"Rethinking DX: A Digital DSM" looks at how the Diagnostic and Statistical Manual of Mental Disorders (DSM) quietly shapes almost every part of mental health care—from who gets a diagnosis and insurance coverage to how people understand their own symptoms and identities. In this conversation, Lita and Jean Marie unpack what the DSM actually is, why the current DSM‑5‑TR matters, and how a future, fully digital "DSM‑6" could function as a living document that updates more quickly, links to decision‑support tools, and better integrates real‑world data from electronic health records.​

They explore the growing push to move beyond symptom checklists and include factors like biology and inflammation, social determinants (poverty, racism, housing instability, community violence), culture and language, life stage, trauma history, and even nutrition and the gut–brain connection when understanding mental health. The episode also imagines what a visit with a clinician using a digital DSM might look like—from plain‑language criteria and prompts about trauma and physical health, to culturally sensitive questions and age‑specific guidance—while encouraging listeners to bring their whole story to appointments, ask how environment and biology interact in their own case, and get involved in shaping future DSM updates through advocacy and lived‑experience input.​

Over the next decade, medicine won't just add new gadgets—it will change what it feels like to be a patient. In this episode of PodcastDX, we explore how AI as a clinical co‑pilot, stem cells and regenerative medicine, genomics and precision care, wearables, and hospital‑at‑home models could reshape everyday care. We talk about the promise of earlier detection and more personalized treatment, the risks around bias, privacy, and hype, and why equity and shared decision‑making must stay at the center as technology races ahead. Most of all, we ask how patients and caregivers can be partners—not passengers—in guiding the future of medicine.

AI in medicine is best understood as a powerful tool and a conditional partner that can enhance care when tightly supervised by clinicians, but it becomes a problem when used as a replacement, deployed without oversight, or embedded in biased and opaque systems. Whether it functions more as a partner or a problem depends on how health systems design, regulate, and integrate it into real clinical workflows.​

• Decision support and diagnosis: AI can read imaging, ECGs, and lab patterns with very high accuracy, helping detect cancers, heart disease, and other conditions earlier and reducing some diagnostic errors.​

• Workflow and documentation: Tools that draft visit notes, summarize records, and route messages can cut administrative burden and free up clinician time for patients.​

• Patient monitoring and triage: Algorithms can watch vital signs or wearable data to flag deterioration, triage symptoms online, and guide patients through care pathways, which is especially valuable with clinician shortages.​

• Errors, over-reliance, and "automation bias": Studies show clinicians sometimes follow incorrect AI recommendations even when the errors are detectable, which can lead to worse decisions than if AI were not used.​

• Bias and inequity: If training data underrepresent certain groups, AI can systematically misdiagnose or undertreat them, amplifying existing health disparities.​

• Trust, explainability, and liability: Black-box systems can undermine shared decision-making when neither doctor nor patient can understand or challenge a recommendation, and they raise hard questions about who is responsible when harm occurs.​

• Potential partner: By handling routine documentation and data crunching, AI can give clinicians more time for conversation, empathy, and shared decisions, supporting more person-centered care.​

• Potential barrier: If AI outputs dominate visits or generate long lists of differential diagnoses directly to patients, it can increase anxiety, fragment communication, and weaken relational trust.​

• Keep humans in the loop: Use AI as a second reader or coach, not a final decision-maker; clinicians should retain authority to accept, modify, or reject suggestions.​

• Demand transparency and evaluation: Health systems should validate tools locally, monitor performance across different populations, and disclose AI use to patients in clear language.​

• Align incentives with patient interests: Regulation, reimbursement, and malpractice rules should reward safe, equitable use of AI—not just speed, volume, or commercial uptake.​

In practice, AI in medicine becomes a true partner when it augments human judgment, enhances relationships, and improves outcomes; it becomes a problem when it is opaque, biased, or allowed to replace clinical responsibility.​

This week we will discuss Multi-Organ transplants with Zachary Colton.  Zach is 35 years old and recently underwent a successful 5 organ multivisceral intestinal transplant surgery at the Toronto General Hospital in his home country of Canada. The organs he received were: stomach, small intestine, colon, liver, and pancreas.  

In 1954, the kidney was the first human organ to be transplanted successfully. Liver, heart and pancreas transplants were successfully performed by the late 1960s, while lung and intestinal organ transplant procedures were begun in the 1980s.

​From the mid-1950s through the early 1970s, individual transplant hospitals and organ procurement organizations managed all aspects of organ recovery and transplantation. If an organ couldn't be used at hospitals local to the donor, there was no system to find matching candidates elsewhere. Many organs couldn't be used simply because transplant teams couldn't locate a compatible recipient in time. 

​Since that time UNOS was created in order to provide guidance to patients and physicians in the US with a goal of providing a more equitable base for individuals in need of transplanted organ(s).

​The United Network for Organ Sharing (UNOS) is a non-profit scientific and educational organization that administers the only Organ Procurement and Transplantation Network (OPTN) in the United States, established (42 U.S.C. § 274) by the U.S. Congress in 1984 by Gene A. Pierce, founder of United Network for Organ Sharing. Located in Richmond, Virginia, the organization's headquarters are situated near the intersection of Interstate 95 and Interstate 64 in the Virginia BioTechnology Research Park.

• Managing the national transplant waiting list, matching donors to recipients.

• Maintaining the database that contains all organ transplant data for every transplant event that occurs in the U.S.

• Bringing together members to develop policies that make the best use of the limited supply of organs and give all patients a fair chance at receiving the organ they need, regardless of age, sex, ethnicity, religion, lifestyle, or financial/social status.

• Monitoring every organ match to ensure organ allocation policies are followed.

• Providing assistance to patients, family members and friends.

• Educating transplant professionals about their important role in the donation and transplant processes. (CREDITS: Wiki)

• Educating the public about the importance of organ donation.

This week we will discuss Ectoparasites.  The CDC says: "Although the term ectoparasites can broadly include blood-sucking arthropods such as mosquitoes (because they are dependent on a blood meal from a human host for their survival), this term is generally used more narrowly to refer to organisms such as ticks, fleas, lice, and mites that attach or burrow into the skin and remain there for relatively long periods of time (e.g., weeks to months). Arthropods are important in causing diseases in their own right, but are even more important as vectors, or transmitters, of many different pathogens that in turn cause tremendous morbidity and mortality from the diseases they cause.
 

Over 200 years ago Louis Pasteur was born in Dole, France. Among Pasteur's major contributions and their benefit to society, the most important is the heat treatment of foods and beverages to reduce spoilage and eliminate pathogens for consumers.

Probably the greatest achievement of Pasteur was the process that bears the name of this famous scientist who perfected the technique: pasteurization. For liquids, this process does not involve boiling the product to sterility but simply applying just enough heat (ie, par-boiling) to 50–60°C for a specified period to reduce spoilage microbes and potential pathogens. Pathogenic microbes have a lower heat tolerance than most other bacteria. Recognizing that many individuals, from the highly educated to the peasantry, were aware of the effect, it took someone like Pasteur to formalize this knowledge into specific time-temperature standards to assure consistency. 

Unpasteurized foods are sold even though they have not been treated with high temperatures. Foods that haven't been pasteurized include: 

• raw milk
• some artisanal cheeses
• some unpasteurized versions of juices and meats

Many food safety concerns and a high risk of foodborne illness are associated with eating unpasteurized foods, although there may be a few benefits.

Still, evidence indicates that the health risks appear to outweigh any potential benefits in most cases.

Here are the benefits and downsides of unpasteurized food products.

Unpasteurized food is more likely to retain its organoleptic properties and may sometimes have greater nutritional value. The term "organoleptic properties" refers to the food's taste, appearance, and smell.

Exposure to high temperatures during pasteurization not only kills harmful bacteria and viruses in foods. It may also negatively affect the nutritional quality, appearance, and flavor of the food.

For instance, some research demonstrated that pasteurization reduced the protective antibodies and immune-supportive vitamin C and zinc in donor human milk. 

However, other research shows that these nutrient losses in human milk are minor and that the benefits of pasteurization are greater than the risks. 

Unpasteurized foods are associated with the occurrence of foodborne illnesses from bacteria, such as Brucella, Cryptosporidium, Listeria monocytogenes, and antibiotic-resistant Staphylococcus aureus.

In particular, scientific literature frequently mentions that unpasteurized milk and dairy products are particularly high risk foods and common causes of these foodborne illnesses. 

These bacterial infections may last from days to weeks. Effects range from mild symptoms — like fever, diarrhea, vomiting, muscle aches, abdominal pain, and poor appetite — to severe outcomes like miscarriage and even death. 

Unpasteurized foods present even greater health risks and are more dangerous to people with compromised immune systems, such as older adults, pregnant people, young children, and those with health conditions like cancer.

Unpasteurized foods are slightly more likely to retain natural tastes, appearances, flavors, and nutrients, but they are strongly associated with foodborne illnesses. Evidence indicates that the risks of consuming unpasteurized foods greatly outweigh the benefits, especially for immune-compromised people.  (CREDITS)

In this episode we are talking again with our audio editor Jack Scaro.  The topic again is: spontaneous pneumothorax, or collapsed lung.

Spontaneous pneumothorax is an abnormal condition of the lung characterized by the collection of gas in the pleural space between the lungs and the chest wall. This condition occurs without an obvious etiology and can be classified as either primary or secondary. Patients may present with symptoms such as tachycardia and dyspnea. The diagnosis is based on clinical suspicion and can be confirmed with imaging. 

Jack had this condition which surprised everyone since he was a healthy 20 year old with no risk factors except.... you'll have to listen to this week's episode to find out what it is and whether you or a loved one could be at risk!

This week we will continue our coverage of Bile acid malabsorption (BAM),  a gastrointestinal disease. It's a common cause of chronic diarrhea. When bile acids aren't properly absorbed in your intestines, they build up, upsetting the chemical balance inside. Excess bile acids trigger your colon to secrete extra water, leading to watery stools.

This week we will continue our coverage of Bile acid malabsorption (BAM),  a gastrointestinal disease. It's a common cause of chronic diarrhea. When bile acids aren't properly absorbed in your intestines, they build up, upsetting the chemical balance inside. Excess bile acids trigger your colon to secrete extra water, leading to watery stools.

Bile acid malabsorption (BAM) is often misdiagnosed as Irritable Bowel Syndrome or is overlooked in individuals with Crohn's disease.

Bile Acid Malabsorption happens when the small intestine is unable to direct bile acid back to the liver. This means that the body doesn't absorb water properly and affects digestion. The condition results in what is known as Bile Acid Diarrhoea.

