Podcasts about Stroke

Dr. Andy Southerland talks with Dr. Seemant Chaturvedi about recent research presented at the 2026 European Stroke Organization Conference.  Read more about TAPIS trial.  Read more about the ODEA-TIA trial.  Disclosures can be found at Neurology.org.   

Is your health really as good as you think?

Want to share your feedback? Send us a message!Catherine Theys, Ph.D., Professor at the University of Canterbury in New Zealand, joins host Sara MacIntyre, M.A., CCC-SLP, to discuss acquired stuttering, including both neurogenic stuttering and functional stuttering. Drawing on her clinical and research expertise, Dr. Theys provides an overview of acquired stuttering, different subtypes, and how it differs from developmental stuttering in terms of etiology, presentation, and experiences. The conversation explores assessment, differential diagnosis, and treatment considerations, including the unique challenges faced by individuals who develop stuttering later in life. Dr. Theys also shares insights from the research literature, highlighting the need for more systematic investigation in this area and discussing projects her lab is pursuing to advance our understanding of the neurobiological mechanisms underlying acquired stuttering and improve clinical assessment and intervention. Throughout the episode, listeners gain practical guidance for evaluating and supporting individuals with acquired stuttering while developing a deeper understanding of this less frequently discussed area of stuttering research and clinical practice.Resources for further learning:Theys & Fairbairn (in press). Acquired stuttering: recent developments. In: The Routledge International Handbook of Stuttering. Howell & Gattie (Eds.). Routledge International Handbook of Stuttering. Grout-Brown & Theys (2025). Assessment and treatment of acquired stuttering: A single subject study. Journal of Fluency Disorders, 84, 106121.Theys, Jaakkola, Melzer, De Nil, Guenther, Cohen, Fox & Joutsa (2024). Localisation of stuttering based on causal brain lesions. Brain, 147(6), 2203-13. Gooch, Melzer, Horne, Grenfell, Livingston, Pitcher, Dalrymple-Alford, Anderson, McAuliffe and Theys (2024). Higher frequency of stuttered disfluencies negatively affects communicative participation in Parkinson's disease. Journal of Speech, Language, and Hearing Research, 67(10), 3631-42. Gooch, Horne, Melzer, McAuliffe, MacAskill, Dalrymple-Alford, Anderson & Theys (2023). Acquired Stuttering in Parkinson's Disease. Movement Disorders Clinical Practice, 10(6), 956-966. Theys & Tetnowski (2023). Case reports of acquired stuttering. In: Case Reports in Stuttering and Cluttering. Eggers & Leahy (Eds.), pgs. 114-123. Routledge, Taylor & Francis Group. Theys & De Nil (2022). Acquired stuttering: etiology, symptomatology, identification and treatment. In: Stuttering: Characteristics, Assessment and Treatment (4th ed.). Zebrowski, Anderson & Conture (Eds.), 33 pgs. Thieme Publishers. De Nil, Theys & Jokel (2018). Stroke-related acquired neurogenic stuttering. In: Aphasia Rehabilitation: Clinical Challenges. Coppens, P. & Patterson, J. (Eds.), pgs. 173-202. Jones & Bartlett Learning. Theys, van Wieringen, Sunaert, Thijs & De Nil (2011). A one-year prospective study of neurogenic stuttering following stroke: Incidence and co-occurring disorders. Journal of Communication Disorders, 44, 678-687. Theys, van Wieringen, Tuyls & De Nil (2009). Acquired stuttering in a 16-year-old boy. Journal of Neurolinguistics, 22, 427-435. Theys, van Wieringen & De Nil (2008). A clinician survey of speech and non-speech characteristics of neurogenic stuttering. Journal of Fluency Disorders, 33, 1-23. Bio: Catherine Theys is a Professor at the University of Canterbury in New Zealand. She trained in Speech-Language Therapy and Audiology at KU Leuven (Belgium), where she also completed her PhD in Biomedical Sciences. Her research seeks to advance understanding of speech and language difficulties by integrating behavioural and neuroimaging approaches. Her key research interests include developmental and acquired stuttering, acquired neurogenic communication disorders, and the neuroscience of speech and language. 

The following article of the Health industry is: “Before the Stroke: From Genetic Risk to Preventive Solutions” by Gustavo Rodríguez Leal, Founder and CEO, NutriADN.

Michael Jackson film review. God said your thoughts are not His. Kier Starmer resigning.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-490 Overview: In the US, maternal morbidity and mortality rates are among the highest in the western world, and stroke is one of the leading causes—responsible for 1 of 12 maternal deaths. This rate is estimated to be much higher in high-risk pregnancies. Join us as we discuss a recent study examining rates of maternal stroke in which 1 in 4 women with stroke experienced a missed diagnostic opportunity and hear what these findings mean for your practice. Episode resource links: Haghighi N, Bourscheid RM, Shang C, et al. Identifying missed diagnostic opportunities in maternal stroke. Stroke. 2026;57(2). doi:10.1161/STROKEAHA.125.052995 Chen Y, Shiels MS, Uribe-Leitz T, et al. 2025. Pregnancy-Related Deaths in the US, 2018-2022. JAMA Network Open.  Lappen JR, Pettker CM, Louis JM. 2021. American Journal of Obstetrics and Gynecology. Society for Maternal-Fetal Medicine Consult Series #54: Assessing the Risk of Maternal morbidity and Mortality. American Journal of Obstetrics and Gynecology. Miller EC, Bello NA, Chen PR, et al 2026. Prevention and Treatment of Maternal Stroke in Pregnancy and Postpartum: A Scientific Statement from the American Heart Association. Stroke.  Bushnell C, Kernan WN, Sharrief AZ, et al. 2024. Guideline for the Primary Prevention of Stroke: A Guideline from the American Heart Association/¬American Stroke Association. Stroke.  Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Falls Prevention After Stroke: What the Latest Research Reveals About Staying Safe and Mobile For many stroke survivors, the fear of falling is a constant companion. It’s there when you get up from the couch, when you navigate the kitchen, when you try to walk further than you did yesterday. That fear is rational, falls after a stroke are common, and their consequences can be serious. But according to Associate Professor Kate Scrivener, a stroke rehabilitation researcher at Macquarie University, that fear doesn’t have to define your recovery. In Episode 409 of the Recovery After Stroke podcast, Kate returns to the show where she first appeared in Episode 257 to discuss her HiWalk walking program and share the results of two major research projects: the published Phase II results of HiWalk, and a new systematic review focused specifically on exercise-based falls prevention after stroke. Who Is Kate Scrivener? Associate Professor Kate Scrivener leads stroke rehabilitation research at Macquarie University in Sydney, Australia. Her work sits at the intersection of real-world clinical practice and rigorous research. She doesn’t just study stroke recovery, she designs and tests the programs that can change it. Kate first appeared on this podcast to talk about HiWalk, a high-dose walking intervention designed to push the limits of what long-term stroke survivors can achieve. Now, with the results published, she’s back to talk about what the data actually showed and what it means for survivors who want to reduce their fall risk. The HiWalk Results: What Happened When 47 Survivors Walked Hard HiWalk was built on a straightforward but ambitious premise: what happens if stroke survivors, who have been living with their disability for years, are given a truly high-dose walking program? Not a gentle weekly session, but 43 hours of structured walking across just three weeks. The Phase II randomized trial enrolled 47 participants and produced results worth paying attention to. Attendance was 91%. Retention was 98%. For a physically demanding trial involving chronic stroke survivors, those numbers are remarkable, and they tell their own story about what survivors are capable of when given a real opportunity. For participants who were not already in active rehabilitation at the time of the trial, walking speed improved by 0.24 metres per second, a clinically significant gain. Self-efficacy, a measure of how confident participants felt in their own ability to walk and function, also improved significantly. The overall group walking speed trend was positive but did not reach statistical significance across the full cohort, partly because HiWalk was a Phase II feasibility trial, designed to test whether the program could be delivered safely and whether participants would complete it. It was not powered to detect large group-wide effects. What it demonstrated is that this kind of high-dose program is feasible, achievable, and produces real gains for the right participants. Why Falls Prevention After Stroke Is Harder Than It Sounds Falls after stroke are not simply a balance problem. They involve fatigue, reduced sensation, spasticity, cognitive changes, and the interaction between all of those things in the unpredictable terrain of daily life. Most stroke survivors are told to be careful. Very few are given a structured, evidence-based program designed specifically to reduce their risk. Kate’s systematic review, published in Clinical Rehabilitation in 2026, searched the global literature for exercise-based trials targeting falls prevention in community-dwelling stroke survivors. Only three trials worldwide met the inclusion criteria. That number alone says something significant. Falls after stroke are widely acknowledged as a major problem. The research base for solving it is thin. Of the three trials identified, exercise trended toward reducing the rate of falls, but the effect on the total number of people who fell was less clear. The standout result came from the FAST trial, which reduced fall rates by 33%. All three qualifying trials were conducted in Australia, raising important questions about whether these findings can be replicated in different healthcare systems with different levels of access to physiotherapy and structured exercise. What This Means for Stroke Survivors Right Now Kate’s research points to two things survivors and their families can act on. First, walking intensity matters. The HiWalk results suggest that long-term survivors who have plateaued in conventional rehabilitation may have more capacity than they or their clinicians assume. High-dose, structured walking appears to produce gains that lower-intensity programs don’t reach. If you’re a survivor who has been told to keep active but hasn’t been given a specific, progressive program, that’s worth a conversation with your physiotherapist. Second, exercise for falls prevention works, but it needs to be the right kind, delivered consistently. Gentle movement is valuable. But the evidence base Kate’s review maps out points toward structured, progressive exercise as the mechanism that shifts fall rates meaningfully. The FAST trial’s 33% reduction didn’t come from telling people to be more careful. It came from changing what they were physically capable of doing. Bill’s book, The Unexpected Way That A Stroke Became The Best Thing That Happened, explores the tools and mindset shifts that underpin a recovery built on action rather than waiting. You can find it at recoveryafterstroke.com/book. The Gap Between Research and Practice One of the most important threads in this conversation is the distance between what the research supports and what most survivors actually receive. Kate’s systematic review found only three qualifying trials globally. HiWalk’s feasibility results are published, but the next step, a large-scale Phase III trial, requires funding, time, and institutional will. For survivors, that gap can feel frustrating. The science is pointing in a clear direction. The programs aren’t yet widely available. Kate’s work is part of closing that distance. Listen to the Full Conversation Episode 409 with Associate Professor Kate Scrivener is available on all major podcast platforms, search Recovery After Stroke and on the Recovery After Stroke YouTube channel. If this show has helped you on your recovery journey, you can support it financially at patreon.com/recoveryafterstroke. This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. The post Walking More, Falling Less – A Researcher’s Mission to Stop Stroke Survivors Hitting the Ground appeared first on Recovery After Stroke.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-490 Overview: In the US, maternal morbidity and mortality rates are among the highest in the western world, and stroke is one of the leading causes—responsible for 1 of 12 maternal deaths. This rate is estimated to be much higher in high-risk pregnancies. Join us as we discuss a recent study examining rates of maternal stroke in which 1 in 4 women with stroke experienced a missed diagnostic opportunity and hear what these findings mean for your practice. Episode resource links: Haghighi N, Bourscheid RM, Shang C, et al. Identifying missed diagnostic opportunities in maternal stroke. Stroke. 2026;57(2). doi:10.1161/STROKEAHA.125.052995 Chen Y, Shiels MS, Uribe-Leitz T, et al. 2025. Pregnancy-Related Deaths in the US, 2018-2022. JAMA Network Open.  Lappen JR, Pettker CM, Louis JM. 2021. American Journal of Obstetrics and Gynecology. Society for Maternal-Fetal Medicine Consult Series #54: Assessing the Risk of Maternal morbidity and Mortality. American Journal of Obstetrics and Gynecology. Miller EC, Bello NA, Chen PR, et al 2026. Prevention and Treatment of Maternal Stroke in Pregnancy and Postpartum: A Scientific Statement from the American Heart Association. Stroke.  Bushnell C, Kernan WN, Sharrief AZ, et al. 2024. Guideline for the Primary Prevention of Stroke: A Guideline from the American Heart Association/¬American Stroke Association. Stroke.  Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Golf: The U.S. Open Joaquin Niemann's 2 Stroke Penalty - June 22nd, 9:25amAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

The Shirley Ryan AbilityLab says its study finds stroke survivors gain a greater range of joint motion and increased step length and height using exoskeleton therapy vs conventional therapy.

The Shirley Ryan AbilityLab says its study finds stroke survivors gain a greater range of joint motion and increased step length and height using exoskeleton therapy vs conventional therapy.

The Shirley Ryan AbilityLab says its study finds stroke survivors gain a greater range of joint motion and increased step length and height using exoskeleton therapy vs conventional therapy.

At a party in Chicago, America saw what we once were, and may yet be again. And Ms. Michele scorched Nitwit Nero worse than burnt milk in a hot iron skillet. Kudos, Mrs. Obama for playing your own part in Stoking the Stroke! He, meanwhile, continues to fall apart. His candidates are perverts (surprise!) and his nominees have no self-respect. OTOH, he showed up in Europe (of all places!) without his makeup and looked like the fragile, old, frail, husk that he is.  And his bootlickers finger the cigarettes in their pockets.  Hell, I may spark a stogie on The Day.

Today our guest just wants to remind stroke survivors that nomatter how hard thimgs seem, it could always be worst. CONNECT @linktr.ee/klsurvivor101CONNECT @https://youtube.com/@karinalemire?si=wC3ZdIJTqMsSP8-jMEDICAL DISCLAIMER: Any content used in this or amy other episode of SSTO are those of the creator and should NEVER be replaced for professional physicians help.___________________________Take part of RECLAIM YOUR IDENTITY coaching program.https://forms.gle/CroK1pvb7WN8eePv6#stroke #selfhelp #nrainstemdissection #truckdriver #strokesurvivor #strokesurvivorpodcast #journey #ranking

On Episode 65 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the June 2026 issue of Stroke: "AI-Derived LA Volume Index, LA/RA and LA/LV Volume Ratios From Coronary Artery Calcium Scans Predict Long-Term Atrial Fibrillation and Stroke" and "Prevalence and Association of Atherosclerosis to Ischemic Stroke in Patients With Atrial Fibrillation on Anticoagulation." She also interviews Dr. Randolph Marshall, principal investigator of the Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis–Hemodynamics (CREST-H) study. For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20260603.690307

In this episode we talk Financial stability & little victories....CONNECT @ linktr.ee/Klsurvivor101 CONNECT @https://youtube.com/@karinalemire?si=KwG0H2WHic1u6o1T_____________MEDICAL DISCLAIMER: Any content used in this or any other episode of SSTO are those of the creator and should NEVER be replaced for professional physicians help. ___________________#stroke #recovery #coach #strokesurvivor #strokesurvivorpodcast #financialstability #marathon #selfconfidence #tbisurvivor #brainstemdissection #swimming #triathlon #ranking #awareness #mindset #acceptance

Lazlo got freaky with SlimFast's wife. Is debtors' prison real? Lazlo immediately knows his groceries are going to be messed up if the delivery guy's name is Steve. Our boss asked SlimFast to dial back the drunks. Would you pay fifty bucks for a Teenage Mutant Ninja Turtles pizza? Lazlo's seeing someone and wants to get a no-eared dog named Bombpop. SlimFast thinks he can undercut the local poop squad. China has a robot toilet that comes to you. Where's the robot that blows you? Stream The Church of Lazlo podcast on Apple Podcasts, Spotify, or wherever you get your podcasts!

