27 Burst results for "Orthopedic Surgeon"
Interview With Dr. Laura Forese, COO, New York Presbyterian
"Welcome to our women's history month series on skimmed from the couch. Where we're telling you about the women who made history. This past year. Dr laura for east joins us on today's episode. She's the chief operating officer of new york presbyterian one of the largest nonprofit hospitals in the country on her leadership newyork presbyterian has been on the front lines fighting the covid nineteen pandemic since last year. Dr freeze thank you so much for joining us and welcome to skin from the couch so much. It's great to be with you. Your resume is very long as as i think. Doctors and chief operating officers at ten to be wants one job or when experience. You've had that means the most you. I started wanting to be a doctor from the time i was a little girl so it really is about for patients. But i really have shifted. After i was in practice for about ten years. i'm orthopedic surgeon. And i moved to become a fulltime hospital executive. Because i thought i'd be able to have more impact in so now is the chief operating officer of big hospital system. My job is really to make sure that the business runs so that our doctors nurses have everything that they need to do what they do best which is care for our patients so in some ways come full circle from where i thought i was going to be when i was a little girl. How did you know that you wanted to be in medicine when you were a kid. You know carly i have no real good answer for that it just from the time. It was a little girl. I thought that would be a great job. Every kid knows what a doctor is. They're going to help you get better and i was say my parents were always very encouraging. I don't have doctors in my family. But i had that as a little girl and i stuck with it when reading about you. What stood out is that you have one of the things that many that stood out was that early on in your residency twins. And i know everything there to know about med school residencies. Because i've seen grace anatomy. So i am very very educated on your fields. I still watch it. So i feel like i'm right in there but i want you to take us back to to that time. What was that time like for you. Especially at a time when there were very few women in orthopedics. Well let me start with there. Were very few women in medical school class. Unlike today where we have more women medical students than men. It was unusual then and i chose a field that had very few women in it.
"orthopedic surgeon" Discussed on Healthcare360
"Our guest today is a genuine. Upstanding man and i am so happy. Introduced this edition. In innovative..
"orthopedic surgeon" Discussed on Entrepreneur on FIRE
"First Rachel and why don't you just KINDA LEARN How you kind of got into this at all and what do you define as a hard to market business which has been what you've really kind of focused on as your specialty shore. So I got into this I started my business in two thousand, twelve before that I was working for my family business which encumber real estate and I was Yeah I. was doing a lot of the marketing there, and we were using facebook to bring in leads people that were interested in office space and I remember one day. My mom just said, you know, why don't you start your own business and it was something I really wanted to do and then I just got into it and I started getting new clients With different types of people and then really focusing in on these like hard to market businesses and so really what I define as a hard to market business it's it's a business with a product or a service that doesn't provide instinct gratification or it requires some sort of customization to suit the customers needs. So for example, if you wanted to buy like customize deal horse stable to house your five. It's not going to be like as simple as just buying a t shirt online from your favorite store where you can just add it to your card, and then it's at your doorstep There's a lot more that goes into it when you're orders ordering something like this There is customization so you may have to fill out a form on a landing page or website that goes to the company that asks specific questions like what kind of features do you want for your co Horse Sable, what are the dimensions and then after that, you'll probably end up getting a call from them more an email just to clarify things and to make sure that they're on the same page as you and they can accomplish what you're looking for So it's it's not easy as you know, one, two three, you're done You know another quick example is like a nor an orthopedic surgeon is also a hard to market business. You know someone can't just go online and buy new replacement they have to go through a journey they you know they may see an ad for an orthopedic surgeon and again have to fill out a form and provide more information. Let them know what type of insurance they. Have Secede. The surgeon can even help them and again, then they'll have to speak with someone on the phone and and you know again, get more clarity to make sure that the surgeon can actually help them. So there's really like these types of businesses they require a lot of care effort and creativity to get people in the door. He I think it is fascinating and win you know kind of going over this episode and looking at the title from. Surgeons to steal suppliers I mean this is really what comes to when it comes to mark business because of that journey fire nation and what's really interesting. Rachel is that I actually recently purchased the empty lot next to me here in Puerto Rico and I think we're going to build a yurt here and so well, what was I doing the last couple weeks? I have been searching like how to build a Europe or specifically like you know how to find a builder to build this and this very. Specialty like what size and materials and the know the person has to be fairly local or at least willing to come to Puerto Rico. So it's kind of one of those hard to market businesses and it was a really interesting journey and how I found the person now communications with but I'll tell you it would have been fascinating had like I you know been doing my searching and then got on facebook the next day and been served some you know, hey, we can build our Europe for you and Porto Rico like. A super cool ad I would've been like Oh my God I'm jumping all over that like I need to figure out what they're talking about because that's exactly what I'm looking for. So I really interesting stuff and I love fire nation how race was going to be giving us ideas and concepts as we go throughout and you know one thing that you've really been a big fan of A. Very successfully, Rachel is build trust through facebook ads. So what are some ways that fire nation can build that trust you've been able to accomplish as your specialty? There are many ways that you can build trust on facebook Specifically with facebook ads, you can build trust through consistent branding a remarketing techniques and and really understanding your audience. So your audience is really key here. So you have to know what's important to them what are the problems that they're facing and how can you help that? Because that's what's going to create that emotional connection. With them and and bill trussell really people need to be guided through a journey and to get to know your product or your service in order to build that trust and nut that's going to happen click by click scroll by scrawl and you really have to be the guide so I'll give your audience an example on one way we build trust through facebook ads for an orthopedic surgeon. I What will happen is we'll create an ad where we'll target their specific market potential patients. They'll see an ad that has video of the orthopedic Surgeon He'll be he or she will be talking about what they do why why they love to do what they do and how they help people get their lives back and they'll see this ad this video, and it just a great way for the audience to connect with the surgeon without even meeting them I and. They're seeing them virtually Then we have some great ad copy to go along with it, and that's really key too because you want to make sure that your ad copy in your video, really go together well and have a clear message The audience will also see like an offer. So for an orthopedic surgeon, we may put an opera and the ad copy that says I'm offering ten consultations for the month of October click the learn more button to book an appointment with. Me and Charlene from my office will contact you to schedule one and you you do WanNa get personal so charlene is is an example of someone that is actually you know they are one of my clients and she does handle a lot of the leads for a specific practice so having her name, there is key it creates at personalization So what will happen is one people I see that ad they may take action immediately they may fill out the form and then and they may be ready to go because they're just in so much pain but others, they may not take any action. The first time they may they may need to see another added nuts were remarketing comes in to build this trust. So a remarketing add, we can target individuals who have watched fifty percent of the video and run a remarketing campaign that just hits them. We can also do a remarketing campaign that his individuals that have visited the landing page and. Target them So these remarketing is just so helpful for Building Trust the copy the ad copy in your remarketing campaign will be different than your first campaign. You'll have maybe In this example, we will use like a patient testimony new video in our remarketing campaign, and we'll have some ad copy that goes with that, and then again, we'll have a call to action like learn more fill out the swarm and will contact you to to schedule an appointment. So that's Really you know it is a journey. Those are just some examples on how you can build trust through facebook ads, consistent branding remarketing techniques. How can you fire nation help them that has always beat the forefront of your mind is your solution going to help them better than other solutions may be stumbling across and how can you speak directly to that and then guide them through the journey because this is that journey because that's how you're going to build that trust people are going to. See an ad for the first time and immediately fall in love with you and your brand and your company. Your partner, your service they're going to need to see it's potentially once twice three.
"orthopedic surgeon" Discussed on Entrepreneur on FIRE
"Rachel say what's up to fire nation and shears the interesting about yourself that most people don't new high fire nation. . Thank you so much for having me. . John Ya something about me that most people don't know it's I actually wrote and developed for short films with my sister and we recently finished writing our first feature film. . That's a family drama and we're planning to shoot that in April twenty twenty one are we talking an upcoming netflix original? ? Rachel. . Maybe we're not are not sure yet it say it's actually a family drama film. . It's based off of one of our shorts but cool out we'd. . Love to get it on the streaming <hes> platform and everything I love actually about Netflix and the other shooting platforms you're experimenting with a ton of different things like it's not just these hour and a half blockbusters anymore there's like one minute video six, minute , video shorts all these different themes I mean man to me this is the glory time for both actors, , actresses, , writers, , producers there's just so much opportunity out there super bowl but fire nation as I shared in the introduction when we're talking how facebook ads can specifically scale any business. . So first things first Rachel and why don't you just KINDA LEARN How you kind of got into this at all and what do you define as a hard to market business which has been what you've really kind of focused on as your specialty shore. . So I got into this <hes> I started my business in two thousand, , twelve <hes> before that I was working for my family business which encumber real estate and I was Yeah I. . was doing a lot of the marketing there, , and we were using facebook to bring in leads <hes> people that were interested in office space <hes> and I remember one day. My . mom just said, , you know, why , don't you start your own business and it was something I really wanted to do <hes>, , and then I just got into it and I started getting new clients <hes>. . With different types of people and then really focusing in on these like hard to market businesses <hes>, , and so really what I define as a hard to market business it's it's a business with a product or a service that doesn't provide instinct gratification or it requires some sort of customization to suit the customers needs. . So for example, , if you wanted to buy like customize deal horse stable to house your five. . It's not going to be like as simple as just buying a t shirt online from your favorite store where you can just add it to your card, , and then it's at your doorstep <hes>. . There's a lot more that goes into it when you're orders ordering something like this <hes>. . There is customization so you may have to fill out a form on a landing page or website that goes to the company that asks specific questions like what kind of features do you want for your co Horse Sable, , what are the dimensions and then after that, , you'll probably end up getting a call from them more an email just to clarify things and to make sure that they're on the same page as you and they can accomplish what you're looking for <hes>. . So it's it's not easy as you know, , one, , two three, , you're done <hes>. . You know another quick example is like a nor an orthopedic surgeon is also a hard to market business. . You know someone can't just go online and buy new replacement they have to go through a journey they you know they may see an ad for an orthopedic surgeon and again have to fill out a form and provide more information. . Let them know what type of insurance they. . Have Secede. . The surgeon can even help them and again, , then they'll have to speak with someone on the phone and and you know again, , get more clarity to make sure that the surgeon can actually help them. . So there's really like these types of businesses they require a lot of care effort and creativity to get people in
From Orthopedic Surgeons to Steel Suppliers: How Facebook Ads Can Scale Any Business with Rachael Doukas