How will a new test for Bile Acid Malabsorption be developed?

Currently, the only test for bile acid malabsorption is the SeHCAT test which is expensive, time consuming and uses radiation.

The team have developed a test which they believe will diagnose the condition more rapidly and cost effectively than the current test. For its initial testing phase, it will be used on stool (poo) samples, and in its second phase the research team will assess whether it can also guide treatment decisions on what dose should be given to individual patients.

The aim of the study is to establish a better test for BAM, do the groundwork for a future study of the role of faecal bile acid measurements within the NHS, and use the data collected from this trial to prepare other studies to assist with the diagnosis and treatment of individuals with BAM.

Chronic diarrhea is one of the most common reasons why people get referred to specialist gastroenterology clinics, and can account for as many as 1 in 20 referrals. Bile acid malabsorption is a major cause of chronic diarrhoea and is thought to affect up to 1 million people in the UK.

As well as individuals with Crohn's disease, as many as one in three people diagnosed with IBS with diarrhoea (IBS-D) may actually be experiencing BAM but the current gold standard SeCHAT test is only available in certain UK centres. It is also time consuming and costly.

In 2012 the National Institute for Health and Care Excellence's Diagnostic Advisory Group concluded that a new test for the diagnosis of BAM was needed. (credits: Diagnosing bile acid malabsorption - Bowel Research UK :Bowel Research UK )

This week we will discuss Bile acid malabsorption (BAM),  a gastrointestinal disease. It's a common cause of chronic diarrhea. When bile acids aren't properly absorbed in your intestines, they build up, upsetting the chemical balance inside. Excess bile acids trigger your colon to secrete extra water, leading to watery stools.

​

Bile is a substance your liver makes while filtering your blood. Your liver sorts waste products, such as toxins, dead blood cells and excess cholesterol into bile. Bile acids come from synthesizing these products together. The different acids in bile help to stabilize the lipids in the mix and keep them in a liquid form.

Your liver sends bile through your bile ducts to your small intestine to help with digestion. Bile acids in your small intestine help break down fats for absorption. When that work is done, they are supposed to be reabsorbed themselves, returning to your circulation and then your liver to be recycled into bile again.

​

Malabsorption is any failure of your intestines to absorb all of the chemicals they're meant to. Malabsorption can be a problem with your intestines themselves, or it may result from a chemical imbalance. For example, you may have too much or too little of a certain chemical for your intestines to absorb.

​

BAM has been historically underdiagnosed due to a lack of accessible ways to test for it. But studies now show that at least 30% of those diagnosed with functional diarrhea disorders may have BAM. Functional disorders are those that have no apparent cause and are likely to go undetected during a medical examination, such as irritable bowel syndrome (IBS).

BAM is seen in people with conditions such as:

• Microscopic colitis.

• Crohn disease.

• HIV-related enteritis.

• Diarrhea that persists after a bacterial infection.

• Exocrine pancreatic insufficiency.

It can also happen in people who receive certain medical treatments including:

• Surgical bypass or resection of the ileum, the last section of the small intestine.

• Gallbladder removal (cholecystectomy).

• Radiation therapy, especially in the abdominal-pelvic region.

• Chemotherapy.

• Metformin, a treatment for type 2 diabetes.

​

Typical symptoms include:

• Watery diarrhea.

• Frequent bowel movements.

• Painful stomach cramps.

• Urgency and difficulty holding bowel movements in.

Some people also have:

• Abdominal bloating.

• Gas and gas pain.

• Steatorrhea (fatty stools.)

• Indigestion.

Long-term symptoms can include:

• Dehydration.

• Fatigue.

• Headaches.

• Dizziness.

• Nausea.

• Weight gain.

• Weight loss.

About half of people have constant symptoms, and the other half only report occasional symptoms.

The symptoms of bile acid malabsorption — primarily, bile acid diarrhea, or BAD — result from the buildup of bile acids in your colon, where food waste turns to poop. Normally, 95% of the bile acids in your small intestine are reabsorbed in the last segment (the ileum) before passing on to your colon.

When too many are left over, however, they pass into your large intestine with the rest of the waste. Bile acids in your colon irritate the mucous lining, triggering it to secrete extra fluid and speeding up the muscle contractions that move poop along. This causes frequent, urgent diarrhea and cramping.

What causes bile acids to build up in your intestines is another question.

Researchers have classified the possible causes of BAM into four different types. Sometimes they classify BAM as either primary or secondary.

​Primary BAM is caused by your liver overproducing bile acids (types 2 and 4.)

​Secondary BAM is caused by damage to your small intestine due to disease, surgery or radiation treatment (types 1 and 3.)

Type 1 BAM is caused by a problem with your ileum itself. This is considered true malabsorption, because the problem begins at absorption stage of the bile acid cycle. You may have type 1 BAM if you've had the last part of your small intestine surgically removed, altered or bypassed to treat another condition. Certain diseases, such as Crohn's disease, and treatments such as radiation therapy can also damage the ileum. Significant damage impairs its ability to absorb.

​Type 2 BAM has sometimes been called "idiopathic," which means that it happens spontaneously or for unknown reasons. However, current research suggests that it's a problem with the chemical signaling between your intestines and your liver. This signaling is what normally regulates your bile acid cycle (enterohepatic circulation.) Chemicals in your blood signal when your liver should produce and deliver more bile acids and when it's time to stop, reabsorb and recycle them. But with type 2 BAM, your liver doesn't get the memo to stop. So, it keeps sending bile acids — too many for your ileum to absorb.

​Type 3 BAM is caused by gastrointestinal diseases that can affect your ileum along with other parts of your digestive system. These include celiac disease, chronic pancreatitis and small intestinal bacterial overgrowth (SIBO).

​Type 4 BAM is caused by excessive bile acid production as a side effect of taking Metformin.

This week we will discuss a Veteran's hesitancy to receive healthcare at the government hospital system known as Veterans Administration or "VA".  Although many veterans may share the concern over receiving care through a government agency due to the medical care they got while in training or active duty; i.e. sucrettes and tylenol being the standard of care when Jean Marie and I were in training. Our guest, Mark Frerichs, has different reasons to question the quality of care. Mark, a Navy veteran who continued working as a contractor post-war in Afghanistan.  It was during his work after the war that created a hesitancy in trusting anything related to the government.  

​

Mark Randall Frerichs (born July 13, 1962) is an American civil engineer and former US Navy diver who disappeared in Afghanistan in January 2020 and was later confirmed to be captured by the Haqqani network, a group closely aligned with the Taliban. In September 2022, Frerichs was released by the Taliban-led government of the Islamic Emirate of Afghanistan in exchange for Bashir Noorzai.

Frerichs is a director of International Logistical Support whose work had led him to visit Afghanistan multiple times since 2012.  He served in the United States Navy as a diver.

​https://www.tiktok.com/t/ZTLL8pHkA/ 

Frerichs disappeared in Kabul, Afghanistan, on January 31, 2020. The Associated Press reported that US intelligence officials tracked Frerichs's cell phone and raided a village near where he disappeared, approximately a week after his disappearance. Although they rounded up individuals from that village, the raid proved unproductive. The next month, Newsweek magazine reported that officials had confirmed that Frerichs had been taken captive by the Haqqani network, a group closely aligned with the Taliban.

Frerichs's sister, Charlene Cakora, questioned why the US government "signed a peace deal" with the Taliban in early February 2020 that did not include a provision for releasing her brother. The Federal Bureau of Investigation, the lead agency of the Hostage Recovery Fusion Cell, issued a statement saying the cell was working to ensure "that Mark Frerichs and all Americans held hostage abroad are returned home."

On May 10, 2020, the FBI offered a $1-million reward for information that helps lead to Frerichs's release or rescue. In addition, the Rewards for Justice Program offered a $5-million reward for information leading to his location. That same day, Taliban spokesmen asserted that they had conducted an inquiry of their subordinate and associated groups and confirmed they were not holding Frerichs.

​The New York Times reported Frerichs was still a captive on November 21, 2020, when Secretary of State Mike Pompeo traveled to Afghanistan to personally participate in peace negotiations with the Taliban. They reported it was unknown whether Pompeo raised Frerichs's captivity as an issue during the talks.

​On April 1, 2022, a video was released showing Frerichs pleading for help. Following the release of Safi Rauf, an American aid worker who was held captive by the Taliban between December 2021 and April 2022, the US State Department began an attempted inquiry into the release of Frerichs. The inquiry did not result in substantial headway in brokering Frerichs' release. Frerichs's family was a part of the Bring Our Families Home campaign.

​On September 19, 2022, Taliban Foreign Minister Amir Khan Muttaqi told reporters in Kabul that his government and a US delegation swapped prisoners at the Afghan capital's airport. Frerichs was exchanged for Bashir Noorzai. (credits: Mark Frerichs - Wikipedia)

In this episode we discuss adrenal insufficiency 

You can have either primary, secondary, or tertiary adrenal insufficiency.

Primary adrenal insufficiency is also called Addison's disease. When you have this type, your adrenal glands are damaged and can't make the cortisol you need. They also might not make enough aldosterone.

Secondary adrenal insufficiency is more common than Addison's disease. The condition happens because of a problem with your pituitary gland, a pea-sized bulge at the base of your brain. It makes a hormone called adrenocorticotropin (ACTH). This is the chemical that signals your adrenal glands to make cortisol when your body needs it. If your adrenal glands don't get that message, they may eventually shrink.  This is the type our guest on this week's episode is dealing with.

Tertiary is due to hypothalamic disease and a decrease in the release of corticotropin releasing hormone (CRH). Causes can include brain tumors and sudden withdrawal from long-term exogenous steroid use (which is the most common cause overall)

The most common cause of Addison's disease today is an autoimmune problem, when your immune system malfunctions and attacks and damages your own body, in this case, your adrenal glands.

Have you ever wondered "what would happen if you or a family member had a medical emergency while using public transportation"  Today we feature Bill H. who had a cardiac event after boarding a Chicago Metra train and the two bystanders that weren't about to let these be his LAST train ride!

Automated external defibrillators can help save lives during sudden cardiac arrest. However, even after training, remembering the steps to use an AED the right way can be difficult. In order to help keep your skills sharp, we've created a quick step-by-step guide that you can print up and place on your refrigerator, in your car, in your bag or at your desk. This way, you can review the AED steps any time, at your convenience, and keep them fresh in your memory.

