Podcasts about Tylenol

Emerald Necklace Conservancy President Karen Mauney-Brodek and NAACP Boston's Ed Burley join to discuss their group's opposition to Mayor Wu's White Stadium plan.NBC Sports Boston anchor-reporterTrenni Casey on the battle over security funding for the FIFA World Cup in Foxborough.Boston Medical Center's Dr. Katherine Gergen Barnett discusses a new study that finds Tylenol use in pregnant women declined after President Trump and RFK Jr.'s made unfounded claims last fall that the drug cases autism. GBH executive arts editor Jared Bowen joins us to discuss the BSO declining to renew Andris Nelsons' contract.

Friday, March 6. The seven stories you need to know today.Read today's briefing.

THE TYLENOL MURDERS: A Father's Confession to His Son and the son joins us on TRUE CRIME UNCENSOREDChicago, 1982. Seven people swallowed Tylenol capsules meant to heal, then they died within minutes. America changed overnight, then the killer vanished into darkness, and that darkness lived in my home.I was eleven, and my father was The Tylenol Killer that terrorized a nation.He created chaos, and confessed with his last breath. I uncovered the truth, and the rot behind his badge. He built lies, and I built a case. I tore the mask from the madness and discovered that each clue led deeper into a labyrinth of deceit.I stripped his name from mine, and I stripped his power too. He found me, and threatened my life, but I did not run. Instead, I shined a light into his darkness.From the son who would not stay silent, THE TYLENOL MURDERS: A Father's Confession to His Son reveals a confession buried under four decades of fear, complicity, and blue-walled denial.The truth is not a eulogy. It is an indictment. “Cyanide pills … I did it.” His final words weren't confession. They were performance.”“My father was not only a complex man. He was a dark man. His shadow was not chance or mistake. He engineered it. He weaponized it. He designed pain with precision. He walked corridors of cruelty.”“This book is the reckoning. This book is the closure. This book is the confrontation. I tell it not because I wish to, but because I must. Some truths demand air. Some truths, once unearthed, cannot be buried again.”Joseph Cibelli is a former salon entrepreneur turned author, legal scholar, and forensic psychologist. After decades in the beauty industry, he pursued law school and earned a PhD in forensic psychology. He wrote The Tylenol Murders, investigating a family confession and the 1982 Chicago Tylenol murders in depth.THE TYLENOL MURDERS: A Father's Confession to His SonWhen the Tylenol murders follow you home. The son who dared to expose the truth.Chicago, 1982. Seven people swallowed Tylenol capsules meant to heal, then they died within minutes. America changed overnight, then the killer vanished into darkness, and that darkness lived in my home.I was eleven, and my father was The Tylenol Killer that terrorized a nation.He created chaos, and confessed with his last breath. I uncovered the truth, and the rot behind his badge. He built lies, and I built a case. I tore the mask from the madness and discovered that each clue led deeper into a labyrinth of deceit.I stripped his name from mine, and I stripped his power too. He found me, and threatened my life, but I did not run. Instead, I shined a light into his darkness.From the son who would not stay silent, THE TYLENOL MURDERS: A Father's Confession to His Son reveals a confession buried under four decades of fear, complicity, and blue-walled denial.The truth is not a eulogy. It is an indictment. “Cyanide pills … I did it.” His final words weren't confession. They were performance.”“My father was not only a complex man. He was a dark man. His shadow was not chance or mistake. He engineered it. He weaponized it. He designed pain with precision. He walked corridors of cruelty.”“This book is the reckoning. This book is the closure. This book is the confrontation. I tell it not because I wish to, but because I must. Some truths demand air. Some truths, once unearthed, cannot be buried again.”Joseph Cibelli is a former salon entrepreneur turned author, legal scholar, and forensic psychologist. After decades in the beauty industry, he pursued law school and earned a PhD in forensic psychology. He wrote The Tylenol Murders, investigating a family confession and the 1982 Chicago Tylenol murders in depth.Filed Under: Bestseller True Crime, New Releases, The Tylenol Murders, True Crime, True Crime Audiobooks, True Crime Books

Dr. Deb Muth 0:00 Welcome back to Let’s Talk Wellness Now. I’m your host, Dr. Zab, and we are continuing our discussion this week on 0:08 peptides. And so, if you haven’t heard our first conversation about peptides, 0:13 please go back and look at that episode. We talk all about the manufacturing, the safety, the quality of peptides, and we 0:20 dove into GLP1s. And today we’re going to dive into peptides for sexual 0:26 wellness, immune function, growth hormone, and all the amazing fun things 0:32 we can do with peptides. So, as usual, grab your cup of coffee or tea, settle 0:37 in, and let’s talk wellness now. And we’re going to take a short pause from our sponsor. I know we’ve got to do 0:44 that, you guys. They’re who keep us on the air. So, I’m going to pause for just a minute and be right back after this 0:50 message from our sponsor. Ladies, it’s time to reignite your vitality. Primal 0:56 Queen supplements are clean, powerful formulas made for women like you who want balance, strength, and energy that 1:03 lasts. Get 25% off at primal queen.com. Serenity Health. That’s primalqueen.com. 1:10 Serenity Health. Because every queen deserves to feel in her prime. All 1:15 right, everybody. We are back. And are you ready? We are talking all things peptide and I am opening the show today 1:23 with sexual wellness. Yes, I’m going there, you guys. I am going there. You 1:29 know, this has really become a big issue for people um of all ages. It’s not just 1:3 4us older people. It’s younger people, too. And there’s a whole variety of reasons why we have sexual dysfunction. 1:42 And when we’re talking about sexual dysfunction, we’re not just talking about it doesn’t work, right? Or I can’t 1:48 reach orgasm. A lot of it is around desire and um the thought of it and 1:54 wanting to connect, wanting to be kinder to one another, wanting to be touching 2:00 one another. A lot of it resolves or revolves around that. And so there are some peptides that can help us and I’m 2:08 really excited to be able to talk about those today. So the first one is called PT-141. 2:14 This targets the brain not the periphery. Right? So for many women I 2:20 will always tell you sex starts between here. It is a brain thing for us. It is 2:26 not necessarily a physical thing. For guys that’s a little different. It’s very physical. For women it’s all in our 2:32 brain. So tip for you men that are listening. You have to prime your woman’s brain first if you want her to 2:38 have sex with you that night. You have to be nice to her. You have to bring her flowers. Do the dishes for her. Do 2:45 something kind. Bring her a cup of coffee or tea or a glass of wine. Take her to dinner. You have to woo her. And 2:51 I don’t care how long you’ve been married. That has to happen. And tip number two, don’t say anything stupid 2:57 that day. I’m just being honest. When you guys say things that make us upset, 3:03 that lingers with us for the rest of the day. And it’s it’s a turnoff for us. And 3:08 for a lot of women, we can’t get past that when it comes time to snuggle at night. And sex doesn’t always have to be 3:14 at night either. So, you can tell I really love talking about this conversation, but we’re going to get into the peptide part of it because this 3:21 is going to help people. So, um, PT-141 is marketed as I’m going to slaughter 3:28 this name, Vali, and it represents a fundamentally different approach to 3:34 sexual dysfunction than the PDE5s inhibitors like Slenden, Viagra, 3:40 Tedataphil, which is Seialis. And while the PDE5 inhibitors work specifically by 3:47 enhancing blood flow to the genital tissues, PT-141 works centrally in the brain by 3:54 modulating neural s neural circuits involved in the sexual desire and 4:00 arousal. Now PT-41 is a cyclic hpatipeptide. It’s seven amino acid 4:07 peptide arranged in a cyclic structure that acts as a melanoortin receptor 4:13 agonist and with particularly the infinity for MC3R and MC4R subtypes. 4:20 It’s actually a metabolite of the melanotan 2, a peptide originally 4:26 developed for tanning that was also found to enhance sexual desire in early 4:31 studies. Now the melanoortin system in the brain is involved in multiple functions including energy homeostasis 4:39 but it also is involved in sexual motivation and arousal behaviors. The FDA approved PT-141 in 2019 specifically 4:48 for the treatment of acquired generalized hypoactive sexual desire 4:54 HSDD in permenopausal women. So for the first time we have a medication that was 5:01 approved by the FDA to use for women for sexual dysfunction. We have had all of 5:07 these seialis tedataphil viagros for men but we had nothing for women. And so 5:12 this is amazing that this is available for women and approved by the FDA. It’s a big deal. This represents the first 5:19 and only FDA approved medication specifically targeting these circuits of sexual desire rather than the peripheral 5:27 arousal mechanisms. And this indication is quite specific, meaning it was developed at some point, not lifelong. 5:35 So I if you’ve had sexual dysfunction your entire life, this medication was 5:40 not approved for you. But if it’s something that you developed over time, like when you went through pmenopause or 5:46 menopause or some women have this experience happen after childirth, that’s what we’re talking about here. 5:53 Now, it’s also not just um supposed to be used if you dislike your partner, 5:59 right? If your relationship is bad and you dislike your partner, this probably isn’t going to fix a ton. It might help 6:05 a little bit, but that’s not what it’s meant for. So, you really have to know what you’re using it for and why. And 6:11 the other thing that I would say is this is something that we don’t go to if your hormones are not balanced properly. You 6:17 have to balance your hormones properly before using something like this because it still may not work. Now, the only 6:24 caveat to that is if you’re a woman that has a risk of breast cancer and can’t use hormones, then that’s a different 6:31 story and we would have that conversation about whether or not this medication would be appropriate for you. Now, the FDA label specifies PTA1 uh 6:39 PT-141 as it not being indicated for HSDD in causes where low sexual desire 6:46 is due to coexisting medical or psychiatric conditions, problems with relationships, like we had talked about, 6:53 side effects to medications or other substance use. This specifically reflects the importance of differential 6:59 diagnosis. Low sexual desire can have many root causes and PT-41 is only 7:05 appropriate when those causes have been ruled out. Now, I have I used PT41 in 7:10 people who have sexual dysfunction issues as a result of using 7:16 anti-depressants. Yes, I have. I’ve used Flynn in that effect as well. And it 7:21 does work sometimes, but it doesn’t work completely. But you need to know that that is not what the approval is for the 7:27 FDA. So that is done in something that we call off label use. So very important 7:33 to know. Now in these clinical trials leading to FDA approval, this was published by Kinsburg and colleagues in 7:40 obstetrics and gyne gynecology in 2019. PT-141 demonstrated statistically 7:46 significant improvements in sexual desire and decreases in distress related 7:51 to low desire compared to placebo. The effects manifest over 45 minutes to 7:56 several hours after the injection and the mechanisms involved modulation of dopamine and melanoorton pathways in the 8:04 hypothalamus and the brain regions that involved sexual motivation. Now cardiovascular effects of PT 141 require 8:12 careful attention. This drug causes transient increases in blood pressure about 3 to four points and transient 8:20 decreases in heart rate. And because of this, it is contraindicated in patients 8:25 with uncontrolled hypertension or known cardiovascular disease. And it has been studied in patients who’ve had recent 8:32 cardiovascular events or sorry hasn’t been studied hasn’t been studied in patients who’ve had recent 8:39 cardiovascular events. So patients need to have their blood pressures checked before starting therapy. Nausea is 8:45 extremely common. It is one of the biggest things I often will tell people to take an anti-nausea medicine if 8:52 they’re going to do this because the last thing you want to do is inject this medication and think it’s going to give 8:57 you this great time with your partner and you’re so nauseated that you can’t even perform, don’t want to kiss, don’t 9:05 want to do anything. It it can be pretty profound for some people. um it does affect about 40% of the patients in 9:12 clinical trials which is why many clinicians require or recommend an 9:17 anti-nausea medication like I had just said other common adverse effects include flushing injection site 9:24 reactions headache in about 13% of the population which I have seen worse if 9:30 people are prone to headaches and the headaches are pretty intense so I will also have them premedicate if they have 9:36 that um sensitivity ity with a Tylenol or Advil, Alie, whatever it is they 9:42 typically use for their headaches to help prevent that from occurring. Now, some patients also experience a 9:50 generalized hyperpigmentation of their skin, particularly in areas with chronic friction, and this may not be reversible 9:57 after discontinuation. So from an integrative perspective, PT-41 10:03 represents one tool in addressing female sexual dysfunction, but it should never be the first or only intervention. And 10:11 low sexual desire in women is complex. Multiffactorial involving hormonal imbalances, low testosterone, estrogen 10:18 deficiency, progesterone imbalances, thyroid dysfunction, adrenal dysfunction, and with elevated or 10:24 disregulated cortisol levels, sleep deprivation, relationship issues, unresolved trauma, including sexual 10:31 trauma, chronic pain, body image concerns, and medication side effects such as SSRIs are notorious for this. So 10:39 a comprehensive hormone panel including total and free testosterones, estradile, 10:45 progesterone, DHEA, thyroid function in cortisol assessment, ideally four-point 10:51 cortisol, salivary should precede any pharmacological intervention. And additionally, addressing the 10:57 psychological component and relationship dimensions through appropriate therapy is necessary. I have a lot of patients 11:03 that say, “This is just too much work for sex. I don’t want the side effects. I don’t want to deal with this.” and that’s totally fine. But for some 11:09 people, their sexual dysfunction is actually causing more problems on their 11:14 relationship and they want to do something to fix that. And just know that if you’re using a peptide like this 11:20 that comes with some of these side effects and you have to premedicate for it, it is not the end of the world. Um, 11:27 but it may be a possibility that you may need that. So, let’s dive into body composition and growth hormone access. 11:34 So Tesmarellin is the only FDA approved GH 11:40 analog. Tesarelin is marketed as Agrifta and Agria SV. It is a synthetic analog 11:48 of human growth hormone releasing hormone. So GH RH human growth hormone 11:53 releasing hormone. These things are such long names it’s confusing and it’s difficult to spit out, right? It 11:59 consists of 44 amino acids. The structure is identical to our own 12:05 body’s growth hormone GHR um with the addition of trans3 hexonol group which 12:14 stabilizes the molecule that extends its half-life compared to the native GHR. 12:19 The mechanism of tesmarellin is elegant in its preservation of physiological 12:24 growth hormone GH secretion patterns and rather than administering an exogenous 12:30 growth hormone directly, tesmarillin binds to the GH receptor in the anterior 12:36 pituitary gland stimulating the indogenous pulsatile release of GH. So 12:42 you know it it’s slower in that stimulation and it pulsates instead of a direct rise and fall. This pusile 12:49 pattern more closely mimics natural GH secretion which occurs in bursts 12:54 primarily during sleep. The GH then stimulates the liver to produce insulin-like growth factor IGF-1 which 13:01 exerts many of the downstream metabolic effects including lipolytic effects on 13:07 the atapost tissue. So fat atapose and how we break that down. The FDA approved 13:13 tesmarellin in 2010 for a very specific narrow indication, the reduction of 13:19 excess abdominal fat in HIV infected patients with lipodistrophe. This 13:25 condition characterized by abnormal fat redistribution with accumulation of visceral body fat and the loss of 13:32 subcutaneous fat in face and limbs developed as a complication of an 13:37 antiviral therapy particularly with older protease inhibitor reg uh 13:42 regimens. The visceral fat accumulation in patients is not just cosmetic. It’s associated with increased cardiovascular 13:49 risk, insulin resistance, and inflammatory markers. The pivotal trial that led to the FDA approval included 13:56 work by Stanley and colleagues published in the annuals of internal medicine in 2014. It demonstrated that tesmarillan 14:03 significantly reduced the visceral atapose measured by CT scan by approximately 15 to 20% which is a 14:10 significant difference to placebo over a short period of time only 26 weeks. Now, 14:16 interestingly, the total body uh weight typically remained stable or even 14:21 increased slightly as the reduction of visceral fat was sometimes offset by increases in lean body mass or 14:28 subcutaneous fat. This highlights an important point. Tesmearellin is not a weight loss drug in its conventional 14:34 sense. Its effects are specifically on body composition and fat redistribution. 14:40 Now the glucose metabolism effects of tesmarellin do require careful monitoring because GH and IGF1 can 14:47 induce insulin resistance. Tesmearellin can increase glucose levels and hemoglobin A1C and in these clinical 14:54 trials glucose tolerance and new onset diabetes occurred in some patients. So 14:59 this creates a therapeutic paradox while res reducing visceral fat we should theoretically improve metabolic health. 15:07 The GH mediated insulin resistance can worsen the glycemic control and patients 15:12 with diabetes require particularly close monitoring. The potential need for adjustment in diabetic medications can 15:19 occur. So I already know what you guys are thinking. Can I use Tesmarellin and 15:24 GLP1 at the same time? And the answer is yes. Especially in those people that we 15:30 know have an insulin resistance already or are prone to that, we can use lowd 15:36 dose micro doing GLP-1 along with tesmarellin to help prevent this from 15:42 occurring um or reduce the risk of it occurring. Now there are some other adverse related problems to growth 15:49 hormone access which include fluid retention which can uh manifest as uh 15:55 ankle swelling, joint pain, muscle pain, paristhesas, carpal tunnel syndrome is 16:01 common to see. Of course you can always see injection site reactions reported about 26 to 30% of the time in the trial 16:08 participants. And this also theoretically has a concern about IGF-1 elevation potentially promoting 16:14 malignancy through long-term data is limited. So we have to be cautious about 16:20 this but it is a growth hormone and anything that is a growth hormone can cause cells to grow and it cannot 16:26 necessarily differentiate between healthy cells and bad cells. So the drug is contraindicated is contraindicated in 16:33 patients with active cancer and in patients with the disruption of the HPA access from conditions like pituitary 16:40 tumors, pituitary surgery, head of radiation um and traumatic brain injury. 16:46 Now off label use of tesmarellin for general anti-aging or body composition 16:51 optimization in non-HIV population, it doesn’t have FDA approval. There is no 16:58 FDA studies. um that promote this, but practitioners do prescribe it for these 17:04 purposes under an experimental and not supported by FDA approved indications. 17:10 And um from an integrative medical standpoint, optimizing natural growth 17:15 hormone secretion through lifestyle interventions, high quality sleep is important. GH primarily is excreted 17:22 during sleep and deep sleep waves. So improving your deep sleep is important. Intermittent fasting can also increase 17:28 growth hormone by five-fold as demonstrated in a Hartman and colleagues uh study from the journal of clinical 17:35 endocrinology and metabolism in 1992. And highintensity interval training, adequate dietary protein, blood sugar 17:42 control, these all can help naturally increase your growth hormone. So, let’s 17:47 dive in now and talk about bone health. peptide hormones um such as oh I’m gonna 17:54 I’m gonna really slaughter this name. Terraparatide is a true bonebuilding 18:01 peptide. It’s marketed as forio. It’s a recumbent form of the first 34 amino 18:08 acids out of 85 of the human parathyroid hormone PTH. It represents a unique 18:13 approach to osteoporosis treatment because it’s one of the few truly anabolic anabolic bone therapies meaning 18:21 it actively binds new bone rather than simply preventing bone loss. The biology 18:26 of parathyroid is fascinating and seemly contraindicated or uh contradictory. 18:32 Continuously sustained elevations of PTH as occurs in hyperarathyroidism 18:37 is catabolic to bone. So people who have hyperarothyroidism typically have significant bone loss 18:44 especially before it’s diagnosed and it causes causes increased bone 18:49 reabsorption loss of bone density increased fracture risk and however 18:55 intermittent exposure to PTH as achieved with once daily uh injections of forio 19:01 has the opposite effect. This intermittent exposure preferentially stimulates osteoblasts bone building 19:08 cells over osteoclasts bone reabsorbing cells and it leads to 19:13 the net bone formation. So terraparatide binds to the PTH receptors on 19:20 osteoblasts and renal tubular cells in bone. It increases the number of 19:25 activity of osteoblasts stimulating the differentiation of osteoblast precursor cells and may 19:32 reduce osteoblast apoptosis basically programmed cell death allowing this bone 19:37 building cell to work longer. The result is increased bone formation, improved bone architecture and tbacular 19:45 connectivity and ultimately increased bone mineral density um particularly in the hip and the spine which is so 19:51 difficult to regain. The FDA approved this medication in 2002 based on pivotal 19:57 studies by Near and colleagues published in the New England Journal of Medicine in 2001 which demonstrated significant 20:05 reductions in vertebral and non-vebral fractures in post-menopausal women with 20:11 osteoporosis. specifically uh reduced new vertebral fractures by 20:17 65% and nonvettebral fragility fractures by 53% 20:23 compared to placebo over a median followup of 21 months. This is really 20:29 incredible because we have not seen this kind of um change uh in other 20:35 medications that we’ve used for osteoporosis. So current FDA approval 20:40 indicates uh this for post-menopausal women with osteoporosis at high risk for 20:46 fracture, men with primary or hypoconatal osteoporosis at high risk for fracture 20:53 and men and women with glucocord cord glucocordide 21:00 induced osteoporosis at high risk for fracture. The high risk qualifier is 21:05 important. uh terrapeptide is reserved for patients with severe osteoporosis, 21:11 multiple fractures, very low low bone density and those who have failed or are 21:16 intolerant of other therapies. The most significant concern for this medication 21:21 is highlighted in a boxed warning with rat toxicology studies where it caused 21:27 osteioaroma which is a bone cancer in a dose dependent and treatment duration dependent manner. The revolence of this 21:34 finding to humans is debated. Rats have fundamentally different bone biology than humans with continuous bone growth 21:41 throughout life and different PTH receptors. Now post marketing 21:46 surveillance in humans hasn’t shown a clear increase in osteocaroma risk but 21:51 theoretically concerns persist and because of this terapeptide is 21:57 contraindicated in patients at risk baseline risk for osteioaroma 22:02 including those with pageantss disease of the bone unexplained elevations of alkaline phosphate prior skeletal 22:10 radiations bone metastases or skeletal malignancies and pediatric patients or young adults 22:16 with open hyes. There’s also a lifetime treatment duration of only 2 years and 22:22 terrapeptide can cause transient hypercalcemia. So an elevated blood calcium and as PTH normally increases 22:31 calcium levels by enhancing bone reabsorption, increasing renal calcium 22:36 reabsorption and promoting activation of vitamin D which increases intestinal calcium absorption. Some patients 22:43 experience orthostatic hypotension within 4 hours of injecting requiring 22:48 caution in at risk populations for blood pressure. Common side effects include 22:53 muscle pain, joint pain, pain in the limbs, nausea, headache, and dizziness. So from an integrative bone health 23:00 perspective, terrapeptides should be part of a comprehensive strategy. Adequate calcium intake, 500 to a,000 23:08 milligrams of calcium a day from food and supplements combined. and vitamin D. 23:13 Getting vitamin D levels of at least 50 to 80 are essential for the drug to work 23:20 optimally. But beyond this, bone health requires vitamin K2, which directs calcium into the bones rather than soft 23:27 tissues, magnesium as a co-actor in bone metabolism, trace minerals like boron, 23:33 copper, silica, and of course, adequate protein intake, which many of us, especially as women, don’t do 0.8 8 to 1 23:42 gram of protein per kilogram of body weight, weightbearing exercise. Of 23:47 course, these all provide mechanical signals that complement the biochemical 23:52 symbol uh signals of terrapeptide. Sequential therapy is also critical. The 23:58 bone mass gains from terraparatide can be lost if patients don’t transition to 24:05 an anti-resorbbitive agent a bisphosphinate after completing this therapy and the anabolic effects to 24:12 build bone but maintaining the new bone requires preventing excess reabsorption. 24:18 So positive things about this but there are definitely some concerns as well. So 24:23 the next one we’re going to talk about is Lu Prolrooide. It is marketed under 24:29 the multiple brand names of Lupron, Depo, Eligard, and it’s a synthetic 24:34 nonapeptide analog of naturally occurring ginonadotropen releasing 24:39 hormone G&R, also called luteinizing hormone releasing hormone, LHR. 24:46 It’s a fascinating example of how manipulating natural hormonal feedback systems can create therapeutic effects. 24:53 So, G&RH is normally secreted in a pulsatile fashion by the hypothalamus 24:59 and travels to the anterior pituitary where it binds to G&R receptors and 25:05 stimulates the release of luteinizing hormone LH and follical stimulating hormone FSH. These ginatotropins signal 25:13 the ovaries or the testes to produce sex hormones, estrogen, progesterone in 25:18 women, testosterone in men. Uh, luoprololi lupron as a GNR agonist 25:26 initially mimics the action of natural G&R causing an acute flare response with 25:33 uh increased LHFSH secretion which temporarily increases sex hormone 25:38 production. However, the continuous administration which is in the depo 25:44 formulations, the GNR receptors in the pituitary become desensitized and 25:50 downregulated. And after about 2 to four weeks of continuous exposure, LH and FSH 25:56 secretion is profoundly suppressed, leading to what’s termed as chemical 26:01 castration. Testosterone levels in men drop to castrated levels less than 50 26:08 and estrogen production is marketkedly suppressed in women. This bifphasic 26:13 response creates both therapeutic applications and management challenges in prostate cancer where tumor growth is 26:20 typically androgen dependent and the ultimate goal is testosterone suppression. However, the initial 26:27 testosterone surge during the flare phase can temporarily worsen symptoms potentially causing increased bone pain, 26:34 urinary obstruction, or even spinal cord compression in patients with metastatic 26:40 disease. This is why uh luoprolide is often started with an anti-ad androgen 26:47 like bicladamide for the first two to four weeks to block the effects of the 26:52 testosterone surge. The FDA has approved lupalide for multiple indications across 26:59 formulations. In oncology, it’s used for palletive treatment of advanced prostate cancers. In gynecology, various 27:06 formulations are approved for endometriosis, for pain management and lesion reduction and for fibroids. 27:13 Typically for pre-operative uh hematological improvement in anemic patients. In pediatrics, it’s used for 27:20 central precocious p puberty basically to halt the premature sexual development of these young people. Now, there are 27:28 adex uh adverse effect profile that reflects profound hormonal suppression. 27:34 In men treated for prostate cancer, hot flashes affect about 59% of the patients. Other common effects include 27:41 general pain, swelling, bone pain. Um long-term use of these medications leads 27:47 to metabolic changes. It increases fat mass. It decreases lean mass. It worsens 27:53 insulin sensitivity, disrupts the cholesterol uh lipid panels, increases 27:59 diabetic risk, has some concerns over cardiovascular disease. And the metaanalysis have shown increased risks 28:06 of heart infarction, myocardial inffection, sudden cardiac death, and stroke in populations receiving 28:13 long-term androgen deprivation therapy. The bone effects are particularly dramatic. Without sex hormones, bone 28:20 density decreases significantly, typically 3 to 4% per year during the 28:26 first two to three years of therapy. And this bone loss may not fully be reversible after the the therapy 28:32 discontinues. The American Society of Clinical Oncology recommends bone density monitoring and consideration of 28:39 bisphosphinates uh in men receiving long-term androgen deprivation. In women treated for 28:46 endometriosis or fibroids, the estrogen suppression creates a hypoestrogenetic state similar 28:54 to menopause. Hot flashes affect 90% of patients with other common effects 29:00 including headaches, emotional irritability, decreased sex drive, vaginal dryness, bone density loss. And 29:08 because of these bone concerns and treatment duration with endometriosis, typically limited to six months, though 29:14 some formulations allow for longer use with adback hormonal therapy to 29:20 partially mitigate these side effects. The mood and cognitive effects can be s 29:25 significant. I’ve seen it over the years. the depression, the memory impairment, difficulty focusing and 29:31 concentrating. It can be very very traumatic and the quality of life that 29:37 happens for these uh women and men can be unbearing for many of them. Um, from 29:44 an integrative perspective, patients receiving this medication need comprehensive support care. Bone health 29:51 interventions using calcium, vitamin D, vitamin K2, weightbearing exercise, 29:58 cardiovascular risk management becomes critical, including blood pressure monitoring, lipid management, diabetes 30:05 screening. For hot flashes management, some patients respond to black coohos, 30:10 sage, or vitamin E. Though evidence is mixed and individual response varies, 30:16 omega-3s may help with the mood and the inflammation, resistance training becomes specifically important to 30:22 preserve lean muscle mass in the face of hormonal suppression. 30:27 Now there’s something called calcetonin salamon which is marketed as miaelin. 30:34 It is a nasal spray. It is now discontinued. And foral is the new 30:39 synthetic polyeptide hormone of 32 amino acids identical to calcetonin of salamon 30:47 origin. It represents an interesting case study in how initial promise gives 30:52 way to safety concerns that regulate a therapy to historical footnote status. 30:58 Calcetonin is naturally occurring hormone in humans. It’s secreted by the paraphalicular sea cells in the thyroid 31:04 gland. Its primary physiological role is to lower blood calcium levels by 31:10 directly inhibiting osteoclast activity, reducing bone reabsorption, increasing 31:16 renal calcium secretion or excretion, and possibly reducing the intestinal 31:21 calcium absorption. So, salamon calcetonin is used therapeutically because it’s more potent and longer 31:27 acting than human calcetonin. The FDA initially approved calceton and salmon 31:34 for several indications post-menopausal osteoporosis in women more than five 31:39 years post-menopausal when alternative treatments are not sustainable. Padet’s 31:44 disease for bone and hypercalcemium as emergency treatments. The nasal spray formulation is particularly popular for 31:53 osteoporosis because it offered a non-injectable alternative to bisphosphinates. 31:58 However, in 2012, the European Medicine’s Agency, EMA, conducted a 32:05 comprehensive safety safety review after a poolled analysis of 21 clinical trials 32:10 involving over 10,000 patients showed a statistically significant increase in 32:15 malignancy risk in patients treated with calceton salamon compared to compared to 32:21 placebo. The overall malignancy rate was 4.1% in calcetonin treated patients 32:28 versus 2.9% in placebo patients. The types of cancer 32:34 varied with no single cancer type predominating, making it difficult to establish a clear mechanistic link. 32:41 However, the signal was concerning enough that the EMA restricted the use of calcetonin containing medicines. In 32:48 the United States, the FDA issued communications about malignancy signal and conducted its own review. While they 32:56 didn’t fully withdraw the drug, the cons consensus shifted dramatically. The nasal spray formulations miaelson was 33:03 voluntarily discontinued by the manufacturer and current clinical practice guidelines now consider 33:10 calcetonin salamon as a second line or lower option for osteoporosis. While 33:15 behind bisphosphinates, dennism mob, uh, terrapeptide, the analesic effect of 33:21 calcetonin in bone pain, particularly in acute vitibbral, uh, compression 33:26 fractions from osteoporosis or pageantss disease may still provide a role for short-term use in these selected 33:32 patients. The mechanism of this pain relief is unclear, but may involve 33:38 effects of endorphin systems and/or direct actions on pathways. The history serves as an important reminder in 33:45 peptide medicine. Initial approval and early clinical use does not guarantee 33:50 long-term safety effects. Post marketing surveillance and poolled analysis of the clinical trial data can reveal adverse 33:58 effects that weren’t apparent in initial studies. It also underscores why newer 34:04 agents with better safety profiles um have largely replaced calcetonin in 34:10 clinical practice. So this is really an important thing. Not one thing stays the same forever. We have to change as we 34:18 identify new and better products as we identify problems and concerns. I will 34:24 always tell my patients if you are uncertain of taking a new drug which we 34:30 all should be wait five years. Within five years we are going to find the 34:36 problems that they didn’t find in the clinical studies. Remember, a lot of these clinical studies are small, small 34:43 groups, short periods of time. It’s expensive to do these trials. So, if you 34:49 wait for five years, in the first two to three years, you will see the problem start to emerge. And what are you going 34:55 to look for? You’re going to look for the the news um commercials from lawyers 35:02 suing a drug. And they will tell you what the problem is. and then you can decide, is this something that I want to 35:09 use or not. Don’t jump on bandwagon and be the first one to do this, especially 35:14 if you’re sensitive. You know, give it time so you can see exactly what’s going on. So, I’m going to end our show on 35:22 this and we are going to pick up on part three of peptide therapy in our next 35:28 segment where we’re going to talk about the investigational peptides and some 35:34 exciting things that are happening with that. So, I want to thank you for joining me today on Let’s Talk Wellness 35:39 Now. It’s always a pleasure having a conversation with you guys and I hope this brings value to you with what we’re 35:45 talking about. If you have ideas for topics that you want me to discuss, 35:51 please message us, you can share your comments on Facebook, you can email us, 35:58 um you can get a hold of us however you would like to share that. I do look at the comments below in the episodes as 36:04 well. So you can place your comments there. And once again, one of the best things you can do for me is like, 36:11 subscribe, and share so that we can spread the messages of what we’re doing. 36:16 I do this at no cost. I don’t make any money out of this. I do this as an 36:21 educational purpose for everybody else. I love doing it, but it really helps us 36:28 on the algorithms if you would be just willing to like, subscribe, and share. 36:33 So, thank you for spending your time with me. I know time is important.The post Episode 257 – Peptides for Sexual Wellness & Hormonal Health: PT-141, Growth Hormones, Bone Health & More! first appeared on Let's Talk Wellness Now.

