Podcasts about tylenol pm

Today we talked primarily about how to get a better sleep naturally without using sleep medications like Ambien or Tylenol PM which (in my opinion and I am not a medical doctor) are damaging to the liver and other internal organs. Insomnia is a huge issue in our culture. So many people wake up in […] The post 29 Strange Tips For Better Sleep, Insights on Light, Show Recaps, 2 Product Recommendations, Listener Questions & More! appeared first on Extreme Health Radio.

 Do you want to be proactive about your health, or do you just shrug your shoulders and figure you play the cards you're dealt? And the big question is, what difference does it make? Today we're going to look at 10 things that contribute to the development of dementia and what, if anything, you can do about it.  I'm Dr.Vickie Petz Kasper. I practiced obstetrics and gynecology for 20 years until I landed on the other side of the sheets   as a very sick patient. When my own body betrayed me, I took a handful of pills to manage my disease and another handful to counteract the side effects. My health was out of control. Through surgery, medications, and lots of prayers, I  regained my strength only to face another  diagnosis.  My doctor challenged me to make radical changes through lifestyle medicine. Now I feel great and I want to help you make changes that make a difference. Healthy Looks Great On You podcast takes you to mini medical school so you can learn the power of lifestyle medicine. If you're ready to take control of your health, you're in the right  place. Whether you're focused on prevention or you're trying to manage a condition. I'll give you practical steps to start your own journey toward better health because healthy looks great on you.   This is episode 155, Ten Must Know Risk Factors for Dementia.  Which ones can you alter, and which ones you just gotta accept. Here's the deal, dementia isn't just one condition with one cause, it's more like a puzzle with pieces that fit together differently for each person. And some of these pieces are fixed, but others, well, they're more like clay that you can reshape. And that's exactly what we're going to dive into today.   What if I told you that some of the choices you're making right now, today, could be tilting the scales either for or against your brain health. It's never too early or too late to make changes that affect your overall health, and that includes your brain health. So, whether you're in your 30s or in your 60s, stick around.  We're about to break down these 10 risk factors for dementia and what you can do about it. Number one on the list is age. Yeah, I know, there's not a thing in the world you can do about it. This is one you have to accept. And if you're a woman, aged 45, your chances of developing dementia during your lifetime are 1 in 5. If you're a man, it's one in 10. And even though I didn't include biologic sex in this list, clearly women are at increased risk, but there may be reasons for that that you can alter. Bottom line is age is the biggest risk factor for dementia and the older you get, the greater the risk. In fact, the chances double every five years after age 65.  To quote Andy Rooney, it's paradoxical that the idea of living a long life appeals to everyone. But the idea of getting old doesn't appeal to anyone. And that's generally true and with good reason. I mean, it's not called over the hill for nothing.  They say you should grow old gracefully. Ha! There's nothing graceful about some of the tolls the years take. And according to George Burns, you know you're getting old when you stoop over to tie your shoelaces and wonder what else could you do while you're down there.  George Burns, remember him? He lived to be 100 years old and was pretty healthy. We're gonna come back to that, so be sure you listen until the end. But age is just one risk factor you have to accept.  But while you're practicing acceptance, here's another one you can't control. Family history.   If someone in your family had dementia, then you are at increased risk. And if more than one somebody in your family had dementia, you're at even more risk. And you know what they say, you can't change the past, but you can change the future. You can start where you are and change the ending. And I want you to remember that quote as we talk through this, because even if you have a strong family history of dementia, your fate is not sealed, but it is at risk. So, think about your family history. You tend to inherit your lifestyle from your family. Okay, not always, but a lot of our habits are ingrained at an early age. We sort of eat the same things and live in similar environments.  Education levels and socioeconomic advantages or disadvantages are often generational, and those things are passed down, but they're not inherited like our genetic code. So I want to challenge you to start where you are and see if there's anything you can do to change the ending.     Number three is similar to family, but not exactly the same. Genetics. Pop quiz, true or false, you can alter your genes.  I want you to stay tuned next week because we are going to talk more about the genetics of Alzheimer's.  The best way to not miss an episode is to subscribe to my newsletter. You can visit my website,  www. healthylooksgreatonyou. com or I put a link in the show notes. I share tips, recipes, and lots of other resources. So why don't you just push pause right now on the podcast and do it before you get busy or forget. Each week on the podcast, I take you to mini medical school And this week, we're going to take a closer look at our  DNA. Don't worry. It's a short course and it's never boring. Do not argue with me. Science is fun if you do it right.  DNA stands for deoxyribonucleic acid. See if you can say that three times really fast. Deoxyribonucleic acid, deoxyribonucleic acid, deoxyribonucleic acid. Now you'll remember it, even if I did annoy you a little bit. I won't say it again. I'll just use the nickname, DNA. So what is it? It's like a double stranded helix, and I'm sure you've seen pictures before. Looks like a twisted ladder. It's a molecule made up of four nucleotides, C G A T. That's cytosine, guanine, adenosine, and thymine, and these little dudes are held together by hydrogen bonds in different combinations. And here's the exciting part. Every cell in your body follows the code that is written into your DNA. It's like an instruction manual. And each person's DNA is unique. That is why human life is so sacred. Because this coding determines your eye color. your hair color, facial features, and ultimate height, as well as whether or not you're born a boy or a girl.  And here's the deal, it's all determined at the moment of conception. When the egg is fertilized, wow, we are indeed fearfully and wonderfully made. Now, inside of each cell, there's this little part called the nucleus, and that's where most of the chromosome forming DNA lives.  And all of this is foundational to understand genetics but not only does your genetic code determine aspects of your health. But your environment, behavior, and lifestyle can impact genetic expression. Meaning genes can be turned off, turned on, regulated up, regulated down, and we call that epigenetics. It can even happen in the womb before you're born. So you really are what you eat, how you act, and what you do. DNA can also be damaged, so gene expression is affected by age, exposures, environment, and other factors that we're going to look at.  But since I mentioned environmental and exposure, let's move on to number four on the list of risk factors for dementia, and that is air pollution. I bet that surprised you. Turns out that pollution causes damage to the nervous system. Things like exhaust from cars in the city or wood burning in the country. And you want to know what else pollutes the air? cigarette smoke. Smoking is a risk factor for dementia as well as a host of other conditions. Your mind may go straight to cancer, but it also increases the risk of heart disease, stroke, diabetes, and even macular degeneration, which can lead to blindness.  And it turns out that number five on the list is uncorrected hearing loss.  and uncorrected vision loss. Remember when I snorted about growing old gracefully? Well, yeah, I'm over here putting in my hearing aids and groping around for my glasses and I don't think any of that is graceful,  but I do it anyway. Now I can't see without my glasses, so they're not optional, But,  uncorrected vision loss does increase the risk of dementia, and the worse the uncorrected vision loss, the worse the risk.   But again, this only applies to people with uncorrected vision loss, and I think most of us wouldn't skip wearing our glasses or contacts, But, I do see a lot of people skip on wearing hearing aids. Now, my husband would argue with this, but I can hear pretty well.  He just talks really soft.  And isn't that what everyone with hearing loss says?  Quit mumbling!  The deal is most people can get by with some hearing impairment. But it does increase the risk of dementia.  Why is that? Well, maybe because you're not processing spoken words and that part of your brain isn't getting used and it shrinks along with everything around it. Or maybe your brain is actually devoting all of its energy to try and understand those mumblers. And it neglects keeping the rest of the brain humming along at full speed.  Experts don't really know exactly why hearing loss is associated with dementia, but it's felt to be responsible for 8 percent of cases. So get over it. Go to the audiologist fork over the cash and get your hearing aids. Your brain's worth it.  Another theory about the impact of hearing loss is interference with social activity. I mean, if you can't hear, you can't participate in conversations or play games or just connect as well. And that leads us to number six, social isolation. We're created to be connected. Isolation is associated with an increased risk of dementia as well as a whole lot of other health conditions. When I say we need each other, I mean we need each other, but I want to make a point. I've talked about the impact of loneliness on this podcast before, and I'll link those episodes in the show notes. It contributes to high blood pressure, heart disease, obesity, anxiety, depression, increased inflammation in the body, and alterations in the immune system. But listen, loneliness and social isolation are not the same.  You can live alone. and not be lonely. And you can be surrounded by people and feel loneliness. It is connection that matters. So phone a friend, text a friend, or even send an email. Even simple things like that matter and they'll appreciate it. According to the National Institute on Aging, one in four people over 65 experience social isolation. Now, I picture someone sitting home alone watching TV. Social isolation decreases the opportunity for engaging activities like playing cards. And it decreases the likelihood of staying fit. Think about how many pieces of home exercise equipment serve as just a place to hang your clothes. Going to the gym is a way to get the body fit and connect socially. People who are socially connected typically smoke and drink less. And of course, that depends on who you hang out with, but clearly, people who are trying to quit benefit from community. We all do. And speaking of quitting, many people observe dry January, and it's a great idea because number seven is alcohol. Drinking alcohol does not increase your risk of Alzheimer's,  but it may worsen it.  But hold your beer. You might remember that Alzheimer's is a type of dementia, but not all dementia is Alzheimer's.  There are several other types of dementia and one uniquely occurs in people who consume heavier amounts of alcohol. It's even called alcohol related brain damage.  Here's what happens. Alcohol causes a loss of white matter. This is where the action happens. Neurons send signals to different parts of the brain and with heavy alcohol use the brain actually shrinks, and with less volume, there's less function.  Alcohol can cause atrophy of the cells, and inhibit the growth of new neurons via a process that we call neurogenesis. Alcohol ages the brain faster and contributes to other diseases that are associated with Alzheimer's dementia and other forms of dementia as well. These conditions are things like high blood pressure and heart disease.   But wait! I thought drinking red wine prevents dementia. And this is a hot topic of research and debate. I mean, when you look at the Mediterranean diet and all those blue zones, most of them are in areas where grapes are grown. And when the fruit of the vine is ripe, well, you know. So the debate continues. And whenever there's controversy, it helps a bit to understand statistics. There's something called a J curve, and the theory was that teetotalers had a slightly increased risk of things like heart disease and brain disease, which, by the way, go together. Then, it decreased with a glass or two of red wine a day, and then the swoop up in the letter J indicated an increased risk with heavy drinking. However, whether or not there's any benefit to consuming red wine is now being challenged. And many experts assert that there is no safe level of drinking.  And if you've ever met my mother, you know she agrees wholeheartedly.  But here's the deal. There is no question that excessive drinking increases the risk of,  you name it. And it's especially harmful in midlife. Besides that, it increases your risk of everything I'm going to mention for number eight on the list, which is head injury.  And it's more common than you might realize. Over 23 million adults over the age of 40 have had at least their bell rung. That's slang for a concussion. It can be from falling, car wrecks, or sports injuries. And the more times your brain gets conked, the greater the risk. That's what we call dose dependent. Preventable? Often. Wear a helmet if you're riding a bicycle, snowmobile, motorcycle, or snowboarding or skiing.  And always, always, always wear your seatbelt. But here's where the rubber meets the road.   And that's number nine, certain chronic medical conditions. And here's the deal. Anything that affects your blood vessels affects your heart and brain. So, things like high blood pressure and diabetes, which damage blood vessels, they aren't good for the old ticker and they aren't good for the noggin either.  Okay, I don't know about you, but I'm ready for some good news.  You too, huh?  Well, how about this? Everything that keeps your blood vessels healthy is affected by lifestyle. If you didn't know that was coming, I'd like to welcome you to your first episode of the Healthy Looks Great On You podcast. But seriously, not smoking, limiting alcohol use, maintaining physical fitness, social connectedness, managing stress and things like depression, as well as eating whole foods.  That's your best weapon to prevent dementia, protect your heart and maximize your overall health.  Now if you already have one of these conditions, hear me.  Sometimes, it's not necessarily too late. Remember You can't go back and change the beginning, but you can start where you are and change the ending. now, let me give you this caveat. Sometimes, it is too late, and conditions are not reversible, and that's often the case. So, prevention is super important.  And also, it's felt that 40 percent of dementia cases can be prevented. That leaves 60 percent that cannot.  Diabetes, high blood pressure, and obesity can be prevented, treated, and sometimes even reversed with lifestyle changes.  I won't go into each one now, but there are lots of episodes that address these six pillars of lifestyle medicine, as well as specific recommendations for each of these conditions. Just head over to my website, www. healthylooksgreatonyou.  com, and browse for them. Included is an episode on preventing cognitive decline, and I'll link this one in the show notes.  But, before we say goodbye Let's say goodnight, because number 10 on the list is sleep.  The first question is, does poor sleep increase the risk of dementia or does dementia interfere with good quality sleep? And the answer is yes, both are true.  On top of that, people have more difficulty sleeping as they age. And here's another conundrum. Do prescription medications for sleep increase the risk of dementia? I mean, if poor sleep is a risk factor, shouldn't we just head to the pharmacy and pick up a bottle of sleeping pills? Well, a recent study showed that certain sleeping medications increase the risk of dementia in white people to the tune of 79%.  Now, that's in people who either often or almost regularly took sleeping medications compared to people who rarely or never took sleeping pills.  And by the way, white people use way more medications for chronic insomnia. Medications like Xanax and Valium. Trazodone, Halcion, Dalmane, Ambien, and Resoril. They're prescribed to white people 10 times more often.  But, despite these risks, 10 percent of older adults regularly take sleeping medication. And, guess what? Women are the biggest users.  Okay, fine, what if you just take over the counter medications like Benadryl, or Diphenhydramine, or Tylenol PM?  The common ingredient, diphenhydramine, has some evidence that it's associated with a higher incidence of dementia.  So what are you supposed to do if poor sleep increases your risk and medication increases your risk too? Well, I'm so glad you asked.  Sleep is complicated, but it's essential. I'll share some previous links to episodes in the show notes if you struggle with sleep. I have some good news. Coming soon, I'm doing a month long series on sleep, so make sure you stay tuned because I'm going to do a series of live webinars, too.  And if you go to my website, there are a couple of downloads that you can snag. Three simple ways to improve your sleep and what to do if you're tossing and turning because your mind won't shut off.  Okay, before we finish, what about George Burns?  Well, he lived with good health and a sharp mind until he was 100 years old. Think he didn't have risk factors? Think again. He started smoking cigars when he was 14 years old, but never cigarettes, and like Bill Clinton's joint, he didn't inhale. He had two to three drinks a day, and sometimes more, but he says he never got drunk. And he had a serious head injury after falling out of the bathtub.  He adored his wife of 38 years and looked forward to joining her in heaven. In the meantime, he exercised daily. He swam, walked, and did sit ups and push ups.  But maybe, just maybe, his biggest strength was the laughter he generated. He says he didn't tell jokes, but rather anecdotes and lies.  But he was a funny guy.  Now, I'm not saying that laughter will keep you from getting dementia or make you live longer, but it sure will put more joy in your life.  So laugh and be healthy, because healthy looks great on you.       The information contained in this podcast is for educational purposes only and is not considered to be a substitute for medical advice. You should continue to follow up with your physician or health care provider and take medication as prescribed. Though the information in this podcast is evidence based, new research may develop and recommendations may change. RESOURCES: The Deadly Epidemic of Loneliness From Loneliness to Belonging How to prevent, treat and reverse type 2 diabetes 4 Reasons to control your BP Preventing Cognitive Decline Why is Sleeping so Hard? The Mood Mechanic and the work of sleep Healthy Looks Great on You website Join the email list for all the resources  

This week, we talk to director, comedian, visual artist, writer, and conjurer of groovy worlds, RACHEL LICHTMAN (Programme 4, Easy AM 66), about one of the most surreal episodes of the fabulous variety series The Hollywood Palace!  Our deep dive leads us into one of the strangest and funniest episodes ever of Revolutions Per Movie, where we take apart (and at times destroy ‘with love') the show—complete with the mind-twisting commercials of the day. We discuss how the host, quadruple artistic threat Sammy Davis Jr., is likely the greatest TV host of all time, Rachel's deep knowledge of 60's and 70's pop culture and how she channels it seamlessly into her own art, the sadness of going to fancy restaurant as a kid with your parents, what a bummer Peter Lawford is in this episode and his vomit inducing version of Aquarius, Sammy Davis Jr. and Mama Cass Elliott killing it while performing together, the various 'mouthwash for lovers' that were being sold at the time of this episode, The Groove Tube, family bands, The 5th Dimension cop show that Rachel dreamed up, The Rolling Stones' first U.S. TV appearance on The Hollywood Palace where they got roasted by host Dean Martin, The Lawrence Welk Show, the incredible Emmy-winning production design of the show and how they were originally going to put a swimming pool floor into the theater, a very influential jazz musician-themed Kool cigarette commerical, getting a cigar sent to you in the mail, dicking around and the smells of old recording studios, working with Ted Leo & Juliana Hatfield, the Free Love movement, Redd Kross, soul legends The Dells, the Alka Seltzer politcal ad, Mad Men, the end of the variety show era, what the fuck is GrapeBerry Juice, Rosey Greer and his soul song, The John Cassevettes' styled commercial for Tylenol PM, The Electric Company & Rhoda, & the electrifying conclusion to this whirlwind show full of jaw-dropping strangeness.Be sure to watch the episode along with us in the show notes below so you can also scream in terror at Peter Lawford's counterculture attempt at being The Now Thing!!!RACHEL LICHTMAN:https://www.programme4.tv/WATCH THIS EPISODE OF THE HOLLYWOOD PALACE:https://www.youtube.com/watch?v=ePGjB13X1I0REVOLUTIONS PER MOVIE:Host Chris Slusarenko (Eyelids, Guided By Voices, owner of Clinton Street Video rental store) is joined by actors, musicians, comedians, writers & directors who each week pick out their favorite music documentary, musical, music-themed fiction film or music videos to discuss. Fun, weird, and insightful, Revolutions Per Movie is your deep dive into our life-long obsessions where music and film collide.The show is also a completely independent affair, so the best way to support it is through our Patreon at patreon.com/revolutionspermovie. By joining, you can get weekly bonus episodes, physical goods such as Flexidiscs, and other exclusive goods.Revolutions Per Movies releases new episodes every Thursday on any podcast app, and additional, exclusive bonus episodes every Sunday on our Patreon. If you like the show, please consider subscribing, rating, and reviewing it on your favorite podcast app. Thanks!SOCIALS:@revolutionspermovieX, BlueSky: @revpermovieTHEME by Eyelids 'My Caved In Mind'www.musicofeyelids.bandcamp.comARTWORK by Jeff T. Owenshttps://linktr.ee/mymetalhand Click here to get EXCLUSIVE BONUS WEEKLY Revolutions Per Movie content on our Patreon Hosted on Acast. See acast.com/privacy for more information.