Many people worry about memory loss and cognitive decline as they age. In this episode of Health Matters, host Courtney Allison speaks with Dr. Matthew Fink, neurologist-in-chief at NewYork-Presbyterian and Weill Cornell Medicine, about how lifestyle choices—especially diet—can help protect the brain. Dr. Fink explains the MIND diet, a combination of the Mediterranean and DASH diets, which emphasizes whole foods like leafy greens, berries, fish, nuts, and olive oil while limiting salt, sugar, and ultra-processed foods. He breaks down how key nutrients such as B vitamins and antioxidants support brain metabolism, reduce inflammation, and may slow the aging process. The conversation also highlights the brain's high energy demands and why proper nutrition is essential for cognitive function. Dr. Fink shares research showing that healthy lifestyle interventions can significantly lower the risk of dementia and discusses the broader benefits of the MIND diet for heart health and stroke prevention. Finally, Dr. Fink outlines additional habits that support brain health, including regular physical activity, quality sleep, and social connection, emphasizing that even small, gradual changes can lead to meaningful long-term benefits.   Chapters 00:00 – Why Brain Health Is in Your Control How lifestyle choices can reduce dementia risk and why prevention starts early 03:00 – What Is the MIND Diet? Key components of the Mediterranean and DASH diets and how they support the brain 06:00 – Brain-Boosting Nutrients and Foods to Avoid The role of B vitamins, antioxidants, and which foods increase risk 10:30 – Beyond Diet: Exercise, Sleep, and Daily Habits How movement, rest, and social connection contribute to cognitive health     Key Topics Covered MIND diet overview Mediterranean diet and DASH diet Brain metabolism and energy use B vitamins and brain health Antioxidants and inflammation Foods that support cognitive function Foods to limit (salt, sugar, processed foods) Dementia and Alzheimer's prevention Stroke and heart disease connection Exercise and brain function Sleep and cognitive health Lifestyle changes for healthy aging   Takeaway Message You have more control over your brain health than you might think. By focusing on whole, nutrient-rich foods, limiting processed options, staying active, and getting enough sleep, you can significantly reduce your risk of cognitive decline and support a healthier brain as you age.   Doctor Bios Matthew E. Fink, MDis currently the Louis and Gertrude Feil Professor and chair of the Department of Neurology at Weill Cornell Medicine, and neurologist-in-chief at NewYork Presbyterian/Weill Cornell Medical Center.  In addition, he is chief of the Division of Stroke and Critical Care Neurology at NewYork-Presbyterian/Weill Cornell Medical Center, and vice chair of the medical board. Dr. Fink attended college at the University of Pennsylvania, medical school at the University of Pittsburgh, and served as resident and chief resident in internal medicine at the Boston City Hospital. He came to New York and trained in neurology at the Neurological Institute of NewYork-Presbyterian/Columbia University Irving Medical Center, and served as chief resident under Dr. Lewis P. Rowland. Subsequently, he joined the faculty of Columbia University and became the founding director of the Neurology-Neurosurgery Intensive Care Unit at NewYork-Presbyterian and was appointed associate professor of clinical neurology and neurosurgery while at Columbia. Dr. Fink was a founding member and chair of the critical care section of the American Academy of Neurology, and the research section for neurocritical care of the World Federation of Neurology. He is board-certified in internal medicine, neurology, critical care medicine, vascular neurology, and neurocritical care.  He has been elected as a Fellow of the American Neurological Association, the American Academy of Neurology, and the Stroke Council of the American Heart Association. Throughout his career, Dr. Fink has been involved in the education and training of students, residents and fellows in the field of stroke and critical care neurology, as well as an active participant in clinical research within this field. He is a leader in this new specialty, has lectured widely, and has published many research and clinical articles in the field of stroke and critical care. In addition, he currently serves as editor of the monthly publication, NEUROLOGY ALERT, and is a past-president of the New York State Neurological Society.

Primary stroke prevention is a critical opportunity for neurologists, with most stroke risk driven by modifiable factors such as hypertension and lifestyle behaviors. This episode highlights practical tools and strategies, including Life's Essential 8 and contemporary risk calculators, while also exploring evolving approaches to shared decision making and secondary prevention. In this episode, Katie Grouse, MD, FAAN, speaks with Mitchell S. Elkind, MD, MS, FAAN, author of the article "Stroke Prevention" in the Continuum® June 2026 Cerebrovascular Disease issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California, San Francisco in San Francisco, California. Dr. Elkind is the Chief Science Officer for Brain Health and Stroke at the American Heart Association in Dallas, Texas, and a professor of neurology and epidemiology at Columbia University in New York, New York. Additional Resources Read the article: Stroke Prevention 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 Guest: @MitchElkind Full episode transcript available here Dr Grouse: Neurologists have generally been more involved in secondary stroke prevention, but primary stroke prevention is increasingly recognized as an important topic of discussion for neurologists. Today, I have the opportunity to interview Dr. Mitchell Elkind, who wrote the article on stroke prevention in the newest Continuum issue on cerebrovascular disease.  Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Grouse: This is Dr. Katie Grouse. Today, I'm interviewing Dr. Mitchell Elkind about his article on stroke prevention. This article appears in the June 2026 Continuum issue on cerebrovascular disease. Welcome to the podcast, and please introduce yourself to the audience.  Dr Elkind: Thank you so much, Katie. So, my name is Mitch Elkind, and I'm the Chief Science Officer for Brain Health and Stroke at the American Heart Association and a stroke neurologist by background.  Dr Grouse: Well, I just want to start by saying that I really enjoyed reading this article. I think this is just a really wonderful article I recommend strongly. Such a high yield, an important topic for a lot of us who see patients who are interested in learning about their stroke risks or need help with, uh, stroke prevention after having a stroke. So, I wanted to start. What's changed in the last couple of years? You know, what are some big highlights that you really want to stress that are different from maybe the last time we reviewed this topic?  Dr Elkind: Sure. Well, there's been a lot of development in the field of secondary stroke prevention, for one thing. But even beyond that, I think we increasingly appreciate how important it is to control what we call the social drivers of health on the earlier side, primordial or primary prevention. And that has been a big advance, I'd say. And I would also say, I think it's really important for neurologists to understand some of those questions about primordial and primary prevention. You know, we tend to get involved with patients after they've had a stroke or maybe a TIA, some kind of event. But sometimes we find people who are following for, you know, non-stroke related conditions who have risk factors also. And we can really play an important role in identifying those risk factors and helping to prevent a first stroke or vascular event as well. So, I think it's real important for us to be doctors even before we're neurologists. So, you know, Katie, about ninety percent of stroke risk is modifiable, so we can do a great job as neurologists in preventing stroke. And one of the most important things that we can do is to identify and treat high blood pressure. And recently, actually, the American Heart Association, American College of Cardiology guidelines on the management of hypertension have said that treatment of high blood pressure not only prevents stroke, but it can also help to prevent cognitive decline and dementia. And this is the first time that we've had a class of recommendation one and level of evidence A, the highest level of recommendation we give for the use of blood pressure treatment to prevent dementia. And that's largely based on the results of some large trials that have come out recently showing that you can prevent dementia with blood pressure control. So that's a really exciting link, I think, between cardiovascular risk factor control and subsequent brain health. It just illustrates the role that neurologists can play in, so many conditions outside of stroke as well.  Dr Grouse: That's a really great point, and I want to get a little more into the idea of primordial stroke prevention. Can you tell us a little bit more about what that might be?  Dr Elkind: So primordial prevention refers to addressing how we can prevent risk factors from occurring in the first place, and how can we improve the environments in which people live. You know, we know that only about twenty percent of health outcomes is dependent on what happens between the patient and their doctor in the office. About eighty percent of it is due to what happens in the environments in which we live, work, pray, and play. And so that's what we mean when we refer to the social drivers of health. What is the neighborhood like where somebody lives? Do they have access to healthy food? Do they have places where they can go to exercise? Is there air pollution in the area that may affect their health? You know, one really interesting fact that's become apparent in the last few years is that air pollution is a major risk factor for stroke. Something like a sixth of all strokes can be attributed to the quality of air. And so, what are the things we can do at the broader public policy, community level to reduce the risk of risk factors like high blood pressure and diabetes even before somebody has an event that brings them to the attention of the doctor? So that's what we're thinking about with regard to primordial prevention. It's the earliest stage in prevention.  Dr Grouse: And that's really fascinating. You know, I think an area that we haven't, as neurologists, really put a lot of our time thinking about, but clearly a very important thing. I really appreciated reading your article about how you incorporated the fact that, you know, a lot of these risk factors overlap very, very closely with all the risk factors for various types of cardiovascular events. And I would imagine that the work you've done as the Chief Clinical Science Officer for the American Heart Association has informed a lot of the way you've thought about-Trying to bring all these risks together and think a little bit more holistically about the whole thing. Could you tell us a little bit more about that and the work that you've done on the American Heart Association's Life's Essential 8 score?  Dr Elkind: Sure. I can't take credit for it. It's really work that was done by others at the Heart Association, particularly a cardiologist and epidemiologist named Don Lloyd-Jones. But many other volunteers participated. Life's Essential 8 is our approach to primary stroke prevention and cardiovascular prevention more broadly. We say Life's Essential 8 because it includes four health behaviors and four health factors that people can observe to reduce their risk of cardiovascular disease. The four factors are kind of things like know your numbers, your blood pressure, your blood sugar, your body mass index, right, which is a combination of weight and height, and your cholesterol level. So, know those numbers and keep them within the recommended ranges, and talk to your doctor if they're not. And then four lifestyle behaviors. So, one of them is to eat a healthy diet, and typically that means the Mediterranean diet. It means getting regular exercise, and we recommend 150 minutes a week of moderate to vigorous physical activity. Of course, it means abstinence from smoking or other tobacco products. And the last one, the eighth one, which I was so excited about when we added this, is sleep, recommending at least seven hours of sleep a night. So, I was really excited about this because we used to talk about Life's Simple 7, and then the last iteration of our recommendations included this recommendation for adequate sleep because of the mounting evidence of the importance of sleep to cardiovascular health. But sleep is really a brain function, right? And so, it was really the first, in a way, specific brain function that was added to our recommendations. So that's Life's Essential 8. People can read about it online at heart.org and recommend it to your patients as a simple way for people to understand the best approach to reducing their risk of cardiovascular disease, including stroke.  Dr Grouse: I checked it out myself after reading the article. It's very accessible to patients. It's a great education tool. And they can, you know, see their own score and use that in their own way to, to think about what their risks are and how they can help mitigate and then rescore themselves down the line. There's also, though, on the kind of more the clinician side, the PREVENT calculator as well. Could you tell us a little bit more about how we could use that in approaching this patient population?  Dr Elkind: Yeah. So, I think of Life's Essential 8 as being a patient-focused tool that people can use. PREVENT is really more for clinicians. Anybody can look it up online and enter your data into it. There's a risk calculator online. But the basic idea behind PREVENT and other similar risk calculators is that it's a way to estimate somebody's risk of having a cardiovascular event like stroke or a heart attack or even heart failure by entering information about your health. And we used to think, we used to use something called the ASCVD, atherosclerotic cardiovascular disease risk calculator, or the Framingham score. Framingham Heart Score, for example, was another one. PREVENT is the latest version, and it has several advantages over those earlier types of risk predictors. For one thing, it predicts risk at younger ages as well. It goes down to age 30. It predicts risk over a longer duration of time, so over 30, 10 or 30 years. It eliminates the use of race as an item to put into the calculator and substitutes for that socioeconomic status, so it's not a race base, but a measure of social disadvantage. And it also includes kidney elements, kidney measures. It includes renal function, for example, that weren't included in prior measures, and it can also be used to predict heart failure, which was not part of the original calculators. Another major advantage of the PREVENT study is that it was based on real-world data from about three million patients, many, many more than the 50,000 or so that the earlier risk calculators were based on. So, it has a much more robust data set and therefore allows a bit more precision in the ability to predict future risk of events. And typically, primary care doctors would enter their patient's data, calculate a risk, and then based on the results of the risk calculator, they can make recommendations about what type of medications a person should take or what other strategies they could use to reduce their risk. And so that's the role that PREVENT plays, is really being focused more for the clinician than the patient.  Dr Grouse: Really great tool for us to be aware of. You earlier alluded to the fact that neurologists are in the situation where we sometimes are helping patients with this primary prevention. But you also make a case for why it's in the patient's best interest for us to be involved in, in these conversations when we can, when we have the opportunity. Can you tell us more about that?  Dr Elkind: Shared decision-making is really important because we know that people aren't going to lead the healthiest possible lives if they're not invested in their care. And so, a doctor telling somebody what to do if the patient doesn't want to do it is gonna have limited benefit.So we emphasize the importance of shared decision-making as much as possible. And I think that where this comes up a lot is actually in the situation of, for example, atrial fibrillation, where patients will often be put on a blood thinner. And many people are fearful of blood thinners. They worry about the risk of bleeding. Maybe they know a relative who's had a bleeding complication from a blood thinner, and so they may be disinclined to try it. And so, it's really important to have these discussions about the risks and the benefits of medication and engage the patient in thinking about this. And there are even tools and visual aids that people can look to to help explain some of these complicated concepts to patients. So, these are the kinds of things that reflect implementation science as a way to improve adherence. We know what works in a clinical trial setting often, but the challenge is translating that into the real world and getting our patients to use the medications that we believe scientifically have been shown to be of benefit. I've actually been surprised sometimes at conversations I've had with people, in some cases, healthcare professionals who resist going on blood thinners because of their fear of the complications. And I feel like the evidence is there. Why don't they believe me? And that's why it's really important to have the conversation. Even our peers and colleagues can sometimes question the evidence, and it's important for us to be aware of that.  Dr Grouse: Absolutely. I think that sounds very reasonable to me, and hopefully these tools will help us with making some of these decisions with our patients. Now, turning our attention a little bit to secondary prevention. So, you know, someone's already had a stroke or a TIA, sort of thinking about what we can do to optimize their risk factors for further strokes. You know, I think there has been some changes that have happened, I think, in the last few years that might be affecting some of the decisions we're making and some of the advice we're giving our patients. I wanted to talk a little bit about GLP-1 receptor agonist medications. Is the data there to support use of this either in secondary prevention or even in primary prevention in the case of stroke?  Dr Elkind: There is evidence that supports the use of GLP-1s for stroke prevention. We need more data, though. We need trials that focus only on patients with stroke, for example, there have been studies in patients with cardiovascular disease broadly that include stroke patients. But if you look at the subcategory just of stroke patients alone, the data in that subgroup alone don't always show a benefit. And so, we need more data that's focused on stroke patients alone. So, I think the data are continuing to emerge, but we need more still.  Dr Grouse: Is there any development in the thought about whether we should be putting patients on antiplatelet therapies for incidental, incidentally identified strokes? For instance, if you got an MRI for migraine or for other reasons and you found one, no history of any stroke-like symptoms. Should we be putting these patients on aspirin or any other types of therapies?  Dr Elkind: That's a really great question. And again, it's an area where there's some controversy and really, there's really no definitive data that would support using antiplatelet therapy in people with incidentally discovered infarcts or what we call, you know, whispering strokes or silent strokes. Many stroke neurologists will use antiplatelet agents. This is one of those areas where it's so important to identify the risk factors. As we were saying before, patients who have other neurological disorders like migraine or epilepsy may turn out to have cardiovascular risk factors like diabetes and high blood pressure. That's why it's so important for neurologists to be able to treat those patients or refer them to specialists who can. Patients who have incidentally discovered lesions similarly are a group where we should be looking for risk factors. So, I don't think of it only in terms of do we put them on an antiplatelet or not, but really more holistically, can we identify their other risk factors and address those? Should the patient's information be entered into a risk calculator like PREVENT, for example, so that we can come up with a more global or holistic measure of their cardiovascular risk and address that as appropriate? Because if they are at risk for stroke, they're also at risk for cardiac events, including heart attack, heart failure, sudden cardiac arrest, and so forth. So, I think of it as a, as a great kind of teachable moment or an opportunity to catch somebody and bring them into the healthcare system more broadly and address those other potential risk factors.  Dr Grouse: Speaking of, of risk factors that we often like to think about and work up when possible, in cases where it seems certainly possible the patient had an embolic stroke, but perhaps we've done a few weeks or four weeks of cardiac monitoring, have not found any evidence of atrial fibrillation. What's new and what's the current recommendations for doing further monitoring when there's high suspicion for cardioembolic stroke?  Dr Elkind: This is a really active area of investigation, and guidelines suggest that we should do some cardiac monitoring for atrial fibrillation after an unexplained stroke, but it's not clear how much we should do. Studies generally show that the longer you follow somebody on a cardiac monitor after stroke, the more likely you are to detect atrial fibrillation. It could be as high as thirty percent after a few years. And that's great. And if you detect atrial fibrillation, people usually end up being recommended for a blood thinner. But how extensively we should monitor remains unknown. And I think a lot of the investigation recently has been around the question of, are there other ways to get that information rather than waiting six months or a year for the person to develop atrial fibrillation?It's a little bit funny logically to think a person has a stroke today, a year later you discover atrial fibrillation on the monitor, and you say, "Oh, now I know what caused your stroke a year ago." Right? The temporality, the causality perhaps is off in that case. And so, wouldn't it be better if we could tell what somebody's risk of having another cardioembolic stroke is, or the likelihood that they have atrial fibrillation is at the time that you first see them for the stroke, you know, in the hospital, for example. And so, there's some really new technologies that have evolved like AI or artificial intelligence interpretation of EKGs that can give a really good indication of which people are gonna go on to develop atrial fibrillation. And so, I think we need some more trials in that area to demonstrate that we can detect the risk of AFib and treat that even before it appears on one of those delayed monitors. That's an area that I think is very exciting right now. There's also a further question with regard to how to treat these patients, which is that sometimes atrial fibrillation is a consequence of the stroke itself. So, we can think about what people call known AF, meaning atrial fibrillation that's known about before the stroke even occurs, versus AF that's detected after a stroke, or AF-DAS, people will say. Those may have very different implications for the risk of recurrence and what the person's cardiovascular status is. So, I think what we've learned over the last few years is that atrial fibrillation, it used to be like the slam dunk for a stroke neurologist. It was the easy thing. You know, you had a stroke, you have AFib, you should be on a blood thinner. Now we know that there's lots of different kinds of AFib. There's AFib before stroke, there's AFib after stroke, there's burden of atrial fibrillation. So, some people may have 30 seconds of AFib, some people may have several hours, some people may be in it continuously. It comes and goes, and that can make it challenging to manage. So, we have a lot more work to do to understand this problem better.  Dr Grouse: That also gets me into some other interesting areas that I think there's still some question, you know, how aggressive should you be? How often is it a case of is this correlated or is this causative? For instance, when a patent foramen ovale is, is discovered in patients with cryptogenic stroke. Are there any tools or new developments to help us understand whether these PFOs should be closed in these cases?  Dr Elkind: PFO and stroke is a great story that's been going on for decades. And again, we've made tremendous progress in the last several years. So, it's true that about 20% or so of people have a PFO, and because of that, it can be really hard to say with any certainty whether an individual patient sitting in front of you, that the PFO was the cause of their stroke. Rarely we can have a really high degree of certainty. You know, if somebody has, uh, a DVT, for example, and shortly after that maybe they have pulmonary embolism and then a stroke, and we can say, "Oh, clearly this was a paradoxical embolism," went to the lungs and then some crossed over and went to the brain. That happens really infrequently. Most of the time you're faced with a patient who has a PFO and a stroke, and they may have some other risk factors. There are some tools that we can use to help figure out the likelihood that a PFO is related to a stroke. One of those is called the ROPE score or the risk of paradoxical embolism score that was developed by David Thaler and, uh, David Kent from Tufts and a group of other investigators as well. That score allows one to say what the likelihood is that the PFO was causative of the stroke, and it's based on a person's risk factors such that the younger you are, the more likely it is the PFO caused the stroke. And the absence of risk factors make it more likely that the PFO caused the stroke. So, the higher your ROPE score indicating the fewer other reasons you have a stroke, the more likely the PFO is to be causative. So that can be helpful in identifying patients who may have had a stroke due to their PFO. There are other features that are identified in something called the PASCAL score, which is a way of assessing the degree of shunting and whether or not there's an atrial septal aneurysm that can be used as additional factors that lead to the likelihood that a PFO was causative rather than just incidental. So, by putting this kind of information together, we can kind of do precision neurology or precision prevention by identifying which patients with a PFO are really the ones we need to worry about and do procedures like closure.  Dr Grouse: I look forward to hearing more and learning more as more advances are made in these areas. Dr Elkind: Thank you.   Dr Grouse: And thank you so much for joining us today to talk about your article.   Dr Elkind: Oh, I appreciate it. Thank you for giving me the opportunity. I really enjoyed it.  Dr Grouse: Again, today I've been interviewing Dr. Mitchell Elkind about his article on stroke prevention. This article appears in the June 2026 Continuum issue on cerebrovascular disease. Be sure to check out Continuum Audio episodes from this and other issues, 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, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Welcome back to your two favorite girlies!! Today we had an INCREDIBLE guest that truly left us inspired.    We talk with Paulette about aging, being courageous to take chances, and to rebrand your life!! We can't wait for you to hear this episode and leave it feeling as inspired as we both were.    About our guest: Paulette Szalay at the age of 57 weighed 264 pounds at the height of 5'4". She survived an ocular stroke and three and half years later, at the age of 61, Paulette lost 148 pounds naturally and became a model and actress. She has been on the cover of Woman's World Magazine and in countless other magazines, a guest on the Sherri Shepherd Show - Fit Over 50 segment, commercials, a movie and so much more.   Guest links:  Instagram / Threads: https://www.instagram.com/pszalay01/  Website: pauletteinspires.com Youtube: Sherri Show Fit Over 50 Segment - https://www.youtube.com/watch?v=S7E0gCKn-JM Today.com: https://www.today.com/health/diet-fitness/woman-loses-130-lbs-post-menopause-strength-training-low-carb-diet-rcna237318   Follow maddy's dating page here: https://www.instagram.com/its.maddymartinez?igsh=MXNvODZkNndlem5haA%3D%3D&utm_source=qr    To apply for Ali's Hot Mom Scholarship go here: https://forms.gle/mLBpP2n6Fu1Bs2Jv8  Find Ali here on  instagram:https://www.instagram.com/aliwagnercoaching/     Maddy's favorite redlight here and save: https://tinyurl.com/kindahot-hooga  Maddy's favorite Matcha brand:  https://tinyurl.com/kindahot-matcha  Maddy's favorite makeup: https://tinyurl.com/kindahot-subtlbeauty    Make sure to subscribe so you don't miss an episode and send us your health / relationship / life / just need advice on, submit your questions here: https://bit.ly/KHKH-ask-my-question   Find us on all streaming platforms here, including the full video experience on our YouTube channel