Did you know it's illegal to bring certain medications into Japan, even with a prescription? Medications that contain stimulants are banned, so what does this mean if you regularly take Adderall, Tylenol 3s, or decongestants with pseudoephedrine? We provide details on how or if you can bring these meds with you while traveling in JapanEpisode Resources:Ministry of Health, Labour, and Welfare of Japan websiteJapan Narcotics Control Department websiteSupport the Travel Mug Podcast by buying us a coffee! You'll make our day & you'll get access to fun stuff like bloopers and extra content.We have Merch! Shop the Travel Mug Podcast Store Check out our fav items here: Our Favourite Travel ProductsGRAB OUR MASTER PACKING LIST HERE*****************************************We are travel enthusiasts who do not claim to be professionals! Instead, we are two Halifax, NS natives with travel blogs who somehow found one another on the internet, and now, we have a podcast!!Join us every week as we talk about our favourite destinations, travel tips, travel fails, and all things travel!We have a big passion for travelling and talking about travel, so we hope you will listen and join the conversation.You can find us here:Our WebsiteFacebookInstagramJenn's Travel Blog Jenn's YouTube channelDisclaimer: All episodes are based on our opinions and experiences. Always do your research and make travel plans based on your budget and comfort levels.Support the show

Chicago, 1982. Seven people swallowed Tylenol capsules meant to heal, then they died within minutes. America changed overnight, then the killer vanished into darkness, and that darkness lived in my home.I was eleven, and my father was The Tylenol Killer that terrorized a nation.He created chaos, and confessed with his last breath. I uncovered the truth, and the rot behind his badge. He built lies, and I built a case. I tore the mask from the madness and discovered that each clue led deeper into a labyrinth of deceit.I stripped his name from mine, and I stripped his power too. He found me, and threatened my life, but I did not run. Instead, I shined a light into his darkness.From the son who would not stay silent, THE TYLENOL MURDERS: A Father's Confession to His Son reveals a confession buried under four decades of fear, complicity, and blue-walled denial. The truth is not a eulogy. It is an indictment. And it bears my name. THE TYLENOL MURDERS: A Father's Confession to His Son—Joseph Cibelli

Autism, Functional Medicine, and Personalized Interventions: A Conversation with Theresa Lyons, PhD, a Yale-trained scientist and medical strategist who became an autism expert after her daughter's diagnosis and now runs AWEtism.net. Lyons describes dissatisfaction with conventional guidance that offers limited drugs for irritability and primarily ABA (Applied Behavioral Analysis), which is insurance-covered, often recommended at 40 hours/week, uses extrinsic rewards, and may help some skill-learning but has controversies and limitations for social development; she contrasts newer approaches such as RDI (Relationship Development Intervention) and PRT (Pivotal Response), which aim to build intrinsic motivation but are typically not covered by insurance. The discussion covers autism heterogeneity, changes in diagnostic categories (e.g., Asperger's folded into autism), and research including a Boston Children's Hospital study reporting 37% of children in a cohort lost their autism diagnosis over time (diagnosis based on observation). Lyons addresses debates about rising autism prevalence, noting multiple potential contributors and rejecting single-cause explanations, while citing risk-factor examples such as family autoimmune history and air pollution exposure. She outlines a functional medicine “why” approach using constipation as an example (root causes vs. symptomatic treatment), and emphasizes basic, low-risk steps such as evaluating diet, inflammation, hydration/electrolytes, and blood work for nutrients. Specific topics include gluten-free approaches (mechanisms involving gut permeability, immune burden, and CNS effects), dairy/inflammation, vitamin D deficiency and monitoring, melatonin as a well-studied short-term aid in autism (considered safe for a couple of years in studies) while still seeking underlying causes, and omega-3 fatty acids for focus and inflammation. Lyons explains leucovorin (folinic acid, prescription vitamin B9) as a targeted approach for children with folate receptor antibodies (reported in ~70% of autistic children), discusses the value and cost (~$300) of specialized testing from one U.S. lab, and notes reports of major speech and behavior improvements in responders, with dosing nuances. The episode also reviews evidence and cautions around the microbiome, including fecal microbiota transplant (FDA-approved for C. difficile; discussed as having an ~80% response rate in autism-related studies when gut issues are a key driver, but with major donor/compatibility considerations) and probiotics (some small trials and high costs). Other themes include “clean eating,” organic foods and toxin-load considerations tied to genetic detoxification vulnerabilities, discussion of acetaminophen/Tylenol in pregnancy in the context of glutathione pathways and personalized risk, and using genetics to guide interventions. Lyons warns that analysis of top autism TikTok videos found ~70% were inaccurate or overdramatized, recommending social media only for ideas, not decision-making. She also highlights parent stress, citing emerging research on increased PTSD risk among autism parents, and emphasizes support and community. Lyons advises parents to understand their child's specific health drivers and match them to appropriately specialized clinicians, noting her curated doctor listings in The Lyons Report.

Ready to get to the bottom of your sleep issues so you can consistently feel rested and full of energy every day? Apply for Complete Sleep Solution program: ⁠https://l.bttr.to/Y70npIf you've been dealing with insomnia for years and you're starting to wonder if you'll ever get deep restful sleep again, this episode is for you. Carol was barely sleeping. She was mixing melatonin, valerian, Tylenol pm, even NyQuil, just trying to get a few hours. She felt irritable, discouraged and scared by what her body was doing at night, and it wasn't just affecting her, it was affecting the people around her. In this episode, you'll hear exactly what was keeping her stuck, what started helping immediately, and what ultimately restored her sleep for good.00:00 Introduction: Overcoming Chronic Insomnia01:05 Meet Carol: A Struggle with Sleepless Nights01:27 Initial Challenges and Frustrations03:07 Failed Remedies and Realizations04:23 Discovering the Root Causes05:20 Implementing Effective Changes06:56 The Journey to Better Sleep08:48 Life After Insomnia: A New Beginning09:36 Final Thoughts and Advice10:26 Conclusion: Take the Next Step

There have been a ton of talk out there, but what does the science actually say? Welcome to the Dr Jake show with Dr Jake Schmutz, NMD and cohost, Theresa Marie Hemsath. Dr Jake Schmutz is an integrative physician and naturopathic medical doctor in Utah, CA. He specializes in autoimmune conditions, chronic fatigue, and chronic disease - with a root cause approach. He uses the wisdom of root cause medicine with the advancements in western medicine for a truly integrative approach that helps you control symptoms immediately while healing your body down to the root cause.

FROM THE VAULT | In 1982, a series of sudden, unexplained deaths in the Chicago area sparked nationwide panic and forever changed how consumer products are packaged and protected. Victims had taken capsules of Tylenol that had been secretly laced with cyanide. The case, which became known as the Chicago Tylenol murders, remains one of the most chilling unsolved crimes in American history.

We examine why U.S. maternal mortality headlines mislead, showing overdose and violence dominate early postpartum deaths while obstetric causes decline. We then cover strong evidence for opportunistic salpingectomy, debunk a shaky Cochrane-fueled home birth claim, clarify Nexplanon's five-year approval and bleeding management, confirm no Tylenol-autism link, and walk through modern syphilis testing in pregnancy before closing with pragmatic magnesium use after delivery.• overdose and violence as leading postpartum deaths• pitfalls of cross-country maternal mortality comparisons• fentanyl trends and infant risk• opportunistic salpingectomy reduces ovarian cancer risk• how bad meta-analyses distort home birth safety claims• intent-to-treat and risk matching in birth setting data• Nexplanon five-year efficacy and bleeding treatments• no association between acetaminophen and autism• syphilis screening algorithms and pregnancy timing• magnesium postpartum as seizure prophylaxis, not BP treatmentBe sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram0:00 Setting The Agenda: What Really Kills Moms0:33 Redefining Maternal Mortality And Comparisons2:11 Violence, Overdose, And Postpartum Risk5:33 State Variability And Media Narratives8:15 Data On Drugs, Fentanyl, And Infant Harm11:06 Opportunistic Salpingectomy: New Evidence14:06 Population Study And Risk Reduction Ranges16:16 Cochrane Review And Home Birth Claims20:24 Why Bad Meta-Analyses Mislead24:15 Real-World Data And Intent-To-Treat For Birth Setting28:02 Pain, Epidurals, And Cultural Narratives31:00 Nexplanon Five Years And Bleeding Fixes35:21 Tylenol And Autism: Meta-Analysis Revisited38:04 Syphilis Testing In Pregnancy: Why It's Hard42:25 Traditional Vs Reverse Algorithms Explained47:05 Managing Discordant Results And Reinfection50:11 History, Ethics, And Tuskegee Lessons54:15 Listener Question: Magnesium Duration Postpartum59:05 Clinical Judgment Over Dogma And WrapFollow us on Instagram @thinkingaboutobgyn.