These AED steps should be used when caring for a non-breathing child aged 8 or older who weighs more than 55 pounds, or an adult.

After checking the scene and ensuring that the person needs help, you should ask a bystander to call 911 for help, then:

1.  Complete the CHECK and CALL steps

2.  As soon as an AED is available, turn it on and follow the voice prompts

3.  Remove clothing and attach pads correctly

• Remove all clothing covering the chest. If necessary, wipe the chest dry
• Place one pad on the upper right side of the chest
• Place the other pad on the lower left side of the chest, a few inches below the left armpit

Note: If the pads may touch, place one pad in the middle of the chest and the other pad on the back, between the shoulder blades

4.  Plug the pad connector cable into the AED, if necessary

5.  Prepare to let the AED analyze the heart's rhythm

• Make sure no one is touching the person
• Say, "CLEAR!" in a loud, commanding voice

6.  Deliver a shock, if the AED determines one is needed

• Make sure no one is touching the person
• Say, "CLEAR!" in a loud, commanding voice
• Push the "shock" button to deliver the shock

7.  After the AED delivers the shock, or if no shock is advised, immediately start CPR, beginning with compressions

This week we are speaking with Dani, AKA, Stoned Zebra. It took almost 7 years of her health declining after giving birth, until she finally received her EDS diagnosis. She was initially misdiagnosed with Lupus, Fibromyalgia, Neuropathy, or chronic pain syndrome.  Her gastroparesis, symptoms (bloating, nausea, early satiety, severe constipation, weight loss, dehydration, belching, belly pain) began July 2022, and after a ton of aggressive testing, she was diagnosed in May 2023. 

EDS just tacks on chronic pain, joint instability and other comorbidities like POTS, MCAS, and OH that she also developed. She currently is primarily tube fed, via GJ. She will soon have separate stomas placed due to EDS complications.

If you would like to follow her rare disease journey, send a follow request @stonedzebra along with a message of where you found her page! Her rare journey is only available to friends on TikTok, she keeps her circle small. If you'd like to follow and see her handmade gifts/online store, she is on TikTok Shop at SZ Creations, and @stndzebracreations.

• Electronic Health Records (EHRs) & Analytics: Widespread EHR adoption (95% of hospitals by 2017) streamlined data, enabling better analytics for management, diagnosis, and care coordination, notes HNI Healthcare and Becker's Hospital Review.
• Telehealth & Wearables: Virtual visits, health apps, and fitness trackers (like heart rate monitors) became common, improving access and remote monitoring, says ThriveAP.
• Artificial Intelligence (AI) & Machine Learning: AI now analyzes complex data for diagnostics, research, and clinical decisions, says Health Tech Academy and National Institutes of Health (NIH) | (.gov). 

• Consumerism: Patients demand convenient, personalized care, challenging traditional models, notes Marathon Health and NEJM Catalyst Innovations in Care Delivery.
• New Care Models: Integration (ACOs, hospitalists) aimed at better quality/cost, but challenges in coordination persist, according to the National Institutes of Health (NIH) | (.gov).
• Population Health: Greater focus on prevention, chronic disease management (diabetes, obesity), and public health crises (COVID-19), says Health Data Management. 

• Precision Medicine: Tailored treatments using biomarkers are improving efficacy, notes faCellitate.
• Rising Costs: More expensive tech, drugs (like gene therapies), and increased demand contribute to significant spending increases, say National Institutes of Health (NIH) | (.gov) and Springer Publishing Company.
• Data & Billing Changes: The shift to complex coding (like ICD-10) improved data but added operational hurdles, say Becker's Hospital Review and National Institutes of Health (NIH) | (.gov) pmc.ncbi.nlm.nih.gov 

. 

This week we will discuss a topic that is of concern for millions of people: "Long Covid" and our guest this week is Grace Miller.  Grace is 20 years old, and lives in Iowa. Currently attending college, where she is president of the honor society and finishing up her gen eds. She plans on pursuing a degree in Communication Disorders and become a speech pathologist. Some of her hobbies include crocheting, singing, playing the piano, and learning. 

Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC). Long COVID is broadly defined as signs, symptoms, and conditions that continue or develop after acute COVID-19 infection.

This definition of Long COVID was developed by the Department of Health and Human Services (HHS) in collaboration with CDC and other partners.

​People call Long COVID by many names, including Post-COVID Conditions, long-haul COVID, post-acute COVID-19, long-term effects of COVID, and chronic COVID. The term post-acute sequelae of SARS CoV-2 infection (PASC) is also used to refer to a subset of Long COVID. (Credits: CDC)

Continuing a mini-series on obesity, we welcome once again Dr. Ifland.   She founded the online Addiction Reset Community (ARC) in 2016, www.foodaddictionreset.com. The Facebook group, 'Food Addiction Education' (2014) and www.foodaddictionresources.com (2014) provide free support.  Reset Week  is the first online live video program for withdrawal (2018).  ARC Manager Training is a program training future Addiction Reset Community leaders (2020).

Dr. Ifland is the lead author of the first scholarly description of processed food addiction and definition of addictive foods.

Dr. Ifland earned her PhD in addictive nutrition at Union Institute and University (2010); her MBA at Stanford Business School (1978) and her BA in Economics and Political Science at Oberlin College (1974). She currently resides in Seattle.

Social Media links: 
Facebook - https://www.facebook.com/groups/1806154526275515

​Twitter
 https://twitter.com/JoanIfland

​Instagram 

https://www.instagram.com/foodaddictionreset/

This week we will discuss the obesity problem for children in the US.  Our guest, once again, is Dr. Joan Ifland.  Dr Ifland has been creating breakthroughs in recovery from food addiction from 1999 with her first popular book to 2018 when her textbook, Processed Food Addiction: Foundations, Assessment, and Recovery was released by CRC Press.  

​

She founded the online Addiction Reset Community (ARC) in 2016, www.foodaddictionreset.com. The Facebook group, 'Food Addiction Education' (2014) 

and

 www.foodaddictionresources.com (2014) provide free support.  Reset Week  is the first online live video program for withdrawal (2018).  ARC Manager Training is a program training future Addiction Reset Community leaders (2020).

Dr. Ifland is the lead author of the first scholarly description of processed food addiction and definition of addictive foods.

Dr. Ifland earned her PhD in addictive nutrition at Union Institute and University (2010); her MBA at Stanford Business School (1978) and her BA in Economics and Political Science at Oberlin College (1974). She currently resides in Seattle.

Social Media links: 

Facebook - https://www.facebook.com/groups/1806154526275515

Twitter

 https://twitter.com/JoanIfland

Instagram 

 https://www.instagram.com/foodaddictionreset/

 Childhood obesity is a complex disease with many contributing factors, on including genetics, eating patterns, physical activity levels, and sleep routines. About 1 in 5 American children has obesity. Compared to children with healthy weight, children with obesity are at a higher risk for asthma, sleep apnea, bone and joint problems, type 2 diabetes, and risk factors for heart disease such as high blood pressure. 

"Childhood obesity continues to rise around the world, and the World Health Organization has called it "one of the most serious public health challenges of the 21st century."

Yet the prevalence of childhood obesity appears to vary across countries.

Island nations in the Pacific, such as Nauru and the Cook Islands, appear to have the highest obesity rates among children 5 to 19, but the countries Ethiopia and Burkina Faso appear to have the lowest rates. The number of obese or overweight children 5 and younger climbed from 32 million globally in 1990 to 41 million in 2016, according to WHO data. If current trends continue, the number of overweight or obese children in that age group could increase to 70 million by 2025." (CNN Health News)

Skilled Nursing care, also known as Post-Acute Rehabilitation, is for those who need short-term care following an injury, surgery, or illness. The goal with this level of care is to successfully transfer patients from hospital to home, or senior living community, by providing the tools and resources for each phase of recovery. A stay at a skilled nursing, rehabilitation, and post-acute care center is meant to be a transitional period to help patients recover and return to their everyday lives.

Our Co-Host Ron had shoulder surgery recently and needed this type of care until he could regain use of his "good-arm".  As you probably know from an episode we did (again with Ron as the guest) very early in our podcasting to discuss his life with a disability.  You see, Ron was hit be a motor vehicle as a child and lost the use of one of his arms.

You can understand how rehabbing after shoulder surgery would be impossible without help!  He is here to explain that process, and I'd like to report he is now back to his version of 100%!  He is even going to the Vegas-Shoot in a couple of weeks to compete once again in target archery.

This week we will discuss the confidence building in children with returning guest, Casey Hersch!  

​

​Casey Hersch is a licensed clinical social worker, psychotherapist, author, Latin ballroom dancer, health journalist, and animal advocate. She uses holistic and resilience-based models to help children and families cope with trauma, stress, and illness.

​A Regent's scholar and CSU Chico's social worker of the year, she has devoted her career to helping children, parents, families, and communities build resilience and minimize the effects of stress, trauma, and adverse childhood experiences throughout the lifespan. During her childhood, Casey witnessed the toll of trauma and stress on her health. She has spent most of her adult life overcoming Crohn's disease (autoimmune) and mental illness (anxiety), which further motivates her to create resources for children. Her passion for giving voice to the health benefits of animal rescue and pet companionship granted her recognition for excellence by the Cat Writer's Association. Her work is published in a variety of venues.

Casey's diverse clinical experience as a psychotherapist, child custody investigator, educator, and community organizer inspired I Am Pawso. All too often Casey sees toddlers, tweens, teenagers, and adults who missed out on early interventions. These mental health resources in schools, homes, and communities can reduce the long-term consequences of stress and trauma, such as chronic illness, mental illness, anger and behavior management issues, depression, and violence. Casey's evidence-based philosophy is simple: When we provide children the lessons and resources they need to build resilience, emotional intelligence, and healthy brain neural pathways, we give them the best opportunities to thrive. I Am Pawso is Casey's gift to children: An intervention providing them the tools and confidence they need to live healthy and successful lives.

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I Am Pawso is a family labor of love. Casey's rescue cat, Pawso, is the main character. Her husband, Scott, illustrated the book by taking real photographs of Pawso. When Casey is not writing, she is Latin Ballroom dancing, serving her community, and playing with her cats, Pawso and Samba.

This week we will discuss severe Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).  Our guest is Galen Warden, the mom to six adult children, one being her son James Strazza.  Galen is now a full time caregiver to James due to the severity of his disease. 