"Rachel say what's up to fire nation and shears the interesting about yourself that most people don't new high fire nation. Thank you so much for having me. John Ya something about me that most people don't know it's I actually wrote and developed for short films with my sister and we recently finished writing our first feature film. That's a family drama and we're planning to shoot that in April twenty twenty one are we talking an upcoming netflix original? Rachel. Maybe we're not are not sure yet it say it's actually a family drama film. It's based off of one of our shorts but cool out we'd. Love to get it on the streaming platform and everything I love actually about Netflix and the other shooting platforms you're experimenting with a ton of different things like it's not just these hour and a half blockbusters anymore there's like one minute video six, minute video shorts all these different themes I mean man to me this is the glory time for both actors, actresses, writers, producers there's just so much opportunity out there super bowl but fire nation as I shared in the introduction when we're talking how facebook ads can specifically scale any business. So first things first Rachel and why don't you just KINDA LEARN How you kind of got into this at all and what do you define as a hard to market business which has been what you've really kind of focused on as your specialty shore. So I got into this I started my business in two thousand, twelve before that I was working for my family business which encumber real estate and I was Yeah I. was doing a lot of the marketing there, and we were using facebook to bring in leads people that were interested in office space and I remember one day. My mom just said, you know, why don't you start your own business and it was something I really wanted to do and then I just got into it and I started getting new clients With different types of people and then really focusing in on these like hard to market businesses and so really what I define as a hard to market business it's it's a business with a product or a service that doesn't provide instinct gratification or it requires some sort of customization to suit the customers needs. So for example, if you wanted to buy like customize deal horse stable to house your five. It's not going to be like as simple as just buying a t shirt online from your favorite store where you can just add it to your card, and then it's at your doorstep There's a lot more that goes into it when you're orders ordering something like this There is customization so you may have to fill out a form on a landing page or website that goes to the company that asks specific questions like what kind of features do you want for your co Horse Sable, what are the dimensions and then after that, you'll probably end up getting a call from them more an email just to clarify things and to make sure that they're on the same page as you and they can accomplish what you're looking for So it's it's not easy as you know, one, two three, you're done You know another quick example is like a nor an orthopedic surgeon is also a hard to market business. You know someone can't just go online and buy new replacement they have to go through a journey they you know they may see an ad for an orthopedic surgeon and again have to fill out a form and provide more information. Let them know what type of insurance they. Have Secede. The surgeon can even help them and again, then they'll have to speak with someone on the phone and and you know again, get more clarity to make sure that the surgeon can actually help them. So there's really like these types of businesses they require a lot of care effort and creativity to get people in
Interview with bio-mechanics expert Lisa McFadden, PhD
"Welcome back to another edition of moving to live our ethos movement is a lifestyle notches activity. We tried to interview professionals across the movement spectrum because we understand at the end of the day, anybody who is involved in movement either wants their clients patients or athletes to either move more or move better whether it's to move with less pain or to move more efficiently. Some of our best guests come from recommendations from other guests and a big. Thank you to Andy Gillam who recommended today's guest Lisa McFadden they arresting thing with podcasting is i. now have lineage of three people in a row starting with Brian Gary To. To Doctrine McFadden today hopefully two or three more as far as I can trace it's not who you know is who you know who knows somebody. So Dr McFadden thank you for taking time to talk to moving to live this afternoon. Absolutely thank you for having me. My favorite question I always ask on moving deliver the first one I. Always ask is to get an elevator. You get to talking because the elevators really slow because somebody's pressing all the buttons and they say, so what do you do what your thirty second? Not In a negative way elevator spiel my name is Lisa McFadden and I. I'll man and this one's a Turkey one I wear lots of different hats But yeah so. The way I look at what I do is I really put science into practice whether it's with athletes or with patients and Meyer expertise is in bio mechanics. So I like to used by mechanics to help people move better and then I also liked to inspire whether that's inspiring communities around science or whether that's inspiring. Students through mentorship in education. Right. Now, if I'm correct your in South Dakota. Yes that's correct. I work at Stanford Health See Falls South Dakota. And I know we were chatting a little bit before we started recording and both of us grew up in upstate new. York and I have to be honest I never thought I would end up in Pittsburgh. Pennsylvania, I never thought I would go to Grad School in Alabama and I would imagine that there's an interesting story going all the way from New York state with multiple stops all the way to South Dakota and I would imagine if you're anybody else like anybody else in the movement field is probably a few more stops along the way before you retire. Well, it's funny. I almost ended up in Pittsburgh. Along my way and I've spent some time in Alabama on a couple of different business trip. So it sounds like we've got a similar. Set of journeys But yes I I grew up in upstate New York in a little town called the sweet go not quite as little as where I heard you up. But? Yes. So I grew up on Lake Ontario My Dad was a doctor in I. Always always wanted to be a doctor specifically pediatric Orthopedic Surgeon, and my dad always told me no, you do not He said you really WanNa be an engineer and I said, no, No, no dad engineers are big nerds. And he said you're really good at math and you you have passion for this and I. Really suggest you become an engineer. So I very boldly went to the University of Rochester Pre and applied math saying you're wrong dad. But you know had a had a moment of clarity probably after my first year I did realize and did some self reflection and thought you know the type of. Mother that I wanted to be in the type of you don't grown up that I wanted to be really do not not focus around having call and prioritizing patients, which is absolutely something that you have to do but really being able to have a little bit of flexibility in In my lifestyle and so I finally listen to my father after a long time of not and. decided that I would actually transfer into biomedical engineering where I ended up focusing on bio mechanics as my concentration with minors in mechanical engineering and applied math. throughout my Undergrad I really really enjoyed all of that and so as I started thinking about what was next I started getting really interested in robotics and in two that feel that was emerging back. Then decided that I really wanted to go and get a PhD in that. So I had been at ski resorts I grew up ski racing and I was in Montana with our family on vacation and watched a bunch of ski. Racers who had disabilities whether they were in a sit ski or whether they were missing leg skiing and I was just very inspired I looked at them versus like while they're amazing. They're they're better skiers than I am and then you could see that as soon as they were off the hill where they were excelling the rollout of daily life challenges. So I started getting really interested in prostates wanting to kind of help people that you needed additional help outside of. Being Super, rockstar athletes to help them in their daily lives and so robotics was sort of that pathway for me. My senior design project ended up being a surgical robot and then I ended up getting into Carnegie Mellon at the Robotics Institute which is where I almost went to Grad School and then the University of Utah in my husband and I. Boyfriend at the time looked at each other and said, we should go skiing. So, Kinda took that wildcard robotics institute was number one ended the US at the time but decided to go out to Utah where they had just one anger from the NSF in robotics, and so I was in the bio engineering department and kind of hybrid into mechanical engineering. So I really took courses and had faculty the Committee from both worlds and I was able to do there was. My my PhD was focused on spinal cord injuries and what we were working on with functional electrical stimulation, supporting an array of electrodes and putting them into the peripheral muscles, and then stimulating those and my job was to figure out what the mechanics looked like. So creating models of the limb and then creating control algorithms to figure out how we can control this limbs yet somebody to go from sitting to standing. And to do it in a way that they didn't get tired while they were standing because the way our muscles work. If you contract one all the way, you might get yourself to go into a specific movement but then that muscles eventually wanting to fatigue and you can't can't sustain it. So what does that look like as well?
"orthopedic surgeon" Discussed on Velvet's Edge
"And where else can people find you? The. Called the doctor and he the then doc journey dot. com. As a series of emails, Webinars, question and answer period. But also an APP that takes you too much is is designed to create these safety experiences Basan workshops, awareness hope forgiveness in play. And so it's being released last week we're excited about it so much more streamlined way of getting through the visionary of steps that you need. It's called the dog journey dot com. And again think I'm so excited about this white practices that. Is is so is disturbingly simple rush. How much you can do for yourself is self directive. And that's why we think from a public health standpoint that we've got to get this diagnosis of anxiety cry of knoppien psychological. threat. Because it really just officially treat each other both personally as a family in society. So that's my biggest semesters. Look you gotta get this diagnosis, right? You got get to the root cause of disease other way or continue to come more and more six. Yeah. And where can people find the plan? A the thrive and survive covert is that on the back in control dot com or on doctor dot com. Does somebody website. The website now is Dr David Come forward, we associated the websites Dr David has he can access everything including the APP on the website..
"orthopedic surgeon" Discussed on Velvet's Edge
"I'm working with Dr Steven Portnoy who is up becoming a friend of mine with his polly veto theory and what I just didn't realize. For instance, we need a deep breathing exercise you're slow extra slow breathing. which you're doing, you're directly stimulating the pair sympathetic nervous system through the Vegas nerve actually filed drops down twenty markets. This one of the switches for the cover crisis, the sympathetic responsible Tori markers but the para sympathetic nervous system or the Vegas actually flat out his anti Amatori. So deep breathing slow breathing recruits Vegas. Humming. gration back your throats delays serve. If you breathe through your nose increases, the levels of chosen by fifteen hundred percent really what happened and Oxytocin is strongly, Matori's wasn't Social Bonnie molecule. And we always say the knocks you in terms of lactation and pregnancy. Is One of the oldest molecules in the body. In Dr reporters, his wife Sue harder is when the international experts in chosen. and. She tells in maybe the hormone were looking for his wife social connection is so effective for chronic pain by the way as far as going back to the anxiety. Fifty three percent of Americans are socially isolated recruits the same symptoms as chronic pain and the highest association by the way, our people in their twenties. Really. Yep. The big thing studies in two thousand eighteen that did a huge survey of twenty thousand people. and. Fifty three percents of Americans in every city county small town village were socially isolated. With the highest problem was that kids I'm sorry people in their twenties they felt that they felt that social isolation had the same effect on your health as smoking about fifteen cigarettes per day. Wow. Really. I can't get over the twenty somethings with what are they doing? Why are they so isolated? Well, I don't know I think the electron admitted to different things that they're so much mandate as far as homework and accomplishments and. That I'm noticing also first of all the other thing me just step back for a second. So I love working with people in their teens and twenties and thirties because their brains are very narrow plastic. Changes quickly I can only tell you that once somewhere stands that anxiety is necessary is powerful to. In control, but you learn how to work with that. Scheme on your brain physically changes structure but your brain so much plastic and cheese were quickly at that age. So we have stunning results very very quickly and pupil that age group is wonderful. Well, it's interesting because we kind of we got off on tangents anxiety because I'm fascinated by this too. But we were talking about the covid stuff and earlier you mentioned to me in the treatment for even the the patients in ICU. One of the main things that was probably inhibiting their healing was the isolation and I said to you that during. The part where I I had covid. That was the hardest part for me being separate from everyone and even people's reaction to you. When you have covert, it's kind of like Oh God. Oh Gosh you know didn't nobody wants to be around it right now I understand but that was so hard. The physical part was so much easier to get over for me than the emotional aspect of being isolated. So that is so what do you tell the listeners what you told me about that the ICU patients and your recommendations? I mean part of the problem is, is that the mask also sourdough portis points out that you can't see most people's facial expression rape. Says called correlation whereas if I meet you I'm assuming you're nice person. So my pair sympathetic nervous Jason Aguirre to see things are safe is how mammals interact with each other reptiles. and. So facial expression causes co-regulation but cover shows ever the mask is a big problem. In the ICU people are isolated? And what I don't understand. This is part of our plan B. Solution is that. Okay, you need human contact to stimulate the pair sympathetic nervous system me nicely, people that I see you. So we're giving us a threat not safety. If you're if you're in the ICU you're already at zero of getting the virus because you already have it. Right you're almost zero risk for getting it over get a couple of negative cultures in the ICU. Most the time by the time people are sick the point of garnered ICU appreciating the virus contagious anymore. So why are we not allowing families to see patients in the ICU? It's not just for the families social situation, but also a healing factor again. Uh, psychologically directly stimulating vegas nerve was social contact. To major healing factor I one hundred percent by into that because I told you I was isolated and then we found out my boyfriend had it and so we were able to be around each other and now we're both fine lake. It helped so much I mean I'm sure there was a lot of other factors but it did the healing process seems like for us it happened pretty quickly and I was doing a lot of your did the expressive writing I've been meditating and all of those things I do believe physically helped me as well, which was just super fascinating to me. Absolutely no I mean, the human connection is a major factor healing else's. Parties Cornell retain more violence both domestically in the streets. You don't co-regulate in other words. You're not interact with other people calming down sympathetic nervous system. Then people get violent they go and see what happens when you go into this defensive fight or flight mode. Than the blood supply to the frontal lobe of your brain, which the thinking centers actually goes off line. You don't even have united. You can't think properly because the blood supply to that party branch.