After reading Joe's book, and getting to know him for a little bit, I do hope that this case can be brought to a conclusive end, Not only for closure for Joe, but for all of the families of the victims of the Tylenol murders. They all deserve that much, don't you think? But, I do reiterate, the end to this interview certainly took me by surprise. And I don't surprise easily. To this day I have issues with jacks-in the-box. But I encourage you to check out the book when it is released. Definitely a memorable read. Thanks for coming on the show, Joe!Follow Joe on Facebook: :https://www.facebook.com/profile.php?id=61587684045766 (He DID set it up because of me...sort of....welcome to the land of Spam bots!)Here's the link to "The Tylenol Murders: A Father's Confession To His Son": https://tinyurl.com/2df4k4pzProgramming note: Catch "Sherpa Selects" on Saturdays. It's the episodes you tried to avoid the first time around!Music Credits/Voiceovers: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠The Sherpa-lu Studio Players; Music from #Uppbeat (free for Creators!):https://uppbeat.io/t/goods-cargo/blurLicense code: SEGQXRLESQA3PHDZYouTube: @sherpalution5000 @sherpalution : social media for IG, Threads, & TikTok (@sherpalution1);Link pages: https://linktr.ee/sherpalution , https://chirp.me/sherpalutionHere's our website: https://shows.acast.com/the-sherpas-podcast-picksEmail:jimthepodcastsherpa@gmail.comSupport:Review the show on Apple Podcasts or Spotify**AI disclaimer: Any use of artificial intelligence in the voiceovers that may be used in this show are strictly for entertainment purposes. They are not used to mislead or disparage the content in this podcast, any guests, or the podcast platform that you are listening on. But I, as your Sherpa, have faith in YOUR intelligence as a listener, and know that you were already aware of this. Thanks for listening!Become a Rebel of the Sherpalution! Please subscribe to the show (for free) through your favorite podcast listening medium, so you don't miss an episode. (What if you miss one, and then we have a test????) If I'm not on your favorite medium, let me know, and I'll bribe my way on it! (That's assuming I actually have money...) Also, please reach out to me through my social media channels or email address. I'd love to hear what you think.And PLEASE let me know if there's a podcast I should be checking out...even if it's one you host! Hosted on Acast. See acast.com/privacy for more information.

(00:00-19:32) Breaking news: Tony Clark is resigning from his role as MLBPA executive director. Interesting timing with the looming work stoppage. Yadi walked by, does that count? Predictionary is filling up quickly. Steamy paperbacks. Boogie boarding. Jackson's swimming acumen.(19:40-34:40) We apologize on behalf of the whites. Jackson left Martin some Tylenol on his pillow. Taco Tuesday. Favorite chain restaurants. RIP Robert Duvall. Jackson talking film at dinner. Over/Under 89.5 for Jackson today.(34:50-45:29) Great day to be alive. The Linda Sniffer is getting desperate. Jackson just wants to work hard during the day and then golf and relax. Bets are rolling in on Jackson's golf round.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

On today's Good Day Health Show - ON DEMAND…Host Doug Stephan and Dr. Ken Kronhaus of Lake Cardiology (352-735-1400) cover a number of topics affecting our health. First up, Doug and Dr. Ken begin with the brain, specifically how it can be enhanced and how it can be damaged. There's a new study about a silent brain disease, Amyloid protein buildup in the brain being a hallmark of Alzheimer's disease and other neurodegenerative conditions, and a massive review on how to best help your brain through depression. Moving on to AI diagnostics, the latest in medical technology involves an AI system capable of interpreting MRIs in seconds, flagging strokes or hemorrhages, and drastically cutting down the time to treatment in ER settings.Then, a focus on men's cardiovascular health showing an increase in cardiovascular disease risk, starting at age 35, much earlier than women, suggesting the preventative screening needs to begin by mid-30s. Lastly, a recent scientific review as provided reassuring data for pregnant women that there is no increased-risk of autism , ADHD, or any intellectual disability in children. It's important to remember to follow dosage guidelines when it comes to acetaminophen (Tylenol).  Website: GoodDayHealthShow.com Social Media: @GoodDayNetworks

Still driven to matter. Desperately. Almost 73. And I can't unwind… busted springs, broken dancer in a jewel box. This piece isn't an answer. It's an accusation. And underneath? A terrified question I can't stop asking.Is listening more your thing? Hit the headphone icon

Miracles can happen on Christmas Eve.Based on a post by auguy86, in 2 parts. Listen to the ► Podcast at My First Time.Ken Dix flipped through the TV guide at a moderate pace; “500 channels, and nothing but Christmas specials on.”Finding nothing but disappointment at every turn. As it was Christmas Eve, every show was a mushy feel-good romp spouting lines about family and goodwill to others. None of that spoke to Ken in the slightest.“Ken?” a voice came from the kitchen.“What’s up, Mom?”“I’ve got my hands full with making everything for dinner tonight, but I’m going to run short on a couple of ingredients,” Helen Dix said, poking her head into the living room. “Can you run to the store real quick for me please?”“Sure thing,” Ken replied, seeing as he had nothing better to do.“Great, thank you. I made a list on the counter for you. The store should be open for another hour or two. The main things would be the eggs; I don’t have enough to finish my famous chess pie. If they have tea by the gallon, grab one sweet and one unsweet. The rest are great if you find them, but not essential.”“Got it,” Ken said as he took the list from the counter.Heading out to his car, Ken cranked up his Honda Civic and pulled out of the driveway. As he made his way into town, Ken reflected on his current situation. Though he loved his mom, being home for the holidays was always nerve-wracking for him. His hometown of Alpharetta, Georgia was crawling with former high school classmates of his, people he’d just as soon never see again. But up at MIT, he was actually among peers that he could relate to on an intellectual level. Not that he’d made that many friends up there. As a nineteen-year-old freshman, he was still stuck in the same boring math and science classes as everyone else. He couldn’t wait until he could start his health sciences training. Maybe then he could meet some decent people, perhaps of the female variety.Ken soon arrived in the parking lot of the local Kroger. It was soon obvious that the place was packed with last-minute shoppers, all trying to find that one final ingredient they were missing. Locking his car, Ken sauntered into the store, grabbing a shopping basket along the way. He found the shelves of the store well picked over, striking out on the nonessential items on his mom’s list. Making his way to the drinks aisle, he was pleased to see that the store was keeping the gallon jugs of tea well stocked for the holidays, and picked up a pair.Ken soon arrived in the refrigerated section of the store. Almost every shelf was empty, but he did manage to find one last carton of six eggs, just what his mom needed. Depositing the carton in his shopping basket, Ken made his way back to the front of the store, checking out in the express lane. He gripped the shopping bags tightly, being careful that the eggs weren’t harmed from the swinging of the bags. Arriving back in the parking lot, he was pleasantly surprised to see one of his former classmates, Jacqueline Brown. As he approached, she saw him coming.“Ken? Kenneth Dix?”She was extremely pretty, as was befitting one of the most popular girls in school, and kept her chestnut-brown hair cut just below her jawline. Her soft, warm facial features and bubbly personality belied the sharp intellect hiding underneath. She and Ken had been partners a few times in various subjects, and he had helped craft her entrance essay to the University of Washington. This earned her a full ride scholarship. In spite of her popularity, they had worked well together, and Ken even dared to call her a friend, at least in his own mind. They had never hung out on a social basis; her circle of friends would never have let her live that down. Still, times had changed. They were both out of high school, after all. What could it hurt to ask?“Jacqueline? Wow, I never thought I’d see you back here. Thought you escaped to cooler climates?”“Yeah, Seattle is nice, but nothing beats Christmas at home,” she replied, adjusting her UW sweatshirt. “You back for the same reason?”“Uh huh. Mom pretty much insisted. She won’t settle for anything less than a full family gathering on Christmas Eve. I’m just grabbing a few last things for her. But yeah, it’s great seeing you again. You, uh, you look good.”“Um; thanks,” she replied with hesitation.“I’m, uh, gonna be home for a couple of weeks. Would you want to, I don’t know, hang out sometime? Maybe grab a bite to eat? My treat.”“Well, Ken, that’s sweet of you to ask.” she said almost to herself. As she paused, her eyes suddenly lit up as if she had gotten an idea. “Alright! Here, let me give you my number.” She scribbled a series of digits down on a scrap piece of paper, writing her name next to them. “I’ll, um, talk to you later, I guess?”“Sounds great!”Ken couldn’t believe it; he had actually done it! He had asked out the prettiest girl he had ever known! Moreover, she had given him her number! Things were definitely looking up.“Dick!” a voice behind them yelled.Ken turned, immediately recognizing Jason Brown, Jacqueline’s fraternal twin brother, along with his two flunkies, Brian and Barrett Sullivan. Jason had been the star quarterback at his high school, and the Sullivan boys were his best offensive linemen. They often served as his muscle off the football field, as well. Ken was intimately familiar with these three, as they had made it their mission in high school to make his life a living hell. Being stuffed in lockers, having his wallet stolen, all were commonplace with them. The three approached, attempting to appear imposing, which they were from the perspective of the ever-scrawny Ken.“I’ve got nothing to say to you guys,” Ken muttered as they approached.“Well I’ve got something to say to you, Mr. Kenny Dick,” Jason growled.“Just shut up and leave me alone,” Ken replied, his blood boiling at the use of Jason’s longtime nickname for him.“No! You shut the fuck up and listen!” Jason said, grabbing Ken by the collar of his tee-shirt and flinging him against his car. In the process, Ken dropped his shopping bags, the jugs of tea landing directly on the egg carton.“Jason! Stop it!” Jacqueline protested.Undeterred, Jason threatened. “Listen fuck-wad, you stay the hell away from my sister!”“She’s an adult, dickhead! She can have anyone she wants as a friend!” Ken protested.“You don’t belong on the same Planet as her! You’re nothing’! A pathetic sack of guts your dumbass mother decided to give a name to! Know what? Just do us all a favor and drop dead!”Enraged at the insult to his mom, Ken swung a wild haymaker at his assailant, but Jason was more than ready, pinning Ken’s arm back against his car. Jason then delivered a crushing punch to Ken’s gut, dropping him down to his knees. Before leaving, Jason knelt down next to his gasping victim.“Next time, I won’t be so nice. Next time; I might just kill you myself. See ya around. Dick.” Turning to his sister, Jason said, “Come on, time to go home.”Jacqueline looked down at the pitiful form of Ken before muttering, “Sorry, Ken.”The trio of boys sauntered off across the parking lot, laughing and high-fiving at their antics. Jacqueline followed right behind them. Ken picked himself up and inspected his groceries, discovering the crushed eggs in his bag. Swearing and cursing, he grabbed the misshapen carton and went to throw it in a nearby trash can.“No chess pie tonight.”As Ken returned to his car and began his drive home, Jason and his flunkies watched on from his car, still pleased with their efforts.“You shouldn’t have done that,” Jacqueline said in a lecturing tone.Jason turned to face his sister. “I do what I gotta do, Jacqueline. That fuck-wad has no business getting friendly with you. He needs to learn his place.”“Be that as it may, I can take care of myself,” she replied firmly.“Take care of yourself? Wait; you didn’t?”“I did. Jason, someday you’ll learn that there are more subtle and effective ways to ward off undesirables. Trust me, Ken won’t bother me ever again.”Back at Home.Upon arriving back home, Ken couldn’t bring himself to tell his mom about the incident with the eggs. He instead told her that the store had run out altogether. She had spent many sleepless nights in the past worrying about the constant bullying her son was subjected to in school. Ken didn’t want to give her anything else to worry about. By this time, has uncles had started arriving, and the living room was soon filled with the sounds of football games. In Ken’s mind, these were no more thought provoking that the mindless Christmas specials he had found earlier. Ken went up to his room to take a hot shower, as well as get some alone time in the process. As he stripped down, he saw a bruise beginning to form on his stomach from Jason’s punch. He winced in pain as he touched the tender skin.Shit; that’s not going away for a while.Ken took some Tylenol for the pain before stepping into the shower. The hot water helped relax his body, and the steam gradually built up, clearing his mind a bit. He finished after a while and, after making sure his door was shut, flopped facedown onto his bed. After laying there for around an hour or so, his mom finally called him down to rejoin the family for dinner.Taking his seat at the table, Ken glanced around the room at his various family members. His mom had two older brothers, Lee and Stan. Though Lee was tall and still relatively youthful looking at forty-five, Stan was shorter and beginning to bald as he approached fifty. Still, both of them had one notable thing in common as far as Ken was concerned: they were both still jocks at heart. Ken had never known his father; it had always just been him and his mom. He could tell that his uncles tried to be male role models for him, but their efforts were usually ill-conceived attempts to “man him up.” Never once did they understand his introverted tendencies, and always tried to get him to be more of a people person. After a while, Ken stopped paying their advice any attention.It was striking to Ken how similar Lee and Stan’s families were. They had both married beautiful, blonde cheerleaders, and now both had sixteen-year-old daughters, both of whom were among the most popular girls in school. It all sickened Ken; they were just perpetuating the stereotype of pretty and popular being the be-all, end-all in life. As the family ate, Ken remained silent for the most part. The adults were engrossed in discussions about their jobs, and the two daughters were giggling and playing on their phones the entire time. None of this was relevant to Ken.“You know, I saw something interesting today,” Lee said as dessert was being brought out. “I was at Kroger filling up my car, and saw you in the main parking lot, Ken. Looked like you were, uh, having some words with a few guys out there.”Shit! He saw that?Not wanting to worry his mom, Ken replied, “It; it was nothing.”“Nothing, eh? Is that why that punk punched you in the gut?”With a worried look on her face, Helen asked, “Ken, sweetie, what is he talking about?” She walked around the table to Ken’s seat and lifted up his shirt, seeing the bruise on his abdomen. “Was it that Jason boy again?”“Mom, just let it go.”“No! Ken, you know I worry about you!”“You worry about Me? I think you need to worry more about your brother!” Ken shouted, his anger exploding at last. “Right, Uncle Lee? Come on, you see your own nephew being ganged up on in a parking lot, yet you do nothing to help him out?!”“A man’s gotta learn to fight his own battles,” Lee replied in a calm voice.“No. You want to know what a man does? A man sticks up for his Family! No. Matter. What! You stood there and watched your own nephew get beaten up. That says a hell of a lot more about you than it does me. And if that’s family; I don’t want any part of this one.”Without a word, Ken stood and left the dining room. He then grabbed his MIT hoodie and headed for the front door. As he was about to get into his car and drive off, he saw to his frustration that his uncles’ cars were parked in the driveway behind him, blocking him in. Cursing under his breath, he prepared to leave on foot.“Ken! Come back inside, please!” Helen called after him, running down the driveway.“No. I’ve got to go out; clear my head.”“Ken, it’s Christmas Eve. Please, come be with your family.”“Mom, aside from you, not a single person in that house feels like family to me,” Ken replied coldly. “I’ll; I’ll call you after while.”Ken walked off into the cold Georgia night, not knowing for sure where to go or what to do. Nobody else was out, as they were all at home with their families. Remembering the square in historic downtown Alpharetta, he decided to head in that direction. Maybe the quiet walk would do him some good.Arriving in the town square, Ken walked along the sidewalks for a bit, peering into the darkened windows of the various shops and restaurants. Everything looked so different to him with everyone gone for the day; it all seemed so peaceful. As he continued to walk, he soon saw City Hall in the distance. In front of the building was a large green space, which was teeming with a surprising amount of activity for it being Christmas Eve. Ken moved closer, now spying a large gathering of people sitting on picnic blankets, all bundled up in coats and hats. Ahead of them, a large screen projected the classic film, It’s a Wonderful Life.Though Ken was never into the Christmas cheer, as it were, he felt strangely drawn to watch a few minutes of the film from a distance. He soon began to regret that decision, as the movie had reached the point where George Baily had an arrest warrant out for him, lashing out at his family in anger. Watching him get drunk and punched in a bar fight, Ken began to feel sick with anger. Despite all his efforts to help better the world around him, the universe conspired against George Baily; just as it seemed to be conspiring against Ken. Unable to watch a moment more, he turned and walked into the nearby park.Again alone with his thoughts, Ken sat on a bench near the fountain in the center of the park. He contemplated many things, as he often did in solitude. He thought about his piss poor excuse for a family, intent on changing him into what they say he should be. If only they could love him as he is. He thought about Jason Brown, a perpetual asshole that managed to get all the beautiful women his heart desired. If only the universe would serve up his just desserts, rather than conspiring against Ken. Sighing in frustration, he stuffed his freezing hands into his jeans pockets.Jacqueline!Feeling the scrap of paper still in his pocket, Ken suddenly felt a glimmer of hope in an otherwise dreary day. He needed something, anything to lift his spirits, and hearing her kind, sweet voice might just do it. Hell, he didn’t even care anymore if she was interested in him in a romantic sense; he just needed someone to listen and understand him. Digging out his phone, he dialed the number. After a single ring, a message began to play, seeming to be read by a game show host.“Congratulations! You’ve reached Live 95.5 FM’s world-famous Loser Line! Live 95.5; featuring the best entertainment in Seattle! If you’ve reached this message, you have attempted to hit on a girl Way out of your league! That poor young lady wants nothing to do with you, but you just couldn’t help creeping on her! That’s where we come in! Now you know what a loser you really are! So leave the girl alone, loser! You’re doing everyone a favor! If you’d like to leave a message for the world-famous Loser Line, begin speaking at the tone!”Beep!Ken hung up the phone in quiet disbelief. How could he have been so wrong about Jacqueline? They had worked so well together in school, and he even considered her a friend! She always spoke so kindly to him, how could this have happened? Was she really as nasty and shallow as her dumbass brother? Was she really just that good of an actress? As he pondered all this, Ken’s rage finally exploded out of him.“That two-faced bitch! Who the fuck does she think she is?! I trusted her! Hell, she would never have gotten a full scholarship without my help! All I ever did was Like her! And after all that, she doesn’t even have the decency to turn me down to my face?! What The Fucking Hell? At least her brother was honest about his disdain. She’s far worse! I can’t imagine how evil she’d be if a person actually offended her?”Slumping back down onto the park bench, every thought that entered Ken’s mind brought him lower. Jason was an ass, but then again, he didn’t know how to act any different. Uncle Lee was a moron, but then again, he had no malicious intent. But Jacqueline; she was the last straw. He had trusted her, opened up to her, and she repaid him by committing the single most cruel and senseless act Ken could ever imagine. Everything was crashing down around him. As he continued to sulk, Jason’s words entered into his mind once more.“I should just do everyone a favor and drop dead; is that what you want, Jacqueline? Seems like you agree with your brother, or you wouldn’t have given me that number.”Ken reached into his pocket, withdrawing a folding knife. It had been a high school graduation present to him from his grandfather, before he passed a few months later. A far cry from the typical Swiss Army knife, he unfolded the shiny, four-inch blade, which stood in beautiful contrast to the wooden handle. Inscribed in the wood were Ken’s initials. He had not used it for anything yet, never had any need to. As he stared at his reflection in the blade, Ken kept replaying Jason’s cruel words in his mind, to do the world a favor and drop dead.“Maybe that’s not such a bad idea.” Ken mumbled.Just as he took a firm grip on the handle, preparing to take the knife to his throat, an unfamiliar voice came from off to the side.“Hey!”Gabrielle’s Christmas night.Gabrielle Libertine relaxed in a lawn chair, savoring the crisp, cold air of Christmas Eve. This was her favorite time of the year, and being able to enjoy an outdoor showing of her favorite Christmas film, It’s a Wonderful Life, made it even better. It all fit in perfectly with her life philosophy: live for happiness. Not only her own, but as much as could be had for the world around her too.“You want the moon? Just say the word, and I’ll throw a lasso around it and