Here are her words:  "James was a healthy young man until he very slowly, because of medical ignorance and poor advice, became weaker and sicker following a severe case of the Epstein Barr Virus when he was just 19. After a few years, he slowly lost his ability to drive, to stand in his kitchen and prepare food for himself, then to walk more than a few steps, to use an electric wheelchair, and finally, to even sit up if carried onto a commode. He's been 100% bed bound for three years. What is this bizarre disease that so many medical doctors prefer to pass off as psychological, psychosomatic or self-inflicted? Myalgic Encephalomyelitis was, in the past, known only as Chronic Fatigue Syndrome. An unfortunate name because it's so easily dismissed as simple chronic fatigue, familiar to many with autoimmune diseases. ME/CFS is entirely different. It's a disease not known, not taught, but not rare. Just rarely acknowledged, and more rarely understood....

ME appears to be a post-viral disease. The onset can be caused by Epstein Barr, Dengue Fever, Covid 19, and other viral illnesses. Now, research is so urgent because Long Covid is impacting thousands who are unaware of the potential that they could end up like James.

Post-viral Covid could easily continue to progress to Severe ME/CFS if patients are not aware of how to manage their overwhelming weakness and fatigue. They must rest and never push themselves. They need the early support of their families to pick up the burden of making meals, driving them, helping them rest as much as possible. Because, if they don't allow them to rest now, caring for them will become a very heavy burden.

These patients, with their desperate families, their disbelieving caregivers and puzzled doctors, are why I'm compelled to add documenting our experience to my long list of weighty obligations."

This week we will discuss how to avoid toxins when cooking for a crowd.  The following comes straight from the CDC:

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Feasting with family is part of many holiday celebrations. Follow these tips to help prevent food poisoning, or foodborne illness, during the holidays.

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• Keep foods separated. Keep meat, chicken, turkey, seafood, and eggs separate from all other foods at the grocery store and in the refrigerator. Prevent juices from meat, chicken, turkey, and seafood from dripping or leaking onto other foods by keeping them in containers or sealed plastic bags. Store eggs in their original carton in the main compartment of the refrigerator.

• Cook food thoroughly. Use a food thermometer to make sure meat, chicken, turkey, seafood, and eggs have been cooked to a safe internal temperature to kill germs. Roasts, chops, steaks, and fresh ham should rest for 3 minutes after you remove them from the oven or grill.

• Keep food out of the "danger zone." Germs can grow rapidly in the danger zone between 40°F and 140°F. After food is prepared, keep hot food hot and cold food cold. Refrigerate or freeze perishable food like meat, chicken, turkey, seafood, eggs, cut fruit, cooked rice, and leftovers within 2 hours (1 hour if food is exposed to temperatures above 90°F, such as in a hot car). The temperature in your refrigerator should be set at 40°F or below and the freezer at 0°F or below.

• Use pasteurized eggs for dishes containing raw eggs. Salmonella and other harmful germs can live on both the outside and inside of normal-looking eggs. Many holiday favorites contain raw eggs, including eggnog, tiramisu, hollandaise sauce, and salad dressings. Always use pasteurized eggs when making these and other foods made with raw eggs.

• Know that raw flour and eggs can have germs. Uncooked dough and batter made with flour or eggs can contain harmful germs, such as E. coli and Salmonella. This includes dough or batter for cookies, cakes, pies, biscuits, pancakes, tortillas, pizza, or crafts. Some companies and stores offer edible cookie dough made with heat-treated flour and pasteurized eggs or no eggs. Read the label carefully to make sure the dough is meant to be eaten without baking or cooking.

• Thaw your turkey safely. Thaw frozen turkey in the refrigerator, in a sink of cold water (change the water every 30 minutes), or in the microwave. Do not thaw turkey or other foods on the counter. A turkey must thaw at a safe temperature to prevent harmful germs from growing rapidly. Learn more about preparing turkey safely.

• Wash your hands with soap and water during these key times when you are likely to get and spread germs:

  • Before, during, and after preparing food

  • Before eating food

  • After feeding pets

  • After using the toilet

  • After changing diapers or cleaning up a child who has used the toilet

  • After touching garbage

  • Before and after caring for someone who is sick

  • Before and after treating a cut or wound

  • After blowing your nose, coughing, or sneezing

Some family and friends may be at higher risk for serious food poisoning. Take steps to help prevent them from getting sick this holiday season by choosing safer food options for

• Adults over 65

• Children under 5

• Pregnant people

• People with weakened immune systems

Our guest is a mother to a child with FoxG1, Ilissa Reich.  Ilissa is a former fashion executive who transformed her career into being a fierce advocate for families of children with special needs.

When her now-3-year-old son, Eli, was diagnosed with FOXG1 Syndrome, a rare brain disorder with no cure, she spun into action and co-founded Believe in a Cure (webelieveinacure.org), a 501(c)(3) non-profit foundation working to develop a treatment for FOXG1.

Founded in 2019, Believe has raised millions of dollars and funded over 40 research and development projects around the world.

long the way, the foundation has partnered with preeminent institutions ranging from the National Institutes of Health to Harvard, MIT, and Tel Aviv University, to biotechnology companies in Europe, Asia, and the United States.

​Renowned scientists from industry and academia serve on the scientific advisory board of the foundation, and several notable leaders serve on the foundation's lay advisory council, including former U.S. senators Joe Lieberman and Paul Kirk, the former CEO of Staples Ron Sargent, mediation czar Ken Feinberg, and many more.
This journey has opened Ilissa's eyes to the experiences of countless other families who struggle each day, and despite her own anguish, Ilissa endeavored to create a platform for mothers of kids with special needs to build community and offer support.

​She has appeared on the Today show, in People magazine, and a host of other outlets profiling her efforts.

A native Long Islander, Ilissa previously worked in fashion at notable brands Tibi, Free People, Splendid, and Alternative Apparel.

She studied business in college at The George Washington University. She lives in Port Washington with her husband, Scott, and their three children.

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When asked: 'What has enabled you to be successful?' she responded-

"I always aspire to be a good role model for my children. I want to be someone they're proud of."

This week we will discuss M-RNA vaccines.  Our guest is Thomas VanCott, PhD.  Thomas VanCott is currently the Chief Scientific Officer for Combined Therapeutics, a Boston based biotech company developing targeted mRNA therapies.  Prior to this he served as the Chief Technology and Strategy Officer for Catalent Cell & Gene Therapy, a global CDMO manufacturing viral vectors for gene and cell therapies as wells as plasmid DNA & mRNA platforms based in Baltimore, MD.  He was responsible for strategically enhancing CMC services to meet the market demand of increasingly complex gene and cell therapy products as well as leading the product development and internal R&D teams.  Prior to this, he was the CEO for 10 years at a Maryland-based CMO/CRO (ABL) where he was responsible for the strategic international growth of the company.  He has been involved in biologics product development for over 25 years.  He has a PhD in physical chemistry and started his career as a Captain in the US Army stationed at Walter Reed Army Institute of Research (WRAIR) studying and developing HIV vaccines for international deployment from initial construction through preclinical development, GMP manufacturing and clinical development.

​Vaccines help prevent infection by preparing the body to fight foreign invaders (such as bacteria, viruses, or other pathogens). All vaccines introduce into the body a harmless piece of a particular bacteria or virus, triggering an immune response. Most vaccines contain a weakened or dead bacteria or virus. However, scientists have developed a new type of vaccine that uses a molecule called messenger RNA (mRNA) rather than part of an actual bacteria or virus. Messenger RNA is a type of RNA that is necessary for protein production.  Once cells finish making a protein, they quickly break down the mRNA. mRNA from vaccines does not enter the nucleus and does not alter DNA.

​mRNA vaccines work by introducing a piece of mRNA that corresponds to a viral protein, usually a small piece of a protein found on the virus's outer membrane. (Individuals who get an mRNA vaccine are not exposed to the virus, nor can they become infected with the virus by the vaccine.) By using this mRNA, cells can produce the viral protein. As part of a normal immune response, the immune system recognizes that the protein is foreign and produces specialized proteins called antibodies. Antibodies help protect the body against infection by recognizing individual viruses or other pathogens, attaching to them, and marking the pathogens for destruction. Once produced, antibodies remain in the body, even after the body has rid itself of the pathogen, so that the immune system can quickly respond if exposed again. If a person is exposed to a virus after receiving mRNA vaccination for it, antibodies can quickly recognize it, attach to it, and mark it for destruction before it can cause serious illness.

Like all vaccines in the United States, mRNA vaccines require authorization or approval from the Food and Drug Administration (FDA) before they can be used. Currently vaccines for COVID-19, the disease caused by the SARS-CoV-2 coronavirus, are the only authorized or approved mRNA vaccines. These vaccines use mRNA that directs cells to produce copies of a protein on the outside of the coronavirus known as the "spike protein". Researchers are studying how mRNA might be used to develop vaccines for additional diseases.  (credits: Medline Plus)

This week we will discuss how important it is to continue masking and keeping away from crowds as a chronically ill or immunocompromised person.  Our guest today is Veronica Hanway.  Immunocompromised individuals are not optimally protected by COVID-19 vaccines and potentially require additional preventive interventions to mitigate the risk of severe COVID-19.

Veronica, a Latina mother and first generation Geography PhD student in her second year, is 35 years old and has had a lifetime of chronic migraines. With her first migraine at just three years old, she is no stranger to migraine symptoms, MRIs, CTs, neurology appointments, and treatments.

 She is an advocate for public health and community care during the ongoing SARS CoV 2 (Covid 19) pandemic. Veronica is committed to protecting her immunocompromised child and her high risk family while also continuing her National Science Foundation Graduate Research Fellowship doctoral studies. Her passions include spending time with her family, advocating for safer spaces for disabled, high risk, immunocompromised, and BIPOC communities, learning how people have adapted to avoiding Covid infections and reinfections, and how people have created Coviding communities.

She loves painting, singing, having fun, and reading with her son and partner. She is committed to helping others know that they aren't alone in navigating health issues while the effects of climate change and pandemic rage on. 

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This week we discuss stem cells.  Having great therapeutic and biotechnological potential, stem cells are extending the frontier in medicine. Not only replace dysfunctional or damaged cells, the so-called regenerative medicine, stem cells may also offer us new perspectives regarding the nature of aging and cancer. This review will cover some basics of stem cells, their current development, and possible applications in medicine. Meanwhile, important remaining challenges of stem cell research are discussed as well.

​Stem cells are unique, unspecialized cells that can divide to create more stem cells (self-renewal) and can transform (differentiate) into various specialized cells, acting as the body's repair system to generate new cells for growth, repair, and maintenance, with different types existing in embryos (pluripotent) and adults (multipotent) and being studied for treating diseases like paralysis, diabetes, and heart disease.  