If you've tried what seems like everything to sleep (melatonin, magnesium, CBD, herbs, sleeping pills, Tylenol PM, sleep trackers, a new mattress, essential oils, a cooling pad, etc) and nothing has helped, this is for you! Find out more about the Complete Sleep Solution program.

In this podcast series, you'll learn what causes poor sleep and how to “cure” your insomnia so you can sleep better permanently and naturally. Resources -Download the checklist to find out what could be causing your sleep issues -Use code SLEEP20 to get $20 off the Sleep Essentials course -Sign up for the Insomnia Insight program to find and fix the root cause of your insomnia so you can sleep well without meds. Client Testimonial My client Susan said: “​​The content you send out each week is phenomenal and I've never experienced a more comprehensive sleep program that addresses every underlying issue that could be causing sleep problems. Now that it has been six months, I do find my anxiety around sleep is much better, I am almost off of my Unisom…I feel lighter and more vibrant with the food I'm eating.” Show Notes A healthy body sleeps well. If you have trouble sleeping, it's a sign that your body isn't healthy. Even if you feel healthy. Even if you live a healthy lifestyle. If you can't sleep normally, there are things going on in your body and your mind that are keeping you awake at night. I work with clients who have tried many different things to help them sleep: melatonin, magnesium, CBD, herbs, sleeping pills, Tylenol PM, sleep trackers, a new mattress, essential oils, a cooling pad, etc. and nothing really worked. If this sounds like you, there are several reasons why these things haven't improved your sleep. Find out what they are in this episode! We can help you get 7+ hours of consistent, uninterrupted sleep.

In this episode, we follow the story of John Anderson, a seemingly healthy man in his late fifties who discovers a hidden danger lurking in his everyday routine during a routine check-up with Dr. Reddy. When unexpected liver enzyme levels raise concerns, a deeper investigation reveals that John's nightly use of Tylenol PM, a common over-the-counter medication, has been silently causing severe liver damage for years. Through his experience, we uncover the often-overlooked risks of regular acetaminophen use, especially in combination with other medications, and explore practical steps for managing pain and sleep issues while safeguarding liver health. This story serves as a critical reminder to remain vigilant about even the most familiar medicines and to prioritize informed, cautious decisions for long-term well-being.

Grab the tissues for this one. I sit down with Azure, the creator of sober.chronicles. Azure is a mom, a wife, a hospice nurse and a sobriety advocate. Azure recently hit 18 months of sobriety. Yay! Her main inspiration that led her to examining her own relationship with alcohol, came after losing her little sister, Karenza, at only 29 years due to complications of liver failure. "The kindest, funniest, clumsiest soul I have ever known suffered so silently that nobody, and I mean NOBODY knew. You would have never guessed when she walked into a room with her infectious smile and laugh. She suffered from anxiety and insomnia and tried everything in her power to just try to sleep. Using prescription and over the counter sleep aids, in addition to wine, she tried desperately to calm her mind and rest. But her liver couldn't handle it. She woke up one morning in full-fledged liver failure and battled it for 5 months before she died. This entire account, all of the effort I put into making sure this doesn't keep happening to people, is to honor my sister. I will continue to educate about the harms of alcohol. I will continue to advocate for sobriety. I will continue to use scare tactics if I have to. Because this shit is REAL. And alcohol should scare you.ESPECIALLY if it's used in conjunction with any type of anxiety medication and/or Tylenol PM. I recover out loud so nobody like Karenza has to die in silence. If you are struggling, PLEASE reach out. You are not alone. You don't have to do this alone. You are loved." Join the SobahSistahs Sobriety Club today with this 30-Day FREE Trial

Michelle Keller is an assistant professor of gerontology and the Leonard and Sophie Davis Early Career Chair in Minority Aging at the USC Leonard Davis School. She spoke to us about her research focused on improving patient-clinician communication, medication management, and the identification of dementia in minority older adults. Here are highlights from our conversation. On polypharmacy “When it comes to older adults and medications, it's important to understand that while medications can be incredibly beneficial for treating various conditions, they can also present really unique risks in this population. Older adults often take multiple medications at the same time. This is what we call polypharmacy.” “Older adults can be more sensitive to certain medications, they might experience side effects more intensely or even at lower doses than younger individuals. … This is particularly true for medications that affect our central nervous system, our brain, right? So, thinking about medications that are sedating or that have some sort of psychoactive effect. These medications, especially when they're combined together, can lead to things like confusion, dizziness and an increased risk of falls.” On her study of interventions to address polypharmacy “What we found in this study was that interventions to address polypharmacy can do a great job of reducing medications which are potentially harmful, identifying which medications people should be taking, improving the appropriateness of the medications people are taking, and reducing the total number of medications. So thinking about outcomes related to medications, what we have found is that it is really hard to change more downstream clinical outcomes, things like mortality, falls, hospitalizations, and emergency department visits. We did find that interventions that had multiple components; in other words, where a clinician is meeting face to face with a patient, reviewing their medications, reviewing all the chronic diseases that they have, along with their full patient history of what has happened to them in the past, those interventions tend to have a greater effect on mortality. So in other words, those types of interventions are reducing the risk of that someone actually dies.” “We also found that falls decrease when patients fully stop potentially harmful medications. These may be medications where somebody is feeling very dizzy or that make people feel very dizzy or drowsy, medications that may control somebody's blood sugar a little bit too much… So, their blood pressure's a little too low and they may actually fall as a result of these medications. But what we found was that stopping medications such as benzodiazepines, which are often taken for sleep or anxiety, can take months. These types of medications can have withdrawal effects. And so it's really, really important for somebody to work very closely with a healthcare provider to slowly taper these medications down to try to reduce those withdrawal effects.” “What we have found in working with other researchers and clinicians is that when patients team up with a healthcare provider, such as their primary care physician or clinical pharmacist who's embedded in the healthcare system, they really are able to stop taking some of these medications, and they feel a lot better. They feel much more energy, they're able to do the things that they really enjoy. They have a greater quality of life. But it's something that just takes time.” On the Empower Intervention for benzodiazepines “The typical recommendation for benzodiazepines is that they really should be taken short-term. These are medications that physicians typically recommend somebody take for a maximum of four weeks. What we have found in some of our research is that people are actually taking these for years, if not decades. And so stopping these medications can be quite challenging, and sometimes patients aren't fully convinced about why they should be stopping these medications. So, we took an intervention that started in Canada. It was developed by researchers in Quebec, and this is called the Empower Intervention. And what we did is we tailored it to a health system here in the US. The Empower Intervention is a really great brochure that contains some pretty striking facts about benzodiazepines.” “To give you some examples of benzodiazepine, these are like your Xanax, your Ativan, your Klonopin; these are the medications that we're talking about here. These brochures highlighted some really interesting facts, such as the fact that they can be harmful or linked to hip fractures and car accidents, and they can make people feel very tired and weak. What we did for this intervention is we sent these brochures to about 300 people along with a letter from their primary care physician, emphasizing that these medications can be harmful if taken for too long and especially among older adults. So what we did for this study is we compared patients who had received these brochures to patients who did not receive them. So they're going on usual care. Their physicians may have mentioned something to them, this was our control group, right? We didn't send anything to this particular group.” “We reviewed the medical records for both groups, and we looked at what kinds of medications they had been prescribed. And what we found is that patients who received the brochures were really activated. You know, when they received this messaging they would send messages in the patient portal to their physicians saying, ‘I didn't know that there were these risks of these medications. I would really like to come in and talk to you about them.' They made appointments to start tapering down these medications. What we found was for every 10 brochures that we sent, one person completely stopped taking these medications, which is a really good return on investment. This is a simple intervention. It has now been done in some other health systems in the US, particularly the Veterans Affairs health system.” On challenges in de-prescribing “I think some of the challenges that physicians face in de-prescribing is that de-prescribing takes a lot of time. As we all know, our primary care visits are very short; physicians, particularly in the primary care setting, are really rushed through their visits. And so I think having some of these conversations can just be something that's challenging. I also think they're quite complex conversations to have. They may not have received the training, for example, on how to taper a medication in a safe way so that a patient does not feel withdrawal effects. And I do think that there is something about getting physician buy-in … they are concerned [that] if they bring it up, the patient may be angry with them; they may be upset. And so I think really showing physicians ways in which this can be brought up that are really framed around ‘how do we center the patient's health and quality of life' – I think those are still questions that we as researchers are working on.” On the role of caregivers “It's really important for caregivers to be aware of the medications their loved ones are taking for many reasons. I think they can be amazing advocates in helping bring up potential side effects during doctor's visits. So, for example, if a caregiver is noticing that someone is feeling drowsy or doesn't have that much energy or is feeling dizzy, any sort of cognitive impairments such as those that may be seen in dementia, [they] may actually be a result of medication side effects. So, I think really becoming an advocate for somebody when seeing the doctor is one really important thing that caregivers can do.”  “Another area where caregivers can play a really important role is among people with dementia. People with dementia can have really some challenges in managing their medications. They may miss doses, they may take several medications twice, so they may have an overdose, or they may take the wrong medication altogether. So, caregivers can play really pivotal roles in helping somebody manage medication changes. There have been some early interventions looking at how to engage caregivers and persons with dementia. And some of the challenges that those researchers have seen is that there [is] often more than one person actually caring for somebody with dementia. And so, engaging that whole group of people who may be working with that person has been a real challenge.” On challenges facing patients with language barriers  “There is research showing that patients with language barriers have a greater risk of being hospitalized or re-hospitalized because of some of the communication challenges that come with medication management. So, you can imagine that, for example, older adults and their caregivers with language barriers may have a difficult time understanding medication instructions, which can lead to improper use. So when and how to take medications, recognizing potential side effects, understanding the purpose of each medication. And on top of that, you can layer on things, like if somebody doesn't have a great understanding of the condition. We call that disease literacy, or they may have health literacy issues.” “Right now, a mentee and I are working on this review of interventions that have been done specifically for patients with language barriers focused on improving medication management. And what we found was that interventions that really engaged people from communities with language barriers have been some of the most effective ways to really help people learn about which medications are working really well for them, how to improve medication adherence and other important outcomes. So, for example, an intervention that we found was researchers engaged folks in the community, co-created videos about medications in the community and why it was important to take them. And then when they actually distributed these interventions, they made sure that both in terms of the videos and some of the other educational materials that were handed out to folks that these really were very tailored both language-wise, literacy-wise, and culturally tailored to the communities that they were serving.” On new dementia medications and disparities in the diagnosis of dementia  “We are learning that older Black and Latino adults tend to get diagnosed with dementia once the disease has progressed more. And what that means is that they may not have received some of the kind of services that may help them or their families. So, for example, they may not have received enough support to be able to plan for the rest of their lives, or their families may not necessarily have received caregiving support early on in disease progress.” “I think in regard to these particular dementia medications, for example, if older adults are diagnosed with dementia at a place where they're no longer eligible to receive these medications, I think that'll be a really pretty serious health equity issue. So, I am really interested in how we make sure that people are getting diagnosed in time to make them eligible for really potentially beneficial treatments that may help them down the road.” On effective strategies for de-prescribing  “The most effective strategies that we see de-prescribing these medications is offering something else. So, for example, some of the most evidence for insomnia really exists around the use of using cognitive behavioral therapy. There's also been well-done systematic reviews that have found evidence that music or acupuncture may help people with insomnia. … I think one thing that's very important to think about when we de-prescribe medications is what else can we offer people? We're not just leaving people in the lurch and saying, ‘We're taking this away and we're leaving you with nothing.' We're actually able to offer them some non-pharmacological options as well.” Transcript Speaker 1 (00:02): One thing that's very important to think about when we de-prescribe medications is: what else can we offer people? We're not just leaving people in the lurch and saying, we're taking this away and we're leaving you with nothing. We're actually able to offer them some non-pharmacological options as well Speaker 2 (00:17): From the USC Leonard Davis School of Gerontology, this is Lessons in Lifespan Health, a podcast about the science and scientists improving how we live and age. I'm Orli Belman, Chief Communications Officer. On today's episode: how Professor Michelle Keller is working with older adults, caregivers and clinicians to manage the use and potential overuse of high risk medications. Michelle Keller is an Assistant Professor of Gerontology and the Leonard and Sophie Davis Early Career Chair in Minority Aging at the USC Leonard Davis School. Her research is focused on improving patient-clinician communication, medication management, and the identification of dementia in minority older adults. Hi, Michelle. Welcome and thank you for joining us today. Speaker 1 (01:06): Thank you so much for having me. Speaker 2 (01:08): I wanna start by asking you to talk about older adults and medications. We can all understand why medications are beneficial, but when it comes to older adults, what are some of the ways they can be problematic? Speaker 1 (01:19): Absolutely. So when it comes to older adults and medications, it's important to understand that while medications can be incredibly beneficial for treating various conditions, they can also present really unique risks in this population. So older adults often take multiple medications at the same time. This is what we call polypharmacy. Polypharmacy can increase the risk of drug interactions, right? So I like to think of the example of a suitcase, right? So imagine that you are packing up, getting ready to go to a trip. You start putting one thing into the suitcase, gets a little heavy, but you can manage it, right? You're suddenly adding more and more things and the suitcase is getting heavier and heavier to the point where you actually throw out your back at the airport, right? This is really what I think of when our bodies are kind of processing multiple medications at once with the additional challenge that some of these drugs may actually interact with one another. Speaker 1 (02:15): This is why it's so important for patients to talk to their doctors about the medications they're taking and the potential risks of each medication as people get older. I think one thing that people don't often think about is that when clinical trials are being done, often many clinical trials have excluded older adults. So we don't always have a great sense of how these medications work in older adult populations. And on top of that, they may exclude people with chronic conditions who are already taking a variety of other medications. And so as a result, what is happening now is that we have many people who are taking these medications, and it hasn't been well tested in these populations. It hasn't really been, you know, we don't have a clear sense of what is happening when all of these medications are being taken together. So polypharmacy can really increase the risk of drug interactions. Speaker 1 (03:09): As I was saying, when one medication affects another, and this can lead to a variety of adverse effects. So for example, if someone is taking multiple medications that make you feel drowsy or sleepy when you stack them on top of each other–thinking again about that suitcase, that can lead someone to have an increased risk of falls, potentially a fracture resulting from those falls, car accidents if they're feeling very drowsy or dizzy and other medications can increase our risk of internal bleeding. Another thing that's really important to think about for older adults is that as we get older, our bodies undergo various changes that can alter how our medications are absorbed, distributed, and actually excreted from the body. So for example, kidney and liver function can really decline with age. And so that can actually affect how well we process the drugs through our body. Speaker 1 (04:05): What that means is that drugs may stay in our bodies for longer periods of time leading to more side effects or adverse effects. The last thing I really wanted to bring up is this idea of how things change as we get older. So we maybe have been taking a medication for many years, but as we get older because of the changes that are happening within our body, some medications, which were fine for us when we were younger, are now gonna lead to more serious adverse effects now that we're older. So older adults can be more sensitive to certain medications, so they might experience side effects more intensely or even at lower doses than younger individuals. They might feel the effects. So this is particularly true for medications that affect our central nervous system, our brain, right? So thinking about medications that are sedating or that have some sort of psychoactive effect. Speaker 1 (05:04): These medications, especially when they're combined together, can lead to things like confusion, dizziness, and an increased risk of falls. One medication which people often take to help them sleep is Benadryl or Tylenol PM. This medication is actually a drug that's really recommended to avoid in older adults because it can be very sedating, making people feel very drowsy throughout the day. And it actually also has the effects on the brain and has been associated with a higher increased risk of dementia. So these are medications that again, we don't think of as generally harmful, but again, in an older person might really be an issue. Speaker 2 (05:46): That's a really helpful example 'cause that's just an over the counter medication that anyone can get, even without a doctor. You recently published two papers looking at interventions for addressing polypharmacy. The first one was a review of several studies. What did you learn in that review about the effectiveness or not of programs that are designed to reduce harmful polypharmacy? Speaker 1 (06:08): So we reviewed several systematic reviews. These are collections, as you mentioned, of numerous studies to understand how well interventions to address polypharmacy are working. Many of these interventions include a process called de-prescribing, which is the process of systematically reducing or stopping medications that may no longer be beneficial or might be causing harm, particularly in older adults. The goal of deprescribing is to optimize an individual's medication regimen to improve their overall health and quality of life. What we found in this study was that interventions to address polypharmacy can do a great job of reducing medications which are potentially harmful, identifying which medications people should be taking, improving the appropriateness of the medications people are taking, and reducing the total number of medications. So thinking about outcomes related to medications, what we have found is that it is really hard to change more downstream clinical outcomes. Speaker 1 (07:11): Things like mortality falls, hospitalizations, and emergency department visits. We did find that interventions that had multiple components, in other words where a clinician is meeting face-to-face with a patient, reviewing their medications, reviewing all the chronic diseases that they have along with their full patient history of what has happened to them in the past, those interventions tend to have a greater effect on mortality. So in other words, those types of interventions are reducing the risk that someone actually dies. We also found that falls decrease when patients fully stop potentially harmful medications. So these may be medications that make people feel very dizzy or drowsy medications that may control somebody's blood sugar a little bit too much and so they're actually feeling very low blood sugar or medications where their blood pressure is overly controlled. So their blood pressure's a little too low, and they may actually fall as a result of these medications. Speaker 1 (08:12): But what we found was that stopping medications such as benzodiazepines, which are often taken for sleep or anxiety, can take months. These types of medications can have withdrawal effects. And so it's really, really important for somebody to work very closely with a healthcare provider to slowly taper these medications down, to try to reduce those withdrawal effects. And because it takes so long to fully stop these medications, it's hard for studies to really find an effect unless they're following that person for a long period of time, which studies often don't. And so that's one of the challenges that we've seen in the research is that studies haven't followed people for enough time. Or at the time that they're measuring some of these clinical outcomes, not enough time has gone by to really see the full effects. So what we have found in working with other researchers and clinicians is that when patients team up with a healthcare provider such as their primary care physician or clinical pharmacist who's embedded in the healthcare system, they really are able to stop taking some of these medications and they feel a lot better. They feel much more energy, they're able to do the things that they really enjoy. They have a greater quality of life, but it's something that just takes time. Speaker 2 (09:28): And I imagine it's something you have to balance when someone really might need a medication to treat something and then managing the side effects. That's really interesting. I know the second study looked at a particular intervention and this was the use of educational materials for benzodiazepines. What led you to explore this area and what did you find? Speaker 1 (09:49): Great question. So benzodiazepines are, as I mentioned earlier, medications that are often used for sleep or anxiety. The typical recommendation for benzodiazepines is that they really should be taken short term. These are medications that, you know, physicians typically recommend somebody take for a maximum of four weeks. What we have found in some of our research is that people are actually taking these for years, if not decades. And so stopping these medications can be quite challenging and sometimes patients aren't fully convinced about why they should be stopping these medications. So we took an intervention that started in Canada. It was developed by researchers in Canada, in Quebec, and this is called the Empower Intervention. And what we did is we tailored it to a health system here in the US. The Empower Intervention is a really great brochure that contains some pretty striking facts about benzodiazepines. Speaker 1 (10:45): To give you some examples of benzodiazepine, these are like your Xanax, your Ativan, your Klonopin. These are the medications that we're talking about here. These brochures highlighted some really interesting facts such as the fact that they can be harmful or linked to hip fractures and car accidents and they can make people feel very tired and weak. What we did for this intervention is we sent these brochures to about 300 people along with a letter from their primary care physician, emphasizing that these medications can be harmful if taken for too long and especially among older adults. So what we did for this study is we compared patients who had received these brochures to patients who did not receive them. So kind of they're going on their usual care, their physicians may have mentioned something to them. This was our control group, right? We didn't send anything to this particular group. Speaker 1 (11:40): We reviewed the medical records for both groups and we looked at what kinds of medications they had been prescribed. And what we found is that patients who received the brochures were really activated. You know, when they received this messaging, they would send messages in the patient portal to their physicians saying, I didn't know that there were these risks of these medications. I would really like to come in and talk to you about them. They made appointments to start tapering down these medications. What we found was for every 10 brochures that we sent, one person completely stopped taking these medications, which is a really good return on investment. This is a simple intervention. It has now been done in some other health systems in the US, particularly the Veterans Affairs health system. And you know, groups have found similar effects. We also found that the probability that someone in the intervention group completely stopped their medications was about 10% greater compared to the group that did not get the brochure. Speaker 1 (12:41): So again, you know, for a cheap simple intervention, we were pretty excited about these results. What's been really interesting is I just came back from two conferences, the US De-Prescribing Research Network and the Society for General Internal Medicine Annual Meeting. And we find that other researchers are also finding that engaging patients in reducing these potentially harmful medications is actually one of the most effective forms of deprescribing. There have been plenty of studies where researchers have actually engaged physicians and those have not been as successful. So what I'm really excited about in terms of thinking about future interventions is, how do we really engage patients in learning about what are the best options for them to manage their health? Speaker 2 (13:28): So you just said that physicians, it's been a little harder to see change in their prescribing behaviors. What do we know about ways they can introduce the idea of reducing or stopping a medication? Speaker 1 (13:39): Yeah, I think it's a great question. I think communicating when, how and why a medication should be reduced or stopped can be really challenging. What researchers have found is that when physicians focus on improving a patient's quality of life, that is what is most effective. So for example, thinking about stopping or reducing certain medications can give somebody more energy, help them move around better, they're not feeling as unsteady on their feet or dizzy. They can think more clearly because they're no longer feeling feelings of brain fog or sleepiness or drowsiness. I think these can be some really effective messages. I think some of the challenges that physicians face in de-prescribing is that de-prescribing takes a lot of time. As we all know, our primary care visits are very short. Physicians, particularly in the primary care setting, are really rushed through their visits. And so I think having some of these conversations can just be something that's challenging. Speaker 1 (14:41): I also think they're quite complex conversations to have. They may not have received the training, for example, on how to taper a medication in a safe way so that a patient does not feel withdrawal effects. And I do think that there is something about getting physician buy-in, in terms of, they are concerned about, you know, if they bring it up, the patient may be angry with them, they may be upset. And so I think really showing physicians ways in which this can be brought up that's really framed around, how do we center the patient's health and quality of life? I think those are are still questions that we as researchers are working on. Speaker 2 (15:17): We've talked about physicians and obviously patients themselves. How about caregivers? What role can they play in helping address some of these issues? And are there interventions that especially aim to include them? Speaker 1 (15:28): Yeah, great question. I think it's really important for caregivers to be aware of the medications their loved ones are taking. For many reasons. I think they can be amazing advocates in helping bring up potential side effects during doctor's visits. So for example, if a caregiver is noticing that someone is feeling drowsy or doesn't have that much energy or is feeling dizzy, any sort of cognitive impairments, right? So, such as those that may be seen in dementia, may actually be a result of medication side effects. So I think really becoming an advocate for somebody when seeing the doctor is one really important thing that caregivers can do. Another area where caregivers can play a really important role is among people with dementia. People with dementia can have some challenges in managing their medications. They may miss doses, they may take several medications twice, so they may have an overdose or they may take the wrong medication altogether. So caregivers can play really pivotal roles in helping somebody manage medication changes. There have been some early interventions looking at how to engage caregivers and persons with dementia. And some of the challenges that those researchers have seen is that there are often more than one person actually caring for somebody with dementia. And so engaging that whole group of people who may be working with that person has been a real challenge. Speaker 2 (16:54): Are there particular challenges faciing under-resourced communities or populations with language barriers? I imagine some of this communication is even harder in these cases. What do you think needs to be done in these areas? Speaker 1 (17:09): Absolutely. There is research showing that patients with language barriers have a greater risk of being hospitalized or rehospitalized because of some of the communication challenges that come with medication management. So you can imagine that for example, you know, older adults and their caregivers with language barriers may have a difficult time understanding medication instructions, which can lead to improper use. So when and how to take medications, recognizing potential side effects, understanding the purpose of each medication. And on top of that, you can layer on things like, you know, if somebody doesn't have a great understanding of the condition, right? So we call that disease literacy. Or they may have health literacy issues, or on top of that, we may even have literacy concerns where the person does not know how to read or has a limited ability to read. So layering on all these challenges can really make it difficult to both manage your medications and communicate with physicians about their concerns or side effects regarding medications. Speaker 1 (18:14): Right now, mentee and I are working on this review of interventions that have been done specifically for patients with language barriers focused on improving medication management. And what we found was that interventions that really engaged people from communities with language barriers have been some of the most effective ways to really help people learn about which medications are working really well for them, how to improve medication adherence and other important outcomes. So for example, an intervention that we found was researchers engaged folks in the community. They co-created videos about medications in the community and why it was important to take them. And then when they actually distributed these interventions, they made sure that both in terms of the videos and some of the other educational materials that were handed out to folks, that these really were very tailored both language wise, literacy wise, and culturally tailored to the communities that they were serving. Speaker 2 (19:16): Another area I wanna touch on is your work improving doctor patient communication. And I'm curious if your background as a newspaper reporter has informed your research in this area, and what are some of the ways that patients lose out when communication is not clear? Speaker 1 (19:32): So I think a lot about how we can help clinicians communicate complex information about medications and other treatments in simple, accessible ways. Which is really something that I aimed to do as a reporter, right? When I worked as a reporter, oftentimes I would take studies from medical journals and I would break them down in a way that was really easy and accessible for the public to read. And so that is really something that I'm very interested in. How do we help clinicians do the same thing? Or if we're designing interventions for patients, how do we do something similar? How do we make the risks and benefits of medications very clear to people so that they're able to make the best decisions about those for their health? So one area that I'm really interested in is these new medications for dementia that have come out, which are the anti amyloid medications. These medications have some pretty potentially serious side effects such as brain bleeding and swelling. And I'm working on a research proposal thinking about, how do we best present these medications to patients in a way that they feel like they're able to make the best decisions for themselves and their loved ones? I think it'd be really critical, particularly in terms of health equity for people to have a very good sense of how these medications can potentially help but also understand the serious risks associated with the new dementia medications. Speaker 2 (21:02): And speaking of dementia, I think you've also looked at the diagnosis of dementia and whether or not there's differences in minority populations. Is that something you can tell us a little bit about? Speaker 1 (21:14): Absolutely. So that is an area of research that I'm actually just starting to get into because what we are learning is that older black and Latino adults tend to get diagnosed with dementia once the disease has progressed more. And what that means is that they may not have received some of the services that may help them or their families. So for example, they may not have received enough support to be able to plan for the rest of their lives, or their families may not necessarily have received caregiving support early on in disease progress. I think in regards to these particular dementia medications, for example, if older adults are diagnosed with dementia at a place where they're no longer eligible to receive these medications, I think that'll be a really pretty serious health equity issue. So I am really interested in, how do we make sure that people are getting diagnosed in time to make them eligible for really potentially beneficial treatments that may help them down the road? So I'm thinking about how do we train physicians who are working in under-resourced settings, which may serve large proportions of black and Latino older adults, how to diagnose dementia in a primary care setting, and working with some colleagues in the Los Angeles Department of Health Services on how we can think about making physicians feel more confident, their diagnosis of dementia among older adults. Speaker 2 (22:40): And I wanna go back to sleep and anxiety because I know that's something that affects so many people at all ages. If these interventions are successful and people are able to stop taking some of these medications, are there strategies or interventions that we know might work for helping them with the initial conditions they were struggling with to begin with? Speaker 1 (23:01): Yeah, absolutely. I think that's a really good question because sleep and anxiety are things that can really affect somebody's quality of life and functioning, right? The most effective strategies that we see de-prescribing these medications is offering something else. So for example, some of the most evidence for insomnia really exists around using cognitive behavioral therapy. There's also been really well done systematic reviews that have found evidence that music or acupuncture may help people with insomnia. So I think one thing that's very important to think about when we de-prescribe medications is what else can we offer people? We're not just leaving people in the lurch and saying, we're taking this away and we're leaving you with nothing. We're actually able to offer them some non-pharmacological options as well. Speaker 2 (23:48): That's a really helpful note to end on. Thank you for joining us, and I know that people are really gonna benefit from learning about all you've been working on and all your work that's gonna continue in the future. Speaker 1 (23:59): Thank you so much for having me today. It's been a real pleasure. Speaker 2 (24:02): That wraps up this lesson in Lifespan Health. Thanks to Professor Michelle Keller for her time and expertise and to all of you for choosing to listen. Join us next time for another Lesson in Lifespan Health, and please subscribe to our podcast@lifespanhealth.usc.edu. Lessons in Lifespan Health is supported by the Ney Center for Healthspan Science.