What happens when a woman who spent decades holding everyone else together finally has no choice but to let go? In episode 265 of Joy Found Here, Florence Acosta — former Certified Registered Nurse Anesthetist, healthcare executive, and the person everyone leaned on — shares how a stroke at 50 became the moment that shattered her old identity and cracked her wide open. Her story is a powerful reminder that sometimes the body says stop long before we ever will.In This Episode, You Will Learn:(3:46) How Florence went from holding everything together to having a stroke at 50(6:05) Why chronic givers struggle to receive — and the mindset keeping them stuck(7:43) The sisterhood circle that cracked open her awareness around control and letting go(11:51) The childhood moment at age three that silently took her voice for decades(13:17) How writing on Substack became an unexpected act of reclaiming her voice(20:54) How the Miracle Morning helps Florence create space and stay grounded in recovery(23:04) The "Question of the Day" ritual she runs for her Substack subscribers(24:15) Florence's new business venture with her sister — and why she broke her own rule(26:41) Her "C-cubed" self-care approach: cooking, crocheting, and creative writing(31:03) Why people want to help — and how telling them how changes everythingFlorence Acosta spent nearly 30 years in healthcare — first as a Certified Registered Nurse Anesthetist, then as executive director of a surgical center — carrying the weight of patients, teams, and everyone around her without ever pausing to fill her own cup. At 50, a stroke caused by an undetected arteriovenous malformation forced her to stop, and through the slow road of recovery, a women's sisterhood circle, and the discovery of writing, she found the voice she had quietly lost decades before. Today she writes about intentional living, mindset, and personal development through her Substack publication Becoming You with Florence Acosta.In this episode, Florence shares how decades of over-giving as both a healthcare professional and the person everyone leaned on ultimately led to her stroke — and how that rupture became the catalyst for rebuilding on her own terms. She traces her lifelong silence back to a childhood moment at age three, and how Substack became the unexpected place where she finally reclaimed her voice. Florence also opens up about her Miracle Morning practice, a new business venture with her sister, and her "C-cubed" self-care approach — cooking, crocheting, and creative writing — while delivering a powerful message to fellow chronic givers: open your hands and let people in before life forces you to.Connect with Florence Acosta:SubstackInstagramLet's Connect:WebsiteInstagram Hosted on Acast. See acast.com/privacy for more information.

En este episodio de Actitud Saludable, el podcast de Hospital Galenia, el Dr. Raúl López Serna, especialista en Neurocirugía, nos habla sobre los tumores raquimedulares, una condición que afecta la médula espinal y puede impactar seriamente la movilidad, sensibilidad y calidad de vida de los pacientes. A lo largo del episodio, conocerás qué son estos tumores, cuáles son sus principales síntomas y por qué un diagnóstico oportuno es clave para evitar complicaciones neurológicas. Además, exploramos cómo la neurocirugía y la tecnología médica actual permiten ofrecer tratamientos más precisos y seguros para mejorar el pronóstico y bienestar de los pacientes.El Dr. Raúl López Serna te invita a escuchar el #podcast para conocer más del tema. ¡No te pierdas sus recomendaciones! ¡Disfruta del episodio 319 y continúa escuchando cada uno de nuestros #PodcastsMédicos  preparados especialmente para ti!➡️ ENLACES DE INTERÉS

Stroke Impact on Family: When the Caregiver Becomes the Patient There is a particular kind of reckoning that happens when the person who has spent their life caring for others suddenly needs care themselves. For Kathy Cunningham, that moment arrived without warning. Kathy worked in healthcare for years, a field built on attending to others in their most vulnerable moments. When stroke entered her life, she was confronted with something her training had never quite prepared her for: accepting help. In Episode 408 of Recovery After Stroke, Kathy sits down with her sons Sean and Paul Monahan to talk openly about the stroke’s impact on the family, not as a concept, but as a lived experience shared across three people who navigated it together. When the Expert Becomes the Patient Healthcare professionals develop a particular relationship with illness. They understand the biology, know the pathways, and can often anticipate the trajectory of a condition before the patient has fully processed what is happening. That knowledge is a professional asset. In a personal medical crisis, it can also become a barrier. Kathy’s background meant she understood exactly what a stroke meant and what recovery would require. What it did not prepare her for was being on the receiving end: needing to ask, needing to wait, needing to trust others to do the things she had always done herself. Her sons Sean and Paul were part of that support system, two adult men who stepped into a caregiving role they had never anticipated, in a household that was already carrying more than most. A Household Navigating Stroke More Than Once What makes Kathy's story particularly complex is the context it unfolded in. Her household had already been touched by stroke before her own diagnosis, meaning Sean and Paul weren't approaching caregiving as something entirely new. They were deepening an already demanding commitment. The stroke impact on family is rarely a single event. It accumulates. Each new development shifts the balance of who does what, who needs what, and who is available to give it. For Sean and Paul, supporting their mother meant learning to hold space for her recovery while managing the weight of their own experience alongside it. That is the part of stroke that rarely makes it into clinical documentation: the sustained psychological and logistical load that falls on the people closest to the survivor, day after day, over months and years. The Challenge of Accepting Help One of the most consistent patterns across stroke recovery is the difficulty survivors have in accepting help, and it is amplified, not softened, when the survivor has a background in caring for others. The implicit logic runs: I know how this works. I should be able to manage this. Kathy speaks to this directly in the episode. The process of allowing her sons to step forward to organise, to accompany, to simply be present and available required a different kind of skill than anything her career had developed. It required recognising that accepting care is not evidence of incapacity. It is its own form of strength. For families supporting a stroke survivor, this distinction matters. When a survivor resists help, it is not always stubbornness. Often, it is someone navigating an identity that has been fundamentally disrupted by what happened to them. What the Family Perspective Adds Sean and Paul's presence in this conversation shifts something in the usual stroke recovery narrative. Most episode conversations centre on the survivor. This one deliberately includes the view from the other side, the sons who watched, worried, helped, and carried their own weight through it. What they share is instructive for any family in a similar position. Stroke impact on family plays out differently depending on who is watching, who is helping, and who is still finding their way back to the person they knew before the stroke. Their account is not about burden. It is about recalibration, finding a new way to be a family when every role has shifted. What Families Can Take From This Conversation If you are supporting a stroke survivor or a survivor who has struggled with accepting help, three things stand out from this episode. The first is that a survivor's professional identity shapes their recovery. Someone who has spent their career as a carer may need more time and explicit permission before they can accept care themselves. Naming this directly with patience, not pressure, opens the door. The second is that adult children carry more than they show. Sean and Paul's willingness to speak plainly about their experience is a reminder that caregiving has an interior weight that often goes unspoken. Creating space for that conversation within a family is not weakness. It is what keeps families intact through long recoveries. The third is that stroke impact on family is not a moment – it is a process. It evolves, shifts, and asks different things of different people at different stages. Families who move through it with honesty tend to find a stronger dynamic on the other side. If this episode resonates with you, Bill's book The Unexpected Way That A Stroke Became The Best Thing That Happened explores the tools that have helped stroke survivors and their families navigate the long road back. You can find it at recoveryafterstroke.com/book. If the show has helped you or someone in your life, you can support it financially at patreon.com/recoveryafterstroke. This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. The Nurse Who Had to Learn to Accept Care | Kathy Cunningham with Sean & Paul Monahan When the family’s caregiver becomes the patient, everything changes. Kathy Cunningham and sons Sean and Paul Monahan share the unfiltered truth. The transcript will be available soon… The post The Nurse Who Had to Learn to Accept Care | Kathy Cunningham with Sean & Paul Monahan appeared first on Recovery After Stroke.

Episode 26 of Season 3 of The RUN TMC Podcast is our Season Finale and Part 2 of our long form conversation with Coach Steve Lavin. Recorded at The Hub and The Brazen Head, this episode digs into Lavin's UCLA national-title year and his standout players (Earl Watson, Rico Hines, Baron Davis). We also cover Bob Myers's early UCLA connection, Tyus Edney's buzzer-beater, the culture and rituals of Lavin Camp, his St. John's and San Diego tenures, and how broadcasting shaped his coaching. Expect behind-the-scenes locker-room stories, coaching philosophy, reflections on NIL and the transfer portal, and plenty of vivid, personal recollections. Steve Lavin's Full Bio on Wikipedia Steve Lavin's UCLA Bio Season 4 Sponsorship Packages Available Now! 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 email us at: theruntmcpodcast@gmail.com follow us on Instagram @theruntmcpodcast check out our website at: theruntmcpodcast.com thank you to our sponsors: The Hub in San Anselmo Encore Custom Apparel Online and in downtown San Rafael  Batiste Rhum  The Social Klub in Sausalito San Domenico Nike Summer Basketball Camps      

