1. Institute for Integrative Medicine Louisville, KY
  2. RFA – A New Alternative to Thyroid Surgery
  3. University of Louisville Pharmacology & Toxicology Program
  4. Health Talk, Alternative medicine: 01 September 2018
  5. Unusual Therapy: 5 Alternative Programs That Have Helped Anxiety, Depression & Overall Mental Health
  6. UofL Dept. of Medicine Grand Rounds: Dr. Benjamin Rogers
  7. Careers in Alternative Therapies

Institute for Integrative Medicine Louisville, KY

you,integrative medicine is a relatively new,port with medicine that involves healing,the whole person body mind and spirit we,know that many physical modalities have,a psychological emotional component and,we also know that many physical,illnesses that we treat people have a,root cause from emotion or psychological,issues so when you treat a person and go,all your specs body mind and spirit,thats when health this transplant and,thats when true healing occurs so here,conventional and traditional as well as,what people consider an alternative,which is acupressure,stunning traditional Chinese medicine,one of our,new programs,p OMG,this is a gene that was just discovered,in late 1970s,basically theres three a little types,there too,you have one from your mother 14,so theres six different possible,combinations in other words,2223 absolutely,the miniatures,just most common,some healthy,what you can sing,that one diet does not,one,our treatment plans are based on,individual perspective,just each person too,so these treatment play,for mental patient when I first started,coming that was what the idea in mind,that I wanted to work with someone who,repelled me with over all encompassing,wellness program to bring my health up,to a level just happiness,Kim has done that for me she has been an,apartment that has evolved through the,years as my needs and my help me to,change she has lent those and I have to,give her credit for that and myself a,little bit too because I follow what she,we see a wide variety of patients here,the Institute of Medicine some pain,issues,which the AMA therapy loud feedback is,wonderful,dont exactly know why theyre coming,just have a complaint,what the reason is,integrated medicine focuses on,prevention,from our traditional,because traditionally wound,kind of way to get sick and then try to,place it,focuses on prevention we know many of,the illnesses that lose,rampant in the United,such as heart disease stroke diabetes,thats I would recommend this type of a,health program for anyone in this day,and age with stress and the load of,responsibility that we all carry we need,to have the kind of tools that she can,give us to really

RFA – A New Alternative to Thyroid Surgery

hi dr. Keith Fort Worth coming to you,from Louisville Kentucky today were,gonna be talking about thyroid nodules,and what we can do about them and Im,really excited to introduce to you a,brand new technique that we can use to,not necessarily eliminate thyroid,nodules but to substantially reduce,their size,thats non-surgical it is much safer,than surgery and its a great new,alternative for the right patients so,lets first start with the thyroid so we,have the thyroid low in the neck and as,you know the thyroid is a,butterfly-shaped organ and sometimes,what well find is that a nodule will,begin to grow inside the thyroid and,that nodule if it grows bigger and,bigger and bigger can become a problem,now we first need to figure out whether,or not a nodule is benign or malignant,because if its a malignant its not,really a nodule its really a thyroid,cancer and that is not something thats,dealt with in any other way than surgery,because surgery is such a good cure for,thyroid cancer but if were talking,about benign thyroid nodules then we,have a few options and traditionally a,nodule would be taken care of by,surgical removal okay and that could be,either a heavy thyroidectomy where we,take out half the thyroid or a complete,thyroidectomy if you had large nodules,on both sides but we have an alternative,and this is called RF that stands for,radiofrequency ablation and its a new,technique here in the United States but,its actually not new this has been done,in South Korea for at least a decade and,its been done in Europe and its been,done in South America so theres a large,body of experience but its a new,technique here to the United States it,was just approved by the FDA about a,year ago and its becoming more and more,of a popular option so let me tell you,what RFA does well first we mentioned,before its a non surgical technique and,we take a probe and we use radio,frequency energy to ablate the,inside of a thyroid nodule so for just,clarity lets just say that this is my,thyroid nodule what we do is we take a,probe and we come down into the bottom,of it and we apply this radiofrequency,energy and it ablates the tissue in a,one particular spot and so we advance,the needle and progressively we make,internal lesions inside the nodule,itself then we move the needle and we,begin doing it progressively until we,get the entire nodule treated and what,we expect to find is about an 80%,reduction in the size of a nodule over,the course of about six months now most,of this happens in the first month,predominantly in the first one to three,months but you can still get shrinkage,of the nodule up to six months and we,expect a nodule to be reduced by about,80% with a single treatment that can be,done just under local anesthesia in the,office so its very very safe who is,this RFA procedure good for well its,good with anyone who has a nodule whos,not looking for a surgical solution,someone who lets say has a nodule,thats very visible and they dont like,the unsightly look of it this will,reduce it by 80% and most time will take,a very visible nodule and turn that into,a nodule that virtually no ones going,to notice its also good for people,where the nodules are beginning to press,in and reduce the size of the airway so,for people over having compression of,their airway its a very good technique,also if you have a nodule thats big,enough many times that nodule will be,pushing it on the esophagus and people,feel that while theyre swallowing,sometimes people will complain that the,food or pills will get hung up near,where that nodule is and so theyll have,trouble swallowing and reducing the size,of it in this non-surgical manner takes,care of those type of symptoms the other,beauty of our fa is that it doesnt,leave a single scar in fact its just a,small little needle entrance point that,heals up,for great so we wont we wont be,leaving any scars behind and we do this,with the patient awake so its very safe,it doesnt leave a scar it reduces the,size of benign nodules by about 80% in a,single treatment and its a great option,for people who have thyroid nodules that,are needing to be tackled and its a,great alternative to surgery it may not,be for everybody so you do need to talk,to your surgeon about this but for those,that do qualify for this its a great,option and if you have any questions,about that wed be happy to talk to you,about it check out our website well,have more information on this and well,also be looking at putting some patient,testimonials up and some video to,further get you informed on this great,new technique