"orthopedic surgeon" Discussed on Velvet's Edge
"I mean at all ages fifteen, twenty, three's manage say my generation I'm and I'm sixty seven where it was in the late thirties or forties people would quote have a nervous breakdown. and. Right now, we have this epidemic of seen hang sidey millennial anxiety and it's horrible. You can talk a lot of the reasons for that. We have more physical conference than we've ever had. And probably, these unmet expectations are probably the biggest threat that we have. We have body image disorders. We also have modern marketing. Telling us who we should be. And so they're tone us. There's something wrong with us because we don't look or act a certain way. But then they could sell you solutions to fix it. So there's this in the same sidey. Then we don't play together no those tonic screens, but we know that human brain develops through play. Implies to the brain during the day as sleep is as dreams are at night to the brain. Other words you need plays organizing principle is three dimensional despite language evolve. But normal human development depends on play and guess what we're locking classrooms were being given a lot of material to learn without the interact with as a human beings. Again. Know. But is there. But again, when you are not relaxing interacted regenerated again, your costume threat, your body's on fire. And we know collide us through the ceiling now autoimmune disorders through the site in teenagers. The instance, Cry Penis gone up at least eight, hundred percent in ten years. Time hundred percent. So again, I I gave a lecture to high school in Seattle a few years ago not fifteen hundred students. Five hundred of them, I'm sorry three hundred of them were on chronic medications that the school nurse how to give them every day. So. The thing is a member of the NFL. How about the word stress management and would you agree that the word stresses you construed as as a psychological construct data I. Yes. Okay it's not. It's your body's your total body's reaction to the environment. And the stress that is the most stressful distress if you can't control. Wherever. There's the threat and there's stress response, and so you you can't control most of the things in your environment that are stressful because again, the most stressful are stressful went to the wedgie control. Go what you can do. You can learn the tools and strategy to minimize stress response drop down the body's chemistry we're bringing Saudis. Sation generated by elevated stress, chemicals wave decreasing so simply decreased chemicals. Is. Unconscious Brain Processes is about twenty million bits of information per second compared to forty four, zero per the conscious brain is twenty, million, forty ratio you can't control it. and. So you to process and Laura's stressed chemical. Response. That's how you thrive. I my brain is going eight hundred million dollars right now because I find this. So fascinating, just our bodies reaction it's sort of what you're saying too about stress being psychological I was just thinking if you've ever done any sort of meditation practices, the first thing you always do is relax your shoulders. You do some deep breathing and most of the time I know for me, I do not realize how clinched up my body is you know in response to maybe I'm going about my day and the stress that I'm dealing with or even the anxiety, and so it's just interesting to think that we're just a little bit out of touch with our bodies response to all of these things. Well what if I know.
"orthopedic surgeon" Discussed on Velvet's Edge
"It goes through all of these practices. That to me when I first read it I was like just just wasn't what I was expecting. You know when you are sick especially with something like covid you think okay. Well, what do I take? I'm sure. Anita sleep a lot. Maybe I need a drink a lot of water need to be doing anything else and a lot of it was the same things that you're describing the expressive writing treating anxiety getting asleep as you said, but practicing forgiveness was one and I just thought these were really fascinating so when I was able to talk. To you, we talked a lot about the effects of anxiety physically on your body which I know anxiety is comp-. is so much more prevalent than it used to be or it's talked about a lot more but I don't feel like a lot of people talk about the physical symptoms that come with that. So can you kind of talk us through that? Well. What happened we do come up with the solution for the colored pandemic by the way. So plan a is a series of steps you can do to lower your phlegm Tori markers jiffy get sick when you have this call. Sign Storm Horizons. Which are planetary proteins your status whole stay below the threshold tells you. SO THAT'S PLAN A. Turns out that all the interventions on the so that work ripken together around chronic pain turned out that the solution for code is the same solution for chronic pain. You take multiple proven interventions in implement them in an organized fashion you can drop down Toria markers. TURNS DOWN IT turns out that anxiety is an inflammatory disorder. So. Paradoxically would've worst ways of creating Saudis uncertainty which right now, we cannot live in Morris Right what heavens the certainty is the threat. The inflammatory inflammatory reaction is response. And, the season generated by Tori reaction is king citing. Whereas insight is a reaction to the threat not the cause of the threat. To we've uncertainty big problem. So. Anger. Cranks up inflammatory started kinds of even more. So it sounds psychological nobody deal but guess what has a direct physiological impact on your body? So if you are anxious. Or there's lots of ways you can manifest that when he actually get sick with the virus, you'll have is increasing Clem Tori response. And what happens if you cross the threshold and you're going to die however, I have to just emphasize that if you're generally healthy the chance of diners actually quite low the elephant in the room. So to speak is that almost every person that's died from Cova has. Risk factors right right. Everyone of those risk factors involved elevated inflammatory markers. So adult onset diabetes. Lung Disease Alzheimer's all those are laboratory disorders and anxiety bipolar depression schizophrenia are all of Matori Disorders they're all the same thing. So, what you doing with the steps on his thrive and survive and Thrive and survive, survive, and thrive. is at the data shows very clearly as you train your body to thrive. Is that your chances of living longer got dramatically. So people that thrive live the average of seven years longer. Have half the insists of heart disease pressure promise in diabetes. And so She used these tools, twenty markers you call it the up life goes up your length of life goes up your health goes up. And so they're very concrete steps for instance in anti inflammatory diet. Don't even you don't even have to lose the weight. Go to anti-inflammatory again drops your side clients right down. Your risk is lower. Is it is it true that inflammation is the cause of most disease even cancers? Yeah. That's where actually this workgroup is going an interesting direction because I didn't know this learn more than six hundred, thirty years I'm yeah. Unbelievable comets information runs through the human body and it makes sense. Right I mean if you're under I, guess he humans have upon that he called the cursor consciousness is that we can escape her thoughts. So we all have a sustained threat. And people that are born with a very chaotic abusive childhood have. Less equipment to deal with life and artist resilient. So they don't coca stress as well. So that started their starting out in life handy people that have abusive charge much higher rates of suicide depression obesity diabetes than the average population by a lot. Not Subtle. Let's been well documented. So. This ongoing. So if you're somebody comes from a very nurturing peaceful childhood. I don't want you usually resilience because that's not quite the right word but you have a higher capacity to handle life stresses if you were trained that life is basically safe versus life is basically dangerous solar metaphor like to us is that if you nervous system was like a Ford Pinto versus our Ferrari. Those are two different systems right and when the Pinto. So. The Ferrari by the way can take more stress but again, when that threshold is reached response the same. So, presence a person who is this Ferrari every nervous system might be a see over company though in here she breaks guess what the reaction is the same if somebody raise abusive childhood yelled at by a by a clerk. And so the stress response, the same either way. Just, if you come from the chaotic abusive childhood where you weren't trained to feel safe because guess what it wasn't save. The Iraq. Higher. But affectionately physical health or profound. I just find it. So fascinating because I do think it's sort of like how you described what happened with you were you were just suppressing suppressing suppressing for so long and I find that to be a very common theme in our society especially amongst minutes seems I. Think because as men you're trained like you can't have these feelings like you can't have these emotions you know from an early age and I'm just curious. Like how would you? What would you say to someone who you know might just not even be aware of the amount of stress like how do we get in touch with the amount of stress that we are carrying because like in your boogie described things like ibs s even being a symptom of inflammation and stress and anxiety in your body and I think a Sony people just like take a pill for that. You know. Right well, remember this right.
"orthopedic surgeon" Discussed on Velvet's Edge
"The person would come in with the chronic pain and they would do the process, the director on care that's the DNC. That's what you refer to. As this all the things that we're talking about the writing, the sleeping all of the other things. So when they would start that process with that, he'll their relationships in turn a lot of times as well. Yes well, we we pick it part of the website so. What's happening in the book back? Control is surgeons or about a chronic pain. The website back in control a calm was the action plan. So between the book and the websites about nine percent self dirigible also put up a whole stricture around the family dynamics. So now to counter, this does not take my time, but once we set this arbitrary set of roles look just stop if you triggered do not engage was one of them. Also commit to making your house a safehouse words. Create a structure that allows the house to calm down to be peaceful which Ludger nurses mecom down to be peaceful. So it's a very, very self reggie process that being said if we if counselors and people that help us much more desirable, unfortunately, a lot of medicine medical insurance doesn't in pay for the resources we need to actually solve the problem, but it's not that hard. Right. Well I can only imagine I'm just thinking this situation of a family but like when you when someone comes into your office and you're like Oh, you're having this chronic pain. Okay. Well, I'm GonNa give you this riding exercise and we're going to talk about the amount of sleep that you get I'm GonNa talk about your relationships and how you interact with them. I can just imagine that some people would be like. Are you serious like this is what you're gonNa tell me as a doctor. So are were you getting a lot of those reactions when you first started this kind of practice? Yeah definitely I. Mean People See I was I was actually even more at a disadvantage because I'm a big time surgeon right? We're coming to for logistics fix s so I always look this is not sure to call their incredibly disappointed in angry. Kim before surgery right. Then the they want a quick fix but what this is actually much faster than going through an operations. The number one factor that predicts a successful outcome from chronic pain is one is to engage. Whereas so that anger frustration you talked about people simply wouldn't do that. They were they were go to another surgeon had the Surrey John Officer was catastrophic outcomes and obviously, I'm not going to say I told you so but was very disheartening wash people walk right into a buzzsaw. DOSA. Very disheartening to me that medicine even offers operations that has about a twenty percents accessory. Right there's some responsibility to figuring this out they should not. Responsibly on the physicians, not the patients say look, this is not surgical. So say look. I see if let's pretend you're my patient for seconds. Here you are. I don't see things her to call. I'm going to ask you to do some homework so I would give I would give them my book. I would say police liquor the website. And we change it. Now I just released this. This week is called the doctor Dot com, which includes an APP which is a much more streamlined approach to start in the process. So I say look here's the book. This is your homework. I want you to start the expressive writing. You. Don't have to believe one word that I said in fact embracing the discipline is actually critical because they're not in positive thinking this is done about believe and David has come. What the DOT project does by the way wishes for direct your own care you're taking known establish well-documented medical interventions. In present presented them in an organized structured manner. The words this implement will we already know works everything we do is documented on hundreds of research papers. But right now medicines during the data. So. So you don't have to believe me just starting Gatien improve practices or just go to work. So that they're more in factor if people don't want to engage the angry frustrated guess what they don't do well. And I I learned she looked here you go I can help you or not. If I try to convince people to get better why they're just get angry he get more reactive and more resistant. It turned out that the more open I was just say look here's some horror because you've got a couple of weeks. It was much more effective. So fascinating to me. So we're talking about in relation to back surgery obviously because that is where you started the books that you referenced twice I mean are you books back in control was the first book? The new one is, do you really need spine surgery in back in control dot com you guys can find all of these books, but I also WanNa talk about Cova did because I was able to speak to you a week ago or A week and a half ago when I got a positive test and the things that we're talking about right now in relation to needing surgery and physically healing. Healing your chronic pain by dealing with a lot of your mental and emotional stuff you also sort of in. Put into practice with Cova treatment and I found that. So fascinating, you have a new new thing out called plan a, it's thrive and survive. It's actually available on your website as well. The BACK IN CONTROL DOT com, but.