Miracles can happen on Christmas Eve.Based on a post by auguy86, in 2 parts. Listen to the ► Podcast at My First Time.Ken Dix flipped through the TV guide at a moderate pace; “500 channels, and nothing but Christmas specials on.”Finding nothing but disappointment at every turn. As it was Christmas Eve, every show was a mushy feel-good romp spouting lines about family and goodwill to others. None of that spoke to Ken in the slightest.“Ken?” a voice came from the kitchen.“What’s up, Mom?”“I’ve got my hands full with making everything for dinner tonight, but I’m going to run short on a couple of ingredients,” Helen Dix said, poking her head into the living room. “Can you run to the store real quick for me please?”“Sure thing,” Ken replied, seeing as he had nothing better to do.“Great, thank you. I made a list on the counter for you. The store should be open for another hour or two. The main things would be the eggs; I don’t have enough to finish my famous chess pie. If they have tea by the gallon, grab one sweet and one unsweet. The rest are great if you find them, but not essential.”“Got it,” Ken said as he took the list from the counter.Heading out to his car, Ken cranked up his Honda Civic and pulled out of the driveway. As he made his way into town, Ken reflected on his current situation. Though he loved his mom, being home for the holidays was always nerve-wracking for him. His hometown of Alpharetta, Georgia was crawling with former high school classmates of his, people he’d just as soon never see again. But up at MIT, he was actually among peers that he could relate to on an intellectual level. Not that he’d made that many friends up there. As a nineteen-year-old freshman, he was still stuck in the same boring math and science classes as everyone else. He couldn’t wait until he could start his health sciences training. Maybe then he could meet some decent people, perhaps of the female variety.Ken soon arrived in the parking lot of the local Kroger. It was soon obvious that the place was packed with last-minute shoppers, all trying to find that one final ingredient they were missing. Locking his car, Ken sauntered into the store, grabbing a shopping basket along the way. He found the shelves of the store well picked over, striking out on the nonessential items on his mom’s list. Making his way to the drinks aisle, he was pleased to see that the store was keeping the gallon jugs of tea well stocked for the holidays, and picked up a pair.Ken soon arrived in the refrigerated section of the store. Almost every shelf was empty, but he did manage to find one last carton of six eggs, just what his mom needed. Depositing the carton in his shopping basket, Ken made his way back to the front of the store, checking out in the express lane. He gripped the shopping bags tightly, being careful that the eggs weren’t harmed from the swinging of the bags. Arriving back in the parking lot, he was pleasantly surprised to see one of his former classmates, Jacqueline Brown. As he approached, she saw him coming.“Ken? Kenneth Dix?”She was extremely pretty, as was befitting one of the most popular girls in school, and kept her chestnut-brown hair cut just below her jawline. Her soft, warm facial features and bubbly personality belied the sharp intellect hiding underneath. She and Ken had been partners a few times in various subjects, and he had helped craft her entrance essay to the University of Washington. This earned her a full ride scholarship. In spite of her popularity, they had worked well together, and Ken even dared to call her a friend, at least in his own mind. They had never hung out on a social basis; her circle of friends would never have let her live that down. Still, times had changed. They were both out of high school, after all. What could it hurt to ask?“Jacqueline? Wow, I never thought I’d see you back here. Thought you escaped to cooler climates?”“Yeah, Seattle is nice, but nothing beats Christmas at home,” she replied, adjusting her UW sweatshirt. “You back for the same reason?”“Uh huh. Mom pretty much insisted. She won’t settle for anything less than a full family gathering on Christmas Eve. I’m just grabbing a few last things for her. But yeah, it’s great seeing you again. You, uh, you look good.”“Um; thanks,” she replied with hesitation.“I’m, uh, gonna be home for a couple of weeks. Would you want to, I don’t know, hang out sometime? Maybe grab a bite to eat? My treat.”“Well, Ken, that’s sweet of you to ask.” she said almost to herself. As she paused, her eyes suddenly lit up as if she had gotten an idea. “Alright! Here, let me give you my number.” She scribbled a series of digits down on a scrap piece of paper, writing her name next to them. “I’ll, um, talk to you later, I guess?”“Sounds great!”Ken couldn’t believe it; he had actually done it! He had asked out the prettiest girl he had ever known! Moreover, she had given him her number! Things were definitely looking up.“Dick!” a voice behind them yelled.Ken turned, immediately recognizing Jason Brown, Jacqueline’s fraternal twin brother, along with his two flunkies, Brian and Barrett Sullivan. Jason had been the star quarterback at his high school, and the Sullivan boys were his best offensive linemen. They often served as his muscle off the football field, as well. Ken was intimately familiar with these three, as they had made it their mission in high school to make his life a living hell. Being stuffed in lockers, having his wallet stolen, all were commonplace with them. The three approached, attempting to appear imposing, which they were from the perspective of the ever-scrawny Ken.“I’ve got nothing to say to you guys,” Ken muttered as they approached.“Well I’ve got something to say to you, Mr. Kenny Dick,” Jason growled.“Just shut up and leave me alone,” Ken replied, his blood boiling at the use of Jason’s longtime nickname for him.“No! You shut the fuck up and listen!” Jason said, grabbing Ken by the collar of his tee-shirt and flinging him against his car. In the process, Ken dropped his shopping bags, the jugs of tea landing directly on the egg carton.“Jason! Stop it!” Jacqueline protested.Undeterred, Jason threatened. “Listen fuck-wad, you stay the hell away from my sister!”“She’s an adult, dickhead! She can have anyone she wants as a friend!” Ken protested.“You don’t belong on the same Planet as her! You’re nothing’! A pathetic sack of guts your dumbass mother decided to give a name to! Know what? Just do us all a favor and drop dead!”Enraged at the insult to his mom, Ken swung a wild haymaker at his assailant, but Jason was more than ready, pinning Ken’s arm back against his car. Jason then delivered a crushing punch to Ken’s gut, dropping him down to his knees. Before leaving, Jason knelt down next to his gasping victim.“Next time, I won’t be so nice. Next time; I might just kill you myself. See ya around. Dick.” Turning to his sister, Jason said, “Come on, time to go home.”Jacqueline looked down at the pitiful form of Ken before muttering, “Sorry, Ken.”The trio of boys sauntered off across the parking lot, laughing and high-fiving at their antics. Jacqueline followed right behind them. Ken picked himself up and inspected his groceries, discovering the crushed eggs in his bag. Swearing and cursing, he grabbed the misshapen carton and went to throw it in a nearby trash can.“No chess pie tonight.”As Ken returned to his car and began his drive home, Jason and his flunkies watched on from his car, still pleased with their efforts.“You shouldn’t have done that,” Jacqueline said in a lecturing tone.Jason turned to face his sister. “I do what I gotta do, Jacqueline. That fuck-wad has no business getting friendly with you. He needs to learn his place.”“Be that as it may, I can take care of myself,” she replied firmly.“Take care of yourself? Wait; you didn’t?”“I did. Jason, someday you’ll learn that there are more subtle and effective ways to ward off undesirables. Trust me, Ken won’t bother me ever again.”Back at Home.Upon arriving back home, Ken couldn’t bring himself to tell his mom about the incident with the eggs. He instead told her that the store had run out altogether. She had spent many sleepless nights in the past worrying about the constant bullying her son was subjected to in school. Ken didn’t want to give her anything else to worry about. By this time, has uncles had started arriving, and the living room was soon filled with the sounds of football games. In Ken’s mind, these were no more thought provoking that the mindless Christmas specials he had found earlier. Ken went up to his room to take a hot shower, as well as get some alone time in the process. As he stripped down, he saw a bruise beginning to form on his stomach from Jason’s punch. He winced in pain as he touched the tender skin.Shit; that’s not going away for a while.Ken took some Tylenol for the pain before stepping into the shower. The hot water helped relax his body, and the steam gradually built up, clearing his mind a bit. He finished after a while and, after making sure his door was shut, flopped facedown onto his bed. After laying there for around an hour or so, his mom finally called him down to rejoin the family for dinner.Taking his seat at the table, Ken glanced around the room at his various family members. His mom had two older brothers, Lee and Stan. Though Lee was tall and still relatively youthful looking at forty-five, Stan was shorter and beginning to bald as he approached fifty. Still, both of them had one notable thing in common as far as Ken was concerned: they were both still jocks at heart. Ken had never known his father; it had always just been him and his mom. He could tell that his uncles tried to be male role models for him, but their efforts were usually ill-conceived attempts to “man him up.” Never once did they understand his introverted tendencies, and always tried to get him to be more of a people person. After a while, Ken stopped paying their advice any attention.It was striking to Ken how similar Lee and Stan’s families were. They had both married beautiful, blonde cheerleaders, and now both had sixteen-year-old daughters, both of whom were among the most popular girls in school. It all sickened Ken; they were just perpetuating the stereotype of pretty and popular being the be-all, end-all in life. As the family ate, Ken remained silent for the most part. The adults were engrossed in discussions about their jobs, and the two daughters were giggling and playing on their phones the entire time. None of this was relevant to Ken.“You know, I saw something interesting today,” Lee said as dessert was being brought out. “I was at Kroger filling up my car, and saw you in the main parking lot, Ken. Looked like you were, uh, having some words with a few guys out there.”Shit! He saw that?Not wanting to worry his mom, Ken replied, “It; it was nothing.”“Nothing, eh? Is that why that punk punched you in the gut?”With a worried look on her face, Helen asked, “Ken, sweetie, what is he talking about?” She walked around the table to Ken’s seat and lifted up his shirt, seeing the bruise on his abdomen. “Was it that Jason boy again?”“Mom, just let it go.”“No! Ken, you know I worry about you!”“You worry about Me? I think you need to worry more about your brother!” Ken shouted, his anger exploding at last. “Right, Uncle Lee? Come on, you see your own nephew being ganged up on in a parking lot, yet you do nothing to help him out?!”“A man’s gotta learn to fight his own battles,” Lee replied in a calm voice.“No. You want to know what a man does? A man sticks up for his Family! No. Matter. What! You stood there and watched your own nephew get beaten up. That says a hell of a lot more about you than it does me. And if that’s family; I don’t want any part of this one.”Without a word, Ken stood and left the dining room. He then grabbed his MIT hoodie and headed for the front door. As he was about to get into his car and drive off, he saw to his frustration that his uncles’ cars were parked in the driveway behind him, blocking him in. Cursing under his breath, he prepared to leave on foot.“Ken! Come back inside, please!” Helen called after him, running down the driveway.“No. I’ve got to go out; clear my head.”“Ken, it’s Christmas Eve. Please, come be with your family.”“Mom, aside from you, not a single person in that house feels like family to me,” Ken replied coldly. “I’ll; I’ll call you after while.”Ken walked off into the cold Georgia night, not knowing for sure where to go or what to do. Nobody else was out, as they were all at home with their families. Remembering the square in historic downtown Alpharetta, he decided to head in that direction. Maybe the quiet walk would do him some good.Arriving in the town square, Ken walked along the sidewalks for a bit, peering into the darkened windows of the various shops and restaurants. Everything looked so different to him with everyone gone for the day; it all seemed so peaceful. As he continued to walk, he soon saw City Hall in the distance. In front of the building was a large green space, which was teeming with a surprising amount of activity for it being Christmas Eve. Ken moved closer, now spying a large gathering of people sitting on picnic blankets, all bundled up in coats and hats. Ahead of them, a large screen projected the classic film, It’s a Wonderful Life.Though Ken was never into the Christmas cheer, as it were, he felt strangely drawn to watch a few minutes of the film from a distance. He soon began to regret that decision, as the movie had reached the point where George Baily had an arrest warrant out for him, lashing out at his family in anger. Watching him get drunk and punched in a bar fight, Ken began to feel sick with anger. Despite all his efforts to help better the world around him, the universe conspired against George Baily; just as it seemed to be conspiring against Ken. Unable to watch a moment more, he turned and walked into the nearby park.Again alone with his thoughts, Ken sat on a bench near the fountain in the center of the park. He contemplated many things, as he often did in solitude. He thought about his piss poor excuse for a family, intent on changing him into what they say he should be. If only they could love him as he is. He thought about Jason Brown, a perpetual asshole that managed to get all the beautiful women his heart desired. If only the universe would serve up his just desserts, rather than conspiring against Ken. Sighing in frustration, he stuffed his freezing hands into his jeans pockets.Jacqueline!Feeling the scrap of paper still in his pocket, Ken suddenly felt a glimmer of hope in an otherwise dreary day. He needed something, anything to lift his spirits, and hearing her kind, sweet voice might just do it. Hell, he didn’t even care anymore if she was interested in him in a romantic sense; he just needed someone to listen and understand him. Digging out his phone, he dialed the number. After a single ring, a message began to play, seeming to be read by a game show host.“Congratulations! You’ve reached Live 95.5 FM’s world-famous Loser Line! Live 95.5; featuring the best entertainment in Seattle! If you’ve reached this message, you have attempted to hit on a girl Way out of your league! That poor young lady wants nothing to do with you, but you just couldn’t help creeping on her! That’s where we come in! Now you know what a loser you really are! So leave the girl alone, loser! You’re doing everyone a favor! If you’d like to leave a message for the world-famous Loser Line, begin speaking at the tone!”Beep!Ken hung up the phone in quiet disbelief. How could he have been so wrong about Jacqueline? They had worked so well together in school, and he even considered her a friend! She always spoke so kindly to him, how could this have happened? Was she really as nasty and shallow as her dumbass brother? Was she really just that good of an actress? As he pondered all this, Ken’s rage finally exploded out of him.“That two-faced bitch! Who the fuck does she think she is?! I trusted her! Hell, she would never have gotten a full scholarship without my help! All I ever did was Like her! And after all that, she doesn’t even have the decency to turn me down to my face?! What The Fucking Hell? At least her brother was honest about his disdain. She’s far worse! I can’t imagine how evil she’d be if a person actually offended her?”Slumping back down onto the park bench, every thought that entered Ken’s mind brought him lower. Jason was an ass, but then again, he didn’t know how to act any different. Uncle Lee was a moron, but then again, he had no malicious intent. But Jacqueline; she was the last straw. He had trusted her, opened up to her, and she repaid him by committing the single most cruel and senseless act Ken could ever imagine. Everything was crashing down around him. As he continued to sulk, Jason’s words entered into his mind once more.“I should just do everyone a favor and drop dead; is that what you want, Jacqueline? Seems like you agree with your brother, or you wouldn’t have given me that number.”Ken reached into his pocket, withdrawing a folding knife. It had been a high school graduation present to him from his grandfather, before he passed a few months later. A far cry from the typical Swiss Army knife, he unfolded the shiny, four-inch blade, which stood in beautiful contrast to the wooden handle. Inscribed in the wood were Ken’s initials. He had not used it for anything yet, never had any need to. As he stared at his reflection in the blade, Ken kept replaying Jason’s cruel words in his mind, to do the world a favor and drop dead.“Maybe that’s not such a bad idea.” Ken mumbled.Just as he took a firm grip on the handle, preparing to take the knife to his throat, an unfamiliar voice came from off to the side.“Hey!”Gabrielle’s Christmas night.Gabrielle Libertine relaxed in a lawn chair, savoring the crisp, cold air of Christmas Eve. This was her favorite time of the year, and being able to enjoy an outdoor showing of her favorite Christmas film, It’s a Wonderful Life, made it even better. It all fit in perfectly with her life philosophy: live for happiness. Not only her own, but as much as could be had for the world around her too.“You want the moon? Just say the word, and I’ll throw a lasso around it and