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University of Louisville Pharmacology & Toxicology Program

[Music],the pharmacology and toxicology graduate,program at the university of louisville,in louisville kentucky has a long,history we issued our first graduate,degree in 1937,and as of today weve issued 340,graduate degrees when you graduate you,graduate with a degree in both,pharmacology and toxicology which is,really quite a unique thing about our,program because were one of only,probably 12 programs in the nation,that allow you to get a degree in both,pharmacology and toxicology,when a student enters our program they,first,choose a lab we have people in our,program that are considered primary,faculty,as well as secondary faculty totaling,over about 60 faculty members whose labs,that you can join,and these areas of research are very,diverse from neurotoxicology,cannabinoid research cancer biology,environmental toxicology metals,toxicology,a wide range of topics that students can,do research in,the first two years are where they do,all their coursework you take major,courses in in pharmacology and,toxicology,as well as courses in biochemistry cell,biology,physiology scientific writing,statistics when youre done,your coursework um you,you do whats called advanced to phd,candidacy,and your research is really intensive,after that its mainly research after,that whereas before candidacy youre,doing research and coursework,and at that point students really focus,on doing their research for their phd,dissertation,which they defend at the end of four or,five total years in the program,our students graduate with degrees and,go on to have careers,in industry in the government with the,epa,with the national cancer institute at,nih doing postdoctoral fellowships at,academic institutions all over our,students have gone on to get faculty,positions,in academia and to,to start up uh companies actually in,pharmacology,so our students have had a lot of,successes and were very proud of,our the pharmacology and toxicology,program at the university of louisville,is a combined program that starts out,with students taking blended coursework,in toxicology and pharmacology and after,two years of courses,they start into their research program,where they choose either a toxicology,direction or a pharmacology direction,in my case my expertise is in toxicology,which is the study of how things poison,biological systems,the cool thing about toxicology is that,its an apex science,it sits on top of the other sciences so,you have to,use all of the various disciplines that,you would use,in other fields so the students that,come into this program are students are,really looking,to solve significant problems they kind,of want to be detectives,in a science setting to try to,understand what is a chemical doing to,poison,either people or the environment or,perhaps,animals,so one of things you may not be aware of,is that when youre a graduate student,in a biomedical program,typically the university is going to pay,for the first two years of your,education,both the tuition and pay us diaper one,of the strengths of the uofl program is,that we have whats called the t32,training grant thats funded by the,national institute,of environmental health sciences as a,graduating student here at the,university of louisville i,found that there are a number of,programs that have really helped me,accelerate,and prepared me to graduate and become,an independent researcher,one of those being the t-32 program,which is sponsored by the niehs,and this program has allowed trainees to,participate and explore,different avenues throughout the,toxicology portion of the program,it provides funding for the third and,fourth year of your program,and that therefore allows you to really,concentrate on your research knowing,that you have funding and also the,resources available to you,one of the great things here at,university of louisville is the,collaboration between the t-32 program,and the superfund program and what this,is is it allows trainees from both,programs to,have access to resources and,opportunities they may not otherwise,have,there are seminars that are combined,there are also professional development,opportunities and opportunities to work,with other trainees,in research areas you might not,otherwise have discovered,[Music],seven years ago dr david hein invited,me to play a role as a,curriculum coordinator of the r25 cancer,education program and youre probably,wondering where is she going with this,and how is this going to,increase my chances to attend graduate,school,the r25 cancer education program,will position you to partner,with a faculty member thats engaged in,clinical basic or translational research,in addition you will work very closely,with me,as well as other faculty members that i,collaborate with,so that you can hone in on some career,enhancement and professional development,skills you will learn how to,enhance your scientific writing and oral,presentation skills,you will have an opportunity to,participate in some really cutting edge,programming that will allow you to,network with faculty graduate students,postdocs and even clinicians and you,will have the opportunity,to participate in a summer research,program,that will give you a competitive edge to,attend graduate school here,[Music],another unique component to the uofl,program is that we have the capacity to,study,medicine and toxicology from a one,health perspective,and what a one health perspective is is,the international movement,to understand that health is,interconnected,if you walk around and talk to people,who do research sometimes you talk to,people who do human health,and some people do animal health and,other people may do ecosystem help,and from a certain vantage point that,looks like theres three different,health,but really theres only one health and,that we all share,humans animals ecosystems we all share,the same health,and one of the things were able to do,at the university of louisville is study,the interconnectedness of health,be it humans animals ecosystem even,plants,at the university of louisville our,students have access to,modern research facilities in fact the,building that were in right now is,called the clinical translational,research building,its only about 10 years old and its,extremely modern,we have core facilities and common,equipment,on every single floor pretty much,anything you,need to do you can do in this building,without even leaving,in addition to our building we have,students that do research in other,buildings,on campus that have access to core,facilities,that are available to them through our,environmental toxicology,program grant that was just awarded,several different large cobra grants,that,are awarded to establish areas of,research focus,in alcohol research in cancer immunology,dental oral health so,our students have access to a lot of,expertise on this campus,to help them ensure that theyre doing,top-notch research,so why would you love to come to the,university of,louisville well number one the research,environment,is highly collaborative number two,you will have an opportunity to,participate,in our summer research program that will,give you,a competitive edge for your career we,welcome you we,invite you to apply to graduate school,at the university of louisville in the,department of pharmacology and,toxicology,if a student is very interested in,identifying a target,and developing a drug for that target,and then learning how to take that drug,target and that drug candidate from the,bench all the way to the bedside,and do that as part of their lifelong,career this is the program,for the student because theyre going to,learn every step of the way,how to do that process and do it in a,way,that also on the other side of the,equation limits the toxicity,effects of these drugs looks for toxic,effects of drugs,if youre interested in environmental,toxicology louisville is one of the,biggest,places in the nation as far as,environmental,toxicology and expertise in that area,our students come here,theyr