Fluent Fiction - Japanese: Finding the Stroke of Confidence in Tokyo's Museum Light Find the full episode transcript, vocabulary words, and more:fluentfiction.com/ja/episode/2026-06-13-07-38-19-ja Story Transcript:Ja: 東京の美術館に春の光が降り注いでいた。En: Spring light was streaming into the Tokyo museum.Ja: 広いガラス窓からの光は、日本の書道の特別展を優しく照らしていた。En: The expansive glass windows cast a gentle light on the special exhibit of Japanese calligraphy.Ja: 足音は静かで、まるで空間全体が息をひそめているかのようだった。En: Footsteps were quiet, as if the entire space was holding its breath.Ja: 拓海は静かに歩いていた。En: Takumi was walking silently.Ja: 若いアーティストとしての道に疑問を抱いていた。En: As a young artist, he was questioning his path.Ja: 自身の作品に自信が持てず、どう進むべきかがわからなかった。En: He lacked confidence in his own work and didn't know how to proceed.Ja: 彼の横にいるのは姉のゆきこ。En: Beside him was his sister, Yukiko.Ja: 成功した美術史家である彼女は、拓海のことを心から心配していた。En: A successful art historian, she was genuinely worried about Takumi.Ja: だが、時にその心配は過度になり、拓海を苛立たせることもあった。En: Sometimes, however, her worries became excessive, which frustrated him.Ja: 「この作品を見てごらん」とゆきこが言った。En: “Look at this piece,” Yukiko said.Ja: 彼女の指さす先には、見事な筆遣いで書かれた一枚の書があった。En: She pointed to a calligraphy work with an impressive brushstroke.Ja: それは、力強くも繊細な筆跡で、観る者の心を捉えて離さない作品だった。En: It was a piece that captured the hearts of those who saw it, with its powerful yet delicate strokes.Ja: 「僕にはこんな作品、到底無理だよ」と拓海は呟いた。En: “I could never create a piece like this,” Takumi murmured.Ja: 彼の声には不安と焦りが混じっていた。En: His voice was a mix of anxiety and impatience.Ja: 「そんなことはないわ」とゆきこは優しく言ったが、拓海はうつむいたまま。En: “That's not true,” Yukiko replied gently, but he remained looking down.Ja: 彼は姉の成功を羨み、そして自分の未熟さを恥ずかしく思っていた。En: He envied his sister's success and felt embarrassed about his own inexperience.Ja: 展示室をさらに進んだ。En: They moved further into the exhibition room.Ja: ある瞬間、拓海は立ち止まり、ある作品の前でその場に棒立ちになった。En: At a certain moment, Takumi stopped and stood frozen before a particular piece.Ja: その書は、単純かつ力強い線が美しいバランスで並べられていた。En: The calligraphy had simple yet powerful lines arranged in beautiful balance.Ja: 視線が釘付けになり、心が揺さぶられた。En: His gaze was fixed, his heart stirred.Ja: 拓海の心から言葉が溢れ出し、「これは……素晴らしすぎて怖い」と声に出た。En: Words spilled from Takumi's heart, “This is... so amazing, it's scary.”Ja: この突然の感情の爆発に、ゆきこも驚いていた。En: This sudden outburst of emotion surprised Yukiko as well.Ja: 彼女はそっと弟の肩に手を置き、「そうやって感じ取れるのも才能よ」と静かに励ました。En: She gently placed a hand on her brother's shoulder and quietly encouraged him, “Being able to feel that way is its own talent.”Ja: 拓海はその場で初めて話した。自分の不安と疑問について、ゆきこに率直に打ち明けた。En: For the first time, Takumi spoke of his anxieties and doubts openly to Yukiko.Ja: 「僕はいつも姉さんと比べちゃうんだ。だけど、僕はどう進めばいいのかわからない」En: “I always compare myself to you, but I don't know how I should proceed.”Ja: ゆきこは弟の言葉を聞きながら、初めて彼に寄り添うように努めた。En: As she listened to her brother, Yukiko tried for the first time to truly be there for him.Ja: 「拓海、それでいいのよ。En: “That's okay, Takumi.Ja: 比べなくても。En: You don't need to compare.Ja: あなたはあなたの道を見つけるわ」En: You'll find your own path.”Ja: その言葉に拓海の心は少し軽くなった。En: Those words lightened Takumi's heart a bit.Ja: 彼はゆっくりと深呼吸をし、「ありがとう、姉さん」と感謝の言葉を口にした。En: He took a slow, deep breath and expressed his gratitude, “Thank you, Sister.”Ja: その後、二人は美術館の中を共に歩き続けた。En: After that, the two of them continued to walk through the museum together.Ja: 拓海は新たな視点を手に入れ、自分の道を進むための自信を少しだけ得ていた。En: Takumi gained a new perspective and a bit more confidence to pursue his path.Ja: ゆきこもまた、弟を自分の方法で支えることを学び始めていた。En: Yukiko also began learning how to support her brother in her own way.Ja: 春の光の中で、美術館の作品たちもまた、新しい物語を紡いでいた。En: Amidst the spring light, the museum's artworks were also weaving new stories.Ja: 拓海とゆきこは、その中で新たな一歩を踏み出していた。En: Takumi and Yukiko were taking new steps within them.Ja: 二人には新たなる理解が生まれ、それぞれの道を進むための力となった。En: A new understanding was born between the two, providing the strength to walk their own paths. Vocabulary Words:streaming: 降り注いでいたexpansive: 広いcast: 照らしていたexhibit: 特別展footsteps: 足音holding its breath: 息をひそめているquestioning: 疑問を抱いていたconfidence: 自信proceed: 進むsuccessful: 成功したart historian: 美術史家genuinely: 心からexcessive: 過度brushstroke: 筆遣いdelicate: 繊細なanxiety: 不安impatience: 焦りenvied: 羨みembarrassed: 恥ずかしくinexperience: 未熟さbalance: バランスgaze: 視線stirred: 揺さぶられたoutburst: 爆発encouraged: 励ましたanxieties: 不安gratitude: 感謝perspective: 視点pursue: 進むweaving: 紡いでいた

Stephanie is again joined by Jody Hamilton. They dissect Trump's repeated declarations of imminent deals with Iran, questioning the credibility of his statements as he seems increasingly detached from reality. The conversation takes a humorous turn as they highlight his bizarre behavior during public appearances, including falling asleep on stage and his drugged demeanor. They also touch on the political implications of Trump's actions, from his perceived threats to Iran to the ongoing cover-up of serious allegations against him. With special guests John Fugelsang and Frangela, they explore the outrageousness of the current political climate, the hypocrisy of Republican narratives, and the need for accountability in the face of such overwhelming chaos.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

John talks about Trump's repeated declarations of imminent deals with Iran, questioning the credibility of his statements as he seems increasingly detached from reality. He highlights Trumps bizarre behavior during public appearances, including falling asleep on stage and his weird drugged demeanor. John also discusses Trumps ​new ​nominee ​for ​Director ​of ​National ​Intelligence, ​Jay ​Clayton. ​And ​if ​you're ​wondering ​what ​intelligence ​experience ​Clayton ​has ​that ​qualifies ​him ​to ​oversee ​your ​country's ​entire ​intelligence ​apparatus, ​the ​answer ​is... ​he ​went ​on ​CNBC ​this ​week ​and ​hinted ​that ​California ​elections ​might ​be ​rigged. Next, Ann Larson, author of "Clean Up on Aisle Five," joins the conversation, shedding light on the struggles of grocery workers during the pandemic and the systemic issues of poverty and exploitation in the food industry. Together, they explore the implications of corporate greed and the urgent need for a living wage for essential workers. Then, Simon Moya Smith and Julie Francella, return for another edition of "We're Still Here". One of the standout moments in the episode is the discussion around the upcoming House of Smoke and Ash event, organized by the James Beard Foundation. This indigenous culinary event showcases the rich foodways and traditions of native chefs, emphasizing the importance of food sovereignty and the need for greater recognition of indigenous contributions to our culinary landscape.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

It feels like in every practice area, the importance of the vagus nerve is being talked about.But nowhere is it being researched as much as vagal nerve stimulation post-stroke. And the initial results are promising — as long as it is paired with rehabilitation. The stimulation sets the body up for new motor learning, but then the rehab actually creates the change.In this beginner's course, I'm excited to talk to Sarah Blair, OTR/L  from Vivistim about what she has learned about this relatively new intervention and what generalist OTs need to know about this option.See full course details here:https://otpotential.com/ceu-podcast-courses/the-vagus-nerve-and-stroke See all OT CEU courses here:https://otpotential.com/ceu-podcast-coursesCheck our our live webinar schedule here:https://otpotential.com/live-ot-ceu-webinarsSupport the show by using the OTPOTENTIAL Medbridge Code:https://otpotential.com/blog/promo-code-for-medbridgeTry 2 free OT Potential courses here:https://otpotential.com/free-ot-ceusSupport the show

In this episode of A Tale of Two Hygienists, Jessica and Dave welcome back Dr. Emily Boge to explore the evolving balance between ultrasonic technology and hand instrumentation in modern dental hygiene.   We dive into why ultrasonics are powerful tools — but not magic wands — and why mastering hand instrumentation remains essential for effective patient care. We look into a humbling calibration story that changed the clinical approach and the importance of diagnostic instruments, assessment skills, and clinician awareness in achieving better outcomes.   This conversation is a reminder that great hygiene care is not about choosing between technology and technique — it's about mastering both.   Guest: Dr. Emily Boge Ereinert@hotmail.com   What We Discuss:   Why ultrasonics require balance, technique, and intention   Why hand instrumentation still matters in modern hygiene care   A practice-changing calibration experience   The importance of diagnostic instruments and assessment tools   How clinician awareness impacts patient outcomes   Resources & Links: LinkedIn: https://www.linkedin.com/in/emily-boge-edd-rdh-cda-faadh-fadha-cdipc-8a648916/   Call to Action: If you enjoyed this episode, subscribe to A Tale of Two Hygienists, leave a review, and share this episode with fellow clinicians and educators.

Suspense is up first on this week's show. We'll hear, Dead Of The Night, from November 16, 1944. (30:35) Stroke Of Fate follows with its episode from December 20, 1953, America's First Secret Weapon. https://traffic.libsyn.com/forcedn/e55e1c7a-e213-4a20-8701-21862bdf1f8a/RelicRadio1001.mp3 Download RelicRadio1001 | Subscribe | Spotify | Support The Relic Radio Show If you'd like to support Relic Radio, please consider a donation at Donate.RelicRadio.com. It [...]

Click to Text Thoughts on Today's EpisodeWhen a friend described drooping eyes, slurred words, and fuzzy thinking at brunch — and then brushed it off as anxiety — I knew something wasn't right. That conversation sparked this important Common Sense episode on recognizing the warning signs of stroke, TIA, and heart attacks, and why acting fast can make all the difference. I hope this episode gives you a little more confidence and a little less hesitation if you ever need it. Share it with someone you love. It might matter more than you know.In This Episode:Why women are more likely to dismiss their symptoms — and the cost of waitingThe FAST acronym for stroke and TIA: F — Face droopingA — Arm weaknessS — Speech difficultyT — Time to call 911What a TIA (transient ischemic attack) is and why feeling better doesn't mean you're in the clearAdditional stroke warning signs beyond FASTHow heart attacks present differently in women — including jaw pain, back pain, nausea, fatigue, and shortness of breath with no chest pain at allWhy you should call 911 instead of driving yourselfA personal reflection on loss and the what-ifs we carryEpisodes Discussed:500th Episode: ​5 Uncomfortable Lessons from 500 Episodes​For more information on heart attacks and stroke visit:American Heart Association — heart.org — covers both heart attack and stroke, very thorough, well-organized for general audiencesAmerican Stroke Association — stroke.org — technically a division of AHA but has its own dedicated stroke content including FAST informationMy latest recommended ways to nourish and move your body, mind and spirit: Nourished Notes Bi-Weekly Newsletter30+ Non-Gym Ways to Improve Your Health (free download)Connect with Amy: GracedHealth.com Instagram: @GracedHealthYouTube: @AmyConnell