Types of Stem Cells

• Embryonic Stem Cells: Pluripotent (can become almost any cell type) and come from early embryos. 

• Adult Stem Cells (Tissue-Specific): Multipotent (limited to certain cell types within their tissue) and found in adult organs like bone marrow, skin, and the brain. 

• Induced Pluripotent Stem Cells (iPSCs): Adult cells reprogrammed in the lab to act like embryonic stem cells, offering a path to personalized medicine. 

​Sources of Stem Cells

• Embryos (for research),

• Umbilical cord blood,

• Bone marrow,

• Other adult tissues (like fat or skin).

​Medical Significance (Stem Cell Therapy)

• Regenerative Medicine: Uses stem cells to repair or replace damaged tissues and organs. 

• Treatments: Already used to treat blood cancers (like leukemia) through bone marrow transplants. 

• Research Focus: Investigated for treating conditions such as spinal cord injuries, Parkinson's, Alzheimer's, heart disease, and diabetes. 

​There is some stem cell controversy, primarily centering on the ethics of using human embryos, particularly embryonic stem cells, which hold vast potential for medicine but require destroying the embryo, raising moral debates about the embryo's status as human life, with opponents seeing it as the destruction of life and proponents viewing it as a moral imperative to cure disease, though adult stem cell research and induced pluripotent stem cells (iPSCs) offer less controversial avenues.  We don't discuss this aspect of the therapeutic use but if you are interested you can find out more with a simple internet search.

​Stem cell therapy in the US is not banned but restricted. Only FDA-approved products (such as cord blood transplants and CAR-T cell therapies for blood conditions) are fully legal. Other uses are allowed only in limited cases under the 361 HCT/P pathway.

 This week we will be talking about Sick Sinus Syndrome (SSS) with Audrey Brown.  Sick sinus syndrome (SSS) is a disease in which the heart's natural pacemaker located in the upper right heart chamber (right atrium) becomes damaged and is no longer able to generate normal heartbeats at the normal rate. It may be a result of other medical conditions that damage the sinoatrial node (SA node) over time or may be a result of certain medicines. This can result in heartbeats that are too slow, too fast ⁠— or heartbeats that alternate between slow and fast. (credits Johns Hopkins)

Audrey is 35 years old and has had a life full of health issues, one of the most life altering is Sick Sinus Syndrome which she was diagnosed with while undergoing pretesting for her Hysterectomy at 33. She also has multiple other health issues including POTS, Chronic Autoimmune hives, chronic gastritis, occipital neuralgia. Migraines and more. Though she admittedly struggles physically she maintains a positive outlook through all of this and credits her childhood overseas. She has seen what life in under-privileged countries is like and focuses her mind on positivity and thankfulness that she is able to get the care she gets. Audrey is dedicated to helping others navigate chronic illness (both physical and psychological) and spends her time between dr's appointments napping and hanging out with her husband and their fur babies.

This week we are talking once again with Dan "Dry Dock" Shockley on "Staying Healthy as a Veteran"  For Veteran's Day this year we are featuring Dan because even though he has been dealt a hard blow with a hereditary colon cancer gene he is not letting that slow him down one bit!  As a matter of fact he is thriving and advocating for others around the globe as a hereditary colon cancer ambassador! 

Here is some more about Dan:  

• Dan Dry Dock Shockley, retired U.S. Navy veteran; Operation Desert Storm; Enduring and Iraqi Freedom veteran and 9 hereditary colon cancer WARRIOR. 

• The U.S. based Colon Cancer Alliance featured his journey for their Veterans Day blog. The below url provided for your reading pleasure:

https://www.ccalliance.org/blog/prevention/dan-drydock-shockley-colon-cancer-warrior-forges-on

• Also, in honor of Rare Cancer Day, 30 September, the NORDpod featured him as a special guest.

The below url provided for your listening pleasure:

https://open.spotify.com/episode/6cJJwWXEp34wD8ulFBXNQu?si=m6_V8YwJRwqEAWxXzTp3Cw&utm_source=native-share-menu&dl_branch=1 

• Additionally, he has been a regular contributor to the UK based Rare Revolution team. They recently invited me to be part of their National Patient Advocate Day campaign. My input can be viewed on Instagram:

https://www.instagram.com/tv/CSwmNDwjuLQ/?utm_medium=copy_link

• In closing, here's his latest article which was featured by the Montreal based, RareDIG Organization.

https://www.raredigmcgill.com/HORD/Season-Four

On today's show, we are talking about knee replacement surgery with Dawn Richardson, a friend I met in my last couple of years in the Army. Dawn is a retired Navy Captain, former restaurant manager, and former Bed and Breakfast owner who is delighted to say she's now retired and finds fulfillment in her volunteer activities and personal pursuits. 

About 4% of people 50 and older have knee replacements.  At age 80, that number is above 10%. The average age is 65 and more women than men have knee replacements. 

Three facts we were surprised to hear after speaking with Dawn: 

1. You aren't supposed to travel for 6 weeks
2.  You aren't supposed to kneel on that knee for 6 months
3.  You shouldn't have any non-emergency dental work for 6 months to include cleanings

These surgeries have evolved greatly after the use of minimally invasive scope-type surgeries.  

Total knee replacement is a type of surgery to replace a damaged knee joint. A minimally invasive surgery uses a smaller cut (incision) than a traditional total knee replacement. This type of surgery typically requires special tools so that the surgery team can see and do the procedure through the smaller incision.

The knee has several parts: the lower end of the thigh bone (femur), the upper end of the shin bone (tibia), and the kneecap (patella). A smooth substance called cartilage caps the ends of these bones and keeps the bones from grinding together. When there is damage to the knee joint, these bones may scrape together abnormally and cause pain.

During minimally invasive total knee replacement, your surgeon makes an incision to access your shinbone and thigh bone. Next, he or she removes a portion of the bones that make up the knee joint. Your surgeon replaces these bone parts with metal components that recreate the joint surface. A layer of plastic is placed between the metal components for smooth gliding.

Minimally invasive total knee replacement often takes place under general or spinal anesthesia. (credits: Johns Hopkins Medical)

Cerebral palsy is a group of disorders that affect movement and muscle tone or posture. It's caused by damage that occurs to the immature brain as it develops, most often before birth.

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Our guest today is Zain Bando, a Chicago area, 21-year-old college student and is studying journalism at the University of Illinois at Urbana-Champaign as a junior. He hopes to pursue a career in broadcasting after graduation and currently resides in Downers Grove, IL with his family.

This week, we address the reemergence of leprosy, a disease rarely seen until now, with particular attention to the warning by New York University physician Marc K. Siegel. While the United States generally reports only 150 to 250 leprosy cases yearly, globally, 2 to 3 million people grapple with leprosy-related disabilities. Siegel emphasizes the risk in certain US cities, such as Los Angeles, where unsanitary conditions among the homeless population create fertile ground for diseases like leprosy to thrive. Leprosy, caused by Mycobacterium leprae, can spread more easily in overcrowded, unhygienic environments.

Early detection is vital, but homeless individuals often lack access to medical care, risking severe complications if left untreated, including nerve damage, skin lesions, and blindness. Siegel stresses the need for attention to permanent disabilities and the potential for public panic if leprosy takes hold among the homeless population.

This week we discuss the application of Artificial Intelligence (AI) in medicine is revolutionizing healthcare, contributing to improved outcomes, more efficient processes, and reduced costs.

 Here are some key benefits:

1. Enhanced Diagnostics: AI algorithms, especially those based on deep learning, can analyze complex medical data like X-rays, MRIs, CT scans, and genomics with a high degree of accuracy. They can detect patterns and anomalies that may be invisible to the human eye, or interpret large volumes of data quickly, leading to early and more accurate diagnoses.

2. Personalized Medicine: AI helps in analyzing data from genetic testing, medical records, and wearable health devices to tailor treatments to individual patients. This personalization can lead to more effective treatment plans and medication, reducing the trial-and-error approach associated with treating complex or rare conditions.

3. Predictive Analytics: By assessing medical records, social determinants, genetics, and lifestyle data, AI can predict the likelihood of disease and help in preventive medicine. Early intervention in high-risk patients can lead to better health outcomes and reduced healthcare costs.

4. Drug Discovery and Development: AI expedites the process of drug discovery by analyzing complex biochemical interactions. It helps in identifying potential drug candidates, predicting how they will work, and foreseeing potential side-effects, significantly reducing the time and cost of bringing new drugs to market.

5. Robotic Surgery and Assistance: AI-enhanced robotic systems can assist surgeons in performing precise and minimally invasive procedures. These systems can provide stability, dexterity, and endurance beyond human capabilities, reducing recovery times, and improving outcomes.

6. Remote Monitoring and Telehealth: AI-driven applications enable patients to receive medical consultations and monitoring without visiting a clinic. This is especially beneficial for patients in remote areas, those with mobility issues, or during public health crises (like the COVID-19 pandemic).

7. Administrative Workflow Assistance: AI can automate administrative tasks like scheduling, billing, patient communication, and maintaining records, reducing the workload on healthcare professionals and allowing them to focus more on patient care.

8. Clinical Trials: AI can identify suitable candidates for clinical trials more efficiently by matching individual health profiles with study criteria. This accelerates recruitment, making the development process for new treatments faster and more effective.

9. Resource Allocation: In scenarios like pandemic outbreaks, AI can assist in planning and optimizing resource allocation (e.g., ventilators, hospital beds, medical staff) based on predictive modeling of disease spread and healthcare needs.

10. Reducing Burnout: By taking over routine, time-consuming tasks, AI can reduce the workload for healthcare providers, mitigating burnout and allowing them more time for direct patient interaction and care.

Despite these advantages, it's crucial to approach AI in medicine with caution, considering challenges like data privacy, algorithmic bias, the need for extensive validation, and ensuring the explainability of AI decisions. Moreover, AI should be viewed as a tool to augment human healthcare providers' capabilities, not replace the essential human touch in medicine.

This week we will discuss mental health impacts from living with a chronic illness with our guest, Christy Amos (aka Christi Winstead)

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Christy Amos is a compassionate and resilient individual who has made it her mission to help others navigate the challenges of living with chronic illnesses. With a Master's degree in Counseling, she has acquired a deep understanding of the emotional and psychological impact that chronic conditions can have on individuals and their loved ones.