In this podcast series, you'll learn what causes poor sleep and how to “cure” your insomnia so you can sleep better permanently and naturally. Resources -⁠Download the checklist⁠ to find out what could be causing your sleep issues -Use code SLEEP20 to get $20 off the Sleep Essentials course -Sign up for the Insomnia Insight program to find out exactly what's causing your insomnia and get a plan to fix it within 30 days. Client Testimonial My client Susan said: “​​The content you send out each week is phenomenal and I've never experienced a more comprehensive sleep program that addresses every underlying issue that could be causing sleep problems. Now that it has been six months, I do find my anxiety around sleep is much better, I am almost off of my Unisom…I feel lighter and more vibrant with the food I'm eating.” Show Notes A healthy body sleeps well. If you have trouble sleeping, it's a sign that your body isn't healthy. Even if you feel healthy. Even if you live a healthy lifestyle. If you can't sleep normally, there are things going on in your body and your mind that are keeping you awake at night. I work with clients who have tried many different things to help them sleep: melatonin, magnesium, CBD, herbs, sleeping pills, Tylenol PM, sleep trackers, a new mattress, essential oils, a cooling pad, etc. and nothing really worked. If this sounds like you, there are several reasons why these things haven't improved your sleep. Find out what they are in this episode! We can help you get 7+ hours of consistent, uninterrupted sleep.

The year 2020 will forever be etched in the minds of those who lived to tell the tale. Oh, the stories we will tell. The smoke and mirrors were dispersed and the United States revealed its true self. We bore witness to Riot, after Riot, after Riot. The revolution appeared to be televised after all. But deep in our communities the true revolution was brewing. Many Black women and birthing people continued to give birth despite the headlines, the statistics, and the odds stacked against them. But they didn't just give birth; they gave birth how they wanted, where they wanted, and focused on what was most important to them. A surprise pregnancy anchored Chris and Raquel's growing family and allowed them to sway but not break during an uncertain time. Raquel entered the pregnancy unemployed due to a hiring freeze, from the shutdown, that kept her from starting her new position. Chris became the sole provider as they moved forward with the pregnancy.  The first few weeks of pregnancy brought about two different mental shifts. Anxiety filled Raquel as she continued to apply for jobs and manage the COVID-19 pandemic while pregnant. The isolation was challenging but allowed for a slower pace and opportunities to be introspective. Chris had a more challenging experience with his employer and managing how he would navigate the birth and postpartum period. He did not have paternity leave and intended to take leave without pay. The thought of it was scary as he knew he would be bucking the system. The Williams chose to keep their pregnancy to themselves aside from their parents. Their birth plans were kept under wraps and allowed them to keep out the noise, opinions, and outside stressors. Chris and Raquel chose a homebirth with a midwife and a doula. They utilized their resources and access to do it their way. Raquel dove into research on birth and parenting. Chris had the mentality of being ready when the time came. He found himself focused on trying to go against the negative stereotypes of Black fathers. Holistic care equipped Raquel with education, mental fortitude, and an understanding of what childbirth could include. When she started to feel the small ripples of early labor she contacted her birth team which included her midwife, doula, and birth photographer. Chris was spending the day attending graduation ceremonies for his students. Raquel told Chris he was fine to go and she knew it would be fine. They had a late dinner but didn't set up the birthing tub because it was too late in the day. The waves were not close enough for her to think that she was in active labor. She checked in with her midwife and she told her to use her discernment. Raquel took a Tylenol PM and they enjoyed a movie and facials until she fell asleep. Around four in the morning, Raquel stated that she had to poop. They went down together, Chris could see her from the door, and as Raquel made a maneuver he said, “I don't think that's poop.” Chris was scared that the baby had died, due to the shape and stillness of her head. Meanwhile, Raquel was in a calm, zen state as she assured Chris the baby was ok. They were able to Facetime their midwife to manage the delivery of the baby. Chris caught their baby with a nuchal cord and unwrapped it and placed the baby on Raquel's chest. The midwife entered the house shortly after. Dani and the birth photographer joined them shortly afterward for postpartum support and photography. Immediately postpartum, they walked back down the hall with their baby. The experience of having their team come to them and the care that was provided for them had them in awe. Raquel believes that everything we need to have children… we already have it. We've been having babies like this forever.

3pm - John accidentally took 3 Tylenol PM’s before the show // New documents show Jay Inslee may have known about 40 cents rise in gas prices nearly a decade ago // More on the Tuna Checks // The Mariners and Live Nation hold a press conference to announce a Billy Joel concert at T-Mobile… Is Billy Joel still press conference worthy? // The laziest person’s guide to feel healthier without working very hard // If you ever go deep sea fishing, be sure to wear a watch