Miracles can happen on Christmas Eve.Based on a post by auguy86, in 2 parts. Listen to the ► Podcast at My First Time.Ken Dix flipped through the TV guide at a moderate pace; “500 channels, and nothing but Christmas specials on.”Finding nothing but disappointment at every turn. As it was Christmas Eve, every show was a mushy feel-good romp spouting lines about family and goodwill to others. None of that spoke to Ken in the slightest.“Ken?” a voice came from the kitchen.“What’s up, Mom?”“I’ve got my hands full with making everything for dinner tonight, but I’m going to run short on a couple of ingredients,” Helen Dix said, poking her head into the living room. “Can you run to the store real quick for me please?”“Sure thing,” Ken replied, seeing as he had nothing better to do.“Great, thank you. I made a list on the counter for you. The store should be open for another hour or two. The main things would be the eggs; I don’t have enough to finish my famous chess pie. If they have tea by the gallon, grab one sweet and one unsweet. The rest are great if you find them, but not essential.”“Got it,” Ken said as he took the list from the counter.Heading out to his car, Ken cranked up his Honda Civic and pulled out of the driveway. As he made his way into town, Ken reflected on his current situation. Though he loved his mom, being home for the holidays was always nerve-wracking for him. His hometown of Alpharetta, Georgia was crawling with former high school classmates of his, people he’d just as soon never see again. But up at MIT, he was actually among peers that he could relate to on an intellectual level. Not that he’d made that many friends up there. As a nineteen-year-old freshman, he was still stuck in the same boring math and science classes as everyone else. He couldn’t wait until he could start his health sciences training. Maybe then he could meet some decent people, perhaps of the female variety.Ken soon arrived in the parking lot of the local Kroger. It was soon obvious that the place was packed with last-minute shoppers, all trying to find that one final ingredient they were missing. Locking his car, Ken sauntered into the store, grabbing a shopping basket along the way. He found the shelves of the store well picked over, striking out on the nonessential items on his mom’s list. Making his way to the drinks aisle, he was pleased to see that the store was keeping the gallon jugs of tea well stocked for the holidays, and picked up a pair.Ken soon arrived in the refrigerated section of the store. Almost every shelf was empty, but he did manage to find one last carton of six eggs, just what his mom needed. Depositing the carton in his shopping basket, Ken made his way back to the front of the store, checking out in the express lane. He gripped the shopping bags tightly, being careful that the eggs weren’t harmed from the swinging of the bags. Arriving back in the parking lot, he was pleasantly surprised to see one of his former classmates, Jacqueline Brown. As he approached, she saw him coming.“Ken? Kenneth Dix?”She was extremely pretty, as was befitting one of the most popular girls in school, and kept her chestnut-brown hair cut just below her jawline. Her soft, warm facial features and bubbly personality belied the sharp intellect hiding underneath. She and Ken had been partners a few times in various subjects, and he had helped craft her entrance essay to the University of Washington. This earned her a full ride scholarship. In spite of her popularity, they had worked well together, and Ken even dared to call her a friend, at least in his own mind. They had never hung out on a social basis; her circle of friends would never have let her live that down. Still, times had changed. They were both out of high school, after all. What could it hurt to ask?“Jacqueline? Wow, I never thought I’d see you back here. Thought you escaped to cooler climates?”“Yeah, Seattle is nice, but nothing beats Christmas at home,” she replied, adjusting her UW sweatshirt. “You back for the same reason?”“Uh huh. Mom pretty much insisted. She won’t settle for anything less than a full family gathering on Christmas Eve. I’m just grabbing a few last things for her. But yeah, it’s great seeing you again. You, uh, you look good.”“Um; thanks,” she replied with hesitation.“I’m, uh, gonna be home for a couple of weeks. Would you want to, I don’t know, hang out sometime? Maybe grab a bite to eat? My treat.”“Well, Ken, that’s sweet of you to ask.” she said almost to herself. As she paused, her eyes suddenly lit up as if she had gotten an idea. “Alright! Here, let me give you my number.” She scribbled a series of digits down on a scrap piece of paper, writing her name next to them. “I’ll, um, talk to you later, I guess?”“Sounds great!”Ken couldn’t believe it; he had actually done it! He had asked out the prettiest girl he had ever known! Moreover, she had given him her number! Things were definitely looking up.“Dick!” a voice behind them yelled.Ken turned, immediately recognizing Jason Brown, Jacqueline’s fraternal twin brother, along with his two flunkies, Brian and Barrett Sullivan. Jason had been the star quarterback at his high school, and the Sullivan boys were his best offensive linemen. They often served as his muscle off the football field, as well. Ken was intimately familiar with these three, as they had made it their mission in high school to make his life a living hell. Being stuffed in lockers, having his wallet stolen, all were commonplace with them. The three approached, attempting to appear imposing, which they were from the perspective of the ever-scrawny Ken.“I’ve got nothing to say to you guys,” Ken muttered as they approached.“Well I’ve got something to say to you, Mr. Kenny Dick,” Jason growled.“Just shut up and leave me alone,” Ken replied, his blood boiling at the use of Jason’s longtime nickname for him.“No! You shut the fuck up and listen!” Jason said, grabbing Ken by the collar of his tee-shirt and flinging him against his car. In the process, Ken dropped his shopping bags, the jugs of tea landing directly on the egg carton.“Jason! Stop it!” Jacqueline protested.Undeterred, Jason threatened. “Listen fuck-wad, you stay the hell away from my sister!”“She’s an adult, dickhead! She can have anyone she wants as a friend!” Ken protested.“You don’t belong on the same Planet as her! You’re nothing’! A pathetic sack of guts your dumbass mother decided to give a name to! Know what? Just do us all a favor and drop dead!”Enraged at the insult to his mom, Ken swung a wild haymaker at his assailant, but Jason was more than ready, pinning Ken’s arm back against his car. Jason then delivered a crushing punch to Ken’s gut, dropping him down to his knees. Before leaving, Jason knelt down next to his gasping victim.“Next time, I won’t be so nice. Next time; I might just kill you myself. See ya around. Dick.” Turning to his sister, Jason said, “Come on, time to go home.”Jacqueline looked down at the pitiful form of Ken before muttering, “Sorry, Ken.”The trio of boys sauntered off across the parking lot, laughing and high-fiving at their antics. Jacqueline followed right behind them. Ken picked himself up and inspected his groceries, discovering the crushed eggs in his bag. Swearing and cursing, he grabbed the misshapen carton and went to throw it in a nearby trash can.“No chess pie tonight.”As Ken returned to his car and began his drive home, Jason and his flunkies watched on from his car, still pleased with their efforts.“You shouldn’t have done that,” Jacqueline said in a lecturing tone.Jason turned to face his sister. “I do what I gotta do, Jacqueline. That fuck-wad has no business getting friendly with you. He needs to learn his place.”“Be that as it may, I can take care of myself,” she replied firmly.“Take care of yourself? Wait; you didn’t?”“I did. Jason, someday you’ll learn that there are more subtle and effective ways to ward off undesirables. Trust me, Ken won’t bother me ever again.”Back at Home.Upon arriving back home, Ken couldn’t bring himself to tell his mom about the incident with the eggs. He instead told her that the store had run out altogether. She had spent many sleepless nights in the past worrying about the constant bullying her son was subjected to in school. Ken didn’t want to give her anything else to worry about. By this time, has uncles had started arriving, and the living room was soon filled with the sounds of football games. In Ken’s mind, these were no more thought provoking that the mindless Christmas specials he had found earlier. Ken went up to his room to take a hot shower, as well as get some alone time in the process. As he stripped down, he saw a bruise beginning to form on his stomach from Jason’s punch. He winced in pain as he touched the tender skin.Shit; that’s not going away for a while.Ken took some Tylenol for the pain before stepping into the shower. The hot water helped relax his body, and the steam gradually built up, clearing his mind a bit. He finished after a while and, after making sure his door was shut, flopped facedown onto his bed. After laying there for around an hour or so, his mom finally called him down to rejoin the family for dinner.Taking his seat at the table, Ken glanced around the room at his various family members. His mom had two older brothers, Lee and Stan. Though Lee was tall and still relatively youthful looking at forty-five, Stan was shorter and beginning to bald as he approached fifty. Still, both of them had one notable thing in common as far as Ken was concerned: they were both still jocks at heart. Ken had never known his father; it had always just been him and his mom. He could tell that his uncles tried to be male role models for him, but their efforts were usually ill-conceived attempts to “man him up.” Never once did they understand his introverted tendencies, and always tried to get him to be more of a people person. After a while, Ken stopped paying their advice any attention.It was striking to Ken how similar Lee and Stan’s families were. They had both married beautiful, blonde cheerleaders, and now both had sixteen-year-old daughters, both of whom were among the most popular girls in school. It all sickened Ken; they were just perpetuating the stereotype of pretty and popular being the be-all, end-all in life. As the family ate, Ken remained silent for the most part. The adults were engrossed in discussions about their jobs, and the two daughters were giggling and playing on their phones the entire time. None of this was relevant to Ken.“You know, I saw something interesting today,” Lee said as dessert was being brought out. “I was at Kroger filling up my car, and saw you in the main parking lot, Ken. Looked like you were, uh, having some words with a few guys out there.”Shit! He saw that?Not wanting to worry his mom, Ken replied, “It; it was nothing.”“Nothing, eh? Is that why that punk punched you in the gut?”With a worried look on her face, Helen asked, “Ken, sweetie, what is he talking about?” She walked around the table to Ken’s seat and lifted up his shirt, seeing the bruise on his abdomen. “Was it that Jason boy again?”“Mom, just let it go.”“No! Ken, you know I worry about you!”“You worry about Me? I think you need to worry more about your brother!” Ken shouted, his anger exploding at last. “Right, Uncle Lee? Come on, you see your own nephew being ganged up on in a parking lot, yet you do nothing to help him out?!”“A man’s gotta learn to fight his own battles,” Lee replied in a calm voice.“No. You want to know what a man does? A man sticks up for his Family! No. Matter. What! You stood there and watched your own nephew get beaten up. That says a hell of a lot more about you than it does me. And if that’s family; I don’t want any part of this one.”Without a word, Ken stood and left the dining room. He then grabbed his MIT hoodie and headed for the front door. As he was about to get into his car and drive off, he saw to his frustration that his uncles’ cars were parked in the driveway behind him, blocking him in. Cursing under his breath, he prepared to leave on foot.“Ken! Come back inside, please!” Helen called after him, running down the driveway.“No. I’ve got to go out; clear my head.”“Ken, it’s Christmas Eve. Please, come be with your family.”“Mom, aside from you, not a single person in that house feels like family to me,” Ken replied coldly. “I’ll; I’ll call you after while.”Ken walked off into the cold Georgia night, not knowing for sure where to go or what to do. Nobody else was out, as they were all at home with their families. Remembering the square in historic downtown Alpharetta, he decided to head in that direction. Maybe the quiet walk would do him some good.Arriving in the town square, Ken walked along the sidewalks for a bit, peering into the darkened windows of the various shops and restaurants. Everything looked so different to him with everyone gone for the day; it all seemed so peaceful. As he continued to walk, he soon saw City Hall in the distance. In front of the building was a large green space, which was teeming with a surprising amount of activity for it being Christmas Eve. Ken moved closer, now spying a large gathering of people sitting on picnic blankets, all bundled up in coats and hats. Ahead of them, a large screen projected the classic film, It’s a Wonderful Life.Though Ken was never into the Christmas cheer, as it were, he felt strangely drawn to watch a few minutes of the film from a distance. He soon began to regret that decision, as the movie had reached the point where George Baily had an arrest warrant out for him, lashing out at his family in anger. Watching him get drunk and punched in a bar fight, Ken began to feel sick with anger. Despite all his efforts to help better the world around him, the universe conspired against George Baily; just as it seemed to be conspiring against Ken. Unable to watch a moment more, he turned and walked into the nearby park.Again alone with his thoughts, Ken sat on a bench near the fountain in the center of the park. He contemplated many things, as he often did in solitude. He thought about his piss poor excuse for a family, intent on changing him into what they say he should be. If only they could love him as he is. He thought about Jason Brown, a perpetual asshole that managed to get all the beautiful women his heart desired. If only the universe would serve up his just desserts, rather than conspiring against Ken. Sighing in frustration, he stuffed his freezing hands into his jeans pockets.Jacqueline!Feeling the scrap of paper still in his pocket, Ken suddenly felt a glimmer of hope in an otherwise dreary day. He needed something, anything to lift his spirits, and hearing her kind, sweet voice might just do it. Hell, he didn’t even care anymore if she was interested in him in a romantic sense; he just needed someone to listen and understand him. Digging out his phone, he dialed the number. After a single ring, a message began to play, seeming to be read by a game show host.“Congratulations! You’ve reached Live 95.5 FM’s world-famous Loser Line! Live 95.5; featuring the best entertainment in Seattle! If you’ve reached this message, you have attempted to hit on a girl Way out of your league! That poor young lady wants nothing to do with you, but you just couldn’t help creeping on her! That’s where we come in! Now you know what a loser you really are! So leave the girl alone, loser! You’re doing everyone a favor! If you’d like to leave a message for the world-famous Loser Line, begin speaking at the tone!”Beep!Ken hung up the phone in quiet disbelief. How could he have been so wrong about Jacqueline? They had worked so well together in school, and he even considered her a friend! She always spoke so kindly to him, how could this have happened? Was she really as nasty and shallow as her dumbass brother? Was she really just that good of an actress? As he pondered all this, Ken’s rage finally exploded out of him.“That two-faced bitch! Who the fuck does she think she is?! I trusted her! Hell, she would never have gotten a full scholarship without my help! All I ever did was Like her! And after all that, she doesn’t even have the decency to turn me down to my face?! What The Fucking Hell? At least her brother was honest about his disdain. She’s far worse! I can’t imagine how evil she’d be if a person actually offended her?”Slumping back down onto the park bench, every thought that entered Ken’s mind brought him lower. Jason was an ass, but then again, he didn’t know how to act any different. Uncle Lee was a moron, but then again, he had no malicious intent. But Jacqueline; she was the last straw. He had trusted her, opened up to her, and she repaid him by committing the single most cruel and senseless act Ken could ever imagine. Everything was crashing down around him. As he continued to sulk, Jason’s words entered into his mind once more.“I should just do everyone a favor and drop dead; is that what you want, Jacqueline? Seems like you agree with your brother, or you wouldn’t have given me that number.”Ken reached into his pocket, withdrawing a folding knife. It had been a high school graduation present to him from his grandfather, before he passed a few months later. A far cry from the typical Swiss Army knife, he unfolded the shiny, four-inch blade, which stood in beautiful contrast to the wooden handle. Inscribed in the wood were Ken’s initials. He had not used it for anything yet, never had any need to. As he stared at his reflection in the blade, Ken kept replaying Jason’s cruel words in his mind, to do the world a favor and drop dead.“Maybe that’s not such a bad idea.” Ken mumbled.Just as he took a firm grip on the handle, preparing to take the knife to his throat, an unfamiliar voice came from off to the side.“Hey!”Gabrielle’s Christmas night.Gabrielle Libertine relaxed in a lawn chair, savoring the crisp, cold air of Christmas Eve. This was her favorite time of the year, and being able to enjoy an outdoor showing of her favorite Christmas film, It’s a Wonderful Life, made it even better. It all fit in perfectly with her life philosophy: live for happiness. Not only her own, but as much as could be had for the world around her too.“You want the moon? Just say the word, and I’ll throw a lasso around it and

