading major league teams, including his latest role as GM of the Minnesota Twins. Discover how his experiences in sports management have shaped his approach to analytics, recruitment, and team culture. This interview was conducted on November 22nd, 2024 and was originally published as Episode 10 of Season 2. Show Notes: (G): Content is Mostly Global Interest Topics (M): Content is Mostly Inside Marin Topics Musical intro credit to Stroke 9//Logo credit to Katie Levine Content and opinions are those of Dave, Duffy and their guests and not of affiliated organizations or sponsors. Platinum Sponsor: Encore Custom RostersToRings email us at: theruntmcpodcast@gmail.com check out our website at: theruntmcpodcast.com AI Summary Welcome to the latest episode of the Run TMC Podcast, where we delve into the intricate world of sports management with former Minnesota Twins General Manager, Thad Levine. In this engaging conversation, Thad shares his remarkable journey from the start of his career, waxing poetic on the hard work and serendipity involved in reaching the upper echelons of Major League Baseball's front office. Discover the evolution of analytics in baseball and how it has transformed player evaluation, the challenges and excitement of being a GM, and the delicate balance of decision-making in high-stakes environments. Thad also provides a firsthand account of working alongside legendary figures and his refreshing take on the importance of culture and character in sports teams. Whether you're an aspiring sports professional or a seasoned fan, Thad's insights offer a unique perspective on the intersection of sports and humanity. Don't miss this in-depth episode as we explore the past, present, and future of sports through the lens of a seasoned general manager.
This episode is taken from our latest Feedback Friday video. We have a triathlete from Sydney who holds 1:30/100m on his Ironman swims. Let's take a look at his strokes and see where he can find additional speed. Watch on Youtube: https://www.youtube.com/watch?v=7kEXXSc9eac 00:37 Head Position 01:04 Body Position 04:10 Reach And Extension 06:13 Arm Angle Grab the freestyle checklist here: https://effortlessswimming.com/freestyle-checklist/ Work with us (stroke analysis coaching): https://effortlessswimming.com/es-training-and-membership-page/ Join a camp: https://effortlessswimming.com/camps
Conversations Like No Other presented by Valley Health System
Strokes happen to people of all ages in all walks of life. Recognizing the signs and reacting fast can make all the difference. Understand the signs and symptoms of a stroke to be prepared to help in this medical emergency.
Sheryl Glick host of Healing From Within Interviews Erica Tucci author of Radiant Survivor- How to Shine and Thrive through Recovery from Stroke, Cancer Abuse Addiction and other Life-Altering Experience. Erica Tucci was actively engaged as a corporate manager of a Fortune 500 company, a healing arts business owner and author of three books. Unaware of any major health issue, one morning, much the same as any other morning, Erica suffered a major stroke that left her completely paralyzed on her right side. During a long recovery, Erica gained much wisdom about what is really important in life and now draws on her experiences through her healing process to use her story as an inspiration for others facing life challenges, which we all have, whether big or small. Learn more about Sheryl here: http://www.sherylglick.com/
Interventional cardiologist Dr. Jennifer Rodriguez breaks down the link between hypertension and stroke, sharing expert insights and prevention strategies. Visit www.cardio.com for more information or to schedule an appointment with one of our providers.Visit www.cardio.com for more information or to schedule an appointment with one of our providers.