Despite facing her own health battles, Christy's determination and empathy have driven her to become a patient advocate. Drawing from her personal experiences with multiple chronic illnesses, she uses her expertise to support and empower others in similar situations. Her dedication to improving the lives of those affected by chronic illnesses has made her an invaluable resource in the social health community.

In addition to her advocacy work, Christy is a freelance author. She shares her wealth of knowledge and personal insights on chronic hives and asthma through her contributions to respected platforms such as chronic-hives.com and asthma.net. Her writing not only educates and informs, but also serves as a source of comfort and inspiration for individuals living with these conditions.

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Christy's unique perspective as both a patient and a professional counselor allows her to approach chronic illnesses holistically. She understands the complexities of managing physical symptoms while also addressing the emotional and psychological impact of these conditions. Through her writing, counseling, and advocacy efforts, she strives to promote understanding, raise awareness, and facilitate meaningful conversations about chronic illnesses.

​Christy's commitment to making a difference in the lives of others shines through in everything she does. Her courage, resilience, and unwavering determination serve as an inspiration to those who have the privilege of knowing her or benefiting from her work. With her profound understanding of the challenges that chronic illnesses present, Christy Amos continues to transform the lives of individuals and families affected by these conditions, bringing hope and support to countless people in need.

This week we will discuss Eye Safety for children.  Eye injuries affect about 2.4 million people every year. Household products cause more than 125,000 serious eye injuries. Hospital emergency rooms treat nearly 23,000 victims of eye injuries from sports. Toys and home playground equipment cause more than 11,000 injuries to young eyes. Below are tips for preventing injury to your child's eyes. 

Here are some tips for eye safety for children: 

• Avoid sharp, broken toys and objects.

• Wear sport goggles and sunglasses.

• Do not play around lawn mowing and fireworks.

• Avoid BB, pellet, NERF®, and dart guns.

• Always carry pointed objects such as scissors, knives or pencils with the sharp end pointing down.

• Never shoot objects (including toys) or spray things at others, especially in the direction of the head.

• Read and follow directions before playing games or using equipment.

• Make sure your child wears safety goggles or glasses during sports and leisure activities.

• Make sure your child wears sunglasses that have 100% UV protection.

• Only buy toys meant for their age.

• Show them how to use their toys safely.

• Supervise them when they play.

• Look into the durability of lens material.

• Ask for warranty information on both the frames and the lenses.

About 90% of eye injuries can be prevented with protective eyewear. 

An ophthalmologist, primary care doctor, school nurse or children's health service should examine the eye as soon as possible, even if the injury seems minor at first, as a serious injury is not always immediately obvious. Delaying medical attention can cause the damaged areas to worsen and could result in permanent vision loss or blindness.

While seeking medical help, care for the child as follows:

• DO NOT touch, rub or apply pressure to the eye.
• DO NOT try to remove any object stuck in the eye. For small debris, lift eye lid and ask child to blink rapidly to see if tears will flush out the particle. If not, close the eye and seek treatment.
• Do not apply ointment or medication to the eye.
• A cut or puncture wound should be gently covered.
• Only in the event of chemical exposure, flush with plenty of water.

Credits:

URMC / Encyclopedia / Preventing Eye Injuries in Children

Search Encyclopedia 

This week we will discuss LED (light-emitting diode) therapy, a type of treatment that uses lights of different wavelengths to treat a variety of skin conditions, such as acne, scar tissue, and the effects of aging. Most commonly, red and blue lights are used for these treatments.  Light therapy can be performed in a healthcare provider's office or at home. Multiple treatments are required to get results.  There will not be a guest for this week's episode

This week we will discuss Metabolic Systems with our guest,  Francis Fessler.

A certified personal trainer and conditioning coach for the last 25 years, Francis Fessler has built a career by designing programs and coaching professional and amateur athletes, celebrities, business professionals, parents and children to achieve their wellness and fitness goals. Throughout his time in the health and wellness world he evaluated, tried and tested countless 'diet and nutrition plans' and could not find one that had consistent results for both women and men- so he built one. Francis created F2 Wellness and the highly successful F2 Weight Loss Program for not only his clients, but for anyone looking for a simple, successful and sustainable weight loss program.

Have you ever experienced tiredness in your muscles while working out and you couldn't continue exercising after a certain point? Have you wondered what can make you lift heavier weights or run longer than you can today? If you have, understanding the mechanism of the body's energy system can help you find answers to these questions.

Three metabolic pathways generate the energy required to perform an exercise: the phosphagen pathway, the glycolytic pathway, and the oxidative pathway, together known as the energy systems. Although your body is always using all three simultaneously, depending on the intensity and duration of the exercise, your body will choose from which pathway it will use the largest percentage of its energy.

​As you may know, all energy used by our bodies is generated from the breakdown of food and drink. The three macronutrients are protein, carbohydrate, and fat. Those are metabolized to create adenosine triphosphate, which is the source of fuel for all body processes, including muscle contraction.

​Unfortunately, the supply of readily available ATP is very limited. It means our bodies constantly have to produce the substance; otherwise, muscle contraction would stop. This re-synthesis of ATP is done by the three energy systems.

​The first 10 to 20 seconds of high-intensity physical activity is fueled by the "ATP-CP," also known as the phosphagen energy system. Once the available ATP is used up, which occurs in a few seconds, a molecule called phosphocreatine is used to re-form ATP in the muscle. This energy system operates very quickly and can bring the highest output of the three systems. However, it is limited by the availability of creatine phosphate, which is usually consumed within 15 seconds.

​Your body can eventually refill these stores when you rest. This is why this system is most active for athletes who engage in short bouts of very intense, explosive movement, such as a the 50-meter dash or powerlifting. This is also the reason we can sprint at full speed for only a few seconds or lift maximum loads only 1-2 times before requiring rest or a decrease in exercise intensity using another metabolic pathway.

​The second pathway, the glycolytic pathway, is the primary energy system used for exercise lasting from 15 seconds to three minutes. People running an 800-meter event, for example, use this pathway the most. This energy system uses the glucose stored in the muscle, broken down primarily from carbohydrates, to form ATP. The benefit of this pathway is that it kicks in quickly, but it doesn't make very much energy; it can only supply a maximum of about three minutes of energy. This pathway is responsible for the buildup of lactic acid in our muscles, which contributes to fatigue.

For exercise lasting longer than three minutes, the oxidative pathway is used. Unlike the others, this energy system requires oxygen. The increase in respiratory rate meets the oxygen demand during physical activity. The oxidative system is slow, but is also the most efficient. Using fat as its primary energy substrate, it produces enough ATP to sustain longer duration activities, but only at submaximal exercise output. It means fat is the predominant fuel source used during low to moderate-intensity activity, like biking or jogging long distances.

​Now you are more knowledgeable on how your body relies on each of these systems working together to meet the energy demands needed for activities of daily living and exercise.

The system your body will use primarily depends on the type of activities you mostly engage in. The more you train in that particular type of exercise, the better your body adapts to being able to efficiently use that energy system.

​For example, individuals who have trained in powerlifting can store more phosphocreatine and ATP than a marathon runner or sedentary individual. On the other hand, endurance-trained individuals have better ventilation ability, maximizing oxygen availability for the oxidative pathway. At the end of the day, consistency is key. If you want to excel at a particular type of exercise, just keep doing it and in time, your body will adapt. (Credits: US Army)

Functional fitness is a simple, effective way to keep your body moving and reduce restlessness. It focuses on exercises that help you perform everyday activities more easily and safely—like getting up off the floor, carrying groceries, or reaching for items on a shelf.

By training your muscles to work the way you actually use them in daily life, functional fitness reduces injury risk and improves overall quality of life. It helps you move through your day with more confidence, strength, and ease.

Fitness expert Brad Schoenfeld describes functional fitness as existing "on a continuum." In other words, almost any exercise can be functional if it improves your ability to move well in real life. While general strength training is beneficial, exercises that mimic everyday movements tend to offer the greatest payoff.

Functional fitness also improves balance, endurance, and flexibility—benefits that matter at every age.

Below are 13 functional exercises suitable for adults of all ages. Choose five or six and perform them three to four times per week. All can be done safely at home with minimal equipment.

Squats mimic sitting and standing from a chair, making them one of the most important functional movements. Move slowly and with control. To modify, reduce depth or use a chair for support.

This exercise strengthens the muscles used to push yourself up from the floor or a surface. It's a gentler alternative to pushups and works the same muscle groups.

Planks build core strength, balance, and mobility—skills needed for getting up and down from the floor. Focus on maintaining good form rather than duration.

Wall squats provide added support and reduce strain on the lower back while still strengthening the legs.

This movement improves balance and stability and mimics stepping down from stairs or high surfaces.

Rows strengthen the back and arms, helping with tasks like lifting objects from shelves or pulling items toward you.

Lunges replicate the motion of standing up from the ground and improve leg strength and joint mobility.

Step-ups strengthen the muscles used for climbing stairs and stepping onto raised surfaces.

Single-leg exercises improve balance and core stability, which helps prevent falls.

Side planks target the oblique muscles and support overall core strength.

This yoga pose builds strength, flexibility, and balance while supporting your body weight.

Deadlifts train the hip hinge and strengthen multiple leg muscles, preparing you for lifting objects safely.

This combined movement challenges balance while strengthening both the lower and upper body.

Functional fitness prepares your body for real-life movement. It emphasizes performance over appearance, uses minimal equipment, and carries a lower risk of injury than high-intensity training styles.

Because it focuses on practical strength and movement quality—not muscle size—it's accessible, effective, and appropriate for people of all ages and fitness levels. If you have existing injuries or medical conditions, consult a healthcare provider before starting.

On this week's episode we are running a rare re-run on the aftermath of 9/11.

The tragic events of September 11, 2001, remain etched in the collective memory of not only Americans but also people worldwide. Beyond the immediate devastation, the aftermath of the World Trade Center (WTC) attacks brought forth an enduring health crisis among those who selflessly rushed to aid their fellow citizens. First responders, the courageous individuals who braved the smoke, debris, and toxic fumes of Ground Zero, now face a formidable foe: cancer. This essay delves into the harrowing issue of cancers among first responders as a result of their heroic work at the World Trade Center on 9/11.

The Heroic Sacrifice

On that fateful Tuesday morning in 2001, first responders raced against time to rescue victims, provide medical aid, and extinguish fires at Ground Zero. Their unwavering commitment to their duty and fellow citizens was nothing short of heroic. However, in their pursuit of saving lives and clearing the wreckage, these valiant individuals unwittingly subjected themselves to a hazardous environment, the consequences of which continue to haunt them.