"orthopedic surgeon" Discussed on Velvet's Edge
"Incredibly discouraged of course, physician and surgeon. I tried everything everything real vote my disposal. Nothing work, and of course, when the biggest promise people get into the doctor's duchess tell you can't say the wrong it must be psychological and that's untrue. Your body's inflamed. Your body is inflamed and on fire that's a problem is not psychological. So. There's a sequence of steps with the first. Bean. Will we call simple expressive writing. So remember the mental pains of bigger problem than the physical pain because you can escape your thoughts. They're just simple exercise that has been documented and over eight thousand, one thousand research papers to be a factor was called expressive writing. Is if we write down your thoughts and you tear them up. and. You can't escape your thoughts, but you can separate from them. For some reason is this incredibly powerful tool use the first seven my. Fifteen year journey chronic pain actually started to start at change things. Is. The only mandatory requirement of the entire healing processes is as expressive writing is something solution, but as the starting point. To remember the way self chronic pain is you create new circuits, round the old circuit based on your plasticity. Your apostasy is a process of awareness of separation to start and then reprogramming. And so at the writing desecration awareness of the negative thoughts or any thoughts. Now you separated with a paper on the table and that Space Connecticut with vision feel. Then, the reprogramming can be all sorts of stuff huckabee mindfulness. I'll be right now just drop your shoulders for a second industry where you're sitting. And so what you're doing, you put your brain on a different sensation. And so what you're doing, you learn tools dropped on the body's chemical response. So expressive writing is always a first step which by the way also fixed sleep. Second step is Colo after meditation. We just simply put your brain on a different sensation. The next one of course is sleep, which is on topic but again, extremely factor dropping information and dropping down pain but the other one which has been really. We learned this at our workshops. That we would do these three to five day workshops in New York at the Omega, institute? In probably Ableson people into pain-free within those three to five days every time. We cannot understand what had happened has happened every time. To not recreated a major chemical shift people's brains and they're shifting back onto safe pathways as opposed to threat. BEAVER. Also talking to each other we know social connections a big deal. But when the cardinal rose this workshop.
"orthopedic surgeon" Discussed on Velvet's Edge
"Sleep is one of them. So why would you jump towers of surgery? If you haven't found out the somebody's sleeping, right? Right. And that's what started. The whole dot project has in my own chronic pain crosses i. read our sleep I started to work on it with myself. Who was my patient is very concrete is always solvable. And I notice a dramatic decrease in their paying just with the sleep. Conversely. If we didn't get to sleep under control early nothing else for. So CPA solvable. It's always number one. There's a bunch of ways of getting there. In chapter, Fourteen in my book back control is just about sleep. And Sleep is absolutely foundation started the whole process. What about when your patients came in and you know? They're mentioning this back pain or these specific symptoms and were you getting to the place where you would start to say, okay like you mentioned the sleep thing and then are you asking them questions about the stress levels in their life to also determine what's going on personally? Yes. It doesn't was two things. I can do I mean first of all treating chronic pain is actually very time efficient because of the material off questionnaire and people put it down I mean people. Have had for ten years in the payment of started a year ago something. In variably is almost alive. Stress is a loss of a job loss of a family member domestic abuse. I can't begin to tell you how much people suffer that come into my office and chronic pain. In again that's suffering translates into inflammatory changes in the body which increases the pain. So. You can't treat Cincinnati what medicines right our throwing random simplistic solutions at a complex problem. You can't treat a patient in isolation because their response to the environment changes at body's chemistry. So somebody's going home to an abusive relationship Surgeries not going to help that. And that is not psychological that is a flat out. Huge threat. Your body's on fire. In the root causes the formation not structure. Right because the structure is meant, it's not like you're saying there's no reason to ever do surgery right because I. Think like you know a lot of people I do talk about holistic approaches a lot because I really buy into our the like our bodies healing themselves I think they're incredible. The way they can do that if you can however, there are situations where there's a structural issue and you do need to have surgery. So it's not always that, but you're just saying you look at the bigger picture such as stress such as lack of sleep whatever other emotional mental things are happening these people's lives that they're not dealing with but what I found was so. Is People's resistance to this kind of mentality. So did you bump up against that a lot? Well I mean people have a we're so programmed to think that the structures the problem in this is going to solve that Ryan. Okay, but again, by the time I does my practice with the data says to do this has been around for fifty years again. Is that you do asleep anxiety, it testifies depression exercise but occasionally. We call prefab. We put all patients through three to four months of this before we did any surgery. Into my larger surges spinal deformity surgeries I would do it for a year. It what would happen is the starter normalized body's chemistry the pain would disappear even with major surgical problems, they would cancel the surgery. Not, because he wanted to live with the pain, the pain would Ashley Disappear? They'll just shock I always said if you're a structural problem, fix it quickly, but it turns out that the Patriots is it does get connected with more more life is life experiences. And so what you're doing around. Hanes. Which of these permanent pathways like bicycle. Recruiting detoured around those. No convince you can actually program your brain around anything. And as recently had a gentleman who had twenty seven surgeries in twenty years. And he was a mess. opioids, alcohol divorce. All sorts of stuff is fine is been pain-free for four years. I didn't think that was possible. Spent limping no arm no legs still the pain. and. They can program sells around. So what you're doing is like installing a virtual desktop computer with the new desktop not having. Hey. It's it's remarkable neural plasticity where your brain is physically changed in every second or what you're doing. You're directing traffic for your brain. Goes a certain direction. So. When you say our our bodies memorized pain, how does that happen? Well I mean it's like Michael me with any skill you focus on it and you learn with repetition mean what I use is a metaphor it's like learning a new language. The way you learned French as you read the book, you learn the Burbs you listen you may immerse yourself in lanes listen and five years you can speak. French. Your brain changed you have new neurons. Derides, new mylan nuclear cells in your brain changes every second. So it happens to something muscle memory is actually your brain. Changes pressure. Once those pathways or SORTA embittered in your brain, you can't get rid of them I. Guess like riding a bicycle with repetition J. programming issue. And.
"orthopedic surgeon" Discussed on Velvet's Edge
"Bacteria or Predator. And Mental Trust could be negative thoughts emotions but even more importantly repressed emotions and look I mean to serious troll as a spicer to Howard you very five spine. Fellowship. Spicer is stressful especially accomplished by surgery now as a master as supressing fear emotions. And in a way I did that was bringing on I can take anything I was tough was really really tough. And the promise us so good suppressing emotions I. really the word in psychology would be called associated a- and from lily heavy knowing shoddy to a panic attack one day. And after the panic attack I could not stop it. In is the first thing I left they. Couldn't really control I mean is it sort of a joke but not really that surgeons have control issues And we do. We want to control environment. We want control the outcomes we want to control everything. Would you can't control as your body's chemistry. So, with the panic addict as a masters depressing and repressing emotions and when I when they exploded, there's like live blown off of a pressure cooker. Horrible. So so you were having anxiety and panic attacks where you having any sort of physical pain. What would happen under sustained threaten over? No human being can escape your thoughts or emotions. So we their self worth or or repress him. What happens threat? Puts the body on defensiveness, which includes the immune system which includes inflammatory cells. What happens with inflammation causes physical tissue. Damage. We know this, we know that chronic stress or sustain threat causes disease and the and the question is why Know a highnesses of autoimmune disorders. Irises Cancer Heart Disease Suicide in shoddy depression. Is What how much we sustained levels of inflammation causes tissue damage. Is Over thirty physical symptoms of Sustained Threat Response At the worst part of my ordeal is seventeen to these at the same time. So. I'd migraine headaches. Reena my ears burning my feet, my scalp, which he's getting restaurants where pop up I had back pain neck pain tendinitis. All of these were the result of sustained threat. Sustained information. When I learned the tools, a columnist stuff down to comedies plan between markets down all infants disappeared I'm fine. Okay. So that sounds like a little bit of your experience was tying chronic pain to the nervous system and it's also it's highly what you've experienced with your patients right so can you talk us through how that works? Chronic pain evolves yeah and just how it's connected to the nervous system. So. I, you probably have had the you've heard the term holistic medicine or mind body medicine. Yes. So those are terms that he's pretty frequently that I really object to because the mind and body just a unit in other words. Your body doesn't. NERVOUS SYSTEM OUR SYSTEM CAN'T Function without a body support. So say trying to fly a Boeing. So it's just an easy unit. So the only place in the body that pain is perceived as in the brain. What your body is a bunch of receptors vision feel touch taste, Sharp Dole, all these sensation coming into your body that are then sent to your brain. Your brain interprets that is safe or angels. So things you're safe. You're full of anti-inflammatory kind result little anti-inflammatory proteins, your pulling Avakian tocine growth, hormone, dopamine Serotonin these great drugs. Your Body regenerates. So this entrepreneur by your nervous system. Nurses in every second is interpreting every sensory input they're all competing for attention. In the sum total is summarize every second, your brain it safe, neutral or dangerous. What happens with ongoing again, mental by the way mental paints a bigger problem than physical pain because thoughts create the same. Reaction in the brain as a physical threat. But a sustained. So, then you have a process where you have sustain impulses. Athlete learning skill programming. Problem. So. With repetition your brain first of all becomes sensitized and we know the analogy of water torture which is. A little challenging even to talk about but. This a poor pressure down to a board and drip drop water and his or her forehead. Is just a drop of water. The drop of water does not change was in a short period of time that becomes a sledgehammer every drop every time nothing changed. They've also done research my schedule show that over course of tying. Brain becomes five hundred percent more reactive to the same impulse. Coupon chronic pain get worse even without additional injury because of the sensitization process. The next step is with repetition against program problem like a baseball pitcher learning how to throw a baseball at a hundred miles. An hour takes less repetition. Is, the brand gets programmed in. Once he gets programs like riding a bicycle becomes memorized in hermit. Painting pulses coming in. So quickly that memorization occurs with this six to twelve months that's been well documented with research. MRI Scans. Then the final phase is there's factors that affect the perception of paying wrenches lack of sleep. Causes Pain. which is people chronic pain potentially because of the pain, right? Not True is actually the lack of sleep actually causes chronic back pain. which is in Tudor right right. But what happens lack of sleep causes increased your formation, which increases the speed of nerve conduction. So you feel the pain. Wow. So okay. Because when I in your book, you talk a little bit about the factors just determine the state.