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Health Talk, Alternative medicine: 01 September 2018

[Music],[Music],what are peoples choices between,conventional and alternative medicine,sometimes in a messiah thousands is our,would repeal the menus are some services,a child,yeah I wasnt on a local campaign,meaningfully real ago is Luo man,rotatable burned up I will clarify it,man is importance women doing in about a,routine which by Tata I mean until,available,listen to our now – ray Mnemosyne,demonic activity uncheck ignore Marat,what was it but whatever homie paid,Loomis was to come up Im a carving just,Razia is really I wanna get a scene -,you know Dean Corll nos into would you,we are sure shall always knew so,traditional medicine is often tempt,complementary and alternative medicine,or simply chem now this is the term used,for medical products and practices that,are not part of conventional mainstream,or standard care some people define it,now conventional care is what medical,doctors and allied health professionals,such as nurses and physiotherapist,practice now complementary medicine is,any practice used together with,conventional medical treatment in the,belief that it complements the treatment,alternative medicine and on the other,hand is any practice used in place of,conventional medicine purported to be,having healing effects of medicine now,examples of you know complementary and,alternative medicine practices include,such practice such as homeopathy,chiropractic traditional Chinese,medicine various forms of acupuncture,now other common practices are include,spiritual and traditional healing so,today we discuss complementary,alternative and traditional medicine I,guess today our director of traditional,methods from the National Department of,Health a member of the complementary,medicine committee South African Health,Products regulatory authority or simply,called Sabra the registra from the,Allied Health Professions Council of,South Africa a family physician an,acupuncturist a homeopathy a spiritual,healer and psychic medium and a,traditional healer and also the,chairperson of the Health Products,Association of South Africa she will be,joining us from our studios in Cape Town,you can tweet us at SABC her talk or,simply interact with us on our Facebook,page,si,so sit back relax and land from this,bumper sure head coming to you just a,special Im not a selamat oh man this is,after,[Music],[Music],ones life can change in an instant,it is then that you need fast and,efficient service and that is why as,Apple created the instant groceries,benefit for you minutes after a came an,electronic voucher for two and a half,thousand grand will be sent to your cell,phone and within an instant you can,start doing shopping at all the major,stores more than seven hundred thousand,customers have already received the,instant groceries benefit get yours in,an instant SMEs call two three two eight,one three we are losing the best of,[Music],apparently Im a cameraman in the cooler,mobile app and Angelas cool Umaga,McCarville it can be can be nearly oh,yay level 7 DC motors in Baku Catalan,animal they come little ones which a,steaming-hot was with a familiar theme,bottom two logos equivalent and then la,palma connection it can be any logo,changing al Maleh prevent above event,osteology Kuna banned by github at,Alabama 2nd Sabina Camila Louisville,amenable to Caliban table in a bottle a,masseur geetam Obama surrogate relevant,abominable up in de musica impeller,McCanless abilities effusive in Sanaa,auto attila manga difficulties if a,sting out or tearaways long CM lion,would have able to work till internet,research and say well through sauna and,about our television cylindrical large,in my lap and lava infinitely,instability that comes a basement a,traditional ability in felony,accommodation innovative in the rally,was seen to say to Samantha Bama cupola,which are pharmacy for my from Alana was,quoting a between a developing the,boo-boos are donkeys if water fear was,would signal attend Jacob and Emma 7 win,them over,alright so lets try and pack all of,these issues around complementary,alternative and traditional medicine and,its a great pleasure to introduce our,special guests first closest to me is,Bruce and busy now Bruce is director for,traditional medicines at the National,Department of Health,welcome John stock please thank you very,much and thank you to all the viewers,are they all right next to Bruce is,professor Davis Carrera and Carrera is,member of the complementary medicine,committee for the South African Health,Products regulatory authority or sopran,we want to call it that welcome to El,Topo,thank you very much pleasure to be here,alright and last but not least is dr.,Lewis Melinda with Registrar of the,Allied Health Professions Council of,South Africa or H a HPC as a welcome,thank you very much pleasure to be here,alright first gentlemen lets lets,start by defining all of these you know,and,and perhaps before we start with with,our introductions on you know,definitions lets cross over to Cape,Town and welcome another special guest,Maria I sense ow,whos chairperson of the Health Products,Association of South Africa welcome to,health dr. Maria good morning dr. Saylor,and thank you for having me on your,program and thank you to the viewers all,right its probably because you way out,in Cape Town that we almost forgot to,introduce you but were gonna come back,to you just now lets come back to our,guests here in Jovic and talk about all,of these first establish peoples,tradition I mean you you involved with,traditional medicine perhaps you cannot,you can define to us what traditional,messiness and have to tell us what then,you do in the Department of Health okay,AM traditional medicine I think is a,very wide concept that I think sometimes,its very much difficult to to explain,but what is traditional medicine in,South Africa is that weve got we,defined traditional medicine in two the,first one weve got the African,traditional medicines which which is the,traditional medicine that is indigenous,to South Africa and also we have got the,complementary and alternative medicines,which are also traditional medicines but,are those traditional medicines that are,actually coming from other countries so,even if even in terms of regulating both,of them they are related separately in,South Africa so so so this is concept of,you know when you say alternative or,complementary,its against some lets call it standard,what your views on that well its its,actually from our definition its a use,definition so you could say take herb,which is traditional because traditional,is is based on knowledge passed from,generation to generation so you could,take a product that is traditional in,every nation or every country in the,world has,tradition of use of medicines blood,right so you could take that but then,you decide to use it and compliment what,we would call conventional medicine so,take for instance someone undergoing,radiotherapy they might then decide to,use a particular herb to help with side,effects of of above or off of the,radiotherapy so in that case they are,complementing the healthcare with,something traditional however that,person could decide they would stop,radiotherapy and just use the herb for,whatever reason now that is alternative,so they are used they are not longer,using what is conventional we have now,gone alternative and from surpress point,of view from a regulator point of view,we do not encourage or regulate,alternative practices right yes all,right when I come back you know to what,exactly you regulate lets get a comment,from dr. Melinda your comment in terms,of the definitions first of all and well,thats focusing a lot more on the,practitioners you we talked about allied,health professionals what are we talking,about well there is a disjunct in terms,of legal definition and international,usage so allied health practitioners are,in terms of international terminology,are generally persons such as nurses or,physiotherapists or psychologists but in,South

Unusual Therapy: 5 Alternative Programs That Have Helped Anxiety, Depression & Overall Mental Health