While last week's episode was my deepest one up to that date, this one today takes the icing on the cake. In early 2021, I was diagnosed with an extremely serious back condition that was going to lead to a 14-hour back surgery. I was already burnt-out. I was already shot. I had just had my 2nd knee replacement 6-weeks prior. And I was now facing my biggest physical challenge in my 50-years of living. And today, I discuss  ALL OF IT and why this episode will go down as my deepest episode in the history of the IMPACT SHOW. And I hope I don't have one in the future that tops this one.   Specifically, in today's episode, I share: - What happened to my back, the diagnosis, and why my doctor asked me if I had served in Afghanistan. - What happened on Feb 17, 2021, and how my 20th wedding anniversary soon changed from a great day to one of misery. - My trip to Sedona, AZ, and how I couldn't even walk. - Why I was sleeping only 3-4 hours a night and why I was relying on Tylenol PM to try and sleep more. - My back brace and why I didn't tell anyone about my back. - My visit to the “Back Deformity Specialist” and how and what he said to me was permanently etched in my head. - My breakdown in March 2021 and what Melanie said to me that I will never forget. - What happened to my back in Cabo, Mexico, and how it almost led to a trip to an Emergency Room in Mexico. - Dropping my son Luke off to college his freshman year but why I was stuck in my hotel room. - Epidurals, painkillers, 6 back-doctors, and a lot of PAIN! - What pain does to your mind, how pain zaps your energy, and why it's so hard to serve others when you are in chronic serious pain. - My Top Lessons from the “Year of hell” and what I would say if/when you go through a bout of serious pain. - Broken or blessed? How my faith carried me through the desert when I had very little left. - What happened, how I avoided surgery, some of my top hacks to “get out of pain” almost a year later.   My friends, this was a very difficult episode to share. It's one of the darkest periods of my life. While most didn't know what I was battling, I found solitude and peace in serving & creating as it fed my soul. I think it will make sense when you listen to the story but I'm so grateful and happy today that I got through it. I share it because you can probably relate in some way. Whether you had physical pain or mental anguish, a massive challenge you had to overcome, or perhaps you are there today….or tomorrow, my hope is that you can come back to this episode at any time and realize that “GETTING YOUR MIND RIGHT” is way more than just a saying or mantra. It's a way of life.   Thank you. Thank you for giving me this space & podcast a great place to share. And thank you for listening or watching. And thank you for your feedback. I read every single text, DM, email, or message. Please keep them coming.   If you can please SHARE this episode on your social media, I'm confident that there is someone in your circle that can benefit from this very episode.   SHARE & TAG: IG & Twitter: @ToddDurkin FB: @ToddDurkinFQ10 Linked-In: @ToddDurkin   Additionally, please make sure you: 1.  Please make sure you are subscribed to the Todd Durkin IMPACT SHOW podcast. 2.  Be a part of my TEXT COMMUNITY. 619.304.2216. Sign-up to not miss a single text from me. And yes, it is ME on the other side of that. 3. After listening to today's episode, can you please text me or email me any QUESTIONS you have stemming from the episode. 4. Lastly, I have my new 2.0 version of “Dose of Durkin” emails and messages beginning to drop next week. You will get 1 workout challenge and an inspirational verse or quote every Thursday. 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Sydney joins Meagan on the podcast today to share her VBAC story and talk about her experiences going past 42 weeks for both of her pregnancies. Meagan shares a story about one of her doula clients who went past 43 weeks! Sydney and Meagan discuss how due dates are calculated and the flaws behind the method that is so widely used.Meagan shares evidence-based information about the risks involved with being pregnant longer than 42 weeks as well as risks surrounding the choice to induce earlier. Having multiple sources of information along with your personal experiences and feelings will help you feel more empowered to make the right decisions surrounding when to birth your baby!Additional LinksBirthful Podcast Episode on Due DatesEBB: Evidence on Due Dates BlogHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode DetailsMeagan: Hello! It is The VBAC Link. My name is Meagan and we have another VBAC story for you today. In addition to the VBAC story, we're going to be talking about postdates. This is a really hot topic especially in the VBAC world because we have a lot of people, I don't want to say forced necessarily, but pressed to induce their labor. I think after the ARRIVE trial came out, it's become even more pressing to have a baby by 39 weeks. I feel like the way we view the new due dates is that 40 weeks is 41. 39 is 40. 38 is 39. I feel like in a lot of areas in the world, that is how our mental state has shifted and we don't really hear 41 weeks or 42 weeks as much anymore. Today, we have Sydney, and guess what you guys? She had 42 weeks and 5 days, right? Is that right Sydney with your first? Sydney: Mhmm, that's right. Yes. Meagan: And then 42 weeks and 3 days with the second. So you are one of those mamas that carry further along than a lot of people. We're going to actually make sure to have it here in the show notes but the Birthful Podcast, I don't know if you guys listen to Birthful Podcast but I love it. I'm not even expecting anymore. I'm done having kids but I still love listening to it because the guests that she has on there are just filled with information. I want to say the guest she had, her name was Gayle I want to say. Don't quote me on that. But she has an episode all about due dates and talking about how the body carries. Review of the WeekWe are going to get some more into that at the end but of course, we have a review of the week and then we will have Sydney share her VBAC story with you. This review is by Rachelmademusic. It says, “Such a gem of a show. Thank you, thank you, thank you, Julie and Meagan, for creating this supportive and powerful space for mamas like me to learn and prepare for our VBACs. I'm currently 33 weeks pregnant and preparing for my own VBAC. I can't begin to express just how thankful I am to have found this podcast. I am truly grateful for this resource and for all of the mamas who come onto this show and share their stories. There is such an incredible strength and collective wisdom to be found here and I highly recommend this podcast to anyone preparing for VBAC or not.”Oh, thank you so much Rachelmademusic. I would agree. This podcast is such a great platform for first, second-time, third-time moms, fourth-time moms, and not even just VBAC moms because there is so much information that is shared on this podcast that talks about how to avoid a Cesarean. When we have a Cesarean in the US, it's almost 32%. That's pretty stinking high especially when it used to be 5% way back in the day. Although our VBAC rates are also going up, Cesarean rates have just skyrocketed. So if we can learn how to avoid an unnecessary Cesarean or undesired which a lot of us have had undesired and unplanned or maybe unnecessary Cesareans, we can start lowering that. I think it could be super impactful to a lot of the world because as part of these stories, we hear these first-time Cesareans or second-time Cesareans and they don't always resonate with positivity. That is hard because we want our birth experiences to be positive. So yeah. I think that it's super important that anybody listens to all of these birth stories. Sydney's StoriesMeagan: Okay, welcome to the show, Sydney. Thank you so much for taking time out of your day to be here with us and share these stories. Sydney: Thank you. Meagan: Are you in Virginia? Is that correct? Sydney: Yep, I'm in Virginia. Meagan: Awesome. We're going to start trying to say where people are because a lot of the times, we'll get messages that will say, “Oh my gosh, I'm in the same area. Is there any way I could get their providers?” So it's fun to be like, “I'm in Virginia. I will listen to this too because I want a VBAC and I want to learn who is supportive or who is maybe not supportive.” Yes, okay. Well, I would love to just hear your story and share this with all of you women of strength listening. Sydney: Yeah, great. Okay, thanks. Yes, I'm Sydney. I'll just jump into my first birth story. I was pregnant actually during the pandemic. My due date was August 8, 2020. Meagan: Okay, in the thick of it, really. Sydney: Yes, right in the midst of it. We were planning to birth with our birth center here locally. I actually was living in Tennessee when I got pregnant then moved about halfway through and started prenatal care with a birth center here so I was planning for a natural birth and just sort of assumed everything would be fine. Women had been giving birth forever. I come from a lot of strong women having a lot of babies so I just did not even think. I assumed it would be fine. Meagan: Yeah, you didn't think anything of it. Yeah. Sydney: Yeah, this is just what people do. I'll be fine. Everything was pretty normal with the pregnancy. I got to 40 weeks and had no signs of labor. I was not really worried about it at that point. Then I started getting to the end of 41 weeks and I was like, “Hmm. Huh. What do I do now?” The midwives were really helpful and gave me of course all of the things to try. I tried all of the things. I was going to the chiropractor multiple times. I tried acupuncture. I was drinking tea. I was pumping and doing all of the things that they told me I should do to try and get labor going. I just was not having much luck. So finally we decided, “Okay.” I was going to be 42 weeks on a Saturday so we thought, “I'll try the big guns, castor oil, on Saturday.” Something happened with the midwife. She wasn't ready for me to do it on Saturday so we had to wait until Monday which was 42+2. I took it first thing Monday morning at 6:00 or 7:00 AM. I could not keep it down. I threw it up so I had to do it again which was horrible. I hated it. I was like, “I'm never doing this again.”Meagan: Did you drink it straight? Did they have you mix it in a concoction? Sydney: They had me do a milkshake with vanilla ice cream, peanut butter, and castor oil. Meagan: Yeah, that's actually similar to what I drank. Sydney: Really? Okay. Meagan: Yeah, with my second. It's gross. Sydney: It was still so disgusting. Meagan: Yeah, yeah. Sydney: I did it a second time. The castor oil did its job. It got some contractions going but I was walking a lot to just keep them doing anything. That sort of continued through Tuesday. I was having just mild contractions on and off. Then by Wednesday morning which was when I was 42+4, they were strong and consistent. The midwives were like, “Okay, we think you're ready to come in. Let's get things going.”I remember they had to meet us at the birth center. It was 7:30 in the morning. I got there and apparently, another mom had beat me there. She was also in labor. So as soon as I walked in, I'm a first-time pregnant mom, she is pushing her baby out and screaming. It was the most terrifying thing I had ever heard. Literally, I think my cervix just closed up and was like, “Nope. Not doing that.” I literally didn't have contractions for a couple of hours after that. It all stopped. Meagan: Yeah. Sydney: That was unfortunate, Meagan: That can happen. That can really happen though. It doesn't even matter. Maybe nothing significant like a woman screaming in labor, it doesn't have to seem significant. It can be just shifting from the car to the hospital or your home to the car or downstairs to upstairs. Something off can calm things down. Sydney: It did, yeah. Meagan: Sometimes it's just your body responding and needing a break. Sydney: Yeah, yeah and that's really what happened. The midwives worked with me all day. We were doing Miles Circuit. I remember that it was August so it was scorching outside. They had me climbing hills and stairs and curb walking. They made my husband stay inside and take a nap because he was exhausted. I was doing all of the things, pumping every half an hour and they were giving me tinctures every 30 minutes. Still, by 5:00, I think I was maybe 3 centimeters but contractions were not picking up. They weren't strong enough and we were both exhausted so the midwives were like, “All right. I think the best plan is for you to go home, drink a glass of wine and take some Tylenol PM. Let's get these mild contractions to stop so you can relax and then you probably need to go be induced in the morning.” Because at this point, we were 42 and 4. I was starting to get uncomfortable. I was just exhausted. They were like, “It probably would be beneficial for you at this point to be induced and have an epidural so you can just rest and relax and let your body do what it needs to do.” That was our plan. We went home and did that. It worked for a couple of hours but the contractions actually really picked up overnight so by 4:30, I was like, “We need to go. I can't do this anymore.” I think we did the wine and Tylenol PM again later in the night and it just was not working. So at this point, I was like, “Okay. We're ready to go.” We ended up going to the hospital. By the time I got there, they were like, “You do not need to be induced. You're already in active labor.” I was like, “Okay, great. Let's do this.” We labored for a while and decided later that morning to try for an epidural so that I could just get some rest because we were so tired. As soon as I got into position for the epidural, the baby's heart rate decelerated so there was panic. There were a ton of people in the room. They were doing oxygen. They wanted to check the baby's position to see if the baby had maybe dropped or something but the baby stabilized almost immediately. They said I was at an 8. I was like, “Oh wow. Okay. Forget the epidural. Let's just do it.” I continued to labor for a couple of hours and they checked me again. This was probably at 11:00 and they said I was at a 4. Meagan: What?!Sydney: I was like, “Huh? What?” I don't know if the first person got it wrong. I have no idea what happened but I was in a different position when they checked me. It was a whole thing. Meagan: It's happened. I've been to births where that's happened where they were like, “Oh, you are 9 centimeters,” and getting the cart out, then getting the provider to come in then the provider comes in and is like, “She's 5 centimeters,” then we're like, “What?” The one provider explained to me and the team said that sometimes if we have a really, really stretchy, favorable cervix, especially during a contraction or certain positions, it can feel thinner than it is or feel like it is dilated more than it is and then they change that or a different person checks and they're like, “Yeah, no.” But man, that's a frustrating scenario. Sydney: I was devastated. So at that point, I was like, “All right, bring me the epidural.” I'm only at 4 centimeters.Meagan: Yeah. Change of plans, let's do that again. Sydney: I cannot go much longer. So they were bringing the epidural. Meanwhile, they decided to break my water because she could feel the water and there was meconium in it so that gave them a red flag. When they went to bring the epidural and I got into position, the same thing happened. Baby's heart rate went this time way, way down into the 20s. Meagan: Like something is being compressed. Sydney: Yeah, so at that point it wasn't even a question. They rushed me out for a C-section immediately. By the time we got to the OR, baby had stabilized but they were like, “You're both exhausted. We need to get this baby out. You've been doing this way too long,” and I was postdated and there was meconium so I think there was a lot of concern. Then they went to give me a spinal tap so I could be awake and it didn't take. They did it twice and it didn't take. Meagan: Did the baby's heart rate react then?Sydney: Not that I know of. Meagan: It's not working. It's not working, yeah. Sydney: So they put me under and I birthed my baby asleep which was a whole thing but she was on my chest not too much after she was born and I was able to nurse immediately. They tried to be really accommodating to me and they were very mother/baby friendly. Meagan: Yeah. Did they bring you back pretty quickly? Sydney: Yeah. Meagan: Like you were awake right after? Sydney: Yes, pretty much. I think they were still working on me while I was awake. Meagan: Okay, yeah. Sydney: And then my husband was able to be there. He got to see her first while they were examining her. It all was fine. We were both healthy and we were okay but it was a little bit of a traumatic experience and not what we were planning for at all from a natural birth to a total C-section. Moving on to being pregnant again, I was like, “All right. What do I want to do now because it feels like the natural birth didn't go well but this time around–” I don't know. I felt like I was more prepared and knew a lot more. There were a lot of choices I made with the first birth that I knew I wouldn't make with the second. I had said, “I'm not going past 42 weeks.” Obviously, I didn't but that was my mindset. I was like, “I'm going to do what I can to have the baby ahead of time.” So anyways, my second baby was due July 10, 2022, so just under two years later. I did decide to go with the birth center again, the same birth center. We had a good prenatal experience there and I love the midwives there. And again, I felt like I was more knowledgeable this time around. I knew that I was getting a doula. I did not have that the first time. I knew that I wanted to set myself up for success as much as I could. So again, I was doing everything I knew to do to shorten the pregnancy. I went to the chiropractor early and I went consistently every week. I drank lots of the Nora tea. I started pumping at 36 weeks every day. I was taking Gentle Birth and walked consistently. Meagan: So great. Sydney: I was doing everything. The pregnancy was fairly normal. This baby was breech at 34 weeks and I was so discouraged because I was like, “I'm a VBAC. A lot of people aren't going to want to do that.” Even my midwives were a little bit hesitant to do that because I had never had a vaginal birth. They usually are good with breech births, but with my situation, they were like, “We're not sure we want to take that risk.” So I knew my chances of VBAC with a breech baby were very low. So I was doing inversions. I did acupuncture. I put frozen peas on my belly. I did everything that people told me to do. He did flip by 36 weeks which I was very thankful for. So anyways, I'm doing all of these things to make sure that this pregnancy is shorter. At 40 weeks, I upped the walking. I started swimming but no signs of labor at all. At 41 weeks, the same thing. Not dilated at all, getting discouraged. And of course, during this time, we're doing a lot of non-stress tests and trying to make sure that baby is still doing well. Around 42 weeks again, I said, “I'm not going past 42 weeks,” but of course when it gets to that point, I'm like, “Just a couple of more days. I want to do everything I can to have the birth that I want.” So at 42 weeks, I was 1 centimeter and we were all so thankful. The midwife did a sweep and I did castor oil again. I tried to hit it with everything in one day. I think I ended up doing the castor oil three times because it wasn't doing anything. Meagan: Oh my goodness. Sydney: So eventually, it worked and I got some contractions at midnight to 3:00 AM and then it just sort of fizzled out. I just kept having really mild contractions. At 42 weeks and 3 days, I decided that there was not much more I can do at this point. I need to go be induced because we really were trying everything. They were not getting strong enough or consistent enough to make any progress. Meagan: Again, post date. Sydney: Right, right. My body is going this long, so do I trust that? I know that the risk goes up significantly after 42 weeks from what I've heard and read so it's weighing that balance of, “I know baby's okay but how long am I willing to wait this out and take risks?” So I decided to go be induced. They put me in triage at 7:00 AM on a Saturday and of course, the nurse was basically like, “You're this huge fish that doctors never see because you're a transfer. You're a VBAC. You're post dates.” Just all of these different things that made me an interesting patient. Meagan: All of the checkmarks against you here. Sydney: Yes. They were able to get us into a room later that morning. It had a tub. The nurse we had was really sweet. She knew that we were from a birth center. She was like, “I have this room with a tub. Someone's in it but if you can wait a couple of hours, you can get into that room.” So we got into the room with the tub. They started me with a Foley balloon and that did not take very long at all and then they started Pitocin at a very, very low level, like a 2 I think. Meagan: That's a really great, nice way to induce. A Foley with a low dose of 2 or 4 milliliters of Pit for a little bit. Sydney: Yeah, yeah. I was able to be in the tub for a little while. I stayed in there for a couple of hours and then I think around some time that afternoon at 3:00 I did ask for an epidural because again, I had been up for days at this point and needed to just rest. Meagan: So tired, yeah. Sydney: The anesthesiologist was in surgery so it was a few hours. I think they didn't come until 7:30 that evening. This time, everything went fine. I was able to get the epidural and get some rest. It was just like, “Wow. I did not anticipate feeling this good right now.” It was such a relief and I was able to get some rest. My doula came around then and was very helpful and sweet. Then around 11:30 that night, I started throwing up. They thought maybe it was the epidural. They said that can sometimes make people nauseous. They were checking all that and my doula was like, “She might be in transition. Why don't we check?” And I was fully dilated which was so exciting. I was getting ready to push and I was happy to finally be doing something and feeling productive. I was pushing for a while. After about an hour or so, the doctor that was with me switched out with another doctor. I think she had another surgery to be in or something. The doctor that came in was the doctor that did my first C-section. He almost immediately– he hadn't been in the room very long but he said that if I couldn't push the baby out that they would have to use forceps or do a C-section. Meagan: Had he been pushing with you at all at this point or did he just bluntly say these things before even assessing? Sydney: Yeah. He had been in there maybe for five minutes. I was so discouraged and my doula just looked at me and winked like, “Don't worry about that.” Meagan: Don't worry. Yeah. Ignore what he just said. Sydney: Yeah. I think it took me– we started pushing around 12:30 and then he was born I think at 2:30 or so. So 2-2 ½ hours of pushing. Meagan: That's not long at all. Sydney: It wasn't too bad. That was really sweet. I finally got to have a vaginal birth. My husband was there. He got to announce the gender and cut the cord. I got him on my chest immediately and it was really sweet. I did have a 3A tear which was–Meagan: 3rd degree, yeah. Sydney: Yeah. It was a tough recovery with that but otherwise, it was a really, really good experience. Again, not in the birth center, not the natural birth that I had envisioned but it went so much better than I could have anticipated. Meagan: Good. Sydney: I'm really thankful for that. Meagan: I want to talk about that a little bit before we get into due dates. Like you said, it wasn't the natural birth you anticipated, but in the end, you had an epidural that truly was such an amazing tool in your labor. At first, you couldn't get it, but then you were able to rest, and like you said, “I didn't anticipate feeling this good.” The world puts such shame on people for both sides actually of, “Hey, if you don't go unmedicated then you're crazy and you're going to have a C-section,” or “Hey, if you go unmedicated, you're crazy and then if you get an epidural then you're crazy and you're going to have a C-section.” It's just not that way. We need to take out these absolute statements of, “If you do this, you won't have this,” because it's not true. I can't tell you enough. We get so many emails of, “I really want to VBAC so badly but I just don't feel I can go unmedicated. It's not my personality. It's not what I desire.” They're like, “It just sucks that I can't have a VBAC because I don't want to go unmedicated.” I'm like, “Wait, wait, wait, wait. If you want a VBAC, you don't have to go unmedicated.” It's the same thing with induction. Are there some things around induction that may increase some risks or some chances? Yes. That doesn't mean it's going to happen though, right? This provider that started you out with this induction is a really great way to induce. Yeah. You had progressed a little bit before with your first so that's also a really great factor, but yeah. You don't have to go unmedicated to have a vaginal birth in general. I mean, look at all of the people that truly don't go unmedicated. It doesn't make you less of a person if you don't have an epidural. Something I love about your stories, both of them, is that you had the discussion with the midwives but you had this thing of, “Okay. We're going to go to the hospital now. I'm making this choice for me, for my baby, and this is what I feel good about.” I think that's important to note too. Sometimes plans change and plans can change. Sydney: Yes, yes. I held it a lot more loosely the second time around than I did the first. Meagan: Yeah. Well, I think it's just because in the world we get a lot of pressure and shame for decisions that we make. My kids are in a lot of sports and I get shamed for my kids being in sports and that has nothing to do with anybody else's life. Yeah. Listeners, you guys birth the way you desire. If that's a repeat Cesarean, that's a repeat Cesarean. If that's an induction, that's an induction. If it's unmedicated, medicated, or whatever it may be, birth the way you want. But on the way to birthing the way you want, make informed choices by getting the education and the knowledge behind every choice that you are making. Okay, so due dates. Here you have two babies that have gone over 42 weeks. Neither of them had many issues or anything. Maybe we had some mec which is common, especially in postdate babies. So I want to talk about what postdate means or what all of the terms mean. An early-term baby is between 37 and 38+6. That's an early-term baby. A full-term baby is 39 to 40+6. A late-term baby is 41-41+6 and then a post-term baby is 42 weeks or later. Technically, you had two postdate babies. I had an early, a full, and a late baby. I had three different ones. One of the resources that we love so much is Rebecca Dekker at Evidence Based Birth. If you guys have not checked out that website, it's so amazing. They turn studies into English for the people who can't understand a lot of these studies because it's really hard. They turn them into English. One of the things that she talks about on this specific blog which we'll have in the show notes is titled “Evidence on Due Dates.” One of the things she talks about, and shame me if I'm pronouncing this wrong, but it's called the Negel's Rule. It's something I had never really heard about until probably a year ago but back in the 40s, a professor in the Netherlands created this rule on how to calculate estimated due dates. She says, “Based on the records of 100 pregnant women, they have figured an estimated due date by adding 7 dates to their last period,” then that is 9 months. It's crazy though because if you think about this world and our periods as women, we are not the same. Nobody. I can guarantee you that I am not the same as my neighbor or my friend or even my sister. We have different cycles and this was based on a 28-day cycle ovulating on the 14th day. That just doesn't happen all of the time. I don't love the method because it can be different. On the Birthful Podcast, we talk about how people sometimes carry longer. That doesn't mean that they're super, super, super overdue. It just means that they have carried longer. In her blog, she talks about a person that had a 44-day cycle so she may have been viewed as 42 weeks or 41 weeks + 2 days, but really, she was 40 weeks. So we were adding a week and two days onto this due date and we're telling people that we're got a higher chance of stillbirth and things like that but really because of her long cycle, she is 40 weeks. It's just so hard. It's so hard. I mean, there is research and this blog is amazing but even then, it's hard. But we do want to talk about the risks of going past your due date. What risks, Sydney, did people tell you about going past your due dates? For you and baby, was there anything said that was very specific like, “If you go one more day, this is going to happen or more than likely to happen?” Sydney: The biggest thing that stands out in my mind is the meconium and the risk of baby aspirating and then also just the general risk of stillbirth going up after 42 weeks were the two obvious things that I remember. Meagan: Yeah. That is correct. The risk of moderate or thick meconium increases every week starting at 38 weeks. It's interesting. We don't know exactly why a baby has a bowel movement in utero all the time. Sometimes it's due dates. Maybe sometimes it's stress or a really fast transition or whatever. They just do. We don't know exactly why all of the time, but it does seem to peak between that 38-42 weeks. It's 3% at 37 weeks, 5% at 38 weeks, 8% at 39 weeks, 13% at 40, 17% at 41 and 18% at 42 weeks. An 18% chance that a baby may have a bowel movement within that 42 weeks. 18% might sound really, really high but to some people, they're like, “Okay, well if it happens.” Then like you were saying, we worry about the risk of aspiration. Sometimes it happens and sometimes it doesn't. If it does, sometimes we have other issues. Another risk for infants is the increased chances of NICU admission. They were the lowest at 39 weeks at 3.9% and rose up to 7.2% at 42 weeks. Again, some people may look at that and say, “That's enough for me to have a baby at 39 weeks.” Some people might be like, “7.2%. I'll take the chances.” It's a totally personal preference. One of the other risks, and when I say risks, I'm really putting quotations around this because it's one of those eye-rollers for me. It's a big baby. A lot of providers will say, “Oh, your baby is going to get way big. You might not be able to have that vaginal birth.” Especially with VBACs, it's like, “Last time, your baby was larger.” Let's say last time your baby was 8 pounds, but this time it could be really big if you keep going. It shows that for greater than 9 pounds, 15 ounces rose during 38 weeks which is 0.5%, and then doubled at 42 weeks which is 6%. But I mean, we recorded a story last week with Morgan whose baby was 10 pounds, 12 ounces. Big babies still come out and they're just fine. It's hard to hear the risk of the big baby because why are we shaming these babies? It's fine if they're big. It's fine if they're chunky. We love when they're chunky. And then some of the risks of having a lower APGAR score or stillbirth. The stillbirth I think is probably one of the most intense risks that we look at. It's the scariest risk for obvious reasons. It says, “Absolute risk is an actual risk of something happening to you. For example, if the absolute risk of having a stillbirth at 41 risks was 1.7 out of 1000, then that means that 1.7 mothers of 1000 or 17 out of 10,000 will experience a stillbirth.” So you hear that and it's very scary. Then it says, “Relative risk is the risk of something happening to you in comparison to somebody else. If someone said that the risk of a stillbirth at 42 weeks compared to 41 weeks was 94% higher, then that sounds like a lot but some people may consider that that actual or absolute risk is still quite low at 1.7 versus 3.2.” We've had a post like this. It actually stirred up a lot of angst because we talked about some absolute risk and some relative risk and actual risk, but really it can be very scary to hear a 94% higher chance than a 3.2% chance. Ultimately, yes. There are risks of stillbirth the longer we go. There are risks of placental issues or infections in moms because there is a whole other category of risks for moms that we a lot of the time don't talk about too much. But yeah. It's just a matter of what is best for you. At the beginning of the podcast, you said, “I haven't met a lot of people who have carried as long as me.” I was telling you that in eight and a half years of being a doula, I have had one client specifically– I've had some 42-weekers at one or two days, but one client specifically who went 43 weeks and 1 day. It started at 40 weeks. Her provider was like, “You have to induce. You have to induce. You have to induce. She was like, “No, I don't want to.” Then at 41 weeks, the same thing happened. “You have to induce.” At 42 weeks, she was like, “I'm over it. I don't want to be here anymore.” She called me and she was like, “I'm changing providers. Does that change anything?” Her home was farther away from me than her hospital location so she was like, “I'm changing providers. Does that change anything to do with you supporting me? Because I need to know if I need to find a provider closer to you or if you'll come to me.” I'm like, “Yeah. I'll go wherever you go.” So she called I think it was the next day. At this point, she was 42 weeks + 1 day. She was like, “I found a provider. She's out here by me. She's going to support me.” I'm like, “Okay, great.” She goes to 42 weeks and the doctor is like, “We're going to do two non-stress tests this week. We're just going to check.” They did and they were like, “Everything's great. No problem. Baby might be on the larger side, but other than that, everything's looking great.” At the next one, she was like, “Yep. Everything's looking good.” She's now at 42 weeks and 5 days. I'm like, “Wow.” This is the first and this is in the very beginning of my doula career. I'm like, “Does this really happen? What is happening?” I was feeling nervous because I still didn't know much then. Anyway, at 43 weeks or the day before 43 weeks, she went to her provider and they were like, “You're really not showing a ton of progress. You're barely effaced. You're maybe a centimeter.” Sydney: Oh my gosh. So triggering for me. Meagan: Yes. Well and for her, she was like, “I'm never going to have a baby.” She said that. She was anxious. She was like, “I think I'm going to be pregnant forever.” I'm like, “No, you're not going to be pregnant forever.” But you can understand where she's coming from. Sydney: Yeah. I just don't believe that people go into labor on their own. I just don't get that concept. Meagan: Yeah because of your situation which I totally understand. Yeah. They were like, “How about you come in tomorrow? Let's do this. Let's induce this labor. Let's have this baby.” So she called me and I was like, “Yeah, do it if you want to.” We went over everything so she was like, “Yeah, okay. I'm going to do it.” She actually started contracting through the night and we were like, “Oh, she's going into labor.” I do think she was actually going into labor because we went in. She had only progressed another half a centimeter but she was contracting. I wouldn't say that they were anything too crazy strong or anything but they were there. But then they did induce the labor with those contractions and at 43 weeks + 1 day, she had a really chunky little boy. Everything was really great. Nothing was wrong. He did have meconium. He pooped. They believe that he pooped on the way out so he wasn't super gray or anything but yeah. It's just very interesting. It's very, very interesting. Due dates are interesting and it might be a hangup for you for a long time. Sydney: Mhmm. I always was so curious about this and they said, “We think you're probably just one of those women that if we let you go, you would naturally go to 43 or 44 weeks. Some women just carry longer. Some women carry shorter. Everyone is different.” Meagan: Yep. Yep. I keep thinking Gayle. Gayle is what is coming to my mind for the podcast with Birthful. She talks about that. Some people just go to 43 and 44 weeks. It's crazy but again, back to what was in that study on Rebecca Dekker's blog is that it's not that she was 42 or 43 weeks. That's where the hangup in my mind comes from. This is where she is based on her last period based on this calculation that Google does or the little wheel. My doctor back in the day had a little wheel to tell me when I was due. That doesn't mean that that's when my baby is due and it doesn't mean that I had that 28-day cycle and I ovulated at day 14. Really, that's my hang-up in my head. What more can we do with these due dates? How can we calculate these due dates better because, in my opinion, induction is also really, really high? We've got a high Cesarean rate, a high induction rate, and a lot of people going in. Induction is just fine if that's what you are wanting but a lot of people are getting that pressure to induce and they are getting these scary things being said. Let's figure out what these due dates and these guesstimation dates really mean. Honestly, there is not enough evidence without induction and stuff like that, I don't think, to really, really, really, really know what the average length of pregnancy is. Sydney: Yeah, that's probably a good point because people just don't go that long. They get induced. Meagan: Yeah, they just don't. In your mind, you're like, “I wholeheartedly do not believe that anyone can go into spontaneous labor. I don't get it,” because you've had two experiences and it makes sense. You're welcome to feel that way but at the same time, it's like what is missing here? Like your midwife said, “You're probably one of those that we would let you go and you would go.” But does that really mean you're 44 weeks? Does that mean you're 41 or are you actually 42 at that point?”Sydney: Yeah. We do plan to have more at some point, but I'm going to track my cycle consistently and track the actual conception date if I can and make sure I know exactly when and probably even do an early ultrasound which I haven't done before just because it's always the question people want to ask. “Well, are you sure about your due date? Are you sure about your cycle?” I can't be 100% sure about my cycle but I can be 100% sure about when my last period was. I know what that is. Yeah. I field that question a lot. Meagan: You know, it's an interesting thing that just popped into my head. Remember when I told you earlier that I've had an early term, a full term, and a late term? With my third baby, we were crazy. We were trying for a boy specifically and my friend was like, “Read this book.” I was like, “I'm going to follow this to a T.” We had two girls and my husband was like, “This is the last. You have one more try to get your VBAC.” He was really, really stern on this one more baby. I was like, “Okay, fine.” I was waiting for him. Before he was ready, I started temping. I mean, going more extreme. It consumed me a little bit but I really got familiar with my body because I really wanted to try for this boy. Anyway, so I had temped and done everything. We conceived. I knew almost the hour. It was ridiculous. It was absolutely ridiculous. I knew exactly when I got pregnant and I was 41 weeks, 5 days but with my first, they said that my due date originally was October 26th and then she was measuring small so then they bumped it up to November 6th, 10 days later. She ended up coming November 4th but then I wondered, “Was I early? Was I late? What was I?” because I wasn't tracking. With my second, she came at 38 weeks, 5 days so it makes me wonder there too because I wasn't really paying attention but I felt very pregnant. But then she was small so they were like, “No, it was totally fine.” I'm like, “She was measuring small from the very beginning.” It always makes me wonder. Maybe I was closer to the 40-week mark or maybe I was almost 41 weeks. I don't know. It's fascinating. Sydney: It is, yeah. Meagan: And it's hard. It's hard because we don't know and we are only trying to do what's best. We are only trying to do what we are given the information on. As always, we have to follow our gut and decide what's best for us. We'll make sure to include those studies. If you guys are listening and you find this interesting too, go down to the show notes. Find it. Read them. Listen to the podcast. It's a really, really great episode. Anyway Sydney, thank you so much. Sydney: Thank you for having me on. Meagan: Thank you for bringing this conversation to the table because it's not one that we talk a lot about. But I'm sure you've got some frustration. Like you said, “It's kind of triggering to hear that.” Sydney: Yeah. It's not fair that I have to do all of this work before I actually go into labor. We'll see what I do for the next one. I've said, “I'm not going to do anything. I'm just going to get induced at 42 weeks.” But I'm sure when the next one comes along, I'll be like, “No, I really want to try and do it naturally.”Meagan: Let's do the castor oil again. There are some ways to naturally induce like breast stimulation or sex and starting sex earlier on or evening primrose oil and things like that. Things that we can start doing at 38 weeks leading up. But even then, it's not a guarantee and sometimes it can be frustrating when you're like, “I'm doing all of the things. I'm taking castor oil and I've puked it back up three times and I'm still not having a baby.” Sydney: Yes. Well at this point, it will probably be a matter of, “I'm just going to trust my body. My body knows. My baby knows when they're ready to come out.” I just need to follow my intuition and weigh that risk like you talked about. Meagan: Yeah. Sydney: Yeah, but we'll see. I don't have to worry about it yet. I'm not rushing it. Meagan: You don't. You don't. You don't have to worry about it but keep grabbing the information so then you'll be prepared. Sydney: Yeah. Yeah. Thank you very much. Meagan: Awesome. Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