Kiera is joined by the tooth-healer himself, Jason Dent! Jason has an extensive background in pharmacy, and shares with Kiera where his pharmaceutical experience has bled over into dentistry. This includes the difference between anti-quag and anti-platelet and which medications are probably safe, what to do to shorten the drag time in the pharmacy, how to write prescriptions most efficiently, and more. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:00) Hello, Dental A Team listeners. This is Kiera and today is a really awesome and unique day. It is, think the second time I've had somebody in the podcast studio with me live for a podcast and it's the one and only Jason Dent. Jason, how are you? I'm doing well. Good morning. Thanks for having me. It is crazy. I I watch Instagram real like this all the time where people are like in the podcast and they're hanging out on two chairs and couches and now look at us. We're doing it. Cheers. Cheers.   That was a mic cheer for those of you who are only listening, but yeah, Jace, how does this feel to be on the podcast? It's weird. Like I was not nervous at all talking about it. I got really nervous as soon as you hit play. So if I stumble over my words, please forgive me ahead of time. Well, Jason, I appreciate you being on the podcast because marketing had asked me to do a topic about teledentistry and I was like, oh shoot, that's like not my forte at all. so   You and I were actually chatting in the hot tub. call it Think Tank session and you and I, we have a lot of good ideas that come from that Think Tank. A lot of business. no phones. That's why. We do leave our phones out. But I was talking to Jason and this is actually a podcast we had talked about quite a while ago. Jason has a lot of information on pharmacy. And if you don't know, Jason isn't really, we were going through all of it last night. It's kind of a mock in the tub. And I think it's going to be great because I feel like this is an area, I'm working at Midwestern and   knowing about how dentists, pharmacology was surely not your favorite one. Jason actually helps a lot of dentists with their clearances. And so we were talking about it and I like it will just be a really awesome podcast for you guys to brush up on pharmacology, different things from a pharmacist's side. So Jason, welcome. Thank you. Yeah, no, we were talking about it and here's like, what should I talk about on the podcast next? I have all these different topics and she's like, what do you know? And the only real interaction I have with dentists is doing clearances for procedures. We get them all the time, which makes sense.   Lots of people are on blood thinner, I've always told Kiera, like, hey, I could talk about that. Like, that's kind of a passion of mine. I'm not a dentist. Or my name is Jason Dent. So in Hebrew, Jason means tooth. No, no, no, sorry. Nerves are getting to me. Jason means healer and Dent means tooth. So my name means tooth healer. So, here's a little set. Hold on, on, hold Can we just talk about? I brought that up before you could talk about it more. So.   My name means tooth healer but I did not become a dentist. I know you wanted me to become a dentist. did. I don't know why. I enjoy medicine. I know what you're going to get to already. The things you're going to ask me. There's been years of this. But nevertheless, that's my name. We'll get that out of the way. But you did give me a great last name. So I mean, it's OK. You're All is fair and love here. SEO's up for that. But yeah, Jason, I'm going to get you right into the show. And I'm going to be the host. And we're going to welcome to the podcast show. Jace, how are you?   Good, good, good. Good, good, good. So by getting into clearances, right? This is what you're kinda talking about with you know, before we get to clearances, I actually wanted Jason, for the listeners who don't know you, who haven't talked to you, who don't know, let's kinda just give them like, how did you go from, Kiera wanted you to be a dentist, to now Jason, you are on the podcast talking as our expert on pharmacy. fantastic. I've always really loved medicine, a ton. As a kid getting headaches and taking Excedrin, like you just feel like a miserable pile of crap.   and then you take two pills and all of a sudden you feel better. Like that's amazing, like how does that happen? Also getting ear aches as a kid, just being in so much pain and then taking some medicine and you start feeling a lot better. I always had a lot of appreciation for that. I've always been mechanically inclined. I went to, started doing my undergrad and took biology and learned about ATP synthase, which is a spinning enzyme that's inside the mitochondria, like a turbine engine. I used to work on small engines on my dirt bike and thought that is so cool. So I really got wrapped up into chemistry.   All the mechanics of chemistry really pulled me in. I'm not getting goosebumps. checking. I usually get goosebumps when I think about chemistry. But it's so cool. You think an engine's awesome, like pistons and camshafts and pressures, the cell is the same thing. It's not as loud, so it's not as cool. But it's fascinating. that's why we're like. ⁓   chemistry and really got into coagulation. So I did my residency after pharmacy school. we went to Arizona for three years. ⁓ You did and your main focus, you were never wanting to be the guy behind the counter. No, I haven't done that. Yeah. No, I love them though. I've always really want to go clinical. ⁓ But I love my retail ⁓ pharmacists. They're amazing resources. And ⁓ I use the retail pharmacist every day still to this day, but I went more the clinical route, really love the chemistry aspect of it.   did my doctorate degree and then I did my residency in Reno. Reno's kind That's how we got here everybody. Welcome to Reno. Strategically placed because I was really interested in critical medicine and where we're located we cover a huge area. So we pull in to almost clear, we go clear to Utah, clear to California, all of Northern Nevada. We get cases from all over. So we actually are kind like the first hub of care for lot of areas. So we really get an eclectic mixture of patients that come in that need-   all kinds of different cases that are coming to them. So it's what I really wanted. So I did my residency in critical care there. And then for the next 10 years, I worked in vascular medicine with my final five years being the supervisor of the clinic. Ran all the ins and outs of that. So my providers, two doctors were on our view. So when we talk about dentistry, talk about production, those kinds of things, totally get it. My doctors were the exact same way, my vascular providers. ⁓   There's some pains there, right? You wanna be seeing patients as much as possible, being able to help as many people, keeping the billing up. And had other nurse practitioners, four practitioners, a fleet of MAs, eight pharmacists. We also had that one location we had, going off the top of my head, I think we had eight locations running as well. And we took care of all the different kinds of vascular cases that came to us. Most common was blood clots, ⁓ which is just a...   which is an easier way of saying VTE. There's so many different ways to say a blood clot. Like you might hear patients say, I've had a PE or a DVT or a venous thromboembolism or a clot in my leg, right? They're all clots, but in different locations. Same with an MI, and MI can be a clot as well. ⁓ there's a lot of, everybody's kind of saying the same thing, but sometimes the nomenclature can make it sound hard, but it really is actually pretty simple.   No. And Jason, I love that you went through, you've been in like, and even in your, ⁓ when you were getting your doctorate, you were in the ER. You also worked in retail pharmacy. remember you having a little sticker on your hand. And retail pharmacy, I have a lot of respect for those guys. They have a lot of pressure on them. and then you also, ⁓ what was that test that you had to take that? I don't know. You were like studying forever for it. ⁓ board certification for, ⁓ NABP. Yeah. So I did that board certification as well.   And now you've moved out of the hospital side onto another section in your career. Now in the insurance, right? So it's really, really interesting. So now I'm on the other side reading notes and evaluating clinical appropriateness and trying to help patients with getting coverage and making those kinds of determinations. So yeah, I've really jumped all over. Really love my clinical days. I know. don't I don't I do miss them. But yeah, kind of had a good exposure to a lot of.   pharmacy a lot a lot of dentists actually with all the places that come through which Jason I really appreciate that and honestly I know you are my spouse and so it's fun to have you on but when I go into conversations like this I don't know any of this information and so finding experts and Jason I think here's me talk more about dentistry and my business than I do hear about him on pharmacy so as we were chatting about this I really realized you are a wealth of knowledge because you've been on the clinical side so you've done a lot of patient care and you've seen how   medications interact and I know you've had a few scares in your career and ⁓ you've known some physicians that have had a few scares and ⁓ you've seen plenty of patients pass away working in the ER and gosh in Arizona drownings were such a big deal. I remember when you were in the ER on your rotations I'd be like who died today? Like tell me the stories and you've really seen and now going on to the insurance side I felt like you could just be such a good wealth of knowledge because I know dentists are sometimes so   I would say like maybe just a little more anxious when it comes to medications. I know that dental students from Midwestern were like here was like four months and we had to like pass it, learn it. And Jason, you've done four years plus clinical residency, plus you've been in it. And something I really love about Nevada Medicine is they've been so collaborative with you.   like your heart, your cardiologist, they diagnose and then they send to you to treat with medicine and... Yeah, I've been really lucky being here in Reno too. The cardiology team has been amazing to work with. We started a CHF program, sorry, congestive heart failure program for patients. So we would collaborate with cardiologists. They'd see the cardiologists and then they send them to the pharmacist to really manage all the medications. So there's pillars of therapy ⁓ called guideline directed medical therapy and the pharmacist would take care of all that. So that's gonna be your...   your beta blockers, your ACEs, your ARBs, your Entresto, which would be a little bit better, spironolactone. So just making sure that all these things are dosed appropriately, really monitoring the heart, and make sure that patients are getting better. we've had real positive outcomes when the, sorry, this is totally off topic. do, talk about that study. When we looked at when patients were coming to see our pharmacists in our clinic that we started up, the patients were half as likely to be readmitted. And this was in 2018, and our pharmacists,   We're thinking about all the medications. We're usually adjusting diabetes medications too at the same time. Just kind of naturally just taking care of all the medications because we kind of got a go ahead from the providers, a collaborative practice agreement that we could make adjustments to certain medications within certain parameters. So we weren't going rogue or maverick, but we were definitely trying to optimize our medications as much as possible. And then years later, some studies came out with, I'm sure you've seen Jardins and Farseegh. not trying to, I'm not.   I don't get any kickback from them. I have no conflicts to share. But because our pharmacists were really optimizing that medication, those medications were later shown to reduce hospitalizations and heart failure, even though they're diabetes medications. Fascinating. So it wasn't really the pharmacists. It was just the pharmacists doing as much as they can with all the tools that were in front of them. And then we found out that the patients were going back to the hospital.   half as much as regular patients. So, yeah, being here, it's been so amazing to work with providers here. the providers here want help, want to help patients, don't have an ego. I mean, I just, it's awesome. I love it. I do love how much I think Jason sees me geek out about dentistry and I watching Jay's geek about his pharmacy and how much he loves helping patients. And ⁓ really that was the whole idea of, all right.   Dentistry has pharmacy as a part of it. And I know a lot of dentists are sending in clearances and I know working in a chair side, it would be like, oh no, if they're on warfarin or on their own blood clot, you guys, honestly don't even know half of what I'm talking about because this is not my jam, which is why Jason's here. But I do know that there was always like, well, we got to talk with their provider. And so having Jason come in and just kind of explain being the pharmacist that is approving or denying or saying yes or no to take them off the blood thinners in different parts, because you have seen several dental   I don't know what they're called. What is it? Clarence's? that what comes to you? don't even know. All day my mind, it's like, here is the piece of paper that gets mailed to you to the pharmacist and then you mail it back. So whatever that is. But Chase, let's talk about it because I think you can give the dentist a lot of confidence coming from a pharmacist. What you guys see on that side. When do you actually need to approve or disapprove? Let's kind of dig into that. Yeah. Well, first of all, I think I'm not a replacement for any kind of clinical judgment whatsoever. Every patient's different. But the American Diabetes Association, you   I work with diabetes a lot. American Dental Association has some really great guidelines on blood thinners and I would always reference them. I actually looked at their website today. Make sure I'm up to speed before I get back on this again. They have resources all around making decisions for blood thinners. And I think the one real important thing in putting myself in the shoes of a dentist or any kind of staff that's around a patient that's in a chair, if they say I'm on a blood thinner, right, a flag goes up. At least in my mind, that's what goes up.   Like, okay, how do we get across this bridge? And I think the important thing to really distinct right then when they say they're on a blood thinner is that is kind of a slang word for a lot of different medications, right? Like it's the overarching word that everybody pulls up saying, I'm on a blood thinner. It's like, okay, but I don't know what say. It's like, I have a car. You're like, okay, do you have a Mazda? Do you have?   Toyota, Honda, what do you have? or even worse it'd be like saying I have a vehicle, right? So when somebody says they're on a blood thinner, it opens up a whole box of possibilities of what they're Blood thinners are also, doesn't, when they're taking these types of medications that are quote unquote a blood thinner, it doesn't actually thin the blood, like adding water to the blood, if that makes sense, or like thinning paint, or like thinning out a gravy, right? It doesn't do the same thing. Blood thinners, really what they're doing is they're working on the blood, which.   which is really cool, try not to tangent on that. ⁓ When they're working on the blood, it's not thinning it per se, but it's making it so that the proteins or platelets that are in it can't stick together and make a cloth quite as easy. So whenever somebody's on a blood thinner, I usually ask, what's the name of the blood thinner that you're on? It's not bad that they use that slang, that's okay, on the same page, but it's really broken into two different classes. There's anticoagulant and antiplatelet.   And a way to kind of remember which is which, when residents would come through our clinics, the way that I teach them is a clot is like a brick wall. You know, it's not always a brick wall. Usually the blood is a liquid going through. But once they receive some kind of chemical message, it starts making a brick wall with the mortar, which is the concrete between the and the bricks, the two parts. When it's an anti-quagent, it's working on that mortar part. When it's an anti-platelet, it's working on the bricks part, right? You need both to make a strong clot or strong brick wall.   But if you can make one of them not work, obviously like if your mortar is just water, it's not working, right? You're not gonna make a strong brick wall. So that's kind of the two deviants right there. So that's what I do in my mind real quickly to find out because antiplatelets are usually, so that's gonna be like your Plavix, Ticagrelor, Brilinta. And hold on, antiplatelets are bricks? Good job, bricks. They're the bricks. And so the reason I was thinking you could remember this because I'm, antiplatelets, it's a plate and a plate is more like a brick.   And anti coagulant, I don't know why quag feels like mortar to me, like quag, like, know, it's like slushy in the blood, like it's coagulating. It's a little bit of that, like, honestly, I'm just thinking like coagulated blood is a little bit more mortar-ish. And so platelet is your plate, like a brick, and anti-quag is like.   the gilly between the bricks. Okay, okay, I got it. Yeah, so there's an exception to every rule, but when they're on that Don't worry, this is Kiera, just like very basic. You guys are way smarter listening to this, and that's why Jason's here. No, no, you helped me pass pharmacy school. When we were doing all the top 200, you helped me memorize all know what flexorill is, all right? That's a muscle relaxant. Cyclo? I don't know that part. It's a cyclo, because you guys are cycling and flexing. I don't actually know. just know it's a muscle relaxant, so that's about as far as I got. When we're looking at antitick platelets, so that's the brick part, so that's going to be your, you know,   Hecagrelor, Breitlingta, Clopidogrel is the most common one. It's the cheapest one, so probably see that one the most. Those, I mean, there's an exception to every rule, but that's generally being used after like a stent's placed in the heart. It can be used for VTE, there's some out there, but that's pretty rare. But also for some valves that are placed in the hearts, it can be used for that as well. So antiplatelet, really thinking more like a cardiac event, right? Like I said, there's always an exception to every rule, but that's kind of where my mind goes real quickly, because we're gathering information from the patient.   They're on anticoagulant. Those are like going to be the new ones that you see commercials for all the time. So Xeralto, Alequis, those are the two big ones right now. They're replacing the older one. And also we were supposed to do a disclaimer of this is current as of today because the ADA guidelines do change. this will be current as of today. And Jason, as a pharmacist, is always looking up on that. I had no clue that you are that up to speed on dental knowledge. so just throwing it out there that if you happen to catch his podcast,   a few years back that obviously check those guidelines for sure. But the new ones are the Xarelto and Eloquist. They're replacing the older ones of warfarin. Warfarin's been around for a really long time. We've seen that one. Those are anti-coagulants. So when you're looking, when a patient says that, generally they're on that medication because they've possibly had a clot in the past or they have a heart condition called atrial fibrillation. Those are kind of the two big ones. Like I said, there's always caveats to it, but that's kind of where my mind goes real quickly. And then,   as far as getting patients cleared, the American Dental Association has really good resources on their website. You can look at those and they're always refreshing that up. They even say in their own words that there's limited data around studying patients in the dental chair and with anticoagulants or anti-platelets. It's pretty limited. There's a few studies, some from 2015, some from 2018. There's one as recent as 2021, which is nice. But really, all of those studies come together and it's really more of an expert consensus.   And with that expert consensus, they have kind of simplified things for dentistry, which is really nice. ⁓ comparing that to, we have more data for like total hip replacement, total knee replacement. We have a lot of data and we know really what we should be doing around then. But going back to dentistry, we don't have as much information, so they always say use clinical judgment, but they do give some really great expert guidance on that. So if a patient's on an anticoagulant, ⁓   they generally recommend that it doesn't need to be stopped unless there's a high bleeding risk for a patient. as a provider or as a clinician in the practice, you can be looking at high bleeding risk. Some things that make an oral procedure a little bit lower risk is one, it's in the compressible site, right? Like we can actually put pressure on that site. That's the number one way to stop bleeding is adding pressure. It's not like it's in the abdominal cavity where we can't get in and can't apply pressure. So number one, that kind of reduces the bleeding risk.   is number one. Two, we can add topical hemostatic agents. Dentists would know that better than me. There's a lot of topical ways to do that. So not only pressure, but there's those things as well. And also, but there are some procedures that are a little bit more likely to bleed. And that's where you and dentists would come in hand in What's the word in APO? Oh, the APOectomy. I got it right. Good job. like, didn't you tell me last night that the ADA guideline was like what?   three or four or more teeth? great question. So you can extract one to three teeth is what their expert consensus One to three teeth without. Without really managing or stopping anticoagulation or doing anything like that. I think that's some good guidance from them. I'm gonna add a Jasonism on that though. So with warfarin, I do see why dentists would be a little bit more conservative or worried about stopping the warfarin because warfarin isn't as stable as these newer agents. Warfarin, the levels.   quote unquote levels can go really high, they can go really low. And if the warfarin levels are high, they're more likely to bleed. So I do think it makes sense to have a really recent INR. That's how we measure what the warfarin's doing. I think that makes a lot of sense, but the ADA guidelines really go into the simplification version of all these blood thinners. Generally, it's recommended to not stop them because the risk of stopping them outweighs the benefit of stopping them in almost every case. Almost every case.   ⁓ So when you're with that patient, right, they say I'm on a blood thinner, finding out which kind of blood thinner that they're on, you find out that they're on Xeralto, right? How long have you been on Xeralto for? I've been on it for years. You don't know exactly why, but if they haven't had any recent bleeding, you're only gonna remove one tooth. ⁓ You can do what's called a HasBlood score. That kind of looks at the bleeding risk that they'd have. That'd be kind of going a notch above, but in my mind, removing one tooth isn't a real serious bleeding risk. I'd love to hear from my dentist friends if they...   disagree, right, but ADA says one to three tooth removals, extractions, that's the fancy word. Extractions, yeah, for extracting teeth out. Is not really that invasive. Sure. It's not that high risk, so it's usually perfectly fine. So if a patient was on Xarelto, ⁓ no other, this is in a vacuum, right? I'm not looking at any other factors, which you should be looking at other factors. I would be perfectly fine to just remove one to two.   And when those clearances come in, because dentists do send them, talk about what happens. You guys were working in the hospital and you guys would get these clearances all the time. do. We get them so often. I mean, we get like four or five a day. We'd love to give it to our students, student pharmacists, and ask them what to do. And they would usually look up the American Dental Association guidelines and come up with something. We're like, yep, that's what we say too. In fact, we say it so many times a day that we have a smart phrase.   which just blows in the information real quickly and faxes it right back to the So it's like a copy paste real quick. So what I wanted to point out when Jason told me this is dentists like hearing this and learning this, this can actually save you guys a ton of time to be able to be more confident, to not need to send those clearances on. And we were actually talking last night about how I think this might be a CYA for dentists. like, as we were talking, I think Jason, you seeing so many other aspects of medicine, like you've literally seen patients die, you've seen other areas.   And so coming from that clinical vantage point, we were realizing that dentists, we are so blessed to live in an injury. I enjoy dentistry because possibly there's someone dying, not super high, luckily in dentistry. The only time that I have actually had a doctor have a patient pass away, and it was only when they were completely sedated and doing ⁓ some other things, but that was under the care of an anesthesiologist. And so that's really our high, high risk. And so hearing this, Jason,   That was one of the reasons I wanted him to come on is to give you doctors more confidence of do we have to always send to a pharmacist? I mean, hearing that on the pharmacy side, they're just sending these back and not to say to not see why a to not cover this because you might be questioning like, well, do I really need to? But you also were talking about some other ways of so number one, you guys are just going to copy back the 88 guidelines. So so 88 guidelines. Yeah. And I think that that gives a lot of confidence to a provider or a dentist is that you can go to the 88 guidelines and read them, right? Like you're listening to some   nasally monotone pharmacist on a podcast. Rumor has it, people love him at the hospital. were like, you're the voice, he's been told he has a good radio So for the clinic, I was the voice. Like, yeah, you've reached the vascular clinic, right? And they're like, oh my gosh, you're the voice. But sorry, you me distracted. That'll be your next career, Jace. You're going to be a radio host. OK. I would love that. I love music. But you're hearing from a nasally guy, but you can actually read the ADA guidelines. You just go right to the ADA, click on Resources, and under Resources, it has the   around anticoagulants, I think that's the best way to get a lot of confidence about it because they have dentists who are the experts making calls on these. I'm just reiterating what they say, but I think it makes a lot of sense to help providers. And the reason why my heart goes out to you as well is having the providers that used to work underneath me, they're always looking for our views, which is a fancy way of making sure that they're drilling and filling. Can I say that? Yeah, can say drilling and filling. They're being productive, right? They're being productive, right?   They're always looking to make sure if a patient's canceling, like get somebody in here. Like I need to be helping people all day long. That's how I, we keep the lights on. That's how I help as many people. And so if you have a patient coming in the chair and it has an issue, they say I'm on Xeralto. Well, you can ask real quickly, why are you on Xeralto? I had a clot 10 years ago. my gosh. Well, yeah, we're pretty good to go. Then I'm not worried. We're only removing one tooth or we're just doing a cavity or a cleaning. Something like that. Shouldn't be an issue whatsoever because there's experts in the dental. ⁓   in the dental society, the ADA guidelines that recommend three teeth or less, minimally invasive. They really recommend if it's gonna be really high bleeding risk. And clinically, that's where you would come in, ⁓ or yourself. know, apioectomy is one that's like on the fence line. I don't know where implants set. though, and like we were talking, implants aren't usually like a date of procedure. Most people aren't popping in, having tooth pain, and we're like, let's do an implant. Now sometimes that can be the case, but typically that one's gonna have   a few other pieces involved. And so that is where you can get a clearance if you want to. ⁓ But we were really looking at this of like so many dentists that I know that you've seen will just send in these clearances because they are. And I think maybe a way to help dentists have more confidence is because you know, I love routines. I love to not have to remember things. So why don't we throw it in, have the team member set it up where every quarter we just double check the ADA guidelines. Are there any updates? Are there any other things that we need to do on that? That way you can just see like   getting into the language of this, of what do I need to do? Because honestly, you guys, know pharmacy was not a big portion for it, so, recommending different parts, but I think this is such a space where you can have confidence, and there's a few other things I wanna get to, and I you- I some pearls too. Okay, go. I'm so when she get me into talking about drugs, I'm not gonna stop. So, some other things around that too is these newer blood thinners like Xarelto Eloquist, they now have reversal agents, so a lot of providers in the past were really worried about bleeding because we can't turn it off. We can turn those off. Warfarin has reversal as well, right?   So I'm looking at these patients. It's really low risk. It's in the mouth, generally speaking. Very rarely are they a high bleeding risk. Now if you're doing maxillofacial surgery, this does not apply, right? This does not apply whatsoever. you're like general dentist, you're pediatric dentist. Yeah, yeah, and it's kind of on the fly. So just trying to really help you to be able to take care of those patients on the moment, have that confidence, look at the ADA guidelines, have that in front of you. I don't think it's a bad thing to ever...   check with their provider if you need to. If you're thinking, I feel like I should just check with the provider, I would never take that away from you. But I just want to kind of steer towards those guidelines that I have to help. But what did you want to share? No, yeah, I love that. And I think there were just a few other nuggets that we were chatting about last night that can help dentists just kind of get things passed a little bit easier. So you were mentioning that if they were named to their cardiologist, what was it? was like, who is the last? Great question. Yeah, when a patient's on a blood thinner,   It could be prescribed by the cardiologist. It could be prescribed by the family provider or could have been punted to like a vascular clinic like where I was working. It can go to any of those. And when you send that fax, right, if it goes to the cardiologist and it's supposed to go to the family care provider, like it just kind of goes, goes nowhere, right, from there. So I think it's a really good idea to find out who prescribed it last. If the patient doesn't know who prescribed their blood thinner last, you can call their pharmacy. I call pharmacies all day long.   I have noticed in the last year, they are way easier to get a hold of, which has made my job a lot easier, working on the insurance portion. So reaching out to the pharmacy, finding out who that provider is and sending it to them, because they should be able to help with that. I thought that was a good shift in verbiage that you had of asking instead of like the cardiologist, because that's who you would assume was the one. But you said like so many times you guys would take care of them, and then they go back to family practitioner, and you guys would get the clearances, but you couldn't clear because you weren't overseeing. So just asking the patient.   who prescribed their medication for them last time. That way you can send the clearance to the correct provider. then- And they might not know. You know patients, right? They're like, I don't know, my mom's or else, I don't know who gave it to me. Somebody told me I need to be on this. But at least that could be another quick thing. And then also we were talking last night about-   ⁓ What are some other things that dentists can do when like writing scripts to help them get what I think like overarching theme of everything we discussed is one how to help dentists have less I think drag through pharmacy. ⁓ Because pharmacy can take a little while and so perfect we now know the difference between anti-quag and anti-platelet. We know which medications are probably safe. We know we can check the ADA guidelines so that we were not having to do as many clearances. We also know if they're on a medication to find out and we do need a clearance.   who we can go to for the fastest, easiest result. And now, in talking about prescriptions, you had some really interesting tips that you could share with them. Yeah, so with writing prescriptions, right, pharmacies are pharmacies. So I'm not gonna say good thing or bad thing. There are challenges working with pharmacies. I'm not gonna play that down at all. ⁓ If you're writing prescriptions and having issues and kickbacks from pharmacies, there's some interesting laws around ⁓ writing prescriptions. Say that you're trying to ⁓ prescribe   augmentin, you know, 875 BID, and you tell the patient, hey, I want you to take this twice a day for seven days, and then you put quantity of seven, because you're moving fast, right? You want it for seven days, quantity of seven. Quantity would actually be 14, right? It's not that big of a deal. Anybody with common sense would say if you're taking a pill for twice a day for seven days, you need 14 tablets. But LAHA doesn't allow pharmacists to make that kind of a change, unfortunately. They have to follow what you're saying there. So you're going to get a...   An annoying callback that says, you wrote for seven tablets. I know you need 14. Is that OK? Just delays things, right? So ⁓ I really like the two letters QS. That's Q isn't queen. S isn't Sam. Yeah. It stands for quantity sufficient. So you don't have to calculate the amount of any medication that you're doing. So for me, as a pharmacist, when I was taking care of patients, I hated calculating the amount of insulin they would need for an entire month. So I would say.   Mrs. Jones needs 15, I'd say 15 units ⁓ QD daily. ⁓ And then I say QS, quantity sufficient, ⁓ 90 day supply through refills. So the pharmacy can then go calculate how much insulin that they need. I don't have to even do that. So anytime you're prescribing anything, I like that QS personally. So that lets the pharmacy use ⁓ common sense, as I like to call it, instead of giving you a call. I think that's super helpful. I also thought of one thing too.   going back to blood thinners is when it's kind of like a real quick, like they're not gonna have you stop the blood thinner at all. like you're seeing if you can stop the blood thinner for a patient, there's some instances it's just not gonna happen. And that's whenever they've been, they've had a clot or a stroke or a heart attack within the last three months. Three months. Yeah, that's kind of like the.   Because so many people are like, they had a heart thing like six years ago. And so I think a lot of my dentists that I worked with were like, we got to stop the blood thinners. But it sounds like it's within three months. Yeah, well, I'm just the time. Like this is general broad strokes. What I'm just trying to say is when you want to expect a no real quick. Got it. Right. So because benefits of stopping a blood thinner within those first three months of an event is very, very risky versus the, you know, the benefit of reducing a little bit of blood coming out of the mouth. Right. Like that's not that bad.   when somebody's had a stroke or a heart attack or pulmonary embolism, a clot in the lung, like we can't replace the lung, heart or brain very easily. We can replace blood a lot better. We've got buckets of it at most hospitals have buckets of it, right? So I'm always kind of leaning towards I'd rather replace blood than tissue at all times. So that's kind of a quick no. If they've had one those events in the last three months, we are really, really gonna watch their brain instead of getting.   root canal, right? Like really worried about them. So you'll just say no. And they could the dentist still proceed with the procedure or would you recommend like a three month wait? Or is it provider specific way the pros and cons because sometimes you need to get that tooth out. Great question. think then it's going to come into clinical. That's that's when you send in the clearance, right? Like, and it's great to reach out to the provider who's managing it for you. But I think it's kind of good to know exactly when you get a quick no quick no is going to be less than three months.   ⁓ Or when it's going to be like a kind of a typical, yeah, no problem. If it's been no greater than six months, they're on the typical anticoagulants or alto eloquence. Nothing crazy is going on for them. You're only removing two teeth. This is very, very low risk. But again, I'd urge everybody to read the ADA guidelines. That way you feel more comfortable with it. I'm not as eloquent as they do. They do a real good job. So I don't want to take any of their credit. I think they do a real good job of simplifying that and making you feel confident with providing.   more timely care for patients. Which is amazing. And Jayce, one last thing. I don't remember what it was. You were talking about the DEA and like six month rule. yeah. Let's just quickly talk about that and then we'll wrap this because this is such a fascinating thing for me last night. Yeah. So when comes to prescribing controlled substances, most providers have to have a DEA license. OK. First of all, though, what's your take on dentist prescribing controlled substances? ⁓ I don't think, you know, I worked on the insurance side of things. Right. And I look at the requirements for the   as the authorizations, what a patient, the criteria a patient needs to hit in order to qualify for certain medications. A lot of times for those controlled substances, they have pretty significant issues going on, like fibromyalgia or cancer-related pain or end-of-life care versus we don't, in all my scanning thread, I don't have a ⁓ perfect picture memory. Sure. But I don't usually see oral.   pain in there. There is some post-operative pain that can be covered for those kind of medications but I really recommend to keep those lower and in fact in a lot of our criteria it recommends you know have they tried Tylenol first, they tried, have they filled NSAIDs or are they contraindicated with the patient. So really they should be last line for patients in my two cents but there's always going to be a caveat to the rule right? Of course. comes through that has oral cancer and you're taking   like that would make sense to me. Got it, so then back to the DEA. Yeah, okay. Okay, ready. So as a provider, you should be checking the, if you're doing controlled substances, you should be checking the prescription drug monitoring program, or sometimes called the PDMP, looking to see if patients are getting ⁓ controlled substances from another provider. So it's really just a check and balance to make sure that they're not going from provider to provider to getting too many narcotics and causing self harm or harm to others.   And so with checking that PDMP before prescribing, I think a lot of providers do that. A lot of softwares that I'm aware of, EMRs, electronic medical records, sometimes have links so that you can do that more quickly. However, I don't think it's as intuitive that they need to be checking that every six months in some states. And like here in Nevada, you're supposed to be checking it every six months, not for a patient, but for your actual DEA registration to see if anybody else is prescribing underneath you. Because if you don't check that every six months, you could get in some serious trouble with...   not only DEA, but even more the Board of Pharmacy and your state. Now, I don't know all 50 states, so I check with your state to see if you need to be checking that every six months, but set an alarm just to check that real quickly, keep your nose clean. ⁓ I've had providers, I've had to remind to do that. And if somebody was using your account, prescribing narcotics, you'd never know unless you went and checked that PDMP.   Yeah, I remember last night you were like, and if that was you, I would not want to be you. The Board of Pharmacy is going to be real excited to find you. So that was something where I was like, got it. So, and we all know I'm big on let's make it easy. And Jason, I love that you love this so much and you just brought so much value today. And like also for me, it's just fun to podcast. fun. Yeah. But I got a nerd out on my world a little bit. Bring it into yours. I work with dentists or at least you know, when I was working in Vascular Clinic all day long. Great questions that would come through. Yeah.   So I think for all of us, as a recap on this is number one, I think setting yourself ⁓ some cadences. So maybe every quarter we check our ADA guidelines and we check our, what is it, PDMP. PDMP. so each state, so they call it Prescription Drug Monitoring Program. We need that. Yeah, but there are different acronyms in different states, though. That's just what it's called in Nevada. I forget what it is in California, but you can check your state's prescription monitoring program, make sure that opioids aren't being prescribed under your name. Got it. So we just set that as a cadence.   We know one to three teeth most likely if they're on a blood thinner is According to the 88 as of today is good to go You know things that are going to get a quick know are going to be within the last three months of the stroke the heart attack or the Clot I'm thinking like the pulmonary embolus. Yeah, that's what we're trying to prevent   Those are gonna be quick knows and then if we're prescribing, let's do QS. We've got quantity is sufficient so that we're not getting phone calls back on those medications that we are. And then on narcotics, just being a bit more cautious. Of course, this is provider specific and in no way, or form did Jason come on here to tell you you are the clinical expert.   Jason's the clinical expert on medications. And if you guys ever have questions, I know Jason, you geek out and you want to talk to people so that anyone wants to chat shop. Be sure to reach out and we'll be able to connect you in. we've even talked about possibly, so let me know listeners. You can email in Hello@TheDentalATeam.com of ask a pharmacist anything. I talked to Jason. I was like,   We'll just have them like send in questions and maybe get you back on the podcast or we do a webinar. But any last thoughts, Jace, you've got of pharmacy and dentistry as we as we wrap up today? No, I think that's pretty much it. So check the ADA guidelines. I think it's really good to have cross communication between professions. Right. If you're working with the pharmacy, CVS, Walgreens or something like that or Walmart, I know that it can be challenging. Right. They're under different pressures. You're under different pressure. So I think ⁓ just coming in with an understanding, not being angry at each other.   you know what mean, is super beneficial and working together. When it comes to it, every dentist that I've talked to is actually worried about their patient. Every pharmacist that I've worked with is really worried about the patient as well. So we're trying to accomplish the same thing, but we have different rules and our hands are bound in different ways that annoy each other, right? Like I know Dr. Jones, want 14 tablets, but you said seven. And I know Common Sense says I should give them 14, but I've got to make that change.   knowing that their hands are tied by the law. They can't use as much common sense, which is aggravating. I mean, that's why I love what I gotta do here. I gotta just kind of help a lot more and use common sense and improve patient care. But those kinds of things I think are really beneficial as you work together and then not being so afraid of blood thinners, right? So I think those guidelines do a great job of giving you confidence and not worrying about the side effects. And there's a lot of things that you can do locally for bleeding.   You have a lot of control over that. I think that's pretty cool, the tools they have. Yeah. And at the end of the day, yes, you are the clinician. You are the one who is responsible for this. so obviously, chat, but I think collaborating, talking to other pharmacists, talking to them in your state, finding out what are the state laws, things like that I think can be really beneficial just to give you peace of mind and confidence. And again, dentistry, are maybe a bit more risk adverse because luckily we don't have patients dying That's great thing. Yeah, that's fantastic. I want my dentists to be risk adverse. I think so too. But Jason, I appreciate you being on the podcast today.   And for all of you listening, ⁓ more confidence, more clarity, more streamline to be able to serve and help our patients better. if we can help you in any way or you've got more questions, reach out Hello@TheDentalATeam.com. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.  