The Toxic Fallout

The collapse of the Twin Towers released a vast plume of dust and debris, laden with a toxic cocktail of chemicals and substances. This included asbestos, lead, dioxins, and various carcinogens. The first responders breathed in these harmful particles, exposing themselves to long-term health risks. Moreover, the fires at Ground Zero burned for months, releasing even more hazardous pollutants into the air, further endangering the health of those on the front lines.

The Alarming Statistics

Over the years, an alarming number of first responders have fallen victim to cancer. The statistics are sobering, with many developing rare and aggressive forms of the disease. A study conducted by the World Trade Center Health Program in 2020 revealed that cancer has become a leading cause of death among 9/11 first responders. The incidence of certain cancers, such as prostate, thyroid, and multiple myeloma, among this group is significantly higher than in the general population.

The Struggle for Recognition and Assistance

First responders who survived the immediate aftermath of 9/11 are now faced with another daunting battle – the fight for recognition and assistance. Many of these heroes have struggled to receive adequate medical care and compensation for their illnesses. The process of proving that their cancer is linked to their exposure at Ground Zero can be arduous, and the burden of proof often falls on the shoulders of the afflicted.

Legislation such as the James Zadroga 9/11 Health and Compensation Act has provided some relief by establishing healthcare programs and compensation for affected individuals. However, the fight for ongoing support and comprehensive healthcare continues, as the prevalence of cancer cases among first responders only grows.

The Psychological Toll

Beyond the physical health challenges, the psychological toll on first responders cannot be understated. Witnessing the loss of colleagues and experiencing the long-term health impacts has led to significant mental health struggles within this community. Many suffer from post-traumatic stress disorder (PTSD) and anxiety, adding to the already burdensome weight of their physical ailments.

The cancers afflicting the first responders who valiantly served at the World Trade Center on 9/11 represent a tragic and enduring consequence of that fateful day. These individuals sacrificed their health and well-being in the pursuit of saving lives and aiding their fellow citizens. As a society, it is our moral duty to recognize their sacrifice, provide them with the necessary medical care and support, and continue research to better understand and combat the long-term health effects of their selfless actions. The cancers among first responders of 9/11 are a stark reminder that their heroism should never be forgotten, and their needs should always be a priority.

This week we will discuss being Bi-Polar with Kitt O'Malley.  

Kitt is an author, mental health advocate, and former psychotherapist who lives with bipolar disorder. Both her personal experience and clinical background inform her writing and enable her to help herself and guide others toward mental health recovery. She has a bachelor's in legal studies from UC Berkeley, a master's in psychology from New College of California, and has attended seminary. Visit kittomalley.com for more information.

BOOK

"Balancing Act - Writing Through a Bipolar Life" offers hope to those living with mental health conditions and their loved ones. As a therapist who left her career due to a mental health crisis, O'Malley educates the public about mental health and fights stigma against those living with mental health conditions by challenging stereotypes.

O'Malley's writing recounts her struggle with bipolar disorder, the two decades it took to receive a proper diagnosis, and how her journey gave her purpose. O'Malley balances living with bipolar disorder with her work as a mental health advocate and former caretaker of her son and parents.

This week we will discuss Young Onset Parkinson's with Jennifer Crowder.

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Jennifer has been living in the uncomfortable space of not using her career or family role to define herself for many years. Instead, she describes who she is as a person - she is tenacious, creative, stubborn, sarcastic, relentless, driven, compassionate, and courageous. Her proudest moments are making people laugh when they least expect it and finding a quick and simple solution to a complex problem. She spends most of her time in a boxing gym or carving eggshells. She has been living with Parkinson's disease for 27 years. 

​In reference to advice about starting rock Steady Rock Steady, Jennifer wanted you to know...

​*Don't wait until you feel good to go.

*Go when you're tired.

*Nauseated

*In pain

With this disease, if you wait to feel good enough to go, you'll never go. The first few weeks are undeniably hard. Pain and fatigue from the workouts, pain and fatigue from the disease. But if you stick with it- go every class you can and give 100% each workout, the disease symptoms reduce. I'd rather have the pain from a good workout. It allows a more productive life. 

This week we will discuss lasting symptoms months after catching COVID-19, also known as long COVID.  A recent study has found Long COVID  more than doubles a person's likelihood of developing cardiovascular issues.  (credits: https://bit.ly/45gJq4e )  We will not have a guest on this episode.  If you or someone you know has Long COVID and had a healthy circulatory system until recently we would love to have you as a guest for a future episode. 

This week we will discuss a serious motility disorder: Gastroparesis.

Our guest is a strong advocate for this community and we are honored to have her join us today.  Melissa Adams VanHouten is a wife, mother, and former university political science instructor and corporate trainer who holds a B.S. in Political Science from St. Joseph's College and an M.A. in Political Science from Indiana State University. After being diagnosed with gastroparesis in February of 2014, she became a passionate advocate for those in her community who feel voiceless and ignored. She currently serves as the Association of Gastrointestinal Motility Disorders (AGMD) Public Policy and Outreach Director.  She is also the co-author of the book, "Real Life Diaries: Living with Gastroparesis," and manages several online patient support and advocacy groups, the largest of which serves more than 46,000 members.  She spends her days advancing the cause of those who struggle with the sometimes devastating and life-altering effects of gastroparesis, and it is her fondest desire to empower others to advocate for awareness, better treatments, and, ultimately, cures.

This week we will discuss a new rapid response test for Sepsis with one of the developers, Richard Brandon.

​Sepsis describes a syndrome that occurs when severe infection results in critical illness and affects 750,000 Americans annually. Sepsis occurs when a bacterial, viral, or fungal infection causes a significant response from the body's immune system, causing a high heart rate, fever, or fast breathing. Severe sepsis develops when the infection causes organ damage. Septic shock is the most severe form in which the infection causes low blood pressure, resulting in damage to multiple organs. About three in every 10 patients with severe sepsis, and half of those with septic shock, die in the hospital.

​

Consider asking the following questions:

"Does my loved one have sepsis or septic shock?"

"Do we know what organism is causing the infection in my loved one?"

"Do we know where the infection came from?"

"How well are my loved one's organs working?"

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Antibiotics and intravenous (IV) fluids are two of the most important treatments for sepsis. Studies have shown that delays in receiving the right antibiotics can double the risk of death. Patients are usually started on antibiotics that treat many different types of bacteria—"broad-spectrum antibiotics"—until test results are available to help physicians select antibiotics that treat the specific bacteria causing the
illness—"narrowing antibiotics". These tests are often referred to as "cultures", where bodily fluids such as blood, urine, and phlegm, are sent to the laboratory to identify disease-causing bacteria. Preliminary results from cultures may be available within 24 to 48 hours; final results from these tests often take several days. (credits: ATS) 

Time is critical as you can see!  With Richard Brandon's new test, the results are rapid!! 

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Chief Scientific Officer – BVSc (Hons), PhD, MBA

35 years' experience – veterinary immunologist, molecular biologist, pathologist, animal and human healthcare R&D executive: Cornell, Sloan Kettering Cancer Research, University of Queensland, various private pathology laboratories, Genetrax, Plasvacc, BioNiche. A listed inventor on most Immunexpress patents; architect of IP strategy.

On today's show, we are talking about the complex world of multiple chronic illnesses once again with Anna Cooper. Anna is a 35-year-old female who has an independent spirit inside of a body that holds an alphabet of health conditions. Anna worked as a case manager for individuals with intellectual and developmental disabilities, where she loved to advocate for her clients. When her health forced her to take a step back from working, things have been rough as she looks for a new way to advocate for herself and for others.

The Difficult illness we will discuss today is Mast Cell Activation Syndrome or MCAS.  According to the National Institute of Health: Mast cell activation syndrome (MCAS) causes a person to have repeated severe allergy symptoms affecting several body systems. In MCAS, mast cells mistakenly release too many chemical agents, resulting in symptoms in the skin, gastrointestinal tract, heart, respiratory, and neurologic systems. Mast cells are present throughout most of our bodies and secrete different chemicals during allergic reactions. Symptoms include episodes of abdominal pain, cramping, diarrhea, flushing, itching, wheezing, coughing, lightheadedness and rapid pulse and low blood pressure. Symptoms can start at any age, but usually begin in adulthood. The cause of MCAS is unknown. Diagnosis is based on the symptoms, clinical exam, and specific laboratory testing. Other conditions may need to be excluded before MCAS can be diagnosed.

This week we will discuss Achalasia of the Esophagus

Achalasia occurs when nerves in the esophagus become damaged. As a result, the esophagus becomes paralyzed and dilated over time and eventually loses the ability to squeeze food down into the stomach. Food then collects in the esophagus, sometimes fermenting and washing back up into the mouth, which can taste bitter. Some people mistake this for gastroesophageal reflux disease (GERD). However, in achalasia the food is coming from the esophagus, whereas in GERD the material comes from the stomach.

​There's no cure for achalasia. Once the esophagus is paralyzed, the muscle cannot work properly again. But symptoms can usually be managed with endoscopy, minimally invasive therapy or surgery. (Credits: Mayo Clinic)

​Our guest on this episode is Bridget Oyen, known in the TikTok world as @LiveSickDieslowly.

Bridget is 30 years old and has been struggling with Achalasia since the age of 15. In addition to that, she has Gastroparesis, Fibromyalgia, and is Autistic and ADHD. She is an advocate for the disabled community, and loves to help educate others on how to be mindful in regards to disability and chronic illness, and aims to break down stigma surrounding these topics. 

This week we will discuss the complexity of being chronically ill with multiple diagnoses.  Our guest for this week is Christy Amos, a compassionate and resilient individual who has dedicated her life to helping others navigate the challenges of living with chronic illnesses. Despite her own battles with multiple chronic health conditions, she has become a powerful patient advocate, leveraging her personal experiences to support and empower others. As a freelance author, she shares her expertise and insights on living with chronic conditions, providing education, comfort, and inspiration to those affected. 

In this episode we will discuss Vectors.  Specifically MOSQUITOES!

Mosquitoes cause more human suffering than any other organism -- over one million people worldwide die from mosquito-borne diseases every year. Not only can mosquitoes carry diseases that afflict humans, they also transmit several diseases and parasites that dogs and horses are very susceptible to. These include dog heartworm, West Nile virus (WNV) and Eastern equine encephalitis (EEE). In addition, mosquito bites can cause severe skin irritation through an allergic reaction to the mosquito's saliva - this is what causes the red bump and itching. Mosquito vectored diseases include protozoan diseases, i.e., malaria, filarial diseases such as dog heartworm, and viruses such as dengue, encephalitis and yellow fever. CDC Travelers' Health provides information on travel to destinations where human-borne diseases might be a problem. (from the American Mosquito Association)

By the end of the first week of the new year, nearly 77% of New Year's resolutions have already failed (Norcross, 1988). That's discouraging—but it doesn't mean you should stop trying.