EWOT for Stroke Recovery: The Affordable Alternative to Hyperbaric Oxygen Therapy Brad Pitzele did not set out to become an oxygen therapy equipment maker. He set out to survive. After years of battling significant health challenges, conventional medicine had given him answers that kept failing him. He tried around 200 treatments. Some helped. Many did not. Then he found EWOT Exercise With Oxygen Therapy, and something finally shifted. Brad’s journey is not the same as a stroke. But what he discovered about oxygen, inflammation, and cellular energy maps directly onto one of the most stubborn obstacles stroke survivors face: the feeling that the brain has gone offline, that the body is running on empty, and that the path back is either impossibly expensive or simply does not exist. In Episode 407 of the Recovery After Stroke podcast, Brad shares what EWOT is, why it works, and why he now makes affordable EWOT systems through his company, One Thousand Roads, specifically so survivors do not have to remortgage their homes to access oxygen-driven recovery. What Is EWOT? EWOT stands for Exercise With Oxygen Therapy. The concept is straightforward: you breathe high-concentration oxygen through a mask while exercising even lightly, and that combination pushes oxygen into parts of the body that normal breathing cannot reliably reach. Most people assume oxygen therapy means a hyperbaric chamber: a pressurized tube, a clinic, a course of treatments costing tens of thousands of dollars. Hyperbaric oxygen therapy (HBOT) is effective. Brad describes it as “a heroic treatment.” But it is also inaccessible for most survivors, financially and logistically. EWOT operates on a related principle without the chamber. The key mechanism is not about oxygenating red blood cells; they are already carrying close to their maximum load under normal breathing. The target is the blood plasma. Plasma does not carry oxygen efficiently under resting conditions, but during exercise, even light exercise, blood pressure and circulation increase enough to force dissolved oxygen into the plasma. That plasma can then reach the micro-capillaries, the tiny vessels that feed tissues deep in the body, including areas of the brain that become inflamed and oxygen-starved after a stroke. The Post-Stroke Energy Problem One of the most commonly reported and least-explained symptoms after stroke is fatigue that does not go away, no matter how much a survivor rests. Most survivors are told that is just part of it. Brad’s framework centres on mitochondrial dysfunction. Mitochondria are the energy-producing structures inside cells. After stroke, the cells in and around the affected area are often not dead; they are in a kind of low-power state. Brad describes it as a “brownout”: the lights are on, but dimly. The mitochondria are not producing energy at full capacity, and one significant reason for that is insufficient oxygen supply to the tissue. “The cells that are offline after a stroke are not all dead. Some of them are just starving. Oxygen is part of what feeds them back.” — Brad Pitzele, Episode 407 When EWOT increases plasma oxygen during exercise, it can reach those inflamed, under-oxygenated micro-capillaries that larger vessels cannot access. The result, for some survivors, is a gradual improvement in energy, cognition, and physical capacity, not because the therapy is miraculous, but because it addresses a specific physiological deficit that conventional post-stroke care often does not target. EWOT vs. Hyperbaric: What’s the Real Difference? The honest answer is that EWOT and hyperbaric oxygen therapy are not equivalent. HBOT delivers oxygen under pressure, which drives it into tissue more forcefully. For certain conditions, particularly in acute or severe cases, hyperbaric oxygen has a stronger evidence base.  But for many stroke survivors in the subacute or chronic phase of recovery, access is the defining variable, not theoretical ceiling. A home-based hyperbaric unit costs $50,000 to $75,000. A clinical course can run to $60,000 or more. EWOT systems are available for under $2,000.  The question Brad puts to survivors is not “which is better in a lab?” It is: “Which one can you actually do, consistently, at home, over the months and years that brain recovery requires?” Consistency matters more than peak intensity in long-term neurological recovery.  Starting EWOT With Deficits EWOT does not require running on a treadmill. The exercise component can be a stationary bike, a recumbent bike, or simple seated leg movements with one limb strapped in. The goal is to raise circulation enough to push oxygen into the plasma, not to hit a cardiovascular fitness target. For survivors exploring this option, Brad’s team has built a specific resource at onethousandroads.com/stroke-recovery with a listener discount of $100 to $500, depending on the package. There is also a broader introduction to EWOT at onethousandroads.com/pages/exercise-with-oxygen-therapy. Recovery Is Possible — And It Does Not Have to Be Expensive If this episode resonated with you or if you want to explore more conversations about recovery options that do not require a second mortgage, Bill’s book, The Unexpected Way That A Stroke Became The Best Thing That Happened, is available at recoveryafterstroke.com/book. And if the Recovery After Stroke podcast has been useful to you, you can support it financially at patreon.com/recoveryafterstroke. Every contribution helps keep the show going and these conversations accessible to survivors around the world. This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. EWOT for Stroke Recovery: The Affordable Alternative to Hyperbaric Oxygen Therapy Why pay $60,000 for hyperbaric oxygen? EWOT brings oxygen therapy into your living room — and could help the brain cells that are only offline. One Thousands Roads Exercise With Oxygen Therapy (EWOT) YouTube Channel Highlights: 00:00 Introduction and Background 05:37 Challenges in Stroke Recovery and Treatment Options 13:45 Understanding Oxygen Therapy and Its Mechanism 15:51 Oxygen Toxicity Explained 19:24 The Importance of Oxygenating Blood Plasma 24:53 Oxygen and Mitochondrial Function 31:16 Adapting Exercise for Stroke Survivors 38:27 Cost and Accessibility of Oxygen Therapy Devices Transcript: Introduction – EWOT for Stroke Recovery Brad Pitzele (00:00) like many of your listeners, when you have a medical issue that isn’t treated by traditional medicine and you’re desperate to get your life back, you’ll try just about anything. You, the lens it goes through is like, Well, how bad can this hurt me? BIll Gasiamis (00:15) Welcome back to Recovery After Stroke. I’m your host, Bill Gassiamas. Today’s guest is Brad Pitzele, founder of 1000 Roads, who overcame significant health challenges of his own and along the way discovered the science behind exercise with oxygen therapy. In this conversation, we get into how increasing oxygen saturation in the blood, specifically in the blood plasma, can help reach the inflamed microcapillaries. That are blocking oxygen delivery to cells in the recovering brain. We talk about mitochondrial dysfunction, post-stroke fatigue, and why Ewatt is worth understanding as an accessible alternative to hyperbaric oxygen therapy. Before we get into it, if you’ve found value in this podcast and want to support it financially, you can do that at patreon.com/slash recovery after stroke. And if you haven’t yet read my book, The Unexpected Way That a Stroke Became the Best Thing That Happened, it is available at recovery after stroke dot com slash book. Here’s my conversation with Brad. BIll Gasiamis (01:19) Brad Pitsley, welcome to the podcast. Brad Pitzele (01:22) Thank you so much. BIll Gasiamis (01:24) Thanks for reaching out and ⁓ connecting with me to educate me on another thing that I can bring to stroke survivors that could potentially help them in the rehabilitation side of their brain. The the thumbnail that people found on YouTube is probably gonna have E W O T on it somewhere. E what. And it sounds something like something out of that ⁓ space war out of out of what is it? Brad Pitzele (01:53) Star Wars. Star Wars. BIll Gasiamis (01:54) Star Wars. Like the Ewok, right? And it doesn’t really mean anything to me. But before we descri tell people what Ewok is, ⁓ tell me a little bit about your background, the work that you do and how it is you came to be on the podcast today is for s for for the specific discussion that we’re gonna have. Brad Pitzele (01:58) Yep. Sure. ⁓ yeah, so I ⁓ I I’m an e recovering engineer. I like to joke. I spent my first decade of my life engineering. later on in life, I left engineering and went into different pursuits and I became chronically ill, had a variety of medical issues, ⁓ cancer, autoimmunity, and eventually Lyme disease. And I was in really bad shape. And a doctor recommended I look into either hyperbaric oxygen or this exercise with oxygen therapy, EWAT, that almost no one had heard of, and I’d never heard of it. ⁓ I I I had tried like everything to get better at this point. I was many years in special diets, ⁓ all sorts of supplements and ⁓ all sorts of modalities and things. And nothing really worked. There was nothing in a matter of fact, some of the medications I took actually gave me cancer. So it kind of forced me on this road to try something different. ⁓ and eventually I found my way back to health through exercise with oxygen when so many things weren’t working. ⁓ and actually later paired that with ⁓ red light therapy. ⁓ and along the way I started because I’m an engineer and I’m inquisitive, I like It was Lyme disease is kind of a do-it-yourself disease. ⁓ so I started digging in and pouring into research, not just on Lyme disease, but autoimmunity, ⁓ chronic illness, ⁓ trying to figure out what the heck was going on with me. And so ⁓ what I found about exercise oxygen therapy along the way was really fascinating to me. and about a year into using it, I went back to that same doctor and he was kind of shocked. At my turnaround, and he was like, What did you use? Did you do oxygen? And I said, I did. And he was like, Who’d you buy it from? I want to tell my patients about it. And I said, I didn’t buy it, Doc. I actually ended up making my own. And he was kind of surprised by that for obvious reasons. And then he said, Well, gosh, would you consider making it for my patient? And so, my patients, and so that’s how we got into this business back in two thousand eighteen. We launched one thousand roads to kinda make exercise with oxygen therapy accessible to people who are dealing with chronic health conditions. BIll Gasiamis (04:39) Okay. And it stems from science, right? There’s scientific data that backs up this exercise with oxygen therapy. Before you go into that a little bit, we don’t have to go deep into it, but we can just ⁓ chat about it. ⁓ when I talk to stroke survivors, they get stuck always with what should I do? What should I do? What should I do? They want the The blue pill, take that one, everything gets fixed. I mean, stroke is not like that, right? And it’s and it’s stroke is also a you’re on your own kind of thing. Because once you get out of the acute phase, once you get sent home, the ⁓ follow up and the medical fraternity doesn’t have a system to kind of say to you, we can’t help you. Speak to that guy. ⁓ that guy might not be able to help you, but but there’s a guy over there. Brad Pitzele (05:09) Yeah. Challenges in Stroke Recovery and Treatment Options BIll Gasiamis (05:33) Like there’s none of that. And stroke survivors need podcasts. They need ⁓ people selling all sorts of crazy stuff that they will almost try almost all the time. They’ll try everything. And then they’ll pick and finally stumble into one that helps and gets them a result. But before we talk about all of that, what I want to do is also go back to what you said about ⁓ a year later, you went to your doctor, he was stunned at the result. We can’t put that down just to eat what? We can’t put that down just to exercise with oxygen therapy. Give me the brief steps on the other things that you also attended to because people miss that. Brad Pitzele (06:15) Yes. Yeah. I well, here’s what I’ll tell you. I started I started to get arthritis in my hands in like 2010 or eleven. and then I started taking traditional drugs for it. And one of the side effects of the drugs is higher risk of cancer and specifically melanoma, which I developed in two thousand thirteen, I wanna say, maybe two thousand fourteen. And that kicked me off the traditional medical path. ⁓ to your point, you don’t you don’t in the stroke recovery, there’s not a traditional path. There it was a traditional path, but it was clear that it was a you know it was a choice between cancer and autoimmunity, and neither one seemed great to me. ⁓ from there I tried so many things, Bill. I did s I actually made a list recently and looked at it because I had it like just off the top of my head, I came up with 200 different things I did try. We’re talking special diets. Eating all sorts of weird, strange things, all sorts of supplements, antibiotics, because it’s Lyme disease, herbal protocols, ⁓ ozone treatments, sa various different types of saunas, ozone sauna, infrared sauna, ⁓ heat steam saunas, ⁓ colonics, coffee enemas, ⁓ weird stuff, you know, you’d never think you’d do. I mean BIll Gasiamis (07:39) You are committed Brad Pitzele (07:42) ‘Cause like many of your listeners, when you have a medical issue that isn’t treated by traditional medicine and you’re desperate to get your life back, you will you’ll try just about anything. You the the lens it goes through is like, Well, how bad can this hurt me? Like like ’cause I know where I’m going right now. For me at least it was a I was just like this gradual step down. It was like I knew like I I couldn’t do this. I had a young family. so, you know, that doctor, I remember him saying, like, look, Brad, we’re trying all these things, we’re gonna get you on thyroid medications and get that right, and we’re gonna do this. ⁓ there on that list of 200, there were about eight things that gave me any kind of benefit that I could identify. ⁓ But I remember he’s like, Brad, we’re gonna take out the big dog. We’re gonna do this ozone treatment. And it’s a special kind where we remove the blood from your body, we inject ozone, put it through UV light, and put it back into your blood. And this helps everyone. Like if nothing else works, this helps, but it’s really expensive. So we’re saving it, kind of. So he he did it. He’s like, do a course of three of them. And he’s like, You might feel bad after it the next day because it kills a bunch of stuff and might you might feel toxic. Or you might feel better. We’re not sure. And give it a few days. And like I did all three of them, I never noticed a difference. And it was ⁓ the most depressing, scary part was like going through that. So when he said go do oxygen, I was like, Okay, like I’ve done everything else. I’m just gonna check the box so the doctor knows that’s not gonna work, so we can go try to find something else. ⁓ And I didn’t believe it was gonna work. I I you know, I didn’t jump on the the bandwagon gung-ho. I was, you know, kind of kicking and screaming. And that was part of the reason I built my own, is because at the time they were so expensive and the they were five to twenty-five thousand dollars. And I was like, I just can’t spend, you know, ten thousand dollars on an experiment. I just can’t do that. ⁓ And he also suggested maybe hyperbaric and that was like fifty or seventy-five thousand dollars. And I was like, geez, if I knew this was the the blue pill, as you said it, if I knew this was the blue pill, I’d go mortgage the house and I’d go do it because like then I could work full and I could do all the things, I could be present for the family, but ⁓ I couldn’t. BIll Gasiamis (10:05) And and and you know what? And it’s not, and and the reason it’s not for a lot of people is because you need to have penumbras the brain from a stroke survivor perspective that are recoverable and that you can bring back to life that are offline, not dead by ⁓ cell death because of the stroke. And there’s no diagnostic process in the majority of the people I’ve spoken to, you can’t diagnose somebody and then work out whether they’re a candidate, and that really Brad Pitzele (10:20) Yeah. Right. BIll Gasiamis (10:33) Pisses me off to somebody gonna have to spend 50 grand to find out if they’re gonna get a result, right? The s the guys that who I’ve interviewed about hyperbaric oxygen therapy, ⁓ Viv clinics, ⁓ those guys will do a thorough diagnostic beforehand to determine whether somebody is a candidate. And whatever that costs, even if it’s five grand, I don’t know what it does cost, but even if it’s five grand, at least you can go, you’re not a candidate, don’t spend any more money. Brad Pitzele (10:38) Yeah. Right. higher yes, you have a higher level of certainty before you spend the money. BIll Gasiamis (11:04) Yeah. And if you do do it, you’re doing it for the other ⁓ non-brain related benefits that you’re gonna get from hyperbaric oxygen therapy. And that’s totally up to you. But it’s not the thing to supposedly fix the arm or the leg that doesn’t work, or to ⁓ repair the damaged cells in your brain. So that part really frustrates me. And if I’m gonna spend that much money, then there’s the opportunity cost as well. It’s like Brad Pitzele (11:33) Yes. BIll Gasiamis (11:34) Now I can’t spend that somewhere else. Brad Pitzele (11:36) Exactly. That was me too. It was like you you knew you had and I was like, man, if I spend this kind of money on it and it doesn’t work, like nothing’s worked for the last, I don’t know, almost ten years at this point. Like how many of these shots do I have in the cannon, right? Like you you know, now I’m I’m depleted and I’m still sick. And that’s even i and you know this, when you’ve got a chronic health condition, sometimes the psych psychology of it all is just as hard as the condition. And If you’re like, wow, now I don’t have money. I feel trapped. There’s nothing I can try. Then hope starts to dwindle. And I say like hope is is like the most potent weapon in recovering from a chronic health condition. It’s a double-edged sword because like you’re s afraid to get hope up because you’ve been let down. But it’s also the thing you need. You ha like when when you start losing hope, and I and I’ve been at that point, it just gets incredibly dark. ⁓ and incredibly scary. so I I think that was part of it. I just wouldn’t allow it. It was the financial part. I you’re right. You only have so many shots out of the bow. But it was also like if it doesn’t work and I am depleted financially you know, I don’t like that that brings me to a a level of hopelessness I I’m not sure I can confront. BIll Gasiamis (12:53) Yeah. And then in order to get back up, you’re getting back up, you’re financially depleted, you’re energetically depleted, your health is depleted. And it’s like, my God, that is a that is like the lowest place that you can find yourself and to get back up is a lot harder. And yet people have still done that, but I know the task is harder. I’ve been in a similar sort of situation. Brad Pitzele (13:12) Yeah. We all love we all love reading that inspirational story. No one wants to live it if they can avoid it, I’ll tell you. Understanding Oxygen Therapy and Its Mechanism BIll Gasiamis (13:23) Avoid it. Yeah, a hundred percent. ⁓ so so you’ve tried all this stuff, you’re unwell, and then somebody says to you, try oxygen. Now, what I imagine when I hear oxygen is get a can from the local gas supplier, ⁓ pop pot in a tube, put it on the back of your chair, wheelchair. You know, I’ve seen a lot of older guys who have got it, and then they’ve got oxygen attached to their face and they’re breathing in oxygen. What specifically did your doctor tell you to get and if you didn’t get what he suggested, like w what did it look like for you? Brad Pitzele (14:00) Yeah, so the challenge with bottled oxygen is number one, it’s almost impossible to get. number two is when you exercise, you can take in a massive amount of oxygen, and that’s part of what makes the the therapy really cool. So y you and I sitting here, maybe we’re taking in three liters of oxygen a minute, okay? ⁓ three liters of air a minute, maybe something like that. ⁓ When you’re exercising, you can easily take in 50 or 60 liters. So it’s a massive multiplier. So you need something that’s going to give you a large amount of oxygen. Now, there’s two ways you can get oxygen in your home. One is that bottle you mentioned, and then you’re always refilling it, and you can imagine lugging one of those things around. ⁓ the other way is there’s a device called an oxygen concentrator, and all you do is you plug it into the wall. And it turns the it purifies the oxygen in the room. So, you know, at sea level, the oxygen in the room has 21% oxygen and it can purify it to 93%. Now, the challenge with these devices is they put out either five or ten liters of oxygen in a minute. So not enough to exercise with. If you were to try to exercise with it, you would also be sucking in this air at 21% and diluting it. ⁓ and so what you do is you take this device and you fill a large reservoir, it’s about a thousand liters, ⁓ and you fill it up. using this device and then you hook up a hose with a mask on it and then you breathe through the mask while you do a fifteen minute exercise session. BIll Gasiamis (15:41) Okay. A reservoir, ⁓ water tank. Oxygen Toxicity Explained Brad Pitzele (15:45) It well it it’s like it looks like a big pillow. So it’s like six you know, two meters by two meters, sort of ⁓ big pillow, six feet by six feet for us still on Imperial. And you fill it up so a thousand liters and it’s you know it’s it’s thin film and so it’s not a a rigid body of something, and then yeah, it’s a bag. BIll Gasiamis (16:06) It’s a bag. Like a bagpipe, a massive bagpipe. Brad Pitzele (16:10) There you go. BIll Gasiamis (16:12) Okay. Okay. W I’m sure there’s an image of that, right? We’ll put it on the screen. People can see it while we’re talking about it, trying to work out what it is. Okay. So this thing is something that you accessed and you used specifically for yourself, how many years ago? Brad Pitzele (16:16) Yeah. Yeah. I’ve s I’ve been using it for a decade straight now. BIll Gasiamis (16:33) Okay. This stuff’s been around for about a decade. This Brad Pitzele (16:37) It’s well, the the research on it goes back to the nineteen sixties and seventies. This it’s really fascinating. actually some of the early research goes back to the turn of the ⁓ twentieth century, the nineteen hundreds. So in the early nineteen hundreds, a gentleman named Otto Warburg won a Nobel Prize for proving that he could turn any cancer or any regular cell into a cancerous cell by depriving it of oxygen. ⁓ and so there’s this really well-established linkage between oxygen and cancer. Even today, a ton of research on that. So in the 1960s and 70s, there was a a German physicist and prolific inventor named Manfred von Arden. Now, and he started to want to do research on Otto’s work, and he he actually started doing research on exercising with oxygen as an anti-cancer protocol. And some of the research he found was really fascinating. what without getting overly technical, basically it our circulatory system, obviously, this is really relevant to stroke, ⁓ people deal in strokes, is as you get down into the the end runs of your circulatory system, there’s capillaries and they’re like thinner than a human hair. And this is where your nutrients and your oxygen are actually exchanged with the cell. And what he found is as we age naturally this inflammation builds up on the lining of our capillaries. And it actually causes the capillaries to swell shut so that now none of your red blood cells can get by. Now, I mean, this is how exquisite our body is designed. ⁓ our capillaries are actually thinner than a red blood cell. So under the most healthy of conditions. A red blood cell actually needs to fold up like a taco to get into our capillaries and deliver that oxygen in the last mile of our circulatory system. So any swelling in that capillary can cause a blockage. And now all the cells downstream are not getting oxygen and in a sufficient quantity. And so they kind of go into what they what he kind of referred to as like a brownout, right? Like it’s a low energy state. They’re doing anaerobic respiration to get some energy. Maybe some of the smaller red blood cells might squeak by here and there and give a little bit, but they’re not getting the full oxygen they need. And what he found is by doing this procedure, just a few times he had very elderly people with very inflamed ⁓ capillaries. He was able to re-establish normal blood flow. And the reason is is oxygen is incredibly anti-inflammatory. ⁓ and a lot of research on that we can go into a little bit later. The Importance of Oxygenating Blood Plasma So, number one, it causes this anti-inflammatory reaction inside these inflamed capillaries to reopen them. But it also does something really amazing that he discovered is when you’re doing this procedure, ⁓ it causes the oxygen to not just attach to our red blood cells like it always does, but it also saturates our blood plasma, which is this clearish liquid that our red blood cells ride on. And Our blood plasma is a thousand times thinner than a red blood cell. So if you imagine these blockages, red blood cells are not getting through, but obviously the blood plasma can get through as long as it’s like as thin as water. So as long as there’s any opening there, and it can immediately deliver oxygen downstream, both to cause an anti-inflammatory impact in the capillaries, but also to all those cells that are starving. And so you can obviously, as we’re talking through this, you can kind of see how this fits folks who are dealing with various different strokes ⁓ and how that can help them as well. BIll Gasiamis (20:32) Yeah. Okay. I d before we spoke I did a little bit of research and found ⁓ as well that there’s some there’s a lot of relevant data with regards to oxygen and ⁓ increasing the oxygenation in the blood. you so tell me a little bit about oxygen. I I don’t understand exactly what that is. I’ve heard of people becoming ill. Because of too much oxygen, ⁓ ill because of not enough oxygen. So what is what what is becoming ill of too much oxygen and why is ninety nine percent saturation not that? Brad Pitzele (21:18) Yeah, yeah. ⁓ good question. So oxygen toxicity can occur if you get too much oxygen under certain circumstances. So if you’re in a hyperbaric chamber too long, it can cause oxygen toxicity. And basically that’s when oxygen gets trapped in your bloodstream and it can’t