"orthopedic surgeon" Discussed on Velvet's Edge
"And pieces are big generator recovery much more than just a simple crush. and. I'm to research complex surgeries. Why deal with ultra to reduce I've had one gentleman gentleman who had twenty-nine surgeries in twenty years so I'm the person just with a very ended alliance tough, but with disconcerting. Look back their original scans and I was quite diligent and looking at. Probably most of the time that proporation did not need to be done. Operation done at least cascade effect. Did. You need more and more surgeries to take care of the problems created by prior surgery. It's a nightmare for the actual surgery then creating more problems than the person had to begin with. Correct. What happens is you do a spine fusion in other words you well, the tuber together with ruse plates and bone graft. You're taking this beautiful mobile spine humidity generated. This still moves it has rhythm to. Putting, a stiff piece of bonus. Kardashian biddle the spine. There's a stress point above blow that fusion. That with. REPETITION breakdown. Thirty to forty percent chance of respond breaking down within ten years with his fusion. Which finally drove me to quit spine surgery is that it became more common the more clear the data became. The End, every paper, twenty, thirty percents success rate at the volume of Spicer continues to increase. Then what's happened, they're doing eight ten and twelve fusions instead of one of users for back pain. There's no data to support it. Forty level abused for back pain as for your neck to your palace. In. The complication rates over seventy percent. That's when I decided I just could not do this anymore. Yeah, I think it's so interesting because. We have this mentality about surgeries and medicine and I feel like a lot of times in our culture. If you go see a doctor, they're like here, take this pill and it doesn't actually treat the root cause of what's going on adjust treats the symptom and so what I heard a lot in or read a lot in your book was just that exact thing doctors like you said, not having the data that backed up, that's the surgery was even going to help but it was just like here. Let's do this surgery that may not even actually fix the root cause of your patients problem. Well exactly. Well, it gets it gets pushed for complicated in that, but just keep it really simple is that. If you're if you're into your car Carter mechanic, you want you want to know what the diagnosis is. Correct right fix that problem. So it happens was spine surgery occasionally there's. A. Perfect bone spur the printers given her the symptoms match. Exactly. Surgery works beautifully. But see back pain is very. We know that district generation as normal as you age and we start to a fusion on on a given disk. There's no way of proving that it is the source of the pain. In fact. It's been shown that disk are not the source of chronic pain. Then additionally, we know that within six to twelve months the brand simply memorize the pain. Like riding a bicycle when she had this pain, memorize such a programming problem. Once you have pain memorized, you cannot learn it like riding a bicycle. So you have memorized pain, you have disc that are not because of pain. You do a fusion or memorize pain in your during fusion for a problem that's has been proven not to be the problem. Again the success rates are about twenty percent and I was surprised that high. Security works. Well, we've been matching symptom matching ecology. And you do the operation of what my book did call do you really need spinal surgery push people in one of four quadrants with various being the structural problem? Yes or no words surgery even possible if you can't see it, you can't fix it. They call that non-structural. Structural surgeries possible. In the state of the nervous systems either calm or fired up or hyper vigilant. So, if you have a hyper provision part of nervous system, any procedure can make things worse. So right now, we're doing a lot of surgery people have nothing you can see on a test that's why I think seventy percent of Spicer simply should not be done at least seventy percent. Wow, your big thing with patients. I mean this maybe before you actually quit doing surgery altogether. But your big thing that you said was you just have to get to know your patient and so i WanNa talk a little bit about that because what you just said is you're not actually seeing are pinpointing the pain where it's coming from it's just doing these surgeries and so what were you seeing a lot of your patients that made you say wait a second like why would we go directly to surgery? Well, he knows as shepherd through my own thirteen experience with our ordeal on a peanut came out of chronic pain I did learn it was logical problem. In that even with a structural problem that you do surgery on if you don't come down the system I, the results are not very good. So what I learned is that we were looking at me very carefully. In this three parts is helping paying one is awareness that we're in the diagnosis understand the nature pain in the nature of the solution. then. The second aspect is paint is complicated survey by lack sleet stress. Medications exercise. Nutrition. All of those things affect pain. and. You have to address all of those simultaneously. And the third thing is as paints complex and each person is individual person has to take charge of their own care. So what we found out consists of we have I saw hundreds and hundreds of patients go through a similar process that I learned myself the hard way. As watching it is it's essentially self directed minimal to no risk. So watching these people. Go to pain free with minimal risk minimal cost. In having a horrible comes really expensive risky.
"orthopedic surgeon" Discussed on Velvet's Edge
"So. You basically become become known as the orthopedic surgeon known for not for taking patients out of surgery providing an alternative method to go to that's for pain free, and so I'm just curious how you got there because you practice as an orthopedic for so many years and then in two thousand eighteen, you just completely quit surgery. So let's go back and talk a little bit about the process that Gotcha there. Have Been One of the few search engine who's been on both sides of this and I went to a very high level spine fellowship in Minneapolis Minnesota. Six. Human Seattle Eighty six, I was one of the group of sturge did nine. For sponsored per capita. Entire country. So I was jealous. The answer back pain was fusion. We had no Schmidt stationed. We thought we were on the forefront of. Medicine doing these operations. But there's no data. and. Three came out. The. Success rate of his spine fusion. Back. Twenty percent. And I just thought I didn't know what to do but knew wasn't going to keep doing this. In the meantime running around in that period of time. Of severe. CHRONIC MYSELF Thirteen years I cannot come out of. Over seventeen because he goes comes and it was coming out of this process of the mall in the process of coming out chronic pain. But I did notice surgery joy. I was very, very aggressive in the surgery. To not work. So you said, it was a twenty. What would you? What was the percentage twenty twenty, two, percent annual. Rate. So I thought, it was ninety percent I mean this is a big operation. Weld together. Complication. Rates. Twenty percent a reiteration within two years after the surgery. I thought it was success rate and there is nothing one research paper in sixty years. The documents that spine fusion to good idea for back pain. Or over twenty billion dollars a year in Spicer. With a lot of for that. So, why is it recommended? So often if it does not even have a high rate. I don't know honestly I you can blame the financial issues I mean usually spicer is considered one of the number one or two revenue producer hostile. And pieces are big generator recovery much more than just a simple crush. and. I'm to research.
"orthopedic surgeon" Discussed on Velvet's Edge
"The world is shaped the voices we choose to guide us. The ideas we choose to embrace what if we made the choice right now to create a new world with better outcomes for Morelos by listening to the voices of the world's most inspiring women, join us at P. and G. and choose equal for an equal future. Listen to Seneca's one hundred women to hear a new podcast by Seneca. Women supported by PNG on the iheartradio APP. Wherever. You get your podcasts on. Crooked. Chase. Nashville chats a visit with global superstars, Brian Kelly and Tyler Hubbard of Florida Georgia line. Now they've made history with their music and have been just as successful off St however there's one thing they've decided they won't do during the pandemic you'll learn what and why plus a chat about explore next and fashion family in out of nowhere but. It's tyler and vk with CNC. Listen subscribe on the iheartradio. APP. Apple podcasts or wherever you listen to podcasts. This is Kelly. Henderson and you are listening to the velvet edge podcast my guest. This week is orthopedic Surgeon Dr David Come Dr. Hanson made a name for himself for many years as one of the top spinal surgeons, and now completely quit surgery and as making waves by actually talking patients out of surgery and providing alternative methods to alleviate their chronic pain and. Live Life pain-free Dr Hanson is also a fellow covid patient and I was able to talk to him about my symptoms after testing positive he has created an entire plan for treating Cova that involves treating things like anxiety and stress. Two of the root causes of inflammation in order to fight the virus. Sounds it worked for me and I. Believe. It helped me heal much more quickly Dr Hanson broke down all of the details of why that works. Here's our conversation..
Operating in the Time of Coronavirus
"Dock style reps podcasts. We're here today with Dr Ken Hood a fantastic and reputable spine surgeon from Phoenix Arizona. Dr Hood it's great to have you on the show now. The novel Coronavirus Cova Nineteen has caused a sharp decline in elective spine surgeries as an esteem. Spine Surgeon Operating Multiple Times. A week during the middle of this global pandemic. We thought you would be uniquely qualified to talk about how the novel coronavirus has impacted your practice. But before we get started we'd like to learn a little bit more about your professional background. Hey thank you so much for having me on the PODCAST The first time that I'm doing this and I think what's exciting venue Be More than happy to answer some questions today. in regards to my background. I'm Orthopedic Spine surgeon up in private practice now for five and a half years Prior to becoming a spine surgeon night training in Orthopedic Surgery Residents in Riverside California there was during my residency program that I became interested in spine surgery itself as a sub specialty so after orthopedic residency which is five years then went on to do a complex in minimally invasive spine surgery fellowship at the University of California San Diego and that was a urine length and then thereafter A signed for my first job at the University of Arizona in Tucson. I was there for several years and then subsequently have moved to Phoenix Arizona where continued to practice today fantastic. Let's go back a little bit further though. When did you decide? That medicine was the career for you. What was what was the motivation for that. So my my interest in medicine actually dates back to well before attending medical school It was during my undergraduate years The University of Rochester where I was actually an economics major and during one summer break I had the opportunity to shadow a orthopedic surgeon I wasn't specifically interested in orthopedics at that time that I just on the back of my mind. Medicine was a potential possibility so It was able to shadow orthopedic surgeon during the summer months and see his day today and and see the the types of things that he was able to do in that really sparked my interest. My Mama's retired nurse. And so you know the medical field is always been a part of my life to in in that regard but UH specifically That that that summertime shadowing of the orthopedic surgeon so it really sparked my interest interesting that that's a that's a different sort of spark that I've heard from from other medical professionals. Now I understand that you're second child. The daughter was just boring. Congratulations thank you. Yes yes Just two weeks ago. Healthy baby girl so Everybody's doing well how. How was that process a during the pandemic how how is the whole process of having a birth and going to the hospital for for that specifically or did you yes? says the very interesting obviously with covid nineteen and restrictions in place. Most hospitals The process at least from my standpoint was much different. We have another daughter is one and a half years old and comparing the two experiences was Pretty interesting so With our newborn I wasn't presents at any of the the the the prenatal visits So just here for my wife thinks going because they wanted to minimize People in and out of the allocation offices When the pandemic broke out Luckily by the time that she was ready to deliver they did allow one visitor after the birth so I was actually not physically present during the birth itself but afterwards was able to visit which was great but definitely a different experience than with our previous child. Were able to be present for the entire process. Now how is it balancing your personal life and operating at a trauma one centers? Is it difficult or have you found your way into it? Pretty easily It definitely has its challenges. I would say that over time. I've been able to develop a routine and schedule. That helps me navigate the day today even with that though taking level one spine trauma call does throw curveballs into your into your plan. Schedule on a daily basis The the balance is key Between personal and Work Life. If you focus solely on either components the other will suffer significantly And it's tough because sacrificing time with your family friends it's hard And at the same time you know if you ignore your practice or your patients Bad things happen as well So what I tend to do is try to stick to it daily routine Monday through Friday. I usually get up between four thirty to five o'clock in the morning trying to get some exercise in before heading into work the day to day various between clinic and operating room as well as call stuff but most days. I'm done by somewhere between five and six. Pm and then once I get home. It's one hundred percents Family time occasionally. I'll get called in the middle of the night and have to go into operation. Fortunately most things can till the following warning but it is a challenge And I feel like There's no perfect answer. Perfect scenario you just have to try to find as much balancing your life account
Laura Prepon Opens Up About Having Eating Disorder
"It's so interesting in doing prep for this interview. That in seeing you from that seventy show to October road and two oranges a new black. You've always come across as so confident in this book you bravely right about your experience suffering from an eating disorder during your early years as an actress and you were struggling with your body image. An industry that is very focus on appearance. How did you get out of that? What was your road to recovery? Like will you bring up a really good point? Which is yes in my industry. Unfortunately the way that you look. There's a Lotta pressure for that. Which is why I was so fortunate to be on something. Like orange is the new black. Because it's so celebrated women of all different shapes and ethnicities and backgrounds. But the thing about what happened with my mother. Yes she equated. Being thin things successful hundred percent and another thing I had to do was look at how she was raised and get understanding. Because I couldn't understand why you would teach your child while teaching them all these other great things and then you teach kind of dysfunction. That did take me years to get out of. But it's really understand where they came from the fact that she equated that with success in thought she was helping me. That's what was very complicated about it and for us for myself on my mother it was. It was a shared secret. It was how we bonded and because I so badly wanted to bond with my mother you know this was how we would spend time together and when we were growing up my mother was always off doing some. She was eccentric chef. She was always off doing things at restaurants perfecting her picking duck recipe. And all these odd wonderful things that I grew up with but when I did get time and spend time to hang out with her. I couldn't wait and my father. He was an orthopedic surgeon most of cases in two hospitals. We never saw him either. He was gone in the morning before we went to school and he would come home very late at night. It was a very odd upbringing. You know and then so when I have this time to be with my mother. It was really special. So that's what was so hard about this thing that she taught me and the other thing too is the reason why I struggled with this dysfunctional relationship. To food for so long is because you have to eat to survive. You can't just quit smoking or stop drinking alcohol or stop doing drugs and things like that. You have to eat to survive so there's triggers all day. It got to a point where it was just. It was bad and then when my mother was diagnosed with Alzheimer's that's was a game changer. For me while the blame Ya. I don't think that the dysfunctional eating attributed to that it might have. I don't know but when that happened I couldn't help but wonder could it have been different if she was so better care for self and that was a game changer for me and then when I got pregnant it's like a switch left and when I got pregnant. That's when everything truly shifted for me. I would never even think of doing that kind of abuse to my body