It means most of us are setting resolutions in ways that don't work.

You aren't weak or lazy. More often, the problem is a misaligned system—one that relies too heavily on willpower and short-lived motivation. Motivation naturally fades over time, even when our intentions are good.

Think about how often you enthusiastically agree to plans weeks in advance, only to feel tired or unmotivated when the day arrives. Or how many times you've started a project—cleaning a room, taking a course, planning a trip—only to watch your early excitement slowly disappear. We're excellent at strong intentions; follow-through is harder.

The good news? Not all resolutions fail. That same research found that 19% of resolutions are still maintained two years later (Norcross, 1988). We just don't spend enough time learning from what does work.

Resolutions that try to overhaul everything at once are overwhelming and fragile.

Examples:

• "New year, new me—I'll reinvent my career, relationships, and lifestyle."

• "I'll work out every single day this year."

• "I'll triple my income or eliminate all my debt."

Why this fails:
One setback can feel like total failure, making it easy to quit entirely.

Goals rooted in self-criticism, embarrassment, or self-loathing undermine motivation.

Examples:

• "I need to get my life together."

• "I have to lose weight so I don't look bad."

• "This year I'll stop being lazy."

Why this fails:
Shame erodes self-belief and increases anxiety, making lasting change harder—not easier.

Unclear goals are difficult to act on.

Examples:

• "I want to be healthier."

• "I'll work on myself."

• "I need better boundaries."

Why this fails:
Without clear actions or markers of success, procrastination takes over and goals fade.

Choose one small, consistent practice that reflects what truly matters to you.

Examples:

• "Every Sunday evening, I'll spend an hour writing, painting, or making music."

• "Once a week, I'll take a phone-free walk to reflect."

Connect your resolution to generativity—contributing beyond yourself (Erikson, 1950).

Examples:

• "I'll volunteer or mentor through an organization like SCORE or Rotary."

Create simple, recurring rituals with others.

Example:

• "I'll schedule a weekly call, walk, or shared meal and treat it as a real commitment."

Traditional New Year's resolutions don't fail because people lack discipline. They fail because they're poorly designed—too big, too vague, or rooted in shame.

When resolutions focus on "fixing what's wrong," they often lead to self-criticism once early motivation fades. In contrast, resolutions grounded in meaning, purpose, and connection are more sustainable.

If you're among the 77% whose resolution didn't stick, don't fall into the shame trap. A broken resolution isn't failure—it's feedback. Reset your expectations, adjust your strategy, and start again with something manageable.

Move away from punishment and toward practices that bring joy, meaning, and connection. That shift alone can make the difference between another abandoned resolution and one that truly lasts.

May your year be filled with meaning, purpose, and connections that sustain you.

(CREDITS: PSYCHOLOGY TODAY)

This week we will discuss a rare type of cancer.  Our guest on today's show is Chris White.  Mucosal melanoma is a rare but aggressive disease usually diagnosed in advanced stages. Unlike most melanomas, which start in the skin, mucosal melanoma starts in the moist membranes that line the inside of the body, including the digestive tract.

All melanomas start in pigmented cells called melanocytes. Mucosal melanoma accounts for 1.4 percent of all melanomas, according to a 2018 review in Melanoma Management.

​Most mucosal melanoma cases start in the lining of the head, neck, anus, vagina or vulva. Cases inside the gastrointestinal tract are less prevalent.

The disease may be called invasive if it's spread deep into the tissue and metastatic if it's spread to distant parts of the body, such as the liver or lungs.

​​Mucosal melanoma hasn't been linked to any specific causes. Generally, older people are diagnosed, with the median age being 70. While the rate of skin melanoma cases has risen in the past 20 years, the rate of mucosal melanoma has always been fairly similar over time.

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More About Our Guest

Chris's story begins in Colorado Springs where he was born in 1982. His parents and two siblings moved to Irvine California where he grew up before moving to North Texas. He received his Associates of Arts degree at Collin College, followed by his BA at University Texas Dallas in 2005. After college, his career path included time in the in the oil and gas industry, working with independent SAP contract consultants as well as working in the Golf department at Gleneagles Country Club in Plano, Texas. His career path took a turn in 2016 when he worked in the home building industry as a construction manager. An avid snowboarder, he has always been active, enjoying outdoor activities.

His cancer journey began in the summer of 2018 when what he had believed was a hemorrhoid actually turned out to be cancer. Not just any cancer, but the diagnosis was Anorectal Mucosal Melanoma which is an extremely aggressive cancer with a low survival rate.  The following months included multiple surgeries, immunotherapies, chemotherapy and radiation. Despite the treatments, the cancer had metastasized throughout his body to his lungs, liver, kidneys and brain. His health was declining rapidly, and without any other options, he was fortunate enough to qualify as the last patient admitted to a TILs Therapy Clinical Trial at the University of Colorado Health Cancer Care located at the Philip Anschutz Medical Campus in Aurora Colorado. The TILs therapy was done in January of 2020 and within less than a year the tumors were gone. Not in remission but gone. The TILS therapy is revolutionary in that it eradicates the tumor rather than leaving it dormant. This clinical trial for TILS therapy saved his life. He was able to go back to work in homebuilding but realized his passion is sharing his cancer survival story.

Currently he works as a Certified Melanoma Educator through the Melanoma Research Foundation. He is involved with many melanoma patient advocacy groups throughout the world listening to other stories while sharing his own via group chats, industry panels and forums any format that can offer some patient the comfort that there may a cure for their cancer. Any contribution to the MRF aids the fight against Melanoma and Chris thanks you for your support and generosity.

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This week we will discuss Palliative vs Hospice with Dr. Karl Steinberg. 

Palliative Care, Hospice Care, End-of-Life Care, Serious Illness Care, and Advance Care Planning/POLST all represent important elements of care for individuals dealing with serious illness, particularly those facing end-of-life situations. These are related but distinct concepts within the healthcare system.

1. Palliative Care: This is a type of care that is focused on providing relief from the symptoms and stress of a serious illness. The goal is to improve the quality of life for both the patient and the family. Palliative care is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment. It's not limited to end-of-life scenarios and can help patients manage symptoms and side effects of disease or its treatment.

2. Hospice Care: This is a specific type of palliative care for patients who are in the final stages of an incurable disease and have chosen to focus on comfort and quality of life rather than treatments aimed at cure. Generally, hospice care is considered when patients have a life expectancy of 6 months or less. It is often provided in the patient's home but can also be provided in hospice centers, hospitals, long-term care facilities, and nursing homes.

3. End-of-Life Care: This refers to the support and medical care given during the time surrounding death. End-of-life care can include a broad range of possible treatments and support, depending on the patient's needs. It might include treating pain and other uncomfortable symptoms, providing emotional and spiritual support, and helping the patient and their family make decisions about care. Both palliative and hospice care can be part of end-of-life care.

4. Serious Illness Care: This is a broad term that includes all types of care that someone with a serious, potentially life-limiting illness may receive. This can include everything from aggressive treatments aimed at curing or controlling the disease to palliative and hospice care aimed at managing symptoms and improving quality of life.

5. Advance Care Planning/POLST (Physician Orders for Life-Sustaining Treatment): Advance Care Planning involves making decisions about the care you would want to receive if you become unable to speak for yourself. These decisions are often documented in an advance directive. A POLST form is a type of advance directive that becomes an actionable medical order when signed by a healthcare provider. The POLST form helps ensure that a patient's wishes regarding life-sustaining treatments are honored by emergency medical personnel, nursing home staff, and healthcare providers.

​All of these concepts share a common goal: to ensure the best possible quality of life for patients facing serious illnesses, while respecting their values, preferences, and goals for care.

About Our Guest

Dr. Karl Steinberg has been a nursing home, hospice, and home health agency medical director and chief medical officer in the San Diego area since 1995.  He received his bachelor's in biochemistry from Harvard and studied medicine at The Ohio State University College of Medicine, then completed his family medicine residency at University of California San Diego (UCSD) in 1990.  He has board certifications in family medicine and in hospice and palliative medicine, and is certified as a nursing home and hospice medical director in addition to having a certification as a healthcare ethics consultant.  

Dr. Steinberg also serves as president of the National POLST Collaborative, and is a past president of AMDA and CALTCM and past chair of the San Diego and California Coalitions for Compassionate Care.  He serves on the National Advisory Board for the CSU Shiley Haynes Institute for Palliative Care and is the recipient of the 2022 Doris Howell Award for Excellence in Palliative Care. 

Dr. Steinberg is on the Board of Directors of the San Diego County Medical Society and serves as a delegate to the AMA and California Medical Association's House of Delegates.  He is also an appointee to the California Insurance Commissioner's Long-Term Care Insurance Task Force.   

​Dr. Steinberg enjoys presenting at educational conferences to professional audiences and the public, and also serves as a consultant and testifying expert witness in civil lawsuits and regulatory matters.   He hosts two podcasts for AMDA, called JAMDA-on-the-Go and Caring-on-the-Go.  Dr. Steinberg is perhaps best known for taking his poodles on nursing home rounds with him.   

This week we will discuss processed food addiction.  This is a rerun of an episode we posted awhile back.  

Dr. Ifland has been creating breakthroughs in recovery from food addiction from 1999 with her first popular book to 2018 when her textbook, Processed Food Addiction: Foundations, Assessment, and Recovery was released by CRC Press.  

She founded the online Addiction Reset Community (ARC) in 2016, www.foodaddictionreset.com. The Facebook group, 'Food Addiction Education' (2014) and www.foodaddictionresources.com (2014) provide free support.  Reset Week  is the first online live video program for withdrawal (2018).  ARC Manager Training is a program training future Addiction Reset Community leaders (2020).

Dr. Ifland is the lead author of the first scholarly description of processed food addiction and definition of addictive foods.

Dr. Ifland earned her PhD in addictive nutrition at Union Institute and University (2010); her MBA at Stanford Business School (1978) and her BA in Economics and Political Science at Oberlin College (1974). She currently resides in Seattle.

Social Media links: 

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https://www.facebook.com/groups/1806154526275515

​https://twitter.com/JoanIfland

​https://www.instagram.com/foodaddictionreset/