get out. and You can actually get it without hyperbaric. So hyperbaric is oxygen under pressure. You can get it at normal barracks. So if you were just sitting on the couch breathing oxygen, you could eventually get oxygen toxicity. Now, it would take over twenty-four hours. So if you were breathing just pure oxygen, no exercise, sitting on your couch for 24 plus hours, it starts to get into the risky zone. When you’re doing exercise with oxygen, that’s actually one of the cool things about it that because of the synergies of exercise and oxygen, it’s impossible to get oxygen toxicity for two reasons. one is that reservoir is only a thousand liters. it’s not a high enough dose that you could get a oxygen toxicity. It is a massive dose, it’s about the same amount of oxygen you take in in a day, and you can take it in in 15 minutes, but it’s not more than. And the second reason, even if we could make our reservoir 10x, 100x, and you could exercise nonstop, you still couldn’t get oxygen toxicity because when you’re exercising, your body produces a massive amount of carbon dioxide gas. And that goes into our bloodstream and it increases pressure in our circulatory system. And that actually forces the oxygen out of the circulatory system and into the cells. So it works as a protectant as well from oxygen toxicity. So that’s oxygen toxicity. It’s a real risk. ⁓ Most of the time it’s a very controllable risk. You know, if you’re doing hyperbaric, they’re gonna keep you in there for so long so that you’re not gonna be at risk generally. ⁓ if you’re assigned to do oxygen while you’re stationary at home, they have protocols to make sure you’re not doing it, you know, twenty-eight hours nonstop sort of thing. ⁓ or they have you wear a cannula where where you’re also taking in air and it’s diluting it. ⁓ and in exercised oxygen therapy, it’s not really possible because of the massive amount of carbon dioxide. ⁓ now, not enough oxygen. So if you if you want to measure your oxygen in your blood, the way they normally do it is a device called the pulse oximeter. You can get one for 20 bucks off Amazon. What it does is it looks at how much how many of your red blood cells are saturated with oxygen. And what you’re gonna find in most folks. Is it’s close to a hundred percent. It’s ninety-eight percent, it’s ninety-six percent, ninety-seven percent. ⁓ there’s not a lot of room in our blood for more oxygen. So that’s why it’s important that ewak can actually oxygenate our blood plasma. The same with hyperbaric does the exact same thing, it oxygenates our blood plasma. So BIll Gasiamis (24:26) Okay. I think before you go on, that’s the key ingredient. It’s oxygenating the plasma as well. Where where previously you’ve got let’s say ninety seven, ninety eight percent saturation of your red blood cells. What we’re doing is adding that little bit of extra oxygen into the space where the plasma is. That’s kind of the key difference. Brad Pitzele (24:36) Yes. And there’s two reasons why it’s important. so normally, just for comparison, you and I sitting here, maybe 2% of all the oxygen in our blood is in our plasma, so it’s not very much. ⁓ but under these conditions of IWAT and hyperbaric, we can saturate that blood plasma. And it’s important for two reasons. One, obviously, it increases the oxygen carrying capacity of the blood, but that’s the more minor one. The more major one is that the blood plasma can get into let’s just say the nooks and crannies, smaller spaces in our body where inflammation is blocking off access of red blood cells to downstream cells. And so it can deliver a dose of oxygen where it normally is not able to get. BIll Gasiamis (25:40) You you’ve spent a lot of time on this topic by the sound of things. ⁓ and that’s really awesome. So before we talk about how to actually use a device, how to get a device, how to how to behave while you’re using a device, I wanna understand like how Oxygen and Mitochondrial Function Brad Pitzele (25:52) Yeah. BIll Gasiamis (26:02) How you notice the difference in yourself? Because a lot of people ask me what I did in my own stroke recovery. And Brad’s experience is going to be different from the stroke survivor’s experience. My experience was ⁓ I’ve got nothing from the doctors other than let’s monitor your bleed, let’s give you brain surgery. I mean, that’s not nothing. That’s amazing. Like I’m very Brad Pitzele (26:05) Yeah. Yes. BIll Gasiamis (26:31) Grateful for all of that. That removed the the blood vessel that was leaking that was going to potentially kill me. ⁓ so the immediate risk was gone. And then what what I mean I I got nothing is the specialists did their specialty and then I got nothing because they don’t do nutrition, they don’t do exercise, they don’t do meditation, they do brain surgery. And it’s really important for stroke survivors to understand that when you go to a doctor, a neurologist, whoever. Brad Pitzele (26:55) Yeah. BIll Gasiamis (27:00) They do a specific thing, and once they’ve done it, they can’t do anything else. And you need to get over the fact that you ⁓ might feel disappointment at the at that I don’t know where to go next, and they don’t know where to send you. Okay, they’re not trained and they cannot legally send you elsewhere. That’s why you’re kind of on your own. So I did meditation, I did nutrition, I did all this kind of stuff and Brad Pitzele (27:16) Yeah. BIll Gasiamis (27:27) Somebody who’s interviewed you is Dave Asprey. I would I’ve been following Dave Asprey and a whole bunch of other guys ⁓ probably since around 2012, 2013. And what I learned was how do I reduce the inflammation in my brain? And I had that one area of inquiry, the one area of inquiry that I could personally impact positively by taking out inflammatory foods from my diet. And before that it was, you know, ⁓ processed white bread, it was alcohol, it was cigarettes, ⁓ it was all the stuff that you get in a packet that doesn’t really help to nourish the body, right? So I went back to basics. We’ll call it just for the simplicity of the explanation, we’ll call it protein, ⁓ vegetables and basic carbohydrates like rice or potato. And then what I found was that inflammation decreased, and that was a game changer in how I experienced my brain. And it was a game changer in how quickly I improved neurologically. But just so that people know, it wasn’t the be all end all, it didn’t remove the damaged cells that still are in my head that mean I experienced my the left side of my body in a completely different way than my right side. I’ve got numbness, proprioception issues. I’ve got ⁓ tingling, I’ve got burning, I’ve got ⁓ spasticity, you know, the muscles are tight. So all that stuff is still there. But I have a better experience of the rest of my body and brain because of the things that I took out. But what I didn’t have was the link between exercise, which I do, light exercise, because I’m a stroke survivor. I can’t. use the left side of my body like I used to. so I would do exercise ⁓ like riding an electric bike because it’s easier to pedal, like walking and like doing very light weights at the gym. ⁓ but I didn’t have that oxygen part of the the therapy. And that’s kind of why I interviewed the guys about hyperbaric to understand how oxygen supports how mimicking i a hypoxic brain in the chamber supports ⁓ so how how does like what’s the next part like how does that support the brain to heal let’s give stroke survivors an understanding so that they can kind of grasp that I know we spoke about how oxygen gets into the ⁓ into the red blood cell we spoke about how it gets into the plasma but like Brad Pitzele (30:15) Yeah. BIll Gasiamis (30:20) Why is that the next step? Brad Pitzele (30:21) What’s it too? Yeah. It’s a good question. I think you’re right. I you know, we don’t I will say we don’t try to go out and pitch like exercise with oxygen therapy is a panacea or it’s everything for everyone. Even the name of our company, ⁓ one thousand roads, is about paying homage to everyone’s own healing journey and recognizing everyone’s unique journey. So I’ll say that, but So I’ll say that, but what I found about oxygen was in IWA in particular. What was fascinating to me was for me when I was dealing with Lyme disease, which similar to folks who are dealing with the stroke, there’s a variety of different symptoms and s from different causes. And I was trying to treat all these things with different protocols, different supplements that and I found that when I started digging into oxygen, I was shocked at how many of them came back to it. So when you have A stroke, often there’s a lot of ⁓ emerging research about mitochondrial dysfunction. And this is interestingly, mitochondrial dysfunction. Now ten years ago when I was researching it, no one heard of it or cared about it. And it’s really burst onto the scene because you’re gonna find it ⁓ At the heart of so many chronic health conditions, right? ⁓ you’re gonna it’s actually they’re looking at it in cancers, ⁓ chronic illnesses of all sorts, Alzheimer’s, all sorts of cognitive and ⁓ autoimmune conditions, etc., etc. So ⁓ you have this disrupted mitochondria, right? So there was a period of time when your cells were not getting enough energy, whether it was a hemorrhagic stroke and Blood wasn’t being delivered to those cells, so no nutrients, no oxygen, or an ischemic stroke where they were just cut off ⁓ because of a clot or whatnot. And so they were not getting nutrients. In each of these cases, what happens immediately when the cell runs out of oxygen, like I was talking about that brownout, it goes from aerobic respiration to anaerobic respiration. And anaerobic respiration, ⁓ it’s It only can produce 5% of the energy as aerobic. So the cell is in a low energy state, which is the first problem, which means it doesn’t have energy to repair, it doesn’t have energy to take out the trash, detoxify. so it’s kind of stuck. But also ⁓ it creates a lot of metabolic waste. So it creates lactic acid, it creates free radicals, all these things produce more inflammation, like you were talking about. So Now we’ve got these mitochondria, which are dysfunctional. They don’t have the energy to repair. They don’t have the energy to take out all these dead cells or ⁓ you know, all these other byproducts of the immune system and the natural kind of response to this damage, which then leaves more of it hanging around to produce more damage, and they’re producing more damage themselves. So it’s kind of like this swirl, and it’s ⁓ you know, it’s a downward swirl, if you will. ⁓ so When you can re-oxygenate the mitochondria, the first thing you’re doing is you’re giving them the energy to do whatever it is they need to do. ⁓ and that can be the immediate like feeling sharper, like, ⁓ I feel like I can get my thoughts together quicker. ⁓ it can be, ⁓ I feel like I’m more in control of my emotions. And I I don’t feel like sometimes I have a disproportionate emotional response to something. It can be I I don’t have that brain fog. ⁓ you know, that sort of thing. Or I literally have energy. So our brain actually consumes like 20% of all the oxygen in our body. And it’s only like two percent of the mass. So it’s like punching 10x its weight, right? So when your body starts running low on oxygen, it starts conserving. And the one of the things it tells you to do is like cool it, like stop using your muscles. You’re tired. You need to just sit there and veg out. BIll Gasiamis (34:06) Mm-hmm. Brad Pitzele (34:27) while our mitochondria try to catch up. And so that’s often that chronic fatigue that folks with a variety of health conditions, including stroke, feel, which is their bodies like, stop using energy, we don’t have enough. We need to redeploy it for something else more pressing. And so When you can reestablish normal oxygenation, it improves energy. ⁓ it improves sleep, it improves memory. and the the cells have energy to start repairing and detoxifying. ⁓ and then obviously I always think it’s cool because we’re pairing it with oc with exercise. And there’s so much research on the benefits of exercise. You mentioned it was so important, Bill, in in your healing journey. And you know, we know how important exercise is for a stroke survivor. Well, now we’re pairing it with oxygen and we’re using that exercise to catapult more of that oxygen around the body through the circulatory system while your blood vessels are dilated and opening up. So if you’re still dealing with blockages in your microcirculation, which most stroke survivors are. You’re opening them as wide as they they naturally can at that moment, and that’s when we’re feeding more oxygen to them. So it works it kind of hand in hand in that respect. BIll Gasiamis (35:48) All right. Now one glitch. Stroke survivors often are struggling to get into the physical recovery, right? Because the body goes offline, one of the legs doesn’t work, one of the arms doesn’t work. It’s a real challenge, right? So how how can we benefit from that even though we are at just after the acute phase where there is not a lot of capability for Brad Pitzele (36:00) Yes. It’s perfect. Yeah. BIll Gasiamis (36:17) physicality and I I say that so that the stroke survivors listening know that what I’m leading to is that early on it’s probably harder to do ⁓ physical therapy, exercise, et cetera. But again, with time and hope, all of those things can improve. Right. So I I wanna put that out there for stroke survivors, but also like it’s a can it’s a it’s a constraint. Brad Pitzele (36:48) Yeah. And you know, because a lot of our customers are dealing with chronic illness, this is a question that’s not uncommon is like, yeah, but I can’t I’m not out here to run a mile, Brad. I’m like eighty years old and I’m sick or whatever it is. The really ⁓ the really cool thing about ⁓ Ewatt is that it will meet you where you are at. So there is something all of us can do. The goal is to increase your heart rate and your circulation. Cost and Accessibility of Oxygen Therapy Devices and breathe the oxygen. So there’s a few ways you can do it. you know, it doesn’t have to be banging it out on a treadmill trying to get your seven minute mile. ⁓ you don’t need to do that. We have folks, you know, depending on where they are, you can start with slow walking on a treadmill. You can start with calisthenics. You can start with stretching. ⁓ gentle aerobics in your living room. You can start by, you know, lifting weights. You could be sitting and lifting weights with the the hand that’s not. We have folks, and this is probably not so much for ⁓ stroke survivors, but maybe jumping on a ⁓ a rebounder, like a little trampoline if you’ve got the balance one with the handle. ⁓ we have people using under-the-desk pedal bikes, the ones you can get for $49 on Amazon while you’re sitting. BIll Gasiamis (38:03) Beautiful. Brad Pitzele (38:04) while you’re sitting in a chair. And then for the folks who can’t do any of that, we have we even have them doing what I call passive Ewatt, which is they will breathe the oxygen while they get in like a an infrared ⁓ sauna blanket. So infrared sauna will increase your heart rate. And so you will get some benefit out of it. And what normally happens, the the really cool thing about exercising with oxygen is The first thing folks notice, the very first benefit most folks notice when they start doing is the exercise is easier. So I always describe this like if you were ⁓ jogging on a treadmill at, I don’t know, pick a number, you know, four miles an hour and you put the mask on, you wouldn’t feel like you were getting the same exercise at four miles an hour. You you crank it up to four and a half, and then later you crank it up more. And Your endurance actually improves much more quickly than if you were just doing exercise alone. ⁓ and there’s a ton of actually research on you know Olympic athletes using it for performance enhancement, which is not what we’re using for in this, but it’s kind of a nice little side effect. So we have folks who come to us who who are out of condition. We’re not talking about the physical disabilities, but out of condition, we’re like, I couldn’t do. And they’re shocked at what they’re doing and they come back and tell us in three months, look what I’m doing, sort of thing. ⁓ But it will meet you where you’re at. So if you want to do passive Ewatt, you can do that for a while as you’re working and as you start to feel better. Then maybe you’re using the under desk pedal bike. And as you’re getting your balance back and feeling better, maybe it’s a a real stationary bike later or walking on a treadmill and so on and so forth. ⁓ the goal isn’t to bust hump and like try to, you know, get a new record. As a matter of fact, I find that for most folks that sets you back. You wanna kind of you wanna do within an envelope that you’re comfortable with because If we work out too hard, also we set ourselves back because in most chronic health conditions and in stroke, additionally, we talked about this fatigue that’s due to an energy deficit. So if you go out there and overwork, you’re just putting your body in more of a deficit and potentially putting it in more of an inflammatory environment. And we’re trying to do this at a level that’s in you know anti-inflammatory and helping you recover. BIll Gasiamis (40:30) I love that. I love your whole explanation. So in my what I was hoping was you were gonna say that I could just sit there and almost do nothing ⁓ as a stroke survivor, where I’m completely in in just, you know, like week three of the acute after the acute phase, and fatigue is a massive issue and energy is a massive issue, and I’m barely able to stay awake, ⁓ and all of that stuff. And then ⁓ you could do just I hope you I was hoping you were gonna say, But you said the equivalent of ⁓ chair yoga, you know, where all I had to do was just move an arm or move a leg and do something just to get me physically going and then it would benefit. That’s what I love about it. The under-the-leg pedal bike, ⁓ under-the-desk pedal bike is one of the best things because you can strap in your leg with the deficits if you have a leg that has deficits, and you can do all the or the majority of the pedaling with the other leg, which is strapped in. Brad Pitzele (41:07) Mm. BIll Gasiamis (41:29) And you don’t you’re not gonna fall over ’cause you sit in in a chair. ⁓ probably you’re doing it inside your house so the the temperature, the weather is always perfect and ⁓ and you don’t have to door for long, right? You only have to door for a few minutes to start with. Brad Pitzele (41:45) And you’re pulling that other leg around and it’s starting to fire inside here and rebuild those connections. And and as you know, exercise increases ⁓ brain drive neurotrophic factor, which is a growth factor in our brain for BIll Gasiamis (41:51) Mm. Brad Pitzele (42:00) neuroplasticity. So you’re getting you’re getting all of these benefits. So you to your point, for someone who’s if it’s my right leg’s not working and I’m strapped in and my left leg’s doing it, my right leg is firing and it’s firing those neurons at the exact time you have that B D N F as it’s called. So BIll Gasiamis (42:17) BDNF’s amazing. And I also interviewed ⁓ recently a gentleman who ⁓ had spoken about ⁓ Jack Clifford on episode 402 who spoke about kind of ⁓ a protocol that enables you to regenerate blood vessels around the area that’s injured ⁓ to increase the oxygenation and the blood flow ⁓ to potentially those areas where ⁓ brain is offline, not dead. ⁓ so all of these things, ⁓ the previous episode that I recorded with Jack, your episode right now, like all are things that you can do that support brain health, brain recovery, ⁓ overcoming all the some of the challenges that stroke causes. And what I love about this specifically is that you can do it from your house. and you don’t have to go anywhere, but there is a cost. So let’s talk about the cost a little bit because I I want to mention it because of the massive difference to hyperbaric, which can cost up to sixty grand if you go on the right protocol. And ⁓ that’s unattainable for most people, let alone a stroke survivor who just lost their ability to earn ⁓ and may not have sixty grand to splash. Brad Pitzele (43:48) Yeah. BIll Gasiamis (43:48) ⁓ so what is the cost of getting a machine, setting it up and putting it in your house? Brad Pitzele (43:54) Yeah. So we sell two different machines. ⁓ we have one machine that’s eighteen hundred and ninety-nine dollars and the other one that’s twenty-four ninety-nine. ⁓ that’s everything you need to get going other than the exercise equipment. and the machines last a long, long time. I think I You know, I think we actually we’ve been in business since 2018 and we had our first customer come back and tell us they wore out their machine like this year. So I have to stop saying we’ve never had one wore wear out yet. So we’ve had one. ⁓ so it it’s one of I think that’s one of the things that’s great about it is it’s something you can do in your house. It’s something that doesn’t take a lot of time. When I was dealing with my chronic health issue, I was joke around about the ceremonies of counting pills and doing this modality and doing that. And they all in stroke survivors, I think, recognize the same thing. It starts to crowd out your life. And then eventually you kind of throw your hands up. You’re like, I it might be helping, but I just don’t have four hours a day for all this stuff. Like I just I need to go on and and live my life too. So it’s something that ⁓ it’s 15 minutes. You do it three to five times a week in your home. ⁓ it’s a one time expense and then it’s you know, it’s something you’ll have for many, many years. BIll Gasiamis (45:12) I love it. Where are you located? Brad Pitzele (45:15) We’re in a Dallas, Texas area. BIll Gasiamis (45:17) Okay. And are these things easy to get and distribute throughout the United States and other places in the world? I don’t know I’ve never heard of it before. So are there other people around who who sell a product that’s similar or can you access them easily? Brad Pitzele (45:35) Well, we do ship worldwide. ⁓ we ship with US power, so people get a power converter we’ve sold to the UK, to Australia, to all over Europe, Asia, ⁓ South America, ⁓ and of course across North America as well. So ⁓ they’re readily accessible. Kind of our mission was You know, when the doctor asked me if I’d make him first patients, I I I I thought about what you were saying about how like spending sixty grand to find out if something’s gonna work. And I felt like I was taking advantage a lot when I was very ill. So we wanted to make something that was accessible to people who are chronically ill. They might not have the ability to earn money. They’re on a fixed in like I have a I guess a deep personal experience and empathy there sort of thing. So ⁓ that’s yeah. So we ship worldwide. BIll Gasiamis (46:27) Yeah. If somebody wanted to reach out to you just to get more information, to have a chat with you, to look at your website, where would they go? Brad Pitzele (46:35) They would go to 1000roads.com slash stroke recovery. We do. And you can find it at the bottom of that webpage, but it’s 1000 Roads HQ. BIll Gasiamis (46:42) And you have a YouTube channel. Okay. What kind of ⁓ things can people find on the YouTube channel? Brad Pitzele (46:56) you can find everything about protocols, benefits, ⁓ how to use it. ⁓ we hit have some customer testimonials and parts of that. ⁓ just talking about the science of it, people’s experience with it, et cetera, et cetera, different use reasons people use it. BIll Gasiamis (47:17) I think it’s very important to bring information like this to stroke survivors so that they can access things in their own home that’s going to make their life better. I wrote a book, The Unexpected Way That a Stroke Became the Best Thing That Happened, for the explicit reason to give people like a path forward, a journey forward as to how to ⁓ s how to kind of obtain the silver lining in stroke recovery. And when I wrote it ⁓ in 2018, when I started writing it, something like that, 2018, 2019, I was lacking a lot of the extra pieces that I could put into ⁓ the mindset chapter, for example, or the exercise chapter, or, you know, the nutrition chapter. And In the last five or six years, I’ve been picking up those pieces to sort of attach to those chapters because they’re really relevant. And with the exercise chapter, I think this protocol was the one thing that was missing because I made the point of how important exercise was. I didn’t make the point of how you can exercise and get more bang for your buck during that exercise by Increasing the amount of oxygen that you were getting into your ⁓ bloodstream. How would I have known that if I hadn’t come across the science, which I hadn’t? Plus, there’s only so much you can put in each chapter, but this is the perfect addition. Like, and I love it. So I can go on and on about how much I think this is amazing. Brad, I really ⁓ want to thank you for reaching out and joining me on the podcast. Thanks for the work that you do. I’m glad that you’ve been able to get your health back and now you’re helping other people. Brad Pitzele (49:06) Thank you so much, Bill. I appreciate you having me on. BIll Gasiamis (49:08) Well, that’s it for another episode of the Recovery After Stroke podcast. I hope you enjoyed this episode. Might be worth listening to it again. The science here is worth sitting with, oxygenating the blood plasma, reopening inflamed microcapillaries, giving mitochondria what they need to shift out of that low energy state. And the fact that it can be done at home at a fraction of the cost of hyperbaric oxygen therapy makes it worth knowing about. If you want to learn more, or explore the equipment, head to 1000Roads.com Stroke Recovery. Brad has arranged a discount for listeners of this show of between one and 500 dollars, depending on the package you choose. This episode pairs well with the episode 402 with Jack Clifford, which covers a protocol for regenerating blood vessels around the injured area of the brain. The two conversations complement each other. Worth going back to if you haven’t heard it yet. Now, if this episode was useful, please share it with someone who could benefit. And my book, The Unexpected Way That a Stroke Became, the Best Thing That Happened, is available at recoveryafterstroke dot com slash book. And if you’d like to support the show financially, I would love it if you could. You can go and do that via patreon.com/slash recovery after stroke. I’m Bill Garciamas. Thanks for listening. See you on the next episode. The post Brad Pitzele – How Exercise With Oxygen Therapy Brings Hyperbaric-Style Benefits Home appeared first on Recovery After Stroke.