J. Alexander: You know, even Jesus wept. Even Tupac cried, you feel,me? So miss me with that hard stuff.,Tony Sondaval: They get so wrapped up into what theyre doing with,the bees, they forget about whats causing them the stress even a,little bit, a lot of times it helps.,Kristina Sabasteanski: VAST gets people out of their house each,week, hang out with other vets, get some activities, exercise.,Narrator: Therapy is not one size fits all. For some, talk therapy,is a helpful tool for their mental health. Others may need to think,outside the box, like smashing glass bottles or cuddling with,farm animals. Here at Stitch, we celebrate the ways everyday people,are making this country a kinder place to live one incredible story,at a time. And kindness, after all, comes from within. Our first,story is paving, or should we say shaving, the way for men of color,to be able to open up about their feelings. An effort to fight,stigmas about mental health is happening in barber shops across,the country.,Dominic Collins: So I come into this galaxy away from the worries,,and I step into this chair and I sit down. And I just give my all,to him, I express how Im feeling or how my day was.,J. Alexander: We dont necessarily open up right away about your,feelings. We actually go through these four principles you alluded,to.,Narrator: The Confess Project trains barbers with guiding,principles, like effective listening, to normalize talking,about mental health.,J. Alexander: That ear for validation, and then you have that,positive communication, and then you have the removing of the,stigma of not being able to be vulnerable or open up as a African,American male, you know what Im saying?,Narrator: Studies show that black men have a myriad of issues they,worry about daily, like poverty, unemployment, issues with police,,and their sense of inclusion within society.,J. Alexander: And oftentimes when you dont have a sense of,belonging it actually weighs on you. I dont care who you are, you,can act like youre tough and all of that and say ‘Me, me, me, me,,myself and I’ and all of that, but at the end of the day youre,probably hurting too.,Narrator: Dominic grew up often getting ridiculed for his colorful,style and how different he was. Now he has a sense of pride,,thanks to the program, and J.,Dominic Collins: He has given me so much confidence to embrace who,I am as a person, to be different.,Narrator: The advice hed give to his younger self proves that.,Dominic Collins: Just be yourself. Be confident in who you are. And,just go for it. Believe in your dreams and aspirations and just,fight for who you are as a person.,Narrator: Up next, an unconventional way of expressing,emotions is helping people get their frustrations out, one bottle,smash at a time.,Sean Moorefield: Somebody said, ‘I can’t believe that were allowed,to just do this.’,Narrator: A practice that some may consider out of the ordinary is a,huge stress relief for patrons of the 412 Rage Room.,Sean Moorefield: We realize that theres rage out there and people,have rage, but there really hasnt been a good way to release that.,So were just offering a fun way to release your rage.,Narrator: The business allows people to smash all kinds of,things. Bottles, televisions, computer monitors. If its,breakable, youll probably find it here.,Sean Moorefield: Theres a wide variety of things you can break to,release your rage, and also people can bring a few items themselves,as long as they pre-approve it and make sure its nothing that’s,going to be harmful or detrimental.,Narrator: But you might be thinking…why? For many, its a,way to release pent up emotion or aggression.,Sean Moorefield: I just know the feeling that you get when you,release the anger that you might have inside. And I know how its a,release, and you feel better, and then you can go out and deal with,a little bit more and be able to carry on.,Narrator: While its not an accredited form of mental health,therapy, an hour or so spent breaking