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In today's episode I'm talking about how a lack of sleep is highly correlated with trouble making decisions, solving problems, remembering things, controlling emotions, and coping with life changes. So, say you are doing all of the standard sleep hygiene activities to set yourself up for sleep success, but are still having trouble falling asleep, reaching for Tylenol PM or waking through the night and not able to fall back asleep. I have two nutrients you may want to consider to help you get on track with your sleep.   For non-sedating sleep support: Cortisol Metab https://drwholeness.myshopify.com/collections/nutritional-supplements/products/cortisol-metab Peace Maker https://drwholeness.myshopify.com/collections/nutritional-supplements/products/peace-maker   Want 12 of my favorite, simple and delicious recipes? Download the Healthy Meals Made Easy PDF ⬇️⬇️⬇️ http://go.drwholeness.com/healthymealsmadeeasy Ask your lifestyle health questions on social media, tag @drwholeness and use #accumulatehealth. -- Connect with Dr. Matt online:

Sign Up for Free Marketing Coaching HERE during Farm Marketing Week. I used to wake up every night about 1:30-2:00 AM and just toss and turn for the next couple of hours, worrying about my farm, family, and my to-do's. It wasn't even productive or useful because I wasn't actually doing anything! I was just looping & spinning. But I couldn't stop it, either. Then, I'd wake up on time in the morning, but groggy and tired. I thought it was normal because most of my friends had the same struggle! I thought it was just how life was as a busy farmer + parent + managing the house and business. It sucked, though, to be tired a lot of the time. I knew it wasn't productive but I didn't know how to stop it. I actually thought it was just how life was going to be, forever. I even had friends advise me to drink alcohol before bed and then I'd sleep straight through... didn't work, though! Then my other friend said she takes Tylenol PM every night...  People suggested melatonin and magnesium and specific teas. I tried it all. Nothing worked and I wondered "is this all there is in life for the next 30 years?" Then I found the work that I'm teaching you today. What I'm teaching you today changed my life and now my clients are able to improve their sleep and they've shut off the daytime spinning and looping, too! One of the hugest payoffs to stopping the spinning & looping that goes on in my clients' heads is they find 10-20 MORE hours in their weeks. And I want this for you, too! Today's podcast episode will help you stop the spinning and looping in its tracks!   Implement the steps, practice them, and then let me know how you do! This is something I coach on regularly, too - if you're not yet a client - this podcast will get you on your way to managing how you think so you can create way more time and success. Warmly, Charlotte PS: Click the link above and learn how to calm your mind down once and for all.