Everything is fine. Work is going well, family is in cruise control. Life is good. And then moments later you cannot walk, talk or use your hands like you could when you woke up that morning. On this weeks show, Kurt and Chad welcome Mark Green to talk about life before and after a stroke, and how one of the worst days of his life turned out to be one of the most important. The guys talk about the connection between your inner world and your outer world, and how both need to be cared for in a man's life.

It's Monday, June 8. Here are today's top stories around Central Indiana. Want to go deeper on the stories you hear on WFYI News Now? Visit wfyi.org and follow us on social media to get local news every day. WFYI News Now is hosted by Barb Anguiano and produced by Zach Bundy. Subscribe wherever you get your podcasts.

1. Jill Biden and President Joe Biden Jill Biden’s remarks about President Biden’s debate performance. She feared he may have been having a stroke, arguing that: Her actions afterward (campaign event, public praise, restaurant visit) contradict that concern. This suggests either exaggeration or dishonesty. Claims that President Biden experienced cognitive decline. Allegations that political leaders and media knowingly concealed this. Media organizations and Democratic officials were aware of Biden’s alleged condition. There was a coordinated effort to hide or minimize it. They frame this as an example of: Political power being prioritized over transparency. A broader credibility problem in U.S. politics. 2. U.S. Shipbuilding and National Security Key points: Heavy reliance on foreign-built ships is presented as a national security risk. A major funding initiative (~$24 billion) for the U.S. Coast Guard is described. Investment includes: New ships and helicopters Arctic icebreakers Shipyard construction (notably in Texas) Claimed benefits: Increased domestic manufacturing Job creation (thousands of jobs) Strategic competition with China and Russia in the Arctic The senator describes: Internal negotiations over where shipbuilding contracts would go (Texas vs. Louisiana). Involvement of the White House and President Trump (in this narrative timeline). Emphasis is placed on: Negotiation strategy Achieving a “win-win” outcome Expanding production beyond initial goals 3. College Sports Crisis and NIL Issues Problems identified: Escalating athlete compensation (tens of millions per team) Transfer portal instability Financial losses for universities Elimination of non-revenue sports (e.g., tennis, Olympic sports) Proposed solution: A bipartisan bill called the “Protect College Sports Act” Supporting arguments: College sports provide educational opportunities for disadvantaged students They promote social unity and personal development Includes testimony from Nick Saban highlighting unsustainable financial trends. Please Hit Subscribe to this podcast Right Now. Also Please Subscribe to the 47 Morning Update with Ben Ferguson and The Ben Ferguson Show Podcast Wherever You get You're Podcasts. And don't forget to follow the show on Social Media so you never miss a moment! Thanks for Listening YouTube: https://www.youtube.com/@VerdictwithTedCruz/ Facebook: https://www.facebook.com/verdictwithtedcruz X: https://x.com/tedcruz X: https://x.com/benfergusonshowYouTube: https://www.youtube.com/@VerdictwithTedCruzSee omnystudio.com/listener for privacy information.

In part two of this series, Dr. Andy Southerland and Dr. Dan Ackerman discuss a few rapid‑fire concepts from the 2026 guidelines, focusing on what is new and how emerging data may shape patient care.  Show transcript:  Dr. Andy Southerland: Hello, everyone. This is Andy Southerland from the University of Virginia. And for today's Neurology Minute, I'm speaking with my friend and colleague, Dan Ackerman, Chief of Neurology and Director of Stroke at St. Luke's University Health System. We've been speaking in the main neurology podcast on tips for updated clinical practice related to the 2026 American Heart Association guidelines for the early management of patients with acute ischemic stroke. I'm going to hit Dan with a few rapid fire concepts that were touched on the guidelines that I think are new or provide some new insights, new based on the data and to how we treat patients. So Dan, you ready for it? Rapid fire, acute stroke treatment decision making? Dr. Dan Ackerman: Absolutely. Hit me. Dr. Andy Southerland: All right, Dan. I'm a resident going to my first stroke alert on July one this year and I've got a patient coming in, they're having disabling stroke symptoms and they're, in every other way, eligible to receive thrombolysis, but they have a history of paroxysmal atrial fibrillation. They are on apixaban and they took a dose of that apixaban. They forgot to take one yesterday, but they took one the day before, had the evening before. And so 36 hours ago, they took a dose of their apixaban. So based on previous dogma, I think prior guidelines might've said if it's within that 48 hour window, that's a relative contraindication of thrombolysis. What, say, you based on the new guidelines and then how do they inform us about making that decision? Dr. Dan Ackerman: I would actually say the new guidelines are a little bit more aligned with what you just said. You mentioned it as a relative contraindication to thrombolysis. I think before these guidelines came out, a lot of people would've said, "No, that is a strict contraindication to thrombolysis." And a lot of folks would run a stroke code or a stroke lid a little slower knowing that, hey, this person is on, whether it's apixaban, rivaroxaban, edoxaban, dabigatran, et cetera, any of these direct oral anticoagulants and say, "Well, no, we know that person's not a candidate for thrombolytics." Well, no, the newer guidelines would suggest that that is a relative contraindication, not a strict contraindication. And when we look back at studies on this, it has not been suggested that there is a big contribution in terms of exactly how long ago that last dose was. Was it two hours ago, 12 hours ago, 20 hours ago? And there has not been shown to be a clear benefit of testing for factor Xa activity levels, bleeding time and the like. So the guidelines do suggest that, hey, we need more data on this. It's not to, say, that this is 100% perfectly fine. Remember, that's a relative contraindication, so it's still a risk benefit discussion, but studies have not shown an increased risk for hemorrhagic complications in patients who have had recent DOAC exposure who receive IV thrombolysis otherwise according to the guidelines. So I would tend to offer it in that situation and make sure that we document what drugs someone's on, how long ago was their last dose, all of this kind of information in addition to what we might normally otherwise get down. Dr. Andy Southerland: Does that change, Dan, if they took the DOAC in the last 24 hours or even 12 hours? They took it last night, and they're presenting in the morning with their stroke-like symptoms? Dr. Dan Ackerman: The guideline just suggests less than 48 hours, and the data, to my knowledge, doesn't really delineate, at this point, any particular timeframe where we would say, no, there's a cutoff there at two hours or eight hours or 12 hours. So at this point, I would not use that as a way to decide not to offer thrombolysis based on that timeframe. Dr. Andy Southerland: Fair enough. I think that's very reasonable. And I think, again, it's always a good conversation to have either with your attending, if you're that resident on July 1, but particularly with the patient and their family on the risk-benefit of what we know based on the data. Well, that's all the time we have for this Neurology Minute. We hope this discussion will continue to help everyone out there in the hyperacute management of patients with acute ischemic stroke, making those difficult treatment decisions. Good luck.  

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Episode SummaryIn EP328 of Hard Parking, Jhae Pfenning starts with his signature Car News segment on recent Dodge SRT and Dodge Hellcat stories, then welcomes Phat “Phil” Cao — stroke survivor, podcaster, and founder of Hope4StrokeSurvivors. Phat opens up about his hemorrhagic cerebellar stroke experience, the road to recovery, mindset shifts, and building new habits while helping others through advocacy and community.This candid conversation offers hope, practical insights, and resources for stroke survivors, caregivers, and anyone facing life-altering challenges. A must-listen for inspiration and real talk on resilience.Follow Phat Cao: @phatmindset & @hope4strokesurvivors on Instagram | Hope4StrokeSurvivors on YouTube.Timestamps00:00 - Intro & Welcome to the Episode00:02:00 - Car News: Dodge SRT & Dodge Hellcat Stories00:05:30 - Introducing Phat “Phil” Cao & Hope4StrokeSurvivors05:00 - Phat's Stroke Story: "Heard a Pop in My Head"15:00 - Immediate Aftermath & Recovery Challenges25:00 - Mindset, Habits, and Long-Term Healing35:00 - Supporting Survivors & Caregivers45:00 - Resources, Advocacy, and Community55:00 - Final Thoughts & Messages of Hope1:05:00 - Wrap Up & How to ConnectGuest Links:Phat Cao / Hope4StrokeSurvivors - Instagram | @phatmindset | LinktreeRelevant Resources:- Phat Cao Stroke Story: "Heard a Pop in My Head"ContactEmail: info@hardparking.comWebsite: www.hardparking.comPatreon: patreon.com/hardparkingpodcastInstagram: https://www.instagram.com/hardparkingpod/YouTube: youtube.com/@HardParkingTikTok: https://www.tiktok.com/@hard.parking.jhae

Drs. Saver and Sanossian discuss ISC 2026 data highlighting neurologists' frequent inaction on markedly uncontrolled hypertension in high‑risk stroke patients and the need for specialists to “own” blood pressure management at every visit. They also review refinements in patent foramen ovale (PFO) risk stratification, including Pascal algorithm-defined “possible” PFO cases, and explore how a “clinical trial effect” may lower stroke risk through greater patient engagement.