and smashing seems to,help those who have gone to the Rage Room. And, not to mention…,Sean Moorefield: Its also fun to break things.,Narrator: When you think of therapy animals, dogs are probably,the first thing to come to mind. These next critters prove dogs,arent mans only best friend. Scatter Joy Farms uses beekeeping,,along with other animal therapies, to help veterans with PTSD,practice the art of calm.,Tony Sondaval: It makes you focus on what youre doing. It makes you,focus on not getting bees upset. So youre not thinking about other,things and youre focusing very much on your movement and your,activity and being very calm, because the bees need you to be,calm.,Unknown: Hi Mr. Donkey!,Narrator: These donkeys, named Cookie, Celeste and Jesse helped,college students take a break for cramming for finals to relax.,Nabila Mohammed Jibril: Things like this and having fun with,other people and seeing people happy helps you not feel too,stressed out.,Narrator: And finally, youve heard of a bull in a china shop.,But this 2000 pound bull in a nursing home, named Ole, is as,gentle as any other therapy animal.,Unknown: Im used to animals.,You are?,Yes, theyre gorgeous.,Narrator: Giraffes, ducks and kangaroos, Oh my! A former,preschool teacher is creating unique comfort animals in our next,story.,Tonia Bolton: It was always something that was in my,classroom.,Narrator: After working as a preschool teacher for 14 years,,Tonia was familiar with weighted objects being used to help,children experiencing anxiety. But they werent always convenient.,Tonia Bolton: Therapists would send weighted vest or blankets,,and those are hot. And if youre the only one in the classroom, and,youre carrying this big blanket, sometimes that stands out a little,bit.,Narrator: So why not a huggable horse instead?,Tonia Bolton: Not everybody is born with everything that,everybody else is, so lets have something that matches you and,tells you that you are beautiful no matter what. Hes my newest,piece.,Narrator: Tonia says the weighted animals also help children with,sensory disorders.,Tonia Bolton: I wanted to be the light in the dark.,Narrator: When the pandemic pushed her away from her teaching career,,Tonia knew she still wanted to help children. She launched her,brand, The Firefly Patch, and her animals are sold both locally,and online.,Tonia Bolton: It is weird to be living your passion, to be able to,do your passion. Teaching was my passion and still is, but COVID,showed me that its okay to change.,Narrator: Camaraderie, physical activity and connecting with,others who have had similar experiences helped to ease the,minds of the veterans in this next group. Kristina is familiar with,the unique challenges veterans face, especially those with,disabilities.,Kristina Sabasteanski: So I was in the army for 10 years, and I know,a lot of veterans coming home just often get stuck into the community,and oftentimes veterans wonder where they fit in. So when you get,veterans together, its like a safe place and everyone can,understand, whether youve been in combat or not, what youve been,through.,Narrator: She created the organization Veterans Adaptive,Sports and Training, or VAST, where veterans can connect and,de-stress through physical activity and friendship.,Patty Carter: This program has literally saved my life.,Narrator: Their sports range from cross country skiing in the winter,to archery, biking and tennis in the summer. For members like,Patty, the impact has been profound.,Patty Carter: Im having a blast. Its unbelievable. I mean, I was,in a real major depression three months ago, and now Im out here,and I go hiking on Mondays, come here on Wednesdays. Its been an,incredible transformation for me.,Kristina Sabasteanski: Its just the camaraderie knowing that,somebody, you know, can understand you, someone cares about you. We ,augh, we joke, we make fun of each other in a good way. Its just k,nd of a stress relief.,Narrator: We hope you enjoyed learni