Exam Question: Trimalleolar Ankle Fracture After a Fall
"All right so we have a sixty one year old woman with no past medical history or family history or heart disease presents with a try. Malaya Lar- ankle fracture after a fall. As part of her pre-operative workup an e. C G has obtained a portion of the rhythm strip is shown above which of the following is the most appropriate. Okay so this is a two step question and the first part is to take a look at the rhythm strip and interpret the rhythm ship because that is going to be important to answer this question and when we look at the rhythm strip we see a p wave cure s complex t wave P wave curious complex t wave so we have a P. before every cure s the only thing. I see here abnormal that the PR interval appears to be a little prolonged so it is greater than one whole box here The width of box. So this is going to be a little greater than two hundred milliseconds however we see no drop p waves and so this is consistent with first degree heart block okay so now that we have in E C G A rhythm ship with first degree heart block. Let's take a look at our clinical scenario and trying to affect the question and what is asking so the question wants to know which of the following answer choices is going to be most appropriate here. So let's read. Those answer. Choices a administer I v Calcium Chloride Insulin Glucose and sodium bicarbonate answer choice b order cereal cardiac biomarkers and admit to cardiology. See Place Trans Cutaneous Pacer Pads and make arrangements for Trans Venus Pacemaker. Md reassure the patient and orthopedic surgeon that no treatment is necessary so when we look at this question the key thing here is that we have a pretty typical presentation of primordial or ankle fracture and the question is telling us there's no heart disease here and at the patient has no past medical shree so when we are given this information in a question. It's for a reason right. And so when we look at the C. C. G. A lot of people say well. Maybe it's a little abnormal. Maybe we should do a a workup or something. Let's go through answer choices and see why this information of no past medical history and no heart disease annonay symptomatic patient is important so answer choice a IV calcium chloride. Insulin Glucose Sodium bicarbonate. That's the treatment for hyper Kaley. Mia We have no indication at this. Patient has hyper Kalia. There's no peeking of the t wave. There's no widened cure s complex. So answer choice. A I'm going to cross out it's choice. B Order Cereal Cardiac biomarkers and emits cardiology. Well with an abnormality in E C G in an older woman. Who's sixty one you know? It's something to think about right. However in this case the patient is otherwise as she has no past medical history or hard sees and really a first degree heart block. On an EC- G. is can be abnormal. Right it's abnormal but it doesn't necessarily mean that there's disease right you could get first degree heart block in young healthy athletes. You get it from some medications such as Beta blockers. You could get it with individuals who just have a little increased. Vega tone than normal so as long as the patient is. Acm thematic knock complaining of chest pain. There's no need to order cereal. Cardiac biomarkers and admit the cardiology. So let's cross that out. Answer Tracy Place. A TRANS CUTANEOUS PACER PADS and make arrangements for transient is pacing. This patient does not need a pacemaker. Even Trans Cutaneous if a patient has complete heart block and so for example. If this patient was coming in with chest pain shoes Dr Frederick and there was a heart block. We'd be concerned that that may progress to complete heart block and in those cases you may want to consider Trans Cutaneous Pacer pats. However this patient is totally fine otherwise other than the ankle fracture. So let's cross off answer choice. See that leaves us with answer. Choice de reassure the patient and the orthopedic surgeon that no treatment is necessary. And I'm GonNa Choose Anti-choice D. and sure enough. That is the correct
AI and New Tech in Orthopedics
"Phoenix surgeon. The Nice thing about incorporating technology into our work today is that there's many different facets we can utilize it one area that I would say in regards to reduce provisions that we talked about is how do we make our practices. Smarter Redo His from Radiology Perspective. So I definitely use. Ai and clever was some individuals to look at media graphs not just that the hip and knee which we look specifically but other areas around it but also using a. I the diagnosed utilize ai to identify implants which we can't do as well with the human eye. An area of interest for myself and Thurston is infections and so we're using technology tech infections earlier because we know that earlier detection is earlier treatment which is outcome for patients. So this is done with sensors. Sometimes you the placement skin placed inside intense themselves and when it comes to technology another area that I'm interested in investigating is when do implants fail so when we look at technology today when I can tell implants? Failing my biggest indicator is a patient coming in with pain after getting an implant placed in. It's not a very sensitive indicator by far so people are developing who we call smart implants where you're putting in technology into implants themselves that can detect these problems of loosening beforehand. So we can utilize those regular everyday practices. Hossan M I. I couldn't agree with you more. I think the The future really is in technology and algae via from numerous ways You know the I think the idea of implantable smart. Implants has has huge potential. Identifying you can start off the bio mechanics. Amazing why they fail. You also can monitor patients much better. We're going to be doing much of our Care has to be much more cost. Effective way to be a monitor them from afar That would be far superior. We can identify patients who need more. You would know much more about this than I do. Because you're the infection grew as here but I could imagine implants that someday. We'll be able to pick up infections before we know they're infected. Maybe self diagnosing type implants also if you look at it. There's some areas that that are so fundamental if you think of what we lack in and there's such a need for technology were just beginning to scratch the surface on that we don't balance a knee until maybe more the last five years any differently than John. Insult did it thirty years ago. It's I think this is good. And we don't know what we think is bounced stays the same balanced two months later two years later which patients loosen which patients don't loosen. We don't we haven't had objected ways. I think with the sensor technology with robotics we will gain insight to know how we should treat various different patients and really go to individualizing the patient. And then you begin to say using the data that we are deriving could derives law all these technology. This is torsten and I think I agree with both of you guys and and I think Antonio spot on if you look at the use of I in in healthcare. I think the area that we're most advanced is the imaging area. They are advanced algorithms available. That disappoint even read at an accuracy that succeeds ever trade yards. So I think this is a huge area. If an orthopedic surgeon that uses x Ray every day to follow patients to diagnose patients determine their readiness for surgery to say that. Hey we're reaching this point where you probably going to be candidate for for total joint replacement and you can incorporate dad on the Tele Medicine Platform. You can get x-rays anywhere and I read it and then refers the patient A personal interest of mine where I use. Ai and machine learning is in predicting outcomes We have been for the past three years. I've been working on projects trying to predict length of stay cost overrun in a in a bundled episode Predicting adverse events such as readmission Divas it's Or DISCHARGE DISPOSITION. The challenges there. Is You machine? Learning models depend on the accuracy of the data that you feed into the model also accurate coding and ended event trade for this especially orthopaedics. Elective surgery is fairly small. So you need large numbers to get. Akron models But I think that that has a tremendous Opportunity in that area when it comes to a If you talk about technology and orthopedics and I don't think I think Steve mentioned going as like I think one area that we really have come a long way and that we're making rapid improvements. It's using robotics sensors. I I to balance the using robotics to do the cops. Think these areas Extremely fast growing areas with companies diving into it and rapidly releasing new technologies reducing revisions conference. We talk a lot about this kind of edge of the circle research. The things that you all just mentioned and what you're excited about what you discussed. What would you say to those listening? patients providers technicians. Do you think is the most tangible rate Just right on the circle of we'RE GONNA. This thing is about to be across the country and available in all markets. Why are you excited about that? Particular piece of technology. I think what is middle available at this point in most of the hospitals I would say the market penetration close to fifty sixty percent. Now is some type of robotic technology or navigation technology. It's available implant placement. I think that that is something that patients can have a conversation with the provider about the benefits and risk without. But that is Fandy. Well penetrated an orthopedic market. And then if you if you go and shift to value based environment and look at what is available there. Several companies smaller companies platforms that offer. Ai Technologies or communication technologies to provide us to interact with patients and that goes as far as as using tell them visits and Ritual follow ups and I think Dole Todd technologies that in my opinion they bay exciting something that comes in handy during this code nineteen crisis as
"orthopedic surgeon" Discussed on Outcomes Rocket
"Her name is Dr Karen Sutton. She's an orthopedic surgery at hospital for Special Surgery. She's she's got a lot of different hats she's also an associate professor at Cornell Medical School. She's the head team physician for the US Lacrosse team the ladies team. She's a chief medical officer at the International Federal Lacrosse Organization. She's a researcher. Mama for has worked with peewee athletes elites all the way to the Boston. Red Sox Bruins. This lady is moving shaken and healthcare. And it's a pleasure to have on the podcast so I want to give you a warm welcome Karen. Thanks for joining us. Thank you for having me. It is a pleasure so tell me. Is there anything I missed in your intro that you wanna tell the listeners about one thing just to exaggerate eight onto the position now with chief medical officer for the Federation of international across. We're looking towards making Lacrosse a more international and hopefully Olympic sport. So I really had had the privilege to get the ground running with that quest for the sport of Lacrosse outstanding. Yeah I mean it definitely is a sport. Not sure why it's not in the Olympics yet. So I think it's a it's a great endeavor for you was moving forward. What would you say the time to make it half the news? We're helping maybe twenty twenty eight where the Olympics are going going to be in Los Angeles. That's what we're shooting for. That would be awesome. That would be amazing. I'd be thrilled. Definitely wish you the best in those efforts and they pick the right woman for for the job. Thanks appreciate it absolutely so care and tell me a little bit. About what got you into medicine to begin with probably started from working with my dad when I was little and just learning to write he was doing. EKG's and reviewing them as a cardiologist. And I used to follow his lead and pretend to copy his writing even though not one word was eligible from my point. But I thought I was doing a good job as a junior cardiologists then nice. I followed the lead going into college where I a major in chemistry with a focus in biochemistry and enjoyed the research aspect of that started shadowing some doctors especially my father wanted me to shot. A women surgeons surgeons to understand what the lifestyle is female versus a male surgeon in the field. Because it's a lot more balancing from my perspective for sure. Then when I got into Medical School I shadowed and mentor with an orthopedic. Surgeon named Dr Mormon who at the time was the team surgeon for the ravens so he was fantastic. We wrote wrote Lacrosse research papers together. He really motivated me into the field of orthopedic surgery and despite the fact that he was probably six five and a few pounds heavier than I was he convinced that Orthopedic Surgery was the way I should go and take on that I love it. So it's just amazing right. I mean the influence that are mentors enters have growing in this field and festival today share. He's very proud him. And your father for all the things that you've done and so now you're here her doctor Sutton. What would you say a hot topic that needs to be an every medical eaters agenda today? And how are you all approaching that I think a hot topic compared to maybe maybe a decade or two ago is personalized medicine for patients who are getting all of these data points on people. Whether it's genetic advanced imaging being able to put a puzzle piece together a lot better than we have in the past. The other thing is partnering with a lot of these wearable devices where we can get in real time. What especially actually athletes are doing? What's their average heart rate? How much are they exercising? You can even have them track their calories so you can get the energy. They're using the energy. They're are putting out and tailor treatment to that scale bad. That's a really really a neat approach Karen and you know we recently just did an interview with Keith He's over at L. RV capital. He was talking about the digital front door of healthcare and you know much like you mentioned this consumerism. Approaches is definitely becoming the focus. Give us an example of how you and your practice or or one of the organizations that that you're part of have have enabled this one organization. I work with so I. I used to work with the Yale athletes and we found a lot of stress. Fractures were happening happening on one of the teens with the female athletes so we needed to get some feedback in terms of how they were eating. What were they doing on the field and some of the trainers were able to track some of their nutrition and we realized that in terms of availability for their nutrition after practice there were limited resources so we start to get an odd blip in terms of what they were eating after practice and certainly a stress fractures multifactorial but if we can control at least the energy that they're taking in it will help to prevent progression of stress fracture even a stress fracture from starting so we were actually able to work with the university to determine more cafeterias more options for the athletes to eat after practice and that was one way of dealing with