This week we have the very funny and talented Adam Peacock perving out with us on the pod! Adam hosts the always funny and delightfully spooky My Neighbors are Dead podcast which was named one of Vultures best podcast of 2021! We chat'n'prov about why the Midwest is best, leaky apartments, and the Tylenol PM epidemic. You can listen to all episodes of Adam's podcast My Neighbors Are Dead on https://podcasts.apple.com/us/podcast/my-neighbors-are-dead/id1223768363 (Apple) and https://open.spotify.com/show/6S5coQAPY4iGa11yHGbDGm (Spotify)! Performers: Adam Peacock (https://twitter.com/adampeacock13 (@adampeacock13)) Tim Lyons (https://twitter.com/timlyons (@TimLyons)) Dan White (https://twitter.com/atdanwhite (@atdanwhite)) Support the pod! Join our Patreon for an extended version of this episode, weekly bonus episodes, and additional premium content. https://my.captivate.fm/www.Patreon.com/improvisdead (www.Patreon.com/improvisdead)

I have taken Tylenol PM the last two nights to try to prevent another insomniac cycle and I think it's working. I finally got myself to the gym and I feel better - funny how that works. I have a long way to go, but this is a start. I would love for you to subscribe and like this video and also subscribe and rate my podcast! https://podcasts.apple.com/us/podcast/the-not-so-sexy-sexy-podcast-with-liv-milano/id1450218171 Youtube: https://youtu.be/vdW-onp93K4   Here are links to all of the equipment & podcast platform I use. These are affiliate links and if you purchase, I may receive a commission, but it will be no extra charge to you.   LIBSYN (up to 2 months free to start your own podcast): https://signup.libsyn.com/?promo_code=SEXY Microphone: https://amzn.to/3u7K5nA Headphones: https://amzn.to/3tgjIww Audio Recorder: https://amzn.to/3icXkxC Macbook Pro: https://amzn.to/3662Ork Iphone 13 Pro: https://amzn.to/3u0q6XR   https://survey.libsyn.com/thenotsosexysexypodcast

On this episode we celebrate Jimmy's birthday! Don't worry, we still have fantastic sketches, just written a little tipsy.

SUBSCRIBE to The Grey Matters Podcast https://podcasts.apple.com/us/podcast/the-grey-matters-podcast/id1475573434Josh Perrywww.JoshPerryBMX.comInstagram.com/JoshPerryBMX

Keem and Hollywood discuss fan brawls, R.Kelly, and much more.

A healthy body sleeps well. If you have trouble sleeping, it's a sign that your body isn't healthy. Even if you feel healthy. Even if you live a healthy lifestyle. If you can't sleep normally, there are things going on in your body and your mind that are keeping you awake at night. I work with clients who have tried many different things to help them sleep: melatonin, magnesium, CBD, herbs, sleeping pills, Tylenol PM, sleep trackers, a new mattress, essential oils, a cooling pad, etc. and nothing really worked. If this sounds like you, there are several reasons why these things haven't improved your sleep. Find out what they are in this episode! If you're ready to sleep better soon, book a call with me to find out more about my program and to see if you're a good fit: https://completesleepsolution.10to8.com

This week I'm back catching up with you guys talking a little Sports talk a little life talkin a little Walgreens version of Tylenol PM. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

] What happens when you’ve desired and planned for a homebirth for a decade… but then you’re faced with a long, intense exhausting labor?  How do you cope with what you’ve wanted, yet what you’re experiencing?    This week we’re speaking with Caitlin Ackermann, who met her midwife in her high school health class.  She’s experienced two vastly different births, and she’s going to share them both with us today.  Caitlin’s stories show the two extremes of labor, so you know there will be so much to glean from this one. Let’s take a moment to thank our reviewer of the week, ilovepodcastsrrkkrr, who writes “Great for all expecting parents!” This is a fantastic podcast and goes through lots of different pregnancy and labor/birth stories.  Very empowering and educational at the same time.  Thanks so much ilovepodcastsrrkkrr, I’d love to send you a happy homebirth podcast sticker, so email me at katelyn@myhappyhomebirth.com   And of course, if you are loving this show, would you go show some love on apple podcasts?  It’s a free, relatively easy way to support the mission behind Happy Homebirth and get this show into the ears of the mothers who need it.    And finally, before we head in, here’s something really exciting: This episode was is sponsored by Baby Trend andThe Cover Me 4-in-1 Convertible car seat   I opted to skip the newborn carseat with my second daughter, and this carseat is so unique in that it addresses the number one complaint by experienced mothers: Sun in your baby's eyes. The Cover Me seat is able to do this with its integrated canopy that offers height adjustability, ratcheting coverage, and side sun protection.  The cover me has a usage rating from 4-100 lbs, so you can install it for your infant and adjust it as your child grows from rear facing to forward facing all the way up to belt positioning booster.  It’s got a recline system that allows your child to find a comfortable position and it’s designed to take up a limited amount of space even in the rear-facing position.  And it’s got some super cool features that help make life easier for mom and kiddo, including a no-twist harness indicator, a no-rethread harness, and a comfort cabin, which is its multi-layered padding system, letting your baby or child feel snug and secure.  So go to https://babytrend.com/ossa and use the code CoverMe20 for your new convertible carseat.   Alright, let’s jump in.  Please remember the opinions of my guest,  and this show is not meant to prescribe or treat- it’s an educational tool, so continue to take empowered responsibility for your health and your family.   Show Notes Growing up, she loved the book “A Child is Born” and wanted to be a “baby doctor.” In high school, her best friend’s mom had homebirths In health class growing up, her health teacher had a midwife come speak.  She felt the midwife was incredibly calm and nurturing— She knew immediately she wanted her to be her midwife one day. In college she watched The Business of Being Born and was completely on board Her husband, whom she met at 17, was always on board as well. They became pregnant immediately after beginning to try, which was unexpected for Caitlin.  She was so excited to finally call her midwife, Bonnie! She loved the flexibility of her midwives.  She doesn’t eat white sugar, so her midwives allowed her to do gestational diabetes testing by eating a pancake breakfast with the correct amount of maple syrup When she was 6 months pregnant, she had severe back pain for 6 weeks that made her think she’d never want to have children again. Luckily it did go away. She was due 10 days before her best friend’s wedding- she made it to the wedding!  The next morning, she had a membrane sweep, which she felt was the culmination of midwifery care: It was done comfortably and gently at her midwife’s. The night she went into labor, she was awake until 2 am— she decided to take a Tylenol PM to get some sleep… and then at 3am labor began “I wanted to be prepared for everything but not set on anything” She began throwing up at 5am (after 2 hours of labor) Caitlin labored in the tub for 8 hours- her body stopped regulating temperature, so she got out. At 1 pm, her midwives came and she was 6 cm At 5pm she was feeling very tired By 7 pm the midwives mentioned the baby having a heart arrhythmia.  They chose to wait 15 minutes to see if it went away or to transport She honestly wanted to transport— she was exhausted by that point.  But her husband reminded her that she wanted this homebirth, and he asked her to take it hour by hour.  She needed the reminder that she wanted it and could do it.  At midnight she was 10 centimeters, she got in the shower, squatted and gently pushed, but he wouldn’t budge Suddenly, everything changed, his head came down, and he was out within 2 pushes This baby was born with a tongue tie, and breastfeeding was very painful.  Her midwife caught it immediately and clipped it, but it was still very difficult           Episode Roundup If you’re in Vermont, you’re definitely going to want to hire Caitlin to be your doula, right?  She’s experienced so much, and she is so insightful.  In today’s episode roundup I’d love to discuss a few of the aspects that she so brilliantly brought up.   It was so much fun hearing how Caitlin and her midwives chose to replace the traditional glucose test with a maple syrup test.  Talk about individuality of care.  And that’s what I love, and what I bet you love too, about the midwives model.  This is your pregnancy, your birth and your baby.  In the ideal midwife client relationship, You make the decisions, and your midwives support you.  They tailor their care to you.  I love that Caitlin felt empowered in her second pregnancy to do even less testing and be more lowkey.  Not because there’s anything wrong with wanting tests— if you do, that’s great!— But because she clearly felt the confidence and power to choose for herself.  And that’s what I want for all of you. Favorite quote award goes to:  I wanted to be prepared for everything, but not set on anything.  And this…. This is why Caitlin is going to make such an incredible birth worker.  This is wisdom, my friends.  Take note of it.  Rigidity in birth can be cause for dashed dreams and sadness, even when everything goes right to the outside world.  This concept— of being prepared for it all, but being accepting of what’s to come— this is it.  This is what it’s all about.  If you can adopt this frame of mind, you can give your birth the credit it is due, no matter how it unfolds.  That’s not to say that you have to think it was perfect when it was hard— obviously, Caitlin is a great example of that.  But I feel strongly that this attitude can greatly cut down on the feelings of “my birth wasn’t good enough because…”. Thank you, Caitlin, for putting it so eloquently. I also want to bring up what Caitlin mentioned about her postpartum.  It was hard having visitors.  Gosh, it can be so tough turning people away, especially with your first baby.  You’re proud, and you know your well-meaning friends and family want to see this sweet new life.  But when you’re in the throes of learning your newborn and learning the skill of breastfeeding, it can be all too much.  Inside of Happy Homebirth Academy we talk about this in depth— setting those boundaries prenatally so that you already have a plan to stick to postpartum.  I was the same as Caitlin— It took me learning through experience the importance of being alone as a family in those first special days and weeks.  I pray you can learn through our experiences, those of you who are preparing for your first— and set the boundaries the first time.  You won’t regret it! And finally, let’s end on the reminder that sometimes things go “wrong”, even at home.  Caitlin’s second son took 7 minutes to really perk up and come around after birth.  But Caitlin, when sharing this part of the story, was calm.  She was calm in the moment and felt confident in her team.  This speaks to two things: 1. The fact that midwives are skilled workers and have the necessary techniques to handle these types of situations and 2. Caitlin did a wonderful job at selecting her midwives.  Women she trusted and had great confidence in.  This is so important.  Not every midwife is for you, and it’s important to feel confident in both your midwife’s skills and demeanor. Okay, my friends.  What a beautiful episode.  I’m going to go finish my coffee with maple syrup… and that’s all I’ve got for you today.  I’ll see you back here next week. 

Episode Description Hi, my name is Kristina. I'm diagnosed with Bipolar type 2 and Borderline Personality Disorder. Growing up I experienced depression, low self-esteem, eating disorder behavior, and self-injury. I always poured myself into academics and was able to get into my first-choice school. I starting my college journey attending a small, private university in New York studying aerospace engineering. I started abusing alcohol and one night while drinking I overdosed on Tylenol PM. I had to go to the hospital and after I started going to therapy. A few weeks later I cut myself while I was drunk. My school decided that it wasn't safe for me to stay on campus, so I was forced to take a medical leave of absence and go into treatment. That is when I got my diagnosis, 2005. After that first psychiatric hospitalization, I decided to transfer to a university in Alabama. I made the move and brought my psych meds with me. I had a counselor on campus and phone appointments with my psychiatrist in Vermont. But the meds made me tired which made it hard to study, so I decided to stop taking my medication. I was actually OK for a little while and I even got married in 2006 when I was 20. After I got married, I transferred schools again because my husband got a job in a different city, I lived off-campus and poured myself into academics. I graduated Summa Cum Laude with a degree in Latin American Studies and International Business in 2008. After graduating, I lost all the structure that was keeping me together. My mental health declined and I had to be hospitalized. This was a very dark, scary time. I was too depressed to move. When I wasn't depressed, I was really, really mean to my husband. I would scream at him and spit on him and tell him that I hated him. When he would start to walk away, I would start crying and tell him how much I loved him. This was very confusing for him. I also stopped eating and lost too much weight. I went to hospitals and treatment centers all over the country. A specialized mood disorder program in Arizona, eating disorder residential in Nashville, a Christian residential program In Louisiana…it was all very expensive. The stress of me being gone for so long was really hard on my marriage... If you need the full biography of Kristina you can reach out. If you are looking for all things James Edgar Skye, you can find his social media visiting https://linqapp.com/james_skye The Bipolar Writer Podcast is listener-supported, and for as little as $5 a month, you can help support the mental health advocacy that I do by visiting www.buymeacoffee.com/jamesedgarskye. Please help this podcast grow by sharing with friends or anyone that you think will benefit from the experiences of others and myself. You can also find me on the following websites. You can also find me on the following websites to book your interview, ask questions, and reach out to me. www.jamesedgarskye.me Purchase my books at: https://www.jamesedgarskye.me/jamesedgarskyebooks --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/jamesedgarskye22/message Support this podcast: https://anchor.fm/jamesedgarskye22/support

Sleep is a place where our bodies heal, process trauma and information that we've experienced in our lives. Sleep is so healthy for us to get but what do you do when you can't sleep at all? Here are my tips for you :1. Brain Dumping  This is especially helpful for when you try to lay down and you cannot turn your brain off. When all the things going through your head are on repeat and you can't sleep, you should try it. Brain dumping is where you just take everything that's going on in your head and put it on to a piece of paper. For some reason, writing it down helps lessen the racing in your mind. Write for as long as you need, and keep the journal by your bed, so that you can continue to get things out of your head as needed.2. Prescribed Sleep Medicines For a time period, I needed to take something to help me sleep. I had originally asked my midwife for a medication that was safe in pregnancy. In the meantime, I never ended up taking it because I found other things that work. Like I say- I'm not a medical professional and I'm not giving you medical advice, but this is what I ended up doing for a little while to help me sleep. I took Melatonin, along with Tylenol PM. I also had to sleep in my own room because of my trauma.I could not sleep with anyone else. Otherwise, I spent the whole night checking on everyone around me. 3. Essential Oils :I used an essential oil called Tranquil from Plant Therapy. I have used this ever since Aria died, and anytime I have insomnia. It's amazing. I put a dab behind each ear and a dab on the sole of each foot. This has helped me in many ways get a good night's rest.Recommendation : Plant Therapy Tranquil Essential Oil Blend 4. Magnesium LotionI'm not sure why I started trying this in the first place, but I had made a foot salve that had magnesium in it. And ever since then, I've noticed that when I put that on my feet as well right before bed, I'm able to fall asleep much faster, and be able to stay asleep longer. I made my own magnesium foot salve, but you can buy it online somewhere. I've also bought it from a local shop that sells lots of natural products.5. Rescue Remedy/ Rescue Sleep Another product I've used, not for myself, but for my kids who have been affected by sleep, anxiety, or nightmares, I've given them Rescue Remedy. You can buy this online, or at Whole Foods or Fresh Thyme or that kind of place. I've been absolutely amazed by how when I give this to my kids after a nightmare or they can't sleep, it's been so helpful. For some reason I've never thought to take it myself, maybe because I have so many other things to help me.If you want more tools to help you, I have a workshop called Stop Talking Start Feeling, it's a workshop that dives into emotions, what they are, and how you can begin to feel and process them and get them out of your body instead of stuffing them down. It also goes specifically into processing and releasing the emotions of guilt and sadness. You can get access to this workshop and all the extra things I have in there for only $27. Go to www.stoptalkingstartfeeling.com to check it out. If you are a grieving mother and looking for others who know the pain of child loss, come join my free Grieving Moms Community Facebook group: www.meganhillukka.com/community

In this week's episode, we talk about the Tylenol challenge for the new years. We look forward to the new year 2021 and what it brings and new things we want to do and try for the new year. We talk about the hidden episode that we did a few months ago. We talk about the legalization of weed in the state of NJ. We talk about our mule aka Milton full of grace. We thank you guys for listening to our podcast and we discuss a few new ideas for 2021.

What if I told you that you can eliminate the 3pm energy dip you get every day WITHOUT USING CAFFEINE? What if I told you that there are ways to get better sleep that DON'T involve knocking yourself out with a Tylenol PM every night? In today's episode on Root Awakening: A Health Podcast we're talking about BETTER SLEEP AND SUSTAINABLE ENERGY. Most people are getting a poor quality of sleep. Most people can't function without coffee or caffeine every single day. Sleep deprivation and low energy levels are actually what's more normal in our society right now. Once you think about it, our society actually celebrates the people who are overworking and under prioritizing sleep. But are sleepless nights the only option in order to be successful? NO! Absolutely not. Actually, once you start getting more restful and consistent sleep, you'll be amazed at how you can gain so much time in your day to create a work life balance and still have time to work on self development. There are secrets on how to achieve this quality of life, and in this episode I will be sharing these exact secrets with you. You'll hear about how to get better sleep, how to get more restful sleep, and tips to help you stay consistent with sleep. You'll find out what you are currently doing that is ruining your sleep quality, how to lull yourself to sleep every night, how to boost your energy during the day WITHOUT using caffeine, and how to wake up feeling RESTED instead of AWFUL when your alarm goes off. I'll even give you some tips on how to quit caffeine. Say goodbye to the afternoon energy dips and say hello to sustainable energy, consistent productivity, and deep sleep in this episode on better sleep and sustainable energy. - CONNECT - Connect with Emily to ask any questions that you have, get more exclusive health how-to's, and discover more life changing wellness rituals that you won't find anywhere else. INSTAGRAM: @emilys.rootawakening | https://www.instagram.com/emilys.rootawakening FACEBOOK: @emilys.rootawakening | https://www.facebook.com/emilys.rootawakening APPLY FOR THE ROOT AWAKENING MASTERMIND: https://rootawakening.clixli.com/apply - LEARN - **TAKE ADVANTAGE OF THIS 20% OFF DEAL WHILE IT'S STILL ACTIVE** Learn how to change your life, feel incredible every day, and become who you want to be through The Root Awakening Mastermind. This mastermind is a supportive, inclusive community of individuals that honor their bodies, their health, their spirituality, they are self-care warriors, and if you love the information I talk about they will likely be on your wavelength. You are incredible and capable of whatever you want- it's past time that you truly believe that! To find out how to join our Mastermind community, head to https://rootawakening.as.me and schedule a call with me. Can't wait to chat with you! **We are currently offering 20% off The Root Awakening Mastermind subscription price! DM me on Instagram or schedule a call to leverage this low price while it's still available!** - SUPPORT - I've put my heart and soul into this podcast, and it's part of my life's purpose to make natural health accessible to everyone. I would love your support in this quest too! Spread the word, review this podcast, share this podcast with loved ones, share this podcast with your community, discover the resources available to you in the Root Awakening Mastermind, or become a part of the Mastermind community. I am so grateful for very action you take, whether large or small. Let's lift each other up and become empowered together! MUSIC BY: Pluto Monday | Esan is an incredible, painter, musician, artist, and all around spectacular human. Support his work and prepare to soak up some creative energy: @plutomonday | https://www.instagram.com/plutomonday

In this issue of Radioactive Spider-Pod… the Warriors are back and Kingpin nears his goal of ultimate power! Thrill as powerful, marketable heroes are forgotten in favour of several senior citizens! Gasp as Kingpin willingly ignores the traitor in his employ for the sake of a plot twist! Join Peter, Véro, and Kevin as they spurn supervillain strategies and stare in shock at… THE SIX FIGHT AGAIN!    Original Air Date: October 10, 1997