UofL Dept. of Medicine Grand Rounds: Dr. Benjamin Rogers


to grand rounds,uh february 2021,and it is my distinct pleasure to,introduce,uh a colleague now benjamin rodgers who,we were successful,in recruiting to our faculty,this uh this past summer he came along,with his wife,amanda rogers whos in peds neurology,and i remember when i interviewed him a,couple years ago it was all about mary,and so mary is his beautiful their their,beautiful daughter,i want to say a few things about ben he,is from bowling green kentucky,and he had undergraduate training at,western kentucky university,in biology and psychology he went on to,graduate school here at university of,louisville and first got a masters,degree in biophysics and physiology,prior to matriculation from our medical,school in 2014.,he continued training postgraduate at,washington,university in st louis doing his,internal medicine residency there and,eventually also his,fellowship in gastroenterology,now all during that time hes known for,being a mentor,a teacher receiving multiple teaching,awards,hes a promoter of others and youll,find throughout the lecture that hes,very funny and very engaging and so hes,naturally a very good teacher,he has over 25 publications over 10,abstracts,a book chapter several grant,publications,and hes working collaboratively with,other researchers,still at washu on some innovative um,uh artificial intelligence uh type,technology,so hes hes one of those guys that um,is going to be unassuming but hes,theres a lot,that he does so then teach us something,about motility at the university of,louisville,thanks very much dr kruger so um i have,no financial disclosures,so today were going to discuss the,evaluation of common gi presentations,um were going to talk briefly about how,these tests guide,management and i want to say also that,i understand theres an opportunity to,type in questions if you want jason to,interrupt,me please you know let him know that im,more than happy to be interrupted,either by text or or directly by voice,so please,chime in anywhere you have questions,so dr cougar gave most of this,information um,im going to be a little nostalgic for,just a few seconds,uh i know its this this sounds a little,bit silly even but this this picture at,the bottom is our farm those,um we dont have both of those horses,still we saw one of those horses but,thats the exact spot i was standing,when i,when i thought to myself that you know,maybe i could become a doctor and i,remember the moment vividly,and i was just on a dr krueger alluded,to this but,when i was an intern in st louis i went,to my division chief and he was like,well tell me where youll be in 10 years,you know of course,everyone gets that question and i was,actually on a phone call with him a,couple of days ago and he said that i,told him,right off the bat that i wanted to be in,louisville kentucky uh doing exactly,basically what im doing now and so i i,hope that,um everyone can at least appreciate that,this is,this is the dream job for me uh and so,its a great,privilege for me to be talking to you,all this morning,certainly for me so so thank you for the,opportunity,before i get started too i want to say,that,this talk is going to focus on very,common things very common presentations,and,were not going to deviate a whole a,whole lot from that and the second,caveat,is that um our team has uh,you know when i say team i mean doctors,able and stalker,weve got two nurse practitioners um all,kinds of staff and its growing,and so um you know weve got a huge team,working on,motility things at the university of,louisville and please know that and i,think that,you know this is going to focus on some,of the adjunctive things that we do to,gastroparesis since i know the,the you know doctors doctors able and,stalker have a,um a rapport in town with most of you,and so,i know that you know them very well,lets talk about some of the,some of the quote unquote upper gi stuff,first so,this patient has chest pain miss,abbotts a 45 year old