Dr. Robert Baron outlines major updates in type 2 diabetes care, emphasizing that blood sugar control alone does not significantly reduce cardiovascular risk, though it helps prevent microvascular complications. New guidelines now prioritize medications with proven cardiovascular and kidney benefits—GLP-1 receptor agonists and SGLT2 inhibitors—over traditional first-line therapy like metformin. Baron explains how these newer drugs not only lower blood sugar but also reduce the risk of heart attack, stroke, kidney disease, and heart failure, with added benefits such as weight loss. He also covers changes in screening, diagnosis, blood pressure goals, and individualized treatment strategies based on age, comorbidities, and patient preferences. [Health and Medicine] [Show ID: 40756]
At 26, Katherine Wolf survived a massive brain stem stroke that left her with significant disabilities she's learned to navigate over the past 17 years. As an overcomer radiating gratitude and joy, Katherine shares her transformative take on the body and the power of healing in community. Listen as she disrupts these common myths: Joy can only coexist in a pain-free life. Suffering is the end of the story Healing is not the same as curing. Katherine Wolf is a sought-after author, speaker, and co-founder of Hope Heals, a ministry dedicated to making hope accessible by creating sacred spaces of belonging and belovedness for people with disabilities. Through initiatives like Hope Heals Camp and Mend Coffee and Goods, she fosters community and connection for those navigating similar journeys. Are you ready to lead others to health and wholeness as a Revelation Fitness Instructor or LiveWell Health Coach? Sign-ups close August 15 for fall training! Download a packet here. Get connected: revelationwellness.org | Instagram | YouTube Please consider following this show (and sharing it with a friend), leaving a review, and telling us what you think with a voice message! If you leave us a voice message, be sure to include the episode number. Follow | Leave a Review | Send a Voice Message
Send us a textWe often hear about heart disease prevention, but stroke—a condition nearly as common and often more disabling—gets far less attention. In this episode, Dr. Bobby is joined by cardiologist Dr. Anthony Pearson to uncover what science really says about stroke prevention, the distinct types of strokes, and what practical steps you can take today to lower your risk.Together, they explore the two major types of stroke—ischemic and hemorrhagic—and explain why strokes caused by clots or vessel rupture can have very different causes and consequences. The data shows nearly 800,000 Americans experience strokes annually, and about half of survivors live with long-term disability (CDC; NIH). Yet most of us are unaware of the modifiable risk factors that account for up to 90% of stroke risk (INTERSTROKE Study).Dr. Pearson emphasizes the number one culprit: high blood pressure. It triples individual risk and contributes to half of all strokes, with randomized trials like SPRINT showing that aggressive control reduces both stroke and mortality (SPRINT Study). Both doctors also discuss physical activity—while Dr. Bobby cites strong associations between exercise and reduced stroke risk (BMJ Review), Dr. Pearson cautions that current evidence is largely observational and inconclusive.They also explore the role of lipid levels, citing that high ApoB or LDL may increase risk in strokes caused by carotid atherosclerosis, but not necessarily in cardioembolic strokes. Dietary improvements, particularly following a Mediterranean-style diet, have shown benefits, including reduced stroke risk in randomized trials like PREDIMED.Beyond traditional risk factors, they also explore loneliness as a newer area of concern. A recent study linked persistent loneliness in adults over 50 to a 50% increased stroke risk (Lancet eClinicalMedicine), highlighting the complex social and behavioral factors at play.Dr. Pearson discusses atrial fibrillation (AFib) and why it's a key cause of cardioembolic strokes—especially relevant given that wearables like Apple Watch now help detect AFib early. They also touch on controversial screening approaches, warning against routine carotid ultrasounds and unwarranted treatment of asymptomatic brain aneurysms.Importantly, Dr. Bobby highlights the signs of stroke—sudden weakness, numbness, speech difficulties, or confusion—and urges immediate ER visits to enable timely treatment like thrombolysis, ideally within four hours of symptom onset.As always, they wrap by challenging popular myths. Dr. Pearson explains why aspirin, once widely promoted for primary prevention, is no longer recommended due to increased bleeding risk, especially into the brain. He also debunks the idea that supplements like fish oil or B vitamins help prevent strokes, noting no benefit in recent large trials.Takeaways:Know your blood pressure and cholesterol levels—and treat them if needed. These remain the top modifiable risks for stroke.Prioritize physical activity, even if trial data is imperfect—it benefits vascular health broadly and may reduce stroke risk.Stay socially connected: chronic loneliness has emerging links to stroke risk, highlighting that prevention isn't just physical—it's relational.To continue learning how to live long and well, visit drbobbylivelongandwell.com.
Dr. Doug Lucas tackles a common myth: that topical estradiol increases stroke risk. After hearing his wife's OBGYN repeat this warning, he investigates where this misinformation comes from. He finds that even AI tools and FDA drug labels conflate oral and topical estrogen data. Citing multiple large studies, Dr. Doug explains that oral estrogen and synthetic progestins may increase stroke risk, but transdermal (topical) estradiol—especially when paired with oral micronized progesterone—does not. He emphasizes the importance of separating hormone types, delivery methods, and doses when assessing safety, and calls for better education to prevent fear-based decision-making in women considering HRT.*STUDIES*https://pubmed.ncbi.nlm.nih.gov/20670199/https://pmc.ncbi.nlm.nih.gov/articles/PMC4927222/https://pubmed.ncbi.nlm.nih.gov/28626058/
At 26, Katherine Wolf survived a massive brain stem stroke that left her with significant disabilities she's learned to navigate over the past 17 years. As an overcomer radiating gratitude and joy, Katherine shares her transformative take on the body and the power of healing in community. Listen as she disrupts these common myths: Joy can only coexist in a pain-free life. Suffering is the end of the story Healing is not the same as curing. Katherine Wolf is a sought-after author, speaker, and co-founder of Hope Heals, a ministry dedicated to making hope accessible by creating sacred spaces of belonging and belovedness for people with disabilities. Through initiatives like Hope Heals Camp and Mend Coffee and Goods, she fosters community and connection for those navigating similar journeys. Are you ready to lead others to health and wholeness as a Revelation Fitness Instructor or LiveWell Health Coach? Sign-ups close August 15 for fall training! Download a packet here. Get connected: revelationwellness.org | Instagram | YouTube Please consider following this show (and sharing it with a friend), leaving a review, and telling us what you think with a voice message! If you leave us a voice message, be sure to include the episode number. Follow | Leave a Review | Send a Voice Message
Podcast summary of articles from the June 2025 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include Artificial Intelligence in X ray interpretation, metoclopramide, antipsychotics, stroke treatment, carbon monoxide toxicity, and organophosphate toxicity. Guest speaker is Dr. John Bennison.