Is this too wild? Pat and Mags try to keep Aunt Patty awake by diving into the Québécois, cheating the cruise industry, and emergency contacts who'll remove your condiments. TW: Mel Gibson. Aunt Pat - Colleen Doyle Auntie Mags - Dana Quercioli Aunt Patty - Katie Rich Theme song - The Qs Outro - Debra Duncan Artwork - Jordan Stafford Mauntras - Carol Doyle Editor - Colleen Doyle Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/the-babymakers/support --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/the-babymakers/support

Christine Buckley is the author of Plant Magic: Herbalism in Real Life. More on Asclepius - https://www.ancient.eu/Asclepius/ To offer your own advice, call Zak @ 844-935-BEST CHRISTINE: This is advice that's attributed to, I think a demigod. ZAK: The only demigod I know is Maui from Moana. CHRISTINE: Oh yeah, that's a good Demigod. I should watch Moana tonight. ZAK: It's really good. Who is this demigod? CHRISTINE: I actually don't know how to pronounce his name but Asclepius of Thessaly. He was the son of Apollo. ZAK: I looked it up. It's actually Asclepius. He was also the Greco-Roman God of Medicine. CHRISTINE: My name is Christine Buckley. I'm a community-based herbalist and professional cook. ZAK: So, Asclepius' advice went like this. First the word, then the plant and lastly, the knife. CHRISTINE: This is all in regard to some kind of therapy for your body or mind. ZAK: First the word, then the plant and lastly, the knife. What is an actual, real-world application for this principal? CHRISTINE: Ok, so right now, lots of us are alone and on top of that we're dealing with many other things. So, as an herbalist my advice would be to just step outside and to see that you're part of this earth where there are trees growing and flowers beginning to form. So I think that would be the first step to ease this loneliness. ZAK: Right, so that's the first part of this advice. First the word. The word in this case being...go outside. CHRISTINE: The next thing is, ok, maybe that's not enough. We're gonna put some plants in our body. Then in this context that would be things like, nerviness to calm your nervous system to help alleviate the anxiety and stress that you're feeling. ZAK: So that's step two, the plant. And if that's still not enough. CHRISTINE: Then you move on to the next strongest thing which is like, maybe you need to take a Tylenol PM to help you sleep. Or maybe you need that beer to help you calm down. Like, see how it gets progressively stronger? That's what we're talking about. We don't just jump right into the strongest thing first. We move through little shifts because what happens in little shifts are windows into change that can be longer lasting. Whereas like, the further you get down the line, it makes you feel better immediately but it doesn't really solve the foundational problem. ZAK: First the word, then the plant and lastly, the knife. Christine Buckley's new book is called Plant Magic: Herbalism in Real Life. If you're finding this show valuable, consider sharing it with a friend. I really appreciate it. We live at BestAdvice.Show. Talk to you soon.

Today we have the second of our two-part interview with Dr. Tommy Wood. Ken and Dawn talk to Tommy about his ongoing research into lifestyle approaches that can improve people’s health span, lifespan and physical performance. Tommy also talks about the physiological and metabolic responses to brain injury and how these injuries can have long-term effects on brain health. In part one of our interview, episode 110, Tommy shared his thoughts on the research he has done on the importance of metabolic health as a way to for people to protect themselves from COVID-19. Tommy also talked about his work on developing accessible methods to track human health and longevity and his research on ways to increase the resilience of developing brains. Tommy is a UK-trained physician who is also a colleague of ours here at IHMC. In addition to being a research assistant professor of pediatrics at the University of Washington  in the division of neonatology, Tommy occasionally spends time at IHMC as a visiting research assistant. For a more detailed explanation of Tommy’s background, check out the introduction to part one of our interview, episode 110. We also recommend checking out Tommy’s earlier appearances on STEM-Talk, episodes 47 and 48. Show notes: [00:02:50] Dawn continues our interview with Tommy asking why some people refer to Alzheimer’s as type-3 diabetes. [00:05:00] Dawn refers to a chart that Tommy incorporated into his IHMC lecture in February of this year, which was part of a paper that showed how glucose responds with age. Dawn asks Tommy to walk listeners through what the chart details. [00:06:38] Dawn asks if Tommy agrees with Art De Vany, who in his most recent appearance on STEM-Talk, said that insulin resistance is associated with nearly every major disease that people worry about today. [00:07:38] Tommy talks about the mean amplitude of glycemic excursions and how this is the best predictor of cognitive functions. [00:09:31] Dawn asks about the waffle/fast-food study, and what the results of that paper mean for the effect of the modern American diet on health and cognitive ability. [00:11:00] Dawn asks about the effects of stress on memory and mood. [00:13:39] Dawn posits that we see many a public-service announcement about the dangers of smoking and alcohol consumption, and asks if the case could be made that we should also have public service announcements about the dangers of high blood sugar, as it is even more of a public-health issue than smoking and alcohol consumption. [00:15:42] Tommy transitions to talking about the importance of sleep in regards to brain health. [00:17:01] Ken mentions that in response to the common advice of getting eight hours of sleep, Tommy has made the point that perhaps more important than the number of hours is the quality of those hours of sleep. [00:20:15] Dawn asks Tommy about the use of Tylenol PM, or Ambien before bed for those people who have difficulty getting to, or staying, asleep. [00:22:07] Ken asks if it is true that muscle mass and body composition are exceptionally important in regards to brain robusticity. [00:24:43] Ken asks about Tommy’s favorite paper, “1,026 Experimental Treatments in Acute Stroke,” and why he loves this paper so much. [00:27:31] Tommy gives an overview of what happens as a result of an acute brain injury across the lifespan. [00:29:35] Tommy discusses Creatine, which is a compound derived from amino acids that has been shown to be effective in treating brain injuries. [00:32:56] Dawn asks Tommy what he has learned in terms of the overall therapeutic effects of ketones. [00:40:20] Dawn asks what would be one question that Tommy wishes health experts contemplated more often, in terms of health span, and what would be his answer to said question. [00:42:35] Dawn mentions that Tommy has done a lot of work helping individuals overcome chronic health conditions,

Eric holds Jeremy's eyelids open and forces him to watch his six-hour long one-man show about a chimp who becomes addicted to Tylenol PM then they discuss the Stanley Kubrick film "A Clockwork Orange" Visit patreon.com/ericandjeremy to get access to almost-weekly bonus episodes and more very cool perks

Hello all of my quarantined friends! Today I tell you a little secret about myself. Next I talk about my new hobby and how all the stuff that’s good in life is bad. Last but not least, I talk about how dumb the Sound Of Music is and how my parents used to make us sing for the elderly like we were the von Trapp young uns. I know, I know, you’re jealous right? Thanks for listening and stay safe! Peace Topics for the podcast/questions/feedback: glenthinksstuff@yahoo.com Twitter: @GlenThinksStuff --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Michael Lewis, MD, FACPM, FACN, is the president of the Brain Health Education and Research Institute, which he founded in 2011 upon retiring as a Colonel after a distinguished 31-year career in the US Army. In this interview, Lewis provides listeners with an overview and update on the clinical applications of cannabidiol (CBD). In addition to discussing recent research, Lewis describes mechanisms of action, safety, and dosage of CBD in clinical practice. About the Expert Michael D. Lewis, MD, FACPM, FACN, is an expert on nutritional interventions for brain health, particularly the prevention and rehabilitation of brain injury. In 2012 upon retiring as a Colonel after 31 years in the US Army, he founded the nonprofit Brain Health Education and Research Institute. He is a graduate of the US Military Academy at West Point and Tulane University School of Medicine. Lewis is board-certified and a Fellow of the American College of Preventive Medicine and American College of Nutrition. He completed postgraduate training at Walter Reed Army Medical Center, Johns Hopkins University, and Walter Reed Army Institute of Research. He is in private practice in Potomac, MD, and is a consultant to the US Army and Navy as well as several nutrition companies around the world. A highly sought-after speaker, Lewis has done hundreds of radio shows, podcasts, medical conferences, and television appearances and is the author of the Amazon best-selling book, When Brains Collide: What Every Athlete and Parent Should Know About the Prevention and Treatment of Concussions and Head Injuries. About the Sponsor CV Sciences is on a mission to improve the well‐being of people and planet. We believe that the future of hemp is unlimited. Through innovative and responsible application of science, we strive to enhance the prosperity and health of our employees, customers, and communities. We are committed to pioneering the CBD evolution as the leading producer of quality hemp CBD products under the PlusCBD™ Oil brand. For more information please visit www.PlusCBDoil.com. Transcript Karolyn Gazella: Hello. I'm Karolyn Gazella, publisher of the Natural Medicine Journal. Today I'll be talking with Dr Michael Lewis about the clinical applications of cannabidiol, or CBD. Before we begin, I'd like to thank the sponsor of this topic, who is CV Sciences Incorporated. Dr Michael Lewis is the president of the Brain Health Education and Research Institute, which he founded after retiring as a colonel in the US army. Dr Lewis, thank you so much for joining me. Michael Lewis, MD, FACPM, FACN: Oh, it's a great pleasure to be with you today. Gazella: So before we begin, I'm always curious about why physicians are interested in what they're interested in. So, as a physician, what draws you to the use of CBD in clinical practice? Lewis: Well, the easy answer is because it's effective, but of course there's always a longer story. How did I fall into this? I mean, I spent 31 and a half years, my entire adult life in the army. And cannabis is not something that's a particularly ... It's rather frowned upon as, as you might guess. And so I really had no experience with cannabis or cannabidiol at all, but I've always been open to nutrition, and in the last 10, 15 years more much more open towards is there ways we can use targeted nutrition or nutritional therapy to ... I was in the army, so I was looking at it for helping people, helping soldiers recover from traumatic brain injury or concussions. So it really started out of fish oil and omega 3s, because the brain's made of fat. And then it kind of ... As I started to learn more and more, there started to be this interaction with the CBD industry. I finally, after I retired from the army, took a good look at it, and, more importantly, started to get great experiences with my patients using the combination of fish oil and CBD. Gazella: Yeah. And you focus a lot on brain health, so that makes sense, the connection between a traumatic brain injury. So what conditions ... In addition to, I'm assuming traumatic brain injury, what conditions do you feel that CBD works well for either as a primary or adjuvant treatment or even as proactive prevention? Lewis: Well, the biggest thing is as far as any specific one thing I would have to say anxiety, for sure. So 100% of my patients have issues with anxiety, and pretty much there's lots of anxiety just in today's society, with a 24-hour news cycle and all the craziness that's going on in the world. So it's about balance, and CBD, it interacts with our cannabinoid receptors and it's really about kind of achieving that balance. Not so much like that pharmaceutical model where you kind of hit something and you shut off a process and relieve the symptoms. The use of CBD is really much more about achieving a better balance, and nowhere has that been more important for my patients than in the world of anxiety. Helping calm that voice down in the back of your head. But I also find that it helps with chronic pain, particularly headaches. Can help decrease it. It doesn't always eliminate them, but I can tell you without a doubt, anxiety is my number one reason, whether you have a head injury or just dealing with anxiety. Gazella: Yeah. That makes a lot of sense. Now you're talking about balance and that speaks to potential mechanisms of action, how CBD actually works in the body. Can you expand on that a little bit more? How much do we really know about how CBD works in the human body? Lewis: Well, the interesting thing is we've known about CBD and its uses medicinally for thousands of years. Every major culture in the history of the world has used cannabis for medicinal purposes. So we know a lot, but yet we don't. Because of the issues with prohibition and then the war on drugs … we really kind of missed this golden era of clinical research, scientific research where we're really able to understand the mechanisms. Whereas in for thousands of years it was used because we just knew it was effective. Now we have a much better way of understanding why, and the why is really ... The why and the how is really it turned out that we have these indigenous cannabinoid receptors throughout our body and principally in our brains, CB1, or cannabinoid type one receptors, CB1 receptors in our brain associated with neurons and, and neuronal function and CB2 type receptors more closely associated with our immune system. So when you're out of bounds and you think about you're out of balance on your immune system, you're more susceptible to colds and viruses and infections and stuff like that. So it's about this homeostasis, this balance, not just with your immune system but with our brains, with how we're thinking. And the really neat and interesting thing is ... One way to try to describe it is the CB1 receptors in particular, we have these chemicals that are in our bodies. I mean, we know about serotonin and therefore you have serotonin reuptake inhibitors, for example, SSRIs for antidepressant medicines. Well, we also have these internal cannabinoids that we now know about. One in particular, anandamide ananda meaning bliss, or an anandamide bliss molecule, and it's an on-demand thing. So we used to call them endorphins. That runner's high, we would say that's an endorphin rush. We now know that that's our own body making on demand this stuff called anandamide that interacts with these receptors that keeps us happy, keeps us calm, keeps us thinking more clearly. And you can imagine, as somebody that's struggling with brain health issues maybe from concussion or from chemotherapy or just chronic stress in life, that can really make a difference. Whether or not somebody's happy and functioning in life is whether their cannabinoid system is working internally, but nature also gives us a way to interact with that through the cannabis plant, and as well as diet and exercise. Gazella: Yeah, it does seem like we're learning more and more about the endocannabinoid system and the fact that that system in the body has such wide-reaching health effects, and I'd like to talk a little bit about the research. I understand what you're saying that we lost some opportunities in researching this plant because it was, frankly, hard to get and illegal and researchers had difficulty in doing really highly organized research. However, it does seem like the research is increasing. Now recently I read a study that was presented at the International Society of Sports Nutrition conference specifically on CBD. Can you tell us a little bit about that study? Lewis: Well, I wasn't involved in the study. I'm only somewhat familiar with it, but it was a placebo-controlled randomized clinical trial and it was really looking at healthy people and to see if CBD versus a placebo would make a difference in everyday life events, such as quality of sleep and perception of how clear am I thinking, how am I doing throughout the day, energy levels and so on. And there was a ... It hasn't been published yet, but there was a, I'll say, statistically significant difference, particularly, my understanding is with the quality of sleep that those people that were put on the active CBD versus the placebo had a much greater reported quality of sleep, using very standardized sleep quality indexes that are used in research every day. Gazella: Yeah. That's what drew me to this study is the fact that it was done on healthy people and it did in fact impact sleep quality, because that's a huge issue. And somebody can be deemed as being healthy and yet still struggle with sleep. So I really liked that about that study. Now, what else does the previous published research tell us about the efficacy of CBD? Have there been a lot of studies on efficacy and CBD? Lewis: There's not been ... Relative to a lot of other things, whether you're talking omega 3s, fish oil or pharmaceuticals, there's not been a lot of research, published research. So it's really just because we're kind of coming out of this prohibition era, there's lots of research starting to get done, and there's some issues on how to actually go about doing some of the research, because your cannabis plant and my cannabis plant may not be the same. Gazella: So Dr Lewis, you were just talking about the variance between the plants, the cannabis plant, like one plant can be different from another plant. So when we're dealing with any botanical, the way that we extract the active compounds is so important. Tell us about the extraction process that's used for CBD oil. Lewis: Well, so the extraction is really important, but it actually starts way before that. If you want a consistent product at the end, you've got to have consistency all the way through. And one of the things about Plus CBD Oil that I really like is ever since they even began, when they started to import ... And they're the largest importer of European hemp. It's grown in the Netherlands, it's processed in Germany. But ever since the very beginning, they've only used 2 strains of the cannabis plant. And so the seeds are highly controlled, always using these 2 strains, and so you get consistency all the way from the seed through the entire process. If you're buying hemp left and right from Colorado and from California and from Europe and from Kentucky, you're not going to get that kind of consistency. And I would hope that that's what people want in a product. Certainly one of the things that I think sets Plus CBD Oil apart is that consistency. And then when it's extracted from the plant, it's not using solvents and alcohol or other things that can adulterate the plant. And we certainly see that with some of the cheap brands that are out on the market. But what we use is a CO2 extraction. So you're not getting that issue with solvents and other things that can adulterate it. And so consistency is really, really important. Not just to me, but to the product and hopefully to the consumer, all the way from the seed to the end product that sits on the shelf. Gazella: Yeah, that makes a lot of sense. Consistency from seed to extraction. Now, is there anything else that you look for when choosing an effective CBD product? Lewis: Well, one of the things of course is good documented third party testing. So as an example, there's a barcode or what's the ... QRS code? I always forget the name of those little square codes, but they're on the label of every product and you can scan that and actually pull down that third party certificate of analysis of what's in that particular lot of that particular bottle of that product. And so you're able to look at that and that's really, I think, very important to know what it is that you're taking. One of the concerns is the cannabis plant is widely varied. Everything from how much THC content to CBD content to the turpines to the flavonoids, to the minerals and so on, and different strains, different products are going to be widely varied and so you really want to know what you're going to consume. It's helpful to have that kind of a third party analysis that's right there available to anybody that wants it. Gazella: Oh, I agree. And the convenience factor alone is great for our healthcare professionals who want to look at that third party testing. That's great. Let's talk a little bit about dosage. So what dosage do you recommend for CBD, and more importantly, does the dosage vary based on if you're using it for proactive prevention or if you're using it for treatment, and if you're using it for treatment for anxiety versus dramatic brain injury? Talk a little bit about dosage and how it's used in clinical practice. Lewis: Well, it's one of the greatest challenges, I think, that we face as practitioners is knowing what dosage to use because everybody's different. And here's the problem is that your dose and my dose may be very different. And so we've got to start somewhere. And I've got a pretty typical way that I like to start with patients, but I'm always ... It's all about educating the patient and to emphasize that you've got to find your individual dose. So if we look at the Plus CBD Oil products, I think the thing that's made the biggest difference for me and my patients was about 3 or so ... 3 or 4 years ago, they came out with little soft gels, tiny little pearl-sized soft gels. That to me may make all the difference in the world. I mean, tinctures and drops under the tongue and lysosomal and all these different ways to do and deliver CBD are great, but patient compliance is so much better when it's just a tiny little pill, and you know, for example, the gold soft gel, you're getting 15 milligrams of CBD as part of the whole plant, broad-spectrum hemp complex. But you know every soft gel you're getting 15 milligrams, and you can look at the certificate of analysis and third party studies by consumer labs and so on to know that they're always dead on, and there that's not necessarily the case with a lot of other products. They're widely varied. So I think that that is really important. I like 2 different products and the 3 main lines, they have soft gels, they have a red label, which is for their raw product and that's actually mostly CBDA, the acidic form of the cannabinoid, of CBD and the other cannabinoids. And then it's gently heated because you have to decarboxylase the CBDA and the other cannabinoids to make them active, which is why in terms of marijuana you have to smoke marijuana or bake it because you have to activate it for it to be active for it to cross the blood-brain barrier and do the job on the brain that you want to use THC for. But with hemp of course we're only dealing with trace amounts of THC, virtually none, but still trace amounts. So I actually ... The function of CBDA in their raw product is very different than the CBD. It's great for inflammation, great for the body. And then I like to combine that with one that's really good for the brain, and that's their more concentrated product, their gold product. So I actually start patients on a gold and a red soft gel, and I start them twice a day, one of both morning and bedtime, and then have to educate. Some people, they don't like how the gold makes them feel during the day and they like to only take it at night. I have patients that take 3 at night and none during the day. I have people that take 2 every couple of hours during the day. So it just really depends on the person. But the easiest thing is start twice a day and adjust from there, either more frequently, or to a higher amount. Gazella: Yeah, that makes a lot of sense. Because we are very individualized, especially when it comes to a substance like this. So let's talk a little bit about the future. As a clinician, I'm curious as to what you would like to see happen with CBD in the future? What more needs to be done from a research or clinical perspective when it comes to the use of CBD? Lewis: Well, I think the obvious thing is that it's not widely accepted, and this holds true for a lot of botanicals, but the stigma that cannabis has had for the last 70, 80 years, it's going to take a little bit of time to overcome that. And one of the ways we can overcome that is with good science to prove that it works, but we'd certainly have challenges because the variability in a plant and the variability in products. We always try to boil it down to what's that one thing? And that one thing we always [inaudible 00:19:04] nomenclature we say at CBD ... Well, when we talk about CBD oil, almost always we're talking about not really CBD oil. We're talking about industrial hemp oil that happens to have CBD and has a lack of THC. But that strain and this strain can be very different. So that consistency among products is really difficult. How do you do research around something that varies so widely? And that's one of the bigger challenges. Well, again, we will always want to boil it down to that one thing and that's why the FDA approved Epidiolex, because it's 99.9% pure CBD, but it misses out on all of those other important things in the hemp plant that make that entourage effect, that synergistic effect between all the different things. And so the safety profile is actually very different compared to something like Plus CBD Oil that has a tremendous safety profile. Gazella: Yeah, I was actually going to ask you about safety. So are there any patients who should not use CBD? Lewis: Every once in a while you run into a patient that just is exquisitely sensitive to pretty much anything. And so whether it's Tylenol or Benadryl or other things. Most patients, if you give them Benadryl, it makes them sleepy. That's why I send Tylenol PM or Advil PM, so on. But every once in a while you run into that patient that is a hyper metabolizer, and Benadryl makes them wired. It keeps them awake. Well, you can have a similar thing with CBD, it's processed through the P450 system in the liver. So genetically some people are just prone to have different effects in medications that are metabolized by the liver. So those are the ones that you have to watch out for. So what I typically do is I drop them way back and start them really, really low dose, like get a dropper, and we just do one drop or one spray once a day and see how they do, and then go to 2 and then 3 and then 4 and build them up so that their body gets used to it. It doesn't mean that they don't need CBD or else I wouldn't be doing this with a patient, but their bodies just need a much slower ramp up to be able to adjust to it. Gazella: You know, that makes a lot of sense. Because I've heard about the reverse effect with other substances like melatonin, you mentioned Benadryl. It's good to know that if there is that reverse effect that you don't have to just stop completely. You can just do this titration where you start really small and just ramp up slowly, so that's good to know. And you've had good luck with that in clinical practice? Lewis: Very much so. And those are the patients that ... I'm dealing, again, with head injury patients or concussion patients that have been struggling for months or even years with the symptoms following a concussion and they're the ones that really need it. They really need the CBD. And so I'm not so quick to just say, "Stop taking it." But where I've found the success is, all right, we're going to start back over at ground zero and we're going to step up really cautiously, really slowly. And once you work through that process over a month or so, it is absolutely life-changing for those patients. Gazella: That's great. That's good to know. And I would agree with you. I think in the future it would be good to see the stigma ... To overcome that stigma, to get some more consistency with the plant and some more human trials associated with the efficacy of CBD. I think those are all really great future goals for this particular substance. Well, Dr Lewis, once again, thank you for joining me today, and I'd also like to thank the sponsor of this topic, and that is CV Sciences Incorporated. Thanks again, Dr Lewis. Lewis: Oh, my pleasure. Hopefully we can do it again sometime soon. Gazella: Absolutely. Let's stay in touch. Well, have a great day everyone.