woman without,much past medical history who comes into,your office with chest pain,it occurs often i would say several,times per week and sometimes daily so,this is a pretty frequent,this is a symptomatic person she has,trouble identifying exacerbating and,leaving,alleviating factors right off the bat at,least and she thinks that,antacids might might help so shes,taking tums and she really doesnt feel,that much better,and she doesnt really have anything,alarming so she doesnt have any no you,know no nausea vomiting,no weight loss you see there at the end,no fevers no b symptoms,not having trouble swallowing anything,like that and shes not having blood in,her stool,um and so you you know the basic workup,you know,cbc and cmp are in the chart shes got,no new medication,so um you know sort of a a basic,initial presentation of of chest pain,and,the first thing to talk you know to to,mention is that,we should always remember that that the,uh,the the heart is a more acute organ and,so,uh whenever possible uh you know,bring that to the to the front of your,mind and make sure and thats thats,according to guidelines obviously,and make sure that the person doesnt,have any cardiac issues and and and so,youll see that on the slides but just,remember that even though im not going,to mention it throughout that i do,recognize the importance of that in in,literally every patient with chest pain,and in my mind at least,i i try not to get too hung up,and so um,you initiate a ppi trial on this patient,which is,which is which is fine when we talk when,we talk about,atypical chest pain its important to,remember that you know according to some,estimates even even in er,presentations um as much as a third of,of chest pain will be gastrointestinal,and so once youve ruled out cardiac,issues its its really not a bad idea,and especially as well go through the,talk youll see that as you talk to,people more in your office youll see,that oftentimes people lack the,vocabulary to adequately describe what,theyre feeling and so,you know thinking about gi issues in the,study of chest pain is completely,reasonable,and should be done in my opinion so you,initiate a ppi trial,no response and here well,pause to say too because this is also,going to become a common theme,if everyone responded to a ppi life,would be life would be peachy but thats,not the reality the reality is is that,some reports suggest that as many as 40,percent of patients will not respond to,ppi and so,those are the people that were talking,about trying to trying to sort out,so an endoscopy has also been previously,performed you do a chart check and you,see that,normal including biopsies and the barium,in this person even had a barium,esophageal before presenting to you and,they say,reflux to the thoracic inlet so what,does that mean,really not much and so what are you,going to do,now youve got somebody who you talk to,them a little bit further theyve got,some,theyve got some you know atypical sort,of,symptoms for what might be gerd but you,know i think that youll often find that,as you talk to these individuals,that the the chest pain comes with,certain factors or,is related to eating or things like that,and so,in the evaluation of of atypical,symptoms which,and even chest pain again i would not,say is any typical symptoms but,one of the things that you can reach for,is you can try to decide,exactly how often uh a person is having,reflux and so ambulatory reflux testing,is depicted by this diagram and youll,see,so on the right this is this is all,its it is as simple as it looks we put,a probe on someones nose,those electrodes are monitoring,impedance which is to say that,it follows a simple physical rule which,is that electricity is conducted,uh easier through through liquid and so,impedance goes down,in in liquid and impedance goes up when,theres air so if a person belches,impedance goes up if they reflux,impedance goes down,and you can see that theres a ph sensor,down there and it dangles above the,lower esophageal sphi