Len and Beave truly revisit the music of their youth when they talk the music of Billy Squier and Eddie Money! The two artists go up against each other in Len's latest Facebook bracket, and they go through all their (numerous) hits, career arcs, career-ending videos (OK, just one). Who's better? And where do they rank in the 80s pantheon? And why are Len and Beave going off the rails to also discuss Loverboy and Paul Davis? Tune in for some VERY specific 80s jams!
Sweet poison? New doubts cast over safety of erythritol; Is Greek yogurt a good way to enhance protein intake? Comparing whey, soy, and pea protein isolates; When taking supplements, is it advisable to take periodic breaks to enhance their effectiveness? Tommy John surgery pioneer and longtime Mets medical director dies at 68; Ivermectin, once branded useless “horse paste,” may prove a new weapon against malaria; New findings challenge notion that humans and apes share 99% of their DNA.
A ski accident led to a stroke, but what followed was resilience, reinvention, and a surprising new purpose in life. The post From Stroke to Service: Lara's Unlikely Recovery Journey appeared first on Recovery After Stroke.
Discover the ultimate guide to erg training for HYROX athletes. Rich Ryan and Meg Jacoby dive into SkiErg, RowErg, and BikeErg strategies, recovery tips, equipment rankings, pacing insights, and how to avoid common form mistakes. Whether you're a beginner or elite, this episode is packed with practical advice to level up your erg game and race performance..00:01 - Return of the Meg: Meg's walkout song and return to training03:45 - Overcoming long-term injuries and what finally worked06:10 - Introduction to erg training as a recovery and performance tool09:30 - Home gym erg equipment rankings: bike, ski, row, and why14:50 - Using the BikeErg for low-impact intensity and FTP progress22:35 - Why the SkiErg matters more than the RowErg on race day28:20 - Structuring weekly erg sessions and matching threshold to running35:40 - Threshold testing on ergs using the 5K as a baseline51:25 - Common form mistakes on the SkiErg and RowErg (and how to fix them)1:07:00 - Stroke rate, damper settings, and how they translate to race performance
SEE THE BOYS LIVE - https://www.samtallent.com/ SPONSOR: Cash App - Download Cash App Today: https://capl.onelink.me/vFut/g0yurtz9 #CashAppPod. As a Cash App partner, I may earn a commission when you sign up for a Cash App account. Cash App is a financial services platform, not a bank. Banking services provided by Cash App's bank partner(s). Prepaid debit cards issued by Sutton Bank, Member FDIC. Visit https://www.cash.app/legal/podcast for full disclosures. PATREON EPISODES: https://www.Patreon.com/chubbybehemoth This week the boys are all together in SLC. Sam teaches the boys about complimenting eyebrows, is afraid he's turning his niece into a pro wrestler, and proposes his new glass cube performance idea. Nathan doesn't need another hero to be taken down, remembers Sam's weird kiss, and can't imagine wearing that poncho in public. Nathan Lund and Sam Tallent are Chubby Behemoth Mutiny Coffee: mutinyonmainstreet@gmail.com
Obsessive vinyl collector and radio & MTV legend Matt Pinfield discusses his music collection, holy grails, music industry stories, his recent health scares and sharing stories at the Punk Rock Museum. The Punk Rock Museum info and tickets are here Matt's book "My Insane Improbable Rock Life" is here Topics Include: Matt discusses his post-stroke meal plan after months without solid food Friends like Mike Ness from Social Distortion visited him in hospital Stroke happened at drummer John Tempesta's house, remembers calling EMS Had both stroke and meningeal pneumonia with 85% mortality rate Daughters told he would die, was touch and go situation Lost feeling on right side, still numb but walking with cane Previous near-death experiences: aneurysm at 15, car accident, sobriety struggles Recovery includes acupuncture from former punk drummer and intense physical therapy Currently doing tours at the Punk Rock Museum in Las Vegas Favorite museum artifact is rare Germs concert footage never released Stories of interviewing Iggy Pop who once knocked microphone from hands Hosted Wayne Kramer tribute concert at Sing Sing prison for inmates Getting punk acts on MTV 120 Minutes easier than expected Started in college radio at Rutgers, only 