Autism has a long history of misinformation that continues to today. The Trump administration has perpetuated some of this misinformation in the last year. Among other things, officials have claimed certain groups of people don't get the condition and that taking Tylenol while pregnant causes autism to later develop in children. Today, NPR Science Correspondent Jon Hamilton sets the record straight with host Emily Kwong on what scientists do and don't know about autism. If you liked this episode, check out our episodes on an Autism researcher's take on Trump's claims about Tylenol and a Fragile X treatment that may be on the horizon.Interested in more science in the news? Email us your question at shortwave@npr.org.Listen to every episode of Short Wave sponsor-free and support our work at NPR by signing up for Short Wave+ at plus.npr.org/shortwave.This episode was produced by Berly McCoy. It was edited by Rebecca Ramirez. Tyler Jones checked the facts. The audio engineer was Damian Herring.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net.Today on the podcast, Rachel Bridwell and Brit Long cover acute acetaminophen toxicity, as well as some evidence updates. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

In this episode of Quah (Q & A), Sal, Adam & Justin answer four Pump Head questions drawn from last Sunday's Quah post on the @mindpumpmedia Instagram page. Mind Pump Fit Tip: Which Rep Range Is Best for Your Goals? (2:16) Research on how much acetaldehyde is released in the gut. (32:15) The rules of the bathroom. (36:02) Carnival King. (41:02) Will resources solve all our problems? (42:13) The dangers of Tylenol/acetaminophen. (51:00) Ready-to-go protein drink that can go mainstream! (54:27) Eating for abundance, and kids & food preferences. (57:10) #Quah question #1 – Maybe this is silly, but I'm trying to take rest periods seriously and have a question. During my two to three minutes, do I need to sit still that whole time or can I prep the bar for my next workout and/or like stretch? (1:04:25) #Quah question #2 – How can I build my legs/glutes when I have really bad knees? (1:07:37) #Quah question #3 – Why can't you do trigger sessions all at once like a set of three instead of three different times a day?! (1:10:32) #Quah question #4 – What are the pros and cons of cold plunge/ice baths, sauna, and hot tubs/hot baths? Is one better for weight loss, muscle gain, and mental health/recovery? (1:12:22) Related Links/Products Mentioned Visit Pre-Alcohol by ZBiotics for an exclusive offer for Mind Pump listeners! ** Code "MINDPUMP26″ for 15% for first-time purchasers on either one-time purchases, (3, 6, 12-packs) or subscriptions (6, 12-pack). ** Experience the difference of Liposomal Technology. Use code MINDPUMP for 20% OFF everything. Visit: https://www.rhonutrition.com/discount/MINDPUMP January Promotion: Code NEWYEAR50 at checkout for 50% off the following programs: MAPS Starter, Transform, Anabolic, and Performance! Visit: http://mapsjanuary.com/  Mind Pump Store Mind Pump #1827: The 3 Best Rep Ranges to Build Muscle & Burn Fat What Is Acetaldehyde and How Is It Linked to Alcohol? Elon Musk SHOCKS! "10 Billion Humanoid Robots by 2040" Elon Musk Says Saving for Retirement Is Pointless "It took me 50+ years to realize what I'll tell you in 69 minutes" - Tony Robbins Major review finds no autism or ADHD risk from pregnancy Tylenol Visit Seed for an exclusive offer for Mind Pump listeners! ** Code 20MINDPUMP for 20% off your first month of Seed's DS-01® Daily Synbiotic. ** MAPS Prime Pro Webinar The Most Overlooked Muscle Building Principle - Mind Pump Media Sauna Use Associated with Reduced Risk of Cardiac, All-Cause Mortality Mind Pump Podcast – YouTube Mind Pump Free Resources People Mentioned Stan "Rhino" Efferding (@stanefferding) Instagram Alex Hormozi (@hormozi) Instagram Tony Robbins (@tonyrobbins) Instagram Peter Attia, M.D. (@peterattiamd) Instagram  

For the next few weeks, the guys will be re-airing some of their favourite episodes from our archives.After debriefing about the return of Jimmy Kimmel (1:15), in the second emergency podcast in as many weeks, Asif and Ali discuss President Trump's recent press conference linking autism to Tylenol use. Ali starts off by asking Asif about autism (8:27). Asif discusses what it is, how common it is, and the theories about why the prevalence of autism has been increasing over the past 2 decades. He then goes over the genetic causes of autism and the common questions he asks if he sees a patient who he suspects may have autism. Finally they discuss current treatments for autism.The guys then go over what exactly Trump said in his press conference about Tylenol and autism (33:33), followed by Asif describing the studies which refute and support these claims. They also talk about the dangers of pregnant women not taking medications to treat fevers as well of the dangers of ibuprofen use in pregnancy. Finally, Ali asks Asif about the controversial link between autism and vaccines and disgraced physician Andrew Wakefield. The opinions expressed are those of the hosts, and do not reflect those of any other organizations. This podcast and website represents the opinions of the hosts. The content here should not be taken as medical advice. The content here is for entertainment and informational purposes only, and because each person is so unique, please consult your healthcare professional for any medical questions. Music courtesy of Wataboi and 8er41 from PixabayContact us at doctorvcomedian@gmail.comShow Notes:Autism Canada: https://www.autismcanada.org/diagnosisTrump links autism to acetaminophen use during pregnancy, despite decades of evidence it's safe: https://edition.cnn.com/2025/09/22/health/trump-autism-announcement-cause-tylenolAcetaminophen in Pregnancy and Attention-Deficit and Hyperactivity Disorder and Autism Spectrum Disorder: https://pubmed.ncbi.nlm.nih.gov/39637384/Evaluation of the evidence on acetaminophen use and neurodevelopmental disorders using the Navigation Guide methodology: https://pubmed.ncbi.nlm.nih.gov/40804730/Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability: https://jamanetwork.com/journals/jama/fullarticle/2817406Maternal Acetaminophen Use and Offspring's Neurodevelopmental Outcome: A Nationwide Birth Cohort Study: https://onlinelibrary.wiley.com/doi/10.1111/ppe.70071ACOG Affirms Safety and Benefits of Acetaminophen during Pregnancy: https://www.acog.org/news/news-releases/2025/09/acog-affirms-safety-benefits-acetaminophen-pregnancyMotherToBaby | Fact Sheets: Ibuprofen: https://www.ncbi.nlm.nih.gov/books/NBK582759/ Hosted on Acast. See acast.com/privacy for more information.

Just a half teaspoon of this natural anti-inflammatory acts as a potent ibuprofen substitute for inflammation and pain relief. Discover the best home remedies for pain and inflammation, and learn how to address inflammation at the root. 0:00 Introduction: Natural ibuprofen substitute 0:18 Curcumin, the natural anti-inflammatory 1:58 Pain relievers and ibuprofen comparison 2:08 Ibuprofen effects 3:25 Turmeric as a natural remedy vs. ibuprofen 4:32 More natural pain relief alternatives 6:15 Triggers of pain and inflammation8:25 Preventing inflammation Turmeric contains a potent compound called curcumin that can naturally alleviate pain and inflammation.There are 4 biochemical pathways that act as “master switches” to turn pain and inflammation up or down:1. Pain and inflammatory factory2. Master inflammation on-switch3. Inflammation megaphone 4. Backup inflammatory alarm system Many inflammatory treatments do not address all four pathways. Ibuprofen is great at turning the pain and inflammation switch off, and does so very quickly. Unfortunately, this pathway protects the stomach and kidneys, so ibuprofen can cause stomach ulcers and kidney issues. It also doesn't address the other inflammatory pathways, which is why people often have to take it repeatedly. Tylenol works in the brain, affecting the central nervous system, but does not relieve any inflammation. Similar to ibuprofen, aspirin works on the first inflammatory pathway, which can also affect your stomach.Turmeric affects 3 out of the 4 inflammatory pathways! A double-blind randomized controlled study found that taking 1500 mg of turmeric with black pepper produced results comparable to ibuprofen without the side effects. Extra-virgin olive oil mimics ibuprofen's effects at the molecular level. Try adding it to your salad regularly! Ginger and omega-3 fatty acids also work to reduce inflammation. Boswellia targets the 5-LOX pathway, also known as the backup inflammatory alarm system.There are 5 primary causes that flip the inflammatory switches on, leading to pain and inflammation in the body. By addressing the root cause, you can correct the pain rather than simply managing it. The following 5 factors turn on all of the inflammatory switches:1. Insulin resistance2. Mitochondrial damage3. Chronic oxidative stress4. Leaky gut5. Chronic infectionsTo prevent inflammation and address the root cause, try the following:• Low-carb diet • Eliminate ultra-processed foods• Intermittent fasting/prolonged fasting• Magnesium, vitamin D3, zinc, omega-3sDr. Eric Berg DC Bio:Dr. Berg, age 60, is a chiropractor who specializes in Healthy Ketosis & Intermittent Fasting. He is the Director of Dr. Berg Nutritionals and author of the best-selling book The Healthy Keto Plan. He no longer practices, but focuses on health education through social media.Disclaimer: Dr. Eric Berg received his Doctor of Chiropractic degree from Palmer College of Chiropractic in 1988. His use of “doctor” or “Dr.” in relation to himself solely refers to that degree. Dr. Berg is a licensed chiropractor in Virginia, California, and Louisiana, but he no longer practices chiropractic in any state and does not see patients, so he can focus on educating people as a full-time activity, yet he maintains an active license. This video is for general informational purposes only. It should not be used to self-diagnose, and it is not a substitute for a medical exam, cure, treatment, diagnosis, prescription, or recommendation. It does not create a doctor-patient relationship between Dr. Berg and you. You should not make any change in your health regimen or diet before first consulting a physician and obtaining a medical exam, diagnosis, and recommendation. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.

Can we crack the code on aging, or are humans just “term-limited”? What are some of the most promising anti-aging interventions currently under investigation? We may be curing more cancers, and discovering them earlier, but certain cancers are increasing in incidence, especially among the young; Why extreme old age may be protective against cancer; Big meta-analysis confirms cardio benefits of low-carb diet; Patients with depression who've tried everything obtain surprising relief from vagus nerve stimulation; Blood sugar spikes after meals—even absent diabetes—can drive Alzheimer's risk; New study pushes back on Tylenol-autism link, but highlights poor diet, chemical exposure , pre-natal anti-depressant use as potential culprits.

About this episode: It started as a time-limited series of interviews with public health experts at the start of a global pandemic. Over nearly six years, Public Health On Call expanded to a wide range of topics, including humanitarian health, aging, and vaccines, becoming a home for nuanced public health discussions and analysis. In this episode: Hosts Stephanie Desmon, Josh Sharfstein, and Lindsay Smith Rogers reflect on 1,000 episodes of the show, the challenges of covering complex health topics, and what issues they want to focus on next. Note: This episode is also available as a video on YouTube. Guests: Stephanie Desmon, MA, is a former journalist, author, and the director of public relations and communications for the Johns Hopkins Center for Communication Programs. Dr. Josh Sharfstein is distinguished professor of the practice in Health Policy and Management, a pediatrician, and former secretary of Maryland's Health Department. Lindsay Smith Rogers, MA, is the producer of the Public Health On Call podcast, an editor for Expert Insights, and the director of content strategy for the Johns Hopkins Bloomberg School of Public Health. Episodes mentioned: 001 - Global Preparedness, Misinformation and Community Transmission—March 2020 060 - The Epidemic Within the Pandemic: Opioids and COVID-19—April 2020 064 - How COVID-19 Has Changed a Baltimore Public School—May 2020 132 - The Enemy of the People, by Henrik Ibsen and Parallels to the COVID-19 Pandemic—August 2020 169 - Online Learning with Baltimore Public School Principal Matt Hornbeck—September 2020 285 - COVID-19 and the Arts Part 2: Performing Arts and the Pandemic with Marin Alsop—March 2021 311 - A Baltimore Public School Reopens—May 2021 401 - School in the Time of COVID: A Tour Of Hampstead Hill Academy—November 2021 465- A Special Mother's Day Episode—May 2022 653 - Back to School: How One K-8 School Is Getting Ready for the Fall—August 2023 751 - The New Federal Regulations Aimed Making Methadone More Accessible—And Less Stigmatizing—April 2024 823 - Special Episode—The Fight For A Swimmable Harbor in Baltimore—November 2024 862 - The Misinformation Around Seed Oils—March 2025 891 - B'More For Healthy Babies: A Look Back at 15 Years of Infant Mortality Reduction in Baltimore—May 2025 953 - Interpreting the Data on Tylenol, Pregnancy, and Autism—September 2025 967 - An Update on Baltimore's Swimmable Harbor and the Pistachio Tide—October 2025 973 - Baltimore's Record Low in Homicides—November 2025 979 - Why Are More People Choosing Not to Vaccinate Their Pets?—November 2025 Transcript information: Looking for episode transcripts? Open our podcast on the Apple Podcasts app (desktop or mobile) or the Spotify mobile app to access an auto-generated transcript of any episode. Closed captioning is also available for every episode on our YouTube channel. Contact us: Have a question about something you heard? Looking for a transcript? Want to suggest a topic or guest? Contact us via email or visit our website. Follow us: @‌PublicHealthPod on Bluesky @‌PublicHealthPod on Instagram @‌JohnsHopkinsSPH on Facebook @‌PublicHealthOnCall on YouTube Here's our RSS feed Note: These podcasts are a conversation between the participants, and do not represent the position of Johns Hopkins University.

On this episode of Guest Commentary, the Secretary of Health doesn't apologize — even when he is proven completely wrong about the link between Tylenol and autism

The news to know for Tuesday, January 20, 2026! We'll tell you about the latest developments out of Minneapolis — including a new court order and a new investigation. And why today's date is sparking protests around the country. Also: why President Trump says he no longer needs to think purely of peace when it comes to Greenland. Plus, what a new major review found about whether Tylenol is linked to autism, how the world is remembering a fashion icon, and which two people are getting credit as Indiana makes college football history. Those stories and even more news to know in about 10 minutes!    Join us every Mon-Fri for more daily news roundups!  See sources: https://www.theNewsWorthy.com/shownotes Become an INSIDER to get AD-FREE episodes here: https://www.theNewsWorthy.com/insider Get The NewsWorthy MERCH here: https://thenewsworthy.dashery.com/ Sponsors: Visit TrustDirectMail.com to get Gundir's FREE 2026 Direct Mail Lookbook — hand delivered, of course. To advertise on our podcast, please reach out to ad-sales@libsyn.com    

We're back for Part 2 with Jena Oschner, and this one goes deep. In this week's episode, we talk about detoxing your home, ditching everyday toxins, and the products we actually use, without shame or fear. From face taping to Tylenol alternatives to artificial dyes, we're covering the real-life ways we're learning, adjusting, and finding what works for our families. Jena also shares about her journey into homeopathy, ozone therapy, functional testing, and the things she keeps with moderation in mind. If you've ever felt overwhelmed by all the swaps, this episode will help you focus on progress over perfection. Listen to Part 1 if you missed it! Resources & Links: Episode 85. Journey to Wellness with Jena Oschner Episode 138. Girl Talk (with Jena Oschner): Rethinking “Health” Part 1 Good Life Beef Farm Wife Tallow Radiance Rebel Vlasic Purely Pickles (dye-free) Arnica Montana Simply O3 Ozone Generator Redmond Real Salt LMNT electrolytes EWG Healthy Living App Toups & Co Dry Shampoo Zoya nail polish Isle of Paradise self-tanning drops Rebounder Join The Directory Of The West Get our FREE resource for Writing a Strong Job Description  Get our FREE resource for Making the Most of Your Internship Get our FREE resource: 10 Resume Mistakes (and how to fix them) Get our FREE resource: How to Avoid the 7 Biggest Hiring Mistakes Employers Make Email us at hello@ofthewest.co Subscribe to Of The West's ⁠Newsletters List your jobs on ⁠Of The West Connect with Jena: Follow on Instagram @jenaoschner Listen to her podcast Beyond the Crops Visit her website Connect with Jessie: Follow on Instagram @ofthewest.co and @mrsjjarv Follow on Facebook @jobsofthewest Check out the Of The West website Be sure to subscribe/follow the show so you never miss an episode!  Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of The Mindful Womb Podcast, Clara is joined by pediatrician and integrative medicine practitioner Dr. Joel Gator Warsh for a calm, evidence-based conversation about routine newborn interventions and how families can navigate them with clarity rather than fear.Together, they explore the why behind common recommendations — without oversimplification or pressure — so parents can feel informed, grounded, and confident in their choices.What You'll LearnWhy newborn medical decisions often feel overwhelmingWhat vitamin K does and how it reduces the risk of rare but serious bleedingWhat erythromycin eye ointment actually preventsWhy hepatitis B vaccination is offered at birth — and how guidance is evolvingHow to think about individual risk vs. population-level recommendationsThe nuance around Group B strep and antibiotics in laborWhat the evidence actually shows about Tylenol, vaccines, and autismHow to evaluate health information without falling into extremesLearn More from Dr. GatorDr. Gator shares more in his book “Between a Shot and a Hard Place” and on his Substack, Instagram, and X accounts—platforms dedicated to bridging the space between polarized medical narratives. Check out this episode's blog post for more!***If these topics light you up, please rate and review the show on Apple Podcasts, Spotify, or wherever you're listening.After you review the show - snap a pic and upload it here - and I'll send you 70 printable affirmation cards as a thank you.Your feedback helps this podcast grow, and I am so grateful for your support! Disclaimer: The information provided in this podcast is for educational and informational purposes only. Consult with a qualified healthcare professional for personalized advice.