Careers in Alternative Therapies

Alternative Therapies Career Chat. We are very fortunate to have two Centre alums with us. We have Anya Miller and Anya has the,short hair, shes this way, and she does Equine Therapy that is her alternative therapy.,Then we have Kelsey Lownds, she is a board certified Music Therapist, and youre in Nashville and youre in Ohio, right?,Each of them are going to talk about their career field and give tips about the inside and then after that we are going to let you ask questions.,my name is Anya as he said and I graduated in 2015 with a bachelors in psychology,Im currently Ohio diversity Southern which is up in Franklin furnace Ohio and,Im the program assistant for the Center for therapeutic horsemanship here I did,get an associates in Applied Science after I left Centre College I graduated,in 2018 with that and then immediately started my position here I am a path,registered level certified instructor path is kind of like the organization /,therapeutic horsemanship its a professional association of therapeutic,horsemanship theyre the one who does our certifications and a lot of people,mix therapeutic riding with type of therapy have you guys heard of,hippotherapy youre more often to hear of that then you are a therapeutic,riding well hypnotherapy is basically a physical occupational or speech therapy,treatment utilizing equine movements whereas therapy riding where equine,Assisted activity for the purpose of contributing,positively to the cognitive physical emotional and social well-being of an,individual who has special needs so right now we are just a certification so,you dont necessarily need a degree to go into this however having some sort of,background in psychology Social Work something along that lines does help you,because if unless you go into one of the higher ed programs which theres only,five in the u.s. most of you go into one of those its a 90 percent failure rate,for a self-study test so its not something you can just do on a whim and,something that you have to study for you have to work for there are two phases in,your certification your first one one you have to be 18 and a path member you,have to have your CPR and your first-aid you have to do what they call it equine,skills checklist thats basically do you know your safety around the horses can,you identify breed color do you know how to feed walk and ride them then they,have a standards core standards is just our rulebook for what a therapy lesson,should look like as well as a Therapy Center so here at Southern we are a path,accredited sort of center here so we have to follow all of these standards,which theres over 300 of them some may apply to you some may not because not,only does it cover therapeutic writing it covers vaulting and driving so,dragging with a car and then vaulting is basically gymnastics on horseback and it,covers those as well you have a self-study course which is where any of,your training and any disabilities would come in handy,because thats covered in the self-study course and then you have assault,assessments that you have to complete once you get all of that which is a lot,to get and all the equine and the self-study course I did,OU and then some of my degree with some center played into the self study,once you complete that you get this letter its your instructor and training,letter once you have that then you can start teaching they require you to teach,a group of two or more riders and they can have physical or mental emotional,disabilities it doesnt matter which and you can mix you could have an ADHD,individual with someone who has a traumatic brain injury and you can as,long as they have similar goals and its safe to have both individuals in a,lesson they can be mixed together you have to have 25 hours teaching groups,and that has to be overseen by someone whos already certified so I also do,that here at the at our Therapy Center I oversee a lot of the instructors in,training that we have here who are getting ready to certify this requirement,this summer and then you have to go through a workshop and the certification,is a riding test plus you have to teach a 20-minute lesson teaching a skill to,riders here that we provide for you and does anyone can anyone think of what the,effects of horseback riding what therapeutic effects that could be,getting confidence yeah what about on the physical side,yeah so horses are one of two animals that move the human exact way that the,human hip moves so theres horses and then theres giraffes so when youre on,horseback your hips move and the exact same motion as if youre walking on the,ground so if you have someone who has eliminated mobility that helps,strengthens the muscles and build their muscle tone as well as balance think,about it youre on a moving animal so you have to be able to keep your balance,your trunk stability what else what else could possibly benefit a rider so weve,got physical weve got our emotional what about any cognitive effects you guys can,guess its ok to guess he doesnt know anything,yeah so the sequencing that you need to do helps train your brain also if you,have someone who has ADHD getting them to focus and really be aware of their,own attention span helps them and then timing because if you time things wrong,youre not going to be able to communicate correctly with your equine,and then also you know theres the social interaction you have with your,equine with your instructor if youre in a group with other riders volunteers so,some of our riders like one of our riders that if you go to our website,youll see his names Lance Ill call he was hit head-on by a drunk driver and it,resulted in a TBI he lost function on his left side I believe and when hes,riding he needs to have someone leading the horse as well as two people on,either side theyre called side walkers and they help him maintain his balance,up there and theyre there for safety and forever,for whatever reason he fatigues too early or if something like a seizure,will happen theyre there to help right now it is just a certification,so unfortunately insurance is not covering were working in the next five,years to get it to be a licensed profession where we would be able to,build insurance and thats what sets us apart from thats another thing that,sets us apart from hippotherapy so with hippotherapy you have physical,therapists and occupational therapists or a speech therapist thats theyre,giving the therapy so they bill through their own through their office whereas,like here well you know we do have one social worker who comes and and bills,specifically for her clients in general we dont have anyone whos licensed here,to do that so theyre either reliant on donations from community members who,donate to our program or there are they pay out of pocket where one of the more,affordable programs in Ohio its thirty five flat whether youre in a group or,individual and thats for an hour one-on-one with an instructor or in a,group and then or you have programs like safe harbor which is our local domestic,violence also they pay for their kids to come out here as well as doing,equine-assisted learning or a EAL and thats unmounted so with that they get a,lot of feedback from the horses so what happens if you come up to the horses,what do you think would happen if you came up to the horse and youre really,angry or you come up and you how do you know youre youre standing tall you,come at them quickly what do you think theyre going to do,what do you think could potentially happen in a session if a kid comes up,angry to a horse it could spook them or the horse could just simply step back,so that gives the child or adult we do both here that gives them some feedback,on how their how their mental state and how their emotions and actions affect,another individual and but its very we have a lot of horses here especially one,of my favorites to do EAL with is George he is 17 hand thoroughbred that we,have here and hes very very expressive and you know i

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