13 alternative stations existed CBGBs regular, Athens Georgia born with B-52s/R.E.M. connections there Kevin Bacon joked there's only two degrees of separation with Matt Neil Young remains his interview "holy grail" Matt is a serious 45 RPM collector Lived in Paul Kantner's old apartment with psychedelic laser showerhead DJed at clubs where James Gandolfini was regular Friends with Don Bolles from Germs, both love 70s glam records Personal rule: must buy something from every record store visited Also supports opening bands by buying their vinyl and t-shirts Postal service recently stole entire box of rare 45s shipment Still searching for holy grail records like Panic Squad 12-inch single Tom Petty acetate test pressing gift from friend Chuck Rocha Found rare Cherry Slush single that climbed charts before label folded Optimistic about vinyl's future as young people discover physical music Believes vinyl offers irreplaceable warmth and "whole other world" experience Plans Vegas record shopping and Australian record exchange with Nate High resolution version of this podcast is available at: www.Patreon.com/VinylGuide Listen on Apple: https://apple.co/2Y6ORU0 Listen on Spotify: https://spoti.fi/36qhlc8
Primary Articles* As-Needed Albuterol–Budesonide in Mild Asthma* Early versus Later Anticoagulation for Stroke with Atrial FibrillationReferenced Articles * Albuterol–Budesonide Fixed-Dose Combination Rescue Inhaler for Asthma* Stopping Randomized Trials Early for Benefit and Estimation of Treatment Effects: Systematic Review and Meta-regression Analysis This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe
A patent foramen ovale (PFO) is present in approximately 25% of all adults. Author David M. Kent, MD, MS, of Tufts Medical Center and JAMA Associate Editor David Simel, MD, MHS, discuss how to evaluate the likelihood that a PFO was causal in a patient with a cryptogenic ischemic stroke, and closure of a PFO to lower the incidence of recurrent strokes for affected patients. Related Content: Patent Foramen Ovale and Stroke Patent Foramen Ovale and Dysarthria in a Man in His 60s Management of Patients With a Patent Foramen Ovale With History of Stroke or TIA Heterogeneity of Treatment Effects in an Analysis of Pooled Individual Patient Data From Randomized Trials of Device Closure of Patent Foramen Ovale After Stroke Transesophageal Echocardiogram Detecting a High-Risk Patent Foramen Ovale ----------------------------------- JAMA Editors' Summary
While we take a season break, we're bringing back this conversation with Rus Devora Wallen, who shares her own experience with a stroke, and lessons from her clients on how the greatest descents in our lives are often a preparation and a catalyst for unparalleled ascent. Find more of Rus Devorah's work on toratherapeutics.com ||* * * * * * *To inquire about sponsorship & advertising opportunities, please email us at info@humanandholy.comTo support our work, visit humanandholy.com/sponsor.Find us on Instagram @humanandholy & subscribe to our channel to stay up to date on all our upcoming conversations ✨Human & Holy podcast is available on all podcast streaming platforms. New episodes every Sunday & Wednesday on YouTube, Spotify, Apple Podcasts, and Google Podcasts.* * * * * * *TIMESTAMPS0:00 - Introduction 1:55 - Meet Devora Wallen: Licensed Clinical Social Worker3:25 - Understanding Yerida L'Tzorech Aliyah (Descent for Ascent)5:46 - The Stroke Story: Shavuos Morning Crisis7:26 - Emergency Signs: When Something Goes Wrong9:50 - Hospital Experience & Spiritual Tools12:15 - The Turning Point: Gratitude & Second Life13:44 - Physical Transformation: Better Than Age 2515:26 - Managing High Energy Positively18:11 - Client Story: Postpartum Psychosis Recovery21:07 - Mirror Neurons & Relationship Dynamics23:41 - Unexpected Healing: Tourette's Syndrome Improvement24:44 - The Three-Legged Stool: Mind, Body, Soul26:36 - Depression 29:02 - Caring for Aging Parents & Life Changes30:43 - The Bike Ride Breakthrough31:41 - Moving Creates Motivation34:14 - Mitzvah Leads to Mitzvah35:20 - Three-Legged Stool Method Explained37:35 - Bedtime Breathing Contest Technique39:45 - Basic Breathing for Beginners41:12 - Live Meditation Demonstration Begins45:01 - Post-Meditation Discussion & Benefits46:54 - Mental Muscle Training & Daily Practice48:14 - Meditation as Mental Exercise, Not Relaxation49:30 - Closing Thoughts