Dr. Jeffrey Kopin, Chief Medical Officer for Northwestern Medicine Catherine Gratz Griffin Lake Forest Hospital, joins John Williams to talk about the latest on flu cases in Illinois, and a new study that concluded that there is no link between Tylenol/acetaminophen and autism.

Dr. Jeffrey Kopin, Chief Medical Officer for Northwestern Medicine Catherine Gratz Griffin Lake Forest Hospital, joins John Williams to talk about the latest on flu cases in Illinois, and a new study that concluded that there is no link between Tylenol/acetaminophen and autism.

Familiares del migrante muerto en Texas piden investigación.Familia devastada tras la muerte de migrante bajo custodia de ICE.Pentágono prepara posible despliegue de soldados en minnesota.Detalles del accidente en la ruta ferroviaria de los dos trenes que colisionaron en España.México endurece ley contra fabricación o comercialización de vapeadores.Chicago bajo el hielo del vórtice polar.Habla la esposa del migrante que logro escapar de ICE y hoy está detenido.No relacionan consumo de Tylenol en el embarazo con autismo.Escucha de lunes a viernes el ‘Noticiero Univision Edición Nocturna' con Elián Zidán.    

Los líderes de los partidos de Groenlandia rechazaron los reiterados llamados del presidente Donald Trump.Familia devastada por la muerte de migrante bajo custodia de ICE.Solo el 6% esta satisfecho con la información sobre el caso Epstein.Suman 39 muertos por accidente de trenes en España; gobierno decreta tres días de luto.Choque en cadena de más de cien vehículos provoca el cierre de la autopista.Sheinbaum: operaciones militares de EE.UU no afectan a México.Grave devastación por los incendios forestales en Chile.La batalla judicial del príncipe Harry contra la prensa.Muere el legendario diseñador Valentino Garavani.No relacionan consumo de Tylenol en el embarazo con autismo.Migrante se arrepiente de firmar su auto deportación.   

Dr. Jeffrey Kopin, Chief Medical Officer for Northwestern Medicine Catherine Gratz Griffin Lake Forest Hospital, joins John Williams to talk about the latest on flu cases in Illinois, and a new study that concluded that there is no link between Tylenol/acetaminophen and autism.

For the Good of the Public brings you news and weekly conversations at the intersection of faith and civic life. Monday through Thursday, The Morning Five starts your day off with scripture and prayer, as we also catch up on the news together. Throughout the year, we air limited series on Fridays to dive deeper into conversations with civic leaders, thinkers, and public servants reimagining public life for the good of the public. Today's host was Michael Wear, Founder, President and CEO of the Center for Christianity and Public Life.  Thanks for listening to The Morning Five! Please subscribe to and rate The Morning Five on your favorite podcast platform. Learn more about the work of the Center for Christianity and Public Life at www.ccpubliclife.org. Today's scripture: Mark 12:28-31 (NIV) News sources:  https://www.cnn.com/2026/01/17/middleeast/iran-supreme-leader-khamenei-protests-criminal-trump-intl-latam  https://www.nytimes.com/2026/01/18/us/politics/pentagon-troops-minnesota.html  https://www.nytimes.com/live/2026/01/18/us/trump-news/2fef14fd-dc41-523e-8195-66413ea655dd?smid=url-share  https://www.nytimes.com/2026/01/16/health/tylenol-autism-acetaminophen-study.html  https://www.washingtonpost.com/national-security/2026/01/16/trump-minnesota-walz-frey-criminal-investigation/  https://www.cbsnews.com/news/justice-department-investigating-tim-walz-jacob-frey-minnesota/  https://www.nbcnews.com/news/us-news/minnesota-sues-federal-government-immigration-agent-rcna253686  https://www.kttc.com/2026/01/17/minnesota-national-guard-mobilized-direction-governor-walz/  Join the conversation and follow us at: Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@michaelwear⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, @ccpubliclife Twitter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@MichaelRWear⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, @ccpubliclife and check out ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@tsfnetwork⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Music by: Amber Glow #politics #faith #prayer #scripture #news #Iran #Minnesota #Greenland #Trump Learn more about your ad choices. Visit megaphone.fm/adchoices

Back in 2005 Dan Buettner patented Blue Zones. He's written 9 books, of which 5 were NY Times bestsellers, and has another one in the works. His 2023 Netflix documentary series “Live to 100: Secrets of the Blue Zones” won Emmy awards and was widely viewed. Many of the main points that Dan has emphasized over the years—healthy diet (he highlighted whole grains, beans, nuts, greens, and “peasant food” here), physical activity, social engagement, and sense of purpose—are backed up by randomized trials and/or large, prospective studies, as I reviewed in Super Agers. In this interview, I asked Dan about the critique he's faced, predominantly from Saul Newman, a biologist in the UK, about accuracy of the data for extreme longevity in the blue zones. In December 2025, two of his collaborators published in The Gerontologist a rebuttal response (open-access) entitled “The validity of Blue Zones demography: a response to critiques” on the rigorous demographic work they've done. We also discussed the marketing and business operations of Blue Zones LLC, the company he sold to Adventist Health in 2020. His son, Danny, is the EVP of the company and likely successor to Dan's work in the future. As Dan said, “He's my genetic upgrade.”I hope you find this conversation informative. An AI-generated transcript is available in the tab at top right above. Some biomedical updates from the past week:* A vaccine to prevent colon cancer in carriers of mutations of Lynch Syndrome looks good for strong immune response and safety, ready for Phase 3 clinical trials * A review of the data of Tylenol during pregnancy reaffirms its safety and lack of increased risk for autism, ADHD, and intellectual disability.* Our perspective/review on how AI and large language models can reduce global health inequities* Another big jump vs refractory autoimmune diseases, this time for hemolytic anemia, using engineered T cells. See my recent review of this topic, from treatment to cures.* A pair of new large prospective cohort studies that reinforce the importance of even small increases in physical activity, along with sleep and diet, for reduction all-cause mortality and improvement in healthspan.Thanks to Ground Truths subscribers (nearly 200,000) from every US state and 210 countries. Your subscription to these free essays and podcasts makes my work in putting them together worthwhile. Please join!If you found this interesting PLEASE share it! Paid subscriptions are voluntary and all proceeds from them go to support Scripps Research. They do allow for posting comments and questions, which I do my best to respond to. Please don't hesitate to post comments and give me feedback. Let me know topics that you would like to see covered.Many thanks to those who have contributed—they have greatly helped fund our summer internship programs for the past two years. It enabled us to accept and support 47 summer interns in 2025! We aim to accept even more of the several thousand who will apply for summer 2026Thank you Annie Fenn, MD, Harshi Peiris, Ph.D., Strategy Shots, Rebecca Moore, Lynn L, and many others for tuning into my live video with Dan Buettner! Join me for my next live video in the app. Get full access to Ground Truths at erictopol.substack.com/subscribe

Minneapolis is imploding in flames YET AGAIN as ICE straight-up arms ruthless Somali invaders and violent communist gangs with pilfered federal guns—while barely deporting anyone amid the 50-MILLION alien swarm orchestrated by globalist elites! George Papadopoulos joins Stew to discuss the latest.   Larry Fink and BlackRock are forcing tokenization on everything you own—your house, your car, all of it—turning it into blockchain tokens they control so they can rip it away the second you step out of line. Carlos Cortez joins Stew to expose this World Economic Forum Mark of the Beast track-trace-control system.   Big Pharma has poisoned millions of Americans with deadly opioids and even everyday Tylenol, turning chronic pain sufferers into addicts or corpses. But Angie, a former world-class athlete turned health revolutionary, exposes the simple, drug-free secret to cleaning blocked joints and restoring your body—empowering you to break free from pain and take back your life starting today.

The Justice Department is investigating Minnesota Gov. Tim Walz and Minneapolis Mayor Jacob Frey over an alleged conspiracy to impede federal immigration agents. From whiteout pileups in New York to frozen iguanas in Florida, winter is making a harsh comeback across the eastern U.S. A new report finds no link between Tylenol, or acetaminophen, used during pregnancy and autism, ADHD or other intellectual disabilities in children. It counters claims made by Health Secretary Robert F. Kennedy Jr. To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

It regulates 20 percent of the U.S. economy, and its commissioner has an aggressive agenda — faster drug approvals, healthier food, cures for diabetes and cancer. How much can he deliver? (Part two of “The Freakonomics Radio Guide to Getting Better.”) SOURCES:Marty Makary, commissioner of the Food and Drug Administration. RESOURCES:"Clinical Trials Affected by Research Grant Terminations at the National Institutes of Health," by Vishal Patel, Michael Liu, and Anupam Jena (JAMA Internal Medicine, 2025)."What the evidence tells us about Tylenol, leucovorin, and autism," by Matthew Herper (STAT, 2025)."I Run the F.D.A. Pharma Ads Are Hurting Americans." by Marty Makary (New York Times, 2025).Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health, by Marty Makary (2024). EXTRAS:"Are You Really Allergic to Penicillin?" by Freakonomics Radio (2025)."How to Fix the Hot Mess of U.S. Healthcare," by Freakonomics Radio (2021)."Bad Medicine, Part 3: Death by Diagnosis," by Freakonomics Radio (2016). Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this episode I sit down and share the entire inspiration for this D-Now, Winter Retreat & Summer Camp on-going games with my friend, Andrew Jansen. Andrew is a 10+ year youth worker, and his assassin game sparked this entire podcast mini-series. He expains his creative (and super CHEAP) adaptation to this game. Plus! Andrew shared his lock-in survival guide for FREE! Andrew's Lock-in Guide: https://www.patreon.com/posts/10-year-veterans-146449370?utmmedium=clipboardcopy&utmsource=copyLink&utmcampaign=postsharecreator&utmcontent=join_link SHOW NOTES Shownotes & Transcripts https://www.hybridministry.xyz/184 BECOME A HYBRID HERO https://www.patreon.com/hybridministry ❄️ WINTER SOCIAL MEDIA PACK https://www.patreon.com/posts/winter-seasonal-144943791?utmmedium=clipboardcopy&utmsource=copyLink&utmcampaign=postsharecreator&utmcontent=join_link

This episode explores public concerns about using Tylenol during pregnancy and examines the scientific evidence behind claims linking it to autism. Dr. Fox and economist Emily Oster break down why current studies are flawed, how sibling-comparison research offers clearer answers, and why existing high-quality data does not support Tylenol as a cause of autism. They also discuss the real-world consequences of misinformation, such as rising parental guilt, unnecessary fear, and the risks of avoiding needed treatment during pregnancy.

We jet-set from Beverly Hills to Palm Beach with special guest Taja Abitbol—entrepreneur, wellness visionary, and star of Netflix's hot new reality series Members Only: Palm Beach. Taja, known for her luxury wellness brand Taja Drip, shares her journey from her hippie-named, Moroccan-Tunisian roots to pioneering anti-aging treatments in Miami's Faena Hotel. No booze, no Tylenol, just peptides, NAD, glutathione, and a glowy lifestyle that keeps people guessing her age (she looks 28, but that's not the number!). Taja breaks down how NAD slows aging, and teases her soon-to-launch ingestible wellness line—no gummies, just potent, high-dose liquid formulas. We share hilarious IV therapy memories from OC Fashion Week, complete with cleavage-forward nurses and jokes about IV swapping gone wild, as we bond over clean living, hot hair (shoutout to Paris in Beverly Hills), and spiritual connection, before diving into the real secret to longevity: love, joy, and meaningful relationships. The conversation turns intimate as we all reflect on our long-term relationships (Taja's been with her Capricorn partner for 15 years!), the sacredness of loyalty, and not forgiving people who knew exactly what they were doing. Patrik drops wisdom about dialing numbers with intention and calling people spiritually, while Pol' brings his signature warmth and Saint Peter Paul origin story full of Armenian heritage and holiday birthday charm. She spills the tea on the show's glam cast, wild country club culture, and behind-the-scenes drama—think Palm Royale meets Housewives with fashion, philanthropy, and the occasional pineapple-shaped clue about swingers. The show's origin story? Manifested by Taja herself, passed on by a hairdresser, and guided by a psychic who predicted a producer switch. Fate works fast when you're fabulous.

What do you think of serrapeptase for reducing coronary plaque?We were told to get a TDAP vaccine or we wouldn't be able to see our new grandchild for 8 weeks!Do I have lupus?Which supplements tend to reduce negative effects of X-rays?

The Holiday Season in NYCPeanut allergies cause and effectWhich calcium supplements can I take if I'm allergic to cow protein?Can my husband take saw palmetto in lieu of his prostate medications?What do you think of traction to help bulging discs?What is your take on green powder supplements?

SPONSORS: - For simple, online access to personalized and affordable care for Hair Loss, Weight Loss, and more, visit https://Hims.com/YMH. - Go to https://quince.com/mom for free shipping on your order and 365-day returns. - New Customers Bet $5 Get $200 in Bonus Bets If Your Bet Wins. The Crown Is Yours! Sign up using https://dkng.co/mom or through my promo code MOM. #DKPartner - Head to http://Wayfair.com right now to shop all things home. Hallelujah! Where's the Tylenol? It's a very YMH Christmas, and the studio is lit up like Clark Griswold's house because comedy legend Chevy Chase stops by! Tom and Christina unwrap holiday trauma, German Christmas music meltdowns, Santa vs. Baby Jesúska, dangerous European elevators, and the evolution of internet weirdos. Then Chevy joins to talk SNL, Three Amigos, the making of Vacation, Forrest Gump almost being his role, improv secrets, wild celebrity encounters, and why Richard Pryor was untouchable. Grab your eggnog and your wolf coat—this one is a Christmas classic. Your Mom's House Ep. 841 https://tomsegura.com/tour https://christinap.com/ https://store.ymhstudios.com https://www.reddit.com/r/yourmomshousepodcast GAMBLING PROBLEM? CALL 1-800-GAMBLER, (800) 327-5050 or visit https://gamblinghelplinema.org (MA). Call 877-8-HOPENY/text HOPENY (467369) (NY). Please Gamble Responsibly. 888-789-7777/visit https://ccpg.org (CT), or visit https://mdgamblinghelp.org (MD). 21+ and present in most states. (18+ DC/KY/NH/WY). Void in ONT/OR/NH. Eligibility restrictions apply. On behalf of Boot Hill Casino & Resort (KS). Pass-thru of per wager tax may apply in IL. 1 per new customer. Must register new account to receive reward Token. Must select Token BEFORE placing min. $5 bet to receive $200 in Bonus Bets if your bet wins. Min. -500 odds req. Token and Bonus Bets are single-use and non-withdrawable. Token expires 1/11/26. Bonus Bets expire in 7 days (168 hours). Stake removed from payout. Terms: https://sportsbook.draftkings.com/promos. Ends 1/4/26 at 11:59 PM ET. Sponsored by DK. Chapters 00:00:00 - Intro 00:00:11 - Merry Jeans-mas! 00:06:57 - Opening Clip: Cure For A Bad Day 00:08:57 - Threads, Diddy Doc, & Day Of The Jackal 00:19:51 - Clip: Chinese Girlfriend Song 00:20:49 - Situational Awareness 00:26:05 - Chevy Chase 00:30:15 - Saturday Night Live & Studio Comedies 00:39:42 - Other Roles, Directors, & Dan Aykroyd 00:46:53 - Presidents 00:50:12 - Carlin, Pryor, & The Bomb Squad 00:56:31 - The Legacy Of Vacation 01:03:05 - Wrap Up 01:04:41 - Closing Song - "Bedspread Shit" by Unknown Learn more about your ad choices. Visit megaphone.fm/adchoices

President Trump signed an executive order directing the reclassification of marijuana, but the order doesn't legalize it. It is an attempt to reclassify marijuana as a less dangerous drug moving it to a Schedule 3, alongside Tylenol instead Schedule 3 drugs like LSD and heroin. It is also expected to expand its medical use, ease restrictions purchasing and selling marijuana, and possibly make it easier for cannabis businesses to deal with banks. FOX's John Saucier speaks with Mark Meredith, Washington D.C.-based correspondent for the FOX News Channel (FNC), who explains what this executive order does and reaction from both lawmakers and Trump supporters on the decision. Click Here⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ To Follow 'The FOX News Rundown: Evening Edition' Learn more about your ad choices. Visit podcastchoices.com/adchoices

Why is autism rising? Is it genetic, environmental, or just overdiagnosed? And what's the deal with Tylenol? Phoenix pediatric neurologist Richard Frye joins the program to answer the questions millions of American couples find themselves asking as they become parents. Watch every episode ad-free on members.charliekirk.com! Get new merch at charliekirkstore.com!Support the show: http://www.charliekirk.com/supportSee omnystudio.com/listener for privacy information.

This week, Dr. Marty Makary — the newly confirmed FDA Commissioner, surgeon, researcher, and bestselling author — joins us to pull back the curtain on what he discovered inside the agency and why it made him furious. We get into the internal pressure, the conflicts of interest, how dissent was punished, and what he, Trump, and RFK are doing to overhaul food, drug, and vaccine regulation. He also dives into Tylenol in pregnancy, hormone therapy myths, over-vaccination, and what real accountability should look like.Thank you to our sponsors!GEVITI: Use code ALEX to get 20% off your first purchasePALEOVALLEY: Use code ALEX for 15% off your first orderA'DEL NATURAL COSMETICS: Use code ALEX for 25% off first-time ordersUTZY: Use code ALEX for 20% off, or FIXMYLIFE for an extra 10% off subscriptions (25% off your first subscription order)CROWDHEALTH: Use code CULTURE to get your first three months for only $99/monthCOZY EARTH: Use code ALEX for 40% offOur Guest:FDA Director- Dr. Marty MakaryDr. Marty's Links:X: @MartyMakaryInstagram: @martymakaryTikTok: @marty.makaryBook — Blind Spots: Available on Amazon

Once primarily limited to severely disabled people, autism began to be viewed as a spectrum that included children and adults far less impaired. Along the way, the disorder also became an identity, embraced by college graduates and even by some of the world's most successful people, like Elon Musk and Bill Gates.Health Secretary Robert F. Kennedy Jr. has called the steep rise in autism cases “an epidemic.” He blames theories of causality that mainstream scientists reject — like vaccines and, more recently, Tylenol — and has instructed the C.D.C. to abandon its longstanding position that vaccines do not cause autism.Today, Azeen Ghorayshi explains what's really driving the increase in diagnoses.Guest: Azeen Ghorayshi, a science reporter for The New York Times.Background reading: Should the autism spectrum be split apart?There are no easy answers for parents of children with autism.Photo: Eric Gay/Associated PressFor more information on today's episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday.  Subscribe today at nytimes.com/podcasts or on Apple Podcasts and Spotify. You can also subscribe via your favorite podcast app here https://www.nytimes.com/activate-access/audio?source=podcatcher. For more podcasts and narrated articles, download The New York Times app at nytimes.com/app.