just tracking nutrition? And then how you can impact change after that. That's pretty cool. So a lot of it came from what the girls were eating so were the results after they sort of changed their eating so looking at both eating as well as foot where. I think that we noticed that they needed to have a lot more footwear on the field. You can't just wear cleats. Throughout turf versus says grass versus artificial turf as well and everything has a different length and needs a different grip with the cleats. So once we changed cleats and then nutrition started to see a trend trend to wear certainly decreased incidence of stress fractures. That's awesome congratulations on making those tweaks to help. The players really be healthier and more productive on the field. That's a big win. Yeah it's Nice. It's always good when organizations to are very responsive to changes. That need to happen absolutely now. Tell us a time when things. It didn't work out something that you experienced a setback and what you learned from. The first thing that comes to mind is going from middle school and then playing volleyball in in high school. One of the coaches of the volleyball team asked our gym teacher in Middle School. Who are the best athletes? Who Do you think could be recruited to play volleyball so freshman your eye out for the volleyball team made it? And it just didn't seem to be my forte. I was setting which I did a fairly good job Abbott but I had to take a step back and really assess my strengths and weaknesses. Because I felt like I wasn't really progressing as a volleyball player. One thing I do in many aspects of my life is trying to get a three hundred sixty degrees view of what's going on so I talked to the coach. I talked to the players. I just looked at different training techniques and I started realizing I'm much more of a sprinting athlete on the field pivoting cutting athlete. And so I was talking to some of the other coaches and ended up switching over to feel hockey so I think get a lot of us have to delve deep within ourselves and decide is the path that we're going down. How do you make the most of your talents as well and looking looking in life? Especially as you're driving your career even as you're driving your recreational activities making sure that you have those efficiencies that you're reviewing Karen what a great example and I think I think this is one thing that that applies as much on the field as to people's careers in businesses and. It's hard to make those decisions that hey you know what. I've got to change what I'm doing. What kind of advice would you offer to the folks listening? That are maybe in the middle of something that they know deep down inside. Hey you know what. I'm maybe maybe not the best that this. How do I think one thing is to take a step back so we all want to just keep going going going and move forward and make a change? Possibly possibly in an irrational decision so it's always important to have a quiet space start keeping a journal and I learned from Oprah always that we need to write down. Our immediate media. Goals are short term. Our long-term goals in our lifetime goals and start deciding. Is Your Life at that time. Really lining up with how those goals are forming it. Fortunately unfortunately I guess assoc changed throughout our life. Where your goal? When you're twenty is definitely going to be different than your goal when you're forty so one thing when I started out as a surgeon in your first couple years as you're not as busy clinically? So I had a few friends. Tell me words of advice to start sitting down and decide where you want to go with your career as a surgeon. One thing I always wanted to do is get back to the sport of Lacrosse. So I started looking into the options for being a team physician for the United States and I talked to some of my connections and got some feedback how to get to that pathway then I reached out to US Lacrosse and they ended up having a under nine hundred. Nineteen that was going to Germany and they asked if I would be willing and able to service team physician for that team and I certainly jumped at the chance and have gone forward ever since with them. That's awesome what a great step by step step process that you laid out here for the listeners Dr Sutton and and I think it's something that we definitely need to do. More of we tend to WANNA go. Go go without having to take a step back and that step back getting clarity and Mike Herron said writing out your clear objectives will definitely help you navigate the system a lot better as well as your career. Tell us a little bit more about a time that you are the most proud of Karen something that happened in your medical. The leadership experience today one was probably joining the hospital for special surgery. Staff Hospital for special surgery is the number one orthopedic hospital in the country and I always thought in the back of my mind that it was someplace that I wanted to be. They just really focus on patient care. It's an amazing experience when somebody walks in the door there from the person who greets you to the person who's walking you into the operating room to of course the surgeon and the supporting staff around you one of my mentors virtually really. I think she knows it now but she didn't know it back in the day. 'cause I was always following what she was doing with Dr Joe Hannifin. She's a leader in the field of women's sports medicine and she he was conducting all of this research on a scale injury on female athletes. She was the first to start a women's sports medicine program and she actually reached out to me last July and asked if I would join the HSS restaff and of course when your mentor or your virtual mentor asks you to do that. It was something that I.
"orthopedic surgeon" Discussed on The mindbodygreen Podcast
"Children Type two diabetes is over simplification of it is where the metabolism tablet is broken not functioning optimally and there's a spectrum you know it doesn't it's not like you wake up one day and you weren't type two diabetic medic yesterday. And now you. Are you know how we got here. I think there's a lot of from dietary standpoint. There is a huge change from how we ate for thousands of years. And it's not like we're living to one hundred sixty thousand years ago and you know now. Now we're living seventy-five although you know the the this is the first year again. It's the expected. Age keeps has taken a turn in the wrong direction so it was increasing for a long time. And there's a lot of factors around that But we're seeing. The overall life expectancy start to decrease in the United States And we see this a lot. I mean the number of Children Brin who are going to be diagnosed now in the future with type two diabetes. Is You know brings pains in my heart. Because you know it's such a problem and those kids it is far easier. I think to work on prevention prevention than it is once you've gotten into where your metabolism is broken. I think that's part of why it's so hard to lose weight and keep once we've lost it to keep it off and there's some studies that that support that And so the epidemic of obesity in kids is creating problems for you know a lifetime from now. Sure so you know a lot of it. Our lives have gotten really busy. We don't focus on family meals. We eat on the fly. We eat a lot of processed food. You know there was a study that I just saw recently. That showed that a highly processed plant based Diet increases your risk of cardiovascular disease and but a whole foods one decreases it. So you know we need to find better tools in the low carb diet. I mean the data for a long time. It was just lose weight and take medications and there is mounting data that a very low carbohydrate diet can be powerful for patients who you know have metabolic issues in have blood sugar problems. I don't think the goal is really metabolic flexibility like my kids are not on a low carb diet. My kids are active and eat a predominantly whole foods like we try and minimize the amount of processed foods that are in our our house and teach them you know food balance and you know try and keep out all of this next but it is hard because they go to their friends and then they eat you know chips and cookies and crackers and they get a taste of that and then like mom. I don't want this like Uber. Healthy thing that you want me to eat. I want to eat that stuff and I will watch them. Eat more of that stuff. Then they would what I feed them with. You know whole ingredients gradients and I think that that's part of where you know we get into trouble. It's and it can be the treat. It doesn't matter it can be Kito treats to like I can be totally full. And if there's Kito chocolate cake around I am having some so I think the hyper palatable not necessarily the process nece is i. I think it's confounding. So do you have any general advice for someone is pretty healthy but just balancing blood sugar in the afternoon just like awesome best practices as people struggle from a blood sugar standpoint. The carbs that you eat are the thing that matters. I think that we need to be you. Know dispatch dispatch. It depends where on the spectrum. You are some people will have problems with you. Know even the carbs from something that like a whole food like a sweet potato whereas there's other people do just fine with it. Some people have problems with chickpeas whereas other people do just fine with it and I think we're learning how the GUT microbiome plays a role in that as well but in general if you're having blood sugar issues and you're having weight issues the Lok what's nice about the low carb Diet as you get things that you can measure in addition to just you know wait and you know I can check my kitone levels with A finger stick. I can watch my blood sugars on. I wear a continuous glucose monitor so I can see what goes on with my blood sugar all day and you know for somebody who just wants to lose ten pounds. I think the advice is different than a type two diabetic who's on four different medications and wanting to really really reverse out of that. That's where continuous glucose monitors. I think are the most impactful because when you can see what happens to your blood sugars. It's really powerful The you know for this person who is metabolic we healthy and they just WanNa stay healthy. It's eat whole real foods and you you know how much animal protein is in there. I think is individual and there's a lot of factors that go into that but whole foods and eat when you're hungry and not eat for the other other psychological reasons you know and move every day and make sure that you're lifting things so that you're maintaining it it can be bodyweight exercise. I mean I think pilates Yoga and body weight exercise are great. You need to go to the gym. You don't need to have special workout clothes. You can do it in fifteen minutes getting hang out of bed in the morning to maintain muscle strength so something you mentioned earlier is intermittent fasting different for men and women. A lot of things are different from. I'd like to say they are. They are different. It is because women are hormone levels can be impacted you know. We have estrogen and progesterone and testosterone thrown all three and those can be thrown off. I do well with you know eating late like I don't eat until later in the day and I do well without. I've never run into a problem. There are other women who tend to be super lean although not necessarily who have more struggles with that people with thyroid problems can have more struggles with intermittent fasting and they actually do better to eat. Smaller amounts throughout the day. And this is where I go to. There's not one right answer I can go. Do you know five days in do a water fast which I certainly don't. This is not medical advice for type one diabetics to go out and do that for you. Joe Cross us that whereas I have other friends who have different body types. Who you know? Don't do well with it at all. All can't go a day and a half and I don't tend to do that as much like now. I'll do a really low protein. You know based on some of ultra-long goes work and things like got and play with that and what it helps me reset things whether it's physiologic or psychological. I can't tell you the answer to that but it you know. uh-huh helps me sort of reset from the standpoint of my hunger cues and how I respond to them if I take those breaks and it also means I'm not thinking about food is much and you know not overeating at times. When I might be interested would snack doc? I wouldn't otherwise snack. So what's interesting to you right now. Where do you think the conversations going to be in the future? Say a year from now. What are we going to be talking about? Hopefully so I think you know I mean. I don't know that it'll happen a year from out but my hope is that we can sort of stop the Diet wars and that we can learn for me. The biggest thing is learning from people who struggle and how to help them struggle how to partner with them how to give them things that they can use in measure to know that they're you know on the right pathway So my hope is that were talking more about. How do we really work with somebody and stop like the arguments of animal protein versus non animal protein? I mean the. There's some environmental things that are are factors for both of those. Thank you know. Growing mono-crop is a problem. And and you know what we've done to the soil as a problem but animal like it. All of those things are really really important. I mean I want my kids. Kids kids to have a planet that they can live on But the thing that I would love to hear from a dietary standpoint is really understanding understanding the different tools that we can use for people to help them achieve success and to be able to partner with them on that and that would be you know from an ideal standpoint where I think I would like to see it go. I think low carb is incredibly helpful for a lot of people. There are some people who you know their markers going the wrong direction with and you know that's the thing that I've found. I've had some patients who their markers. There's going the wrong direction and we shift to plant based Kito. You know. Maybe it's got fishing it. Maybe it's one hundred percent plant based and their markers improve and it is. It's there's not one right way. It's how do we figure out okay. You're more likely to be successful on this and when you're not here's our next branch point. Here's where we go to like. That's where I would. Ideally love to get to is. How do we make it look different for different? People based on their goals in their outcomes. And do you have any general advice for someone is yes. Struggling with managing diabetes. Food matters a lot. I mean you know often. I see a lot of patients who are just given more medication. here's here's the new medicine and they're told lose weight like here's your prescription. Go lose weight and they don't really helpful. No it's not. We need to give people tools fools and things that they can follow in. There are some people that we can just hand. A you know photocopied diet too and they do amazingly well and they find support you know. Having support is also really important. I mean again. It goes to the whole thing like when when I give a patient a diet if their spouse doesn't do it or worse she added their spouse S- pushes against it. They don't succeed nearly as well as when the family partners with them so having programs uh-huh that people can follow that have variation in them and you know have things that people can measure are the ways that I think we can improve success. Which is why you know? I've been interested in in in working with Ethan on the Kito Eight. Oh program is because it it does that and that was what was so fascinating to me with what they were doing was okay. There's there's traditional Kito. which is you know high in saturated fat? And then here's these more heart healthy options but then we can be fully plant based and you can be anywhere anywhere on that spectrum and then you can use the breadth of ice so that you can figure out am I. Is this working for me from that. You know marker and so those are the things that I'm excited about is. How do we build the tools that people can be successful? And that's you know what what I'm having fun getting to do close without. I'm very excited about Kito. Kyi Te'o your your your new start up with with Ethan wise so let's talk about But so I came in leader into the game so it was you know eat them in and race started the company and they reached out to me when we were talking about the when I posted on instagram..