CBD caught the eye of Second Self Brewery co-founder Jason Santamaria thanks to his grandad. 97 years old, Santamaria's granddad was having issues sleeping. He didn't want to take Tylenol PM for help. His grandson did some research on CBD. After seeing the medical benefits, he decided to use it to help re-introduce his granddad to a good nights sleep. He would later take his new found knowledge and added it to a beverage. Cirrus is a CBD infused sparkling water. A little more a month owned, the brand has already made a big impact on Atlanta. We spoke with Santamaria about Cirrus, what liquor goes best with it, side-eyes from competition and more.

Davidson County Museum of Art Director William Mark Alley disappeared on February 2, 2000, from Lexington, North Carolina. Mark was confronted by his coworkers about a discrepancy in the museum’s finances that morning. He left the museum and stopped at a gas station to buy some Tylenol PM. This is the last time anyone has seen Mark.He was married at the time with a young son and a pregnant wife. By all accounts, Mark had a good life and was well respected in the community. Why did he disappear? Did he choose to leave? Was he kidnapped? Kristi looks in to the different possibilities in this compelling case.Southern Gone is an independently produced podcast. This means everything we do is on our time and our dime. If you enjoy this podcast please leave a 5-star review and comment for a chance to be featured on a future episode. For everything Southern Gone visit our website www.SouthernGone.com.Investigating these cold cases is truly our passion project and we would not be able to do it without you! If you would like to support this podcast consider becoming a patron on patreon.com/southerngone.Grab a chair, a glass of sweet tea, and get GONE with Southern Gone!

Welcome to Episode 11 and our Con-tastic year in review! We are here once again with our usual shenanigans and rants. This is the The Cosplay Cast and we thank you for joining us. If it's your first time listening, welcome! If you've heard us before, welcome back and don't forget to subscribe. This week's topics will cover: 1. DragonCon Post Mortem 2. Con Year-in-Review: Best of, Worst of 3. We circle back to "Rey of Sunshine" in this week's Host's Corner -- Amelia discusses organization 4. Featuring our Cosplayers and Photographers of the Week Cosplayer/Photographers of the Week: 1. Blackstar Cosplay (https://www.instagram.com/blackstarcosplay/) 2. Baldgroove Photo (https://www.instagram.com/baldgroovephoto/) 3. Melpool (https://www.instagram.com/melpoolcosplay/) People & Stuff Mentioned During This Week's Episode: 1. Lauderee 2. Hamilton 3. Sara's Bad Ideas Cosplay 4. AnimeUSA 5. Derpycon 6. Sara Cosplays 7. Jen Glinzak Costumery and Couture 8. Goodbye Midnight Cosplay Stuff We Love and Shameless Plugs 1. Airline Status and Points 2. Tylenol PM 3. Taco Tuesday Conventions / Events Mentioned in This Week's Episode: 1. Dragon Con (http://www.dragoncon.org/) 2. Star Wars Celebration (http://www.starwarscelebration.com/) 3. Derpycon (https://www.derpycon.com/) 4. AnimeUSA (http://animeusa.org/) 5. Katsucon (https://www.katsucon.org/) 6. MAGFest (https://www.magfest.org/)   Where can you find us on social media? Rey_Dot_Ham IG: www.instagram.com/rey_dot_ham FB: www.facebook.com/ReyDotHam/ Jay's Fine Art Photography IG: www.instagram.com/jaysfineartphotography/ FB: www.facebook.com/JaysFineArtPhotography/ Lena Volkova IG: www.instagram.com/lokelicious FB: www.facebook.com/lokesanna Twitter: @YeCrimsonFuckr

Missy Owen on why she and her husband started the Davis Direction Foundation~ “This shouldn't happen in families. And, we were bound and determined that we were going to find out how to prevent it from happening to others because people shouldn't have to go through that." Missy Owen, Co-Founder and CEO Davis Direction Foundation and her family Announcer: This is Opioids: Hidden Dangers, New Hope. Here’s Brian Wilson. Brian Wilson: The story of Missy Owen and her son, Davis, though tragic is far too common in a country that finds itself in the grip of an opioid epidemic. I spoke with Missy co-Founder and CEO of the Davis Direction Foundation about her son and discovered a unique perspective on our society's shared challenge on this issue. Brian Wilson: Tell me about your oldest son, Davis. What kind of kid was Davis? Missy Owen's son, Davis. Davis Owen Missy Owen: Davis was an amazing kid. He was a boy, boy. He was a baseball player. He was smart beyond his years. He was a gifted child all through elementary school, middle school, and high school. Everybody loved him. He was very involved in the school system. He was, as a student government person, he was a volunteer during his freshman year, a sophomore senator, a junior class president, and as the senior class president, he gave the graduation commencement speech to over 3000 people in attendance that day. Davis Owen: Dr. Daniel, amazing faculty and staff, proud parents, and fellow classmates: Congratulations to the Senior Class of 2011. We made it. Brian Wilson: This was a young man who was on a good trajectory at this point. Missy Owen: Oh, absolutely. He was hall of fame, editor of the yearbook. He had National Honor Society. He had everything in the world going for him. Brian Wilson: Well, then there came a time, however, when apparently he got into some of the drugs that were in the medicine cabinet. Can you tell me about that? Addiction Started in the Medicine Cabinet Missy Owen: Well, between high school and college, he got into a really stressful situation. It's stressful enough going from high school into college, but he just had a lot of anxiety that summer and got very stressed out, and he went to the medicine cabinet because he couldn't sleep. So, he was probably looking for something like Advil PM or Tylenol PM, and instead, because we didn't have those, instead he found an old bottle of Vicodin that said "May cause drowsiness." Because we didn't have any education really back then, back in 2012, about opioids and the devastating effects and all, he thought it was part of our medicine cabinet, it was a legally prescribed pill from the doctor, and he took it thinking that he would sleep. He did. He slept and he slept well, and he took it again the next night and the night after that, and before you know it, he became dependent on those pills. Brian Wilson: So what happened then? Struggles With Addiction Missy Owen: Well, after taking the pills for quite some time, he started buying them from the street, or taking them from other people's homes when he would be there, or sharing them with others that had some to share. One thing led to another, and after he had pawned pretty much everything that he had to pawn, he turned to heroin because it was much cheaper and much more readily available. Brian Wilson: Now, we hear this story a lot, that it starts out with "Okay, I see a pill here. It solves my short-term need," but then they become addicted to the pill, and it gets very expensive to buy more opioids on the street in pill form. Then, they turn to heroin. When did you start to detect that there was a problem? Missy Owen: Well, one morning we were headed to my hometown on Thanksgiving, and my husband went to get the shotguns because we go and shoot out there, as people in the Georgia do, and there was a BB gun in place of the shotgun that should've been there. It came to light that the shotgun had been pawned.

Happy almost Halloween! This week, Jonny makes Max cringe through the Rob Zombie classic "House of 1,000 Corpses." They chat about Max's time abroad, Jonny's self-inflicted Tylenol PM affair, and a couple beers befitting of this time of year. Enjoy!

Episode 23-Subtitled:Boardroom Ayahuasca Day If you replace whiskey and taffy with a whole bunch of cold medicine, you end up with graphic descriptions of what VW/Audi's "service position" actually means, hallucinating Nissan executives, and instructions for using a Lexus to shave your down parts. Once the Tylenol PM high starts to wear off, you might hear about auto show news, cautious optimism about the Ford Focus RS, and what's hot in driving video games. But then you double down on codeine and get a defense of minivans, the El Chapo of conference rooms and a giant ginger yelling at you in German. Sorry for all the sick-human noises. Hey! Did you know you can view the full episode description for links! Yeah! Click on stuff! TeamClearCoat website TeamClearCoat Instagram TeamClearCoat Twitter TeamClearCoat Facebook

Part one is re'corded after a marathon drive of 8.5 hrs home. Got the kids in bed, got the wife in bed and wanted a raw version of my immediate thoughts on Universal, Cabana Bay, and family vacations in general. A much more polished trip report to follow, but here are my immediate thoughts once the fam went to bed and I could reflect with a cold beverage and a Tylenol PM. Enjoy. Live the adventure. I feel like I just did. Tweet me @Litemandhide with feedback and Q's for the "real" trip report coming in the next 48 hrs.

Claire has been out of the gym for 10 days because of a chest cold, which is lame. But she did learn that while Tylenol PM knocks her out, Nyquil makes her realize she knows all the words to the entire Spice World CD. Other important revelations are made in this episode as well, like the fact that Claire is still apathetic about the Open, Joy is still trying to process the Biggest Loser finale scandal with the contestant who may or may not have an eating disorder (but is that really our business?), and we also talk about Joy's woes with starting a new Wellness Committee at work. But the most important revelation is that Joy finds out that butt implants are a thing. Who knew (Hint: not Joy)!

Click to Subscribe to All Ben's Fitness & Get A Free Surprise Gift from Ben. Click here for the full written transcript of this podcast episode In this January 13 free audio episode: how to pick supplements, tylenol PM for sleep, what are oxalates, coffee in the evening, multivitamins and urine color and how to run faster. Remember, if you have any trouble listening, downloading, or transferring to your mp3 player just e-mail ben@bengreenfieldfitness.com.And don't forget to leave the podcast a ranking in iTunes - it only takes 2 minutes of your time and helps grow our healthy community! Just click here to go to our iTunes page and leave feedback. ---------------------------------------- Listener Q&A: Do you have a question for Ben? Just call 1-877-209-9439 and leave a voicemail, leave a Skype voicemail to username "pacificfit", or e-mail ben@bengreenfieldfitness.com. Listener Kai asks: "Here is a fundamental question regarding nutrition – how can the average person make educated decisions on what their intake should be?  There is a massive amount of information out there regarding what people should / should not eat or take in terms of supplements, but the challenge is deciphering what is valid science and what is marketing.  Good recent example – I know you had a podcast on fish vs. flax seed oil and the verdict was flax seed.  At an intuitive level the analysis made sense to me.  I opened up the recent issue of Men's Fitness, and there is a small paragraph about some study that concluded flax seed was linked to something bad (don't have the article in front of me now).  It seems very difficult at times to make intelligent decisions given the volume of conflicting information out there.  Any guidance on some basic principles / rules?" Listener Bryan asks:"Do you have any thoughts on the use of Tylenol PM. Even with heavy training and being tired I still have sleep issues of falling to sleep or being such a light sleeper I awaken thru out the night. To overcome such I have been using the Tylenol PM but don't like and wondered about using it often." Listener Jason asks: "What are oxalates and should I be concerned eating too many of them  if I especially enjoy eating foods such as sweet potatoes and spinach?  I have also read about certain foods containing "enzyme-inhibitors" and was wondering if this is the same as oxalates and if those should  possibly be avoided as well?" Listener Tracey asks:"I am interested in finding the best resource(s) on functional training, and wondered if you could tell me what you recommend.  I live in Canada where I have just begun to teach “CAGE Fitness” classes, and I'm a certified personal trainer who does in-home training with clients who have little or no equipment.  I bring along bands, and some light weights, but I am limited in the amount of weight I can bring to my clients.  I am new to personal training, but I have been doing MMA for a few years and have found that bodyweight and functional training are the best for overall fitness, and I'd like to have an arsenal of funcitonal training exercises that range from beginner to expert to use with my clients." Ben recommended to Tracey the free exercises photos and videos at http://www.pacificfit.net, as well as the highly function moves in the book at http://www.shape21.com. Listener Pete asks: "You talk about green tea or coffee in the morning before going for the morning movement session, and was wondering about any similar protocol before bed. I've been making sure I eat at least 2 hours before sleeping, though am curious to know if there is any benefit/adverse effect from drinking coffee or green tea within that 2 hour period before sleep or should I just stick with water? Obviously, some people have trouble sleeping as a result of the caffeine, though I never really have this problem." Listener Jason asks:"Been listening to your podcast for a few months now and just had a question for you. I have recently started taking a multivitamin and have noticed that the color of my urine is much more yellow than it was previously. I typically drink a lot of water during the day and always have clear to lightly colored urine, so I don't think that dehydration is responsible for this change. I'm guessing that this color difference is due to excess vitamin which is not absorbed by the body being excreted in the urine. My question is, is this safe? By ingesting more of certain vitamins and minerals than my body is using, am I making my kidneys work overtime to get rid of the excess? The point of taking the multivitamin is to benefit my health; I want to make sure that I'm not unknowingly damaging it. Also, if you think it is okay to continue use, are you familiar with this product and do you think it is a good choice for multivitamin? Many thanks for your help, and love listening to your show." Listener Lisa asks: "New to your podcast (which I think are awesome) and new to triathlon.  I did a few sprint distance races last year and my goal is an olympic distance this year.  Here's my question...my swim and bike times are competitive with my age group (I'm 43), but my run time is slooooow...it's killing my overall time.  How can I improve my speed?" ---------------------------------------- For  the next 2 weeks, the podcasts from Ben Greenfield Fitness will primarily focus on "Listener Q&A's", due to Ben's undertaking of a huge triathlon-focused side project that is going to bring you an instant and affordable way to get customized triathlon training advice! For more information on that project, and to stay in the loop on what's going on with that project (called the Rock Star Triathlete Academy) simply go to http://www.rockstartriathlete.com.