Microplastics and Stroke Risk: What a Landmark 2024 Study Found Inside Human Arteries In 2024, a team of Italian researchers published a study in the New England Journal of Medicine that stopped the cardiovascular science community in its tracks. They found microplastics, tiny synthetic fragments embedded inside the carotid artery plaque of more than half the patients they examined. And the patients who had them faced more than four and a half times the risk of a serious cardiovascular event compared to those who didn’t. This isn’t a distant, theoretical risk. These are living people who had already been identified as having carotid artery disease, and plastics were found inside their arterial walls. For stroke survivors and those at elevated risk of stroke, this study raises important questions that the medical system has not yet caught up with. What the Research Found The study by Marfella et al., published in the New England Journal of Medicine (2024), enrolled 304 patients who were undergoing carotid endarterectomy, a surgical procedure to remove plaque from the carotid arteries. Researchers analysed the excised plaque for the presence of microplastics and nanoplastics. Their findings: 58% of patients had detectable levels of polyethylene, polyvinyl chloride (PVC), or polystyrene in their arterial plaque. This was not contamination from the surgical procedure; it was already there. Over a 34-month follow-up period, patients with microplastics in their plaque had a 4.53 times higher risk of a combined endpoint: non-fatal myocardial infarction, non-fatal stroke, or death from any cause. Inflammatory markers were significantly elevated in the microplastics-positive group. IL-18 and TNF-alpha proteins associated with systemic vascular inflammation were markedly higher in plaque samples that contained plastics. This suggests the mechanism is not simply physical obstruction, but an inflammatory cascade triggered by the presence of synthetic material in arterial tissue. What This Means for Stroke Survivors The carotid arteries are the primary conduits supplying oxygenated blood to the brain. Plaque accumulation in these vessels is one of the leading causes of ischaemic stroke, and carotid artery disease is a condition many stroke survivors are already living with. “The patients with microplastics in their plaque had a 4.53 times higher risk of stroke, heart attack, or death over the 34-month follow-up. That’s not a marginal finding. That’s a signal the research community needed to take seriously.” The NEJM study doesn’t yet tell us whether removing microplastic exposure after the fact reduces risk. It doesn’t confirm that healthy individuals with no existing carotid disease are accumulating plastics at the same rate. And it cannot tell us which plastic sources are most responsible because we’re exposed to microplastics through drinking water, food packaging, air, and a dozen other vectors simultaneously. But what it does tell us clearly and with high statistical significance is that microplastics in arterial plaque are associated with dramatically worse cardiovascular outcomes. What the Research Does Not Yet Tell Us Science at the frontier moves in one direction at a time. This study establishes association, not causation. It cannot yet answer: Whether people without existing carotid disease are accumulating microplastics at comparable rates. Whether reducing exposure actively reverses or slows plaque-associated risk. Which types of microplastics are most biologically harmful? Whether there will be a clinical screening tool for this in the near future. These are the questions the next generation of research will need to answer. In the meantime, it’s reasonable to act on what we do know. Practical Steps to Reduce Exposure No clinical screening currently exists for microplastics in arterial plaque. There is no blood test, no imaging, no biomarker that your GP can order today. What you can do is reduce your ongoing exposure, particularly through food and water contact with plastics. Evidence-informed steps worth discussing with your treating team: Use glass, stainless steel, or ceramic containers rather than plastic for food and drink storage. Avoid microwaving food in plastic containers; heat accelerates the leaching of plastic particles. Filter your drinking water; some filters (carbon block and reverse osmosis) reduce microplastic levels significantly. Reduce consumption of highly processed foods in plastic packaging. Bring this study to your vascular neurologist, cardiologist, or GP and ask whether it’s relevant to your personal risk profile. This is not a recommendation to take a supplement or start a treatment. It’s an invitation to have an informed conversation with the people responsible for your care using the best available evidence. If you found this useful, my book walks through the science of stroke recovery in the same evidence-first, no-hype way. Find it at recoveryafterstroke.com/book. Want to go deeper and support the channel? Join the community at patreon.com/recoveryafterstroke. The post Plastics in Your Arteries: The Stroke Risk Study You Must Know appeared first on Recovery After Stroke.

In part two of this series, Dr. Andy Southerland talks with Dr. Dan Ackerman about a few rapid‑fire concepts from the 2026 guidelines, focusing on what is new and how emerging data may shape patient care. Disclosures can be found at Neurology.org.

In part one of this series, Dr. Andy Southerland and Dr. Dan Ackerman discuss what stands out in the latest thrombolysis guidelines, how these decisions are applied in stroke center practice, and how to educate residents and fellows on incorporating new evidence into treatment choices. Show transcript: Dr. Andy Southerland: Hi. This is Andy Southerland from the University of Virginia, and for today's Neurology Minute, I'm speaking with my friend and colleague, Dan Ackerman, Chief of Neurology and Director of Stroke at St. Luke's University Health System. I've been speaking with Dan on the main neurology podcast regarding updates to acute stroke treatment related to the 2026 American Heart Association guidelines that came out in late January of this year on the early management of patients with acute ischemic stroke. For our episode today, we might focus our discussion around thrombolytic therapy thrombolysis, which is at the core of what we do as acute stroke neurologists when it comes to treatment decision-making. So maybe as a first prompt, Dan, when you look at these guidelines, what stands out to you as you're thinking about how you practice, how you all are practicing at your stroke center, and then specifically how we educate our residents, our fellows on what they need to know, particularly the newness of it when it comes to making thrombolysis treatment decisions? Dr. Dan Ackerman: With all the discussions we've had in the past, there have been a lot of specifics about certain studies and how they might affect practice, but this guideline really opened up a lot and gave us an opportunity to do things in a way that makes really good clinical sense and really brings a lot of practices that have now become common at some centers into the fore so that we can get that information out to everyone and make sure everyone has that same really high level of stroke care everywhere they go. I think the first thing that stands out to me is what did not change. And want to reinforce that, particularly for people who are just getting into this, stroke alert is a screening tool, not a severity score. It's not like an MI alert where you do an EKG and you see the tombstone wave and you say, "Oh, there's an MI and we're taking them to treatment." This is a screening tool, so it is meant to be highly sensitive at the cost of being specific. At our shop for a long time now, we have initiated stroke alert for anyone who presents either within 24 hours of acute onset of neurologic symptoms or has an unknown onset of acute neurologic symptoms and they are still symptomatic to some degree at the time of their presentation, and that's it. We don't make any other statements about how severe something is or what kinds of symptoms someone necessarily has to have. We purposely keep it as broad as possible, again, because we're trying to screen. And the other thing that has not changed, time is still brain. So with all of these different nuances on how we can treat patients and who might be candidates for intervention, it is still a matter of understanding these guidelines, applying our best evidence, but doing it as quickly as possible to make sure that we are rescuing as much of that ischemic penumbra as we possibly can. Now, aside from that, in terms of what stands out that is different, I think one of the early things for me are the recommendations for extended time window for IV thrombolysis. So when you look at the original studies, we understand that when you get out beyond four and a half hours, if you just take all-comers, the risk is going to start to outweigh the benefit. But that doesn't mean there's zero benefit or that no one would receive benefit, but it's a question of, well, how do we cherry-pick those patients who may still receive benefit? And there are a few real specifics in the guideline that help us figure that out. One is for patients who have an unknown time of onset, but they're within four and a half hours of symptom discovery. And for those patients, they would suggest that doing a stat MRI and comparing a DWI lesion with the corresponding area flare to determine if you see DWI hyper-intensity and the flare image is nice and normal, that would suggest that stroke is young enough that it may still be appropriate to treat that patient. But we would also say for folks who have salvageable ischemic penumbra, so again, brain at risk that is not core yet, who either awoke with stroke symptoms within nine hours from the midpoint of sleep or, and this is the kicker, are within four and a half to nine hours from last known well. So in other words, they may have been symptomatic already for more than four and a half hours. If those patients have an appropriate ischemic penumbra, it may be reasonable to treat them with IV thrombolysis to improve functional outcomes. Dr. Andy Southerland: Well, that's all for this Neurology Minute. We hope this vibrant conversation will help all those who are out looking to make the best treatment decisions for their patients, both based on established evidence and most recent evidence in our new guidelines.  

What happens when a man walks through addiction, trauma, broken relationships, and a near-death experience—and comes out the other side with clarity, faith, and purpose? In this long-form conversation, Jeff Gould sits down with longtime friend and broadcaster Bill Palanuk for one of the most honest and revealing discussions you'll hear. This is not a surface-level interview. It's a deep, unfiltered conversation about the realities of addiction, the weight of personal history, and the difficult but powerful process of rebuilding a life from the ground up. Bill's story spans decades. From his early years in radio, living the fast-paced “on-air personality” lifestyle, to quietly battling nicotine addiction, alcohol dependency, and internal struggles that few people ever saw. He opens up about what it took to finally say enough—walking away from smoking, chewing tobacco, and drinking, not through perfection, but through a moment of truth that forced him to confront who he had become. But that was only the beginning. Shortly after making those changes, Bill suffered a stroke—an event that stripped away his ability to speak, process language, and function normally. What followed was not just physical recovery, but a profound internal shift. During that experience, Bill describes a level of peace and calm that fundamentally changed how he views life, death, and everything in between. As doctors searched for answers, they uncovered something even more shocking: a hole in his heart that had been there since birth. A condition that, in many ways, explained a lifetime of symptoms and struggles. The procedure to repair it, the complications that followed, and the long road back add another layer to an already extraordinary story. Throughout this conversation, Bill also speaks candidly about PTSD, family trauma, and the long-term effects of growing up in an environment shaped by addiction. He shares how those experiences influenced his behavior, his identity, and the way he navigated the world for years. This is also a conversation about transformation. Bill talks about sobriety—not just as the absence of alcohol, but as a way of thinking, living, and processing life differently. He breaks down the daily practices that keep him grounded: gratitude, faith, discipline, and connection. He shares the principles he now lives by—God, love, forgiveness, gratitude, serenity, courage, and wisdom—and how those guide his decisions today. There are also moments of reflection on friendship, storytelling, and the lost art of truly listening. Jeff and Bill revisit their early days in broadcasting, the discipline required in radio, and the difference between interviews and real conversations. This episode is not rushed. It takes its time. And it rewards you for staying with it. If you've ever struggled with addiction, faced a health scare, questioned your path, or wondered if it's too late to change—this story will meet you where you are. Subscribe for more long-form conversations that go beyond the surface and explore what really shapes a life. New episodes released every Thursday. #BillPalanuk #JeffGould #americasstoryteller #Storytelling #AddictionRecovery #SobrietyJourney #StrokeSurvivor #NearDeathExperience #PersonalTransformation #FaithJourney #Resilience #LifeLessons #SelfImprovement #MentalHealthAwareness #PTSDRecovery #TraumaHealing #RecoveryStory #OvercomingAdversity #GrowthMindset #Inspiration #Motivation #LifeAfterAddiction #SpiritualGrowth #AuthenticConversations #PodcastLife #LongFormContent #HumanExperience #RebuildingLife #SecondChances #PurposeDrivenLife #DeepConversations ____ Learn all about America's Storyteller on his website: https://www.ilikethatstory.com Buy Jeff's books, CD, and audio book: https://www.ilikethatstory.net/shop Get urgent one-on-one coaching with Jeff now: https://calendly.com/jeffjgould Connect with Jeff on social media: LinkedIn — jeff-gould-americas-storyteller Twitter/X — https://x.com/jeffgouldstory Instagram — jeffgouldilikethatstory Facebook — jeffgouldilikethatstory For booking, contact: Email: book@ilikethatstory.net Phone: (605) 215-6414 or https://www.ilikethatstory.net/contact Send business/sponsorship inquiries to book@ilikethatstory.net © Jeff Gould, America's Storyteller This video is not to be reproduced without prior authorization. The original YouTube video may be distributed & embedded, if required. Callers waive all rights to privacy on this public call in show. If you need private coaching, pay for and book a call at https://www.ilikethatstory.com

Welcome back, everyone. Today we're diving into one of the most hotly debated topics in obstetrics- should we be treating preeclampsia without severe features with antihypertensive medications during expectant management? Now, if you've been following the literature- and our show, you know that the landmark CHAP trial changed the game for chronic hypertension in pregnancy. It showed us that targeting a blood pressure below 140 over 90 reduces serious maternal complications, without harming the baby. That was a big deal. But here's the thing, CHAP studied chronic hypertension. Then there was the CHIP trial- that also found that tight control of gestational hypertension and nonproteinuric chronic hypertension was also beneficial. These did not address preeclampsia without severe features, and yet, the ripple effects of that trial have sparked a global conversation about whether we should be extending those same treatment principles to women with preeclampsia who don't yet have severe features. And this is where it gets really interesting, because the guidelines don't agree. In the United States, ACOG and the Society for Maternal-Fetal Medicine still say: hold off on antihypertensives unless blood pressures hit the severe range at 160/110. But step outside the US, and you'll find the World Health Organization, the International Society for the Study of Hypertension in Pregnancy, FIGO, NICE, and Hypertension Canada all recommending treatment at 140 over 90, regardless of whether the diagnosis is chronic hypertension, gestational hypertension, or preeclampsia. So who's right? And more importantly what does this mean for the patient sitting in front of you right now, at 34 weeks, with a blood pressure of 150 over 95, some proteinuria, but no severe features? Today, we're going to break this down. We'll review the controversy, walk through the divergent guidelines, and most importantly talk about the real, practical implications that favor treating these patients during expectant management. Because when you're watching someone with preeclampsia, waiting for the right time to deliver, there's a strong argument that controlling their blood pressure isn't just reasonable…may be protective. So grab your coffee, settle in, and let's get into it.1. Society for Maternal-Fetal Medicine Statement: Antihypertensive Therapy For mild chronic Hypertension in Pregnancy-The Chronic Hypertension And Pregnancy Trial. American Journal of Obstetrics and Gynecology. 2022. Society for Maternal-Fetal Medicine; Publications Committee. 2. Preeclampsia. The New England Journal of Medicine. 2022. Magee LA, Nicolaides KH, von Dadelszen P.3. Antihypertensive Drug Therapy for Mild to Moderate Hypertension During Pregnancy.The Cochrane Database of Systematic Reviews. 2018. Abalos E, Duley L, Steyn DW, C.4. Prevention and Treatment of Maternal Stroke in Pregnancy and Postpartum: A Scientific Statement From the American Heart Association. Stroke. 2026. Miller EC, Bello NA, Chen PR, et al.5.Hypertension in Pregnancy: Diagnosis, Blood Pressure Goals, and Pharmacotherapy: A Scientific Statement From the American Heart Association. Hypertension. 2022. Garovic VD, Dechend R, Easterling T, et al.

Welcome to Last Call, a look at the biggest stories Jim and Greg covered over the past week on the 3 Martini Lunch.This week they discuss former First Lady Jill Biden lying to us yet again about Joe Biden's condition in 2024, the attempted swatting of Supreme Court Justice Amy Coney Barrett, Los Angeles Mayor Karen Bass facing allegations of flouting election laws, and Virginia Democrats postponing their congressional campaigns.First, Jim and Greg hammer Jill Biden after her CBS News interview in which she claimed she thought President Joe Biden was having a stroke during his 2024 debate against President Trump. She also insisted she had never seen Biden in that condition before or after that night. Jim and Greg call out her lies as Mrs. Biden pushes her new book.Next, they condemn the latest threat targeting a U.S. Supreme Court justice after Justice Amy Coney Barrett was the target of an attempted swatting - sending police to a home under false pretenses. Thankfully, police quickly recognized the hoax before it escalated. Jim and Greg also reflect on how political violence and intimidation have continued to worsen since the attempted assassination of Justice Brett Kavanaugh four years ago.Then, they react to Los Angeles Mayor Karen Bass holding a campaign event next to a ballot drop box while supporters submitted ballots during the event. Challenger Spencer Pratt has filed a complaint alleging Bass violated election laws. Jim and Greg explain why ballot drop boxes are a horrible idea and how candidates just don't seem to care if they are breaking election laws.Finally, they have fun noting several Virginia Democrats are quietly ending their congressional campaigns now that this year's elections will be held under the existing congressional map and not the egregiously gerrymandered map struck down earlier this month by the Virginia Supreme Court.Please visit our great sponsors:Fast Growing TreesBetter plants, better growing, and an extra 20% off with code MARTINI at https://FastGrowingTrees.com/Martini for a limited time; terms and conditions may apply.New episodes every weekday. 

Jill Biden's eyebrow-raising claims about the infamous debate, a roast of the disastrous America 250 concert lineup, Hakeem Jeffries' latest FaceTune fail, and the fellas welcome Vivek Ramaswamy to the progrum to discuss Medicaid fraud, healthcare costs, and his vision for Ohio's future. Plus: a legendary King of the Hill showdown, a one-handed driver's traffic stop gone hilariously wrong, and plenty of Friday chaos along the way. #ruthlesspodcast #VivekRamaswamy #America250 #JoeBiden #hakeemjeffries 00:02:56 Jill Biden Claims She Thought Joe Biden Had a Stroke 00:05:12 Debate Fallout and the Biden Family Cover-Up Debate 00:11:49 Democrat Civil War Reignites Over Biden's Exit 00:19:25 America 250 Concert Lineup Gets Roasted 00:28:24 Young MC Bails on America 250 Celebration 00:39:18 Hakeem Jeffries Caught Using FaceTune Again 00:45:23 Does James Talarico Really Avoid Meat? 00:50:29 King of the Hill: Adam Kinzinger vs. Joe Walsh 01:01:00 Florida Deputy Tickets Driver for Using a Hand She Doesn't Have 01:08:06 Vivek Ramaswamy on Medicaid Fraud and Ohio's Future 01:37:20 Why Vivek's Medicaid Fraud Plan Could Become a National Model Learn more about your ad choices. Visit podcastchoices.com/adchoices

"The Five" on Fox News Channel airs weekdays at 5p.m. ET. Five of your favorite Fox News personalities discuss current issues in a roundtable discussion. Learn more about your ad choices. Visit podcastchoices.com/adchoices

For more coverage on the issues that matter to you, download the WMAL app, visit WMAL.com or tune in live on WMAL-FM 105.9 from 9:00am-12:00pm Monday-Friday  To join the conversation, check us out on Twitter @WMAL and @ChrisPlanteShow Learn more about your ad choices. Visit podcastchoices.com/adchoices

In an interview, Dr. B claimed she thought Joe Biden was having a stroke during the 2024 debate, she then took him to a post-debate event at a Waffle House.  Visit the Howie Carr Radio Network website to access columns, podcasts, and other exclusive content.