A Place Where The Opioid Problem Is Upside Down
"This message comes from NPR sponsor xfinity. Some things are slow like a snail races. Other things are fast like Xfinity X. by get get fast speeds even when everyone is online working to make WIFI simple easy awesome more at xfinity dot com restrictions apply all right here in the United States too much access to opioids has led to rampant addiction and overdose but we're going to hear from a part of the world facing the exact opposite problem a lack of powerful pain medications in the Gambia in West Africa. Doctors want greater access to opioids. They say they can help speed a patient's recovery. NPR's Jason Bovine traveled there recently as part of our ongoing look at treating pain and and the story does contain some uncomfortable medical details. It's mid morning at the Gambia's only teaching hospital orthopedic Surgeon Cabot Marina is talking with several nurses about two operations that they're about to start. I just bring it into the United States. It's not going to be perfect. MARINA IS A fit thirty seven year old. He's pulling on scrubs. He and his staff are looking up an X. Rays of leg bones and a light box on the wall. A curtain divides the operating room into on the left is a fourteen year old. He fractured his knee in a soccer game in a collision goalie. His parents say he almost scored on the right is a twenty nine year old man. He was in a nasty car crash a week earlier and Tibia is now protruding coming from his Shin Doctrine says operations like these pain is unavoidable hammers and saws and Gills and things like that so so afterwards old patients expected how some pain but in the Gambia managing that pain can be difficult. I the Gambia is one of the poorest countries in the world. Many medications including painkillers are in short supply and even if Moreno can get powerful opioids for his patients nurses on the general wards aren't trained to administer or monitor them. Dr Moreno spent the last thirteen years working in the United Kingdom. He says one of the striking things about returning. Home is the contrast pain management everyone I I end up. I have to leave the world when they were doing dressings because I couldn't handle the screams but you get used to it which is not great but it's what you have to do. In order to survive in the environment lived in the operating room. Dr Moreno does have access to anesthesia for the two surgeries on this day. Each patient will get a spinal block. It makes their legs. Go numb highly effective. You've at one point the fourteen year old asks. What's my leg doing up there as a nurse moves them around on the bed patient on the right is getting a steel pin driven vertically from mm-hmm is need to almost as ankle to stabilize his broken? Tibia in the UK. Both these patients would be completely asleep under general anesthesia but not here. That's partly because this country of two million people doesn't have any anesthesiologists. The only ones working in the Gambia are doctors on loan from China or Cuba so ninety eight percent of Anaesthesia Services Don byas Mahmoud El Moussa borrow heads the College of Nursing at the American International University West Africa in the Gambian capital bright across the country all had facilities well rations stick. Please where what you find the semester these specially trained nurses. I can do many of the procedures that full anesthesiologist would but there aren't many of them and they tend to work mainly in surgical operating rooms they aren't present and labor in delivery wards leaving most women here to give birth with no pain medication at all back at the surgical ward doctrine just finished resetting setting the bones and the teenagers knee he twisted the leg back into place drilled three hole through the top of the knee and secured the joint with wires sitting have to open the skin off but it still we'll be painful think you saw how. I had to bend it back into place the start and he will be sore afterwards. If I have been doing this operation in England the boy would have gotten a local anesthetic around the joint ease the pain as he wakes up but again not here the pain meds that are readily available in the Gambia are generic versions of pilot and advil an aspirin. The only narcotic clinicians sometimes dispense is a synthetic opioid called tram at all. It's considered less powerful and less addictive than opioids like oxycodone or morphine. Meanwhile the operation on the other table is continuing north comedic surgeon from China is literally hammering Rod until the twenty nine year olds leg first couple of attempts didn't go so well. I may have to back out the Pan A. and try again but doctrine is confident. It will all work. He says these pins are highly effective before they made up and walking and they usually went home. even the next day broken leg one day walking out onto the streets of London the next but only because their pain was well controlled with opioids doctrine doesn't predict such a tranquil post surgical recovery for this guy. The patient is clearly uncomfortable gripping the table as the hammering continues and he still under under the spinal anesthetic off in about six hours time then there's usually some screaming on the words and and it just takes some getting used to the patient and stuff as well in the absence of a strong pain medication. It'll be several days. Maybe a week before this man can put any weight on his leg. These patients are also likely elite experience flare ups of what Dr McCall's breakthrough pain in the UK Moreno with treat this with oral morphine but morphine isn't available on the wards here for the fourteen year old who just had knee surgery his recovery starts on a trip on a Gurney to the pediatric ward. The Children's Ward is actually sleep in another building across the street from the main hospital. There are no rails on the Gurney and he slides around as the orderly pushes him through the potholed streets. Finally he arrives at the crowded kids ward. His legs are still numb from the anesthetic during surgery his father Hassan Manual. Camara says they know his recovery will take time where they were. Just try to support him as much as possible. Kamara worries about his son being in pain but he recognizes that he just had surgery. He doesn't expect his son to be comfortable. Dr Moreno wishes he had stronger pain meds for his patients. This teen will be hurting for the the next few days but despite that Renna says this operation was a success is now he's going to straight Meghan into suffer the rest they may not have access a strong opioids but Dr Moreno and the other caregivers here have confidence that their patients will heal and eventually the pain will go away Jason Bobi. NPR N._p._R. News the Gambia.
Dr Robert Rogue, President And CEO And Wellington discussed on Mike McConnell
"This week speaking with our guest, Dr Robert rogue and orthopedic surgeon who specializes in conditions of the hand, the wrist the elbow. Also, the president and CEO of Wellington orthopedic and sports medicine and partners with mercy health, so wrist injuries, the discussion here, and as the doctor you can tell exactly what point do, you know, it's time to go. See a doctor. Well, if the if the wrist itself appears to formed or out of place, obviously, you want to go seek medical attention. But if the pain in your wrist is severe or simply just not getting better quickly. Definitely see a doctor. It's it's difficult for any average person to really truly know if a wrist injury is just mild or even serious so getting x rays
California physician, girlfriend allegedly drugged, raped women; officials fear ‘many’ more victims
"Robichaud in orthopedic surgeon has been charged with rape by use of drugs and other crimes on at least two women. But a say there could be several other victims Robichaud ANSA Riley were arrested last week, Orange County DA Tony recall Casse showed video evidence of women pulled from robots shows phone who appeared intoxicated beyond the ability to consent or resist to sexual advances. Recall ca says, he believes the defendants charm, the women into becoming their victims both Robichaud, and we are free on one hundred thousand dollar
"orthopedic surgeon" Discussed on WZFG The Flag 1100AM
"I remember talking with her about a uragan she said it really changed her perspective on what types of medicine she wanted to practice but also even some of the medicine that she felt she could practice i wonder what that meant for you and and you're calling in your career now because originally you wanted to be an orthopedic surgeon i did i was a tricky near it i didn't have a doctor that wasn't a third in that hatton pc back together no naturally i thought that what i wanted to do it can help people so when i got sick and for a little while my in cardiff say anything but eventually when i was a little bit further out from treatment he can't think mieno you're going to be an on collagen and i thought you are it hey look like a how i wonder why it would want to do this every day i i'm not sure bet if earner i got out from my experience clinical rotation i mean that people are related to my cancer patient and i just started kind of become a little bit more openminded about what direction i might be headed internet maybe that happened to me for reason kinda changed my clarkson and you know in a certain cancun glad that it did because i think i'm doing exactly what i was put under eu at that point did you decide you wanted to go into oncology while you were still undergoing treatment or was that after the treatment it was a bit after i mean i had to have a little bit of personal distance from it before i could clearly than imagined because when you're in it i mean everything is different it changes everything in your life that you can get your gold your perspective what's important if i had to be a little bit further out before i could even imagine if being camping i could do every day i wonder what was it like being a patient and how has that informed how you practice now uh now one of a funny story that came out of my initial month hospital with airway at a particular day i'm not where i was very ill and and i had gone down for like my third radiology advocating their left me in a hallway with like a call button.